HomeMy WebLinkAbout0021 WIANNO AVENUE - Health 21 27 `VIANNO AVE.
OSTERVILLE
A = 117 098
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No. �` J 1 1,J Fee vU
THE COMMONWEALTHfOF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Rpplitation for Disposal 6pstem Construction Permit
Application for a Permit to Construct( ) Repair A Upgrade( ) Abandon( ) ❑Complete System Individual Components
Location Address or Lot No. oZ' W 1.41JO0 &)t; 6,5-10 Owner's Name,Addre s,and Tel.No.
W`4W"o Pzs4-t 05
Assessor's Map/Parcel I 17 PC) PRIOX 3 f4 _50VIO DWJAJIS "4
Installer'sMPC Name,Address,and Tel.No.,!5�026—(P77—f58 77 Designer's lame,Address,and Tel.No.
r
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
FRU4C.6 N - H-a0
TLIS
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 Certificate of
Compliance has been issued by this Board of Health.
Si Date
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. �� Date Issued /a)
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No. J — (� * Fee /OU
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. r'
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
0[pplitation for Disposal *pstrm Construction Permit
Application for a Permit to Construct( ) Repair{A Upgrade( ) Abandon( ) ❑Complete System Individual Components
Location Address or Lot No. a' Wt 000 (�C O�. Owner's Name,Addre s,and Tel.No.
�
W t�4 T/IVO Pt, I -its✓s�^'
Assessor's Map/Parcel ( o g PO Pt,-X 3(4 �jurI4 be AIlS "/4
Installer's Name,Address,and Tel.No. —�T]—f5g-7 Designer's Name,Address,and Tel.No.
G° 4PE�i Dr✓r trN7�4�0lS�S � � . �, �/�
S C� K•t ,61
Type of Building:
Dwelling No.of Bedrooms )/ Lot-Size sq.ft. Garbage Grinder( )
Other Type of Building r No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided, gpd
Plan;' -Date Number of sheets Revision Date
Title
Size-of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or'Alterations(Answer when applicable)
REPS n-wx M-a o
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 Certificate of
Compliance has been issued by this Board of Health.
Sig Date (o
,. Application Approved bydi Date - 2 1- (S
Application Disapproved by Date
for the following reasons
Permit No. � O �� Date Issued
------------------------------------------------------------------------------------------------------------------------------- -------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
(Certificate of Compliance -
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(X) Upgraded( )
Abandoned( )by CA Q w(a6 4..LC
at Q ( 1,0 1&VU0 Pf U tg 66Tf71'11/ has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.)a�f-19 r dated 2
Installer C,�49E�U1 D� � � �� Designer N�!-�
#bedrooms Approved design flow Al lzi. gpd
The issuance oft s p rmit sha11 not be construed as a guarantee that the system will dune io as designe .
Date `71111 Inspector ( CU
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No. ���� �y )
Fee 10a
THE COMMONWEALTH OF MASSACHUSETTS �-
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Misposal �&pstern Construction Permit
Permission is hereby granted to Construct( ) Repair(x) Upgrade( ) �Abanddoon( )
System located at ; U '/J I knjyn Aug G7 5Z�?zw t C S..l—
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
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Provided:Cons ctionrust a completed within three years of the date of this permit. ('
Date ! 1_ // S Approved by �L
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U►05 15 08:29p p.1
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Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
21 Wianno Ave
Property Address f
Wianno Plaza Trust
Owner Owner's Name
information is =�
required for every OSterviNe MA 02655 7-2-15
page. Cityrrown Stale Zip Code Date of Inspection
.Paw
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
fillip out forms / /�/} OFuriir�
on the computer, y/ d t�7 7� ��``�N,
use only the tab 1 Inspector.
key to move your =�! JAMES
cursor-do not James D.Sears
use the return Name of Inspector c �:vi
key.
CapewideEnterprises,LLC
Company Name 5_153 Commercial Street '''��•,; , , ; PEC
'�`•\``
Company Address
Mashpee MA 02649
CityrTown State Zip Code
508-477-8877 S 1623
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. t 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 Evaluation'by the Local Approving Authority
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7-2-15
;pefcto4res Signature Date
The system 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 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 wilt perform In the future under
the same or different conditions of use. r�
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[Sins^al13 Tide 5 Official Inspection Form:Subsurface Sewage Disposai System-Page 1 of 17
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Jul 0515,08:30p p.2
Commonwealth of Massachusetts
_ Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
21 Wianno Ave
Property Address
Wianno Plaza Trust
Owner Owner's Name
information is Osterville MA 02655 7-2-15
required for every
page. CityrTown State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E I 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:
Note: Five store's-two septic tanks-one G.T_ two D Box's seven chamber's..
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 I
determined," please explain.
The septic tank is metal and over 20 years old"or the septic tank(whether metal or not) is structurally j
' 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):
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t5ins•3l13 Title 5 Offidal lnspeamn Fonn:SubsWace Sewage Disposal System•Page 2 of IT
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Jul 0515,08:30p p.3
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments,
21 Wianno Ave
Property Address
Wianno Plaza Trust
Owner Ownei s Name -
information is ostemlle AAA 02655 7-2-15
required for every --
page. Cityrrown 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 (cunt.):
❑ 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):
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❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below):
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❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
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❑ 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):
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C) Further Evaluation is Required by the Board of Health:
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❑ 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 enviironment:
❑ 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
[Sins-3h 3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17
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Jul 0515 08:30p p.4
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
21 Wianno Ave
Property Address
Wianno Plaza Trust
Owner Owner's Nameinforrnat .
required+foon e Osterville MA 02655 7-2-15
required for every
ci frown state Zip Code Date of Inspection
page. tY P Pe
B. Certification (cunt.)
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
t 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:
. II
'*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.
