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HomeMy WebLinkAbout0026 APOLLO DRIVE - Health 26 Apollo Drive W. Barnstable ' A = 131 044 I, } I r i. TOWN OF BARNSTABLE j , LOCATION APolfo ®r SEWAGE# Q�` VILLAGE W, ASSESSOR'S MAP&PARCEL 134-9t/ INSTALLERS NAME&PHONE NO. tyA^ e.�6,.�sz^ Seth` Serr�w SEPTIC TANK CAPACITY /60p LEACHING FACILITY:(type)_3X5—,o6 ����.� ll� (size) 33_j x!d•S X 2 NO. OF BEDROOMS OWNER o cn 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) /O 7 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) /d/ Feet FURNISHED BY TO3 C6,5 - oes.j, ply. ofay.� C, P LO 0-a- 39 SP.' o 0 A.3: 3� No. f�b L) O --,--0 Fee BOARD OF HEALTH TOWN OF BARNSTABLE ZippYicatiou jfor Yell Cougtructiou Permit Application is hereby made for a permit to Construct( ), Alter( ), or Repair( ) an individual well at: vi \Loc tion-Address Assessors Map and Parcel Owner ` �Adddrress (� Installer-Driller Address Type of Building Dwelling Other-Type of Building No. of Persons Type of Well LAtI `�V� Capacity Purpose of Well Agreement: The undersigned agrees to install the afore described individual well in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation-The undersigned further agrees not to place the well in operation until a Certificate of Com i nce s been ' ued by the Board of Health. Signed , Date o�� Application Approved 6 to / Date Application Disapproved for the following reasons: Date r> Permit No. `��� ,� V©� Issued Date -------------------------------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed( ), Altered( ), or Repaired( ) by all C'�� �Q.`I l\ � � Installer at °Flj �4 6� Il� has been installed in acco ance with the provisions of the Town of Barnstable Board of Health Private Well Protection. Regulation as described in the application for Well Construction Permit NoW')O (�)O Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector No. w b•0 0 d Fee BOARD OF HEALTH TOWN OF BARNSTABLE Z(ppYicatiou _for Vern Cou5tructiou Permit Application is hereby made for apermit to Construct( ), Alter( ), or Repair( an individual well at: ` Looation-Address Assessors Map and Parcel Owner Address ' Installer-Driller T�_ Address Type of Building Dwelling Other-Type of Building No. of Persons Type of Well Capacity Purpose of Well Agreement: The undersigned agrees to install the afore described individual well in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation-The undersigned further agrees not to place the well in operation until a Certificate of Compl''nce s be 4ued by the Board of Health. Signed77 i Date Application Approved y u)�Q )c/ Date Application Disapproved for the following reasons: 1 \ t \ Date Permit No. "v� I�1 —C` (_�Issued Cn , (�� Date BOARD OF HEALTH TOWN OF BARNSTABLE (tertificate of (tompliauce THIS IS TO CERTIFY,that the individual well Constructed( ), Altered( ), or Repaired( " by I G\ V Installer at has been installed in acco dance with the provisions of the Town of Barnstable Board of Health Private Well Protec io Regulation as described in the application for Well Construction Permit Nd?J—"G )L-1 -G 60 Dated (o 3�� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector BOARD OF HEALTH TOWN OF BARNSTABLE Yell (Cow6tructiou Permit No. � L) G ` -0 Fee Z Permission is hereby granted to c C.,t Kan ! Installer to Co n struct; Alter( ), or Repair( an individual well at: i No. � -,)PjO Street � / as shown on the application for a Well Construction Permit No. C� -� —"--,,—Dated Date 1� 3�/ Approved B PP y O � CERTIFICATE OF ANALYSIS Page: 1 M" Barnstable County Health Laboratory ss�.cHus Report Prepared For: Report Dated: 4/20/2007 Gerald Poyant Order No.: G0740162 26 Apollo Drive West Barnstable, MA 02668 Laboratory ID#: 0740162-01 Description: Water-Drinking Water Sample#: Sampling Location 26 Apollo Dr.W.Barnstable,MA Collected: 4/18/2007 Collected by: G.Poyant Received: 4/19/2007 Routine ITEM RESULT UNITS RL MCL Method# Tested Nitrate as Nitrogen 0.20 mg/L 0.10 10 EPA 300.0 4/20/2007 Copper ND mg/L 0.10 1.3 SM 3111 B 4/20/2007 Iron 0.21 mg/L 0.10 0.3 SIA311iB 4/20/2007 Sodium 14 mg/L 1.0 20 SM 311113 4/20/2007 I Total Coliform Absent P/A 0 0 SM9223 4/19/2007 Conductance 110 umohs/cm 2.0 EPA 120.1 4/19/2007 pH 6.5 pH-units 0 EPA 150.1 4/19/2007 Water sample meets the recommended limits for drinking water of all the above tested parameters. Approved By: (Lab, irector) ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 . j P#Town of]Barnstable ��-� `3 Department of.Regulatory Services Public"ADM Health Division Date KAM $ _. t6Jp �e 1200 Main Street,Hyannis MA 02601 i /6 Date Scheduled - - - -' Time Fee Pd. _ ►foil Suitability Assessment for ewage V osal Performed By: Witnessed By: LOCATION& GENERAL INFORMATION Location Address'. e),to )^ Owner's Name 6'R�� ��Y�-(V r , I n 1�) �� �✓ I Address Its �/ ��/� Assessor'sMap/Parcel: �Q Engineer's Name4 NEW CONSTRUftON REPAIR �� Teie Aone# O v i . i Land Use Slopes(%) Surface Stones Distances from: Open Water Body ft Passible Wet'Area ft Drinking Water Well R C) Drainage Way ft. Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) - - QX7 a tr W I IO [ GROUNDWATER ADJUSTMENT O i J EXISTING GROUNDWATER LEVEL J I BASED ON WATER LEVEL OBSERVED IN ADJACENT STREAM. I� OBSERVED GW 18.70 1K I I F t INDEX WELL SDW-252 ZONE B R�"S'RE,M READING DATE MARCH• 2mm6 } READING 46.5 ADJUSTMENT 0.9 ADJUSTED GW 19.60 Parent material(geologic) i Depth to Bedrock I Depth to Groundwaldr- Standing Water in Hole: i Weeping from Pit Face i Estimated Seasonal:High Groundwater Dt ERMNATION FOR SEASONAL HIGH WATER TABLE Method Used: i Depth Clbperved standing ut obs.hole: __In. Depth tb Sol]MOttlt s: ln• Depth toiweeping from side of obs.hole: in, Otoundwnter Adjustment ft. Index Well# Reading Date: Index Well level a a Adl.