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HomeMy WebLinkAbout0008 WEST BAY ROAD - Health $ Vest F3ay Road - _ Osterville' { x� A= 117-087 o ° 1 ° o YOU WISH TO OPEN A BUSINESS?- For Your Information: Business certificates (cost$40.00 for 4.years). A business 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: .,Fill in please: YOUR NAME/S: 1 �- APPLICANT'S' y BUSINESS YOUR HOME ADDRESS: f,.. rSF , �iS t r gJlf' I � I I J�fi TELEPHONE # Home Telephone Number - !7s 1L�dlaS4/iJ3t;d � .: di;;.iv:.a,ri{•;r:�.j:;9: OR E I N #:' E-MA I L: i ,n ew y orn NAME OF CORPORATION: NAME OF-NEW BUSINESS d. ct ao li TYPE OF BUSINESS!(FP,S p hc, La..S h_��e K.v�S �F"►S IS THIS A HOME OCCUPATION? YES "NO ADDRESS OF BUSINESS 1 MAP/PARCEL NUMBER [Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regufations'of the Town.of Barnstable. This form is intended 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 op _ usiness in this town. 1. BUILDING COMMISSIONER'S OFFICE-- This individual has been.in med ny permit requirements that pertain to this type of business. AuthorizECI Signat r * COMMENTS: 2. BOARD OF HEALTH This individual has been info r the permit requirements that pertain to.this type of business. Authorized ignature** 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 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you 1 must do by M.G.L.-it does-not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st FI., 367 Main St., Hyannis, MA 02601. .(Town Hall) and get the Business Certificate that is required by law. 01, DATE: ( I •�(• �� Fill in please: l APPLICANT.0 'S YOUR NAME/S: NNA-(LLi Poy'M NN 1 E,CIL t BUSINESS YOUR HOME ADDRESS: 3,�OLD GO0- 1�j VyA-V 1 f, ,r�,._ � l s.rr�[ ,0�6$� I�$� ��LA 33$ 59-11 TELEPHONE # Home Telephone Number rf'.:• „-ott.[t: :«"s'er,j•.r.+;� E—MAIL:CA117CCODtJ �NE," SS C. �GhA'1L. .M NAME OF CORPORATION: NAME OF NEW BUSINESS5'I Ck V)WT2,96064d TYPE OF BUSINESS rAASSAG% IS THIS A HOME OCCUPATION? . YES ND ADDRESS OF BUSINESS. . W B R -O E.QU'LI- •- O GSS MAP/PARCEL.NUMBER (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist youJn 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 yourb�s$ in pown. 1. BUILDING COM SI ER'S OFFICE This individu ha e in r f(n,. er re Uire 'ts that pertain to this type of business. VK., � ut o izad Signature** * � - COMMENTS. , 2. BOARD OF HEALTH - This individi_ial has been informed f ermit requirements that pertain to this type of business. Authorized 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 pr YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $40.00 for 4 yearn. A Business Certificate ONLY REGISTERS YOUR NAME in the Town (WHICH YOU'MUST DO according to 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, 1St FI., 367 Main St., Hyannis, MA 02601(Town Hall) and get the Business Certificate that is required by law. DATE F!Il in please: p / APPLICANT'S YOUR NAME/CORPORATE NAME (�C �)/J �j/v Jt�LI !�Z)s(,� C�L BUSINESS TYPE: (_ C- BUSINESS YOUR HOME ADDRESS: S(f�- No.0007 p TELEPHONE # Home Telephone Number S'� 0 Z_ NAME OF NEW BUSINESS L�uit�tP�l1S�S�(_LL R E � Q O Have you been given approval from the building divlsion7 YES O ADDRESS OF BUSINESS o S,7Z V. O Z& S MAP/PARCEL NUMBER When starting a new business W s era hings you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist y u 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. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: o 2. BOARD OF HEALTH, This individual ha bee or d of the permit requirements that pertain to this type of business.. Authorized 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: TOWN OF BARNSTABLE ' 1 . A LOCATION SEWAGE # 7a- VILLAGE 4 54 ASSESSOR'S IVI:AP & LOT INSTALLER'S NAME&PHONE NO. V /' "G ZA ). SEPTIC TANK CAPACITY r � LEACHING FACILITY: (type) L (sizeY ���/ NO.OF BEDROOMS BUILDER OR OWNER �I�,ala/ PERMITDATE: 1- 91 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) Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by f� M1f QQ/ e No. r Fee E�-�e::�oV THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS IL 01pplication for IDi!5poml bpg;tem Construction Permit Application for a Permit to Construct( )Repair(v/ Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location 1Address or Lot No. �/Q �,�� Owner's Name,Address and Tel.No. Asse�or'S ea Maplarc711_' tl A. 9 tJ 14 C 4 6 st e-�I eA MA11j �i Installer's Name,A(dress,and Tel.No. Designer's Name,Address and Tel.No. ZA'us Mvro,a /'e+ft �vjjjv,j j a. ao)e Cs9 tiA 311 -3010 T- 33 Type of Building: Dwelling No.of Bedrooms Lot Size 3 sq.ft. Garbage Grinder( ) Other Type of Building (aJ 00%7 No.of Persons Showers( ) Cafeteria( ) Other Fixtures 1*1 Design Flow _ gallons per day. Calculated daily flow a ga gallons. J Plan Date joe- Zb. M 4 Number of sheets Z Revision Date$ . 6- . _, f n Title S'2 0a.., fit; a'.tJerf flea-T ',Y){t'„n+1 d�,'}toad 6? Size of Septic Tank %SO d Type of S.A.S. Description of Soil 5,-,0.)p Nature of Repairs or Alterations(Answer when applicable) 2 iDM." 5,0,0 ke Sv vier, Date last inspected: 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 'tle 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Boprd of a lth. Signed ` "�' Date %D Application Approved by Date j! _ 2� -- 'Iat Application Disapproved for the lowing reasons Permit No. Date Issued TOWN OF BARNSTABLE LOCATION / SEWAGE # - 74 VU-LAGE 8 54 te� (/r! ( 'Q ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. 6 l� SEPTIC TANK CAPACITY /�d' O LEACHING FACILITY: (type) 3 X a44e—. (size NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: J4•aA'—9 wCOMPLIANCE DATE:_JIzl Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and LeachingFacility. (If any wells exist / on site or within 200 feet of leaching facility) d Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by i � j No i Fee G THE COMMONWEALTH F MASSACHUSETTSEntered in computer: 1 O I Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 2ppftcation for Mitpoo'l *pgmem Construction permit Application for a Permit t1 Construct( )Repair( /Upgrade( )Abandon( ) ElComplete System ElIndividual Components Location Addressor Lot N' f We 0 Soy Owner's Name,Address and Tel.No. . l QS-tpRw`11e., A. �ior�i� C (J o,fd���ic ;sYC. Assessor's Map/Pareel 77U A ml)),j dsfnKydk Installer's Name,A dress,and Tel.No. Designer's Name,Address and Tel.No. J, Ws Mort;,,., /Pe- ��lJ�ua�. f d. -pox, t;s'9 v s4,4t, riA 34Z -1010 9 V?- 33 V Type of Building: Dwelling No.of Bedrooms Lot Size 3 2 Z G sq. ft. Garbage Grinder( ) Other Type of Building tk/Bd Q No. of Persons Showers( ) Cafeteria( ) ther Fixtures Design Flow gallons per day. Calculated daily flow 01912 gallons. Plan Date j voc 26 lq9 g Number of sheets Z Revision Date S 6.