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0524 WIANNO AVENUE - Health
524 Wianno Ave �+ Osterville {. A= 163-027 w, Y a 6 t t t TOWN OF BARNSTABLE LOCATION 52-4 \Macho Avg SEWAGE# 6?0 1S d. VILLAGE (35N-2fv►I f_ ASSESSOR'S MAP&PARCEL 16-3 ,M INSTALLER'S NAME&PHONE NO. GLT (90§�)-m -9391 SEPTIC TANK CAPACITY (J_)Z5d0 H-16 U-) 1$00 H-ZO LEACHING FACILITY:(type)Q0> 50-D cje,\�eA h-16 (size) NO.OF BEDROOMS (� OWNER c' PERMIT DATE: 4• � * o�� COMPLIANCE DATE: 7 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility �P Feet Private Water Supply Well and Leaching Facility Of any wells exist on site or within 200 feet,of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY <b ►srA ze, 61 vp&% t No. 90 b 7-g Fee 7 V THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 4pliLation for ]Disposal .4pstemr-Co trUttion Vprmit P Application for a Permit to Construct('Repair( ) Upgrade( ) Abandon(' omplete System ❑Individual Components Location Address or Lot No. w'W.',q-,in o v2 Owne 's Name,Address d Tel No. os¢ rv�'lle .M A Em"T", �e " rPvSf Assessor's Map/Parcel / 3 027 Installer's Name,Address,an Tel.No. S 4F- �.�i_ Desi ner's Name,Address,and Tel.No. Epp 'iSY�° �_ 9 399 �'ril�da� &i iReeA(1K, Sal Type of Building: //,. Dwelling No.of Bedrooms l© 0/ Lot Size ®$ b` L sq ft. Garbage Grinder( ) Other Type of Building Sl:,D iW/f No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.re uired loo G Pa gpd Design flow provided l y/� gpd Plan Date Number of sheets Revision Date Title Si` kj� Size of Septic Tank 2�1) �`l qt �yogl N Type of S.A.S. /D'S c n Description of Soil NJ-a 0-2 `z O ,4- .,v- 600--1 ZY-e1Z" to£' sAd L-Z&S %fie 1'e- v S 9o-iZ Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and mainte of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environment ode a not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed - Date / Application Approved by Date `7 Application Disapproved by Date for the following reasons Permit No. v 6 Date Issued "t - 9— ' J ., No.:., G. I ' Fee V THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: - PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 4 Zlpplirati0n for Mispbsal 6 strut-Con trurtion Permit Application for a Permit to Construct 'Repair( ) Upgr de( ) Abandon( Complete System ❑Individual Components -Location Address or Lot No. Z Y b!/q nn o v 2 Owner's Name,Ad ress, d Tel No. osf r�,YIP .�A G�ar .'� raf� rr�sf Assessor's Map/Parcel /6 3 o Z 7 Installer.'s Name,Address,and Tel.No. S--D�__ —71 k�1-t ��►�►a-' 9 39 9 Designer's Name,Address,and Tel.No. ��Jp—yZ�G 33Yy Type of Building: rr)) d Dwelling No.of Bedrooms Lot Size ¢OMLsq ft. Garbage Grinder( ) Other Type of Building 5 D W/{ No.of Persons- Showers( ) Cafeteria( ) ` Other Fixtures'. J1 Desigfi`Flow(mien.required /00 gpd Design flow provided y/E gpd Plan Date -k cwp � `1 Number of sheets Revision Date �® Pt 6,. Title/ �foLeSefJMD/oyp/>1t'h +�3 ,Size of Septic Tank 2S Uay Gpll 4hg//5V0�,A/ H �ype of S.A.S. A0 S Z 6rllpr 1 Y / Description of Soil 7`f f.�: 0-Z%'+ Locr ti SiAJ c/2-90 o% Le AV—'- 'v Z La �Q 1 e 4j,,1 14iWe1,*7 59 90-i z Nature of Repairs or Alterations(Answer when applicable) u Date last inspected: Agreement:`"` The undersigned agrees to ensure the construction and mamte ance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental-Cod" e andnot to place the system in operation until a Certificate of Compliance has beenf°issued by this Board of Health. ` Signed 1 Date f Application Approved by 0 Date �� --� —f 5 i Application Disapproved by A Date for the followingerea sonsf a. Permit No. � THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance -- THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( Ir)�—Repaired( ) Upgraded( ) Abandoned( )by Ka/��.i 21. C,Q rn CjR�-t-j S� ` at 5 2�� l f;gnsga A-c has been constructed in accordance`, with the provisions of Title 5 and the for Disposal System Construction Permit No.oZ o 15— dated Installer Designer #bedrooms /p ��(crvhn Approved des' n flow 6 (; !/G� r t�17 gpd The issu Ice of his permit shall not be construed as a guarantee that the system wi I fun do as designe . Date ( � Inspector _> ------------ ------------------------------------------------------------------------------------------------ No. O I — b 7 o Fee �Sy THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Disposal *pstem Construction permit Permission is hereby granted to Construct( _ Repair( ) Upgrade( ) Abandon( Ll� System located at LT 2 LV (J,c,rr`i r, 1 t,� . ! w f re 4 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with I Title 5 and the following local provisions or special conditions. J Provided:Construction must be completed within three years of the date of this permit. Date LI � � — � S Approved by � " / JUL-20-2015 23:29 From: To:15087906304 Page:V2 Tewtt•a��BariastatiIe•> ' ' ' j RCtiilaltOry Services . ;:; �' + `' RiCBa�S.V..�feplt�ieter,Im DirectoC'' �' „+�ti�' ?' 1!ublic Health Divislan: 1 ^is+P• - . Tbgiiis"s.bic[t:cpd,•Dfieetti'r • 30k:\iain,Stll>••nants,,hlA026A1•` ^ I • '.QlTicr%508:85't4644 :�Fa>c 503:79.0`•6101•• InststllElLdf Dp9icnei Ch itdcatlan Poi[pl`; 'Dcst er< ;:v ' �?;�.ra: 'Iostalltrc�a.^-:, '�!?-•, �' , .. . ;AdditeYeF '�Fa�; .Ftl' -Address: �-r1.�•1`�' ',L_71�_ .. • ' •• i'. ' —�111' � 1Vasi3sae .a',pyi�tiltO,{nsmll.0. . sietn lit: 1k3'tu i 1] bascd'dp'o detig cbpvM'bYr . t:cettify iliai•cfie scj►cie•sys�em cpfcrenced'ubnvo Tvsa WWllal:iutieladtioliy,:ddco+ding'ui,; include;:tnu10�..aPPro ...... is Ewh',sii'Isti l reloeeNori.oi•}tie::'. diadbution,bdkIll d!or:s_epiit:tahv .Sa,p a rc�ut�ed);�4�t •ui 1i>dtra+d ttie soils. i a+erE'$utfd 9stisfaixuty: . I:Ceili tbadi0e ir, p';ticsyskm CfCre+ieod:nEnve'•wns`itistallcdiwilh'n>+IIorcfiarigcg•(i:c Sim;uny",��gGyl?iclo inn'of' coinP!3= ! telti!'an 10'•liite7al'idocslitlq'oF1hc . nfthc:aep{ic'3y9 )' ,�vitt:rStaso:bti;Load:ltc leiiorls:•Pl�l;trsytsionor..