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0031 COLUMBIA AVENUE - Health
31 Cdluifibia Avenue Marstons Mills P A = 103 023 i I i oll TOWN OF BARNSTABLE V LOCATION 3 / eof c N,61,4 A y r SEWAGE# VILLAGE 14 - A W f ASSESSOR'S MAP& LOT LO- - "3 iNSPf ct.',cs sQ/ RR'S NAME&PHONE NO. �� (�i�/►�Po SEPTIC TANK CAPACITY 57 Ar7l J 71 o t�- biACHING FACILITY: (type) (size) Nth.OF BEDROOMS BUILDER OR OWNER PERMTT.DA_lt ; ` 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 7)Ec/c �r r 3� .. 5.1 y8 r New S Yf T� 3H0A/) COMMONWEALTH OF MASSACHUSETTS w EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS + d DEPARTMENT OF ENVIRONMENTAL PROTECTION F ti I y �q,y Sv0 350 MAIN STREET Wit" It]rE WEST YARMOUTH,MA .y g ^_ 508-775-2800 V� DEC 0 8 TITLE 5 TOWN OF BAR OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION MAP 103 PAR 023 \ �� Property Address: 31 COLUMBIA AVENUE MAP MARSTONS MILLS,MA 02648 Owner's Name: ATSIKNAUDAS,ANGELO PARCEL Owner's Address: 125 BELMONT STREET LOT b BELMONT,MA 02478 Date of Inspection NOVEMBER 17,2003 Name of Inspector:(please print) JAMES D. SEARS Company Name: A&B Canco Mailing Address: 350 Main Street West Yarmouth,MA 02673 Telephone Number: 508-775-2800 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. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ./ Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: "_, Date: �� O The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent tot he buyer,if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 1 Page 2 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 31 COLUMBIA AVENUE MARSTONS MILLS,MA 02648 Owner: ATSIKNAUDAS,ANGELO Date of Inspection: NOVEMBER 17,2003 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: ✓ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: N/A One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined" please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health)" broken pipe(s)are replaced obstruction is removed ND explain: Title 5 Inspection Form 6/15/2000 2 Page 3 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: 31 COLUMBIA AVENUE MARSTONS MILLS,MA 02648 Owner: ATSIKNAUDAS,ANGELO Date of Inspection: NOVEMBER 17,2003 C. Further Evaluation is Required by the Board of Health: N/A Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety,or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in m o a manner that protects the public health safety and environment: Y g P P � Y The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance **This system passes if the well water analysis,performed at a DEP certified laboratory,for 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,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Title 5 Inspection Form 6/15/2000 3 Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: 31 COLUMBIA AVENUE MARSTONS MILLS,MA 02648 Owner: ATSIKNAUDAS,ANGELO Date of Inspection: NOVEMBER 17,2003 D. System Failure Criteria applicable to all systems: N/A You must indicate"yes"or"no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in leaching is less than 6"below invert or available volume is less than'/x day flow ✓ Required pumping more than 4 tunes in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation N/A Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply N/A Any portion of a cesspool or privy is within a Zone 1 of a public well N/A Any portion of a cesspool or privy is within 50 feet of a private water supply well N/A Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. (This system passes if the well water analysis performed at a DEP certified laboratory,for 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 or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.) NO (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: N/A To be considered a large system the system must service a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well. If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system is failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. Title 5 Inspection Form 6/15/2000 4 Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 31 COLUMBIA AVENUE MARSTONS MILLS,MA 02648 Owner: ATSIKNAUDAS,ANGELO Date of Inspection: NOVEMBER 17,2003 Check if the following have been done. You must indicate"yes"or"no"as to each of the following Yes No N/A Pumping information was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ Has the system received nonmal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection? ✓ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? ✓ Were all system components,excluding the SAS,located on site? ✓ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum ✓ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)has been determined based on: Yes No ✓ Existing information. For example,a plan at the Board of Health. ✓ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] Title 5 Inspection Form 6/15/2000 5 I Page 6 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 31 COLUMBIA AVENUE MARSTONS MILLS,MA 02648 Owner: ATSIKNAUDAS,ANGELO Date of Inspection: NOVEMBER 17,2003 FLOW CONDITIONS RESIDENTIAL Number of Bedrooms(design): 2 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms: 220 Number of current residents: 0 Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): YES Seasonal use(yes or no): NO Water meter readings,if available(last 2 years usage(gpd)): N/A Sump pump(yes or no) NO Last date of occupancy: UNKNOWN COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CM 15.203): Basis of design flow(seats/persons/sqft,etc.): 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/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: N/A Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: gallons—How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM ✓ Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no)(if yes,attach previous inspection records,if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank Attach copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: SYSTEM INSTALLED IN 1992,PERMIT#92-366.NEW LEACHING PIT IN 1999,PERMIT#99-534. Were sewage odors detected when arriving at the site(yes or no): NO Title 5 Inspection Form 6/15/2000 6 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 31 COLUMBIA AVENUE MARSTONS MILLS,MA 02648 Owner: ATSIKNAUDAS,ANGELO Date of Inspection: NOVEMBER 17,2003 BUILDING SEWER(locate on site plan): ✓ Depth below grade: 30" Materials of construction: Cast iron 240 PVC _ other(explain) Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK(locate onsite plan): It Depth below grade: 2' Material of construction: J concrete metal fiberglass polyethylene _ other(explain) If tank is metal list age: Is age continued by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1,000 GALLON PRE CAST Sludge depth: 3" Distance from top of sludge to the bottom of outlet tee or baffle: 27" Scum thickness: 2" Distance from top of scum to top of outlet tee or baffle: 8" Distance from bottom of scum to bottom of outlet tee or baffle: 24" How were dimensions detennined: ASBUILT AND TAPE Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): MAIN TANK AT WORKING LEVEL.TANK AND COVER T BELOW GRADE. INLET TEE,OUTLET TEE. NO SIGN OF OVERLOADING OR LEAKAGE. GREASE