4
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 aeeppoot is less than 6" below invert or available volume is less
than %day flow 4 64c*jy/eve
t5ins•3M3 Title 5 Official Inspection Forth:Subsurface Sewage I)Isposal System•Page 4 of 97
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,Jul 0515 08:31 p p.5
Commonwealth of Massachusetts
Title 5 Official Inspection Form
a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
21 Wianno Ave
Property AWress
Wianno Plaza Trust _
Owner Owner's Name
information is
0stervilfe MA 02655 7-2-f5
required for every _
page. City/Town state Zip Code Date of Inspection
B. Certification (cunt.)
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 pprn,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this forreil.]
❑ ® 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 fn 310 CMR 15.303, therefore the system fairs. The 1
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 foffowing, in addition to the
questions in Section D.
Yes No s
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❑ ❑ the system is within 400 feet of a surface drinking water supply j
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
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El ❑ 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•3113 Title 5 Official Inspection Form:subsurface Sewage Disposal System•Page 5 of 17
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Jul 05 15 08:31 p p.6
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
21 Wianno Ave
Property Address
Wianno Plaza Trust
Owner Owners Name
information is
required for every Ostetviile MA 02655 7-2-15
page. Cityrrown 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?
i ❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
i Were as built plans of the system obtained and examined? (if they were not
® 0 available note as N/A)
0 ❑ 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?
ElWas 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. E
❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue I`I
approximation of distance is unacceptable)1310 CMR.15.302(5)) i
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): Number of bedrooms'actual):
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms):
t5ins•3113 Title 5 Official Inspedim Form:Subsurface Sewage Disposal System•Page 6 of 17 I
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Jul 05 15 08:31 p p.7
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
21 Wianno Ave
Property Address
Wianno Plaza Trust
Owner Owner's Name
information is sterville MA 02655 7-2-15
required for every O
page. City/Town State Zip Code Date of Inspection
D. System Information
Description:
The system is a 1500 Gal. Tank- 1000 Gal Tank. 1000 Gal. G.T.-Two D Boxs and seven 500
Gal. dry well chambers.
Number of current residents:
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Does residence have a garbage grinder? ❑ Yes ❑ No
Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ❑ No
information
ton 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: Dace ---�--
Commerciallindustrial Flow Conditions:
Type of Establishment:
Retail- Rest-Cheeze Shop
832
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
22 Seats 7,847 Sq. Ft.
Grease trap present? CK 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: 2013-15,000 Gal's/2014-13,000 Gal's
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t5ins•3113 Title 5 Official hspection Farts.Subsurface Sewage Disposal System•Page 7 of 17
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Jul 05 15 08:32p p•8
Commonwealth of Massachusetts
iwi
- = Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
21 Wianno Ave
Property Address
Wianno Plaza Trust
Owner owner's Name
information
required for every Osterville MA 02655 7-2-15
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancyluse: Date
Other(describe below):
General Information
Pumping Records:
Source of information: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:
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® Septic tank, distribution box, soil absorption system
❑ Single cesspool
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❑ 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):
G.T. `
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tSins-3113 Tile 5 official Inspection Form Subsurrace Sewage Disposal System•Page S of W j
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Jul 05 15 08:32p p.9
Commonwealth of Massachusetts
-- Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
21 Wianno Ave
Property Address
Wianno Plaza Trust
Owner Owner's Name
information is Ostterville MA 02655 7-2-15
required for every _-_ ,
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed(if known) and source of information:
G-T.&one tank NA/Newer tank-D Box and leaching 2000 permit#99-822 7-2015 New D Sox.
Were sewage odors detected when arriving at the site? ❑ Yes [E No
Building Sewer(locate on site plan);
i 2,
Depth below grade: feet
Material of construction:
i -
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.):
Pipeing is cast iron from BLDG and 4" PVC SCH 40.
Septic Tank(locate on site plan):
I Depth below grade: 11& 14"
t feet
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Material of construction:
®concrete ❑ metal ❑fiberglass ❑ polyethylene ] other.(explain)
If tank is metal, list age: years
w
Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No
Dimensions:
1000 Gal. & 1500 Gal.
1°
Sludge depth: 211
15ins-�3113 Title 5 Offidlel Inspedlon Fomr.Subsurface Sewage Disposal System-Page 9 of 17
,Jul 051.5 08:32p p.10
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
21 Wianno Ave
Property Address
Wianno Plaza Trust
Owner Owner's Name
information is
required for every Osterville _ _ MA 02655 7-2-15
page. Cityrrown 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 28" _- 29
Scum thickness ill 011
Distance from top of scum to top of outlet tee or baffle 12' 8
Distance from bottom of scum to bottom of outlet tee or baffle 17" 18"
How were dimensions determined? As S lu : -Plan
Sludgee Juudge
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Both tanks at working level w/steel covers in black top. Tank#2 1000 Gal. inlet baffle and tee.
