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2950 FALMOUTH ROAD/RTE 28 - Health
2950 Falmoutha 122-002 Marstons Mills Town of Barnstable P# Departiment of Regulatory Services Public Health.DivisionMASS, Date /0 to 3�9.F. 200 Main Street,Hyannis MA 02601 Date Scheduled /lJ✓// iJ Time U(//l FeePd. ��� SOU S uitabilio Assessment f or S e .Disposal Performed-By: Witnessed By: LOCATION& GENERAL INFORMATION Location Address �9So f0jM0 V9 q Owner's Name / -( //� M.I " Address Assessor's Map/Parcel: /2-2•/ 2- Engineer's Namc �0 vJ vt NEW CONSTRUCTION REPAIR Telephone# ()P� 366 _— land Use: P(A r k i n C/— . . Slopes(96) � Surface Stones /'A/Gh� Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line ft Other ft SIMTCH:(Street name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands.In proximity to holes) i O Parent material(geologic) Pro 0 /I Depth to Bedrock Depth to Groundwater. Standing Water in Hole„ A/ Weeping from Pit Fnee /V/T Estimated Seasonal High Groundwater- DETEERMINATION FOR SEASONAL I3lOH WATER TABLEMethod Used: Depth Observed standing in obs.hole: In, Depth to soil inottles: ln, Depth to weeping from side of obs.hole: In, Groundwater Adjugiment ft. Index Well# Reading Date: Index Well lryel _ Adj,factor— Adj.Groundwater Level Observation JPERCOLATI.ON T +'ST Date Thus___ Hole# Thne at 9" Depth of Pere g Time at 6" Start Pre-soak Time @ Time(9"G") End Pre-soak Rate Min.Anch L Site Suitability Assessment: Site Passed Sitq Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back---------- ***I£percolation test is to be conducted within 100' of wetland,you must first notify the ! Barnstable Conservation Division at least one(1) week prior to beginning. Q:IS EPTIC\PERCFORM.D OC DEEP.OBSERVATION HOLE LOG Hole# I Depth from Soil Horizon Soil Texture Sdil Color Soil- Other Surface(in.) (USDA) (Munsell) Mottling (Structure, Stones;Boulders, L)TISiStCP17y,y2'Gravel) 10(o— a CC /ti& IOyR DEEP OBSERVATION HOLE LOG Hole# Z Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling - g (Structure,Stones,Boulders. - CoLigistrnov,'%Gravel) 'M/CS 10 YA P/y DEEP OBSERVATION HOLE LOG Hole#. Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Grilvell i v ` DEEP OBSERVATION HOLE LOG Role# L Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones',Boulders. Co si tan y Flood Insurance Rate Map; A/ Above 500 year flood boundary No— Yes " Within 500 year boundary No Yes Within 100 year flood boundary No. Yes Y rY � ....� Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas obstrved throughout the area proposed for the soil absorption system? y e S If not, what is the depth of naturally occurring pervious matarlal? Certification I certify that on S// Z (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise and experience described in�10 CMR 15.017. Signature �— �i�-z-..��` ' Date Q:1S.EPT1aPERCF0RM.D0C TOWN OF BARNSTABLE aE71 a - 3 S`7 LOCATION qq 50 "�, h QA SEWAGE# VILLAGE M14(� M.IJS ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. 13 Ch_u K Ca SEPTIC TANK CAPACITY �{ ,poo -t- L oc� 1 oGCS 6— LEACHING FACILITY:(type` r6'J5C�dca+. D%tze"' V `� NO.OF BEDROOMS "/ . OWNER PERMIT DATE: 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 Cr J.fr . 4,OdO 0' O S-t GT h P a-�OpV S eP- i i A A I 3454199 1.0 �1 v as A, 43 tax k 102 28'S V 15 fiA D log 33 93'5%'5 qo a �� Jy Y u Ue )-tQ- S4f. I om W,f aq, S Or O Olt t No. O� � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS= ftplitation for Misposal 6pstem Construction Vermit Application for a Permit to Construct( ) Repair(v6pgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 3.9 50 0JWIOu3� 1W ra 41Owner's Name,Address and Tel. 60A1 Le Assessor's Map/Parcel La 1 nk V tt t lG M& O y6° Of3 37 Z In�s,stal er's Dame Address,and T No. 5p8 4S 3 -o 5l$o D igner's Name,Address,�nd Tel.No. 50 to ur Ou-, Co mic own Cade frn Int,�vcv' L 361�4 i ;4 6rcak Wcsicyn 144 IA"w.49 ftvdr0),&4 t Ma,n S+' e+nowl�F1 ova ry►A Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building � r� No.of Persons Vj"o 5.t Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided ,q 4 gpd Plan Date 16 ( i t, Number of sheets I Revision Date i c, B 1�- Title �6+IC— T &-e7 a tr S, ( � Size of Septic Tank `t00L)� ?7c>00 Type of S.A.S. �D COA' COW'), of, R)D u0 n 14,& 1* Description of Soil Nature of Repairs or Alterations(Answer when applicable) 000 h-ew (CA-" a.K ' c�.vutt� � 0 r." 930c�((,n rows �Z' 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 gne � Date I Application Approved by Date Application Disapproved by Date for the following reasons Permit No. f 3 Date Issued �-- fee 6 Z uter: Et�,�, iri cor� THE COMMONWEALTH OF MASSACHUSETTS 'I I--yes PUBLIC HEALTH DIVISION s-JOWN OF BARNSTABLE, MASSACHUSETTS application for Disgoia- 1 6pstrut Construction Permit Application for a Permit to Construct( Repair(Upgrade( Abandon( ) D Complete System El lndividual-Ctaffpo_nents Location Address or Lot No. JL9 50 L0 h Rol i r Owner's Name,Address,and Tel.No. LC A Y-Y)4 0:) c � ��-7 3 7 Assessors Map/Parcel A,:L y Installer's Name,Address,and Tel.No. 4 2, Designer's Name,Address,and Tel.No. T�c (7/e F 4 vsj, Lvc, to(u,I KI 4 n-)4 c)Wd' q r, n ic_ 1 4 rr)11 Type of Building: 4 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) 1/, gpd Design flow provided gpd Plan Date (6 Number of sheets 1 Revision Date Title- Size of Septic Tank [)GU Type of S.A.S. e,c,c r(,,c7 ha"kevic, Description of Soil 4, 6j J Nature of Repairs or Alterations(Answer when applicable) Y�_e� G& g, Date last inspected: Agreement: The undersigned agreo 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. Date I Application Approved by Date I Application Disapproved by Date for the following*reasons Permit No. Date Issued -----------------------------------------------------Nl�---------------I------------------------------------------------------------------ 1t47311;7- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed Repaired(/ Upgraded( Abandoned by Eo b,-44 f5 6( * Lo at �(i 50 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.!k I a— 35 dated Installer jll[ Designer yu rnt cw-QLe I 1_4,! 