TRAP(located on site plan) N/A Depth below grade: Material of construction: concrete metal fiberglass polyethylene other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Title 5 Inspection Form 6/15/2000 7 r Page 8 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 31 COLUMBIA AVENUE MARSTONS MILLS,MA 02648 Owner: ATSIKNAUDAS,ANGELO Date of Inspection: NOVEMBER 17,2003 TIGHT or HOLDING TANK: N/A (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass polyethylene other(explain) Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no) Alarm level: Alarm in working order(yes or no): Date of last pumping Comments(condition of alarn and float switches,etc.): DISTRIBUTION BOX: ./ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: 0 Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.,): DISTRIBUTION BOX IS 16"x16",38"BELOW GRADE.ONE LINE IN,ONE LINE OUT. BOX IS CLEAN. NO SIGN OF OVERLOADING OR SOLID CARRYOVER. PUMP CHAMBER: N/A (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Title 5 Inspection Form 6/15/2000 8 Page 9 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 31 COLUMBIA AVENUE MARSTONS MILLS,MA 02648 Owner: ATSIKNAUDAS,ANGELO Date of Inspection: NOVEMBER 17,2003 SOIL ABSORPTION SYSTEM(SAS): ./ (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: J leaching chambers,number: FOUR NEW AND THREE OLD leaching galleries,number leaching trenches,number,length leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) OLD SYSTEM: LEACHING IS ONE ROW OF THREE INFILTRATORS. NEW SYSTEM:LEACHING IS ONE ROW OF NEW FOUR INFILTRATORS 4'xI 1'x25'. LEACHING IS 38" BELOW GRADE.NO SIGN OF OVERLOADING. CESSPOOLS: N/A (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): 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.) Title 5 Inspection Form 6/15/2000 9 I Page 9 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 31 COLUMBIA AVENUE MARSTONS MILLS,MA 02648 Owner: ATSIKNAUDAS,ANGELO Date of Inspection: NOVEMBER 17,2003 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two pennanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. I � V '� FC¢ SS 3�. sy' L Title 5 Inspection Form 6/15/2000 10 Page 1 1 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 31 COLUMBIA AVENUE MARSTONS MILLS,MA 02648 Owner: ATSIKNAUDAS,ANGELO Date of Inspection: NOVEMBER 17,2003 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to no groundwater 8 feet Please indicate(check)all methods used to detennine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: J Observation site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation Accessed USGS database-explain: You must describe how you established the high groundwater elevation: DUG TEST HOLE,ROCK AND ROCK HARD GROUND. TEST HOLE 8'NO WATER. TEST HOLE Y BELOW BOTTOM OF LEACHING. U J?0//a^ Title 5 Inspection Form 6/15/2000 I I TOWN OF B4Y6 ARNSTABLE iBUELDER G 4 3/ F04t an/A vo SEWAGE # E I�1 A111 L s ASSESSOR'S MAP & LOT ER'S NAME&PHONE NO. TANK CAPACITY � dUO G FACILITY: (type) �.11Z_,7 /�T 1 (size) V ll EDROOMS OR O PERMIT DATE: VIM COMPLIANCE DATE: 1 Separation Distance etween 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 G�. F 1 1 3 f33. C No.gf— —3 1' Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Migogaf *p5tem Cow6tructiou Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System 14Xdividual Components Location Address or Lot No. C� a& ` 1 Owner's Name,Ad press and Tel.No. p Assessor's Ma /Parcel I v��f v A � Installer's Name,Address,and Telco. Designer's Name,Address and Tel.No. �t111 i 0�-ON K-`� 15 1&As � Type of Building: Dwelling No.of Bedrooms 13 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow _3�k gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank eec-c !;;'tch< \Od?D Type of S.A.S. i C Description of Soil Nature of Repairs or Alterations(Answer when applicable) 'T�-Ll -r — c(=k 1r CA,, Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has ue y t s o Signed Date Application Approved by r Date1100, �3 Application Disapproved for the following reasons Permit No. Date Issued Z No. / — S-3 Ll d7 ,.. Fee 's __—,10 1 THE COMMO R ALTH OF MASSACHUSETTS Entered in computer: ✓✓✓ • C•"' i - Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS 0(pplication for Migogar *p!6tem Congtruction permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) El Complete System &Individual Components Location Address or Lot No. 3 C.D O�yq,� f A.,AtW� OwneName, d(ress and /Tel.No. Assessor's Map/Parcel Yrvr � � E /—s AA_e V Installer's Name,Address,and Tel.-No. Designer's Name,Address and Tel.No. t51 (91..1 S� Type of Building: Dwelling No.of Bedrooms `3 Lot Size sq. ft. Garbage Grinder( ) Other Type of Building,''. .-" No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow ��� gallons per day. Calculated daily flow _3!�6 gallons. Plan Date Numberlof sheets Revision Date - r Title r ` ---Size of Septic Tank 2�: < (__�t c/> i067r) Type of S.A.S. if C c Description of Soil ! jam Nature of Repairs or Alterations(Answer wl�en�appl cable) - i r L L� r"e L. E Date last inspected:, y Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site,sewage disposal system accordance accorda ,ce with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- w -cate of Compliance has 4emiTsued"by this 130, 1 Signed �-- ~~ Date c, Application Approved by - Date Ove 3 r Application Disapproved for the following reasons a Permit No. - y # Date Issued Z 31517 r THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS "' Certificate of Compliance THIS IS TO CERTIFY that he On-site Sewage Di s osal System Constructed( )Repaired ( )Upgraded(V/� Abandoned( )by r- l at 0 b A. c+ c m—'r- &N hasibeen constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. "J•'"3 dated ? 3 Installer Designer fl rl G' The issuance of this pe- 't h�l o e c�o strued as a guarantee that the syst £Action �,e i�g/ d� Date Ll Inspector ✓ � -�✓/! E G` . ------=--------= _ .---=_-_-----_--- No. / Fee 3 ....''. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Migpogal *pgtem Congtructton Verna Permission is hereby granted to Construct q )Repair( )Upgrade( andon( ) System~located at 2,. and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Constructio must be completed within three years of the date of this rmit. Date: Y ZC / Approved by % 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL �- WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) hereby certify that the application for disposal works construction permit signed by me dated /�' '��] , concerning the property located at C Q1 0 6 meets all of the following criteria: "• The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. 4��The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. �There are no wetlands within 100 feet of the proposed septic system • here are no private wells within 150 feet of the proposed septic system There is no increase in flow and/or change in use proposed �There are no variances requested or needed. • e bottom of the proposed leaching facility will not be located less than five feet above the v maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] • the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: �j 2 A) Top of Ground Surface Elevation(using GIS information) O �� B) G.W.Elevation +the MAX.High G.W. Adjustment.