• outlet tee. Tank#31500 Gal. in and out let tee's. No sign of leakage or over loading.
Grease Trap(locate on site plan); .
Depth below grade: feet
Material of construction;
® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
Dimensions: 1000 Gal.
Scum thickness 1
811
Distance from top of scum to top of outlet tee or baffle
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Distance from bottom of scum to bottom of outlet tee or baffle
35"
Date of last pumping: na _
Date i
t5ins-3n3 Title S Offidel Inspedion Form:Subsuface Sewage Disposal System-Page 10 of 17 i
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Jul 0515 08:33p p.11
Commonwealth of Massachusetts
Title .5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
21 Wianno Ave
Property Address
Wianno Plaza Trust
Owner Owners Name
information
required for every Clsterville MA 02655 7-2-15
page. City/Town State Zip Code Date of Inspection
D. System Information (coat.)
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):
Dimensions: i
Capacity: i
gallons
Design Flow:
gallons per day
i Alarm present: ❑ Yes ❑ No
i Alarm level: Alarm in working order ❑ Yes ❑ No
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Date of last pumping: Date
Comments(condition of alarm and float switches, etc.):
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*Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
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t5ins-3113 Title 5 Oftidal Inspection Form:Sibsinface Sewage Disposal System..Page 11 at 17
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Jul 0515 08:33p p,12
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
21 Wianno Ave
Property Address
Wianno Plaza Trust
Owner Owners Name
information is Osterville MA 02655 7-2-15
required for every
page. Citylrown 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 0/0
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.):
D Box#1 is T below grade wlone line out. D box#2 is 20" below grade wl three Sines out. .
Both D Boxes have steel covers at grade in blacktop_ D Box#2 is new 7-2015
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No*
Alarms in working order El Yes ❑ No*
Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.):
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" If pumps or alarms are not in working order, system is a conditional pass.
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Soil Absorption System(SAS) (locate on site plan, excavation not required):
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If SAS not located, explain why: -
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t5ins•3/13 _ Tides OfTiaal Inspection Form:SubwAeos Sewage Disposal System•Page 12 of 77
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-Jul 0515 08:33p p.13
Commonwealth of Massachusetts
• Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
21 Wianno Ave m
Property Address
Wianno Plaza Trust
Owner Owner's Name
information is required for every Osterville MA _ 02655 i7-2-15
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cons.)
Type:
❑ leaching pits number:
® leaching chambers number 7
❑ leaching galleries number.
❑ leaching trenches number, length:
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❑ leaching fields number, dimensions: —
❑ overflow cesspool number.
❑ innovative/alternative system
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Type/name of technology:
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
leaching is seven 500 Gal. Dry well chambers 13'x64'xT. Four steel cover's in black top wlvent.
2"water in chambers.Wall's are clean like new. No sign of over loading or solid carry over.
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
I
Indication of groundwater inflow ❑ Yes ❑ No
15ins 3r13 Idle 5 Official Inspac on Fond'Subsurface Sewage Disposer Syslem-Page 13 of 17
-Jul 0515 08:34p p.14
Commonwealth of Massachusetts
r Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments . .
21 Wianno Ave
Property Address
Wianno Plaza Trust
Owner Owner's Name
equir required
a osterv7te MA 02655 7-2-15
required for every -
page Citylrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments(note condition of soil, signs of hydraulic failure, level of pon ding,.condition of vegetation,
etc.):
I '
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Privy(locate on site plan):
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Materials of construction:
Dimensions
Depth of solids
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
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t5ins 13113 Title 5 Official Inspection Fam:Subsurface Sewage Disposal System-Page 14 of 17 `
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,Jul 0515 08:34p p.15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
UVSubsurface Sewage Disposal System Form-Not for Voluntary Assessments
21 Wianno Ave
Property Address
Wianno Plaza Trust _
Owner Owner's Name
information is Ostemille MA 02655 7-2-15
required for every --
page, Cityrrown State Zip Code Date of Inspection
D. System Information (cone.)
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
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t5ins-W3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17
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Jul 05 1.5 08:34p p.16
Pit-
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-Jul 05 1.5 08:35p p.17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
21 Wianno Ave_
Property Address
Wianno Plaza Trust
Owner Owner's Name
information is Osterville MA 02655 7-2-15
required for every
page. cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check Slope
❑ Surface water
❑ Check cellar
❑ Shallow wells
IVv 30'+
Estimated depth tojGgh ground water. 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-99
❑ Observed site(abutting propertylobservation hole within 150 feet of SAS)
i
❑ Checked with local Board of Health-explain:
❑ Checked with local excavators, installers-(attach documentation)
❑ Accessed USGS database -explain:
I
You must describe how you established the high ground water elevation:
G.W.Per Plan 12-3-99 30'+below bottom of leaching.
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Before filing this Inspection Report,please see Report Completeness Checklist on next page.
