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0035 MARSTONS LANE - Health
35 Marst®ns sane - , 350-001 Barnstable a t f ; a a / n b 1� 4 f i 1. \. MI® ® NO. 1521/3 BLU `..�. 10% 4 p �f.. .�- ��:� 4 A C. — � �i � ��(Uav"l G✓� ('p u tic i 6 /� � OV� r� .Lnt�� (� t� �-e o � � � e G E a M i r, x g �, �; � i � , � Y # , R i� ,, k P } �� k - � Ii { { �� is I� E o u_ • � � �) f: PF 5ks �5 ts) &Ap roo (pub l i AA r In E^ C u 1 i Town of.Barnstable Regulatory Services Richard V. Scali, Interim Director * snexseABLK 9� MAS& ,�� Public Health Division �fo 39. Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: _ K5- Sewage Permit# ' O Assessor's Map\ParceI Designer: ;. �L eoC�r Installer: Vu�ye Address: Address: 13 f lklnLez_Qori1� �sMk A'bq&Y� Onr Q�c�1*r�z�t C/� j l was issued a permit to install a da e) a�� (installer) Q septic stem at. : �S l V ased on a design drawn b P Y �� P1 N�� �lS'�A��b gn y (address) t p � A` � • (L R 04N� dated `(, `� 11e\ 1 l6 *�( (taesigner) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the. distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory. I certify that the system erenced above was constru ce with the terms of the IAA approval le (if applicable) sTEPHEN yc D. m MATSON CIVIL in (Insta ler's Signature)' No"46345 0 0'o<c SS�DNAL ENG ( esigner's Signature) (Affix Designer s Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 8-14-13.doc BAXTER WE ENGINEERING & SURVEYING Registered Professional Engineers and Land Surveyors 78 North Street,31 Floor,Hyannis,MA 02601 Tel: (508)771-7502 Fax: (508)771-7622 February 27,2015 - Mr.Thomas McKean Barnstable Health Department 200 Main St. Hyannis,MA 02601 - !; RE: 35 Marstons Lane—Cummaquid Golf Club BN Job#2013-072 Dear Tom: Cummaquid Golf Club desires to have a temporary food use for 20 seats setup in the small maintenance building located on the golf course property(see the proposed floor plan as attached). This,temporary food use is expected to be used from April 2015 to approximately the end of.June 2015. This is being requested temporarily until the new club house construction is completed. For your review we provide the following. The septic system that serves this maintenance building and the adjacent larger maintenance building.is permitted under Septic Permit#86-1108. The 2002 design and construction plan approval for the new maintenance buildings identifies an approved septic system capacity of 535 gpd(I've attached a copy of the approved site and septic plan). The design flow for these buildings is: • 8 employees within the maintenance buildings x 15 gpd/person(warehouse) = 120 gpd • Temporary additional use: 20"fast food"seats.x 20 gpd =400 gpd Total Design flow=520 gpd<535 gpd existing system capacity. We appreciate your review and consideration of the above. Please let us know if you need anything further. Thank you. Very truly yours, iatth er Nye Engineering&Su eying w Eddy,P. . Managing Member Cc: File 0:\2013\2013-072WDMIMLETTERS\2013-072 L5 TomM barn health temp flow.docx r„ Land Surveys • Site Design • Subdivisions • Septic Design • Wetland Filings • Planning A,(5V BIKE Barnstable o� TOW'n of BarnstableA&AMMIN CRV MASS% Board of Health 200 Main Street, Hyannis MA 02601 2007 Wayne Miller,M.D.. Office: 508 62 4644 O 8 FAX: Paul Canniff,D.M.D. 508- 62- W Junichi Sawayanagi November 24, 2014,, Mr. Matthew Eddy Engineering & Surveying , Baxter Nye Eng g y 9 78 North Street Hyannis, MA 02601 RE REVISED PLAN„ _sarlance Declslon, Cummaquld Golf Club, Marsfon's.Lane,`Cumma uld°_ A .350,OQ.135,_ " Dear Mr. Eddy, You are granted conditional variances, on behalf off Cummaquid Golf Club, to construct an onsite sewage disposal system utilizing the revised plan dated_ November 4, 2014, at.35 Marston's Lane, Cummaquid. The variances granted are as follows: 310 CMR 15. 221 (7): To install the two soil absorption.systems in areas where the depth of soil cover ranges from 5.35 feet deep to 2.45 feet deep, in lieu of the maximum 36-inches of soil cover allowed. 310 CMR 15. 240 (7):* To install the two soil absorption systems underneath impervious areas. These variances are granted with the following conditions: (1) The System Owner shall strictly adhere to all conditions contained within_ the Presby Enviro-Septic Wastewater Treatment System approval letter from the Department of Environmental Protection.(DEP) entitled `General Use Certification' dated March 19, 2014. (2) The Company (Presby Environmental Inc.) shall strictly adhere to all conditions contained within the Presby. Enviro-Septic Wastewater Treatment System approval letter from the Department of Environmental Q:\WPFILES\EddyRevisedPlansCummaquidGo1f2014.doc Protection (DEP) entitled `General Use Certification' dated March 19, 2014. , (3) The Installer(s) of the System shall strictly adhere to all conditions contained within the. Presby Enviro-Septic Wastewater Treatment System approval letter from the Department of Environmental Protection (DEP) entitled `General Use Certificated' dated March.19, 2014. (4) The septic system with innovative technology components (Presby Enviro- Septic Wastewater Treatment System) shall be installed in strict accordance with the revised engineering.plans dated November4, 2014. (5) The Designer shall strictly adhere to all three conditions contained within the Presby Enviro-Septic Wastewater Treatment System approval. letter from the Department of (Environmental Protection (DEP) entitled 'General Use Certification' dated March 19,,2014. (6) The designing engineer shall supervise the construction of the onsite sewage disposal system with innovative technology components-and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the revised February 24, 2014 plans. The engineered plans were. recently revised due to poor soils encountered. The recent