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Kjbff'�11�' j.111 r ii,7%,�:­":� I i ; ".�� f "J., , , "? ,�, . . . :� : 4 ,., , ,,,,L . ,� . " - - Atli. :1���, " " �_',_ ,:� ', � _-00100CAUT If"' PNM 0 1 -,?-,,. , , ,, , � � , * � � � � , , f :1� "',N 1� � � I T`�,:� . � 11 , , , , , , , , - , � ;_j, "M , ­ , -j1VQ1Jn"_"v ��'."'. _i ,� t lllii� :,,-"",VK11,i7jAs ,-,""�,�,,,,_ �1�,,6'11,',' I'll qMy- Ky- � . � xh,��,',!ilw; � .11 Qp"Pi 61"Z"� A 1 I � --i. ( HS e Y- - /,g TOWN OF BARNSTABLE I,OCATION 1 SEWAGE # VILLAGE l -4— d ASSESSOR'S MAP& LOT/9— 0 INSTALLER'S NAME&PHONE NO. C MA O 3 SEPTIC TANK CAPACITY 0 LEACHING FACILITY: (type) F -zzl - NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water.Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by y �- J .. t. � � ' i ..} } � v k ! ` ��� a I �/ � ® \. 1 � :� � /�/�/ I� � Commonwealth of Massachusetts Title 5 Official Inspection Form lh Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1336 Main Street Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville 1/ MA 02655 3/6/2020 , page. City/Town State Zip Code Date of Inspection: Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. Inspector Information filling out forms �- Ilal.`qq on the computer, use only the tab .lames Ford key to move your Name of Inspector cursor-do not Ford Septic Services, LLC use the return Company Name key. P.O. Box 49 � Company Address Osterville MA 02655 City/Town State Zip Code ran 508-862-9400 S12482 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails It AAb L 3/6/2020 Inspe s Signature Date The�;em inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 c Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments e !% 1336 Main Street u— Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old' or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 ♦ c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1336 Main Street v-- Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ .N ❑ ND (Explain below): ❑ obstruction is removed " ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation,is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 18 i c Commonwealth of Massachusetts Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments !% 1336 Main Street u- Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering.vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 . 4 , Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1336 Main Street Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is Osterville MA 02655 3/6/2020 required for every page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of�the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of.a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable.water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section CA. Yes No ❑ ® the system is within 400 feet of a surface drinking water supply ❑ ® the system is within 200 feet of a tributary to a surface drinking water supply ❑ ® the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 4 Commonwealth of Massachusetts Title 5 official Inspection Form I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1336 Main Street U- Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes"or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ❑ ® Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on ® ❑ Existing information. For example, a plan at the Board of Health. ® El approximation in the field (if any of the failure criteria related to Part C.is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 c Commonwealth of Massachusetts �v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments !% 1336 Main Street Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): n/a Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Description: Number of current residents: n/a Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Currently Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form I1� Subsurface Sewage Disposal System Form - Not for Voluntary Assessments !% 1336 Main Street u Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is Osterville MA 02655 3/6/2020 required for every page. CityrFown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Fittness Center Design flow(based on 310 CMR 15.203): N/a Gallons per day(gpd) Basis of design flow.(seats/persons/sq.ft., etc.): N/A Grease trap present? ❑ Yes ® No Water treatment unit present? ❑ Yes ® No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ® No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ® No Water meter readings, if available: 2019 -36,000 gals. 2018-39,000 gals. Last date of occupancy/use: Currently Date Other(describe below): The Septic services a fittness center. I could not find a design plan for the system. Its been.a fittness center for some time. 3. Pumping Records: Source of information: unknown last date of pumping Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments cam!% 1336 Main Street V Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system . ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: as built shows installed on - 12/14/1999 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form - is Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c 1336 Main Street Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 12"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 2000 H-10 Sludge depth: 2 Distance from top of sludge to bottom of outlet tee or baffle 24 Scum thickness 1 Distance from top of scum to top of outlet tee or baffle 6 Distance from bottom of scum to bottom of outlet tee or baffle 13 How were dimensions determined? measure Comments (on pumping recommendations, inlet and outlet tee or baffle.condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tee's were present and there was no sign of leakage. Both covers were to grade. recommend pumping every 1 to 2 years t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 I • c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments cam !% 1336 Main Street u— Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): N/a Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): N/a Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts p Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1336 Main Street u Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. Citylfown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): N/a "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Even Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): The D-box was normal and no solids were present. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 f c Commonwealth of Massachusetts �q Title 5 Official Inspection Form �I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments !% 1336 Main Street u— Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): n/a * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 4-500 gal. chambers H-10 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 c Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1336 Main Street u� Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS)'(cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The chambers were dry and clean.There was no sign of failure. NOTE, On last report dated 7/21/2016 aspalt parking area was over part of leach chambers. Since then a parking space was removed and a fence was installed so no vehicle traffic can drive over it. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): n/a t5insp.doc-rev-7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 r c Commonwealth of Massachusetts Title 5 Official Inspection Form iI Subsurface Sewage Disposal System Form - Not for Voluntary Assessments !% 1336 Main Street u- Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) I 13. Privy (locate on site plan): Materials of construction: N/a Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 ".` Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °Gc1 / 1336 Main Street Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville. MA 02655: 3/6/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: i Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately �a \A FO� W WA F10T, 0 i a L(9 ag Fc.w�e. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 16 of 18 •' Commonwealth of Massachusetts Title 5 Official Inspection Form �- Fig Subsurface Sewage Disposal System Form - Not for Voluntary Assessments cam !% 1336 Main Street Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 35 +/ feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Topo and water contours maps ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: see above Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 y Commonwealth of Massachusetts ,IP Title 5 Official Inspection Form �I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c !% 1336 Main Street u Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank-Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 1 T=` Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments - 9 p Y Y r,+ c � 1340 Main Street u Property Address 1340 Main Street Osterville LLC Owner Owner's Name r information is required for every Osterville MA 02655 3/6/2020 k! page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. Inspector Information filling out forms on the computer, use only the tab James Ford key to move your Name of Inspector cursor-do not Ford Septic Services, LLC use the return Company Name key. P.O. Box 49 r� Company Address Osterville MA 02655 City/Town State Zip Code ran 508-862-9400 S 12482 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. Fails 3/6/2020 Inspect6r"s Signature Date The s t m inspector shall submit a copy of this inspection report to the Approving Authority (Board of Healt or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1340 Main Street Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. CitylTown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 2) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally_ unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 �T Commonwealth of Massachusetts �v Itisp Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1340 Main Street Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): i ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 cam, Commonwealth of Massachusetts p Title 5 Official Inspection Form I, Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u— 1340 Main Street Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ........... !% 1340 Main Street Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. Citylfown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/z day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. El ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section CA. Yes No ❑ ® the system is within 400 feet of a surface drinking water supply ❑ ® the system is within 200 feet of a tributary to a surface drinking water supply ❑ ® the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 4 c � Commonwealth of Massachusetts F. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ` 1340 Main Street Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes" to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ❑ ® Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 i. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ............ a 1340 Main Street Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): n/a Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Description: Number of current residents: n/a Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Currently Date t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u- 1340 Main Street Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Office building Design flow(based on 310 CMR 15.203): N/a Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): N/A Grease trap present? ❑ Yes ® No Water treatment unit present? ❑ Yes ® No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ® No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ® No Water meter readings, if available: 2019 - 163,000 gals. 2018- 125,000 gals. Last date of occupancy/use: Currently Date Other(describe below): The Septic services a office building. I could not find a design plan for the system. 3. Pumping Records: Source of information: unknown last date of pumping Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 official Inspection Form I, Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ..........cV0 1340 Main Street Property"Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: as built shows installed on - 1/29/1995 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade:` feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 c Commonwealth of Massachusetts ,p Title 5 Official Inspection Form IIb Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1340 Main Street V� Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 3.5 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 H-10 Sludge depth: 2 Distance from top of sludge to bottom of outlet tee or baffle 25 Scum thickness 2 Distance from top of scum to top of outlet tee or baffle 6 Distance from bottom of scum to bottom of outlet tee or baffle 13 How were dimensions determined? measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tee's were present and there was no sign of leakage. The inlet cover was 6" below and the outlet cover was 12" below. recommend pumping every 1 to 2 years t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c / 1340 Main Street Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): N/a Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,.evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: . ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): N/a Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .cam s!% 1340 Main Street Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): N/a *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Even Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): The D-box was normal and no solids were present. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c !% 1340 Main Street Property Address 1340 Main Street Cisterville LLC Owner Owner's Name information is required for every Cisterville MA 02655 3/6/2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): n/a * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: 6-cultecs with ® leaching chambers number: 3.5' stone ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:.Subsurface Sewage Disposal System-Page 13 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1340 Main Street Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osteryille MA 02655 3/6/2020 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The cultec's were dry and clean. There was no sign of failure. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): n/a t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form lI; Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ........... 1340 Main Street Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osteryille MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate on site plan): Materials of construction: N/a Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts 1. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments c � 1340 Main Street Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately . IMA iA I A B � � b ?A��'^S a 1 a s 63 Sq 3 y pS _)o t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 c Commonwealth of Massachusetts �p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4 � 1340 Main Street V Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 35 +/ feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Topo and water contours maps ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: see above Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 te. Commonwealth of Massachusetts p Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1340 Main Street Property Address 1340 Main Street Osterville LLC Owner Owner's Name information is required for every Osterville MA 02655 3/6/2020 page. CitylTown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn'on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 Bae table �`I T Town of Barnstable Regulatory Services Department , m'caC j • BAMSTABM 9 MASS.: ,�� Public Health Division 200 Main Street, Hyannis MA 02601 2007 a Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2848 2220 August 10, 2016 l Eben LLC P.O. Box 710 Cotuit,MA 02635 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 1340 Main Street, Osterville, MA was inspected on 07/21/2016 by James Ford, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Conditionally Passes" under the guidelines of 1995 TITLE V (31.0 CMR 15.00) due to the following: • H-10 under parking area. You are ordered,to repair or replace the septic system within two,(2)years from the date you receive this notification. .Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD, OF HEALTH, QomasMc McKean, R.S., CHO �� I Agent of the Board of Health y t J Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\1340 Main Street Osterville.doc SECTION • DELIVERY SECTIONSENDER: COMPLETE THIS A Signature o _Q �Agent ■ Complete items 1,2,and 3.Also complete �,� n " item 4 if Restricted Delivery Is desired. X ;..� A�4'*-J't ❑Addressee ■ Print your name and address on the reverse C.Dat of D livery so that we can return the card to you. B. Received by(Printed Name) ■ Attach this card to the back of the mailpiece, t or on the front if space permits. D. Is delivery address different from item 1? Yes 1. Article Addressed to: If YES,enter delivery address below: [3 No 'Eb If,/7 L. pabov � CLI�'�,�' I"1 n 0 l^ 7insured '/.' �J ail® Priority Mail Express Return Receipt for Merchandise Clil ❑Collect on Delivery ivery?(Extra Fee) ❑Yes 7012 1010 0000 2848 2220 PS Form 3811,July 2013 Domestic Return Receipt Page 1 of 3 Stanton, David From: Michael Schulz [mschulz@schulzlawoffices..com] Sent: Tuesday, October 11, 2016 9:27 AM To: Stanton, David Cc: Michael Schulz Subject: Fwd: Sent from my iPhone Begin forwarded message: From: Jill Schulz<jschulz ,schulzlawoffices.com> Date: October 11, 2016 at 9:25:20 AM EDT To: Michael Schulz<mschulzgschulzlawoffices.coru> 4 j a 10/11/2016 k - . _ �v.,..5 ... �,y,',r:.k:.� ,, �, .... �*;n�i "`�„ �:?rd,•w.a �,�",�;.. '�.,� . '^*fit',Y °`7�..•,�.� "d'+� 74 .... # ,9'„ •:fir` ,Y,„ $ ;:a*`' . .,� wo - w t Y!Y rl ,k d �y k Y � W • t e D e t . r aft i�y � � � a,�'� .s►, .fit : . v#. �gg � •� •t �4:� a y �}4a m ..x f x�i � a d,• � �d i %. �r. ❑� t4 t= k f t. 2 �.A`' •t §, Ile L t 1 , � Page 3 of 3 i Sent from my iPhone 10/11/2016 + + Town of Barnstable., + + IARNSIAHLE, Regulatory Services Department '0rfa ram+'' Public Health Division 200 Main Street, Hyannis MA'02601 Office: 508-8624644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 5/11/16 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15,000) An"x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA. ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1) YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution.box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes:if the water analysis indicates the well is free from pollution), TWO (2)YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any"conditionally passed systems" (broken cover,relocation of a pipe, relocation of a driveway due to H-10 components, etc) ❑ Leaching pit or cesspool with high liquid level, <12"below inlet(per Town Code §360-9.1) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER at Ir 011111-0� t1e 1 ) r Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc ` Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System /Form - Not for Voluntary Assessments 1340 Main Street ugu.���10ii✓ Property Address Eben LLC, Joan.Bentinck-Smith, Manager Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. CitylTown State Zip Code Date of Inspection tV Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms 3 4 `I ki on the computer, use only the tab 1. Inspector: key to move your cursor-do not James Ford use the return Name of Inspector key. Ford Septic Services, LLC � Company Name P.O. Box 49 Company Address Osterville MA 02655 Cityrrown State Zip Code 508-862-9400 S12482 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this.address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ❑ Passes Conditionally Passes ❑ Fails ❑ Needs Further Ev u tion by the Local Approving Authority Wh 8/1/16 Insp or's Signature Date Th s tem inspector shall submit a copy of this inspection report to the Approving Authority(Board of th or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. 15ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 . t . Commonwealth of Massachusetts v Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1340 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ® One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ® N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-,Page 2 of 17 l Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1340 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owners Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ® N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ® N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ® N ❑ ND (Explain below): I ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ® N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ® N ❑ ND (Explain below): "'System is Cultecs and in the dirt parking area.There is no info saying it is H-20 loading C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is)not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1340 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owners Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system(SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: t `*This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to_overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/z.day flow 15ins•3/13, Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments � a 1340 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owners Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments •''� 1340 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owners Name required for is every Osterville required for eve MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ . Has the system received normal flows in the previous two week period? , ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ❑ ® Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): n/a Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 15ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M a 1340 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. CitylTown State Zip Code Date of Inspection D. System Information Description: , Number of current residents: n/a Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail unavailable Sump pump? ❑ Yes ® No Last date of occupancy: currently Date Commercial/industrial Flow Conditions: Type of Establishment: office building Design flow(based on 310 CMR 15.203): n/a Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): n/a Grease trap present? ❑ Yes ® No Industrial waste holding tank present? ❑ Yes ® No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ® No Water meter readings, if available: l5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w 1340 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: currently Date Other(describe below): system services an office building, I could not find an design plan for the system General Information Pumping Records: I Source of information: pumped yearly per manager Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): 15ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 'wM a •''F 1340 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owners Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: system installed - 1/29/1995 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): I Septic Tank (locate on site plan): Depth below grade: 3.5 feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ® other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gal. H-10 Sludge depth: 2 Mrs•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1340 Main Street Property Address E_ben LLC, Joan Bentinck-Smith, Manager Owner Owners Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 27 Scum thickness 2 Distance from top of scum to top of outlet tee or baffle 6 Distance from bottom of scum to bottom of outlet tee or baffle 12 How were dimensions determined? measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tees were present and there were no signs of leakage. Both covers are up to grade. The tank is in the grass right next to the dirt parking area and I would recommend putting something to block vehicles from accidently driving over the tank Grease Trap (locate on site plan): Depth below grade: n/a feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: • Date 15ins-3l13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Y Commonwealth of Massachusetts Title 5 Official Inspection Fora, Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1340 Main Street rV^A,A V Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State l Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): i• Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): N/a Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a,• 1340 Main Street Property Address E_ben LLC, Joan Bentinck-Smith, Manager Owner Owners Name information is required for every Osteryille MA 02655 7/21/2016 page. CitylTown State Zip Code Date of Inspection Do System Information (cont.) Distribution Box (if present must be opened)(locate on site plan): Depth of liquid level above outlet invert even Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): The D-box is H-10 and in the dirt driveway. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No' Alarms in working order: ❑ Yes ❑ No" Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: (Sins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments „a •'• 1340 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) - Type: ❑ leaching pits number: ® leaching chambers number: 6 cultecs-3.5' _stone per asbuilt Elleaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: i ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The cultecs looked clean, but they are in the dirt parking area. The info does not say they are H-20 loading. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration n/a Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 l Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a 1340 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owners Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/a 151ns•3/13 Title 5 offic:ial Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts H _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1340 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owners Name - information is required for every Osteryllle MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately MAifi S` . A 6 l t i l r A 6 t�. it rT 3 ?Ark%A% I (Sins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form. Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1340 Main Street Property Address Eben LLC, Joan Bentinck-Smith Manager Owner Owners Name isrequired for every Osterville MA 02655 7/21/2016 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 35+/- feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health - explain: Topo and water contours map. ❑ Checked with local excavators, installers -(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: see above 4 Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -.Not for Voluntary Assessments °w 1340 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. CityfTown State Zip Code Date of inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or,attached in separate file t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 i 'THE T Town of Barnstable Barn AD-Amedcacity Regulatory Services Department BARNSTABLF- 9 639, ,0� Public Health Division m 200 Main Street, Hyannis MA 02601 2007 1 ' F Office: 508 862-4644 Richard V.Scali,Director . FAX: 508 90-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2848 2220 August 10, 2016 Eben LLC P.O. Box 710 Cotuit, MA 02635 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at`1336 Main Street, Osterville, MA was inspected on 07/21/2016 by James Ford, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Conditionally Passes" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • H-10 under parking"area.` You are ordered to repair or replace the septic system within two (2)years from the date' you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH mas McKe , R.S., CHO Agent of the Board of Health Q..SEPTIC\Letters.Septic Inspection Failures or Future Evl\1336 Main Street Osterville,doc ,- Town of Barnstable s a a f • BARNSTAHLE, 1639. ,�� Regulatory Services Department '0�fa rub" Public Health Division 200 Main Street,Hyannis MA'02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 5/11/16 I DEADLINES.TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15,000) An"x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1)YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2)YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any"conditionally passed systems" (broken cover,relocation of a pipe, relocation of a driveway due to H-10 components', etc) ❑ Leaching pit or cesspool with high liquid level; <12"below inlet:(per Town Code §360-9.1) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER fl-10 unhr 6. like- Repair deadline: ' ,f Q:\SEPTIC\DEADLINES TO REPA/ FAILED SYSTEMS.doc Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments r( 1336 Main Street kl' 4 Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owner's Name information is required for every Osterville ,/ MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information c on the computer, use only the tab 1. Inspector: key to move your cursor-do not James Ford use the return Name of Inspector key. Ford Septic Services, LLC rab Company Name P.O. Box 49 Company Address r Osterville MA 02655 City/Town State Zip Code 508-862-9400 S12482 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true; accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ❑ Passes ® Conditionally Passes ❑ Fails ❑ Needs Further Evalimlion by the Local Approving Authority 8/1/16 Ins pecto Signature Date The s t m inspector shall submit a copy of this inspection report to the Approving Authority(Board of Heal or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1336 Main Street Property Address Eben LLC, Joan Bentinck-Smith Manager Owner Owners Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) i Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ® One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ® N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts H Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �w 1336 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ® N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ® N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ® N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ® N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ® N ❑ ND (Explain below): ""'System has Leach Chambers that are under the asphalt parking lot. C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 1336 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owners Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. - ❑ The system has a septic tank and SAS and the SAS is less than 100 feet'but 50 feet or more from a private water supply well". Method used to determine distance: *' This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes _ No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than'6" below invert or available volume is less than '/ day flow 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1336 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owners Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ' ❑ Z The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ El Area system is located in a nitrogen sensitive area (Interim Wellhead Protection Area — IWPA)or a-mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. l5ins 3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1336 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owners Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ❑ ® Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): n/a Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 f Commonwealth of Massachusetts a Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments j 1336 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: n/a Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: unavailable Sump pump? ❑ Yes ® No Last date of occupancy: currently Date Commercial/Industrial Flow Conditions: Type of Establishment: Fittness Center Design flow(based on 310 CMR 15.203): n/a Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): n/a Grease trap present? ❑ Yes ® No Industrial waste holding tank present? ❑ Yes ® No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ® No Water meter readings, if available: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachutetts . Title 5 Official Inspection Form 9 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1336 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: currently Date Other(describe below): system services an fittness center, I could not find'an design plan for the system General Information Pumping Records: Source of information: pumped yearly per manager Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box,'soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewa ge Disposal System Page 8 of 17 Ys 9 Commonwealth of Mas'sachuretts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments e 1336 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State tion D. System Information (cont.) Zip Code Date of Inspec Approximate age of all components, date installed (if known)and source of information: system installed - 12/14/1999 per as-built Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 12" feet Material of construction: ® concrete ❑ metal ❑fiberglass, ❑ polyethylene ® other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 2000 gal. H-10 Sludge depth: 2 151ns•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1336 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 25 Scum thickness 2 Distance from top of scum to top of outlet tee or baffle 6 Distance from bottom of scum to bottom of.outlet tee or baffle 12 How were dimensions determined? measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tees were present and there were no signs of leakage. Both covers are up to grade. Grease Trap (locate on site plan): Depth below grade: n/a feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1336 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 1 page. Cityrrown 6tate Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): N/a Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ��M A,•''y 1336 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert even Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): The D-box is H-10 and looked normal. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No' Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: 15ins•3l13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1336 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owners Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: I ❑ leaching pits number: ® leaching chambers number- 4-500 gal. chambers ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The chambers were clean, they had 2"of water,on the bottom. They are under the asphalt parking area. The concrete top measured 5"thick. I talked with Shorey precast and H-10 loading should be 4" thick and H-20 6"thick? Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration n/a Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No 15ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 f Commonwealth of Massachusetts : Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1336 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owners Name information is psterville required for every MA 02655 7/21/2016 page. City/Town State Zip Code Date of inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/a t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 i Commonwealth of Mastachusetts { W Title 5 Official Inspection F p orrn s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °�M A 1336 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. Cityfrown State Zi Code P Date of inspection- D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate 1 where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately IFT Lo WAlt W4 p4 rk;,A* Gr�Ss 3 l Oark,� l I Q C y o tell Q a y9 a8 l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage.Disposal System•Page 15 of 17 1 Commonwealth of Massachusetts 4 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1336 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water �I ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 35+/- feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed" Date ® Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Topo and water contours map. ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database,-explain: You must describe how you established the high ground water elevation: see above Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° 1336 Main Street Property Address Eben LLC, Joan Bentinck-Smith, Manager Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. CitylTown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 i " / Page 1 of 2 Stanton, David- From: ,Michael Sl chu.lz-[mschulz@schulzlawoffices.com] Sent: Tuesday, October 11, 2016 9:30 AM To: Stanton, David Cc: Michael Schulz Subject: Fwd: Sent from my Whone Begin forwarded message: ; From: Jill Schulz<ischulz2schulzlawoffices.com> Date: October 11, 2016 at 9:27:55 AM EDT To: Michael Schulz<mschulzkschulzlawoffices.com> a -a cY .jq f ,#Ip .i # l _ 10/1.1/2016 Page 2 o r Sent from my iPhone 10/11/2016 Page 2 0 2 Sent from myih n . . . ' 10 11/OI6 No. Fee C THE COMMONWEALTH OF MASSACHUSETTS r Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 21ppYicatiou for Mizpaar *pgtem Cougtruction Permit Application for a Permit to Construct( ✓j Repair(✓)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 1?C 4tE!