�,: ` k icni 6ut;iil�aeiedidanue SN,-.:1,. ed�$'U1c5o�a; '� iitisidui';tiuilttiye; `*:!o.rolto:- sfii�.iiyr(riYgi4q$e),'avest!±�l�+t . ,�•... - � ' - ' oiii�d:ss6sfa '^'" ►' • 't'�[ctatiii'Y•t stem rcfCrelteed above we§'ot+nstnleiod ui aog11111aaaiy"}!h�ibc�etmY, : � ;a';[v •tetttas(tPappbcsNle) ¢�"mkt r I .i ;{a ixtis: - 117C).; '17V.R6.IE .. - J, ' '.. �.��•..; •, .�: ,' �' ,!. - a�f. is •__ ., �eslgne;s'.:a'►stole)' ( i•em)- WiS j bbl ' • 11[IV+•T,O •�'• itl:rr`t'UDi: '.1 RrL'' Yli •tfi VI1:L s' rUlYl'IL"":, bTH. .110 ., . . "�. i y F M h �, _ , _: :. l P i Town of Barnstable r# _' 7ttE fig'' 1)epartdient of RegWatory Services i 4 : . , ,�,� �'ubl c Heal.1 Division Date "�,� :/�{ ,� ,unss 1� sbjg.^1 Mam Street,Hy is MA 02601 0�p - 200 ,�� » r, ��' Y�. 5 u $ - °a { i k Date Sclieduled � °`rsr� .d �f : r Time Fee Pd , ` CMG! eae�. r z � f s v , • i d s Sdil ztabzh ": &s ssment or S d a D s °sal t ' .f g 1� �L4 Performed By ;: w�:►�VIC ��l7 i/�Ci�lJ; C, Witnessed By t _. �I + O,CATIOIV& GENIZAL INFORMATION //��'�"' Location Address 1" 1 Owners Name'C ha r/eS. l Tu�It'� ��' y C�sfery I! . ". C . fib Rd, Address : 1 e /VeW :, rn p „o�y59 `at Assessor sMap/Parcel �,A 3 Qaa /� : Engineer's NameS'V I I i YA-It_ 1- i ��f i i ' - 'I } NEW CONSTRUCTION U8 NaS 3y REPALR Telephone# I�. Land Use S,`c�ti fo ct ( ' Slopes(%)�,� �4- .Ica° Stuface Stones r 1 64.�" Distances from open Water B AYy.' 2_S.'� r ft Possible Wet Area,a e r tt Dniilcmg Water Well it C w 1 ., ., t Drama e W a ' , ZO-ZS g Y ft Property Line A Otfier ft ti ts, I 1,:. f ' SI�ETCII:(Street name,dimensions of to exact locations of test holes&perc tests locate wetlands in proximity to holes) r apt :'`? -� 1' iI 4 I� ct �: i rr� �F3 1PudbNlt ,i fi x i a =S h ' 1 't p �i- !i�yr� t s �t 'i "Frl it j Ile=kiil n 11� i.,i C II till 4 �, ak , z t x 9 �: _ J :°fie y �� :r zl t �',u I�. i tla 9}r t 163027 19 524 , I . x \ is n • � i X # t ' P5 1 i r .1,. t � �i yµ x r f t :[ 5 rr: ! $Nll�GA.t t��1.1 m.t ll. ". a .. '- 11 t o; 11 ;,I y I ;y �. s t .,I '`: e t �� - r� "' ' r) :.:, , Vo rI p ' - a r. , L a ;"7 c Parent:inatenal.(geologic)s:':(�� G✓Ylf d o k �C9o. 'r � Depth to Be r c . Depfh to Groundwater Standuig Water m Hole �'`I- Weeping fromlP,t Face ! `�>tQ_' . Esftated Seasbnal Htgh Groundwater Y. x r'. I I I I I¢ i TI� I DLTE"Yc�Vl l�(A FOR SEAS : NAI,HIGH WATER TABLE Method Used _ F Depth Obsetved standing,h bbs hol m Depth to•soil mottles m. a ; Depth to wi;ep,t gjfro�n side of obs: tole in Groundwater AdU*ustment $. Index Well# ReadmgiDate Ltdex:Well level Add"factor Adj,Groundwater Level ,. . ` �I1 RCOLATI0i� T I i .,.'Bate G.'t2-ly�ri__ !►AM Observation Hole#. _ _ Tine at 9' ` YZ�� L/ Depth of Perc T "� ,I Ttme at 6 ti f � Start Pre soak Time @ Tune(9' 6 ) End Pre soak 3:C�Q I C t j�` Rate Mm./Etch S Zi�r�+�/i n ,'G 2.*d',n l Stte Suitability Assessment: Site Passed Site Failed Add,, . Testing Needed,(Y/N) ongigal Pubhc Iiealut Division Observation Hole Data.To Be Completed on Back ---- *� If percula. test IS to be conducted wrtbin 100' of wetland,you must first notify the k Barnstable Conservation.Div><sion at least one(1)week prior to beginning°` Q\SEPTIC�PERCFORM.DOC i 4 4 . . :. . � IV- . ,� �:ittttittti .. . � 1- 1.�:� DLI+dJP 011lal$Vt�'1'IOI'�T I30Lq.L LOG < dole#I f Ueplh from l Soil Ho�mpli Soil Denture Sd11 Color Soil other Surface(tn) (U,DA) 0. r. (Munsell) Mottling (SlnuclUre;5lones Boulders r �� :11 o tststencV ;'6 t3tsvcll 0 2111. O� ' Lr i.: t ��.,. s�v lZt;�� � j; .f,.ai,of 2.rs f' ?�. .F ,� I�' 3 , I ,. 3 a r i I �a I 4r it �I♦;1.LP'1: & I I� A,i IO "'Hf7L1J LOG Hole# � Depth froth Soil Fioriz ul V. �` Soil Ie>Eture: I. Soil Calor Sul[ Olher urface ttri.) (USDA) (Mutisellj Motlltn ,g (Sfritct ute;Stones 1loulder$ r basis en o r8 Z.Z 7.07. L ' , _ , "OKOYMP 2 Y r C" /n[ J�/� AW Y� `� M. Sq�v{ 2 S f`1 , i , 7.1 AI';L :OiV�j 'Ib►r�tIOL LOG Hole#_ _ ' Depth from1. Sofl Norizo 5o11"'Iexiure Soh Color"! Soii Otttet` Surface(in) ' ([1,s3llA) (Munselij. Motdln (StnlctUre,Stones,Doulders AMM C i to c �y `' ®l ' L ,,: j 7, - 9 -i: lj r �j �octn / �qA� © � �TY _ �� 7`( l2� �Z I �r 3 �� 2 S Y ? 3 a 1 Jllkhsghh�s DL k'„ ?41 *EjtvA� IO IiOL1;LOG Hole# Depth frririt Satl Hartzbt Soli fixture Soil Color: 5011 Otiter Surface(it.) (U�ifjA) (Mansell)' Mgttiing (Straoture,Sl nes,Boulders 1 <.:. C 1111 UftB ten r /' �l`r CJ l i �04 R ! ' I.I 1 I.� i '. -�— J i i� 11, his 05 Q Q ,till 7m;pt, ::�, ' m Vag i l tanI F r -� ' ' i� f I'IotJII,Li urnttce It t. 1V1au: i /lbovc 500 year flo �tbutt�gry ;fro;' I „ Yes f . w i I s :, Witldn500yearltoitnd'fy No' li Yes i� jr60 rR r<, urn 2e��e cor�eS u l=d�S{�S ?3(1�' f/— Goc 01-( Pa�Ce ,h ✓ztoa �(m� chid i Wilbur tbU year b .ildo�l titiifdar� No,I ' " Yesz. �j t?: e/ Iiii .11 t Dull><otNaturully O;L�c�ul `I ervl+o Mii6ir Does at least four feet T, a utftlly occ[)` tag pervious ina(eria dMA ui all atet- oU"e. v. l dtrnughout q{:L area ro osed fo'r[(ie sol� ,tar lion s tem'1 �` P p yi - If.not,what ts;rite depl�t o t altirally bccumnj pervious maloYlal . i_. r r r yMiAly i Gei ti�icatiou I Z . . I cet ttfy that on ` 7 (date),[have passed the soil:evaluator examination approved by th1.e i Department of En N.tronmentat Protectlof�ano:14,t the above analysts teas perforated 'y the conslstetI with lie required tr��bltun oXperltse`and expi'ttence descrtie't�ed in Il.0 P.CMIt 15 ,j k , 'd I j r J / Stgnatttre Date F 0... - - Atolls yin - Q 1RErriC�E'6RCm a, - roof below deck bath v-- z � o g game rroo o pen FZ � below 524 Wlanno 5chematic Third Floor Plan roof below r\Lbelow porch bedroom 2 porch ❑ open to hvmg below _ stair up to 3 ❑ ❑ U bath E::J and open open to entry it ❑ bath ❑ ❑ roo below bedroom 3 Bedr" oomll _ 524 Wlanno 5chematic Second Floor Plan I" = 8' 8/18/14 dining pool kitchen hmng entry hall ❑ ❑ hall — q N I stay u cl O study y down bath entry � O Master-Bedroom - t o u t h se Garage r�n S air cown guest Path :bed room rg:u_e5t- �bedro-6m 524 Wanno Schematic Carriage House 2nd Floor l ,* __ I L 0 CATION SEWAGE PERMIT NO. VILLAGE INSTA ., LE 'S NAME A ADDRESS D UIL0ER OR OWNER - ��ca.