revisions were reviewed by a representative of Presby Environmental who determined the plan conforms with the standards contained within the. AES Design and Installation Manual.. These variances are granted.because the designing engineer previously testified that it is extremely difficult to provide less than 36 inches of cover over a large system (that is effectively 154 feet by 72 feet in.area) and design grading that is functional for the site at the same time which is..gravity fed. Also, the engineer testified that this area selected for the SAS, beneath an impervious parking lot, is the most logical location-based on the layout of the proposed club house.and: topography of the surrounding area. Sincerell yours, Wa& Miller M.D. Chairman Q:\WPFILES\EddyRevis6dPlansCummaquidGolf2Ol4.doc PE PRESBY ENVIRONMENTAL, INC. 143 Airport Rd.,Whitefield, NH. 03598 Tel: 1-800-473-5298 Fax: (603)83779864 www.presbyenvironmental.com info@presbyeco.com e November 17, 2014 Baxter Nye Engineering&Surveying 78 North Street—3 rd Floor Hyannis, MA 02601 Re: Design Certification Design plan entitled: Proposed Club House,Cummaquid-Golf Club,UtilityPlan,SheetC5.0 Dated: Revised to 11/04/14 f Gentlemen, This letter is being written specifically;regarding the above named Design Plan and in reference to "Company Requirements"as stated Jn MassDEP, Standard Conditions A. for Alternative Soil Absorption Systems with General Use Certification and/or Approval for Remedial Use;revised September 26,2014. Section V. 3 of the above states in part: "... the Company shall submit to the,Desigrer and the System Owner, a°certification by the Company or its authorized agent that the design conforms to the Approval and all Company requirements and that the proposed use of the System is consistent with the Technology's capabilities...". Certified by Presby Environmental, Inc. The staff at PresbyEnvironmental Inc. is committed to the success of e� . very, . System that is implemented. Our technical advisory team is on call to support regulators, , designers, and owners alike.Feel free to contact us for the assistance you need. Sincerely, , Mark Vander-Heyden, Technical Advisor Presby Environmental, Inca mark.vander-heyden(opresbyeco.com (800)473-.5298 - (603) 837-9864 fax v 143 Airport Road Whitefield,NH 03598-3427 Message Page 2 of 3 BAXTER NYE ENGINEERING & SURVEYING•78 North Street-3rd Floor •Hyannis,MA 02601 Ph:508-771-7502 x17 Fax:508-771-7622 •email:meddy(ftaxter-nve.com •www.baxter-nve.com From: McKean,Thomas [ma ilto:Thomas.McKean @town.barnstable.ma-us] Sent:Wednesday, November 05, 2014 9:17 AM To: Matthew Eddy Cc:Wayne Miller; Miorandi, Donna Subject: RE: Cummaquid Golf Course Good Morning, Revised plans and a letter from Presby were received late yesterday. However: -The second compartment of the septic tank shows an incorrect inlet tee length. - Note#10 calls for filling of the tanks and grease trap with water and "pumping dry." Why will the clean water be pumped out? This will be an added unnecessary expense. - Please provide us with a copy of ASTMC1227.9.2. Sincerely, Thomas McKean -----Original Message----- r From: McKean,Thomas Sent: Tuesday, November 04, 2014 9:03 AM To: 'Matthew Eddy' Cc: 'Wayne Miller'; Desmarais, Donald; Miorandi, Donna Subject: RE: Cummaquid Golf Course Good Morning, The submitted revised plan contains a number of errors (i.e incorrect inlet and outlet tee lengths on the septic tank and grease trap, missing data regarding witnessed or unwitnessed percolation tests and deep test hole data). Please ensure that you correct all errors onto a revised plan. Also, please submit certification from Presby Environmental , Inc. the following as required per Section#18 of the Standard Conditions for I/A Systems Letter from DEP which reads as follows: "Upon submission of an application for a Disposal System Construction Permit, the Designer shall provide to the Local Approval Authority: (b) certification of the design by.the.Company for any residential system with a design of 2,000 gpd or more or for any proposed non-residential system...." Once we receive these documents, we will be able to move forward. Sincerely, Thomas McKean 11/1/2014 Message Page 1 of 3 Miorandi, Donna From: McKean, Thomas Sent: Friday, November 07, 2014 8:29 AM To: 'Matthew Eddy' Cc: Wayne Miller; Miorandi, Donna; Stephen Matson Subject: RE: Cummaquid Golf Course Thank you. Yes this addresses these comments. Also David contacted DEP this morning and you are correct in regards to the inlet tee length at the second compartment. The outstanding issue is the Board of Health condition which requires construction in accordance with the approved plans during the Board of Health meeting. Last week, I informed you by e-mail that you will have to re- file with proposed amended plan with the Board of Health for the November 18th meeting. Has this been done? In the meantime, I will be in contact Dr. Miller for any additional information. -----Original Message----- From: Matthew Eddy [mailto:meddy@baxter-nye.com] Sent: Thursday, November 06, 2014 12:07 PM To: McKean, Thomas Cc: Wayne Miller; Miorandi, Donna; Stephen Matson Subject: RE: Cummaquid Golf Course Hi Tom, Responses to your two outstanding items are as follows: 1. Title V. requires the minimum inlet tee length to be 10 inches. We have the inlet in the 2nd compartment at 29" which matches the outlet (there is no max length identified. We typically match the outlet tee length in the 2nd compartment as a practice). This is intended to bring it below the scum layer. The water flow is hydraulic through available head. a. We feel the length is correct. If you want us to change it what do you want it changed to— 10"? 