�75 c4lr� Owner's Name,Address and Tel. 4 �Z?j 7 00V 13o4 t�iN gT' G(A�_ _ Assessor's Map/Parcel I I /FA1�� 97Q Q i 6O � (I OA Installer's Name,Address,and Te.i`oo.. - -- De�si,1g�ner's Name,Address and Tel. ,08Cn iF .4Z -024 ro MA- l4 vZW .qAType of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons i� Showers( H Cafeteria( ) Other Fixtures d Design Flow 400 gallons per day. Calculated daily flow er gallons. Plan Date C I QqS G2 IQAM Number of sheets 3 7 10T74-- Revision Date C I cJ'/j�O/R8 Title r' I •C�J S Qom. (x:ft G2 -AnMK-9YST VeML1 C Z 12/I19 1 Size of Septic Tank Z09V G-ft— Type of S.A.S. L0� Description of Soil Nature of Repairs or Alterations(Answer when applicable) CZ-OA1QN1� EAST, !2!:jj! ��- '5 Y:;i t�cu- p ur U ccj=4*_i s^%-,D ; l 1 5?cL.L- co M b t-i Q�tg Date last inspected: U✓f� Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Enviroppental Code and not to place the system in operation until a Certifi- cate of Compliance has been issue b - H th. ' Signed 4 Date Application.Approved by Date Z 7 Application Disapproved for the following reasons Permit No. — ` Date Issued 7 v Irk ✓ 4�-ktr,ayw�ig = ' ^� _ Oil, i• n' •• .l � .., ., .., '�'�3.' -."�•...�._ if'7,1 -No f G/ r S t �1 _...__ Fee �U V f:.. t z ' �ia� Entered in com`uter. � r THE-C©MMO .W ALTH OF-MASSACHUSETTS•., p � f _� �,,.-«.a . , t °- r Yes `. K PUBLIC f4EALTH DIVISION -sit O�I RPIF.,BAR;NSTABLE, MASSACHUSETTS- • " ricatibri for iogafp�temongtuction Permit Application for a Permit to Construct(,ve�1epair`(✓)Upgrade(' )Abandon( ) [IComplete System ❑Individual Components Location Address or Lot No. F r tE!�,e>, c4 t - 4 ';t Owner's Name,Address and Tel. 4 IAA 1(P Z5/ _ � n� Assessor'sMap/Pazcel ` ` i yA ��� , 19 . �Q -!;T YI, , G r Installer's Name,Ad&ss,aril Tel.No. ] j Designer's'�iame,Address✓anld Teel.NNo. tit-- "9,08CA p d `,4z0 ?924 .. ro `$`� 73� N>q per. 04 a 49 Types of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( ) �4 4 Other Type of Building No.,of Persons 1-0 Showers,(t.-) Cafeteria . Other Fixtures t Design Flow -400 gallons per day. Calculatedaily flower gallons. k Plane Date C 1 6/1�99 C2/��Number of sheets 3 'r0 ice-- Revision Date Cl %4�0198 Title- C'[,,69W ! i2Lft--, G2 tiemc. 5Y5(- I-)Zn-r CZ 1 d/i 199 Size of Septic Tank 2� G.Al.— Type of S.A.S. LO�C.HFINC. CI-t'�'4� e1 1 . Description`of Soil Nature of Repairs or Alterations(Answer when applicable) i ZOM0\1 t G/1.5r• nomc TN4 i � '� S ' NS M t { (W 1, s Date last inspected: u✓1L Agreement:. The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by s fir of H lt'h. Signed J Date Application Approved by Date Application Disapproved for the following reasons �. Permit No. 9 5 2'/ Date Issued / ? P THE COMMONWEALTH OF MASSACHUSETTS Y� BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO C t e On-sit wa a I�AposaI System Constructed( ✓�R paired( )Upgraded( ) Abandoned( )by at /3a�Z ilif Q ��•rc _ !�S --•/� has been constructed in accordance - with the provisions of Title 5 and the for Disposal System Construction Permit No. q9—A Z / dated 2—7—, / r Installer Designer % C a The issuance of this, e 't ail e construed`as a guarantee that the s to l funct* as d e }= bate' �:1_L1 Inspector °` r/ Y --------- --------------------------- No. 2 �.- Fee �d THE COMMONWEALTH OF MASSACHUSETTS j°J —6"19 PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS H d �3a Permissign is hereby granted to Construct( Repair( )Upgrade( )Abandon( ) System located at 4 /t//'�r.N-, c}- d S ,4?,•-•- and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Constru t be coADIete(dd Within three years of the date of thisfrmit. ction mu - Date: ✓1 / Approved by 71 �� ✓S� 04`OWN'/4 BARNSTABLE LGCATION SEWAGE by VILLAGE 'fPo`*'jZ ASSESSOR'S MAP & LOT ---o INSTALLER'S NAME & PHONE NO.(,�,¢� ,�5� 5 SEPTIC TANK CAPACITY___1 5 60 LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNERj�/`r/�/�✓ DATE PERMIT ISSUED: Zo DATE COMPLIANCE ISSUED: �/ VARIANCE GRANTED: Yes �r i rz `� V r ti 1-90 No....f•J-•••-•-30 V Fes$•�......................... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE , Ap.pliratinn for Bi-nVini al Workri Tnnitrnr#inn ramit Application is hereby made for a Permit to Construct ( ) or Repair "( an Individual Sewage Disposal System at• / r l ®----......_�i�..--- ------------------• --'----- r^ .............r---••--•-:-.------'.'.:------...__. /� ocatt n--/:\�ddfr�css or Lot No. ....__ -.... ----------------------- ------------------------ wncr Address Installer Address d Type of Building Size Lot............................Sq. feet V Dwelling— No. of Beclrooms,3--------------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No. of persons____________________________ Showers — Cafeteria a' Other fixtures ............................... . . W Design Flow--------------------------------------------gallons per person per day. Total daily flow............................................gallons. - WSeptic Tank—Liquid capaeity......_.....gallons Length................ Width---------------- Diameter_.-. .......... Depth................ x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No...................... Diameter--.-.-..--..--_--.-_ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by----------------------------------- ...................................... Date........................................ a Test Pit No. I----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ Test Pit No. 2__________ _____minutes per inch Depth of Test Pit.................... Depth to ground water....._.................. R+ ------------------------------------------------------------------------------------•-•-•---.._..•--......................................................... ODescription of Soil...................................................-.................. -----------------------------•---------•---------=-----------------------------------------•----. x U W ----------------- -- --** -------- --------------------.....----------- .......... UNature of Repairs or Alterations—Answer when applicable._._C�_.-1___ -•---------------------------------•------------------------ �----- Y -- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complianc s b issued by e board eof health. 44 ,22 Signed ------ �--- - - --------- - - ------------------- ------- /. ..:/....J-.. to Application.Approved By ................... ��w�t�', ---' -- -----.. .. 7.......---....--------"-----....—..................---...... .. ......—'.Date------- Application Disapproved for the lowing reasons: ...................... ............................................................................................................... -------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------- -------------------------------------- Date Permit No. ...............75-- ....3 ...L-/..... Issued ............ Date iI - \ ! L _i • �-, �, -� �- THE COMMONWEALTH OF MASSACHUSETTS - BOARD, OF HEALTH TOWN OF BARNSTABLE Appliratiou for Di-tipwial Works Tomitrnrtinn Pumit Application is hereby made for a Permit to Construct ( ) or Rcpair ( 4) 9ndividual Sewage Disposal System at 1 k F ' s - Locati n-i\ddress or Lot No. l O�ner W Address �, Insfaller Address Q Type of Building ''� Size Lot-----...--------------------Sq. feet a� Dwelling— No: of Bedrooms .......... ....� H-_______--____Expansion Attic "( •,) -. I Garbage Grinder ( ) 04 Other—Type of Building f.`.--�?-.-----_-__-°___.__-_ No. of persons___--.-_.'-----------(____rShowerst(1 y) f Cafeteria ( ) d t 11 i6ther,fixturesr= `v----••------------------------------•---.---•---------•-•--------. y W D+sign_Flow..........._i.�.........._.�;._._..._____gallons per person per day.,,,Total daily flow--------------------------------------------gallons. 04 --Septic Tank—L'iquid capacity___-'._._..gallons Length________________Widthf.!'._.___.____ Diameter---.------------ Depth................ W Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. x - Seepage Pit No--------_-_------- Diameter--------------.::._. Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) ^ ' Dosing tank ( ) Percolation Test Results Performed by------_------- --------------------------------------------------------- Date...................................... a Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ (Y4 Test Pit No. 2................minutes per inch Depth of Test Pit--------_........... Depth to ground water__..-______--__-_._____- C>♦ _------•-------------------•--------•---------------------•-•------------------------------•---•-•• ••----------- •--- ---------------- ------------------------ Descriptionof Soil......................................................................................................................................................................... - x W ----------------------------------------------------------------------------------------------------------- = = �A U Nature of Repairs or Alterations—Answer when applicable.___:......'..__. _ U P ----- !--- .........- f P3 1.. ------------------••---------------------••--- ............................................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been i-ss�ued by the board of health. Signed � 4./ :.f' . ... ' - -- �`.� .. -. ... .. Application,Approved By Dace Application Disapproved for the following y ae sonr: Dace Permit No. .. ... ---- r1^".... ....: .0 L/. +'� Issiied".441.:.. f / Dare.. .... .. F 1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH a TOWN'OF BARNSTABLE *� ' 1 �ez#t�trtt#e�"N t. ��`�` f ..: THIS IS T0,CER7IFY fiat the Individual Sewage Disposal System constructed ( ) or Repaired by .........---- ._. ---------------- ----------------------------------------- lier Ao at .......... / +ter � ' ..� A ^a .. .. , .. b e4�}F.. ... .--- ....----- Environmental Code as described in hhe applicationllfor(Disposal ordaWorkstConst u aonl Permit f TITLE . o - - Stet, a dated .... ,.-—.��.,.--) I" .... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT;THE``� SYSTEM WILL FUNCTION SATISFACTORY., DATE _...._. .....^".. _(g- "-..1.. Inspector -- J-- -a-' ------------------------------------ ----__---______-_.------------------•------___--- -.may__._._---_._.__.-__, THE COMMONWEALTH OF MASSACHUSETTS ( � oo rp ,I BOARD OF HEALTH 0 TOWN OF BARNSTABLE' Q No... �?...- y r.: FEE ... {. �. Permission is hereby ..................... to Construct ( ) or Repair (Aran Individual Sewage-Disposal System . ----•-.-••-- ------•••----_.- t �ovo f O "-S[reetl 1 9 as shown on the application for Disposal Works Construction Permit No...2C 32 _ Dated...... �'_- /I._ ............................... ---............................................................... Board of Health DATE----••--------------- �---- I- ��--------....--------....__...... FORM 36508 HOBBS Q WARREN,INC..PUBLISHERS TOWN OF BARNSTABLE LOCATIONf,3,/? Q SEWAGE VILLAGE Pe" ASSESSOR'S MAP & LOT —off INSTALLER'S NAME & PHONE NO.(t /}l� SEPTIC TANK CAPACITY Z 5 LEACHING FACILITY:(type) /9� (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER .DATE PERMIT ISSUED: �J DATE COMPLIANCE ISSUED:�� �,� VARIANCE GRANTED: Yes No — �old '` 1 TOWN OF BARNSTABLE 1 may— C r LOCATION � " / ` ' / ' SEWAGE # ASSESSOR'S MAP &LOT G 17 VILLAGE INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: f NO.OF BEDROOMS —i 1r, BUILDER OR OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Feet Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet oleachin facility) exist Edge of Wetland and LeachingFacility(If any Feet within 300 feet of leaching facility) Furnished by . ------ I SPR 086-99 The Farm, 1304 Main St., Osterville (R119-079) Michael Grotzke presented a proposal to expand The Farm, a fitness center. The applicant seeks to add a nautilus/weight room, locker room and showers for twenty members. General discussion ensued during which, Tom McKean attempted to determine the current status of the facility's compliance with the Title 5 regulation. Mr. Grotzke elaborated, commenting that the fitness center was not attempting to increase its membership but is attempting to obtain more amenities for its current members. Tom McKean noted that the flow calculations were based incorrectly upon country club usage. The flow formula is the number of members X the allowance per classification. Since the designated classification has changed, the calculations are amended to reflect 80 members X the gym allowance of 25 gal. (80 x 25 =2000). The pre-existing presence of other buildings and uses on this 5.7 acre site(i.e. antique store,restaurant & greenhouse) greatly alters the calculations for this proposal. The shower room would exceed the flow limit of 330 gals per day per acre of its own accord. Steve Pisch commented that the prior applications were submitted and erroneously approved based on water meter readings obtained from the applicant's previous site. He indicated that the run-off from the addition needs to be contained on site and should be designated on a plan. He also noted that wheel stops need to be provided for the rear parking lot. Art Traczyk mentioned that a 1995 application indicated that the Farm intended to remain small and did not desire to install showers. He reiterated the 330 rule and supported Health's position to oppose the project. The Building Dept. inquired about the applicant's desire to officially amend the proposal to exclude the shower. Mr. Grotzke agreed and requested the amendment. Conclusion: Continued The applicant shall submit drainage calculations, show containment of run-off on site and provide wheel stops for the rear parking lot. The applicant was referred to Gloria Urenas,Zoning Enforcement Officer regarding the sign application and any proposed change or addition Saad Dale From: McKean Thomas To: Giangregorio Robin Cc: Saad Dale Subject: THE FARM/1304 Main Street Osterville Date: Friday, October 01, 1999 9:27AM I am in receipt of a site plan review application regarding 1304 Main Street Osterville and I submit the following comments: s1.�w -The site plan should be revised toil all the buildings on the parcel. -This site is located within a zone of contribution to public water supply wells and is restricted to 330 gallons per acre per day. Therefore,the applicant shall hire a professional engineer to determine whether this proposal could be approved, in view of the fact that there multiple buildings including a restaurant on this property of 5.7 acres. The professional engineer shall determine the Title V estimated wastewater discharge flow rate for each individual building along with the proposed wastewater discharge rate and shall calculate a total sum of the proposed wastewater discharge for the entire parcel. -Title V requires an inspection of the septic system whenever there will be an increase in flow. The applicanmt shall hire an engineer or other D.E.P. certified-septic system inspector to: (1) determine whether the existing septic system is capable of handling the proposed flow rate and (2) to complete a ten page inspection report as required by Title V the State Environmental Code. Page 1 III .. .� • �'� rl Li 1.1 LEI LEE a� EQUIPMENT LAYOUT PLAN OSTERVILLE FITNESS CENTER K, NOT TO SCALE 1356 MAIN STREET, OSTERVILLE, MASSACHUSETT r,' :JL 3S z 7S , L�5 NOW Septrc W ,b _�. �` ;;. � ��. c -, ,,.;. - .r"�: .�- .r� �-. ,rpF�' ,.;, u. „ .,::.. .= ram" •• Parcel. 119-079 Location: 13 d MAIN STREET(OST.} Ostervitle Owner 1340 MAIN STREET OSTERVILLE LLC ........ ........_.................................................... Septic 1, 12/7/1999 Septa 2 3/9/199 Seplrc`S; /9 I995 i New Septre ` ' I Permit number: 1999821 Permit type: Select type �� Complete system: [j , Issue date :52J711999 Complete date : 1214I1999 Septic tank size: Type/Size of SAS: Installer: Select Installer (v Card on file: [Q Innovative Alternative Tedinolo" t "e: ' I/A service type Select sennceYp Variance date :F.___ m __._... Abandon coplete date (—�� Abandon permit number. Repair deadline date : 8110,'2018 Repair notification date: 8/10/2016 Keyword i Comments: i created from well permit Delete Septic ' • TT ti InspectionIraspetion �raspcCraia� Irnspe�tir�ks 7/21/2d16 7J2tl2ol� /72/2"B 4 1f/199s inst,�rt . I (Number Inspection Date Inspector _ Result 11766 7121/2016 1i Ford James M , Ford Septic Services CP+R (CP Repaired) " m:,, . . , Received Date Comments i 340 (office) . Fixed, photo attached with repot""7 D21et8I1l5peCtiOn showing septic blocked off from ❑ ivarq ever _ __J 8/8/2016 I t ............................................. ..................... ....,....... .......... . ........ .':::::: .:::... .. ..._:.::. .. ... .. ..:..... .. ..... Save Septic Chances Return to Lookup J. ...:. ..t,. MI ...,.. ..,�.�_t 1..,"e �'%r..f,,..... ....,.» ..,,,.✓. .v,«�.'..,,.asw.�:s.., .. ..._.``. »w ..., ,,,, w`.x. ,a,,,._x.u. `.��"m .. .gym.,..,.,.wP a`" - ,,.m,-w....................^,.,,.,...m.....,......�:....m,,,..,....,..�: Thursday,Jun 06,2019 09:50 AM 12/d2/99 23:04 FAX 508 539 0800 THE PHOENIX GRP Z 02 1UP phoenix Or,; ip E!IGIFIEERS o LANDSCAPE AA MECTS PROJECT MANAGERS P.O.Box 1735,Maahpae,MA 02P9 508-531;-0800 Fax 508-539-3780 094apeWd.nat 2 December, 1999 Thoma;McKean Town a Elarnstable Board c f Health 367 Main Street Hyannis I,MA 02601 Re: !Cbe Farm, 1304 Ms 1 Street, Osterville Proposed Ezpamsio of the Fitness Center Dear M%McKean, In accoi da-icewith our disci lions with your office today,we are modifying the flow summary and calculations for the aboi -referenced project. Septic'E:vs:--em/Q—roundwater lischacge Summary The pro:to:Led expansion ene ►aches partially onto the space occupied by elements of the exiwdng septic s-q,stem. The submitt( plan relocates the septic system and brings ii.into conformance with the cLrrent groundwate lischarge regulations per 310 CMR 15.00(`Title 5'). The lot: 3 located within a Z Le U groundwater protection district. The total discharge permitted by the T om n of Barnstable is .30 gallons per acre. At 5.7 acres,the allowable flow is 1881 gpd. The pro:*:,ed flow for the ei re lot is summarized below. I Les taurant(`La Petit viaison') 22 seats @ 35 gpd/seat 770 gpd �laique Store 2104 sq ft @ 5gpd/100sf 105 gpd Pitiless Center 80 members @ 5gpm/d •400 gpd Onenhouse 0 gpd I"olai Flow 1,275 gpd )dlowable Flow on L 1,881 gpd The actL al flow for the Antic Store,the Fitness Center,and the Greenhouse(they shared one meter)is calculated at 128 gl ,well below the calculated design value of 505 gpd for these facilities. A copy of the watt invoice is attached. Thank you for your assistant and time on this project. Please contact us if you have any further question;,regarding this appl ition. Very tru::y 3'ours, `— Michael 11 Grotzke,P.E. Director M. F. Curran :set Iron access cover with 77 rams and grots, fNll mortar ad, sit to grads,LeBaron :at No. LAIR or approved goal or concrete cover and Isar, H-20 load rated. Sr+•(7 Existing Grads:Elav CML ENGIIiEE'I THE PHOENIX GROUP 1' Deep min. Top of Leaching 3 MALL WAY /washed stone Chambers: Elev. P.O, BOX 1736 bash MASHPEE, WA 02649 41111111 508.539.0800 tx Min Slope 31r To t 1/r 508,539.3780 FAX LNU� ----� Effective Depth 2- S=r TPGOCAPECOD.NET I 14 1 5,R 4 Bottom of Leaching �a r �- Chambers! Elev, — Invert I Invert p ]sv-T CJl3 Elev..