•UCH" � - +� _�,. DATE PERMIT ISSUEDy � � (, DA E COMPLIANCE ISSUED_T ,� / fA �s I I u EAD THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH �u. .... o ��AG ,-►,..R "C ,> ............................... ApplirFation for Biipusal Works C omitrudinn ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at, l, / Location-Address -•-----•-• _- •-••••- --•---•-•-•-or-Lot No. .... Owne Address ................., -:o-......, --........--•--.----......... .................................................................................................. Installer Address Type of Building Size Lot.....U2._ 4T,.. �-, Dwelling—No. of Bedrooms.___.___.............................Expansion Attic (L,� Garbage Grinder 5 aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ------------------------------------------------------....-------------------------------------------------•-•----.......------------.._..........---- W Design Flow.....6 .-T5•QX............gallons per person per day. Total daily flow..... ......................gallons. � WSeptic Tank—Liquid capacityJ51CQallons Length-lO-I—a-_. Width.__-. , .. Diameter^______ Depth. _ _-- x Disposal Trench—No. .................... Width...........:........ Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.___._�_______. Diameter.__._. __- De th below inlet.......I&....... Total leaching area..................sq. ft. z Other Distribution box Dos• tank ( _ aPercolation Test Results Performed by ��-4-t_V.��._ _._l!�1�Y ..._.. Date t�l.,a_:� _ ..... a Test Pit No. L./__'.Z_....minutes per inch Depth of Test Pit----- .......... Depth to ground water.l o�fi3-�t.oes�,` 4i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth'to ground water........................ a -- .................. f Description of Soil... --- �.. x W ------------------------- ---------------------------------------------------------------------------------------------------------------------- ..................................................... 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 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 issued the b rd h lth%/ Signed .._ _._ .... - 1 61 Date ApplicationApproved By.................................................................................................. Date Application Disapproved for the following reasons---------------•------------------------------------------------------------------------------------------...•--- ....--•--------------------------------------------------------••---------------••--•.._......----------•--------------------------------------....-----------------------------------•--=-----•-••-••-- Date Permit No......�� Z____-__--�_.__._---- Issued....................................................... Date No.--C.--- ---------: F:m .............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1... � ------....o (,,.. ............•---•-.........--•-- Applirattion for Disposal Works Tonstrurtion Permit Application is hereby made for a. Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .... _.........• --.......... ......................................... •-•-----•-------•••---..............•----•---•••-•---••----•--•-•----..._.....................---- ' Location-Address or Lot No. a Ow� Address ... ........... ........... .......:---`--•---•--�.............................. ............ .....--�........................... Installer Address Q Type of Building Size Lot..... -Sq~-feet• U Dwelling—No. of Bedrooms....................................Expansion Attic (1 )�? Garbage Grinder `(�C Other—Type of Buildin No. of persons............................ Showers Ga YP g -------------•-•-----------• P ( ) — Cafeteria ( ) dOther fixtures ............................ . W Design Flow...._c?:...�.... .�.............__gallons per person per dAy. Total daily Qow__-_- ?:.:. .....................gw1ons.�r WSeptic Tank—Liquid capacity.�.�allons Length.P��-.�... Width._ .`.mob... Diameter_""'"__."""' Depth.,_."4.. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No------�_�.r_.......... Diameter......6........ Depth below inlet.......r�._..... Total leaching area..................sq. ft. Z Other Distribution box Dos tank (W.)j�" t Percolation Test Results Performed by...__c crc �_ �....�... >4 `f' .. A_� ....... Dater #� Z!_ Test Pit No. 1.. :...minutes per inch Depth of "Test Pit.......t.......... Depth to ground lz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Q+' :.........-•---------------------•-•----------•---•-------••-------------•..� a............ D Description of Soil--- { _.car-^Mw.� .... �u� 1 �_ i 1 i'�"-- G.0 x W UNature 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 TITTIS 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issu d y he bo dp1jielth. Signed--_...� ..... ....••-- Date Application Approved By---•---•--•••-•••-•--•-•••--•--••-•....-•---------•--•--•. Date Application Disapproved for the following reasons----------------------------•---•-----------------------•---•----------------•--•------------•••-•-------•--•---- ---------------------•-------•-----•-••-•----•--------------.....----------------•---....-----------------••----•-----•.....•----••------•--•-------••••---•---•----•--------••-------•----•-••--------- " ,� / 2 Date Permit No.......Z1�.-, f � J Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ..tt...!�...r.- , ........O F.........1 .: .a�.