2. As to the dewatering of the tanks after the water tight tests we identify for the contractor to perform this so when all the facilities are turned over to the owner we can do a final inspection that all facilities are clean and there are no deleterious materials in any structures. We identify this as part of our specifications for the project and should have nothing to do with your approval. a. I've attached an excerpt from ASTM C1227—section 9.2. This identifies the testing methods. We typically use the Water Pressure test. I trust this addresses all of your comments. I you could please review with Dr. Miller as soon as possible and hopefully provide us with the okay to proceed. Thank you, Matt Matthew Eddy, P.E. Managing Partner 11/7/2014 PE i Ql PRESBY ENVIRONMENTAL, INC. ��, ,flNQLL ��f�6'' G/ 11ANGfE1 143 Airport Rd.,Whitefield, NH 03598 Tel: 1-800-473-5298 fax: (603) 837-9864 wwN.presbyenvironmental.com info@presbyeco.com November 4, 2014 if Stephen Matson, P.E. Baxter Nye Engineering& Surveying 78 North Street—3 rd Floor Hyannis, MA 02601 Re: Cummaquid Golf Club Barnstable, MA Dear Stephen, F - I have reviewed the septic design for the site noted above as requested by your office. The design as revised to 11/04/2014 conforms to the requirements laid out in our AES Design and Installation Manual. No personnel from Presby Environmental have visited this site to verify the accuracy of the information presented on the plan and we offer no warranty of successful system operation as a result of this review. If you have any further questions or concerns do not hesitate to call. Sincerely, Mark Vander-Heyden, Technical Advisor Presby Environmental, Inc. mark.vander-heydena-presbyeco.com (800) 473-5298 (603) 837-9864 fax 143 Airport Road Whitefield,NH 03598-3427 t BARTER NYE ENGINEERING & SURVEYING Registered Professional Engineers and Land Surveyors 78 North Street,P Floor,Hyannis,MA 02601 Tel: (508)771-7502 Fax: (508)771-7622 November 3,2014 Dr.Wayne Miller,M.D.Chairman Town of Barnstable Board of Health 200 Main Street Hyannis,MA 02601 RE: 35 Marstons Lane Cummaquid Golf Club BN Job#2013-072 Dear:Dr.Miller and Members of the Board; The purpose of this letter is to clarify the changes to the originally approved design for the septic system for the above referenced project,more specifically changes to the spacing of the Presby pipe system.The changes are dimensional only based on encountered in-situ soils only. They are not a change to the type or structural components of the Presby IA system. When the contractor encountered unacceptable materials.as they were excavating to install the approved soils absorption system(SAS)it was determined that an over dig was required.Exploratory excavation was done to determine the soil condition underlying the unsuitable.The underlying soils were determined to be Class I medium/coarse sand.The acceptable material encountered was consistent throughout 4 different locations which were investigated across the bottom of the SAS. As part of the BOH approval a confirmatory perc was required. Three confirmatory peres were performed and witnessed by the Health Department at this Class I material/horizon on Wednesday October 29,2014. The new perc tests,and new soil logs have been-added to the revised plans dated October 30,2014. The Class I soil now becomes the underlying soils. The original design was based on previous test logs and perc tests identifying the soil as Class II with a perc rate of 20 minute per inch.When the system we excavated to the bottom of the SAS this Class II material was not present and the identified unsuitable material was encountered. This unsuitable material will be removed. The underlying material is now a Class I with a perc rate of 3.3 minutes per inch,the Presby layout based on Class I materials and a revised LTAR from the Presby Design Manual(from 0.833 to 1.233)changes the pipe spacing. The pipe spacing and the width of the beds are the only changes. This change in the LTAR changes the required SAS width on each bed from 28 f.to 22.25 ft. for each of the three beds or overall by 17.25 ft. (see attached email document from Presby agreeing with the spacing change). We have also shifted the location of the dbox. The variances approved were for depth of cover and SAS under impervious areas. These changes do not affect these variances or the approval conditions as granted on March 17,2014(see attached approval letter).The design is still. 100% in compliance with all conditions containedmithin the Presby Enviro-Septic Wastewater Treatment System approval letter from the Department of Environmental Protection(DEP)entitled`General Use Certificate' dated MIirch 19;2014. In addition the revised design of the system adheres to all,conditions contained'within the�Standard Conditions for Alternative Soil Absorption Systems with General Use Certification and/or Approval for Remedial;Use from the Department of Environmental Protection(DEP)dated December 17,2013. y Thank you for consideration.If you have any question please contact us. Very truly yours, i aear Pyngineerin ,&Su eying' ...- Stephentson,P.E. Project Engineer Cc: File Land Surveys • Site Design • Subdivisions • Septic Design Wetland Filings • Planning November 3,2014 Dr.Miller,Board of Health Re:Unsuitable Materials—Cummaquid Golf Club ' 0.'a013\2013-072\ADMIN\PERMITS-Applications and Approval3\BOH\2014-10-28 SAS RESUBMITTAL-SIZE REDUCTION\2013-072 Itr to Dr Miller date 10-31-14.doc Page 2 BAXTER NYE ENGINEERING& SURVEYING d 78 North Street,3` Floor,Hyannis,MA 02601 Tel: (508)771-7502 Fax: (508)771-7622. I j oF1►+E Bnrn-stabi.e o� Town of BarnstableAIPA,eicaC sass. hoard-of Health �. ra+" 200 MV in Street,HY6i its MA.02601 2007. Office:ce: 508862.4644 1Vayne MIIIer,, FAX: 508-790-6304 `Paul Canniff,D V DD_ 'JunichiSi3i�apahagi:. Mar6h;17, 20;14 Mr 'Matthew Etldy Baxter Nye.Engineering & Surveying 78 North:Street: Hyannis,.MA 02601" RE Variance Decision/ Cumm quid Golf Club. A 350 009 35 Marston`s Lane; ffi_a-quld F... Dear'W. Eddy: You are granted conditional variances; on behalf of Cummaqu'id Golf Club, :to construct,an onsite sewage disposal system at'3.5 Marstor''s Lane, Cummaquid. The variances;granted'are as follows:: 3-10 CMR 15. 