1
t5irs 3/13 Title 5 Official fispeclion Form:Subsurfam Sewage Disposal Systam•Page 16 of 17 ;
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Commonwealth of Massachusetts
Title 5 Official Inspection Form
F�
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
21 Wianno Ave
Property Address
Wianno Plaza Trust
Owner Owner's Name
information
required for every Osterville MA 02655 7-2-15
page. Cityrrown 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
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15ins-3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 17 of 17
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Health Complaints
04-Oct-01
Time: Date: 10/4/2001 Complaint Number: 3101
Referred To: Taken By: DANIELLE ST.PETER
Complaint Type: ARTICLE XXXIX HAZARDOUS WASTE
Article X Detail:
Business Name:
Number: 21 Street: WIANNO AVE
Village: OSTERVILLE Assessors Map-Parcel:
Complaint Description: APROX. 1/4 GALLON OF GASOLINE
SPILLED FROM A CAR PARKED OUTSIDE IN
A PARALELL PARKING SPACE ON SIDE OF
THE ROAD.
Actions Taken/Results: SPEEDI-DRI WAS APPLIED BY FD.THERE
WERE NO CATCH BASINS CLOSE BYE AND
THE SPEEDI-DRY WAS KEEPING IT IN
PLACE.
Investigation Date: Investigation Time:
1
22N
BRUCE P. GILMORE AA
ATTORNEY AT LAW
1170 ROUTE 6A
WEST BARNSTABLE, MA 02668
(508) 362-8833
FAX: (508) 362-5344
Mailing Address
P.O.BOX 714
WEST BARNSTABLE,MA 02668
July 26, 1999
Thomas
o McKean, Health Agent
Board of Health
Barnstable Town Hall
367 Main Street
Hyannis, MA 02601
Re: 21, 23, 25, 27 Wianno Avenue, Osterville, MA
Dear Tom:
I,have spoken with my client, Norman Boucher relative to the septic system problem at
the properties located at 21, 23, 25 and 27 Wianno Avenue. Mr. Boucher has retained the
services of Peter Sullivan to have a new system designed which will comply with the
regulations of Title V. In the interim, Mr. Boucher agrees to having the liquid level
inspected weekly with pumping done as needed. `..
�f.
I trust that this answers the concerns of the Board of Health as raised in your letter of July
16, 1999. Should you have any questions, please don't hesitate to contact me.
Thank-you.
Very truly yours,
�0
Bruce P. Gil Ye
egg
cc: :, N.-Boucher
CA
CENTERVILLE-OSTERVILLE-MARSTONS MILLS FIRE DISTRICT
1875 ROUTE 28
CENTERVILLE, MA 02632
(508)790-2380IFAXS(508)790-2385
OILIHAZARDOUS MATERIAL RELEASE FORM
F.A.# Q I - G _ r,a?
LOCATION:
ADDRESS OF RELEASE: 441 62/a a.4jQ j of
!l<Ti r�trr. r G A4.4
oo
DATE OF RELEASE: In i
PRODUCT RELEASED:
ESTIMATED QUANTITY: fit . _ 1
CORRECTIVE ACTION TAKEN BY RESPONSIBLE PARTY: 1 t,A
"I -ps nL q .1
NOTIFICATIONS:
FIRE DEPARTMENT: YES(X) NO( } DATE: i Igm TIME /ct%7
NATIONAL RESPONSE CENTER YES(, )/NO( } DATE: TIME: r c-� e-2
DEPT. OF ENVIRONMENTAL PROTECTION YES( O( } DATE:La&i_TIME:j.
OIL SPILL COORDINATOR: YES( ) NO(v} DATE: 'TIME:
TOWN BOARD OF HEALTH: YES(,lyNO( ) DATE._LaLd y,LTIME: /�/->
TOWN HARBORMASTER: YES( } NO( � DATE: ' TIME* '
OTHER AGENCIES::�2 =:a.,, rr
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COMMENTS: �.��_. �e► . to � t /_ / . s . �_ .� C
REPORTED BY: �,a n�_ /_ /"I DATE: A /n �
WHITE COPY-FIRE DEPARTMENT YELLOW COPY-D.E.P. PINK COPY-BOARD OF HEALTH
C-O- M FORM#58
AsBuilt Page 1 of 1
TOWN OF BARNSTABLE
x7
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LOCA N SEWAGE#` �.
,yn1 n A(/ p9- g
VILLAGE O S7'eR V111-e ASSESSOR'S MAP&LOT
INSTALLER'S NAME&PHONE NO. J,/ oM A C 0 A d efe.. SON
SEPTIC TANK CAPACITY Z•r 0 0
LEACHING FACILITY: (type)7-AY0W CA4At/Se4 5 (size) Sdo G 4,4-e
NO.OF BEDROOMS
BUILDER OR O
PERMIIDATE: -COMPLIANCE DATE: too
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
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http://issgl2/intranet/propdata/prebuilt.aspx7.mappar=117098&seq-1
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Sullivan Engineering Inc.
_ 7 Parker Road ..
r ,--Box 659 Osterville MA C2655 '
Peter Sullivan RE . Mass, Registration No. 29733
Phone 5081428-3344 ; `T Fax 508-428-31,15
_.e-mail:__psullpe@aol.com, -_u
,.t,September.,2.7,.=2000
Town of Barnstable
Board of Health
Attn: Donna Miorandi
367 Main Street ,
Hyannis, MA 02 601
RE: 21-27 Wianno Avenue, Osterville, MA (Map 117 Parcel 098)
Permit No. 99-822
Dear Ms. Miorandi,
This letter is to confirm that as the designing, engineer; I supervised the,
installation of the septic system at the above referenced property and it
was installed in accordance with with plan.