- Title S, La P/g.. Weft il✓. IX)S -'e-1 (IJ +ia_f Size of Septic Tank /S100 Type of S.A,S. Description of Soil Y,&,)2 Nature of Repairs or Alterations(Answer when applicable) aa Le Wevo 510,0V Cam)j iek" .1 . Date last inspected: 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 issuCdby this Bo d of lth. Signed. - ` � Date Application Approved by Date Application Disapproved for the FkifowiAg reasons Permit N.o. cl X - _7ot, Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THI51S TO CERXIF>that e On-bite''Sewage Disposal System Constructed( )Repaired (Upgraded( ) Abandoned )by � � _ t at has been constructed in accordance with the provisions of Title 5 and Wfor Disposal System Construction Permit No. r�:_"'494 —dated Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will�nction as designed. Date I 'k 4� Inspector \ �. -- --- ==—^--_ -----—---------------------- c. No. ! R- -706 Fee l !?y THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Migogal *p!5tem Con,5truction permit Permission is hereby granted to Pnstruc ( )Re air( pgr e( )Abandon System located at and as described in the above Application for Disposal System Construction Permit.The a plicant recognizes his/her duty to comply with Title 5 and the following local provisions or;special conditions. Provided:'Construction must be completed within three years of the date of Chis p unit. Date: -3 -Cl f� Approved by f ' I � , � r':•a ?3;,.'v '• i'�,+k#�. SF�� ^ 'Fs��` •9 Y%` t 1fi e ;+.. .maP ''1'^'. ,"` ' �'. .-�+,. A r.5�c. �'�i.t- ��y � ' ' r '_. a..:,trr�' E A t•�,� �� ,3'`'�"! r'.z:�.,�t �4 v.r �. �i��fi�c 2 ys r�t�.�,;e��, ss� � ,.," �,. e ',�'":}r';-�.8a �N"._ 's��� '�h:• e•� �,'4 '�:� v.�-s�.�� .r`•:.x'Fur 9.H }`" w .<y l4 ._.'%'�� �.:.;Kih"...�per:, � R. a � '- " = v��'�'iz'S,, €`##���tk(ac+4 r.:�I'�,..ly����.y;•.r-€� ���,,..l� :yet '� $/^`�.r,s�t �G�:9,�t. � � - � .a,R,t fyj�. .x r�� j� �r�'� r,• _�`.• �'�'�^�' �y�„ :'. tz .% BORTOILOTTI CONSTRUCTION, :N 11.0 % " m 765 WAKEBY ROAD,MARSTONS MILLS, MA �_6''8 508-771-9399 508428-8926 FAX: 500 428-93 6 �`' • �! SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION ORM B PART A .... CERTIFICATION. Property Address: Date of Inspection: In ctor's ante: Or ler' 'am4 and Address: CERTIFICATION STATEMENT: ` I certify that I have personally inspected the sewage disposal system at this address and that the informa- tion reported below is true,accurate and complete as of the time of inspection.The inspection was per- formed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The System: Passes Conditionally Passes Needs Further Ev tion B t Local Aproving Authority z• Fails Inspector's Signature: Date:- The System Inspector shall sub t a copy of this inspection report to the Approving authority within thir- ty(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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer,if applicable and the approving authority. INSPECTION SUMMARY* A)SYSTEM PASSES: 1 have not found any ipformafion which indicn!ec that 0te system violates any of the fmlure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B)SYSTEM CONDITIONALLY PASSES; One or more system components need to be replaced or repaired. The system,upon comple- tion of the replacement or repair, passes inspection.- Indicate yes,nor,or not`determined(Y,N,OR ND). Describe basis of determination in all instances. if not determined",explain why not. The septic tank is metal,cracked,structurally unsound, shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing sep- tic tank is replaced with a conforming septic tank as approved by The Board of Health. Sewage backkup or breakout or high static water level observed in the distribution box is dine to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of The Board of Health): - 1 - f � � yam•� .,y..