221 (7J: To install.the two soil,absorption systems in areas:w-' the.depth of soil eaves ranges,from 5:5 feet,deep to 2.45 feet deep; in lieu ofthe maximum 36=10ches of soil cover.allowed'. 31 O.CMR:.15. 240.(:7): To install the two coil;absorption systems underneath iiimperv.io:us areas.. These variances.are granted:wlth "tile f6 lowing conditions:; (1) Additional; test.;holes shall: be excavated at ;the proposed reserve area(sj prior to.construction:of the septic system; (2). The System Ownerzhall sttletly'adhereto ali:conditions contained within he Pre by Env ro Septic: Wastewater Treatment System ;approval letter from the pepartment of Enirironmental Protection_ (D'EP) e. 1. d``General Use Certification' dated March 19,,_2014. Q 11 P(It FS\CununagWdG61, cpty 4014Appioved doc'; i 4 The Company (Presby Environmental; Inc)" shalt strictly adhere to ail: O conditions. contained within the Pros Enviro=Septic Uastewater Treatment System approval letter from the De;partmenf 'of Environmenta Protection (DEP) entitled. 'General Use Certification' dated March 1"9; 2.014.. (5) The tnstaller(s of the System _shall strictly adhere to all condifions: contained:within the Presby Enviro-Septic Wastewater Treatment System, approval letter from, the Department ;of. Environmental Protection (DEP) entitled'General;Use Certificated' dated :March 9 9, 2014. (6) The.septic system with innovative'te6hriology components (Presby Enviro= Septic astewat6r Treatment System) shall be installed in strict. accordance.with:the revised'February 24', 2014`engmeering:pians, .(7) The Designer shall strictly-adhere to all'three conditions :contained within. the: Presb Enviro-Septic Wastewater Treatment System: approval letter from the Department of Environmental Protection CDEP) entitled 'General Use Certification' datedMa.r:ch 19,2014 (8): The designing ;engi:n,eer shall. supervise the Construction of the onsite sewage disposal system with innovative technology components and shal-I certify m writing' to the Board of.Health., that the system. vvas installe°d in substantial compliance with;the revised February 24;:2Q14 plans. These variances are granted because the designing engineer previousiy testified that it is extremeiy-difficult to prow de..iess than 36 inches of cover over a large system.(that:is effectively 154 feet.:by 72 feet in area:) and .design grad►ng:that is functibnal' for: the site'at the: same time.which_ is.gravity. fed. Also, the engineer aestified..that this area selected for the SAS, beneath an impervious parking lot; is the most.logical location based on .the layout of.the proposed. c(ub house and .. topogracihy of the:surroundng area., _ Sincereyyours', a , ;f :. Received; W4. e filler, Chair µr APR 16: 2014 GO, Englneedng&suneYing. Q.1'1P 4LESTummnquidG61fSePt c20l4App oved doc Town of Barnstable P# Department of Regulatory Services B"NSTABLE, Public Health Division Date B 2 c MARS. 200 Main Street,Hyannis MA 02601 Date Scheduled' Time Fee Pd..SM'Suitability Assessmentffor Sewage Disposal Performed By:_ Q... '00 et a Witnessed By: x � LOCATION & GENERAL INFORMATION .' Lo cati on Address PYA l F/� Owner's Name Address `3 w•4.r5}e,-s 1 An e VQj ps�e✓t 5�� � V. Assessor's Map/Parcel: ® ��� Engineer's Name qqj�� � A[)/Y 1 4-14- NEW CONSTRUCTION REPAIR Telephone# ' -o g 1- t ®Z Land Use O (0 Slopes(%) o Surface Stones r Distances from: Open Water Body O t ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line li_ft Other ft SKETCH.'(Street name,dimensions of lot;exact locations of test holes&'perc tests;locate wetlands in proximity to holes) I'I ,�� ,� -1• i��'I '� ' � i 't y� '� ,S r .�r.r� I,:? �S{�' i�;� l r, .� ;1 t,x,r�' i4� r I t t,: 3.�r-P,f �•�j.';i'/ j ,.-� �� ! �' r -, 't.' {3 �� 1.3i i`'.� 1 .�ar{ J i E.•: F."f � 'JAI• ,., �a� `Y.. � r r Parent material(geologic) �C��`�� •3 Depth to Bedrock toot Depth to Groundwater: Standing Water in Hole: afl or e- Weeping from Pit Face dw-4 - Estimated Seasonal High Groundwater j ,DETERMINATION FOR S S�HIGH WATER TABLE Method Used t Depth Observed standing in obs.hole- v4, r in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: r in.\",Groundwater Adjustment ft. Index Well# Reading Date: _Index Well level Adj.factor Adj.Groundwater Level mm PERCOLATIONTEST _ ,u bate Time l Q� Observation Hole# 2 Time at 9" Depth of Perc i S2 _ ola P_ Time at 6" t ( : Start Pre-soak Time @ ®:�� OLD 11 °�`� Time(9"-6") End Pre-soak �t t (1 1 57 Rate Min./Inch .42 ►«��, i h Site Suitability Assessment Site Passed ` Site Failed: r rr! Additional Testing Needed(Y/N)' f, .-.tip. _ Original:'Rublic Health Division a 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. Q:\SEPTIC\PERCFORM.DOC 5 a( 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) 1 c- 08,I'Ll JOVA 6 't R v►�`' .DEEP OBSERVATION HOLE LOG , ' Hole# Depth from Soil Horizon y Soil Texture g,Soil Color Soil Other Surface(in.) (USDA) .(Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Graven 0-v F-,LL t I lt3 t Lj/ON w. 1`0y6 5A - F 1 K yvx @ef- Loft w• h 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) LX tv �I DEEP OBSERVATION HOLE LOG Hole# LJA Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) 0 FL GL 1 41� SAwy� �0 1K100)3 Flood Insurance Rate Map: Above 500 year flood boundary No— Yes Within 500 year boundary No Yes Within 100 year flood boundary No Yes Depth of Naturally OccurrinE Pervious Material Does at least four feet of naturally occurring pUperofmaterial? aterial exist in all areas observed throughout the area proposed for the soil absorption system? 