I trust this meets your present needs. If-you have any questions,
please contact my office. Thank you.
V truly yo ,
�,��
Peter Sullivan P.E.
Sullivan Engineering Inc.
PETER
SuLLIVAN
p C29
tIL
ST
- s -
Members of
American Society of Civil Engineers, Boston Society of Civil Engineers
TOWN OF BARNSTABLE
LOCATION 1" x 7 W I A n!d n A IO C' SEWAGE # 99r
VILLAGE OSTeR V/Ile ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. J '/' M A C d m 9 ell? SON
SEPTIC TANK CAPACITY Zs0 0
LEACHING FACILITY: (type)7-/DLO GtJ C11.4A isNe S (size).
j NO. OF BEDROOMS
i
BUILDER OR OWNER 1�
�EJJWPERMITDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
j 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
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• Department of Health, Safety, and Environmental Services
Public Health Division
AIF�'AP�A P.O. Box 534, Hyannis MA 02601
Office: 508-790-6265 Thomas A.McKean,RS,CHO
FAX: 508-790-6304 Director of Public Health
Mr. Norman Boucher 7/16/99
Wianno Plaza Trust
P.O. Box 2216
Hyannis,MA 02601
ORDER TO COMPLY WITH 310 CMR 15.00, THE STATE ENVIRONMENTAL
CODE, TITLE 5.
Records reveal that the cesspool/septic system was pumped excessively at 21, 23, 25,27
Wianno Avenue, Osterville.
The inspection of your septic system showed that your system has failed under the
guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following:
• Overflowing septic and excessive pumping during the past year.
You are directed to hire a professional engineer to provide plans of a replacement system
within ten (10) days, before July 28, 1999.
You are also directed to bring the septic system into compliance within thirty (30) days of
receipt of this order letter. Therefore, the construction of replacement septic system
component(s) must be completed on or before August 18, 1999.
You are further directed to maintain the system by hiring a licensed septage hauler to
pump the septic system to prevent discharge of sewage or effluent into the buildings, onto
the surface of the ground, or in to surface waters.
Any person aggrieved by any order issued by the local approval authority may appeal to
any court of competent jurisdiction as provided for by the laws of the Commonwealth.
PER ORDER OF THE BOARD OF HEALTH
� 7/
4m5as A. McKean, R.S., C.H.O.
Agent of the Board of Health
TOWN OF.BARNSTA.BLE
LOCATION.)./- Z 7' iV I A,pi t/n A y ie SEWAGE # 99 g
I
VILLAGE O STeR ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO.
I of. S oA/
SEPTIC TANK CAPACITY _/Sd O
LEACHING FACILITY: (type)7/GLO cu Gf/iQ,N iSe.t''S
(size) Sd o 6.9 L--e.
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
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LOCUTION ' 5EWaC4E PERMIT UO.
- 9 Fa L -VILLAGE ,
IW.57ULLER 5 W&&AE ADDRESS
�UILDE 5 Q &ME ;UDDRE55-
DIQTE PE NAIT 155UED,'=jA-/Y
DATE COMPLI Ut,ICE ISSUED : — — —
3�
Illy" ,
TOWN OF BARNSTABL,E
LOCATILO 7' Wf A n/A/n A IO d' SEWAGE #
VII.LAGE O S) ,ek IJ/11-f ASSESSOR'S MAP LOTP T-
INSTALLER'S NAME&PHONE NO. e o A d eR., s a v
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type)7 r'LDW C&-0 9ef�S (size) .S60 6 lq, �
NO.OF BEDROOMS
BUILDER OR OWNER. A-10 PMA 6QKC-,86Q
PERMTTDATE: 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 20Q feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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-74(Put 074,10 a
LOCATION , SEW®GCE PERMIT UO.
VILLAGE —
_ _2 .- - -
IW.STQLLER,S W&NEE ADDRESS
-e'allLD.E 5 1J &"E gADDRE SS
DfaTE PE t�1T 155UED 3
DATE COMPLI &MCE ISSUED . — — —
----� v;,
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No......................... .. ..................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F HE LTH
d.—tcl -----------OF....... .. .............. ........ ...............-----
Apphration -fur 43hiVuuttl Worko Towitrurtiuu Vrrutit
Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal
System at:
./44.d7Tioot_Tp...MA2Il__.F_�2Y;;-_'�:sTRiL ........._
------•-----...-•-•---•-------•---------••--•.................•--•--......•--------------.....--
Location.Address or Lot No.
................................ Location-
t6U.MiN_O_._P�.41A.7RuT --•--•-----------•.
w Owner Address
Installer Address
UType of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms............................................Expansion At/tic ( ) Garbage Grinder
per, Other—Type of Building�mia.xi_...A��:t�"ie1c No. of persons-----------,T------------ Showers (--) — Cafeteria (--)—
Other fixtures---------- -------------------------------
w Design Flow...................31_.__................gallons per person per day. Total daily flow--------Le/®------------------------gallons.
WSeptic Tank—Liquid capacity/63V-gallons Length................ Width---------....... Diameter---------------- Depth.__.----__----.
x Disposal Trench—No. .................... Width-------------------- Total Length-------------------- Total leaching area--------------------sq. ft.