( Y= L I J DIFFERENCE BETWEEN A and B SIGNED : DATE: [Sketch proposed plan of system on back . q:health folder:cent ,� �' . ;�� , O v - �_ r� �. _.�., TOWN OF BARNSTABLE LOCATION 3I C 041,4 A tl SEWAGE # VILLAGE i� ® �Iir[ r ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY ,wrl0 LEACHING FACILITY: (type) ,�4//Z__7k 'Tc � (size) l� NO.OF BEDROOMS BUILDER OR O PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 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 DG � jP -] 4 h t 93 —37-7 —"'I McKean Thomas From: McKean Thomas To: Maloney Kathy Cc: Locke Janet Subject: SP#43-94/ Nehemiah Lovell Real Estate Trust Date: Wednesday, October 05, 1994 5:37PM The following are the comments of the Barnstable Health Division regarding the proposed project (SP#43-94): *The submitted application form states that only 9016 square feet of office space is proposed. However, the submitted Subsurface Sewage Disposal Plan "SY describes a total of 9988 square feet of total office space proposed. There is a discrepancy between the application and the submitted plans. *The design capacity for the septic system which is connected to 'BUILDING A" is 498 GPD based on 5,490 square feet of office space. Has the size of building "A" increased? Also, the design capacity for the septic system which is connected to Buildings"B" and "C" is 396 GPD based on a total of 4,498 square feet of office space. Has the size of either of these buildings ("B" or"C") increased? *Buildings "B" and "C" are one story buildings. Will any space be used on any other levels (the upper or lower levels) of these buildings as an office? Page 1 FO.eKean Thomas From: McKean Thomas To: Maloney Kathy Cc: Saad Dale Subject: SITE PLAN REVIEW COMMENTS/29-94/31 Columbia Drive Date: Wednesday,August 24, 1994 3:22PM I am in receipt of the above referenced site plan review application dated August 22, 1994 and'offer the following comments and questions: 1. How many bedrooms does this dwelling consist of? This property is located within a GP district is therefore under the restictions of the Town Ordinance,Article 47, Regulation of Wastewater Discharge. The lot size is only 20,750 square feet. Sewing rooms, dens, finished cellars, sleeping lofts,and similar-type rooms are considered bedrooms according to the Board of Health and the MA DEP definitions;therefore the existing daily flow estimate would increase by 110 gallons. One cannot exceed 330 gallons per acre in a GP or WP district according to this Ordinance. Please be advised that the Town Council or the Board of Health cannot grant variances from the Town Ordinance-Article 47. Therefore, it is likely that this applicant cannot proceed with this requerst. 2. Is the proposed basement office room floor to ceiling height more than 50% below grade and subject to chronic dampness,? The above items#1 and#2 are the questions and comments of the Health Division. r n i oi - ,..V.<�s� Wit°• SFP Y A51:+ ; .p d.i at rv��a �� F'.tM ' ,� ` [ `sws�.ti �."•} '.�°'is �+'�,n ,r s ` Page I , 163 �No..J.q _3 Fa=___71Q • THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH N TOWN OF BARNSTABLE Appliration for 131opooul Works (nonstrurtlun Vrrmit Application is hereby made for a Permit to Construct ( ) or Repair (,Wan Individual Sewage Disposal System at: sal_.....___akufvx�. . el.�............. _ Laatlon-Address�......................................... Owner Addrca r.................................................. ........RCQ !�`�...4�...:...........EtS.e9r!n ,S,.__.... Installer Addeeas Type of Building Size Lot Sq. feet Dwelling—No. of Bedrooms..................._.........._......."».Expansion Attic ( ) �' Garbage Grinder (` ) 004 Other—Type of Building ............................ No. of persons_.:..............:.......... Showers ( )_Cafeteria ( ) a' Other fixtures Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid capacity............gallons Length................Width................Diameter................Depth................ W Disposal Trench—No.....................Width...................Total Length....................Total leaching area...................sq.ft. Seepage Pit No.................... Diameter.................... Depth below inlet....................Total leaching area.................sq.ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by............:.......... .......................................... _.....:. Date...................................... Test Pit No. l................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (3� Test Pit No. 2................minutes per inch Depth of Test PiL................... Depth to ground water........................ cx _. _... O Description of Soil... �--...2...�................. . ............_.."."".""............ ....Ll..�. ......:�"�+!!� M , V ...........................................................................................................................»....................__........_................._.. _..._---.... ...............................................................................................................__...........................:.......__._.. ._...............___.... U N ore of Repairs or Alterations—Answer when applicabla...l fl....... \1R -::........1.`!!►.l -a.T!Sk�OR�_.._.-.-. ?f.............�.......... v&T. bl%...........Stir!AEI.1.!!: .................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed .r.Sr............................................. . ....... ..L �9Z Application Approved By ...................... �. ......T..--;1..7...412.. Application Disapproved for the fol owing rearon.r: ................................................................................................................4............._.... ..................................................................................................................................................._.._...................................._............ ..................................' Permit No. 7A 3.6..E?........................... .:Issued _.:.�. .:_..:.__... _.._ _......a.:_.. }•. , DM M. - AC 1 0 It tS'� t f .. .. �Air �4a la dl� '7{ Z��� .�t sy •>< r Y ,ny rxt R�,tdy�-�" k _ �,•.. f Sea '^? q. .y IY 'tom ha .*6.a� P +S +iP' 1 g5 j k�J:p •:d - � ic 14 HM ] 31 H E A L T H M A S T E R ] HELP [ ] R E C O R D ) ACTION IJ For Parcel Number 103] 023] ] ] Rental Property(Y/N) [ ] Owner' Name PALMER, MATTHEW & LISA BARR ] Zone of Contrib(Y/N) [ ] Location 31 COLUMBIA AVE MM ] Contaminant Rel(Y/N) [ ] Business Name [ ] :Area Number Contact Person [ ] Phone 'tOOO] [ ] Fuel Storage Tank Permit [ ] Card on File Perc Test Well Septic File/Permit No. [ ] [ ] [92„,366 ] Issuance Date [ ] [072792] Completion Date [ ] [072192] Last Communications [ ] (MMDDYY) Comments [REPAIR ] Cancel [ ] NEXT SCREEN [HM ) ACTION [ ] PARCEL NBR [ ] [ J [ ] TANK NBR [ ] ] [ J " L i4 Yak..3' '`�'..9 ,1"��.k, *�'Yt' ro a-°r ••A ,s 4 Y'' i�k..