14 lez I I 9(ttr t design-how #bedrooms Approved des gpd �ip The issuance of this permit shall t b t d as a guarantee that the system w Lc ion as de Date no e 7ns rue Inspector ) \ A I ;> ----------------------------------------------------------------------------------------------------------------------------- --------- No. �Ao s Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstrm Construction Permit Permission is hereby granted to Construct Repair Upgrade Abandon System located at �B so; rnr,,Z,_.4 E� e�)9;�41 rg4L - 11 1 1 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. Provided:Construction must be completed within three years of the date of this permit. Date Approved by��S�L V I I I 5 ' i • r I I i I i � I j TRANS. NO.: z CITY/TORN: ZWMI�` a+ti/� I APPLICANT: i ADDRESS: DESIGN FLOW: gpd REVIEWED BY: DATE: ry �}� ¢IN/A OK,,,,, NO "'DEN, s .,. Legal boundaries denoted[310 CMR 15.220(4)(a)] Street, Lot, tax parcel number and lot number noted on plan [310 CMR 15.220(4)(u)] Locus Provided [310 CMR 15.2204(t)] Plan proper scale? (1"=40' for plot plans, 1"=20' or fewer for components) [310 CMR 15.220(4)] Easements shown 310 CMR 15.220 4 System located totally on lot served[310 CMR 15.405(1)(a) for i upgrades]- if not, a variance is required [310 CMR 15.412(4)] j I Location of impervious surfaces (driveways,parking areas etc.) [310 CMR 15.220(4)(d)] Location all buildings existing and proposed 310 CMR 15.220(4)(c)] I Location and dimensions of system components and reserve aras. [310 CMR 15.220(4)(e)] System Calculations [310 CMR 15.220(4)(f)] °` ° daily flow j septic tank capacity(required and provided) soil absorption system(required and provided) ` whether system designed for garbage grinder , North arrow [310 CMR 15.220(4)(g)] '` Existing and proposed contours [310 CMR 15220(4)(g)] � Location and log of deep observation holes (existing grade el. on i each test) [310 CMR 15.220(4)(11)] V. hare. Names of soil evaluator and BOH representative [310 CMR 15.220(4)(h) and (i)] Location and date of percolation tests (performed at proper elevation?) [310 CMR 15.220(4)(i)] Percolation test results match loading rate? [310 CMR 15.242] 04- i Certification statement by Soil Evaluator [310 CMR 15,220(4)0)] Observed and Adjusted groundwater (method for adjustment / w/ � given or indicated) [310 CMR 15.103(3) and 310 CMR VVV -- 15.220(4)(n)] i ZQ1�o i 2� Address Sheet 1 of 7 f i i N/A ® NO j Location of every water supply,public and private, [310 CMR I 15220(4)(k)] within 400 feet of the proposed system location m the case 71 of surface water supplies and gravel packed public water supply within 250 feet of the proposed system location in the case within 150 feet of the proposed system location in the case { of private water supply wells 1 Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed in 310 CMR 15.211 and any catch basins located within 50 ft. [310 CMR 15.220(4)(1)] i Water lines and other subsurface utilities located[310 CMR 15.220(4)(m)] (if water line cross see 310 CMR 15.211(1)[1]) Profile of system showing invert elevations of all system components and the bottom of the SAS [310 CMR15.220(4)(o)] Stamp of designer [310 CMR 15.220(1) and 310 CMR 15.220(2)] Stamp of Registered Land Surveyor(required if construction activities within 5 ft. of lot line) [310 CMR 15.220(3)] Test Holes adequate (two in each of the primary and reserve unless trenches as permitted in 310 CMR 15.102(2) or as I li approved for an upgrade under LUA at 310 CMR 15.405(1)(k)] I � Test hole adequate to demonstrate four feet of suitable material? j [310 CMR 15.103(4)] ✓ /� j Test Holes adequate to confirm adequate groundwater separation? j j [310 CMR 15.103(3)] Benchmark within 50-75' of system [310 CMR 15.220(4)(q)] Materials specifications noted? [various sections of 310 CMR ,�J 15.000] System components not>36" deep (unless Local Upgrade Approval or LUA requested) [310 CMR 15.405(l(b)] i i i I I J I 1 I I I I I i i j Address Sheet 2 of 7 I i ' 1 i I i I I N/A ®K 1V0 lv4�s°�'� vIY���l�t�" ����y�� � �'' ��{�t� v 1 n ��uAw �� e a7u�rq Sa Yr r'7 F 1"'"'aS'i':• i i .. .,•t, . .a„F•e.. ,n,.'@:c...'� ."sTi`w"4 !" -.�t1 e4" n�u, `',hx x .•''�i+C`-v�!i'�trmr� ''"' 'aPC F �,c;t'tiar S y;:5rr:: ,�. Size OK? [310 CMR 15.223(1)] j Inlet tee located ten inches below flow line [310 CMR 15.227(6)] j Outlet tee 14" or 14" + 5" per foot for increase ft depth[310 CMR I 15.227(6)] . I Outlet tee with gas baffle or approved filter [310 CMR 15.227(4)] I Not regarding installation on stable compacted base [310 CMR 15.228(1)] a j Separation between u11et and outlet tees(no less than liquid j depth) [310 CMR 15.227(2)] Inlet/Outlet elevations at least 12" above high groundwater j i (except as described 310 CMR 15.227(5)) or permitted for i upgrades under LUA[310 CMR 15.405(1)(k)] Minimum cover 9" (Tanks buried more than 9" must have risers on all openings and on the d-box) [310 CMR 15.2228(1) and 310 I CMR 15.232(3)(f)] I Three access covers (inlet and outlet must be 20" or greater) - middle access at least'8" (by 7/07) [310 CMR 15.228(2)] Access to within 6 " of grade - one port for systeins<1000gpd, two for systems>1000 gpd[310 CMR 15.228(2)] i All at-grade covers secured to unauthorized access? [310 CMR l 15.228(2)] i I > 10 ft fiom building foundation [310 CMR 15.211(1)] " Buoyancy calculation Required/Done [310 CMR 15.221(8)] I f j H-20 Where appropriate? [310 CMR 15.226(3)] i Setbacks from resources [310 CMR 15.211] I S'.n s �"Y"� s?A''��'Sf'14>ff'NXc•Stems 3'�L! 1. p 1 i 19uL� o7mrp,artanenTanit Required when other than single-family dwelling or flow>1000 j gpd [310 CMR 15.223(1)(b)] i First compartment 200% daily flow; Second compartment 100% / I v daily flow [310 CMR 15.224(2) and(3)] f "U"pipe through or ove-L baffle, outlet of each cornpart-ment with i gas baffle or approved filter [310 CMR 15.224(4)] I I I I S I i I I I i i i I I ' I I I. I _ I Address Sheet 3 of 7 j I . f i i I N/A OK NO i ldR.cit� 1 'FYYC"_3r5;3:v�.4z ..4i, �t'. Located at least ten feet from any water line? [310 CNM 15.222(2)] / Disposal piping at least 18"below water line(when water and sewer cross, see 310 CMR 15.211(1)[1]) Cleanouts required/provided? [310 CMR 15.222(8)] ✓ Thrust blocks specified in force mains? 310 CMR 15.221(6)(c)] Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable / [310 CMR 15.222(6)] Proper pitch on all runs? (.005 within gravity-distributed trenches and beds) [310 CNIR 15.251(9) and 310 CMR 15.252(2)(c)] Siphon problem/ (leachfield below pump chamber) i Endcaps or vent manifold specified? Size and orientation of discharge holes specified? (not smaller than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310 j CMR 15.252(2)(h)] i Materials specified (310 CMR 15.251(5) specifies various pipe I types allowed) ! Stable compacted base [310 CMR 15.221(2) and 310 CMR 15.232(2)(a)] Splash plate or baffle tee required on inlet/provided? (when pressure sewer to d-box or steep pitch of gravity sewer) [310 CMR 15.323(3)(a)] Riser if deeper than 9" [310 CMR 15.232(3)(f)] l Inside minimum dimension 12" [310 CMR 15.232(2)(b)] i Minimum:sump 6" [310 CMR15.232(3)(e)] i Watertight cover if<2000gpd); waterproof manhole if>2000gpd [310 CMR 15.232(3)(d)] art :a P�4, 1. AA Capacity(emergency storage above working--design ilow)? [310 CMR 231(2)] J j Proper setbacks [310 CMR 15.211 (same as septic tanks)] Watertight 20-in minium access manhole at least 20"MUST BE TO GRADE [310 CMM 15.231(5)] Service components accessible (not too deep with piping, I disconnects accessible) Alarm floats - alarm on circuit separate from pumps specified? f Exceeds two units must have two pumps operating in lead-lag mode. [310 CMR 15.231.(6) and(8)] i Stable Compacted Base [310 CMR 15.221(2)] ' Buoyancy calculations needed? Provided? [310 CMR 15.221(8)] I ' Address Sheet 4 of 7 I i I ' I I , I i lYh�BtSO 'T'• ISYS ?B+M � StiS �,4iFA } �rcr sir rn ] i .. ...