(aotor, Adj.0-oundwaterLevel,, s i PERCOLATION TEST . Date,,v..sa 'I7ttte—. Observation i Time at 9" Hole# i Depth of Perc Time at G' Time ff-6") Start Pre-soak Time.0 End Pre-soak Rate Min./inch Site Suitability Assessment: Site Passed Site Failed; Additional Testing Needed(YIN) Original: Public Hehith Division Observation Hole Data To Be Completed on Back-------- ***If Pemolafiitin test is to he conducted within 100' of wetland,you must first notify the NO TEST PIT 1 PARENT MATERIAL: PROGLACIRALD OUTWASH ELEVATION = 32.OJZ +- PERC AT 64 in 2 MIN/INCH IN C SOILS 1 DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING 32.00 0-20 FILL 20-26 O LOAMY SAND 10 YR 3/3 NONE FRIABLE 28-44 E LOAMY SAND 1Z YR 5/4 NONE FRIABLE 28.33 j 44-126 A MEDIUM SAND 10 YR 6/3 NONE LOOSE 2150 I NO GROUNDWATER ENCOUNTERED TEST PIT I PARENT MATERIAL: PROGLACIAL OUTWASH ELEVATION = -32.1Z +- 2 MIN/INCH, .IN C SOILS f DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE •(MUNSELL) MOTTLING 32.10 0-10 FILL. 18-18 O LOAMY SAND 10 YR 3/2 NONE FRIABLE 16-42 E LOAMY-SAND 10 YR 5/4 NONE FRIABLE 28.60 42-126 A MEDIUM SAND 10 YR 6/3 NONE LOOSE 1 21A3 Depth from Soil Horizoo Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Oravel TION HOLE LOG :DEEP OBSERVA Hole#T Depth from Soil Horizon Soil Texture Soil Color Soil other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc Ora el Flood Insuranie Rate Map: Above 51N1 year flood boundary No Yes _� Kthin 100 yza bcurdaey_ __ No.r._. Yes Within 100 year flood boundary No Yes Depth of Natuoft Occurring Pervious Material Does at least fo r feet of naturally occurring pervious material exist in all areas observed throughout the area proposed f6r the soil absorption system? If not,what is the depth of naturally occurring pervious material? Certification I certify that on. (date)I have passed the soil evaluator examination approved by the Department of environmental Protection and that the above analysis was performed by tt�e consistent with the required training,expertise and experience described in 310 CUR 15.017.. Signature Date Q:1SEPTICVERCt0RM.D0C No. ��� 33 J { Al00 .00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes RpPlication for �Digogal 6p5temc Construction Vermtt Application for a Permit to Construct O Repair]K) Upgrade O Abandon O ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. 7 7 6-1 7 6 8 26 Appolio D , W Barnstable Gerald & Jane Poyant Assessor'sMap/Parcel 13 44 26 Apollo Dr, W Barnstable Installer's Name,Address,and Te.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No.3 6 4-0 8 9.4 Wm E Robinson Sr Septic Eco-Tech PO Box Cirf Sandwich Type of Building: Dwe'ling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( np Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow proyided gpd t Plan Date Number of sheets ! Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Install a new Title 5 leach system to plans of Eco-Tech, #ETE-2304 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 Environriptal Code nd not to place the system in operation until a Certificate of Compliance has been issued by this Board of He h. Si ed Date —67-6 Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. C^XW CO 33 f Date Issued No. Feed 00.00 THE COMMONWEALTH'10F MASSACHUSETTS`' Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pprication for Migo al *y!aem Con5tructiou 3permit Application for a Permit to Construct( ) Repair(4) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components t Location Address or Lot No. Owner's Name,Address,and Tel.No. 7 7 6—1 7 6 8 26 Algol D Barnstable Gerald,& Jane Poyant Assessor's Map/Parcel j , fk 26 Ap011fiDr, W, Barnstable e Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No.3 6 4—0 8 9 4 Wm E Robinson Sr Septic Eco—Tech PO Box 1089., Centervil1le3 Triangle C' Sandwich Type of Building: t t. r Dwelling No.of Bedrooms--'" 4 + Lot Size sq.ft. Garbage Grinder ( np Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures l 1 Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil ,. Nature of Repairs or Alterations(Answer when applicable) Install a new Title 5 leach . system to plans of Eco-Tech, #ETE-2304 �,_:• Date last inspected: Agreement: r 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 Environ ntal Code nd not to place the system in operation until a Certificate of -;-Compliance has been issued by this Board of Heath. •` Si ed Date Application Approved by Date _16151(0 Application.Disapproved by: Date \ t; for the following reasons �. •~ Permit No. 33 / Date Issued -------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS Poyant BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (X ) Upgraded ( ) Abandoned( )by Wm E Robinson Sr Septic Service y at 26 Apollo Drive, W. Barnstable has been constructed in accordance with the provisians of Title 5 and the for Disposal System Construction Permit No. �=-^ - dated � Jr/ Installer \I Y� Y (\ Designer C 0 U� *-low ZC #bedrooms Approved djin fl gpd The issuance of this permitsshhallnbt b cconstrued as a guarantee that the sys em wtt n , de igned. Date �J_/ tP Inspector THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS Poyant 1=i.zpo.5ar *p5tem Con5truction Permit Permission is hereby granted to Construct ( ) Repair ( X ) Upgrade ( ) Abandon ( ) System located at 26 Apollo Drive, W. Barnstable and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special con - tons Provided:C nso t otion st be completed within three years of the dat f A i�� -�, Date Approved by Town of Barnstable Of THE 1p� •Pam. .o• Regulatory Services BARN STABLE, Thomas F. Geiler, Director • y MASS.t639 Public Health Division ,0� ArfD ►s Thomas McKean, Director 200 Main Street, livanuis, CIA 02601 Office: 508-862-4644 Fax: 508-790-630► Installer & Designer Certification Form Date: Sewage Permit# Assessor's i\IapTarcel 130 Designer: Eco-Tech Installer: Wm E Robinson Sr Septic Address: 43 Triangle Circle Address: PO Box 1089 Sandwich Centerville On y U Wm E Robinson Sr Sept icwas issued a permit to install a (date) (installer) septic system at 26 Apollo Dr, W Barnstable based on a design drawn by (address) Eco-Tech dated 04-26-06 (designer) certify that the septic system referenced above was installed substantially accordin�t, 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 (Le. greater than 10' lateral relocation of the SAS or any vertical relocation of any component t of the septic system) but in accordance with State & Loc l tions. Plan rep:isiort ur certified as-built by designer to follow. ZNOFM,yssc .. 