-'s` 3',! - _ r� e TOWN OF BARNSTABLE SITE PLAN REVIEW DATE: August 22, 1994 TO: Thomas Marcello FROM: Janet Locke RE: Site Plan Review Number: Mathew A.Palmer&Lisa M.Barr f 31 Columbia Avenue Marston Mills MA 02648 Application for home occupation Please submit this form,with any comments or additional requirements you may have regarding the above referenced application,to the Building Inspector's office as soon as possible. Applicant will be at the August 25, 1994 meeting. I have the followinglattached 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) r /r rum Orr I CE USE: ON Appl,1 CAT 1 UN 1 UR SITE PLAN KE:V 1 EW DATE RECEIVED ' . ACTION DUE BY LOCATION S�octiC Legal Descriptions_ SING�C ^�`� R- — planning Board Subdivision Number+ / c Assessor's Map and Parcel Nu�be ram` Property Address' OWNER OF PROPERTY ;r- APPLICANT wame+ cw A. nc���- L gilt Namet J'q.tiE 4ddress s Cow�3�A /�� Address t ,�'1.4 its i"�lS /h�u.s MA od 6Yl Phone, �� �f� - to3 Phones ENGINEER AGENT(lnterest owner or applicant) Names vames Address Address, P Phone, honey S7�?�:A+ E TANk� i�7lLIIIES 'ZONING CLASSIFICATION S :1I57li+G FRi�FOSEO Sewer Districts N r(oNL Public --- •---FIood Hazard, Number: oN� Numbers Groundwater Overlay, Suet Si—es— Private Above Ground: Above Ground:, fire District: �-4-MM Ut:deroround:__ Underground: dater: LOT AREA, sq. Conteni�: Contentst - ---- Yobbo-� Private:____ NUMBER OF BUILDINGS Fire Protectiont_ Existing# LARI.ING � RB CUTS Proposed# D DeooIfttont =eQu:redt =- tzistingt Electrical: rov t Jed t_ Froposed t Ari a2 s•.Z )» Sites _- 7o Closet U:idergroc:nds_ TOTAL FLOOR AREA (in _.. Totals Gass Residential+ ?rf Sites Natural t Offices 9 es no) Fro ones— Medical Offices JN�1S?OkICAL fkI=T9 CX:(y ).._ P' Commercials IN AREA uF__CRi71C�AL ENVITONt?ENTA (specify ttse) Wholesale FFOJECT t717�1JN !00' OF 17ETLARD RESOURCE AREA: (yes)_ O Institutionals Industrials WEKMFe nqAUG .' 2 2 -1994 REC 'Eov ,r �r Zoning District o 0 r 0!d Kinq' s Highway OtstCtct �— in National and/or State Register of Historic Places Listed 3� Perimeter set backst Front Side 3 see Rear r© : Lot Coverage s. c Tupe of Use ( zoning) �(o�c Ou�PRTt�/Y yft Flood Plain Zone Elevation 1 Number of Floors Floor Area+ 1st 2nd Other (specify) Se�rf•�r d�i��Cc-' F(� I parking RequirementsI Required i Provided Handicapped Spaces Are there accessory buildings2 Accessory Buildings Floor Area PLEASE PROVIDE A BRIEF, NARRATIVE DESCRIPTION OF YOUR PROPOSED PROJECT. t'j(:tt 1;L C.1G10JC-Crt(KG c.voRK. /VO Cc kN-0 ire �rAL.cTY. ANO d D f/Crlf/1F/4C Nf wcCc (k� �v�jr./ �� /jrcra! G •9/y���1' wrci. /3c' Jr ai-��cc= �Cc-�J c�+� -�PE�J' , or caused to be completed) this page, t I assert that I have completed site Plan Review Application and the checklist on the backthe informationofhe application and that, to the best of my knowledge, submitted here is true. (signature) date) 9 I b ' _ CG:.iti�iS of Slll PtAI� The Site Plan shalt Include one or We ePproprtately scaledv4Ds or drawings of_ the property. drawn to an en9_Ineers$ state. clearly and accurately Indicating such elements of the following Information a$ are Pertinent to the development activity Propostol F-K1) Legal description, Planning board Subdivision Number Ilf applicable). Assessors' Map and Parcel number and address (if,appllcable) of the Property. 2) Name. address and phoAe number of the property owner, and applicant If different than the property owner. 914 ❑ j) Name, address, and PWt or� of the�presedevelopers eve �er. contractor# engineer, other and g professional design E1111"4) Complete property dimensions, area and zoning classification of property. �I� ❑ S) Existing era proposed topogrrphlcal contours of the property taken at two-foot (t'1 contour Intervals by a registered engineer or registered I" surveyor. N lA. ❑ 6) The nature, location and size of ell significant existing natural land features. including. but not limited to, tree, shrub, or brush masses, all Individual trees over ten Inches (IO') to caliper• grassed areas, ,large surface rock In excess of six feet (61) In diameter and soli features. ❑ 7) location of ail wetlands or waterbodles on the property and within one hundred feet (I001) of the perimeter of the development activity• N'R 0 8) The location. grade and dimensions of all present and/or proposed streets, ways and easements and any other paved surfaces. 9) Engineering cross-sections of proposed new curbs and pavements. and vision • 1AA O triangles measured to feet from any proposed curb cut along the street on which access Is proposed. 10) location. height, elevation. interior and exterior dimensions andlocationsnumber use area all res• Of buildings or struct type f dwellings ed unitnsdt location= of emergency exits. retaining . floorsi number and type walls, existing and proposed signs. �11) location of all existing and proposed storage t8ts asss hooting aapge plicaatble appppiroval$ sewer comections, septic systems and any ` if recelved. Q 12) Proposed surface treatment of paved areas and the location and design of drainage N, s prepared by a registered civil engineer. systems with drainage caiculatton plan, if Q 13) Complete parking and tai;=1C circulation stops., required buffer areas and and (�►� dimensions of parking stall. • planting beds. 1. 14) lighting Plan Showing the locations direction and Intensity of existing and - N� Q proposed external light fixtures. ❑ IS) A tandscaptng plan showing the location, name, number and size of Plant types, and 4 the iocatlons and elevation and/or height of planting bedst fences@.walts. steps and ths. 6) ion A location snap or other drawing at appropriate areasscale six frog whe then fcsievantral •tthe and relatiop of the property to surrounding zonii►g iKd 1 u4of nearby or 6dj facilities. fLi@1t Ltd tX14ttMi 4Lredt 4Ysttdt IQ the area and loc ati ❑ 17) tocatton within an Historical" the rictage a an a ntype of therach e designation as rg and N1� an Historically Significant property, 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 1ne.1 Boston, KA. dated September. 198S, which Is on file with the Town Clerk. N1�t ❑ 19) location of site with regard to flood Areas regulated by Section 3-S.i herein. ern as Q Q 20) location of site wnweaithregard of Massachu etts. Critical Exec"wtiveEoffice ofaEnvirroonmental designated by the Co.,. Affairs. F t f II L.r _ o Oil j 01t Q=i 11) 1 '7 NOTE:pt This ss a rwl rj ry rt nN o ..t o tol. tur E•'is EyE�sh,r>y�•rae>vrty;:r;�da,neQ�os,or arY pvjw' w vtnhr tn,0 its ori0tndi,ntent. i h„��sdn w84 Ar6w1 rcr t1� �+ r1 C:r�`OBAS iiti'y. .Ji t•'v t� 2t�;.'�r'fE.Q. MORMAGE SURVEY PLOY MLAN SCALE: t inch _ (1FLs r• rt►rr... EER i1r4iF _i`�• L�_ �..vuiiJGi=r'SttV�] At,aL) yt,)1't�re� tiL� 665 HANCOCK S-f , QUINCY �. CtIg!f�' to the - t `•� DEED AND PLAN FtcFi°ry &;k) ;. _. a J, 4' +iiry:,lrL�LflafQS Shown on this E;1nn Irf? }ht 1.. �• Ir,,r le$i rrafeU m cor, ---.. ___ Htr'!3try r,f L�%,vds 9 pliar,ct with the4ppliGaL;ie zonir•9 b?'iawa Of Cwd t3��l, � �, .� p e 1�trte rnunici;.•aftty whe!I ce,�r'tructee ami to rFstrictic;;,;err, r PIanm 7 s r sOt !; be .....Offset dimerSiOn c L�vk p,�;:erty 6ne3. ❑ Meet; requireme-)IS for,- Ch481 GL c.40A Sec 7 :oar,trWttM rolm�!ncwer, ant'b�ll�fihdtmaaU�ct�ro nuwn(ih+,1,1. tr , Approved 11i10/87 �rna <dteaw1l'OraSACCIA:FLCC•DMA.tAA0AA'-II t,>r mapp p!. i Lr1Wt DWA W. ,/� Qy�T��t1 .1�, / �` ,r �l, r. rar 6�e L'� Deryrr�t��Hr„rarr.y d vroan DtrnecCm�nt„INOti _.ac'�v „r�,d'y't Kam%J F'�.i.� ..