�. ;M. ;;h. �, s.; �"i"� � ��, � E��np �«�`i �' a 5 , "`'"F�r•.q� '� �,„*,- t�,.,,- .+�i.�.,kl.� Ya, .. ��`� ,�S�r i��`�i`f., ; 'M ' AS , f t �.�. F �j" 5�,'' y«, e.'^�f''��yn"..r..� p .y: ��A''+� �'�r �r;% t',�1E... ...�j �• �S• 5�,;-. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM �<4 PART A CERTIFICATION(continued) Broken pipe(s)replaced Obstruction is removed Distribution Box is levelled or replaced The System required pumping more than four 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 Obstruction-is removed .. .- - 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 the public health,safety and the environment. 1)SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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. 2)SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER,IF APPROPRIATE)DETERMINES THAT THE SYSTEM IS FUNCTION- ING IN A MANNER THAT PROTECT THE PUBLIC HEALTH;AND SAFETY AND THE . ENVIRONMENT: The system has aseptic tank and soil absorption system and is within 100 Feet to a surface water supply'or tributary to a surface water supply. The system has a septic tank and soil absorption system and is with a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 Feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 Feet but 50 Feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from the facility and the presence of_ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. D)S TEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health sho be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of efluent 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 clog - 'ged SAS or cesspool. ; , 4 Liquid depth in cesspool is'less than 6"below invert or,available,volume is less than 1/2 day flow. Required pumping more,than 4 times in the last year N01 due to clogged or obstructed pipe(s). Number of times pumped -2- ��,�{�Y...'` sr^w-�t •.�':�"'r.'.ti4A':� ` °r,>' :F.'" �' �-�. '"�:fi X.-�,6F �F' hz3. , tag 'S.... �'w+.& �lr-'"vim zxk �,r.,i-ik x- x4;.r. y - " t '"'o"`.�•`F '.°z ,�z.'nx :' S .:>°bia,. '^, {. ��z •h. F... +..w c sty - - E f �W �� � �Ie ' "«'3.W,.,�6 �h F-Y i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a 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 I of to public well. Any portion of a cesspool or privy is within 50 Feet,of aprivate 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. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E)LARGE SYSTEM FAILS: The following criteria apply to a large system in addition to the criteria above: The design flow of a system is 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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 11 of a public water supply well. The owner or operator of any such system shall bring the system and facility into full compliance with tlae - groundwater treatment program requirements of 314.C.MII 5,00 and 6.00. Please consult the local regional office of the Department for further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Check the following have been done: �+ Pumping information was requested of the owner,occupant,and Board of Health. `)`lone of the system components have been pumped for alleast 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. _�/As-built plans have been obtained and examined. Note if they are not available with N/A. P*The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. _ The site was inspected for signs of breakout. system components,excluding the Soil Absorption System, have been located on site. _4/fhe septic tank manholes were uncovered,opened, and the interior of the septic tank wa:s in- ' spotted for condition of baffles or tees,material of construction,dimensions,depth'of liquid, de h of sludge,depth of scum. e size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. -3- .' °'�.v �.