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HomeMy WebLinkAboutWIANNO GOLF CLUB - FOOD �WIANNO GOLF CLUB 10-7 llu2--o2�k - `� Town of Barnstable BOARD OF HEALTH John T. Norman Board of Health Donald A.Gaudagnoli,M.D. t BAILMSTABL . F.P.(Thomas)Lee T MASS Daniel Luczkow,M.D. Alt. 200 Main Street, Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 107 Issue Date: 01/01/2022 DBA: WIANNO CLUB OWNER: WIANNO CLUB INC Location,of Establishment: 107 SEAVIEW AVE OSTERVILLE, MA 02655 Type of Business Permit: FOOD SERVICE Annual: Seasonal: YES IndoorSeating: 200 OutdoorSeating: 0 Total Seating: 200 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: - - ----------- - —— MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: i PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: Town of Barnstable Initial Date Paid $?W »Sze ; Inspectional Services MAM 1639. a`� Public Health Division Check# 5D2 � i of c _ Thomas McKean,Director J 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 l APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE �/ID Z?/ NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT:_ W IM11 D Clcc cyYb C ADDRESS OF FOOD ESTABLISHMENT: 101 5ta-V I�u& AV I, 05f" r 1 Qj OAPS5' MAILING ADDRESS(IF DIFFERENT FROM ABOVE): -pl) Qae V i/ bZ66✓ �5 E-MAIL ADDRESS: li*-i a- WowODC GW ayy- , TELEPHONE NUMBER OF FOOD ESTABLISHMENT: QeD_4a_(0A 91 Z4?aV 1�,W LkI r2Z BW1 qzyn 7-1-7TOTAL NUMBER OF BATHROOMS:� tD i ,D Mk) DR rq I WELL WATER: YES NO ...(ANNUAL WATER ANALYSIS REQUIRED) rewo_at 602— ANNUAL: SEASONAL: DATES OF OPERATION:J' /10/22io 1V/�1 /� v�s 'S ('00� �� b NUMBER OF SEATS: INSIDE:535 OUTSIDE: 120 TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? n TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ...(MONTHLY LAB ANALYSIS REQUIRED) CATERING ...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) ** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application FormsTOODAPP 2020.doc _OWNER INFORMATION: FULL NAME OF APPLICANT !/t��` nC) Club c SOLE OWNER: YES/ f0 � OWNER PHONE# 6Z ADDRESS_ ' �GV/ t1 � /�"V (� 06-kwdl e CORPORATE OWNER: CORPORATE ADDRESS: j� PERSON IN CHARGE OF DAILY OPERATIONS: Mark- k alb-5 List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date / NO�- - 2.jh'e, -1)1 su' ' l o Lt 275 2� darn 9 Z°( IZU 3 / Z2 SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until t-he above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at httt)://www.townofbarnstable.us/healthdivision/auplications.asi). OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1st to Dec.31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:\Application Fo-msTOODAPP REV3-2019.doc C s Y x"r p r Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BArRN9TABM + Paul J.Canniff, D.M.D. MAS.4 F.P. Thomas Lee Alternate 4q? .039. 200 Main Street, Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstablems Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111,Sections 5 and 127A, a permit is hereby granted to: Permit No: 107 Issue Date: 01/01/2021 DBA: WIANNO CLUB OWNER: WIANNO CLUB INC Location of Establishment: 107 SEAVIEW AVE OSTERVILLE, MA 02655 Type of Business Permit: FOOD SERVICE Annual: Seasonal: YES IndoorSeating: 200 OutdoorSeating: 0 Total Seating: 200 FEES - -. - --- —— -- FOODSERVICEESTABLISHMENT: $300.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B- FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE -ICE CREAM: FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: a ' 4 For Office Use Only: Initials: i"�'°'�. Town of Barnstable Date Paid Amt Pd$,36D— .,�,,,�,,B�E Inspectional ServicesNIM j �� 9�p•E�a�•� Public Health Division I Check Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE I IZI NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: W imno Club <=io ADDRESS OF FOOD ESTABLISHMENT: !Cq & 0 Avu ut C6feI� MAILING ADDRESS(IF DIFFERENT FROM ABOVE): P 6 'Ba 2 Llq 6)S-f ZtV1'1(e 0146— E-MAIL ADDRESS: J tKI, l- �O;Anna al" , Cuyn- TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: ��C� ��'}� 7 WELL WATER:YES NO �` ...(ANNUAL WATER ANALYSIS REQUIRED) /p (P2` ANNUAL: SEASONAL: DATES OF OPERATION: J9 I/ TO f y l /Z/ Z I NUMBER OF SEATS: INSIDE: 5- OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ...(MONTHLY LAB ANALYSIS REQUIRED) CATERING ...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REOUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application FormsTOODAPP 2020.doc I ,x J OWNER INFORMATION: FULL NAME OF APPLICANT W� nV `� v n C SOLE OWNER: YES//NOS OWNER PHONE# J � Ga�� {O 7�0✓y� ` ADDRESS I bg CORPORATE OWNER: CORPORATE ADDRESS: ,,�I/ PERSON IN CHARGE OF DAILY OPERATIONS: Y�(nw"y- Xwb-s List (2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 1.CYl�C hael �p111o��!IQ— , �2 , ZZ 1.I'Y►� ���IGt�P�(��--�i 3 i Z� 2. 2-:3 i 23 V� SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to openina!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.ast). OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec.31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC Ist. Q\Application FormsTOODAPP REV3-2019.doc f �► Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BAMSTABU, + Paul J.Canniff,D.M.D. 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 3056, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 107 Issue Date: 01/01/2020 DBA: WIANNO CLUB OWNER: WIANNO CLUB INC Location of Establishment: 107 SEAVIEW AVE OSTERVILLE, MA 02655 Type of Business Permit: FOOD SERVICE Annual: Seasonal: YES Indoor5eating: 200 OutdoorSeating: 0 Total Seating: 200. FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: FROZEN DESSERT: ' Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: i \X of rqy For Office Use Only.• Initials: ti Town of Barnstable Q' Date Paid� I � Amt_Pd$, BARNSTABLE, ,'r Inspectional Services /� d 1 �-/ suss (heck# ®�"!�6 1�" 1 a' '°rFCMo+a`0 Public Health Division ; Thomas McKean, Director 0 200 Main Street, Hyannis,MA 02601 . Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT � + DATE w NEW OWNERSHIP RENEWAL_y NAME OF FOOD ESTABLISHMENT: wah nb UVID Jac ADDRESS OF FOOD ESTABLISHMENT: 101 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): �U �`�" V�l�'�I �l� !I VLEIA_ E-MAIL ADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT:5b ) - f�! �-'" " '"/1zb l l ern 7-1-7 TOTAL NUMBER OF BATHROOMS: ��j -�(�jY� /� / WELL WATER: YES_NO ... (ANNUAL WATER ANALYSIS REQUIRED) I Y,,,, T) I v' ANNUAL: SEASONAL: � DATES OF OPERATION: 5 //J/2&O 0113/R) I� gal-ishol S I NUMBER OF SEATS: INSIDE:5j�5_ OUTSIDE:12-U TOTAL: I®'")S' SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. , ' ,�C IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? V J IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) ** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q1Application FormsTOODAPP 2020.doc op OWNER INFORMATION: PP''..�� _ FULL NAME OF APPLICANT SOLE OWNER: YE /NO OWNER 1 PHONE # 1/ nn��U�—! I ADDRESS '<�C< V 1 f 4.j V S4. {Vl I tee. /► V 1 —62105-5 CORPORATE OWNER: CORPORATE ADDRESS: /n PERSON IN CHARGE OF DAILY OPERATIONS: `�-' 'h G-VI List (2) Certified Food Protection Managers AND at least (1) Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date �h �0/07///a- Ll / 12- / Z-2- /7-Z 2.,iini tr Le / 2-3 / 23 C� SIGNATURE OF PLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townotbarnstable.us/healthdivision/al)plications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1st to Dec.3151 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q\Application FormsTOODAPP REV3-2019.doc , a Bellaire, Dianna From: Jeri Mooney <jeri@wiannoclub.com> Sent: Wednesday, March 25, 2020 12:20 PM To: Bellaire, Dianna Cc: Miorandi, Donna; Darin Crippen Subject: RE:Wianno Club- Renewal I am sorry Dianna, I prepared the renewal and the check and didn't check first. We will NOT be doing soft serve. Should I issue a new check and mail to you? Jeri Mooney, CHAE, CHTP Chief Financial Officer Direct (508) 428-6022 Mobile (603) 321-0826 FAX (508) 428-9036 EMAIL jeri@wiannoclub_com From: Bellaire, Dianna<Dianna.Bellaire@town.barnstable.ma.us> Sent:Wednesday, March 25, 202012:05 PM To:Jeri Mooney<ieri@wiannoclub.com> Cc: Bellaire,!Dianna <Dianna.Bellaire@town.barnstable.ma.us>; Miorandi, Donna <Donna.Miorandi@town.barnstable.ma.us>; Darin Crippen<darin@wiannoclub.com> Subject:Wiainno Club- Renewal Importance: High Hi; I received your application. I wanted to verify if you would be opening the soft serve ice cream. I know there was an issue last year and you closed the machine down for most of the season. Please verify you will offering soft serve ice cream. You paid for the service in the check, but I had it as closed down. I don't want to process your check if you aren't offering soft serve Ice cream. I dealt with Mr. Crippen on this matter last season. Thank you. Dianna Bellaire Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 P:508-862-4643 Fax:508-790-6304 Email.-Dianna.lBellaire@town.barnstable.ma.us CAUTION:This email originated from.outside of the Town of Barnstable! Do not click links open attachments:or reply, unless you recognize the sender's email address and know the content is safe;!' 1 r Bellaire, Dianna From: Bellaire, Dianna Sent: Wednesday, March 25, 202012:26 PM To: Miorandi, Donna Cc: Bellaire, Dianna Subject: Wianno Club Hi; I received their renewal and as you know I am trying to see if they are going to have the soft serve ice cream. However, we need to verify the seating in this place. They sent me a note with the following: NEED TO VERIFY SEATING-SEAVIEW 40/120 OUT, BALLROOM 217,WICKER ROOM, 50, MAIN DINING 191-TERRACE-62, BAR-15 TOTAL SEATS INSIDE 575? OUTDOOR 120. We have 200 inside seating and no outside seating on permit. I know you can't address this until you get back. Dianna Bellaire Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MAD2601 P:508-862-4643 Fax:508-790-6304 Email:Dianna.Bellaire@town.barnstable.ma.us > 1 Town of Barnstable BOARD OF HEALTH ; Y Paul J Canniff,D.M.D. Board of Health Donald A.Gaudagnoli,M.D. rAatr STABM John T.Norman MAS& F.P. Thomas Lee Alternate .esa 200 Main Street, Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 30SB, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 107 Issue Date: 03/26/2019 DBA: WIANNO CLUB OWNER: WIANNO CLUB INC Location or Establishment: 107 SEAVIEW AVE OSTERVILLE MA 02655 Type of Business Permit: FOOD SERVICE Annual: Seasonal: YES IndoorSeating: 200 OutdoorSeating: 0 Total Seating: 200 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: ---- -- - - ----- MOBILE-FOOD: MOBILE -ICE CREAM: C�n FROZEN DESSERT: $30.00 Thomas A. McKean, IRS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: i u t t ! 's OPINE Tp� Initials; Town of Barnstable s Date PaidC�j Amt Pd$ +IBARNWABLE, r Inspectional Services y MASS. g 4 �A ib79. �oA�A Public Health Divis )�Q ion 3. Thomas McKean, Director 200 Main Sheet, Hyannis,MA 02601 xJ Office: 508-862-4644 Fax: 508-790-6304 u Ii APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT E G DATE I NEW OWNERSHIP RENEWALVI . NAME.OF FOOD ESTABLISHMENT: ADDRESS OF FOOD ESTABLISHMENT4-7 e< l°G /�✓�� '. 6SI e" ' ' lel ff Lk v Z&s e MAILING ADDRESS (IF DIFFERENT FROM ABOVE): Po —gvn. 7-49 W!&V ) tM—.. �, ` n� f E-MAIL,ADDRESS; / ��� V2V�1" O� �� o to Lio TELEPHONE NUMBER OF FOOD ESTABLISHMENT: Jl/�, I�O Z17 TOTAL NUMBER OF BATHROOMS: MO-41 D IR `C� WELL WATER; YES NO' ... (ANNUAL WATER ANALYSIS REQUIRED) �e"U& (�Z / TO I yl14-J9 5 ANNUAL: SEASONAL: DATES OF OPERATION:5____//�fg i NUMBER OF SEATS: INSIDE:5-6 OUTSIDE: IZZ TOTAL: _ _ c. SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE.DINING,MUST 13E APPROVED BY THE HEALTH DIV.AND LICENSING AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OIJTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? n O i TYPE OF ESTABLISHMENT; (PLEASE CHECK ALL THAT APPLY BE, xFOOD SERVICE RETAIL FOOD-ONLY required for TCS foods (foods requiring refrigeration/freezer) BED&3REAKFAST CONTINENTAL 13REAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) _MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) TOBACCO SALES ... (ANNUAL TOBACCO SALES APPLICATION REQUIRED) i *** SEASONAL,MOBILE c&NEW FOOD ONLY*** F REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED g Q:\AppficaJon Forms\F00DAPPRGV2013.doc 9 a ' Y I 1 i V �yy V i i PLEASE CALL 508-862-4644 OWNER INFORMATION: FULL NAME OF APPLICANT' SOLE OWNER: YES NO OWNER PHONE# 5P0 ADDRESS ��� =V,! I,bcv N z- 09 11e , �- y21 CORPORATE OWNER; FEDERAL ID NO. : f CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: List (2) Certified Food Protection Managers AND at least (1) Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You inust provide new copies and POST THE? CERTIFICATES at your food establishment. Certified Food Managers Expiration Date lerRen-Awareness Expiration Date F J tt 10<21 & (,,o IZ- / Z,3 SIGNATURE O ICANT DATE r S ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. Lior to openine!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days hn advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Pennit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at httn://www.towriofbarnstable,us/heaIthdivision/api)licadons,asp. 1. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited, F TOBACCO ESTABLISHMENTS; All tobacco establishments must complete an Application for Tobacco Sales Permit and 1'< Employee Signature Form. NOTICE: Pennits nun annually from January Istto Dec.31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE CONII'LETED APPLICATION(S)AND REQUIRED FEES BY DEC I st. ` r; Q;Ulpplication Forms\F00DnPPRBV2018.doc f `o.tNE.o�i TOWN OF BARNSTABLE. HEALTH INSPECTORS Establishment Name: Date: Page: of OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-,9:30 A.M. BARNSTABLE. • 200 MAIN STREET 3:3o-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. MON.-FRI. "rFUMa+"m HYANNIS, MA 02601 508-862-464a No Reference R-Red Item PLEASE PRINT CLEARLY.. FOOD ESTABLISHMENT INSPECTION REPORT Am d F Ge-(' Q,feey A64. Name Date Vb/ Type of Tvoe of Inspection p Routine Address �f Risk Food Service Re-inspection Level a al Previous Inspection I �' Telephone Residential Kitchen D O _ Mobile Pre-operation r 3 ` Owner HACCP YIN Temporary Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP /` 3 r 1I(y I Other Inspector J� Out: `ice ^� - id /zA Le,,Y 3r Each violation checked re uires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ '�`� � 3 �� Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ v j,� f i /�� 3(0 F Action as determined by the Board of Health. Allergen Awareness 590.009(G) 3 yt ClC FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands / ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS �>t/ ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives _ ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals ��. FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) y� ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures tL e, IA & !� Tf/ l Gt_e_,_W ❑ 5.Receiving/Condition ❑ 17.Reheating L// ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling v / /G✓ ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding " }_ PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control vkL4{ � ', Ll ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY 1 ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories • L I Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations c,, ilk r_eg (/ce y Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No j ❑ Yes Non-critical(N)violations must be corrected immediately or _ ew within 90 days as determined b the Board of Health. Overall Rating Y Y � ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. ElEmbar o g ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical, results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than 4 non-critical violations re 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical " water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7590 )( .008 9) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 9,veanrcritical violations=C. 30.Other DATE OF RE-INSPECTION: Inspect s,Si natur Ze�' int: 31.Dum r screened from public view ---'" Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N GGG #Seats Observed Frozen Dessert Machine lg s: Outside Dining Y N P s nature Print: Self Service_ Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N `-rti-n=-�-�M:.-..�r+s".:�1..` .+ ° 'L .a r__�li.. -'ice." n-... eti. r-.-�`T°.w-y°��+.�...-.--v. .--w-"-'-----�.r---1. _.s. -. ,a..^'-.t__ .: �vr y-':--...ram.�--.-� -... .w-.r r. -. •-. a -- �^�-t*+.. -ti_i'�!Y-'Tr-^.-.f. ....�-.�-...�.r.�� � �.r»-�. .'-'ma's'�» 1 - er�.�+�'._ -� Violations related to Foodborne Illness Violation Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients { 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Storage* - Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 590.003(E) Removal of Exclusions and Restriction g 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP s Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* 3-401.11 A(1)(2) Eggs-155°F 15 sec Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* - Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective innoor 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 77 Reheating for Hot Holding Requirements.practices ld be debited under#29-Special n r Using Tobacco* * 2-401.11 Eating,Drinking o g 3-403.11 A D PHFs 165°F IS sec R ivin /Condition ( )&( ) $ ece g 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity* g g 3-403.11(C) Commercially Processed RTE Food-140°F * 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F[0 41°F/45°F Tags/Records:Fish Products L6-30I. Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3 402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans Hand Drying Provision 129. special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. °p:*ME Tok, TOWN OF BARNSTABLE - HEALTH INSPECTOR'S Establishment Name: Date: Page: of 1 OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-930A.M. BARNSTABLE. ` 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified e 9- �0� HYANNIS,MA 02601 MON"-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY 508-862-4644 - rFDMP+ FOOD ESTABLISHMENT INSPECTION REPORT Name // /� � Datel1 ,/ L Tvne of Tyge of Inspection �S �" vv Routine I�l Address ®� G/)v!� !�- Risk Food Se Re-inspection Level Retail Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operate Owner HACCP Y/N Temporary Suspe s Caterer General Complaint / Person in Charge(PIC). Time Bed&Breakfast HACCP Inspector 1/ (7 Out: other � A`, Kv Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ JjW/ ` 1j 7/ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities / � r EMPLOYEE HEALTH PROTECTION FROM CHEMICALS GQ CL_�b lCI !h d" ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) 92 ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating - y{�L� ,�j®�✓ %� ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control Vb1 ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY - o �a El11.Good Hygienic Practices ❑22.Posting of Consumer Advisories I l � � Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations B ' Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No El Yes Non-critical(N)violations must be corrected immediately or Overall Rating 1 - within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. I ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than non-critical violations 9 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27:Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of ( )(� ) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Tuxic Materials FC-7 �90.008 9 within 10 days of receipt of this order. violation,4 to 8non-critical violations=C. 29.Special Requirements (590.009) y p 30.Other DATE OF RE-INSPECTION: Inspector' SA�ate Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N 's e n ure Print: #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC 9 Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N �,�-v;.... �.'v_"y..-ti�_.-t_..-v.. _'--'-.. --..-.-"- -_....,._:�._�--..--•• ---•,ter-_--.�.,�...»-. -�....-_ _._.�.- ...._.-��...,_.� .-, -.- _- _ _�._ --... _-_ .. -�„'.,-. +^ _- _,„ .-� --.-�-.. _ -. Y-. - ._-..--•s �-.- - � - ....-.--�. .,- _ ._-...�.--. -ter--` -•- _ a i- -� Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F)- 2 590.003(C) Responsibility of the Person-in-Charge to Other* 3-501.16A 7-102.11 � Common Name-Working Containers* ( ) Hot PHFs Maintained At or Above 140°F*Require Reporting by Food Employees and Contamination from the Environment * 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Se azation-Storage* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.00411 Variance Re uirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and AdulteReserrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E)� Removal of Exclusions and Restrictions Disposition ofAdulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteuri ed Eggs* 590.004A-B with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) Compliance P * 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Roden[Bait Stations 3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) I Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardne.gc* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section temporary and - ide in cater- * Ratites-165°F 15 sec* in mobile food,tem or and residential Sources 10 Proper,Adequate Handwashing g' P Game and Wild Mushrooms Approved B 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority Y 2-301:11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. * 2-301.14 When to Wash* 3-401.11 A 1 b All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms ( )( )( ) 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A Cooling Cooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) g 3-203.12 Shellstock Identification Maintained* Conveniently Located-and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item I Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-20411 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 . 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials I FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. `oaTHE rOw� TOWN OF BARNSTABLE HEALTH,INSPECTOR'S Establishment Name: Date: Page: _of OFFICE HOURS P ° PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified � 6 : �0$ HYANNIS, MA 02601 -FRI MON . 3 . No Reference R-Red Item PLEASE PRINT CLEARLY p'EDN1A�A FOOD ESTABLISHMENT INSPECTION REPORT s08-8e-asz4saa f Name J`G Daid . ?� Type o Type of Inspection I &V/ - /G?A 7M�-O;!�:) Routine ' Cell. (�i!?�'Address O� /^ �� Ris Ona ood Re-inspection vl .�/ Level Re a Previous Inspection / Telephone Residential Kitchen Mobile rPre-operationOwner HACCP Y/N Temporary s Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: � Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ Afi73l FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands Kd� ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives �✓Q ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEfrEMPERATURE CONTROLS(Potentially Hazardous Foods) Y� / ❑ 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION' ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations 'z7d l Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items Embar o checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ g ❑ Emergency Closure Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than non-critical violations 9 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot C=2 critical violations and less than non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to 8non-critical violations=C. 29.Special Requirements (590.009) y p • 30.Other DATE OF RE-INSPECTION: Inspector's S' atur Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's qig ure Print: Self Service Wait Service Provided Grease Trap Size Variance Letter.Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 19 PHF Hot and Cold Holding e 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 95 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11.. _ Identifying Information-Original Containers* Other* 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F Require Reporting by Food Employees and Contamination from the Environment 7-201.11 Separation-Storage* 3-501.16(A) Roasts Held At or Above 130'F Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control*' Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 3-304.11 Food Contact with Equipment and Utensils* 7.203.11 Toxic Containers-Prohibitions* ( ) q 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and P 4-501.111 Manual.Warewashin Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* P 7-206.13 Tracking Powders,Pest Control and * 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.I IA(1)(2) Eggs-155'F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption_of 4-60L11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* gg Not Otherwise Processed to Eliminate Equipment* ( )( ) Pathogens*590.006(A) Bottled Drinking Water* 3-401.11 A 2 Comminuted Fish,Meats&Game g * Effective rirrzoor 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201:15 Molluscan Shellfish from NSSP Listcd Chemical* g 590.009(A)-(D) Violations of Section temporary and a ide in cater- * Ratites-165'F 15 sec* in mobile food,tem o and residential Sources 10 Proper,Adequate Handwashing g' P Game and Wild Mushrooms Approved By * 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Gamea and Wild horny 2-301.11 Clean Condition-Hands and Arms 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. * 2-301.14 When to Wash* 3 401.11 A 1 b All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms ( )( )( ) 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirem npractices os ld be debited under#29-Special 5 Receiving/Condition 2-401.11 . Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165'F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items non-critical 23-30) 3-202.15 Package Integrity Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* Lu Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A Cooling Cooked PHFs from 140'F'to 70°F 3-202.18 Shellstock Identification ( ) g Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41'F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. L,p THE r TOWN OF BARN.STABLE. _ HEALTH INSPECTOR-s Establishment Name: Date: Page: ( of r OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30A.M- % BARNSTABLE, ` 200 MAIN STREET 3:3o-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified � e3q: `0$ HYANNIS, MA 02601 58-8 08-8MON -FRI.62-4644 No Reference R-Red Item PLEASE PRINT CLEARLY ptFD MP'�°' - - • FOOD ESTABLISHMENT INSP CTION REPORT Am-&zj I Name Date� Tyne of Type of Inspection Routine Address Risk ood Re-inspection Level Retail Previous Inspection Telephone Residential Kitchen Date: Mobile re-ooperat�n Owner HACCP Y/N Temporary Suspe-cTTlrness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. /zL�Ll y -e tl Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilitiest" EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ! - n G ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) / ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures �i( CL ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control !/ ,�9� � ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating ,®--- within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items F] Embargo Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. Emergency Closure Voluntary Disposal ❑ 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than non-critical violations 9 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 too Gaon-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot C--2 critical violations and less than 9 non critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7590 )( .008 9) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements . (590.009) within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspecto�S�ig�natlure Print: 31.Dumpster screenedfrom public view �" LAI& Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N PIC's Si ure Print: #Seats Observed Frozen Dessert Machines: Outside Dining Y N g Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions . Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* F 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers* * 2 Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* * 7-201.11 Separation-Storage* Applicants 3-302.11(A) Food Protection* 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* * 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR . 3-306.14(A)(B)Returned Food and Reared orce,of Food 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 ' Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY * Concentration and Ilardness* 22- 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Equipment* Not Otherwise Processed to Eliminate, 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef/dive 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency rf ces of Equipment* of Utensils and Food 3-40L11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) ._ Violations of Section 590.009(A)-(D)in cater- * Ratites-165°F 15 sec* in mobile food,temporary and residential Sources 1 p Proper,Adequate Handwashing g' P � Game and Wild Mushrooms Approved By * 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* Blue Items 23-30) 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 8 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A Cooling 3-202.18 Shellstock Identification ( ) g Cooked PHFs from 140°F[0 70°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. DF� r TOWN OF BARNSTABLE .HEALTH.-INSPECTORS Establishment Name: �/�)l Gt. ;,1(9 cj / Date: 2 Page.:�_of 2- 'OFFICE HOURS PUBLIC HEALTH DIVISION , 800=9:30A.M. BARNSTABLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 16 39. �0� HYANNIS,MA 02601 MON.-FRI. No Reference. R-Red Item PLEASE PRINT CLEARLY . . �'rFD MAC° 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT Name + Date 2 Type of f Ins ection O p buatLo s outine S U� Address � S Risk ood Sery a Re-inspection Level , Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation ��� Owner HACCP Y/N Temporary, Suspect Illness I + Caterer General Complaint Person in Charge(PIC) I� In: Other I �r Time Bed&Breakfast HACCP (�. Inspector N S r" Out: ' l o I VQ Each violation checked,req ires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ �n �, s Violations marked'may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ l.E' C e-f-t Ep Action as determined by the Board of Health.. Allergen Awareness 590.009(G) FOOD PROTECTION MANAGEMENT ❑ 12:Pre ntion of Contamination from Hands q ' ^-. p ❑ 1.PIC Assigned/Knowledgeable/Duties .Handwash Facilities �-�- EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives _ ` ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals ,N ' n �' FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures SI✓I�l� 1 ��� YD7Y1'L/'!d7 ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 1$ Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans 19.Hot and Cold Holding L PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control 1'� �T t, t ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) o,ea,,�-�qUW�- ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations rcL _j� Critical(C)violations marked must be corrected immediately. (blue&red items) �.� Corrective Action Required: // ❑ Nofil es Non call(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal - ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel. (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical, results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than non-critical violations 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violatiun,4 to 8 critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector' Ignature Print: 31.Dumpster screened from public view ' Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's 'gn re Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted .Y N Dumpster Screen? Y N n..�-.;.� +T-*«-�`•----•-.��-rya-�� -r. .._e - �. ._..- .^ _ ^Y.- ._� ..r..-�..-,�.,.r-..._-�..--^. ..�....���. �---..'.Y �-.--�-•,^ - - .-.+..�•a.. -..---'•--.--..... _ - ...r Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions _. Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) v FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled[0 41°F/45°F Within 4 Hours* 590.003(11) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12_ _ Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* *- 19 _ PHF Hot and Cold Holding 2-103.11 Pelson-in-Charge Duties - -- 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each .11 Identifying Information-Original Containers 590.004(F) 7-101 * 2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* t Require Reporting by Food Employees and Contamination from the Environment � * 3-501.16(A) Roasts Held At or Above 130°F* Applicants* - - 3-302:11(A) Food Protection* 7-201.11 Separation-Storage*g 7-202.11 Restriction-Presence and Use* _ 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Requirements 590.003(G) Reporting by Person in.Chazge* 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q � - Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* * 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rered or 7-204.12 Chemicals for Washing of Food Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 1590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces .7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Pe 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. L16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made Prom Potable Drinking Water* Concentration and Hardness* 3-401.I1 A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 see* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 4-602.11 Cleaning Frequency of Utensils and Food 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef d-11112001 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* Animals-I55°F 15 sec* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) I Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009 A D m cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* ( )e( ) * - - Ratites-165°F IS sec* in mobile food,temporary and residential � Sources g• P azY 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 3-401.11 2-301.14 When to Wash* A 1 b All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail ( )( )( ) 3-201.17 Game Animals* 11 - Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 - Receiving/Condition - 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165*17 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 Preventing Contamination When Tasting* C Commercial) Processed RTE Food-140°F* flue Items 3-202.15 Package Integrity* 3-403.11( ) Y Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities Cooling Cooked PHFs from 140°F to 70°F 3-501.14(A) ng 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 1590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials I FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. °PINE TOWN OF BARNSTABLE HFAL O F FCEOURSH w3PECTOR,s Establishment Name: V�/P���l� � Date: / Page: Z "of PUBLIC HEALTH DIVISION 8:06-9:30 A.M. - BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified .639. �0� HYANNIS, MA 02601 _ - MON.-FRi. No Reference .R-Red Item PLEASE PRINT CLEARLY ,eEEO MP•1° - - 508-862-4644 -FOOD ESTABLISHMENT INSPECTION REPORT I I yi.i,; -vF41 _ c" Name Dat ,L TyDe of jyaa6qf Ins ec 'on outi V Address ) j��Q_ �S Risk Food.Servi Re-inspection /`, _ Level Retail Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation V IC Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) $ Time Bed&Breakfast HACCP Vvlf) In: 10'3b tli other Inspector Out: l I ,Each violation checked requires am explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Do Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands❑ ��n L 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities �FypdJ �( EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives V�, ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures Cs(iliCi(' �°l ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling U U /'j hf ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding �7 PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control U ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) �! ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP �- ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations X_'ee hw_ ! Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined b the Board of Health. Overall Rating Y Y ❑ Voluntary Compliance ❑ .Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ m 90 Ebar checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Emergency Closure ❑ Voluntary Disposal Other: ❑ 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical, results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than 4 non-critical violations 9 if no critical violations observed,4 to 6von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1"critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 0 non=critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector' Sigrt3t Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PI ature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y- N Dumpster Screen? Y N �.,, ,-s.y-.--"-.�. ��.�,--r.0.-r^^.+v+..w.w--+...n.r,-•rti•-... .v'*s..-. �-.-..-�'� .-ti.^i..:.-.r -- •ti„�..�„-..--c- _ �.' ^..�� :.._ ..a�. - r . - ° - �'g... Violations related to Foodborne Illness `" Violations Related to Foodborne Illness Interventions .. Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003 A Assignment of Responsibility* 8 Cross-contamination Law Cooled to 41°F/45°F Within 4 Hours* ( ) g 14 Food or Color Additives 590.003(B) jDerronstrationof Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 _ Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding- 2-]03.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 2 590.003(C) Responsibility of the Person-in--Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 7-102.11 Common Name-Working Containers 3-501.16(A) Roasts Held At or Above 130°F* * 7-201.11 Separation-Storage* Applicants 3-302.11(A) Food Protection* 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An _ 3-302:.15 _ Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR _ 3-306.14(A)(B)Resumed Food and Reservior of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions - Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources _9 ' - Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 ARodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and-Milk Products* - 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell-Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of - 5-101.11 Drinking Water from.an Approved System* 4601.11(A) Clean Eggs Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eff N" 11112001 _ 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By [2-401.1.1 1.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 1.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 1.14 When to Wash* 3ADI.11(A)(1)(b)All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirements. radicsshould be debited under#29-Special 5 Receiving/Condition . Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 1.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 23-30) 3-202.15 Package Integrity* 1.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* Blue Items non-critical * 12 Prevention of Contamination from Hands 3-403.11 Remaining Unsliced Portions of Beef Roasts* Critical and non-critical violations,which do not relate o then the me 3-101.11 Food Safe and Unadulterated �) g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-20411 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 . 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials I FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria*. 8-103.12 Conformance with Approved Procedures* S:590Formback6.2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 9nfC, r TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: �P 21 Page:. of- ti OFFICE HOURS p ° PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE, - 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified ;79. ��r HYANNIS,MA 02601 MON.-FRI.508-862-0644 No Reference R-Red Item PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPECTION REPORT Name Date Tyne of Tyne of Inspection � l&-i Ty L}J -RL b Q era io s Routine Address O �,� Jt- Risk -'Food Re-inspection QV,, Kt4 a d �� ` o Level etail Previous Inspection Telephone Residential Kitchen Date: cz CL 4 Mobile re-operatic Owner HACCP Y/N Temporary -S-u§p-e-cTTF1ness Caterer General Complaint vtu / t,,,, ,� Person in Charge(PIC) iC) P `� Time Bed&Breakfast HACOther CP �� v t `w ,`�,o, In: �d i t� Inspector Sl]s u Out: tZ Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ f r Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Vas (O U, (C.Qj S k i Action as determined by the Board of Health. Allergen Awareness 590.009(G) FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands \� ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS U" ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) !J ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating 1716.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling rie ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑19.Hot and Cold Holding (M' 1 PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSPY1 }- �� ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY N , � , i I 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories • ���`"'"- i '' `^`�' r,� a�� `'I C Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations ACCO. (�1 Critical(C)violations marked must be corrected immediately. (blue&red items) ✓ Corrective Action Required: ❑ No J. Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ® Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ® Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005 B=One critical violation and less than 4 non-critical violations ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility % (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 rritiCal refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) 9 violation,4 to Snon-critical violations=G. _- 2q.Special Rcquirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Si ure Print:il 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC' Ignature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N f' Violations related to Foodborne Illness - Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) t l FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination F 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) 590.003(C) Responsibility of the Person-in-Charge to 2 EMPLOYEE HEALTH. � 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* P g Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits Restriction-Presence and Use*its and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q i Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)l Resumed Food and Rrated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated g ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 183-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145F 15 sec*' Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective iiuzooi 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) I Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section temporary and - ide in cater- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.l l(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 2-30114 When to Wash* 3-401.11 A 1 b All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms* . ( )( )( ) 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. $ Receiving/Condition g• g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165'F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 Preventing Contamination When Tasting* * (Blue Items non-critical 23-30) 3-202.15 Package Integrity* g g 3-403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the Foodborne 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated* ( ) g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) r5. Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* Management and Personnel FC-2 .003 5-204.I I Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials I FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes.critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. of- rok TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: W U✓l Date: Z Page: 2 of 4 OFFICE HOURS P ° PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. • 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MONM6}q• 0� HYANNIS,MA 02601 508-808-8 -FRI.62-4644 No Reference R-Red Item PLEASE PRINT CLEARLY �plED MPS° � FOOD ESTABLISHMENT INSPECTION REPORT Name �� ✓ Date :� Type o Type of Inspection O s Routine d)4,-,a--elu Address l ! � Risk rood Service Re-inspection L" Level Previous Inspection �-Cw Telephone Residential Kitchen D Mobile �e-o�peatiOwner HACCP Y/N Temporary s C'2,- rb I yl aw Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other i Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ �lS�cvl Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ / FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands �C ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals •QM� FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating � ., 1` "Av- 6.❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories �V��r1!/�'✓� Yf Nv)l &A, ✓`�7 Q, ,C c \ Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations �-p CieA Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. EEI ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal.Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 6=One critical violation and less than 4 non-critical violations 9 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i non-critical. . f critical water,sewage back-up,infestation of rodents or insects,or lack of be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) 9 violation,4 to 8non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Sign u Print: 31.Dumpster screened from public view �- Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N c 1 AvN 1 C, Dumpster Screen? Y N 1`� Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45'F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH. 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* 87-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* * 7-201.11 Separation-Storage* Applicants 3-302.11(A) Food Protection* 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Emits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Resumed Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(1--)) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Pe 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* Equipment* gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg cnw 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or Ratites-165°F 15 sec* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved B 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority y 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11 A)( )( )1 b All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail ( 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. $ Receiving/Condition g. g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C * (Blue Items 23-30) 3-202.15 Package Integrity ( ) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodbome 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated* ( ) g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* L18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 1.003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3 402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredlents` Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision _ 29. 1 Special Requirements 009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. i °p THE r TOWN OF BARNSTABLE HEALTH INSPECTOR,s Establishment Name: ,� ��Date: - Page: of Y OFFICE HOURS PUBLIC HEALTH DIVISION b 8:00-9:30 A.M. BARE. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified Mai. `0$ HYANNIS,MA 02601 M-8 -FRI.62�644 No Reference R-Red Item PLEASE PRINT CLEARLY ))}LLG 508-8 PrFO MP�p FOOD STABLISHMENT INSP TI N REPORT ° Name Date Irl4rve of Tyne of Inspection f n s Routine Address Risk ood Se Re-inspection Level Ret ' Previous Inspection Telephone A ,I esidential Kitchen Date: Mobile e-operati Owner HACCP Y/N Temporary Iness r Caterer General Complaint Person in Charge(PIC) km Bed&Breakfast HACCP Other Inspector wig-, Each violation checked requires an explanation on the narrativ page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ITT ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities �. EMPLOYEE HEALTH PROTECTION FROM CHEMICALS v ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling I ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control r ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) AA 17 ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY L LA L�6 ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories � z Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations IN yl / / Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. F] Embargo ❑ Emergency Closure Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than non-critical violations 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8von-critic violations. If 1 critical refrigeration. 29.Special Requirements (500.009) within 10 days of receipt of this order. 4 to 8 nui5-uitical violatio -C. 30.Other DATE OF RE-INSPECTION: In qor's. uK- 31.Dumpster screened from public viewPermit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC Pr�(stt� \ \ Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N \. •\1 C"��-'.�`� \,��Q\\�, Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45'F 590.004(F) * EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* g3-501.16(A) Hot PHFs Maintained At or Above 140'F* 2 590.003(C) Responsibility of the Person-in-Charge[0 7-102.11 Common Name-Working Containers* * Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 .Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 .3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004A-B Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) I Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water'" Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601. Clean and Food Contact Surfaces of * Animal Foods That are Raw,Undercooked or 11A 5-101.11. Drinking Water from an Approved System* ( ) an UtensilsEggs-Immediate Service 145°F 15 sec Not Otherwise Processed to Eliminate Equipment* ( )O Pathogens*590.006(A) Bottled Drinking Water* 3-401.11 A 2 Comminuted Fish,Meals&Game g * s ealve rruzoor 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155'F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g M 590.009(A)-(D) Violations of Section temporary and - ide in cater- * Ratites-165`F 15 sec* in mobile food,tern or and residential Sources 10 Proper,Adequate Handwashing g' P Game and Wild Mushrooms Approved By * 3-001.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild 2-301.11 Clean Condition-Hands and Arms 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to Regul3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 3-41.11(A)(1)(b)2-301.14 When to Wash* 0 All Other PHFs-145'F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practiceRequirement rhos ld be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items non-critical 23-30) 3-202.15 Package Integrity Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* F 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45'F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction*. Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 * 5-205.11 Accessibility,Operation and Maintenance 3-402.12 Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials I FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 1 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. CLU-6 `oFTNe roe, TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: I / l -(�U6 Date Page:�J of 1.0 � OFFICE HOURS i�AR E. PUBLIC 2 0 MAN STREET 3:30-4:30 P.M. DIVISION : 0- :30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified HYANNIS,MA 02601 MON.-FRI. No Reference R-Red.Item. PLEASE PRINT CLEARLY 508-862-4644 p'FD MP+p O FO E T I HM -NT INSPEC71ON REPORT Name a of o inspection + Routine Risk F Servi Re-inspection Address Level Previous Inspection Telephone Residential Kitchen / . Mobile Pre-operati Owner HACCP Y/N Temporary Suspe era Caterer General Complaint r. Person in Charge(PIC) Time Bed&Breakfast HA CP 49 I Cr Inspector1.226M -f7 -1/ Each violation checked requires an explanation on the narrativ page(s)and a citation of specific provision(s)violated. s Violations Related to Foodborne Illness Intervention andZsk Factors(Red Items) Anti-Choking 590.009(E) ❑ AA 4A Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ " FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands A (> ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEfTEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures L IV& 1 ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling I� P ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSPId ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY W -ten ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories `'I 1✓� Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations v Critical(C)violations marked must be corrected immediately. (blue&red items) _ Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating S I Iq within 90 days as determined by the Board of Health. ❑ Voluntary Compliance . ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by.a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005 B=One critical violation and less than 4non-critical violations 9 ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) PY within 10 days of receipt of this order. viol ' ,4 to 8 non-critical viola' s= 30.Other DATE OF RE-INSPECTION: Ins or's i In t e 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N `1 , \ Dumpster Screen? y N �t ` `C.'� \ `� Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs _ Cooked and RTE Foods' * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives - Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers*7-102.11 Common Name-Working Containers 590.004(F) * 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* P * 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* 590.003(G) Repo Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Requirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Tonic Containers-Prohibitions* ( ) q rting by Person in Charge* Contamination from the Consumer ' 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition ofAdulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water I Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Thinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs s Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or _ Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell 155 Shelfsh and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-1 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Aut Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority .,� 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b)All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 ' Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. � 5 Receiving/Condition g. g 8 3-003.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received Temperatures* ived at Proper Temperats* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C CommerciallyProcessed RTE Food-140°F* (Blue Items non-critical 23-30) 3-202.15 Package Integrity ( ) Critical and non-critical violations,which do not relate to the Foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* 590.004(E) Preventing Contamination from Employees* illness interventions and risk factors listed above,can be found in the 8 Tags/Records:Shellstock g18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F * Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3 402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 1 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' { Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand�Yin Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. �p INE rok, TOWN OF BARNSTABLE .. .,HEALTH INSPECTOR'S Establishment Name: Date: Page:. of 1 OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. B.RNSTABL 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified ,639: `0$ - HYANNIS, MA 02601 508-862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY, FOOD ESTABLISHMENT INSPECTION REPORT / .e, L\r%l " 10 ® i Name t .t � at /jeraof o ion e f,l outig o� � Address /� ; Risk ood Service J Re-inspection - �' Level Retail Previous Inspection Telephone Residential Kitchen Date: _ Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint �� �' Person in Charge(PIC) Time Bed&Breakfast HACCP , A,IE In: Other F I Inspector Out: 4. - Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ - �_ , FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands '+ / ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities " EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives `y t ,, "► ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating 1011, f �-�' /- if ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health ControlAl ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) - ^j � 1719.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY _ El 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories AX Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations i - Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: El No El Yes Non-critical(N)violations must be corrected immediately or Overall Rating a within 90 days as determined by the Board of Health. N `^ ❑ Voluntary Compliance. ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an nspected today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical, results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6rion-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) 9 violation,4 to anon-critical violations=C. 29.Special RequiramPnts. (590,009) within 10 nays of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view f J - Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats ObservedDessert Machines: Outside Dining Y N PIC's Signature Print: - Frozen g ,. ,r. `�t\ n�✓�1 Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N I�- \, \/ !. \\ h Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) z, FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding 2-103:11 '- Person-in-Charge Duties - 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE 590.004(F) * - I - HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* . 