�.;. ,,.,• Silt.Y:�•.Ivra�ia 1,:r�lniq!rrrtt;Af S -.-..........r._.....,, .,_. ....__. !V/ iiep�stbnxr lira�,rve•,r.- l rJ ice NumaE THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I m ^C&E DATA TOWN BARNSTABLE, MASSACHUSETTS U'L I D � . To 2 93 N4 3641i A=103-'�L3 D�:C�.mbc.'z �-7 , (g PERMIT NO. �\ DATE APPLICANT Ma%tthew Palmer ADDRESS Owner Listed Below caner (N0.) (STREET) (CONTR'S LICENSE) BER OF PERMIT TO Add Room 'In Basemll�nt) STORY Single Family Dwelling DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING RF AT (LOCATION) 31 Columbia Avenue, Marstons Mills DISTRICT— (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) Sewage #93-396 REMARKS: AREA OR No Area Chan1, 000.00 PERMIT $ 50. 00 VOLUME g ESTIMATED COST (CUBIC/SQUARE FEET) Matthew A. Palmer & Lisa M. Barr ' OWNER � BUILDING DEPT. o is venue, arstoris Mills BY ADDRESS pcf,, Phase 10 Amperage Service,entrance.Voltage. Wire:size(cu,:or al.) r Conductor per ase r ,A Off peak: Yes No ./'''1� ; Number of(meters Waterlheater, �,g ,L'_Motors,'UP.&Phase f, yr�� x"" t.y a G r 1_ off d kw.lights f VaL1 kw. KanBe�--dryer Estjmated load.Electric heat, Ready,for final inspection L 1/21 Read ">for fustinspa on - # Tele pho ne F . Electrical ��Ilt �.,,, tT t..t►� .c Address +.....i c.tM/'tc'•�(.�� oo', �fvc'.✓E`�i Additional Remarks: N JOBS ' ■ M li 11 1 mown BEEN ANS--�Lfrl.Y'aliiiii➢�[a0li �i y;TFLSiYJ�IilEiirlYCa�,Yi1e1a =iriir ■�i.�i f�'Fi■lid#.1�E1�L ie�i'�i �1♦l i�1�I ppE�� � � ! { la i�lla1i111 fir. 1paa�a!i� :i�1�lr, t�IIiE� n� !!1! -was���a � n mumum 1 el i!!!1• lomm®imlli� E 1l1�Ea a�1 11�Li1,7{= anEii � l l�a�t 1�11�"am111�ifa ! (1�I1D011 t llalllalall !!l1E� NaimoliEi�I� l �3�1�1 iflEl�EliEl ��ll E1Ri� !!!EI•EII�►�®iE1 1.l ID i! i IIE E1!E3s I! ''�I'1� ��rg +;Zu` rlE�{!! Bill 1 aint111°�fEmusm _:�€1�1!l1 a a Ili EI�»El�llllfE�E/a! !! l l i'�dL 11�ala! AC II�tI�an Ei! 1E1�wngmm�� Nis !!!' ltll l 11E iEl "How i Eill; i!la lam!! a!!!a! siv,1111E ® IV �EE� i16E�1 ��tE�li6li�l ! 11111Xld!!l1111�a!!a!!1l10lae{aa11i�! ►.li�!l1lii� i! �i�i! 11i11 riEliitEl�Iilit� ll�Eiia�llaalaa v®!{�Ei{Ii®! 1!!!" piiiiiil 1� ali i �!a �!!•a!l i�!{i,��sa�.t 1� C► � i E�!!L"„�!°"E{liil:'1i a��140 !!11l.� ■1�llLi a 1 Ma{I{t aar, a> {i11<!a!!!a!!!!!laaa! l{I111�1i�! 1i1{iul1 {1� 111�l11rEaSAW �a 1�tlaall�il l�1 !!!1f!!> illril!!a!1/!!alalEl�i:aa!! inisi an _lEtPallflME! ! aiE ®11�aIEi!!! li�allalf!!llE1fll9Eli!!lE�laifEl�il�ElE��!��eia����s�����r�►� a! E�IIEi�illfi11i�1� � a'�a�l1�a!!!�1•'RUN lElE1i!!!!l��la�rael�� E�i!!1llIE1!1111 !1!!1 lSaai!!aa!!1!laaltlilmmm�on$ m1 l a 1 ; 1�> 011114 ; ■E .2 on i a�l�llE�!!!/ii�lallliin �� • EH'Stl�alalut�'_'�"■�CCalaa! il�E!®la a a1{ !!ii►'�al�a�a '!iE1Elis�li,!lB1110i alalal/� t�M lrl�� lEa�® u�oEa �laly►iraa➢iasmal!!r 1 ■ 31 v ® ;•`�•••' ice'71`'\' r 'i ROBERT J. BAUM, P.C. COUNSELLORS AT LAW 20TH FLOOR FIFTY MILK STREET BOSTON. MASSACHUSETTS 02109 TEL(617) 292.8877 FAX (617) 482.9710 October 20, 1994 By Hand Ralph M. Crossen Building Commissioner Town of Barnstable 367 Main Street Hyannis, MA 02601 Re: SPR 43-94 Nehemiah Lovell Real Estate Trust Dear Mr. Crossen: The following is intended to respond to your letter of October 13, 1994, which you confirmed to me in our telephone conversation of Monday afternoon, as setting forth the only remaining areas of concern regarding the Site Plan for. this project since we met with the Site Plan Review Group last Thursday: 1 . CERTIFICATION OF ENGINEER: Enclosed please find a letter of Ralph H. Cole, R.L.S . which certifies distance between the foundation for the Building "C" on the Site Plan dated September 27, 1994, on which my client intends to build a new structure reasonably duplicating the former Lovell House, as was approved by the Cape Cod Commission, and the location of the foundation for the original historic structure. 2 . FLOOR PLANS AND GROSS SQUARE FOOTAGE: Enclosed please find copies of the floor plans for each of the Buildings shown on the Site Plan along with pertinent calculations of gross square footage. Please note that the second floor to Building "C" has been modified to eliminate a portion of the occupied space thereby reducing the area to 367 s . f. 3. CURB CUTS ON REVISED PLANS : n that this conversation, d From our telephone c , I understand pertains to showing the detail for handicapped accessibility to the curb on the sidewalk along Main Street. The revised plans, which I enclose, show that . detail. 4. AMENDED PARKING PLAN: Please note that on the enclosed revision there is an amended parking plan for the southeast corner of the site which deletes the compact parking and replacing it with two parallel spaces and makes a modification to most easterly space so as to comply with the requirements of the Bylaw. I trust that the foregoing and the enclosures meet and satisfy each of the concerns set forth in your recent correspondence. In addition, there were a couple of other items that my notes indicated that we agreed to clarify. One related to the handicap access ramping and a detail for the ramp at Building "A" has been prepared and is enclosed. The last related to the septic system capacity and that is clarified on the enclosed plan revision. Very truly yours, Robert aum, P.C. RJB/abl Enclosures cc: Catherine McDowell, Esquire Silvia & Silvia Associates, Inc. FEB-03-'00 FR1 04:47 ID: TEL MD: 4092 P01 b ifs!-17-1994 03:34P'M FROM P.M. WILSM4 ASSOC- TO 16175,Mage7 P.02 A.M.WUSM Aw oeides Inc• 9ctabor 17, 1994 Ralph Crosson, Building Comnisaionar Town of Barnstable 367 Main Strast Hyannis, MA. 02601 RE; Nehemiah LOV611 pro j6ct Q� t t 6'� 68� Mein � xee 4 ste vi r lle (our file 2.0656. 3) Deer Crosson: Mr. Cr s se : in responses to your letter of October 13, 1994, I have reviewed our survey plans for the original location of the former Nehemiah Lovell building and the existing location of the new foundation for Building "C". As measured off the street line, the northeast corner of the old building measured ±92.8 ft. off the street where the corresponding corner of the foundation .ie 85,53 ft. off the street. This: indicates a mover of ±7.3 ft. toward the street. The northwest corner of the old building Wag ,i57.8 ft. tiff the Street. Tho corresponding corner of the new foundation is 49.44 ft. otr the street. This equateP to a relo0ation of ±8.4 ft. closer to the atreat• If you compare the northeast corners of the new foundation and the Old building, the now foundation is •s f't, forward of the old one. The northwest corners show a difference of 10.5 ft. As you may hea aware, the Nehemiah Lovell. House had an irregular rubble foundation. The corners were not 90 degree angles and the walls themselvas were irregular. The new foundation is square at the corners. its shape is somewhat narrower and slightly longer than the former building. The position of the .now foundation was Also rotated slightly an the southeast corner to ma]oe it more parallel to the other buildings on the site. Consequently, the west face of the foundation exhibits greater displacement from the original building than does the east side. 811 Man$V"t 508 4281460 OslervRle.MA 02655 FAX a20185Q 1FEq-03-,QP FRS ©4:48. ID: TEL NJ: #G1ri2 P 02 I trUAt thfe UEWers your question. Yours, Ralph M. 