�s I .�tp y J I v GROUND WATER ELEVATION OR.BOTTOM OF TEST PR: -EM PROFILE -t� FARM CATIONS 13C4 MAIN 5TRETT of system shall be closely monitored by engineer. No deviations from the design plane shop be allowed or review and consent by the Engineer and the Board of Health, Sell conditions shall be reviewed by C15"ERVILLE. MA or at the time of system Instollotlan for confor mc:nce with the design. nshlp and materials shall conform to DEP Title 5 and the Town of Mashpea regulotiona and the requirements n. ants of the system shall be capable of withstanding H-10 load rating unless they are within to feet of drives, arldng coda, in which case they shall be capable of withstanding 4-20 load rating. MAP 'GZci / PARCEL 07a1 F;EVISIONS - N0, DE5CR.a'T10N DATE 0 APA�I�iL. IS•E• � PROJECT Nu„ 38402 DATE 11/26/99 DRAWN MHG CHECKEII SCALE N.T.S. SEPTIC SYSTEM °T DISINFECTION UNiT (IF REOUiRED) lye, � :'>R D ET>�L I I,S i� dlsinfecllon unit shall be provided, The wastewater stream Shall ed to IN radiation of W0. !900 Angstroms. A maximum wastewater penetration a be g inches. The unit shall'be 6 d to provide a minimum W dgse of 16,00 eq cm. UV lamps shall be smalpsed in aloes leeve. A manual or aworn ng device aha11 be Installed to clean the quort:.9lass 'f�r5 fc4•'t@ The W lamp shall ed at one year intervols, unless the manufacturer specifies a longer ! lamp life, shall be protected from dual, heat and freezing. The gwart= glass enclosure la spat fayr tlmaa o ygar.. The W lamp intonelty ahotl be testae al the time of and at annual Intervals to confirm that the min'mum Mama lo gchleved, esss�s CF Z. 90Qj JHD KIN3011d HH,L 0090 6£9 909 YVA t0:U 66/Z0/9T N n.f.� .M er,eA.l. 177 d6An 17ad AbdN a nm. Fw 11..1 hn.ca.�aver dIn � lfyialC��AAA>LK� °' ii.r""eeL�1. co I cf fro.u+8a n,M-20 lard Ad. ��Ed.till fd.N:Ew 11'p CML ENGINEER N + MI,cab: THE PHOENIX GROUP .-.� 1.O.W ndn: T —- 3 MALL NAY ~1p1• abef.:Ew� .. RO. BOX 17.16 ,P If boo -' MASHPEE, MA 02649 . lAmdwLGM_ J . _ +e ua +/'.a,,n SOa.5jvj7V0 Kh-� OK-4', 1g4 I 90E.9J9a760 FAX Dav �nrrl_Ip„ EwWw On*2' wo sw�c MyOX=5', 19" TPGOCAPECOD.hIET re OKaW. 2 " Oi � • f 14 I 5�r1 4 eat.m a K El:. I cr.. � r o0 78 GFALWO.KIEA QEVOM VI- ea ow earrod°` o d�� a 0 0 2W GAL CONWITE SEPIC T" wt ba*w s bI f a 34c �"' • 4y AWIr vas SYSTEM PROFILE THE FARM SPECIFICATIONS 1304 MAIN STREET 1!wlollairt a Mf.m.bw b fi...Il mrnitr.d W w. Na ee,Arwm rfrn af.ew1En M.•.Pban bw ab.w w EOA pe-a 66 w:.d Aam �w nnw�en an cand2aa.Aron a no-d b C)STERVILLE. MA y r------------------ x M.blr.rN�M marbb fltaa m.f>n.o OEP TM�.f.n.O.Te.n d 11wMM.s9M11w.any t4.....M.me+U O.aoin c— a..n..I A:.f., AM a.rw—W of Iw.Vd,. .wn w c p.fA.of.Ma11,6M"-IQ lard MI.g urAs Awl In dAN. fs Iw.d .•'IA'9 O .W h e...f..y.Iwb b.a.par.d vMMland"U-7n M.d mlip- ` I MAP 119 / PARSEC 079 I I' REVISIONS ' o 0 NO- DESCRIPTION DATE i PUN OF SEPTIC TANK PROJECT Np.: 364U2 2 DRAW 7 jR6/36 yTE 6 rm TEST_ 1 DRAWN 4HG •cST Ov:N G wtNasm ar: DESIGN CALCULATIONS: CHECKED N0. OF MEMWR`a MMMAAOM lum._ESL-WANCn 61UfA-0 wI 4"LAWW-) GARDE DISPOSAL UNIT Y SGLLE : N i S n�Lv ERi�Lv ti f TOTAL ESTIMATED FLOW:q2 GPO SEPTIC LANK REWIRED: L SEPTIC O° o LEACHING AREA REQUIREMENTS: _ H MJ6f.AV j2. B w.M4 12, EFFLUENT LOADING�K� 0_�4 CPO/So FT SYSTEM sIOEWAIl AREA: — ' DETAILS frod0 ,24� ds.aa SIDEWALL LOADING' GPO ULTMNOILI CMFUMM UNIT(IF PMTA tM) 101. ffe `. hlEfl - Qf BOTTOM AREA SO FT - aOTTOM LOADING: - tnw.a.roe dhlMNn.nN drn w.,.Had.ih..wf..w ar.en, to w ro.WAen TOTAL AREA: SO FT 2=a?am MlPln.n..A med..dn.a t.r.W lrolydiw b.2 l d— 7.udt.1w.6. �62lf.fl q2" ecmwc7.d b 6'a"I••a aiMm.m W sa.d 16. ffl rn W W."0.0 6..wW"M. • HF� TOTAL LEACNING CAPACTFY: G GIRD a quwl.sw...A..w.•nrolwl r 6a ~a wlaw.A.awn Mu�tr M� •••f .". SMfD dww.. Tw w tebp a f.r p ba.K,, APPROVEO: BOARD OF HEALTH 6"•�'f"d ta.m Mw 6AaE b Pa1.f1.6 ffbb duA.b.a.d f. img. Tw.pmv Syba rWae,aa wal b a f. Una.a pw_ Tb.uv 1=Nt..n4 w.n b.wow a Uw Wn.a =� 7,w, - vp_. t�2 vpy� Ir aw60.rM a rl..a bltr v waTrm Ulm a.m.dnw.W Ow b.eff.pw. w�ia dd.-4{LF t ant- ow.3Jk9 f M7[ AWrt I'Ertrlr r wn Z OF 2. 'J eP —Conerete accost cover with concrete riser to *Rhin 12, of finish grade or lase. y Ca ! 1rc n, be To of Poundation�� G_ eq p r—'St•0 eq lie 9' Mirc over 21< Min Skpe -- 1X Min SIc a minimum 3�— Inve ®X=4'. 1¢" Elev t Inert l OX=S', 19" Elev lO" Tee , E1N, r ag+®uunnaw OX=6 , 2�" ft W MR CUT areusr we on EQUAL X Invert A In Elev �/ Ell 2000 CAL CONCRETE SEPTIC TANK got tank an Ir boo. of J/r screened gravel, eairpated {e SOX dry density, SYST! SPECIFIC Inefallation � withaut prlo r-- the Englneei Al workman 21" 010. Y1• Dlo of this plan. Cleanout Cover Cleanout C. r f i All aampone areas or rar L _ _._ _ - -_ - _ - - J PLAN OF SEPTIC TANK 2 os+-- DATE OF PER 0AL ON TEST: Ib P�r � 4�-�""������''�,���� DE$9GN CALCULATIONS: a TEST BY: PA Cl WITNESSED BY. elc�3�J]IJ�'�`3]t NO. OF MWWIS PERCOLATION RATE: MIN.IINCH e a:L&J2 t4Or s�LlP�Q�� GARBAGE DISPOSAL UN—IT Y J TEST "id, , TEST PIT 2 , TOTAL ESTIMATED FLOW: E ±= GPD ELEV. ERV• Lv=v SEPTIC TANK REQUIRED: . t05 _GAL 0 e o LEACHING AREA REQUIREM NTS- 12e Imo' i.Ly EFFLUENT LOADING RA 0,�--GPD/SQ 7 8 loobmY 5 t,0An%1 SIDEWALL AREA: _ SO F1' slwv 24" spr+t� SIDEWALL LOADING: ' ____—� GPD UU AAM E C BOTTOM AREA: ?`�_ SO F1 SPNp BOTTOM/ LOADING; a—__._� GPD uhro2400 ialel 1 __ SO FT cons to 2. TOTAL AREA: constructed MEV �2 TOTAL LEACHING CAPACIT =(:Z- s GPD a quartz g S�gtp enclosure. guaranteed APPROVED: BOARD OF II� ALTH J shall be ell Bottom of P,jt OF Bottom of P�� occur� PERMIT PIUtdBER �OQj dHD XINSOHd 311,E 00H 6£S 909 YVA bO:£Z 66/ZO/ZT 12/02/99 23:04 FAX 508 539 0800 THE PHOENIX GRP 903 _ a:T,UN THIS PORTION FOR l'Ot'R RP:('(iNpti SERVICE )DRESS ACCOUNT NO.PREVRws _MAIN ST 1300 1RALAHCE WATER IILI S UNPAID AFTER(30)1 YS FROM DATE OF ISSUE ARE SUBJECT FAl'?.IE!4TS TO INTE REST CHARGES,AND TEI '[NATION OF SERVICE FOR ACCOUNTS &CREDITS PAST A.JE (I20) DAYS. ALL IN ''CORDANCE WITH CENTERVILLE- OSTERI ILLE-MARSTONS MILLS 1TER DEPT.RULES AND REGULATIONS INTEREST TELEPH:)NI:.(508)428-6691. CHARGE F 'EAIOD CO RED REVIOUSMETER CURRENTMETER CONSUMPTION CURRENT I)M TO READING READING I000'sOFGAL. CHARGES "99 1 06/99 260 283 23. 4W RATE:i PER THOUSANI GALLONS EXCESS CHARGE� 8.70 $15. )0 QUARTERLY P NIMUM PERIOD COVERED MINIMUA4 $2. .)O OVER 20 h TO 200 K JULY-SEP 99 CHARGE � 15_00 $3. 45 OVER 200 P USE WATER. 4 SELY 'LEASE CONS RVE ANAUAL INTEREST ATE 14% DATE OIFISSUE TOTAL VISIT US AT 07/01/99 AMOUNT DVE 23.701 WWW„I:.A'ECOD.NET/CC MWATER/ Zjhl I-1104 Vs � 11 --J 1 _.Iits.. �" I L s Q . B•y�;t I D a I r'4 III a I 6a'9t a•i � � ddd� Ott} B'flira HIM 11 l! �a rR a� {� ,8 Y��i ➢I QN ; .a ■ ) .tp, 1 a' ate �. � ��P t• � �r g P i a $ pW�6` leas t � t Y1 � E it�tt� ��Y � �Q� 1 `�•� ��6Y 4 RFe y� Q F ` P II i d�yy♦ � �� R .. gyp` gig ` O f _ CO) a. o® a i 0 �I � I lit •s di i 1 � i� 4 ® The Phoenix Group ENGINEERS •LANDSCAPE ARCHITECTS •PROJECT MANAGERS P.O.Box 1736,Mashpee,MA 02649 508-539-0800 Fax:508-539-3780 tpg@capecod.net 2 December, 1999 Thomas McKean Town of Barnstable Board of Health 367 Main Street Hyannis, MA 02601 Re: The Farm, 1304 Main Street, Osterville Proposed Expansion of theFitness Cente� Dear Mr. McKean, In accordance with our discussions with your office today, we are modifying the flow summary and calculations for the above-referenced project. Septic System/Groundwater Discharge Summary The proposed expansion encroaches partially onto the space occupied by elements of the existing septic system. The submitted plan relocates the septic system and brings it into conformance with the current groundwater discharge regulations per 310 CMR 15.00(`Title 5'). The lot is located within a Zone II groundwater protection district. The total discharge permitted by the Town of Barnstable is 330 gallons per acre. At 5.7 acres,the allowable flow is 1881 gpd. The proposed flow for the entire lot is summarized below. Restaurant(`La Petite Maison') 22 seats @ 35 gpd/seat 770 gpd Antique Stol 2104 sq ft @ 5gpd/100sf 105 gpd Fitness Center 80 members @ 5gpm/d 400 gpd Greenhouse 0 gpd Total Flow 1,275 gpd Allowable Flow on Lot 1,881 gpd The actual flow for the Antique Store,the Fitness Center, and the Greenhouse(they shared one meter) is calculated at 128 gpd, well below the calculated design value of 505 gpd,for these facilities. A copy of the water invoice is attached. Thank you for your assistance and time on this project. Please contact us if you have any further ` questions regarding this application. Very truly yours, Michael H. Grotzke, P.E. Director cc: F. Curran r • ® The Phoenix Group ENGINEERS •LANDSCAPE ARCHITECTS •PROJECT MANAGERS P.O.Box 1736,Mashpee,MA 02649 508-539-0800 Fax:508-539-3780 tpg@capecod.net 12 October, 1999 Edward F. Barry, Health Inspector Town of Barnstable, Board of Health 367 Main Street Hyannis, MA 02601 Re: Septic Repair, Fitness Center, The Farm, 1304 Main Street, Osterville Dear Mr. Barry, It is proposed to reconstruct the existing septic system at the Fitness Center site due to a conflict ...� with the proposed building expansion. The reconstructed system as proposed conforms to the current Title 5 regulations and will accommodate the calculated flow of 400 gpd for the proposed lockers for the club members. A summary of the total flow for the lot is as zwmrriarized below. Restaurant.('La Petite Maison') - 22 seats @ 35 gpd/seat 770 gpd Antique Store a 2104 sq ft @ 5gpd/100sf 105 gpd ^ ' Fitness{;enter g0 r 2&IG&-emr 400 gpd Greenhquse x 0 gpd Total Flow 1,275 gpd Allowable Flow on Lot 1,881 gpd We proposed to confirm the soil conditions during the installation of the system. The existing septic tank will be removed and the leaching pit will be filled with clean sand. A copy of the system plans are attached for your review and comment. The proposed expansion to the Fitness Center building in under review in the Site Review process on Thursday, 14 October 1999 at 9:20 AM. Please call me if you have any questions. Thank you for your assistance. Very truly yours, Michael H. Grotzke, P.E. Director Enclosures: Septic Construction Permit Application Drawings C1, C2 ® The Phoenix Group ENGINEERS •LANDSCAPE ARCHITECTS •PROJECT MANAGERS P.O.Box 1736,Mashpee,MA 02649 508-539-0800 Fax:508-539-3780 PhoenixGroup@cape.com i 29 November, 1999 Jerry Dunning, Health Inspector Town of Barnstable.:Board of Health 367 Main Street Hyannis, MA 02601 Re: The Farm- OstervilleFitness Center Dear Mr. Dunning, b Attached please find plans C1.and C2 revised to reflect the percolation test information performed at the above-referenced site. The proposed new system will replace the existing system due to a conflict in location with the proposed expansion for the locker room. The existing system will be abandoned and removed or filled with clean sand, as noted on the plan. .. Please contact me if you have any questions. Very truly yours, Michael H. Grotzke, P.E. Director Enclosures: Cl, rev. 4 dated 11/26/99 (6 copies) C2, dated 11/26/99 (6 copies) ' r , • �• The Phoenix Grol ENGINEERS •LANDSCAPE ARCHITECTS•PROJECT MANAGERS P.O.Box 1736,Mashpoe,MA 02649 508-539-0800 Fax:508-539-3780 PhoenixGroup@cape.com 28 October 1999 Robin Giangregorio, Site Plan Review Coordinator Town of Barnstable, Building Division 367 Main Street Hyannis, MA 02601 Re: The Farm, 1304 Main Street, Osterville Proposed Expansion of Fitness Center Dear Robin, We have revised the attached plan(revision 3)per comments received from your engineering department(Steve Peitsch). The revisions include the addition of drywells at the Fitness Center to collect.and percolate stormwater runoff from the roof drains. We have also included a note regarding site drainage in general requiring that all stormwater runoff be contained on site. Please advise if there are any further requirements which may be required prior to the issuance of a building permit. Very truly yours, Michael H. Grotzke, P.E. Director Attachment: CIA, Revision 3, General Site Plan, Revised 10/28/99 cc: F. Curran C. Reilly file E PLq N . 8699 s , Town of Barnstable Application for Site Plan Review Location Business Name: Assessors Map , Parcel Number: MAp 119 pA �-- �79 Property Address: �� Wkt4 �'T G A L-�� �Z�55 � Owner of Property Applicant FS CURZAN Name: N.unc: G-�Q?.t. Address: F O WX O Address: 05TCV-'et LLe N A 02655 Phone: �9 • 42$•(0237 Plionc: FAX: Emincer Agent N.une -ri r= N.une - Aciciress: pC �'13So Address:. Phone: Phone: Storar;e Turks Utilities Zoning Classification Existing Proposed Sewer District: Number: , 'Number: Public Flood Hazard: C Size: 2-75 ��st- Size: 5AM` Private ✓ Groundwater Overlay: 2-IT Above Ground: y' Above Ground: Fire District Lot Area: 5.7 A ug Underground: Water Number of Iiuildins.�s Underground: gT Contents: G Contents: Public: ✓ Existing: ej �. Private: Proposed: 5 Parkinsr Spaces Curb Cuts Fire Protection: Demolition: ----! Existin - Electrical Total Floor Area Required: 68 b• 3 d Pro ose : Aerial: ✓ Residential: O Provided: 70 P 3 Oil-Site To Close: — Underground: Office: Off-Site: Totals: 3 Gas Medical Office: Natural: IEZ5 Commercial: 13o EZ) AWT1Q •8 sVxe Propane: (Specify Use) 2104 Rum TE VAtSo a • 1� �P �c11.1 C L' 18 ♦20 126-maZ AE Wholesale: 62gcal Environmental Concern Institutional: In Area o(E.O.E.A) Ycs/Io Industrial: ees f BRA t4T: 1128 Project within 1 UO' ol•Wedand Resource Area: Y 4 — e�►2 ►�IOU►,. = 14� Old King's Highway Regional Historic District: tAQ Approved? Yes/No Zoning Board of Appeals action? N� Listed in National and/or State Register of Historic Places: tilD Perimeter setbacks: Front: 20 Side: Rear: 9bLot Coverage: ;STING 934 -40 ?V. ,fuses•. 11,bZ-14a f r 4 ? 7v Number of Floors: 1 Floor Area: Soho First: l lGn,!��111 5a Second: Other (Specify): Parking Requirements: Required: �O Provided: Handicapped Spaces: Are there Accessory Buildings? —' - Accessory Building Floor Area: Please provide a bnel*narrative description of your proposed project. I•l G:'G BUJ O2-S Psl-'D ROOM III? ^^ .z. , T�- 20zS. I assert drat 1 have completed(or caused to he completed)this pac and the Site Plan Re iieiv Application:uld that, to the hest of my knowledge, the information submitted here is true. cpo% 9�!99� Date Signature 5 L t ® The Phoenix Group ENGINEERS •LANDSCAPE ARCHITECTS •PROJECT MANAGERS P.O.Box 1736,Mashpee,MA 02649 508-539-0800 Fax:508-539-3780 tp9@capecod.net 29 September, 1999 � " Robin Giangregorio, Site Plan Review Coordinator Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Street Hyannis, MA 02601 Re: Proposed Expansion to Fitness Center,The Farm, 1304 Main Street, Osterville Dear Ms. Giangregorio, It is proposed to expand the Fitness Center at the above-referenced address to include a weight and nautilus room and to provide the members with 20 lockers and showers. Plans for the proposed changes are included herewith. This site has been recently reviewed for the restaurant at the site - La Petite'Maison (reference SPR-061-98). Please advise if any further information is required in support of this application. Thank you for your assistance. Very truly yours, Michael H. Grotzke, P.E. Director Attachments: Site Plans Cl, 2 sheets Architectural Elevation Plans, reduced, A4, A5 Site Plan Review Application(2pp) Drawing of Proposed Sign at Driveway Entrance RECEiV G - SEP 2 ,9 1999 c��GgjcQ TOWN OF BARNS Town of Barnstable Application for Site Plan Review Location Business Name: TNT +R1`/1 Assessors Map and Parcel Number: MAp 119 Pit-- o79 Property Address: J?xD4 M 6t4 IMF—C=f—�T'T C 'A Owner of Property Applicant Naunc: G-}�2t..�! 5S CAAR4 AN Name: Address: P O 0DX fop Address: 05t»t Phone: 5U8. 428•(0237 Phone: FAX: Enc�inccr Agcnt Nanic -ri-1E ?rjC@NV Sao�p Naive Address: fo eKp)C t7? . Address: MD- 0800 Phone: Phone: 508 . 39• Slorac;c TanksUtilities - Zoning Classification Existing Proposed Sewer District: Number: 1 'Number: P Public Flood Hazard: C Size: 2-�rj Cam Size: 5AMe— Private V Groundwater Overlay: 2-IT Above Ground: ✓ Above Ground: Fire District Lot Area: $ .7 AGES Underground: Underground: Water Number of Buildings Contents: (� Contents: Public: ✓ Existing:. �j -� Private: Proposed: 5 Parkins; Spaces Cur_ Fire Protection: Demolition: —1 Required: 65 Existing- 3 Electrical Total Floor Area Provided: 70 Proposed: ?j Aerial: ✓ Residential: O On-Site To Close: Underground: Office: C,dJ Totals: 3 Gas Medica1011ice: Off-site: Totals: g 3Fj - e%) Natural: `(1j �o Alt,m ue 15� i4 'SP Propane: , (Specify Use) 2104 QUAC5) "Icpoa • 1(0 �P f F Tµ�6 CO ,�ECL' 18 +20 �z" ''� Wholesale: c Institutional: n Area of (:ngccal Environmental Concern (E.O.E.A) Yes/ Industrial: 1 Io OMPLWAsT 18 28 Project Nvidun 100' of*Wetland Resource Area: Yes/6c ►�U3� = 14� 4 Old King's Highway Regional Historic District: tAQ Approved? Yes/No Zoning Board of Appeals action? N� Listed in National and/or State Register of Historic Places: ND Perimeter setbacks: � u Front: 20 Side: Rear: 96Lot Coverage: F. 45TlNG 942`off — 3•g In P�2o rosr�.•. 1 V,b27 Oa fT -- a,7 9n Number of Floors: t Floor Area: T0 �t �to27 zo FfE First: L I��Z7 5a Fr Second: Other (Specify): Parking Requirements: Required: Cv8 Provided: 70 Handicapped Spaces: , Are there Accessory Buildings? fi Accessory Building Floor Area: Please provide a brief narrative description of your proposed project. F.�P•'�Nsto N � Q�15���r>�>�s G - " -ti It204t Dc— WT 1JE.C�LU S Ml�Gk}t N Room ,AID I -�'�-- b�01`/1 W 62HO ucwus Ate -- 20 pzS. I assert that I have completed(or caused to be completed) this page and the Site Plan Rei,7e.cvApplication and that, to the best ol'myknowledge, the information submitted here is true. q2o 9•z9.9� Signature f r Date 5 • _C.E,N TE III ; 3 56 r*119iN STRE E T - E!I . - 1q S S t To Cie itrn. ec� P-tG_pGscd Stctn [p be lorArc ., West . si-de. o'r enfrANCCr drlyc ►�— — ._._.bc ...._._�i9 c-� c�urth _. PIrT.