-_ .t-'"_ Fes! ... ....... .......I.. ........... .......... .... . . ........... TFrtifirFate of Tomplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.......-•------• 3 ;1 == /�-=-•L ----.....•---'••--------••--•----•--••..........................•----•----•-•--•••-••-•-------••-••......•-•-....-•-------•-- Installer _ ----------p----------------- --..........................................................= .............................................................. has been,installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal'Works Construction Permit No...... Zn_r_.l_ ..`....... dated...... ._z.. c�' .._. . . . THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONStRIIED AS A GUj4ANTEE THAT THE SYSTEM WILL FUNCTIO ) S TISFACTORY. �� DATE................•............. 1.. --.. .........•-•-••...--•.._..•--• Inspector..................................................................................... THE COMMONWEALTH OF MASSACHUSETTS /BOARD OF HEALTH - ��....,�✓......OF................:�--`..r"�.................................................... .t .......................... FEE---- C/ Dispostal Works Tono#ra ion rrmi# Permission is hereby granted............ !� y XX --=� ---- -------�--------------------•-----------•---.- ..........................-........... .... to Construct ( ke)" or Repair ( ) an Individual Sewage Disposal System r- W , t.......- �... '-j'........ �'1� f i�r-rU t.,i-------,:,•-rj.................. J Street ff as shown on the application for Disposal Works Construction Permit �lL. Dated..... f ,� DATE........-----------••--- .................................................. Ord of Healt FORM 1255 HOBBS & WARREN. INC., PUBLISHERS Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 524 Wianno Ave Property Address Todd Bodell Owner Owner's Name information is required for every Osterville Ma. . 02668 8/9/2011 page. Cityrrown 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 on the computer, use only the tab 1. Inspector: key to move your cursor-do not Robert Paolini use the return Name of Inspector key. Robert Paolini Septic Service � ,Company Name 17 Playground Lane Company Address Yarmouthport Ma. 02675 CitylTown State Zip Code (508)362-3555 S14454 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: w .. ❑x Passes ❑ Conditionally Passes ❑ 1,,P6ils '.• , E ❑ Needs Further Evaluation by the Local Approving Authority 8/9/2011 _ Inspector's Signature Date W 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 r 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-11110 Title 5 Official Inspecdon Form:Subs r"c Sewage Disposal System-Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 524 Wianno Ave Pro a�Y Address P Todd Bodell Owner Owner's Name information is required for every Osterville Ma. 02668 8/9/2011 page. Cityrrown 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: ❑x 1 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: The septic system is in proper working order at the present time. 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 524 Wianno Ave Property Address Todd Bodell Owner Owner's Name information is required for every Osterville Ma. 02668 8/9/2011 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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): 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .` 524 Wianno Ave Property Address Todd Bodell Owner Owner's Name information is required for every Osterville Ma. 02668 8/9/2011 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 ❑ rx� Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ 0 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 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 524 Wianno Ave Property Address Todd Bodell Owner Owner's Name information is required for every Osterville Ma. 02668 8/9/2011 page. Cityf town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ n Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ n Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ 0 Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ 0 An portion of a cesspool or privy is within a Zone 1 of a public well. Y p P P vY ❑ 0 Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ N 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. ❑ R 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 ❑ 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 524 Wianno Ave Property Address Todd Bodell Owner Owner's Name information is required for every Osterville Ma. 02668 8/9/2011 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 ❑x ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ 0 Were any of the system components pumped out in the previous two weeks? ❑x ❑ Has the system received normal flows in the previous two week period? ❑ 0 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) ❑x ❑ Was the facility or dwelling inspected for signs of sewage back up? 0 ❑ Was the site inspected for signs of break out? ❑x ❑ 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? ❑X ❑ 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: ❑ O 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): 7 Number of bedrooms (actual): 7 ` DESIGN flow based on 310 CM 15.203 (for example: 110 gpd x#of bedrooms): 770 t5ins•11/10 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 524 Wianno Ave Property Address Todd Bodell Owner Owner's Name information is required for every Osterville Ma. 02668 8/9/2011 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ❑x No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ❑x No Laundry system inspected? 