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H.orl :ontal doVertical Scale 1 0 0 0rwto McKean Thomas From: McKean Thomas To: Maloney Kathy Cc: Saad Dale Subject: SITE PLAN REVIEW COMMENTS/29-94/31 Columbia Drive Date: Wednesday, August 24, 1994 3:22PM I am in receipt of the above referenced site plan review application dated August 22, 1994 and offer the following comments and questions: 1. How many bedrooms does this dwelling consist of? This property is located within a GP district is therefore under the restictions of the Town Ordinance, Article 47, Regulation of Wastewater Discharge. The lot size is only 20,750 square feet. Sewing rooms, dens, finished cellars, sleeping lofts, and similar-type rooms are considered bedrooms according to the Board of Health and the MA DEP definitions;therefore the existing daily flow 2 BJ1T01,*S estimate would increase by 110 gallons. One cannot exceed 330 gallons per acre in a GP or WP district 0e,sib according to this Ordinance. Please be advised that the Town Council or the Board of Health cannot grant i I ,a variances from the Town Ordinance-Article 47. Therefore, it is likely that this applicant cannot proceed with this 7 requerst. ✓'- 2. Is the proposed basement office room floor to ceiling height more than 50% below grade and subject to IV chronic dampness? S The above items#1 and #2 are the questions and comments of the Health Division. Page 1 -- -- 16 3 tins v p13 No.-A-.3,& THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Disposttl Works Tonotrurtion Vermit Application is hereby made for a Permit to Construct ( ) or Repair ((-"ran Individual Sewage Disposal System at: ..........Avg....................... .........: .................. I"ocation-Address .....••'.uoP a ............�3-451........................................ t!�• aN's ,Gr... . _....__..... Owner .-. Address ....--- Installer Address Type of Building Size Lot............_......_......Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building No. of persons............................ Showers — Cafeteria G. Other fixtures .................................. ...... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W Septic Tank—Liquid capacity............gallons Length................Width................Diameter................Depth................ x Disposal Trench—No.....................Width....................Total Length....................Total leaching area....................sq.ft. Seepage Pit No..................... Diameter.................... Depth below inlet....................Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by............:............................................................. Date........................................ 11 Test Pit No. l................minutes per inch Depth of Test Pit.................... Depth to ground water......................-. t?, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a' ........................................................................ .. .. ODescription of Soil....�.. .Z.5 ..............Sv- ....................................... -cr.......... ......1... _.......:�tk±.... X V .........................................................•-•-.--•------•------------..._.......-•---.........---..................................................__...................._...._..--- .._................................................................................................................._.................................. ........................... U N�ure of Rl pairs or Alterations—Answer when applicable...V ........ '�1't¢ .........1`a.F.�L.1 K ........ ...... .............. ..... .1:S�.1... --------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by theboard of health. Signed.-..--�c..„►` �F-�'� 1�Z ......................... ........... .... ...... ............ [brc Application Approved By ................... . �. ...... Application Disapproved for the fol owing rearons: ....................................................................................................................................... ................................................................................................................................................................................................................ ........................................ q �rc PermitNo. ....... ,� 3b!?........................... Issued .................................................................... Ga SAC� f Stt Istc It O t 1 HM ] 31 H E A L T H M A S T E R ] HELP [ ] R E C O R D ] ACTION I] For Parcel Number 103] 023] ] ] Rental Property(Y/N) [ ] Owner Name PALMER, MATTHEW & LISA BARR ] Zone of Contrib(Y/N) [ ] Location 31 COLUMBIA AVE MM ] Contaminant Rel(Y/N) [ ] Business Name [ ) Area Number Contact Person [ ] Phone [000] [ ] Fuel Storage Tank Permit [ ] Card on File [ ] Perc Test Well Septic File/Permit No. [ ] [ ] [92 366 ] Issuance Date [ ] [072792] Completion Date [ ] (072792] Last Communications [ ] (MMDDYY) Comments [REPAIR ] Cancel [ ] NEXT SCREEN [HM ] ACTION [ ] PARCEL NBR [ ] [ ] [ ] TANK NBR [ ] ] [ l TOWN OF BARNSTABLE SITE PLAN REVIEW DATE: August 22, 1994 TO: Thomas McKean FROM: Janet Locke RE: Site Plan Review Number: Mathew A.Palmer&Lisa M.Ban 31 Columbia Avenue Marston Mills MA 02648 Application for home occupation Please submit this form,with any comments or additional requirements you may have regarding the above referenced application,to the Building Inspector's office as soon as possible. Applicant will be at the August 25, 1994 meeting. 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) f t FUR Off iCE USE on APPLI CAT I uN FUR 5I TE FLAN KEVJ EW DATE RECEI VED - ACTION DUE BY LOC H -s(Ocpe( Legal Descriptions_ SINGeC Planning Board Subdivision Numbers Assessor's Map and Property Address, X, OWNER OF PROPERTY APPLICANT !name r cw A. ncM��- L 1s?k Address s f ACE-- 4ddress r o�'`i3i'4 �"� Phone r 5� �i - Phone r ENGINEER AGENT(interest owner or applicant) Name# names Address* Addresst Phonet Phone: 1I!£S 'ZONING CLASSIFICATION(S STo)i.Ai3E T V i�7IL R( ' ITIES Districts 1511N, PROPOSED ----Flood Hazards Nunber: NoNj5 Nunber: 90w Public ._ sizes Si-es Private Groundwater Overlays Above Ground:— Above Grounds_ Fire Districtt C-D-MM il�:deraroa»dt__ Undergrounds Waters LOT AREAS �0 50 s4. Contents: Contentst Yublio-)(— Privates____ NUMBER OF BUILDINGS Fire Protections _ Existings AR}.1Nc+ �P#AAt;G3 !GRB CUTS Proposed# D E--- Electricals Demolition#_ -e4sureds�=- txistingt %rovsdeds_ Froposeds Arials-, Sio Closes Undergrounds___ TOTAL FLOOR AREA (In ,sq In ..ites -- Restdentials� off Sites _.. Total s Cass Natural I-K- Offices �6 Medical Offices IN BISTOkICAL f:17RIC1:(yes)� no) Fropanes^ Commerciali 1N AkEA .GF_CRi?1C�AL ENVIRONhENTA (specify use) CONiEFN (E.O.E.A._L: (s+es)_ (no)� Wholesale FF�)JE�T__WI7NIN Ih0' OF QETLAND RESOURCE AREA: (yes)_ no Institutionalr Industrials (� Fi ogiv .9 rya AUG 2 2 1994 Zoning Utstrict or UldKinq ' s Highway District �_ National and/or State Register of Historic Places .