��i,5 (loud `O-F crk�cr OPeVCL Im, . wco� poSf to Ac. Iq kt Ci/Ny e �)5hr /0 9G /'A� �j�`o1u^ 'VOrL✓fr. P -}�- J �d tel Ih� _ 1 McKean Thomas From: McKean Thomas To: Ritchie Carol-Ann Subject: Osterville Fitness Center/SP 29-95 Date: Wednesday, April 19, 1995 6:10PM Priority: Low As of this date, I have not received the following information requested: -On April 13, 1995,the Building Commissioner determined that this is a change in use. Therefore a certified septic system inspection is required. The results of the inspection must be detailed on an approved DEP form and must be submitted to the Health Division. -The applicant disagreed with Title 5 regarding the use of an estimated flow rate of 25 gallon per participant per 7 .day. Therefore,the only alternative is to utilize water meter readings. The applicant agreed to obtain water meter readings from a similar size facility with the same type of use and to double the readings as allowed under theTitle 5 regulations. This information may be used to determine the daily sewage flow for the proposed use. However,to date ,this information was not received at the Health Division Office for evaluation. Due to the fact that the above information.requested on April 13, 1995 was not received, I am not able to approve this site plan review application at this time. Page 1 OSTERVILLE FITNESS CENTER 1356 MAIN STREET - P. O. BOX 217 OSTERVILLE, IAA 02655 April 18, 1995 Mr. Thomas A. McKean, R. S. , CHO Director of Public Health - Town of Barnstable Health Department 367 Main Street Hyannis, MA 02601 SUBJECT: Osterville Fitness Center (lot 1322) 1356 Main Street , Osterville, MA Dear Mr. McKean: Thank you for taking the time to meet with me Friday. I believe the information received has enabled us to meet the criteria required by current Board of Health Guidelines. The following information applies: - The existing Title V system (Permit #78-790 issued to Walter Lewis, 11/27/78) is designed to handle -a daily flow of 427 gallons. - Walter Lewis , Certified Septic System Installer will inspect the system using current Title V criteria and have the report due for your review by Wednesday , April 19, 1995. - Both the R & R Gym and Aerobics 12 Thornton Street and the Womans Body Shopp , Hyannis Village provide shower facilities and are not a comparable facility. However , I have attached the water Sills 1993 and 1994 for 4650 Falmouth Road, Cotuit . Average usage 62 ,000 gal.. per year or approximately 248 gal/day based on a five-day work week. This commercial location houses the Cotuit Rehabilitation Center (now the Osterville Fitness Center) plus Cotuit Chiropractic , Ames Electric and several other business offices. It could be assumed that the Rehabilitation Center contributes approximately 1/3 of the usage or 90 gallons per day to that usage. We respectfully request that ,you accept _5 gals. per person• per day as the flow indicator. . We anticipate no more than 50 people per day at our facility or a total of 250 gal/per/day usage . If you have any question on the above or if I may be of any further assistance please call me at your earliest convenience. • I can be reached at (508) 477-0477. Sincerely , �- ri C l Hid gg Re na d in s g Attachment (1) McKean Thomas From: McKean Thomas To: Ritchie Carol-Ann Subject: SP#29-95/ 1356 Main Street Osterville Date: Thursday, April 13, 1995 8:53AM Priority: Low offer the following comments regarding the proposed fitness center/massage therapy center: -The facility must be licensed by the Board of Health for Massage. -The individual(s)who practice massage must be licensed by the Boad of Health. The septic system must be inspected by a DEP certified septic system inspector for the proposed change in use. What is the design flow for the proposed use and is the existing septic system designed to handle the proposed uses? A professional engineer would compute the design flow. ra, Page 1 I' y McKean Thomas From: McKean Thomas To: Ritchie Carol-Ann Subject: SP#29-95/1356 Main Street Osterville Date: Thursday,April 13, 1995 8:53AM Priority: Low offer the following comments regarding the proposed fitness center/massage therapy center: -The facility must be licensed by the Board of Health for Massage. -The individual(s)who practice massage must be licensed by the Boad of Health. { The septic system must be inspected by a DEP certified septic system inspector for the proposed change in use. -What is the design flow for the proposed use and is the existing septic system designed to handle the proposed uses? A professional engineer would compute the design flow. a e Page 1 • e Vl. to McKean Thomas To: Ritchie Carol-Ann Subject: SP#29-95/ 1356 Main Street Osterville Priority: Low offer the following comments regarding the proposed fitness center/massage therapy center: -The facility must be licensed by the Board of Health for Massage. -The individual(s)who practice massage must be licensed by the Boad of Health. he septic system must be inspected by a DEP certified septic system inspector for the proposed change in use. -What is the design flow for the proposed use and is the existing septic system designed to handle the proposed uses? A professional engineer would compute the design flow. Page 1 TOWN OF BARNSTABLE SITE PLAN REVIEW DATE: April 5, 1995 TO: Tom McKean FROM: Carol Ann Ritchie, Site Plan Review Coordinator RE: Site Plan Review # 29-95 Osterville Fitness Center 1356 Main Street, Osterville. Map/Parcel: 119/079 Proposal: Fitness center, massage therapist, free standing sign. Please submit this form, with any comments or additional requirements you may have regarding the above referenced application, to the Building Commissioner's office by April 13, 1995. I have the following/attached comments/requirements regarding this application for Site Plan Review . I do not have any comments/requirements regarding this application for Site Plan � Review at this time. (Signature) e —Mo At PLI CAI I �N t uK l ^ � ^L • �^ ORT£ RECEIVED a ACTION DUE BY ' LOCATION Legal Descriptions Osterville Fitness Center Planning Board Subdivision Numbers Assessor's Map and Parcel Number+ Man # 119 - Parcel ?9 Property Addresst 1356 Main S ree Osterville ;MA - k APPLICANT OWNER OF PROPERTY Name+Osterville Fitness Centel games Freder'ck J Curran Address+ 8 Turtle-Lane Address+ P. 0. Box 217 p p Box Fi71 nctP-rvi 1 le; MA 0265f_. f DnvPr -MA 02030 Phones Phones-15os) 477-0477 AGENT(Interest owner or at �, ,c ENGINEER names Names l4uGc..�r Addressr Address: B a• fox boy Phone t Phones 5o� y 77 a�/77 L� ` ( ST,)F:At=E TaNk(al QT1LITIES� 'ZONING CLASSIFICA :1l571Nr PROPOSED Seuer Districts �3� Number: I Nur,ber;_ Fublic_ Flood Hazards Ad". a ,�.es�SG_p� size; iriV-:tee Groundwater Overlay r Above Graund;X Above Ground:_ Fire Districts s1i:d?rarounds Undergrounds dater: i LOT AREA u Contents; Contents Public x Frivate:— NUMBER OF BUILDIN ! Fire Protection: Existings 1 s 7 a LAF�}_IN(: f'FAACi Zi* CGRB CUTS Proposed+ =zquireds ^Z O Ezistings t, Electricals Demolitions rovided: Proposed: Areal: 1 In Site: 2 .5 _ To Closes Underground:­�—x TOTAL FLOOR AREA Site: _ . Totals_ Gas: Residentfal+ Nafural: Na" office: IN ii157QF:ICAL G/�TF:ICT:(yes) No (no) Propane':_ tledfcaI Offices --- Commercial+ Servi 1N A(�EA OF_CR;7ICAL ENUIRi?NnEN7AL - (specify use) — - - - Fitness Center CONCERN rE.ri.E.A. 1s (t'es)_ (no)_ _ f°- -- wholesale FF.OJECT VITNIN 100' OF UETLAND RESOURCE AREA: (yes)_, (no)_X: Institutional: Industrials TOWN OF BARNSTABLE! / 5� /-�.r r 7 SITE PLAN REVI7W D APR 4 1995 I"' YC_hL I t wLl rt._t •.1l.il hl. _ 'if.,n� - � 1 ' r._ Zoning District _ BA old King' s Highway District No or Listed in National and/or State Register of Historic Places NA Perimeter set backsr Front 110' Side 160` Rear 240' Lot Coverage Lot is 5.7 acres in total size i Type of Use ( zoning) Exercise Recreation Flood Plain Zone A. P. t < Elevation 52' „ k, Number of Floors Floor Area: 1st 1588' 2nd 376 ' other (specify) Stora e approx. 1200' Parking Requirements:.. Required 20 Provided 25 Handicapped Spaces , ' Are there accessory buildings?No Accessory Buildings Floor Area No j� PLEASE PROVIDE A BRIEF, NARRATIVE DESCRIPTION OF YOUR PROPOSED PRO The fitness center ...is an exercise facilt for ma ure ersor (average age 55 years) . They have supervised access to approx. exercise machines fo-r- maintaining muscle tone and. fitness. Body builders , strength yompetitfts will be encoura suitable to that clie tele. � 1 assert that I have completed (or- caused to be completed) this pa Site Plan ,Review Application and the checklist on the back of the application and that, to the best of myiknowledge , the Informatior. submitted here is true. l 3 -3�-1 ( 1 njtu {da.te; OSTERVILLE FITNESS CENTER, INC: P. O. BOX 217 , 1356 MAIN STREET OSTERVILLE, HA 02655 Alarch 29, 1995 Carol Ann Ritchie The Town of Barnstable Department of Health , Safety and Environmental Service zr Building Division 1 367 Main Street Hyannis, MA 02601 a Dear Ms. Ritchie: Attached are six copies - 'Pages 4 and 6 of the Application for Site Plan Review:. - The Plot Plan for 1356 Main .-Street showing the building location, septic placement and parking area. - Sign Permit Requirements and plans. opiES The building to be used has recently been renovated and is .ideal for this planned facility, u The Osterville Fitness Center °currently operates as the Cotu:it Rehabilitation Center located at 4650 Route 28, Cotuit ; MA. The current owner is discontinuing its. operaton and the premises must be vacated by April 29, 1995. The fitness center serves approximately 60 'local , mature residents (average age 55 years) who wish to perpetuate the availability of this non-competitive, non-sweaty environment. It is this group that has raised the funds to purchase the equipment and ' Move it and the ' current instructor to a new location. . i Pending approval by the Building Department we' would ' like to, be operational at this new location on May 1 , 1995. I apologize for the short notice. Anything your Department can do to provide us adequate planning and moving time will be, greatly appreciated. If I can be of any assistance , please call me on. (508) ' 477-'0477. " si_n�cerely, Regi ld H'uggl s General Planager. f 10 CMR: DEPARTMENT OF ENVIRONN&AL PROTECTION 15.300: continued ' (3) The Department shall annually produce educational materials suitable.for distribution to the general public describing the importance of proper maintenance and operation of on- site systems and the impact of such systems on public health and the environment. In addition to its own distribution,the Department shall make such materials available to local approving authorities and other interested persons. # _ (4) Any person owning or operating a facility on which an on-site subsurface sewage treatment and disposal system is installed shall be responsible for the inspection and k. maintenance of, and any necessary upgrades to, the system. 15.301: System Inspection (1) A system shall be inspected at or within nine months prior to the time of transfer of title to the facility served by the system. If weather conditions preclude inspection at the time of transfer, the inspection may be completed as soon as weather permits, but in no event later i than six months after the transfer,provided that the seller notifies the buyer in writing of the requirements of 310 CMR 15.300 through 15.305. This provision shall not apply to refinancing or a change in the form of ownership among the same owners, such as placing the facility within a family trust of which the owners are the beneficiaries. A copy of the i inspection report shall be submitted to the buyer or other person acquiring title to the facility served by the system. S` (2) A system shall be inspected upon any change in use or expansion of use of the facility served,for which change or expansion ebuilding permit or occupancy permit from the local } building inspector is required. Unless the system is a cesspool, failing as set forth in 310 CMR 15.303 and 15.304(i), or a significant threat to public health, safety and the environment as set forth in 310 CMR 15.304(2),upgrade of the system is not required if the system was designed to accept design flows resulting from the change in use or expansion of use. Upgrades to accept increases in actual or design flow to any cesspool or to any other system above the existing approved capacity shall be in accordance with 310 CMR 15.352. Whenever an addition to an existing structure which changes the footprint of a building is proposed, the system inspection shall include an assessment to determine the location of all system components, including the reserve area, in order to ensure that the proposed construction will not be placed upon any of the system components. If official records are available to make a determination regarding location of system components,an inspection is not required for footprint changes. ;. (3) Systems with a design flow of 10,000 gallons per day or more at full build out shall be inspected by January 1, 1996 in accordance with the provisions of 310 CMR 15.006 (transition rules) and the applicable provisions of 310 CMR 15.300 through 15.354. Such systems shall be reinspected at least once every three years thereafter. (4) Shared systems shall be inspected annually. (5) When a facility is divided or the ownership of two or more facilities is combined as specified in 310 CMR 15.010(2) or(3), all systems serving the facility or facilities shall be µ inspected. (6) All systems shall be inspected when the owner or operator thereof is ordered to do so by the local approving authority, the Department or court. (7) The results of any inspection(s)required by 310 CMR 15.301 shall be submitted to the approving authority on a System Inspection Form approved by the Department within 30 days of the inspection by the approved System Inspector. Inspections for systems with design flows over 10,000 gpd and shared systems shall be submitted to the Department by the approved System Inspector and the owner. All inspections required by 310 CMR 15.301 shall be conducted by a currently approved System Inspector. }`. r 3/24/95 (Effective 3/31/95) 310 CMR- 544 ,a THE COMMONWEALTH OF MASSACHUSETTS 't BOARD CQF HEALTH L>Zi1�1.................OF.... .... n: ....::....... ApV1,irFation for Dhipoii al Works' C9nnitrurtivii V.ernti.t Application is hereby made for a Permit to Construct (- ``') or Repair (X an Individual Sewage Disposal System at ................... A(!j.. i 05/e ........................................... ............ ............ .. ............ ..... L/9caio/on� -Add,. r - •.•-.- - F. ,T .... li/kdL ..l......t.4: i.. �' or Lot No. ! C fS....................... !-:......L,eN ...:..:... J ✓ ............. ....... Owner /Address/f.. ...........0. .................................•............... ....... U`../---r_ 1. ! Installer Address Type of Building _ Size Lot............................Sq. feet VDwellingNo. of Bedrooms.....................:..........::..........Ex Expansion Attic � -� P ( ) Garbage Grinder ( ) a Other—Type of Building ..�_�1Gp.............. No. of persons....... ................. Showers ( ) — Cafeteria ( ) d Other fixtures .................... !/c `...i....sr. . ...... Design Flow. ... :. ................gallons per person',per day. Total daily flow........P/..........................gallons. . . Septic Tank r-L..iqui...d. capacity-�..0-DT/_..--gallons Length................ Width.................Diameter................ Depth................ Disposal Trench—No. .................... Width...................... Total Length............ ...... Total leaching area....................sq. ft. Seepage Pit No....... .......... Diameter........ Depth below inlet...... a ....... Total leaching area. U.l....sq. ft. z Other Distribution box ( ) . Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date---- ........... Test Pit No. 1................minutes per inch Deptli"of Test Pit.................... Depth to ground water.._-..__................ rJ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -------------- ----------------- -.......... -........... .......... ._..........:..:. .........:......... 0 Description of Soil...............................::..................:................... .... x x ---•--•.............------..........--••••--------•---•--•-...--•---•---•-----•...•................................ ................................••------- •---•-• ................. U Nature of Repair or Alterations—Ans GSr,when appli ble......,.. ���ac ... ct�._..{�Cc� ug�-•-r,r_ __ ...................... •-------------•-, ........................................................ Si�� �..._.�9! ... F�. r_�i�... a�1.....i ..,.. y// �'. .-:..--- •-•--.... -----•-- . Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has.been is ued by the board of health: Signe • c�. �'i„ ,�••> �' 7 1�........�..�L�. Date Application Approved By.. . ...... .._ .. ^ --.. ------•-. .... Date Application Disapproved for the following reasons:---:..--••----•-••........:....................•--•--••---••---............•....................-••......._.... - ................ ....... .•.... Date Permit No............................................ ... -- Issued.....ll`3 :.: : ......... --- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF' HEALTH . . A 1. ....................................... . Tertif iratr of (Compliatta THIS IS T CERTIFY hat the Individual Sewage Disposal System constructed ( ) or Repaired AA by... ....:: rah • � ' tY-• = --= t •- � Instal - ':' ,�.. �,,C �.. fir. at...... �,J'. .��J ��... t �............. ..s sit.... ....--•-•-......--•---.........•........ has been installed in accordance with the provisions of TI " 5)of The State Sanitary Code as described in the application for Disposal Works Construction Permit Noi�-. . 1 PP 1 dated_...tr�` 7`..7� ................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE........................................................I............ .....--- ' Inspector............................. ......................................................... 7-HE COMMONWEALTH OF MASSACHUSETT5 BOARD OF HEALTH N �a ,l :..............OF %Jc....r.1';t�F�........................... ................... Rapaottl o k.0 Toniitrwwh n Permit Permission is hereby granted......... iJs _( '��1.....,F�P 4%t..................... . to Construct ( ) or Repair ( &-ran Individual Sewage Disposal System at No..•--..... '',3:L?-...../'�l,ciR.........s..l!'..r`.._._........ Street as shown on the application for Disposal Works Construction Peymit Dated../ -2/7.._-7) ................ ..'