0 Yes ❑ No Seasonal use? ❑x Yes ❑ No Water meter readings, if available last 2 ears usage NA 9 ( Y 9 (gPd))� Detail: Sump pump? ❑ Yes N No Last date of occupancy: 8/9/2011 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): 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•11/10 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 M 524 Wianno Ave Property Address Todd Bodell Owner Owner's Name information is required for every Osterville Ma. 02668 8/9/2011 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Robert Paolini Septic Was system pumped as part of the inspection? ❑x Yes ❑ No If yes, volume pumped: 1500 gallons How was quantity pumped determined? Measured Reason for pumping: Maintenance Type of System: 0 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 I ❑ Tight tank. Attach a copy of the DEP approval. IIII ❑ Other(describe): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 524 Wianno Ave Property Address Todd Bodell Owner Owner's Name information is required for every Osterville Ma. 02668 8/9/2011 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: Were sewage odors detected when arriving at the site? ❑ Yes ❑x No Building Sewer(locate on site plan): Depth below grade: 2'feet Material of construction: ❑cast iron 0 40 PVC ❑ other(explain): 10'+ Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of Ieakage.System vented through the house vents. Septic Tank(locate on site plan): Depth below grade: 1411 feet Material of construction: Z 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 gallon Sludge depth: 7" t5ins•11/10 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 524 Wianno Ave Property Address Todd Bodell Owner Owner's Name information is required for every Osterville Ma. 02668 8/9/2011 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 25" Scum thickness 8" Distance from top of scum to top of outlet tee or baffle 3" Distance from bottom of scum to bottom of outlet tee or baffle 6" How were dimensions determined? Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pump tank every two years.Inlet and outlet tees are in place.No evidence of Ieakage.Tank appears structurally sound. Grease Trap(locate on site plan): Depth below grade: 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•11/10 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 ° 524 Wianno Ave Property Address Todd Bodell Owner Owner's Name information is required for every Osterville Ma. 02668 8/9/2011 page. City/Town State 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): 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.): M *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•11110 rifle 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts IVA Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 524 Wianno Ave Property Address Todd Bodell Owner Owner's Name information is required for every Osterville Ma. 02668 8/9/2011 page. Cityrrown 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 No 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.): Box is level.Box has two outlet laterals.No evidence of solids carryover.No evidence of leakage. 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.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: I t5ins•11110 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 M 524 Wianno Ave Properly Address Todd Bodell Owner Owner's Name information is required for every Osterville Ma. 02668 8/9/2011 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑x leaching pits number: 2 ❑ leaching chambers number: ❑ 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.): Sandy soil.No signs of hydraulic failure.Pit#1 water level was 4' below invert with a stain line 3' below.Pit#2 water level was 5' below invert with a stain line 2' below invert. 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 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 524 Wianno Ave Property Address Todd Bodell Owner Owner's Name information is required for every Osterville Ma. 02668 8/9/2011 page. Cityrrown 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.): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Map Page i of 2 Town of Barnstable Geographic Information System Parcel View Custom Map Abutters Map Size Zoom Out er In C�� ter,El T 33 - 7q6 �a vy "y s +L.fz 0 21 e Set Scale 1" _ 20 I Aerial Photos y ( MAP DISCLAIMER f—rinHt 7fV1F_7MA T—in of Rnrnafnhln PAA All rinht.roenrsi, http-//66.203.95.236/arcims/appgeoapp/map.aspx?propertyl D=163027&mapp... 8/11/2011 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 524 Wianno Ave Property Address Todd Bodell Owner Owner's Name information is required for every Osterville Ma. 02668 8/9/2011 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: Check Slope ❑x Surface water ❑ Check cellar ❑ Shallow wells Bottom of LP 6' Estimated depth to high 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 ❑ Observed site(abutting property/observation hole within 150 feet of SAS) 0 Checked with local Board of Health-explain: As-Built ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: USED:USGS Observation Well Data.USED:Technical Bulletin 92-0001 plate#2 annual ranges of groundwater elevations. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 524 Wianno Ave Property Address Todd Bodell Owner Owner's Name information is required for every Osterville Ma. 02668 8/9/2011 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist 0 Inspection Summary: A, B, C, D, or E checked 0 Inspection Summary D(System Failure Criteria Applicable to All Systems) completed 0 System Information—Estimated depth to high groundwater 0 Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file I t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 09/07/2011 09:52 FAX 508 888 6446 ENVIROTECH LABORATORIES 110001/0001 . ..... .......... . ENVIROTECH LABORATORIES,INC. MA CERT.NO.:M-MA 063 8 Jan Sebastian Drive Unit 12 Sandwich,MA 02563 (5 08)888-6460 1-8 00-339-6460 FAX(508)888-6446 Client Name Women's Workout Co. LOcatioh Hyannis,Ma Address 855 Aitucks lane Hyannis,MA 02601 Sample Date o9low l Collected By Client Sample Time NA Sample Type Swimming water Date Received o9tov11 Lab Order Number PS-11os59 1*Qcalltrn.Source: Dpte Colledtell: Time Collected Cortainrenr(s' Pool - Analysts Requested Units Recommended Limits Analysis Result Method IDateAnalyzedl Analyzed By Total Coliform 1100 ml 2 0 9222 B 9/1/2011 RL Standard Plate Count ll ml 200 NT 9215 B 9/1/2011 RL _..._...