Seepage Pit No-------/........... Diameter/6P!�V,_ Depth below inlet.................... Total leaching area------------------sq. ft.
z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by-------------------------------------------------------------------------- Date----------------------------------------
,� Test Pit No. 1----------------minutes per inch Depth of Test Pit.-.-_-_-.___--_____. Depth to ground water_..---_----_-.--_._.._.-
fZq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water__._...__-_-..._---..___
O Description of Soil........................... �(j
. .. � .X `- •------ -----
w
-- ---- ------------------------
VNature of Repairs or Alterations—Answer when applicable._----------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------- •------•--- ..............
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has b issued by the b rd of health.
Signed --------------- ---------------------------
---- ---- - ' ---- -��---Date------------
Application Approved BY- - - % •- Date
Application Disapproved for the following reasons:-----------_____ ___ ______ __________ _ _ ---------------------------
= - -------------
/ fat
YPermit No......................................................... Issued...___....':Z.- --------------•-•-•---•----•--
Date
a /
No........�J-....----_.. /j...............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F HEALTH
-------
.OF.......0,. . ,.................................
Appliration -for Bhipoiini Works .Tonfitrurtion PPrntit
Application is hereby made for a Permit to Construct (1y or Repair ( ) an Individual Sewage Disposal
System at:
Aad;rr,oLl,7,3 MA,rz �� ��a� -4 &T1ZIle
.......•------ ----------------•------.......•. -- ---- ---...............�.._..
Location-Address or Lot No.
liJ 1 A�N� h V —WI-/�NIVg PL/� /1 -i J1U5.)--
Owner Address
Installer Address
Q Type of Building Size Lot----------------------------Sq. feet
V Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( Garbage Grinder (—)
aOther—Type of Building No. of persons...........y------------ Showers () — Cafeteria
Q' Other fixtures --------------------•-----_--__ . .
W Design Flow..................�Z4................gallons per person per day. Total daily flow......... 0........................gallons.
WSeptic Tank—Liquid capacity/6-,TV--gallons Length................ Width................ Diameter-----........... Depth.-.._.----------
x Disposal Trench—No. .................... Width---------------..... Total Length--_-------____.--_.. Total leaching area--------_--_----.-sq. ft.
Seepage Pit No-------L----------- DiameterZ�UoS!?.... Depth below inlet____________________ Total leaching area..--____.-..__-_sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed bY.......................................................................... Date...............................--------
Test Pit No. 1----------------minutes per inch Depth of "Pest Pit-------------------- Depth to ground water--------.__--___-.-_----
fiq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--..-.--_---.--..------.
..............---- -- -- - � ---------- - - -
Description of Soil -- - --- �!' -G�l---. { �y� tf G*
. ------ .........ate.. ' ..-
w ----x ------------------ -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
U Nature of Repairs or Alterations—Answer when applicable------------------------------------------------------------------------------------------------
-------------- ---------------------------------------------------------------------------------------------------------------------- -----------------------------------------------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has b e issued by the b rd of health.
Signed--- A -•-• ••. ------------ -----
Date
Application li Approved lvl.....
Date
PP d By-------- i� - -- ------ 1 -i1/1--/.�c,./ ------
Application Disapproved for the following reasons:-------------------------------------
-----------•-------------------------------•---- ------------
----.....•-•.........-•-••••----.----•-•-•--------------------•--•-------•-•-•-•---•-------------------------••--------•-----------------------•----- -------.-.---------------------------------.-----
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD O HEALTH
..... (�s �L...........OF.......... _ .. .... `..........
uprdifirnte of 10,11ontplialtrr
T�0 CEVT1at the Individual Sewage Disposal System constructed ( ) or Repaired__by..._.... -- . . a --------------------------scalier------t'i/L i i i-c, l �; j
_ /� �� �/ G
at ,` l ----- ' `•1 0 '�'1' =''s 1--- ----- --------•---�J.s.r�-s�s�--44' -- - — `"�-''
has been installed in accordance with the provisions of . XI of The State Sanitary Code as described in the
application for Disposal Works Construction Permit N ...7 --------------- ..............
THE ISSUANCE OF THIS CERTIFICATE SHALL, NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
.L_...-
DATE-------- + �•�- ....-•-•----•••----------------••--------•-------_.... Inspector--------
1 THE COMMONWEALTH OF MASSACHUSETTS
BOARD HEALT
76
... ... ..of........ lvi- -.- ...... ..................
NO.. FEE./.tl)---�_'�
nttrttrtion �rrntit
Permission ereby granted !� 1- ........................................................... ---- .........
to Construct ) or Repa• ( ) an Ind• '. al ewage s osal System `L
at y
treet
as shown on the application for Disposal Works Construction it No_ ...4�__ _. Dated-. ---3_ _-.��--_-__•--•.---
--- --- ......��� --- �. -.
// Board of a th
DATE.f•_'?...�..�`
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
774
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Subdivision of Land & Lot 5 F R
Shown on Plans 20329A & 12546 .