2 590.003(C) Responsibility of the Person-in-Char Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* ge•to _ - - - 7-102.11 Common Name-Working Containers* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Applicants* - 3-302.1I(A) Food Protection* 7-201.11 Separation-Storage* 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An _ 3-501.19 Time as a Public Health Control* _ 3-302.15 Washing Fruits and Vegetables Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Requirements 590.003(G) Reporting by Person in Charge*r 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q - - •' Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions :::]_ Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* !_ 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid'Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* - Concentration and Hardness* 163-401.11A(1)(2) Eggs-155'F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of Equipment 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 - ' Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 4-602.11 Cleaning Frequency of Utensils and Food 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* E�cme 11112001 Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellrrsh.and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* r 4-702:11` Frequency rf ces Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009 A (D) Violations of Section 590.009 A 3-201.15 Molluscan Shellfish from NSSP Listed ?Chemical* ( ) ( )-(D)in cater- * -`- Ratites-165°F 15 sec* in mobile food,temporary and residential • Sources 10 Proper,Adequate Handwashing g' P m*3' Game and Wild Mushrooms Approved By- 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 - Shellstock Identification-Present* -_ 2-301.12 1 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 2-301.14 When en to as * Other 590.009 violations relating to good retail • 590.004(C) Wild Mushrooms_* Wash*_ _ v _ _ 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practiceRequues rhos ld be debited under#29-Special 5 Receiving/Condition - - 2-401.11- Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-4 13.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-30112 Preventing Contamination When Tasting* 3-403.11(C) Commercial] Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity Y Critical and non-critical violations,which do not relate to the foodbome * 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated O g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3 402.11 Parasite Destruction* Temperature Ingredients to 41°F/45'F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied w th Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans - 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced.Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. OF 114E Tok, TOWN OF BARNSTABLE _ HEALTH INSPECTOR'S Establishment Name: Date: Page: of �f ti OFFICE HOURS PUB2 C HEALTH 0 MAIN STREET 3:30-4:30 P.M.DIVISION. : 0"-4:30 A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. g,e}9. �0 HYANNIS,MA 02601 MON.-FRI.soe-862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY P'FD1AP'' FOOD ESTABLISHMENT INSPECTION REPORT -- - Name DatY2.le e o Type of Inspection a r to Routine _ i Address ` Risk Food Service Re-inspection lk Level Retail Previous Inspection - Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness ' Caterer General Complaint ae- _ - Person in Charge(PIC) Time Bed&Breakfast HACCP r In: Other / Inspector Out: /e Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories 1 Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating _.I t .1 within 90 days as determined by the Board of Health. - ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑.Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Prepa regardless(FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than 4 non-critical violations 26.Water,Plumbing and waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6npn-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i non-critical. . f critical water,sewage back-up,infestation of rodents or insects,or lack of be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) 9 violation;A to anon-critical violations=C. - 29.Special Requirements (59p nnq) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view r Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N fff #Seats Observed Frozen Dessert Machines: Outside Dining Y N jSign tune Print:Self Service Wait Service Provided Grease Trap Size Variance Letter Posted YN Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT _ PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003 A Assignment of Responsibility* 8 Cross-contamination Food or Color Additives Law Cooled to 41'F/45`F Within 4 Hours* ( ) g 14 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 19 PHF Hot and-Cold Holding 3-302.14 Protection from Unapproved Additives* - Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH � 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) \ 2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130'F* * 7-201.11 Separation-Storage* - - - Applicants 3-302.11(A) Food Protection* 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-501.19 Time as a Public Health Control* _ 3-302.15 Washing Fruits and Vegetables Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* 590.003(G) Reporting by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils* 7-203.11 Toxic Containers-Prohibitions* 590.004(11) Variance Requirements Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR _ 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for Washin Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated g Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145'F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* gg _ Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg cri e 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130'F 121 min* Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* aces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g �' 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165'F 15 sec* Sources* 10 Proper,Adequate Handwashing ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165`F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145`F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes;Nose and Mouth* 3-403.11(B) Microwave-165`17 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 * (Blue Items 23-30) 3-202.15 Package Integrity (C) Commercially Processed RTE Food-140'F Critical and non-critical violations,which do not relate to the foodborne * 12 Prevention of Contamination from Hands 3-403.11E Remaining 3-101.11 Food Safe and Unadulterated ( ) g Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* Lu Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient. 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45'F 25. Equipment and Utensils FC-4 .005 3-002.12 Records,Creation and Retention* 5-205.11, Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Spec al Requirements .009 3-502.11 Specialized Processing Methods* 30. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* ti _ S:590Formback6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Town of Barnstable Inspectional Services Department 9 a� ��� Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4988 1401 December 31, 2019 WIANNO CLUB PO BOX 249 OSTERVILLE, MA 02655 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 The septic system located at 107 Seaview Avenue, Osterville,MA (Main Club and Tiffany Cottage) was inspected on 11/04/19 by Douglas A. Brown, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Needs Further Evaluation by the Local Approving Authority" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: C Leaching facility with standing liquid level at or above the invert pipe (per Town Code 360—20 h). You are ordered to upgrade the septic system within two (2)years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF TH)BOARD OF HEALTH f------ Tho- om c ean, R.S.,-CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\107 Seaview Avenue Main Club and Tiffany Cottage Osterville -Copy.doc r / Town of Barnstable MASS nax�srnsi.e, A 6 q A Inspectional Services Department rED►ap'� Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 4/26/19 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An "x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ❑ Structurally unsound septic tank or SAS ONE (1) YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any "conditionally passed systems" (broken cover, relocation of a pipe, relocation of driveway due to H-10 components, etc) eaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) LOTHER It-Ce Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts ip Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments , v � 107 SeaviaAve Osterville Wianno Club Main Club and Tiffany Cottage Property Address R Owner Wianno Club information is Owner's Name,/ required for Osterville V Ma 02655 11-4-19 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. Inspector Information 6-3 When filling out #�-/L�43 forms on the computer,use Douglas A Brown only the tab key Name of Inspector to move your D.A.Brown Inc cursor-do not Company Name use the return key. P.o Box 145 Company Address Centerville Ma 02632 City/Town State Zip Code 508-420-4534 S14297 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5(310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ❑ Passes 2. ❑ Conditionally Passes 3. ® Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails of✓�' 11-4-19 Insp toes Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts ►F Title 5 Official Inspection Form 11. Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 107 Seaviwe Ave Osterville Wianno Club Main Club and Tiffany Cottage Property Address Owner Wianno Club information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rev.W2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts �. OF Title 5 Official Inspection Form (( Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4' 107 Seaviwe Ave Osterville Wianno Club Main Club and Tiffany Cottage Property Address Wianno Club Owner information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ® Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(Ib)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•rev.7'26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �n e= 107 Seaviwe Ave Osterville Wianno Club Main Club and Tiffany Cottage Property Address Owner Wianno Club information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Citylrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: *"This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: Further Evaluation needed. The s.a.s was monitored over the past few months and was found to be functioning but at times of heavy usage ( club functions )thes.a.s would become full to the top of system risers(no overflowing ). After functions were over the leaching galleys wold slowly go down to a working level. 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.726/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts ►ip Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 107 Seaviwe Ave Osterville Wianno Club Main Club and Tiffany Cottage Property Address Wianno Club Owner information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® 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 '/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 SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CM 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. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. 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 t5insp.doc rev.7/26/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 107 Seaviwe Ave Osterville Wianno Club Main Club and Tiffany Cottage Property Address owner Wianno Club information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes" to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® 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) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 107 Seaviwe Ave Osterville Wianno Club Main Club and Tiffany Cottage Property Address Owner Wianno Club information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms(design): 6 tiffany iff an Number of bedrooms (actual): 6 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 660 Description: 66 flow is for Tiffany Cottage only. Total design flow is 8530 gpd. Number of current residents: Does residence have a garbage grinder? ❑ Yes ❑ No Does residence have a water treatment unit? ❑ Yes ❑ No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ❑ No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonaluse? ❑ Yes ❑ No Water meter readings, if available (last 2 years usage (gpd)): Detail: water usage is in separate documents supplied by Wianno Club Sump pump? ❑ Yes ❑ No Last date of occupancy: Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts ►F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 107 Seaviwe Ave Osterville Wianno Club Main Club and Tiffany Cottage Property Address Wianno Club Owner information Owner's Name is required for Osterville Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/industrial Flow Conditions: Type of Establishment: Club, Restaurant, Inn, Cottage, Snack bar. Design flow(based on 310 CMR 15.203): 6970 +900+660 =8530 totalGallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): rooms and seats and bedrooms Grease trap present? ® Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: attached separately from Wianno Club Last date of occupancy/use: Mostly summer seasonal Date Other(describe below): 3. Pumping Records: Source of information: Facilities Manager states Yearly pumping of all systems for maintenance. Grease traps on a schedule Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 107 Seaviwe Ave Osterville Wianno Club Main Club and Tiffany Cottage Property Address Wianno Club inform Owneration is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 4. 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) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ® Other(describe): Grease trap and pump chambers also Approximate age of all components, date installed (if known) and source of information: plan dated 11-10-93 actual install date unknown Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron ❑ 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts �. Iio Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments J 107 Seaviwe Ave Osterville Wianno Club Main Club and Tiffany Cottage e Property Address owner Wianno Club information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑.polyethylene ❑ other(explain) There are several tanks and pump chambers and grease traps of different sizes. ( see attached design plan). If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 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 How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tanks and grease traps were all opened and at time of inspection were functioning properly at time of inspection. All tanks and grease traps are on a maintenance pumping schedule. t5insp.doc•rev.7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts 1p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u J 107 Seaviwe Ave Osterville Wianno Club Main Club and Tiffany Cottage Property Address Owner Wianno Club information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Design plan shows 4 grease traps"A""B"" C" and "D"A is shown as 1000 gallon B is shown as 2000 gallon D size is not shown and C is shown as 1000 gallon Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date � Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dime nsions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts �9 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments V 107 Seaviwe Ave Osterville Wianno Club Main Club and Tiffany Cottage Property Address Wianno Club inform Owneration is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 3 d boxes all functioning properly. 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.): There are 3 G boxes all were functioning properly. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 Commonwealth of Massachusetts ip Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments L � 107 Seaviwe Ave Osterville Wianno Club Main Club and Tiffany Cottage Property Address Owner Wianno Club information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ® Yes ❑ No* Alarms in working order: ® Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Pump chamber, Alarms ,and floats were all functioning properly at time of inspection. The inside of the chamber had some slight greasy carry over. * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ® leaching galleries number: 48 44 Galleys ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form JA Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 107 Seaviwe Ave Osterville Wianno Club Main Club and Tiffany Cottage Property Address Owner Wianno Club information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Galley chambers were monitored over a few months period and wer found to be full at times of functions and heavy usage and then would drain down to a working level mostly during the week during times of less usage. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solid's layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): l5insp.doc•rev. /26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Massachusetts Commonwealth of �. ig Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4� f� 107 Seaviwe Ave Osterville Wianno Club Main Club and Tiffany Cottage Property Address Owner Wianno Club information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 Commonwealth of Massachusetts lip Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 107 Seaviwe Ave Osterville Wianno Club Main Club and Tiffany Cottage Property Address Owner Wianno Club information i.s Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5insp.doc•rev.7./26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts �. IF Title 5 Official Inspection Form 11� Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 107 Seaviwe Ave Osterville Wianno Club Main Club and Tiffany Cottage Property Address owner Wianno Club information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: attachedbott galley at elev 16 no gw at 7.7 Date ❑ Observed 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 ground water elevation: attached design plan Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 4 , Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 107 Seaviwe Ave Osterville Wianno Club Main Club and Tiffany Cottage Property Address Wianno Club Owner information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria)and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 I —NCH VIGW quell. UJ i AAn n C-ku6 ---- -G c y- 3� 4/0 'T FPAA� s /Soo aboo 10 000 Se�'it,y COlrAjt GmAse— 6 ot;l �o GA�'Cy3 ACroZ sr 39 a� 31 3-7 aoov A) p�� claMS� 3 ly 061 SAAc k �soo iw� 1, oo rows ones igsc 4 LDS `' ' cb � M V V� t 6 L 8/7 q„wfrn wo�� s-1.��j�� I C �Lh -LWJP&H 0 _d y • »,� •7i�• M'a!1)bas, ' r r l - � tT Town of Barnstable Inspectional Services Department anatvfrraet.£, 16 9. Public Health Division i6$4 1� f° 200 Main Street, Hyannis MA 02601 Office: 508-3624644 FAX: 508-790-6304 Thomas A.McKean CHO CERTIFIED MAIL#7015 1730 0001 4988 1395 December 31, 2019 WIANNO CLUB PO BOX 249 OSTERVILLE, MA 02655 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 107 Seaview Avenue, Osterville, MA (Beach Cottages) was inspected on 11/04/2019 by Douglas A. Brown, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 (half) day flow. You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH hoakt McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\107 Seaview Avenue Beach Cottage Osterville.doc tIH%E rgsti Town of Barnstable � HAfLVStAHLE, A b q ,.�A Inspectional Services Department TfD MP'� Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 4/26/19 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An "x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ❑ Structurally unsound septic tank or SAS ONE (1) YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis" indicates the well is free from pollution). TWO (2)YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any "conditionally passed systems" (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components, etc) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) . OTHER OT -d dqP 4 i M LefTool 15 '-e J f r "-�e/tv in✓e r l-P Vo l"m e. �S Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc r Commonwealth of Massachusetts o?—���f t r: IP Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 9 p Y rY u- 107 Seaview Ave Property Address ;w Wianno ClubOwnei formation is Owner's Name ` ,7 required for Osteryille Ma 02655 11-4-19 { every page. City/Town State Zip Code Date of Inspection`;' Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. Inspector Information When filling out CJ`' N3 forms on the computer, use Douglas A Brown only the tab key Name of Inspector to move you- D.A.Brown Inc cursor-do not Company Name use the return key. P.o Box 145 Company Address 1.6 Centerville Ma 026.32 `I\A Cityrrown State Zip Code ! 508-420-4534 S14297 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5(310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ❑ Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ® Fails �� 11-4-19 If►spee s Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. f Please note: 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. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts ► Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 107 Seaview Ave Property Address Owner Wianno Club information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts ► Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1, 107 Seaview Ave Property Address owner Wianno Club information is Owner's Name required for Osteryille Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. 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: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts �e Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments / 107 Seaview Ave Property Address Owner Wianno Club information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: — Yes No ® El clogged 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 t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 r Commonwealth of Massachusetts �9 Title 5 Official Inspection Form 11. Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 107 Seaview Ave Property Address Owner Wianno Club information is Owner's Name required for Osterville Ma 02655 114-19 every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® 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/z 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 SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ® ❑ 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. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section CA. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts �d Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 107 Seaview Ave Property Address Owner Wianno Club information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® 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) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts �6 Title 5 Official Inspection Form [/ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4' 107 Seaview Ave Property Address owner Wianno Club information is Owner's Name required for Osteryille Ma 02655 11-4-19 every page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential'Flow Conditions: Number of bedrooms (design): 8 Number of bedrooms (actual): 8 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 880 Description: 3 1,000 gallon septic tanks and 5 cesspools were found none of which appeared to be H-20. Number of current residents: Does residence have a garbage grinder? ❑ Yes ❑ No Does residence have a water treatment unit? ❑ Yes ❑ No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ElYes ElNo information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ❑ No Water meter readings, if available (last 2 years usage (gpd)): Detail: Wianno club has water usage documentation. Sump pump? ❑ Yes ❑ No Last date of occupancy: seasonalDate t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts �d lF Title 5 Official Inspection Form I° Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 107 Seaview Ave Property Address Wianno Club Owner information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts r: �9 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments " 107 Seaview Ave Property Address Owner Wianno Club information Is Owner's Name required for Osterville Ma 02655 11-4-19 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. 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) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ® Other(describe): 3 1,000 gallon septic tanks and 5 cesspools. Approximate age of all components, date installed (if known) and source of information: unknown Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron ❑40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 107 Seaview Ave Property Address Wianno Club Owner information is Owner's Name required for Osteryille Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: - Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 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 How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tanks did not appear to be H-20 all outlet covers were to grade all inlet covers were under asphalt. Tanks did appear to be functioning properly. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts IR Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments e 107 Seaview Ave Property Address owner Wianno Club information is Owner's Name required for Osteryille Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): B. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments `�- 107 Seaview Ave Property Address Wianno Club Owner information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm ❑ Yes resent: No p ❑ Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert na 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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 Commonwealth of Massachusetts ►13 Title 5 Official Inspection Form �I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 107 Seaview Ave Property Address owner Wianno Club information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ® overflow cesspool number: 5 ❑ innovative/alternative system Type/name of technology: t5insp.doc-rev.7/2E./2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 Commonwealth of Massachusetts ,IF Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 9 P Y rY u � 107 Seaview Ave Property Address Owner Wianno Club information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): All 5 cesspools were opened#4 and 8 on as-built were dry#5 had 2 ft of liquid and numbers 6 and 7 were full ( over inlet pipe). 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 5 in line supposedly Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): As-built card shows 5 inline but that does not make sense because the 2 end ones were empty and the others were not so I am not sure exactly how they are piped. We did not pump because the pools were all at the same elevation and the 2 end ones were dry with no ground water inflow. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts �. lP Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 107 Seaview Ave Property Address Owner Wianno Club information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 Commonwealth of Massachusetts F Title 5 Official Inspection Form I 1° Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 107 Seaview Ave Property Address Owner Wianno Club information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 f Commonwealth of Massachusetts �. P Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments •�=` 107 Seaview Ave Property Address Wianno Club inform Owneration is Owner's Name required for Osteryille Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ 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 ground water elevation: Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/2Ed2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts �m Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 107 Seaview Ave Property Address Owner Wianno Club information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 Page 1 of 1 l i .y = �- ►E- MIL wt • n ii 41 vO d I https://townofbarnstable.us/propertyimages/00/18/89/51,jpg 11/10/2019 Page 1 of 2 t . TOWN OF BARNSTABLE J I LOCATION (07 • SCQ V w SEWAGE# VILLAGE- ASSESSOR'S MAP&PARCEL 6,Z' Q��l r t . INSTALLERS 14A1a&PHONE NO, SEPTIC TANK CAPACITY LEACHING FACILITY:(type) size) NO.OF BEDROOMS 7 OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facilityg r e IPrivate Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Edge of Wetland and Lea Feet chug Facility(If any wetlands exist within 300 feet of leaching facility) Feet i FURNISHEDBX Tr1s7 , ; IP-Z7(a av, sq. l 3 yo a36 a 3 30 g 6 sr VY y� 3y 6y a9 hq://www,townofbamstable.us/Assessing/HMdisplay.asp?maDDar=162024&.cPn=') ' COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS .DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM.-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Main Club and Tiffany Cottage Property Address: 107 Sea View Avenue /��` T/ �`• Osterville, MA 02655 Owner's Name: Wianno Club Owner's Address: Date of Inspection: April 25, 2006 � R Name of Inspector: (Please Print) James M. Ford 's _ =• { r Company Name: James M. Ford 4 �� Mailing Address: P.O.Box 49 Osterville.MA 02655-0049 Telephone Number: (508)862-9400 r— CERTIFICATION STATEMENT + I certify that I have personally inspected the sewage disposal system at this address and that the info ation 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 Need urther Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: May 7 2006 The system inspector sha\submicopy of this inspection report to the Approving Authority(Board of Health or DE?)within 30 days of completing this inspection. If the system is a shared system or has a design flow of.10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent-to the buyer, if applicable,and the approving authority. 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 page I ` Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 107 Sea View Avenue Osterville, MA Owner: Wianno Club Date of Inspection: April 25, 2006 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: 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 a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. 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: 2 r Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 107 Sea View Avenue Ostervilk MA Owner: Wianno Club Date of Inspection: April 25, 2006 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board`of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to,a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliforin 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: 3 Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 107 Sea View Avenue Osterville, MA Owner: Wianno Club Date of Inspection: April 25,2006 D. System Failure Criteria applicable to all systems: You must indicate either"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 cesspool is less than 6"below invert or available volume is less than 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 SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion of a cesspool'or privy is within a Zone 1 of a public well. ✓ Any portion of a cesspool;or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspoolor 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 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.] 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 System: To be considered a large system the system must serve 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: (Th--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 has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 A Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 107 Sea View Avenue Osterville.MA Owner: Wianno Club Date of Inspection: April 25, 2006 Check if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No ✓ Pumping information was provided by the owner,occupant, or Board of Health ✓ Were any of the system components pumped out in the previous two weeks ? ✓ Has the system received normal flows in the previous two week period? ✓ 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)on the site 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 approxumation of distance is unacceptable) [310 CMR 15.302(3)(b)]. 5 i ` Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 107 Sea View Avenue Osterville, MA Owner: Wianno Club Date of Inspection: April 25, 2006 - - RESIDENTIAL(Tiffany.House) FLOW CONDITIONS Number of bedrooms(design): 6 Number of bedrooms(actual): 6 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 660 Number of current residents: 0 Does residence have a garbage grinder(yes or no): n/a Is laundry on a separate sewage system(yes or no): n/a [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): Yes Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Sumner use C'OMMERCIAL/INDUSTRIAL Type of establishment: _ Golf clubhouse/restaurant Design flow(based on 310 CMR 15.203): -- gpd Basis of design flow(seats/persons/sgft,etc.): -- Grease trap present(yes or no): Yes(2) Industrial waste holding tank present(yes or no) No Non-sanitary waste discharged to the Title 5 system(yes or no): No Water meter readings, if available: Unavailable Last date of occupancy/use: Mostly Sunnier use OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Pumped vearly for maintenance-per mana ement 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 ✓(2) 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 a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Date of installation unknown Were sewage odors detected when arriving at the site(yes or no): No 6 f Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) .Property Address: 107 Sea View Avenue Osterville, MA Owner: Wianno Club Date of Inspection: Al2ri125, 2006 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC _other(explain): Distance from private water supply well or suction line: Coirnnents(on condition of joints,venting, evidence of leakage,etc.): SEPTIC TANK: 1(2) (locate on site plan) Depth below grade: 2' / 10" / 18" , Material of construction: ✓ concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 10.000 QaL club / 1500 gal (bathrooms and snack bar) /1 500 aL(tijnv house) Sludge depth: -- Distance from top of sludge to bottom of outlet tee or baffle: 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: How were dimensions determined: _Measuring stick Comments(on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Cover was 6"below grade for the first 2 tanks Tees were present The inlet cover for the tifanv house was 2"below. The tanks were pumped months prior for maintenance GREASE TRAP: _ 1(2) (locate on site plan) Depth below grade: 8" / 12" Material of construction: _concrete _metal _fiberglass_polyethylene _other (explain): Dimensions: 2 000 gaaL ows to 10 000 al. tank / 1000 al. snack bar Scum thickness: 3" / 1" 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.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 107 Sea View Avenue Osterville MA Owner: Wianno Club Date of Inspection: April 25, 2006 TIGHT or HOLDING TANK: None (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: allons Design Flow: eallons/day Alarm present(yes or no); Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: _ ✓(3) (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even 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.): The D-Boxes were level. No solids were present. PUMP CHAMBER: ✓ (locate on site plan) Pumps in working order(yes or no): -- Alarms in working order(yes or no) -- Cornments(note condition of pump chamber,condition of pumps and appurtenances,etc.): The pump chainber was pumped with the other tanks. Did not acle through. 8 Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY.ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 107 Sea View Avenue Osterville MA Owner: Wianno Club Date of Inspection: April 25, 2006 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: leaching chambers,number: ✓ leaching galleries,number: 48-4'x 4'gallevs W 4'st me(per design plans) 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.): The alle s were driv and clean. The bottoin to grade was 7'. There did not a 2pear to be anv signs of failure. CESSPOOLS: None (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: None (locate on site plan) Materials of construction: Dimensions: Depth of solids: Coirunents(note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 ' Page 10 of 1 I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 107 Sea View Avenue Osterville, MA Owner: Wianno Club Date of Inspection: April 25, 2006 SKETCH OF SEWAGE DISPOSAL SYSTEM -Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. See, 1 AL( Pra��s 10 r Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 107 Sea View Avenue Osterville, MA Owner: Wianno Club Date of Inspection: aril 25, 2006 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed 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 ground water elevation: According to the design plans.on file, no water was observed at 12'below grade This report has been prepared only for the septic system and components described herein. This septic system has been inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the septic system, the inspection, this report and/or any components of the septic system which have not been located and inspected. 11 SeA vices Ave.. w►AAA\0 c-lu6 N G C y- 3"1 yo Ti PIPAAN s isoo Qboo ( 0o0 s «y C°���� GrtA_e- 6 GAt�cys Ae-roZ A /Y S 39 a� a a� a1 (0 31 3-7 a000 to pomp 64ML' 3 3 ylo 41(o 141 a Sn,4c k /Soo Al \ 3A� 1� oo �oonAs 're,gSt 4 -- J 9,T) 4�,� S-l.�a�Id4 1w'jp,-N 0 -y �1 b� COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION C JI9 329 Golf Club b Property Address: Parker Road Osterville MA 02655 Owner's Name: Wianno Club Owner's Address: js Date of Inspection: April 25, 2006 Name of Inspector: (Please Print) Janzes M.Ford Company Name: James M. Ford Mailing Address: P.O.Box 49 Osterville,MA 02655-0049 _ t Telephone Number: (508) 862-9400 : CERTIFICATION STATEMENT c 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. 11 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system! ✓ Passes Conditionally Passes Ne s Further Evaluation by the Local Approving Authority Fa s Inspector's Signature: Date: 7, 2006 The system inspector shall sub it a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer,if applicable, and the approving authority. 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 page 1 f T Page 2 of 11 J OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 32 2 Parker Road Osterville MA Owner: Wianno Club Date of Inspection: April 25. 2006 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: V' 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: 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 a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. 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 ND explain: obstruction is removed 2 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 329 Parker Road Osterville MA Owner: Wianno Club Date of Inspection: April 25, 2006 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has aseptic 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: I 3 r • .Page 4 of 11 y OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 329 Parker Road Osterville MA Owner: Wianno Club Date of Inspection: April 25, 2006 D. System Failure Criteria applicable to all systems: Ycu must indicate either"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 cesspool is less than 6"below invert or available volume is less than '/z 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 SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion of a cesspool or privy is within a Zone 1 of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100.feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for 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.] 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 System: To be considered a large system the system must serve 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 has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 2 4 r Page 5 of 11 f OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 329 Parker Road Osterville MA Owner: Wianno Club Date of Inspection: April 25, 2006 Check if the followi.ng have been done: You must indicate es"or"no"as to each of the following: Yes No Pumping information was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ Has the system received normal flows in the previous two week period? ✓ 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)on the site 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)]. i 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 329 Parker Road Osterville MA Owner: Wianno Club Date of Inspection: April 25, 2006 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Ni:mber of current residents: Dees residence have a garbage grinder(yes or no): Is laundry on a separate sewage system(yes or no): [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use(yes or no): Water meter readings,if available(last 2 years usage(gpd)): Sump Pump(yes or no): Last date of occupancy: COMMERCIAL/INDUSTRIAL Type of.establishment: _ Golf club Design flow(based on 310 CMR 15.203): 2690 gpd Basis of design flow(seats/persons/sqft,etc.): -- Grease trap present(yes or no): Yes Industrial waste holding tank present(yes or no) No Non-sanitary waste discharged to the Title 5 system(yes or no): No Water meter readings,if available: Unavailable Last date of occupancy/use: Mostly Summer use OTHER(describe): GENERAL INFORMATION Pumping Records Source of information:_Pumped yearly for maintenance-ber mana ement 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 a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Date of installation unknown Were sewage odors detected when arriving at the site(yes or no): No 6 r Page 7 of 11 i OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 329 Parker Road Osterville MA Owner: Wianno Club Date of Inspection: April 25, 2006 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 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 on site plan) Depth below grade: 8" Material of construction: ✓ concrete _metal ._fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 4500 gal. Sludge depth: -- Distance from top of sludge to bottom of outlet tee or baffle: 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: How were dimensions determined: Measuring stick Comments(on pumping recomunendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Tees were resent. There did not ggpear to be any signs of leaka e. GREASE TRAP: ✓ (locate on site plan) Depth below grade: 8" Material of construction: ✓ concrete —metal _,fiberglass _polyethylene _other (explain): Dimensions: 1000 gal. 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: 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.): The outlet cover was to jzrade. There did not appear to be any signs of leaka 7e. 7 r Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 329 Parker Road Osterville MA Owner: Wianno Club Date of Inspection: April 25, 2006 TIGHT or HOLDING TANK: None (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: allons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: , . Coirunents(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even Cormnents(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.): The D-Box was level. No solids were RLqsent. The cover was 2'below garade. PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alanns in working order(yes or no) Continents(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 t Page 9 of 11 J OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 329 Parker Road Osterville. MA Owner: Wianno Club Date of Inspection: April 25. 2006 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: S-4'x 6'(600 Qal.)w/4'stone-per design plans leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding;damp soil,condition of vegetation, etc.): A video camera was used to ins ect all of the leach 12its. There did not an ear to be anV si ns of failure. The bottoms to rade were approximately 5.5'. CESSPOOLS: None (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: None (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.): i 9 r �• Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 329 Parker Road Osterville MA Owner: Wianno Club Date of Inspection: April25. 2006 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Fol 6 A CA c. y a A I .23 1 3 1 q T7 , 10 r Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 329 Parker Road Osterville, MA Owner: Wianno Club Date of Inspection: April 25, 2006 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 12 +/- feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked with local Board.of Health-explain: topographic and water contours maps Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using Barnstable topographic and water contours ni yRs the Wraps were showing approximately 12'+/ to ground water at this site. According to the design plans, the water table is 5'below the bottom of the leach pits This report has been prepared only for the septic system and components described herein. This septic system has been inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future: There have been no warranties or guarantees, either expressed, written or implied, relating to the septic system, the inspection, this report and/or any components of the septic system which have not been located and inspected. 11 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION- J AN i � 2004 TO,!, %OF BARNSTABLE HEALTH DEPT. TITLE 5 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 329 Parker Road(Golf Club) Osterville, MA 02655 MAP Owner's Name: Wianno Club Owner's Address: PARCEL ; 22 Date of Inspection: January 2, 2004 LOT Name of Inspector: (Please Print) James M. Ford Company Name: James M. Ford Mailing Address: P.O. Box 49 Osterville,MA 02655-0049 Telephone Number: (508) 862-9400 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: January 7, 2004 The system inspector shall submi a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. 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 page 1 I Page 2 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 329 Parker Road(Golf Club) Osterville, MA Owner: Wianno Club Date of Inspection: January 2, 2004 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: 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 a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. 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: 2 Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 329 Parker Road(Golf Club) Osterville, MA Owner: Wianno Club Date of Inspection: January 2, 2004 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool o-privy is within 50 feet of a surface water Cesspool o: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 any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system.has a septic tank and SAS and the SAS is within a Zone I of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well", Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for 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: 3 I Page 4 of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 329 Parker Road(Golf Club) Osterville, MA Owner: Wianno Club Date of Inspection: January 2, 2004 D. System Failure Criteria applicable to all systems: You must indicate either"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 cesspool is less than 6"below invert or available volume is less than '/z 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 SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion of a cesspool or privy is within a Zone 1 of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for 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.] No (YesfNo)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 System: To be considered a large system the system must serve 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 has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 329 Parker Road(Golf Club) Osterville, MA Owner: Wianno Club Date of Inspection: January 2, 2004 C. eck if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No ✓ Pumping information was provided by the owner, occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ _ Has the system received normal flows in the previous two week period? ✓ 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 battles 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)on the site 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)]. 5 I • Page 6 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 329 Parker Road(Golf Club) Osterville, MA Owner: Wianno Club Date of Inspection: January 2, 2004 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Number of current residents, Does residence have a garbage grinder(yes or no): Is laundry on a separate sewage system(yes or no): [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use(yes or no): Water meter readings, if available(last 2 years usage(gpd)): Sunp Pump(yes or no): Last date of occupancy: COMMERCIALMSDUSTRIAL Type of establishment: Golf/Country Club Design flow(based on 310 CMR 15.203): 2.690 gpd Basis of design flow(seats/persons/sgft,etc.): -- Grease trap present(yes or no): Yes Industrial waste holding tank present(yes or no) No Non-sanitary waste discharged to the Title 5 system(yes or no): No Water meter readings, if available: Unavailable Last date of occupancy/use: Mostly summer use OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Pumped May 29102- per treatment plant 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 a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Unknown-no information available Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 329 Parker Road(Golf Club) Osterville, MA Owner: Wianno Club Date of Inspection: January 2, 2004 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 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 on site plan) Depth below grade: 8" Material of construction: ✓ concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dirr:ensions: 4500 gal. Sludge depth: 1" Distance from top of sludge to bottom of outlet tee or baffle: -- Scum thickness: 0" 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: -- How were dimensions determined: Measuring stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tees were present. There did not appear to be any signs of leakage. GREASE TRAP: ✓ (locate on site plan) Depth below grade: 8" Material of construction: ✓ concrete _metal _fiberglass _polyethylene _other (explain): Dimensions: 1000 gal. Scum thickness: 1" 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: -- Date of last pumping: May 29102 Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): The liquid level was up to the outlet pipe. There did not appear to be any signs of leakage. The outlet cover was to grade. 7 Page 8 of 1 I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 329 Parker Road(Golf Club) Osterville, AM Owner: Wianno Club Date of Inspection: January 2, 2004 TIGHT or HOLDING TANK: None (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 alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even 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.): The D-box was level. No solids were present. There did not appear to be any signs of failure from the pits. The cover was 2' below grade. PUMP CHAMBER: None (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.): 8 I ' Page 9 of 1 I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 329 Parker Road(Golf Club) Osterville, MA Owner: Wianno Club Date of Inspection: January 2, 2004 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type v' leaching pits, number: S-9'x 6'(600 gal.)-per design plans leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): There did not appear to be any signs of failure from the pits. The bottom to grade was approximately 5.5. CESSPOOLS: None (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: Dep,.h 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: None (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.): 9 r c Page 10 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 329 Parker Road(Golf Club) Osterville, AM Owner: Wianno Club Date of Inspection: January 2, 2004 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. JI\ 194k J, is ay� S3G 53 O 10 p Page 11 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 329 Parker Road(Golf Club) Osterville, AM Owner: Wianno Club Date of Inspection: January 2, 2004 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 12 +/- feet Please indicate (check) all methods used to determine the high ground water elevation: ✓ Obtained from system design plans on record-If checked, date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked with local Board of Health-explain: topographic and water contours maps Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using the Barnstable topographic map and water contours map, the maps were showing approximately 12'to ground water at this site. According to the design plans on file, the water table was 5'below the bottom of the pits. This report has been prepared and the system inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the system, the inspection and/or this report. 11 Yh c � Or /0&�Q- COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS,,,,4 a& DEPARTMENT OF ENVIRONMENTAL PROTECTIONjw-6r TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Beach Cottage Property Address: 107 Sea View Avenue Osterville. MA 02655 Owner's Name: Wianno Club Owner's Address: Date of Inspection: April 25, 2006 Name of Inspector: (Please Print) James M. Ford Company Name: James M.Ford c, Mailing Address: P.O.Box 49 Osterville.MA 02655-0049 = Telephone Number: (508)862-9400 F CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported L below is true,accurate and complete as of the time of the inspection. The inspection was performed biased on my training.and experience in the proper function and maintenance of on site sewage disposal systems. Ilam a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CAM 15.000). The system: Passes Conditionally Passes ✓ eds Further Evaluation by the Local Approving Authority as Inspector's Signature: Date: Mav 14, 2006 The system inspector sh)sub ' a copy,,pf•this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of.10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments NOTE.System is under an asphalt parking lot and is H-10 loading. Needs further evaluation. ****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 page 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: 107 Sea View Avenue Osterville, MA Owner: Wianno Club Date of Inspection: April 25, 2006 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: 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 a complying septic tank as approved by the Board of Health. *A.metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. 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: 2 L Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 107 Sea View Avenue Osterville MA Owner: Wianno Club Date of Inspection: April 25, 2006 C. Further Evaluation is Required by the Board of Health: ✓ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone I of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance **This system passes if the well water analysis,performed at a DEP certified laboratory, for 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: The system is under an asphalt narking lot and is H-10 loading Further evaluation is needed 3 L Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 107 Sea View Avenue Osterville, MA Owner: Wianno Club Date of Inspection: April 25, 2006 D. System Failure Criteria applicable to all systems: You must indicate either"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 cesspool is less than 6"below invert or available volume is less than 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 SAS,cesspool or privy is below high groundwater elevation. ✓ Any,portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion of a cesspool or privy is within a Zone I of a public well. _ ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for 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.] 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 System: To be considered a large system the system must serve 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 has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 I Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 107 Sea View Avenue Osterville, MA Owner: Wianno Club Date of Inspection: April 25. 2006 . Check if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No ✓ Pumping information was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ Has the system received normal flows in the previous two week period? ✓ 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)on the site 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)]. 5 I Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 107 Sea View Avenue Osterville, MA Owner: Wianno Club. Date of Inspection: April 25. 