/ .............................. DATE. /' � 7' 7i� Board of H�ale6 FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS L— f _ ... GATE PERMIT ISSUED DATE COMPLIANCE ISSUED51 JA -zT i �. F SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Address of property 13 rd a `t 1A `�- own er's name "Fwekeuc04(.3Y C-"v-V`a'-c� C.GL��CES Date of Inspection C�t k C [,$ ttc ct PART A CHECKLIST Check if the following have been done: Pumping information was requested. of the owner, occupant, and Board of Health. y/None of the system components have been pumped for at least two weeks and •the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. G� As built plans have been obtained and examined. Note if they are not available with N/A. t/ The facility or dwelling was inspected for signs of sewage back-up. c/ The site was inspected for signs of breakout. All system components, excluding the SAS, have been located on the site. (/ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. v The size and location of the SAS on the site has been determined based on existing information or approximated by non-intrusive methods. v/The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of SSDS. ` I 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION FLOW CONDITIONS If residential number of bedrooms number of current residents garbage grinder, yes or no laundry connected to system, yes or no seasonal use, yes or no If nonresidential, calculated flow: Water meter readings, if available: Last date of occupancy GENERAL INFORMATION Pumping records and source of information: ' lo System pumped as part of inspection, yes or no if yes, volume pumped Reason for pumping: Type of system Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Ac, Shared system (yes or no) (if yes, attach previous inspection records, if any) Other (explain) Approximate age of all components._ tDate .installed, if known. Source of information: t �" Sewage odors detected when arriving at the site, yes or no SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SEPTIC TANK• (locate on site plan) depth below grade: material of construction: i/concrete metal FRP ___other(explain) dimensions: l sludge depth distance from top of sludge to bottom of outlet tee or baffle scum thickness distance from top of scum to top of outlet tee or baffle distance from bottom of scum to bottom of outlet tee or baffle Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, recommendations for repairs, etc. ) DISTRIBUTION BOX: (locate on site plan) depth of liquid level above outlet invert Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, recommendation for repairs, etc. ) PUMP CHAMBER: (locate on site plan) pumps in working order, yes or -no Comments: (note condition of "pump chamber, condition of pumps and appurtenances, . recommendations for maintenance or repairs,etc. ) 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued �- SOIL ABSORPTION SYSTEM (SAS) : (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type U1 leaching pits and number leaching chambers and number leaching galleries and number leaching trenches, number, length leaching fields, number, dimensions ' ` overflow cesspool, number Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc. ) CESSPOOLS (locate on site plan) : number and configuration depth-top of liquid to inlet invert ' depth of solids layer depth of scum layer dimensions of cesspool materials of construction indication of groundwater inflow (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs, etc. ) PRIVY: (locate on site plan) - materials of construction dimensions depth of solids Comments : (note condition of soil , signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs , etc. ) - 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100 ' �00tLC-- L , to o � DEPTH TO GROUNDWATER - / depth to groundwater' method of determination or approximation: i • 1.2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C FAILURE CRITERIA Indicate yes, no, or not determined (Y, N, or ND) . Describe basis of determination in all instances. If "not determined", explain why not) _ Backup of sewage into facility? Discharge or ponding of effluent to the surface of the ground or surface waters? Static liquid level in the distribution box above outlet invert? Liquid: depth in cesspool <6" below invert or available volume< 1/2 day flow? l� Required pumping 4 times or more in the last year? number of times pumped Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank failure imminent? Is -any portion of the SAS, cesspool or privy: below the high groundwater elevation? within 50 feet of a surface water? within . 100 feet of a surface water supply or tributary to a surface water supply? _ within a Zone I of a public well? \ within 50 feet of a bordering vegetated wetland or salt marsh— (cesspools and privies only, not the SAS) ? \` within 50 feet of a private water supply well? less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis? If the well has been analyzed to be acceptable, attach copy of .well water analysi for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. 13 SUBSURFACE SEWAGE ,DISPOSAL SYSTEM INSPECTION FORK PART D CERTIFICATION Name of Inspector Ctjct Company Name p t ` Q C_ 6e -I Company Address' jS0 / s 7`e.h V' Certification Statement I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true, accurate and complete as of the time of inspection. The inspection was performed and any recommendations regarding upgrade, maintenance and repair are consistent with my. training and experience in the proper function and manitenance of on-site. .sewage disposal systems. Chick one: I have not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15.303. Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. I have determined that the system fails to protect public health and the environment as defined in 310 CMR 15.303. The basis for this determination is provided in the FAILURE CRITERIA section of this form. • 1 Inspector's Signature Date Original to system owner Copies to: Buyer (if applicable) Approving authority Ms. Carol Ann Richi December 9, 1995 J Page Two The following documentation is provided: . • 1356 Main Street is served by a single water meter, #9793. (A three-year usage summary provided by the Water Company is attached. ) • A private water line from this meter serves the Farmhouse Antiques, 1340 Main Street; The Greenhouse; and the barn used by the Osterville Fitness Center. • The Greenhouse was not in use during 1995. • Farmhouse Antiques is not a residence. • The Osterville Fitness Center has one toilet and one sink. We did use considerable water during the dry summer in an attempt to save several newly planted trees. • A total of 8000 gallons of water was registered at this meter for the six-month period ending November 1995; a period of .213 days. We would like you to accept that the Osterville Fitness Center used 80% of this water. 8000 gal. x 80% = 6400 gallons. • The Osterville Fitness Center which opened May 1, 1995 was in operation 161 days during this period and used 39 . 75 gallons per day of operation ( 6400 = 161 ) . • The doubling of our capacity may increase water usage to 80 gallons per day. This is well within the 475 gallon capacity of the existing septic system as certified by Walter Lewis on April 18, 1995. The Osterville Fitness Center is unique by intention. It is designed to accommodate a relatively small group of mature people who are not comfortable in a gymnasium environment. The planned expansion is needed only to provide variety and help maintain the economic viability of the Fitness Center. The addition of heavy competitive exercise equipment and clientele would, in fact, require showers and perhaps mirrors and a juice bar. It would also require membership in the thousands. That will be for another generation and another Site Plan Review Board. This Osterville Fitness Center would cease to exist. Yeg erely, al H4ug in Vice President and General Manager Attachments McKean Thomas From: McKean Thomas To: Ritchie Carol-Ann Subject: Osterville Fitness Center/SP#123-95 Date: Monday, December 04, 1995 4:28PM I am in receipt of a site plan review application regarding the Osterville Fitness Center dated November 30, 1995. 1 offer the following comments/questions: - Is the proposed maximum daily participant capacity 75 persons? The septic system must be large enough to handle the proposed capacity utilizing the sewage flow estimate table in Title 5. According to this table, a gymnasium generates 25 gallons per participant according to Title 5. 25 gallons/part./day X 75 participants= 1875 gallons. The existing septic tank and leaching pit are not large enough to accomodate the proposed sewage flow of 1875 gallons. [NOTE: If this establishment is not a "gymnasium" because of some reason as provided by the applicant, designs flows can be based on 200% of average water meter readings to assimilate maximum daily flows. It is the applicants responsibility to furnish water meter readings from a similar size and similar type of fitness club in order to determine the sewage flow.] Page 1 TOWN OF BARNSTABLE SITE PLAN REVIEW J DATE: November 30 1995 T Tom McKean FROM: Carol Ann Ritchie, Site Plan Review Coordinator RE: Site Plan Review # 123-95 Osterville Fitness Center 1356 Main Street, Ostervile Map/Parcel: 119/079 Proposal: Replace 1,200 ft. structure with 1,500 addition. Please submit this form, with any comments or additional requirements you may have regarding the above referenced application, to the Building Commissioner's office by December 11, 1995. I have the following/attached comments/requirements regarding this application for Site Plan Review . I do not have any comments/requirements regarding this application for Site Plan Review at this time. (Signature) OSTERVILLE FITNESS CENTER, INC. h P. O. BOX 217 (1356 MAIN STREET) yJ OSTERVILLE, MA 02655 November 28, 1995 Ms . Carol Ann Ritchie The Town of Barnstable - Department of Health, Safety and Environmental Service Building Division 367 Main Street Hyannis, MA 02601 Dear Ms. Ritchie: Attached are six copies : - Pages 4 and 6 of the Application for Site Plan Review. - The Plot Plan for 1356 Main Street showing the building location, septic placement and parking area. - April 18, 1995 letter to the Health Department with Subsurface Sewage Disposal System Inspection Form dated April 18, 1995. We are requesting authority to expand our existing exercise facility at 1356 Main Street, Osterville. We are currently using 1092 square feet of space for exercise- and 416 square feet for a massage therapist. Our current operation consists of 16 machines used for strength training, etc. To successfully maintain our current noncompetitive environment serving a mature clientele, we need to add variety and interest to existing programs. We would do so by removing and replacing the attached storage shed (approximately 1000 sq,ft. ) with a 27 ' X 56 ' attached building providing a hardwood surface for step classes, aerobics, yoga, etc. We would be adding one handicap equipped toilet facility. No showers are planned or- needed as clients stop in, exercise 45-60 minutes, and return home or to business. If I can be ofNQvy�ags��s nce, please call me on ( 508 ) 477-0477. ISincerely, Regi ald J. Hugg inss General Manager Attachments DATE RECEI VED • ION DUE BY LOCATION al Descriptions OSTERVILLE FITNESS CENTER anning Board Subdivision Number, essor's Map and Parcel Number: MAP 4119 - PARCEL 79 perty Addressr1356 MAIN STREET, OSTERVILLE, MA OWNER OF PROPERTY APPLICANT e: Frederick J. Curran Namer Osterville -Fitness Center, dress, 8 Turtle Lane Address:P. 0. Box 217 P. 0; Box 671 Osterville, MA' 02655 Dover MA 02030 oner ( 508) 785-1604 Phone: ( 5o8) 428-3775 ENGINEER AGENT( Interest owner or applicant) me: Name: Reginald J. Huggins dress: Address:-P. 0. Box 209 Mashpee, MA 02649 one: i Phone: ( 508) 477-0477 'i'OFA,:E TAN i OTIL/TIES ZONING CLASSIFICATION(S) SI1N1? FROPOSED ;a:►e District: BA ueber: 1 !�unoer: Pt:blic Flood Hazard: A.P. 'iZef. 275 gal Prjv-t x Groundwater Overlay: t-ove !=rourd:X At,ove Grotind:— Fire gist:ict: c'oMM :1:11•?rerot!nd: Vndzrvroutid: rater: LOT AREA: r,,7 A PublicX Private:— NUMBER OF BUILDINGS Fire Protection: Existingr 1 'AF), IN►; sPAACEZ: CURB LVTS � Proposed, aired: Existing: ' 2 Electrical: Demolition, ,vided:_2 Proposed: , 2 Arial:_ Site: _ To Close: : Undergrrottnd: X TOTAL FLOOR AREA (in sq.ft. ) f Site: _ Total: ' ' 2 Oas: Residential, Natural: None Office: IN HISTORICAL DISTRICT: (ves)&P (no) Fropane:_ Medical Office: *Commercials Service IN AREA OF CRITICAL EHVIRQHhENTAL (specify use) CONC£FN (E.O.E.A. ) : (yes)_ (no) X 3008 total Wholesale PROJECT UITHIN 100' OF 9ETLAND RESOURCE AREA: (yes)_ (no)X Institutional, industrials * We wish to add approximately 1500 sq. ft. of exercise space to the current 1092 sq. ft.' used for fitness machines. The 416 sq. ft. used by the Massage Therapists would remain as is. The second floor loft would continue to be used for storage. ` . A t 1 Zoning District BA ' Old King' s HighwaV District NO or j Listed in National and/or State Register of Historic Places NA Perimeter set backs: i Front 110' Side 160' Rear 240' Lot Coverage LOT IS 5 7 ACRFS ZN mnmAr_ SIZE Tupe of Use ( zoning ) ,', EXERCISE N, MASSAGE THERAPIST Flood Plain Zone A.P. i Elevation 52 ' i Number Of Floors 1 i/2 Floor Arear lst 1588 ' EXISTING i 2nd . 376 ' EXISTING Other (specify) RE LAL NG APPROXIMATELY 1200 ' STORAGE WITH 1512 FEET STRUCTURE FOR EXERCISE Parking Requirements: Required I Provided 25 Handicapped Spaces Are there accessory ! buildings? NO Accessory Buildings : Floor Area i PLEASE PROVIDE A BRIEF NARRATIVE DESCRIPTION OF, YOUR PROPOSED PROJECT. i THE EXISTING EXERCISE FACILITY SERVES -35 PEOPLE MACHINES FOR STRENGTHENING AND EXERCISING MATURE CLIENTELE. WE WISH TO REPLACE 1200 FEET OF SPACE USED AS STORAGE WITH A NEW STRUCTURE TO ACCOMMODATE YOGA,STEP CLASSES, AEROBICS, ETC. THIS WOULD EXPAND CAPACITY BY 30-40 PEOPLE PER DAY. the I assert that I. have completed (or caused to be completed) this page, Site Plan Review ApPlitvtLhe best and tof myeknowledge ,on tthebinformation of the application and thatt submitted here is true. 43n4to (date) 6 OSTERVILLE FITNESS CENTER 1356 MAIN STREET - P. O. BO% 217 OSTERVILLE, MA 02655 April 18, 1995 Mr. Thomas A. McKean, R.S. , CHO Director of Public Health - Town of Barnstable Health Department 367 Main Street Hyannis, MA 02601 SUBJECT: Osterville Fitness Center (lot 1322) 1356 (►lain Street , Osterville, 11A Dear Mr. McKean: Thank you for taking the time to meet with me Friday . I believe the information received has enabled us to meet the criteria required by current Board of Health Guidelines. The following information applies : - The existing Title V system (Permit #78-790 issued to Walter Lewis,. 11/27/78) is designed to handle a. daily f.l.ow of 427 gallons. - Walter Lewis, Certified Septic System Installer will inspect the system using current Title V criteria and have the report due for your review by Wednesday , April 19, 1995. - Both t..he R & R Gym and Aerobics 12 Thornton Street and the Womans Body Shopp, Hyannis Village provide shower facilities and are not a comparable facility.. However, I have attached the water ®ills 1993 and 1994 for 4650 Falmouth Road, Cotuit . Average usage 62 ,000 gal . per year or approximately 248 gal/day based on a five-day work week. This commercial location houses the Cotuit Rehabilitation Center (now the Osterville Fitness Center) plus Cotuit Chiropractic , Ames Electric and several other :business offices. I-t could be assumed that the Rehabilitation Center contributes approximately 1/3 of the usage or 90 gallons per day to that usage. We respectfully request that you accept 5 gals . per. person per day as the flow indicator. We anticipate no more than 50 people per day at our facility or a total of 250 gal./per/day usage. If you have any question on the above or if I may be of any further assistance please call me at your earliest convenience. I can be reached at (508) 477-0477. r Si-5cerely, i Reg 'nald iiuggins Attachment (1 ) Apr. 18'95 10:57 COPIES & MORE TEL 5084777785 /� P. 2 a - 0STERVILLE FITNESS CENTER l� Cb REcEwEO 1356 FAIN STREET .- P. 0. BOX 217 APR 1 g 1�9� 0STERVILLE, AAA 02655 dD � W April 18 , 1995 9 CA Mr. Thomas A. McKean, R.S. , CHO Director of Public Health - Town of Barnstable Health Department 367 Main Street Hyannis, MA 02601 SUBJECT: Ostervi.11e' Fitness Center (-lot- 1322) 1356• Main Street , Osterville, HA Dear Mr. McKean: Thank you for taking the time to meet with me Friday . I believe the information received has enabled us . to meet the criteria required by current Board of Health Guidelines . The following information applies; , - The existing Title V system (Permit #78-790 issued to Walter Lewis , 11/27/78) is designed to handle a daily flow of 427 gallons. - Walter Lewis , Certified Septic System Installer will inspect the system using current '.title V criteria and have the report due for your review by Wednesday , April 19 , 1995 . - Both the R & R Gym and Aerobics 12 Thornton Street and the Womans Body Shopp, Hyannis Village provide shower facilities and are not a comparable facility . However , l have attached the water dills 1993 and 1994 for 4650 Falmouth Road , Cotuit . Average usage 62 ,000 gal . per ,year or appx-oximately 2.48 gal/day based on a five-clay work week. This commercial location hoi.ise-- the Cotuit Rehabilitation Center (now the, Ostervil.le Fitness Center) plus Cotuit Chiropractic , Arles Electric and several other business Offices. It could he assumed that the Rehabilitation Center contributes approximately 1/3 of the usage or 90 gallons per day to that usage. We respectfully request that you accept 5 gals, per Person per day as the flow indicator. We anticipate no more than 50 People per day at our facility or a total of 2,90 ga] /per/clay aisage. If you have any question on the above or. if I may roc of any furthcr assistance please call, me at your earliest convenience. I can be reached at (508) 477-0477 Si-�cc�,rely , � Kegi'nald Huggins Attachment (1 ) Apr. 18 '95 10:58 COPIES & MORE TEL 5084777785 P. 3 ., lal;RvlcE AnnRF'ss f NxNVIrK Nu• IftEV10G;; NTH l8 nnLnNcha PERIOD GOVF:REii) 1,IiF:vIUI:S 11h;'I'I:ft Cnl. (1 . 'f(1 _ 11N(; itl�;A131NG f`CINtit:�fi . Cl1 ti c:ui�r�r;rv•r O g/3 0 Q.L .1_..�..�-----.._ __._.... .. .._—..: .....------ UX MISC.*DESCRM'IUN MISC.AMOUNT AI�N1;r11., M1\1h1U1\I: 40 M GALLONS AL,LOWI;I) i i 0000 - 80000 51 . 45 j l� 00 0 GAL . 0 l ''TAL ■ti►.;1" ' IS( AL 1J� ... CHARGES F111.L&UNPAID 80 DAYS AFTER ISSUE A �S TOTAL ARE St'CIII:CTTn 30'4 LA'f1 F'A1',MFNTC)IAR i I. 4 i f i f i S�1Q AD9itE86� �' SRRVI(•R N0. I'Hf.VIUUS 64 50 }'ALMOUTH ROAD 1.2Ii:3 COVERED .R PREVIOUS METER bALL�ONS CURRENT wa: , READING READING _ CONSUMPTION CHARCF O9J3U/�l3 1 O/(1I /;a.1 'el�):I li1.)(; 1 11000 6"1000 L _ Ml5CrDESCRIPTION _ MISC,AMOUNT ANNUAL.MININIUM: 40 M GAI,LONS'ALLOWED 40U00 - 89'000 56 . 35 2 . 45 P E k ,'7 0 0 0 C A f.. 1 1 TOTAL. MI CELLAN26US CHAR(.,, ;S BILLS UNPAID 80 DAY$AFTER ISSUE DATE OF ISSUE 1'0'rAL ARE SUBJECT TO 10% LATE; PAYMENT CHARt.1- 1 1 /U 1 /9� AMOUNT DUE t OSTERVILLE FITNESS CENTER 1356 MAIN STREET .- P. 0. BOX 217 OSTERVILLE, MA 02655 i ' I April 18 , 1995 i Mr. Thomas A. il.4cKean, R.S. , CHO Director of Public Health - Town of Barnstable Health Department 367 Main Street Hyannis, !.,,IA 62601 i SUBJECT: Osterville Fitness Cente% (lot 1322) 1356 Main Street , Osterville, MA i i Dear Mr. McKekn: i Thank you' for taking the time to meet with me Friday . I believe the information received has enabled us to meet the criteria. required by current Board of Health Guidelines . The following information applies : - The existing Title V system (Permit #78-790 issued to Walter Lewis ,) 11/27/78) is designed to handle a daily flow of 427 gallons. - Walterl Lewis , Certified Septic System Installer will inspect the system using current Title V criteria and have the report due for your review by Wednesday , April 19 , 1995. - Both the R & R Gym and Aerobics 12 Thornton Street and the Womans Body Shopp, Hyannis Village provide shower facilities and ate not a comparable facility . However. , I have attached the w ,ter ®ills 1993 and 1994 for. 4650 Falmoi:ith Road , Cotuit . Avera e usage 62 ,000 gal . per year or approximately 248 gal/day basedlon a five-day work weep. This commercial location houses the Cotuit Rehabilitation Center (now the Osterville Fitness Center', ) plus Cotuit Chiropractic , Ames Electric and several other !business offices. It could be assumed that the Rehabilitation Center contributes approximately 1/3 of the usage !or 90 gallons per day to that usage. We respectfully request that ,you accept 5 gals . per person per day as the flow indicator. We anticipate no more than 50 people per day at our facility or a total of 250 gal./per/day usage. y If you have Any question on the above or if I may be of any further assistance please call me at your earliest convenience . I can be reached at (508) 477-0477 . Si�cerely , i Reg �nald Iluggin s Attachment (1) SERVICE ADDRESS SERVICE:No. PREVIOUS + I TH BALANCE. PERIOD COVERED CURRENT METER PRF,VIOUS METER GALLONS ! CURRENT FROM — TO -- — READING READING CONSU.N1PT10.N .1 CHAR.C.ES '1 1 Q(1 6.