•. _. _ ..( )!r J :1.�`.: �izS Calculations correct? 4 feet of naturally occurring material demonstrated? [310.CMR 15.240(1)] Required separation to groundwater? [310 CMR 15.212)] j Aggregate specified as double washed[310 CMR 15.247(2)] ✓ j System Venting required/provided? (system under driveway or / >36" deep) [310 CMR 15.2411 i Inspection parts specified and within 3"final grade? [310 CMR 15.240(13)] j Breakout requirements met? (No violation of breakout elevation I within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and Guidance Document] rALES;�IT� ziJ�+� 3�1:0C11Vi �553 Fr #` add,Y � Chambers and Gal, in trench configuration supplied with valet every20 ft. [310 CMR 15.253(6)] Each structure with one inspection manhole(if>2000 gpd must I be to grade) [310 CMR 15.253(2)] i i Aggregate I'minimum-4'maximum. [310 CMR 15.253(1)(b)] 2' sidewall credit maximum[310 CMR 15.253(1)(a)] In b�eldd configuration,inlet every 40 sq. ft. [310 CMR 15.253(6)] f Width 2'minimum 3'maximum [310 CMR 15.251(1)(b)] 100 feet-maximum length [310 CIA R 15.251(1)(a)] Minimum separation 2x effective depth or width whichever I j greater(3x if reserve between trenches) [310 CMR 251(1)(d)] Situated along contours [310 CMP. 15.251(2)] Breakout OK? [310 CMR 15.211(1)[4] and Guidance Document] �JSMS ( aianu �ofb�eelo� e1d5U00c1 "< minimum 2 distribution lines [310 CMR 15.252(2)(a)] Maximum separation between lines 6' [310 CM R15.252(2)(d)] ✓� Maxil-num separation between lines and outside of bed 4' [310 CMR 15.252(2)(e)] Aggregate depth below discharge pipes 6"minimum, 12" I maximum: [310 CMR 15.252(2)(g)] +� Separation between beds 10'minimum. [310 CMR 15.252(2)(f)] Bottom area used in calculations only[310 CMR 15.252(2)(i)] i I i I i I I i i i j Address Sheet 5 of 7 f I I I ! N/A ®K NO DID ' +LPAF1w7Y0I ' } "� b3`r1 �€'04 IN _` , Pressure Dosed Systein ? Provided pump and piping calculations as required [310 CMR 15.220(4)(r)] Pressure dosing required on all systems>2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and I/A Remedial Use Approvals] i If used in gravelless system-make sure jet is directed as not to scour soil interface [Guidance Document] i Inspections once per year(systems<2000 gpd) or quarterly (>2000gpd) good to note on plan [310 CMR 15.254(2)(d)] Construction in fill -Did the plan specify that the fill shall meet j the specification of 310 CMR.15.255(3)? Impervious barrier and/or retaining wall? [Guidance Document] Impervious barrier installation must be supervised by j designer [310 CMR 15.255(2)(b)] ✓ I Retaining wall must be designed by Registered Professional Engineer [310 CMR 15.255(2)(a)] Side slope not exceed 3:1 ? [310 CMR 15.255(2)] I` Breakout requirements met? [310 CMR 15.252(2) and ,( Guidance Document] / At least 5 ft. from impervious ban-ler to edge of SAS (10 ft. recommended) [310 CMR 15.255 (2)(e)] I Check DEP Approval letters for credits and design conditions If used with pressure dosing do not allow pressure discharge to scour soil interface w eW-0 5�e i S s'e�T1 A o a� e tees Was DEP Approval Letter provided and/or have you j reviewed the letter for conditions? r Is the technology being properly applied and does it meet all DEP Approval Conditions? Is there a note on the plan regarding the requirement for i perpetual maintenance agreement? Any alarms involved on separate circuits i Did the applicant submit an operation and maintenance manual? M Has applicant submitted a copy of a maintenance t rice •-� I Are the variances listed on the plan? [310 CMR 15.220 (4)(q)] l RLS Stamp necessary on plan if a component is within five ' feet of property line [310 CMR 15.412(4)] i New construction or increased flow proposed- [Refer to 310 CMR 15,414] i Address Sheet 6 of 7 I i i N/A ®K NO -' u� u� 'tu �4c �'r �2&�•.X ti �ne"� i,. 'Ytt ( S 77�.�a�)z7 k}rii�°rr 4 1Vitroge�� Is the system in a Designated Nitrogen Sensitive Area(Zone U for ' a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and / 310 CMR 15.216 - also refer to Policy regarding upgrades of such existing systems] i Is the system proposed on the same lot as served by private well ? [310 CMR 15.214(2)] i Are the nitrogen loads proposed in complianr? [310 CMR 15.216(1)] -F ow WIeS qv-, 'i Yt-� z� +. {! E ru �p�. ( 5�4�1!� ('rr SFr L ����yyL� �f'�wr h� *�,7� e htY"'�' � hn� ��{ �,-� l v-" tvy q y �• y i � 7Vlcscella�teores ;t�,�`,'„�K;r�tilFea�`��•�.'�`'��`u'�ad �kii'��`>T �9e �� �`��� ��,r� ,(�t R:� t �iX a . �-r �t,;f�)+'"b`„ ' +i;to'Z f,;�. Pumping to septic tank ? [ 310 CMR 15.229] Shared System [310 CMR 15.290] i i i i I i I i f I ` i i i I i i i i i i i i I i i i i i. i I 1 I i i Address Sheet 7 of 7 I i r l y Se;ndees (ry• 'n` �� T Povitsas F. G ei eT, a, Tj11`ec or BA STABLE. homes McKean, Director 200 Main Street,Hyannns,R1U 02601 Office: 505-962-4644 Fax: 509-790-6304 lnst2dUer L DL1R:gmer cCertffication For rn Date- Sewage 1permmiV4 2 �1� "Jc� � Assesser's mapTarrce, � Z r � D �L Designe': �6v)kie ! ✓ivy llnstc�lllle�e fo�leo,J Address- � mtlt Q fy, . Address- 0 On was issued a permit to install a (date) (installer)17 //,^,II septic system at 4— ro�Rnl� J U�� oared on a design drawn by (address) % Q,h el �`l-• A-1 Cam. Per AS dated (desib r) I certify that the septic system referenced above was installed substantially according to the design.; which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local regulations. plan revision or certified as-built by designer to follow. �ZN OF MAS DANIULA. o OJALA (Installer's Signature) CIVIL c No.46502 �0501�G/sTE��Oa``�/ �S'S/ONA 1 EI�G esigner's Sib ature) (fin Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PU LIC MEA.L'9 H DIVISION. CERTIFICATE OF a inie��x"LIATIC.E f L tdt�T €� 655� lJP�R'L BOTH 'THIS EOI�� AND �.S-BUILT C ARE RECEIVED D BY TBE BARNSTABLE PUBLIC HEALTH DrVISIION. THANK YOU f Q:=1ea1'th/Septic/Designer Certificatio- Fr,-,m 3-26-04.doc YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $40.00 for 4 years. A Business Certificate ONLY REGISTERS THE BUSINESS NAME in town (which you must do by M.G.L.