__......_._.........._........................................- _....._:..............--.... ... ... ..............-........... ......__._.. Pseudomonas Aeruginose 1100 ml 1 NT 9213 E 9/112011 RL ................................_....._............_. .,....._.. .. . Cnnrrrtatrtc: .. Yes-Water is suitable for swimming for p tsmeters tested. ............ -, ..I✓`�-- ,/r� ..- Q-,�. -._.._-._.. .......Date ..._.. /`..............._......_ Rona :Jflarl G Llaboralory Di eC - BRL=Below Reportable Untts Page 1 of 1 °See Attached 09/07/2011 09:54 FAX 508 888 6446 ENVIROTECH LABORATORIES a0001/0002 EAVIROTECHL.ABORATORlES,I?VC. JVA CERT.NO.:M-MA 063 8 Jim Sebastian Drive Unit 12 Sandwich,MA 02563 (508)888-6460 1-800-3 39-6460 FAX(508)888-6446 Client Name Hyannis Days Inn Location Hyannis,MA Address PC Box 1687 ' Hyannis MA 02601, Sample Date 09/01/11 Collected By Client Sample Time NA ` Sample Type Swimming water Date Received o9/o1/11 Lab Order Number PS-11o857 LocatiSource Date Collected: Time Collected Co%tirttents ':. A;. 911120ii NA IndotirPool::: Analysis Requested Units Recommended Limits Analysis Result-1- esult Method DateAaalyzed Analyzed By Total Coliform /100 ml 2 0 9222 B 9/1/2011 RS Standard Plate Count /1 ml 200 NT 9215 B 9/1/2011 RS .... Pseudomonas Aeruginosa /100 ml 1 NT 9213 E 9/1i2011 RS - LucatrortSuaree; 1)ule C'illt cltl Tlnae Cutlec7ed Crtni>rtertts 8'' 91112011 NA �. Gutddor Ppd;> ., Analysis Requested. Units Recommended Limits Analysis Result I Method jDateAnalyzedj Analyzed By Total Coliform /100 ml 2 0 9222 B 9/112011 RS _........ ......__.. .........-..... _.__._....._...--._..._..-.._..- -._.._...-..._...._...-_......_.._......_.._.....__........................... .. _........_... - - — Standard Plate Count /1 ml 200 NT 9215 B 9/1l2011 RS _......................................_. __......_... -- - --,.,.,.,,,,,,,..,.,.. .............................. Pseudomonas Aeruginosa /100 ml 1 NT 9213 E 9/1/2011 RS ..._............ -...............- - - ---................... .. ... .._..- - ................................_...--:.__.._.....-....._... ............_........:_.........:......_._..............._..- --- --_........_.._.........__.-._ Comments: II Yes-Water is suitable forswi mfrtg for parameters tested. `, Date Ronald J. aar, Laboratory Direlt r M BRL=Below Reportable Limits Page 1 of f °See Attached i 09/07/2011 09:55 FAX 508 888 6446 ENVIROTECH LABORATORIES a0002/0002 ENVIROTECH LABORA TORIES,INC. MA CERT.NO.:M-MA 063 8 Jan Sebastian Drive Unit 12 Sandwich,MA 02563 (508)888-6460 1-800-339-6460 FAX(508)888-6446 Client Alame Hyannis Days Inn Location Hyannis,MA Address PO Box 1e87 Hyannis MA 02601 Sample Date o9lov11 Collected By Client Sample Time NA Sample Type Swimming water Date Received o9/ol111 Lab Order Number PS-110857 Location',Source l?ule Collected' Tdme Collected.,., -, :: '; Con►nents .. Analysts Requested Units Recommended Limits Analysis Result-1- esult Method jDaale Analyzer Analyzed By Total Coliform 1100 ml 0 0 9222 B 9/1/2011 RS - -- - — - ._.............. _............. - - _......................__. ------- -.....-...- -._.......... Standard Plate Count 11 mi 200 NT 9215 B 9/112011 RS - _...._.......................- ...._.._...-.... ---................--...-.. _.__._._.........._.........-....-... ...._.._._....... - ..... Pseudomonas Aeruginose /100 mi 0 0 9213 E 9h12011 RS Comments: Yes-Water is suitable for swimming forparameters tested. Date Ronald J.y�ari Laboratofy irector BRL=Below Reportable Limits Page 1 of 1 *See Attached i - __ -----------------------------------. .......... .- - a I ,S I = o c� _ �b OVERLAY DISTRICT: i Area Summary(Lots Combined) \ \ / P Inr►e S / 8 AP—Aquifer Protectien DWHO 108,64OtSF-2.491AC Total(to mlw) a A �„e, _ 79,600.*SF- 1.83:kAC Upland �Effj�MAay r4 Xnd [■no u\ e /� �/ j ZONE: J•� .,�� Area(min. 87,120 SF Secondary Buffer Zone Calculations —\ \ \ .' - - / Edge Note-No Existing or Proposed Hordscope \ \_ ��\\\1- �-R / / / F tI.70State ' within Buffer Zones to Primary Resources. �r _ - - Exiat(ng Proposed Mitigation Required - \ \ \ ` / Rea 15' j Building=0 SF Building= 0. a \\\ . >�__' /'� N FLOOD ZONE: Pool 0 SF Pod=615 SF - \-\\ \/ �\ � mrs'� -.-=T / Zones VElELf3),s x " Number Patio=0 SF Patio=855 SF a �\ / Total-0 SF rotot=.1,470 SF (1,470 SF)X 4 5,880 SF Il \ \ =`� ,� % \. ���` --- - #25WIconul Location Map: ggg \ \ ._/ h July 1&2014 50-100, 50-100' Buiding= 1.060 SF. Building= 3,070 SF / ---_ - ' - Pool=o Poe=345 SF °"■D a / \ Y/ ` L ASSESSORS REF-: Patio= 775 SF Patio=890 SF l i i \ \ .• DIRECTIONS: Total= 1,835 SF Total=4.305 SF (4,305 SF- 1,835 SF)X 3= ,o1Ei0 S� �q.w N�16J.Parcels 27 1 1 \\ f 1 / ( , / J \ / i F Hyonnb-F -Yob,Street to.the - - Total Required= 13,290 SF' aa I I 7 - ' e�,P�DD—* west End Rotors and tlen take Scudder- , Total.Provided= 41.550 SF(S�e Reaforafion Plan' / / / Ave.;At the et1p epn take a rfght onto ppp �111 �y \\ I I/1 / \� r oe.a®empme®NoaPo 9n/th Stroet ehkA merges with 6dg,91e —eis—se— Beady React At the stop Ilgl,t take left \`.