2006 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): n/a Number of bedrooms(actual): n/a DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): n/a Number of current residents: 0 Does residence have a garbage grinder(yes or no): n/a Is.laundry on a separate sewage system(yes or no): n/a [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): Yes Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Summer use COMMERCIAVINDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): epd 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: Pumped yearly for maintenance-per management 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 10) 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 a copy of the DEP approval Othe-(describe): Approximate age of all components,date installed(if known)and source of information: Date of installation unknown Were sewage odors detected when arriving at the site(yes or no): . No 6 Page 7 of 11 i OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 107 Sea View Avenue Osterville. MA Owner: Wianno Club Date of Inspection: April 25. 2006 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC _other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓(3) (locate on site plan) Depth below grade: All 12"below grade ' Material of construction: ✓ concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: All 1000 gal. (H-10) Sludge depth: -- Distance from top of sludge to bottom of outlet tee or baffle: 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: How were dimensions determined: _ MeasurinQ stick Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Tees were present. Steel covers on the outlet side ofthe tanks NOTE:Tanks are H 10 and under a driveway Further evaluation is needed frons the Board of Health GREASE TRAP: None (locate on site plan) 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.): I . 7 v Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 107 Sea View Avenue Osterville, MA Owner: Wianno Club Date of Inspection: April 25, 2006 TIGHT or HOLDING TANK: None (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 alarm and float switches,etc.): DISTRIBUTION BOX: None (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: 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.): PUMP CHAMBER: None (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.): 8 • 9 yr Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 107 Sea View Avenue Osterville. MA Owner: Wianno Club Date of Inspection: April 25, 2006 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: ✓ overflow cesspool,number: S 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.): All of the cesspools were S'W x 6'T x 9'bottom to grade Steel covers were to grade There did not appear to be any signs of failure. NOTE: The cesspools are under an asphalt parking lot and are not H-20 loading Further evaluation from the Board o0lealth is needed. CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Nuriber 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: None (locate on site plan) Materials of construction: Dimensions.- Depth of solids: Continents(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 Q Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 107 Sea View Avenue Osterville, MA Owner: Wianno Club Date of Inspection: April 25, 2006 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. A g A � i as -7(o 3 yp y10 -7g -7 Y6 3Y (� aq 10 - Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 107 Sea View Avenue Osterville, MA Owner: Wianno Club Date of Inspection: Apri125, 2006 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 15+/- feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Topographic and water contours maps Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using Barnstable topographic and water contours maps, the snaps were showing approximately 15'+/ to ground water at this site. This report has been prepared only for the septic system and components described herein. This septic system has been inspected and further evaluation is required as of.the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed,written or implied, relating to the septic system,the inspection, this report and/or any components of the septic system which have not been located and inspected. 11 ' - se4_ .11 �, & 7/// re-�, . Sullivan Engineering Inc. �- 7 Parker Road, Box 659,Osterville MA 02655 508428-3344 a-mail:owHpeAwl.com fax 508428-3115 June 12, 2006 Thomas McKean Town of Barnstable Board of Health 200 Main Street Hyannis, MA 02601 RE: Wianno Club/Clubhouse&Tiffany/ 107 Sea View Avenue, Osterville Dear Mr. McKean, We appreciate your quick response to our previous letter dated June 7, 2006, and understand your concern about ensuring.that the 11 bedrooms will not be used. We have attached Minutes of the Wianno Club Board Meeting-from-April 8, 2006, and a copy of the Wianno Club Sandpiper from June/July 2006. We believe that the highlighted portions from the General Manager provide the insurance that you are requesting. I trust this meets your present needs. Please feel free to call if you have any further questions. Very truly y rs, John O'Dea Sullivan Engineering Inc. - -_ Cc: Wianno Club John Alger, Esq. r.; Q !" Members of The American Society of Civil Engineers and The Boston Society of Civil Engineers Sullivan Engineering Inc. 7 Parker Road, Box 659,Osterville MA o2655 508-428-3344 a-maik psuftc(&aoLcom fax 508 428-3115 June 7, 2006 Thomas McKean Town of Barnstable Board of Health 200 Main Street Hyannis, MA 02601 RE: Wianno Club/Clubhouse&Tiffany/ 107 Sea View Avenue, Osterville Dear Mr. McKean, The Wianno Club would like to offer it's members a casual dining area. As such, architects have developed preliminary plans for a covered porch area located off of the east end of the building, and we have been tasked with evaluating the septic system. Please note that the septic system serving the Clubhouse and Tiffany Cottage passed a Title 5 inspection, which was performed on April 25, 2006 as required by the Board of Health as part of the Stables approval. Although we believe that in actuality the flow to the septic system is limited by the number of members, and that having additional seats in a casual area as an option for the members should not affect the design flow, Title 5 does not allow for such considerations. Instead of having to move seats from one area to the next as the members so choose, the Club would like to permanently add the casual dinning seats,but does not want to have to construct a new septic system. To handle this additional flow the Club would like to remove flow from elsewhere .= within the system, so as to not be considered new construction. As such we are recommending that Tiffany Cottage, which based on our personal inspection and recent history from the Club Manager, appears to have always consisted of 11 bedrooms. Although historical interests prohibit the Cottage from being demolished at this time, the Club does not intent to use it, as it does not appear to be suitable for occupancy. We believe that the elimination of these 11 bedrooms would allow for 121 additional seats to be added to the Clubhouse without the need for an upgrade. We would w appreciate your thoughts. : I trust this meets your present needs. Please feel free to call if you have-any further ti questions. cr:j Ve truly � — P te� John O'Dea Vj ®� Sullivan Engineering Inc. h ,� ,Cc: Wianno Club ��o CMS w,(� John Alger, Esq. Members of The American Society of Civil Engineers and The stun Society of Civil Engineers L r - wiamo Club Minutes of the Board Meeting 8 April 2006 The regular meeting of the Board of Governors was convened by President Swan at the Harvard Club of Boston at 9:00 AM this date. Other Board members in attendance in person were Charles Cramb, Mrs. George Edmonds, Mrs. Gary DiCamillo, Stephen J. Healey, IV, Peter C. Holcombe, Mrs. Paul Kaneb, Mrs. Robert Morrison, David Rockwood,Andrew Taylor, Jr., and Anthony Will. Also present and attending by telephone were Robert Baer, James Kjorlien, James Morphy and Robert Young. Dr. Thomas Cochran attended as a guest of the Board, representing Mrs. T. Dennis Brown and the Membership Committee. Also in attendance was Club General Manager Jack Thomson. Minutes The minutes of the meeting of 10 December 2005 were amended to include discussion of a proposal to invite members of Oyster Harbors Club to enjoy Wianno Club dining until their new clubhouse is completed. A motion was made and seconded to invite Oyster Harbors members to enjoy Main Club dining from the time our Club opens until the new Oyster Harbors clubhouse is completed. The motion was approved. (Subsequent to the meeting,Mr. Swan did write a letter to John Drew as President of Oyster Harbors and a copy is attached.) Treasurer Mr. Cramb presented the attached written report. In a discussion of capital spending progress, Mrs. Kaneb indicated that most spending for this year is complete but that her committee is considering substantial investments in the near future in dining room carpeting, guest room bathroom upgrades and the Wicker Room, which was originally scheduled to be redone this year. General Manager The report of the General Manager is attached. Subsequent to Mr. Thomson's report, a motion was made to close Tiffany to guest occupancy. The motion was seconded and carried unanimously. f Mr. Swan appointed a committee of Mr. Young and Mr. Rockwood to investigate the possibility of getting Tiffany removed from the National Register of Historic Places. It was moved and seconded to add John B. Williams to the Facilities Planning Committee. Motion carried. Personnel Committee Mr. Swan proposed the makeup of the Personnel Committee for the coming years as follows: • t •f Charles Lanigan, Chairman Timothy Fulham Geoffrey Ballotti The proposal was moved, seconded and carried unanimously. President's Report Mr. Swan presented the attached written report. Mr. Swan emphasized the importance of the Boards unification on the need for the new kitchen and informal.dining areas. There was lengthy discussion of many of the questions that will arise from the membership. These included concern for the need for a new kitchen,the possibility of closing off part of the present dining room for casual dining,the specific answers to these concerns and a general view that the project would be enthusiastically received by the members. It was agreed that a coordinated, supporting statement should be available to the Board members so that they speak with one voice and that the Board should encourage open discussion of the subject with the membership at every opportunity. Tennis Mr. Kjorlien reported.that the backboard is complete, only needing some additional paint, and that the hitting surface is much larger than previously. He has visited approximately fifteen clubs in the New York/Connecticut areas and none have a facility as good as ours. He reported on the installation of the new closets and cabinets and icemaker. Returning Tennis Pro Jeff Daly is looking forward to a great season. Golf Committee Mr. Taylor reported that the department is gearing up, that Rebecca Hayes is continuing as Head Professional, assisted by Cody Bradford. Mike Farrell, who formerly served the Club in an intern capacity, is returning as second assistant professional. Mr. Taylor summarized the tree planting that has taken place,both on the 2nd fairway to protect the Ross property and on the 61h fairway to protect the Siscoe property. He also noted that the committee is continuing to investigate future building projects, including deck expansion, etc. Risk Management Mr. Baer reported that James Hance and Pete Buck are new members of the Risk Management Committee and that the committee is currently reviewing emergency preparedness plans. Also, the committee is seeking to limit Club liability on golf carts with language in the yearbook placing responsibility for any personal injury or property damage on the operator. Committee member Albert Schulz is drafting a notification to be distributed to guests, probably by the starters, notifying them of their similar responsibility. The Directors and Officers Liability policy has been increased to the level of our umbrella coverage, $20M, at an additional cost of$4350. A subcommittee consisting of Mr. Hance and Mrs. Stephens is reviewing our methods of club governance and will report at a later date. Membership Committee Dr. Cochran submitted the following candidates for membership: Michael White Regular Sam Traywick Junior Plus Tiffany Swan Junior Plus The motion was seconded and carried. Four Non-Resident Member candidates were presented for approval: Jacques Solvay Andrew Edmonds David Ray Frank Weis The motion was seconded and carried. Dr. Cochran noted that there are many good candidates for membership from all age groups. Mrs. Kaneb stated her opposition to the recent proposal disallowing spouses of Board members from writing sponsorship letters. Dr. Cochran replied that the committee felt that allowing such spouses to write such letters could put the Governor and the Committee in an awkward position in the event of a rejection. He did, however, encourage these spouses to write"letters of support,"as opposed to assuming sponsorship. Restaurant Committee The written report of the Restaurant Committee is attached. Long Range Planning Committee Chairman Will presented the attached report proposing an update of the Club's mission statement. After short discussion, it was felt the Committee should continue to tune the statement for final approval at a later date. Mr. Will expressed comfort at there being no final decision at this time. Paddle Tennis Mr. Holcombe reported on conditions at the paddle tennis courts, commending the new superstructure and heaters. Mr. Holcombe reported that Donald and Jacquie Martin had served as co-chairs for many years and that they were asking to resign,to be replaced by John C. "Jack"Mechem and I his wife, Mary S. "Mike" Mechem. The Board accepted the change and commended Mr. and Mrs. Martin on their years of faithful service. Other Business Mrs. Edmonds reported that letters had gone out to members of the former guest clubs by Mr. Swan,to club managers by Mr. Thomson and that Janet Sheehan is currently finalizing a letter to go to "membership secretaries" of several clubs. All of these are intended to make qualified individuals aware of the availability of Non-Resident memberships. Mrs. Edmonds also reported that the Bridge Festival has been sold out and all rooms are filled for those dates. I Mr. Swan reported the new PKF annual report, "Clubs in Town and Country" is out and that Wianno Club is not out of line with other similar clubs nationwide, as it relates to income and expenses. The Board was made formally aware of the untimely death of our former Assistant Golf Professional, Dale Morrison. Mr. Swan read a letter from Shauna Shane thanking the Board for allowing her to use Club facilities for her art show at the end of last summer. There being no further business,the meeting was adjourned at 12:15 PM. Respectfully submitted, Jack L. Thomson, CCM General Manager and Acting Secretary r " M THE k A Y Vol.=111 No. 1 Published by Wianno Club, Inc., Osterville,Massachusetts June/July 2006 JULY 4th EVENTS Wianno Club SATURDAY,JULY 1 Gourmet Dinner GOLF- FOURTH OF JULY Friday, .lime 16 ,STROKE PLAY 7 p.m. Cocktails in the Wicker Room F/ IY BARBECUE AND 8 p.m. Dinner in the Main Dining Room LOBSTER DINNER Choice of seating in the Tent,Ballroom or r Main Dining Room Menu RESERVE BY RETURNING THE POSTCARD ENCLOSED Braised Breast of Tender Veal IN YOUR INVITATION Thyme & Maple Roasted Anjou Pear Mache 5:30 p.m. Cocktails/Juice Bar 6:00 p.m.Dinner Music by Bob Hayes Puree of Sweet Pea Soup Cream Fraiche Entertainment by Fun Clowngg'h of Adults$30 for Barbecu Prosciutto de Parma Ham $47 for Lobster' Youth(ages 7-15)$18I - Children(age 6&under)dd$12 Medallion of Venison Grilled Polenta Cake, Creamed Spinach Event Chair: Mrs.Douglas Homberger Sauteed Fresh Foie Gras, Lingonberries SUNDAY,JULY 2 SUNDAY NIGHT BUFFET Mocha Mousse Filled Genoise Cake 7:00 p.m. with \ f Chocolate Buttercream and Macerated Fruit >UESDAY,JULY 4 RLY SPORTS DAY $90.00 per person All Day.No fees for family members playing golf or tennis. (Includes Wine and Champagne) Tee tines required at golf. JUNIOR ACTIVITIES PARADE Mrs. Raymond F. Burghardt, Chair 11:00 a.m. All children are invited to join in! BOARD OF GOVERNOR'S FATHER'S DAY CRYSTAL LAKE P,Ic� C/ RECEPTION BREAKFAST 12:00 noon LSunda June 18 Adults $15 Childre $9.Sa y' Sunday, June 18 FROM OUR GENERAL , Tiffany Helen Swan Kouri MANAGER Peter James=Smai1 Welcome home, one and all,to beautiful.. Samuel Clay Traywick Cape Cod! We're glad you're back!- Peter Grant Webster 1 ®. Michael D.White This was a comparatively mild winter(at least compared to some we have had in re- _ WELCOME SEASONAL cent years) and we got quite a few things MEMBERS done around the Club. Earl golfers,have Y g Staff members Debbie Bryant and Gary'I'oolas The following people have been granted. noticed the redecorating that has taken brave the December 9th snowstorm "Seasonal"privileges for 2006.Please place at Golf House and,as this is written welcome them! TM ' we are awaiting delivery of new chairs exemplified by people like Chef James, and table tops over there. returning after umpty-ump years and Mai- Michael Champa tre d' Jenn Powers who started with the Tennis has had quite a facelift too, with Club while a student at Sandwich High. Proposed by Victor Pesek new bathroom flooring,interior doors and Megan Barford is back at JA for her sixth Daphne Cross Rayment paint. Some new cabinets and shelving season and Jeff Daly has been running the P g show over at tennis for nine. Maureen and Proposed by Heather Markey Zink J should contribute toward a neater appear- ance, and how about that new practice Sonny Tavares are here for their twelfth P Robert L.Rewey backboard? Chairman Jim K'orlien says season in Housekeeping and many, many I Y of our rank and file,.including some of the Proposed by Sandra Packard we have as nice a tennis facility as he has seen anywhere and I'm in no position to foreign students have returned for mul- Y P tiple summers. Bruce is back at the front William Paul Sommers argue. proposed David H.Ellsworth door, and I think Scott Chamberlain may Pro P b Y Beachgoers will soon see a huge improve- have been born here. David H.Rowe ment in the changingibathrooms down Of course,and not to be forgotten,are the proposed y ro osed b David B.Temple there, the whole interiors having been who hold things together Year around staff upgraded. We hope you'll agree this is a ff Steven C.Walske welcome improvement. through the wintertime—Mark Williams b Michael J.Ruberto and Crew on the golf course, Gordon and proposed Y On a down note, your Board of Gover- Dana in Maintenance, Rebecca and Cody at the Golf House. WELCOME NON-RESIDENT nors has closed Tiffany to any occupancy MEMBERS to the presence of possibly hazardous re- Of great importance are the folks in the Mr.and Mrs.J.Bradshaw Griffith molds. Correcting the problem will quire sizeable expenditures that have e- back office who have been toiling all win- Mr. and Mrs.Frank Weise ter putting together the various programs scheduled as a future priority. j and events that make our Club such a spe- IN MEMORIAM NO WINE TO GO cial place. They include Debbie, Janet, Members Those of you who reside in Massachusetts • Anne, Charleen and Pat, not to mention Charles T."Ted"Bellingrath are aware of the recent regulation change Gary Toolas, who counts it all up. And Mrs.William Brown that allows restaurant and hotel patrons to don't forget George,who's waiting to help. Warren Red Cross , carry out unfinished bottles of wines after You plan your next party. Mrs.Robert(Susan)Macallister enjoying a meal. Unfortunately,the legis- Former Members lation does not . Unfortunately, currently apply to holders All of us together want to wish you a huge, Eliza Betsy Bentley pP Y "WELCOME HOME!" We hope you will Kenneth W. Cameron of"Club"liquor licenses, such as Wianno Lily Lambert McCarthyClub. The Club Managers Association call on us often. Y and the Mass. Restaurant Association are Former Staff Member currently working with the Liquor Control Jack L.Thomson,CCM Dale J.Morrison Commission toward modifying the regu- WELCOME NEW MEMBERS lation in our favor and we will inform you Jennifer Callen Beveridge NEXT SANDPIPER if and when wine-to-go becomes available Dana J.Cuffe DEADLINE to our members. John Duggan AUGUST/SEPTEMBER 2006 Michael K.Furey ISSUE I think one of the important signs that a Thomas M.Greene Deadline:July 10,2006 club such as yours is a good place to work Meredith James Hance The Sandpiper is published by is by looking at the numbers of returning Jonathan B."Jon"Hill Wianno Club,Inc.,Osterville,MA staff each year. In Wianno's case, that's Steven George Hoch Editor:Janet E.Sheehan 2 9 i 'rr FROM THE SOCIAL ACTIVITIES For members and guests of all ages,a spe- shu, the very language that once brought COMMITTEE cial event on Thursday July 13th is the these two girls together,that ultimately de- The Wianno Club has a great line-up of "Cirque de Sea",a fascinating,interactive stroys their relationship.A misunderstand- activities for all ages and interests dur- Performance and meal. Two other oppor- ing arises when context in the language is ing the summer of 2006. Whether you tunities for inter-generational fun will be ignored. Misinterpretation leads to a fatal are interested in an entertaining Saturday on July 19th(JA Mad Science Night)and judgment,until all that is left of this once night,a festive Fourth of July,informative August 17th (The Gizmo Guys). In addi- amazing relationship is regret and a des- speakers, weekday fun and artistry, or a tion, Putt `n Punch is an every-other Fri- perate plea for forgiveness. welcoming reception,Wianno has a lot to day afternoon opportunity for young and offer. old to test their skills on the putting green Amy Tan called it,"A marvel of imagina- at the Main Clubhouse. tion... so mesmerizing that the pages float Our social season starts officially on Fri- away and the story remains clearly before day, June 16th with the popular Gour- The Wianno Club is also a busy place dur- us from beginning to end." met Dinner which is usually a delicious ing the day. Yoga will be offered Monday sell-out. Soon after that is the "Glorious and Bridge Lessons are scheduled every Fourth Weekend" with a Family Bar-B-Q Wednesday morning. For the artist in all and Lobster Dinner on Saturday, July 1st of us, classes in watercolor, Sailor's Val- combined with a series of sports events entines,Decoupage and Flower Arranging and the JA parade over the next few days. will be offered. There will also be Junior Art lessons for our oun members. For The following weekend will be a special Y g � 4 opportunity to welcome new members the readers among us, a Book Group will �K to Wianno at the bi-annual New Member meet twice this summer to share thoughts Cocktail Reception on July 8th. Make it on two designated books. Check the cal- S a special evening with reservations to endar for details. _ Dinner and Dancing immediately follow- Never Let Me Go ing the reception.This year, we will have Susan DiCamillo,Chair by Kazuo Ishiguro r dancing to live music in the Buffet Room SUMMER BOOK GROUP Tuesday,August 15 4:00 p.m. while you order from the menu in the Main Dining Room. For additional flex- Please plan to join us for one or both of Another suspenseful, moving and beauti- ibility, you can opt to join friends just for our book group meetings! This year's se- fully atmospheric novel by the author of dancing. lections are: "The Remains of the Day." As children, Kathy,Ruth and Tommy were students at ®agaueraeg�e+a n Later in the season, our Saturday nights ` - Halisham, an exclusive boarding school will sparkle with a casual Mid-Summer Stow secluded in the English countryside. It Cocktail Party under the stars on July 29th V W%W1 was a place of mercurial cliques and mys- and a Casino Night on August 12th. The RP10' terious rules-and teachers were constant- season will close with a Labor Day gather- ly reminding their charges of how special ing on September 2nd. they were. Years later,they look back at their shared Weeknights will also be busy. Duplicate Bridge and Buffets start Monday nights _. past and understand what makes them so on June 5th, while Tuesday nights will special - and how that gift will shape the offer Bingo and Buffet starting on June rest of their time together. 27th. Our Wednesday evenings will again provide a stimulating Speaker Series fea- The New York Times referred to the story P g P Snow Flower and the Secret Fan as,"A Gothic tour de force...a tight,deftly turing authors,experts and CEOs starting by Lisa See controlled story - melancholy and alarm- on July 12th. A special Wednesday night Tuesday,July 18 at 4:00 p.m. will be August 9th with the preview of the I ing. Members Arts and Crafts Sh6w which will Lisa See's book reveals a world where F run on Thursday,August loth. All mem- women spend their days in upstairs cham- Book e Group Cra Chair bers are encou-aged to-share their talents bers,kowtowing to elders,serving tea,and Book C at this event. communicating in secret code through nu JOIN US FOR shu.As Lily and Snow Flower grow older, DINNER AND DANCING The Wianno Club likes to welcome its in- they share their innermost fears on being SATURDAY,JULY 8 house guests and members with a recep- on being matched with a suitable husband, tion on Thursday nights starting on July surviving harsh mother-in-laws,and bear- FOLLOWING A 6th. Please join us for a drink and conver- ing healthy sons to increase their house- RECEPTION TO MEET sation at 6:45. hold status.It is through the sharing of nu NEW MEMBERS 3 I 200.6 SPEAKER SERIES tographer.Richard T. Macdonald will ex- Hows the Squid?Wednesdays at 6:00 p.m. plain how it works. Our .speaker Series He will -3ffer an introduction to digital !- begins on July 12th with Professors Mar- photo raphy with,emphasis on the future shall and Merle Gold- of photography(digital or analog?).Bring - -- a — man who, together Your questions! will deliver a talk We are pleased to have � - Merle and Marshall entitled "China and author Susan Butler `— Goldman Russia: Superpowers join us on July 26th 11 c Past,Present to talk about her new and Future." book My Dear Mr.Sta- lin the story of Frank- The cover of New Yorker cartoonist Jack Marshall I. Goldman is the Kathryn W. lin D. Roosevelt and Ziegler's book"How's the Squid?" Davis Professor of Soviet Economics at Joseph Stalin during On August 16th, Wianno member Jack Wellesley College and the Associate Di- Wusarut WWII. Smith, former CEO of General Motors, rector of the Davis Center for Russian and will talk about "The General Motors Ex- Eurasian Studies at Harvard University. In 2001, Susan Butler perience." •He is also a Senior Fellow of the Gor- accidentally uncovered the WWII Gor- bachev Foundation of North America at respondences between Franklin D. Roos- On August 23rd,the Honorable Nonnie S. Northeastern University.He earned a B.S. evelt and Joseph, V. Stalin while doing Burnes will talk of her experiences in "A in economics from the Wharton School research at the FDR Presidential Library View from the Bench:Unveiling the Mys- of the University of Pennsylvania(1952), in Hyde Park. Realizing the monumental teries of Being a Judge." and an M.A.and Ph.D.in economics from significance of the numerous letters, she Harvard University, as well as an honor- said, "I knew these would make a great Nonnie Burnes was appointed by the Gov- ' ary Doctor of Law degree from the Uni- book. These messages are ,history that error in 1996 to be a justice on the Mas- versity of Massachusetts,Amherst, 1985. isn't known and I was instantly intrigued sachusetts Superior Court. She presides He has also been elected to the American by how vital they are to our understanding over both civil and criminal trials, with Academy of Arts and Sciences. of the relationship between America and juries and without. The jurisdiction of the Russia during WWIL They offer valu- Superior Court is very broad. Civil cases Dr. Goldman's latest book, The Pirati- able insight on the brilliance of political include large business disputes, personal nation of Russia: Russian Reform Goes play and complexities of war between two injury cases, medical malpractice claims, Awry, was published by Routledge in great rr_inds and two great nations." administrative law appeals, among oth- April2003. ers, and criminal cases include charges On August 2nd,New of murder, rape, assault and battery with Yorker cartoonist Merle Goldman, "Professor Emerita of ��. a dangerous weapon, drug law violations Chinese Historyat Boston University, is Jack Ziegler, will y - and others. the author of a number of books on mod- give a brief history ern Chinese history and culture. Her last of, the New Yorker Judge Burnes is married to Richard M. two books, China's Intellectuals: Advise 4, magazine followed Burnes, Jr. She has three children and and Dissent 1981 and Sowing the Seeds = by a slide presenta- ( ) g � �� eight grandchildren. She is an avid sailor, of Democracy in China (1994), were se- tion of his cartoons. skier and gardener. She has been coming lected by the New York Times Book Re- to the Wianno,area for over 40 years. view as among the notable books of their Born in New York respective years.The latter book was also ac'-5 ieg er City,Jack majored in On August 30th, we'll welcome author selected by the American Association of Communication Arts George Howe Colt who will speak about Publishers, Professional and Scholarly at Fo--dham University. He has been a his book, The Big House: A Century in Publishing Division, as the best book on major cartoonist for the New Yorker since the Life of an American Summer Home. government published in 1994.She is also 1974. Several collections of his draw- When former Life magazine reporter(and the coauthor with John K. Fairbank of ings have been published beginning with former Cape Cod singing waiter) George China: A New History published in 1998 Hamrurger Madness in 1978 followed Colt set out to write a memoir on behalf of and has completed "From Comrade to by Fi'thy Little Things, Marital Blitz, Ce- his 100 year old summer house, he knew Citizen in late Twentieth-Century China," lebrity Cartoons of the Rich and Famous, the old cottage had a story to tell. Come which was published by the Harvard Uni- Wors' Case Scenarios, The Essential Jack and hear about the book that garnered him versity Press in 2005. Ziegler,How's the Squid?(A book of food a 2003 National Book Award nomination • cartoens) and Olive or Twist? (a comic for non-fiction. Can't quite figure out that digital camera? cocktail of drinking cartoons). Don't miss Well,join us on July 19th when club pho- this fan evening! John and Susan Connor,Co-Chairs of demonstrations and competitions -,you a could win a ribbon and a prize!There will also be refreshments and treats for all! n BRIDGE LESSONS Just one thing—in order to participate,you y must be friendly and you must obey your with MEL MARCUS i handler.Please behave(no fighting or bit- ing)—the judges will have the right to ex- cuse those who"are not behaving. July 5 through August 30 Practice your tricks and wags and come INTERMEDIATE BRIDGE Watercolor of Nauset Light to the Crystal Lake field on August 6th! 10:00 a.m. - 12:00 noon JOIN A There will be a sign-up sheet posted at (no lesson on July 19) the Wianno Club. Please sign-up early so "PLAY OF THE HAND" ONE DAY WATERCOLOR we'll know just how many people and pets CLASS to plan for! 1:15 -3:15 p.(no play on July with 19) JEAN BURKE Abby Mullin and Henry Smithers DUPLICATE BRIDGE MONDAY,JULY 24 AND/OR Canine Co-chairs The Bridge Committee is hopeful that you MONDAY, AUGUST 14 stuck our flyer on your forehead and are already picking your seats for our first 9 a.m. -3 p.m. game on June 5. Paint a watercolor (suitable for framing Nothing has changed (except that we're and/or for Christmas cards) in just one all better players,of course): day! Roll Call at 5:20 PM. Opening Bids Promptly at 5:30 PM. Jean Burke's July selection is the quaint Play Faster Than'Speeding Bullets Until "Nauset Lighthouse" and in August, the 7:50 PM. selection will be "Looking Through a Cocktails From 7:50 to 7:55 PM. Window at Christmas" suitable for use Enter Dining Room for Buffet at 7:55. as Christmas cards. Jean will explain the TABLE SETTINGS Awards Ceremonies and Ice Cream at procedure for having cards printed from 8:45-9:00 PM. your painting. It's fun and all are wel- ` FLOWER ARRANGING CLASS WITH HBT(Stolen from Sally Edmonds). come! Sign up today for one or both! JUDY LEWIS THURSDAY,JULY 20th For you unfulfilled thrill seekers breathing Cost is$65 per one day class and$15 for AT 1:00 P.M. heavily over the prospects of participating lunch (optional). All materials provided. Judy Lewis of Cotuit is returning to teach in this heady competition but unsure of the Minimum of six students, maximum this very popular class! Judy is a past process and liability insurance required, of fourteen. The full $65.00 fee.will be president and member of the Osterville please inquire of your bridge playing charged to anyone who enrolls and does Garden Club, the Naples Garden,Club in friends or connect with Jacquie Martin, not attend. Florida and a Life Member of the Garden Chairlady, or Martin Traywick, First Go- Club Federation of Massachusetts. She pher,for pharmaceutical advice and body Betsy Homberger,Chair has won many blue ribbons and major armor recommendations. awards in flower arranging over the past SAVE THE DATE several years and enjoys teaching Basic We are vastly relieved to welcome Jim SUNDAY,AUGUST 6, 2006 Design Classes. Tullis back as our Exalted Director and THE 1ST WIANNO CLUB have agreed to his terms of sponsorship "DOGGIE DO" PLEASE NOTE for knighthood, a condo on Key Biscayne You must bring flower arranging scis- and multiple passports. During June, we an .you look like your owner?Can you do sors or clippers, pencil and paper. Flow- may share some of our empty seats with any terrific tricks or do you have an un- ers,containers and oasis will be provided. players from Oyster Harbors while their usual wag? If so, please sign-up for our Class is limited to 15 students.The cost is playhouse is being finished or until they first annual DOGGIE DO where we will $40.00. If you must cancel, please do so start winning too much. Please pose all compete in many light-hearted competi- by July 13th to avoid being charged. If problematic questions to the Chairlady tions. over-subscribed, names will be taken for and compliments to the First Gopher. a wait list. Our owners,Susan Mullin and Gigi Smith- FG Martin Traywick ers,are busy planning a fabulous afternoon Ellen MacColl Jacquie Martin 5 i a 71 Men's.&Ladies'Singles PADDLE TENNIS Paddle Tennis saw a banner year this past TENNIS August 12-13 season! Winter was truly recognized and Mixed Doubles the Wianno Club transformed its cold- We are fortunate to have Jeff Daly return- weather facilities to ensure a NUMBER ing as Head Pro this summer, along with August 19-20 ONE sport! three new assistants,Alex White, Garrett Ladies'Doubles Gates and Ransom Cook. In the shop,we Paddle Tennis players relished in the won- are glad to have Delia Glover returning for August 26-27 der of it all! Both courts had complete her third summer. Men's Doubles facelifts with strong,shiny supports,tight- ` ened wires, and sparkling new lights. For Garrett just finished his sophomore year at Jim Kjorlien,Tennis Chair the safety of all,heaters were installed For Bowdoin,where he played#2 singles. He un- der both courts to prevent any dangerous and his doubles partner were ranked in the � — rr' slips on ice. The new facilities are super top 10 nationally in Division III doubles. t and each time a ball passed over the net, Garrett grew up in Fairway,KS,and,spent thanks were sent to the Club! the past few summers at the Carriage Club in Kansas City, MO, and at the Prouts What a season it was! Play was very suc- Neck Country Club in Prouts Neck, ME, cessful and popular.The Wianno Board of 1 assisting with junior and adult tennis clin- Governors created a"Paddle Tennis Privi- ics, teaching private lessons, organizing a lege Seasonal Membership," conditional junior tennis league and running tourna- to recommendation by the Paddle Tennis ments. Committee for a one year "privilege" at February's"Love-One"winners Peter Holcombe, the Paddle facilities only,renewable each Cam Ellsworth Jac Martin and Dick De Alex graduated from Milton Academy in Cam uie 4 � �w year. Guests pay a fee and are limited to t 2005, and just finished his freshman year playing six times. Approximately twenty at Bowdoin, where he played #3 singles j and#2 doubles. When he played in the 18 ` ' families or singles applied and were ac- f „ cepted this season, and the atmosphere, &Unders, he was ranked in the top 10 in the competition and good sportsmanship New England. Alex was raised in Boston, and spent the past three summers teach- were contagious! ing clinics and private lessons at the Nike Join us next winter - warmth and cheer tennis camp in Williamstown,the Quincy abound at Sunday round-robins! Tennis Camp,and at Tenacity in Boston. Jacquie and Don Martin, Retiring.Co- Ransom will be a junior at the University Chairs of Redlands (Redlands, CA), which is Mike and Jack Mechem,New Co-Chairs a Top Ten Division III school. Ransom David Cudlipp,Liz Berkery,Jennifer Cahen Bev- was on the team roster and played some eridge,Drew Callen Committee Barbara Blaze exhibition matches this year. When her k� a..,i David Ellsworth played in the 18&Unders,he was ranked ° Jim Germani #9 in New England and #105 nationally. Peter Holcombe Ransom is from Brookline and spent last * David Rockwood summer teaching tennis at the Nike tennis �< ' Fred Waterman camp in Williamstown. __ Our tournament schedule will be as fol- lows: Drew and Dicksie Callen ' r a July 8 Men's Member-Guest July 15 �r Mixed Member-Guest July 17 '} Ladies'Sanders Invitational July 29-30 `f Parent-Child �'3 August 5-6 Barbara B9aze and David Ellsworth R John Williams 6 o fw r GOBBLER OPEN *'Gobbler Open Loses Trademark Case ` The Massachusetts Supreme Judicial _-f Court, by a 4-3 margin, has ruled that Gobbler Open organizers failed to trade- - mark the tournament name and so have lost all rights to the country's oldest sport- ing event. f The case of Gobbler v. Blaze has been working its way through the Massachu- setts court system for more than two years, The Gobbler Open group ever since Jerry Blaze announced that he . was the registered owner of the "Gobbler Open" name and hence owned all rights ; '`' to it.Tournament organizers protested that the'event'had historical significance and _ 4 so-could not be trademarked.Blaze's re- sponse was z succinct,"Trademark this." 411 Blaze's attomey said that his client also owns the web-site www.gobblerope.com. The tournament was first played in 1620, _ at Plymouth, MA, between the Pilgrims Gobbler Open Winners Tony Capo and Peter Holcombe and Indians and has since been held for Cam Ellsworth 385 consecutive years, most recently at '� ` the Wianno Club in Osterville,MA. [ f4 Organizers, who plan to appeal the rul- ing to the Federal Court of Appeals, have promised to hold next year's event even ' if it must be conducted under another name.Don and Jacquie Martin,recent- :- =-- ly retired as chairs of Wianno's paddle committee,said that"The Wishbone Pad- � dle Wackers"is NOT one of the names un- f.; i F � � der consideration. t - 4, 1 The winners of the 2005 Gobbler Open were Peter Holcombe and Tony Capo. Lasky . Don Martin David Ellsworth and Jean Las Respectfully submitted, " John Alden Fred Waterman Myles Standish Jim Germani and Peter Holcombe HYPERLINK ANNUAL MEETING DINING PRIVILEGES Now that just about every .home has a FRIDAY,AUGUST 18 AT 3:00 EXTENDED TO OYSTER computer, and now that the Internet has P.M. HARBORS CLUB MEMB ERS become a primary source of information The Board of Gove-rrors,on behaL'of the and means of communication, it is time MEMBERSHIP COMMITTEE Wianno Club membership, has extended for the Wianno Club to take advantage dining privileges to the-nember3 Of Oys- of the new technology. COCKTAIL PARTY ter Harbors Club tc utilize our Mein club FRIDAY; DULY 28 dining facilities until the Oyster Harbors This summer,members will be able to go The Membership Committee and the Clubhouse is compete,which is expected j to www.wiannoclub.com.Because Wian- Board of Governors invite members to to be on or about July 4th.. no is a private club, most of the web-site bring current and potential candidates for will be in a"Members Only"section.En- membership to a. reception immediately JOIN A DECOUPAGE CLASS! ter your account number where indicated. following the Informational Meeting on August 22,23 and 24 Your password is the first initial and last Friday,July 28. name of the account holder. We are pleased to have Olga Gcff with us JUNIOR SPORTS AWARD DIN- this su_nmer to instruct members in mak-' Members will be able to seethe sum- NER FRIDAY,AUGUST 11 ing a d-coupage lamp over a three day pe- mer schedules for tennis, golf,junior ac- 6:00 P.M. riod,August 22,23 and 24.Clas ses will be tivities, lectures, bridge, and every other held frz)m 9:30 a.rr_.to 1.00 p.m. each day. Club activity. The current www.wianno- Supplies will be provided,with the excep- golf.com web-site will become part of the WIANNO MEMBER'S CRAFT tion of good needlepo_nt scissors which club's web-site.Members will also be able PREMIER GALA students are asked to bring with them. to find the names and e-mail addresses for August.9 and 10 the Club's top staff, and contact informa- At the first class,students will Select a de- tion will also be available for other Club Don't forget to bring your best and favor- sign and begin cutting. The secz)nd day, members. ite handiwork to display for the enjoyment cutting will be corapleud and designs will of our membership!Preview cocktails and be glued to the iiside of the grass. The In an effort to provide a "one-stop shop- hors d'oeuvres will be Wednesday eve- third class will be spent painting. Mrs. ping"web-site,we will also provide driv- ning,August 9th, 6:00—7:30 p.m. Please Goff will have extra lamp bases on hand in ing directions to the Wianno Club and make your dinner reservations with us fol- case anyone chooses to do a pair of lamps golf course, pictures of the Club's rooms lowing`the preview. (at an extra charge). and bedrooms,tidal charts, and (and this should impress you) traffic-cam views of Handicrafts would include such items as The cost of the three-day class is$300.00. both the Sagamore and Bourne Bridges knitting,crochet,paintings,carving/wood- for those Sunday afternoon departures. work,needlework,ceramics,quilts,paint- Susan Mullin,Chair ed furniture, flower arrangements, jew- We will gladly listen to members' sug- elry designs, Sailor's Valentines, baskets gestions for what to put on the web-site (Nantucket or otherwise)... or whatever ' because good ideas can come from any- else has been making your creative juices _ ",* where. Janet Sheehan will be in charge of flow within the last three or four years. If our web-site, so please let her know your h you have any eligibility.questions,contact thoughts. event chair Mary McCusker. _ - ; YOGA BEGINS ON JULY 10 Share your talents —we can't wait to ap- a We are so pleased to have Maria Mangos plaudthem! , returning to teach yoga! Please note our 6 modified schedule which is as follows: Items may be dropped off at the Wianno Monda s Onl Club Front Desk between Tuesday af- Y y Y ... {, ternoon and Wednesday noontime. Items _ Level I at 9:30 a.m. must be retrieved NO LATER THAN 6:00 . Level 11 at 11:00 a.m. P.M.ON THURSDAY SAVE THESE DATES - Mary McCusker,Chair A_ INFORMATIONAL MEETING ' FRIDAY, JULY,28 AT 4:00 P.M. A Jecouoagz clamp- 8 q • DON'T MISS THESE SPECIAL EVENTS k, ! s Wianno Club�� I JUNIOR ACTIVITIES brings you Calling all JA campers! + i Here's what's new at JA for 2006.. _ "Cirque de . If 'you haven't recently Y received the 2006 Sea"" . Preliminary Weekly Highlights, please contact the Club for a co Here you will copy. y ; �.." A comedy for adults find information on our exciting theme and children ,y i weeks which will be loaded with fun,spe- k featuring 11 cial events and programs including a"Mad s 9 Science Fire and Ice Family Night." i . GIANT puppets and masks 0 Emily Murray and Tamara Harper from ¢ 1 the Harwich Junior Theatre will be offer- In a rollicking tale about the ing a new "creative drama" program and drama' of Say life and the Coby Vincent of Cape Cod Hip Hop and a developing oyster, Jazz will offer a Wednesday afternoon SAMMY SPAT f program for all young dance enthusiasts. 10 Participants from both programs will per- Thursday, July 13, 2006 0 form at the JA Dinner Theatre in August. Performance & Dinner It will be a cool summer at JA thanks to a new ventilation system with "natural light" solar attic fans installed in the Big Room and both changing rooms. Sports enthusiasts will want to check out our newly designed"Sports Closet." # ' We thank Megan Barford, our Director, for all of her hard work and efforts in plan- ning a super,fun-filled summer. Megan is 4. back for her sixth season and we all look forward to a great season at Crystal Lake! ` Patrice Fallon MaryEllen Browne Co-chairs BEACH OPENS JUNE 23 y . RULES •Syvim o I` in areas marked with life line. •All children under the aA�otwelve ImusIbe supervised •The use of floatation devices'is at the" diTft sic etionyof-the�lfeguards. •Fo'od,t coolers,cans or-g ss bottles are y not allowed on theibeaeh •Keep Atf rocks,jet[ies anld concrete wall.� •No pest allow d, •Water sorts' perm Y e on the beach C®m®d a gg l e rs to the left of the ramp: •Guests must be accom�-a ied by a �-�- Thursday August 17 member-and be s gi - in. 9 J _ bership may be met by a member of the a- Po Membership Committee at these events. Hosted by Dick and Ginna Harrison, our Social-Activities' Committee and the _. ,� . •, ., � � Membership hi� Committee. THANKS OGGIE...... Special thanks to Oggie Pesek for re- 1 furbishing the Main Club flagpole! The weathervane at the top is completely new j� and replicates the original and the pulleys that the halyards ride in have been replaced i MP= IM 4 r with slick new ones that make keeping a flag over Wianno Club much easier. And, i hopefully, it will be quite a while before we need the Fire Department's help in re- stringing the halyards. w Again,a big Wianno Club thank you goes out to Mr. Pesek and others who were in- At the Front Desk and in the office this year are(left to right)Maria.Chamberlain,Front Desk Manager Anne volved in this project. Hams,James Arsenault and Reservation Assistant Pat Mello FROM THE HOUSE AND , GROUNDS COMMITTEE �;. A special thank you to Mrs. Robert WainGA - '�� ` wright (Nancy) and Mrs. William Joyce (Helen) for their generous gifts of beauti- ' ful antique wicker.These wonderful pieces rr have been added to the Wicker Room and sF Card Room furnishings for us to enjoy. The new large-screen television has been installed in the Golf House for everyone's F , v viewing pleasure.The new tables have ar- rived and we await (anxiously) our new chairs. ' ' r The Club is also indebted to Sue Carstensen of Birdsey on the Cape for loaning us the e wonderful artwork which hangs in the Main Club during the summer.Please pop in t her gallery at 12 Wianno Avenue t 0 0 0 a g ry -- - :.- say thanks. Wianno Club Maintenance Supervisor Gordon Smith Baxter Crane was on hand to put the flagpole in place Happy summer to all. and his assistant,Dana Thacher prepare our flagpole on the roof and new weathervane for raising. GUEST WELCOME' Jill Kaneb;Chair PUTT& PUNCH RECEPTIONS THURSDAYS Join us on the Putting Green at the Main BEGINNING JULY 6 Club for a fun putting contest for adults 6:45-7:30 P.M. -� and children! WIANNO'CLUB LIBRARY July 7 and 21 All guests staying.at the Club are encour- August 4 and 28 aged to come to the Library on Thursday evenings for cocktails and conversationVv Connie Miller with members and fellow guests. Those roK Chair,Putt&Punch that have applied.for Non-Resident Mem- Birdsey on The Cape 10 { few of our lines. We also have an exten- sive selection of golf equipment available. ty : a Tremendous technological advances have i been made in recent years,and to help you sort through the many different options, p £a d {r we have demo clubs by Cobra,Callaway, ` GOLF Ping, Taylor-Made, Titleist and Mizuno. ` FROM THE PRO Fitting systems by Cobra and Callaway are Spri ng has returned to Osterville, and we also available for those who want custom- have begun a brand new golf season at fit irons. Any member of the professional Cosmos on Red Stripes by Shauna Shane the Wianno Club. Along with the famil- staff would be pleased to help you select ART INSTRUCTION 2006 iar fairways of the golf course, you will the equipment that best complements your Once again Shauna Shane offers her popu- recognize some familiar faces at the Golf game. lar art classes to the Wianno Club mem- House this year. Cody Bradford, First bership. These classes in oil, watercolor, Assistant, now in his fourth season at the We look forward to seeing you very soon pastel and acrylic are informative and fun, Club, spent the winter months minding out on the golf course... and suitable for any level,even the begin- the golf shop and continuing his studies Mike Farrell will be ner. Beginning each session with an in- at Boston College. MEN S OPENING DAY formative demonstration, Shauna tells her our Second Assistant this season. Mike TEAM QUOTA RESULTS students the "what, why, and how" that was with us in 2004 as an intern while he helps make the complicated seem simple. Pursued his degree in Golf Management 1 st Place: & Individual instruction emphasizes the spe- at Penn State. Alex Masi will be joining Dick Sammis,Bob Macallister cific information that allows each student us as the Caddie Master. Alex has been a Herb Minkel Jr.,David Wilcox caddie at Wianno for many seasons, and to develop his or her own vision into an he has just completed his sophomore year 2nd Place: excellent work of art. at Trinity College. Janie McNally,now in Sandy Taylor,Richard Taylor, Shauna's outgoing personality and post- her third season, will be back in the Golf Drew Callen,Ed Grant tive instruction make her classes a joy Shop with a cheerful smile and a helpful for anyone that shares an appreciation of attitude. Other returning staff members 1 st Place Individual: beauty and a love of art. Her enthusiasm will include Ashley Mersky in the Golf Sandy Taylor for her students' success and her skill at Shop, Starters Bob Cummings and Emil bringing this subject down to size is in- Brodeur on the first tee, and Tim Grace, 2nd Place Individual: formed by 25 years of teaching classes Nick Kortis,Kyle.Kelly and John Mersky Richard Taylor and giving demonstrations for more than in the Bag Room. Everyone on the Golf 32 different art guilds and associations in Staff will work together to make your golf Mixed Memorial Day Connecticut and Massachusetts. experiences as enjoyable as possible every Scramble Results time you visit. New this year are Drawing and Painting 1st Place Gross: classes for Junior Artists. Geared for ages We encourage all members to participate Peter&Kathy Wheeler 9 — 16, we will investigate basic skills in in our many tournaments throughout the Bob Macallister,Kathy Jacobs artistic expression. Forget the notion that season. Whether you play golf primarily you can't draw a straight line;we will learn for the camaraderie, for the challenge of 1 st Place Net: what artistic talent really means. We will competition,or for the simple pleasure of Rik&Sandy Clark learn the steps necessary to be able to ex- being outdoors there should be a tourna- Drew&Dicksie Callen press ourselves artistically,how to see the ment that will fit your game. Closest to the Pin#11 world in a new way, and even more,how to give yourself the gift of confidence. All three of our golf professionals are Alys Bownes available for lessons for players of every JuniorArt Classes are available on Wednes- level. I hope that our staff will be able to Closest to the Pin#I I days,July 26 and August 2,2006. Classes give you a plan that will make your road to Dan Ringeisen are available as two morning sessions,two improvement both smoother and shorter. afternoon sessions,or both.A supplies list We have a fine selection of new golf ap- will be available upon signup. panel and equipment in the shop this year Please join us and have some fun being for men, women and juniors. We will be creative. - featuring Fairway and Greene,Ashworth, Polo, Peter Millar, Adidas, Gear For Shauna Shane Sport,Foot-Joy, and Echo, to name just a 11 Wian-no Club Events MAIN CLUB DINING HOURS:Continental Breakfast on request 7:15-8:00 a.m.•Breakfast 8:00-9:30 a.m.•Lunch 12:15-2.00 p.m. Dinner 7:00-8:30 p.m.(Sunday-Thursday)7:00-9:00 p.m.(Friday and Saturday) SMART CASUAL DINING:Tuesday and Wednesday-6:00-8:30 p.m.Thursday and Friday-6:00-9:00 p.m.(Begins July 1) GOLF HOUSE LUNCH HOURS: 11:00 a.m.--2:00 p.m. BEACH SNACK BAR HOURS: 11:30 a.m.-7 3:00 p.m. JUNE 2006 SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY 1 2 3 Club Opens 7:30a Men's Tennis May 27 Clinics begin 4 5 6 7 8 9 10 8:00a Men's Tennis 5:30 Duplicate Round Robins begin P P Bridge and Buffet 9:00a Ladies'Tennis Clinics begin Men's Golf Mixer 12:30p Shotgun 11 12 13 14 15 16 17 Bridge Group Golf event Ted Turner Tournament 8:30a Pre-season Men's Golf Mixer 8:30a Ladies'Goff Mini Gourmet Dinner 7;15a Breakfast Ladies'Golf Day 12:30p Shotgun Guest Day 8:30a shotgun j Bridge Invitational 18 19 20 21 22 23 24 9:00a Ladies'Golf Father's Day Breakfast 9:00a Ladies'Tennis 8:30a Ladies'Golf Men's Golf Mixer 9 Holers Beach and Snack Bar Point Score begins Opening Day 12:30p Shotgun Open 6:00p Board of Governors 5:30p Duplicate Bridge& (9&18 holers) 11:00a Cape Senior Reception Buffet Golf League 25 26 27 28 29 30 JA Begins 8:30a Ladies'Golf 8:30a Ladies'Golf Mid-Cape League 9:00a Ladies'Golf 5:30p Duplicate Bridge 6:00p Bingo Buffet 9 Holers &Buffet 7:00p Bingo. Men's Golf Mixer 12:30p Shotgun 4:00p Nine&Dine JULY 2006 SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY 1 Men's Golf 4th of July Stroke Play 5:30p Family BBC& Lobster Dinner 2 3 4 5 6 7 8 Tennis Men's Lessons Lowry Trophy Golf 12:30p Sailor's Valentine Art 9:00a Ladies'Golf Member-Guest Family Sports Day 10:00a Bride Lessons Tournament 5:30p Duplicate Bridge 12:30 Men's Golf Mixer 9 Holers 3:00p Main Cl Punch New Member Reception &Buffet 11:00a JA Pa•ade& P 4:OOp Nine&Dine Main Club 7:00p Buffet Picnic at Crystal Lake 7:00p Lobster Night 6:45p In-House Guest Reception Dinner&Dancing 9 10 11 12 13 14 15 7:00p Buffet 9:00a Ladies'Golf Art Lessons 8:30a Ladies'Golf 9:30o Yoga Tennis Mixed 12:30 Sailor's Valentine 9 Holers 10:OOa Bridge Lessons Guest Day P 12:30p Men's Golf Mixer 6:30p"Cirque de Sea" Member-Guest 5:30p Duplicate Bridge& 6:00p Bingo Buffet 6:00p Speaker 6:45 In-House Guest Buffet 7:00p Bingo 7:00p Lobster Night P Reception I Goff Kilo ome Gup 16 7:00p Buffet 17 18 8:30a Ladies'Golf 19 20 21 22 May Jackson An Lessons 9:00aLadies'Goff9Holers Ladies'Tennis Sanders y 12:30 Men's Golf Mixer 1:00 Flower Arranging .9:30a Yoga 4:00p Book Group P P g 9 3:OOp Pin Cl Punch 9 6:OOp Speaker Class Main Club 12:30p Sailor's Valentine 6:00p Bingo Buffet 6.,XIpJAMadSaerwNight 6:45p in-House Guest 5:30p Duplicate Bridge& 7:00 Bingo 7:00 Lobster Night Reception Men's Golf Invftationa! Golf i(ilborne Ct4r Buffet p g P 23 24 9a One-day Water- 25 26 27 28 29 color Class 8:30a Ladies'Golf Jr.Art Lessons 9:00a Ladies'Golf Tenpin Parent•Child 7:00p Buffet 30 9:30a Yoga 31 May Jackson 2nd and 9 Holers Guest Da en'sGott 5:30p Dup y l ) 10:OOa Bridge Lessons y ournameni(Sat&Sun) Intl 8:30a Mixed Bridge& 9:30a Yoga 6:00p Bingo Buffet 12:30p Men's Golf Mixer 4:00p Nine&Dine Mem-Gst Golf gutter 1:oop Ladies' 7:OOp B ngo 6:00p Speaker Member-Guest 4:OOp Informational Mtg "Mid-Summer Tournament Golf Sisters Bowl 7:00p Lobster Night 6:45p In-House 7:o0p Buffet 5:30 Du gr d e&Buffet Guest Rece tion Cocktail Party" 12 r FILE No.002 09/19 '00 03:010ID:ROMTEC INC. FAX:5 60803 PAGE 3 7504aflon Un&rground {/t eft s Rointec's 750-Gallon Underground Vault is a great choice if you design yoLir rest room buildings around its fixed Moor plan.The toilet riser, v ;; , I� UWW � vent pipe and •1 ' �_�p p � eanout �a�spnpve�l fittings are molded right into the top of the vault. 0 `.U.S.Forest Service `a Low Cost, inexpensive shipping(16 units per truck load), ,:.bureau oflandf anagement Nat quick installation and low maintenance cost. A . .-; oval Palk Service 'J Molded One-Piece Design. No joints or scams. C °u M litary '. .q U,S•;Bureau of'Reciamation J Pre-Formed Fittingsfor toilet riser, vent pipe and cleanout _<;`'i; � '&' i: Sf te'tl&.Local Parks t J Fasv Handling&Installation. Weighs only 325 lbs.Can be {] F0&Game Departments buried direCLly in the ground without an excavation liner. ) Prl 9 Vate COunCIS .. . J Reirtomed Structure. Center column is filluJ with concrete `'(.7. Golf Courses&Recreation Areas during installation to fonn a solid support post. Concrete slab extends over entire vault, J Will Not Crack& Leak, One-piece vault is manufactured:from rugged cross-linked polyethylene.Tested to-J 00"F.Will.not crack and lark like concrete and fiberglass. -- —� J Cleaning is Easy,Pumps out quickly from the 24" covered sewage cleanout. rl-d� Bottorn of vault is•;loped for easy cleaning. Srnooth interior surface will not support bacterial growth, 75C•GA.LON VAULT-FLOOR PLAN-SCALE:'i2'=1' T 24"COVERED CLEANOUT VENT PIPE FITTING CEN-ER -•3UPPOPT 84° tn ; fi ; e coLumN � ai k, 10 t;mas linked polyethylene " s.r a,��aySy y �� x> t i /I Ned•y� d „ryF ,. ale 3:a ' {� tl't'` B'' t{f 41190,haescope}, f t tt t t '`�`7: !FE q> to o(epproxlmately 11, muses) a E r + ut»� YrTyq'ty ` ' g � s sf1, t dI wer x 61/2'high z jMt3Js llnk6d,polyethylene cover) TOILET RISER <�.'� at i ti , � °ens r .