- it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the.completed form to the Town Clerk's Office, 1st FL., 367 Main Street, Hyannis, MA 02601 (Town Hall)"and get the Business Certificate that is required by law. Fill in please: Date: I APPLICANT'S NAME: ~ � 4 Y YOUR HOME ADDRESS: _ G %�- BUSINESS TELEPHONE # HOME TELELPHONE #: s08 J/- 813� NAME OF CORPORATION: FID # NAME OF NEW BUSINESS CL &c. „i TYPE OF BUSINESS C IS THIS A HOME OCCUPATION? YES >1/1 NO �1 ADDRESS OF BUSINESS Td1- .1 6,1 J- MAP/PARCEL NUMBERZ yOZ(Assessing) >/l ( . . .. .. :. . . When starting a new business there are several things you must do to be in compliance with the rules and regulations of the Town of Barnstable. This form is to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature" COMMENTS: 2. BOARD OF HEALTH This individual has beFr 7ffo d of the permit requirements that pertain to this type of business. Authorized Signature" COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has 1--en iryfprrrVed of the licensing requirem nts t t perta'n to this type of business. Authorized Signature" McKean Thomas To: Locke Janet; Maloney Kathy Subject: SITE PLAN REVIEW 45-94/ 2946 Falmouth Road, Route 28 Marstons Mills I am in receipt of the site plan review application dated October 7, 1994 The site is located within a GP district; the applicant is therefore subject to the Town Ordinance, Regulation of Wastewater Discharge and to the Board of Health "330 Regulation ". The total daily flow is 935 gallons per day on a lot which is 1.017 acre. Therefore, the wastewater discharge flow already exceeds the maximum flow allowed by these regulations. The request to legalize the walk-in refrigerator and the "bottle cage"would require a Board of Health variance from the above described regulation. Page 1 McKean Thomas To: Locke Janet; Maloney Kathy Subject: SITE PLAN REVIEW 45-94/ 2946 Falmouth Road, Route 28 Marstons Mills I am in receipt of the site plan review application dated October 7, 1994 The site is located within a GP district;the applicant is therefore subject to the Town Ordinance, Regulation of j Wastewater Discharge and to the Board of Health "330 Regulation ". The total daily flow is 935 gallons per day on a lot which is 1.017 acre. Therefore, the wastewater discharge flow already exceeds the maximum flow allowed by these regulations. The request to legalize the walk-in refrigerator and the "bottle cage"would require a Board of Health variance from the above described regulation. 7 Page 1 (0 Z 0 N E O F C O N T R I B U T I O N 2946 Route 28 , Falmouth Road Marstons Mills G P 1 � I «.Z c 1 \ J J. LLI 46 Pr Ex<<,r f'2r��A, � � � E x.�•�T���:�IU\�!�' � � 1. o —o lip,SO O y ' apt o 1I 051E `,.5ri 6-' ja C5 �Ij ce J / ` b r t. !e, Peed.+, 57"es l,�LCI� Lot Lr�e } was �c.�t Si � � -�` �• `�'� — N' N tT /• 'Tom— Ii p6"seo�.n.- Qwr) er- of 2 L o (72 T0e,- S C) , o X � . C3sTer v , LIB , 2 az � ss Fr z r, Le z I� e S - eyl i EXHIBIT AA The land together with the buildings and other structures now or hereafter placed thereon (hereinafter called the "premises") in Barnstable (Marstons Mills) , Barnstable County, Massachusetts, more particularly bounded and described as follows: Beginning at a point of tangency in the northerly line of Marstons Mills-Hyannis Road at the westerly end of the curved inter- section of Marstons Mills-Hyannis Road and Osterville-West Barnstable Road and running N 85133' 10" W bounding southerly on Marstons Mills-Hyannis Road thirty-three and 05/100 (33.05) feet to the southeasterly corner of land now or formerly of Bartlett Realty Co. , Inc. ; Thence turning an interior angle of 135°25'50" and running N 40°59' W bounding southwesterly on said land now or formerly of Bartlett Realty Co. , Inc. , two hundred and no/100 (200.00) feet to a point; Thence turning an interior angle of 69°25'50" and running N 69°35' 10" E bounding northerly on land now or formerly of Frank E. & Malinda L. Hansen three hundred twenty-six and 58/100 (326.58) feet to the westerly line of Osterville-West Barnstable Road; Thence running southerly in a curve to the left of radius two thousand seventy-six and 56/100 (2,076.56) feet bounding easterly on Osterville-West Barnstable Road two hundred and no/100 (200.00) feet to a point of reverse curvature; Thence running southerly to westerly in a curve to the right to radius ninety and no/100 (90.00) feet bounding easterly to southerly on the intersection of Marstons Mills-Hyannis Road and . Osterville-West Barnstable Road one hundred thirty-one and 55/100 (131.55) feet to the point of beginning. Said premises containing one and 17/1000 (1.017) acres. f� - 1zz . 00 ,Z TOWN OF BARNSTABLE _ Board of Appeals 1 .dP..>;.a..l..[!..'..5.....LQ9.,.....Ins;........................_......._.._............ Deed duly recorded in the .......... Property Owner County Registry of Deeds in Book _ __ ..ame_.as.._above.._...-..__.._...._..._._. _ _ _ ._. _ Page -----.._.__._.._ , _.__. ___. —__-Registry Petitioner District of the Land Court Certificate No. __..........__.-, _-___ Book .-- Page — Appeal No. 13.81..- A.......... -Kay ------ —_ 1981 FACTS and DECISION Petitioner __...._.La.P..t. !.n .. ._...(wQ. .....Ln.C... ...._..._......_.._ filed petition on ...Ma.r..th_.9_..__.� 1981 P , requesting a variance-permit for premises at _.Qs.teru.i..l..l.n-_.1�.__ fiarn_....Rd_._) )idQ in the village of ..._.M.ar..s.t.on.s...Mi..1.].s._.--_.—.._.._.._...._, adjoining premises of for the purpose of _S.P.eG..1.a..1.....Eerm.1_t....t.0.._d.1.10W._..c.h.ange....D.f...ntan=Lonfnrm.i.ng._.us:e....__ — _�AP..P..�..!.�a.t.i..o�....ma.d.e.....un.�e.r....S.ec.._..P._._.A..._...�.�1_..,an.d_..(.b.a.....o.f._.th.e_.Znn.i.n.g_h�.1.a,�s..Locus is is presently zonedNotice of of this hearing was given by mail, postage prepaid, to all persons deemed affected and by publishing in Barnstable Patriot newspaper published in Town of Barnstable a copy of which is attached to the record of these proceedings filed with Town Clerk. A public bearing by the Board of Appeals of the Town of Barnstable was held at the Town Office Building, Hyannis, Mass., at ......_.....7_34 ...._XKxK P.M. __.Ap.ri.]..._l6_.__— 1981 , upon said petition under Boning by-laws. Present at the hearing were the following members: .R_i-chard_L..Bgy.___ Chairman At the conclusion of the hearing, the Board took said petition under ads iscmr nt. A ii w of the locus was had by the Board. Appeal No.__._ 1_81- 14_ Page of .....3.............. On 19 11.___, The Board of Appeals found Atty. Richard C. Anderson represented the petitioner and explained their request for a change of a non-conforming use as a gas station to a seven rental-unit retail shopping building at Osterville-West Barnstable Rd. , Marstons Mills in a residence F zoning district. The petition is filed under Sec. P.A. (4) and (6) of the zoning by-laws which allows the extension and change of a non-conforming use by special permit. There are two automobile service station buildings now existing on this site which are in a state of disrepair. The service station has existed since 1934 and there was no abandonment of the use inasmuch as no one was interested in renting this service station. A permit to demolish these buildings was obtained but not utilized. The proposed building would be located to the rear of the lot as shown on the plans submitted with the filing and ingress and egress to the building would be from Osterville-West Barnstable Rd. only. There would be a green belt around the building with extensive landscaping, all as shown on the plan. The building would have an i-nterrupted roof line with the highest point 28 ft. from the peak to the ground level . The exterior would be brick facade with wood siding and the windows would be small-paned with dummy windows on the rear for appearance only. The seven rental-units would have a uniform width of 