�._O.O...c�!...:._._.. _._.. __. .. I MISC.DESCRIPTION a MISC_AXIOUNT ANNUAL, VIINIMUi14: 40 M GALLONS ALLOWED ' i #0000 — 80000 51 . 45 2 . 45 E$1000 GAL . _.__.._..._....._.____! ,R 00 t n L . i - 0 . 00 PER. ( 0 GA 1 TTAL �_;l—L IS("EA a,�{l CHARGES BILLS UNPAID 60 DAYS AFTER ISSUE tk� A TOTAL I ARE SUBJECT TO 10'% LATE PAYMENT CI IAR 1 1 9 AMOUNT DUE ~ 5 1 , 4 5 t � I i I SERV S senvice uo: IC PREVIOUS 1`1-6-50 FAL:MOUTH ROAD ].28 i BALANCE. PERIOD COVERED I R PREVIOUS METER GALLONS CURRENT o±iN:c: i READING READING CONSUMPTION CHARGES 09%30/j93 1(i/c:i l /:a I 20 a .11.JO l 1 1000 6a(100 i MISC.DESCRIPTION_ MISC.AMOUNT — ANNUAL MINIMUM: 40 M GALLONS ALLOWED 40000 — 89000 56 . 35 (� I � _—._.._.,. • 2�45 PER ,, 000 GAL ' TOTAL i*lF'--I MISCELLANEOUS CHARGES BILLS UNPAID 60•DAYS AFTER ISSUE DATE OF ISSUE TOTAL" ARE SUBJECT TO 1017( LATE PAYMENT CHARGE 1 1 /0 1 /9 4 AMOUNT DUE ~ 56 . 35 i M I i i r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPBCTIOM FORM Address of property 1 1 3 a I owner's name �„ �,<<.��C�c c�u.le S .F, C� a a���� Ft,e6 Date of Inspection A-fi a.� ( l � e Q0 t ; ! PART A i CHECKLIST Check if the following have been done: ' f Pumping information was requested of the owner, occupant, and Board of Health. ��None of the! system components have been pumped. for at least two weeks and the systemhas been receiving normal flow rates during that period. Large !volumes of water have not been introduced into the system recently or as part of this inspection. As built planshave been obtained and examined. Note if they are not available with VA. i The facility or dwelling was inspected for signs of sewage back-up. 1--�The site was inspected for signs of breakout. ��All system1components, excluding the, SAS, have been located on the �- site. !/ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. V The size and location of the SAS on the site has been determined based /won existing information or approximated by non-intrusive methods. The facility owner (and occupants, if different from owner) were provided with ;information on the proper maintenance of SSDS. f f i "8 . g SUBSURFA LWAGE DISPOSAL. 91YOTEM IN CTION FORM PART B SYSTEM INFORMATION FLOW CONDITIONS If residential number of bedrooms number of current residents garbage grinder, yes or no laundry connected to system, yes or no seasonal use, yes or no If nonresidential., calculated flow: Water meter readings; if available: Last date of occupancy i GENERAL INFORMATION Pumping records and source of information: i A System pumped as part of inspection, yes or no if yes, .volume pumped Reason for pumping: Type of system Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy [Lo Shared system (yes. or no) (if yes, attach previous inspection records, if any) Other (explain) Approximate age of all components. Date installed, if known. Source of information: 00 Sewage odors detected when arriving at the site, yes or no i f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SEPTIC TANK:_- (locate on site plan) depth below grade: material of construction: �:,-c-oncrete metal FRP other(explain) dimensions: sludge depth distance from top of sludge to bottom of outlet tee or baffle . scum thickness distance from top of scum to top of outlet tee or baffle distance from bottom of scum to bottom of outlet tee or baffle Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, recommendations for repairs, etc. ) DISTRIBUTION BOX: (locate on site plan) i depth of liquid level above outlet invert Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, recommendation for repairs, etc. ) PUMP CHAMBER: (locate on site plan) pumps in working order, yes or no Comments: (note condition of pump chamber, condition of pumps and appurtenances, recommendations for maintenance or repairs,etc. ) I • • 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM ,INSPECTION FORM PART B SYSTEM INFORMATION continued �- SOIL ABSORPTION 'SYSTEM (SAS) : (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type leaching pits and number ' s leaching chambers and number leaching galleries and number leaching trenches, number, length leaching fields, number, dimensions overflow cesspool, number Comments: (note conditionof soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc. ) I CESSPOOLS (locate on site plan) : number and configuration depth-top of, liquid to inlet invert depth of solidslayer depth of scum layer dimensions of cesspool materials of construction indication of groundwater inflow (cesspool must be pumped as part of inspection) i Comments: I. (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc. ) PRIVY: (locate on site ' plan) materials of construction dimensions i depth. of solids .. Comments: (note conditionl* of soil, .signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc. ). ., x. I i • � 11 i I _ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE !DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells .within 100' R i I i j ,f DEPTH TO GROUNDWATER C' f depths to `groundwater method of determination or approximation: I i i 12, SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART; C FAILURE CRITERIA �-- Indicate yes, no, or not determined (Y, N, or ND) . Describe basis of determination in all instances. If "not determined", explain why not) n Backup of sewage into facility? Discharge or' ponding of effluent to the surface of the ground or surface waters? Static liquid level in the distribution box above outlet invert? Liquid depth' in cesspool <6"<. below invert or available volume< 1/2 day flow? i Required pumping 4 times or more in the last year? number of times pumped Septic tank ;i is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank failure imminent? i Is -any portion of the SAS, cesspool or privy: below the high groundwater elevation? i� within 50 feet of a surface water? within• 100 feet of a surface water supply or tributary to a surface water supply? within a Zone I of a public well? within 50 feet .1of a bordering vegetated wetland or salt marsh (cesspools and privies only, = the SAS) ? rl a private water supply well? within 50 feet of p PP less than 100 feet but greater than 50 feet from a private water supply well'. with no acceptable water quality analysis.i If the well has been analyzed to be acceptable, attach copy of well water analysi� for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. _ i • . 13 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART D CERTIFICATION Name of Inspector Company Name Company Address It ��' 'F / �� s �' �'V`�° l �t Certification Statement . I certify that I ;have personally inspected the sewage disposal system at this address and that the information reported is true, accurate and complete as of the time of inspection. The inspection was performed and any recommendations• regarding upgrade .-maintenance :and repair are consistent with my training and experience in the proper function and manitenance of on-site sewage disposal systems. Check one: VI have not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15. 303 .1 Any failure criteria not evaluated are as stated in the FAILURE; CRI�TERIA section of this form. I have determined that the .system fails to protect public health and the environment as defined in 310 CMR 15. 303. The basis for this determination is provided in the FAILURE CRITERIA section of this form. Inspector's Signature Date i Original to system owner Copies to: P Buyer (if applicable) Approving authority i } 78 Adopted Nov. 21 1985--D-3. Atiproved Dec. 6, 1985. AMENDED NOVEMBER 1, 1990 ARTICLE XLVII. REGULATION OF WASTEWATER DISCHARGE _ s SECTION 1 INTRODUCTION 1-1 Findings The health, safety and welfare of the residents of the Town of Barnstable and its neighboring towns are dependent upon an adequate supply of pure groundwater. The Town's entire drinking water supply is derived from groundwater, and the United States Environmental Protection Agency has designated all of Cape Cod as a "sole source aquifer" requiring special care and protection. The groundwater system is internally connected with surface waters, lakes, streams and coastal estuaries, which constitute important recreational and economic resources of the Town. Contamination of the aquifer and related surface water resources pose a serious threat to the health, safety and financial well-being of the Town. 1-2 Purpose yy The purpose of this article protect public throughethehregulation and welfare by maintaining quality groundwater of the volume of certain wastewater discharges. SECTION 2 GENERAL PROVISIONS • 2-1 Prohibition No person, company, corporation, entity, trust or firm shall inatall a new individual on-site sewage disposal system which will produce more than three hundred and thirty (330) gallons per day of wastewater discharge unless in compliance with the standards established by Section 3 herein. 2-2 Certification of Compliance/When Required A certificate of compliance with this article shall be received from the Board of Health or its designed prior to the commencement of any activity regulated by Section 2-1 herein.. SECTION 3 STANDARDS 3-1 Maximum Allowable Wastewater Discharge Within zones of contribution to existing and proposed public supply wells, as determined by SEA Consultants, Inc. , Boston, MA. , in their report entitled "Ground Water and Water Resource Protection Plan, Barnstable, Massachusetts," dated September, 1985, as revised by the SEA Consultants Inc. Report, dated September, 1989, entitled "Update of Townwide Zones of Contribution of Public Supply Wells Barnstable, Massachusetts, " both of which are on file with the Town Clerk, the maximum allowable wastewater discharge from new individual on-site 79 sewage disposal systems shall not exceed three hundred thirty (330) gallons per acre per day. 3-2 Additional Limitation/certain Areas In addition to the standards of Section 3-1 herein, within two thousand (2, 000) feet of existing and proposed public supply wells, as report determined by SEA Consultants, Inc. , Boston, MA. , in their re P entitled "Ground Water and Water Resource Protection Plan, Barnstable, Massachusetts. " dated September, 19s51 which is on file with the Town Clerk, the maximum allowable wastewater discharge from a new individual 000) gallons unlosal essem shall not downgradientefromd two said thousand (2 ) g p existing and proposed public supply wells. 3-3 Flow Rate Determinations To determine compliance with Sections 3-1 and 3-2 herein, wastewater flow rates shall be determined according to Title V of the state Environmental; Code, subject to the interpretation of the Board of Health. 3-4 New System Defined For the purposes of this article, the phrase "install a new individual on-site sewage. disposal system" shall not include the maintenance, repair and alteration of an existing individual on-site sewage disposal system. However in no case shall the discharge of wastewater increase beyond that present prior to such maintenance, repair and alteration. 3-5 Any new system not in violation of the stwithrdd sectiona3ned within Section 3 shall be deemed to be in compliance SECTION 4 ADMINISTRATION This article shall be administered by the Board of Health or its designee by verifying compliance with the provisions established herein. Within ten (lo) working days of receipt of a request for a certificate of compliance, the Board of .Health or its designee shall notify the applicants thereof as to the approval or disapproval of the - request. Upon determination that all provisions of this article are being met, a certificate of compliance shall be issued. However, in instances where an upgrading of an existing individual on-site sewage disposal system is proposed, the Board of Health may require from an applicant evidence that the proposed upgrading will not adversely affect the groundwater quality. SECTION 5 ENFORCEMENT The provisions of this article shall be enforced by the Board of Health or its designee, which may, according to law, enter upon any premises at any reasonable time to inspect for compliance. SECTION 6 VIOLATIONS 80 Written notice of any violation of this article shall be given by the Hoard of Health or its designee specifying the nature of the violation and a time within which compliance must be achieved. SECTION 7 PENALTIES Penalty for failure to comply with any provision Of his article shall be three hundred dollars ($300.00) p Y SECTION S. SEVERABILITY Yf any Each provision of this article shall invalid construed anyareason�athe part of this article shall be held remainder shall continue in full force and effect. Adopted November 7r 1987-Art.3. Approved December 3, 1987. Revised November 4, 1989. ARTICLE XLVIII. FIRE LANES Under the authority of General Laws Chapter the, Section establistxmentCofude fire4t and the Town Manager may require prescribe lanes whenever public safety and necessity so require, and may prescribe the method by which it shall be done. Any person or body, that has lawful control of a public or private way or of improved or enclosed property used as off-street parking areas for businesses, shopping malls, theaters, auditoriums, sporting or recreational facilities, cultural centers, multiple family and residential dwellings, hospitals, nursing homes, or any other place where the public has a right of access as invitees or licensees, shall, when directed by the Town Manager, establish a fire lane. Said fire lane shall be marked by yellow linear at least four (4) inches wide on a diagonal from the point of origin to the curb or sidewalk. The fire lane shall not be less than eight (8) feet wide from the curb, or in the case of a building with no curb or sidewalk less than twelve (12) feet wide from the edge of said building. The legend (Fire Lane) shall be included within the printed area. Signs with the legend "No Parking Fire Town twenty"five shall (25) - erected no more than fifty (50) feet nor less than feet apart along the length of the fire lane. Signs shall be at least " twelve. (12) inches wide by sixteen (16) inches high, and shall be securely mounted at least six (6) feet but not more than eight (8) feet above grade. ENFORCEMENT AND PENALTIES Any vehicle or object obstructing or blocking any fire lane or private way may be removed or towed at the direction of the Chief of Police or such sergeants or other officers of high rank in the police department as he may from time to designate. Liability may be imposed for the - r x YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). Abusiness certificate ONLY REGISTERS YOUR NAME in town [which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis.. Take the completed form to the Town Clerk's Office,.1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: S I I 1 l Fill in please: ,1 u ' APPLICANT'S YOUR NAME/S: ,,,Fill � BUSINESS YOUR HOME ADDRESS: PC ' n s e,�- LIP`? •.3'? ©J\2_Qas1S TELEPHONE # Home Telephone Number `7'? NAME OF CORPORATION: NAME OF NEW BUSINESS C'�5�- y;.\\ t.' �n e s s TYPE OF BUSINESS `r IS THIS A HOME OCCUPATION? YES . NO ADDRESS OF BUSINESS 3 . ;a' o n {Zrc.Q C� ea `� ,` Mj�/IAP/PQRCEL,NUMBER 1. I , C� ~l• 1 [Assessrn 9)' g du� G �3i � g yp p la Whe starting a n u iness ere re sever•al't n s ou must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intende to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. '11. BUILDING CO ' MISSI ER'S OF ICE �l� -- This indivi ual en 4rf©r d an permit requirements that pertain to this type of business. h ,! r. t orized Signatur OMMENTS: "d_ 2. BOA OF HEALTH This individual has bee formed of the p rmit req i ements that pertain to this type of business. ut rized Signature* COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: - i 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Ad ress of property 3 a a `< <� S f `' �V,l `�- owner's name Date of Inspectional t a PART A CHECKLIST Check if the following have been done: L-'�Pumping information was requested of the owner, occupant, and Board of Health. 'None y .None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. Z As built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. The site was inspected for signs of breakout. All system components, excluding the SAS, have been located on the site. C/ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. V The size and location of the SAS on the site has been determined based on existing information or approximated by non-intrusive methods. The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of SSDS. f o'J'►I f 0(7 OSTERVILLE FITNESS CENTER 1356 MAIN STREET - P. O. BOX 217 OSTERVILLE, MA 02655 December 9, 1995 Ms. Carol Ann Richie Site Plan Review Coordinator Town of Barnstable Department of Health, Safety and Environmental Services 367 Main Street Hyannis, MA 02601 Dear Ms. Richie: Re: Site Plan Review No. 123-95 Osterville Fitness Center 1356 Main Street, Osterville, MA In response to the concern expressed by Thomas McKean, Department of Health: At the time of our original Site Plan Review Application (April 1995) we complied with a request to compare our planned facility with like existing facilities. We investigated the R & R Gym and Aerobics, 12 Thornton Street and the Women ' s Body Shop, Hyannis Village. Both provide showers and are not a comparable facility. Since that time, two new facilities have been added, 1 ) The Galaxy and 2 ) Gold' s Gym. They also provide shower facilities. The Osterville Fitness Center is not a gymnasium and will not become a gymnasium. NO showers are needed. NO showers are contemplated, NO showers will be provided. For convenience, we are planning to add one additional toilet and one sink in a handicapped-equipped restroom. The planned addition will be used to flesh out our existing exercise facility by adding aerobics, step classes, yoga, and other noncompetitive physical fitness activity. This facility will accommodate 35-40 people. We respectfully request that the Board of Health accept the actual water usage at this location as an indicator of future use. Assess. s ice(1st floor) 'Row z/ ^ Parcel 7 9 !1Permit• Conse do Office(4th floor)(8:30-9:30!1:00-2:00) �wC �1 ..<<1�� ,�Datate Issued Board of Health(3rd floor)(8:15-9:30/1:00-4:45) F --Wo(4e < <zo) ge- Engineering Dept.