� STACK ?x l � 1t t r20°/S�x 1611210,D,oval z 6'hi h .; 9 !i fi nt Steck,h2 OA,.x ti'/2 high(1111:3 standard 12'ASS pipe) --....._---....._.64"— ----- FOtP' OldB18 8r1(f 1tKWA9S OxibLt ROMTECY I INC. 182orth Bank Rd.,Phone;�541-496-3541 R FaX 541-496 974730 Call today for a FREE VIDEO showing all the features and benefits, plus a complete installation of the Romtec SSTi°Vault Toilet System. 40 pArm ROB,Roseburj,Oregon. 6pWi2tbne and prices siblect to charge Wthold notice. All prices stbleri to the terms and Ilmbfions listed an tie Romtec gwieion and purchase order forms �1997,Ramtoc,fno.®SSTrearociatxredtrademarka'Rcrnr�n•Ira R®S. � INKED POLY t� . . CULTS & RISERS Included-With ALL Romtec SST- Restrooms aste is held securely in Romtec's patented cross-linked polyethylene under- :Romteevaults; ground vaults.Two sizes are available, 750 gallon and 1000 gallon. Romtec vaults acCessorie aid can't crack and leak like concrete.They are environmentally-safe and virtually hardw4r&6ah Fbe indestructible. purchased ♦ Reinforced Polyethylene Structure #separately from Molded ribs provide rigidity.Center column is } reStr00►n5 j fitted with steel post and poured full ofzs: concrete to form a solid support column tied f to a large concrete footing below vault. f ♦ Reinforced Slab Covers Entire Vault Contractor supplies steel-reinforced concrete i slab for foundation and floor. ♦ Molded One-Piece Design No joints to leak.Waste and odor are sealed - away from concrete slab and soil. ♦ Vault&Slab Are Completely Separate ' p y p 750-Gallon; Odors can't seep into building. 1000-Gallon ♦ Quick Installation Light weight for easy handling by small 1000-Gallon Vault backhoe.Can be adjusted once in hole. Fitting Adapter Kit Complete install instructions included. ♦ Easy Maintenance Pumping is,easy from 24" covered sewage cleanout.Bottom of vault is sloped for easy cleaning.Smooth interior will not support bacterial.growth. ♦ Black Color 750-gallon vault has preformed fittings molded in top of Reduces visibility of waste inside vault. vault.1000-gallon fittings are factory installed on top of vault.For Adapter Kit specifications,see Fittings below. ♦ Vault Specifications Patented Design US Patent No.4231482 Material Reinforced cross-linked polyethylene(black) ASTM Test Nom. Value Cross-Linked Poly Toilet Riser(18"Accessible) Density D1505-85 0.944 g/cmt Tensile strength at yield D638-84 3,000 psi Elongation at break D638-84 400% ♦ Virtually Indestructible Tensile modulus of elasticity D638-84 80,000 psi Tested to resist severe abuse.Impervious to Flexural modulus D790-84A 100,000 psi Heat deflection temp.,66 psi D648-82 138°F chemicals;resists staining and etching. Vicat softening temp. D1525-82 248'F Impact bmleness temp. D746-79 <-180°F ♦ Will Not Support Bacteria Dart impact(-40-C) ARM Std.(B) 60 ft.lb.125 mil Envir.stress crack resistance D1693-70 >1,000 furs. Cross-linked polyethylene is an Material Thickness 3/8"average M, inherently resistant material; Dimensions Mid point: 750:84"x 64"; 1000:78"x 78" smooth surfaces clean easily. Depth:48"-54" (bottom has 17ft.slope) ♦ Molded One-Piece Design Volume/Useage 750 gallons/11,000 uses (approx.) No joints or seams to trap dirt, I 1000 gallons/15,000 uses (approx.) odor,bacteria. I Weight 750: 325 lbs.; 1000:4501bs. ♦Fittings Cleanout:24" die.x 6'/2"high (cover incl.) Includes Heavy-Duty Seaftid Riser Stack: 205/8"x 16'/2" o.d. oval x 6"high High-impact polystyrene;heavy - Vent Stack: 12"o.d.x 61/2"high duty mounting hardware. 7 362-4541 926 main street yarmouth mass• 02675 down cope engineering civil engineers&land surveyors structural design Arne H.Ojala P.E.,R.L.S. land court Richard R.Fairbank P.E. surveys site planning April 15, 1986 sewage system designs Barnstable Town Offices Board of Health inspections 367 Main Street ` Hyannis, MA 02601 permits Reference: Wianno Club, Seaview Avenue, Osterville, MA Dear Members: At the request of the Wianno Club I have inspected the sub- surface sewage system shown on the enclosed plan, and find that the grease trap shown on the plan is in existence at the site. The grease trap was uncovered and cleaned out during the past two weeks. Apparently it had not been maintained for some time because of the large amount of grease in the trap and in the first compartment of the septic tank. Since the grease trap has a measured capacity of 145 gallons, it is undersize for the flow at the present time. I am recom- mending that a standard grease trap be installed at the end of this season because the requirement of obtaining conservation approval and of scheduling the work at this date will not leave enough time before the summer season begins. In the recent maintenance of the septic tank and grease trap, in excess of 1000 gallons of grease have been removed from the system. It is my opinion that if the system has continued to function inspite of such gross neglect, no undue stress would be imposed if the sytem is allowed to run with a 30-day maintenance schedule of the existing grease trap now that it has been cleaned. k Y fn16J.V�.I frE3 :Ia, i@faMta VV L W��Q ���� ::�iSx��i �� e f.. �. w,• lii i�° 'n i y�``. S: 14aaa. e0e 4". 02674 - '�' ---- JOHN W. WANNOP AREA CODE 617 TELEPHONE 428-6981 GENERAL MANAGER October 28, 1972 Mr. John Kelley, Health Agent Barnstable Board of Health Town Office Building Hvannis, Massachusetts Dear Mr. Kelley: I thought that it might be a good idea to outline in writing our proposed plans to operate a limited food service facility in the main Club building of this Club as discussed with You and with Mr. Schaefer earlier this fall . I am sure that.you realize that a considerable amount of money is going into this program, and we want to make sure that we are complying with the Board of Health requirements and that there will be no difficulty in obtain- ing a permit when we are ready to start operation. The operation will be in our present cocktail lounge and will be for our membership, serving dinners six nights a week and luncheons on Saturdays and Sundays. This will be buffet service using frozen. convenience foods utilizing plastic (disposable) dinnerware, crystal and club silver service. Refrigeration will be provided by two 12 cubic foot refrigerators and a deep freeze. Vinyl tile squares (a smooth surface for easy cleaning) will be put down in the back bar area and present service bar area. There is a men's room and ladies room presently available. A 3-compartment sink is already available, but a grease trap will be installed in the drain. A washing machine is available for silverware and glassware. Covered sanitafy containers will be available for normal trash and garbage. If there are any Board of Health regulations that-are- not covered by the above and which we should be aware of, I hope that you will get in touch with me immediately. inc ely, John W. Wannop General Manager T - Jj Bellaire, Dianna From: Miorandi, Donna Sent: Tuesday, October 13, 2020 4:15 PM To: Bellaire, Dianna Cc: Michael Pillarella (chefmichael@wiannoclub.com) Subject: Wianno Club on Parker Road, Osterville Hi Dianna: Just one thing for the future (probably spring) . They would like to have a grill outside with some refrigeration just off the deck of the building. They plan on it being temporary and would have a tent and realize they would need Fire Dept. approval. Initially they said no hand sink but I think our office is going to require it as it is probably more than 20 ft.to the sink for the inside kitchen. They also weren't planning on any particular flooring just stone but I said they would probably need something that is washable, scrubbable. Anyhow they are working on plans and pricing but just had me on site to see and possibly answer some questions. It was Chef Michael Pillarella and his assistant Eric that I met with. Don't know if you want to put this in the file for future planning and discussion. But when it does come up I didn't want it to be the first someone heard of it. Anyhow I shall copy Chef Michael on this too. Take care and see you soon in office when I return my phone,tablets, etc. Anna Z a/1/(ioranei, Town of Barnstable Health Inspector Public Health Division 200 Main Street, Hyannis, MA 02601 The information contained in this electronic transmission ("e-mail"), including any attachment(the "Information"), may be confidential or otherwise exempt from disclosure. It is for the addressee only.This Information may be privileged and confidential work-product or a privileged and confidential communication.The Information may also be deliberative and pre-decisional in nature.As such,it is for internal use only.The Information may not be disclosed without the prior written consent of the Director of Public Health and/or the Town Attorney's Office of the Town of Barnstable. If you have received this e-mail by mistake, please notify the sender and delete it from your system. Please do not copy or forward it.Thank you for your cooperation. I 1 ICI }� �D7 — 1 No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: i PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipplication for IN Y *pgtem Con0truction jermcit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. /67 �� �� Own &4,8's Name,Address,and Tel.No. GCJll�it/N4 Assessor's Map/Parcel � Installer's Name,Address,and Tel.No��b9s`�� Designer's Name,Address and Tel.No: �Elj/LfjE�fTJ //1(L- tJL-L ►V Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building A? ��!}L No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) N 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) L-76 &-;�-,(S?1A K 1=7 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 r' nta Code and not to place the system in operation until a Certificate of Compliance has been issued by is Board of Signed Date -� 1.017 ApplicationApprov y Date T✓ Application Disapproved by: Date for the following reasons Perm'.t No. 0-7 Date Issued �°` �''� 7 , r :�, -r�� /, .-•w-- t.�" ;,Y-�"'- r�,. a -' -.,rya..-s'. �./b'�.. --v-.,_;�3..i^1, No. O` �• � ? Fee t � f . THE COMMONWEALTH OF MASSACHUSETTS. Entered in computer: .a PUBLIC HEALTH DIVISION- TOWN OF BARNSTABLE, MASSACHUSETTS Yes 'ZippYication for dig 0 �aC p tent �Cor �truction Permit Application for a Permit to Construct( Repair( Upgrade( ) Abandon( ❑ Complete System ❑Individual Components Location Address or Lot No. �Ur, ����V��'�� Owner's Name,Address,and Tel.No.'' Assessor's Map/Parcel - In/staller's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. ' C jL l��fjc'��7cZtfi� /�vc �uLL v 9,� �iv�/iv�2=�Z �i✓E7 Type of Building: Dwelling No.of Bedrooms of Size sq.ft. Garbage Grinder ( ) Other Type of Building (L //;-c No.of Persons Showers( ; ) Cafeteria( ) Other Fixtures k Design Flow(min.required) A' gpd Design flow provided gpd Plan Date Number of sheets Revision Date Y` Title Size of Septic Tank Type of S.A.S. Description of Soil x Nature of Repairs or Alterations(Answer when applicable) A C_;,?ZL,-7� �j'�S /�/ �i �� /�� �S�l�� iiv E /lr ury /2-0 C)s c 2_� /t")z)a7i 0^j . w Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore descr`.ibed on=site sewage disposal system in accordance with the provisions of Title 5 of the Env o i Code and not to place•the system in operation until a Certificate of Compliance has been issued by Ifis Board of ealth-10' Sig _ c! Date D Application Approved"by Date / Application Disapproved by: _ Date f for the folfowing reasons ,y Permit No. ;L,00-7 ( g}^ Date Issued S~ }-0 7 s THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS %tl ' Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sew a Disposal System Constructed ( ) Repaired ( ) Upgraded ( ) Abandoned( )by �_ /� � at jf� A ) �e _ has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 1 f)U 7 �" dated S Installer /� y',�) / ,, Designer #bedrooms W/1►N!U(,a/ { 7 J M Approved design(flow , / gpd , , y, ��• �... The issuance of this permit shall-not be Eonstrued as a guarantee that the system will]Ifunction as designed. Date .� /�//) / Inspector � �1�/`i/'///,C !� •1 �� �JL'z ———————————r-/—/-----------�--- No. Cy7 IV— /Ott t Fee i THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS wi.5pogar *p!5tem Cow9truction Permit Permission is hereby granted to Construct ( ) Repair ( t/� Upgrade ( ) Abandon ( ) System located at and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. ' Provided: Construction must be completed within three years of the date of this permit. Date - Approved by � to _ f - G f —.o— I oI� v$ M AP 162 ` � t�s a •z 4 .... i���ED Figs....... ...... Barnstable Conservation DeparttT e& E COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH —" � 7OWN OF BARNSTABLE igned S LE Applirtttion for Divjipwi tl Work.6 (famitrurtiun "rrmit Application is hereby made for a Permit to Construct ( ) or Repair (K ) an Individual Sewage Disposal System at: 'A lcn ..... .!:'lr u,� l f...� r a o_... v ..�.M L �Lp �i �c�-t.. �/ ; DSO,-.. — . ....._.... Locat,iPn-t\ddress or Lot E ZAIV,_t41 t? -C.l �7 O ` ( i L_ v ... -8•-- 2 ---- Owner w Address a ....... ....................•-••-------......._--•-r.............._..........................•. Installer Address UType of Building -.MULTI 'Po�.ao�: Size Lot---A.nt.............Sq.-4t Dwelling— No. of Bedrooms....'2,?_-:'t.(a.........................Expansion Attic o4q) Garbage Grinder 40) PL, Other Type of Building ----------------_---------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) pI Other fixturesI_ �►ab. pi� K..'ts:EAi'S- 1. Q w Design Flow........v. --------- .�gallons per da . Total daily flow. . __�"3... ......................gallons. WSeptic Tank—Liquid capacity►b,. 9.g-1 ons L ng�t i'.�..�__ th...--.-_... am ._---- Depth................ x Disposal Trench—No. ....1.............. Width....l,!6----------- 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 b a y... ?A - - 'f.�-s,..�!- _�............. Date...1V ............. Test Pit No. 1...4.9:.....minutes per inch Depth of Test Pit----1Z........... Depth to ground water.. GT14n:4; L^ \-rzv- 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.,......._-.._-_-------- 0 •---•-•---••------------ -----•-••-•--•-••-•--•-••----•-••-•-•--------••-•••---•-•--._.....----------.......•--------•-.......-----•---------•--------.-•--- Description of Soil.......-v 2�5 1 ogwl 5ve35gt4,---- ,- ----12---- ep ���ac� x U .......................................................................................................................................................................................................... w U Nature of Repairs or Alterations—Answer when applicable................................................................................................ ------------------------------------------•----------------------------------------------------....•----------------••-----------------•--•-----••----•---•--••--••••-•••--•••. ....•-•-------•• Agreement-. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system _n operation until a Certificate of Compliance has been issued by the board of health. Signed ................... . .............. ..... ................................................. ................ Dare Application Approved By ...... �.u-�z �............. . ....................... ................................ . .....f n..ZL.�...� Dare Application Disapproved for the following reasons: .................... ........................................I.,............... . . ............. .......................... ........ ................................ .......... .. . ........ .......................... ....................... -- . . --... .-----..................... . ---- ........................................ .Permit No. .......q q t� F.................. Issued .......................... Dare THE COMMONWEALTH OF MASSACHUSETTS J' J BOARD OF HEALTH TOWN OF BARNSTABLE %Q1ertifi ate of 011amplian e THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( '``� (ir Repaired`( ) . r by . . - �.............. �... . " a �...... . ......_-_----------- -- - - - ......--------..._----------------------------- �r-....--°� J, - '---. .. ..4 ._�,.....(.i� r?a . at ---------` '1(`....` ...;. i1S t.1;,.?...0 L ? l v.t ...��N�.h)_l`,l.. t a u4. ...k. F�.`�l.. .. ...&Y......�/J' a --/ .Y.............................. has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works-C,_ns1 r; Ct;on Permit No. ...Z'---: ....( dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT 'IrHir - SYSTEM WILL FUNCTION SATISFACTORY. DATE...... ,7... .._.......... ............._..... Inspector---------�''' ---- ... .....-... ................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No..al.::r'' --�'.:�!<_/i FEE.-41(-) �i��a1�tt1 alrk� ��au�trnrtUan �rrmit Permission is hereby granted........ --------------------------------•__-_-.-_-.-_.__.• to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atNo.....Q)-�.... }_.:__... =.. .! ` 4 i\ �, t i€\,' L1 —. ''`4 v= y I Street as shown on the application for Disposal Works Construction Per 't 1No ��� � 'Dated . ................ .................7 . .. ................ .--. .....:.t ---r--- t -'L_... ,... / B i oar of 14calth DATE---------- �.. = ` � ......-�. r •--•• . . FORM 36508 HOBBS&WARREN.INC..PUBLISHERS - � r No. '' 'AP�dVED y Fxa....... Da...... Barnstable Conservation Departmeq{,iE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH igned OWN OF BARNSTABLE 6�'3 Appliration for Di-nVam lUork.5 Tontitrnr#inn ramif Application is hereby made for a Permit to Construct ( ) or Repair (K ) an Individual Sewage -Disposal System at: $1,Faa,.,,.( alb ,�11 Ito, It:F7 c7 t �l Locati n-:address or Lot LL ....................2 ------------ ---- ---------•-•- Owner Address w 4` Installer . Address U Type of Building --ft%v rt ?6r_e0�e Size Lot...A.t.71.. p-...._.....Sq.-feet ..� Dwelling— No. of Bedrooms.-_.'2.?_ .Via.........................Expansion Attic (1�0) Garbage Grinder (L6) Other—Type of Building No. of ersons---------------------------- Showers C1� YP g ---------------------------- P ( ) — Cafeteria ( ) Other fixtures A-e--q?s ^-UT ................. W Design Flow......_.-53.0.........V..... allons er`daa Totaldaily flow-------- ......................gallons. WSeptic Tank—Liquid capacity►4, .gallons Linn 1--C �.-" t�th_--.-....._ am ee� ........ Depth................ x DisposaI Trench—No. -_.4.............. Width...J(p----------- Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No..................... Diameter...........--------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosinank ( ) i1 ~' Percolation Test Results Performed by.-_. AX T�_41A'.I_ _-�! �..................... Date--_��r .12'.4 _.......... .. Tent Pit No. 1--.�,- .....minutes per inch Depth of Test Pit.... Z_'--_....... Depth to ground water_.�dTlat�c�ac���� 444 Test Pit No. 2................minutes per inch Depth of Test Pit._.-----.-----_-_ - Depth to ground water.....-.................. 9 ------------------------------------------ .................................................................................................................. 0 Description of Soil........73-A7E.-_:Logvv� Svy Spo_ ---- `- - --1'L-_-- ED__-SA�a x ............................................................... U .---------------------------------------•-----------------------------------------------.....------------------------------------------•------- W M. -------------------------------------------------------------------------------------------------------------------------------------------•----------...-----------------------------------------..... U Nature of Repairs or Alterations—Answer when applicable............._..-_..._..--.--_.__--..........-_--.--.__.._...................................... ---------------------------------------------------------------•-•------------------......---.------------------------------------------------------------.....------------------------................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State 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 ---------------------------------------------------------------------- -----------.......... . .. ..................... .------ Dace cy Application Approved BY ------------------------------------------------------------------------------------- -----/, --0 -...lam Application Disapproved for the following reasons- -------------------------------------------------------------------------------------------------------------------------------------- ..... . .. ......................................... ........................................ .. .......... ........................................ Da- Permit No. .......� �...'-..�9...t ----------- ---------- Issued -------------------------- ----------------------- ------- Dace 2� No.../. .- -----_- FIs........ ...`... ... ...... THE COMMONWEALTH OF,MASSACHUSETTS y� BOARD OF HEALTH TH TOWN OF BARNSTABLE t f Appliration for Diovoottl Workii Tonotrnr#inn "motif Application is hereby made for a Permit to Construct ( ) or Repair (K ) an Individual Sewage Disposal System at: j i,vi;=,�P�.� ��� -►t �tia 1a' .....).Ki= .....CQ_ G...:ya j 1�t1•..t_al.oi.��Location-Address -or Lot o. _ l tt�,a�. . .._C:Lu. _._FOa 4q` -tea-ZNV1_EvJ L --'--........................................ ll ...... - - ------ Owner Address W Installer Address ,{ Type of Building - M v L-c l ?U e.cos:= Size Lot...` 01..............Sq.-feet U Dwelling—No. of Bedrooms----i'?.. +.6a.........................Expansion Attic (A0) Garbage Grinder (00) aOther —Type of Building --------------------_----- No. of persons----------..-.-_._....---_ Showers ( ) — Cafeteria ( ) d Other fixtures L?I_ -1c:. Azco. ...4t3c�5_ rs_Tbrk.l- ' `> t. _ __. 2sr! ................. W Design Flow........ ......................gallons;p__ t e rmer day. Total daily flow!... B a ?......................gallons. ;a�v t 4�� l S(L, 1 At_6�Etac.•, TT'_4 WSeptic Tank—Liquld capacity�. .gallons L ngt�i..... 1 th................ Diameter...-. .... ._.-. Depth................ x Disposal Trench—No. ....)............... Width.._14:........... 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. 1...4.Z-----minutes per inch Depth of Test Pit---A?........... Depth to ground water..)%�.r55K n.utv-keZz-j­) 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R; .....•••--•----------------------••-•-•---•---•--•---••---------'--------------•..........--'-'-'---......................................................... 0 Description of Soil--...•.a Z's ..................................c 2 = �2 _ r,� t� x •----------------------•--•------•--"----'------- V ----------------•------•--•---------..•--•---•--------------•------------------•---•-----------•--•-------------------•-•------------•---------- W -----•---•-•-----------------------------------------•---------------------------------------------- -----------------------------------------------.................................................. U Nature of Repairs or Alterations—Answer when applicable................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State 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 ------------------------------------------------------_........................-------------------------- .........................------ Dare ApplicationApproved By ------ ... . .. ... .� . i --------- ---------------------------.........------..------------. ---- /..-.. _e.-..,1r......� Application Disapproved for the following reasons- -------------------- ......... .. ............................................................................. . ......................... ..... ... . --- -- ........... ... ........................................ Da Permit No. ....... - -� ........................ Issued ------------------------------------------------------ re ---- - Date THE COMMONWEALTH OF MASSACHUSETTS ' BOARD OF HEALTH TOWN OF BAR��NSTABLE (Eertif ratr of (V-IImpliance v� �r THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed - ;� r Repair d' ) F ------ ------------------ Fr ' .- ..y.: t--- ' -rK�i�j�(.. Insrailer 07 d..�O ` LDat ..........L ..... ..... tLtr 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. ------.9?-a-_-..�.... .� �� dated - - THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE......... -•---- (--------------------- ---- ,�'`'" �r'...-/.... T'..--. ..-.. Inspector---` � � � ti THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Q TOWN OF BARNSTABLE FEE....l.1�A........... Uiopooal Vorkq �onotrttrtinn hermit Permission is hereby granted------- r46- a to Construct ( ) or Repair ( yC-) an Individual Sewage Disposal System ut • atNo....tQ?__ `f'}I � t��_I_A� AK�a � _t, ��.-- c� ��-c �l� E .../��/ 5 �/���. - ---•� c „ Street as shown on the application for Disposal Works Construction Per t No.- fDated--- .. _.---- Vto l Board of Health DATE ;;- 7 i i FORM 36508 HOBBS 6 WARREN.INC.,PUBLISHERS Fzx_..No. ! �L THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH .. .....------.OF............. ................ .............................. Application for Disposal Works. Tonstrudion Prri ni# Application is hereby made for a Permit,to Construct (A) or Repair ( ) an Individual Sewage Disposal System at: _�/s1........��.-•------••--••--•-•---....-............ :............................................................................._..............._.. '�.A anon- dd ess V Lot No. ._....._.._ -.......N. a. .. ................................. .....•-- T ... _...... .. ...._....-----......_......_...__........ Owner Address W a ......................................................•---••---•------ ..__................... .............................................--••--............................................... Instai er Address q Type of Building Size Lot----------------------------Sq. feet U Dwelling—No. of Bedrooms--------------------------- --- -Expansio Attic ( ) Garbage Grinder ( ) ►-+ `04 Other—Type of Building H4IiV_0AWZ­No. of persons...... .................... Showers ( ) — Cafeteria ( ) WOther fixtures ----------------------------------------------------.:..........._....__ WW Design Flow.............SQ....-.:..._.._....__._gallons per person�er day. Total da' flow..........._ . Q_................... ons. WSeptic Tank—Liquid capacity,/XO---gallons Length.. ........... Width...... ......... Diameter................ Depth..... ........ x Disposal Trench—No..................... Width.................. Total. Length.........�....... Total leaching area...-,._1.._.__......sq. ft. 3 Seepage Pit No.......I............ Diameter.....A?.-........ Depth below inlet.._............ Total leaching area`x��..�_...sq--Ft Z Other Distribution box Dosing tank ( ) Percolation Test Results ``. Performed by //l)C— . Date..-- j`�l g_.......y. ,al Test Pit No. ....minutes per inch Depth of Test Pit..-. N Depth to ground water........�!U� L minutes per inch Depth of Test Pit.. . .. Depth to ground water...........0� tz. Test Pit No. 2.._.._�...__. .. ..___C �+ ------- ------- . ODescription of Soil............... ------- �!T! -------------------------------------------------•--........--.-..------....-•---•-----•.----.... 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 iITIS 1 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the bo rd of health. Signed---- - .. ...... ..... ...... � ate Approved B Y -A Application = 1� . . Date Application Disapproved for the following reasons:...............:...............................................................:..........................___ .................•--••--------............-----------...-----•--•------------•--......----...--------•---------------•--•--•-----•----•-•--•---•---........---•-••-----......-------•-......----------- Date Permit No......U.V:..n y.l..�,.. Issued _ . --• ...............�.... ..............._ ...._.........------------......_ Date _ `tom •..r Z.,,—.,....tea, THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH a............OF......... ��5'T? L ..................•••--•-•- - Applirtttiun for Disposal Works Tonstrudiun 11amit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: ---------------- ............--_ _�... :! � . .pld�O..w..n.er ............................ .---=:------.--•---............--------... ot No.............-.-.-.--............._...._..... ' Nion tdress V � ........................ ......_ ...... ._......_.«..�..�...._....W t Installer Address Type of Building Size Lot...---.........."...............Sq. feet 1 _ _ Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type e of Building f�i-8.JEX1R1 Y� ( )p,t yp g ___________________ ______No. of persons.__.._�_.__.__......_..__.. Showers ( ) — Cafeteria QOther fixtures .. ...... ----•------•------•-•-•--.........• .................................... Design Flow...............5.0 .------------ ...gallons Length.?"-........ Width:_.�....... Diameter................ Depth-... _...... W Disposal Trench—No_____________________ Width... .._---....... Total Length_._...._.....---.. Total leaching area...................sq. ft. x - , 3 Seepage Pit No......./............ Diameter.....ZZ__........ Depth below inlet---.1V........... Total leaching areLt -l....sq-ft:4.Pb. z Other Distribution box (�( ) Dosing tank ( ) Percolation Test Results \\ Performed by...... / -. !� �. l� .....� � D . Date ,.a Test Pit No. 1../Z....minutes per inch Depth of Test Pit....Z.`.. ...... Depth to ground water....�:.�Q!U .._. Test Pit No. 2__Ca v......minutes per inch Depth of Test Pit.=� ...._.. Depth to ground water...............G ;.. ------•----•-----•-.................•--•.......................................................... O Description of Soil----•-•-•--S F l ---------------- - •--•-•------•-----•--•------.....-••--------•---•-----•--------------------------------------------- -------•:------- -------------•••---------------......--•-...-•---................_.............. 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 TITIS 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Si ned.... g As++sue-- Cr--- . /Date ApplicationApproved By...............� i`-----_� t,�.w... ....�-__-_----•-------_-_--__-- ----•---------•-----na......---•------ te Application Disapproved for the following reasons:...............-..........................................................................................---- -•---...--•-----•------.....-••..............•-------•-•--..............--•----•-----------•-•--...._..-.-----•-•-----•--------•----••---•---•---------•--------•-----••------.....---•----•----•--••-- 1 Date 0 PermitNo.•• •61S••----ty•/-:�.--...............-------- Issued_.....................................................- Date -------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH L'L�a ............OF..........� kL1� ...................................... • f�rrtif utttr of f�unt�littnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (>e) or Repaired ( ) by---------------------------------------------------------•-__-----••--••_----•--••-•-_- ------ ---------------•-----_-___-_--_--_-----__-._---_-----_-•--••--------------_--•-•___---•---_-- {� �'j''� .- -Instahle�r � ��..� at.-------_--wx4• -------s--•�•-................. C -�-- -�r•+� -�--------•••---------------------•-•---•------•-------....-•--•-------•-------._----- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.....Z_&.:... ----/- „--.. dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................. ! .�. .-.,............................................- Inspector -_= - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT/�/fH� No.4;l0:. FsE.Z�........... Disposal Works Tunstrurtiun'V.erutit -------------- Permission is hereby granted....................................................... -__.. to Construct ( or Repair ( ) an Individual Sewage Disposal System atNo.......... a$......"*.r.. ............ . .--........•-•------•-=---..........•-----................................. f Street a as shown on the application for Disposal Works Construction Permit Dated.......................................... -----------------------•------.........------------------•----------•--......._-•-••-•................._ Board of Health DATE................................................................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH : 71 .D.W.....?�........O F...... .c�..r.h 1 ,5�..1 �:............................ Appliration for Disposal Works Tonstrur#ion Vernmit Application is hereby made for a Permit to Construct ( ) or Repair (L-�an ,Individual Sewage Disposal System at All-le.� --.._.........:. ............05 5:�f�V���:�.:........................_......_.._..._.. Location.Add ess \ ..--or Lot No. .........---..1���5.�rs t.�!�1.- .�S._\0. .•..•.•.... - _... .................. S •-•-......-----............._................ - --- Oly ner Address ✓ '. .............................. . 8 . .:...�.? `'`•' `= -s--P 14� .---............---- Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building .............. No. of ersons............... __. Showers — Cafeteria a yP g .............• P Q' Other,fixtures .................................•-•••---•--•-•-•-..... -- WW Design Flow...........................:................gallons per person per day. Total daily flow..........;.................................gallons. WSeptic Tank—Liquid capacityc?.VQO•gallons Length...La.''... Width.:7.._...... 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........................................ ,.a Test Pit No. I................minutes per inch Depth of Test Pit..................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ x .-----------------------------------------=------------------•-•----------- .._ ....:.................................................................. 0 Description of Soil...................................................................................................................................................--................... � . W .......•--•------•..................................•--•-----------...----------.........-----•--•-•------•--•••-------------------••-1-- ....... U Nature of Repairs or Alterations—Answer when applicable..:_ .1t4ST SA S_1_....&.0.Q�7__. 14�.--__ ...... .- w Kr..... �( - Agreement: The undersigned agrees to install the aforede.scribed Individual Sewage Disposal System in accordance with the provisions of iITI.I 5 of the State Sanitary Code—The undersigned further a rees not to place the system in operation until a Certificate of Complia een issued by th Signed..-- ...!qna ..��. Date Application Approved By........ M.a,...... �. ... ........................................ Date Application Disapproved for the following reasons:...............-........................................................................... --------_.... ................•-•-------.....--•-----•--•--............._..................•-----...•--..._.....•...._.--•--....----•-•-•-----•---------.......-•------------....._....•--- Date Permit No..........E.7.::�...a..62,7 ..........._.... Issued---------------- ---............................._ Date �.�..--.r1.'--w Rr...-.-. -_...l r.n � ...r-a-.-..y.r-.at,...,..+r.ir. ..r..,•..� _ -a.'W- ......... a - .. � __ �. '-•v .. ti— - - ^w..r•...._ .�_. •..-�J•�rw rY a+...�J -+w�1•. r Y.. .r.- ..fi .�1.., THE COMMONWEALTH OF MASSACHUSETTS BOARD---�OF HEALTH _.. ..W--✓�........OF........... .! ,.�.�n?C _ ..4.f............................. AVVItratfun for Disposal Works Tonstrurtion Errant Application is hereby made for a Permit to Construct_ ( ) or Repair (1-�an Individual Sewage Disposal System at: �....... .. ..... ...................... ................... ....................................... r Location-Add ess or Lot No. .n...._.... �5: •........... .0 lro vin o Owner Address .............................. a Z , e w vL t P S.......................................... V Installer Address Type of Building _ Size Lot............................Sq. feet aDwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria (L_)— a' Other fixtures ..........-•-•-•---..•.................................._. WW Design Flow...........................:................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid'capacity 0RO.gallons Length.... _____ Width....7___...... 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........................................ a ,.l Test Pit No. I................minutes per inch Depth of Test Pit...:................. Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --------------•----------------------------..--------------------------••-------.---------•----------------------------------------------------------------- 0 Description of Soil........................................................................................................................................................................ W . V -•-•--•...............•--•--- ------------------ -....... ------- --------------- ... ... -•-------------•------.......---.------------------------...... . ---- ----------- - U Nature of Repairs or Alterations—Answer when applicable__. T .�_�....._ s'? ..�� �`.[? .............. VSri .. 4._' t.Y?.! t......... ..... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliaryc`has been issued by th board-of-healt . Sied.. ----------------- ------...--- -------------_-.....--•---..�.... gn Date ApplicationApproved By.......vN �....... ---------••-- ....................... ........................................ Date Application Disapproved for the following reasons-------------------------------------------------••-•---•-------•------------....................••---•-•..»»» -----------•------------------------------------•------•-------------------------------------•----.........-•----------.....------........------•--•--......--------•--....---•••----.......•••-•••••••» i Date • Permit No..........R_..7.-._Z_ A 5.�..........»».... Issued................................................_..... Date -------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS II, BOARD OF HEALTH ............a.A �.........OF..... ` .............. Trr#ifutt#r of Toutplinurr THIS ISc-T-0-CERTIFY, That the lnd vidual�Sewage Disposal System constructed ( ) or Repaired ( �) Installer ( { ---•-- Insta --------------•----- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction.Permit No.....R._7.._.____ _ .:a`r.. dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.......... L- ...••� » -----•-••••...._._... Inspector................_ �__� . - .,........-- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ti`- .v ............-------•..................•. 7�--.-- No...g.�.�:.. FsE... .......�.......... Disposal Marks Tuttsirudion permit ` Permission is hereby granted...-•--..�......•-----•��. »».._. to Construct ( ) or Repair (,\ )-an Individual Sewage Disposal System at No.:.- �_:_.._K 4_� fin; ,�' __ - lz I Q� �n t� C ..v ---....-- _ ....... I' Street as shown on the application for Disposal Works Construction Permit No.R7_ 4' ted.......................................... ------•--•-•--------•---•--•--------•--------•------------------------•------------------••--•....---.._ Board of Health DATE...............................................................•------••-••.... L.. N G �uP I No.......... -.Gl3 F�$ .....3. . THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...........................................OF..........................:............................................................... Applira#ion for UiipnaFal Workii Tomitrnrtiun ramit Application is hereby made for a Permit to Construct ( ) .or Repair ( ) an Individual Sewage Disposal System at: ' p Q� ` ................_...1'�.a!-�Ir-Ze m.A.�...-- • ........... ......--........------........... ....................................•.... o VJC.{�LC1f�!►'}sfQ............ _ Address !!I"'_' 46_0 .Lot No. �i(�/i/ ..- ----•............................. ............... G 61 O� � dre a ------ 1�.:.- ----------------------•-•------- -•......-------•--•------.....---....... ....... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.............................. .. _....Expansion Attic ( ) Garbage Grinder ( ) ( /'�'�' ' :__._ No of persons............................ Showers — Cafeteria pa, Otiz r—Type of Building ' _.._....___ ''e' p ( ) ( ) Other fixtures _...i �l "..�:� ._ --------------- --------------------------------------------------------------------------------------- Desi n Flowl!96i .--?'S......2,CA L. allons per person per day. Total daily flow-___ W .g � - g P P P Y• Y ........................dons. WSeptic Tank—Liquid capacity.45V70gallons Length................ Width................ Diameter._.___---_______ Depth................ x Disposal Trench—No.................... Width.................... Total Length..................... Total leaching area....................sq. ft. See e Pit No.... ' .e-D ameter____________________ Depth below inlet.._............._._. Total leaching area� P� ' � P gsq. ft. Z Other Distribution box ( I ) Dosin� tank ( ) l &V Percolation Test Results Performed by...1 .6_ f' .........................:.............. Date_._. �y Z' a . r -------- Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water-__!�.._.__...._. _.. fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...lG_r..._......... f ts� io 64-x ,-,- O Description of Soil a•" -•.Z ..................................•-•---•--•--------� -------------........................................... i... . x ....-�---4r•-----•-•-•-•---- W -------------- -- ..-- 1 / U Nature of Repairs or.Alterations An h swer w _n applicabl'e-_------�___ e .___ ..........I...................................... -•-a��-----`���'�'------�4-c.!�P.-`-----S-����,Z--'---�'-steal_-- -- ------�...��..: ..�... . Agreement: y G. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Ti ITI ILE 5 of the State Sanitary ode—The undersigned furthe'r-agrees not to place the system in operation until a Certificate of Compliance has W isspe+y the board of health. Signed - ---- .------------------------------- -•---------------..... .--------- �o Date Application Approved By...... _ ..... .._2.. � �.��• - Date Application Disapproved for the following reasons:..... ..... ..... .. ............ . .. ......•--------•---•-•---•----•-•----------------•-----•._.....---•-•-•---------•-•-••-•---•-•--•----•---. Date PermitNo......................................................... Issued......................................................... Date s' � l ...... . ..-..��..�3 FBs............................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH `....... ...................-----------.O F.....-................... .-......... Appliration for Disposal Vorkfi Cnnnitrnrtion Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................--......_...................................................................... ........----••-------------•----....-----------•------•--.........-------••-•-------........------ Location-Address or Lot No. .................................................................................................. .................................................................................................. Owner Address W Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) ,G'4 Other—`T e of Building No. of persons............................ Showers YP g -------------•-------------- P ( ) — Cafeteria ( ) 1 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.._ 3 Seepage PIt-NO..................... Diameter..........._........ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (. ) 9p Dosing tank ( ) aPercolation Test Results Performed bY.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ G14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ G4 •---------------------------------------•-------....---•--.........---------•---•---------------•---.............................. O Description of Soil................................:.:. V ---......•-•-----------------------•--------------...----•-.......-----------------••---------------•---......-------------•----------------........................................................... UNature of Repairs or Alterations—Answer when applicable............................................................................................... ---------------------------------•-----......----------•------------------.......---•--.........--------------•-----------------------------•-••------....-•--------------------:........-----......---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance witti the provisions of TIT T.,-. p S of the State Sanitary ,ode—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has i suad-1 y.the board of health. J114, Sined----- --------- ............................................ -------•--•--•--a...._ ._.... <: t Application Approved BY = 1:' ....................... _.......... Date Application Disapproved for the following reasons-----------------------•-----•-••--------------------------------------._...-----•-----•---•---•-....------------ ....---•--•-••---••-•-------••---------------------------------•-•--••-------------...-•-----------------'--------------------------- ' Date E PermitNo......................................................... Issued........................................................ i Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF...............................:..................................................... �rrtif irttte of Toutplianrr THIS IS T CER IF That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by...................... � ......-••------------••-------•-----......•---•--•--•-----------------.....-------•----------•------•----................_...-•-.....--------.-- at. " "" ' !....?...... c. (../ Ii.�• ler has been installed in accordance with the provisions of TIT j f The State Sanitary Code as 'described in the application for Disposal Works Construction Permit No. f. ............... dated......................................._........ ,h THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS'A GUARANTEE THAT THE . SYSTEM WILL FUNCTION SATISFACTORY. DATE ...:........................................................•---.. Inspector................=..................................................-................. V THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ��!.� ...........................................OF....:..................................._...--._..................................... .� �• NO., ?.:�'."gfo.... s- FEE..5a --"'i �i���a�tt1 r�� �n �rnnr�irrn prmi� Permission is hereby granted...............................y ................................................................................................... to Construct ( r Repair an I divldual Sewage Di os ystem at No.......... G vs�r...... it-''1 X--- f Street as shown on the application for Disposal Works Construction Per it No................... ted........................... 5 Board of Health DATE....................-•-------••--- t- FORM 1255 HOBBS & WARREN. INC., PUBLISHERS --- - TOWN OF BARNSTABLE LOCATION �1-24 kY►� ,�� VII LAGE SEWAGE# _ INSTALLER'S N ASSESSOR'S MAP&LOT AME&PHONE NO. a� C.�� fr��o> SEPTIC TANK CAPACITY �5�,� — j'f'// y'}!/,�i- LEACHING FACILITY. / NO.OF BEDROOMS ze) BUILDER OR OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Private Water Supply well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching FacilityIf Feet within 300 feet of leaching facility) ( any wetlands exist Furnished by �, .�, J Feet I I . ,q-�= 147 1--�- p 5 c%L9 �t+b d/ 7 6J /+�' �O emsl�St i�P►'f e+'�9" a O C� / % r Message ` Page 1 of 2 Miorandi, Donna From: Michael Pillarella (V✓ork) [chefmichael@wiannoclub.com] Sent: Tuesday, March 12, 2013 8:57 AM To: Miorandi, Donna Subject: RE: Wianno Club Donna Thank you for being a wonderful resource. I was aware about the code of not reserving the food but it was great to read the code. Thank you again for the information. We are going to go with that it is a "Wianno Club Policy" that guest do not bring it home. At least for out banquets. That just makes me nervous and I rather error on the side of caution. Thanks again it is great to have someone to work.within the department. All.the best. Michael J. Pillarella, CEC Executive Chef Wianno Club P.O. Box 249 107 Sea View Avenue Osterville, MA 02655 Telephone: 508.681.4905 office Direct 508.681.4914 Kitchen Direct 508.428.6981 Main Club ext. 113 office/ext. 114 kitchen Fax: 508-428-9036 From: Miorandi, Donna [ma ilto:Donna.Miorandi@town.barnstable.ma.us] Sent: Monday, March 11, 201? 9:59 AM To: Michael Pillarella (Work) Subject: RE: Wianno Club Good Morning Michael: In reviewing the code there is really nothing that prohibits the bride's mom from taking it Ihome. It is just as if you were in a restaurant and wanted to take your leftovers home in a "doggie bag" However the Wianno Club would not be allowed to take it back into the kitchen and reserve it to a consumer. Food Code 3-306.14 Returned 'rood and Reservice of Food (A) Except as specified in (B) of this section, after being served or sold and in the possession of a consumer, Food that is unused or returned by the Consumer may not be offered as Food for human consumption. Hope this answers your question. Actually, I have attached the section of the Code for your review. Donna Miorandi, R.S. Health Inspector Town of Barnstable -----Original Message----- From: Michael Pillarella (Work) [mai Ito:chefmichael@wiannoclub.com] Sent: Thursday, March 07, 2013 2:37 PM To: Miorandi, Donna Subject: Wianno Club 3/12/2013 r _ Message 4 Page 2 of 2 Donna. Hope you are well and enjoying the beautiful weather we are having. I have a question for you regarding any guidelines governing the removal of"leftover" food ftom a banquet or for the restaurant for that matter. For example there is half of a pan of lasagna left and the bride's mom wants to bring it home. I am not in favor of allowing this as large pans or portions of food are generally not handled well once they leave the building and more likely than not spend too much time in the TDZ. Just looking for you advice. Again I hope all is well and look forward to seeing you soon. Thank you Michael Michael J. Pillarella, CEC Executive Chef 'Manno Club P.O. Box 249 107 Sea View Avenue Osterville, MA 02655 Telephone: 508.681.4905 Office Direct 508.681.4914 Kitchen Direct 508.428.6981 main club ext. 113 office/ext. 114 kitchen Fax: 508-428-9036 3/12,12013 Message `� Page 1 of 2 Miorandi, Donna From: Michael Pillarella (Work) [chefmichael@wiannoclub.com] Sent: Thursday, January 24, 2013 10:57 AM To: Miorandi, Donna Subject: RE: Wianno Club Domia, Thank you it does help. I hope the winter has been treating you well. That was my understanding :from the code. It is always a gray area. I agree that you have to make:it easy for them to use one as it is just human nature not to go out of the way for something. Thanks for the ammunition.. I am going to do my best to get at least one or two more. I am sure I will have some more questions for you.as the season draws near and. I start to open the kitchen and make it safe as it can be and money will allow. Thanks again for being a great resource. All the best. Michael J. Pillarella, CEC Executive Chef Wianno Club P.O. Box 249 107 Sea View Avenue Osterville, MA 02655 Telephone: 508.681.4905 office Direct 508.681.4914 Kitchen Direct 508.428.6981 Main Club ext. 113 office/ext. 114 kitchen Fax: 508-428-9036 From: Miorandi, Donna [mailto:Donna.Miorandi@town.barnstable.ma.us] Sent: Thursday, January 24, 2013 10:35 AM To: Michael Pillarella (Work) Subject: RE: Wianno Club Hi Michael: Yes, I am doing well-thank you! Great for you! Do you know how many restaurants want to ADD more sinks? Usually none of them-it's always a fight. The code does not specifically call out a distance but our department usually states as a policy every 20 feet. The code states, convenient, an adequate number and accessible. To cite a mentor of mine from the State DPH she calls out that you want them "in the way" versus"out of the way" such as those placed in the farthest corner of the food prep area. I personally like some of them to be on the service line for the cooks but designed_ with splashguards obviously. To reiterate, if I haven't mentioned it before, the hand sinks do not need to be the electronic faucets, they can be the 5"wrist blades (approved by this dept.) and considered hands-free. You can never have enough hand wash sinks in my opinion. Anyhow, I hope this helps and if you have further questions please feel free to call or email me back. -----Original Message----- From: Michael Pillarella (Work) (mai Ito:chefmichaelC@wiannoclub.com] Sent: Tuesday, January 22, 2013 12:04 PM To: Miorandi, Donna Subject: Wianno Club 1/24/2013 Message 1 Page 2 of 2 Donna. I hope you are doing well. I have a question.for you regarding the location of hand sinks. Is there a regulation as to where they need to be located with regards to how close they need to be to a "work station"? How many you.need to have for a given area? Thanks for your help. I am trying to get some more installed.to make it easier for my staff to wash.their hands and hope you.had some information for me. All the best and I hope to hear from you soon_ t Have a great day. Michael Michael J. Pillarella, CEC Executive Chef Wianno Club P.O. Box 249 107 Sea View Avenue Osterville, MA 02655 Telephone: 508.681.4905 office Direct 508.681.4914 Kitchen direct 508.428.6981 Main Club ext. 113 office/ext. 114 kitchen Fax: 508-428-9036 1/24/2013 i Ins' OCEAN SIDE KITCHEN �.� O ®�Ill�t �� Ininnunumm�nnnnl�.�i. �,- •V uuu—fa ISSUES loss - . ' - • APPROVAL ■. E]"PROVED"NOTED ■ ■ GENERAL NOTES �©o ���u®®■■©�uuuuuu© ��ouu�n■©MEMMu ono ��uuu�■■■�EuMOuM®mom n©n• ���®mn©■�uuuuuu© n o ��©©uo©©■�uuuuuu non ��uuu�■■■�uuuuuu� non ��uuu�■■■�uuuuuu�• . . . �u®moo■©�uuuuuula oun ��uuu�■■■�uuuu®�� ouo • ���u®®o■©�uuuuuu� ouo • ��uuu�■■■uuuuuuu� emu© �u���u�om■uuuuuuuu>. �®o • ���®umo■©�uuuuuu® 0 0 ��mu®®o■©�uuuuuu� o�io ���u®®o�©�uuuuuu� • • � o®o � uuu�■■■uuu®uuu® EQUIPMENT PLAN quo ��uuu�■■■u®®uuuu� o®o ��uuua■■■�uuuuuurta . ouo•• _ ��uuu�■�■uuuuuuu� . ouo • ��®u��o■©�uuuuuur� "Mn ®uuu o©■uuEOMEMEM o®e ten- =u ■■■�uuuuu® o®a uuu�■■■�uuuuuu® � ono �®uuu.■■■�uuuuuu® �® o®o ��uuu�■■■�uu®uuu® own �uuu�■u�®®uuuum ®= �®n ��uuu�■■■�uuu®uu® ono ®u�®n■©�uuuuuu1310 o®n .. ���u®®o■©�uuuuuu® �� ono ��©uoa©■©auuuuuu� c�� 1 r . I ' D 7 SQGty i i - GF 1-i8 �f0 � Tif=rAN� �: Go— s i O � O O O �c- c� .Lc Kit= Ou i E p 1f1A c{—A&Lc— o C '?r7 C C,*',C lz�i(:-.7 t- i i LIWIITIIUIIU IFIF� F] L.-i o p a a / Rug Town of Barnstable P# 1 7 1 Department of Regulatory Services c , „es, : Public Health Division Date 200 Main Street,Hyannis MA 02601 +"St Date Scheduled Time Fee Pd. oil,Suitability Assessment for Se` age Disposal PerformedBy: UIII A14 Witnessed By: LOCATIOZ&'GE NFORMA N Location Address ! (S��Owner's Name Address2-1 P Assessor's Map/Parceh l Z�, Engineer's Nam IJJ 7L'v y u.IIt� to f y NEW CONSTRUCTION REPAIR Telephone# 609 Lid—'j Land Use 6c,4 Cdv r,,-e Slopes(%) y la' Surface Stones A11& + c A� Distances from: 'Open Water Body ZL� s ft Possible Wet Area ZZS ft Drinking Water Well ft Drainage Way 41 ft Property Line t�S ft Other Al ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests, cate wetlands in _WOW 3TU, IN j ` T �CSC�'uri i4^"m . h i � 1� a b rJ r ! 'Iif was i Parent material(geologic) ----- - Depth to Bedrock 3t✓0 Depth to Groundwater. Standing Water in Hole: ,IV 0, Weeping from Pit Face N A_ Estimated Seasonal High Groundwater 1� (l:(- t �G(L'�.J:3 (,,vv. ,^r►.A?5) DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: qJ�} Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level PERCOLATION TEST Date 101a.11 7 Time(d Observation Hole# — Time at 9" Depth of Perc ��` Time at 6" Start Pre-soak Time @ �,\Io�S' Time(9"-6") End Pre-soak 7 m,e 3 6;i-C Rate Min./lach Site Suitability Assessment: Site Passed Site Faded: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100'of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. QASEPTIC\PERCFORM.DOC DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. Consistency.%Grave) Nv,\ Vili#I 1b sMeq DEEP OBSERVATION HOLE LOG Hole,# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%GrayeD 0�1Zi� LizAv'\ CZ—Zk DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Graven DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture " Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) Flood Insurance Rate Man: Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes Within 100 year flood boundary No ✓ Yes b` DkCd7 5 Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? `10 If not,what is the depth of naturally occurring pervious material? Certification I certify that on I( (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature ` - SC-21 I J. Date ll I Q:ISEPnCTERCFORM.DOC LXeH HOBART HOT 701 S Ridge Avenue,Troy,OH 45374 1-888-4HOSART•www.hobartcorp.com NOTICE 9 7116" Required flowing water pressure to the dishmachine is 15-65 PSIG.It P P2 Pi pressures higher than 65 PSIG are present,a pressure regulating valve must he installed in the water line to the dishmachine(by others). Pressure gauge not required on pumped rinse machines. WALL Important:The chemical containers should be placed no higher - than 10"above floor. 1 If chemical containers are to be placed in cabinet adjacent to machine, O a 1/2"dia.ho'a is required in the cabinet to run chemical supply line. 7 Notes: O 1. All vertical machine dimensions taken from floor may be increased pQ by ill. 2. Moist air escapes from the door. Use only moisture resistant materials adjacent to dishmachine sides and fop. 3. A vent hood Is not recommended above the undercounter dishmachine ' since it does not produce excessive vapors. 9" , Plumbing notes: MIN. ' 1. Water hammer arrestor(meeting ASSE-1010 Standard or equivalent) to be supplied(by others)in common water supply line at service ' connection.. - - - - - - - - 2. Recommended water hardness to be 3 grains or less for best results. 