26 ft. and four of the seven units would be 63 ft. deep and three of them would be 50 ft. deep. The building would be one-story and the type of tenants renting these units would perhaps be a butcher shop, clothing boutique, T.V. shore, barber shop, drug store, etc. Mr. Anderson said the proposed building would upgrade this property since two existing unattractive buildings would be replaced with one building, colonial in design , which would Be an asset to the neighborhood. This lot comprises 1 .02 acres and lighting would be diffused and in the front of the building and store area only. The petitioner will voluntarily give up the right to gasoline storage and the existing underground tanks will be removed or filled with cement. Mr. Cliff Dow was present at the hearing to object to the petition and said that town meeting turned down a rezoning of this area from residential to business and he did not want to see Rte. 28 from Osterville to Santuit become like Rte. 28 in Yarmouth. Mr. Moniz was denied a petition for business use in this immediate area. Barbara Crosby said this would be a mini-mall type of operation and would be detrimental to the neighborhood. Stephen Hayes , representing Bartlett Tree Co. , an abutter, felt - � (cont.) I, .�L�F_ L1. Y _ —__!��s._?�, Clerk of the To�A'n of Barnstable, Barnstable County, Massachusetts, hereby certify that twenty-ogee (21) days have elapsed since the Board of Appeals rendered its decision in the above entitled petition and that no appeal of said decision has been filed in the office of the Town Clerk. Signed and Sealed this dad of : J..._.__.._............._.__ _ 19 .__. _ under the pains and penalties of perjury. Distribution PropertyOwner ._..................................._......_......._..........................._........................_._ .._........ Town Clerk Board of Appeals Applicant Torn of Barn ble Persons interested Building Inspector I Public Infurmation By _._.. ___ .. .. .. _..._..._._.__...__._._.....: Board of Appeals Chairman j), p BOARD OF APPEALS Appeal No. 1981-14 Page 3 of 3 that allowing the proposed use might set a precedent for strip zoning and said the petitioner is requesting a major extension of a non-conforming use. This shopping center would be on the major road to the dump and the many accidents in the area necessitated the placement of the existing traffic lights on Rte. 28. Mrs. Jean Whitely was in favor of the petition and said that she and her neighbors in Marstons Mills felt that this type of business was needed by the area residents. In rebuttal , Mr. Anderson said that the proposed building and use would be no more detrimental than the existing buildings and use and the fact that this intersection is now controlled by traffic lights solves the problem of safety. The Chairman advised that the matter was under advisement and the hearing was closed. The Board voted unanimously to grant the petitioner a special permit for the change of a non-conforming use from gas station to building with six rental-units at Osterville-West Barnstable Rd. Marstons Mills and found that this change of use would not be substantially more detrimental than the existing use and would not be detrimental to the neighborhood nor in derogation of the spirit and intent of the zoning by-laws. The petitioner submitted plans showing a building with six rental-units and the unit as shown on the southwesterly side of the building on the original plan has been deleted. This special permit is subject to the following restriction: 1 . All construction shall be in accordance with the plans submitted and cited as follows: "Proposed Building for Kesten Os rVille, Mass. MarneY. - rec d on 4/30� 1 2. All six units in the building shall be used for retail use only. 3• All outside lighting shall be diffused and shall not reflect on abutting properties. 'PPLICATI�?N FUR, SITE PLAN REVIEW FOR OFFICE USE ONLY DATE RECEIVED ACTION DUE BY LOCATION egal ' Descript ion: See *L ! o F -Th„ F, le lanning Board Subdivision Number: ssessor's Map and Parcel Number: MA F / 22- LoT z• roperty Address: 29 Y& RT• .ZB, Fa I rno v rk �Ro a d M a,-s7-u is OWNER OF PROPERTY APPLICANT ame: L Name,_ ddress: nl..o. B a x iY' ,� Address: 9,0, ri3a x •iy OSTe�✓ /la /"la• 0ZGSS CDs Ter,,.//e:F /"la. OZbs honer k- V ZJ,- Z(Vo o Phone: Vzp - 2(,o o ENGINEER AGENT( interest owner or applicant) ame: IYYE Name: ddress: D.STer•v::le Address: 'honer Phoney :T0FA+:E TASk(ci QTILITIES 'ZONING CLASSIFICATION(S) tIST1SO FROPOSEP wea- District: 6 NllPber:—_ _0 Fcblic� Flood Hazard: i]ze:. o Size. o Erivets-4- Groundwater Overlay: Above Gr-ound: c Above Ground:Q Fire Vlstr ict.- C-0 yy,,36osg -Pr ?"I"i?rvround: O _ Undervround:_0 dater : LOT AREA: /• O 17 A sq. ft. Lontettts:�_ Contents: O FelbllcZC Private:_ NUMBER OF BUILDINGS Fire Protection:_ Existingr / Ea)<),IN_�L'FAACE.6 0jRB LUTS Proposed: O egalred: _ Existing: X_ Electrical: Demolition: t7 'rovsded: _,,:rL� Proposed: Arial:_ n: Site: sY To Close: Undergr-ound:K TOTAL FLOOR AREA (in sq.ft. ) °rf Site: _. Total: J _ Gas: Residential: O Natllf al:—G Office: O IN HISTORICAL GPI STRIt:T:(ves)_ {tto).K, Propane:_ Medical Office: 0 Commercials i0, 24 o IN AREA OF CRITICAL ENVIRONhENTAL (specify use) _ . CONCERN IE.O.E.A. 1 : (fifes)__ (no) � I�eTti 1 Wholesale 0 FFOJECT WITHIN 100, OF IIETLAND RESOURCE AREA: (yes)_ (no) A Institutional: _Q_ Industrials TOWN OF PAnNsTABLE SITE P , OCT 71994 ` 45 � � C � U CU.-IL'II�o I,L NLAI, The $Ite Plan shell Include one or more appropriately scaled maps or drawings of the property, drawn to an engineer's scale. clearly and accurately Indicating such elements of the following Information as are pertinent to the development activity proposed: 1) Legal description, Planning Board Subdivision Number (if applicable), Assessors�')r Map and Parcel number: and address (If applicable) of the property. V.4 ( !;; I 1 ❑ 2) Name, address and phone number of the property owner, and applicant If different / r1 than the property owner. ,// /1/ll1 ❑ 3) ►tame, address, and phone nurr,ber of the developer, contractor, engineer, other desl;n professional and agent or legal representltive. ❑ /) Complete property dimensions, area and zoning classification of property. ❑ 5).Existing and proposed topographical contours of the property taken at two-foot (2') contour Intervals by a registered engineer or registered land surveyor. ❑ 6) The nature, location and size of all significant existing natural land features, including, but not limited to, tree, shrub, or brush masses, all Individual trees over ten Inches (10") In caliper, grassed areas, large surface rock in excess of six feet (6') In diameter and soil features. ;�' 1 ❑ 7) Location of all wetlands or waterbodies on the property and within one hundred feet (iGO') of the perimeter of the development activity. ❑ 8) The location, grade and dimensions of all present end/or proposed streets, ways and easements and any other paved surfaces. ❑ 9) Engineering