(3rd floor) House# d ]a in ept. t floo ch Adm' BldTic ,,� e itive Ian rov by nin ar 19 INS LLED TOWN OF BARNSTAMERONKIEN L C- - 1 !'f..'nq 1 Building Permit Application Project Street Address / lwlllAJ d7� i Village Owner/r--a /?l(-w C uA"tZ Al Address fJ TUR Jt,E 4 4A),C ov.0-6OX G � i Telephone 60s- / D Permit Request /r�EO�«z.E /�s< s�/.�6 ,¢TT/jC/ 'p /040 c2�9'FT Is- First Floor J`�� - square feet Second Floor square feet Estimated Project Cost $ 7 d' S O or) Zoning District ,B�q Flood Plain Water Protection Lot Size A S' Grandfathered? Zoning Board of Appeals Authorization Recorded Current Use 1-`1TN,1595' GE417A1 Proposed Use Construction Type GUGbO �/Li9/!l Commercial Residential i Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure TO r yXlACr Basement Type: Finished (!-CWi04k fz-/y'S Historic House iya Unfinished Old King's Highway No Number of Baths / 770/fir-, / ,S'11-IK 94,Wc- No.of Bedrooms /VO.y/E Total Room Count(not including baths) b.N/E First Floor Heat Type and Fuel Ffi w - o/G Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other i Builder Information Name AVT/%0/Nti /%�i2//'A -/31//cp t!f2 Telephone Number i Address Y DWk1dW0- ? /Zd- License# 6 3 Y/ F- ,C �JlovTt/ rJ2/� D a s3 6 Home Improvement Contractor# J Q 7 r/y 5 3 Worker's Compensation# GEAr< t.i NA/eiT`7 CFP 2G 9*5'a5"1Y z ,NEW CONSTRUCTION OR ADDITIONS RE961RE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. j ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO I �77-dev c/ /5;,, C I SIGNATURE 0' DATE BUILDING PERMIT DENI D FOR THE FOLLOWING REASON(S) I P G s MA�1:�7 i'�s�- �'• ` III _� - � O is NA IN �{ � n � i� run, lid 4 j; ,i,`F •. -�' �:- .t i itLM it ± Y i '•� s.•pr: I I I IIIIL.I.J..a,-�j /, i � li� II r I ! , � i;• . i1T 119 I I , j 1 III f1. . III i TMI 151 I 11 0 l.L__ I I' r II FF 1 f ' . .:�i....::f-a: f V. .: ._:{.:F:- II II OSTERVILLE FITNESS CENTER '1 SCALE ri.Ar[4 lJ\JI�C C/C/ lJV LL�/r,1UV DRAWN Jf ^��) (\(/\'�\' f E e CRO JS [D�V�` Nv lML a0 Ol Slw Im.31, r 02669 �PPO JS .jOVA - r N a b I r—vv rn. b D A rnO OSTERVILLE FITNESS -ENTER acAu AS a'c° IU\\VV�I� \\V/�\\U'/// 3 DRAWN ds� �/('c�,�� ^cv[x1f uC afib g DE�M�.JU V - ao n �a!�sm�•ozeH tA Arro A 1 • 1 yy III .14 � 1 I I1 I , I 3 ' 1 A r+ll'1 j 24 1 I I I I I I 11 I i 1 , 1 I D I Z I I I I I I r I I I 1 I I I I , t 1 I I I � , I I I I I I I I I 1 I 1 I I I 1 , I I II I I I ,i 1 7.�.. n . to-.V' Z gill ��p�'tr y OSTERVILLE ,FITNESS CENTER scwc.,N01[R NEW EMOLAND D t DRAWN JS DCZ ,(v I.MtiWtl OC,IfA , s s - CKO JS ,omxz,r•. Arro Js • w ti r �� s N o1 10 000l / I. 09 V� . rt=�.�?.r y - �tl �y2"t��.i'r � ::'it Via.. � x ..i � �,,•.IJ��.^*�'s. 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I I rn N I I _ " 70 --——- 11 I < I m I I �— —————— — ------------------ ------- ---J ,64 CFP i p o'�1 m p _ >0« T-n p c` w-c7-{ z m :o ff � � ,}, a Q r ZOO t� o a w 0 '�' rn prnczi Zi rn rn cr ®v�, ww f 71) >OD e d N 4 - -- HOSTETTER HOMES 1340-MAIN STREET, OSTERVILLE - 770 Main Street Osterville, MA 02655 o FOUNDATION PLAN 3� Main:508-428-2828 Fax:508.428-1974 1 X UN Z O 0 C 0 Z . DO Z Z rn N NMOa :� — N Z r X G) CD 0) rn �N rrnn70 nO ON n i rn 0 (j,rAn L N p D ' z a? G) -n 70 0 W rnN Z, W 0 O > (� r- rn rn i p x Up 0 NO 0— TI p D D � p? WN Z G) Z � � rn v r 71 �w �w 03— r rn 0 A— OX \ W 01 O v 03 u J i, c_--=_=t-_=t_=-__ n u n n n n 71 71 u u it== .cc tt ttt_=tc ==ai u n u u n u u i ' n u i n n u u ` COMMA cn ED z'L7 0 imp ® OWo CN—�f Y.. �Z v®ve 1340 MAIN STREET,•OSTERVILLE HOSTETTER HOMES N 0 ReWw 770 Main Street Osterville, MA 02655 x � N0 1ST FLOOR FRAMING PLAN Main:508-428-2828 Fax:508-428-1974 &-02"WALL hE16HT 61 2'-OZ l I I D N rn K -7-F rn z D p n D N rn a 8 i D P CA z � rn c : N X D r- r T-10" z rn = 0 rn rn 07� N NCl o x - _ z: x -n _ mN D �' m � � Z r rn - rn 00 � � � � 0 rn oZ zDDO 0 � � " 70 -n /U70Z 70 N rm 0 � � � � n � Z N '" > w � Now c) N 70 Qp rn J W = N rn O Z - N fm rn C z0 ::� '� a rn N QOL D rnC1 = rnZ rnD p 0 Z n > .4 n N Q 20 20 o Z O Z r � r I ZO rn <z D l' 0 > rnX X O 00 cz., '- � � -n -J z 70 z 70 J " �' O z z ® o a� n J � � � n � 0 0 C00M� D 7orn rnNON N00 N 70N Uj rn70OO rn -Chi v�.9<v �rn o c n 0 O p z - '-' cC7Z70 m 0 N y N —I y 0 n O rn r c� > D 0 D Z Z HOSTETTER HOMES o tz W 1340 MAIN STREET, OSTERVILLE 770 Main Street � N (') Osterville, MA 02655 o FOUNDATION DETAILS Main:508-428-2828 Fax:508-428-1974 0 z rn A O t O O rn G r r N X 0 — U1 z cP � 1 II -------------- �.. . �, rn 70 Z p n O O O O N0Orn �°n03 D Z N = y Focn o O 7 O y z n rn w. i O O cn rn rn r IN 1340 MAIN STREET, OSTERVILLE HOSTETTER HOMES Noew w770 Main Street x �! Osterville, MA 02655 0 EXISTING FIRST FLOOR PLAN Main:508-428-2828 Fax:508-428-1974 p O rn N _ J V � N N 1 1' 10" NMOa z OD u n D N N rn rn - Z Z N z , r 60n O � 13 0 o o 0 .. _ rn S O o D. p 03 rn O z 71 'z - p 4 e I - 1340 MAIN STREET, OSTERVILLE HOSTETTER HOMES ouww 770 Main Street oo Osterville•, MA 02655 b NEW FIRST FLOOR PLAN Main:508-428-2828 Fax:508-428-1974 \ 60.3 \ CIVIL ENGINEER PHO THE ENIX GROUP WEIGHT. t}Ai3ltl US:':;:;::':'::i:':::'::':':::;'`:•::'::........': �' -- . 3 MALL WAY P.O. BOX 1736 MASHPEE, MA 02649 508.539.0800 9 800 - ------ ` '_ ---" ..::.'::.'::::. :..':.':.:':..':. :: ::::::. :. ...... 1 508.539.3780 FAX --------- \ ':..':::.:':.::. :.':.'.':.:':::.:.::':::::::::::...... - \ TPG®CAPECOD.NET EXISTING - Iff �` `\ ,52 FITNESS CENTER o' 3350 SQ FT �` \X RELOCATED w CEDAR INV OUT f 2000 GALLON NEW LEACHING SYSTEM: 1\" —2, VARI / SEPTIC TANK OU9 500 GALLON LEACHING �\ \y TO 0 ACME ST-5-5 CHAMBERS (ACME OR EQUAL) `� OR APPROVED WITH 4' WASHED STONE ALL---- EQUAL AROUND. TOTAL LEACHING R6e`PROVIDED: 758 SO FT •::I::i:5i:•i?:. PROPIISED:.: ': Ij r s� ::1:•::•i?:::..a:<9ClSER::'f�00b}a�':it(:'::'::'?. N D 1 ��------ EXISTING ::;'...... .. :i5..:.:.F......ai:(:':'>::': N { Q �z y\ SEPTIC TANK ^ v. .::. :::. m ::'.�::'::':'::':::':: :;y..:.' :::::... ....'....... THE FARM TO BE REMOVED so F -3 PAT 1304 MAIN STRi=ET —�� PATH rRES '� --- _-- -- - �_� --C XISTING PARKING w , - _ -- - , -- 05TERVILLE. MA Q OR 20 SPACES 13 DO STIC W TER___ —J li -- FU RE___ — 1 MAP 119 / PARCEL 079 .x) O — \i REVISIONS w \ EXISTING PARKING NO. DESCRIPTION DATE FOR HEALTH CLUB EXISTING LEACH PIT \�� O 11 11 1 REVISED DETAILS 8 98 0o P 18 SPACES !_. TO BE ABANDONED, 2 REVISED DETAILS PER MTG 9/16/ / o GREENHOUSE- �, i FILLED WITH CLEAN L----- �� N. SAND OR REMOVED. 1400 SQ FT TMP 13.2' ' I PROJECT No. : 38402 LOT, 5 DATE 1 DUNE 1998 5.70 ACRES DRAWN MHG CHECKED ' 'PRIVATE DRIVE' \x I SCALE 1" = 20' GENERAL SITE �•MICHAEL $$ H. n GROTZKE SIGN: ) NO3 4446 JONE WAY �,EP•:`���,� DO NOT. ENG a ' �� A J •ta.99 1 OF 2 \ PATH R I '� , E I - - -- - ---_ _ _--- - _i �XISTI W `, -- -- I` (;OR O liI cy- STIR W FU RE DO- _� I ----- ---------- CIVIL ENGINEER a ` I�JG � ��__-- , .I THE PHOENIX GROUP EXISTING PARKI WAY FOR HEALTH CLUB EXISTING LEACH PIT `, 0 3 MALL P.C. 1736 00 18 SPACES.- TO BE ABANDONED, � '1 J; MASHPEE, MA 02649 �/ �• o GREENHOUSE ��— -'��� H CLEAN SAND FILLED RITREMOVED. � T.�,P `-- '— 508.539.0800 1400 SQ FT — ` 2 I 508.539.3780 FAX TPG®CAPECOD.NET LOT 5 ' 5.70 ACRES � t t SIGN: '"PRIVATE DRIVE' 0 THE FARM C � SIGN: I r S 0NE WAY / ; 1304 MAIN STREET NOT ENTER — _ 05TERVILLE. MA , O 1� \�•� \ �•' ,� i-F FIRE ACCESS ; - / VEHICL RADIUS / MAP 119 / PARCEL 079 REVISIONS PROPO D SIGN: 1 �SIGIJ' / NO. DESCRIPTION DATE OSTERX1 ILL \ \\ ° ONE, `E i i ,WAY 1 REVISED DETAILS 8125198 _ -Fl-T_NESS C NTER `• D0`.,N07 z REVISED DETAILS PER MTG 911619E i ENTER , o � 4t, D� WAY ' ', � REL CATED � � � � PROJECT No. : 38402 ' ! i DATE 1 JUNE 1998 DRAWN MHG �� ` CHECKED SIGN: �\ YY' I PARKIN SCALE 1" = 20' ENTRANCE f ��� PARKIN ONLY © x ! GENERAL SIGN: 41L, 4 0 SITE LA PETI E-, MATS EX TI IsNG>, CTOR •MICHAEL COH. TRA OFEICE / 6AOTzv..E NO34446 :o' --- 'TRASH .� \\ 660 so DUMPSTER - \\ \ I'\ A Na 2 OF 2 I , o�access cover, . • withZ�Ifcrete riser to within 1 2" of finish grade or less. Cost iron access cover with frarne'and grate, full mortar t bed;.set to grade, LeBaron Top of Foundation—I'J_ Cat No. LA164 or approved equal or concrete cover and riser; H-20 load rated. 51/ Existing Grade:Elev.-- CIVIL ENGINEER 1' Min Cover --- THE PHOENIX GROUP 1' Dee min.2X Min n Slope �- P Top of Leaching � 3 MALL WAY 1% Min Sloe washed stone Chambers: Elev. 7 LAYER OF P� base. 1191-1/T I . P.O. BOX 1736 Minimum WASHED STONE MASHPEE, MA 02649 Invert Out 3„ _ Elev r Invert In ®X=4', 14' 15 Min Slope $°� 3/4' to 1 1/2' l I 508.539.0800 Elev� 9 10" Tee ®X=5', 19" 508.539.3780 FAX 2' DEL -- Effective Depth 2' w�sHEo sroNE i - TPG®CAPECOD.NET 0X=6', 24° Invert�(a�ut E-HDIE EleV��O DISTRIBUTION - eox I I I Bottom of Leaching ACME PRECAST -I X oB6 OR EQUAL Chambers: Elev. Invert I Invert 0 t Invert Inn* Elev 4 '5 Elev.4 './ Elev. 9 GROUND WATER ELEVATION OR BOTTOM OF TEST PIT: — 2000 GAL CONCRETE SEPTIC TANK set tank on V' base of 3/4" screened gravel, computed to 98% dry density. SYSTEM PROFILE �i•ITNESS GENTER SPECIFICATIONS 1304 MAIN STREET 2000 GALLON TANK Installation.cf system shall be closely monitored by engineer. No deviations from the design plans shall be allowed without prior review-and consent by the Engineer and the Board of Health. Sail conditions shall be,reviewed by OSTERVILLE r _ — — — — — — the Engineer at the time of system installation for conformance with the design. All workmanship and materials shall conform to DEP Title 5 and the Town of Mashpee regulations and the requirements 21" No. 21' Dia. I of this plan. Cleanout Cover Cleanout Cover I I All components of the system shall be capable of withstanding H-10 load rating unless they are within 10 feet of drives, parking areas or roads, in which case they shall be capable of withstanding H-20 load rating. I REVISIONS N0. DESCRIPTfON DATE L - - - - - - - - - - - - - - - - - - � PLAN OF SEPTIC TANK PROJECT No. : 39111 DATE 1 OCT 1999 DATE OF PERCOALTION TEST: DESIGN CALCULATIONS: DRAWN MHG ,TEST BY: _ WITNESSED BY: — --- CALCULATED FLOW: —_—_400 ___GPD (20 LOCKERS)_ CHECKED. „PERCOLATION RATE: MIN./INCH GARBAGE DISPOSAL UNIT Y / NO f SCALE N.T.S. TEST PIT 1 TEST PIT _— TOTAL ESTIMATED FLOW: _400 GPD ELEV. --- ELEV. _-- SEPTIC TANK REQUIRED: 1500_____—GAL LEACHING AREA REQUIREMENTS: t SEPTIC EFFLUENT LOADING RATE: _0•74GPD/SQ FT SYSTEM SIDEWALL AREA: 220 SQ FT SIDEWALL LOADING: 1163 GPD ULTRAVIOLET DISINFECTION UNIT (IF REQUIRED) I LS BOTTOM AREA: --____-- _-- SQ FT N•R BOTTOM LOADING; ______407 _—__ GPD Ultraviolet disinfection unit shall be provided. The wastewater stream shall osed to UV radiation of •...,SSy 2400 to 29(?0 An stroms. A maximum wastewater °°•�� TOTAL AREA: ------__ 7_70 SQ 9 . penetration d a be 2 inches. The unit shall be ti G 570 constructed to P / q p enclosed in p ��HAEI s rovide a minimum UV dose of 16,00 ec s cm. UV lams shall be enclose M ;" C 2 TOTAL LEACHING CAPACITY: _ GPD a quartz glees sleeve. A manual or autom ning device shall be Installed to clean the quartz glass GROTZ a 4 enclosure. The W lamp shall b ed at one year intervals, unless the manufacturer specifies a longer z y APPROVED: BOARD OF HEALTH guaranteed lamp life. shall be protected from dust, heat and freezing. The quartz class.enclosureNo 34446 shall be clec• east four times d year.. The W lamp intensity shall be tested at the time of y ��.°4� in n and at annual intervals to confirm that the minimum W dose is achieved. '.,�F61StEP �4 Bottom of Pit or Bottom of Pit or ------------------------------------ E 1 OF 1 later Elev`_ Water Elev.__ DATE AGENT PERMIT NUMBER ,. oriLTete access cover with concrete riser I o within 12" of s finish grade or less. Cast iron access cover with frame and grate, full mortar To of Foundation bed, set to grade, LeBaron II P S 3 Cat No. LA164 or approved Sl•O equal-or concrete cover and riser, H-20 load rated. d Existing Grade:Elev. (2CIVIL ENGINEER V Min Cover t THE PHOENIX GROUP 2X Min Sloe 1' Deep min. 3 MALL WAY �� �_ yi washed stone Top of Leaching Y LAYER OF P.O. BOX Y 1% Mi—n Slop„• base Chambers: Elev. V/tr 1/r I Minimum t WASHED sroNE i MASHPEE, MA 02649 Invert out 3�, - O �� 3/,V To 1 1/T I 508.539.0800 Elev r5 Invert I /� ®X=4 , 1 4" 19" Min Slope EleV`J1y ®X=S', 9" LEVEL— '---� Effective Depth 2' WASHED STONE 508:539.3780 FAX 1.0" Tee Invert t !;-: M TPG®CAPECOD.NET ®X=6`, 24„ „Q�' 6-HOLE • Elev DisrRieuTroN •,i ACME PRECAST •' - 5•n 4' Bottom of Leaching 5q X D96 OR-EQUAL !, - Chambers: Elev.�_, Invert Invert t Invert I��� Q 7,9 ,? Elrv.� 3 flev-47 / / I}� GROUND WATER ELEVATION -, OR BOTTOM OF '} TEST PIT: 2000 GAL CONCRETE SEPTIC TANK set tank on 6" base of 3/4' screened gravel, compated to 98% €� dry density. SYSTEM PROFILE 0 FI LE k THE FARM SPECIFICATIONS , { 1304 MAIN STREET Installation of •system shall be closely monitored by engineer. No deviations from the desig'n plans shall be allowed without prior]review and consent by the Engineer and the Board of Health. Soil conditions shall be(.reviewed by _ _ the Engineer at the time of system installation for conformance with the design. OST.ERVILLE. MA —— — — — — — — — — — — — — — — {i All workmanship and materials shall conform to DEP Title 5 and the Town of Mashpee regulations aril the requirements 21" Dia. 21" Dia. of this plan'' o Cleanout Cover Cleanout Cover I �j All components of the system shall be capable of withstanding H-10 load rating unless they are within 10 feet of drives, parking ? areas or'rocds, in which case they shall be capable of withstanding H-20 load rating. MAP 119 / PARGEL 079 REVISIONS f NO. DESCRIPTION DATE ,a I • I 1� I� - - - - - - - - - - - - - - - - PLAN OF SEPTIC TANK PROJECT No. : 38402 r I'I DATE 11/26/99 DATE OF P,,EA�RCCOALTION TEST: Ib N�'3r` 199 01 '� TEST BY: G WITNESSED BY: �Y�r`INNINy DESIGN CALCULATIONS: {� DRAWN MHG _—�_ CHECKED �_--- N0. OF SEDR`@@Ms: 1•fIS�4�S_: 20 � ALE N.T.S. PERCOLATION'RATE: — MIN,/INCH (Z4.7A.IL.e'J 1.1[srSo�L�Q � GARBAGE DISPOSAL UNIT Y V SC TEST P 1 , TEST PR 2 TOTAL ESTIMATED FLOW: �)(2�- 41 �0 GPD ELEV. I� ELEV. —=,0, +} ,+ SEPTIC TANK REQUIRED: _i5052 ___GAL a o 1 sAKi �� ,4d s LEACHING AREA REQUIREMENTS: SEPTIC 2 4 EFFLUENT LOADING RAT 0 74— GPD IZ S FT Q B u0 v g Ar417 SIDEWALL AREA: _ 2 __ SQ'FT �, SYSTEM �aocN D s t7 ----- , 2,1 �` , SIDEWALL LOADING: T�2�_____A GPD I ISINFE C M � ULTRAVIOLET40 CTION UNIT IF REQUIRED S C� p BOTTOM' AREA: _-- _ SQ FT VIF k+.. SPsJfJ f BOTTOM LOADING; ��0 GPD Ultraviolet disinfection unit shall be provided. The wastewater stream shall used to UV radiation'. of e••••••••'•' 9C - .42 TOTAL AREA: — SQ FT 2400 to 2900 Angstroms- A maximum wastewater penetration d a be 2 inches. The unit shall be r µ cHAEL ". M� 5 O Y constructed„to provide a minimum UV dose of 16,00 ec/sq cm. UV lamps shall be enclosed' in M. ' TOTAL LEACHING CAPACITY: GPD q SP�ID Z__--- o quartz gloss sleeve. A manual or autom nmg device shall be Installed to clean the quartz'gloss 2NE ' enclosure. IThe'UV lamp shall b ed at one year intervals, unless the manufacturer specifies o &ppT longer Goo t APPROVED: BOARD OF HEALTH guaranteed'Jamp life, shall be protected from dust, heat and freezing. The quartz glass enclosure f�q .. 132 -- in and at annual intervals to confirm that the minimum UV dose is gehieved, Bottom of Pit a` Bottom of P,i�,�ppr / ------------------- — shall be cle east four times a ear.. The UV lam intensity shall be tested at the time of Water Elev�� Water Elev. DATE AGENT ,PERMIT NUMBER 41 BR0gf573 '� OF 2— 1 pr • _ RE PATH ` \ � ' W - --- - _ -=-- if H p } I 2 W - \ FUT RE DO ----------- -------------- _ p , 1 \x� p. _ I CIVIL ENGINEER W EXISTING PARKING -_ - \ ;4- THE PHOENIX GROUP FOR HEALTH CLUB EXISTING-LEACH PIT `; p 3 MALL WAY TO BE ABANDONED, �� , J MASHPEE MA 02649 • , - i P.O. BOX 1736 ao 18 SPACES , o `GREENHOUSE FILLED WITH CLEAN �__---- j SAND OR REMOVED. n,P 508.539.0800 1400 SQ FTF�— `\ 508.539.3780 FAX TPG®CAPECOD.NET R E C E I V E D LOT . 5 '5.70 ACRES S E P a SIGN:., •,� : - � \ •, , \ „ _ 1 I " "'PRIVATE DRIVE' T J \ f BUILDING DIV. u / j \ � ZTHE FARM r� \ • SIGN ON IN STREET ONEDO -WAY — ENTER ; 1 OSTERVILLE MA h 1 • t i rr O + • ,�,� � i %���\ •, � �' , • , FIRE ACCESS VEHICLE RADIUS MAP 119 / PARCEL 079 REVISIONS PROPO D SIGN: \ , OSIER ILL J \ SIGN, _ NO. DESCRIPTION DATE ON-' WAY -FITNESS C NTER \ _ c� , 4: 1 REVISED DETAILS 8125198 6 / ,, DG NOT 2 REVISED DETAILS PER MTG 9116198 \ EPJTER TED D REL GA R WAY I PROJECT No. : 38402 ; N IN - � � DATE 1 JUNE 1998 \ r { DRAWN MHG CHECKED SIGN: PARKIN ENTRANCE `ti rr �' PARKIN SCALE 1" = 20' ONLY x p / I GENERAL SIGN: 4 0 r --- i '� \ SITE LA PETI E� MAIS / _ , _ II\ - P L ooes,� i\I \ ` /_- � — — ( � — _ — - •_— — I ` �' � EXISTING B O j TRACTOR o B9ICHAEL a I I \ \ CON OFFICE H. $ _ \ I OFFI o 6Rona 0034446 O71 _ _ - TRASH � ' \ \ - '\ - 660 s F-r r 3 E DUMPSTER C\DMGFl D.. OF 2 •- I \\ ® 4' DIA DRYWELL FOR ROOF DRAIN ± ' ' '4'/DIA DRYWELL 0.3 I 1 1 FOR ROOF iP � �� l CIVIL ENGINEER DRAINi'11 ......................................... • THE PHOENIX GROUP ................................ s 1 � 3 MALL WAY _—' J 1 ROPDSED: ::•:::::�:•':'.::::;•:::i:�•::•i:rr:i•?:r:}r::::: �� -- 1 P.O. 80X 1736 ......................... /NAIJTfLU5;;:::<:: ::: i'l MASHPEE, MA 02649 ' I, 508.539:0800 1 ..**..483?SD: Ff? } i is rlr::i r::::i:ri:i}::: 1 1 _. ro _ I 508.539.3780 FAX --`----- --1----_� �.::::::::::::::...:::::::::.:::::::. :.::::. :::::::. . ::::::.::.::.::::.::.:.,...... TPG®CAPECOD.NET ........................................................................ - -- i ----- '� ..::. :. : E 11 ,\ EXISTING 1` FITNESS `CENTER -- `�CUT �\ 10 3350 SQ FT /® FOR I ORYWELL t ' DRAIN Y � m RELOCATED CEDAR INV"OUT 2000 GALLON NEW LEACHING SYSTEM: -2, VARI I? SEPTIC TANK OVI 500 GALLON LEACHING TO 0 " ACME ST-5-5 CHAMBERS (ACME OR EQUAL) im i J OR APPROVED WITH 4' WASHED STONE ALL-- EQUAL AROUND. TOTAL LEACHING; IN fiq-PROVIDED 768 S01 FT Floa(;i k(AGKER & . ExIsrlNc :1:::;.... ...:�s sn:;:Fr N 5 THE FARM If 0 \ SEPTIC TANK yt:F... r. t \\ a TO BE REMOVED . -----_ o �........ ::.: : 1304 MAIN STREET l•.�__ � 3 � PATH. -�/ -,� -- PATH ® ELL r RES , OSTERYILLE. MA ROOF ' 1 1 _ 1 i EXISTIN D ING IPARKINU 1 1 1 FOR HEALTH CLUB 20 SPACES --�-- `���� W ER FU RE DO---- 1 • -------- _ I' \ � 1 11 'I \ 11 11 TP 1 MAP. 119 / PARCEL .079 ------ - , O I REVISIONS 0 — 1 i NO. DESCRIPTION DATE 1 REVISED DETAILS 8 25 98 �^ EXISTING PARKING f '1 t • 2 REVISED DETAILS PER MTG 9/16/98 FOR HEALTH CLUB EXISTING LEACH PIT �� Q 1 1 3 ADDED DRAINAGE, ,NOTES 10/28/9,9 41 Co \•� 18 SPACES TO BE ABANDONED, ��• 11 _J 1' 4 ADDED TEST PIT LOCATION 11126199' FILLED WITH CLEAN 0 1400ESOHFT +/- �- - --- SAND OR'REMOVED. n,P 13.2' PROJECT No. : 38402 I ` I \\ DATE 1- JUNE 1998 LOT 5 ��. DRAWN MHG 5.70 ACRES / \ CHECKED SCALE 1" = 20' � 1 SIGN: "'PRIVATE DRIVE' GENERAL I DRAINAGE: SITE ALL ROOF DRAINAGE TO BE DIVERTED INTO »a.•.;,� Y I DRY WELLS. SITE GRADING SHALL BE SO THAT AI-L STORM- H F �\ 0 WATER IS RETAINED ON SITE: EXISTING y l if t J a ; / DRIVES AND PARKING 'LOTS SHALL REMAIN L O \ / AS PERMEABLE SURFACES t !I. \� 4 it 6 •��' SIGN. ONE WAY S� I c�> � A NAL j 1 OF 2_ F t� 4