Filed with Certs of Title Nos-9025-17031 w c
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THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
_ Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
ZIpprication for �Dizpoar *paem Construction Permit
Application for a Permit to Construct k
Repair X Upgrade( )Abandon( ) El Complete System ❑Individual Components
'Location Address or Lot No.21-V7 o, N a A U G Own rIs Name,Address pand Tel.No. '77 S —9t8
h4O V_v, A) poue-bYE-(Z,
Assessor's Map/Parcel /� 1 1-T QP2c.C 1— 9B 70 60 X ZZL Cp Q 26O
Installer's Name,Address,and Tel.No. Desgner's Name,
,AAddress and Tel.No.
ULLAUP0,3 ?E.
V LI po hV
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder(I c)
Other Type of Building R ETAt t_ No.of Persons Showers(kto Cafeteria(
Other Fixtures QGVTAyf-AtiT (ZZSeA-i'S 17-457 T;b(? zQ GF0/SeA4T
Design Flow 832.. gallons per day. Calculated daily flow M gallons.
Plan Date Number of sheets Z Revision Date I 0 7u E
Title
Size of Septic Tank 15—DD C>At-�-.t�k Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) DESIGNING ENGINEER MUST SUPERyin
1N8:f*ttATi0N AND ERTIFY IN WRITING
THE SYSTGnA WAS eue.TA -- In ACCORDANCE To pi CT
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 issued b this Board of Health.
Signe , W, �✓ Date
Application Approved by Date
Application Disapproved for the following reasons
Permit No. Date Issued
J
'► % ;. ,• `��(" � � ,�. r, _ (/ram-'-/'//''
Entered in computers-•"�
�,• lTHE COMMONWEALTH OF MASSACHUSETTS Yes
PUBLIC HEALTH DIVISION -TOWN'OF BARNSTABLE, MASSACHUSETTS
w .
application for Migpogal *pgtem Congtruction Permit
Application for a Permit to Construct( Repair(Upgrade( )Abandon( ) El Complete System ❑Individual Components
Location Address or Lot No. V-Z`1 1![`� �a ti iv 0 A U t_ Owner's Name, 4%tU &oUCi
Address and Tel.No. T(S-- "9(8 1
i=2
Assessor's Map/ParcelM A1 '7 �R�2 t_.L„ 96 Nl0 ?_M Pa 60 K 2Z1 (p
a,,3 M C�Zb0
Installer's Name,Address,and Tel.No. Desi ner's Name,Address and Tel.No.
Er�f_Z Su t_(_\v raN ?F_ `
71'9A,k-e Z (_osa.J
Type of Building:
Dwelling No.of Bedrooms t,(l J� Lot Size sq.ft. Garbage Grinder( 40.j
Other Type of Building R E na i L_ No. of Persons Showers( k )Cafeteria(
Other Fixtures 1Z t srA v�LAtQ T (ZZ S C A75 Fa sT Fa�9& ZQ G P 0/S CA-T °
Design Flow 832 gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets 2 Revision Date k1 D ky E
Title
Size of Septic Tank IS L t-1 Type of S.A.S. '5'Y C. 'x Z' A.L Lc:�j 'r
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) -
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 issued by this Board of Health.
Signe W• 6r/• Date
Application Approved by .-7 i Date g
Application Disapproved for the following reasons
Permit No. Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
6 BARNSTABLE, MASSACHUSETTS
�� Certificate of Compliance
THIS IS TO &TORTe
tha n-site Se is ystem Constructed( )Repaired,( )Upgraded( )
Abandon d( )by
at has been constructed in accordance
with the provisions of Title 5 and the for DisposalSystem Construction Permit No. ated
Installer Designer
The issu a of t s rmit shall not be construed as a guarantee that the s to ill function as Qgne o o
Date Inspector I/ o Of
No.— ---------------------------------
Fee
THE COMMONWEALTH OF MASSACHUSETTS
,Oq PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Mig ogal gtem Congtruction Permit
Permission is hereby grant d to Co stru t( RZeWra!A 1 )A-andon( IIo'
System located at �� � (/( , � � I Z`
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:Construction must bee 2 completed within three years of the date of this e t. ^
Date: / Approved by
t � s
Sullivan Engineering Inc.
7 Parker Road
Box 659 Osterville MA 02655
Peter Sullivan P.E. Mass. Registration No. 29733
428-3344
fax 428-3115 e-mail-.PSullPE@aol.com
July 28, 1999
Thomas McKean, R.S., C.H.O.
Town of Barnstable
Board of Health
367 Main Street
Hyannis, MA 02601
RE: Norman Boucher
Wianno Plaza Trust (Wianno Ave., Osterville)
Dear Mr. McKean,
This letter is to inform you that I have been retained by Mr. Boucher to provide plans
of a replacement septic system for the above referenced property. Mr. Boucher
received a letter from you dated 7/16/99 which directed him to do said work due to
failure of the present system, as according to records, the existing system was being
pumped excessively.
As per our telephone conversation, I again reiterate that I cannot begin work on this
project for at least 10 to 12 weeks. It is my understanding, that you were going to call
Mr. Boucher and explain to him that he was to keep the existing system pumped on a
regular basis until the replacement system can be done.
I trust this meets your present needs. If you have any questions, please feel free to
contact me.