cross-sections of proposed new curbs and pavements, and vision triangles measured in feet from any proposed curb cut along the street on which access Is proposed. j)2L ❑ 10) Location, height,' elevation, interior and exterior dimensions and uses of all buildings or structures, both proposed and existing; location, number and area of floors; number and type of dwelling units; location of emergency exits, retaining . walls, existing and proposed signs. ❑ 11) Location of all existing and proposed utilities and storage facilities including sever connections, septic systems and any storage tanks, noting applicable approvals if received. ❑ 12) Proposed surface treatment of paved areas and the location and design of drainage systems with drainage calculations prepared by a registered civil engineer. ❑ 13) Complete parking and traffic circulation plan, If applicable, showing location and dimensions of parking stalls, dividers, bumper stops, required buffer areas and planting beds. ❑ 14) Lighting plan showing the location, direction and intensity of existing and proposed external light fixtures. ❑ 15) A landscaping plan showing the location, name, number and size of plant types, and the locations and elevation and/or height of planting beds, fences, walls, steps and paths. ❑ 16) A location map or other drawing at appropriate scale showing the general location and relation of the property to surrounding areas including, where relevant, the zoning and land use pattern or adjacent ProPertle6, trio exlbting street 6Y5tem in the area and location of nearby public facilitles. I:•j,'..' ❑ 17) location within an Historical District and any other designation as an Historically Significant property, and the age and type of each existing building and structure on the site which Is more than fifty (50) years old. ❑ 18) Location of site with regard to Zones of Contribution for public supply wells as determined In a report entitled "Groundwater and Water Resource Protection Plan, Barnstable, Massachusetts" prepared by SEA Inc., Boston, MA, dated September, 1985, which Is on file with the Town Clerk. /`"�'/' ❑ 19) Location of site with regard to flood Areas regulated by Section 3-5. 1 herein. /, ❑ 20) Location of site with regard to Areas of Critical Environmental Concern as N/T4 designated by the Commonwealth of Massachusetts, Executive Office of Environmental Affairs. S ewiwar�rr +a:w,�, :.m Yl-z NO Division of Land Is this a division or fifty (50) acres or more or land which was In I j common ownership as or 1/1/AN? Is tills a divlslun of fifteen (15) acres or more of land which was In common ownership as of 1/1/88 and which Nvas the result of an earlier ( ) (}(J subdivision within the last seven (7) years? Is this a devclopment which proposes to dlvitle bind In eonmton ( j ownership Into thirty (30) or more residential dwclling units? Is this n development which proposes to divide land In common ( i IA ownership Into tell (10) or murc business, office or Industrial premises? Creation of more than 30 dwelling units Is this a developrnetit. Itichl(ling the eximnslnn or c .cuing developments, that, Is planned to create or accommodate ntorc than 30 dwelling units? Commercial Construction Will the development create retail or wholesale business: office or Industrial dcvclopntctit: private, hcakh. rccre t1lonnl, or educational development with a floor area as follows: 1) New constructlon greater than 10,000 square feet? 2) Addition or auxiliary buildings greater than 3,VD0 stinare feet? l I Da 3) Outdoor commercial space greater than 40.000 square feet? ( j NJ 4) Use ch;ll'9vs which have n fluor area greater than 10.0 U square feet? I i IXI FaclUtics for Transportation to or from Barnstable County Will the developmrtrt construct or cxp;ttxl raviltt es for transportullun to or from Darnslab)c Comity? 1 1 IXI Access To The Coast Or A Great Pond Is tills development n bridge. road or drh•ew;ty providini; direct I 1 Ot► vehicular access to lilt. t:aatit or;i great pond? Historic Structures Will the dcvOopincrtt demolish or substantially alter It, Historic structure listed with (lie National or Massachuselts iteglster of i IIstoric Places. outside n immicip;rl historic district or crtttxide the Old Kings Highway Ilislorlc District? (Note: Re pairs, iipgrades, changes, alterations or extensions to n single family home are exempt from Commission review unless life proposed repair, upgrade. change, alteration, or extension Is greater than 259.6 of the Ilour area or the existing dwelling.) 7 j L 1 LCL_h L:.v L;,v!l_L, L. I _I I I 1. L Zoning District %Zsid ewe /e Old King' s Hiqhway District � or Listed in National and/or State Register of Historic Places /Y0 Perimeter set backs: Front AZ D Side lyx Rear z0 Lot Coverage y� Tupe or Use ( zoning ) (2es1 11f e.- F Flood Plain Zone Elevation Number Of Floors Floor Area: lst , 760 2nd Other (specify) Parking Requirements: Required Provided Vry Handicapped Spaces Z Are there accessory buildings? Ye.c Accessory Buildings Floor Area /60-- 12G = 24 J'9fT PLEASE PROVIDE A BRIEF, NARRATIVE DESCRIPTION OF YOUR PROPOSED PROJECT. Several years ago when the "BOTTLE BILL" was passed , I had not space to collect the bottles and. I brought in a container 20' x 8 ' to hold the bottles . At the same time I added -to the rear of the package store a piece.' . .;,; of equipment called a "Walk-in Refrigerator" to store beer in, these two .:.item as well as the bottle cage behind the White Hen, I would like to make legal . 1 assert that I have completed (or caused to be completed) this page, the Site Plan Review Application and the checklist on the back of the application and that, to .the best of my knowledge, the information submitted here is true. Z244(sig�nat �re) (date) TOWN OF BARNSTABLE SITE PLAN REVIEW DATE: October 07 1994 TO: Thomas McKean FROM: Janet Locke, Site Plan Review Coordinator RE: Site Plan Review 45-94 Captains Log Partnership, 2946 Falmouth Road, Rte. 28, Marstons Mills addition of redemption cages for returned bottles Please submit this form, with any comments or additional requirements you may have regarding the above referenced application, to the Building Commissioner's office by October 14, 1994 I have the following/attached comments/requirements regarding this application for Site Plan Review . I do not have any comments/requirements regarding this application for Site Plan Review at this time. (Signature) Citizen Web Request Page 1 of 1 I rF-'� Citizen Request Management LP9 N' Request ID: 31817 Created: 8/16/2010 10:19:27 AM Status: Assigned To Staff Assigned To: Desmarais, Donald Health Office Anonymous: No Category: Article X- Food Product Integrity E.C. Date: 8/30,i2010 i Created By: Parvin, Lindsay Citations: Health Office !Time Worked: 0 Response Time: 0 Request Location: Pizzal Subs2 5D __,2954—FALMOUTH ROAD/RTE 28 Marstons Mills, Ma 02648 Parcel Number: Map: 000 Block: 000 Lot: 000 Request: Requestor reports finding a long rusty nail in the eggplant parmesan sub she had delivered from pizzal/subs2 at 9:30pm on 8/15/2010. Requestor has the sub and nail in her possession. Request Work History: http://issgl2/IntemalWRS/WRequestPrintPub.aspx?ID=31817 8/18/2010 TOXIC AND AZAR® US MATERIALS REGISTRATION FORM Mai I To: NAME OF B U S I N E :S,_ . �W 9AN'C'sBoard of Health MAILING ADDR ,� Town of Barnstable TELEPHONE N BE11 P.O. Box 534 Hyannis, MA 02601 CONTACT PERSON: Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quiantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES . NO This form must be returned to the Board of Health regardless of'a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities totalling more than 50 gallonsliquid volume or 25 pounds dry weight. Please put a check beside each product that you store: Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) - Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents R I Bug and tar removers Household cleansers, oven cleaners ' (GAS White Copy-Health Department/ Canary Copy-Business ... _. < ... .