�k`Y6xtx �i�,r °},. .k 1 ?±ty '...se 4 .hapk'�' x; e 4 r d u.. 1 ''"'` to'd+! :ir• "�'�- i 9 .c z k �� ` y SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST(continued) V The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Subsurface Disposal System SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION FLOW CONDITIONS HYSIDENTIALe Design Flow: gallons Number of Bedrooms: Number of Current Residents: Garbage Grinder: Laundry Connected To System: Seasonal Use: Water Meter Readings,if available: Last Date of Occupancy: / COMMER . AIANDUSTRIAL: v i Type of Establishment:.. rAit /1 . - _ Design Flow: gallons/day rease rap.Present: (yes or ) ! "` Industrial Waste Holding Tank Present: Non-Sanitary Waste Discharged To The Title V System: Water Meter Readings,If Available: Last Date of Occupancy: OTHER: Describe) Last Date of Occupancy: GENERAL INFORMATION "V PUMPING RECORDS and source of information: System Pumped as art of ins ction: 1 ` If es,volume uin ` ' gallon Y P� P - ' �— Y P ped:_. v . .. Reason for pumping: TYPE1OF SYSTEM: Septic Tank/Distribution Box/Soil Absorption System Single Cesspool Overflow Cesspool Privy Shared System(If yes,attach previous inspection records, if any) Other(explain): AP AOX TEAGE of all components,date installed(if known)and source of information: ._..... __ � is � �. _. . ., _ • ._ ,. . Sewage odors detected when arriving at the site: -4- - �x,� _.. � -.. ,d:.t,,,a* . �; :.� •9'z:'�'�"``;��` �-'� ��,,� a ry t ra�.�yry` '� ,;�. pr_�'at�r+,�n.� �:, :X a�tc.'+�' ''' '_ i>. � ic' .�,ti �4', a .,^ t,�n.y.yx � .'�` t.t -: +�'� '��"'r� .;•c• 'nz�.y ,k�K":s. - rat`Ss•,£��x,tih` ;s.+t4 y#':�;� :,�pn ��i' *'r, r :i'T'cf,i.^„'E v s2+:�'�'.,,,,v �,a tr � .#1g �-7 a�2�`- 4'I^'+ *'•�ys'? F' u..Y ' �a ,�^�`,r} .- r �`?�-"�` l iks^�,",'� � 4 ..< t�`i n :: < ♦�.,,i,� v=s''"`y'., � A'� y � c� u� -"�y� �a 3ya r..T'.v���`�;�x ���^'���5`��,a. 1 K ai. s a ' �t�.,,,,s�v. Y - SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C GENERAL INFORMATION (continued) SEPTIC TANK: NCB Depth below grade: Material of Construction: concrete metal FRP Other (explain) Dimisions: g P -Sludge Depth: Scum Thickness: Distance from top of sludge to Bottom 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,etc.) — GREASE TRAP: Depth Below Grade: Material of Construction:_concrete_melal_FRP_OtNer (explain) -, . Dimensions: Scum Thickness: Distance from top of scum to top of outlet tee or baffle:, - Comments:(recommendation for pumping,'conditioii of inlet and outlet tees.or baffles;depth of liquid level in relation to-outlet-invert,structural integrity,evidence of leakage, TIGHT OR HOLDING TANK: Depth Below Grade: Material of Construction;_concrete—nietal_FRP_Other(explain) Dimensions: Capacity: gallons Design Flow: Rallons/day Alarm Level: Comments:(condition of inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX:bb 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,etc.) �. PUMP CHAMBER: is in,working order: Comments: (note condition of pump chamber,condi+ion of putnps:}gad appurtenances,etc.) 4 -r ,ems" �° S� ^tt ..,r': +�i�t r F�"'�`�*4M°�� t .