9 DAVID yGm o D. CO1lGHANOWR No. 1093 (histaller's Sign ure) o &�''iSTSa� SgNI TA'R��'N (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETUWN TO BAKNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE C11: COMPLIA- INCE WILL NOT BE ISSUED UNTIL BOTH THIS FOIUNI AtND AS-BUILT CUM :\RE I; ' RECEIVED BY THE BARINSTABLE PUBLIC HEALTH DIVISION. TH ANI: YOU Q: Healtn:Septic"Designer Certification Forrr:-26AU.doc Parcel Detail Pagel of 2 1 f j �1 k 'Lc.+si c L! - ��f�� r 1`�'�` .s••'"" � l aC-'G�^�.!3.���4'!r^ Ps tL-`L.1" rr.„-.�..,.�...,--. Logged In As: Parcel Detail Tuesday, Ju Parcel Lookup - Parcellnfo Parcel ID 131-044 jI DeveloperlLOT 10 - --- - --- -- -- ------ - - -- Lot Location 26 APOLLO DRIVE I Pri Frontage;60 Sec Road _ I Sec Frontage Village WEST BARNSTABLE - I Fire District W BARNSTABLE Sewer Acct I Road Index 0033 - Owner Info Owner POYANT, GERALD P & JAYNE B I Co-Owner Streets 26 APOLLO DR 'I Street2 City W BARNSTABLE I State MA zip 02668 Country US - Land Info Acres 0.82 use Single Fam MDL-01 I zoning RF Nghbd 0106 Topography Level - Road Paved utilities Gas,Well,Se tic Location - Construction Info Building 1 of 1 Year I Stu�t p I Wall -l p- Built 1983 Gable/Hi Cla board !` Effect Roof - AC• _ - a Area 2113 --_-- _I Cover Asph/F GIs/Cmp__I Type INone - - --- �_ Style Ranch ) Int Drywall I Bed -- Bedrooms -- Wall - - Rooms - -- ail [3AS'; 1-. Ti ,eMY. i Model Residential I Ior P R Carpet I Bath - Floor 2 Full - -- ----- ooms --- -- 3 Grade.Average YPe Hot Water Rooms 6 Rooms F;dP T _ Total stories 1 -StoryHeat Gas Found- poured Conc. - --- Fuel .. _ -----I ation http://issql/intranet/propdata/ParcelDetail.aspx?ID=8330 7/25/2006 Parcel Detail Page 2 of 2 Permit History Issue Date Purpose Permit# Amount Insp Date Commi 11/7/2003 Re-roofing 72849 $2,000 1/5/2004 12:00:00 AM 1/9/1998 Repair Work 20452 $4,500 6/18/1998 12:00:00 AM 5/1/1995 B37782 $4,000 1/15/1996 12:00:00 AM WB EN 5/1/1972 B15080 $0 WB 1.5 - Visit History Date Who Purpose 1/5/2004 12:00:00 AM Martin Flynn Drive by inspection only 3/13/2000 12:00:00 AM Paul Talbot Meas/Listed 6/18/1998 12:00:00 AM Lloyd Kurtz Mea./List Bldg Permit Only - Sales History Line Sale Date Owner Book/Page Sale P 1 3/29/1996 POYANT, GERALD P &JAYNE B 10124/319 2 5/15/1982 WEISS, JOHN A& MARCIA 3488/90 - Assessment Histor y Save# Year Building Value XF Value OB Value Land Value Total Parc( 1 2006 $178,900 $2,700 $41,600 $204,200 ; 2 2005 $165,000 $2,700 $42,700 $163,400 3 2004 $134,100 $2,700 $43,200 $163,400 4 2003 $120,900 $2,700 $44,300 $58,200 5 2002 $120,900 $2,700 $44,300 $58,200 6 2001 $120,900 $2,700 $44,300 $58,200 ; 7 2000 $100,700 $2,600 $28,400 $40,000 ; 8 1999 $100,700 $2,600 $22,700 $40,000 9 1998 $111,900 $2,600 $22,700 $40,000 10 1997 $98,800 $0 $0 $29,100 11 1996 $92,200 $0 $0 $29,100 ; 12 1995 $92,200 $0 $0 $29,100 ; 13 1994 $81,200 $0 $0 $36,000 14 1993 $102,600 $0 $0 $45,100 15 1992 $116,600 $0 $0 $50,100 ; 16 1991 $116,800 $0 $0 $65,500 ; 17 1990 $116,800 $0 $0 $65,500 ; 18 1989 $116,800 $0 $0 $65,500 ; 19 1988 $103,100 $0 $0 $41,000 20 1987 $103,100 $0 $0 $41,000 21 1986 $103,100 $0 $0 $41,000 Photos http://issql/intranet/propdata/ParcelDetail.aspx?ID=8330 7/25/2006 o-) �D'Zo (" I DEED RESTRICTION WHEREAS, Gerald P. Poyant and Jayne B. Poyant of 26 Apollo Drive, West Barnstable, MA are the owners of 26 Apollo Drive located at West Barnstable, MA duly recorded in Barnstable County Registry of Deeds in Plan Book 10124,Page 319. WHEREAS, Gerald P. Poyant and Jayne B. Poyant as the owners of said lot has agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works construction permit in compliance with 310 CMR 15.000 State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage: WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to granting a disposal works construction permit for a septic system in compliance with 310 CMR 15.200, State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the issuance of a building permit for the construction of a single family home on this property, is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document, NOW, THEREFORE, Gerald P. Poyant and Jayne B. Poyant do hereby place the following restriction on above-referenced land in accordance with their agreement with the Town of Barnstable Board of Health, which restriction shall run with E-ie land and be binding upon all successors in title: 1. 26 Apollo Drive,West Barnstable,MA may have constructed upon the lot a house containing no more than three (3)bedrooms. Gerald P. Poyant and Jayne B. Poyant agree that this shall be permanent deed restriction affecting their property located at 26 Apollo Drive, West Barnstable,MA, and being shown on the plan recorded in Plan Book 233,Paged 19. For title of ownership see the following deed: Book 1012i4,'Piage 319. Executed as a sealed instrument this j� ay of �J t� l , 2006. Gei Ja B. oyant Commonwealth of Massachusetts Barnstable, ss. Date: (o Then personally appeared the above-named Gerald P.Poyant and Jayne B. Poyant known to me to be the persons who executed the foregoing instrument and acknowledged the same to be their free act and deed, before me, ERICA K.LEE Notary Public Notary Public Commonwealth of MassachuMft My Commission Expires: S /lJ ate!3 fvmy Commission Expires May 10,2413 LOCATION ®//� ,��rv� SEWAGE PERMIT NO. VILLAGE wr INSTA LLER'S NAME & ADDRESS JOH,N A. AALTO BACKHOE SERVICE ,cn IAI t1j...a StFeet West Barnstable, Mass. 02668 ® UILDER OR OWNER R v elf 014:ss -- D A.T E PERMIT.T U E Q -�ERM DATE C 0 M P L I A N C E ISSUED /j O � L l? r 3l a f r � r 'c -- TOWN OF BARNSTABLE LOCATION 26 A?