5 If not,what is the depth of naturally occurring Certification I certify that onZ L ID '(date)I have passed the soil evaluator examination approved by the Department ofro en al Protection and that the above analysis was performed by me consistent with the required trai ing expertise and experience described in 310 CMR 15.017. , Signature Date Q:\SEPTIC\PERCFORM.DOC R r BAXTER NYE'ENGINEERING & SURVEYING Registered Professional Engineers and Land Surveyors 78 North Street,3`d Floor,Hyannis,MA 02601 Tel: (508)771-7502 Fax: (508)771-7.622 October 28, 2014 Mr, Thomas McKean Barnstable Health Department 200 Main St. Hyannis, MA 02601 RE: 35 Marstons Lane—Cummaquid!Golf Club BN Job#2013-072 Dear Mr. McKean: We are pleased to submit revised plans of the proposed onsite soil absorption system (SAS)for the above reference project, for your review and approval. An over dig, due to unsuitable soils is required for the project.As a result of the over dig,which will replace the unsuitable soil with clean sand per 310 CMR 15.255;the Soil Class used for design changes from Class 2 to Class 1.Therefore,the pert rate changes to less than 2 min per inch and according to Table B of the Presby Design Manual (see attached tables from the Presby Design Manual)the LTAR changes to 1.233.These changes allow for a reduction of the required pipe spacing for the SAS system from 2.5 ft. O.C.to 1.75 ft.O.C.thus reducing the required width of the sand bed area of the SAS by approximately 25 feet(see attached plan sheets C5.0 and C6.0). Thank you for consideration. If you have any question please contact us. Very truly yours, Baxter Nye Engineering&Surveying Stephen D. Matson, P.E. Project Engineer Cc: File 0:\2013\2013-072\ADMIN\LETTERS\2013-072 L4 Tom McKean Rev SAS Layout.doc Land Surveys • Site Design 9 Subdivisions • Septic Design • Wetland Filings • Planning tell Stephen Matson From: Mark Vander-Heyden <mark.vander-heyden@presbyeco.com> Sent: Monday, October 27, 2014 4:26 PM To: Stephen Matson - Subject: RE: Cummaquid Golf Club Revisions Hello Stephen, Looks like the numbers you worked out utilizing the LTAR of 1.233 for type 1 soil are correct. Let me know if there is anything else I can do to assist. Mark Mark Vander-Heyden, Technical Advisor PE a C= ' �a �d A Presby Environmental, Inc. 143 Airport Road,Whitefield, NH 03598 (T)800-473-5298(T)603-837-3826 5 (F)603-837-9864 IXJ -- CD r Car Like us on Facebook! mark.vander-hevdenc@ioresbyeco.com www.PresbyEnvironmental.com This communication is confidential and intended only for the recipient(s). Any other use,dissemination,copying,or disclosure of this communication is prohibited. If you have received this communication.in error,please contact us at 800-473-5298. The technical support staff at Presby Environmental,Inc.is committed to providing comprehensive product information,and support via telephone,website and email at no cost to our customers. The assistance we are able j to provide in this way is based on limited information and therefore should be considered general in nature. Accordingly,Presby Environmental,Inc.disclaims any liability whatsoever in connection with providing technical support.' From: Stephen Matson [mailto:smatson(abaxter-inye.coml Sent: Monday, October 27, 2014 1:11 PM To: mark.vander-heyden _gresbyeco.com Cc: Matthew Eddy Subject: Cummaquid Golf Club Revisions Mark, As discussed please find attached a pdf showing revisions to the sand area and pipe layout spacing calculations (clouded), revised from IS'to 1.75' using a JAR of 1.233 for a TYPE 1 soil. Please review may calculations and send me an email confirming my calculations,as soon as possible, as they are currently excavating to construction the system. If you have any questions please give me a call.. Thanks. 1 . TOWN OF BARNSTABLE LOCATION 3STc'SS SEWAGE# CY VILLAGE` zs J ASSESSOR'S MAP&PARCEL�0 — [gip o INSTALLER'S NAME PHtE NO., �7 -S c g S"D S '7 7-��;�O SEPTIC TA CAPACITY C&iZT-/r-/, LEACHING FACILITY:(type) 5 " /3C//C7 (size) NO.OF BEDROOMS OWNER L " L PERMIT DATE: 8 COMPLIANCE DATE: S Separation Distance B ween ie: 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 lcl,,13AXFC-7'f � / 6i2/,z/C-2-, No. �< �7 �� j Fee t III THE COMII�ONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 21pplitation for Disposal �6pstrm Construction Permit Application for a Permit to Construct(/Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address (,+ d Tel.ITT u Assessor's Map/Parcel `�iU7�-GfL SD �"v 4y V In ler's Name Address,and Tel.No. '9a ,—a l U� 7RDes' 's Name,Address, nd T 11.N wia07Z XAAR15 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building C [J UCas I'' No.of Persons Showers( ) Cafeteria( ) Other Fixtures V Design Flow(min.required gpd Design flow provided gpd Plan Date O? y�Y Number o sheets Revision Date Title S r Size of Septic Tank Tyne of S.A.S. Description of Soil C 1 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and no place the system in operation until a Certificate of Compliance has been issued by this Board pf Healt . igne Date Q l Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Ir Date Issued ,-,. � � No �!I L/ C= 6 a >j ft { r �, W Fee �. , '� Entered in computer: THE COMA NWEO F MASSACHUSETTS""" PUBLIC HEALTH DIVIS - OWN OF BARNSTABLE, MASSACHUSETTS Yes IN ltlYlcati0ll fD� 18 D aY *pkrm ConstrUctiowPermit Application fora Permit to Construct /Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components F Af Location Address or Lot No. ?�s ���? rq Ow}t-r rier's Name,Address; d Tel. Assessor's Ma /Parcel !: C v h14y t U Q C p c —�► g Iri ler's Name�Address and Tel.No. Sr 'Pa -� p� Des';�Name Address,and Tel o. r .v is y e -- Type of Building: Dwelling No.of Bedrooms Lot Size.