�kr:��f��.ry���4�, a ♦t ,;� "5 e=_„��FS +hr.. w' iq�k`��,:� �, + A Yy �, 9 . '::r 1 t° r-(. ,g,,.r e.•,+4? ..a, ,. '�i`r u- x... 1 ) ,s;a t+ $ f +( , ! r;l ari SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) SOIL ABSORPTION SYSTEM(SAS): /�tJ (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, number: Leaching chambers, number: Leaching gallerles,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, etc.) CESSPOOLS: , Number and configuration: - 5 Depth-top of liquid to-inlet invert: � 1 Depth of solids layer: Depth f sewn layer:_-- Dimensions of Cesspool:jEf Gv Materials of construction: c- Indication of groundwater: Inflow(cesspool must be pumped as part of inspection) Comm ts: (note condition of soil lIkll signs of It draulic ffilure, le of ponding,condition of vegeta 'on, etc.) ' PRIVY: NO Materials of construction: Dimensions: hY. Depth of Solids: Comments: (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.) -6- ,a., Any•...�. F "4r.,«;. r3 ,e J�v` w°s.:.e;��r• '� � r:. +�.:i5+� 't n..K M � ; s �i?s .r c f;�e '..5�. •.. .e.�.. � ;...�,e�.} ��'y.� �.. v �.�t.. tom;,.� ( �, �,3 S.°--�, 6�� i.�„,+.•: � � x�.-�Yr tr{s f:-.,t v '' ,•,p � ;;i"q,� s, �?��,,, ''�Ik ��,.a5 '�` ; �+: fit..�,,,#�d - •� L�+`Yati., '�'!y. �,'£ �' �ay.�.7`�i"Y� ��r�,�dl.:7vtrr,� }p���$ j � ��tl 6.t f °5.: r lR.:; ,�,i�� �*i ��'kv�„�`''�"e �''$�YZ ?+kY�-, _ �•V�M1'�i�' v§ =.=�.-i-�7�.�f " ff�t"te�{�a,�y';���"#"Fi`�.s.�`�"•, , fir..t{��61 .�G�,:a. Y � ✓ � s / �' -':t fit'§ .f k r c�`r �`��r� { :'x4 +7r N'y sr �y..¢r' �. �t .-,�1h+ ar.f..t �:.�. "�"r;c _�!: +. t .,a •�'i`3.r3fw- :.t-iw{,��,s�'T3.5�,��'�{�,t+}F,p2s a�1��5�. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) SKETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to atleast two permanent references, landmarks or benchmarks. 0 Locate all wells within 100 Feet. S t- i DEPTH TO GROUNDWATER: Depth to groundwater: 7-3 Feet /1 Method of Determination or Approximation: ;466^O, /&'x /'/S jz-a, ' 4' Cl +' w s.a{ • f Yf ' a _ HI d — •; , �' e j •, ,ram_ 41 �—• .., �•�• �•,•)• • •• is •rid U � .'•• M. • C C � i a u at .•K� •. . C cc N N 3 C t 'v �.• E ,c O y r. .. . C p US 0 C w LOCUS PLAN o M co cc C � o SCALE:I"= 2000� S � o E �,c N � -p + 32 CM _ �V vim�Re 01/4 f` E2 O L N E CD co '5; g. 3 E aE � o 'v �• O' a� � JE QyJ. 2 ajTMo�, General Notes p \\ �,gNMINOV�ISr Assessor's Map 117 Parcel 87 Location. 8 West Bay Road, Osterville 1 �tiST w�Ty '�V T� Owner/Applicant : Hostetter Realty AS 770 A Main Street N Osterville,MA 02655 — h,@20 Ri op y Engineer., Sullivan Engineering Inc. �• �, �w 7 Parker Road Osterville, MA 02655 0� Zoning Classification: BA Setbacks 20/0/0 J W Q ,? F Lot Area: W / IV •,, \ - ea. 13,226 SF± Q N The Site is located within an aquifer protection district. a ,� ••,. . 4 P st ct. W 3 c \ ` \ No wetlands or water bodies within 100'of perimeter. ( UJI m 3 The Site is not located within a zone of contribution � J o s o _ _ _ _ — _ `'. - ._ _. ._ — ` ` ` \ ,; / as per Sea Inc dated Sept. '85 Z J o cr p W The Site is not located w ithin a historic district, FEMA Q h o. flood zone or an ACEC• � . /9 k��(. R'4Cr SST, \ 1 ` \ i� Cn ,�? )�> r 0 F,gCNt 6 q SS dl p ` _ ` .� ` O N � � _, �• -' '_' ` J 000l C1 ER e0 OBI 1`+T '` '�.., t• ,� ,.. ` \ ` \ \ •-..,. S .: _.... . Q. Cj It le w •.ate - M ,x. 4 o DUMPSTk:R SET ON LONG. PAD AND F—NCLO5E0 WITH �. .•_� F6NG$ 10' IN F `r 4 / O , .� ��� vat Par 7 � � Typ \ „\ 4 w 0// N �` J6 p • \ ��, � 6 / z 13,22fi SF •� � �� ,� , 0 \ 8� 1 1 0 Ir } lrlr \\ Pv • 3 �jo, in\ \ tiro 1; •— �., P �O e NI Ved \ \ \ ; \ pox+ 39•, ,• i m 7x1 \ o > 4 LEI .