( -L0 SEWAGE # c�-3 3 S-7 VILLAGE ASSESSOR'S MAP &LOT ! INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 1 � LEACHING FACILITY: (type) (size) 6 NO.OF BEDROOMS 3 BUILDER OR OWNER PERMTTDATE: s s_3&77 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 pf leaching facility) Feet Furnished by �1 �-'�1l 1'�►1W'� T-`[� �t!(� 31 J Z 194 t' REASZ OV DOME N n DECuC `A po , •a V� Ste, ticb ' w a No.f........ � FEs.....Tel .............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ` Applirttiion for Diiipniittl Works Tomitrnrtiun Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ocatioo-Address •-•-'-•-• ....-or Lot No. o •�. :. .� �......................................... Owner Address w ..........Ecnl cMQ.----... ......................................... ........................... ............................--------....... Installer Address } UType of Building Size Lot_._35,52.1.._..Sq. feet Dwelling—No. of Bedrooms......................................Expansion Attic ( ) Garbage Grinder ( ) pa-, Other—Type of Building ---------------------------- No. of persons---------Y-------.--__.-__- Showers (2 ) — Cafeteria ( ) Q, Other fixtures --------------------------------------- - W Design Flow.......... 0.......................gallons per person per day. Total daily flow...........3.3.......................gallons. WSeptic Tank—Liquid capacity./ .gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area.....................sq. ft. Seepage Pit No.__.j0_X(7$J Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed b !,?_' .�� _ .�'t............................ Date.......s2r�� � L............. aTest Pit No. 1......q----.minutes per inch Depth of Test Pit.....13...7.... Depth to ground water........................ f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ------------------•-----•-------•--•---------------•--...............----------..._......._.._....._.......................................................... ODescription of Soil....................................................................................................................................................................... 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 iIT1E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until ertifi t of Compliance has be issued b the board of Health. rie,--- :�..................... •-_.... . ....�..__._. Application Approved BY �--Z----- Date Application Disapproved f o t following reasons:....................................................................... ...................................... Date PermitNo......................................................... Issued........................................................ Date • , FiLE .............. THE COMMONWEALTH OF MASSACHUSETTS BOARD 'OF HEALTH ...... .................................OF................:......................- , fliration for Di-4poott1 orkii Zomitrnrtion rrntit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: -• -------------------•------•--•----.-.....----••--•---..•....---.......-------••-----••........._.. Location-Address or Lot No. .`a ........................................... ---.....--------------------------...........-.......---•-•------................................. Owner Address a -----• � ................................................ -•----•-•----•-----•----....._._......•••-••••--•-.....•---........----•----•-•••..__............. Installer Address t UType of Building Size Lot_3-�r--c_� 7 ...._..Sq. feet Dwelling—No. of Bedrooms..................................__.__..Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons........_................. Showers (2 ) — Cafeteria ( ) dOther fixtures .---_----------------------------------------•-------------------------------------- ------------- .......... w Design Flow..._......34........................gallons per person per day. Total daily flow__....... 3U................_.•....gallons. WSeptic Tank—Liquid capacity�PT_gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area------:.............sq. ft. Seepage Pit No.../_�a'1. i1�. Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing nk0-4 e ( ) Percolation Test Results Performed b .. U "e-- a Y Q Ste, I �r Date `�1-�� L.............. Test Pit No. I.....�.......minutes per inch Depth of Test Pit...j............... Depth to ground water........................ 4q Test Pit No. 2................minutes per inch Depth of_Test Pit.................... Depth to ground water........................ ---------------------------------•-----------•--------.....=•------...-•-----•--•-•--•••-----•.-•--- ODescription of Soil................................----.-........:..--------•---.......-----•----•-•------------------------------••-----...----•----------------------------••---------••- x c, •--•-••••••--•••••-•-••-•--••-••---•-•---•--••.......•-•-•-•--••-•--•---•---=••--•-•••-•--•••---••••-••----••-•--••-•••••••-•-...--•••-•-•--••-•---•••---•-----•••-••----•...............••-----------•- 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 TIT11- 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be -ed th board f health. 1 /�/c !3 =------....-•- -•-••--••-•-•-•--------•--•................•--••- ti= - Application Approved By.......... `l='-= -.._.... ` f` a .... ........ Date Application Disapproved f o th following reasons:-•-----•-------•-------••---------------•----------.....------•-----------------•-----........----._........... .........-•------•----•--...-••--...•-•••.....-••---•••..._...---•-•••••------••--••---••--•-•-•---•...--•••....----•-------••••--•-••••••...