�/ wp po�yygyy anto Mal,S&s@4 ehkh bane lAto South gyre✓ O ;\ \ \ I Mo Take a left onto Meet Bar Road,and . / b;TANK SIZE - tlren a left onto Monno Avenue:Site b the left,1524. Or LEA01ING AREA rm G a\ \ •Q g�--`\ ♦ Y� �I.EACIEJ(}CHAAGM DESIGN 1£ACHINC i p' Bm'�etw.medwa=m.. MAMBO �dddfff tt1155 4� i �� — 1� Me Elb4ra aaWm C Y—s, CROSS SECTION OF CHAMBER NOT TO 3f.41.E �AalAt'r�w'a w°iwt°°'ia a � E ra— s Nee a Ms,) ; a,aaa a e� a. a raa keamm r.eaww g E m ®sq- mvabek-3fnaAe4�- � •mrMb -�� 'i'. OSL /// E�" � 'fie �• a,N.,m.a -lf�as� DEVELOPED PROFILE OF SYSTEM NOT TO SCALE F - a_ /' / 12m 2.Claigmtim,DV/G.t2 Addem¢to mda,611wv"Me Gmenl Cmvmm b,e•omTk PERC TEST:14,392 Ta ae mea®um ma l,wimm or.0 arr'roaar,ramra rmmauaammc pro�,waae. mdobsbebroa me era Nuu mw eYaoe,'BTv aroma aroma me mium.me cm,m, +� 4 /�/ v SE�C NOTES mrrw.wAe�u,anneemr - sr:auuaaoNurm-ewrvANm+m�a+o m^e^'.m+m,ke uom eDDu®bk.aemmomnm ore:gm mawmyrv�=vss awi to .. afLLaVM.WIaaM DJta- VrMV,e Gmael Convecw'a Dlumaivg mbmWn[lnr." . /�� it r`i 9/ ^ ,�b�xW6>daen'�•>�eroro - won®m:DmLvnWIAtlAm.ee—a— - + �> / / e 3Asaaa[b komm�mawrtq�P®mns T.w j \,� / �' �' 3wr.wewe,rwrt>m.wvewetavae,mro`° - 7EST HOLE I ,u TEST HOLE 2 TEST HOLE 3 TEST HOLE 4 W I. ' i ®rm.mrta..tmP�re.we•mrwa:r.aae. a awawra . • Q .. d r .-tA�w+ mo�w.ntsamrc�wb - .. .... U - a�N,ww,aovaew�.we•me.bA®+m. :; tAAM .-w:ie +nave rear \ vemon,m.,Aoanoo•,aan .... \ \ aA�rt9'daewbtbeewlb.U�m . r S AOYmsBreanmPosmlke -a 4■ltlg■atMMMR: YBNAkrsaffiWN i'M1dVMgaYalNf........ 4rell[t'tlft1ttl610N' fpAllYMd Uk ,MMY tlkE4 . hwMYgaNa 4GAMY W� — �� auvarmrnw a�z� , bwaw Akw rob web, .�aa� ,®, m LEGEND: � �'/ '� }9,E arsawtuT�,vW08n.P8m,mlr,meWammAvrmL a•. ,� ,Ar O LWsort \�� aoawerAneemvkm. reerw.ersdrk r®csAre.rema�war.s�'nu r�cawre�mw+eiTAc�orr WW • iM tAereybbam.nPvc PA,PY■LaWn DMds■snw 6A,BT01nwn AIa 40tow I�/ O C^T NlOmt Apauamww.,a.r®,eemalme.rtrx•.ee.e0s� 1 f=.eMm- W.eam D1®.eMmRMs LLCC.... ® New® � ,0. 9almem,mas&pblY4bW� -- 11..1 e SrfE PASSED e'aa N. O Norsawae,JyeCpmakMTm8h.0 a.ma o jD4 e• _ vmra®wry are.e.eau>am.rea.omraa,•m: F- Z ■. Setoff m..men�.�r..�a�rme Yw a®maes W Z raDva ' •• eabwti O agbrt e(nand) t wSQNq: Inn Leaehtl,o n dbnon 4. O (ros e B ml, Q 11 4 Z. —�Iw—o tlka NORM. - ter W'e gdb,gs added PREPARED FOR: PREPARED BY' nn.E --�--a.wam aenma 2B/1(AY/13—AWt Site Plan a 2J/JUL/14—Change Datum to NA VD IBBB I.)the P ore ty ll,e k fe motion mown eaa Ci Sury Proposed Improvements r- LU —PP kam awgode ncard l,fe sew. Charon Realty Trust Sullivan" N LO 54 Grey Cliff Road uva11 Dace -, 23 Meet Bay Rd,Suite D /fit g = � 1 r {� owwwr see 2)The topog Dan atMn.m meag ed Newton MA 02459 ..■ �; Date role NA°2655 524 Wtanno Ave Cu� M1Th an on ae a auney see dbt-bl on (90e)sn-�a/AfA 026m j a beteeen 12/MAR/iJ and T3/APRA tt ^"•T 1)The loft used m d Is NAVD'B&a fled mean sp 0 i to sa ap - ,7fl W ' �-RRL , DATE Barnstable,(o-tervills)Mass. ` a.a bee 3zo3o Job i tC-8001 September30,2014 SCA'E1 7=30' u . 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L________________________ _----_ --____ - IC'-T SS'-1 11/Y I KI <) x I D -t 5'O) GPv LA Ae i7 i es5,7 x C)� 40 SZZ,V.�j 77 wt A 71� r),vl 4 30 —1AKAK, 50 -meF- 73 JZ) 2 17r>" 5s GD 1�1� �Z l4k JA� �CbttWw Edge of Salt Marsh as / Flagged by Brad Hall / •• • ,, , April 24, 2013 OVERLAY DISTRICT: Area SummaryLots Combined \ ( ) ■ / �5 AP - Aquifer Protection District OnMFEMAnMa Lines 108,640±SF - 2.49±AC Total (to mlw) PPinney�'s a ' - 79,600±SF - 1.83±AC Upland Effective Date July 16, 2014 R _ / 62 1 ZONE. ESM 10 x, x \ 1 \ Qe/ RF-1 (RPOD) w 4. de 60 Area (min.) 87,120 SF ..� ) \ ��, `� ✓ Frontage (min) 20' Secondar Buffer Zone Calculations _ s \� Edge of',altmorsh J g , ESM / Width (min) 125 ?; r \ ~ / Setbacks: {' a Note No Existing or Proposed Hardscope \` \ / Fron t 30 within Buffer Zones to Primary Resources. Side 15• ra "I � , SM8 - • - / Rear 15 • � � F Existing Proposed Mitigation Required .; \� . �� i /'� �, \ �,� ,. FLOOD ZONE: Building - 0 SF Building - 0 SF '� \ •• ., ,� _� ;� �,� , , � _ .� . . _. -- ---- - `�.-- Pool = 0 SF Pool = 615 SF �• �, / ESM \._ _..__ �-- Patio = 0 SF Patio = 855 SF � e \ �` \ � - _ � \ �- � `� ~ `� �.-. � Zones AE(EL12), VE(EL15), & X �, '� �'• -'� \ \ Mop Number Total = 0 SF Total = 1,470 SF (1,470 SF) X 4 = 5,880 SF o l \ , �� \� / < .E,SM5 #25001 co776J Location Man. 00 July 6 2 = t 00 1 2 000 50-100 50-100 #510 ` \ 1 _ Building - 1,060 SF Building = 3,070 SF 2 Sty w/f i `: Pool = 0 SF Pool = 345 SF Dwelling \ / 1 , Q Patio = 775 SF Patio = 890 SF ,� ti °� i i ; / ASSESSORS REF.: Total = 1,835 SF Total = 4,305 SF (4,305 SF - 1,835 SF) X 3 = S `l'�,�oyo ;`'•, a.b i 1 • •;j••... , DIRECTIONS: Map 163, Parcels 27 ��0 ,�o`Yo� � ;r ..,« \' \ESM3 .� Lawn From H annrs Follow Main Street to the Total Required = 13,290 SF -_, qb o C! o � DESIGN DATA q _ \ �G`�F. <9,9 '•sFo !v° / ` Single Family Dwelling, West End Rotary, and then take Scudder Total Provided 41,550 SF (S*e Restoration Plan h s9 �F, I' p @ Ave., At the stop sign take a right onto \ di O / / 10 Bedrooms Proposed 110 GPD �, fy • 'f3f / % �•�''•,ti• > Smith Street which merges with Croigville ✓s,' �j, / , '••.,. /ff TotatDailyFtow=llooGPD Beach Road; At the stop light take a left �✓��� , \ �� f I i l r ` With No Garbage Grinder onto Main Street, which turns into South Je�\e�c 15.7' Main; Take a left onto West Bay Road, and x Flag F ? !`�/ 1 TANK SIZE then a left onto Wianno Avenue; Site is on Pole\ / First Tank the left, #524. Garden 1100 GPD x 200%=2,200 Gal ___ \ r_: Use a 2,500 Gal H-20 Tank Q 2 Sty w/f Second Tank Dwelling 0,9 ✓ ;' t \ ' \ �� I]OO GPD x 100%=1,100 Gal TO BE DEMOj<I,SHED _ K�� .... _. ._..._ _.. j Use a 1,500 Gal H-20 Tank Finish Grade c do u ...m... _...... LEACHING AREA � �= == I Max ��� '- fir - = r 3 M __ � � -•,,,.,� 1100 GPD/0 74(LTAR) 1,487 SF Required 9" Min Compacted Fill Filter a �O _._ �i8.`�.