- sq.ft/� Garbage Grinder( ) Other Type of Building C No.of Persons Showers( ) Cafeteria( ) Other Fixtures r - -. Design flow(min.required gpd Design flow provided _.'gpd t - Plan Date p2 p� / Number of sheets Revision Date r Title 4'AG-E w Size of Septic Tank Ty e of S.A.S.. Desctiption/of Soil ' Nature of Repairs or Alterations(Answer when applicable) ` ` or zf a (j - Date last inspected: ..X , t Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of.Title 5 of the Environmental Code and not place the system in operation until aSCertificate of r Compliance has been issued by this BoaAHaealt ?i;ed, Date / Q - Application Approved by Date I Application Disapproved by Date for the following reasons ' i � d Lj> Permit No. Date Issued ------------------------- ----------------------------------------------- �' THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance t 'f _ THIS IS TO IFY,that the On-site Sewage Disposal system Constructed Repaired( ) Upgraded( ) Abandoned( )byJ��� at �_-S ?< /_< ��L� has been constructed in accordance I with the provisions of Title 5 and the for Disposal System Construction Permit N . �/�'� 9jdated 1 � Installer y it�7 n<c/a.(/0_44� Designer #bedrooms Approved design flow gpd /The issuan a of this permits 11 of be construed as a guarantee t n des hat the syste I ctio ' - e 1 1 1 Date c ��N/►Ic ' -Nnspector` ---------------------------- -------------------------------------- G�y No. O� " CT� THE COMMONWEALTH OF MASSACHUSETTS Fee PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS MispoSal ,pstem (Construction 3permit Permission is hereby granted to Construct(t.-r Repair( ) Upgrade( ) Abandon( ) System located at �7Jd��7 S_`�"� 5 � l-j= 7W 55A JS'.L ,F and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction ust b completed within three years of the date of this pe it. Date , t� ' H Approved by BAXTER NYE ENGINEERING & SURVEYING ;Registered Professional Engineers andland Surveyors 78 North Street,3"Floor,Ryan us;lir1.62601; Tel: ($08)77.1:=7. 05 :Far (508)771-1622 Apri1.07,2014. Mr.Thomas Mckean Barnstable Health Department 200 Main St. Hyannis,MA.02601 RE: 35 Iarstons bane-Cumntaquid Golf Club BN Job#2013-012 Dear Mr.V1cKean We are pleasedto;submit the additional information as reviewed at;the Board of Heahh meefing:•for.the_above referenced project, for your review and determination if the garbage grindercan be`installed without;uicreasing the,size of the proposed disposal fields-.,Please note that,,per the Presby-manufacturer installation and,--design guidelines;and the Massachusetts DEP general,perm t:approval'the SAS does not need to be:<upsized:;.whe. ing ii garbage grinder, lease find,attached a data sheet for a.proposed kitchen garbage:.grinder,;plumbing plans. how"ug its location and copy,of the section from the Presby,Design an..d;Installaiion: anual.regarding garbage:grinders. Thank you for your consideration.if you,-.have questions,please contact us. Very truly yo.urs,. BaxterlYye Engineering i&Surveying Stephen:D.:.Nlatson;,P.E. Project Engineer up ec. File O)20't.\2013- 77 DIM MLET`I`ERS\2013'-,072 L3:1'onuii;barn heaith;docx Land Surveys e Site Design e Subdivisions Septic Design Wetl-tnd Filings a Planning ♦CRY 'TI E T Town of Barnstable Barn m6Amedcat5tty °AMMASS.�01�I Board of Health 1 � �39Q 8 D \\fa MA`A 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi 1t r' `oil 0 � n p , March 17, 2014 Mr. Matthew Eddy Baxter Nye Engineering & Surveying 78 North Street Hyannis, MA 02601 RE: Variance Decision/ Cummaquid Golf Club, A= 350-001 35 Marston's Lane, Cummaquid Dear Mr. Eddy, You are granted conditional variances, on behalf of Cummaquid Golf Club, to construct an onsite sewage disposal system at 35 Marston's Lane, Cummaquid. The variances granted are as follows: 310 CMR 15. 221 (7): To install the two soil absorption systems in areas where the depth of soil cover ranges from 5.35 feet deep to 2.45 feet deep, in lieu of the maximum 36-inches of soil cover allowed. 310 CMR 15. 240 (7): To install the two soil absorption systems underneath impervious areas. These variances are granted with the following conditions: (1) Additional test holes shall. be excavated at the proposed reserve area(s) prior to construction of the septic system. (2) The System Owner shall strictly adhere to all conditions contained within the Presby Enviro-Septic Wastewater Treatment System approval letter from the Department of Environmental Protection (DEP)a entitled `General Use Certification' dated March 19, 2014. Q:\W PFI LES\CummaquidGol fSeptic20l4Approved.doc s O� (4) The Company (Presby Environmental, Inc.) shall strictly adhere to all conditions contained within the Presby Enviro-Septic Wastewater Treatment System approval letter from the Department of Environmental I Protection (DEP) entitled `General Use Certification' dated March 19, 2014. (5) The Installer(s) of the System shall strictly adhere to all conditions contained within the Presby Enviro-Septic Wastewater Treatment System approval letter from the Department of Environmental Protection (DEP) entitled `General Use Certificated' dated March 19, 2014. (6) The septic system with innovative technology components (Presby Enviro- Septic Wastewater Treatment System) shall be installed in strict accordance with the revised February 24, 2014 engineering plans. (7) The Designer shall strictly adhere to all three conditions contained within the Presby Enviro-Septic Wastewater Treatment System approval Letter from the Department of Environmental Protection (DEP) entitled `General Use Certification' dated March 19, 2014. (8) The designing engineer shall supervise the construction' of the onsite sewage disposal system with innovative technology components and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the revised February 24, 2014 plans. These variances are granted because the