� Listed in 3 Perimeter set backs# Front 3 Side 9 Rear r Lot Coverage Tope of Use ( zoning) yn±tr Flood Plain Zone Elevation Number Of Floor's Floor Area# 1st 2 n d Other (specify) �tryC,vr 6�f/cc' Parking Requirements# Required �"vt Provided Handicapped Spaces Are there accessory buildings? A' Floor Area Accessory Buildings PLEASE PROVIDE A BRIEF, NA RRATIVE DES CRIPTYON OF YOUR PROPOSED PROJECT. C0vjm a,fW,;t- CING,N CCCf�NG C-v0 . ``II /r?��•�T� AKO (a DEC=�cffJF/4t Nf -,�cc.c_ hc' C�kNT� c/fCc 1i(J J�,j�r�S,I ��cw G .9/.Y+`�.f w►w /�� ��Jl a (�OK, useI assert that I have completed (or cachecklist to eon the eback ofi the a9e, t n Review Application and owledge, the Information site P Ia k f Ipplication and that, to the best o my submitted here is true. (signature) / (date) 'l ~ CG:•tiuti iA Slit P�Atr The Site Plan $hall Include one or We epproprlately scaled "PSor dravtrps of.- the property# drawn to anSuch * the /ol low i g informationlas are pertinentS Scala, et and$the develorpmentyactivityIndlng proposedr1e�nts o► 1) legal description, Planning Board Subdivision Number (If applicable). Assessors' Hap and Parcel number and address (If.appllcable) of the property. 2) Name. address and phone number of the property o.mer, and applicant If different than the property owner. r(� ❑ 3) Name, address, and phone number of the developer# contractor, engineer, other design professional and agent or legal representitive. E]""'I) Complete property dimens ions, area and zoning classification of property. �I� ❑ S) Existing and proposed topographical contours of the property taken at two-foot (2') contour Intervals by • registered engineer or registered land surveyor. l A ❑ 6) The nature, location and size of alt significant existing natural land features. lj l shrub, or brush masses, ell Individual trees over Including, but not limited too tree. ten Inches (10•) to caliper, grassed areas, large surface rock In excess of six feet (6') to diameter and 9,011 features. ,Ifs ❑ 7) location of all wetlands or waterbodies on the property and within one hundred feet (100') of the perimeter of the development activity. A ❑ 8) The location, grade and dimensions of all present and/or proposed streets. ways and tit easements and any other paved surfaces. ❑ g) Engineering cross-sections of proposed new curbs and pavements. ' and vision • lv�t triangle$ measured In feet from any proposed curb cut along the street on which access is proposed. Q� 10) location, height, elevation, interior and exterior dimensions and uses of all buildings or structures, both proposed and existing$ locations number and area of lling units$ location of emergency exits. retaining • floors$ number and type of dwe walls, existing and proposed signs. �11) location of all existing and proposed utilities and storage facilities Including sewer collections. septic systems end any storage tanks, noting applicabie approvals If received. ❑ 12) Proposed surface treatment of paved areas and the location and destgn of drainage N, red by a registered civil engineer. systems with drainage calalettons PCepa ❑ 13) Complete parking and traffic circulation plan, if appttcabte, showing location and N dimensions of parking stalls. dividers, bumper stops, required buffer areas and planting beds. (3 14) lighting Klan showing the button, direction and Intensity- of existing and Nl� proposed external light fixtures. ❑ 15) A landscaping plan showing the 1 ocat ion name number and size of plant types, and N the locations and elevation and/or height of planting beds, fenccs..walts. steps and ths. - 6) A location map or other drawing at appropriateareascaie Showing thererrelcvantat"on and relatlop of the property to surrounding zoning 811d 16$b the U66 p5tttM Or 8dJ ctn i t�Otidbs tf* exlatIng btrat 4yStCff-In the area end location of nearby pub lIC es- ❑ 17) tocation .within an Historical District and any other designation as an Historically Significant site which property, nd t e age andSO) types f each existing building and structure on the d. ❑ 18) location of site with regard to Zones of Contribution for public supply wells as determined In a report entitled "Groundwater and Water Resource Protection Plan, Barnstable. Massachusetts" prepared by SEA Inc., Boston, KA. dated September, 198S, which is on file with the Town Clerk. /r,pp rt ❑ 19) location of site with regard to flood Areas regulated by Section 3-S.1 herein. p ❑ 20) location_ of site with regard to Areas of Critical Environmental Concern as r111n) designated by the Cortnonwealth of Massachusetts. Exec'utive Office of Envlronwental Affairs. _ 1 1� I cr'i 1 1 1 r. f NOTE: This is a Tap* ;urva3y- Not.t•.)to ustrd for E•.t:Gt;stl, ry F•► caarh ,heugos.or ar<Y rurGusv vthar chyn its uripinat ontsnt. �_..�..._M17 p)ar,was Atawi rcr mortrnge C:rt�EcM :iti'/. !Ji t.'ti t� r MOR MIAGE SUnvfy PLOT PLAN 5CAl E: Y inch = ���� twt .�r•. -- 1 CE _Ci r _�.�r i.>:c c;v lJ�cf�tt4 AND �t.)�i�rc` t:C} iJ:Ai WJ5 HANCOCK S- , QUjN.1C.y _._..... ._.�_. RJR tr CBt�tty r Clly a'cnr� sye, �,'�:.�� ��f ire ::.; uar, AND PLAN RQ-FFAENcE: tiR� ructureg shown on',tll$ 1at1 Ire iocal d ran the, �.`. for,designated in coal � �-- - R i�tfy(,f Lltwds 9 pliar;ct with tt)e pplirabie zonin��byiaw3 of D(wd 900k ' r P e 11�. the munici +ality whE;1 col�,tr:)ete0 anti to rFstric)iv t5:rr> rr3. Crd, F'tar l ;n 1` 7 rtf �t dirnerSiOns are i)0t !0 be used f k or estapjl�r,i•ty p,;;,.erfy 11ne;. 0 Meet; requireme,)js for Ch481 GL C.40A Sac 7 :tatrr,,k)na Lrl,.r alf"V-VW40 ani br+118t:hd}fne aUv[I ro•�Gs.n(;r,f -`0 � Ap;)rcved 11%111/87 ryfA0�++0'. cateavrtnlnyspECl�tftOCG+i�LAitq...;t A�n.tsa.tleweGon t1»map ct LAW i� a4r:E(J .liZ 6)tie L; 0"wtn."t�+ (Cnlalr.y d vroan 0�e oprrt,nl c*A'6:Irnrrsr,cnA"entntatratr n Su R6pipwurr lalb y„M•.w 1 _ .�.. __._. _ JCB tvuMr3t ~ THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA U'L TABLE MASSACHUSETTS D ff*1_ TOWN OF BARNS _ A-103�'Q23 DATE Ducembe r 27 , t9 93 PERMIT- NO. NQ 36411 � tthew Palmer ADDRESS Owrier Listed Below -- owner _7 APPLICANT Ma - (ND.) (STREET) (CONTR'S LICENSE) PERMIT TO BER OF Add Room In Basement) STORY Single Family Dwelling DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING RF AT (LOCATION) 31 Columbia Avenue, Marstons M1 S DISTRICT— - •� (NO.) (5TREET) BETWEEN AND (CROSS. STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: SewagePER AREA OR No Area Change - $ 1 ,000. 00 FEE MIT .$ 50. UO VOLUME AR ESTIMATED COST (CUBIC/SQUARE FEET) Matthew A. Palmer & Lisa M. Barr OWNER BUILDING DEPT. ji o is venue, arstons Mills BY ADDRESS Phase n T + , a. Amperage ©y M : >Servrcerez►�trane,,vxoltage Wire s>De(cur'or aL Conductor per ase t f ' °V11ater,heater, peaks Yes °— a.%/+ H P.bt Phase Number of metersLLL 00 kw,Ranged dryer--Motors, Estrrriated to d:Electric heat ---kW�lights , ► T m• 4 Ready;for final inspection 10 i+ Ready for fi&11 OCR Telephone —Lic it s. R Electrical�CAo LPr Address Ar o,of E 'I ,z /y/ 'modnal'Rmarks; 1L10 e m ,µ _ 4 / _, n nr mrr-a#! ���'(''tr>;,. � 1 �f//�i�l C.•� "�� �r MEMO /r!!1 MOWN __ _ > � 1 M -� IH�� a�r`a..'.o..w. :ais:�o�.�.�+��awre.c----s:��c.--�^—^-a--�as�-•..�.,,..��..... ...�., ROME H/ i&OK, 'i �INNUM 1 E a III/I/H11Is/ a/M�.I ;IRt. moms 1 ■ �� �m Tam/ a SUM 11. HIMlEli{EI E4/ / i/ S ! / /•., US H Itl�f/H /AEI Its I INEIMMus /i//1•// /�i/ �i / /I)!t / !/ /// fullEmalm, iE/iill���Sam i �!! Ili/!