�57 26"E lr Sidewall=2(12-10"+89)2'=407 SF _.. ,.. _ r sty w/f J ^�� "" Q CB/DH _ _. O ---'�... Bottom Area=(IT-10"x 89')=1,141 SF nd/Or Garage / a c' �� A � 6+Q 0 7Fnd �i��Os� Provided=1,548 SF (1145 gpd) 2„ 1/8" _ 1/2" O _ oA�o LEACHING CHAMBER DESIGN 3' Pea on 16 gg s, , Q Q 0 15 3/4" - 1 1/2" � O� All Pipes to be Schedule 40. Use LEACHING Double Washed -. _. �O,j, N/F 10-500 Gal.Leaching Chambers in a CHAMBER Stone -j Q i ✓� Douglas C Yearley 03 Revocable Trust IT-10"x 89'Double Washed Stone Field as Shown. �'y� '•., FpG'9,oAl Anne D Yearley & Douglas C Yearley Jr. Trs } Y ; - ►a�9 SFO CROSS SECTION OF CHAMBER Stone Sj .� l Drive SB/DM J SS, O ':' A� \ s - ..,. __� '6+0 ''•./ .,.�FQ AO O"1'�/' �'tn -1 Fnd 66' \ / r o G?00� \ r •. fr G/q Off, �Q,9 O,f, J NOT TO SCALE 4„ PVC Vent w/ Charcoal Filter 9,Q'T! I Field Adjust Final Vent Location To Be As Inconspicuous As Possible 1 r / y ✓�1/ �O \ \ r r Fnd F.F. EI. 18.25 See Note 6 (typ.) t Sty W/f, F.G. EL. 17.50 �h Garage l i , 0� / 00 R _ _ Provide r ✓ J�� \ 1 ?: Fs�c. `'a'• i� Cleonouts F.G. EL. 16.50 Flow Equilizers O~+ s Stone EL: 14.75 As Required , EL: 15.25 2,500 Gallon \ Cora a f� Drive EL. 14.25 9 ro � O I Installer to Confirm H-20 EL. SB/DH X� �, O DO O 'Ll`rFo j 1 Prior to Work Septic Tank 1,500 Gallon EL. 13.65 EL. 1 .17 -20 T� EL. 13.50 Top SB 2�1' NAVD , , d i sa �r� ! S�R�S �� Cyj�j_OSFO SSS• \ J Septic2Tank D-Bqx EL. p /D ,p,9 p /j /1� 5g i �!y �� G+E•,`O.oO`c'Qs OS'Q / -20 /� H O F i Leaching gToo SB/DH o, cB/DH I^ 'Q 1 o Be Installed On Chamber Fnd / t Fnd Stable Compacted ase Bot. EL. 10.50 %K/ Inspection Port, if Encounfered Remove & Replace & Baffels All Unsuitable Soils Within 5' of as Per Title 5 The Outer Perimeter of The System to Shed CBIDH 1 y. of Fnd °�\ Per Test Holee3 St Driveone , ���°J DEVELOPED PROFILE OF SYSTEM (b' NOT TO SCALE f / 20 PERC TEST: 14,392 / SEPTIC NOTES PERFORMED BY:CHARLES ROWLAND- SULLIVAN ENGINEERING 1.Location of Utilities Shown on This Plan Are Approx.At Least 72 Hours SOIL EVALUATOR NO.13,586 Prior to Any Excavation For This Project the Contractor Shall Make WITNESSED BY:DONALD DESMARAIS,RS-TOWN OF BARNSTABLE the Required Notification to Dig Safe(1-888-344-7233). JUNE 12,2014 2.The Contractor is Required to Secure Appropriate Permits From Town SB/DH nd / i O Agencies For Construction Defined by This Plan: N�l - 3.Wherever Sewer Lines Must Cross Water Supply Lines Both Lines Shall ti� pp y TEST HOLE - 1 EL. 16.8 TEST HOLE - 2 EL.16.8 TEST HOLE - 3 EL. 16.0 TEST HOLE -4 EL. 16.2 h 60� / Be Constructed of Class 150 Pressure Pipe and Shall be Water Tested to O/A LAYER O/A LAYER O/A LAYER O/A LAYER Assure Watertightness. In General,Water Lines Shall be Constructed in Coordination With COMM Water,and Shall be in Accordance With 248 CMR 1.00-7.00&310 CMR 15.00. 24" LOAM 14.8 22" LOAM 14.9 14" LOAM 14.8 ill, 15.3 LOAM \ 4.A Minimum of 9"of Cover is Required for All Components. B LAYER I OYR 5/6 B LAYER I OYR 5/6 B LAYER i OYR 5/6 B LAYER t OYR 5/6 ^~ h O 5.All Structures Buried Three Feet or More or Subject YELLOWISH BROWN YELLOWISH BROWN YELLOWISH BROWN YELLOWISH BROWN \ rw LOAMY SAND... I3.5 50" 11.8 48"LOAMY SAND LOAMY SAND .. 12.2 \ O to Vehicular Traffic to be H-20 Loading.It is the Engineer's 42" LOAMY SAND 13.3 40" \ \ ^"� Recommendation that H-20 Always be Used. CI LAYER 2.5Y 6/6 CI LAYER 2.5Y 6/6 Ct LAYER 2.5Y 6/6 C1 LAYER 2.5Y 6/6 \ of LEGEND. SSS• 0 Install Watertight Risers with 18"Max.Covers to Within 6"of Finished Grade OLIVE YELLOW OLIVE YELLOW OLIVE YELLOW OLIVE YELLOW MED.SAND MED.SAND MED.SAND MED.SAND \ f O6. ry �, Over Septic Tank Inlets,Outlets,D-Box,and 1 Leaching Chamber Total. \ % 101 42" PERC TEST 13.3 46" PERC TEST 12.2 F 7.Septic System to be Installed in Accordance With 310 CMR 15.00& 25 GALLONS GONE IN 3 MIN. 25 GALLONS GONE IN 6.5 MIN. 248 CMR 1.00-7.00 Latest Revision and the Town of Barnstable = ` Light t Post 90„ PERC RATE<2 MINAN TAR 0.74 ) 9.3 90" 9.3 74" PERC RATE c2 MIN/IN(LTAR=0.74) 9.8 84" 9.2 g \ Board of Health Regulations. -�y OF�� ® Drain ♦ C2 LAYER 2.5Y 7/3 C2 LAYER 2.5Y 7/3 C2 LAYER 2.5Y 7/3 C2 LAYER 2.5Y 7/3 p\ A,gs 8.All Piping to be Sch.40 PVC. , ��' 9c PALE YELLOW PALE YELLOW PALE YELLOW PALE YELLOW r 9.D-Box Shall Have a Minimum Inside Dimension of 12",and a Minimum � JOH _ n Hydrant / Sum of " 126" MED.SAND 6.3 126" MED.SAND 6.3 126" MED.SAND 5.5 126" MED:SAND 5.7 p NO GROUNDWATER ENCOUNTERED NO GROUNDWATER ENCOUNTERED NO GROUNDWATER ENCOUNTERED NO GROUNDWATER ENCOUNTERED Hose Bib 10.The Separation Distance Between the Septic Tank Inlets and 48168 ® Iron Pipe �� Outlets Shall be No Less than the Liquid Depth.Inlet Tees Shall Extend 0 °R6' a Minimum of 10"Below the Flow Line.Outlet Tees Shall Extend 24"for SITE PASSED * CB/DH the 2,500 Gallon Tank and 14"for the 1,500 Gallon Tank SS/ONAL 0 SB/DH Below the Flow Line,and Shall be Equipped With Gas Baffles. -� Utility Pole Wetland Flag REVISION: Size Leaching basins,. draw in dimensions to 411/15 OW water Gate (round) REVISION: Add Septic Design & Pool Infinity Edge 1129115 © Gas Gate (round) REVISION: Incorporate, Con Com Comments 11/04/14 OHW- Overhead Wires NOTES: 281MAY113 - Abutter's buildings added. PREPARED FOR: PREPARED BY: TITLE:- -25- - Elevation Contour 231JUL114 - Change Datum to NAVD 1988. Site Plan 5 Cedar Tree 1.) The property lineinformation shown was . - _ Ca eSury Proposed Improvements,: 4 compiled from available record information. Chort►n Realty Trust Englnecring& p ss �s 54 Grey Cliff Rood Sullivan Consulting,Inc 23 West Bay Rd, Suite G A o ^sic 2.) The topographic information was obtained Osterville MA 02655 1"► Deciduous Tree from an on the round survey performed on Newton MA 02459 t � r.cros 524 Wianno Ave g y p (508) 420-3994 / 420-3995fax or between 12/MAR113 and 23/APR/13. Coniferous Tree 3.) The .datum used is NA VD '88, a fixed mean Draft: JOD Review: RRL Barnstable, (Osterville) Mass. w 30 0 15 30 60 120 sea level datum. I I Review: PS Job #: C-8001 DATE: September 30, 2014 � rr=30, � SCALE- Project: 32030 Field: WHK/MJD