3 if drain hose is looped above a sink,the soap must not exceed 38"AFF. 2315li 6" CONNECTION INFORMATION (AFF=ABOVE FINISHED FLOOR) T 1-1/2"TRADE SIZE LEGEND `•, , PIPE MIN.REDUCED El ELECTRICAL CONNECTION:1-3/8"DIA.HOLE FOR DOWN C ON(BY CONNECTION(BY 1"TRADE SIZE CONDUIT;4-5/8"AFF. CUSTOMER) P1 SINGLE FILL AND RINSE CONNECTION:3/4"FEMALE GARDEN HOSE FITTING ON 6'LONG HOSE SUPPLIED 321/2" a, Q WITH MACHINE.; ';` 110°F WATER MIN FOR LXeH c P2 RECOMMENDED P2 DRAIN CONNECTION:5/8"BARB FITTING WITH ' 17"OR LESS 6'LONG HOSE SUPPLIED WITH MACHINE. i FLOOR LINE RECOMMENDED WATER L1311 6" SERVICE ROUGH-IN El 1/2"TRADE SIZE 22 5l16" PIPE MIN.W/SHUTOFF VALVE,LINE STRAINER &3/4"MALE GARDEN CHEMICAL BOTTLES HOSE FITTING(BY TRIM STRIP MAY BE LOCATED ON CUSTOMER). (OPTIONAL) EITHER SIDE OF MACHINE i DETERGENT& RINSE-AID 39 1/2" SERVICE ' CLEARANCE M7 ' MIN. i LOADING HEIGHT -_ 3215/16" -- i 10 9/16" , ADDITIONAL CLEARANCE REQUIRED TO 21" SLIDE UNIT FORWARD FOR SERVICE ONLY 1 1/16' 25 9/16" HEAT OUTPUT,BTU/HR SNIPPING WEIGHTS LXeH 431/2" MODEL LATENT SENSIBLE NET WEIGHT OFIMACHINE 150LBS LXeH 4600 4000 DOMESTIC SHIPPING WEIGHT 170 LBS RATED MIN SUPPLY MAX WARNING MODEL VOLTSIHERTZ/PHASE AMPS CKT CONDUCTOR PROTECTIVE Electrical and grounding connections AMPACITY DEVICE must comply with the applicable portions 208.240/60/1 30.5 40 40 of the National Electrical Code and/or LXeH t20/208-240(3W)/60/1 30.5 40 40 other local electrical codes. 208-240/60/3 23.9 30 30 Plumbing connections must comply with MODELS: 22a-240/50/1 30.5 40 ao applicable sanitary,safety and plumbing LXeH NOTE:FOR SUPPLY CONNECTIONS,USE COPPER WIRE ONLY RATED AT 90'C MINIMUM. codes.Drain and fill line configurations `THIS SYSTEM REQUIRES THREE POWER WIRES WHICH INCLUDES A CURRENT CARRYING Vary,some methods are shown on this drawing. 00-947871 NEUTRAL,AN ADDITIONAL FOURTH WIRE MUST BE PROVIDED FOR MACHINE GROUND. REV C ACCESSORY CORD KIT AVAILABLE FOR ALL MACHINES Page 2 of 4 F40332-LXe Hot and Cold - LXe kHOBARTI HOT AND COLD 701 S Ridge Avenue,Troy,OH 45374 1-888-4HOBART•www.hobartcorp.com SPECIFICATIONS DESIGN: Front opening, equipped for installation in either RINSE AND SANITATION: freestanding or undercounter-type operations. . LXeH: Sanitation is accomplished by means of a built-in CONSTRUCTION:300 series stainless steel tank, door booster heater designed to raise temperature of water and top panel. to a minimum of 180°F from an incoming water tem- PUMP:Centrifugal-type, integral with motor, horizontally perature of 110°F. mounted. Pump capacity 38 gpm. • LXeC: Sanitation is accomplished by injection of proper amount of sodium hypochlorite solution (liquid bleach) MOTOR: S^ngle phase,furnished for all electrical spec- into final rinse water to achieve a minimum of 50PPM ifications. Factory sealed lubrication. Inherent overload sanitizing solution. Injection of sodium hypochlorite is protection with auto reset. accomplished by a built-in sanitizing chemical pump. WASH AND RINSE CYCLE:Complete automatic type, PUMPED DRAIN: Machine automatically drains water controlled by solid-state electronics. Cycle may be inter- through a built-in pump. Maximum 38" drain height rupted any time by opening door. Cycle continues when permitted. door is closed. RACKING: Machines accommodate racks from • Initial cycle fills wash tank,to be recirculated each wash 10" x 20" to 20" x 20".Also accepts 16" x 18" cafeteria cycle. Some wash water is drained off before rinse trays. cycle. Rinse cycle refreshes wash water and tank heat. NOTE:Certain materials, including silver, aluminum and RINSE PUMP: Powered by a single phase motor,the rinse pewter are attacked by Sodium Hypochlorite solution in pump is made of high strength engineered composite the chemical sanitizing mode of operation. material. SPECIFICATIONS: Listed by Underwriters Laboratories Inc. and NSF International. MACHINE RATINGS LXeC LXeH Racks per Hour Rate 34 32 Dishes per Hour(25 per Rack Avg.) 850 800 Glasses per Hour(36 per Rack Avg.) 1224 1152 Controls Microcomputer Tank Capacity-Gallons 2.9 Overall Dimensions-H x W x D 321/2" x 2315/16"x 259/16" Cycle Time-Seconds 105 109 Tank Heat 1.8 KW Electric Booster Heater N/A 4.9 KW Water Usage Per Rack-Gallons .74 Drain Design Pumped Door Opening Height 17" Detergent Pump Standard Rinse-Aid Pump Standard Sanitizer Pump Standard N/A Chemical Prime(auto prime). Standard Peak Drain Flow-GPM 4.0 Service Diagnostics Standard 70°Rise Sense-A-Tem '"Booster Heater N/A Standard Incoming Water Temperature Required(minimum) 120° 110° As continued product improvement is a policy of Hobart,specifications are subject to change without notice. Page 4 of 4 F40332-LXe Hot and Cold F40332(REV.03/13) LITHO IN U.S.A.(H-01) 10 Printed on Recycled Paper • s Item# Quantity C.S.I. Section 11400 HOBART LXe = 701 S Ridge Avenue,Troy,OH 45374 HOT AND COLD Q 1-888-4HOBART•www.hobartcorp.com W STANDARD FEATURES MODELS N 32 racks per hour-LXeH ❑ LXeC ® 34 racks per hour-LXeC ❑ LXeH M .74 gallons of water per rack ® Hot water or chemical sanitation units available ACCESSORIES ® Low chemical alert indicators ❑ Power cord kits 10 Sense-A Tempi" booster heater capable of 70° ❑ Stainless steel base with 6" legs rise, provided on LXeH models ❑ 17" stainless steel stand with storage N Delime notification with cycle ❑ External caster kit ® Chemical pump "auto-prime" ❑ DWT-LXe drain water tempering kit N Service diagnostics Specifications,Details and Dimensions on Back. ® Deep drawn stainless steel tank M Microcomputer, top mounted controls with r, digital cycle/temperature display C U` US M Revolving upper and lower anti-clogging wash 1��7 ffl- arms LISTED ® Revolving upper and lower rinse arms M Removable stainless steel scrap screen M Corrosion resistant pump ® Automatic pumped drain ® 171" door opening ® Automatic fill ® Detergent and rinse aid pumps standard (plus sanitizer pump on chemical machine) M Electric tank heat tl M Two dishracks—one peg and one combination type a � a STANDARD VOLTAGES O ❑ 120/208-240(3W)/60/1 (LXeH model only) a "� ❑ 120/60/1 (LXeC model only) --- - „� . Z ° s v OPTIONS AT EXTRA COST R ` ❑ 208-240(2W)/60/1 (LXeH model only) ,4 " 2 � O ❑ 208-240/60/3 (LXeH model only) " r v F40332-LXe Hot and Cold Page 1 of 4 UL f'N^ off` N I t)} v .0# P3 - TERRACE ROOM - ROOM FIN 15H 5 H EDU LE Number Name Base fn5h Floor Finish I Wall Finish Cei ng Finish Comments TRI TERRACE ROOM LOUNGE ETR EXISTING SLATE TILE FLOOR TO REMAIN GWB TO REMAI FABRIC/ OOD NEW QUARRY TILE BEHIND BAR UNLESS NOTED PAINT TR2 STAIR L N/A REFINISH EXISTING WOOD FLOORING N/A STAIN TO MATCH LIVING ROOM TR3 STAIR R N/A NEW WOOD-FLOOR N/A N/A STAIN TO MATCH LIVING ROOM NOISIA10 90 c01 WV L I ij"O b161 312VISM9 J0 Nm%, I ' TOWN OF ARNSTAB LE LOCATIONS_ SEWAGE VILLAGE czr.�` 2 ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. FT1l �r SEPTIC+TANK CAPACITY r CHING FACILITY: (type) _T1, ��� (size) 00.OF BEDROO S BUILDER 0 OWNE PERMTr DATE: IY COMPLIANCE DATE: , o S Separation Distance Between the: I 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 leac ' facility) Feet Furnished by t 3� �5 I k ' 362.4541 926 main street yarmouth mass. 02675 down cape engineeiiag civil engineers& land surveyors structural design Arne H.Ojala P.E.,R.L.S. land court Richard R.Fairbank P.E. surveys site planning April 8, 1985 George Chamberlain sewage system c/o Wianno Club designs Seaview Ave. Wianno, MA 02655 inspections Dear Mr. Chamberlain, permits I have made an analysis of the sewage system shown on the site plan dated April 20, 1945. This system has a capacity of about 6000 gallons per day under the requirements to Title V. The sewage flow estimate would be 3000 gallons per day for the rooms and 5000 gallons per day for the restaurant dining room. The total estimated sewage flow is 8000 gallons per day into the sewage system. It would appear to me that you are running about 35% over capacity during ,the peak (two months) of your season, (during the off season, the system is running much below capacity. ) My judgement is the system 'should continue to function well if carfully maintained and cleaned on a seasonal basis. Since there is no external grease trap, I believe that daily maintenance of the kitchen grease trap is important to the continued function of the system. Sincerely, Arne H. Ojala P.E. AHO/kmk I ICI T07 'r JkwrRr�,* h,^r'a "R t�.'C' ' a` .t^}Ct s 14 ,": .,r;' ' 'Y ,a.v.ae r �'`u 3;,�, ,.-:wSvt'}'.4"r� ��"r`•�-f,',,7"E•- �`�.µ'Y•'•°!�-•�,Ci -7br,.�. S yS, `;+'.� •� '�7.,,�, ti,.:' i,a"..ti.=...,.. 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City 0 s t e ry i l l a .. M._.. City __. .. State State .. -_ - .. __.. . . __ ._. _ _ _._. Date of Plans Phone Architect __._ ..._..- We hereby propose to furnish the materials and perform the labor necessary for the completion of Cape Laud will „ .instq.11 2500 pallon grease t.ra.p.._complet.e .Wi.th,..s_t.eel.,c_over._._and_.,.all-out-- side connection._and. pir,iti ... One.. -el...._....-- sectier?__of. fence. ..Area will be,-left _graded._.smooth_-and.._.rak.e...._out.__w.ith._..__._._ ,lV s�te 'l w 11 be in-T,)eeted. ..bv .llea.lt.h_ll.ept._and_ app.r.oved...__._ _. I`•loinside . T)Iumbinf, included. _..._. _....__._.... __ ._ _ __.. ... _.. _.......... v` r All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications- submitted for above work and completed in a substantial workmanlike manner f7r th sum of Dollars �$ +3 0.00 f with payments to be made as follows: �' + 000•n0 cl egos i_t or first day of ConstrUCtlon. _ � 0.00 to be na.id in full the d.ay, of-_goml)let _on._._.__.. ______- w.__,. Any alteration or cevistion from above specifications involving extra Rodger PE R berts; costs,will be executed only upon written orders,and will become an Respectfully submitted - - extra charge over and above the estimate.All agreements contingent "--' upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado and other necessary insurance upon above work.Work- men's Compensation and Public Liability Insurance on above work to be $ <% taken out by Note—This proposal may be withdrawn by us if not accepted _..._.,._._....._.__._.. _..M...... within ._...:._..__.._..days. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the work as specified. Payment will be made as outlined above. ;; h 9 Signature _..._...... _..___....._._.__.._..... Date Signature TOPS FORM 3850 DUPLICATE ' LITHO IN U.S.A. F 362-4541 939 main street rt 6a yarmouth port mass 02675 dOWO Cope engineering civil engineers& land surveyors structural design Arne H.OJala P.E.,R.L.S. land court Richard R.Fairbank P.E. surveys November 9, 1990 site planning Town of Barnstable Board of Health sewage system 397 Main Street designs Hyannis, MA 02601 inspections Re: Wianno Club permits Members of the Board: As a follow up to my letter dated April 8, 1985 relative to the satisfactory performance of the subsurface sewage disposal system at the Wianno Club on Seaview Avenue, Osterville, I have reviewed records on file at the Board of Health, and have spoken with Mr. John Moniz of Ace Cesspool Company. On April 18, 1985, I made an analysis of the existing septic system and made the determination that if the sys pm was properly maintained it would function in the capacity of a system meeting the requirements of Title V. Since that time the Wianno Club has installed a Z000 gallon grease trap, and has performed routine maintenance on the system by seasonal pumping of both the septic tank and grease trap. I have spoken with Mr. John Moniz of Ace Cesspool Company about the functioning of the system. Mr. Moniz is familiar with the system as he performs the maintenance. John told me that he checks the tank and grease trap for proper operation on a yearly basis, and finds that there are no problems with the functioning of the system. He states that the leaching system functions without any problems. It is therefore my considered opinion that the septic system of the Wianno Club continues to function as a Title V system and will continue to do so as long as it continues to receive proper maintenance. There was a record in the file at the Board of Health which indicated that a 1000 gallon leach pit had been installed at r the Wianno Club in 1987. This is not true. The pit may have been installed for the Wianno Yacht Club, but it was never installed at the Wianno Club. If I can be of further assistance, please do not hesitate to call. very truly yours, /// I gas Arne H.. Ojala, P.E. , P.L.S. AHO/sky aholl.9 .y III I, 14 ­ I I , . ., , I . '. I ­, - - -I �,� - . !� I-� -; , _�I � , I 11 , . �.. .1 - , % �, , 11.1 �,.- .�r`,r _�A%.,V, - ­(- ,- - ...-l-, - -,- , . I , .�;� ". .� i, . __ . . . - -t-I ,I, , - � S0 , ,;'#11 '.. ,� t' ,& �,:t .e "O 1�1 .. t ,.� ,,,, -,.-♦,,,��,t -, ". " .",- e-"'-, - ., tm­z,­,� �-, � .'�I., . 'jk. . .,A ­1 toe, '!W,,,, . . ;1';� "41�.,,I I* .11'r,yr. 1. 4�: x :1, 1 51.", ,� .-,. I, . . ,�, . . . � � A .I 'I., "'i-.." -.;., -1 -- � ,3 . 5." 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I, - � . . . .,I'll � No. 0�� -7 r.• f� DATE yoFTNEto / TOWN OF BARNSTABLE FEE OFFICE OF i BAH NAZIL : BOARD OF HEALTH 7 Ml. p 1639- \�� 367 MAIN STREET 'f0 M0 HYANNIS, MASS. 02601 VARIANCE REQUEST FORM All variance requests must be submitted five (5) days prior to the scheduled Board of Health meeting. NAME OF APPLICANT YYj kfj iC, (f L U 3 TEL. NO. ADDRESS OF APPLICANT CD 51fR\j IL t!z NAME OF OWNER OF PROPERTY W if}toN)O C L v =N C SUBDIVISION NAME DATE APPROVED ASSESSORS MAP & PARCEL NO. LOCATION OF REQUEST w BAN No VARIANCE FROM REGULATION (List regulation) VARIANCE REQUESTED (Specific request) V!&9-- :?t�;QZ (O;P SF ! NC :t'AK) lL D C1 a &S -t QA I� REASON FOR- VARIANCE (May attach letter if more space needed) S TAf�n K3A( y S!!E C a MST R &\ Ni V) AV - A- fie-3 0 o i�--- t< PLANS - Two copies of plan must be submitted clearly outlining variance requested. VARIANCE APPROVED NOT APPROVED REASON FOR DISAPPROVAL Robert L. Childs, Chairman Ann Jane Eshbaugh Grover C.M. Farrish, M. D. BOARD OF HEALTH n^ U •n, \\ \\\\ \` � �W I AIJ 1�lU G LIB►P� PevP� Kt<GNEt�v.tnhrE t_�� rp, > 'J 61 i�� E�� . C�do+a�l�� PeoPo�E� K�r�En► wAs-rE U�l� Z ou�as-rc `UtJE e L�.� (�v7 CGS d�oTG� SEGTtvtJ Q -r,p�K Pl_A,i.4 .Qla �G-lA Grto St �� C-�ezoa E TAP +FL A4 .t' OF OF 00 tvlopt'5icA- nl ,t.�s s� _ AR ►+ ��, chow n caPe en j I oeeri ng ,�. OJAtA TO AGCONIPAt.I`{ aPPUGATiDn! S � G tv(t_ S For— vc.e.(aau� �c- rto CIVIL 30792 L-AKIP o CIs R° a6 KfoTc t �D M 2c� Zg, q'0 A.JZ�It✓ t-1. 61D.lA, r \,�, TAti!Il yETaI uG ' � ` 1'eoP� KI��NE�I w.�chrE ��►�� �`` `; •` W I PLL t�1CJ G I-U P���'ti'`' `�' „YG E�"Cyr��> - > G \\ LAKIE TO P-4E, Glo s � cA�C EV ti S Tic, �X7r✓NC.1;I 20,Z ti (iIa EI.EJ dckarl�� PeOPoyap KiTc,44&nt wa(;,1E Uti(t DwvD PC Z! a Z_::) K ITu-t�LTG U�.IE C CQ.� ( j7 CGS �loT� GT►0�.1 a' -Tbt`1 K PL_D,tit OG r4l-4 K TO I - 4reE Dc.T A Gr.1n S �.e ham' I = 2or C-��ESE TAP FL AKI OF I .UP PTiG �YSTQA � �" of chow n cape en1joe.en nl MoptFl�.a�7lr� :s o'� ARNE H. ®JAtA ..• TO aLCOMPA�`f aPPUC�.Tron1 � ti li I V I L "l KLEf:Z.S Foe- N CIVIL 92 I.AND�Ue�lEYOe.� Wl�•�lr�lO �G-LII� _ i°�o crs R° A2GM i�f0(v D M 28� A�t�t; �. f�1ALA:���. D�-TE r Sullivan Engineering Inc. 7 Parker Road,Box 659,Osterville MA 02655 508 429-3344 e-mail:ysuIlue aoLeom faz 508- 28 3115 September 18, 2006 Thomas McKean Town of Barnstable Board of Health 200 Main Street Hyannis,MA 02601 .RE:, Wianno`Club 7-Putting Green'Cottage North/102`Sea View-Avenue, Osterville Dear Mr. McKean, In response to the Title 5 Official Inspection Form performed by James M Ford,it is our opinion that the septic system at the above referenced location does not meet any of the failure criteria outlined in 310 CMR 15.303,or Article IX of the Code of the Town of Barnstable, and as such does not mandate an upgrade at this time. Please note that the system does trigger Article V of the Code of the Town of Barnstable, and as such the Wianno Club has been made aware that an upgrade will be required during the next building permit process for this structure. I trust this meets your present needs. Please feel free to call if you have any further questions. Very truly you ohn O'Dea - Sullivan Engineering Inc. Cc: Wianno Club 4° N.) John Alger,Esq. V� Jim Ford 1 c.z Members of The American Society of Civil Engineers and The Boston Society of civil Engineers it Sullivan Engineering Inc. 7 Parker Road,Box 659,Osterville MA 02655 50&428-3344 e.-maiL ysnllpe(a?aoLcom. fax 508 429-3115 September 18,2006 Thomas McKean Town of Barnstable Board of Health 200 Main Street Hyannis,MA 0260,1 RE: Wianno Club/Beach Cottage/ 107 Sea View,Avenue,Osterville Dear Mr. McKean, In response to the Title 5 Official Inspection Form performed.by James M. Ford,if is our opinion that the septic system at the above referenced location does not meet any of the failure criteria outlined in 310 CMR 15.303,or Article IX of the Code of the Town of Barnstable, and as such should not require additional evaluation by your department. Please note that the Wianno Club has been made aware that the leach pits are not capable of withstanding H-20 loadings, and should take care not to subject them to such. I trust this meets your present needs. Please feel free to call if you have any further questions. Very truly yours, J hn O'Dea Sullivan Engineering Inc. Cc: Wianno Club John Alger,Esq. } Jim Ford a.v SA� Members of The.American Society of Civil Engineers and The.Boston Society of Civil Engineers AUG.29.2007 8:30AM BARNS.TABIE NO.722 P.2/2 1 rice. D& FEE• SA8rt8FABtrE, REC. 8Y 1.r a acxnn. aATlr � ,hoard, of Health pM 200 Main Street,Hyannis MA.02601 oigae: SOs.sez-asaa w of .. suSM a.RAL<,a.s, FAX: 508-790-6904 8�r1ar ltau�aa,M.B.P.H. Wayne A.Bdilkr,M.D. 107 Sea View Avenue and 379 Parker Road Property Address: As8ess0r'9Map•aa,d.Parce1XUMb09: 162-024 W-115-022 'siuofLot;r_._,^ wct]ands withia 300 Ft, Yea Pjf r Business Nsme: Wianno Club No Subdivision ame: AIMUCANT'SNAME: Phone _-- - ------ ' Did the owner of the property authorize you to reFesenthim or her? Yes x No p�tppTR'�Y O� �A� CdN',C'ACT P'BRB�N Wianno Club, Inc. ` � Jack L. Thomson, CCM Namc: 107 •Sea View Ave. Osterville Address: 508-428-6981 Pl:dna: sae' F QSaeRag.) REASON FOR YAK&=Qriay SUM i£m=space needa4)` W elspar-dose. ed _. f') NATMM 4F WORM fie Addition 13 .govee RMYation d Repat of Fafled Septic System• �!� arson mceivi varionee eat location �' i-' � (so be completed by o,�ce p ng raqu app� ) Yka e,submit copleg to 4 sepoW completed:seiL Four(4)oopies of tits comt pIcW vadam request&xoa. Four(4)copies of aoneerad plan aftitted.(e4s septic system pleas) Fora(4)aopies of labeled dhnensipasl floor pisne'i ubmitted(c.g.lease pl�e or teMtaussatldtobm plan 8*44 kttar stating tt�a*e prt�p W W ova=astbortmed you to sepresaat himlber for this request A"Hoaat undcnz4 that the abutters must be notified by ca tiW mall at least tM days prior to iaeetiag tt at TA.Caat's expana4 (&r Tide V and/or loml sewage regtiilatioa varisum only) N j - Fun menu aub=itsd(sor gees tray+waromo reanaste pAW � " Yar€ance r�aeat applieatiaa fee collected <ao fee fbr lifeguard moM ation ra WAU, grmae trap Vx%= reneaals Game oaaer/leam onIn outside dming vmv=mnewals Coe ovaix/Ieuw only], and va dares to Tq* fazed evnF diws l Mists= [only if no up wim to Se building proposaQ i Variaacc aubmitfed stleast 15 days priot i o tree "date `IAPJANCS APPRD VRD W.yae A.Miler,MM.C.hOA= NOT`APMVED su ctn x REASON FOR DMAPPROV 8nsan C.Rank.R.B, �;\HSA7JTPi�Appiication 8�ore►��VAR.=�Q.DOC I WIANNO CLUB 15 September 2007 Town of Barnstable Board of Health 200 Main Street Hyannis,MA 02601 Dear Gentlemen: Wianno Club understands the intention of Code 322-4 concerning toilet facilities and the requirement to install hands-free faucets in many of the sinks in our food service facilities. Our recent kitchen renovation and casual dining addition includes seven hand sinks,all of which have or will have touchless faucets. We also will install touchless faucets and the new sinks they will require in all employee restrooms prior to opening for the next season in spring of 2008. There are,however, several public restrooms in both our Main Club(hotel)and Golf House facilities which, if required, installation of touch-free faucets would require huge expense for no apparent benefit. These are restrooms that are provided for our members and guests and are not available to food preparation, food service or bar service personnel. Wianno Club does not have a full scale drawing of its main floor, as requested,and therefore asks that you consider the following: ♦ Women's and unisex handicap restrooms 73' from nearest kitchen door in Main Club. ♦ Men's room in Main Club is 126' from nearest kitchen door. ♦ Men's and Ladies' rooms at Ballroom are 200' from kitchen door. ♦ One unisex restroom on the main floor of the Golf House is 36' from the kitchen. ♦ Ladies' locker room in Golf House is on the basement floor and 19' from the kitchen. Men's locker room in Golf House is also on the basement floor and 40' from the kitchen. Together,the above bullet points represent a total of 14 sinks available for the convenience of our members and guests. Their complete replacement would require an enormous expenditure and we respectfully request variance from the requirement to install touchless faucets at this time. Sincerely J k L. Thomson,CCM General Manager P.O. Box 249. Osterville, Massachusetts 02655-0249 Tel: 508-428-6981 • Fax:508-428-9036 wiannocl@cape.com Stanton, David From: Jack—Thomson '��� —}-U h-� di+ IYo✓ 13j o�07 Sent: Tuesday, November 13, 2007 4:15 PM To: 'tom swan'; Charles.Cramb@avon.com; george@wiannoclub.com; Stanton, David; 'John Tobin'; dave@royalbarrywills.com; 'Kathy Cochran'; 'Debbie Bryant; 'Paul Landry' Subject: touchless Lady & Gentlemen— You may recall that, recently, all foodservice establishments in Barnstable received a communication from our Board of Health stating that haridwash sinks had to be converted to touchless by next June. On advice by our inspector, David Stanton, I appealed for a variance, stating that our public restrooms are a long way from the kitchen and not used by employees. A hearing of our case was scheduled for this afternoon. This morning, I was visited by Dr. Paul Canniff, who sits on the B of H, who wanted to see the lay of the land, which I was happy to show him. I arrived early for the hearing and Dr. Canniff beckoned me to the podium where he pointe_d,out thatthe ordinance as it is now written pertains to employee_restroomrsinks, as well as hand sinks in the kitchen. `Ourscasdismrs es d_and,I was "sent home early." So, what all of this means is that we only have to concern ourselves with converting the faucets in the restrooms used by foodservice employees and, by copy of this, Gordon Smith will carry out earlier instructions to do what is necessary to get the conversion accomplished before next season. This will require purchasing some new sinks and, possibly, eight touchless faucets, but will not be nearly as extensive as earlier believed. Of course, the flip side of this is that foodservice employees are prohibited from using the facilities provided for our patrons. Jack 12/11/2007 AUG.29.2007 8:30AM BARNSTABLE BOARD OF HEALTH NO.722 P.2i2 DAM .1A aaarlereat,E, � ' • REC. BY Town of Barnstable l��n. DATEa ,Board of Health 200 Main Street,I-1yaanis MA.02601 Offee so8.86a�644 Susan Q.Rask,R.S. FAX 502-790.6304 SuamarRmAm i4M.821L Wayne A.Miller,M.D. MA =CE REQUEST FOPX L 107 Sea View Avenue and 379 Parker Road ' Property Address; Ass.mor'AMap'and.Parcel Number; 162-024 &'.115-022 'SixeofLot;_ I Wetlands Wia300 Ft Yea �� r BUSH' as N"; Wianno Club Na SuUdivision�isme• AITUCANT'S NAMM Phone ------ ' Did the owner of the property auftrize you to repxes tnYt biro or heft Yes ---No �tOPERTYS���'A1S� CdN'T�CT l�F,RBON Name: Wianno Club, Inc. ` N=e: Jack L. Thomson, CCM ®����Q� 107 •Sea View Ave. Osterville Add PI> e: 508-428-6981 Pho>xe; s �SaeReg.) ItBASQN FOR VARIANG' Day at=%i£m�tpaaa is") `• I — 6r• ! . ,Ad...r•S — — MATM OF WORK: House Addition 13 QC= HOU80R—M. ratim n Repair of Fafled Seph'c SystM,Q (to be completed by ofte s4ff-Person receiving vwgw ee request ap location) ,P'lda�e4ub�caplet�,4 separate camplet�d s� ' Four(4)a*es of the completed vadaz=mFest fbcm _h4& Foy(4)copies of atgfnd plan vAmdtted.(e,g.septic system pleas) Faun(4)aopiec of labeled dhneatdoasl floor plans s'obmitt d(e.g.bouse pleas or rwWv=tktft a plate Signed k tvr stating sham to pmp&V owner autt wimd you to semmt h{m4w for this request Wow ua6at%rAs that the abutters must be noUAd by eatified U ad at least tt days PeW to-meeft Oak at appiioaws CPC44 (fx Til a V and/or lo%l saww==Matron varimmces only) ALt FuU meats s,.tbwnsd(ft ice trap varm a requests o* Vad%= to wt application fee coltected jno to fbr Thpard modification mow*, graasa trap Vatisoae renewals Game owuvieame onl$ oumdo dim S-vtuianee reaav'rals (=e ovwierlAuw only], and variances to tepa{r tailed WNW disposal systems [only if ao v*ansioa to tits buiMing propau dD E Vstiaaca submitte8 aticast IS�pnot to.esg-.dale . VARIANCE APPROV9D W..yne A.Wtf,M.D.Cbe$msm NOT°APMVBD Su amp REASON FOR DTBAPPROV Susan(.Rask.R.6. Q:\HBAil1'Pi\Applicatioa Poro�\VAR2�Q.DOC r 1 WIANNO CLUB 15 September 2007 Town of Barnstable Board of Health 200 Main Street Hyannis,MA 02601 Dear n Ge tlemen: Wianno Club understands the intention of Code 322-4 concerning toilet facilities and the requirement to install hands-free faucets in many of the sinks in our food service facilities. Our recent kitchen renovation and casual dining addition includes seven hand sinks, all of which have or will have touchless faucets. We also will install touchless faucets and the new sinks they will require in all employee restrooms prior to opening for the next season in spring of 2008. There are,however, several public restrooms in both our Main Club(hotel)and Golf House facilities which, if required, installation of touch-free faucets would require huge expense for no apparent benefit. These are restrooms that are provided for our members and guests and are not available to food preparation, food service or bar service personnel. Wianno Club does not have a full scale drawing of its main floor,as requested,and therefore asks that you consider the following: ♦ Women's and unisex handicap restrooms 73' from nearest kitchen door in Main Club. ♦ Men's room in Main Club is 126' from nearest kitchen door. Men's and Ladies' rooms at Ballroom are 200' from kitchen door. One unisex restroom on the main floor of the Golf House is 36' from the kitchen. Ladies' locker room in Golf House is on the basement floor and 19' from the kitchen. Men's locker room in Golf House is also on the basement floor and 40' from the kitchen. Together,the above bullet points represent a total of 14 sinks available for the convenience of our members and guests. Their complete replacement would require an enormous expenditure and we respectfully request variance from the requirement to install touchless faucets at this time. Sincerely, J k L. Thomson,CCM General Manager P.O. Box 249 . Osterville, Massachusetts 02655-0249 Tel: 508-428-6981 • Fax:508-428-9036 ! wiannocl@cape.com 1 41- +t ;rti z .y. r -,c t ,�...,v €- __ s : r ,', 4 _, ,,,r+:.,#`i. ,. .� �, .t.'�.r y`is, gi.i+`} * "" .L i t ", "4 le L z;;i, '� �±r. r'�i'�, w' }., r'.�r_ +-% •d"a •t,k} 4' `� sue; ��t�` s.f".. "t+* r e,�I y.*,�", a ". rr t,�•.y P� iyR �' 3 F a t A s.a . G 4 S s + .,.."kr .Y;F, i '' r s• ,sa-; rb •Z .d,fy,e a ' 1< ,s r fit! �5 "e . , P 4 a } J r'` r t p., } t '• F '. F ,"' ^ 9 F a 's ' "a ,1k} ,',V '`S ,i' 1 '#t, 's *,,, . .,; k r P y t' t i . ✓ r i a s .e ,:+�.�y,},§Vpp i . Cr' r s t, _ �' 7 r# }r`� '._`'1 yr,i r-,- � p�"a ya 'aro .r F ., ,, r av r : ,•' q Y' ,?..� ` `t' �,'..- ,. {ii 4 a r e Py J •e i. r r'-' .t y 9 Y ', , 7 C i. a+z .. x ^' .- jyi 4 11 a } . 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'x aq.u`�'' 'S'"', F r}',oa r' Ik4�~L '•` rr,.�a .w �:b. #jr L ! .`'�- y sa S-'s ��i p sd k y.'sh. '.,� q.,.. iw, sn ts+'►'Y t f {." F �,fit ,W ; ;.."d �q sr"t yr 1 � *':�t�i. `$+�;. k• y$a y�y^F> 4 r; , _.. 4i' ~� S�� - ��r *'}''' r'•tw wy +ny..`,r" ,�dY 1 3':�j't' }�,,J3.'� `�s »ah'� �,'���lyy;k�^„�f t ti�r���,.i } JJ k3#4 4 � 1 t�l ,� Y� i.�. ! �M,\y yl lh}�rtit't' rf��b' �•d 1. 'Enviro-Safe Corporation Environmental Services Field Service Center April 18, 2007 Town of Barnstable Town of Barnstable Health Department John Klimm,Town Manager Thomas A. McKean, Director Town Hall, 2nd floor 200 Main Street 367 Main Street Hyannis, MA 02601 Hyannis, MA 0.2601 RE: Release Notification, Immediate Response Action Completion and Response Action Outcome 107 Sea View Avenue,Osterville, MA RTN 4-0020340, ESC No. 8044 Dear Mr. Klimm and Mr. KcKean: Pursuant to the public notification requirements of the Massachusetts Contingency Plan (MCP), 310 CMR 40.1400, this letter informs your office that an Immediate Response Action(IRA)has been completed at the, above-referenced location. An IRA Completion and Response Action Outcome(RAO) Statement have been prepared and submitted to the Massachusetts Department of Environmental Protection (MA.DEP) Southeast Regional Office in Lakeville, Massachusetts. The Report summarizes site-specific conditions relating to the release, mitigation, and Risk Characterization of a release of petroleum from a underground storage tank discovered at the above noted property. The IRA was completed, a permanent solution was achieved, and a condition of no significant risk now exists at the Site. Conditions at the Site support-a Class A-2 RAO pursuant to the 310 CMR 40.1000'. .No-hazards to health,-safety, public welfare or the environment have been identified or are anticipated at the property. i If you have any questions regarding this notice, please feel free to be. If you wish to review the Release Notification, Immediate Response Action Completion and RAO Statement, please contact the MA DEP Southeast Regional Office at(508)946-2718. 41cere-lu; 9VIRO E CORPORATION raig :ss Senior`Fvironmental Engineer "cc: Robert Berger, LSP ;Wianno Club, Attn`. Jack Thomson 31 Granite Street Milford, MA 01757 • PH (508) 634-9800 • FX (508) 634-8259 Y j cab TOWN OF BARNSTABLE w �t LOCA'.T,'ION :l A ti-�)# 101 Q SEWAGE # J VELLAGE 195 Zefyd � ASSESSOR'S MAP & LOT!6Z V 7 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY ��®®0 � LEACHING FACIL=: (type) `✓ 'Yyl tbSI�2 (size)�i1� NO.OF BEDROOMS {;BUELDER OR OWNER litJ/4' 1�8 G�ll� PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaclnn'g facility) . Feet Furnished by 64f�-tc yi y �4? k ¢, , p �,ql •J' '.%----o.-ram S � } s r �!xc` �r C�a F •�,�i �4 ,fag �',�� 1- ' � 3-rctk3w`b�"{.- ! ara� .r, x"3il<+i °�� a �a ) �'r•% �� ,..�.^ w -Rrd '" �i�����', ,'�'";a;:�� i T•►.dat'�>1v�a9 tie �� p, ��.;�lar.-� Yz6$,}' ,+it�s,� �i TOWN OF BARNSTABLE LOCATION tJ SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. ,�G4XTLlj-177 CA►-I�ST SEPTIC TANK CAPACITY aao �•-B V C�-EACHING FACILITY:(type) (size) NO. OF BEDROOMS 16 PRIVATE WELL OR P B C ~ `TF g BUILDER ORS NECK (�f IAyJi-J 6 64-,Od DATE PERMIT ISSUED: j c-)9A DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No ,oy- rf ° �� TOWN OF BARNS TABLE LOCATION 101 &FA-q 1 k-� SEWAGE tVILLF_GE ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. SEPVC TANK CAPACITY LEACHING FACILITY:(type) 'RAT�t7�1 GL 3 (size) NO. OF BEDROOMS OWNER 1/lJ 1rJ� GLrt,�3 PERMIT DATE: C4'7 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 Leachin F ty(If any we ds exist within 300 feet of leachi Feet FURNISHED BY ► . 2-0 '�' � Z2- C]I3Z- Zzo ��t�� . S= ►3 f (44 3�' TOWN OF BARNSTABLE LOCATION 0-� SCA ( IC W SEWAGE# VILLAGE ()V-t-VAt ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY rA d LEACHING FACILITY.(type) NO.OF BEDROOMS , OWNER ( IA/Yl6 CIU PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY Tit Spcc,'�t� �p 4 ! - A (� B (, A .. A (3 J OL IDS 3 [O j 33 yo3O 7 y s -7 3Y ' TOWN O+F' PARNSTABLE LOCATION /0_ td� A V,!G— SEWA'GE # II.,LAGE v ASSESSORS MAP �& LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILrFY: (type) (size) NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility)- " _ Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by TOWN OF BARNSTABLE LOCATION Off' ��Vices U SEWAGE VILLAGE 0ZrIVZA f— ASSESSOR'S MAP & LOT ' INSTALLER'S NAME & PHONE NO.��c���. ka�✓�S SEPTIC TANK CAPACITY a d O� �o w rot LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL O UBLIC WATER �. BUILDER OR OWNER LL lP-e',y%'a C l Vl l DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: - I � 7 VARIANCE GRANTED: Yes No QOOO (a6'•eu.SGR-ZRA'p F W. .. 1�6� ��tri1LTAN�Z r EXaS'1'r tY , KEWSNSTAI.L.g710 O o � O 3 r U l t G� " wcs W r O A-rO C,l kA-b � �4 5&a►AW TOWN OF BARNSTABLE LOCATION tr Y /A+ 1& WIAM O AVC. SEWAGE# — Co/7 VILLAGE Oj1—Lry��� ASSESSOR'S MAP&PARCEL �Go1' O/Cj INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type)y'/�►t'���/ d (size) /0?( 30A al NO.OF BEDROOMS 3 - R'•4d, OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) //� Feet FURNISHED BY T%roc.Aall � CO/Ci i 13 3 1 ►q !c� C O a46 rllSpcaT. Poi' a,e A. �a a C !�y A A f3 �^sPccr. 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'' -,.��-`: Sick.: ��s..- _tee'^1 Feb. 26. 2007 9: 58AM MASS DEP No. 1735 P. 1/4 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION SOUTHEAST REGIONAL OFFICE 20 Riverside Drive, Lakeville, MA 02347 608 946-2700 DEVAL L PATR,ICK IAN A.BOWLEG Governor Secretary TIMOTHY P.MURRAY ARLEEN ODONNELL Lieutenant Governor Commissioner FAX COVER SHEET FAX # (508) 946-2865 TELEPHONE # (508) 946-2851 I DATE: February 26, 2007 FROM: Roberta Edwards PLEASE DELIVER TO: Barnstable Board of Health 508 790 6304 Barnstable Town Manager 508 790 6226 1 TOTAL NUMBER OF PAGES: 4 (INCLUDING COVER PAGE) PLEASE CALL IF YOU, DO NOT RECEIVE COMPLETE FAX. Notice of Responsibility, Nianno Club T 1 i I This lnformadon 19 available in alternate format Call Donald M.Comm ADA Coordinator at 617-SS&I057.TDD Servlee-1.800-295-2207. DEP on the World wide web: http:0www,mesa.gov/dep Printed on Recycled Paper Feb. 26. 2007 9: 58AM MASS DEP No. 1735 P. 2/4 c* � s COMMONWEALTH OF MASSACHUSET°TS EXECUTIVE OFFICE OF ENVIRONMENTAL AF DEPARTMENT OF ENVIRONMENTAL PRO SOUTHEAST REGIONAL OFFICE 20 RIVERSIDE DRIVE, LAKEVILLE, MA 02347 608-946- DEVAL L.PATRICK LAN A.BOWLES Governor secretary TIMOTI M P.MURRAY ARLEEN O'DONNELL l ieutelant Governor Conmiasioner URGENT LEGAL MAIM:PROMPT ACTION NECESSARY February 22,2007 Wianno Club RE: BARNSTABLE-BWSC 107 Sea View Avenue 107 Sea View Avenue PO Box 249 RTN#9-20340 Osterville,MA 02655 N077CE OFRESPONSMUTY M.G.L c 21E,310 CMR 40.0000 ATTENTION:Jack Thompson On February 20, 2007 at 3:00 pm the Department of Environmental Protection ("MassDEP") received oral notification of a release and/or threat of release of oil and/or hazardous material at the above referenced property,which requires one or more response actions. Excavation activities associated with site i�rovement ruptured a relic abandoned Underground Storage Tank (UST), releasing a lighter end petroleum product into underlying site soils. The Massachusetts Oil and Hazardous Material Release Prevention and Response Act, M.G.L. c.21E, and the Massachusetts Contingency Plan(the "MCP"), 310 CUR 40.0000,require the performance of response actions to prevent harm to health,safety,public welfare and the environment which may result from this release and/or threat of release and govern the conduct of such actions. The purpose of this notice is to inform you of your legal responsibilities under State law for assessing and/or remediating the release at this property. For purposes of this Notice of Responsibility,the terms and phrases used herein shall have the meaning ascribed to such terms and phrases by the MCP unless the context clearly indicates otherwise. MassDEP has reason to believe that the release and/or threat of release which has been reported is or may be a disposal site as defined by the M.C.P. MassDEP also has reason to believe that you(as used in this letter, "you"refers to Wianno Club)are a Potentially Responsible Party(a"PRP")with liability under M.G.L. e.21E §5, for response action costs. This liability is "strict",meaning that it is not based on fault, but solely on your status as owner, operator, generator, transporter, disposer or other person specified in M.G.L. c.21E §5. This liability is also"joint and several',meaning that you may be liable for all response action costs incurred at a disposal site regardless of the existence of any other liable parties. M&Information Is avallable In alternate format Call Donald M.Comes,ADA Coordinator at 617,45&1067.TDD Service-l- O'.299.2207. DEP on the World Wlde Web: hfplAvww.ffaw.gov/dep PAnted on Recyded Paper J Feb. 26. 2007 9: 58AM MASS DEP No, 1735 P. 3/4 4 2 MassDEP encourages parties with liabilities under M.G.L. c.21E to take prompt and appropriate actions in response to releases and threats of release of oil and/or hazardous materials. By taking prompt action, you may significantly lower your assessment and cleanup costs and/or avoid liability for costs incurred by MassDEP in taking such actions. You may also avoid the imposition of, the amount of or reduce dertain permit and/or annual compliance assurance fees payable under 310 CMR 4.00. Please refer to M.G.L. c.21E for a complete description of potential liability, For your convenience, a summary of liability under M.GZ.c.21E is attached to this notice. You should be aware that you may have claims against third parties for damages,including claims for contribution or reimbursement for the costs of cleanup. Such claims do not exist indefinitely but are governed by laws which establish the time allowed for bringing litigation. MassDEP encourages you to take any action necessary to protect any such claims you may have against third parties. Upon coordination with the Licensed Site Professional (LSP)-cf-Record, the, the following response actions were approved as an Immediate Response Actions ORAs): • Continued assessment,to include assessment of groundwater,beach sediments and surface water. • Removal of additional relic USTs if discovered. • Excavation and disposal of up to twenty(20)cubic yards of contaminated soil. • All Remediation Waste must be properly stored/handled and disposed.of within 120 days from the date of generation per 310 CMR 40.0030. ACTIONS REOIARF Additional submittals are necessary with regard to this notification including,but not limited to,the filing of a written IRA Plan, IRA Completion Statement and/or a Response Action Outcome (RAO) statement. The MCP requires that a fee of$1,200 be submitted to MassDEP when an RAO statement Is tiled greater than 120 days from the date of initial notification. Specific approval is required from Mass= for the implementation of all IRAs pursuant to 310 CMR 40.0420 and 310 CMR 40.0443, respectively. Assessment activities,the construction of a fence and/or the posting of signs are actions that are exempt from this approval requirement. In addition to oral notification, 310 CMR 40.0333 requires that a completed Release Notification Form (BWSC-103, attached) be submitted to MassDEP within sixty(60) calendar days of February 20, 2007. You must employ or engage a Licensed Site Professional (LSP)to manage, supervise or actually perform the necessary response actions at this site. You may obtain a list of the names and addresses of these licensed professionals from the Board of Registration of Hazardous Waste Site Cleanup Professionals by calling(617)556-1091 or visiting http://www.statc,ma.us/I§R Unless otherwise provided by MassDEP, potentially responsible parties ("PRP's") have one year from the initial date of notification to MassDEP of a release or threat of a release,pursuant to 310 CMR 40.0300,or from the date MassDEP issues a Notice of Responsibility,whichever occurs earlier,to file with MassDEP one of the following submittals: (1) a completed Tier Classification Submittal; (2) an RAO Feb. 26. 2007' 9: 58AM MASS DEP No, 1735 P. 4/4 i 3 Statement or, if applicable, (3) a Downgradient Property Status. The deadline for either of the first two submittals for this disposal site is February 20,2008. If required by the MCP, a completed Tier I Permit Application must also accompany a Tier Classification Submittal. This site shall not be deemed to have had all the necessary and required response actions taken unless and until all substantial hazards presented by the release and/or threat of release have been eliminated and a level of No Significant Risk exists or has been achieved in compliance with M.G.L. c.21E and the MCP. If you have any questions relative to this Notice, please contact Robert Murphy at the letterhead address or at (508) 771-6088. All future communications regarding this release must reference the following Release Tracking Number:4.20340. Very ytruly yours, Dan Grafton,Act4g ' Emergency Response/Release Notification Section C/RCM/re P'M RTNSW20340 Ostem7le-107 Sea View Avenu$4-20340NORdoc Attachments: Release Notification Form;BWSC-103 and Instructions Summary of Liability under M.G.L.e.21E MassDEP's guide to hiring a Licensed Site Professional. fc: Board of Health Board of Selectmen Fire Dept i 02/Y6/2007 12:11 FAX 508 790 6226 TOWN MANAGER HEALTH 11 001 Feb. 26. 2007 10; IOAM MASS DEP No. 1735 P. 1/4 ILI COMMONWEALTH OF MASSACHUSETTS Fmcu= OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION SOUTHEAST REGIONAL OFFICE U9 20 Riverside Drive, Lakeville,MA 02347 608 946-2700 DEVAL L PATRICK LAN A.BOWLEG Qovernor Se�'etery TIMOnU P.A UTRRAY ARLEEN ODONNELL Lieutenant Governor Commissioner r FAX COVER SHEET FAX # (508) 946-2865 TELEPHONE # (508) 946-2851 I DATE: February 26, 2007 FROM: Roberta Edwarda PLEASE DELIVER TO1 Barnstable Board of Health 508 790 6304 Barnstable Town Manager 508 790 6226 i TOTAL NUMBER OF PAGES: 4 (INCLUDING COVER PAGE) PLEASE CALL IF YOU DO NOT RECEIVE COMPLETE FAX. Notice of Responsibility, Nianno Club n1 .< L CD t Q0 U- s .. I 1 i r TWa Snformadon to avaihble io alterlute formot.Call DOoald M.Gomee.ADA Coordinstar at 617.5561057.TDD Service-1-8Ob299-2207. DEP on the Waft Wide Web: http:/Aww,Mava,govldep Printed on Recycled Paper 02i`26/2007 12:12 FAX 508 790 6226 TOWN MANAGER HEALTH 0 002 Feb. 26, 2007 10: 10AM MASS DEP No. 1735 P. 2/4 0-71? r l Y COMMONWEALTH OF MASSACHUSETTS OEM EXECUTIVE OFFICE OF ENVIRONMENTAL AF DEPARTMENT OF ENVIRONMENTAL PRO SOUTHEAST REGIONAL OFFICE . 20 RIVERSIDE DRIVE, LAKEVILLE, MA 08347 508-948- DEVAL L.PATIaCK IAN A.BOODLES Governor _ Secretary TIMOTHY F.MURRAY ARLEEN aDONNELL Lieutenant Governor Commiasioner URGENT Y.EGA�MATTER:PROMPT ACTION NECESSARY February 22,2007 _D Winrmo Club RE: BARNSTABLE-BWSC 107 Sea View Avenue 107 Sea View Avenue PO Box 249 RTN#4-20340 Osterville,MA 02655 NOTICE OF RESPON5ISIL17'Y M.G.L c.21E,310 CW 40.0000 ATTENTION:Jack Thonpsm On February 20, 2007 at 3:00 pm the Department of Environmental Protection ("MassDEP") received oral notification of a release and/or threat of release of oil and/or hazardous material at the above referenced property,which requires one or more response actions. Excavation activities associated with site unprrovement ruptured a relic abandoned Underground Storage Tank (UST), releasing a lighter end Petroleum product into underlying site soils, The Massachusetts Oil and Hazardous Material Release Prevention and Response Act, M.G.L. c.21E, and the Massachusetts Contingency Plan(the "MCP'D, 310 CMR 40.0000,require the performance of response actions to prevent harm to health,safety,public welfare and the environment wbich may result from this release and/or threat of release and govern the conduct of such actions. The purpose:of this notice is to inform you of your legal responsibilities under State law for assessing and/or reemediatirtg the release at c this property. For purposes of this Notice of Responsibility, the two and phrases used herein shall--have the meaning ascribed to such terms and phrases by the MCP unless the context clearly indicates otherwise. MassDEP has reason to believe that the release and/or threat of release which has been reparted is or may be a disposal site as defined by the M.C.P. MassDEP also has reason to believe that you(as used in this letter, "you"refers to Wiaaao Club) area Potentially Responsible Party(a"PRP")with liability under 3 M.G.L. c.21E §5, for response action costs. This liability is"strict",meaning that it is not based ontfault, but solely on your status as owner, operator, generator, transporter, disposer or other pens specified in M.G.L. c.21E §5. This liability is also"joint and several",meaning that you.may be liabla f all response action costs incurred at a disposal site regardless of the existence of any Other,liable parties. rbls Int'ormatlan Is avalbble in aitaraats tbrmat.Call Donald M.Comm,ADA Coordiaatar at 617Sb67067.TOD SeMce.]4800-396.2207. DEP on the Wodd Wide Web: http:/A w.rmsa.gov/dap Printed on Recycled paper 02/26/2007 12:12 FAX 508 790 6226 TOWN MANAGER HEALTH Q 003 Feb. 26. 2007 10: 10AM MASS DEP No, 1735 P. 3/4 2 MassDEP encourages parties with liabilities under M.G.L. c.21E to take prompt and appropriate actions in response to releases and threats of release of oil and/or hazardous materials. By taking prompt action, you may significantly lower your assessment and cleanup costs and/or avoid liability for costs incurred by MassDEP in taking such actions. You may also avoid the imposition of, the amount of or reduce certain permit and/or aamual.compliance assurance fees payable under 310 CMR 4,00. Please refer p �P to M.G.L. c.21E for a complete description of potential liability. For your convenience, a summary of liability tinder M.G.L.c.21E is attached to this notice. You should be aware that you may have claims against third parties for damages,including claims for contribution or reimbursement for the costs of cleanup. Such claims do not exist indefinitely but are governed by laws which establish the time allowed for bringing litigation. MassDEP encourages you to take any action necessary to protect any such claims you may have against third parties. Upon coordination with the Licensed Site Professional (LSP)-of-Record, the, the. following response actions were approved as an Immediate Response Actions Tw): • Continued assessment,to include assessment of groundwater,beach sediments and surface water. • Removal of additional relic USTs if discovered.. • Excavation and disposal of up to twenty(20)cubic yards of contaminated soil. • All Rsmediation Waste must be properly stored/handled and disposed•of within 120 days from the date of generation per 310 CMR 40.0030, ACTIONS REQIMM Additional submittals are necessary with regard to this notification including,but not limited to,the filing of a written IRA Plan, IRA Completion Statement and/or a Response Action Outcome (RAO) statement. The MCP requires that a fee of S1400 be submitted to MassDEP when an RAO statement is filed greater than 120 days from the date of initial notMention. Specific approval is required from MassDEP for the implementation of all IRAs pursuant to 310 CMR 40.0420 and 310 C1VM 40.0443, respectively. Assessment activities,the cans1auction of a fence and/or the posting of signs are actions that are exempt from this approval requi rw=t, In addition to oral notification, 310 CMR 40.0333 requires that a completed Release Notification Form (BWSC-103, attached) be submitted to MassDEP within sixty (60) calendar days of February 20, 2007. You must employ or engage a Licensed Site Professional (LSP)to manage, supervise or actually perform the necessary response actions at this site. You may obtain a list of the names and addresses of these licensed professionals from the Board of Registration of Hazardous Waste Site Cleanup Professionals by calling(617)556-1091 or visiting http://www.state.ma.usAsp. Unless otherwise provided by MassDEP, potentially responsible parties ("PRP's") have one year from the initial date of notification to MassDEP of a release or threat of a release,pursuant to 310 CMR 40.0300,or from the date MassDEP issues a Notice of Responsibility,whichever occurs earlier,to file with MassDEP one of the following submittals: (1) a completed Tier Classification Submittal; (2) an RAO r 0.2,426/2007 12:12 FAX 508 790 6226 TOWN MANAGER HEALTH 2004 Feb, 26. 2007 10: 10AM MASS DEP No. 1735 P. 4/4 3 Statement or, if applicable, (3) a Downgradient Property Status. The deadline for either of the feat two submittals for this disposal site is February 20,2008. If required by the MCP, a completed Tier I Permit Application must also accompany a Tier Classification Submittal. This site shall not be deemed to have had all the necessary and required response actions taken unless and until all substantial hazards presented by the release and/or tlaeat of release have been eliminated and a level of No Significant Risk exists or has been achieved in compliance with M.G.L. 0.21E and the MCP. If you have any questions relative to this Notice,please contact Robert Murphy at the letterhead address or at (508) 771.6088. All future conmiunications regarding this release must reference the following Release Tracking Number:4-20340. 'Very truly yours, Dan Crafton,Acting 'ef Emergency Response/Release Notification Section C/RCM/re PAER RTNSw20340 OstrYf'lla-107 Sea Yew Avenu*4-20340 NORdoc Attachments: Release Notification Form;BWSC-103 and Instructions Summary of Liability under M.G.L.e.21E MassDEP's guide to hiring a Licensed Site Professional. fc: Board of Health Board of Selectmen. Fire Dept i i m 3 T, 0 Fj 7/.Y0 N i i COMM FIRE DEPARTMENT F A 4-�l `110, 5 0 C-1,9F-i 2-�6 F) all" j Z I-Aake application to local Fire Department. k-1 I Fire Department retains original application and issues duplicate as Permit. 2 5 ur)04 j V11 9'it I e"t W,4 le Lit alah"was fq dAta*ollea V A 1APPLI(C"ATIOIN' and PERMIT for storage tank removal and transportation to approved tank disposal yard in accordance vvith the provisions of M.G.L. Chapter 148, Section 383A, 527 CMR 9.00, application is hereby made by: Tank Owner Name ,please pdnt) 'Wia-nxio C-lub ---- X 107 Seaview Avenue, Osterville, Ma Acdress _12 6 City Slate Company Name En jro--Sape Corr- Co.or lidividual U as D - ari j Sebastian rive Address 14F, Address-3 _4 Pr*n san5wich, MA &,nalue(If' "Applying foe permit) 'Yng f Signature(if, I- Wiled 0!— Tank Location --1-07.—SeuAaw Ay city Ta*Capacity(gallons) 271L_UST Substance Last Stored _4AM1C--E- TaLik Dimensions(diameter x Remarks: A A r, Firm transporting waste_Env iro-Saf e Ccro- State,Uc.It NA029 C37 Hazardous waste manifesi# E.P.A.0 DIA 0000161 0.ppro,4cd tank disposal yard Turner, Iric. Tank yard# Type of inert gas c t t��Crg,�L, MA Lf-0 __C Tank yard address _La 1 City AFRr Town —(3--eLuxyi e FDID# 01920 PermitV Data of issue May 4-j--200—7 ____ Date nf expiration -2i--Y-1-1-1-2 Dig safe approval number: Safe Toli Free Tel.Number-$00-322-46-441 Signature 'Title of Offleer graniln.9 Permit ........... After removal(s)("Consumptive Use"fuel oil tanks exempted)send Form VP-290 signer bye Local Fire Dapf.nUSI'Regulatory Compliance Unli,Department of Fire Services,P.O.Box 1025,State Road,Stow,NA 01778. —14riternatiorial-Fire-C 0deJt-'1stftUte-- �i ,77 F►nd MapParcei 162024 ► y Town of BarnsTOW table Mealtnmpepartment Health System �r _ $ � % ' MaIPa�Ceh� 4 162024 > .< � Tank Nbr 4 Tag Nbr ;0 Instable Locat►on B iv , Nest tJoUficat►on Date Status ; ; Removal Not►ficaton 47 Date Nest Abandon ✓ a 05/04/2007 FueiSto e'd t G lei StorageReason Capac►ty 0g, Leak D54 �etect►on f Cathod►cDeect►on lk MITI No leaks A i ;I i CENTERVILLE-OSTERVILLE-1N1ARSTONS MILLS FIRE '.DISTRICT 1875 ROUTE 28 ' CENTERVILLE, MA 02632 (509)790-2380/FAX##(508)790-2385 k OILIHAZ ARDOUS MATERIAL RELEASE FORM f F.A.## LOCATION: ADDRESS OF RELEASE:_��--# DATE OF RELEASE: � PRODUCT RELEASED: ESTIMATED QUANTITY: CORRECTIVE ACTION TAKEN B`-RESP R(SfBLE PARTY: �� �. r �r r� f NOTIFICATIONS: FIRE DEPARTMENT: YES( () NO( ) DATE:r -;� TIME: 4 ,s� NATIONAL RESPONSE CENTER YES( ) NO( ) DATE: TIME. DEPT.OF ENVIRONMENTAL PROTECTION Yg(X) NO( } DATE: IME* OIL SPILL COORDINATOR: YES( ) NO( } DATE: t -' : —1 j TOWN BOARD OF HEALTH: YES( ) NO( DATE: ^�1"7'4�..��- TIME r . X, M ' TOWN HARBORMASTER: YEN NO( ) DATE: TIME OTHER AGENCIES: X � _'Q + COMMENTS:_ 1 %- --+?Yw'E+04; u _ y- . ` VI 14� 4. PTIP9 LJ .. 1 ` REPORTED BY: ���a+! DATE: .. ., i 1 , WHITE COPY-FIRE DEPARTMENT YELLOW COPY-Q.E.P. PINK COPY-BOARD OF HEALTH I C-O-MM FORM#58 i I f I A MM DD yyyy Delete NFIRS -1 101920 I U 1 02 1 1 201 1 2007 11 I07-0000486 I 1 000 Change Basic FDID State Incident Date Station Incident Number Exposure * ❑No Activity Check =his box to Indicate that the address for this incident is provided on the Wildland Fire Census Tract I BLocation* Module In Section B "Alternative Location Specification". Use only for Wildland fires. ®Street address 107 U I SEA VIEW AV I U U ❑Intersection Number/Mile ost Prefix P Street or Highway Street Type Suffix ❑In front of U ❑Rear of .I OSTERVILLE I IMA 1 102655 -1 � Apt./Suite%Room City State Zip Code [:]Adjacent to I I ❑Directions Cross street or directions, as applicable Incident e * Midnight is 0000 C Type El Date & Times E2 Shift & Alarms 422 (Chemical spill or leak I Check boxes if Month Day Year Hr Min Sec Local option dates are the Incident Type same as Alarm ABM always required 14 Date. 02 20 2007 13:59:01 �J COM23 D Aid Given or Received* Alarm * �� �� ��I I Shift or Alarms District Platoon ARRIVAL required, unless canceled or did not arrive 1 ❑Mutual aid received U ❑ Arrival 1 021 J 201 120071 I14:05:53 E3 2 [:]Automatic aid recv. Their FDID Their 3 ❑Mutual aid given State CONTROLLED Optional, Except for wildland fires Special Studies 4 ❑Automatic aid given I I ❑Controlled " I—J I I I I Local option 5 ❑Other aid given Their LAST UNIT CLEARED, required except for wildland fires I I Incident Number Last Unit Special Special J N ONone ) (19) I �(lI �2� 16I 22.51 I Study ID# Study Value ❑ Cleared I _-1 1 --I F Actions Taken * G1 Resources ,k G2 Estimated Dollar Losses & Values :Check this box and skip this LOSSES: Required for all fires if known. Optional section-if an Apparatus or for non fires. 42 IHaZMat detection, I Personnel form is used. None Primary Action Taken (1) Apparatus Personnel Property $1 Id 000 , 0001El 80 (Information, Suppression] �� Contents $1 000 , 000 ElI Additional .action Taken (2) EMS I PRE-INCIDENT VALUE: Optional 84 IRefer to proper I Other 0004 I 0005 Property $1 000 1 000 El Action Taken (3) ❑ Check box if resource counts I include aid received resources. Contents $1 J , 000 , 000 ❑ Completed Modules Hl*Casualties❑None H 3 Hazardous Materials Release I Mixed Use Property ❑Fire-2 Deaths Injuries N ❑None NN Not Mixed Structure-3 Fire ' I 10 Assembly use ❑ ❑ I� I ) 1 Natural Gas: ale,.leak, no e..avacien or xaaaat actions 20 Education use []Civil Fire Cas.-4 Service U Medical use 2 ❑Propane gas: <n 16. tank can in home saQ grill) 33 ❑Fire Serv. Cas.-5 1 1� []Gasoline: vehicle feel tank table container 40 Residential use civilian 3 0=Pc= ❑EMS-6 4 ❑Kerosene: fuel burning equipment or portable storage 51 Row of stores H2 Detector 53 Enclosed mall []HazMat-7 Required for Confined Fires. 