-•------•••---••--•...-•••- •--••--•---••••............. Date PermitNo..........................=••-•--••-•-------•-•---•--_._.. Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... (Intifirate of Tomplittnrr �TLg1S= CERTIFY, That the :Individual Sewage Disposal System constructed (,; 'or Repaired ( ) by__ • ------------------ --------------------------------------------------•._.....----...............----- -•------- /, �� Installer has been installed in to ance with the provisions of TITIF 5 of.Tate State Sanitary Cods ecri_�ed in the application for Disposa Works Construction Permit No.�I:.................../......._..._._. dated.... "_ '-- ..`tr-:S-__---•---.----.--•--.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRU A GUARANTEE THAT THE SYSTEM WI X I ONCTION SATISFACTORY. DATE......!? �? ................................ Inspector----•---• -•-•••......•--•-•---•-....-•--•-•--•--.._......--•••--...---•-......•. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Permission i;_;/�JWRepair herby granted �''."` I ...----•-----•------•.............•--............................. to Construct ( /p(! )an 1 1,U* L Wage Disposal System XrDisposal Streetas shown on the application `Yorks Construction Permit No..,. ___:`.___.__. Dated__«._ '.f.� ................ ..._.... •----•------ oi-------- ? / Board of Health DATE.................-................ FORM 1255 A. M. SULKIN, INC., BOSTON Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection William F.Weld - -- 4 �R ow.m« Trudy Coxe 9 uct. .eoEn 1gg� David B. Struhs SUBSURFACE SEWAGE DISPOSAL SYSTEM INFORMATION FORM 4,41 Commlationer PART A m "y CERTIFICATION Property Address: 26 APOLLO DRIVE,W.BARNSTABLE Address of Owner: Date of Inspection: MARCH 11. 1996 (if different) 9 Name of Inspector: TAMES A.ORPHANOS Company Name,Address and Telephone number: CERTIFIED INSPECTION ASSOCIATES 47 CAMERON ROAD.N. FALMOUTH.MA. 02556 (508) 564-5653 CERTIFICATION STATEMENT 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. The system: X Passes Conditionally Passes Needs Further Evaluafion By the Local Approving Authority Fads Inspector's Signat Date: MARCH 12. 1996 The system Inspect r shal submit a copy of this inspection report to the Approving Authority within(30)days of completing this inspection. If t sys m is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit th port to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer,if applicable and the approving authority. INSPECTION SUMMARY: Check A,B,C,or D: A] SYSTEM PASSES: X I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B] SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair,passes inspection. Indicate yes;no,or not determined (Y, N,or ND). Describe basis of determination in all instances. If"not determined",explain why not. The septic tank is metal,cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing septic.tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 8/15/95) 1 One Winter Street • Boston,Massachusetts 02108 a FAX(617)556-1049 a Telephone(617)292-5500 A Printed on Recycled Papa SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 26 APOLLO DROVE Owner: TACK&MARCIA WEISS Date of Inspection: MARCH 11, 1996 B] SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed.pipe(s)or due to a broken,settled or uneven distribution box. The system will pass inspection if(with the approval of the Board of Health): broken pipe(s)are replaced _ obstruction is removed distribution box is leveled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection(with the approval of the Board of Health): broken pipe(s)are replaced obstruction is removed c] FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is falling to protect the public health,safety and the environment.. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER,IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone 1 of a public water supply well. The system has a septic tank and soil absorption system and is within 50'of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. D] SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is outlined below. The Board of Health should be contacted to determine what will be necessary to correct the failure.. Backup of sewage into the facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or the surface waters due to an overloaded or clogged SAS or cesspool. (revised 8/15/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 26 APOLLO DRIVE Owner: JACK&MARCIA WEISS Date of Inspection: MARCH 11. 1996 D] SYSTEM FAILS (continued): Static liquid level in the distribution box above outlet.invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone 1 of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E) LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The design flow of system is 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: The system is within 400 feet of a surface drinking water supply The system is within 200 feet of a tributary to a surface drinking water supply The system is located in a nitrogen sensitive area (Interim Wellhead Protection Area (IWPA)or a mapped Zone II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 8/15/95) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 26 APOLLO DRIVE Owner: TACK&MARCIA WEISS Date of Inspection: MARCH 11. 