/:�EiililI well'i/;// ii'/ 4MmSOME FrIC// Et/i Iiti Howl ll�l��/HI��I AM IE,r'+�ll��®®li�ii/ iiiHi iE• a Wi!!I�'r/'SEIil li •IHIE/ R�Smm M ®ft� HiEi /� R�s/gym® O//[ �mEt._�v�ltzl� Iti/IIlESSU : ra�emm// WIMMUSION M/MH>•/ ///////iH/H//r�■!��l11/!� SOMMi /� ADS onH 0 �H///iEl! !HH!//>I !•iii■!!•1•/I�/aN/�!®ail/ /H ammom®IllSION in 'IEI�/////!E/!!t /i !! !/■ice/ 1E /I/i•■MEN ■i ! //i ll�••� :AIE/II/ HI1® H/ WEfit! IS !_ ��/i/ / HRNii M/ l Ilil•1!MUNI �. MOM Manpa H /HHI.....- �®® ®� ►ti�i�i!/Vise �1/� ,. /®IEiiiNMJS �/ �i>• N �! TOWN OF BARNSTABLE LOa ATION \3/ Ljj�uM &A- "6- SEWAGE VYLLAGE A'& ASSESSOR'S MAP & LOT 0 OQ INSTALLER'S NAME & PHONE NO. HfCk-C-� (A,tls Jr f?'j( -y( Z$ SEPTIC TANK CAPACITY /,W LEACHING FACILITY:(type) a fT- (size) 1, ocj?� NO. OF BEDROOMS PRIVATE WELL RLUBLIC WATER BUILDER O OWNER DATE PERMIT ISSUED: 7/�-7 A Z DATE COMPLIANCE ISSUED: 2 /.al VARIANCE GRANTED: Yes l No I� B }. ��c�c_ �� `�°� � r psi( �i ! 4S +., � bl O �� c o �� `� �a, ,�� ..� ��j' ... t , 1: ,./ ,. �` NoIZ:' ®a3 V"""FEB 3.0.... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratiaau for Uiipaaaal lVarkii Tomitrurtiaan ranfit Application is hereby made for a Permit to Construct ( ) or Repair (,1,5"an Individual Sewage Disposal System at: Location,-Address y,p�c � /'`Aot• (�o. ..... - ............. ��±.� ......................................... .C..!!,1 e,_V V 5........Aro >?._.......................................... Owner Address °-c ------------------------------------- :�... ` ......-�.................1Ek5!�*! .. Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other a —Type of Building g ---------------------------• No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures W Design Flow............................................gallons per person per day. Total daily flow............................................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--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed bY.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit............_....... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................ P+' -•---------•••-------••-......----•--•----------------------------------- Description of Soil -••••----• --- ���- .-....i'?-W.........:��1M Z�� c! 7Z� x w x ----------------------------------•-••...--•-------••--•••••---•.......•--•-•-----•...._.-••-••----------•-•---------•---------•----•--....-•-•-•-----••••••-------------..............------------•-_.. U Nature of Repairs or Alterations—Answer when applicable._-_➢ ________-A�1? .........l ........ .........Z............ ...............b........ 1.!!j. �`............ gi�� h -•-•-•--•••••-•••••...............••---•--••---•••. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued byC'the �board of health. Signed ------ \ -------� �-�2 ............................................... Date--- ---..-.-.... Application Approved By ................ .. ...--. .....Z).4 =•� - e7".cl� .. Dat Application Disapproved for the following reasons: .............................................................................. .. ------------------------ -------------------- ------.......................... -- ------------------------ -- ------------------------------------....................... ---................................. Dare PermitNo. .. .... vim.--------3........................... Issued .................................................. Dace 6 la— 3 � THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for 14sposal Works Tons vdian Frrmit Application is hereby made for a Permit to Construct ( ) or Repair (/�Ifan Individual Sewage Disposal System at: - Location-Address w�2 __- ` -. -- - --------- Address w �eowner - O VC Y L^ Installer Address Type of Building Size Lot--------------------_-Sq. feet V Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aa Other—T e of Building No. of ersons---------------------------- Showers YP g ---------------------------- P ( ) — Cafeteria ( ) dOther fixtures --------------------------------------------------------------------------------------------------------------------------------------_ - W Design Flow--------------------------------------------gallons per person per day. Total daily flow--------------------------------------------gallons. WSeptic Tank—Liquid-capacity------------gallons Length---------------- Width---------------- Diameter----------------Depth-------------_- x Disposal Trench—No_____________________ Width-------------------- Total Length------------------- Total leaching area------------------sq. ft. 3 Seepage Pit No--------------------- Diameter-------------------- Depth below inlet-------------------- Total leaching area------------------sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-------------------------------------------------------------------------- Date--------------------------------------- M Test Pit No. 1----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water__--_-__-_---_----- -_ f=, Test Pit No. 2----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water------------------------ P4 -------------_------------------------------------------ ----------------------------------------------------------- - --- O Description of Soil---- --�`` -= -�� -------- - 5---------- e L's^j -n-�-� ------Q!E- W U Nature of Repairs or Alterations—Answer when applicable-_V -Z----_--_T 2 ---------- 163_1�__ I_N Vc t,- ' --N________ -�A` - -------gam``�------------T ks51'I v_.j Str`�A t="•� -- -------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. 1 Signed - - �_ �= -=>`"' �__7_p t Application Approved By ------------------- ----------------- ------------------------------------ ----?- ,1_7_-_-. -2--- �a Application Disapproved for the following reasons: ------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------- _ D. Permit No. -- ----h6------------------------- Issued ------------------ ------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certift ak of Conty iance WIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired S I by o�vv��c3 � �v C �. - -------------- --- --------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------ �mi�r l C (C_k Ll s ----- at ----------------------------------------�O rJ-------------------------------------------------- --------- - - has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. _----C OS-_-__�_I6 --------- dated ----------------------------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE - -----�.�---- �°` ------ Inspector ---------------------------- `r= ----------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH y� 3� TOWN OF BARNSTABLE Diapood Murky Tuntnnctian firmit _ Permission is hereby granted----�`C C 5- `!----------�b^?SV _- ---_-_-- --- ------------- - ------- ----- --------------------------- to Construct ( ) or Repair ( ' an Individualwage Disposal System atNo.---- _._------------------------------------------------------------------------------------ street - T as shown on the application for Disposal Works Construction Permit No '�6__ Dated----------------------------_-- - - - - - " ------------------------- 7_ ') Board of Health DATE-------------- ---.--G-.-.--/--------- =-------------------------------- FORM 36508 HOSM R WARREN,INC..PUBLISHERS