5 ❑Diesel fuel/fuel oil:vehinle fuel tank or portable 58 Bus. & Residential ❑Wildland Fire-8 6 [_]Household solvents: home/office spill, cleanup only 59 Office use 1 ODetector alerted occupants Apparatus-9 7 ❑Motor oil: from engine or portable container 60 Industrial use oPersonnel-10 2[]Detector did not alert them 8 ❑Paint• from paint cans totaling< 55 gallons 63 Military use ❑Arson-11Other:� 65 Farm use U❑Unknown 0 ❑ special xazMat actions required or spill >55ga1., 00 Other mixed use Please a lete the NazMat form J Property Use* Structures 341❑Clinic,clinic type infirmary 539 ❑Household goods,sales,repairs 342❑Doctor/dentist office 579 ❑Motor vehicle/boat sales/repair 131 []Church, place of worship 361[]Prison or jail, not juvenile 571 ❑Gas or service station 161 ❑Restaurant or cafeteria 419[]l-or 2-family dwelling 599 [] Business office 162 ❑Bar/Tavern or nightclub 42 9❑Multi-family dwelling 615 [-]Electric generating plant 213 []Elementary school or kindergarten 43 9❑Rooming/boarding house 629 ❑Laboratory/science lab 215 ❑High school or junior high 449®Commercial hotel or motel 700 ❑Manufacturing plant 241 ❑College, adult education 45 9❑Residential, board and care 819 []Livestock/poultry storage(barn) 311 ❑Care facility for the aged 464❑Dormitory/barracks 882 []Non-residential parking garage 331 ❑Hospital 519❑Food and beverage sales 891 ❑Warehouse Outside 93 6❑vacant lot 981 ❑Construction site 124 ❑Playground or park 938 []Graded/care for plot of land 984 ❑ Industrial plant yard 655 ❑Crops or orchard 946 []Lake, river, stream 669 Forest (timberland) Lookup and enter a Property Use code only if ❑ 951 ❑Railroad right of way you have NOT checked a Property Use box: 807 ❑Outdoor storage area 960 ❑Other street Property Use 144 9 919 []Dump or sanitary landfill 961 []Highway/divided highway 931 ❑Open land or field 962 []Residential street/driveway (Hotel/motel, commercial I NFIRS-1 Revision 03 11 99 COMM Fire District 01920 02/20/2007 07-0000486 R1 Person/Entity Involved Local Cption Business name (if applicable) I I Area Code Phone Number ❑Check This Box if U I I U I I U same address as Mr.,Ms., Mrs. First Name MI Last Name Suffix incident location. Then skip the three duplicate address Number lines. Prefix Street or Highway Street Type Suffix. Post Office Box Apt./Suite/Room City U I I-I State Zip Code More people involved? Check this box and attach Supplemental Forms (NFIRS-lS) as necessary �2 Owner Same as person involved? Then check this box and skip The rest of this section. u u u Local Option Business name (if Applicable) Area Code Phone Number ul Iu1 Iu Check this tox if Mr.,Ms., Mrs. First Name MI Last Name Suffix same address as incident location. I I U I I U u Then skip the three duplicate address Number Prefix Street or Highway Street Type Suffix lines. I U I I Post Office Box Apt./Suite/Room City UI I I State Zip Code i L Remarks Local Option Caller Name : 328 OIC : RODGER Pats. 0 lmotte 2007/02/20 14:05:53 - 306 AT EVENT MANNING IS 2 lmotte 2007/02/20 14:05:56 - 321 AT EVENT MANNING IS 1 lmotte 2007/02/20 14:06:07 - 328 AT EVENT MANNING IS 1 lmotte 2007/02/20 14:04:50 REQUESTING A TIER 1 RESPONS lmotte ; 2007/02/20 14 :05:45 ONE ENGN AND 321 HOLD ENG IN QTRS lmotte ; 2007/02/20 14 : 17:08 CAPT. RODGERS HAS COMMAND lmotte ; 2007/02/20 14 :28:12 CAPT KELLE,R ON LOCATION lmotte ; 2007/02/20 14:28:45 BOB MURPHY ENROUTE MASS DEP FROM HYANNIS lmotte ; 2007/02/20 14:31:31 BOARD OF HEALTH ONLOCATION L Authorization 18390 I I ROGERS, D. BRADY I (CAPT 1 1 I OJ 120 I 2007 Officer in charge ID Signature Position or rank Assignment Month Day Year Bozcif 1 838- 1 1 PULSIFER, FRANCIS I I FIRE PREV. I I I �� I 1 20071 same Position or rank Assignment Month Day Year as Officer Member making report ID Signature in charge. COMM Fire District 01920 02/20/2007 07-0000486 __J I MM DD YYYY 01920 U 1 2 1 20 2007 07-0000486 000 Complete FDID State Incidert Date Station Incident Number Exposure Narrative Narrative: Caller Name : 328 OIC : RODGER Pats. 0 lmotte 2007/02/20 14 :05:53 - 306 AT EVENT MANNING IS 2 lmotte 2007/02/20 14:05:56 - 321 AT EVENT MANNING IS 1 lmotte 2007/02/20 14:06:07 - 328 AT EVENT MANNING IS 1 lmotte 2007/02/20 14 :04 :50 REQUESTING A TIER 1 RESPONS lmotte ; 2007/02/20 14:05:45 ONE ENGN AND 321 HOLD ENG IN QTRS lmotte ; 2007/02/20 14 :17:08 CAPT. RODGERS HAS COMMAND lmotte ; 2007/02/20 14:28: 12 CAPT KELLER ON LOCATION lmotte ; 2007/02/20 14 :28:45 BOB MURPHY ENROUTE MASS DEP FROM HYANNIS lmotte ; .2007/02/20 14 :31:31 BOARD OF HEALTH ONLOCATION lmotte ; 2007/02/20 14 :32:17 COMMAND TO RETURN CALL TO MEMA 508-687-3600 lmotte ; 2007/02/20 14 :45:52 CAPT KELLHER TO CANCELL HAZ MAT RESPONES lmotte 2007/02/20 14 :55:55 COMMAND TERMINATTED 321 E-306 TO QTRS. lmotte 2007/02/20 14 :57:14 FPO PULSIFER TO HAVE THE REPORT lmotte ; 2007/02/20 15:06:20 MASS DEP ONLOCATION lmotte ; 2007/02/20 15:43:57 DEP AND BOH HAVE THE SENCE Recieved call from Gordon Smith, Maintenance Supervisor for the Wianno Club complex 508-367-44.94, stating he had encountered what appears to be an underground storage container during excavation for expansion at 107 Sea View Avenue, Osterville. Responded in 328 and arrived w/b incident to find Gordon Smith with other contractors in the excavated area. Gordon Smith advised that while excavating the area on the "B" side of the structure, the excavator punctured a tank under the ground and the area now has a "gasoline" smell. The excavating contractor is George Botelho, Inc; 508-548-951 (w) and 508-509-8361 (c) . The operator, George Botelho immediately removed the excavator from the area and shut the machine down. I inquired if the site had an active dig safe approval number and the contractors answered in the affirmative. Dig safe approval # 2007-0301531. I investigated the site to find the remains of what appeared to be a copper lined tank, surrounded by 1X lumber and burlap. Tne tank is located on the B/C corner of the structure approximately 30 feet East of COMM Fire District 01920 02/20/2007 07-0000486 ` MM DD YYYY 01920 U 1 2 1 20 2007 07-0000486 000 Complete FDID State Inciden= Date Station Incident Number Exposure Narrative Narrative: the building. The top portion and most of the West wall of the tank was completely destroyed by the excavator. There appeared to be a small amount of standing product at the bottom of the tank with questionable petroleum odor in the air. None of the contractors on site in direct proximity of the .tank exibited medical distress. I called dispatch to initiate an incident response for a hazmat release with unknown product and requested dispatch notify Barnstable County for a Tier I hazmat response. All openings to the Wianno Club on sides B and C were secured to prevent odor/gas from entering the building. All personnel were ordered to evacuate the excavation area and all ignition sources were eliminated from the immediate area. Advised dispatch to notify the Town of Barnstable Board of Health for response and requested weather information. From dispatch in Centerville, skies sunny and clear, 45 deg.F, winds from the West at 10 - 19 mph. Established safe area at 100 ft North of the incident at Sea View Avenue. Captain Rogers in 321 arrived on scene. Conducted a face to face briefing with Capt. Rogers and advised him of the incident, and actions/ notifications to date. Capt. Rogers assumed command post briefing. Crew of 306 with metering using the department 4 gas meter TMX 412 with readings of 02 @ 20. 6% and LEL @ 4% directly over the tank. Using extended reach equipment, obtained a LEL reading of 60% inside the tank approximately 6 inches from the bottom of the tank. The meter is calibrated by Pentane and conversion chart shows 0.8 as conversion factor for ethanol. Captain Bob Kelleher 508-398-2212 from Yarmouth FD responding to the Tier I request arrived on scene. . Capt. Kelleher was briefed of the incident and actions to date. Capt. Kelleher investigated the area and made the determination that with the information available, the tank is possibly 80-100 years old and the product is a petroleum base. Capt. Kelleher advised that it does not appear that there is an extreme risk of fire, explosion or health hazard present and advised to continue response from agencies concurrent with UST release protocol. Captain Kelleher cancelled the rest of the Tier I response after consultation with Captian Rogers and myself. Town of Barnstable Board of Health agent Donna Miorandi 508-862-4644 arrived on scene. Inspector Miorandi was briefed of the incident and response actions to date. She contacted the Department of Environmental Protection for a response. DEP advised and responding from Hyannis. Pictures taken by FPO Pulsifer. Additional site and tank information: tank size is approximate at 200 gallons located approximately 30 ft East of the structure, approximately 30 ft above sea level, and approximately 100 - 120 ft North of the water line for the Atlantic Ocean. The visible soil around the tank does not appear to be significantly wet although container breach to the environment with product release is very probable. No estimation as to amount of product in the tank at the time of the breach. There were no visible characteristics relative to fill and vent piping that we could establish. Contractors report seeing piping running from East to West from the area of the tank toward the building with unknown termination. Piping was excavated and removed prior to this incident. Massachusetts DEP Environmental Analyst Robert Murphy 508-771-6088 arrived on scene. Briefed Mr. Murphy of the incident and actions to date. Introduced Mr. Murphy to all parties present as well as Mr. Jack Thomson, General Manager from the Wianno Club 508-428-6981. Mr. Murphy investigated the site and made the determination on response actions, notifications, and removal information. He discussed this information with Gordon Smith and Jack Thomson. At the same time, Gordon Smith was in contact with Envirosafe to scedule LSP and removal contractors. Envirosafe to respond at approximately 07:00 hours on 02-21-07 to initiate sampling and removal. Mr. Murphy was questioned relative to securing the tank from the environment. Mr. Murphy stated that it would be sufficient to cover with tarps until morning. Contractors on site covered the tank area with tarps. I also advised Gordon Smith to leave the fire line tape in place to deter unwanted entry to the area. COMM Fire District 01920 02/20/2007 07-0000486 MM DD YYYY 1 01920 U 1 2 1 1201 1 2007 1 07-0000486 1 000 Complete FDID State Incident Date Station Incident Number Exposure Narrative Narrative: Scene was turned over to the Town of Barnstable Board of Health and Massachusetts Department of Environmental Protection for release actions. Advised Gordon Smith of the permit process and follow up actions with the fire department relative to UST removal. All units cleared w/o further incident. 02-21-07 I recieved a call from Craig Sasse Senior Environmental Engineer with Envirosafe. Mr. Sasse stated that he is coordinating the removal efforts for the project at 107 Sea View Avenue in Osterville. I briefed Mr. Sasse of the incident and furnished all information I had available relative to the tank and response. Mr. Sasse has been in contact with DEP and recieved approval for removal and sampling of the tank and area. Mr. Sasse estimates the tank size at nearly 500 gallons and stated that initial readings at the site indicate a petroleum product but further lab sampling would be required to determine if any other chemicals were present. I advised Mr. Sasse of the permit requirements and stated that I needed tc be notified prior to the tank removal for documentation purposes. Mr. Sasse will be in to obtain removal permit from the FD. 02/21/2007 09:27:46 fpulsifer i I COMM Fire District 01920 02/20/2007 07-0000486 A MM DD yyyy ❑Delete NFIRS -1 019L0 U 02 1 1 201 1 2007 11 I I07-0000486 I1 000 ❑Change Basic FDIU * State* Incident Date * Station Incident Number * Exposure ❑No Activity Check this box to Indicate that the address for this incident is provided on the wildland Fire Census Tract I I BLocation* Module :n Section B "Alternative Location specification". Use only for wildland fires. ®street address 107 " I SEA VIEW AV Intersection Number/Milepost Prefix Street or Highway �,� Street Type Suffix �In front of I IOSTERVILLE I IMA 1 02655 Rear of Apt./Suite/F.00m City State Zip Code F�Adja=ent to I I Dire=tions Cross street or directions, as anolicable Midnight is 0000 Shift & Alarms C Incident Type �r El Date & Times E2 422 (Chemical spill or leak I Chet): boxes if Month Day Year Hr Min Sec Local Option dates are the Incident Type same as Alarm ALARM always required 14 I COM2 3 Alarm * 02 20 2007 I13:59:01 I U Aid Given or Received* Gate. shift or Alarms District D Platoon ARRIVAL required, unless canceled or did not arrive 1 nmutual aid received I 1 I O Arrival 1 021 1 201 120071 I14: 05:53 I E3 2 nAutomatic aid recv. Their FDFDID Their State CONTROLLED Optional, Except for wildland fires Special Studies 3 ❑Mutual aid given. I 4 n Automatic aid given ❑Controlled " U 11I I Local option 5 ❑Other a_d given Their LAST UNIT CLEARED, required except for w�ildland fires N ONone Incident Number ❑ LClearedast t L_02 1(nlIJ 1 007 i I16 222:51 I Studya ta uIDfi Study Value F Actions Taken* Gl Resources * G2 Estimated Dollar Losses & Values ❑ Check this box, and skip this LOSSES: Required for all fires if known. Optional section if an Apparatus or for non fires. 42 IHazMat detection, I Personnel form is used. None Apparatus Personnel Property $1 , 1 000 ,1 000 ❑ Primary Action Taken (1) f Suppression L�—� �� Contents $1 000 ,1 000 ❑ B0 (Information, I EMS �J PRE-INCIDENT VALUE: optional Additional Action Taken (2) 84 IF:efer to proper Other 0004 Property $U ' U000 � 000 El Additional Action Taken (3) ❑ Check box if resource counts include aid received resources. Contents $1 000 ,L 000 ❑ Completed Modules H1*Casual ties❑None H3 Hazardous Materials Release I Mixed Use Property Fire-2 Deaths Injuries N None NN Not Mixed 10 Assembly use ❑structure-3 Fire U , I 1 ❑Natural Gas: slow leak, no evavation or Hamat actions 20 Education use Service U Medical use ❑Civil Fire Cas.-4 2 ❑Propane gas: <u lb. tank (as in home aBQ grill) 33 ❑Fire Serv. Cas.-5 3 ❑Gasoline: vehicle fuel tank or portable container 40 Residential use Civilian ❑EMS-5 . 51 Row of stores 4 ❑Kerosene: fuel burning equipment or portable storage Detector 53 Enclosed mall ❑HazMat-7 Required for Confined Fires. 5 ❑Diesel fuel/fuel oil:vehicle fuel tank or portable 58 Bus. & Residential ❑ [—]Detector alerted occupants Wildland Fire-8 6 Household solvents: home/office spill, cleanup only 59 Office use 1 Industrial use OApparatus-9 7 []Motor oil: from engine or portable container 60 2 Detector did not alert them 63 Farm Military use OPersonnel-10 ❑ $ OPaint: from paint cans totaling< ss gallons 65 Farm use Arson-11 p Unknown 0 ❑Other: special HazMat actions required or spill > ssgal., 00 Other mixed use Pleas late the HazMat form J Property Use* Structures 341❑Clinic,clinic type infirmary 539 ❑Household goods,sales,repairs 342❑Doctor/dentist office 579 ❑Motor vehicle/boat sales/repair 131 ❑Church, place of worship 3 61❑Prison or jail, not juvenile 571 ❑Gas or service station 161 ❑Restaurant or cafeteria 41 9❑1-or 2-family dwelling 599 ❑ Business office 162 ❑Bar/Tav=-rn or nightclub 42 9❑Multi-family dwelling 615 ❑Electric generating plant 213 ❑Elementary school or kindergarten 43 9❑Rooming/boarding house 629 ❑Laboratory/science lab 215 High school or junior high 4 4 9®Commercial hotel or motel 700 [:]Manufacturing plant 241 ❑College, adult education 4 5 9❑Residential, board and care 819 ❑Livestock/poultry storage(barn) 311 ❑Care facility for the aged 4 64❑Dormitory/barracks 882 ❑Non-residential parking garage 331Hospital 519❑Food and beverage sales 891 ❑Warehouse Outside 93 6❑Vacant lot 981 [:] Construction site 124 ❑Playground or park 938 OGraded/care for plot of land 984 ❑ Industrial plant yard 655 Crops or orchard 946 ❑Lake, river, stream Lookup and enter a Property Use code only if 669 ❑Forest (timberland) 951 ❑Railroad right of way you have NOT checked a Property Use box: 807 ❑Outdoor storage area 960 ❑Other street Property Use 1449 919 ❑Dump or sanitary landfill 961 Highway/divided highway 931 Open land or field 962 []Residential street/driveway (Hotel/motel, commercial NFIRS-1 Revision 03 11 99 01920 02/20/2007 07-0000A86 K1 `Person/Entity Involved Local Option Business name (if applicable) Area Code Phone Number OCheck This box. if Mr�rs First Name MI Last Name Suffix same address as incident location. I I I ) Then skip the three duplicate address Number Prefix Street or Highway Street Type Suffix lines. I I U I I Post Office Box Apt./Suite/Room City U UU-U State Zip Code More people involved? Check this box and attach Supplemental Forms (NFIRS-IS) as necessary K2 owner Same as person involved? Then check this box and skip The rest of this section. Local Option Business name (if Applicable) Area Code Phone Number � � IUI IU Check this box if Mr.,Ms., Mrs. Fi=st Name MI Last Name Suffix same address as incident location. Then skip the three duplicate address Number Prefix Street or Highway Street Type Suffix lines. I I I I I I Post Office Box Apt./Suite/Room City " IU-J-I State Zip Code L Remarks Local Option Caller Name : 328 OIC : RODGER Pats. 0 lmotte 2007/02/20 14 :05:53 - 306 AT EVENT MANNING IS 2 lmotte 2007/02/20 14 : 05:56 - 321 AT EVENT MANNING IS 1 lmotte 2007/02/20 14 :06:07 - 328 AT EVENT MANNING IS 1 lmotte 2007/02/20 14 :04: 50 REQUESTING A TIER 1 RESPONS lmotte ; 2007/02/20 14 :05:45 ONE ENGN AND 321 HOLD ENG IN QTRS lmotte ; 2007/02/20 14: 17:08 CAPT. RODGERS HAS COMMAND lmotte ; 2007/02/20 14 :28: 12 CAPT KELLER ON LOCATION lmotte ; 2007/02/20 14 :28:45 BOB MURPHY ENROUTE MASS DEP FROM HYANNIS lmotte ; 2007/02/20 14 :31:31 BOARD OF HEALTH ONLOCATION L Authorization 1 8390 I I ROGERS, D. BRADY I ICAPT I I I U 1 LLOJ 2007 Officer in charge ID Signature Position or rant: Assignment Month Day Year Check 18381 I I PULSIFER, FRANCIS I I FIRE PREY. I I 1 I 021 I� I 2007 Bor. if same Position or ran): - Assignment Month Day Year as Officer Member malting report ID Signature in charge. COMM Fire District 01920 02/20/2007 07-0000486 MM DD YYYY 01 20 U L� 20 2007 1 1 1 1 07-0000486 000 complete f FDID X State* Incident Date * Station Incident Number * Exposure * Narrative i Narrative: Caller Name 328 OIC : RODGER Pats. : 0 lmotte 2007/02/20 14 :05:53 - 306 AT EVENT MANNING IS 2 lmotte 2007/02/20 14: 05:56 - 321 AT EVENT MANNING IS 1 lmotte 2007/02/20 14 : 06:07 - 328 AT EVENT MANNING IS 1 lmotte 2007/02/20 14 :04 :50 REQUESTING A TIER 1 RESPONS lmotte ; 2007/02/20 14 :05:45 ONE ENGN AND 321 HOLD ENG IN QTRS lmotte ; 2007/02/20 14 : 17:08 CAPT. RODGERS HAS COMMAND lmotte ; .2007/02/20 14 :28:12 CAPT KELLER ON LOCATION lmotte ; 2007/02/20 14:28:45 BOB MURPHY ENROUTE MASS DEP FROM HYANNIS lmotte ; 2007/02/20 14 : 31:31 BOARD OF HEALTH ONLOCATION lmotte 2007/02/20 14 :32:17 COMMAND TO RETURN CALL TO MEMA 508-687-3600 lmotte 2007/02/20 14 : 45:52 CAPT KELLE.ER TO CANCELL HAZ MAT RESPONES lmotte 2007/02/20 14 :55:55 COMMAND TERMINATTED 32.1 E-306 TO QTRS. lmotte 2007/02/20 14 :57:14 FPO PULSIFER TO HAVE THE REPORT lmotte ; 2307/02/20 15:06:20 MASS DEP O-NLOCATION lmotte ; 2007/02/20 15:43:57 DEP AND BOH HAVE THE SENCE Recieved call from Gordon Smith, Maintenance Supervisor for the Wianno Club complex 508-367-4494, stating he had encountered what appears to be an underground storage container during excavation for expansion at 107 Sea View Avenue, Osterville. Responded in 328 and arrived w/c incident to find Gordon Smith with other contractors in the excavated area. Gordon Smith advised that while excavating the area on the "B" side of the structure, the excavator punctured a tank under the ground and the area now has a "gasoline" smell. The excavating .contractor is George Botelho, Inc; 508-548-951 (w) and 508-509-8361 (c) . The operator, George Botelho immediately removed the excavator from the area and shut the machine down. I inquired if the site had an active dig safe approval number and the contractors answered in the affirmative. Dig safe approval # 2007-0301531 . I investigated the site to find the remains of what appeared to be a copper lined tank, surrounded by 1X lumber and burlap. The tank is located on the B/C corner of the structure approximately 30 feet East of COMPS Fire District 01920 02/20/2007 07-0000486 MM DD . YYYY 01 20 U U 20 2007 1 1 07-0000486 000 Complete FDID * State* Incident Date * Station Incident Number * Exposure * Narrative Narrative: the building. The top portion and most of the West wall of the tank was completely destroyed by the excavator. There appeared to be a small amount of standing product at the bottom of the tank with questionable petroleum odor in the air. None of the contractors on site in direct proximity of the tank exibited medical distress. I called dispatch to initiate an incident response for a hazmat release with unknown product and requested dispatch notify Barnstable County for a Tier I hazmat response. All openings to the Wianno Club on sides B and C were secured to prevent odor/gas from entering the building_ . All personnel were ordered to evacuate the excavation area and all ignition sources were eliminated from the immediate area. Advised dispatch to notify the Town of Barnstable Board of Health for response and requested weather information.. From dispatch in Centerville, skies sunny and clear, 45 deg.F, winds from the West at 10 - 19 mph. Established safe area at 100 ft North of the incident at Sea View Avenue. Captain Rogers in 321 arrived on scene. Conducted a face to face briefing with Capt. Rogers and advised him of the incident, and actions/ notifications to date. Capt. Rogers assumed command post briefing. Crew of 306 with metering using the department 4 gas meter TMX 412 with readings of 02 @ 20. 6% and LEL @ 4% directly over the tank. Using extended reach equipment, obtained a LEL reading of 60% inside the tank approximately 6 inches from the bottom of the tank. The meter is calibrated by Pentane and conversion chart shows 0.8 as conversion factor for ethanol. Captain Bob Kelleher 508-398-2212 from Yarmouth FD responding to the Tier I request arrived on scene. . Capt. Kelleher was briefed of the incident and actions to date. Capt. Kelleher investigated the area and made the determination that with the information available, the tank is possibly 80-100 years old and the product is a petroleum base. Capt. Kelleher advised that it does not appear that there is an extreme risk of fire, explosion or health hazard present and advised to continue response from agencies concurrent with UST release protocol. Captain Kelleher cancelled the rest of the Tier I response after consultation with Captian Rogers and myself. Town of Barnstable Board of Health agent Donna Miorandi 508-862-4644 arrived on scene. Inspector Miorandi was briefed of the incident and response actions to date. She contacted the Department of Environmental Protection for a response. DEP advised and responding from Hyannis. Pictures taken by FPO Pulsifer. Additional site and tank information: tank size is approximate at 200 gallons located approximately 30 ft East of the structure, approximately 30 ft above sea level, and approximately 100 - 120 ft North of the water line for the Atlantic Ocean. The visible soil around the tank does not appear to be significantly wet although container breach to the environment with product release is very probable. No estimation as to amount of product in the tank at the time of the breach. There were no visible characteristics relative to fill and vent piping that we could establish. Contractors report seeing piping running from East to West from the area of the tank toward the building with unknown termination. Piping was excavated and removed prior to this incident. Massachuser_ts DEP Environmental Analyst Robert Murphy 508-771-6088 arrived on scene. Briefed Mr. Murphy of the incident and actions to date. Introduced Mr. Murphy to all parties present as well as Mr. Jack Thomson, General Manager from the Wianno Club 508-428-6981 . Mr. Murphy investigated the site and made the determination on response actions, notifications, and removal information. He discussed this information with Gordon Smith and Jack Thomson. At the same time, Gordon Smith was in contact with Envirosafe to scedule LSP and removal contractors. Envirosafe to respond at approximately 07:00 hours on 02-21-07 to initiate sampling and removal. Mr. Murphy was questioned relative to securing the tank from the environment. Mr. Murphy stated that it would be sufficient to cover with tarps until morning. Contractors on site covered the tank area with tarps. I also advised Gordon Smith to leave the fire line tape in place to deter unwanted entry to the area. COMM Fire District Oi920 02/20/2007 07-0000486 MM DD YYYY y01920 U L 2J 20 2007 1 1 07-0000486 000 Complete FDIL * State* Incident Date * Station Incident Number * Exposure * Narrative f Narrative: Scene was turned over to the Town of Barnstable Board of Health and Massachusetts Department of Environmental Protection for release actions. Advised Gordon Smith of the permit process and follow up actions with the fire department relative to UST removal. All units cleared w/o further incident. 02-21-0i I recieved a call from Craig Sasse Senior Environmental Engineer with Envirosafe. Mr. Sasse stated that he is coordinating the removal efforts for the project at 107 Sea View Avenue in Osterville. I briefed Mr. Sasse of the incident and furnished all information I had available relative to the tank and response. Mr. Sasse has been in contact with DEP and recieved approval for removal and sampling of the tank and area. Mr. Sasse estimates the tank size at nearly 500 gallons and stated that initial readings at the site indicate a petroleum product but further lab sampling would be required to determine if any other chemicals were present. I advised Mr. Sasse of the permit requirements and stated that I needed to be notified prior to the tank removal for documentation purposes. Mr. Sasse will be in to obtain removal permit from the FD. 02/21/2007 09:27:46 fpulsifer I COMM Fire District 01920 02/20/2007 07-0000486 �'g pNN�i �'1.L + o� .� .• ., Ste-0-11Ll- 131)L1 I'� 1 OIL SPILL LOCATION: Wiannio Club, Seaview Avenue, Osterville, MA. (Dumpster Area) TIME: 12 : 00 Noon Monday, October 23, 1989 OIL SPILLED: Gulf Hydraulic Fluid lOwgt; Gulf Harmony 46AW, ISO Grade 46 QUANITY OF OIL: 55 Gallons DISTRIBUTER OF OIL: Gulf Oil, Division of Cumberland Farms Inc. Westboro, MA 01581 OIL ANALYSIS: Solvent refind heavy paraffin distilate, Methycylate Copolymer, Silicone Copolomer, Calcium Sulfonate Calcium salt of an alkalated phenol, Zinc diethyolditheophosphate. SOURCE OF OIL: Three ( 3) inch rubber hydraulic supply hose broke on a AAA Disposal Truck, registration #236296 MA telephone # 428-6868. This is the same truck that had an oil spill at the Hyannis East Elementary School last week when a hydraulic hose burst. The driver of vehicle was Jacob Bishop, 14 Oak Avenue, Catumet, MA 02534. NATURE OF SPILL: Fifty-five ( 55 ) gallons of oil spilled on a concrete covered area and flowed down an incline to a catch basin where it fell on to old leaves and other solid debris. The oil reached a depth of about one foot and then dripped down a connecting line to another pit which was about one half ( 112 ) full, three ( 3 ) feet of water and formed a layer on the water. The second pit had an overflow to a third pit which was much larger and had some water in it. No oil went to the third pit. The oil film on the water in the second pit was about fifteen ( 15) inches in dia. This less than the diameter of the pit. The second and the third pit had manhole covers . CORRECTIVE ACTION TAKEN: Craig Whitely, Centerville/Osterville and . Marstons Mills Fire Department notified Town of Barnstable, Board of Health, DEP. , Coast Guard, and LCR Environmental Specialist. Speedy dry was sporead over oil spilled on concrete, mat absorbent boom spread around edge of catch basin and absorbent pads put on oil film in second pit. I I "N Speedy dry was used and swept up, then into fifty-five ( 55) gallon drums a second layer of speedy dry was placed on to the concrete where oil spilled. This second layer of speedy dry worked into cement, swept up and put into drums. The entire contents of the first and second pit vaccuumed out and stored in fifty-five ( 55) gallon drums and sealed. Total contents of oil spilled speedy dry, and debris about six fifty-five ( 55) gallon drums. The drum will be picked up in the next two ( 2) days by A and G Hitchcock Refinery and taken to their operation in Bridgeport , CT. PEOPLE PRESENT: Craig Whitely------Cent/Ost/M.Mills Fire Dept. Dennis Hoffer------U.S. Coast Guard Edward Barry-------Health Dept.Town of Barnstable LCR Environmentalist Robert H. Cox, Jr.----Manager Richard Barthlemes----PE Three Workman 9- ��v -F-4"V 1 i I / � t CENTERVILLE-OSTERVILLE-MARSTONS MILLS FIRE DISTRICT 1875 ROUTE 28 » CENTERVILLE, MA 02632 (508)790-2380/FAX##(508)790-2385 i) �I OIUHAZ.ARDOUS MATERIAL RELEASE FORM I F.A.## Q7-0001234 LOCATION: ADDRESS OF RELEASE: jai Anna cl„h 1 Q2 Saavi aX A-upmjP ngtarvi 1 1 oar MA Q...% DATE OF RELEASE: 2 2 2 2 j PRODUCT RELEASED: anraliuQ ??? ESTIMATED QUANTITY: CORRECTIVE ACTION TAKEN BY RESPONSIBLE PARTY: Prnpg r, Nai-i f i t-a t�nnc NOTIFICATIONS: FIRE DEPARTMENT: YES( NO( ) DATE: qjijp7 TIME: 14'1n NATIONAL RESPONSE CENTER YES( ) NO" DATE:TIME: DEPT. OF ENVIRONMENTAL PROTECTION YES( NO( ) DATE: iIME: 1 Attar OIL SPILL COORDINATOR: YES( ) NO( Ryf DATE: TIME:_ TOWN BOARD OF HEALTH: YES( } NO( ) DATE: c 4A /a r TIME: 1445 TOWN HARBORMASTER: YES( ) NO DATE:� '-TIME: ' OTHER AGENCIES: N4 4 f , COMMENTS: , i SPa attarharl incident ra ar #07-0001234 V ti 16 1 � i 1 CD r- REPORTED BY: Martin MacNeely, FPO DATE: 516/pw I i WHITE COPY-FIRE DEPARTMENT YELLOW COPY-D.E.P. PINK COPY-BOARD OF HEALTH i C-O-MM FORM#58 I } i i - ;I �. _�� y. � JJI I ' 4 � ' • • �' ' � � � � - �. � � � • � t �� � � � � c 1 � • • i � f F�f�L� `r� y` Y:t � � �. Centerville-Osterville-Marston6 Mills Fire-Rescue & Emergency Se�v ices ��•� ' a ; 1875 Route 28 ' � €•�•F U ST4XGa ♦ • Centerville, MA 02632-3117 0 ii r. .� � �� 11 q i1•�+]'..ed� IlI�J�J �� is CD C; Donna Miorandi r r Board of Health awn € Town Building . _ 200 Main Street Hyannis, MA 02601 4 rt THIS ENVELOPE IS RECYCLABLE AND MADE WITH 30% POST CONSUMER CONTENT. Ni MM DD yyyy ❑Delete RS _ A 101920 U 05 03 2007 11 1 07-0001234 000 ❑Change Basic sic 1 .F, FDID * State* Incident Date * Station Incident Number * Exposure * ❑No Activity Check. this box to Indicate that the address For this incident is provided on the Wildland Fire Census Tract BLocation* ❑Module In Section B "Alternative Location Specification". Use only for Wildland fires. ®Street address 107 SEA VIEW AV ❑Intersection U Number/Milepost Prefix Street or Highway Street Type Suffix ❑ front of IJ IOSTERVILLE U I02655 -1 ❑Re Rear Of Apt./Suite/Room City State Zip Code ❑Adjacent to ❑Directions f Cross street or directions, as aonlicable C Incident Type CIF El Date & Times Midnight is 0000 ,+2 Shift & Alarms 400 JHazardous condition, Other I "Check boxes it Month Day Year Hr Min Sec Local option dates are the Io I Incident Type same as Alarm. . ALARM always required L01 u COM2 1 Aid Given or Received* °ate. Alarm * 05 03 2007 114:00 12 Shift or Alarms District DPlatoon ARRIVAL required, unless canceled or did not arrive 1 ❑Mutual aid received I IU ❑ Arrival 1 051 1 031 120071 I14:02:18 2 ❑Automatic aid recv. (Their—FDID Their E3 State CONTROLLED Optional, Except for wildland fires Special Studies 3 ❑Mutual aid given I 4 ❑Automati:c aid given I I ❑Controlled U " u I I Local option 5 ❑Other aid given Their LAST UNIT CLEARED, required except for wildland fires I I I Incident Number Last Unit � ,� Special Special N MR ❑ l Cleared --( 1 031 1 20071 I14:33.32 J Study IDk Study Value F Actions Taken.* Gl Resources * G2 Estimated Dollar Losses & Values ElCheck this box and skip this LOSSES: Required for all fires if known. Optional section if an Apparatus or for non fires. 40 (Hazardous condition, I Personnel form is used. None Apparatus Personnel Property $u , 000 , 0001ElPrimary Action Taken (1) U Suppression � I Contents $1 , 000 , 000 ❑ Additional Action Taken (2) I EMS ��pp�p, I U PRE-INCIDENT VALUE: Optional U I I otherI 00011 1 0001 Property $1 , 000 ,1 000 ❑ Additional Action Taken (3) ❑ Chech box if resource counts include aid received resources. Contents $1 000 , 000 ❑ Completed 'Modules Hl*Casualties❑None H 3 Hazardous Materials Release I Mixed Use Property ❑Fire-2 Deaths Injuries N ❑None NN Not Mixed Fire 1 0 Assembly use ❑Structure-3 I 1 ❑Natural Gas: aI— leak, no evauati=n=r Ha=Mat actions 20 Education use Service L� [--]Civil Fire Cas.-9 2 [:]Propane gas: <u lb. tank gas in home as4 grill) 33 Medical use ❑ Fire Serv.. Cas. Civilian -5 � 3 ❑Gasoline: vehicle fuel tank or portable container 40 Residential use _, ❑EMS-6 � � 4 ❑ men Kerosene: fuel burning equipment or portable storage 51 Row of storesDetector 53 Enclosed mall ❑HazMat-7 Required for Confined Fires. 5 []Diesel fuel/fuel oil:vehicle fuel tank or portable 58 Bus. & Residential ❑ Wildland Fire-8 ❑Detector alerted occupants 6 ❑Household solvents: hems/office spill, cleanup only 59 Office use 1 OApparatus-9 7 []motor oil: from engine or po=table container 60 Industrial use OPersonnel-10 2❑Detector did not alert them 8.❑Paint: from paint cans totaling<'55 gallons 65 MilitaFarm ry use ❑Arson-11 (J❑Unknown 0 ❑Other: special Ha-r actions requi=ea=r spill > ssgal., 00 Other mixed use Plea lets the NazMat form J Property Use* Structures 341❑Clinic,clinic type infirmary 53 9 [:)Household goods,sales,repairs 342❑Doctor/dentist office 579 ❑Motor vehicle/boat sales/repair 131 ❑Church, place of worship 361[]Prison or jail, not juvenile 571 [:]Gas or service station 161 ❑Restaurant or cafeteria 419❑1-or 2-family dwelling 599 ❑ Business office 162 ❑Bar/Tavern or nightclub 42 9❑Multi-family dwelling 615 ❑Electric generating plant 213 ❑Elemen=ary school or kindergarten 43 9❑Rooming/boarding house 629 ❑Laboratory/science lab 215 ❑High school or junior high 44 9®Commercial hotel or motel 700 ❑Manufacturing plant 241 ❑College, adult education 459❑Residential, board and care 819 ❑Livestock/poultry storage(barn) 311 ❑Care facility for the aged 4 64❑Dormitory/barracks 682 [:]Non-residential parking garage 331 ❑Hospital 519❑Food and beverage sales 891 ❑Warehouse Outside 936 ❑Vacant lot 981 ❑Construction site 124 ❑Playground or park 938 ❑Graded/care for plot of land 984 ❑ Industrial plant yard 655 ❑Crops or orchard 946 ❑Lake, river, stream Lookup and enter a Property Use code only if 669 ❑Forest (timberland) 951 ❑Railroad right of Way you have NOT checked a Property Use box: 807 ❑Outdoor storage area 960 []Other street Property Use 1449 919 ❑Dump or sanitary landfill 961 ❑Highway/divided highway 931 ❑Open land or field 962 ❑Residential street/driveway IHOtel�motel, 1 Revision 0 NFIRS-1 Revision 03 11 99 11 C0NA1-Eire District 4 -01920-"-"-057"03/2007-- 07=0001239 -- MM DD YYYY 1 0192-0 U L� U 2007 1� 07-0001234 000 Complete FDIr * State* Incident Date * Station Incident Number N3Liat.lVe * Exposure s Narrative: Caller Name MACNEELY . OIC : MACNEELY Pats. : 0 tgoodear- 2007/05/03 14 :02:18 - 329. AT EVENT MANNING IS 1 tgoodearl 2007/05/03 14 :00:59 INVESTIGATING AN UNDERGROUNT TANK FOUND DURING CONSTRUCTION. . tgoodearl'. ; 2007/05/03 14 :33:01 ENVIROSAFE NOTIFIED, SCENE IS SAFE. Contactec. by Gordan Smith of the Wianno Club reporting an underground fuel tank discovered during excavation for new loading dock on side A of renovated kitchen. 329 on scene with approximately 275 gallon empty underground storage tank. Small amount of sand in tank as result of excavator putting approx 4 inch by 4 inch hole in top of tank when discovered. Tank had petroleum odor but no product within tank. Gordan Smith contacted Enviro-Safe Corporation to arrange removal of tank. Enviro-Safe to be on scene next morning bt 0900hrs for removal and testing of soil by LSP. . Donna Mirorandi from the BOH on location for unrelated septic inspection. Donna Mirorandi inspected tank and agreed with proposed plan. Tank covered and area scecured until arrival of removal company the next morning. 05/07/2007 11:11:35 mmacneely 329 returned to scene at approximately 0930hrs for removal of tank. Craig Sasse Environmental Engineer =or Enviro-Safe determined that tank likely contained gasoline. Tank was inerted with dry -ce and metered until tank atmosphere brought below explosive limits. Upon removal tank found to be in poor condition with at least one small hole found on bottom of tank (see pictures) . Initial soil analysis showed less than 2ppm in both samples from soil beneath tank. More in depth analysis will be completed at a lab though Craig Sasse is not expecting any significant problems. After consult by phone with Donna Mirorandi from BOH she agreed with Engineer to backfill site with clean sand and send out samples for further analysis. 329 cleared scene. 05/07/2007 11:23:59 mmacneely COMM Fire 6is�ic _ - %a:+•�k ------_--•, --0�920---OS/03/2009----09=0001�3-9 1K1 Person/Entity Involved Local Option Business name (if applicable) Area Code Phone Number ❑Chech This Box. if Mr.,Ms., Mrs. First Name MI Last Name Suffix same address as incident location. I Then sY.ip the three U U U duplicate address Number Prefix Street or Highway Street Type Suffix lines. I I IJ Post Office Box Apt./Suite/Room City State Zip Code More people involved? Check this box and attach Supplemental Forms (NFIRS-lS) as necessary K2 Owner ❑ Same"as person involved? I I_ Then check this box and skip The rest of this section. Local Option Business name (if Applicable) Area Code Phone Number II I I u l I u 0 Check this box if Mr.,Ms., Mrs. First Name MI Last Name Suffix same address as I incident location. Then skip the three duplicate address Number Prefix Street or Highway Street Type Suffix lines. I I I I I Post Office Box Apt./Suite/Room City uI -I State Zip Code L Remarks Local Option Caller Name : MACNEELY OIC : MACNEELY Pats. . 0 tgoodearl 2007/05/03 14 :02: 18 - 329 AT EVENT MANNING IS 1 tgoodearl 2007/05/03 14 :00:59 INVESTIGATING AN UNDERGROUNT TANK FOUND DURING CONSTRUCTION. tgoodearl ; 2007/05/03 14 :33:01 ENVIROSAFE NOTIFIED, SCENE IS SAFE. Contacted by Gordan Smith of the Wianno Club reporting an underground fuel tank discovered during excavation for new loading dock on side A of renovated kitchen. 329 on scene with approximately 275 gallon empty underground storage tank. Small amount of sand in tank as result of excavator putting approx 4 inch by 4 inch hole in top of tank when discovered. Tank had petroleum odor but no product within tank. Gordan Smith contacted Enviro-Safe Corporation to arrange removal of tank. Enviro-Safe to be on scene next morning bt 0900hrs for removal and testing of soil by LSP. . Donna Mirorandi from the BOH on location for unrelated septic inspection. Donna Mirorandi inspected tank and agreed with proposed plan. Tank covered and area scecured until arrival of removal company the next morning. 05/07/2007 11:11:35 mmacneely L Authorization 18350 I IMACNEELY, MARTIN 0. IISR. INSPEC I I 11J 104 I 2007 Officer in charge ID Signature Position or ran}: Assignment Month Day Year Coed: 1 835C I IMACNEELY, MARTIN 0. I I SR. INSPEC i I U I� I 2007 sox if }{ same Position or rank Assignment Month Day Year as officer Member making report ID Signature in charge. 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'* h`� Y," r,Ety F.r �#'�rs�ndC v"yt" .% cp,�, '/ S ,✓�*'.Ei`m .- 2�*Win: �,I ��,� S r � z i i� fE�s-„b- ✓S i' � Y,i a'"p ��! FYI �� Y�� � ar^.W.I �`_:, ... u �:y�i .x�5"�£r � V � ,� .�� �r�. ���,.. ;�'^A,�fr• A-" ¢� x` sPi�`��� .z§�� `�'SS�c � �d�. - TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: Mail To: BUSINESS LOCATION: Board of Health � � Town of Barnstable MAILING ADDRESS: ,?Dp P.O. Box 534 TELEPHONE NUMBER: �z7� �Ly �� �� Hyannis, MA 02601 CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES i,/' NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: . - ADDRESS: "A' II TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochernicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes aints, varnishes, stains, dyes Fertilizers (if stored outdoors) aint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business i .k t. TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: /�� _w �. - .!!, Mail To: BUSINESS LOCATION: �� . , Board of Health ,,�.�.� @ �g Town of Barnstable MAILING ADDRESS: a. lg,' 1 P.O. Box 534 TELEPHONE NUMBER: ci ell 2- Cq 1Q ? 1q i Hyannis, MA 02601 CONTACT PERSON: 't� EMERGENCY CONTACT TELEPHONE NUMBER: 52d � Does your firm store any of the toxic or hazardous materials listed below,, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES f/ NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: i77WW3t TELEPHONE: i?p Iy2- 61 e 2- v LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners 5W,,^,_.(• Hydraulic fluid (including brake fluid) Disinfectants Iley Motor oils/waste oils �i-o A5s- Road Salt (Halite) (�� f .1 L>r d,,- .Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil 3,16 -e Pesticides (insecticides, herbicides, � ,f1 Other petroleum products: grease, lubricants 1e)d4 1 rodenticides) f Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink '—A ev,, Battery acid (electrolyte) --- Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents `` Lye or caustic soda bz Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes 9CJ ' a Paints, varnishes, stains, dyes ,� ��� ex4r Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's /rJr Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels .;.� Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business TOXIC AND ,HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: g /0A �� Mail To: BUSINESS LOCATION: /97 fpyie,.; Board of Health MAULING ADDRESS: A har ay Town of Barnstable P.O. Box 534 TELEPHONE NUMBER: Hyannis, MA 02601 CONTACT PERSON: �Eor4� L �c� �►^ EMERGENCY CONTACT TELEPHONE NUMBER: Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO Y _ This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, - Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business WIANNO CLUB (, - :, • - WIANNO -:_MASS - A -meeting-'of :the ,Executiv ..Committee .of •the Wianno ;Club, 'duly- caned, was held at the: winter ,office' -os Uhe -C3,ub; Seav�,e�a l�venue,.r Y��anrio�Ostery 3.le) Mass on' Saturda r; htovel.mber 30, T 3 at, ?� 30 P,1 . r Five' meimbers. o ' the Execuve ,:Ct�r�mttee" onsUutg a' quorum,were preserit .:'ka J� t => EXCERPTS: FROM THE MINUTES .OF 'A ME ET +3G 0, : TR` EX,0T C IITT E OF, THE WTAN140 CLUBS-HELD NQVEkBEk 1130 19 ��� ' ' { . t . T !. ►'.-._: . .T e Chairman. `then. reasi the �1��a1 not ee -of a i Pub� C Hea�3r g' under tl�e ' .r � Zoning By-law' 'to be ha d ' efa e the-. Board o�'' :Apie Y t;x Tawn: of.•'Barnstable,.� µ'- December .5th 1963 at: .15 ,P, ! . µ. �? That notice 3s -of, hearin 'on the pot=►t-on of. FhiliP E. Wh.itely fdr ;special -:permit- to allow the'-'removal o ',, the present_ .Qstervillb,,T4anor main build,-L and .`certain smaller .structu�°es am re'lace them . iith a two story., building con. ; . y 'staining .33" living..units..• • The z,property In, quest ion is--located on West �Liy : 'Road, Ostervil16..and the Wiann.o Club- .is .an abuttor., w.• Cons -discussion followed, :fit w�$ pouted 'oul`.tha�, EJsterville is . primarily a;-reo l,dent ia1 area and Chit the granting of "this, permit ,would encourage additional coma es�cial enterprises within 'othert residential areas - ,of tree village causing a dec'rea.se in•-property value-s . "Ostervl.le Manor :property aoucs h'iarnR$C1b property ..on tt�ao sides Some q r -of this and is low and 'swarm py and the proper handling of ..�� large • volume of � Y e -:Sewage 'as would developsroir�31 units F' or ,que^t honed A 11New property owners are, attracted o,thin., vuzlllage 'be,cause of its charm. } :`aria ,quiet restful. character away ,from -��ie ;co�imerci�.l�sm. of,•other sect ions of. the CApe--- , The m6mbers 'of, the' •C_om ,ittee we��e 'unanimous' fan" their. feel_+;ngs . on this subject F 4 ,;. ' t Upon motion duly. made an d ,seconded, it 7da • - N X/y i .. - - r,: r'� OTED:,. `T'hat the Executive Committee" of "the )ianrio Club oppose .the y "petition of Tr.�?hil: p 'White y 'or a'',s ec al _permit :t`o allow <: ' • tl e' ret�pva of che: i-escAnt ast , l e Mahar-main. bu3.ldi and Lt . ?•� ng ..'smaller structures and replace they,' i h, a x+oQm= unit, coo, story bui din ' 33. 4- _ k`.."The vote was .unanimous and the Clerk °was 'difectod ,to=mWe this ,report_ a the earn . zb t n ; "There being no further basiiaoss . to ,opine hefore° the.rrTeet inga it was r �� �. 4 VOTFb: To ad, Burn r; Ad j our ied;.,a;t 5':.15 g.M. True; CpY':. y f -e r Yy 1 i ! ! • S At .� _ test. John W. !Wannop,' Cle k rS t t W Iwo VIUM -00 MASS �Yr �° '•j� the^. l � � t a'bf the =al � et 1 or the 40ATd ,T e����_ �+4�C�_♦ 4 s s:*"s"1F � r i� • } r :,� . 4' ,_ ,"�, `� as •} } � c 1.. 4 - / ... -• Ywa ', '' �": W6T 7t{ hild theB ,r.dcf o mors ro r ary om her. � Polled In,W4 ntll UGa Valld oset .,. •a 2 - ,� � r��itlrg 'aybc►;�a+,.,t-i he , {ypyy{'y{ y�¢�1 � ofbel , A{ e y ��{bduring .Ofr f+ WSj4'w,` Wii4'�k•'ti'" '*'�.1v +4Gb:h �fyt�„- i'o!;l�J.`iY. LT :'.S/N/'... Vfi'M- i,loard i 0overhors on k 4 �yAy�t�'y� yr� c�w.,yc per�ag��g�osn q���y�yja. ���e�ya d. hereby�� . hereby �ar�sP kY� �'EJoAd, �Ei, �`ti�ic:.' 1 tir'k.e c�,R��Y V`�.,C a Waittea with, , +A f e��,�L4.w.6.�.'�X/*i�'t��... !�f�F�..� 5� :J G }r1 � r •, 4 E4.A - ' 41 .::ter; t ' ♦ a - r ,At�i�lbt•� , C. Ci-e.3•k 3+ Yp., _ "Rr .•#'.is �! r Ss? > �� .., {^ rot, �♦ �� � E # w s i.' i� ,S. '� " .:.a fi' t x_ .:,�: t t' •. a • �t a r s(...E .F• S a F� .'t tati .. 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' Excerpt f om rtic5:e V'I - o#`-the.By laws of the, ,Wianna Chub t "OFFICERS 'AND STANDING .COMMITTEES" - l ) ,a.v�.♦ ... �' # / R �: .X� r i � tt,t,i::T tf f�r� . r r._ . tx T` >f "Thee Beard of Governca s, at a meeting 'to. be. held 'in=ed ely after i •' the Annua Meet�.ng";of' the tub - _sha 7 .Olect' one : of. t eir .number ras Chafirman ,of the' B6ard• a.nd`may` e1ect..a. Secretary aril may`a1so elect..from their` awn riur°nber anti F.xocu;tive . Committee consisting . ,, ; of the. Cha9.rman of 'the .Eoart�, 'the President., ''the T easu ° r,° ad - , " notl more,than seven other ove'rnors� :-w b Committee-Vha:j.l d#A _ _ - w { }-; act- with :sizcn;•power as- the: oarcl 'of .:Governgr ;ahali;, delegs.te ` t:o 3.t. : `Three members of 'tire Exeeut ive�,CQmmittee shall ',son o stitite a quorum ' 'or`the transaet3ot�pf aus�r�ess but'`a ]user ' r number may "adourri .s3.�%e'-d�.e:xor Ito a stated t3mea d place g . w 4 44 True C Opy,. i A . Attest. ., ohn W.%Wannop ,Clerk ^ r t� "yr :�y1iX a .n r+ RAJ J r % 1-'` `;(.# t :: >:_c� h. �b •yuV, '. yy ts .' + y- L� .. .la i ' a p r•' � xa. ''} � - '•' ••Y' 4.4. L s !• G "T� Y .. i " � + v r` J y:� it c I .�•,,+ a f'n i i '� :� 4 , '' ,;Y +• cw•r �y„ t. w' a hr s"' ;.r ° t.t.{•r wat"t'`F-2 .fit° 5,�. �e 7 �§' - t-. a•{=• Via+` +ar ,fir n 'r v �i $ S ti- a M r r y ri r F. _ tl` a •�r d. i � • `� ,t�' F � � aF .n+„y�,»x'c + •.7 � > ;`•T r ,fir, r x �, X .' ,'• + a .M 4, v^ .s f }.+ .t - .J •mow ' i k .+ .t r y„Y�., F3-�• •z�"r x } -::J, .� + t,_« tr.i "rs F)y'-:f •a r r A 44 1. a v ,1�r = si a•• + _'.�r...x 11. KYi^ (• j ,.-H '5 .+ -.7•" MV. 1 '°,� -.i a 2 .. '' F+' �• j �.. ( �, S-_i=� a Var": ggy,a i•• t •f d. � �'.t 1' N ' t• }'' . _ ,. ��,° �T `¢,t� f °; 1 e � ',3 � , �i t, j. ,r � F 1� i• ,'�+ j � r Tf -.d•�•�-r+� � - r t 1 �' 4 r 7 3 . r 6 "' ,1 f: W v .q�' . e r .ELY..BARTLETT,'BROWN &PROCTOR �, �,... >•- _ [ - ..i,. .294 WASHINGTON.STREET .+. i' ,— . .', , M1 f, � '�! .-♦'� 1 ,.y. 1. - "L +r • `� rq4.. .gin i J ,•� � � �iW� i y t 4�� � t .i - - s ?y_=` z'S•� ��°� ` K4 r. .. [. .t se f. ?'.5 st.,� ..,'�' . E��.s [ �. •a` ai-, .5y't �. .� • ��' � � b A Y: � ... '`• t .? i t� s �9pt��yy�y�y�'F��y+y�. �MMyy�� 4 . Y` }� t r r tiO+ < a�♦ .r5 •'ii. �v.J �q"r�•`� S+Y : 5 i��fK'4�ii[kae ..`"°'✓� „ � .f >, ' ^ �V'S Tl�ir L4TfE' P`f ,r [ _ .[ R _ir'� ;`fix; Y •5[.-xl Sal^ sS A.. - .i . = r. s �- �' � assa4xattsetts. r � + ;� F r _ f: •�• ._ .. a �yy�¢ �yy�15 * ....r V. 1 "am in5 receipt or,. letter of '�ove*ber 121#7 903 -add ssed .'"lro ` -the Property wing Mombers-of hIe•` 5anno- Citib" -rqg4r4ihg U6 pubil� s' hearing before ,the-BoAr6 f t�ppeals off'• the T6Wn of, rr - � em er 3 on ,a Pet' n a;�or`a spec�iai pe�.f: relat$ng �0` the gster�ri 5ie+ grope t t eet 3a r Ea t , Oster t .11e,' ix which Vora, stated. ` r that you pure that ` rA a� ' pt ngr a tte 's o anno Club r wn • it �r(yy� ./5� �yq yy�� $ (� }� y�'w �]�{yry ' "•5y� '�j N�'. 7. �+. mar - Y - • .' tan , t o prot o �F th ,y 1 11 ` �ha �1 Cit1M.Ld e% � �f ' fF• � � .1 'r_ �, '. hX sF T "► ' Z` t ,nf 4�n• i ve hMd_�' 6 t thi s Itiat t $°st.5 y' cte�rx*,geore. giz aosioac� fog ar ?f. ,r�` dna . eunent +'te0 that the recipient _5e�€: �r� l tter 6tao id �e rnca . �����* �. ',� . ♦ - -. } :` '` `.; F' ;.. . . 1 x :p, P �. .r t., a ter._ _th6 questions tha to 'm °ars followings ' t,-7 - .si�. �!��k� ��� i1�� 5•i'i.� +�'A���,_iri..�.h � r f �r 5[ I r � .-' .• n t . . r . M "has g `•� i ` + �rs a <� a+hotel and tvotaurant} a -Xt'i s a. ncan-confa ,ng use .fie the on ng 3 ate 4 which is entirely l � , 1"Wh ,ionO t it b et to or the aoomiurday .that it, .. M: be, t�1i36�eml id than that the r d rattle trap te" aiio ed to''fall Idt>t n around ' the ears• of the owner of, the property's The, use nt the .�_ o rg law to force -the wnei of property an which a non confoming' bA,.i oil use r . conducted to aiscontinue his business by st©pplbs h in from modernizing and ,!' ' _ • ELY BARTLEM BROWN &,PROCTOR " " - r - - 294'WA TON STREET vi fie; + # (COPS d t - AMpl+{ ying ' @If �` , Q Zit ► �; Is ' u` j4a64 they,. 1_4� Y '#`Ep� 3 :. +fir , Y ewe 'he 6e the t Orr at el bi _ ace of x Present t 4y yo 6 O Y"`LTG �y,� .t.� �.l�µ. �a './y i ¢►'. nb n 1 7 �GY�'W �C ►fir Ml -10,tab N. r , , +ether �6tels �� ��te�� toa d � tc�V _ toillow* :the der- 6V a .h*te + 0 1 'ids rao YA f " A. ° x • G. _ ! MYhG Y� . + yA ^^'•rd �w: Vl�4i 47I dMil ':l e,�•y Owmgel trom the pre , has be A or li �1.yp �ii3re -the Wlaraw 'Club" 'want tU At tie sent #i� C t . .Lid+ iY d.in lt the � Plrty iind retuM,, 1g o .resid+G�tia ` 4:80�R .��'•� �`�,�rath @ e Id ire .0gr'Want " q . x ` Of YiMYF.!!f'rlsii, Iih hat,,•.. hat {Ir # � %+/Gi�li Giifrr4 � �("W41F+riiV iri ioR ° •+�A!j4'f?: y� t.�y�y^�{`�y{�Ty�.►.q`� yy�� r�y�*]�. « • - u .} ..0V1i�ab4R+4iul9 .71i^su�it4 matter `as this bet� l L �4 s ++ 3 . n e. Ar Ou '4p4 ;b`i Oh t7rMat•, h " €�; jam yi y7 q ._ � aM .r.um a 1EY Nod to have, I to nt � Yid . t M i t tho, lam+ Club. ` wo ..ELY. BARTLETT. BROWN'.& PROCTOR;,. - ' A. tk 1-294 WASHINGTON STREET +•�� yp - _ . - r O(CPS 8�aChusottts , had` ► ato $peak for 'Its `i.a,' ext" in' this matter, tll they hava' r �}/sr�� a•{`f�i 1 3l [\�..yy� }^* [y���yy�(, �},.��,y■j]'J7? jj���f� ��rrry� `pJ �ja jj • f(y� ^€..� .x had �!.e iY`xi ©E">t1F. tl-o , ae'��a •�i'.P- . rw1.#Tr V T�Xr ^�5� „1". T<a T! e1il ^", �t majaa.gemel� 1.6 s authorue . , Alm oe Av r • � .. .. •. '�'`�, '' '' � try r ` , . ..x. a.e •- a.J ' , ,.., ,+, I 1 n '• "_�� J . r. U it k}' : f ,pv l/ ... A ,� + � 1,�, ir. •,y, sf..:�`9•. � x• .,y�y t ntf •n rN � :. .. i zi n� : � o.. ,9� i , � • {> r{ iT. , 'r�`f '+, _ � ,. c a iy;'f4'4'• .i � ,,;, v��• � „, ri., � . •� � � ,. '',.. � v. �t' tl y:..Y y .r-. � -,1 _ ,�, b d `'+..•� +" i, �t� �, ,tkl.. aR 1.4" ', r` ! Y. :r �k*, :.E+ r�� ,.P'' �.; • .r asr' .w' + fir,. 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ATE T rA PUTt: 4 O MASS TD PL ~ E? ry / P•a 7 TA00110RETE T.O.00NORM ____________________________________• -.-_•:y_� _ __ O.b _ •E;E • --------------------.._._.--------------------------------'------- .. - ------ ---- VnANNO CLUB GOLF COUFM COMFORT STA TION O3QUTti ELEVATION WEST ELEVATION -(yam- �1y_ ;•:-. T noaFPEAx :j? ROOF PEAR ] ??i•?i :'':':i tt REED A.dMOORRISON - T' TAPLATS ?1?f `r TA.7FtAn �..� Ec�.Fj i �• F 'ic?c:?i� to Nr.. - _-- - T T0. - 4.t...�...r...a.__•__________________•_._..---------------. - CONCNETE y _��•,. , ; 1 ELEVATIONS SECTIONS ._ .....................----------- .-----------....... •___..... ¢� 3otuo �µ._t•_y NOWH ELEVATION EAST ELEVATION D t s s e t ® A2 ,f _ F hr r , • _ ---- .-- w�cawaauv� - - u �inct row. 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VqANN0 CLUB �::j.}�;.•;:' i ? Ore Lnta .•.:.••: i ::•S;:e .................... _ .. GOLF COURSE COIrII''ORT STATION w i i +•::�:� :. ..... is -"- DaarvQ...Ymadom !� ................._......................................................._......................................_...................... i �: :• ..._... ......................... ..... ... ........ ... ....._...... SON �.......... ------- --------'-- ••------- A I+visa Y -.__._.-. __________________________________________ .: ..................................................... ..........................................................._-_._._-...-.--._..____.___-__._.-__..-_--___- ___._._.-._.--.___.-- -. SECTIONS Dale: Seat OBULOM SE-cTfON O 1 1 AK r _ A=. 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'PYodea wabrymebfp,wear dwffb ddeg. wndoraB.O saemrea,h.mfa�d ame.emla alwm leeamed wraa.wbslem NdaoeePbyaaw,,mmplab vrf. ewtw eab�.mdap emlAbbtrpaa dfnenmbdmweat► aaaw .. oPemb9fblb.eefmEly wd.ewrelybr Mweffeed ens .. _ WAtE1P4WOOFRIO Sartpb.Ye bbe wMlWdbM AmWeethwrmiewm pet Dlrblwpt,&bwm IL i.Hwdad. hdd fVwel.wiMara wOpPoobp paeeudaMl N feiowiwfe.d6e by M M11aCaIN b M AMymeepdbb wml tldOdad �f __ a6eMa wd.a.ar,MwudWL Wdwpmobg b be Trwlwfml Bo by Tia.m a.ppvwd pub - L BO.M- WacrhalbwmmPMdeehawdoww Jlmemn .Par/m WMWdlondwfdd b.gbee bMpmfeeMded>thgmwativm when I mwoewbplmarlb.Mxwdwt.f~. Ox.var.lgm.do 3vdkK-k .. w.cr OE4f R. meua,any .. a I. SPECIFICATION ±"• Drr Scale: S91AD0 NOW s. © A4 STAMP: Wianno ClubNyicker Room Renovation-Misc.Code Review 1. Assembly Use('A') without fixed seats Space size=952 SF(net) 11. Occupant Load(Allowable Max.) = 15 net SF/PP(un-concentrated tables and chairs) Per Table 1004.1.2(p•251) =63.4 occupants =63 occupants in reconfigured "South"event/meeting room c mo NOTE:Room capacity to be fixed at 49 max. 1.."w Q I s � r.5"y j s III. Per table 1006.2.1 'Spaces with one exit or exit access doorway" 1`0 Occupancy'A'with sprinkler system=75 max occupants P,s p O .s IV. Means of egress sizing(per section 1005.3.2&1010.1.1) • Occupant load x 0.21n/per occupant LL a • Exception#1:For other than use Group"Hand 1-2 equipped with automatic sprinkler system=0.15in/occupant 63 occupants x 0.151n/occ.=9.45" • Min.clear width=32"(section 1010.1.1 [p.260]) z I z V. Direction of Swing(1010.1.2.1)p.261 , ~ • Doors shall swing in direction of egress where serving a room w/occupant load of 50 or more Z VI. Per 1010.1-mirrors shall not be used on exit doors m O U Q 1 C C): w r ': - � VII. Table 1017.2 Exit Access Travel Distance e 0 � • Occupancy'A'with sprinkler system=25C ft.max. Vill. Section 1010.1.10-Panic&Fire Exit Hardware • Doors serving spaces with an occupant load of 50 or more in Group'A'.. shall not be provided with latch or lock other than panic hardware or fire exit hardware. NOTE:No panic hardware to be provided-room occupancy to be capped at 49. E105RNG EMIT DOOR C MAIN ENTRANCE C O \ MANAGFR5 OFFICE ^) \1i E DWNG EAT SIGN TO REMAIN I I COM-'LITER RM TV ROOM O > j OFFICE 7 Q W1CIQnR ROOM NORM BALLROOM N'BATHTRAVEL DISr.� _ _ V> � I I OFFICE 7 Cn MAIN DITRY CD � TITLE: / C.,RD ROOM LIBRARY SERVICE MTC„ TEL LIFE SAFETY PLAN/ - CODE SUMMARY WICM ROOM SOUTH - MAx.ocaRUNr LOAD=A j UN15EZ BAm BAR \ / I ® MEN5 —— I TRAVEL DIST. WOMEN5 LIVING ROOM /r35D'dMAX ALLOWED) I I DATE ISSUED: 3.02.2018 __f.A11FRY_____ _II REVISIONS: EXISING EXIT DOOR II NEW ORT SIGN NO. DESCRIPTION DATE I I I I 1 TERRACE I zOMOMo E DRAWN BY: EC/TWS g / SCALE: 1/811 _ -O e DRAWING NO.: Al R5 LIFE SAFEN PLAN/CODE SUMMARY ' 2 1 1/8'=1'-a' -I LEGEND V a Deciduous Tree 0 Misc Monhole ICatch Basin '!/ ® Catch Basin (round) •�/'r, Coniferous Tree ° Hydrant O Iron Pope Light Post p D711 Hole (n . ® Water Gote (round) O CB/DH S ® Gas Gate (round) O SB/OH —OHW— Overhead Wires O Mag Nall —25-- Elevation Contour -0 Guy .......G............ Underground Gas Line 4 Utility Pole e V .L/bble r NIF LIUD �r CD razor Sea Ave _ Ip —_ (40 --25� _ •4e'eo'E I— w _ 'ode) (POtIIIC Way) ®�- N ————— View'w, v Y' ..................................:.............. ... . Of •1 - 1' - 20— '.\ 07 _ fZ - 2s .Y- - - 7— / _ _ _ _ - 1 _ ------ / - 1 r 4 FLOOD ZONE: . Nantucket Zones V11(el.17) & Sound Community Panel No. 250001 0016 D - Revision MAR 74, 2006 LOCATION MAP: Per LOMR case 05-01-0764P Scale: i'= 2000'.* ulru Eux' d. YJr91r. - ASSESSORS REF.: OVERLAY DISTRICT: Map 16Z Parcel 24 AP- Aquifer Protection District GENERAL NOTES: PREPARED FOR:. PR£PARED.BY Title: ZONE: 1.) The property line Information shown was CapeSul V Existing Conditions compiled from available record information. Wlanno Club Sullivan Engineering,Inc. RF.-1 PO Box 659 7 Porker Road P.o. eox 249 Plan of The Marino Club Area (min.) 87,120 SF(RPOD) 2.) The topographic Information was obtained from Osterville, MA 02655 Oster0le MA 02655 Frontage (min) 20' an oh-the-ground survey performed by CapeSury Osterville Mo. . 02655 (508)428-3344(508)428-3115 lox (508)420-3994(508)420-3995 Pox /� �+�+ Width (min) 1 5' on or between I7/MAR/06 and 25/APR/O6, f PsvnaE�,oj— _p_r,*op.wd-f Barnstable (Osterville) (yl�a7a7.. Setbacks: - 0 Front 30' Side 15' 3.) The datum used is NGVD 29, o fixed mean Rear 15 sea level datum. 39 0 15 30 60 120 Draft: DW8/JOD Field: WHK/JPM Comp.: DWB/PS Comp.: WHK/RRL Dote: L thi i d �nnC, Scale: 1 n_�(r T _ a roc 4�aw I Directions From Main Street, Hyannis 90 toward_- Pleasant Street. Continue on Main Street LEGEND Main Street becomes W Main Street E aro M : - Take left on Pine Street 1 _ _y�_ Pine Street becomes S. Main Street �lP� Deciduous Tree O Misc Manhole Turn Left on E. Bay Rood "'�,,,,////�,� ® talcs eosin Turn Right Bates Street Turn Left on Wianno Ave DRAINAGE SYSTEM Ignpann ® Catch Basin (round) Wianno Ave becomes Sea View Ave SCHEMATIC 0 �0n 60n Coniferous Tree Hydrant Arrive at 107 Sea View Ave on left Q Iron Pipe 9, Not to Scale Light Post Q° Dill Hole ® Water.Gate (round) 13 CB/DH ^w� © Gas Gate (round) m SB/DH `v —OHW— Overhead Wires O Mag Nail ——25—— Elevation Contour -0 Guy ev yNa /wue •.••.- G•••••.•.... Underground Gas Line -P Utility Pole -aK...• 11'TQa/IJa New Construction NIP xronno due 3.]/3zr M Proposed Grade �- / 78M Top CB e--'�+. wAr Ew/atMg Pedtyl / S N� Q ?5— ,�- _� Ave 11, Q. p � coop s e \ (40'ode)� -5_ � _ _ \ Public WaY) � 1 N a5-AsSn• Q. View;, a/ ®�.•' ' ds® g N —25— / \ wv \ l t atw ® ® �� \�. — .... / ........ can°euromqpm . ...... ..................I _ N'. R cPFered P zz � - ssr / 1 .. seaw _ _—— cower :\ t tswc�ur. y P / �2 \ arch - Ret �, Porch \ E.Islinq MC // 1 I lPe 1 \``-1 _------- Cowroo' y 'prude _-- \- r' LPorah/ eft Q / \?/— --J' v .I Area —�"'Y ExlatM q•m \ -J \ ` --------------- ------ ,,` \ ° ° Required nflrn171 \ Lawn In! 9 7 21, ¢� \Za— s ser /f s �j/�e - 2)— 1 PnPOrod 0,00 �[JI \ \ I Ewbf n0] Lo / Ad tone f 9JSry — w'/�Clvbeavee +. - -_- 9v oln a dose ji Stoked — ... � ......:. __. — ,.� ——— --—,_'— _^ -�..—_• /apLM oeo errvoe. � ��en \ Pr — Yr —1 — —_ _ ��_ — — _. Lawn LPa 1 J — ..",.r...r-..... ass g �— -- — — ) `• \� -.-- —�'-— -_ —. __ —�———— ——._—...._"_-'•"�-•.�_ ;:I � �— // slurp �� Y5� —— .. •' i � _ - 4.P o°o PM 2.Af/nvmq_ _ \ - - - ---0— -- -_ - ------------ _ ---------- --- !_/ / FLOOD ZONE: Zones 1/11(e1.17) & C Community Panel No. Nantucket �+ RevisonOMAR 07 014, D2006 ASSESSORS REF.: mound " Per LOMR Case J/05-01-0764P Map 162, Parcel 24 r LOCATION MAP: Scale: I" = 2000'_± — ZONE: RF-1 - Area (min.) 87,120 SF(RPOD) 1 Frontage (min) 20' - - Width (min) 125' ' Setbacks: ' Front 5 GENERAL NOTES: PREPARED FOR: PREPARED BY Side 13' Title- Rear 15' Proposed Improvement 1.) The property line information snows was Wianno Club CapeSul d compiled from available record information. Sullivan Engineering,Inc. P.0. Box 249 PO Box 659 7 Parker Rogd Plan of The Manna Club OVERLAY DISTRICT: 2.) The topographic information was obtained from Osterville, MA 02655 Osterville MA 02655 `c an on-the-ground survey performed by CopeSury Osterville Mo. 02655 , ( , , AP - Aquifer Protection District , (soa 42s-33aa s0s ate-31ts fd+. (506,420-3994(508 420-3995 IP+ on or between 17/MAR/O6 and 25/APR/06. �°pecoe.net } PSunPE®boLcom °OpO9Vr Barnstable, (osterville)' Masse 3.) The datum used is NGVD '29, a fixed mean a sea level datum. 30 o t5 ao 60 tzo Draft: 0WB/JOD Field: WHK/JPM a °qte: July 14, 2006 Comp.: DWB/PS Comp.: WHK/RRL Scale: irr_f5or % Review: 97039 Drowinq 9 C515_.4GI // JJ 2X2 MAHOGANY j�on�;rl 7X8 P.T.R W'O.C. T <105 STORAGE ROOM 3'-0°X G'-B" WOOD PAINT WOOD PAINT 'BROSCO°OR EQ.FLUSH DOOR ARCHITECT 70 REVIEW zORDER 1SHOP DRAWINGS(WHERE APPLICABLE) QrA I%,MAHOGANY 106 NEW STORAGE ROOM 3'-O'X 6'-8' WOOD PAINT WOOD PAINT 'BROSCO'OR EQ.FLUSH DOOR -5EE ELEVATIONS FOR STYLE(I.E. JTREADSPANEL CONFIGURATION.GLA55 MUNTINS)I'TREAD ? -DOORS102 L103 TO BE EQUIPPED 8'MAX,RISER WITH AUTOMATIC CL05ERSSMOOTH•HARD(-PLANK' IE>BASEMENTPANELS ON UNDERSIDE OF JOISTS NEW DOOR r NEW CONC.SLAB- U O L- PITCH TO DRAIN rcon ---EXI9TING FOUNDATION STONE RETAINING WALL UI/BLUESTONE CAP DRAIN TO ORTWELL 1-•, �x 2 SECTION AT BASEMENT ENTRY v 2 Oa3 �/ F�1 � of 1 3T-O' DATElLSSUFDFO] AREAS'A'6'B'PER DESIGN BY COASTAL ENGINEERING 9-13-2006 SEE PLANS DATED 10-20-2005 c'-e• lo'-e' L'-e° l0'-I' 13'-8�i` -MECH.VENTS 10'-,Y` EXTENT OF RETAINING WALL AND TERRACE T.B.D. DESIONDBV° / "- 7'-ION.' ( PER'H-Y 9-20-2M NEW AREA:B __ �. �. DESIONDEV. .DOOR TO RECEIVING ABOVE P 6• Ia3d'ID06 EXISTING II"CONC,RETAINING WALL `BUT(E)WALL AS REO'D. "+ Y ------ --- \- ------------- - ----__ ______ _ & FILLED AREA RAMPS AND PATH ABOVE K �L y DD REVISION ! r 11.21.2006. NEW AREA:'A . . . 