designing engineer previously testified that it is extremely difficult to provide less than 36 inches of cover over a large system (that is effectively 154 feet by 72 feet in area) and design grading that is functional for the site at the same time which is gravity fed. Also, the engineer testified that this area selected for the SAS, beneath an impervious parking lot, is the most logical location based on the layout of the proposed club house and topography of the surrounding area. r 6 Sincerely yours, f i Wayne Miller, - ay e M e , M.D. Chairman Q:4PFILES\CummaquidGolfSepfic20 NApproved.doc r EXCERPT FROM THE BOARD-OF HEALTH MINUTES ON 3/11/14: I. Septic Variances: A. Matthew Eddy, Baxter Nye Engineering, representing Cummaquid Golf Club, owner— 35 Marston Lane, Barnstable, Map/Parcel 350-001, 110.3 acres, Presby SAS I/A System, two variances requested, reduction in size of project previously approved. Matthew Eddy and Steven Cook were present. The project was previously approved in year 2012 for a larger design flow. There was discussion about whether garbage grinders were allowed. Matthew said Presby had informed him that the DEP approval does allow for the use of garbage grinders. The Board decided to restrict the use of garbage disposals installed until the staff has been able to check with DEP to ensure the general use of Presby would allow them. Upon a motion duly made by Dr. Miller, seconded by Dr. Canniff, the Board voted to rant the variances on the revised February 24 2014 septic plans with the following 9 Y p p 9 conditions: 1) additional test holes shall be excavated, 2) the system owner, the company, the installer and the designer shall strictly adhere to all conditions contained within the Presby Enviro-Septic Wastewater.Treatment System approval letter from the Department of Environmental Protection (DEP) entitled `General Use Certification' dated March 19, 2014. t lDATE =� :,FEE: - BARNSPABLE � MASS.� aG;q REC.. BY T" ��7 c� a� 1.® 1�. ®� �C� S�R��� SCHED:. DATE.: hoard ®f Iealth 200;Main Street,Hyannis MA 02601 y Office: 508-862-4644` Wayne A.Miller,M.D. FAX: 508-790-6304- ;7unichi.Sawayanagi Paul:J.Canniff,D.M.D. VARIANCE REQUEST FORM LOCATION Property Address: 35 :MARSTONS LANE, CUMMAQUID;, MA. ` Assessor's Map and.Parcel Number. 3`5 0/0.01 Size of Lot: 110.21 AC <••;: - t Wetlands Within 300 Ft. Yes Business Name: CUMMAQUID' GOLF CLUB No: -X Subdivision Name: ` APPLICANT'S NAME:`-CUMMAQUID GOLF CLUB Phone Did the owner of the property.authorize you to represent him-or her? Yes X No PROPERTY OWNER'S NAME CONTACTTERSON - -Name: CUMMAQUID-GOLF CLUB Name: Ma E tthew" ddy;, PE 35 MARSTONS-LANE Baxter-Nye Engineering..... Address: CUMMAQUID, MA Address.78. North'Street, •Hyannis; MA 50:8 771 .7502 : Phone: Phone. VARIANCE FROM REGULATION(List Reg), REASON FOR VARIANCE(May attach if more space needed) 310 CMR 15:221.(T). Depth of cover See :attached 310 CMR 15_240 '(7) System. under See attached parking area Daily. flow greater than 165:0 gnd Proposing to use "Presby Enviro-Septi'c` alt. .tech:. sy em Approval-for alternative aeehnology .system NATURE OF WORK:.House Addition Z) House Renovation Repair of Failed Septic System � . Construction of cs.new ,clubhouse building after tearing'.down the.existing,"i:buildfiikag Checklist-(to be:completed by officestaff-person receiving variance request application). ; 1 Please submit copies in 4 separate completed sets. __= X Four:(4)-copies of the completed variance request form X __ Four(4)copies of engineered,plan.submitted(e.g.septic system plans) X Completed seven(.7)page-checklist confirming review of engineered septic system:plan by'submitting engmeeror registered sanitarian_ E�- X Four(4)icopies:of labeled dimensional floor.plans submitted(e.g.house plans or restaurant,kitchen plans) b 37 _ Signed letterstating that the property owner authorized you:to represent him/her for:.this request X Applicant understands.that.the abutters must be notified by certified mail atleast ten days:prior to meeting'date at applicant's expense (for-'.Title V and/or local sewage regulation variances on NA: Full menu.submitted(for grease-trap-variance requests only) x:. variance request application fee collected:(no.:fee for lifeguard modification renewals,grease trap•variance renewals[same ownerllessee only], ... outside dining variance renewals(same owner/leasee only],andlvariance's to.repair'failed sewage disposal systems[only df nwexpansion,toAhe - building proposed]) X Variance request submitted-at least 15 days prior to meeting date VARIANCE APPROVED , Wayne Miller,Chairman, -' NOT APPROVED Junichi Sawayanagi REASON FOR DISAPBROVAL Paul.J.Canniff;:D.M.D. `C;'\Users\decoll k\APpData\Local\Microsoft\Windows\Temporary Internet , Files\Content.Outlook\BAJ9P9B7\.VARIREQ.DOC BARTER NYE-ENGINEERING .& SURVEYING Registered=Professional Engineers and Land Surveyors 78 North Street,""d Floor,Hyannis,MA:02601 Tel. (508)771 7:502 Fax: (508)771-.7622 ;MEMORANDUM To: " Barnstable Board.of Health From: Stephen D.. Matson, P.E. Date:.. February 24, 2014 Re: Title.5 Variances for Cummaquidi Golf Club""Clubhouse. . cc: The following is a list-of Title 5 variances and reasons for.such requests..This document is to..accompany :the Town of.Barnstable Board of Health Variance Request Form.':.,.._., 1 31.0 CMR.1`5.221(7) Depth of Cover :The depth of cover-provided over the proposedaystern:ranges from:5 35 deep to-2,90'. This variance'is:requested-due,tothe:size of:the system, which consists of three_Soi1 Rbsorptign Systems (SAS)-that are-102' long by 28' wide each.It is.extremely difficultao provide less.:: than 36-inches of coverover:the system that is.T04' by 102' area and design arading`that.is functional for th:e site at the same':time.