Very truly yours,
Peter Sullivan PE
Sullivan Engineering Inc.
cc: Via Fax:
Norman Boucher @ 508-775-9181
Attorney Bruce Gilmore @ 508-362-5344
Members of t
American Society of Civil Engineers, Boston Society of Civil Engineers
.6isign Flow('excluding the Cheese Shop) -
Retait=50 go/10009f FG.40-41 f.G.Varies
40-4
'Retail Area = 6,800 of
Retail Flow MQ M?9 Schedule of Heavy Duty Covers to Finish G-ade n n
PCC Risers to H. Frame 8
Design Flow Cheese Shop i Varies F.G• Cover
Restaurant=20 eons r seat Component Covers Req. 37.5
i - � h = �,� 440 + 36.6 I500 Gallon Top E1.385
Septic Tank 2 Risers as.required , 38 4
C Sop gpd Septic Tank 38.2 Sot.E1.35.5
Retail Space= 1047 sf gp� Distribution Box 1 each box Risers as required ; 36.0
Cheese Shop total 492 gpd Galley Field 4 Risers as`required
Total 832 gpd Bedding as 30.5'
Septic Tank + Per Title 5 ✓
Re use grease trap 8 septic tank for the Cheese Shop iParking Lot 1 Risers as required
Sized 20D%of design flow for retail= 680 gallons j Drainage System Ground Water Estimated a El.&0
Per T.O.B.Ground Water Map.
Use a 1500 gallon tank
A
DEVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM
Leach Field(total building flow Including the Cheese Shop) Not to Scale
Required Area=GPD/0.74 1125 sf ,
Field Size=13'Width x Length
Length= 63.3 If {
r Finish Grade
Use 13'x 64'field with 7(seven)500 gallon leaching drywells
Area Provided= 1140 of
All Components To Be H-20 Filter Conp�d Fill
-
Fabric
Water Motor Readings (Centerville Osterville Marston Stills) � =N 1/8-Ile
1898 68,000 gallons/year r
Pea Stone
, ea 238
9 yy gpd � .
11187 64.000 gallonslyear 224 gpd
Assume 6 days a week for half year and 5 days a week for the balance
1g
hn
for a total of 286 business days _
Leaching *_l w
Design flow Is greater than actual usage by 3.5 a Chamber - Double
o ble
I � 7_10 I -
Notes: ,
1. Filter Fabric is required over the system.
SECTION OF-CHAMBER
2. All Components are to be H-20 CROSSA
Risers d h du covers finishedgrade.^
:NOT TO SCALE
3. sers an ea to heavy duty
4. SY stem must be vented.
= 5. Pump existing septic systems and remove the structures in their entirety.
6. Note,the septic tank and grease trap for the Cheese shop is to be reused(pump both as part of this _ NOTES
repair). ;
7. Remove existing catch basins. L Water Supply ForThis Lot is Municipal Water.. ,
8. Remove all unsuitable soil around both existing septic systems and catch basins. , 2 Location of Utilities Shown on This Plan Are Approx.
9. All stone to be double washed with no fines attached to the stone.The engineer reserves the right to At Least 72 Hours Prior to Any Excavation Far This
!�
'
Pro1ec t The ControctorSh all Make The Required
reject stone that does not meet this spec. Notification to Di Sate(1-800-322-4844) .
10. Piping ten(10)feet out from the building to be cast iron in accordance with the State Plumbing Code j 3 The Contractor is Required to Secure Appropriates
with the balance of piping to be schedule 40 PVC. Permits From Town Agencies For Construction
P•P $ � Defined byThis Plan.
11. Roof nut off may be directly piped into theproposed arldn lot drainage system.Y YPP P 8 $ Y � •
} 4 Install Risers as Re uired to Within 12ssof -
f Finished Grade.
,.0 Q��,A� + 5.All Structures Bdried Four Feet or More or Subject'
to Vehicular Traffic to be H-20 Loading.
' Pj ',� 6 Septic System to be Installed in Accordance With
e�`
aY Sl1LLIVIN11 , 310 CMR 15.00 Latest Revision And The Town of
iS0.297 c i Barnstable Board of Health Regulations
61aJIL T All Piping
p nq to be Sch.40 PVC.
i
Prepared By. Ca eSury Prepared For: Titl`: North Scale Sheet i#
Sullivan Engineering, Inc. p ; E Septic Repair Plan @ Wianno Plaza Date
PO Box 659 7 Parker Road 1 Norman Boucher 21,23,25,27 Wianno Ave. 1Z/03/99 i 2/1
Osterville, MA 02655 Osterville MA 02655 Wianno Plaza Trust Osterville Mass.
(508)428-3344 (508)428-3115 fox (508)420-3994 (508)420-3995 Ihx JOb
PSAPEaFrd.com capesurvatrapecod.net
- _ Assessors Map 117 Parcel 98
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PLAN VI EW o Sfy w
Prepared By. Prepared For: Title: North Scale 1��_2O, Sheet
Ca eSury • Plan Wianno Plaza
S e tic Re air Date
In . Gw
li an Engineering, c p p p
lv Su ,
Bouche
r 1 /2
� Parker Rood .Norman B >< nno Ave. � 12/03/99
x s5s 1 3 2 5 7Wa
Po Box 2 ,2 , ,2
Osterville, MA 02655 Osterville MA 02655 Wianno Plaza Trust
(508)428-3344 (508)428-3115 fax (508)420-3994 (508)420-3995 fox OSterVllle Maas. DW9
PSUI PECOOLcom capesurvOcapecod.net