1 ii CLOS. 109 DEMOLISH .�sr+ " '� '•�"' ''f"i." ' CHASE FORR ELEC.CONDUIT I SHED __'a4 Q lilt PERMIT AGE ROOM -DEMOLISH EX1571NG BASEMENT WALL NEW STOR _A. / LIFT REPLACE E%19 "�� ' Ito DEGREES LAYERS 5/e G.W.B ON _ r BRICK PIERS ui o LALLY'COUMN9 NEW DOOR I RAFIP CEILING ITYP.RHERE 810 N) TO NEVI BASEMENT NEW CRAWL SPACE 4 NEIll ELEC.PANELS 1 G UP L.W.B.SHAFTWALL 103 I LO DEGREES,' 5+/- -.-.-. .-,-.-.-.--.-.e.-.-.-.--.- C.H.-T-4° -.@.--.-.-.� fir __________________ ; £. NOTE;TERRACE RADIUS IS DIMENSIONED D -34•_0• '",' TO FACE OF CONCRETE ON STRUCTURAL PLANS G (E)STORAGE, (E)ELECTRIC r'-DEMOL15H(E)BASEMENT WALL 70•_p• A Cnu WALL BOILER ROOM ROOM STORAGE ROOM a• NEW CASUAL DINING-STORAGE BASEMENT f SLAB REINFORCING PER 5TRUCTURALS CENTEfi OF CIRCLE b OLUMNS TQ RIDGE BEAM L nll POLY VAPOR BARRIER UNDER SLAB . C.H.=l'-,'./- 3-IA'• PER STRUCrUf{AL L.XIOEF. t HALLWAY a- �^ --'-'- - --'- a._'-.---.-.-.a._'-.-.-.-.-.-. .-.-.-.---.-.e._'-.-.-.� COLUMNS,BEAMS PER STRUCTURAL ��• y - - T NEW DOOR t RAMP ® TO NEW BASEMENT A, . s N z p FL.m b 102 DEMOLISH EXISTING RAMP I `")• B`FIELDSTONE VENEER O CUT IS)WALL AS REO'D. y' EXISTING HALLWAY AND STORAGE RAMP _^ 8 C.M.U.BUILDUP BELOW GRADE r FOR NEW DOUBLE DOOR _ ,U,< ® ® , y,r: v=:• 9-w ct.,.t�' - 0T. f; AS REQ'D FROM MAIN WALL FOOTING EXISTING WINDOWS TO REMAIN I+ FILLED AREA BELOW TERRACE ,et='u b BRICK 'e.r: ,<._,•�..,:.-t n+... n.:*?.._ •.'t�'m .e at;,:c� ce._:n.e:s.,aY ..L P �h+rr-111 CHIMNEY pal ®--------------s I 4X4 P.T.POST WRAPPED WITH TRIM ITYP.1 '^ TO CONC.FOOTING •' a DECK ABOVE 0 RETAINING WALL AND RAMP TO BASEMENT DOOR-5EE DETAIL ABOVE START OF CURVE G 44'-,Y' 35'-IN/' C 0 EXISTING WALL UP NEW CONCRETE FOUNDATION WALL 2 � NEW WOOD FRAMED PARTITION WALL CONUND CNM NEW C.MU.WALL 2949 EM NEW STONE VENEER DATE 8-22-2006 DRAWN BY SHEET NO. 1 BAS,S N EMET PLAN u R4 ND.1484 ta sio �'//�) eoH. J / \ice o STO 4 9•y`A(iH OF MPSyc 3353 ®r: -EXTENSION JAMBS TO BE SITE FABRICATED BY CON '`,- �- 103 WHITE - - 205 CASUAL DINING 2'-4"X 7'-O" WOOD PAINT WOOD PAINT CUSTOM-NOTES 1,2.9 1 5 07HERWISE'f DOUBLE HUNG PAINT -INTERIOR CASING TO BE TO DETAIL ° -ARCHITECT TO REVIEW ORDER 1 U , 104 3363 WHITE -WINDOW MUNTINS TO BE T/8"WIDE 204 CASUAL DINING 2'-4'X T-O" WOOD PAINT WOOD PAINT CUSTOM-NOTES 1,2.4 1 5 SHOP DRAWINGS(WHERE APPLICABLE)DOUBLE HUNG PAINT 20T CASUAL DINING (2)3'-4°X T'-O" WOOD PAINT WOOD PAINT CUSTOM-NOTES 12,1 44 C/l -ALL WINDOWS TO HAVE CHARCOAL INSECT SCREEN F E ELEVATIONS FOR STYLE(LE. 105 3353 WHITE 208 CASUAL DINING 12)3'-4'X T'-0' WOOD PAINT WOOD PAINT CUSTOM NOTES 1.2.1 4DOUBLE HUNG PAINT PANEL CONFIGURATION,GLASS MUNTINS)/ 209 CASUAL DINING (2)3'-4'X T-0' WOOD PAINT WOOD PAINT A.D.A. CUSTOM- NOTES 1,2.1 33353 1104 DOUBLE HUNG WHITE PAINT 210 CASUAL DINING (2)3'-4-X T-O' WOOD PAINT WOOD PAINT CUSTOM- NOTES 1.2,1 4107 3353 WHITE AZEK 211 CASUAL DINING (2)3'-4'X 1'-0' WOOD PAINT WOOD PAINT CUSTOM-NOTES 1.2.1 4 NOTE I: 'CUSTOM'CASUAL DINING DOORS DOUBLE HUNG PAINT PAINT 212 CASUAL DINING 2'-4'X T-0" WOOD PAINT WOOD PAINT CUSTOM-NOTES 1.2.4 1 5 TO BE BY'ARCHITECTURAL V 108 3353 WHITE "AZEK' 213 CASUAL DINING (4)T-4"X T-O' WOOD PAINT WOOD PAINT CUSTOM-NOTES 1.2.1 5 OPENINGS'OR EQUAL.SHOP DOUBLE HUNG PAINT PAINT DRAWINGS REQ'D. ( 3353 "AZEK' 214 CASUAL DINING (4)2'-4°X T-0' WOOD PAINT WOOD PAINT CUSTOM-NOTES 1,2,1 5 �W 101 DOUBLE HUNG WHITE PAINT PAINT 215 CASUAL DINING (4)2'-4"X T-O' WOOD PAINT WOOD PAINT CUSTOM-NOTES 1.2.1 5 3353 'AZEK' 214 SERVICE (2)T-6'X 4'-8' STEEL PAINT WOOD PAINT 'THERMATRU°OR EQUAL NOTE 2:TRANSOM PER ELEVATIONS 110 DOUBLE HUNG WHITE PAINT PANT 217 KITCHEN 3'-O'X L'-8" STEEL PAINT WOOD PAINT 'THERMATRU'OR EQUAL Ij 3525 °AZEK' NOTE 3:PANIC HARDWARE REQ'D J III FIXED AWNING WHITE PAINT PAINT 218 CLEANING CLOSET 3'-O'X 6'-8" W00D PAINT WOOD PAINT °BR05C0"OR EQ.FLUSH DOOR 1 II2 FIXED WHITE 'AZEK" 219 DELIVERY ENTRY 2'-8"X 6'-8' WOOD PAINT WOOD PAINT 'BROSCO"OR EQ.FLUSH DOOR NOTE CUSTOM HOLDBACK AND/OR 1-ti DOUBLE HUNG PAINT PAINT 220 FIRE DOOR 90 MIN. (2)3'-0`X C-8° STEEL PAINT STEEL PAINT U.L.APPROVED MANUFACTURER BARRIER TO PREVENT 3357 `AZEK' x^ 113 DOUBLE HUNG - WHITE PAINT PAINT 221 STORAGE ROOM 3'-0°X G'-8" WOOD PAINT WOOD PAINT "BROSCO'OR EQ.FLUSH DOOR FULL SWING OF DOOR PANEL 3357 "AZEK` 222 HALLWAY 3'-O"X T'-0' 5.STEEL N/A "ELIASON'W/VISION PANEL CALL PANELS ARE OPERABLE) { - - "ELIA50N'W/VISION PANEL IIq DOUBLE HUNG WHITE PAINT PAINT 223 HALLWAY 3'-O"X T-O" S.STEEL N/A NOTE 5: NARROW STILES 13 5/81) U IIS 3357 WHITE "AZEK' 224 WOMEN'S BATHROOM 3'-0'X 7'-0" WOOD PAINT WOOD PAINT CUSTOM-TO MATCH MAIN BUILDING E DOUBLE HUNG PAINT PAINT 225 MEWS BATHROOM 3'-0"X T-O' WOOD PAINT WOOD PAINT CUSTOM-TO MATCH MAIN BUILDING �a TRASH COMPACTOR 3 2 - A DELIVERY AREA ' RETAINING WALL I7'.B.D.) I�LIMIT OF ROYAL BARRY WILLS DESIGN WORK EXTENT OF STAIRS.TERRACE AND RAMPS T.B.D. PER LANDSCAPING DESIGN DATE I IS; 21'-0" 39•_0' 9-13.2006 r-e° 113 r-e' 10'-1' 3'-5Y DESIGND III (ABOVE) DOC 112 20 20 'IN 9-20.2006. DESIGND ELEC. 108 BELOW-1 o ® - 105 106 IOl IOB 1°\IF N 7 AND COLD 109 IIO W LL HYDRANT @,_Ly. p_5y• E'-LY• L'-3Y" -OY' -lY' -tY' -t 'Y OY,' 10.30.20V q � RA Q D.D.REV. GAS METER� --�- 9•-q° B R. Q T ENTRT �, o Bs. 11-21-2005 101 102 03 104 ® ''219 O O O-0'P05T S ACING LING • PERMIT *LIVERY ENTRY WOMEN'S ROOM PILASTERS TO DETAIL ® LIFT O O 2 0 ® 7'HR.G.WB. _BF S- j p 91gp yNK m Gn5 WALL 11 AMP EMPLOYEE DINING ROOM -- ® III T Y' 1 i CASED OPENING p�2E R I DASHED LINES EXISTING 8 ___-_ TO BE DEMOLI5HED ITYP.) FIRE OOR5 ON MAGNVTIC 11 D HOL BACKS j °T-O W- II CASUAL DINING ® KITCHEN rt-o rt-o•II 9'-Z Y' -5Y\ C.O. II 39-0' . SEE PLANS'K-I'ETC...FOR DETAILS 2 '� -SOFFIT AND BEAM OVER ALL TRIM 1 CASEWORK EnERGENC7 EXIT of 22 m II TO BE TO DETAIL X -GLASS L'. �IGRGLE CENiEIU �' H• 3'-L'W. B " KITCHEN OFFICE j CO. S, �I 9. 1'. ON. BAS II B. 5': BANQUETTE TO DETAIL 210 0 ®�-IE)STRUC.COLUMNS TYPJ--­► 0�i I I p ® EB T-ULT-INEF .. DIMENSION 15 FOR PROTECT AS ________1— REa•0 ROUGH OPENING I OF DOOR A ® O 0 -------- 1 if________ II pOyN M' g' r IPA OLD WALL LAYOUT NEW POST PER STRUCTURAL ITYPJ DEMOL15H CHIMNEY --------i-}� " 21L I 211 --- LA55 RAILIG PORC IS i PLATFO 2Q b.215 214 213 G N _� �_ � I'- I•_• 2'-1 '2'OY' SE B UES K.JOI® LUESTONE e'-10' Oh 3'_4 °._BY• 9•_BY• 9'_BY• i T L TONE 70 MATCH c�c CURVE OF TERRACE-(RADIAL LAYOUT) r RAL N07UA 1 b 4 EDGE,O FRAMING -ALL NEW EXTERIOR WALL FRAMING NEW WOOD DECK o�' E.. DO NOT DISTURB FACE OF F I TERRACE TO BE 2X6 a 16"O.C. WALLS IN DINING ROOM I `` 52 BLUESTONE )-TEMPERED GLA55 RANNG LATTICE SCREEN` BASEMENT ENTRY BELOW ALL NEW INTERIOR WALL FRAMING TEMPERED GLASS RAILING TO BE 2X4 R 14"Q.C. TYP AP CMG PLANTINGS BELOW IBY OTHERS) -FURR WALLS AS REQ'D TO HIDE FORMAL DINING ROOM 1 COLUMNS 1 PIPES. 39'-0' O O RETAINING WALL com 1 LIMIT OF ROYAL BARRY WILLS DESIGN WORK 29 1 D/ 8-22- DA Al 1 RC SHEF 1 MAIN LEVEL PLAN O L 19t1'd No.1484� K' BOST. Ass. $ . J 09 4' I 1 STAMP.`_ P3 TERRACE ROOM - ROOM FIN 15H :SCHEDULE Number Name Base Firnsh Floor Fm[sh Wall Fmrsh rt Ce[hng Flnish Comments Lv EXISTING CONDENSER TO REMAIN TR I TERRACE ROOM LOUNGE ETR EXL5TING SLATE TILE FLOOR TO REMAIN LLJ GWB TO REMAIN, ,FABRIC/WOOD NEW QUARRY TILE BEHIND BAR m - UNILE55 NOTED PAINT Q qJ SAW-CUT TRENCH EXISTING SLAB ON TR2 STAIR L N/A REf'INISH EXISTING WOOD FLOORING N/A N/A STAIN TO MATCH LIVING ROOM rwo o I GRADE FOR NEW WATER SUPPLY TR3 STAIR R. WA NEVvV WOOD FLOOR WA N/A STAIN TO MATCH LIVING ROOM c SANITARY WASTE LINES. REFER TO PROJECT - I - - - - - - -- ii- _ - u - JI 1F1 I I #3 PLUMBING PLAN FOR DETAILS. FIELD O [ -i IIJI ll i�Cl'�L J ,�UL COORDINATE LOCATION OF RISERS AND j ate(( 11J� ° ��'nnn///"'���IQC S Chi J �� j�i� u 1�� �C�I���[�� �u�l !�JC�uI ]I JI�Clt��uu�L ui ��CI DISTRIBUTION OF PIPING WITH BAR PLANS REFINISH EXISTING I A3.05 b.J. jjuds U N CNN _4 itCi 7-! I6 � STAIR L NEW FLOOR NEW FLOOR DIFFUSER c c WOOD TREAD = °D 00 7�1 �_-_ _��_�_ ��� L� Z �� -'CL�V DIFFUSER W c oN �o r [1 J TR2 — - — — — — - — — __ _ _ — _ NEW WOOD LL ap o L �� C� — - LO - ___ FLOORING ___ El _- L_ �r IAIa o 0 0 — - ___ — V3 - _.I n i i DN 5TAI R R � U = fill u.r�j JI-_ -- l - _ (?S z _L� f NEW TILE FLOORING BEHIND' r i t�t � f I I _ i � - ------ ( MBAR INSTALL FLUSH W EX., -' �- -- i_ i i �I / - EXISTING STEP CUT BACK-REMOVE �_ L � �� ➢""ii � �� i. li It C� � — U - - W JJ �I __ �� . . -_L-Jr SLATE TILE-COORD. rt �- ___ L �� �� PLYWOOD TREAD AND INSTALL NEW -;---- it _-.I �� - - -�-- Q RETURN N05lNG RISER TO WALL EXTENTS W/BAR LAYOUT �' - +'� I TREAD W/PROFILE FIN.TO MATCH F- �r_��� �I D --J @ MODIFIED STEP.PATCH WALL I 1-i_.� -T - -� -'--� - I CUSTOM MILLWORK BASE Z to ---- -i- n _.._ I T J CABINETS 4 COUNTERTOP @ u_ J -! GL1C1 BASEBOARD AS REQ'Dr- -�- ( / - OPIENiNG TREAD OPPOSITE = N [ �l L_ �C�C� IIIIIIIIII , C'L_V-J�'ui� !I 1 LL j ILII r iLn��` %l�L_'CJ�L., I � _ I If�l�: I � / I O r I�1.�-r �., �I �, j r : PATCH ft REPAIR WALL SURFACE @ w GC i_ L r _ ir, u' I'I I r �j it jlUj Cuj-.�u;_�lJ JC Jut.- Cu �. ❑C _t_� iu -Cum M t- ■ . . - - - - - - - - - - - - - - -- - .-.. - - _._/ DEMO'DWALLPANELtPAINTPER Q cn O FIN15H SCHEDULE o NEW FLOOR DIRAIN, EA.SIDE. 1 j REFER TO PLUIMB DWGS FOR DETS. 4 A3.04 6 I 0��- o - - - - - - - - - - - — — —I -� j - — — —SAW CUT TRENCH EX.SLAB AS- _ ` EXISTING PATIO TO REMAIN AS 15 ! -- �- REQ'D TERRACE ROOM LOUNGE — -- .-I— - -----1- G TR I NEW CUSTOM MILLWORK BAR -MAHOGANY TOP W/3 COATS MARINE VARNISH OVER BASE W/ a CEDAR SHINGLE FINISH AND SATIN 13RA55 FOOT RAIL t PURSE(HOOKS - --__-__._-__ EXISTING CONDENSER TO REMAIN _4— -- EXISTING FLOORING TO REMAIN A3.04 r-— -� j Q 3 4- -------- EXISTING PILASTERS I-------- (NO WORK TYP.) O C REMOVE EXISTING FLOOR DIFFUSERS RI5ER5 (TYP. 7 U O LOCATIONS). CUT BACK SLATE TILE AND SAW-CUT SLAB cL/ TO ENLARGE OPENINGS FOR NEW RISERS AND FLOOR GRILLES AS REQ'D. REFER TO MECH. DWGS FOR DETS. W O Z3 Clio i O Q 01 TERRACE LOUNGE PLAN '� j 1 114" = 1'-0" U ~ � -� CD G r— TITLE: P3-TERRACE ROOM PLAN 11411 _ 1 1-011 DATE ISSUED: 9.29.2014 REVISIONS: NO. DESCRIPTION DATE a s m DRAWN BY: Author g PROJECT #: o s DRAWING NO.: A3 , 02 c 0 N L O m�m O i - I STAMP: EXISTING CEILING 112"PLYWOOD SUBSTRATE BY G.C. FOR ATTACHME`.NT OF o O FABRIC PANELS FABRIC PANEL CEILING(SHOWN HATCHED)BY OTHERS.G.C.TO W PROVIDE 1/2"PLYWOOD SUBSTRATE C FIRE RESISTANT FABiP,IC OVER m OVER EXISTING CEILING I I I ® DACRON BATTING B..O.ATTACHED PRE-FINISHED WOOD BATTEN (PROFILE T.B.D.) Q TO 112"PLYWOOD SIUBS'TRATE OVER FABRIC PANEL SEAM,TYPICAL INSTALLED _- -_`' \ \_=,' --- AFTER BATTING FABRIC. FILL NAIL HOLES ;, �-k-"�--� �,• :, � I '.,-, -:� �,=-��; —\ ;\-r-�; I Lrt- -- --r--� ER EXISTING CEI / 3C , y \/ ./' _ - I {-- 1 -' =I - \' ✓� -I�X); -'3E / \-- - FINISH TO MATCH V LIING 3B.-�_-� ;_�f 3B v ', ,;.13B �' -•. x- 3B ��� -�--�3B ~=��� - -�-Y--��- ,. I �� _ / /\ C \ ; \�`� /�Q �\ NOTE: PROVIDE PAINTED WOOD MOUNTING BLOCK FOR \,'_ REMOVABLE PANEL FOR PENDANT LIGHT FIXTURE INTERSECTION OF WOOD \J f \- / \, \, / \j / MAINTENANCE ACCESS TO BATTENS,TYPICAL WHERE LIGHTS OCCUR ON PLAN. U � - I -,--, -. .-- ,- 3B c� c� / \ / /\ / ( / \ / I I I ; / '' / I �\ ` '`' / \ \ ') SKYLIGHT ABOVE DETAILS TO BE COORDINATED WITH FIXTURE SELECTION, OD N /\ -\ OPEN TO EX15T. OPEN TO EX15T I' ' OPEN TO EX15T. O ' I \/ \i I I �. __r__ I I I \, \/ / I I = � / �'is ' DIMENSIONS C MOUNTING REQUIREMENT5 ao I SKYLIGHT I v I �� I SKYLIGHT Iv / I 5KYLl6HT I v I `°- EXISTING SKYLIGHT ABOVE10 I' ) I C I f I I i Ty 4 -5 / W '0 co ' , / (SHOWN DASHED) L,L, `? o0 v/ - .v , ,- , -� , ;v I TERRACE ROOM CEILING - BATTEN DETAIL �-- I / � I'L r I �' =- I I { I v�/_ ! ( I `�',. �.I A/1 I j'\/ 3B �� - �� LO - Iv/ ' \, i _- - - Ivi /\ `y,/I / I 3" - 1 -0 C� 0 0 IL J _.,, _l BATTEN DETAIL W/ _ z �C - - / Vvl00D B L_` / i / / -' i - v A ` ��� -�- y v, A. � PAINTED FINISH OVER FABRIC � - --�_ _- =�i / a \ T _ _ � ' PANEL SEAM,TYPICAL EXISTING CEILING - \ - - - - - -- 3B -- ----- A - -- - - -- -- � yi /,,--- - - -- -- -- - - �— j' ;,• / -- —3D --- �, /�'� - - -r— I- -- ? 1/2'PLYWOOD SUBSTRATE BY \ / / / -\ - - - -� - : -' - - ;�- - /-- �=� - \ G.C. FOR ATTACHMENT OF ,J U • /\ ;EXISTING FIRE\/ . \ ,\ i / / i \ %\/ 'i ` i ' /\/ ' /\/ \ , \.'; \ %\/\'\ i / \1' \ -- -- �' FABRIC PANELS/ \ \5UPPRE5510N PIPES j " \ \ '\ /\i\ /\ / \/ \ / i\ \ / \! \/\/ / \ \/ \/\ \u� /'\/ \i' I, / /\ W j F n Panel C llln \, \; - - - ,. v / / ,dBHOWN D10 ASHED)', / v / V/\ ab�ic'Panel \ v � / Z H 10'-2A.F.F. y - - - - - -- - - - - - _ \•/� / A / / Vjll A/A; IA \/ Aj /\/V \/ / '', A/\. A;A ,1,A.F.F./�i. '•V / ���. ///., / '� \ '�� ��\ I \V A / / �� /V/ -7 \3D --/ --- — — — -- 3D / Lv c�- ALIGN L OF / /\ / /\ '\ -- - 4 CROWN/ -\ / FABRIC;PANEL JOINTS ` \,/ \ \ '\ / \ \ ;• /MOULDING W/PTD./ \ ; I /\/\/` / O (SHOWN DASHED)' / \ \FIN . @ P RM E \ \ \E4, \/\, \/ \/EQ \ \; / - O OF EACH CEILING,, i I --\--- / FABRIC PANEL CEILING 5.0. 0 0 � C i / %\ \; Y, I j, PAINT WOOD MOULDING N --------�- /\j / ATTACHED TO !l2 PLYWOOD PAINTED W CROWN MOU ------- -- --- ------- SU6STRATEO`VEREXISTINGD 0 � %\!\ \j I V!�' - /-v /v \ I � A '\ iv / v /\! CEILING �/ v, � /V 'I /A '`. %\ \;�/� V I`• ,, A /r I ` /„V/\;A i i /\%A % A3 03` j I f ••/ A, v v I --- A ',- v ; I / -/ I- - I --;� --1 „ r,, - I A3 03 - I v ,' I .=/v- I PROVIDE PAINTED WOOD MOUNTING BLOCK FOR PENDANT PAINTED,/ a / EXISTING BEAM TO PATCHED / \/ V \,I /\ A ___ �EQvEQ i A/\ \/ _ LIIGHT FIXTURE@ INTERSECTION OF WOOD BATTENS, �\ AINT D,TYP i v ' Q/ �/ � /_\ \/ / A I TYPICAL DETAILS TO BE COORDINATED WITH FUTURE _f _ - - I -'-- - �\ �i\ ;' SIELECTION, DIMENSIONS t MOUNTING REQUIREMENTS Cn C Q L ; TQERRA11 �CE ROOM CEILING - CROWN DETAIL O -011 CL Of BEAM,TYP. 'NOTE: ALL LIGHT FIXTURE5 ARE PROVIDED BY OTHERS AND INSTALLED BY CONTRACTOR UNLE55 OTHERWI5E NOTED. > O _ � � REFLECTED CEILING PLAN-TERRACE ROOM ��\�• � � 1 O r*101/4 1 0 w G� v� Li htin Fixture Schedule -TR, C :3 9 /� �I y� PROVIDE PAINTED WOOD MOUNTING BLOCK-FOR PENDANT � � vJ j � LIGHT FIXTURE @ INTERSECTION Of WOOD BATTENS, C Type Mark De5Crlption Model Type COmment5 TYPICAL. DETAILS TO BE COORDINATED WITH FIXTURE SELECTION, DIMEN5ION5 t MOUNTING REQUIREMENTS O _ > 3A DECORATIVE PENDANT, NEW JUNCTION BOX CURREY, MARaLLO SMALL#938G OR SIMILAR PROVIDED BY OTHERS, INSTALLED BY CONTRACTOR i 3B 4"RECE55ED LED DOWNLIGHT, EXISTING JUNCTION BOX- RELAMP ONLY TBD PROVIDED* INSTALLED BY CONTRACTOR 3C WALL SCONCE, EXISTING JUNCTION BOX CA5A ACANTO ROPE 5CONCE OR SIMILAR PROVIDED BY OTHERS, INSTALLED BY CONTRACTOR. �;: 3D 4"RECE55ED LED DOWNLIGHT, NEW JUNCTION BOX TBD PROVIDED 1: INSTALLED BY CONTRACTOR ^ ( , 3E WALL MOUNTED EXIT SIGN TBD PROVIDED INSTALLED BY CgNTRACTOR BATTEN DETAIL W/PAINTED v ~ N FIN15H OVER FABRIC PANEL SEAM,TYPICAL 0 PENDANT LIGHT FIXTURE AS SPECIFIED 5 G (PROVIDED B.O., INSTALLED BY G.C.) 5 REFLECTED CEILING PLAN -TERRACE ROOM - FIXTURE MOUNTING DETAIL TITLE: o P3-REFLECTED 3 I CEILING PLAN, --------- ------ A3 4 r A3.05 � — `\ I PAINTED WOOD FRAME BY CONTRACTOR ` SCHEDULE & 4 4 I � — FAIBRIC PROVIDED DETAILS INSTALLED B.O. j DECORATIVE BRACKET 1'-2" ALIGN WITH BOTTOM OF TRANSOM WINDOW AS indicated 01 4 A3.04 6 / / DECORATIVE BRACKET EXI5TING WINDOW TRAN50M � � � DATE ISSUED: / G.IC.TO FABRICATE AND INSTALL CUJSTOM WOOD FRAME*BRACKET ,) WI1TH ARCHITECT PI ORFY LTOIMENSIONS 9.29,2014 FANBRICATION. REVISIONS: � DECORATIVE BRACKET FABRIC AWNING B.O. PAINTED DECORATIVE INTERIOR FABRIC AWNINGS(SHOWN DASHED 1 SHADED). WOOD BRACKETS AT G.C.TO FABRICATE AND INSTALL CUSTOM WOOD FRAME 1 AWNING ENDS ONLY NO. DESCRIPTION DATE BRACKET ASSEMBLIES. FABRIC PROVIDED t INSTALLED B.O. (U.O.N.)BY CONTRACTOR 1 Addendum#1 9/5/14 A3.04 - 4 AWNING FRAMEWORK DETAIL TERRACE ROOM BUILDING 3 LOUNGE Es EXTERIOR CUSTOM WOOD BRACKETS U (MtOJ3� DRAWN BY: 4 3 y, Author PROJECT #: TERRACE ROOM - INTERIOR AWNING `' l/2" _ �'-0" s DRAWING NO.: A3 , 03� � O1 TERRACE LOUNGE - INTERIOR AWNING PLAN � o a Sl GENERAL BAR NOTES: REFERENCE NOTES j INTAKE AND EXHAUST COLD WATER SUPPLY N-1 FILTERED COLD WATER NOT REQUIRED. MANUALLY STUB ELBOWS ABOVE FLOOR AT LOCATIONS SHOWN ON PLAN. J TERMINALS INSTALLED � TO WATER HEATER 1. ALL PLUMBING ROUGHING AND MOUNTING HEIGHTS FILLED ICE BINS METALIC PIPE DEPTH AS REQUIRED TO ACHIEVE i APPROXIMATELY A 90 DEGREE PENETRATION OF SLAB. BY MECHANICAL COLD WATER TO EXPANSION ARE TO BE IN STRICT ACCORDANCE WITH LOCAL CODES. PROVIDE A TEMPORARY PIPE CAP WELDED TO ENDS OF CONTRACTOR TANK AS SHOWN ON PLANS THIS CONTRACTOR SHALL COORDINATE HIS WORK WITH CONDUIT DURING CONSTRUCTION PHASE.TRIM ELBOWS AT HOT WATER TO FIXTURES HOT WATER RECIRCULATION N-2 CONNECT 1 n COLD WATER SUPPLY TO EXISTING TIME OF INSTALLATION OF BEVERAGE LINES TO 6"ABOVE SLAB As SHOWN ON PLANS OWNER SELECTED BAR SERVICE EQUIPMENT AND { NORMALLY AND 8"INTO CABINETRY. AQUASTAT SET AT 10°F LOWER BUILDING DOMESTIC WATER METER. THIS CONTRACTOR SEAL FLOOR PENETRATION WITH CHECK VALVE(TYP) THAN HEATER TEMPERATURE ARCHITECTURAL DRAWINGS, AS WELL AS CONTRACTORS FLEXIBLE,WATER AND FIRE PROOF AUTOMATIC VACUUM RELIEF OF ALL OTHER TRADES, PRIOR TO INSTALLATION. TO ACQUIRE APPROVAL OF EXISTING WATER SERVICE ASSEMBLY ACCEPTANCE. IF WATER AUTHORITY DEEMS MATERIAL TO COMPENSATE FOR VALVE(WHEN REQUIRED) � --- T REPLACE EXISTING WATER ASSEMBLY PIPE EXPANSION ICE BIN CONNECT TO ICE I NECESSARYO BIN DRAIN OUTLET FLOOR SHUT-OFF VALVE(TYP) 2. PIPE ROUTING SHOWN IS SCHEMATIC AND IS NOT BIN REQUIRED RAINOUTLET 4 a o o WITH NEW THIS CONTRACTOR TO PAY ALL RELATED FEES. o THERMOMETER I --� STRAINER INTENDED TO INDICATE EXACT ROUTING OR LOCATION OF Q INDIRECT DRAIN OPEN :s 1 1 PIPING. ANY ADDITIONAL OFFSETS AND FITTINGS TO ATMOSPHERE AT o • ,'.• •• .a. `°•.' ;,..`° °'.vd. a • �` PROVIDE PIPE UNION, — RECIRCULATION PUMP N-3 CONNECT NEW 4" WASTE AND 2" VENT PIPING TO FLOOR DIELECTRIC IF REQUIRED REQUIRED FOR PROPER INSTALLATION AND TO MAINTAIN EXISTING BUILDING D,W,V SYSTEMS. VERIFY EXACT dS Co 3/4"ID FOR DISSIMILAR METALS(TYP) I_- GAS COCK PROPER CLEARANCES SHALL BE PROVIDED AND REFER TO"INDIRECT EXHAUST AND INTAKE J' 6"LONG DIRT LEG INSTALLED BY THIS CONTRACTOR, THIS CONTRACTOR LOCATIONS IN FIELD. j PROVIDE FLOOR SINK AT SIDE EDGE OF /CONDENSATE DRAIN" PROVIDED BY MECHANICAL -- NO 00 INSTALL ASME TEMPERATUREAND SHALL PROVIDE ACCESSIBLE SANITARY CLEANOUTS AND ICE BIN,WHERE ACCESSIBLE FOR DETAIL FOR MORE CONTRACTOR PRESSURE RELIEF VALVE N-4 PROVIDE BOW VENTING FOR HAND SINK. VENT SHALL U N N I CLEANING-NOT UNDER ANY EQUIPMENT SEAL TO CABINET FURNISHED WITH WATER HEATER ALL SANITARY SYSTEM VENTING AND FITTINGS AS PER _ cMo INFORMATION LENGTH AS REQUIRED WATER HEATER i RISE 6" ABOVE SINK RIM. I WITH SILICONE C.,� 1 ccoll UNION WITH GROUND Jowl LOCAL AND STATE REQUIREMENTS. Z 0o ARRANGEMENT SHOWN IS SCHEMATIC.ADJUST AS REQUIRED TO SUIT USE FOUR INCH ELECTRICAL CONDUIT AND FITTINGS. USE EXTERIOR WALL o BD CONDITIONS. VERIFY CONNECTIONS WITH MANUFACTURER. --- PROVIDE A HARD COPPER � _ Lo MINIMUM QUANTITY OF FITTINGS REQUIRED. PROVIDE LONG DRAIN VALVE BY WATER SWEEP ELBOWS AT BOTH ENDS,WITH MINIMUM 30 INCH RADIUS HEATER MANUFACTURER RELIEF VALVE DISCHARGE LIME 3, THIS CONTRACTOR SHALL PROVIDE AND INSTALL ALL N-5 NOT USED a ICE B I N CONNECTIONS (AVAILABLE AS ELECTRICAL CONDUIT-DO NOT USE MULTIPLE FULL SIZE OF VALVE OUTLET ! ; u ELBOWS TO MAKE 90 DEGREE TURNS). PROVIDE TEST OF INSTALL EXHAUST ELBOW C ROUTE TO FLOOR SINK AND APPURTENANCES REQUIRED TO PLACE ALL FIXTURES AND V NO SCALE CONDUIT AFTER ASSEMBLY TO VERIFY WATER TIGHTNESS. AND CONDENSATION HOSE DISCHARGE WITH 6"AIR GAP N-6 1" H&CW RISERS, 2" V UP AND 2" WASTE STACK. 3" REPAIR LEAKS IF INITIAL TESTS FAIL.MAINTAIN PRESSURE FURNISHED WITH HEATER, ' EQUIPMENT IN FULL OPERATIONAL CONDITION. a Z FLOOR SINK APPURTENANCES INCLUDE, BUT ARE NOT LIMITED TO, WASTE DOWN. 0 UNTIL BEVERAGE LINES ARE INSTALLED.AVOID ELBOWS IN PROVIDE MINIMUM 1"100P HORIZONTAL RUN IF AT ALL POSSIBLE.BEVERAGE SUPPLIER IN HOSE(FOR TRAP),AND WILL SEAL ENDS OF CONDUIT WITH FOAM AFTER BEVERAGE ROUTE TO DISCHARGE SHUT-OFF VALVES, FLEXIBLE RISERS, ANGLE STOPS, Z F-- LINES ARE INSTALLED IN CONDUIT. SET WATER HEATER ON 4" N-7 COMBINE ALL VENTS FROM FLOOR BELOW SIX (6) J Q INTO FLOOR SINK CONCRETE EQUIPMENT BASE VACUUM BREAKERS, ESCUTCHEONS, PIPE SLEEVES, „ Ll.i W w REFER TO SPECIFICATIONS,SCHEDULES AND NOTES FOR MORE INFORMATION. PIPING ARRANGEMENT PRV'S, BACKFLOW PREVENTERS, TEMPERATURE AND INCHES ABOVE FLOOD RIM AND RISE 2 VENT STACK UP 5 204 SHUT-OFF VALVE IN SHOWN IS SCHEDMATIC. VERIFY ALL CONNECTION SIZES AND LOCATIONS PER MANUFACTURERS THRU ROOF AND INCREASE PRIOR TO PENETRATING ROOF � = N Q ACCESSIBLE LOCATION EXTERIOR BUILDING WALL PVC BEVERAGE CONDUIT REQUIREMENTS.ADJUST TO SUIT FIELD CONDITIONS. REFER TO FLOOR PLANS FOR PIPE SIZES. PRESSURE GAUGES, T & P RELIEF VALVES, UNIONS, �� / W < ABOVE CEILING �" PROVIDE SEISMIC STRAP OR BRACING IF/AS REQUIRED BY LOCAL AUTHORITIES. PROVIDE HEAT TRAP TO A 3 VTR. V.I.F. EXACT LOCATIONS. O U Iy NO SCALE CLEANOUTS, ETC. 1= AND AUTOMATIC VACUUM RELIEF VALVE REQUIRED BY LOCAL AUTHORITIES. INTERLOCK AQUASTAT Co < xI!_WITH RECIRCULATION PUMP BY ELECTRICAL CONTRACTOR. N O WATER HAMMER ARRESTER N-8 PROVIDE AUTOMATIC TRAP PRIMER (TP-1) LOCATED 4. ALL EXPOSED PIPING SHALL BE PAINTED TO MATCH THE a BELOW CABINETRY WITHIN LOCKABLE WALL RECESSED Q wsULATECOLD WATER PIPE= GAS WATER HEATER AND PUMP APPROVAL OF THE ARCHITECTS CRITERIA. INSTALL O TRAP PRIMER CABINET AND SUPPLY ALL FLOOR DRAIN �� J CEILING FLASHING AND COUNTER- NO SCALE WATER SHOCK ARRESTORS AT EACH FIXTURE OR e M FLASHING OF VTR Is AND FLOOR SINK P-TRAPS. �� o a BY ROOFING CONTRACTOR BATTERY OF FIXTURES. ALL INDIRECT WASTE PIPING 0 04 } INSTALL RISER INSIDE LENGTH OF SHAFT TO , MINIMUM 12"ABOVE RZOOF SUIT THICKNESS OR WALL NORMALLY.EXTEND TC)HEIGHT SHALL BE COPPER AND CHROME PLATED BRASS WHERE PARTITION WHERE CORE DRILL OR PROVIDE OF PARAPET WHEN WIITHIN TEN N-9 REMOVE EXISTING WALL HYDRANT LOCATED UNDER AVAILABLE;REFER TO CUT WALL AS REQUIRED. SLEEVE IF REQUIRED FEET OF PARAPET EXPOSED AND VISIBLE. PLANS.IF RISER IS 31, l EXPOSED,ANCHOR INSTALL WALL HYDRANT, BY TYPE OF ROOF DECK STAIRS AND EXTEND 4 CW TO NEW NON-FREEZE WALL TIGHT TO WALL,INTERIOR GROUT OR OTHERWISE HYDRANT H . V.I.F. EXACT LOCATION WITH ARCHITECT. TowALLwsuLATION REPAIR WALL NEATLY 5. THIS CONTRACTOR SHALL OBTAIN DIMENSIONED NV ) HYDRANT,AROUND FACE WALL HYDRANT,TO SEAL ROUGHING CONNECTION LOCATIONS FROM EQUIPMENT o WATERTIGHT ROOF DECK ANCHOR PIPE TO ROOIF DECK SUPPLIERS, PRIOR TO WORK COMMENCING. N-10 2 H&CW, 1 2 IW (AIR GAP TO FS). ELBOW AS REQUIRED ROOF INSULATION OR JOISTS WITH U-BOLT'AROUNDPIPE AND HOT WATER(120°F)WITH INSULATION EKRJs�MINIMUM I2"BELOW ROOF OR SCREWEDODCDOI 6. THIS CONTRACTOR SHALL FLASH ALL FLOOR DRAINS 1l' 1 UNDERCOUNTER DISHWASHER N-11 '2 H&CW, 1 2�� IW (AIR GAP TO FS), WITH TMV BELOW PROVIDE PIPE INCREASER FURNISHED WITH INTEGRAL 70 DEGREE WATERTIGHT. T T 105 DEGREES F. STRAINER SOLENOID VALVE SET o VA INTERIOR T WA HUBLESS PIPE CONNECTORS ON ,VALVEO WALL WHERE REQUIRED TO MAKE HEATER BOOSTER ♦ '� MINIMUM 3"VENT THRU ROOF CAST IRON PIPE AND VACUUM BREAKER v INTERIOR FLOOR INSTALL 22"ABOVE FURNISHED BY Pc 7. MINIMUM BELOW SLAB/FLOOR SANITARY WASTE PIPING 4� GRADE.ADJUST HEIGHT PRESSURE REDUCING VALVE SET AT20 �� N-12 VENT RISERS TO RISE WITHIN FALSE VERTICAL a) a IF/AS REQUIRED TO NOTE: REFER TO PLANS FOR VTR PIPE SIZES.VERIFY EXACT LOCATKONS PSI,WITH INTEGRAL BYPASS,STRAINER TO BE 3 UNLESS NOTED OTHERWISE. CHASES. VERIFY EXACT LOCATIONS WITH ARCHITECT. (� C SUIT MASONRY JOINTS WITH ARCHITECT PRIOR TO MAKING ROOF PENETRATIONS.LOCATE: AND PRESSURE GAUGE FURNISHED BY ■ VT MINIMUM THREE FEET FROM PROPERTY HEATER MANUFACTURER I ( R U E O RO ERTY LINE, R TWENTY FIVE N O TWE E �V FEET HORIZONTAL OR VERTICALLY ABOVE ANY BUILDING OPENING 1 OR EXTERIOR GRADE, FRESH AIR INTAKE,OR ONE FOOT FROM ANY VERTICAL SURFACE. BAR COUNTER TOP o •+ PAVEMENT,OR SIDEWALK LOCATE VTR MINIMUM 18"FROM PARAPET,EXPANSION JOINT, /yW1 EQUIPMENT CURB,ETC.OFFSET IN CEILING SPACE WHERE REQUIREED '`"� NON-FREEZE WALL HYDRANT TOMES ESECONDIrIQNs. .� 2 No SCALE VENT THRU ROOF (VTR) > -� > NO SCALE TEMPERATURE GAUGE(TYP) COMMERCIAL GLASS EQUIPMENT CONNECTION SCHEDULE o UNION(TYP) I WASHER I (BY OTHERS) THROTTLING n, PROVIDE CLEAINOUTS IN DISCHARGE INTO RECEPTOR W U TURNS/ENDS O F PIPE. �� WITH AIR GAP TO SUFFICIENT SHUT-OFF VALVE(TYP) VALVE • ITEMS PLUMBING GAS REMARKS Co USE DWV FITTINGS IF SIZE REMOVE GRATE AND STRAINER. - IS LARGER THAN 1" MINIMUM GAP=TWICE PIPE HANG PIPE LARGER THAN WOOD STRUCTURE I DESCRIPTION ST W V FCW CW 1400 1200 IW SIZE BTU SLOPE PIPE G� DIAMETER 4"FROM TOP OF JOISTS JL ¢ oElf U) Q AS MUCH AS V ONLY AT PANEL POINT m POSSIBLE HW(120°) HARD COPPER TUBE FULL slzE of 0 2 SLOP SINK - - - - 1/2" - 112" - - - PIPE INDIRECT WASTE TO LW.FLOOR DRAIN TOWARD SIDE BEAM CONNECTOR DISCHARGE I ATTACHED TO TOP W/INSULATION RELIEF VALVE OUTLET TO DISCHARGE O 2 36"ICE BIN - - - - - - - 11/2" - - PIPE INDIRECT WASTE TO I.W.FLOOR DRAIN O MAKE CONNECTION, (D ( CHORD OF WOOD TRUSS ALL-THREAD ROD OVER FLOOR SINK.TURN DOWN WITH 2Cu TO EQUIPMENT ADJUSTABLE BAND HANGER 2"AIR GAP O 2 4H"COOLER - - _ _ - _ - �— AS REQUIRED FOR PIPE 3-1/2"AND " " �� SMALLER AND CAST IRON PROVIDE COPPER ® 1 24 GLASS WASHER - - - - - - 3/4 1 - - MAKE PIPE MINIMUM ONE SIZE PIPE 2"AND SMALLER COATED HANGERS PROVIDE INDIRECT DRAIN TO FLOOR SINK WITH CAST IRON P-TRAP.DO NOT USE PLASTIC O 1 HAND SINK - 1 1/2" 1 1/2' - W" 112" - - - LOCKABLE TEMPERING VALVE BELOW SE 0105 DEGREES F. LARGER THAN EQUIPMENT VERIFY WITH LOCAL WHERE HANGERS PIPE FROM DISHWASHER CONNECTION TO SANITARY MAIN ^' CONNECTION,MINIMUM 3/4". CODES IF/WHEN TRAP CONTACT BARE W USE"M"OR"L"HARD COPPER AND/OR VENT ARE z Z COPPER PIPE UP TO 1"AND DWV COPPER REQUIRED FOR THE LENGTH a_Q L¢ NOTE: BAR EQUIPMENT CASEWORK: THIS CONTRACTOR TO SET ALL TRIM, PROVIDE ALL TRAPS, DRAINS, STO S IES, ■� FOR 1-1/4"AND LARGER OF DRAIN PIPE INSTALLED L a Cn a u°'i PROVIDE GALVANIZED STEEL SHIELD FOR N �� ALL INSULATED PIPE. VERIFY INSULATION EQUIPMENT MANUFACTURERS WILL FURNISH INSTALLATION KITS. BACKFLOW PREVENTERS AND MAKE ALL FINAL CONNECTIONS. COORDINATE WITH ALL BAR EQUIPMENT SPECI CATIONS ROUTE PIPE INCONSPICUOUSLY AND UNOBTRUSIVELY. HANG Lu a 0 w 0 THICKNESS WHEN SIZING HANGERS AND SHIELDS COORDINATE CONTENTS BEFORE SUBMITTING BIDS.ARRANGEMENT SHOWN AND SUPPLIERS TO PLACE ALL EQUIPMENT IN FULL OPERATION. PIPE AS REQUIRED. DO NOT INSULATE INDIRECT DRAIN PIPE a O a i_¢ IS SCHEMATIC. ADJUST AS REQUIRED TO SUIT CONDITIONS.PROVIDE WHEN INSTALLED EXPOSED IN FOOD SERVICE FACILITY. REFER °' V= U)_ CONNECTIONS AS RECOMMENDED BY EQUIPMENT MANUFACTURER. TITLE: TO LOCAL CODES FOR FURTHER INFORMATION, 1/2" 6' 6' PROVIDE UPPER ATTACHMENT AS REQUIRED FOR(CASES NOT SHOWN HERE. DO NOT INSTALL HANGER INSIDE INSULATKON OR OTHERWISE 3/4" 6' 6' PENETRATE VAPOR BARRIER. DO NOT HANG ONE PIPE FROM ANOTHER UNDER COUNTER GLASS WASHER PIPING DIAGRAM vk //b 0� �T EXCEPT IN CHASES. SLOPE ALL WATER PIPING SLIGHTLY TOWARD P 1 E R RAC E 3 INDIRECT/CONDENSATE DRAIN ," 6' ` 8' DRAINABLE LOCATIONS. HANGER SPACINGFORtPIPESIZES:AS 8 NO SCALE NO SCALE 1-1/4" 6' 10' INDICATED IN TABLE. CAST IRON:10'AND WITHIN 1'-01"OF ALL JOINTS. �e/1 r,bi U M ,Q.,� ROOM O O M ROD SIZES FOR PIPE SIZE:2"AND SMALLER=3/8",2 1/2"TO 3"=1/2", !. 1-1/2" 6' 10' 4"=5/8"• LOCATE HANGERS WITHIN V-0"OF VALVES AND FITTINGS. N8 LOCATE SUPPLEMENTAL STEL STRUTS BETWEEN JOISTS IF - ,adz, f � PLUMBING X 2" 10' 10' PROVIDEATE HANGERS WITHIN 1'-0E OF EQUIPMENT CONNECTIONS. ANCHOR NCHOR r 2-1/2" 10' 10' WATER PIPE AGAINST SWAYING DUE TO CHANGES INI WATER VELOCITY. .. ; 4"W,12"H&CW,q"HWR(BS) J 3" 10, 10' CHAINS AND PERFORATED STRAP IRON AND STEEL ARE I NOT ACCEPTABLE. ABOVE SLAB N-7 PLANS DO NOT SUSPEND PIPE FROM JOIST BRACING MEMBERS1 REFER TO CODES -- — 4" 10, 10, AND SPECIFICATIONS FOR FURTHER INFORMATION., PROVIDE SEISMIC _ BRACING IF/AS REQUIRED BY LOCAL AUTHORITIES.. 0 /// I — ------------------------ - 1 i 6 PIPE HANGERS ----------------------- NO SCALE 2 V =�-, <� �- 2"V(As) As indicated i cr 2"V(BS) i 2"�(B ) .� `r ---- d b ---- DATE "Alli i L n S i INS N ISSUED: " " SSU 4 F 1r`l �r � 4 W,11 H&CW BS � ETR GAS SERVICE. METER 2„V(B ® v��-f� ( ) 09.12.2014 TO BE UPGRADED BY LOCAL GAS COMPANY. —u140 --- u140 --- U140 -- U140 - N_7 THIS CONTRACTOR TO PAY = _6 uuo -- +-. U140 -- - i U140 - uu0 --— — u — a u — / U — u — ALL RELATED FEES. uw s=i2s/-r�-- "" --sS=.1251FT �S-.125IF7 "'" FCO REVISIONS: (TOTAL NEW ADDITIONAL BLDG. INPUT:76 CFH) FCO 2"V(BS) � (� � NO. DESCRIPTION BATE EMCAL*STORAGE RJ N`9 5 1 O O - CRAWL5PA GWH- 5 2"V(BS) —`'' O O 1. 50% PROGRESS 08.08.2014 REFER TO WATER LL O f0 E AND HEATER PIPING .L*$UPPLVrJ.A EEcwcAi M N-4 0 O 2. BID SET 09.12.2014 TMV-DIAGRAM. I RP uP 1 STORAGE Roo^ 3. PERMIT SET 09.29.2014 O N-11 CRAM SPADE EMR � - u I 4"W,11"H&CW,4"HWR(BS) wMaeRs roP SPRIN RC 0 ROOM DRAWN BY: 5NOP S=.125IFT ON UP - - --- CAD VIFTING INV NORV G aNrERgsno N_1 N-10 N-10 N_1 PROJECT #: 201401 NOTE: REFER TO GENERAL NOTE NO.54 FOR SPECIAL CONSIDERATION ATKEN WITH REGARDS TO BURIED HAVC SUPPLY AND RETURN DUCT DRAWING NO.: WORK. P3001 O PLUMBING BASEMENT PIPING PLAN 3 O" BAR - UNDERCOUNTER EQUIPMENT PLUMBING LAYOUT NOTFOR I O 1/2" = 1'-011 CONSTRUCTION I __ �D ��7 A T � �TT����+ #AR a WMWAI F248 2 � ter(rw) D-RAIlL AGE-E•1-�J.iY�.�L•�11J-`S RIM INVERT SIZE ' s• wID ABM�"- CLEAR OPENING �r i m t-vz•eAS LPI 24-5 600 GAL WIVOE STONF EDGE OF CURB HOLES ate., r 6W cM f ' CONC. SIDEWALK r tr s HbPE PEELP3 _ 19.0 10fflGAL1W110F9r0NF (CUT ( REPAIR ENTRY APRON AS REQ'D.) ^ 3,01 �°' - LEGEND _(-4 >�-d MM ALL Cowaa TsSTONE TO X U-20 LBO � � -0 .. 4LIVERY AREA i ", GATE ZE awacmr '` �'SPHALT PAVING."-- LF 1 OF STONE O. - �•` � r GATE OPS Deciduous Tree Q Misc Manhole ' "::.. :. Tosco• H: 1,P -0 QQ GAL W/11 OF STONE DRAINAGE SYSTEM ® Catch Basin GATE OPERATOR PLANTINGS Catch Basin round TRASH COMPACTOR r i SCHEMATIC I. 3 ---- 24 0 Az-Will NE Coniferous Tree ( � Qj�g 'M RATHCUBIC YARD 1 -� H dran t �` V-4 WTHON' y ,G � 8'-4 W.X 22'S' L. Not to Scale 0Iron Pipe 1' ON REINFORCED Ligh t Post O Dill Hole CONC. PAD -- - -' PARTIAL PLAN ® Water Gate (round) CA O CB/DH ;' t Scale: 3/32 =I -0 CD L r • " © Gas Gate (round) p SB/OH DRAIN Tb: Y LL PAD ItOUNTE OHW Overhead lyres Mag Noi! (FOR CASUAL Elevation Contour r. .:" GLly a LLARD E PJ & ••••• •••••• Underground Gas Line I " Bo 11560/ /4rJoyty G.-'.'' {} Utility Pole ' . f5 .. j e" Arm :..'..'..':::.'.. New Construction ERS ; ..............................: ... W/onno pub o___ +24 .' �i : . 1313 347,132i ® Proposed Grade � • - •.-. WOOD DECK ........... .: `1 Proposed Ve efaion 3•1 Ratio130 C 1 (Plantings in Consultation With yo �•---�"� / Conservation Commission Staff) �_ TBAI rap ce/Dk -------_•� "��• --._.._____ Exrstrn �rw=2ss' ntc ng 9 r'ark) `� -26- P IY,anno club ® 694.23• _ ea •...,,-,-•. _ t "�• �• \ 347/32f Ave of Pv� \ ` Cde� 5'' Forte PVC * , Q Cr Cone ® 9TsvCi pR�A un"OD/u nb N 45•050 E —Z5- R Lown — ' ~� \ A 0--5e - PR*R nA1. Public Way �. As Re9u/red \ ` _` - — — — — Bit Po* c�o• � / �; J LPN AepvE ( _.•• 13� -... _ 414.37' � ®-- ® Q w ♦p�•+'a\ .•--`•...._ .�. ew ............ ° J � � 381.E f rLh / -` . � �•. ` sy® � ® :, �•� n � ...... ...... .�,.•- • Conc C / t 1 a '�• o ... - of o dewa/k er►eas Got Str�Osed t o C 1 Grove!y ot' ed 419y, o Sjde k 1 H7th Signog �C Way\ (c o Z ts°d 1:20 1 1 $ dards CowN v ! \ 'Wed Por FFa27 f "^--- J9 � t t Ren7o _1tIE-�' -"""(• e/!:' `: +A cfi �-.. _ _ s,• r/ �' k 4, t'Q&*k19 caws•, t P� stY o p ``-, ; and nflor�Q Covered Porch :.\ 1. Exlstcture tP1 Sysf y w� :1 "g r Lawn �� C � r Exfstkry w t } - 1N Stana�f Cottage fwy , n,cture �- �- — t Y r ab 'S r9 t ►\ 7 /'roPas 0,� e d ! xist/n �r Additl \ I Pr _ \ 9 .J S X I S ons \ oA trr --""� -,..,. r T 1 aged sue- \' � � � �..• Y w C Ne osed Lawn P A f w P " i a� r s '-- �' ASr pubMouse CA p� d r.Z D �N p to A 11 1 0 L C Bea 1 a P 1 L V O _ w a � e \ sea�\► '- - •.-.-r-- . - 9 L \ t •JTFi E \ -- -- w5� ,• A \ ( •1 • t t lP .C- _.Zsz• -... 9 —oi, -•' e 1 fawn '•�i )top 'J w _-- •--1.,8 I I o •. - s x r .-.,. -.� _•.• 1 � ••-.. .,,., r,.. � ^ap _ �, \ ' ► 1 ti Ezis a/l�Ce� \ _.y __�_��,... 1 Zone .z- — `•-._13-- -. �__-„ _- _,., ,_,,, .,,.,,-•- �.�,.,� --� ,_.,- _••.... Sepfii'7'fdjl 090% \\� �QI\\ \�'��\ \ Fer�cing \ •° -- —., -•..y. ,.,`"•.•'=- _ •�•� ..- �,.....+- v+....+..... 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"i � / ' ...- --- — — — — — — „_, 1 1 _ ' _ — ~ OC 1 EXISTING SEPTIC COMPONENTS I. 1000 Gallon Grease Trap 2.1500 Gallon Septic Tank FLOOD ZONE: 3.2000 Gallon PUMP Chamber Zones V11(el.17) & C Community Panel No. 250001 Revision MAR 014, 2006 ASSESSORS REF: Per LOMR Case # Ma 16Z Marcel 24 p05-01-0764P Nantucket SouLOCATION MAP: rId Scale: 1" = 2000t REVISION DATE:3/7/07 Relocate 3'OForce Main a Added 4"0 PVC Capped Ends. ZONE: REVISION DATE 2/28/07 Revised Dum sterArea La out ' ZONE:G REVISION DATE:12114106 Delineate Flood Zone Per LOMR Case f 05-01-0764P . t * s~ REVISION DATE:12106106 Modif Vegetated Areas Area (min.) 87,120 SF (RPOD)(min) 20' REVISION DATE: 11 29 2006 B/d . Foot riot & Ve etated Areas Fron t ateWidth min) 125 REVISION DATE: 8 24 2006 Revise FDAccess & Ve etated Areas Setbacs: REVISION DATE: 8 Fron t 30' OS 2006 Revise FD Access & Standpipe Side 15' GENERAL NOTES: PREPARED FOR: PREPARED BY Title: Rear 15' 1.) The property line information shown was Propneed �m rovemer�tp p Wionno Club CapeSurvcam iJed from available record information. Sullivan Engineering, Inge. P. 0 Box 249 •tom•'•' '' -� 'emu � • PO Box 659 7 Parker mood Plan of The Wianno flub :',•y - �►� '- :ae � ��� �•' C\1 OVERLAY DISTRICT: 2.) The topographic information was obtained from Osterville, MA 02655 Osterville MA 02-655 ,.`, t>.: a• ; � � on on—the—ground survey performed by CapeSury /� n �` C� o ^k AP — Aquifer Protection District on or between 17/MAR106 and 25/APR/06. Vsterville, Mo. 02655 (508)428-3344 (508)428-3115 fax (508) 420-3994 (508) 420-3995 fox N ,t ;-• •r.•• - .Y• �� PSui/PEftoLcorrn capeserrvCcopecod.net Barnstable Ostervil�e Mass• ; . ,•�. 3.) The datum used is NGVD '29, a fixed mean >:� '•� �'�{ ►•• sea level datum. � a� 30 0 15 30 60 120 N .,��• �•1« L, �, .. �: Draft: DWB J00 Field. 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I I I I I I I � I � I I I I I I .1 I - I I � I I � � . � I � __T_---_____-_'_______.____________lt_ . � I I . I I I . I I I I . . .,, . . I I I - I I I I I I I I I �11 I ;, 11 . ." I ,.I , I I �', 1 , : I . I I I 11 I � . . I I . I � I I � I - ! I �:. I ­! I I .�,_, 11 :� �t I,� 11 ;, ,. . I � i I I I I 1, � . I � I � I -I I .1 I I I I I �l I I I ��l I I I I � . � � I I I .1 I . 1. I I I - � � I I . � 11 . : I I I I I ,� 11 I '. � I . I I I .- . i . � , I I I - - -- - . I - . I . .1 . I I . I i 1, � ,''I I . I � I � . I . I I � I I I . I . I . I . j � I � � . I I I 11 I I I . . I I I I I . I i � I I I I I I . I � I I I � I I I I I I I � . . 1 I � I I I . I I I I I . I . � I I I I I I . I I I � . I I ,� I I I � I . : t : I I I . I � I I 1: : il � I I I� . - I I I I -11 I I . . � � . 11 . I I 11 I 1, I . , . I 11 I I I I I I I STAMP: , � I , I I . I I I ' 'I .. I �il-l; � :_-�l t,�� , I- ,­ I . I' ' , 1 :, � I I I . I � � I I � � I - I I I." . I . I 11 I . I I � . �� 11 11 . , � . I I . I �, . I . � I . I � - I � � �l . I �� .� ,:I ' ll, - �, 11 .1 I 11 . I:i It - I I I I I � I I GENERAL BAR NOTES: � I ! I � : I I I . I � I I ­1 I . I I I REFERENCE NOTES . I .1 I . I I I . . � � I . 4 -1 I ­ � I I I I I � I I � I . I I ­ I I I I I j �I _., ­ 11 . 1 I I I . ­ ­ I I I I I I � 11 I I � 11 '' � � . I � . � I I . I I I I � . I i , � .I I I I . ,I 1� �-t , I �i� , I i 'I , .11 I !_1 :', ? I � I. I � . I - ­ .1 I I .11 . I I � I I I I INTAKE AND EXHAUST , -r -r- -_ COLDWATER SUPPLY . , . 'I . . i I � I I .1 , I It ,� � � � . -1 FILTERED COLD WATER NOT REQUIRED. MANUALLY i - I � 1; �.I I , ,., , �� 1, � � I STUB ELBOWS ABOVE FLOOR AT LOCATIONS SHOWN ON PLAN. . N I I I 1, ,� . i i:, � 114 , 1"' I �� I 1 1 i TERMINALS INSTALLED I . 1. ALL PLUMBING ROUGHING AND MOUNTING HEIGHTS - I t I I � ,t I I . I I I - I " I I I I i - I I I . TO WATER HEATER � I � . I I 11 . I . . I . I ,�11 I I METALIC PIPE DEPTH AS REQUIRED TO ACHIEVE� � i� , ,, 11 I � � I i I �11 I I I I I I . . � . I I I . I I I I � .1 � I BY MECHANICAL -, � I COLD WATER TO EXPANSION FILLED ICE BINS . . I ,. �� �� I I . I ;, I . . I I � � APPROXIMATELY A 90 DEGREE PENETRATION OF SLAB. I � I I I I � I I , � - I . I i I I . I I . I I . � I I ,, I , f ARE TO BE IN STRICT ACCORDANCE WITH LOCAL CODES. � I � . I I 11, 1 I I . I I I . I I I I I � I � I I . PROVIDE A TEMPORARY PIPE CAP WELDED TO ENDS OF � TANK AS SHOWN ON PLANS I � 1. I i I 11 . � I i . tl I . I I . � I I � I 0 I : � I I I . I . I I . . 1 ! I I I . THIS CONTRACTOR SHALL COORDINATE HIS WORK WITH I I I . I . I I . I I . I I I I 1� I I . � .CONDUIT DURING CONSTRUCTION PHASE.TRIM ELBOWS AT HOT WATER TO FIXTURES I I � I i I I HOT WATER RECIRCULATION . � � I � ­ I I I� � � . I � � � ,", i , � t I ,. . ill .li­�lt �"I� � ':i��� [:,�'�'3 l�.t� � i I I I I N-2 CONNECT 1" COLD WATER SUPPLY TO EXISTING .I � ! l ,� . I � I .11 ­j�I I�, j�, I I I - I I I 1 . I I .1 ., TIME OF INSTALLATION OF BEVERAGE LINES TO 6"ABOVE SLAB I I I AS SHOWN ON PLANS - ,i , I � ��. OWNER SELECTED BAR SERVICE EQUIPMENT AND I � I I � I � I ,i� ,I i I I ,�� ,, , I I i ,�.:�i - NORMALLY AND 8"INTO CABINETRY. I I I � I I I I � I I I I I I i - I I � I , . t 1,�-I ''i ii . I� 2" � ;, I I . I I I � . � I I I I 11 I i ,;�-AQUASTAT SET AT I O*F LOWER ARCHITECTURAL DRAWINGS, AS WELL AS CONTRACTORS BUILDI . I I 1 � . �� �! '' ''. I ; � I I I I ; I it ' ' . I � I I � i I " . I , I I I I ­1 I I I ''I . 11 � SEAL FLOOR PENETRATION WITH � I CHECK VALVE(TYP) I I I � . \ THAN HEATER TEMPERATURE . I . I I I I I I . I I � ,� I 11 I I - � � . I I I 1 . 1. 11 I 1 , . � . I I I I t I I . �� � : ' FLEXIBLE,WATER AND FIRE PROOF I I i I I 11 I I I TO ACQUIRE APPROVAL OF EXISTING WATER SERVICE , . ; I I I. . � � . I . I I I � I OF ALL OTHER TRADES, PRIOR TO INSTALLATION. I I I � I I 1, � !I I I I AUTOMATIC VACUUM RELIEF I I I I I I I I I I I I I 1. . . I . I I I I I � I I � MATERIAL TO COMPENSATE FOR , ; I 11 : -4---lS � I I I I . ., . I � I I '. � I� ..',,� � I VALVE(WHEN REQUIRED) ,_ . I ASSEMBLY ACCEPTANCE. IF WATER AUTHORITY DEEMS , . I . I 1, . . 1, I PIPE EXPANSION . � � --- . 1 . I I I . 1. I � I . I I I . I . I � I . I I , ,. CONNECT TO ICE I . ,� I I � I . ! -_ . , � _1­_�H I I --- .-S NECESSARY TO REPLACE EXISTING WATER ASSEMBLY , 11 , - � � ' ' --- I I � -_ � � ICE BIN ,'' ,," I LO I . ­_ I 1 2. PIPE ROUTING SHOWN IS SCHEMATIC AND IS NOT ti . � r,v � I . I � . 1, I I I 11 i I, F I SHUT-OFF VALVE(TYP) - " I I I � � Lu � . I ; . I I . 11 . 1 I I i �BIN DRAIN OUTLET .1', ; I I ;�: F_ I -I 11 I � � I I � � I I � � . � , WITH NEW, THIS CONTRACTORTO PAY ALL RELATED FEES. . I . I AS REQUIRED 11 � � 4�, � I N I � T I INTENDED TO INDICATE EXACT ROUTING OR LOCATION OF � � � , .�I I , 1 I I I 1 4 � I 1 ,4 �I j 7 I �� ,*r, " � ,� . " ,�,, 1� . I � I . I I . I . I � � �CIO � . I z 11 I -.I- . " . 11 I � THERMOMETER I �, 0 STRAINER .1 I I I I 11 � � I I -1 � I I I , I I � I 1.t . I INDIRECT DRAIN OPEN ., . .. . .­ .,--e,-;; ;q ... ,�;�I .".'- � -.. � . I I I I � I � PIPING. ANY ADDITIONAL OFFSETS AND FITTINGS I I � � I - � < : � I I - �� ' - � I 11 . I I ** . 11 �� �. . - - - I I I � I ! 't, I , I I TO ATMOSPHERE AT, .. �A ..,-,�. � .'...5 ... ...� ..." : . , . ., . �11 � PROVIDE PIPE UNION, . .10 � I I I I z I I I., I I I .: I I . 1. - . �. . ., 4 ..* I T 7 - , , RECIRCULATION PUMP N-3 CONNECT NEW 4" WASTE AND 2" VENT PIPING TO . . r I . . . I I I AINTAIN ' ' I . . I � I � I I I I I � � i, ilj� I� � I - GAS COCK I I I I ' I I � IFY EXACT � � 6 � I . � - 3/4"I D I I I � . I .. I I :�­ I I L, I i . I , .1 ____ll 14-�D F-11I­-+ I I . � I EXISTING BUILDING Di. SYSTEMS. VER I I � - I 0* I � , I I I I I I FLOOR I � I I I I I I . � � I ;, I I I � DIELECTRIC IF REQUIRED REQUIRED FOR PROPER INSTALLATION AND TO M' .. I CO I : I I I : FOR DISSIMILAR METALS(TYP) �, � � I � I I I 1_+_�+ I � I � I I I � -_ PROPER CLEARANCES, SHALL BE PROV'IDED AND - I �. 1, � I = T � I I 1. � 11 �l 1. � 1.11 11 _�­, 11 : �-; I � ; 1, - . I � I . 1 . �.� � � t . 'i . I �L � I . . . . � � �, ! ,: �� I I I I _,�_- L- 6"LONG,DIRT LEG , I I I I I LOCATIONS IN FIELD.� I i�� -�., I � , I I I I I . I � .1. I � 1. 7. I I � -2: 1 1 ''I I . i I I I I I EXHAUST AND INTAKE I � 11 I TOR. THIS; CONTRACTOR I I I I � I I I I . . � I I I I I � I I . . I I I I - , &� co I I I .1 � REFER TO"INDIRECT , I �I i I I . I ; PROVIDED BY MECHANICAL 1-11'1� ­ I I - I INSTALL ASME TEMPERATURE AND INSTALLED BY THIS CONTRAC I � I : � 0 � . I PROVIDE FLOOR SINK AT SIDE EDGE OF I /CONDENSATE DRAIN" I 1. ' I I . 1 . � I .. I SHALL PROVIDE ACCESSIBLE SANITARY CLEANOUTS AND - I � I . I � I I I I I I I I � 'I � �� I 11 I I I -71 � ,:::� . I I - PRESSURE RELIEF VALVE I I ' C.10) ."O I � I � I i:: � _ I � I I � - I ICE BIN,WHERE ACCESSIBLE FOR �: I � DETAIL FOR MORE I 11 I I . . I . I � CONTRACTOR , . I I . t , I . I I . I I I I I I � � I � I I L TO CABIN i I � I � �FURNISHED WITH WATER HEATER � - PROVIDE BOW VENTING FOR HAND SINK. VENT. SHALL:� : I 0 . i I C� I I CLEANING-NOT UNDER ANY EQUIPMENT I Y, . INFORMATION I SEA E� , � � � I - --I I - I I I ALL SANITARY SYSTEM VENTING AND FlITTINGS AS PER , �I � N-4 I I I � . . � I ,; I LENGTH AS REQUIRED ,,,, ,� ,.t ,�; tt - I . . I I ­ I (0 C\l I I I � I I I 1 . . ,1: I , WITH SILICONE : , . ­ . , I 1,C WATER HEATER I I , I . , � � I I I . RISE 6" ABOVE SINK RIM. I I � ! i � M . I I .11. I I ; IL I I I I . ­ .1 I I I I I I I I � .,; I � I I � I � I I I . � I I ,t I L_ - UNION WITH GROUND JOINT. � I I . I . I . � . I : ,I i (0 I . I � I _!, : LOCAL AND STATE REQUIREMENTS. I 00 C? I I , - I I T SHOWN IS SCHEMATIC.ADJUST AS REQUIRED TO SUIT : I I USEFOUR�IN�CH ELECTRICAL�I CONDUIT AND FITTINGS. USE ` ' I ' I I I� � I I I EXTERIOR WALL , I I - A 1.� 11 � . . I I I - I I � 11 I I I I I I I j �I 11 1 . I � . I �I I I � � I z 1 0 00 . I I , 1. 1 �, I t ,. I .., � i . . I I � �� I 1 . I I I I 1: i:� i,�� ,� I I I I . � I � I I MANUFACTURER. � " f" ' I � I I - PROVIDE A HARD COPPER � 11 I I I I I . I I 11 � . I I I UJI i CD I � CONDITIONS. VERIFY CONNECTIONS WITH , MINIMUM QUANTITY OF FITTINGS REQUIRED. PROVIDE LONG i,� � . I I I � I I I I I . � I I I _, ��, .1 � 11 � I I DRAIN VALVE BY WATER I. I � . I I � � . � I � I . I I . I � �, LL T_ U') .� I I � I I I � I . I RELIEF VALVE DISCHARGE LINE � . ' -5 NOT USED I . i, , , , "! , , : I , � I � . SWEEP ELBOWS AT BOTH ENDS,WITH MINIMUM 30 INCH RADIUS I I I � I � � I N I I m I I . � � . . I I ,I , �'� ,I 11 I 1. :, .I— it ' L ' '�' � � HEATER MANUFACTURER -, �, , __ `*� FULL SIZE OF VALVE OUTLET 1 3. THIS CONTRACTOR SHALL PROVIDE AND INSTALL ALL 7 ." L . � . I I I . I I I � I I � I .I �__ I I I I i (AVAILABLE AS ELECTRICAL CONDUIT-DO NOT USE MULTIPLE 1 [ . . . � I �. I I -----_I- -++: � 11 � . . I I I � � . I I . U- I � I I G I I � C/') ICE BIN CONNECTIONS ., � I I ELBOWSTO MAKE go DEGREE TURNS). PROVIDE TEST OF � I I I 1 � � INSTALL EXHAUST ELBOW 1 7 ROUTE TO FLOOR SINK AND � I APPURTENANCES REQUIRED TO PLACE: ALL FIXTURES AND I I I I - . i I I I I I I I I I 0 , , � I I I � � �.. I I I I I CONDUIT AFTER ASSEMBLY TO VERIFY WATER TIGHTNESS. I I� I I I AND CONDENSATION HOSE ! � I I � DISCHARGE WITH 6"AIR GAP � . * I I N-61" H&CVV RISERS, 2" V UP AND 2" WASTE STACK. 3" - I .1 =) I � � 1� � � I I . - � . I I I NO SCALE I I �, ,il , I it , , I I � REPAIR LEAKS IF INITIAL TESTS FAIL.MAINTAIN PRESSURE ' :� � I� 1, I FURNISHED WITH HEATER. I I. I . I EQUIPMENT IN FULL OPERATIONAL CONJIDI'TION. , . � � I � , . I z [ , � I . L � I � � � I I -FLOOR SINK I I I � . I I I I I . - , I (D "I 1 : L L f l�t I , ' ' i 1 ! , T I I WASTE DOWN. I � I I . :: , I � ,� � , ij � �j , : - � , , I .0 I : � I I � - 1�', I . � 11 I --r-,-. ___� I � 11 I I � ­ , 1 � I UNTIL BEVERAGE LINES ARE INSTALLED.AVOID ELBOWS IN , I 11 PROVIDE MINIMUM 1"LOOP I � I � ,� I., L� . I I I I 11 I I I � I � I I I I I I . . _*`11 � I I I I I 11 , APPURTENANCES INCLUDE, BUT ARE NPT LIMITED TO, I . I � I � - , � . I � I � I I 1. I � 1 HORIZONTAL RUN IF AT ALL POSSIBLE.BEVERAGE SUPPLIER . 11 I I I . IN HOSE(FOR TRAP),AND I I ; � . I I - -_ � I � 11 I I I I . . I � I I I � 0 , il� �,I :� I . I . I I � � � 1, � I I �. � I I SHUT-OFF VALVES, FLEXIBLE RISERS, ANGLE STOPS, , � I I . I � z I I I . . I � I �. I . . I � � I I . � I . I I I I i WILL SEAL ENDS OF CONDUIT WITH FOAM AFTER BEVERAGE . 1 1 . I I ROUTE TO DISCHARGE I I __�-�SET WATER HEATER ON 4" � ,� I I - � I 11 . I I � I � � I I . . i I . INTO FLOOR,SINK , . - < � I I -I I I � I � 1 . LINES ARE INSTALLED IN CONDUIT. 1, I ­ I 1; I � 1, ' 'I � � . � I I !_,� I I I I I , N-7 COMBINE ALL VENTS FROM FLOOR BELOW,,SIX (6) � ­ I 0 11 I , _­­­.: .� � _ _ � I ­ I - I I . I �, I I I I I � I . I CONCRETE EQUIPMENT BASE VACUUM BREAKERS, ESCUTCHEONS, PIPE SLEEVES, . - . I . w i � I I � I t I I I . I I I . . . Lu - 1 f­ I I I I . I I I I I I I . I � . I I � I� I �� ,� I . .1 I I I � I � I I I � . '�,v I I � , I I I I � I I . . I I 1 � � . � I - IM AND RISE 2' ENT STACK UP I I I I I I I � I i . I I � I I I . I REFER TO SPECIFICATIONS, SCHEDULES AND NOTES FOR MORE INFORMATIO�!. PIPING ARRANGEMENT PRV'S, BACKFLOW PREVENTERS, TEMPERATURE AND I INi,HES ABOVE FLOOD RI I . 11 I I I � I I I I I . I I I 1, I I 11 , I I I % . I . I I � Z �__ 5 (D I - .. - � � I I � .1 Cq I � I � ' I " I ASE PRIOR TO PENETRATING ROOF � : I , 3: , =F 0 C) I I SHUT-OFF VALVE IN I � � I - I I � I I � ' . I I I , SHOWN IS SCHEDMATIC. VERIFY ALL CONNECTION SIZES AND LOCATIONS PER MANUFACTURERS , I I . I . THRU ROOF AND INCRE � I, I . � I � I I I � I ACCESSIBLE LOCATION . . . I - EXTERIOR BUILDING WALL I(: PVC BEVERAGE CONDUIT I I - I I I I PRESSURE GAUGES, T & P RELIEF VALVES, UNIONS, � I I I F: < I I � � I REQUIREMENTS.ADJUST TO SUIT FIELD CONDITIONS. .REFER TO FLOOR PLANS FOR P PE SIZES. I I � . � I . � .1. � o ABOVE CEILING � '. I 11 I � I I I I . I I � �I I . I , . I I "I . I I I I I TO A 3" VTR. V.I.F. EXACT LOCATIONS. � I � . . -) �O w m I I I � I . I NO SCALE , I � I I PROVIDE SEISMIC STRAP OR BRACING IF/AS REQUIRED BY LOCAL AUTHORITIE3. PROVIDE HEAT TRAP I I CLEANOUTS, ETC. I �.I 11 I . I �11, . I � I � �l . 0 (11w, w - I � - I . . I I . � I . I I I OMATIC VACUUM RELIEF VALVE REQUIRED BY LOCAL AUTHORITIES. INTERLOCK AQUASTAT I I I I 11 I . - � . � . � 11 � I I . 1 I I I I . I . � W �W7 I I � " I I I I I � I I a � I I I I I 11 � . . � I I I � � � � ,� I . AND ALIT I I � I I . I I I I I � I � I � I . _ � I � � � � I I ______ I I ­ I I I ­_­ � I . I I I I 11 I I I I I I , � I I I . I I I 1, I I I 1. Cn I-_ 0 . . I I I � WITH RECIRCULATION PUMP BY ELECTRICAL CONTRACTOR. I . I I I I . .I I U) I I � I I I I ­_­',WATER HAMMER ARRESTER I I I � I . I I I � I . � � � � N-8 PROVIDE AUTOMATIC TRAP PRIMER (TP-1) LOCATED I . � a- . E 1�;__ , , . . I . � � I . I I I I I . . I '� 4. ALL EXPOSED PIPING SHALL BE PAINITED TO MATCH THE I I .1 < _;� m . I . I I - . I I I � . I � I I I � � . . I . . r_l__ 11 � I . . . I I I 1. I i 1 1 1 1 1 1 1 1 � I . 0 �_ . I . I � I I I I I I I 11 I I ITHIN LOCKABLE WALL RECESSED I I m I ,. I I I � � - I I I I � I I I _j D , I I . I I INSULATE COLD WATER PIPE , D_ . I . I ,� I. I I I I I . � - I I I I GAS WATER HEATER AND PUMP . I I I � 1� APPROVAL OF THE ARCHITECT'S CRITEIRIA. INSTALL , . . I . 111 . m , �I _j 0 1 i � . .1 I I I I I � 1. FLASHING AND COUNTER- I - I I . I I I NO SCALE � � I I . I � WATER SHOCK ARRESTORS AT EACH FlIXTURE OR 1, TRAP PRIMER, CABINET AND SUPPLY ALL FLOOR DRAIN I � I . 0 3: 2 � � I . . . I � I I I . I . I I I . I �. I I I I � I � I , . I . I I I 11 EL, ce) w I I 1. � I I I . � � I � � � CEILING I - I I � I . FLASHING OF VTR IS � � . ( ) I I � I BATTERY OF FIXTURES. ALL INDIRECT V\VASTE PIPING , AND FLOOR SINK P.-TRAPS. . I a < I I _____ , I I I - � . I . I � I I . I I 1 . � I I . 1, LENGTH OF SHAFT TO ., � BY ROOFING CONTRACTOR , . ffifimfi= � �-MINIMUM 1T ABOVE ROOF . I . I� I I � I I I I I I I I I I I I . � ,�I 0 " 04 1�>-, . � I INSTALL RISER INSIDE I � I ., � I . I � . I I I 11 I � I I I . . � PARTITION WHERE -1 T I I SUIT THICKNESS OR WALL � � I NORMALLY.EXTEND TO HEIGHT 1 . . I I SHALL BE COPPER AND CHROME PLATED BRASS WHERE � � I ... . I I I I .11 � I CORE DRILL OR PROVIDE I� � OF PARAPET WHEN WITHIN TEN .� � I � I I I � I 1 . I I I I I N-9 REMOVE EXISTING WALL HYDRANT LOCATED UNDER I I AVAILABLE; REFER TO - I . I CUT WALL AS REQUIRED. I SLEEVE IF REQUIRED I - 1 . . I FEET OF PARAPET � � I I I I � I EXPOSE . I - I � I I I I I �� 11 � . � � I I �l I�1, ' '� �t� I I � . I I I . I I I � 11 I , . � � I � . I � � � ,,PLANS. IF RISER Is I � � I � INSTALL WALL HYDRANT_ 2 t ]�, Y TYPE OF ROOF DECK - . I I I I I I I 11 I I I ,, I ­1 I �. I ,� I . � I . I 1. . I I STAIRS AND EXTEND a" CW TO NEW NON-FREEZE WALL � � -i . , I � - I I I I I I I -_- I I I . I I . I I I I I 1 4 � I I � EXPOSED,ANCHOR - �� ­ GROUT OR OTHERWISE , - iiiii %m6mmm . I I I I � I I � I I I . � � . I I (n � . I , I I , , - . I ­ I I I I � I I . TIGHT TO WALL, INTERIOR . . REPAIR WALL NEATLY � ,-,\ I i � � I I � I I 1 5. THIS CONTRACTOR SHALL OBTAIN DIMENSIONED HYDRANT (WH). V.I.F. EXACT LOCATION WITH ARCHITECT. I I � TO WALL INSULATION I I �� I � AROUND FACE OF WALL . �� . I li _., - I. . N - I I I I I I � I ­ I I I I., I- I I I � I I I �� I I � I � I ­,� , , I,�I'll .=3 1 _�_� 1. I . I I � . ift � ROUGHING CONNECTION LOCATIONS FROM EQUIPMENT . I - ,I I I . - � I I,� I I �. I � � I I HYDRANT,TO SEAL I I I ' . I 0 1 . I I I I . I .. I � � � . I I I� 1 . � I 1 �� I I 0 � I I 11 I I � . 'I, � I I I �­ : WATERTIGHT '' I I I� I RO -4-- . I � I � I I I I I . � - . � I ,,:� , .'! I � I I ' ' I .1 � I OF DECK ,-� I I II , ANCHOR PIPE TO ROOF DECK . I HOT WATER(120-F)WITH INSULATION I � � I � I I� I . I 11 I . I I I I I I I I - 2 � I ) 2 1 .1 I I , . j �. ji, I e I . I -1 . I I I I I � I I I I I = * I �ELBOWAS REQUIRED - . I I 11 � � I � I I ROOF INSULATION . - I . I . �I OR JOISTS WITH U-BOLT AROUND . � I � I . I . I� I I I � I I I I I I I I 1. I . � . I I. I I I 1, I I ­ . � I � �1� 1. � .1 � I I - . I 11 I ­ I . I � I . . I I 11 � . I . I t I MINIMUM 12"BELOW ROOF ,� PIPE AND ANGLE IRON WELDED � I I I I : � I . I _',I 1 1 . : , � ..11 I :1.0 . I I I I . I I . . I � . I I I t I I I . � I I . OR SCREWED TO DECK OR JOIST � I I I � � _. . I 1 6. THIS CONTRACTOR SHALL FLASH ALL. FLOOR DRAINS N-11 " H&CVV, 12" IW (AIR GAP TO FS), WITH TMV BELOW � I I . . I I I I I � I �_ � I I 11 . I I i . I I 1 I I �; � It. I . 11 I . � . I I UNDERCOUNTER DISHWASHER I I I' ll I � � I . I . . 1 2 ' I. I I I � . (3) 1 1 1 1 � I � � � . I � I I I - I I I . I I I I I I � I 1 I I � I I PROVIDE PIPE,INCREASER -_ I .I � I � I FURNISHED WITH INTEGRAL 70 DEGREE . WATERTIGHT. � , � . I I - ­ SET,TO 1 1 0 DEGREES F. 1 :3 1 = . . - . I I � , . . I I 1 I . I � . � iiiiiiiiiiiiii,iiii,111110 . I I VALVE INTERIOR TO WALL � � I I � I I I . � � . WHERE REQUIRED TO MAKE I HUBLESS PIPE CONNECTORS ON I I I HEATER BOOSTER I I STRAINER,SOLENOID VALVE I I I � � I . I � I � I � � � I � I . . I . I I I I � . . I I . . I � . I I I I I � � � I I I . I � � I .MINIMUM 3"VENT THRU ROOF - CAST IRON PIPE - . I I I I I I I I AND VACUUM BREAKER . 11 � I I �I I 11, � I I I I I I. I I I I I � I I I I I 1 . I I I � I . � � . I 11 . I I � I I I 11 I . I i 11 � I I . FURNISHED BY PC I I � I . 0 , C: I I I INTERIOR FLOOR � I � . � . I -INSTALL 22"ABOVE I I I 11 I ­!� � I� . I � � I ,� . I . � I I I � . PRESSURE REDUCING VALVE SET AT 20 � 11 I I � 7. MINIMUM BELOW SLAB/FLOOR SANITARY WASTE PIPING I,N-1 2, VENT RISERS TO RISE WITHIN FALSE VERTICAL I I , - 1 4- 1 Im < , � I I .1 .4 � 4 ' �. �. � I�� ., I 11 . �. . - I GRADE.ADJUST HEIGHT ­ I I I I I . � I . . j I -__', I � I I I I � � I . : � . ., , " I I 11 � I I . I NOTE: � REFER TO PLANS FOR VTR PIPE SIZES.VERIFY EXACT LOCATIONS � I � PSI,WITH INTEGRAL BYPASS,STRAINER I � . I TO BE 3" UNLESS NOTED OTHERWISE. I . CHASES. VERIFY EXACT LOCATIONS WITH ARCHITECT. � , I I I I C,� . � > � I I - � � . � ,� .1 I , 11, ". "�:�, %�, - -: �, . I , I ­ IF/AS REQUIRED TO I. , � � WITH ARCHITECT PRIOR TO MAKING ROOF PENETRATIONS.LOCATE � I � I I � I AND PRESSURE GAUGE FURNISHED BY I I I � � I ­ � I I I I I I I 1. I I � . � I I 11 I I 1.0 .. . I 11 1 . � I'll-I . I I . SUIT MASONRY JOINTS �! i , I � I I I � . I � I . � I I . I I I . � . I � I I I ll � � . I I I . � I I I I � . I VTR MINIMUM THREE FEET FROM PROPERTY LINE,OR TWENTY FIVE I . I I .1 I HEATER MANUFACTURER I � . � � � I I ­ � I . 75 1 1 1 . I I I . I � . I I .I I � I. , I I . � ,.i . FEET HORIZONTAL OR VERTICALLY ABOVE ANY BUILDING OPENING OR I I � I I I I I . . I I I � � I � I . I I � . I I . im I <. , , � I I . t; I I � I 1-t . I I I � I C"i" . i . . I� I I I I. ., . I � ' 'I I I I 11 � L EXTERIOR GRADE, , I � 11 .� FRESH AIR INTAKE,OR ONE FOOT FROM ANY VERTICAL SURFACE. � I I I I � I� I I BAR COUNTER TOP I I I � I I � � � I I I ,!, �, i � � i I . � � I I . � � I I I . I � - I PAVEMENT,OR SIDEWALK � LOCATE VTR MINIMUM 18"FROM PARAPET,EXPANSION JOINT, I I I I I I I I � 11 I I I I 1 . I I 0 2 I I I - � � I I I � � . � I I � . . I � I _L_____4_1 �I I � T � I I I I . . � .- I - � I I I , I I I � , I I I I EQUIPMENT CURB,ETC.OFFSET IN CEILING SPACE WHERE REQUIRED I I I � I . I I I I I . 11 I I � I � . I I I I I I I I �: (1) 11 -, � 11 I I � I I � I � . � . �l � . � I I . � 1 -4--i 1 1 1 , , ,:,- :, 1;, I , . I I I I TO M S CONDITIONS. I I I � . � I I � I I . I I 11 I �l m 1. . 1.," , I Iw , = I I 11 � I \ � � I � I . . . NON-FREEZE WALL HYDRAl"i� - 1.11 I . I ­ . ' ' I 1, I 11 '' I �l I I I I I � I...\ . I 1. I I 1 . � . . I � �,#_­,, � I - . 11 ­ 11 11 I - _I 11 I . � . ' ' ' ' I .- m� � I I I I � � I 11 I � VENT THRU ROOF (VTR) I ' 'I � I I I � . I I . � - ­ � I 11 I ,� I I I - . 1 '' .. ­1 � . 11 � � I I I NO SCALE , : , I 11 . "I I .1 I I I � I I � I I � 11 I 1� � � . . I I I . I .1 . I I � I I I . � I TEMPERATURE GAUGE(TYP) I . - COMMERCIAL GLASS I I I > , 40 � > , ?_ I . I I . I I I I I I ( ) �l 11 I . - I � I I I I NO SCALE I I . I I I� I ,� I I WASHER I I � I I 1� I . 11 . . � I � I I I 11 � I � I 11 � ; � i - 1 I I I I . � . 1 . I I I I I I . I . � � � I I I I � r I I I, . I . I � I I � I I � I UNION(TYP) I I I I I (BY OTHERS) I � , EQUIPMENT CONNECTION SCHEDULE � I oi��!, M, .1 I _ I I I I .PRQVIDE CLEANOU,TSIN . � 11 DISCHARGE INTO RECEPTOR � I I 11 � � I � 11 I I I I 11 I I I I I THROTTLING I I I :. I I �­ I I ' ' I I . 1 . . 1 . I I � � a) 7 1 1 1 .1 ..,1 , � . � I . . I � I . I � I I � , SHUT-OFF VALVE(T'?P).,,,,,,, , , - , VALVE � � - I � I I . I 1 44 '11111i , m ,�__o I I I I �.� , - -1 V��% I 11 - I . 1. . I I . PIPE. SUFFICIENT TO � I I ­ I I .: , �- ' 'T�i - ^­1 ��_� i , " '. �., I I I 11 , I I I 11 I � - I I I ­ � � I . 11 I �� I I I 1-I GAS , REMARIK , I C, ""i"'iiiiiiiiiiiii" I : ' I I 11 . . I n ,,, �c I I I I .1 � I ITEMS . PLUMBING S *,.,i � , USE DWV FITTINGS IF SIZE REMOVE GRATE AND STRAINER. � I . .� � � I � I I . I t�, ­ � . - I I I - , . I � . _._l.­____ - _ I I I I 11 . -1 � . I I , I � , I 111) W V) I I � 11 1. I I � � I I I I � � ll� ---.____Dloli.:���� I . I �1114 IST lvw 'V 1 FCW CW 140011120" . I I IS LARGER THAN l" : � MINIMUM GAP=TWICE PIPE I I � HANG PIPE LARGER THAN WOOD STRUCTURE I I I I S I . 1: 0 -1 I I . DESCRIPTION'. . . IW SIZETBfU I . I I I . . � I . I . I I I I I I w - I I � I I I � �I I . TU"S/ENDS OF I GP' ff WITH AIR GAP � �l � . 1 . I � � 11 I � I I , , 1. . I ­ I I I �, I 1 . � 11 : 0 W 0 1 SLOPE PIPE - I DIAMETER I � , I . I 1 4"FROM TOP OF JOISTS - . I I I I I I I I I I � I -ii �_ . I � I I I I �. . I 11, � � I ., I I I I I 1. I 0� I � I . I I .� � � I I I . 11 I .1 I ,� � I . I � I I I I . AS MUCH AS , ,--*" I I I I I� � I ONLY AT PANEL POINT r_�, --- ______ - - - ________L__�4 I 11 I I I I . I � ----I I m i I I ­ ' 'I I � I . I I I I . <D . I I I 1 . I . - I "I r . I 11 I I I I I � I . I I � I C: I . � � I I I I � � I I POSI131BLE .1 . - I I � . I I I �,.I . 1 . � I � I I I ,� I 11 I . ..I . � . . ti I . 1 I I . ", I , HW(1 20-) � � I I 1. HARD COPPER TUBE FULL SI OF . I �(D 2 SLOP SINK I- . - I- 11/2" I- 1/2" 1 - - - I PIPE INDIRECT WASTE TO I.W. FLOOR DRAIN I � I r--_ , . . I I . 1 � I SIDE BEAM CONNECTOR � I � I . ' --- - - I I - I , I I I I I TOWARD I I : I . I � ATTACHED TO TOP � I ll� . I W/INSULATION I 1 � I RELIEF:VALVE OUTLET TO DISCHZAERGE I I I I - - - . - - 11/2" - ­ PIPE INDIRECT WASTE TO I.W. FLOOR DRAIN I � . . � I I . I . . � � I . � � . I DISCHARGE !S�', I . 1 , I , I . . . � � I � � I . � - I I � I .1 I OVER,FLOOR SINK.TURN DOWN WITH I 'll yj__4 (D 2 36"ICE BIN - .I I I I C) - . I I � 10 . S _/ I � I I I I I I . I I I I I --- I - �� . . I I I 1. � � I I I CHORD OF WOOD TRUS � I � � .I I I , . I , '' . Cz I . 1 . I I I I . � I I I . 2"AIR GAP I I ­ . - - I I I I I . � I I I I I . I MAKE CONNECTION � I � � I I I I I ADJUSTABLE BAND HANGER I ALL-THREAD ROD I I � � � � I I I I I I I I �I I I � (�) 2 48"COOLER - - - - . - I . I � � � 1. n� � I I � . . � I I � . . . . . t I � � � I I I I . � I TO EQUIPMENT I I I. 1 11 I � I � I ­ FOR PIPE 3-1/2"AND I I I I I � I : . � � I I ll� I I � I � � "GLASS WASHER - . - I- I : - . 3 " I V - - � � . . I 1. . � I I . I -*' � I � .� . I . I'AS REQUIRED , , , . I I :11 I � I SMALLER AND CAST IRON PROVIDE COPPER A � . (4) 1 24 1 � I v , I I . � I I � � . � . I I I I MAKE PIPE MINIMUM ONE SIZE I " . I I . I I � I I PIPE 2"AND SMALLER COATED HANGERS I I � I I + , PROVIDE INDIRECT DR I AIN TO FLOOR SINK WI-TH CAST IRON P-TRAP.DO NOT USE PLASTIC � � (�) 1 HAND SINK - 1 4/2" 1 4/2" - 112" . 1 10 � . I - - LOCKABLE TEMPERING VALVE BELOW SET TO 110 DEGREES F. � . �: I I ,� - I I . LARGER THAN EQUIPMENT �I I VERIFY WITH LOCAL � I � � ­ I I . WHERE HANGERS I 11 I I I I ,� � PIPE FROM,DISHWASHER CONNECTION TO SANG ARY MAIN r , I - I I I I I I I I . ­ I � . � I I I I I I I I I I I I I ///- I . 11 � I � I � . � . � . I . � I� I CONNECTION,MINIMUM 3/4". 1 CODES IF/WHEN TRAP I I I I � I 0 0 CONTACT BARE I ,. I I I I I I I I I I 11 �� � I . I . �, I I I I I I I I. . 11 ­ 1 . I I I a) I �� I . . I I =3-___ __ -__ � ,_�__ --,.,.---.-, __ - - - __ __ . I __ ____ _­_­ _ ___ --' - I ­­1. � __ � I � - I USE"M"OR-712-HARD COPPER—— --7AND/OR VENT ARE---.- I ­_ I-__­.____.. z , --Z-Ab � COPPER PIPE --_ I I _-CONTRACTO - SUPPLIES -= - - ­_ - i , , - -"--,-.--- -_ ----,. ------- I . 