+a. .. r"h...,.^ ..Irv...-..e.FM�,.......•.• c...r s .. �.'w-.-�.. .mow _ .e�.d-..-._.'. TOXIC AND IIAZAR OUS MATERIALS REGISTRATION FORM ,C �„ 0i Mail To: NAME OF BUSINESS: I�t � f%� f` � r� � �v f � ..;Board of Health MAILING ADDRESS ' Town of Barnstable TELEPHONE NUMBER P.O. Box 534 Hyannis, MA 02601 CONTACT PERSON: Al)1`-' �r . ;�� It� Y Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope yfor your convenience. If you:ariswered,YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOAC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities totalling more than 50 gallonsliquid volume or 25 pounds dry weight. Please put a check beside each product that you store: Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners... Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) a 4 ` Gasoline,=Jet fuel Refrigerants - Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) A Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners ' Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) _ Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents r 1 ��' �, � i t�/N/A A011 Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business OMF�Aj PV- M)M W/ `rY F;1 TOWN OF BARNSTABLE , oMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF EALTH satisfactory 3.PrintersAuto ody Shops nsatisfactory- 4.Manufacturers COMPANY d rs") 5.Retail Stores !) 6.Fuel Suppliers ADDRESS Class: 7.Miscellaneous { v rn jLLS QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) 1 Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: ffif)AAA11A PillA Pjb Q�� J DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply �OL x)-".' "qt"� O Town Sewer Public *O�`n-site OPrivate << f/ 11 l 3. Indoor Floor Drains YES NO O Holding tank: MDC O Catch basin/Dry well O On-site system tile 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank: MDC O Catch basin/Dry well O On-site system 5. Waste Transporter Name of Hauler Destination Waste Product YES NO 1. 2. 1P 0,"6 'A'16, f6-A Persons Interviewea In e or ate r : 4 �' >t « `�' , ,w::,....• A92 > E� 'b °�' t ofw' i � �P ram• �tr= I�� �¢ x fw ofi- cy i �,, � • �° ..:..�,,. �'��C�r�'� *' '*tip zM p N ggq? 1.017 ACRES Y O h S cru' ce,:r :r O R' 2076 ' RODS y . _\ a L k• x xs. r '•-y lO O pr {'Y. S7 a..�Py., BARTLETT REALTY CO.,t NC. _I `y j` b k,1 ri. a -.% v� _ cv I.ROD I.ROD MARST0N'5 MILLS- HYANNIS ROAD 1 PLAN OF LAND r .g IN BARN STABLE , MASS SURVEYED e)y ILB RT MALONEY LANO 'SURVEYORS AUG. 3, 1965 SCALE: I"=40' h I'.!ty"lV ^ ':�>t�.N r�.%~t�'"'^�v i�� �N Q` AS 4_ � x $a6L8ERT , 7' -'I I,h I\.j _ i -'•-� ", art' � ;'� O :y �.., �F su . `PIY3 19 9 Y' 9 f t T ��`t^�' C _ ___ 1 _- i _ __ _ -��-H_._t..__ _-I _ - _ Ir_i !r - __ _ _ •1 f it ;`--eL•--•�_��!--�-i�-� C_ - -� � -� - - � Tf'- � i - - - -i�-� � �� .ram':_-�T•1 1 - — i (. V --T Ta �A n t�`/ -�00'R A y F o b OR A, c. V L L 1 C A Cc cs s Z ZA L lam' �)'Y1d � �"� N Nv;. L Y w o G t7 PA cXA E To Cc I t2,- Tw o ?/Z6 s�. r � .-tco 130o S� FT 130o S'�• FT IS�o SI FT . /56a Sg Fr A'""'Ir-- — � I f 1 I i •� i it �� ^.i'f.".�. .�► _�,/.�� .O I! is I I. • I � s 1 10 1 10 o O NO i Sg F o s8fr /3oo s t 312. 6 FT g' 1 �crveCta Gvirducn'I.'. � �irra �r�c.uz .—�._—II' � •'vim .. 'Sw.---e 71 A I I ' rI 1)of� * / o 0 r- - pizza One- C 7 Svbs Two -lollywaoc� 1�aeK29� t;to1 ' Q �T{ CC t ♦ `i _ t Nc 14 s d y✓� r a n �✓^'1'aTti' �o/Tft �r1ew.�7rvr► � is 11 b4b F0 d r or 2 y F" nti � • wov � � C� s • - -� � /D � — /� co ! I a tn i i 'oW1' es o vv � SC.4•� 1'=2G _��___ — _ at SELFcawraiv� � • ter. - �A eFFUM FW °/. , ° q veol L.I S 1 1 4�,,6 � Jec Paa.v'.S 7"es �u> 1oli 9 I 1 r }} -- t -�_ SIT i \ Y i I � \ I � tvA Rn" szc•5 ' +t; i v 110 Id 62 SELF CONTAINED �I MUM ce i i— \ ✓ 1" F c 1J ems of ry r�tIm VNs4` f or �s 4 lee Pew...4 47"CS �e Id•4 .•'r:j� p tt �-fs 1 iI :V II iY. z � v ; _ 1 i 1Ql,sr a f - i 1 Al op SO IVA '� 22 SELF CONTA M Fwgdruossbftmd bdup errPL WrA Vi V�li6 � t4 - fO O r1 1 lac pazur4 -07 rocs ZJ. S5217-`.��i� it y t LY". 1 I ; so r Yi l Q r I'=2G' — FG- ? t? -21 62 SELF CONTAINED I oil APFUM As Pw fy �S en e r \ J,-eee. Loe[J.iG } wm°1,c"` ..ess5�... � �•1`� �,- � .pyS . �— N-6S•96-lo-w �'+ �r ..,�,�.�� �-.i'�o°�cc..°e Vtf 6 1! Y H i - F. NZ a i Sc L O SRP� / �G°✓5 e� S e ©S 'EKV/LLB �M,4'� /� =T�-T7' riZUsr 3ZG,5 - © P4 A`( � fir /N i _ B4Mp —� ® -ca 4 /bf 'ZI114 co F ZZL ca s _ . v) H-20 RISERS, 24"I.D. m NOTE: ALL SYSTEM COMPONENTS TO MARKED WITH MAGNETIC TAPE OR EQUIVALENT. a GRADE, MORTAR ALL COMPONENTS 24"H-20 CAST IRON COVER N 24"H-20 CAST IRON COVERS (NP.) SLAB ELEV. AT BLDG COR = 58.3' 4"SCH-40 VENTS U Z BLOCK UP D-BOX, 24"I.D. RISER AS INDICATED .� H-20 RATED F&C (2 REQ.) a TO GRADE, MORTAR ALL COMPONENTS Le BARON LB268-3 H-20 OR EQUAL FINISHED INSECT SCREEN m F FILTER FABRIC MANHOLE FRAME AND COVERS GROUND EL. 56.5' 0 w OVER STONE LABELED "SEWER" TO GRADE WHERE INDICATED T J COMPACT BACKFILL TO 95% MOD. PRO �l 10" EXISTING 10" EXISTING •� O 24" PROPOSED 21" EPAIR PAVEMENT AND STRIPING PER EXISTING. F :' TEE 1000 GAL H-20T r. TEE 53.70' 4"OSCH40 PVC AT 1%MIN. 4000 GAL H-20 PIPES LEVEL 1ST 2' TOP OF CONCRETE EL. 53.5' COMPONENTS � O U) EXISTING INVERTS GREASE TRAP :; TEE 10" 2000 GAL H-20 TEE '.' VERIFY SINKS & (RE-USE) TEE SEPTIC TANK 53,Ig'f* TEE SEPTIC TANK BLOCKS OR (TYP•) �r 00 DISHWASHER ONLY 12" CLEAR (RE-USE 53.45 I ,: ROBIN ADD GAS BAFFLE ) ADD GAS GAS BAFFLE V L. 1.6 RISERS SEA �::.> TO GREASE TRAP BAFFLE - - IN 'S E I ' CM OR •: ,..:.....; .,., ... •.. "' E EQUAL '•� P ECAST .. 5' 4" LIQ. LEVEL ';. ° o 0 0 0 •o o°o ' • � __ • 14 - HR 20 2'I.RDIS �� .,. .. r, .. •• ,• •.:. .... .•... ... ': o°o°o°o°o°o°o°o°c =SIT °°O°O°O0 .°�o••o`•o'� •"•.. '••:.•ram .. 4 ••.I: �.. '. �• �.•'.. •v� .. �. ri ®®® ®®® ®®®�. :.. .: :,: .: . Q ® ® ®®®®® ��® ®® ®®®® ®®®®®®®®�®® o o '� 53.23 I °o ®®�®®®®®®®® ®® ®�I ]®®®� ®®®®®®®®®®® o 0 0 0 M o°0°0°0° °°°O°°°° '�'� 6" GRAVEL & MECH. 53.40' DB 11 00000o00 ®®®®®®®®®®® ®® ®®® ®®®® ®®®®®®®®®®® °O°O°O°°° o J Q LOCUS ':. : . .'.: ..:.. 