1996 Check if the following have been done: X Pumping information was requested of the owner,occupant,and Board of Health. X None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. X As built plans have been obtained and examined. Note if they are not available with N/A. X The facility or dwelling was inspected for signs of sewage back-up. X The system does not receive non-sanitary or industrial waste flow. X The site was inspected for signs of breakout. X All system components,excluding the Soil Absorption System,have been located on the site. X The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of SCUM. X The size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. X The facility owner(and occupants„if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. THE AS-BUILT PLAN ON FILE AT THE BOARD OF HEALTH WAS FOUND TO BE INACCURATE, THE SKETCH ATTACHED TO THIS FORM REFLECTS AN ACCURATE LOCATION OF THE SYSTEM COMPONENTS AND HAS BEEN PROVIDED TO THE BOARD OF HEALTH FOR THEIR RECORDS. (revised 8/15/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 26 APOLLO DRIVE Owner: TACK&MARCIA WEISS Date of Inspection: MARCH 11, 1996 FLOW CONDITIONS RESIDENTLAL: Design flow: 330 gallons Number of bedrooms: 3 Number of current residents: 2 Garbage grinder(yes or no): NO Laundry connected to system (yes or no): YES Seasonal use (yes or no): NO Water meter readings,if available: HOME IS SERVED BY A PRIVATE WELL. Last date of occupancy: CURRENTLY OCCUPIED. COMMERCIAL/INDUSTRIAL: N/A Type of establishment: Design flow:_gallons/day Grease trap present: (yes or no) Industrial Waste Holding Tank present: (yes or no): Non-sanitary waste discharged to the Title 5 system: (yes or no) Water meter readings,if available: Last date of occupancy OTHER: (Describe) Last date of occupancy:: GENERAL INFORMATION PUMPING RECORDS and source of information: THE SYSTEM HAS NEVER BEEN PUMPED ACCORDING TO THE OWNER NO System pumped as part of inspection: (yes or no) If yes,volume pumped: gallons Reason for pumping: TYPE OF SYSTEM X 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) Other(explain) APPROXIMATE AGE of all components,date installed(if known)and source of information: 6/3/83.ACCORDING TO PERMIT# 83-387 ON FILE AT THE BOARD OF HEALTH Sewage odors detected when arriving at the site: (yes or no) NO revised 8/15/95) 5 h SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 26 APOLLO DRIVE Owner: TACK&MARCIA WEISS Date of Inspection: MARCH 11, 1996 SEPTIC TANK: X (locate on site plan) Depth below grade: 6" Material of construction: X concrete metal FRP other(explain) Dimensions: 4' WIDE X 8'LONG X 4' DEEP Sludge depth: 3" Distance from top of sludge to bottom of outlet tee or baffle: 29" Scum thickness: U" Distance from top of scum to top of outlet tee or baffle: 12" Distance from bottom of scum to bottom of outlet tee or baffle: . 17" Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity,evidence of leakage,etc.) TANK HAS A PLASTIC INLET TEE AND A CONCRETE OUTLET BAFFLE AND THE LIQUID LEVEL WAS 48" OR AT THE OUTLET INVERT. NO ADVERSE INDICATORS.NO RECOMMENDATIONS. GREASE TRAP: N/A (locate on site plan) Depth below grade: Material of construction: concrete metal FRO 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: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity,evidence of leakage,etc.) (revised 8/15/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 26 APOLLO DRIVE Owner: TACK&MARCIA WEISS Date of Inspection: MARCH 11, 1996 TIGHT OR HOLDING TANK: N/A (locate on site plan) Depth below grade: Material of construction: concrete metal FRP other(explain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm level: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX: X_ (locate on site plan) Depth of liquid level above outlet invert: 0" (STATIC) Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) D-BOX IS LEVEL.NO ADVERSE INDICATORS. NO RECOMMENDATIONS PUMP CHAMBER: N/A (locate on site plan) Pumps in working order: (yes or no) Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) (revised 8/15/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 26 APOLLO DRIVE Owner: TACK&MARCIA WEISS Date of Inspection: MARCH 11, 1996 SOIL ABSORPTION SYSTEM (SAS): X (locate on site plan,if possible;excavation not required,but may be approximated by non--intrusive methods) If not determined to be present,explain: Type: X leaching pits,number: ONE: 6' DIAM.X 6' DEEP leaching chambers,number: , leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions:., overflow cesspool,number: Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) COVER IS AT 3': LIOUID LEVEL IS 18": BOTTOM OF PIT IS 111" BELOW GRADE NO ADVERSE INDICATORS NO RECOMMENDATIONS. CESSPOOLS: N/A (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow(cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation,etc.) PRIVY: N/A (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.) (revised 8/15/95) 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 26 APOLLO DRIVE Owner: TACK&MARCIA WEISS Date of Inspection: MARCH 11, 1996 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' 26 A,POI 16 nRiVF N REAR DECK 15'9" 32' " 32' " '5' 3016" 2 ' 911 35' 581711 NOT TO SCALE DEPTH TO GROUNDWATER Depth to groundwater: >144" method of determination or approximation: TEST PIT DATA FROM A PLAN BY DOWN CAPE ENGINEERING DATED 4/4/83 AND ON FILE AT THE BOARD OF HEALTH. (revised 8/15/95) 9 L -!4.127, < 2 ' Al f 44 - A ?" - , z" x. p i f 61 ' 'N I 41 t Ak. m �tY 1983 • S - • 1+s4, 44 AM; JoUn- A I elso>- 4,�1w= f jft p• o 0 _26Mra - We sit Sarnstaible 1z f Mr. q "Yo'w`are Ir anted,,z0"*a#c- to nstalLe"a W6114 7•feet ftdm , -they­ X1 , ,Septic,le chihg fac* ility In, lieu q'f' the.,req u , :150 ,feet, :o .n 1h � your prqperty at 4pollLo' Drive W69tarnstable%­Vith , , Y.,_77. the fol!64inq 'conditioho,:. cfi'-,�4Ail othdf -r' I -ined' Hof 'A egu Cont4 Ari 4n 7 idi" t 1. �-,dia. And-� table,, w u .-.Statd.En onmen a Co H I li;'Rogulatidns,,tdust, b;a­.do#ijplied with' ea t 4, 4. 'Ithe, tested Aif6t,,,be i1i alled*-'an4. vatpr ally -and, chemidall� `b4ci6riol te pr ior'�tor-the -"dgidc 4,3LS-, .1 , V e -C- t c W it: "Th6�, mat er-.mus '-mdetl�,.,pe A I of,the, tandaroi� _4 Dr in kincj';�'A >f 4­0 w - subtiitted;,pian must-be !.§tr i6reA t6�"ctlY, :adl V �­ K 4 1 Ar,6s'-Ma�, l- -,A98C"-`,. -ance4 This."Varm xp " t,;- " . Y. Vt Y., YoUrs Not q w- be '��, i MRort L �Chldsai 4. � � A 47 IT, 'K. e.� augh, �r m"--;,'n"r- Y N J- 1V z U.