11 . I I � .luj5 0 1 1 � . .1 � . I . I I . � I I I , I I t I I NOTE BAR EQUIPMENT CA8EVVOFRK:: THIS R TO SET ALL"TRIM, PROVIDE ALL TRAPS, DRAINS, STOPS, I I I I UP TO 1"AND DWV COPPER I REQUIRED FOR THE LENGTH I I 1< W9 I I I � � I CL a- DR I � I � I . I I I� . . I I I I , . FOR 1-1/4"AND LARGER OF DRAIN PIPE INSTALLED I I w a-U) I(n PROVIDE GALVANIZED STEEL SHIELD R � � . ERS AND MAitKE ALL FINAL CONNECTIONS. COORDINATE WITH ALL BAR EQUIPMENT SPECIFICATIONS I � � . � .� � . I ­ � � � I . I . I I Ll W CC [L= ALL INSULATED PIPE. VERIFY INSULATli 11 � I EQUIPMENT MANUFACTURERS WILL RURNISH INSTALLATION KITS. I I I . I .� . � . I I I`II`I_ I I , � I � I � � I . . I I I . � �I I U) w U3 _j ul I I I I 1, I I ,� I I I I � � I . ROUTE PIPE INCONSPICUOUSLY AND UNOBTRUSIVELY. HANG - � . I w 0-(5 I 0 , THICKNESS WHEN SIZING HANGERS AND SHIE- I . I COORDINATE CONTENTS BEFORE SUBMITT!NG BIDS.ARRANGEMENT SHOWN I I I AND SUPPLIERS TO PLACE ALL EC)UlIPMENT IN FULL OPERATION. I � . � I I I . I � I CL O< �- � I I I IS SCHEMATIC. ADJUST AS REQUIRED�TO SUIT CONDITIONS.PROVIDE I I I I I I � i I I I . I . I I I . I � � I I � . . I I � . ,� PIPE AS REQUIRED. DO NOT INSULATE INDIRECT DRAIN PIPE I - I . . CL 00-ZX ULU)� � . I � I I I CONNECTIONS AS RECOMMENDED BY'EQUIPMENT MANUFACTURER. . � I I I I I I I I � I I I I TITLE: � . I WHEN INSTALLED EXPOSED IN FOOD SERVICE FACILITY. REFER ' � I PROVIDE UPPER ATTACHMENT AS REQUIRED FOR CASES NOT SHOWN L I I I - I � l I � I � I I I � I I I I . I I I � I I I .I I I TO LOCAL CODES FOR FURTHER INFORMATION. 1 112" 6- 6' 1 HERE. DO NOT INSTALL HANGER INSIDE INSULATION OR OTHERWISE I I I I � I � � I . I � � . I I I � I � I . . I . I I I I . I I I � � I . I I I I I I I . � I I I I I � I I I .I I � 3/4" 6- 6' . PENETRATE VAPOR BARRIER. DO NOT HANG ONE PIPE FROM ANOTHER I . . . I I � - I . I � . � . I I I - EXCEPT IN CHASES. SLOPE ALL WATER PIPING SLIGHTLY TOWARD I UNDER COUNTER GLASS WASHER PIPING DIAGRAM I 11 . 1 � . � � I I � . P3-TERRACE � . I ., I � (: INDIRECT/CONDENSATE DRAIN V 6' 1 8. 1 .DRAINABLE LOCATIONS. HANGER SPACING FOR PIPE SIZES:AS NO SCALE I I . 11 I �, . I I ''I I I I I . � � . I I I I � ; . I � -0"OF ALL JOINTS. I I � I . I I I � I 11 I I NO SCALE I I I I I I 11 1-1/4", 6' 10, I INDICATED IN TABLE. CAST IRON:WAND WITHIN 1' I I I (: y . I I I I I I . I ­1 I I �I t I I . 11 I I . . I I 1, I I I I I . ROD SIZES FOR PIPE SIZE:2"AND SMALLER=3/8",2 1/2"TO W=1/2", 1 � I I I . ".1. � � I � . I I � . . I I . . I I i I . I � ' '. I � I I I I � C)0 I � . . I � � I � I . 1 1-1/2" 6' 10, ANGERS WITHIN V-0"OF VALVES AND FITTINGS. I � � I I I 10 tr - I I . . � . I I N-8 I I I 11 I f I I I I .� . . . I � �. 11 I I I .I I . I - 0. PROVIDE SUPPL I EMENTAL STEEL STRUTS BETWEEN JOISTS IF REQUIRED. � I . I I I I . � �,11 I I [ I I , l . � � - I I . I . I ( �k I) - I' , � I I � I I 11 I I I ' . . �I . . I I I I � . � I � � .I �� . . I I I I � 2' 10, 1 1 -0"OF EQUIPMENT CONNECTIONS. ANCHOR � - I � � . ' ' I I .,�. � I I ' 'I . �%'lll I � I I I I I v a I I � I I PLUMBING I jrg"'l � I ". I I LOCATE HANGERS WITHIN 1' I. I I I I I . I I I � . I . I I I � . .1. I I IA N � . I . 1 5 ? I I I I � I I I I . I WATER PIPE AGAINST SWAYING DUE TO CHANGES IN WATER VELOCITY. �. I I . � . I I I I � 11 . I . . I I 1. � � I I I . . I ' 'I I I � 1 2-1/2" 10' 10' . I I . I I I I I .1 I . I 0("\ � I � ' I . . � I � � , .� � . I I . I . I SLA � '�� 4"W, 2"H&CW,J"HWR(BS) , : I I I � I I I . I I I I I I I vi I Av)� 11 1, I I I I . . I � � I . � HAINS ND PERFORATED STRAP IRON AND STEEL ARE NOT ACCEPTABLE. I � I I � . � I ABOVE Bc I I I 11 I � N 7 � I - ,,, � 1 . 11 ' I ­1 I I I I I .1 11 � I � I . I I I I I ,�I ­. I I I I : I I� � . . I I �I I I I 1 3" 10, 10, DONO SUSPEND PIPE FROM JOIST BRACING MEMBERS. REFER TO CODES I I I I . I � I � I I � .. � ____T f I � I . � � I I . I -- I I I 0 �if ,I�er 1: 11 �, , I I 1 �I I r 11 . I I I I � � I I I I I L------------j _­ __ " , - � I -_ I I - � I I I � I -_ I �B -8 1 1 I 1p. , I . PLANS I � I I . � � I .I I .1 I I I I I I . I �� 4" 10- I 10- AND SPECIFICATIONS FOR FURTHER INFORMATION. PROVIDE SEISMIC ­ I I I I I I I I I I . I � I I . -f ELOW_ LAB= . 1�_�i � . � 11 . I 1 . I I I I . I I I ___�__F , I I _11- . � � . . I � I I I . I I I � . � I . I I ---"--I / . � I . I � . I I I "I I . I I I I I I I I . I I I I I . I I I �I I - . I BRACING IF/AS REQUIRED BY LOCAL AUTHORITIES. . I I I . - � I � - 1 I .0 � _j - , I I VIIN", I � . I I .� � 1 . 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I I �, I I I I � i � � � � I . . .1, . � I . I . I I . 11 I I . I � I I � I I I I . . � I . � I I r I � I I � :� I I I I I I . I . " I I I I I 11 I 11 I I I � . � I . I � � I I I � I I I � I I I . � I I � � I I .. I I .11 I I I I I � . � I � � I I I I .� I I . . I I � � L 1, I I I. I I I I I I I � I � l I I I I I . . . � � I .� ----------r------IT-7----��------- I 11 t _­T_____-­-----,-------- I _­___._­ - __ _______._______­_ -.----- ­_ __i___ ---- ,----- __----- --- I - - - , i .---- : _­_ -1 �---__-_ - - ____ -_ ---------- -_ , I I I I ,____ i __ ------- - t [ i i i 1 � ' ' I I , I I ! i : ; I -_____ -, i : 11 : i I i I : � I 11 , I I I � : : I I it , � , I,: I I � 1 7 1 1 1 1 10! TeAlffk ',O;� United East Foodservice Design, Equipment and Supplies. Foodservice & Interior Design . o 505 Collins Street South Attleboro , MA 02703 Phone: 800-556-7338 Fax: 5 0 8 - 7 6 1 -3 6 0 2 www . trimarkusa . com These Drawings are the sole property of TriMark/United-East and are not to be used in whole or in part without 0 C3 C3J 0 the expressed written consent of TriMark/United-East. -------------------------- 9 il Owner and all Contractors to check and verify existing dimensions --x 7 1 and conditions in the field before starting construction and to — y -------------------------- �� �� x / i notify TriMark/United-East of any material or detail changes. ---------------------------------- C�D WIANNO CLUBTill',� I - - - - - - - - - - - - - - - - - - - - [107SEA VIEW AVENUE 7777� ISSUES - - - - - - - - - - - - - - - - - - - ERVILLE, MA 02655 0 0 -111 0 0 I L� ISSUE DATE DESCRIPTION OF ISSUE BY � I I I � I A a�/22�A DE516N DEVHI�PI�(f � JpA I I I j b 0102114 DE!W* PEVO-01M #2 JA 5 4 8 9 3 4 5 - - - - r` � I I- - - - - - - [:]APPIROVED AS SUBMITTED OAPP'ROVED AS NOTED E]NOT APPROVED/RESUBMIT REVIEW BY: DATE: GENERAL NOTES A THESE PLANS ARE PREPARED FOR THE CONVENIENCE OF OTHERS TO LOCATE MECHANICAL POINTS OF CONNECTIONS FOR FOODSERVICE EQUIPMENT. THEY ARE AS ACCURATE AS CAN BE DETERMINED AT THIS DATE. DISCREPANCIES MAY DEVELOP BETWEEN DIMENSIONS SHOWN,FINISHED DIMENSIONS,AND UTILITY CONNECTION/ROUGH-IN INFORMATION. B EQUIPMENT IUTILITY SCHEDULE TRIMARK/UNITED•EAST IS NOT RESPONSIBLE FOR ANY UTILITY REQUIREMENTS REGARDING EXISTING EQUIPMENT TO BE REUSED. IT IS THE RESPONSIBILITY OF THE GENERAL ELECTRICAL PLUMBING CONTRACTOR AND ELECTRICAL,PLUMBING&HVAC CONTRACTORS TO VERIFY&COORDINATE ALL SERVICE REQUIREMENTS WITH ITEM ITEM OWNER TO ENSURE PROPER CONNECTIONS. REV NO QTY DESCRIPTION MFR MODEL NO. VOLTS PHASE AMPS KW HP CONN. NEMA CW(IN) HVV(IN) 1W DW GAS(IN) MBTU REMARKS NO. C BA(`KBAE2_.rn_nt ER ._P..EBLI.Cx_____ _..DZS6ct _ 12S - _4/4- — C()MPR€SSOR OR -T;AL-Btj4Gif f�LftSS @06R8, CASs€RSA 1 ,r� TRIMARKIUNITED•EAST IS NOT RESPONSIBLE FOR ANY ®P� C��L� 1� 2 1 UNDERBAR HAND SINK PERLICK TS12HSN 1-1/2" W/924GN-LF FAUCET,AND 7054-R/L END SPLASHES. (( j� ,y J y 2 UTILITY REQUIREMENTS REGARDING EQUIPMENT NOT IN KITCHEN EQUIPMENT CONTRACT. IT IS THE RESPONSIBILITY OF 1 PERLICK 924GN-LF 1/2" 112" THE GENERAL CONTRACTOR AND ELECTRICAL,PLUMBING&HVAC CONTRACTORS TO VERIFY&COORDINATE ALL SERVICE 3 1 UNDERBAR TRASH UNIT PERLICK TS12TRA W/CUSTOM BLACK POWDER COAT TRASH UNIT AND PANEL LEG ON LEFT. 3 REQUIREMENTS WITH OWNER TO ENSURE PROPER CONNECTIONS. 4 2 UNDERBAR DUMP SINK PERLICK TS12HS 1-1/2" W/924GN-LF FAUCET,7055-48 WET WASTE BOX,AND 7054-R/L END SPLASHES. 4 D 2 PERLICK 924GN-LF 1/2" 1/2" ALL ELECTRICAL,PLUMBING,AND MECHANICAL UTILITY 5 2 UNDERBAR ICE CHEST PERLICK TS241C10 1/2" W/BW6-24 BOTTLE WELLS, SR-S36R SPEED RAIL,7055-265A BACK SPLASH CUTOUT,AND CILISTOM BLACK POWDER COATED. 5 REQUIREMENT INFORMATION LISTED ON THE FOODSERVICE PLANS, IS SUBJECT TO CHANGE,BASED UPON FINAL EQUIPMENT 6 1 BACK BAR COOLER PERLICK BBS108 120 1 6.3 1/3 DR ALL BLACK WITH GLASS DOORS AND 2-7/8"CASTERS. 6 PROPOSAL SELECTED BY THE OWNER/AND OR CONTRACTOR. 7 1 SPARE NUMBER 7 8 1 UNDERBAR TRASH UNIT PERLICK TS12TRA W/CUSTOM BLACK POWDER COAT TRASH UNIT AND PANEL LEG ON RIGHT. 8 9 1 MODULAR BAR DIE SYSTEM PERLICK MBS W/CUSTOM BLACK POWDER COAT. 9 FOODSERVICE 10 1 UNDERCOUNTER DIISHMACHINE HOBART LXEH-2 120/208-240 1 32.5 6.7 JBW 3/4" 1 5/8" 10 EQUIPMENT PLAN l �, >^ s�� EQUIPMENT SCHEDULE ` AND LAYOUT PROJECT#: 1 4-132 �••- � QUOTE# DRAWN BY: J PA CHECKED BY: MJT i4vk CONTRACT REP: J c DO DRAWING SCALE: SHEET NUMBER: I ' 29A 33A 34A 73A 3A grmnTF- romp F"CIRC j Y G 1 C. TO VERIFY. LOCATION •OF,'RLCHANICAL ROOM _._ ......._ _..._ ._ ...._.•... .- ...-.,.�..... ' (RECOMMENDED. H.P. UP.- TO --25 FEET'. OF'"'.­REFRIGERATION. LINES) S/S WALL SHEATING ! 79B BEHIND COOKING LINE 58 WALL SHELF ; 7�A FIRE SUPPRESSION SYS. 0 , 62 DOWN HAND SINK 04 ` ^� 73. SANDWICH 79 1 SW K 69 O UNIT 56 HOT WATER - � 59 - 3-COMP. SINK 60 IT O INCFREDIE EXHAUST O BOOSTER 57 SINK HEATER VENTILATOR .M BANS 70 74 1 CO I CLEAN DISHTABLE ® F.O RAGE 68 _ _ NOVEN CTION O NEV VENT SSA SHELVING MIXER w 11 FRYER LIFT DELIVERY CE DUCT O • bt • 61 • REST ROOMS 06� WALL SHELF .., O r 75 - 82 55 Fd ♦ F.D. 67A F.L FB I GRIL DISH ® 61 ♦ 61 r ® U WASHER i i 67 i.•' WORK CABINET ">su'�-° ' Sl O STORAGE I� iL — 77 4 RANGE R, REFRIGERATOR F 1> SHELVING 66 ' ' 72 I JANITOR'S SINK, W/ ® 64 O CABINET • i DRAWER BREAD 1 FAUCET BY G.C. FD F.D77 VENT S5A O _ , CABINET --------- f WORK CABINET _ O 3 TIER OF 71 I ® , DUCT DRAWERS SPLASH FA ® 50 ® 6t3 1 80 ,�., .• O REFRIGERATOR '•-- • ----------------•---- BAKER'S O .CLOSET ' TABLE HAND SINK BY C Y, DATE, DRAWN � CHECKED B REFRIGERATOR 27 27 ----- -------------------- F.C.D, D.E.P. 5/4/06 . s oo O ♦ . MOBILE MOBILE DOUBLE SERVICE LSOILED DISHTABLE REV,t DATE• DESCRIPTIONL:. . WORK CABINET WORK CABINET RACK SHELF S3 HAND SINK O 6/26/06 LAYOUT: CHANGE . 4-WELL w SOUP WELLS 47A • . 7%14/06 LAYOUT' .CHAN,GE PLATE MOBILE MOBILE 4g DISPENSERS CABINET STEAM TABLE PLATING 46 4/06 LAYOUT :CHANGE CABINET O STORAGE SHELVING 7/2 O ♦ .• .• �• 88 87 - ® 49 84 CLJO ------- -- - _ KITCHEN WALK IN 8/20/06 ROUGH INS ♦ .• --'�-- OFFICE COOLER WINE • STORAGE ---- WALK-IN - COOLER 85 _ . O • 43 D �4O 41A DREAD UTILITY CABINET: BOX REFRIGERATOR ^ B CABIN OTX REFRIGERATOR N F WAL.L SHELF ,.. UTILITY CABINEt 41 •,,\ 39 rik - WALL SHELF . . . 144 ,F.D. ;2 WELL F.D. F.A . i ' r O SOUP WELLS 42 3A O _. .. .. . % •. 86 - 37 7 36 ♦ ck, 3 O 0 -.-- O _ WALK=�M •-=---=------� 2 NOT EATED WALK-IN , WALK IN , WALK IN f , �i HEATED, ' HEATED NOT HEALED 89 COOLER 1 FREEZER COOLER • FREEZER i.,•;' BEV. CABINET' REFRIGERATOR.': . ALATE STORAGE CABINET PLATE STORAGE CABINET PLATE STORAGE CABINET PLATE STORAGE CABINET `.O COFFEE-GRINDER HE AT LAMPS 28 FULL LENGTH f ' DOUBLE O/SHEL:VES -- - - P • WALL SHELF 1A 35 C - -- -.............. _ — C:_ _ — .. 27 •• ;• 0 O. . .� -....�------- •- •-=Max O % r• REFRIGERATOR FREEZER - REFRIGERATED SANDWICH UNIT MOBILE 34 ; 33 30 WORK CABINET 26 PREP. CABINET PREPARED BY, 90 ❑ 7 PLATE S-WELII PLATE 29 Vi W H F DISPENSER -HOT FOOD DISPENSER BREAD NBOX 26A ALL S EL HOLDING'CABINET CHEATED) STEAM TABLE (HEATED) I. d e.. . p e n n `a s s,o►c i a.e s W.- CABINET E 21 EXHAUST VENTILATOR O � .� .. . F.11 24 32 I . F D i 1 O3 ® EXHAUST .VENTILATOIR F•D 31 12 FO 19 FLOOR TROUGHIJNSUL•TANT REFRIGERATOR ®------ -----—..�._®•---- -- ----•— --®.�..--- O O -•— 1 i iCE;MaKER - RN - -� 14A FOCD SERVICE C . . 1 7 FRYERS ENCLOSED 6 8U ER 6 BURNER OPEN ; WALL SHELF -i .• , _ II - 46 WILCOX AVE. - PAWTUCKET;•--RIO"02860 4 1 O BROILIER STEAMER RANGE RANGE GRIDDLE i 1 N• �"' O ♦ PREP. CABINET 9 SKILLET COMBIOVEN TEL. 401=723-6677 FAX 401=724-1868 ' I 13 I • 14 16 ..._17 18 20 O HAND SINK REFRIGERATOR FISH i O• REFRIG.' PRDJECTt : .. 15 BEHINDA COOKINGTLINE FIRE SUPPRESSION,SYS. 21A ING S ACER SPACER O SINK UNIT O ICE CREAM CAHiNET ' 24A FIRE SUPPRESSION SYS. THE W I A N N C1 `CLUB. 0 11 OUTSIDE PORCH 23 ,f HAND SINK S/S WALL SHEAITING 15A WALL SHELF OBEHIND COOKINGI LINE • PROJECT LOCATION+ EQUIPMENT LAYOUTL SCALE - 1/4"=1'-0" DESCRIPTIONS . EQUIPMENT' LA DWG. NO, I -OF 5 . ��' .f ( ' •. I } / • III I, i E C� U I P I�iEI`�•IT SCH � L UI___ E E Q U I P M E N T MANUFACTURER PL.UMDZNG ELECTRICAL MANUFACTURER PLUMBING ELECTRICAL ITEM # aTY. Z)ZSCRZPTICN MAKE Nana. # VATER VASU GAS 0"AND um cat%, REMARKS . ITEM # 9TY • 232SCRIPTION HAW =M • . . VAT= WASTE GAS (NATURAU LOAD COIL REMARKS TaJ-'S VOLT^ HP. K.V. AMP, H.V. C.V. V. LV. F.L SIZE B.T= VOLT/W t�t.P. IGV. AMp. J.A f:J►. H,V. GV. V. LV- F.B. SIiE a 1 1 BEVERAGE CABINET CUSTOM FAB. S/S 1/2' 1/2' 2' YES x(2)120/1 20.0 YES x . WALL MOUNTED D.R. 47 1 MOBILE STEAM TABLE CUSTOM FAB. S/S IA 2 WALL SHELVES CUSTOM FAB. S/S NEED BLOCKING IN WALL 47A 4 SOUP WARMERS A.P,W. HFW-1D V YES 240/1 1.6 6.7 YES 2 1 REFRIGERATOR VICTORY RA-2D-S7 120/1 1/3 8.2 YES 48 1 MOBILE UTILITY CABINET W/ O/SHELF CUSTOM FAB, S/S M12011 20.0 YES s 'WALL MOUNTED D.R. 3 1 ICE MAKER MANITOWUK S-1400 1/2' 4• YES 120/1 20.0 YES 49 2 PLATE LOWERATORS - 3A 1 ICE MAKER REMOTE COMPRESSOR - - 230/1 2 17.5 YES 50 1 S/S UTILITY CABINET CUSTOM FAB. S/S 1/2, 1/2, (MI YES ,�C2)1C0/i 20.0 YES * WALL MOUNTED D.R. 4 5 HAND SINK ADVANCE 7-PS-80 1/2' 1/2' 1 1/2, 51 2 WALL SHELVES CUSTOM FAB. S/S NEE BLOCKING IN WALL 5 1 REFRIGERATOR VICTORY RA-ID-S7 120/1 1/3 5.5 YES 52 1 REFRIGERATOR N.I.C. EXISTING 120/1 1/3 8.2 YES 6 2 UTILITY CABINET CUSTOM FAB. S/S 53 1 L-SHAPED SOILED DISHTABLE CUSTOM FAB. S/S 1/2' 1/2' 2' YES 7 2 FRYERS PITCO SG14R 3/4' 122,000 120/1 10.0 YES 54 1 DOUBLE RACK SHELF CUSTOM FAB, S/S 8 1 BROILER BLODGETT B32D-171 1' 149,000 120/1 2.0 YES 55 1 DISHWASHER HIIBART CRS66A , 1/2' (2)2' YES _ 3/4' H.W. AT 1 0• INLET FROM BOOSTER"#54 9 1 STEAMER BLODGETT SC-10GH 1/2' 2' YES 3/4' 190,000 120/1 10.0 YES 55A 2 VENT DUCTS CUSTOM FAB. S/S PROM DE 3/4' H.W. AT 10 1 RANGE BLODGETT B36D-BBB 1 255,000 120/i 1.0 YES K - 2 ' S6 1 HOT WATER BOOSTER HATCO S-30 3/4' 3/4' YES 240/1 30.0 125 YES 11 1 S/S SINGLE SINK CUSTOM FAB. S/S 1/2, 1/2, 2' YES W/ SPLASH MOUNT FAUCET 57 1 L-SHAPED CLEAN DISHTABLE CUSTOM FAB. S/S 12 1 RANGE BLODGETT B36A-BBB 1' 255,000 120/1 4.8 YES 58 2 L-SHAPED WALL SHELVES CUSTOM FAB. S/S NEED BLOCKING IN WALL 13 1 GRIDDLE BLODGETT B36N-GGG 1' 96,000 120/1 4.8 YES 59 1 SINK 'SANITIZER HATCO 3CS-9 3/4' YES 240/1 9.0 38.0 YES 14 1 UTILITY CABINET CUSTOM FAB, S/S 1/2' 1/2' 2' YES x120/1 2010 YES. x = WALL MOUNTED D.R. 60 1 3-COMP, POT SINK CUSTOM FABnomommm� . S/S i/2' 1/2' xC3X2' YES * = P.C. TO PLUMB THRU GREASE TRAP 14A 2 WALL SHELVES CUSTOM FAB, S/S NEED BLOCKING IN WALL 61 4 SHELVING UNITS METRO - 15 1 ICE CREAM CABINET - - 1/2, 1' YES 120/1 2010 YES 62 1 SHELVING UNIT METRO - 15A 2 WALL SHELVES CUSTOM FAB. S/S 63 1 SHELVING UNIT METRO - 16 1 REFRIGERATOR N.I.C. EXISTING 120/1 1/3 8.8 YES 64 1 ' SHELVING UNIT METRO - 17 1 SEAFOOD REFRIGERATOR VICTORY FRS-ID-S7 120/1 1/4 8.0 YES 65 1 REFRIGERATOR VICTORY - 120l1 1/3 5.5 ' YES 18 1 BRAISINd PAN BLODGETT BLP-30G 1/2' 1/2' 3/4' 80,000 120/1 20.0 YES 66 1 PROOFER CABINET - - 120l1 20.0 YES 19 1 FLOOR TROUGH CUSTOM FAB. S/S 3' 67 1 S/S UTILITY CABINET CUSTOM FAB. S/S x120/1 20.0 YES x _ WALL MOUNTED D.R. 20 1 COMBI-OVEN BLODGETT BC-20G 3/4' 3/4' 2- YES V 215,000 120/1 15.0 YES 67A 2 WALL SHELVES CUSTOM FAB. S/S NEED BLOCKING IN WALL NNW 21 1 EXHAUST VENTILATOR EAST COAST FIRE S/S 120/1 20.0 YES SEE E.C.F. DRAWING FOR UTILITIES 68 1 60 QT. MIXER HOBART HL600mommoommamign 200-240/1 18.0 YES 21A 1 FIRE SUPPRESSION SYS. EAST COAST FIRE R102 120/1 20.0 YES 69 1 SINGLE COMP. SINK CUSTOM IFAB. S/S 1/2, 1/2, 2' YES own 22 1 EXHAUST FAN & DUCTWORK EAST COAST FIRE SEE E.C.F. DRAWING FOR UTILITIES 70 3 MOBILE INCREDIENT BINS - - 23 1 S/S WALL SHEATING CUSTOM FAB. S/S 71 1 BAKER'S TABLE CUSTOM 'FAB. S/S 24 1 EXHAUST VENTILATOR EAST COAST FIRE S/S 120/1 20.0 YES SEE E.C.F. DRAWING FOR UTILITIES 72 1 S/S UTILITY CABINET CUSTOM FAB. S/S 1/2- 1/2' 1 1/2' 24A 1 FIRE SUPPRESSION SYS, EAST COAST FIRE R102 120/1 20wimmmommmmmobmom .0 YES 73 1 REFRIGERATED SANDWICH UNIT LAROSA 15160-32 120l1 2.0 YES 24B 1 S/S WALL SHEATING CUSTOM FAB. S/S 73A 1 SANDWICH ,iNIT REMOTE COMPRESSOR - 120l1 1/3 YES 25 1 EXHAUST FAN & DUCTWORK EAST COAST FIRE - SEE E.C.F. DRAWING FOR UTILITIES 74 1 DOUBLE CONY. OVEN BLODGETT DFG-200 3/4' 110,000 (2)120/1 6. EA. YES • 26 1 UTILITY CABINET CUSTOM FAB. S/S 1/2' 1/2' 2' YES r120/1 20.0 YES x a WALL MOUNTED D.R. 75 1 FRYER PITCO SSH55 3/4' 80,000 120/1 10.0 YES DRAWN BY, CHECKED BY, DATES 26A 2 WALL SHELVES CUSTOM FAB. S/S NEED BLOCKING•IN WALL 76 1 GRILLE - BLODGETT B24-TT 1' 64,000 F•,G,D, D.E.P. 5/4/06 27 3 MOBILE UTILITY CABINET CUSTOM FAB. S/S 77 1 RANGE BLODGETT -B24-BB 1' 140,000 28 5 HEAT- LAMPS HATCO GRH-72 120/1 L8 YES 78 1 S/S WALL SHEATING CUSTOM FAB. S/S Woodman 29 1 REFRIGERATED SANDWICH UNIT LAROSA L15196 120/1 2.0 YES 79 1 EXHAUST VENTILATOR EAST CIOAST FIRE S/S 120/1 20.0 YES SEE E.C.F. DRAWING FOR UTILITIES REV., DATES DESCRIPTtONs 29A 1 SANDWICH UNIT REMOTE COMPRESSOR - - 120/1 1/2 YES 79A 1 FIRE SUPPRESSION SYS. EAST COOAST FIRE R102 120/1 20.0 YES 30 1 UTILITY CABINiET W/ BREAD BOX CUSTOM FAB. S/S _ SEE E.C.F. DRAWING FOR UTILITIES 6/26/06 LAYOUT CHANGE 79B 1 EXHAUST FAN 6 DUCTWORK EAST CIOAST FIRE 31 2 HEATED PLATE WARMERS - - 120/1 20.0 YES 80 1 REFRIGERATOR VICTORIY RA-ID-S7 120/1 1/3 5.5 YES 7/14/06 LAYOUT CHANGE 32 1 STEAM TABLE LAROSA L-82172 1/2' V YES 240/1 6.0 25.0 YES 81 LOT SHELVING METRO - 33 1 FREEZER BASE LAROSA L-21166 120/1 2.0 YES 82 1 RECEIVING AREA - - 7/24/06 LAYOUT CHANGE 33A 1 FREEZER BASE REMOTE COMPRESSOR - - 120/1 1/2 YES 82A 1 MOTORIZED CONVEYOR BELT N.I.C. BY OTHERS 34 1 REFRIGERATOR LAROSA L-11172 120/1 2.0 YES 83 1 WALK-IN FREEZER (RELOCATED) N.I.C. EXISTING x120/1 20.0 YES W = LIGHTS ALARM DOOR HEATER & RR.P. 8/20/06 ROUGH-INS EXISTING 1' YES x ix = VERIFY W/ EXISTING UNIT 34A 1 REFRIGERATOR REMOTE COMPRESSOR - - 120/1 1/3 YES 83A 1 WALK-IN FREEZER BLOWER COIL N.I.C. pe = VERIFY W/ EXISTING UNIT 35 1 DOUBLE OVER�SHELVES CUSTOM FAB. S/S 83D 1 WALK-SIN FREEZER COMPRESSOR N.I.C. EXISTING x i36 2 S/S PLATE STORAGE CABINET CUSTOM FAB, S/S 83C 1 HEAT TAPE N.I.C. EXISTING 120/1 20.0 YES 37 2 S/S PLATE STORAGE CABINET (HEATED).. CUSTOM FAB. S/S 240/1 5.0 YES 84 1 ' WINE STORAGE ROOM N.I.C. EXISTING 38 1 REFRIGERATOR N.I.C. EXISTING 120/1 1/3i 8.2 YES 85 1 WALK-IN COOLER N.I.C. EXISTING NO WORK IN THIS AREA 39 1 UTILITY CABINET W/ BREAD BOX CUSTOM FAB. S/S x120/1 20.0 YES x = WALL MOUNTED D.R. 86 1 WALK-IN COOLER N.I.C. EXISTING NO WORK IN THIS AREA '� 39A 2 WALL SHELVES CUSTOM FAB, S/S NEED BLOCKING IN WALL 87 1 WALK-IN COOLER & FREEZER N.I.C. EXISTING NO WORK IN THIS AREA 40 1 REFRIGERATOR - N.I.C. EXISTING 120/1 1/13 8.2 YES 88 1 CHEFS OFFICE - -" 41 1 UTILITY CABINET W/ BREAD BOX CUSTOM FAB. S/S xC2>220/1 20Milan .0 YES x = WALL MOUNTED DEmawoom .R. 89 1 WALK-IN COOLER (RELOCATED) N.I.C. EXISTING120>1 20.0 YES _ LIGHTS, ALARM, & DOOR HEATER 41A 2 WALL SHELVES CUSTOM FAB. S/S NEED BLOCKING IN WALL 89A I WALK-IN COOLER BLOWER COIL N.I.C. EXISTING 1' YES x x VERIFY W/ EXISTING UNIT r = VERIFY W/ EXISTING UNIT 42 2 SOUP WARMERS A.P.W HFW-1D 1' YES 240/1 lb 6.7 YES 89B i WALK-IN COOLER COMPRESSOR N.I.C: EXISTING 1. 43 1 UTILITY CABINET CUSTOM FAB. S/S x(2)120/ 20.0 ES x = AL MOUNTED D.R. 90 1 HOLDING CABINET WINSTi ON HA4522-5 120/1 2.29 19.1 YES wommooftm 44 2 WALL SHELVES CUSTOM FAB. S/S NEED BLOCKING IN WALL 45 2 WIRE SHELVING UNITS METRO - 46 1 MOBILE UTILITY CABINET W/ O/SHELF CUSTOM FAB. S/S x 20/f 0.0 YES x z WALLMOUNTED D.R. PREPARED BY, d, e. peen associates FOOD SERVICE CONSULTANT 46 WILCOX AVER PAWTUCKET, RI. 02860 TEL. 401-723-6677 FAX 401-724-1868 PROJECT, THE WIANNO CLUB PROJECT LOCATION, �laTci UNLESS OTHERWISE SPECIFIED, SERVICES SHOWN ON THIS PLAN ARE F'OR FIXTURES BEING SUPPLIED BY WAREHOUSE CO. ONLY, MECHANICAL CONTRACTORS MUST NT BEING RE-USED OR CHECK OW NER'S S PRESENT EQUIPMENT B E T� HI . (NOT IN CONTRA( W CH THAT EQUIPMENT MA RKED N.I.0 IS BEING SUPPLIED BY OtHER S $O THAT SERVICCS REQUIREMENTS ARE CORRECTLY TYPED, ADEQUATELY SIZED, sL ROUGHED-IN PROPERLY (LOCATION L HEIGHT) DESCRIPTION, T FITTINGS REQUIRED ALL LABOR, SWITCHES, DISCONNEC S L P T AS NECESSARY FOR FINAL CONNECTION OF EQUI htEN R G EQUIPMENT TD COMPLY VITA ALL CODES, INCLUDING ALL INTE WIRIN TO BE FURNISHED BY ELECTRICAL CONTRACTOR UNLESS STATED OTHERWISE IN F.B.E.C, SPECS. SCHEDULE ALL LABOR, VALVES, TRAPS, TAILPIECES, STRAINERS, PRESSURE REDUCING VALVES, & FITTINGS REQUIRED FOR FINAL CONNECTION OF EQUIPMENT AS NECESSARY TO COMPLY WITH ALL CODES, INCLUDING ALL INTERCONNECTIONS TO BE FURNISHED BY MECHA NICAL CONTRACTOR UNLESS STATED OTHERWISE IN F.S.E.C. SPECS. DWG. N O. 2OF5 1'V. + 1'-10• LTG , 1/2' GV + 1'-V B.T.G 140A00 BTU'S 77 60 O 1/P' H.V * 1'-8• B.1 C. 1/2' H.V ♦ 1'-2' B.T C. 60 2' 4 1'G + 1 i/ (3) 2' IV.TO F S 64,000 BTU'S Q 1/2' GV + 1'-8' B.T.C. 59 3/4'IV. TO F.i. Pt TO PLUMB tRAp THRU 804A00'. +11-r O FS 7'-4• 1'-6' S'-6' 4• F.5• GV + 1'-4' B.T.C. 69 3/41 G. +1'-0' 74 4. 110,000 BTU'S F.S. 11/2' FLW + 1'-4• B.T.C, 36 3/41 H,V.mo, HDU 1'-6• + 1.V RTr_ F.S. DOWN 36 3/4'H.V.At IBO' OUTLET 3._7. 4• 10• FROM BOOSTER TO DISH HACHDE Oss 3/4'H.V.AT IV DdETFH 3'-2' ON DISH MACHINE FROM BOOSTER 4' F.S. •�3/4'I.V.TO F S � NEV VP' HV • i'-4• &T.C, 50 S6 DELIVERY 1/2' CV ♦ 11-48 I.T.C. 5-Z 1'-5' LIFT ENTRANCE REST ROOMS 4 l3' (2) v I.V. TO F.S. SO ♦ I 10'-81' 0 2'-0• 82 . AREA ®AREA o AREA F.D. F.D. �A II�{Y F.D. 1'-6• F.S. 4► 2'-3' S. (2)2, I.V.TO F.S Ss 12'-7• F.S. AREA - ® ®F F.D. 4 1/2• GV + 4' B.T.G ®F.D A ® F.D.AREA 1 1/2• V. + 4' B. CLOSET 4, 4, 1/2' H.V + 4' B.T.C. ' LIUl 72 4. DRAWN BY, CHECKED BY, DATE+ .� 5/4/06 u2• GW + 1'-2• B.T.C. D.E.P. U. F.S. s3 F.G.D. t I I I 1/2' H.W + 1'-2' B.T.G u1/ GV * 1I'-I &T. F.S. REV., DATE] DESCRIPTIONi 1/2' H.W + 1'-8' A.T.0 4' 4' 6/26/06 LAYOUT CHANGE to• • F.S. _.__.....,. is I.W. TO F.S. 47A 7/14/06 LAYOUT CHANGE 0 0 0 o F.S. , 7/24/06 LAYOUT CHANGE 2'-D• 0 0 0 8/20/06 ROUGH-INS F. G 1/2' C,W + V-4' B.T.C. 12' F.S. 2'-0' 1/ 2' H,W 1-4 B.LG -+�-F.S. F.S. ® F.D. 1I.W. TO F.S. T F DEA AREA F.D ® F.S. 42 F DEA AREA 1' LW. TO F.S. e 0 FF t..l i .S. 1/2' C.W. + 4' B.T.C. 32 89A TO F.S. ® 1' I.W. .__. ♦ ♦ TO F.S. 0\__21 I.W. TO F.S. O o - 3/4" C.W + V-4' B.T.C. 10 1i'-s' F 20 1'G. + 11-01 "�v v 70 0 o2ls,000 atus zb 2 I.W. TO Fs, PREPARED BY,7`� 4` 1/2' H.V + i'-4' H.T.C. 20 2• I.V. TO TROUGH - F.S, 26 • 3• W. + 6' BELOW + 0 d. e. penn associates ® AREA AREA AREA FS. AREA 19 AREA 1/2 C.W 1 4 B.T.C. F.D. ® F.D. ® F.D. ® F.D. V W. 14 FINISHED FLODR F.D. F.S 6'-O' FOOD SERVICE CONSULTANT O2` I.V, n0 F.S. TO s. 1� 46 WILCOX AVE. PAWTUCKET, RI, 02860 �• 3/4' Lv. TD FS -- TEL. 401-723-6677 FAX 401-724-1$68 1/B' LV. TO FS O F.S. 4' 3'-10' i/2' H.W + 1'-8' H.T.C. F.S. 2..2. S. 1 I/2• W. + V-10' B.T.C. O4 12 4• 11� 1/2' C.W + 1'-8' B.T.C. IT 4, 4� 4, 4, 6, PROJECTS PLUMBING LEGEND 1'-4' )'-5' . . . t'-2' 1'-2 ' SYM. ABB. DESCRIPTION ' $-10 1-6 �-2 2-11 2-0 3-4 3-0 6-4 10-10 1�4 12 4-3 12 3 1/2' C.W + 4'-0' B t.C. F.S. , Lv 1/2• GW + 1'-8' B.T.C. 7� ! 4 4 1 Q + I-0' 13 4 4 11�a� 1S 3/4, +11 0• 18 4 THE W I A N N❑ CLUB %A00 DTU'S Q n 4 1 1/2' W.'+ 1'-30' B.T,C, y O O 1/2' H.W + 1'-8' B.T.C. . 1'4 + C-0' O i2/24Aoo; 2ssAoo BTU'S 12 - • o POINT OF EQUIPMENT CONNECTION 1/t•' H V + 1 4 B.T.C. O • H.W. HOT WATER 1/2' H.W + V-4' B.T.C. 1/2' KV + 1'-4' B.T.C. U2' Gv . 14 BTTUU S F� 11 F.S. 14 • C.W. COLD WATER 1/2' C.V + 1'-4• &T.C. 1/2' C.V + V-4' B.T.C. W. WASTE (SOLID CONNECTION) GAS REQUIREMENTS (NATURAL) - O 1/2' C.V + 1'-.4' B.T.C. to Q + 1,-0, o I.W. INDIRECT WASTE 233Aoo BTVS to F.D. FLOOR DRAIN fTEM # DESCRIPTION TOTAL B.T.U'S 3/4•Q + p-0' ® PROJECT LOCATION 0 190,000 STVS 7 FRYER 122,000 ® F.F.D. FUNNEL FLOOR DRAIN 7 FRYER 122,000 ' 8 BROILER 149,000 ® F.S. FLOOR SINK A G. • GAS 9 STEAMER 150,000 .. � - 10 RANGE � 255,000 •• B.T.U. BRITISH THERMAL UNIT 12 RANGE 255,000 PLUMBING ROUGH-IN PLAN STEAM TAKE-OFF 13 GRIDDLE 96,000 SCALE - 1/4"=I'—O" o-- B.T.C. BRANCH TO CONNECTION 18 BRAISING PAN 801000 0-- B.T. BRANCH TO 20 COMBI-OVEN 215,000 + A.F.F. ABOVE FINISH FLOOR 74 DOUBLE CQNV, OVEN 1101000 D.F.A. DROP FROM ABOVE DESCRIPTION, 75 FRYER 80,000 76 GRILL 64,000 rL CENTERLINE PLUMBING PLAN 77 RANGE 140,000 iQ EQUIPMENT ITEM NO. P.C. PLUMBING CONTRACTOR TOTAL B.T.U'S 1,8T8,000 ' K.E.C. KITCHEN EQUIPMENT CONTRACTOR P.C. NSTALL AUTO-MECH, GAS SHUT-OFF RETURN LINE 11-40 goo kH VALVE IN MAIN GAS FEED TO COOKING m • SLURRY LINE DWG, NO. EQUIP. - VALVE BY K.E.C. 3OF5 29A 12OV- 1/2 H.P. 230Vr 2 H.P.- 17.5 AMP. 3A 1 PH: B.T.C. 1 PFi.- B.T.C. 33A iZOV- 1/2 H.P.- 12OV- 1/3 HIP.- 73A 1 PH; B.T.C. 1 PH: B.T.C. 34A I1 V-1 3 H.P.- C. LQ TO P OVJDE ANIT* N ONE s �" u�G°Rp-mnTF C1MPRESCRC N FOR VENTILATOR G.C. TO VERIFY LOCATION OF MECHANICAL ROOM f I�E.C. M PROVIDE L LOCATE PROVIDE LOCATE (RECOMMENDED HIP. UP TO 25 FEET OF REFRIGERATION LINE) L KITCHEN a REMorE PULL STATION ♦ 4'-6' 79B VALL 1N KITj ON/OFF 79A sSVIITCH V/ PILOT LIGHT FOR EXHAUSIll t ' 4 0 J& + 7'-6'- 120V- 79 1-6 2 OV- 3&0.AMP. g9 20.0 AMP,- I PK_ LTr_ 9A IGV:1 PK-B.T.C. A D.F.A. TO 8'-6' AFF: 12OV. A&+ 41-INV- 20.0 AMPS: 1 PH.- H.T.C. 3'-10' 73 2.0 AMID:1PK- B.TC. oAIA DOWN WDkS+ P-61-t2OV- 12' 74 6A AMP.EA.-VK DR t 7'-41-12W- DR+ 1'-6'- 12OV- 52 1/3 M.P: 92 AMP: 1PIK J.B. + 1'-6'-24W- 30A K.V. S6 7S l0A ANN 1PRI gp l2) DR+ 4'-V- 12OV- i2S AMP.: 1 Pit- AT.0 o NEW 10' O 20A AW.EA-IPK ® 68 lu 411 O AMP,-61 ECH40V � DELIVERY 1 6 LIFT ENTRANCE REST ROOMS 97 - 3'-W 5'-6' 1'-6' 4'-6' 2'-10' Q 6. 82 JL ♦ 51-0'-240V- 741 AMP. 55 67 2I�OA+ 4� OV 1 PH.- BJ.C.(ELEC.HEAT) 8• dB. + 5'-0'- 24OV- 221 AMP, 3 1/16 HP: 1 PK- H.T.C. OUTORS) 55 6'-2' 66 DR ♦ 1'-6'- 120V- 20A AMP: VK 2'-4' CLOSET 6s Lp. + r-4'- 12W- 1/3 HP: 55 AMP:IN � 1._Z• i ! DR + &5- 030 1/3 HP: AMP.- IPK DRAWN BY1 CHECKED BY, DATEI e F.G.D. D.E.P. 5/4/06 OSa . 11-6'- 144V-a LW. REV., DATEI DESCRIPTI❑N: 47 26.0 AMP: 1PK 4e Z + 4i- I l2ov- lUt 22U W v- 46 6/26/06 LAYOUT CHANGE 20.0 AMP: Pitt 3'•6• s'-4• s'-s` DR + 41-01-12ov- 39 7/14/06 LAYOUT CHANGE 2010 AMP: IPK o Io ! ! O I P -- aR,+ r-4'-12ov- 38 7/24•/06 LAYOUT CHANGE 1/3 MR-H2 AMP.-!PK o f ! ! ! 8/20/06 R❑UGH—INS D.F.A. TO 8'-6' A.FF: VERIFY VOLTAGE W/ EXISTING COIL 5'-4' 1'-8• 3'-4' 3'-6' 4'-3' 0 i D.R. + 41-01- 120V- 20A AMP; IPK 43 0 DR. + 4'-V-MOV. DR+ T-4'•120V- 40 0 20.0 AMP.EA-IFK 1/3 H.P:82 AMP- IPKo 2 4 42 Ja +4'-240V-32 K.V. D.F.A. TO 8'-6' A.F.F.- 12OW , I&A AMP: IPK- D.T.0 0 DR +41-01- 12OV- 41 89 20 AMP:1 PH. B.T.C. FOR LIGHTS, ,- / � � 83 20ARM,T I PH.- B.T.Co FOR EATER !� P R.P.LIGHTS, 0 20A AMP.EA.-IPK o O ALARM L DOOR HEATER 1 8 34 A AMA-1I lViT.C. 83 2A A 4- 112 BT,C. J& N P.-24W-6A K.V. 32 J& + 4'- 120V• 28 IPK- B.1.C. 7.2 K.V.- IPK- LTZ D.F.A. TO 8'-6' A.F.F; VERIFY VOLTAGE FROM TIME CLOCK AT • PROViDEMItD LOCATE 83A EXISTING CONDENSING UNIT 21 24 EAL SSVIT VI/NPIIILOT LI+GHt�F� BY E.C.- B.T.C. VENTILATOR LIGHTS. I 3'-6' 2'-10' 3'-8' 22 2g ON V P IN K E AND�Ot(� ♦ � DR 4 7'-4'- 120V- 2 � SVIT04 V/P1�T LIGHT FOR V3 HP:8.2 AMP: no E%HAUST FAN 0 1 DR + 4'-0'- lzav- PREPARED BY, 20.0 AMP: IPK [> DR+7'-4•- 12OV- a 1/3 KP: 8.8 AMP:IPK 21 2'-2' 2'-0' ._ . . . . e • . . . • . . . . . . . O 12 6 S-0 12 3-4 1-6 2-2 4-2 1-6 6'-10 29 DR + 7-4- 120V- 17 DFA. TO 8'-6' A F.F: 120V. D.FA TO 8'-b' A.F.F.- d. e. p e n n associates 1L + 4'- 24oV- is +41 240V- DR ♦ 4'- l20V- 1/4 11P:@O AMP:1PK 37 S0 K.V: IPK- I= SA K.Y.-1PH.- B.TC. 20A AMP: 1PK JB + 4'-120V- 9'-10' 20A AMPS: 1 PH: H.T:C. 20A AMP-IPK 20V- 26 83C 120V: 20.0 AMPS.- 1 PH. DR+ 4'-k^OV- 37 31 ��.- �-lGT� I (FOR HEAT TAPE) FOOD SERVICE CONSULTANT 31 20A AMP,- IPK 46 WILCOX AVE. PAWTUCKET, RI. 02860 5'_2• TEL. 401-723-6677 FAX 401-724-1868 3'-6' 1 3'-6� ! Li ELECTRICAL LEGEND PROJECT., 3'-6' 5'-4' 3'-0' 1'-8' 4'-10' 3'-8' 3'-10' 3'-2' 5'-4' P-8' ' J.B.+ 7'-61-IMV- 21p SYM. ABB. DESCRIPTION 0 3 lUL +1'-6'- 120V- GD M 11-61-lwV DR + 1'-6'- 120V- . 20.0 ANP.-1 PK- B.'GC. 20.0 AMP.- IPK 20A AMR- Im 15 J.B.+ l-6-120V- SR t 1-6- 120V- 20 NTONKITC►E A REMOTE E 20.0 AMP.- 1PK• B.LC, 150 AMP.- !PK o L TATION + 4'- 0 POINT OF EQUIPMENT CGNNECTION THE W I A N N CJ CLUB 0 SR + 11-61- 120V- DR + .-I- 120V- 18 90 LO AMP.-IPK 10 D.R. +4-0'- >PpV- 14 2E9 K.V.-191 AMP:IPK 20.0 AMP: IPK O 0 D.R. DUPLEX RECEPTACLE - 90it + r-6'- 120V- 10.0 AHP-61 I � m S.R. SINGLE RECEPTACLE 24A 20A AMP: 1 PK- &Tt DF.A. TO 8'-61 A.F.F.- 120V, 24 IImKIRTGIEt!ALRT DR+ F-6'- 12ov- O 2pA AMPS; ! PH: H.T.C. o J.B. JUNCTION BGX N-V2A AMP:1PK ULL STA IDN + 4'-6' DR + 1'-6'- 120V- 13 DR +1'-6`-112OV 7 4.8 AMP.- IPK EM F.M.AR. FLOOR MOUNT DUPLEX RECEPTACLE . 1 AMP. 1PM't O OA 5 1/3 + .-4- Ws- O []i t;.M,S.R. FLOOR MOUNT SINGLE RECEPTACLE 0 1 3 H.P. 3.5 AMP:1PFl D.R. ♦ 11-61- 120V- (� lu Awi- IPK C.P. CORD AND PLUG PROJECT L❑CATI❑NI 120/1 V/PH. VOLTAGE/PHASE H.P. HORSE POWER K.W. KILOWATTS AMP. AMPERES ELECTRIC ROUGH- IN PL AN LAN $ SW. SWITCH SCALE — 1/4"=1'-0" A.F.F. ED FLOOR ABOVE FINISH LO '�' E Q� B.T.C. BRANCH TO CONNECTION Q_- B.T. BRANCH TO D.F.A. DROP FROM ABOVE DESCRIPTI❑NI CL CENTERLINE ELECTRICAL PLAN Q EQUIPMENT ITEM # E.C. ELECTRICAL CONTRACTOR Ll L K.E.C. KITCHEN EQUIPMENT CONTRACTOR DWG. NO, . 4 ❑FS J I GC TO PROVIDE BACKING GC. TO PROVIDE BACKING ! 58 IN WALL FROM 4'-0' A.F.F. IN WALL FROM 2'-6' AF.F. p TO 6'-0' A.F.F. TO SUPPORT TO 5'-0' A.F.F. TO SUPPORT WALL SHELF. HAND SINK. G.G TO PROVIDE BACKING 12'-30• 1'-9' 1'-6• 79A IN WALL FROM 5'-0• A.F.F. FSUPPORT IRE SUPPRESSION SYSTEM. c IIN WALL FROM 4'-0' A.F.F. 67A IG.C. TO PROVIDE BACKING G.C. TO PROVIDE BACKING 'TO 6'-0• A.F.F. TO SUPPORT IN WALL FROM 4'-0' A.F.F. 58 y-0� !WALL SHELF. G C. TO PROVIDE BACKING TO 6'-0' A.F.F, TO SUPPORT IN WALL FROM 4'-0' A.FF. 51 :IF WALL SHELF. TO 6'-0' A.F.F. TO SUPPORT 8' WALL 'SHELF. 1-31 j •-11'-0' 1_6. 4' x 16' EXHAUST DUCT j COLLAR (400 C.F.M.'S) VENTILATOR TO 3' ABOVE FINISHED CEILING 55A , 3�_8• 6'-4' 4' x 16' EXHAUST DUCT i n COLLAR (200 C.F.M.'S) ' TO 3' ABOVE FINISHED CEILING S5A 1-6' cm 4'-0, N A T V TIL 0R SEE E.C.F. DRAWING DRAWN BY1 CHECKED BYI DATE► - 79 FOR ALL UTILITY REQUIREMENTS F,G.D. D.E.P. 5/4/06 REV.t DATEI DESCRIPTI❑Nt Gr- TO PROVIDE BACKING IN WALL FROM V-6' A.F.F. 2'•O' TO 5'-0' A.F.F. TO SUPPORT O HAND SINK. 6/26/06 LAYOUT CHANGE 7/14/06 LAYOUT CHANGE 7/24/06 LAYOUT CHANGE s r r 8/20/06 ROUGH—INS 1 ARCHITECT TO VERIFY 8'-6' 89 DEPTH OF DEPRESSION FLOOR DEPRESSION 16'-71 r G.C. TO PROVIDE BACKING GC. TO PROVIDE BACKING IN WALL FROM 4'1 A.F.F. 41A 44 IN WALL FROM 4'-0' A.FF. 39A } TO 6'-0';A.F.F. TO SUPPORT TO 6'-0' A.F.F. TO SUPPORT WALL SHELF. WALL SHELF. -- 13- FLOOR DEPRESSION 10 SEE E.C.F. DRAWING 21 FOR ALL UTILITY REQUIREMENTS 00 00 8'-0• O II � GC, TO PROVIDE 7 DEEP Lei • � � G.C. TO PROVIDE BACKING TR13UGHDV R GRA I NG,FOR ACKFOIOLL, TO 6IN A 01' A F.F. TO OSUPPORT IA ® 19 GROUT AND FINISH FLOOR BY G.C. WALL SHELF. Lama PREPARED BY, 9'-0' VENTILATOR GC. TO PROVIDE�BACKING FLOOR ,_ . TO 6A OL AF.F. TO SUPP RAT 26A • . 6 6 0 d e. Denn associates DEPRESSION f WALL SHELF. . z�- 3 FLOOR FOOD SERVICC CONSULTANT DEPRESSION 46 WILCOX AVER PAWTUCKET, RL 02860 VENT 61 4'-6' TEL, 401-723-6677 FAX 401-724-1868 VENTILATOR ® G.C. TO PROVIDE BACKING 2'_7. IN WALL FROM 2'4' A.F.F. O r TO 5'-0• A.F.F, TO SUPPORT 4 HAND SINK. r—s• 1'—l0• '-lo' '_ ► 23'-0• PROJECT: 1 3 0 VENTILATOR G.C. TO PROVIDE BACKING G.C. TO PROVIDE BACKING IN WALL FROM S'-0' A.F,F, 21A THE W I A N N❑ CLUB 14A 15A IN WALL FROM 4'0' A.F.F. TO 7'-6' A.FF, TO SUPPORT G.C. TO PROVIDE BACKINGJ G.C. TO PROVIDE BACKING TO 6'-0' A.F.F. TO SUPPORT ( FIRE SUPPRESSION SYSTEM, 24A IN WALL FROM 5'-0' A.F.F. IN WALL FROM 2'-6' A.F.F. WALL SHELF. TO 7'-6' A.F.F. TO SUPPORT TO 5'-C' A.F.F. TO SUPPORT O FIRE SUPPRESSION SYSTEM. HAND SINK, SEE E.C.F. DRAWING FOR ALL UTILITY REQUIREMENTS SPECIAL CONDITION LEGEND SYM, ABB. DESCRIPTION PROJECT LOCATION, ® EXHAUST DUCT COLLAR ® SUPPLY AIR DUCT COLLAR S.P. STATIC PRESSURE i C.F.M, CUBIC FEET PER MINUTE SPECIAL CONDITION PLAN Em SLAB DEPRESSION SCALE — 1/41=1/-0, ® WALL BLOCKING + A.F.F. ABOVE FINISHED FLOOR CENTERLINE S/S STAINLESS STEEL DESCRIPTION, lU EQUIPMENT ITEM # K.E.C, KITCHEN EQUIPMENT CONTRACTOR SPECIAL G.C. GENERAL CONTRACTOR (� PLAN I Of L=/Lj CNDITI ❑ DWG, NO. 5 OF 5 � ­ , , , I . - I I —qs�, - 7 � . I I I � " I I � 4, . 1 f � I I I 1i I " � I� I I I I -I ­ - � I I I­I 11 - I I I I � .1 � , - I � - 1, 11 , 11 __ - I -1..-11­.- -­__11--l-11-1-_.— 1 ­­­,—-­­1 I ­ ­ , ,,-,r,---- - ,—� _­_,_____­,_, ­ ­ __.__,___ - I I __________��!,_-----­---- . ____--y I 1­,-—----- - "'. I : ��r ,,,, , I �_____ I . I � I � ; � I i 0 "I - I 11 i I 7,� . I .- ����","","I'll","I'll, �11 - I I I I - I I � I I ­- � ,� � I I I , 1121PIRP1111'll, I i - I I I I �I - - 1­ .-.-",, . ­1 _-­­--.,­­-- I - I I I . I- � P/&--- - M,% ;� I- � "I 1..4dM"__T____lT_1�1_ I I'll I p � - ���11 M-M!T Ill",.,I _ I I- ,11-- --v,,r-7--­­ �,` I I � t I I I .,O-,/!. :1.F ': ,3 1�11 ::­� ;- I __1-I - I I - �%��,� ; *1 I � l"' ,� � , I . I � I , � i A ". ,\, �, . , I 'I , I , .0. _]��Iv.:� *> � `11��,��,�'-_1�­ 1-1-. 1, � I ,4,l�k I ly I � -l`S'5'Y___) .7'0 7i'Vi 3 '1* 7. - I � I ,, 1 I "I �, 1 N 11.1," , _`t /it . .. 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TO VERIFY LOCATION OF: MECHANICAL ROOM (RECOMMENDED H,P, UP TO 25 FEET OF REFRIGERATION LINES) S/S WALL SHEATING 79B BEHIND COOKING LINE 58 WALL SHELF 79A FIRE SUPPRESSION SYS, DOWN Nun HAND SINK o4 73 SANDWICH O ,- 1' r, SINK 69 O U�7O 79 HOT WATER _r�- - 59 3-COMP, SINK 60 UNIT O EXHAUST --=•� INCREDI VENTILATOR ,� 56 BOOSTER I 57 SINK HEATER BINS 7a �- ---- CLEAN DISHTABLE ® F,Dr 68 CONVECTION STORAGE b0 QTr _ - OVEN L_-_t� .� NEW VENT 55A SHELVING MIXER ^-_ DELIVERY DUCT O • 6l �• 61 • I1� , FRYER i LIFT ENTRANCE REST ROOMS - 63 WALL SHELF O I 75 , 82 � F,D, j� 67A F.D, �� --- a� _"„� F.D. i GRIL F.D. ;_-___- DISH ® 61 61 ® -r-- WASHER 67 _ .4, ' .' _ WORK CABINET °-1-�' Hl P77 4-BURNER: 51 STORAGE I; ; E 2 RANGE REFRIGERATOR FD SHELVING PROOFER -----+- BREAD ; JANITOR'S SINK, W/ ��- 64 O CABINET i DRAWER FAUCET BY G,Cr F.D. F,D. `�� 'f VENT 55A -- -'3-TIER OF 71 INi CABINET L__"—"--'-- p WORK CABINET -- O 0, SPLASH ®F,A ® SD ® DUCT 65 DRAWERS ' O v / 80 "- -- BAKER'S REFRIGERATOR CLOSET =77 — --- -_-'� ;� TABLE HAND --'' SINK _ REFRIGERATOR DRAWN BY: CHECKED BY: DATE: F,G,D. D,E,Pi 5/4/06 L-~�•�� MQaILE MOBILE DOUBLE SERVICE SOILED DISHTABLE WORK CABINET WORK CABINET RACK SHELF 53 REV.: DATEi DESCRIPTION:.. 54 AND SINK 0 4-WELL O 6/26/06 LAYOUT CHANGE SOUP WELLS 47A 48 47 PLATE MOBILE PMOBILE LATING 46 7/14/06 LAYOUT CHANGE DISPENSERS CABINET STEAM TABLE CABINET O STORAGE SHELVING ,.O7/24/06 LAYOUT CHANGE O KITCHEN WALK-IN _u -� OFFICE COOLER �^^' WINE 8/20/06 ROUGH-INS .' • .• _r 4 STORAGE WALK-IN ,�. COOLER • a3 _� 41A BREAD 40 BREAD- OX _ 38 UTILITY CABINET BOX REFRIGERATOR CABIN T REFRIGERATOR WALL SHELF UTILITY CABINET al 39 7, F.D. 44 F.l L2-WELL F.D, WALL SHELF F,A SOUP WELLS a2 ® � - 39A . . , O 86 37 a O a 37 �6 WALK-IN WALK-IN w/ALK'IN _ 2 NOTiEATED HEATED. HEATED NOT HEATED ._— PLATE STORAGE CABINET PLATE STORAGE CABINET PLATE STORAGE CABINET PLATE STORAGE CABINET B9 COOLER FREEZER GAOLER ,. , WALK IN —BEV. CABINET REFRIGERATOR ' HEAT LAMPS 28 COFFEE GRINDER , , FREEZER �1 ♦ �. O `�`,,,,` 1 ��• FULL LENGTH _ :�'�.--== '= - - __ _ - - --------------- - -- ------------ ------------ ' _- / DOUBLE 0/SHELVES (- --- _��-�------- ( �.�....:. - - - _ -1: WALL SHELF lA 35 -=- --- -: _ -�;---- ---- -- REFRIGERATOR FREEZER O O MOBILE 11 34 33 30 REFRIGERATED SANDWICH UNIT! WORK CABINET ,. ,. 26 PREP. CABINET---�- / 90 [3 DISPENSER HOT FOOD DISPLATE PENSER i29 PREPARED BY: HOLDING NET (HEATED) STEAM TABLE (HEATED) BREAD BOX 26A WALL SHELF— BREAD - CABINET 21 EXHAUST VENTILATOR F.D. F.A a 31 e. perm `assciat05 F.Dr FLOOR TROUGH O ® ® _- EXHAUST VENTILATOR - FD __ QFD REFRIGERATOR - -- -----•-- ----------- � -'"`'--'— --"' ' � FOOD SERVICE C[JNSULTA�IT; ICE;MAKER �� �'� ENCLOSED T- 6-BURNER 10 6-BURNER OPEN WALL SHELF 'r ' 46 WILCOX AVE, PAWTUCKET RI, 02860 FRYERS BROILER StEAM6R RANGE RANGE GRIDDLE ' PREP, CABINET i .�f ,`•. o @ SKILLET TEL, 401-7C3�-6677 FAX 401=724-1868 ai- ' 9 a iL�_Fa 16 17 I 19 COMBI OVENHAND SINK REFRIGERATO2FISH � '"--- RtFRIGr Ll S ACER SPACER 6 SINK UNIT ICE CREAM CABINET S/S WALL SWEATING l PROJECT 24A FIRE SUPPRESSION SYS. O 15 BEHIND COOKING LINE ! FIRE SUPPRESSION SYSr 21A 0 6 11 15A �! THE WIANNO CLUB HAND SINK I� S/S WALL SHEATING O WALL SHELF OUTSIDE PORCH 23 40 BEHIND COOKING LINE I i PROJECT LOCATION: EQUIPMENT LAYOUT PLAN SCALE - 1/4"=1'-O" DESCRIPTION: EQUIPMENT PLAN DWG, NO, �.. �' 1 OF 5 E: QLJIF:> M NT SC E: DLJ E: E: QLJIF> ME: N7 SCHE: DLJ - E: MANUFACTURER PLUMBING ELECTRICAL MANUFACTURER PLUMBING ELECTRICAL ITEM • QTY. _]I S C R I P T I O N NAKE MODEL • VATER VASTE GAS GIROPANE) LOAD COt N. REMARKS ITEM M QTY. I)I S C R I P T I O N MAKE MtiDEI. • VATER VASTE GAS (NATURAU 1.IIAD Cap" REMARKS KV. C.W. W. LV. F.D. SIZE B.TUIS VOLT/M HA. K.V. AMP. J.B. C.P. KV, C.V. V. LV. RA SIZE B.TAk S VM.T/ft H.P. K.V. AMP. J.B. C.P. 1 1 BEVERAGE CABINET CUSTOM FAB. S/S 1/2, 1/2, 2' YES M(2)120/1 204 YES = WALL MOUNTED D.R, 47 1 MOBILE STEAM TABLE CUSTOM FAB. S/S IA 2 WALL SHELVES CUSTOM FAB. S/S NEED BLOCKING IN WALL 47A 4 SOUP WARMERS A.P.W. HFW-ID IN YES 240/1 1.6 6.7 YES 2 1 REFRIGERATOR VICTORY RA-2D-S7 120/1 1/3 8.2 YES 48 1 MOBILE UTILITY CABINET W/ O/SHELF CUSTOM FAB. S/S X120/1 2010 YES x = WALL MOUNTED D.R. 3 1 ICE MAKER MANITOWUK S-1400 1/2' 4, YES 120/1 20.0 YES 49 2 PLATE LOWERATORS - - 3A 1 ICE MAKER REMOTE COMPRESSOR - - 230/1 2 17.5 YES 50 1 S/S UTILITY CABINET CUSTOM FAB. S/S 1/2, 1/2, (2)2' YES IIt(2)120/1 20,0 YES I = WALL MOUNTED D.R. 1 I 4 5 HAND SINK ADVANCE 7-PS-80 1/2' 1/2' 1 1/2' 51 2 WALL SHELVES CUSTOM FAB. S/S NEED BLOCKING IN WALL 5 1 REFRIGERATOR VICTORY RA-ID-S7 120/1 1/3 5.5 YES 52 1 REFRIGERATOR N.I.C. EXISTING 120/1 1/3 8.2 YES 6 2 UTILITY CABINET CUSTOM FAB, S/S 53 1 L-SHAPED SOILED DISHTABLE CUSTOM FAB. S/S 1/2' 1/2' 2' YES 7 2 FRYERS PITCO SG14R 3/4' 122,000 120/1 MO YES 54 1 DOUBLE RACK SHELF CUSTOM FAB, S/S 8 1 BROILER BLODGETT B32D-171 1' 149,000 120/1 2.0 YES 55 1 DISHWASHER HOBART CRS66A 1 1/2' (2)2' YES = 3!4' H.W. AT 180' INLET FROM BOOSTER #54 9 1 STEAMER BLODGETT SC-lOGH 1/2' 2' YES 3/4` 190,000 120/1 10.0 YES 55A 2 VENT DUETS CUSTOM FAB. S/S 10 1 RANGE BLODGETT B36D-BBB 1' 255,000 120/1 1.0 YES 56 1 HOT WATER BOOSTER HATCO S-30 3/4' 3/4" YES 240/1 30.0 125 YES PROVIDE 3/4' H.W. AT 180'F. 11 1 S/S SINGLE SINK CUSTOM FAB, S/S 1/2' 1/2' 1 2' 1 YES W/ SPLASH MOUNT FAUCET 57 1 L-SHAPED CLEAN DISHTABLE CUSTOM FAB, S/S I 12 1 RANGE BLODGETT B36A-BBB IN 255,000 120/1 4.8 YES 58 2 L-SHAPED WALL SHELVES CUSTOM FAB. S/S NEED BLOCKING IN WALL 13 1 GRIDDLE BLODGETT B36N-GG'G i' 96,000 120/1 4.8 YES 59 1 SINK SANITIZER HATCO 3CS-9 3/4' YES 240/1 9.0 38.0 YES 14 1 UTILITY CABINET CUSTOM FAB, S/S 1/2' 1/2' 2' YES 1 *120/1 2010 YES = WALL MOUNTED D.R. 60 1 3-COMP, POr SINK CUSTOM FAB. S/S 1/2, 1/2, *(3)2' YES = P.C. TO PLUMB THRU GREASE TRAP 14A 2 WALL SHELVES CUSTOM FAB, S/S NEED BLOCKING IN WALL 61 4 SHELVING UNITS METRO - 15 1 ICE CREAM CABINET - - 1/2' V YES 120/1 20.0 YES 62 1 SHELVING JNIT METRO - 15A 2 WALL SHELVES CUSTOM FAB, S/S 63 1 SHELVING UNIT METRO - 16 1 REFRIGERATOR N.I.C. EXISTING 120/1 1/3 8.8 YES 64 1 SHELVING UNIT METRO - 17 1 SEAFOOD REFRIGERATOR VICTORY FRS-ID-S7 120/1 1/4 8.0 YES 65 1 REFRIGERATOR VICTORY - 120/1 1/3 5.5 YES 18 1 BRAISING PAN BLODGETT BLP-30G 1/2' 1/2' 3/4' 80,000 120/1 20,0 YES 66 1 PROOFER G%BINET - - 120/1 20.0 YES 19 - 1 FLOOR TROUGH CUSTOM FAB, S/S 3 67 1 S/S UTILI"Y CABINET CUSTOM FAB. S/S IK120/1 2010 YES 9 = WALL MOUNTED D.R. 20 1 COMBI-❑VEN BLODGETT BC-20G 3/4' 3/4' 2' YES 1' 215,000 120/1 15.0 YES 67A 2 WALL SHELVES CUSTOM FAB., S/S NEED BLOCKING IN WALL 21 1 EXHAUST VENTILAT❑R EAST COAST FIRE S/S 120/1 2010 YES SEE E.C.F. DRAWING FOR UTILITIES 68 1 60 QT. MIX!:R HOBART HL600 200-240/1 18.0 YES 21A 1 FIRE SUPPRESSION SYS. EAST COAST FIRE R102 120/1 2010 YES 69 1 SINGLE CD4P. SINK CUSTOM FAB. S/S 1/2' 1/2' 2' YES 22 1 EXHAUST FAN & DUCTWORK EAST COAST FIRE - SEE E.C.F. DRAWING FOR UTILITIES 70 3 MOBILE INGREDIENT BINS - - 23 1 S/S WALL SHEATING CUSTOM FAB. S/S 71 1 BAKER'S TABLE CUSTOM FAB, S/S 24 1 EXHAUST VENTILATOR EAST COAST FIRE S/S 120/1 20.0 YES SEE E.C.F. DRAWING FOR UTILITIES 72 1 S/S UTILITf CABINET CUSTOM FAB. S/S 1/2' 1/2' 1 1/2' 24A I FIRE SUPPRESSION SYS. EAST COAST FIRE R102 120/1 20.0 YES 73 1 REFRIGERAIED SANDWICH UNIT LAROSA 15160-32 120/1 2.0 YES 24B 1 S/S WALL SHEATING CUSTOM FAB, S/S 73A 1 SANDWICH itJ REMOTE COMPRESSOR - - 120/1 1/3 YES 25 1 EXHAUST FAN & DUCTWORK EAST COAST FIRE i - SEE E.C.F. DRAWING FOR UTILITIES 74 1 DOUBLE MtV. OVEN BLODGETT DFG-200 3/4' 110,000 (2)120/1 6.0 EA. YES 26 1 UTILITY CABINET CUSTOM FAB, S/S 1/2, 1/2, 2' YES )K120/1 20.0 YES = WALL MOUNTED D.R. 75 1 FRYER PITCO SSH55 3/4' 80,000 120/1 1010 YES DRAWN BY! CHECKED BY: DATE: 26A 2 WALL SHELVES CUSTOM FAB. S/S , - NEED BLOCKING IN WALL 76 1 GRILLE BLODGETT H24-TT 1 64,000 F�G.D. D.E.P. 5/4/0 6 27 3 MOBILE UTILITY CABINET CUSTOM FAB. S/S t 77 1 RANGE BLODGETT B24-BB 1' 140,000 28 5 HEAT LAMPS HATCO GRH-72 120/1 1.8 YES 78 1 S/S WALL SHEATING CUSTOM FAB. S/S 29 1 REFRIGERATED SANDWICH UNIT LAROSA L15196 120/1 2.0 YES 79 1 EXHAUST VENTILATOR EAST COAST FIRE S/S 120/1 2010 YES ISEE E.C.F. DRAWING FOR UTILITIES REV,, DATE: DESCRIPTION: 29A 1 SANDWICH UNIT REMOTE COMPRESSOR - - 120/1 1/2 YES 79A 1 FIRE SUPPRESSION SYS, EAST COAST FIRE R102 120/1 20.0 YES 30 1 UTILITY CABINET W/ BREAD BOX CUSTOM FAB, S/S 79D 1 EXHAUST FAN & DUCTWORK EAST COAST FIRE - SEE E.C.F. DRAWING FOR UTILITIES 6/26/06 LAYOUT CHANGE 31 2 HEATED PLATE WARMERS - - 120/1 2010 YES 80 1 REFRIGERATOR VICTORY RA-ID-S7 120/1 1/3 5.5 YES 32 1 STEAM TABLE LAROSA L-82172 1/2' 1' YES 240/1 6,0 25.0 YES 81 LOT SHELVING METRO - 7/14/06 LAYOUT CHANGE 33 1 FREEZER BASE LAROSA L-21166 120/1 2.0 YES 82 1 RECEIVING 4REA - - 33A 1 FREEZER BASE REMOTE COMPRESSOR - - 120/1 1/2 YES 82A 1 MOTORIZED 'ONVEYOR BELT N.I.C. BY OTHERS 7/24/06 LAYOUT CHANGE 34 1 1 REFRIGERATOR LAROSA L-11172 120/1 2.0 YES 83 1 WALK-IN FFEEZER (RELOCATED) N.I.C. EXISTING W120/1 20.0 YES m = LIGHTS, ALARM, DOOR HEATER, & P.R.P. 34A 1 REFRIGERATOR REMOTE COMPRESSOR - - 120/1 1/3 YES 83A 1 WALK-IN FIEEZER BLOWER COIL N.I.C. EXISTING If YES V = VERIFY W/ EXISTING UNIT 8/20/06 ROUGH-INS 35 1 DOUBLE OVERSHELVES CUSTOM FAB, S/S 83B 1 WALK-IN FIEEZER COMPRESSOR N.I.C. EXISTING 3w = VERIFY W/ EXISTING UNIT 36 2 S/S PLATE STORAGE CABINET CUSTOM FAB, S/S 83C 1 HEAT TAPE N.I.C, EXISTING 12011 _0,0 YES 37 2 S/S PLATE STORAGE CABINET (HEATED) CUSTOM FAB, S/S 240/1 5.0 YES 84 1 WINE STORr3E ROOM N.I.C, EXISTING 38 1 REFRIGERATOR N.I,C, EXISTING 120/1 1/3 8.2 YES 85 1 WALK-IN CC]LER N,LC. EXISTING NO WORK IN THIS AREA 39 1 UTILITY CABINET W/ BREAD BOX CUSTOM FAB. S/S *120/1 20.0 YES x = WALL MOUNTED D.R. 86 1 WALK-IN CCILER N.I.C. EXISTING NO WORK IN THIS AF2EA 39A 2 WALL SHELVES CUSTOM FAB, S/S NEED BLOCKING IN WALL 87 1 WALK-IN COOLER & FREEZER N.I.C. EXISTING , NO WORK IN THIS AREA 40 1 REFRIGERATOR N,I.C. EXISTING 120/1 1/3 8.2 YES Be I CHEF'S OFF CE - - 41 M 1 UTILITY CABINET W/ BREAD BOX CUSTOM FAB, S/S N(2)120/1 20.0 YES III = WALL MOUNTED D.R. 89 1 WALK-IN CEDLER (RELOCATED) N,I.C. EXISTING 2010 YES = LIGHTS, ALARM, & DOOR HEATER 41A 2 WALL SHELVES CUSTOM FAB, S/S NEED BLOCKING IN WALL 89A 1 WALK-IN COOLER BLOWER COIL N.I.C. EXISTING i' YES = VERIFY W/ EXISTING UNIT 42 2 SOUP WARMERS A.P.W HFW-ID 1' YES 240/1 1.6 6.7 YES 89B 1 WALK-IN COILER COMPRESSOR N.I.C. EXISTING = VERIFY W/ EXISTING UNIT 43 1 UTILITY CABINET CUSTOM FAB. S/SC2)120/1 20.0 YES WALL MOUNTED D.R. 90 1 HOLDING CABINET WINSTON HA4522-5 120/1 2.29 1911 YES 44 2 WALL SHELVES CUSTOM FAB. S/S NEED BLOCKING IN WALL 45 2 WIRE SHELVING UNITS METRO - 46 1 MOBILE UTILITY CABINET W/ O/SHELF CUSTOM FAB, S/S 7H 10120/1 20.0 YES w = WALL MOUNTED D.R. PREPARED BY: d. e. Penn associates FOOD SERVICE CONSULTANT 46 WILCOX AVE, PAWTUCKET, RI. 02860 TEL, 401-723-6677 FAX 401-724-1868 PROJECT; THE WIANNO CLUB PROJECT LOCATION: NnTES..j_, UNLESS OTHERWISE SPECIFIED, SERVICES SHOWN ON THIS PLAN ARE FOR FIXTURES BEING SUPPLIED BY WAREHOUSE CO. ONLY, MECHANICAL CONTRACTORS MUST CHECK OWNER'S PRESENT EQUIPMENT BEING RE-USED OR THAT EQUIPMENT MARKED N.I.C. (NOT IN CONTRACT) WHICH IS BEING SUPPLIED BY OTHERS SO THAT SERVICES REQUIREMENTS ARE CORRECTLY TYPED, ADEQUATELY SIZED, & ROUGHED-IN PROPERLY (LOCATION & HEIGHT) ALL LABOR, SWITCPZS, DISCONNECTS & FITTINGS REQUIRED DESCRIPTION! FOR FINAL CONNECTION Or EQUIPMENT AS NECESSARY E Q U I P M E N T TO COMPLY WITH ALL CODES, INCLUDING. ALL INTERWIRING TO BE FURNISHED BY ELECTRICAL CONTRACTOR UNLESS 'STATED OTHERWISE IN F.S.E.C. SPECS. S C H C D U L E ALL LABOR, VALVES, TRAPS, TAILPIECES, STRAINERS, PRESSURE REDUCING VALVES, & FITTINGS REQUIRED FOR FINAL CONNECTION OF EQUIPMENT AS NECESSARY TO COMPLY WITH ALL "ODES, INCLUDING ALL INTERCONNECTIONS TO BE FURNISHED BY MECHANICAL CONTRACTOR UNLESS STATED OTHERWISE IN F.S.E.C. SPECS. DWG, NO, K - 2 2 OF 5 1' G, + 140,000 BTU'S 1/2' C,W + 1'-2' B.T.C. 1/2' H,W + P-8' B,TA 60 1/2' H.W + 1'-2' B.T.C. 60 1 1/2' W. + V-10' B.T.C. 4 64000 BTU's 76 (3) 2' LW, TO F,S. 1/2, C.W + 1'-B' B.T,C, 59 3/4' I.W. TO F.S. P.C. TO PLUMB THRU 3/4' G, + 11-0' 75 F,S. GREASE TRAP 80400 BTU's B, .C. 7'-4' 111-6' S'-6' 4' 1/2' C.W + 1'-4' T F,S, 69 110,000 BTU's 0' 74 4' LF.S. Fr F 3/4'H.V, (I10' MIN,) -._...,.—�H- 1`-4' 56 + t`-o' BTC _-- _ F.S. _ DOWN 3'_7' 17� 56 FROM BOOSTER TO DISH MACHINE r 3/4' H.W. AT 180' INLET " - '-Jl 3'-2' 55 ON DISH MACHINE FROM BOOSTER AREA _ 4' c F.S. —3/4' LV, TO F.S. ®F,D, (r-- /' -` a.__ _ 1/2 KW + 1-4 B.T,C. 50 56 a'`-' - i 1'-5' NEW DELIVERY , O O „_ _. _ - -- ENTRANCE REST ROOMS r-- 1/2 C,W + 1 4 B.T,C, _ 5'-2. N� a� L �„ f/?_N w.i: LIFT 4, '' ... l3' (2) 2' I.W. TO F.S. 10'-8' s Q 2'-0' _ 82 FAA ��` o¢ d' ,��- ®F DEA 9 , FDA® LIZ`- to _= AREA S. (2)2' ILV. TO F,S, g5 12'-T _ u F.S.TS, ®AREA F,D. 4 _--_ 1/2' C,W + 4" BIt,CI -f AREA ® AREA 1 1/2' W. + 4' B.T.C. I CLOSET eLjj� F,D. F.D. - ��`-^a� _ = ?=a' .! 1/2' H,W + 4' B.T.C. LLDRAWN BY; CHECKED BY: DATE, 1/2' C,W + 1'-2' B,T,C. 1 1 9 8 F,S, 531 F,G,D, D,E,P, 5/4/06 1/2' H,W + 1'-2, B,T,C. ".-.._ 10'-6' 12' 1/2' C.W + 1'-8' B,T,C, F.S. 1 1/21 W, + 1'-10' B.T.C. 40 REV,. DATES DESCRIPTION, 4' 6/26/06 LAYOUT CHANGE — to, F,S, -� -- - 7/14/06 LAYOUT CHANGE F.S. "�----�' ._�' Fls, 7/2 4/0 6 LAYOUT CHANGE UGH-INS Ej ��1 8/20/06 ROUGH-INS 1/2' C,W + 1'-4' B.T.C. �r --""""`..— _ n: -- - 12' Ol F.S. - 2'-0' 1 1/2' H,W + Y-4' B.T,C, -------'�-F,S V I.W. 10 .S, 14" AREA F.D. F.D. 10' 4' � AREA AREA ® 42 ® F DEA ® F.D, +�g an:�^mm�z:.n3lcsrnu:m- m,:ux„RHaH,Hnum,aHurr-{ � / ❑ 1' I.W. TO F.S. 9,_2, _ 1'=5� 1!2' C,W. + 4' B.T.C. 32 89A TO FS.4 83 ?°__ _J O —a tO 1 _ __._ _ -�.w __. - �„ 0 3!4' H,W + 1'-4• B,T,C, /ems' ! c��--- 2' I,W, TO F.I. �_ 3/4' C.W + P-4' B,T.0 ea r' `n, °�' ,� i i _� ''��. w...—___ 1...» ...—....._ Q H _ .+.._�,n,�+_..__...-._. �--•�C:�l lu„wrRHwHHNHR,HIRG.M,R,HH,RI ,n11nM,IRw,111N{111,b.MW„ T _ - 20 215,000 BTU's 26 2' I.W. TO F,S. ❑ � •�----'--• 4' 1/2• H.W + t'-a• B.T.C. PREPARED B Y �� 20_�7 7`_'�) 2 I.W. O TROUGH Ois ,_2 - , F.S.F.S, 26 d. e. Penn associates 27'-6' F.S. 19 FINISHED6F FLOOR F,S 1l2 C.W + 1-4' B.T.C. AREA ® AREA ® AREA 2r IW AREA® ® AREA F.D. - F.D. _ - ---- �--- F.D, _ TO F,SI 14 = F.D. ( 6'_0' FOOD SERVICE CONSULTANT O2' LW, T❑ Fsl _ 15 --- - - - 46 WILCOX AVE, PAWTUCKET, RL 02860 ......._...a 3/4' LW, TO F.S. w E'-�-•._"-�-� - - ----_ - _ ___• ._..__... TO F,S,�-�_ --� V 7 FAX 40 24 1868 1/2' I.W. TO FS O ' _ - '. F.S. 4' - TEL, 401-723-667 1-7 - - -^ 3'-10' 1/1/ , + 1'-8' B.T.C. J S. 0 F. �- E"_ - { 4+� ,I _ .{- 2 2' F, - {� _ 4 11 112'2C,W W.+11-8 0'B B.T.C. _ n RRHn,.nHH�R„ PROJECT 4 4 4' 4• PLUMBING LEGEND 1-1 1-4 7-5 5-10 1-6 2-2 2 -11 F.S. 4 4 i' G r 1'-0' SYM, ABB, DESCRIPTION THE W I A N N❑ CLUB 1/2' C.W + 4'-0' H.T,C. 3/4' G. + Y-0' 13 4' 4' F-4 B.T,+ 80,0 G, + 's O 4' 1/2' C.W + 11-8' B,T,r, 122,0W BTU's 96,000 BTU'; 1'-4' B.T,C IS 80,000 BTU'S O 1 1/2-' W. + P-10' 1 t' G. + E'-o' o PINT OF EQUIPMENT CONNECTION 1/2' H.W + 1'-8' B.T.C. 7 VV G + 1'-0' 255,000 BTU'S 12 O 122,00q BTU's 1/2' H,W + Y-a• B.T.C. i8 • H.W. HOT WATER 1/2' H,W + 1'-4' B,T,C. 1/2' H,W + 1'-4' B,T,C, ` 1/2' C,W + 1'-4' B,T,C. g t' G, + 1'-0' F.S. 11 Fs, i�' ..• C,W, COLD WATER 149,000 BTU'S 1/2' C,W + 1'-4' B,T,C. � 1/2' C.W + 1'-4' B.T.C. ♦ W. WASTE (S❑LID CONNECTION) AS REQUIREMENTS (NATURAL) O 1/2• c,w + 1'-4' B.TIc, Y-o' o I,W, INDIRECT WASTE (-) 255,000 BTU's 10 ITEM # DESCRIPTION TOTAL B.T.U'S 19 1 3/4' + Y-o' ® F.D. FLOOR DRAIN PROJECT LOCATION \/ 190,000 BTU'S 7 FRYER 122,000 F,F.D, FUNNEL FLOOR DRAIN 7 FRYER 122,000 F,S, FLOOR SINK 8 BROILER 149,000 A G. GAS 9 STEAMER 150,000 B.T.U. BRITISH THERMAL UNIT 10 RANGE 255,000 PLUMBING ROUGH - IN PLAN • STEAM TAKE-OFF 12 RANGE 255,000 SCALE - 1/4„=1/-0" o— B,T,C, BRANCH TO CONNECTION 13 GRIDDLE 55,000 0— B.T. BRANCH TO 18 BRAISING PAN 80,000 20 COMBI-OVEN 215,000 + A,F,F, ABOVE FINISH FLOOR 74 DOUBLE CONV, OVEN 110,000 DESCRIPTION: D,F,A, DROP FROM ABOVE 75 FRYER 801000 CENTER LINE PLUMBING PLAN 76 GRILL 64,000 Ul EQUIPMENT ITEM NO. 77 PANGE 140,000 P.C. PLUMBING CONTRACTOR TOTAL B,T,U'S 1,878,000 K.E.C. KITCHEN EQUIPMENT CONTRACTOR P.C, NOTES (p RETURN LINE P.C. TO INSTALL AUTO-MECH, GAS SHUT-OFF VALVE IN MAIN GAS FEED TO COOKING 0 SLURRY LINE DWG, NO, EQUIP, - VALVE BY K.E.C. K - 3 30F5 29A 120V- 1/2 H.P.- 230V.- 2 H.P.- 17,5 AMP. 3A 1 PH.- B.T.C. 1 PH.- B.T.G. 33A IEOV- 1/2 H.P.- 12OV- 1/3 H,P.- 73A I PH.- B.T,C. I PH.- B.T.C. G 12OV- 1/3 H.P.- I PH.- B.T.C. Spiff PROVIDE AND LOCATE r r I ��� 79 SWITCH W1 PILOT LIGHTOFORFF R F M n T[ _ r O M P R r s�I I P s__ VENTILATOR LIGHTS, G.C, TO VERIFY LOCATION OF MECHANICAL ROOM ,���c. TO PROVIDE 5 LOCATE (RECOMMENDED H,P, UP TO 25 FEET OF REFRIGERATION LINES) PULL STATONI+C4E6AREMOTE 79B ON WALL RN,KITCHENN AND L ON/QFF O SWITCH W/ PILOT LIGHT FOR 79A EXHAUST FAN. 111, + 1'-6'- 240V- 38.0 AMP. gq 20,0 AMR- 1 PH: B.T.C, 8 9.0 K.W.- 1 PK- B.T.C. D.F,A, TO 8'-6' A.F.F.- 120V. J.B. + 41- 12OV- 20,0 AMPS.- 1 PH.- B,T.C. 5'-10' 73 2.0 AMP: IPH.- B.T.C. LN 41-4. 4 \ _ 74 (2)DR'S + 1'-6'- 12OV- DOWN 6.0 AMP. EA, - IPH, DR. + 1'-41- 120V- O DR. + 11-61- 120V- 52 1/3 HP.- 82 AMP: IPH, all, + 1'-61- 240V- 30.0 K.W. 56 - 4 „ 75 10.0 AMP: IPK _. 125 AMP: I PH- RT.C, - = s -= -- 10, 50 (2) DR. + 4'-0'- 120V- _ JB. + 1'-6'- 200-240V- --- r _ NEW 20.0 AMP. EA- IPH. ^• 0 68 1g,0 AMP: 1 PH; B.T.C. `0 -- DELIVERY �� 1'-6' TT;' •.� LIFT ENTRANCE REST ROOMS / . _. 5'-6' 1'-6' 4-6 1 _ 2'-10 .._.r fl 6' ._._ .___._.I � „ _. DR. + 4'-0'- 120V- J,H. + 5'-0'- 240V- 74.1 AMP, 55 67 20.0 AMP; IPK El- 81 1 PK- B.T.C, (ELEC. HEAT) 11 M 1 J.B. + 5'-0'- 240V- 22.1 AMP, 55 3'-0' 3 1/16 HP: 1 PH: B.T.C. (MOTORS)O i 6'-2' DR. + 11-61- 120V- --- - - f O 20.0 AMP; IPH. - 2'-4' �" t_ CLOSET D.R. + 7'-4'- 120V- - 1/3 H.P.- 53 AMP: IPK 1•_2. e � � ..----'"'fir.! \. rL__j 80 DR. + 7'-4'- 120V- _,......... a 1/3 HP.- 55 AMP: IPH. -- - f __ DRAWN BYi CHECKED BYI DATE: F,G,D, D.E.P. 5/4/06 O S.R. + 1'-6'- 240V- 6,4 KV REV.! DATE, DESCRIPTI❑N, - 47 26.8 AMP.- 1PK O48 D.R. + 41-01- 120V. 20 AMP-01 I20V- 46 20.0 AMP- IPH, - 6/26/06 LAYOUT CHANGE 3'-6' 5'-4' S'-s• DR. + 4'-0'- 120v- 39 - -^� 7/14/0 6 LAYOUT CHANGE 20.0 AMP.- IPK O ,.- 7/24/06 LAYOUT CHANGE (^- AR + 7'-4'- 120V- 38 � 1/3 H.P.- 8.2 AMP.- IPK ! `° _" _•-�' $9A � 8/20/06 R❑UGH-INS qp D,F.A, TO 8'-6' A,F,F.- VERIFY VOLTAGE W/ EXISTING COIL •cam r:�-a. .;,,,_....-._.__ 'ti�=="•mow .. ..-..�._._.._ 3'-2' 2'-6' 3'-4' 3'-6' --- /_ I- ,- ,- �- Yt•4:t-Fi:L^i:1:10.'tAYut:t1'tC lM:u:/:R!/uYAuuuuiLUN.u1:._-_ • v\ •••'•••. -•-•_••+'-•-� •_•••••••_••_ +-.•w..-.._........ze-11 DR. AMP.0'-120V- 43 (2) DR + 4-0- 120V- 40 - • DR, + 7 4 120V- , (2) AMP, EA- IPK 1/3 H,P- B.2 AMP: 1PK O / J,B. + 4'- 24OV-3.9 IOW. D.F.A. TO 8'-6' A.F.F.- 120V 42 13.4 AMP- IPK- B.T.C. (2) AMP+EA-01PH2OV- 41 89 20ARMP&I PH, B.T.C.HEAT FOR LIGHTS, - �,/� _ % 83 20 AMP.--I P HEATER gOR RIIGHTS, --- � O i -� 34 2A AMP.- 1120V- ,C, 824 AMP.- IPH,- B.T.C. JB. AMP- IPH.- BTC,K,W. 32 7,2 K,W- 1PKVB,T,C. 28 D,F,A. TO 8'-6' A.F.F.- VERIFY "nt-' VOLTAGE FROM TIME CLOCK At E,C�TQ PROVIDE AND LOCATE � � 83A �"'-ir `-;�* 5'-4' ON WALL IN KITCHEN - ON/OFF ^- �� av O EXISTING CONDENSING UNIT SWITCH W/ PILOT LIGHT FOR --` =--� BY E.C.- B.T.C, VENTILATOR LIGHTS. - -_ EEC, TO PROVIDE AND LOCATE , - I I 22 2� ON WALL IN KITCHEN - ON/OFF DR. + T-4'- 120V- SWITCH W/ PILOT LIGHT FOR ____ _ 1/3 H.P.- 8,2 AMP.- IPK O - x= _ - ( � EXHAUST FAN, "'_" ._ ._... �-_, _ . _ _. _ . ...,. - ._. _. - _ ..- _ OI a `. 1 1 2' 0200 D.R. + 4'-01- 120V- 1 AMP- IPK 377 7_ � ,.....,;, . ........_...- ^••--•I _, 7,r_ , �- J - PREPARED BY, DR. + 7'-4'- 120V- 16 1/3 H.P- 8.8 ANP.- 1PK 21 2'-2' 2'-0' 12'-6' 6'-10' 29 DR, + 7'-4'- 120V- 17 • e, p e Cl n associates 1/4 H.P.- 0.0 AMP- IPK D.F,A, TO 8'-6' A.F.F; 12OV, i D.F,A, TO 8-6' A.F.F.- J.B. + 41- 240V- J.B. + 4'- 240V- DR, + 4'- 120V- 20.0 AMPS.- 1 PH.- B.T.C. D.R. + 4'-0'- I20V- 26 83C (FOR HEAT TAPE)- 1 PH, 37 5A K.W- 1PR- B.T.C. 54 K.W.- IPH- B,T,C, 20,0 AMP- IPH, __ -- J.B. + 4'- 120V- 9'-10' _ _ _ _ T- 204 AMP.- IPK DR. + 4- 120V- 37 31 2A AMP: IPH.- B.T.C. /" 31 DR, AMR- 120 � - ~ _ FOOD SERVICE CONSULTANT -"------- ___! --- :-_T - ---�.......--- - - ' '� 46 WILCOX AVE. PAWTUCKET, RI, 02860 5'-2' 3'-6• 3,-6, 1,-1, TEL, 401-723-6677 FAX 401-724-1868 -- lpELECTRICAL LEGEND PROJECT: 3'-2' 5'-4' 1'-8' 8' J.B. + 7'-61- 120V- 21A SYM, ABB, DESCRIPTION 0 D.R. + 1'-61- 12OV- , 20.0 AMP- i PK- B.T,C, 3 D.R + 1'-6'- 120V- 12 4.8 AMP- IPK DR, +AM' 6- 120V 15 49. + 1'-6'- 120V- S.R. + 1'-6'- I20V- 20 ��t�C, TO PROVIDE L LOCATE 20.0 AMP- IPK 0 20.0 AMP- IPH- B.T.C, 15,0 AMP- IPK a OtFWTLL IN KITCHEN A REMOTE - THE W I A N N O CLUB SR + 1'-6'- 120V- D.P. P-6P-120V- 14 PULL STATION + 4'-6' p POINT OF EQUIPMENT CONNECTION 90 10 200 AMR- PH.20V O I$ 0 D.R. DUPLEX RECEPTACLE 2.29 K.W.- 19,1 AMP- IPH, DR. + 1'-6'- 120V- J,B. + 7'-6'- 12av- 10.0 AMP.- IPK 9 O S.R. SINGLE RECEPTACLE J,B. AMP- 1 PH- B.TC. D,F,A, TO 8'-6' A.F.F,- 120V. 24 24A 20.0 AMPS.- 1 PH.- B.T.C. DR, + 1'-6'- lzov- j'1 o J.B. JUNCTION BOX � C. TO PROVIDE L LOCATE 2,0 AMP: 1PK `✓✓ 12OV- PULL STATION I+C4E6A REMOTE DR. + 1'-6IP O ® F,M.D,R. FLOUR MOUNT DUPLEX RECEPTACLE DR, + 1'-6'- 120V- � 4,8 AMP- IPH. 13 ODR. + 7'-4'- 120v- 10.0 AMP: IPK 0 F.M,SR. FLOOR MOUNT SINGLE RECEPTACLE 5 1/3 H.P.- 5,5 AMP- IPH. 00 AMF- IPH120V- ( C,P, CORD AND PLUG PROJECT L❑CATI❑N, 120/1 V/Ph, VOLTAGE/PHASE H.P. HORSE POWER K.W. KILOWATTS ELECTRIC ROUGH - IN PLAN AMP, AMPERES $ SW, SWITCH SCALE - 1/4"=1`-0" + A.F.F. ABOVE FINISHED FLOOR q , B,T.C. BRANCH TO CONNECTION Q_., B.T. BRANCH TO D.F.A. DROP FROM ABOVE DESCRIPTI❑N CENTERLINE ELECTRICAL PLAN EQUIPMENT ITEM # E,C. ELECTRICAL CONTRACTOR K.E.C. KITCHEN EQUIPMENT CONTRACTOR DWG. NO, K - 4 4 OF 5 t� G.C. TO PROVIDE BACKING G,C, TO PROVIDE BACKING 58 IN WALL FROM 4'-0' A.F.F.; IN WALL FROM 2'-6' A.F,F. Q TO 6'-0' A.F.F, TO SUPPOR TO 5'-C' A.F.F. TO SUF"F'!cT WALL SHELF, HAND SINK, G.C, TO PROVIDE BACKING 12'-10' 1'-9' 1'-6' 79A IN WALL FROM 5'-0' A.F.F, TO 7'-6' A.F.F. TO SUPPORT FIRE SUPPRESSION SYSTEM. 4'-10' G.C. TO PROVIDE BACKING " IN WALL FROM 4'-0' A.F.F. 67A G.C. TO PROVIDE BACKING _ TO 6'-0' A,F,F. TO SUPPORT Y f IN WALL FROM 4'-0' A.F.F. 58 _ g'-00 WALL SHELF, G.C. TO PROVIDE BACKING l_ TO 6'-0' A.F.F. TO SUPPORT IN WALL FROM 4'-0' A,F,F, 51 WALL SHELF. + TO 6'-0' A,F,F. TO SUPPORT ® 8' F�U FWALL SHELF, 101-31 11 0 1 -6' 4' x 16' EXHAUST DUCT �° ➢ VENTILATOR COLLAR (400 C,F.M;S> ` i TO 3' ABOVE FINISHED CEILING 55A 3'-2' i 6`-4' 4• x 16' EXHAUST DUCT - -- .`-- -- - COLLAR (200 C,F,M,'S) I _ � V� ' TO 3' ABOVE FINISHED CEILING E-I L wj'NTILATOR_ ILI SEE E,C,F, DRAWING J DRAWN BY: CHECKED B HATE; FOR A y O LL UTILITY REQUIREMENTS Y: -_�___._,.- ___._.........�..-_....... F.G.D. D.E.P. 5/4 /06 d' O o, as REV,: DATE: DESCRIPTION: TG,C. TO PROVIDE BACKING IN WALL FROM 2'-6' A.F.F. -P ' TO 5'-0' A.F,F, TO SUPPORT 4 HAND SINK. 6/26/06 LAYOUT CHANGE 7/14/06 LAYOUT CHANGE 7/2 4/0 6 LAYOUT CHANGE rj I 8/20/06 ROUGH-INS _.__......._ __._.------- _,.,_ ..------ I + ARCHITECT TO VERIFY 8'-6' Ll DEPTH OF DEPRESSION FLOOR DEPRESSION 16'-7' 4'-4' 4'-0' G.C, TO PROVIDE BACKING G,C, TO PROVIDE BACKING IN WALL FROM 4'-1 A,F,F. 41A 44 IN WALL FROM 4'-0' A,F,F. 39A �+ i TO 6'-0' A,F,F. TO SUPPORT TO 6'-0' A.F.F, TO SUPPORT O O WALL SHELF, WALL SHELF, • _...__._ FLOOR .' d DEPRESSION „_ _ SEE E.C.F. DRAWING L } }��_ �,.� ram_•_ _�W- -T 111 - ,. _ _ _ _ z1 FOI? ALL UTILITY REQUIREMENTS G.C, TO PROVIDE 7' DEEP FLOOR DEPRESSION F DO DE ESSIO DR FLOOR - — _ - G.C. TO PROVIDE BACKING /'� ---•-•• ••-•• -•- � 19 TROUGH W/ GRATING. HACKFILL, IN WALL FROM 4'-0' A.F.F, lA � •--" -� Lou ••• �_� GROUT AND FINISH FLOOR BY GC TO 6'-0' A.F.F. TO SUPPORT . , WALL SHELF PREPARED B Y: 8'-0' T-10' 9'_0. PREPG,C. TO PROVIDE BACKING 4'-0' VENTILATOR IN WALL FROM 4'-0' A,P,F, /� Q „ FLOOR 6'-6' TO 6'-0' A.F.F, TO SUPPORT26A W • p G• pen 1 1 associates DEPRESSION } WALL SHELF. FEUD SERVICE CONSULTANT qA FLOOR DEPRESSION ON 46 WILCOXAVE+ PAWTUCKET, RI 02860 "---- 4' 6' :- � . • _ _ �- _+ - 41,6' TEL, 401-723-6677 FAX 401-724-1868 VENTILATOR 1 !!({ p ` ` VENTILATOR G.C. TO PROVIDE BACKING . f �\7 IN WALL FROM 2 6 A,F,R _ ,_•,•_ ,d � �--..___.___._.___ - L-__..--�_—��1 - """"""""°""'°""'°" "^-...r} LL � HANDTO ,-01 SINK,F,F. TO SUPPORT .yLj r PROJECT: 23'-O' �2_0• VENTILATOR THE G,C, TO PROVIDE BACKING G,C. TO PROVIDE BACKING THE W I A N N❑ CLUB 14Ami5A IN WALL FROM 4'-0' A,F,F, IN WALL FROM 5'-0' A,F,F u TO 6'-0' A.F,F, TO SUPPORT TO 7'-6' A,F,F. TO SUPPORT 21A FIRE SUPPRESSION SYSTEM, G,C, TO PROVIDE BACKING L G.C. TO PROVIDE BACKING O WALL SHELF. 24A IN WALL FROM W-0' A,F.F, IN WALL FROM 2'-6' A,F,F, 4 TO 7'-6' A,F,F, TO SUPPORT TO 5'-0' A.F.F. TO SUPPORT FIRE SUPPRESSION SYSTEM. HAND SINK, SEE E.C.F, DRAWING FOR ALL UTILITY REQUIREMENTS 24 SPECIAL CONDITION LEGEND :;YM, I ABB, DESCRIPTION PROJECT LOCATION: Emm EXHAUST DUCT COLLAR Cm SUPPLY AIR DUCT COLLAR SIP. STATIC PRESSURE PLA N C,F.M, CUBIC FEET PER MINUTE SPECIAL. CONDITION PLAN � SLAB DEPRESSION SCALE - 1/4"=1'-0" WALL BLOCKING + A.F.F. ABOVE FINISHED FLOOR CENTERLINE S/S STAINLESS STEEL DESCRIPTION: (1 EQUIPMENT ITEM # K,E,C. KITCHEN EQUIPMENT CONTRACTOR SPECIAL G,C. GENERAL CONTRACTOR CONDITION PLAN DWG, NO, K - 5 5 OF 5