4. COMPACTION (NP.) °°°°° y 00000000 °"- H-20 D-BOX ON 12" COMPACTED GRAVEL \ 4' 3' 6" SUMP, 12" MINIMUM DIMENSION PROVIDE SPLASH BLOCKS UNDER EACH INLET ELEV. 49.6' V J ROUTE 28 4" SCIH40 PVC AT MIN. 1% SLOPE 66' H-20 500 GAL. LEACHING CHAMBER BY ACME PRECAST AT MIIN 1% OR SHEA CONC. PRODUCTS DRY WELL 500 GAL H-20 OR EQUAL. SLOPE (LONGEST) (20) UNITS REQUIRED TOTAL Q *THE INSTALLER SHALL VERIFY THE AT MIN 1% SLOPE 3 4" TO 1-1 2" DOUBLE WASHED STONE 3' MIN. LOCATIONS OF ALL UTILITIES AND ALL SYSTEM PROFILE T SIDES OF PRECAST STRUCTURES & 1.5' AT ENDS U LOCUS MAP NTS BUILDING SEWER OUTLETS AND ELEVATIONS NOT TO SCALE PRIOR TO INSTALLING ANY PORTION OF C ASSESSORS MAP 122 PARCEL 2 SEPTIC SYSTEM \ SITE IS WITHIN A ZONE 2 TO A PUBLIC WELL O SITE IS LOCATED IN A GP OVERLAY DISTRICTEL. EXISTING SEPTIC DESIGN FLOW BEING REDUCED- NOT "NEW CONSTRUCTION" ENGINEER: BAXTER & NYE NO GROUNDWATER BOTTOM TH A O DATE: 1/26/82 NO GROUNDWATER FOUND �-� OWNER: CAPTAIN'S LOG LLC P# 957 � P.O.BOX N SEPTIC SYSTEM DESIGN DATA PRIOR SEPTIC SYSTEM DESIGN DATA OSTERVILLE, MA 02655 0' TH A EL. 56.1 VARIANCE REQUESTED UNDER MAX. FEASIBLE COMPLIANCE (CURRENT DESIGN CALCS) (1982 DESIGN CALCS) ` NO GARBAGE DISPOSAL ALLOWED 15.405 lb: SAS TO BE > 3' BUT < 6 BELOW FINISH LOAM & GRADE (VENT AND H-20 PROVIDED) RESTAURANT: 23 SEA7S @35 GPD/SEAT = 805 GPD (USE 1,000 MIN.) SUBSOIL 5 BAYS RETAIL @1560 SF = 7800 SF RETAIL: 9,000 SF x 50 GPD/1000 SF = 450 GPD 4 r � ' 52.60' WATER USEAGE (GALLONS PER YEAR): sEtl� 42 TEST HOLE LOGS 1,450 GPD TOTAL 7800 SF' @ 75 GPD/1000 SF 585 GPD � ��P`J o%t �P con od'" SEPTIC TANKS: 40 SEAT RESTAURANT @ 35 GPD/SEAT = 1400 GPD 1999: 455,000 s w a _E9� g CO o , 1450 _*200%= 2900 GAL. PEQ. USE 4000 GAL H-20 RE-USE EXISTING 2000: 449,000 0 d o p �}I < a d; ` & Z T r O o u DANIEL E. GONSALVES, SE #13587 _1450__*100%= 1450 GAL. REQ. USE 2000 GAL H-20 (PROPOSED) 2001: 456,000 a Y n w: �. ENGINEER: TOTAL DAILY FLOW = 1985 GPD (3EE 1982 DWCP) 2002: 491,000 a Qe° 4 ' DON DESMARAIS, IRS GREASE TRAP 15(23)= 345 GAL USE 1000 GAL H-20 GREASE TRAP (RE-USE EXISTING) 2010: 409,000 MED. �ti �. WITNESS: 2011: 374,000 DATE: 11/6/12 LEACHING SAND AVERAGE: 439,000 OR 1,202 GPD < 2 MIN/INCH SIDES: 2(88 + 10.83) 2 EFF. 395.3 SF X2 = 790.6 SF X (.74) = 585 GPD NOTE: SHOWN FOR REFERENCE ONLY, USE TITLE 5 r PERC. RATE _ BOTTOM: 88' x 10.83' = 953.0 SF X2 = 1906 SF X 74 = 1410 GPD �ws. DESIGN FLOW CALCULATION. , /11 I 13784 TOTALS: 2696 SF 1995 GPD > 1450 GPD O.K. (OVERSIZE LEACHING FOR FACTOR OF SAFETY) Q �� ` 4 CLASS SOILS P# /LL/ I j ILJ � 5 r_ 1_ U rn , ? Q U o L �20 U o ', ELEV. ELEV. -�s.7s _ � z 0 0 / 156 43.1 �26 , 69 56.85 S7 6.90 y�OSo NO GROUNDWATER ENCOUNTERED FILL FILL -G or cam ,. 53.1 „ .73 .78 G `G �/ W c W TEST HOLE LOG 48 48 53.1 O B B - - . O5 .59 / O cp NOT TO SCALE " J O SL SL \NE O .70 56.52 66" 1.OYR 5/8 51.6' 66" 1OYR 5/8 51.6' Gp,S� s3 -'� L L -- - - - PA PARKING 1.01 _ / ` O _ O r O C C %� FLlj F=- PERC 6.86 GAS 6.03• METERS j56.51 O 0 P BENCHMARK `57.29 ss. z 0 M/CS M/CS GE SLAB AT `` % /7s�.44 . N 35.56 BUILDING COR �l �l � o N / +55,58 EL = 58.33 58.31 57.5� q lI / � N O 10YR 6/4 10YR 6/4 , ' A-57 �' KEY �' 60 6.68 #2950 (AKA #2946) -�-`' 11 a , p `. EXIST. RETAIL/RESTAURANT BLDG. a/ ///; `� I I I 9,352 SF FOOTPRINT 4e Os 6 / N O � a 126" 46.6' 126" 46.6' �\` 8.25 ��.� �57.25 5s1.49.48 - 32� EXISTING CONTOUR 0 0 �� 6 7 456.29 � TH1* LLj Ld Cam, TEST HOLE �I] cn cn NO GROUNDWATER ENCOUNTERED -55.67 �I-5 19 10.8. ; j'�, * CONFIRM SOILS WITH PERC ~ �• 2'-10" - I "1 AT TIME OF INSTALLATION Q w w - , 0 Of Of `\ 7. EXIST. 1000 O ' CATCH BASIN .\ `\ 8.21 8.14 �I`5'7 23'' GAL. GREASE /..:.. / (1-� 0 TRAP :: Q 26" \` �� ���•�' (RE-USE) :,:� p Qy C-� UTILITY POLE O O O 8.14 'S7 30 5 ® 6.2 f,,.••' O m Q N �- j.:;:' ;:� N EPFL EDGE PAVE. FLOW LINE II CD 7.28 �% a EXIST. 4.000 ®5 .59 /::' 3 ; 0 \ 61 -�' o GAL ST 56.38 ?.g• _ /13 LP W m N EWE `� RE-USE ` "' 56.42 EXISTING LEACH PIT 0 w O WOOD RAIL & ( )�� 06 0 8 1/8" METAL FENCE 56.61 O TD. 8'•� 56 6 03 (REMOVE) Q Y Q 0 �57.24 REMOVE 5 � j88 i '� �' • ®5 .57 /:•;�� '� I REMOVE AND+%/ 11 - W- EXISTING WATER SERVICE 0 U (n O 24" ��� r' H A PROP. 2000 %.. ' :':':/ o I RESET LIGHTI1 ll GAL. H-20 O •... .:.:� �' I 1# �� I - G - EXISTING .GAS LINE p, C� \ SEPTIC TANK 05 52 LP II A EXIST. CATCHo LIGHTPOST MANUF. LeBARON, BROCKTON, MA -} 5 7I- 9 BASIN (TYP) �.:.. :: TYPICAL ACCESS COVER WEIGHT: 4300 BS L ' LP �.f' 56.37 �� �� �,56.77 .54 „ // O EXISTING MANHOLE SCALE: 3/4„ = 1,-0., `� .. .Sp �) y�56.2 " MH \` 69 �: '� ' 57. 4 �' �� // �� + 56.2 EXISTING SPOT GRADE Os / :•: a It // lil © FLAGPOLE ^ co 1. THE LOCATION OF EXISTING UNDERGROUND UTILITIES SHOWN ON THIS PLAN IS •51 -`� PROP. H-2G... 284. /56.2 PAVED PARKING .�... ( O LP NOTES. APPROXIMATE. PRIOR TO ANY EXCAVATION ON THIS SITE, THE EXCAVATING �� 6.72 6.30 W W SAWCUT AND �'•'•'• D BOX .. n CONTRACTOR SHALL MAKE THE REQUIRED 72 HOUR NOTIFICATION TO DIG SAFE �� ... �" // r� E-' PATCH AS ••. (DB-11) r,, (1-888-344-7233) AND ANY OTHER UTILITIES WHICH MAY HAVE CABLE, PIPE OR 56.80 REQUIRED TYP. TH % lI "1 p EQUIPMENT IN THE CONSTRUCTION AREA FOR VERIFICATION OF LOCATIONS. ( ) \ 56.39 2. ALL CONSTRUCTION MATERIALS, COMPONENTS, AND METHODS EMPLOYED ON THIS \` LP 0 N ~ Ora PROJECT WORK SHALL CONFORM TO THE TOWN OF BARNSTABLE REGULATIONS �� 5� + ��0 VENT �-56.31 w 0 Q :' :Q . AND/OR THE MASSACHUSETTS DEPARTMENT OF PUBLIC WORKS STANDARD �� .1 6 /y 20 ,/ t---+ o O d SPECIFICATIONS FOR BRIDGES AND HIGHWAYS AS AMENDED TO PRESENT. "��� `L r ai // 'If a 0 ALL SEPTIC WORK AND MATERIALS TO CONFORM TO 310 CMR 15.00 TITLE 5. �':. :'� NEW LEACHING N � '' n z Z < AND BARNSTABLE HEALTH REGULATIONS. ` " SAS h ED a �j� 3. VERTICAL DATUM IS NGVD29. �� 0 56.33 �-� BENCHMARK 32 ii d 4. TRAFFIC SAFETY AND EXCAVATION SHORING AND PROTECTION RESPONSIBILITY OF CONTRACTOR. 56. �'•'•'• •' 2' ®56.73 p �, a 0 RIM CATCH 6.29 5. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHTO-H20 UNLESS NOTED. BASIN .652 14 GUY � U �a 6. THIS PLAN IS FOR PROPOSED.WORK ONLY AND IS NOT To EL - 56.33' SIGN �` WIRES 56.46 BE USED FOR ANY OTHER PURPOSE. `�� 33 05. 6.34 VENTLO 7. 6" LOAM AND SEED ALL DISTURBED AREAS NOT PAVED. C) i 8. ALL SEPTIC PIPING SCH-40 PVC UNLESS NOTED. " 11 ®56.60 A 87 H � 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT 56.52 k56.33 TRAFFIC 56.63 ��.'" 56.45 INSPECTION BY BOARD OF HEALTH AND OWNERS ENGINEER AND PERMISSION OBTAINED %% LIGHT (D+56.73 ,. SITE PLAN . FROM BOARD OF HEALTH AND OWNERS ENGINEER. �'S� 56.57 �` to-, 10. PAVEMENT TO BE REPAIRED AND.PARKING LINES RESTRIPED TO ORIGINAL CONDITIONS. 4= SCALE: 1 " = 2O' PAVEMENT SECTION MINIMUMS OF 8" REPROCESSED ASPHALT GRAVEL, 2" BINDER, 1" TOPCOAT MDPW TYPE 1-1 BITUMINOUS ASPHALT ARE RECOMMENDED, SEAL ALL JOINTS. 11. EXISTING LEACHING COMPONENTS TO BE PUMPED/FILLED OR REMOVED PER TITLE 5 REGULATIONS. 20 0 20 40 60 Feet: 12. CONTRACTOR TO VERIFY EXISTING CONDITIONS- 2003 SURVEY OF SITE SHOWN. FALMO UT'H R DAD (ROUTE 2 8) 0 3- 0 0 2 03-002 z• SHEET 1 OF 1 I