-,.,FInc M. F. A. BOARD op- m 3 -'QL -v: 4�'o. 4,N J, 10 4� April 15, 1983 P.O. Box 230 West Barnstable, Ma. Chairperson, Board of Appeals Town of Barnstable Hyannis, Ma. Dear Chairperson: This is a request to move the well site on Lot #10, Apollo Drive, West Barnstable a distance of 23.8 feet. The reason for this is due to the fact the original site is located directly under a forty (40) foot white pine and would necessitate the removal of a nice tree. Attached is a proposal for the new site from the original. Thank you for your consideration. 1 Sincerely yours, John A. Weiss OWNER 1 CONTOURS f PLAN REFERENCE '" � WELL --- WEST BARNSTABLE MA �r LOCUS af EXISTING - - - - - - - 50 PLAN BOOK 233 PAG 19 4, oc FINAL 50 ASSESSOR'S MAP: 13 N ., �W FmE LOT: 44 �p wa O<W > J U) (D co z tri _ \� 32 PI T(r — — A 1 ^ --� �_ 30 CSC 9R STRe 0� m S _ / —�� —222.36 P� 71 FT --------------- °zo ---___ 26 LOCUS MAP �� �' D°� I UNp4VE0 \ "� NOT TO SCALE co o '°"' �<o .1 \ �Rj�E �Y 1 rn o }`I' N °w� LOT 10CD 1 j J� z �}/' \ E \ \ AREA = 35578 s f +- 1 N J H LL 3 I I WELL J w I W w 4 W u x U _j > L' w} < _j O Lq I < f FROM - / 1 W m X IL W z N E�c.� I m mF W z � (� 134J — ; LEGEND W z / EXISTING WO O 1 �� �(� I 000 GALLON D N I DA> / 1 SEPTIC TANK ry N} J F m I / \ �tiO� •f �Z�� 2 ff P 126 D-BOX 0 ........... //^^ Q � W 0 1 v/ \ VENT W ~J z J O m m � co I � C/�v O M� � � PIPE TEST PIT W Q OJ N Ln c �? Q „ 335 Fix 12.5 ft x 2 ft EXISTING cn --�< m m IL I / I D� LEACHING GALLERY 1 LEACH PIT z v0 N a -0 O W I .� 10 LE CO z W LL w cD z c� 1 M B Z-P / co �z of 1 O L _ \ lV 15-o TREE P U o Z U Wrl rzI -NUMBER REFERS TO DIAMETER F IN INCHES.LETTERDENOTES TYPE WI,j c Z lyfOMAPLEP-PINE / .�-� pJ 1 I I �` W co I I ,p, 0I Pt FRp I Ld < � M STRE,gNj I 1 � � 1 ri e4-0 Q J I OD � I INSTALLER MAY CHANGE � + z N I I LOCATION OF VENT PIPE/ 1 Lo P _ TO A MORE SUITABLE 1 0 BENCH MARK N N � LOCATION IF DESIRED. W m w 3638 ��- W TOP OF FOUNDATION �_�_ / I ELEVATION = 38.69 38 BARNSTABLE GIS DATUM 36 222.36 f E —� � 1 N , j34 32 z 30 F—i z I ' 2B —�J 1� J CO z � SWING TIES 26 SEWAGE DISPOSAL SYSTEM PLAN 0 0 0 om < U DWELLING CORNERS TO PI_A N -TO SERVE EXISTING DWELLING o o LEACHING GALLERY NO OTHER WELLS WITHIN 150 FEET GERALD AND JANE POYANT I m W A B OF PROPOSED LEACHING GALLERY m W 30 0 30 60 SNOFM 26 APOLLO DRIVE WEST BARNSTABLE. MA o + 1 2�.4 ft 34.�5 f't _ qs, c ECO-TECH ENVIRONMENTAL m 2 34.8 ft 2�.8 ft 0 Ala 20 se moo`' DAMD ���, OU3LL SCALE=: 1 to = 30 FE D. , 43 TRIANGLE CIRCLE LL m ., WR Z �No pg SANDWICH MA 82563 Iw W X '�FQ�S7��� 506 364-0694 L� W WVARIANCE REQUESTED 1TA ETE-2304 APRIL 26. 20B 112 MAY BE GRANTED IMMEDIATELY BY HEALTH AGENT OR HEALTH INSPECTOR. kS THIS PLAN IS BASED ON AN INSTRUMENT SURVEY AND IS INTENDED BARNSTABLE LOCAL BEGS - 150 FOOT SETBACK FROM LEACHING TO 1•VELL s � b� �. ��/ SOLELY FOR INSTALLATION OF THE PROPOSED SEPTIC SYSTEM REQUIRED. VARIANCE TO 107 FOOT SETBACK TO ONSITE WELL REQUESTED. ��` DEPICTED HEREON. FOR ANY OTHER CHANGES TO PROPERTY INCLUDING PLACEMENT OF ADDITIONS. SHEDS. FENCES OR SWIMMING POOLS, OWNER SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR. r 7 DATE OF TEST: '` AF•RIL 25. 2006 SOIL TEST L 0 G SOIL EVALUATOR: DAVID- D. COUGHANOWR. RS WITNESSED BY: DONALD DESMARAIS. HEALTH DEPT DESIGN CALCULATIDNS �r V NO GROUNDWATER ENCOUNTERED TEST PIT 1 PARENT MATERIAL: PROGLACIAL OUTWASH DESIGN FLOW: 4 BEDROOMS X 110 GPD = „44 GPD ELEVATION = 32.00 +- PERC AT 64 in 2 MIN/INCH IN C SOILS c7 NP SEPTIC TANK: 4 � GPD X 2 DAYS = 8 D GALLONS r DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER USE EXISTING 1000 GALLON SEPTIC TANK IF IN SOUND STRUCTURAL (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING CONDITION. IF NOT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) 32.00 0-20 FILL DISTRIBUTION BOX: USE 3 OUTLET D-BOX. 20-26 O LOAMY SAND 10 YR 3/3 NONE FRIABLE SOIL ABSORBTION SYSTEM: A 33.5 Ft x 12.5 ft x 2 Ft. LEACHING GALLERY CAN LEACH 26-44 E LOAMY SAND 10 YR 5/4 NONE FRIABLE Abot = (33.5 x 12.5 I = 418.75 sf 28.33 44-126 1 A MEDIUM SAND 1 10 YR 6/3 1 NONE LOOSE A s d w = ( 3 3.5 + 3 3.5 + 12.5 + 12.5 ) x 2 = 18 4.0 s f 21.50 Atot = 602.75 sf NO GROUNDWATER ENCOUNTERED Vt 0.74 x 602.75 = 446.03 GPD 1 0 Vt = 446.03 GPD > GPD REOUIRED MATERIAL: PROGLACIAL OUTWASH USE A 33.5 Ft- x 12.5 Ft x 2 Ft- GALLERY. PARENT TEST PIT 1 �� ELEVATION = 32.10 +- 2 MIN/INCH IN C SOILS DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE fMUNSELU MOTTLING 32.10 LEACHING GALLERY CONSTRUCTION 0-10 FILL DETAIL 500 GALLON DRYWELL DIMENSIONS AND DETAIL 10-16 O LOAMY SAND 10 YR 3/2 NONE FRIABLE SHOREY PRECAST CONCRETE 500 GALLON DRYWELL USE H-10 UNIT LEACHING UNIT OR 18-42 E LOAMY SAND 10 YR 5/4 NONE FRIABLE EOUIVALENT d S T O N INSTALL ONE INSPECTION 28.60 RISER TO WITHIN SIX 42-128 A MEDIUM SAND 10 YR 6/3 NONE LOOSE INCHES OF FINAL GRADE 21.43 33.5 Ft ONDAS-BUILT CARD. TION m 4J 0 33 N0 (V 00 O �QQ� in o0000000000 0�00� NOTES 8.5 6.5 6.5* 1) GARBAGE GRINDER NOT ALLOWED WITH THIS DESIGN 33.5 f t 1�2 in 2) ALL LINES TO BE SCH 40 PVC AND PITCH AT 1/8 INCH PER FOOT MINIMUM. 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REOUIREMENTS OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15) 4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES BEFORE EXCAVATING FOR SYSTEM. 51 EXISTING LEACH PIT TO BE PUMPED. COLLAPSED. AND FILLED. OR REMOVED 6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST IN PLACE GROUNDWATER ADJUSTMENT 7) LINES EXITING D-BOX TO RUN LEVEL FOR 2'-0- BEFORE-,PITCHING DOWN 8) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INST.A'L}L_A-T•IO_N•�OF, LOW FLOW FIXTURES EXISTING GROUNDWATER LEVEL AND APPLIANCES. AND BIANNUAL PUMPING OF THE�,S-EPT-LG `TANK BASED ON WATER LEVEL OBSERVED SEWAGE DISPOSAL SYSTEM PLAN IN ADJACENT STREAM. 9) SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR. LO-ADING:,-D°O NOT OBSERVED GW 16.70 -TO SERVE EXISTING DWELLING PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. INDEX WELL SDW-252 lal INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT-,BE'lFOR'E STARTING WORK. ZONE B GERALD AND JAYNE POYANT ;, w<a READING DATE MARCH. 2006 11) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUEP T --".;T O ;GRADE ON A LEVEL READING 46.5 26 APOLLO DRIVE WEST- BARNSTABLE. MA STABLE BASE THAT HAS BEEN MECHANICALLY COM .ACED:.,A-ND ON..TO WHICH ADJUSTMENT 0.9 SIX INCHES OF CRUSHED STONE HAS BEEN PLAC_ ED ,,T,Ot-MINIMIZE ;UNEVEN SETTLING ADJUSTED GW 19.60 ECO-TECH ENVIRONMENTAL 12) SEPTIC TANK TO BE PUMPED DRY AT TIME OF SYSTEM YREPAIR AND CHECKED FOR STRUCTURAL INTEGRITY. INSTALL PVC OUTLET T,E'E FITTEp .WITH GAS BAFFLE. 43 TRIANGLE CIRCLE SANDWICH MA 02563 ETE-23041 APRIL 26, 2006 2/2 - - - r - .. .y,• .. _.,. "5 - _. �i „ ' .. � ... T« .- • -.e,•i1-+,. ..Irk. ,yam - _ - ... " b M .�. �., _ ..... -{ . t .. .F ,re 4 z /.•..s--.,..•.�' ,CCI'•r t �`4 ••T' . .y. ♦ w"`r'_«.,,'+_•,"_^ `� - �r SECTION - SEWAGE -� , .,. . �>_ _ g r,� •-`- = .� 5 = - LL v \ Sz -SEPTIO-TANK - i 'D` BOX - - LEACH OP FON • - - -~- (MSL) ALL__ Uk.tSL1 rTA43LE MFSfi�.FA� 2"OF ' RTO 14'• ' Falc P DI:TAr.tt6: Oe tQ P�Len S> WASHED STONE '�AtTI i2tE iJE'Au-i.,_C�r7' A«�] 2:="•�.Fl�. w''Tti, INOUT - IN A =�E O uT��1QI --ELEV. ELEV. ELEV. ELEV. 1Q f \ _ 2.4.t L4 vo _ I _-- I �� T.r4•ar 1 ELEV. ELEV -7 _Z_d�. OF 44' WASHED STONE TEST HOLE LOG TEST BY Z.r .2 �d�e 1C ��.. _C'.GIn�O�t7 3A,Z-N.:. P�,O.�i. 0 �� —• —_ 4 I. TEST DATE Sttz Z_ WETNESS S`�} -"�YciIVY ' —�- DESIGN —BtpROOM HOUSE `� --- =r T.H. x 1 T.H. # 2 zS.St / 9 F CD �! ' ELEV. ELEV. NO LoA n Swr3Sor� Lo�n�'ti Su• cl„` C A E Z MIN%IN. DISPOSER DISPOSER j, PER R T I t z� � J ?' 'rid -. z-w•- c.-_ . '1r '�•9 Z4 Z3.� FLOW RATE �Q (GAL , t eLEAPi, N.� - s4�17 r SEPTIC TANK -3 (l.3 L— 49 E REQ'D SEPTIC TANK SIZE ��Q -- )Ss�T Zo.3 Zo.'o S,�rY tc,ry� LEACH FACILITY - 84" t4s'.b SIDE WALL l'o.s�T<,.�) ►`i_�•9tZ S ) _ 14.� GiD. 1 BOTTOM IQ-`a �(�� 6G•�_( I.o } _ Sfm.Co GfD. ��'-t', � �. — _ • �. �' . , / m Fi�,� $�.r.,� cal= s Aao TOTAL = LAQ <s m = S I_3 G/D• 5 � 1 — t USE: — LEACHING' I Ca` UO_WATER ENCOUNTERED -- — - � �• � NOTES: (UNLESS OTHERWISE NOTED) 1. DATUM (MSQ L TAKEN FROM 6^NQ"'_'�_!�.__.-•__._.__QUADRANGLE MAP 4. DESIGN LOADING FOR.ALL RE-CP.ST UNITS: AASHO-. C4 a r y;'` J Z3, A�C 1` 2..b9UNICIPAL WATER .__.._._AVAILABLE -t d{ g9,drr 3. PIPE PITCH: k•'PER FOOT ----•-•- ,o //r 61R1`.�• f.. •< �-� - _ ` 5. MIN. GROUND COVER OVER ALL SEWAGE FACILITIES: (1) FT. {a AN.tIE G'^, C I OJALA �I --a-_DISTANCE AS CERTIFIED ��-� ' " ` - 6. PIPE.JOINTS SHALL BE MADE WATER "TIGHT ( � H• � r " '•'Vr ` "ir '- 2`- � 7- CONSTRUCTION DETAILS TO BE ACCORDANCE WI'TH COMM.OF MASS. { o OJALr� ..n4 V� :i'?3? / - "_� STATE ENVIRONMENTAL CODE TITLE 5 i`� tf'f+32 3 { j '�- j, I HEREBY CERTIFY THAT THE BUILDING - .. SITE P AN '- cis SHOWN CryL, �• � SHOWN ON THIS PLAN.IS LOCATED ON THE GROUND AS SHOWN HEREON & THAT IT_�£ OCUS: CONFORM TO THE ZONINGA r�1LA7 LAWS OF THE w�S� r�A�V f f�3�C MASS.-- _ !1•• _:� ,TOWN OF �FiL�Z_ ---e-- REG. PROFESSIONAL ENGINEER WHEN CONSTRUCTED. DATE 1 . ' REF1•• OF �/ 4 � ~ f1 own C��e enormeering PREPARED FOR: 1 CIVIL ENGINEERS LAND SURVEYORS • BOARD OF HEAL TH I RED_ LA!AlcC S A` {EXISTING) --_ .r . . APPROVED �- farmuil'i+$O'eH^S,tyl•q SCALE_ CONTOURS O IjAlIE _t !v AEI-C a MA 1 Z SECTION - SEWAGE ,,.r.� A \ -SEPTIC TANK - - "D" BOX - - LEACH TOP OF FDN I �.-'r► �'��„r �_~"-' > Mv - "2"OF�eT0 ih"- - - - - - - (MSL) L A ` FDA p, Tbl"rA"c_Q d1= 10 4 i4, Ae=UrwD WASHED STONE LEAC 4 PI-17 A w 17 M_Gi-l.fa-F_ W 11Y4 �`�+ \-14 I � IN OUT- IN OUT ,IN' ZQ.q¢ 7-4.7 / sePTlc TANK ELEV. ELEV. ELEV. \ ELEV. ELEV. ( -i.tfZ OF N."-11/2" fix.,<.,s ---"'. --_",,,•'•-:- $t N Per \ WASHED STONE ���,,,.•,,,JJJ -ate' . , / 40:� / ` V TEST HOLE LOG -' 0 �. N TEST BY �.r�i Q^�-��ar_?E. �C.G WITNESS TEST DATE ..�?L°_ ___ DESIGN __-.-BEDROOM HOUSE /'`'- �45� � r• � T.H. 1 T.H. # 2 t err, ELEV. ELEV. NO / } LOA•n /�S 't3c�pi` �v•nn Su S<�� DISPOSER DISPOSER A i� ` �Ck sp/,. 3=; •. PERC RATE �MIN/IN. ll t ' �.s, -L 9 r 7-3 FLOW RATE 330 (GAL./DAY ) 1 -- 33 f e, GL.6A ►%%j. sAn�o nn� luny IANb SEPTIC TANK 330 ((.5}_ 49`� I . REQ'D SEPTIC TANK SIZE �6?�J �_ _ �____ @41, y CEO• -�- Za.9 �� ` / LEACH FACILITY i •�,� SIL ��N� \ Zp.ea SIDE WALL Co.S Tr t!n/ •Q (2 rS ) s a 44:1 G/D. _ �. BOTTOM 10,5 '' ` u = ISG•�o I l.0 ) �gl..� G/D. +r C o TOTAL - 7-84 .5 S 8 1 .3 USE: LEACHING T I 14^4••"= --I'3.9 l4���----- -- 13.E Co� s~=~.bG't"7"6^i .>< Io.S ��. ��a.. _` ► \`..., �\�1v'\ 3p 1 '� (`tom WATER ENCOUNTERED NOTES: (UNLESS OTHERWISE NOTED) ~1 - tie 1. DATUM (MSL)+TAKEN FROM NNQw�c N _. Of �ZH OF =� - QUADRANGLE MAP \ .� TJ1`Y` �!! '� 4 om 2.MUNICIPAL WATER••,^_^•--•_ --_--_.....................AVAILABLE �� .y1 ,�, W +Z"I•^t 3. PIPE PITCH: 1/4"PER FOOT 9�+y ARNE H. 4. DESIGN LOADING FOR ALL PRE-CAST UNITS: AASHO 1 44 = G OJA(JA �-. LLc� y �, 5. MIN.GROUND COVER OVER ALLSEWAGE FACILITIES: (1) FT. d ARN1 O l IVIL v~i -0--'-DISTANCE AS CERTIFfED t I 6. PIPE JOINTS SHALL BE MADE WATER TIGHT H. 1C• "3IL ~k'- '_- 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM. OF MASS. E34JALA �' I HEREBY CERTIFY THAT THE BUILDING - SITE RUAN --- STATE ENVIRONMENTAL CODE TITLE 5 ,r '�rCiS1'E�``Q ,�/// c 7 SHOWN ON THIS PLAN IS LOCATED ON THE 11 �9 fGISTE� yO `�/ GROUND AS SHOWN HEREON : THAT ITQO_t- +" f ^� I.�OCUS: CONFORM TO THE ZONING BY LAWS OF THE MASS. ----- TOWN OF / aRi•!E_ ` REG. VROFESSIONALENGINEER WHEN CONSTRUCTED. DATE A- -= H `�,� -Pt..,., 3il:�--. Z33 rE+• %ci OJALA �„ REF: Y down cape engineering �� .2634 PREPARED FOR: "�pHO'�' A ' • CIVIL ENGINEERS ,�,� _ •,� '�ij�F. _ MAID.G 1 A Y-1 G-•� S S . . , BOARD OF HEALTH ' LAND SURVEYORS LTH r} _ R L1 D'S R u �u. SCALE— (PROPOSED) 1 ���0._ _�• 4- �S'�j 1 CONTOURS (EXISTING) .-.•--•-•-• - NA3l C Yarmouth&Orleans,MA -O-O-O--O" APPROVED T DATE ---•-••-�•--;- MA DATE -© �. ,t