--• �„ cr 39*� Dc CL V) ; p.• *. . din Zoo .. era �5 NEW OtJTS►rAIs4D .. } 'Ic.N _ 'fit', x• "'` '�> �. ''` �. � _ .. _ , i REPLANTW►';H FESCUL d LOW 514 RUBS x 39.7 Indicates Proposed Spot Elevations 5LOPr VA RIMS � 131TUM OUS PAv�MF-NT' J, J ` U _ _ LL J C-ONC. KNEE _a _ m N WALL __ 6: GINISH ED RADE 7of CO C ) XN Ui Es 1 N S3 V 0 I .r QULLIV No.29733 CIVIL "N0 ` � SEC1 ION A-A PLAN VIEW NoT- &N`I �\A/0Rt4 NNITHIN ROAD LAYOUT RGQUIRRS Not toScaIe Scales I ��= 10' A ROAD OPENING PERMIT. COI�1"TRACTOPR TO Z k COORDIN-ATE W1"rl-4 EN&INEe.RING OL—PARTMtNT , ;•, Z 44 SEPT-1//,1998 SfTE PLAN ReVIL—W COMMENTS © O RGV'510NS Au&.16,1 Y9p SITE PLAN REV IC—w COMMENTS �i Sheet of , ? W " .. f 97041 TS ! N?co LLJ U) C C 3 ° E0 � ac a) ; a' �E oc � a) OL � 8 c5 2 o `a 15 '0 .0 M cN � o o E w -a w- oc t 2E = c of cx.� ai •- o rnN �o, _W ca4) Eco o g. 3 °� oo• oca y o E CL 0 E . t0 $ € � � H ►a-� � I— � to T L N N 3 c) O N Q 00 � V wa UJ UJI W v � •3 Parking Calculations � Z J _J Office: 1 Space per 300 sf plus 1 per enterprise M Q Two Story Building W First Floor 1397 sf = 5 spaces Q U Second Floor 1287 sf = 4 spaces 0 U) O f'• 0 Accessory Building = ~ First Floor (existing ) 600 sf = 2 spaces o: \ Second Floor (proposed) 600 sf = 2 spaces Total Area 3884 sf = a: Total Enterprises 7 = 7-spaces Total Spaces 20 w a o 00 Go V 3 �dth A� t�koTE' D RECTIrcoNT ' E© L THE V60ARD OF HEAf"N• � O40 b/ic � 4 0 S 6 cuv �o yJ Finish g ` ` NOTES Grade • > 33 \ I.Water Supply ForThis Lot is Municipal Water. 1 e�O �\ Location of Utilities Shown on This Plan Are Approx. Filter v c,t ��,��\ At Least 72 Hours Prior to Any Excavation ForThis t Fabric Compacted Fi I I ��" C3 ti Project The ContractorSholl Make The Required _ N b Notification to Dig Safe(1-800-322-4844) N � � \ 1/8 - 1/240 36 The Contractor is Required to Secure Appropriate Pea Stone o�a o 21F Permits From Town Agencies For Construction' ' o w� I I I ��� \ i — — — � � i� 3s _ �— Defined byThis Plan. o Ni _ 4 Install Risers as Required�to,Within 12 of Ica m o \� Parcel 87 � � � � � w v' _• Leaching W o_ �.` \ �6 �i� 0 �- Finished Grade. a Chamber m \ / 13,226fSF 1 �t 3/4 - I I/2 Doubls id 5.All Structures Buried Four Feet or More or Subjecto Washed Iro A�� ��,�\ 3�` to Vehicular Traffic tobe H-20 Loading. ;, \g°o. I 1 - 6, Septic System to be Installed in Accordance With I_ 4 Id I a , \i 1 310 CMR 15.00 Latest Revision And The Town ofL 8 -0 W o 38 Barnstable Board of Health Regulations. N �r A\ ��� ` 9�STy ��� 7. Piping From Building to Septic Tanktobe Cast Iron. _. 3 Rernaini n `�� 9 ; �4 ei,�� b soh.�o PVC ECTION OF CHAMBER� `r CROSS S 7 av� 1 (� ��:NOT TO SCALE a . Get J O \ Q \ N FG.=39.5 a l'Sy N/F •��; 9s UJ DESIGN DATA 37.0 33.0 Z J �' J Office/Professional 3882 SF _� 358 0 Q Q se/bH 36.0 Toa.l=I. 340 J FND X. 75 GPD Per 1000 SF=292 GPD V � m _ Septic Tank: 292 GPD X 200%=584 Gallons 34.0 �:.: Bot.E1.31.0 Use 1500 Gallon Septic Tank 33.8 L9 0 f— 0 Bedding as Z W W LEACHING AREA Per Title 5 26 0 :-�: —292 GPD/0.74=395 SF Required 10 10.5 10 10 12 C Sidewall 2(8 + 31)2=156 SF I Cast Iron Pipe CID 0 Bottom Area 8 x 31=248 SF Ground WaterCa Elev.Less,Than 5' Co LEACHING CHAMBER DESIGN- From T.O.B. Ground Water Ma W rn Total=404 SF EXISTING CONDITION SITE PLAN -- p cp Scale:)"= 20 Use ll3 Pipes Ion Schedule 40 PVC Chambers DEVELOPED PROM E OF PROPOSED SEPTIC SYSTEM w In a 8' x 31' Washed Stone Field as Shown Not to Scale D Sheet 2 of 2 97041