-Furthermore the Presby Enviro-Septic system that.:is proposed is gravity"fed,(pressure dosing,is not required or:allowed with the Presby.System) and the additional depth is".needed to get the wastewater to flow.into:the'system 2. 31O CM 15.240(7) Soil Absorption System (SAS) located-under a..parking,-area, ` The area selected ffor the SAS is the.most logical location.:based on::the layout of.the proposed clubhouse and'ahe topography of theaurrounding'area. The location is adjacenf to the lower;portion of.the building and is close 6 ough'.to.:be-gravity fed: In addition;;:'the`:P_resby Enviro-Septic system is anaerobic system that.requires venting a requirement of'the regulation for placing a SAS under a parking:area. . Page 1 I:1Document TemplatesNemo Template THE DATE: h`vP� �~OOP FEE: RAMSIABLE, ` mass. . D 1639 ,0�_ REC. BY L 1 Town of Barnstable SCHED. DATE: 2 JI Board of Health .200 Main Street,Hyannis MA 026.01 Office: 508-862-4644 Wayne A.Miller,M.D. FAX: 508-790-6304 Junichi:Sawayanagi . Paul J.Canniff,D.M.D. VARIANCE REQUEST FORM LOCATION - Property Address: 3 5 MARSTON LANE, : CUMMAQUID,, ,MA Assessor's Map and Parcel Number: .3 5 0•/0 01 Size of.Lot.. 1,10 .:2 AC Wetlands Within 300 Ft.: Yes Business Name: . CUMMAQUID GOLF ;CLUB No X Subdivision Name: APPLICANT'S NAME:- CUMMAQUID GOLF CLUB ;:Phone Did the owner of the properyauthorize you to representhim or her? Yes X No PROPERTY OWNER'S NAME CONTACT PERSON Name: CUMMAQUID GOLF- CLUB Name: Mat:thew _Eddy,' `PE 35 MARSTONS LANE. Baxter7Nye Engineering_ Address:. CUMMAQUID, MA. Address: 78 North :Street , Hyanni.s ma. 508-771-7501 Phone: Phone: REASON FOR ay attach if space needed O DISCUSSION "ONLY INFORMAL REVIEW REQUESTED °�Tb1:D.ISCU&S :,`�"��'. USE `OF .PRESBY SAS'.SYSTEM I/A SYSTEMr=-, UNDER BARNSTABLE NATURE OF WORK: House Addition House Renovation El Repair,of Failed S tic System.. Checklist (to be completed by office staff-person receiving variance request application) e : - Please submit copies in 4 separate completed sets: . X Four(4)copies of the completed variance request form. X Four(4)copies of engineered plan submitted(e:g.septic.system plans) (INFORMAL) NA Completed seven.(7),page checklist confirming review of engineered septic system plan:by submitting engineer.or registered sanitarian X Four(4)copies of labeled dimensionaf floor plans submitted'(e.g.house plans or restaurant kitchen,plans) Signed letter stating that the.property owner authorized,you to represent.hindher for this request NA Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting.date at applicant's expense.(for Title V and/or local:sewage regulation variances only) NA Full menu submitted(for grease trap variance requests only) NA Variance request application fee collected(no fee forlifeguard modification renewals,.grease trap variance renewals[same owner/lessee only], T. 'outside dining variance.renewals:[same owner/leasee only],and variances to repair failed sewage disposal systems,[only.if no expansionto the building proposed]] X. Variance request submitted:at least 15 days prior to meeting date VARIANCE APPROVED Wayne Miller,Chairman NOT APPROVED Junichi Sawayanagr . REASON FOR DISAPPROVAL. Paul I CannifE,D.M.D.' C.:\Users\decollik'\AppData\Local\Microsoft\Windows\Temporary- .-Internet " :Files\;Con=ent.Outlook\BAJ9P9;B.7\VARIREQ.DOC. OVERALL GOLF CLUB,SEPTIC SYSTEM DESIGN FLOW SUMMARY. CUMMAQUID GOLF CLUB ' January 28, 2014 BN PROJECT# 2013-072 PROPOSED CLUB HOUSE FLOW.FACTOR FLOW GENERATOR QUANTITY UNIT GPD UNIT FLOW COUNTRY CLUB; DINING ROOM SEATS 67 SEATS 10 GPD/SEAT 670 GPD COUNTRY CLUB; LOCKERS 266 LOCKERS 20 GPD/LOCKER 5320 GPD OFFICE SPACE 623 SF 75 GPD/1000 SF 47 GPD r RETAIL SPACE 717 SF. 50 GPD/1000 SF 36 GPD - TOTAL FIOW:.:. 6073 . GPD EXISTING MAINTENANCE BUILDING (7,610 SF) _.,FLOW FACTOR FLOW GENERATOR QUANTITY - " UNIT GPD UNIT FLOW EMPLOYEES`.. 4 EMPLOYEES 15 GPD/SEAT 60 GPD TOTAL GPD GOLF COURSE FLOW 6133 - " ��aFJo6.a�a201'3=032 �diern: 1"CPJMMAQUIDIG©LFCLrli6��°g°� - � ©ale. 1728/201 - .. _ P."`"" 5;4�CU.MM;4't]UID GOL`= 6 3LUB NEYIfe,CLUBFIOUSQ'` ""y""°'�" e' Desr'riei i —SDM'MW9hM - [ENTER VALUES IN GRAY SHADED AREAS). LOADING CALCULATIONS:. POST DEVELOPMENT CONDITION Type of,usage: '. GOL-OOUETSEe - Lot size: iR@4;18;18166 sf Impervious Su-faces: Roof Area: 0 98'OB sf Pavin Area:.. sti791997iWil sf Natural Area: ;equals Lot Area-Impervious Areas). 4 619,012 sf - Lawn Area. (estimated) '1'37r't 45,1z00`sf - - ..Title V Flow: 'ype of.use .- GOLrr+.000S3SE""-�E+s:s.fi Unit per. - Number of units: sf -. _(office=gross floor area) - - - GPD - s r(75GPD/.1000 so): - .. .Flow 9Pd .. .. E 'Location: !E'av1`statiler?Recharge concentration for, Bamstable . 18 in/hr�' (Per.Cape Cod Commission TB 91-001 Table 1) - - WASTEWATER: Flow 6133 gpd - Actual not used with commercial./office) 3.7t35 Ugal ,; .0 09 gpd Assume 2.5 people/unit average occupancy(per CCC iB 91-001)X SSGPDC 23,213:41 Uday ._... Recharge :.. - - 3.785 Ugal - - - 5�'mg/L. - .Wastewater Concentration - 0.00-L/day - 812,469.2 mg/day Loading - _ - mglL -_ 'Wastewater Concentration 0.00 mg/day IMPERVIOUS SURFACES Roof. - 20.198 . . Roof area(sf)• 40 Recharge off of impervious surfaces-in/yr - 0.0065 Conversion to liters per day(1ft/12 in x 28.32 Ucf x 1 yr/365 days) 5,224.01 Uday -. Recharge - - - 0.75 - Recharge concentration-Roof runoff,mgA -`(Per Cape;Cod Commission.T8 91001 Table-1) `- ...3,918.0 mg/day .Loading Paving: . - 179,397: :Paving area 40.00 `Recharge off of impervious surfaces--inlyr - -0:OW5 -Conversion to Liters per day(11`1112.in x 28.32 Uft2 x 1-yr/365 days) " 46,399.24 Uday Recharge.150_ - Recharge concentration-.Road runoff;-mg/I (Per Cape Cod Commission TB 91-001 Table 1) - '-�?%`=;,0�00°/mc. 'Loading Reduction for SWM Treatment'Through Vegetated Areas (Cape Cod Commission Policy) - - - -- 1.500' :*.Recharge concentrations-Road runoff,mgA'(with 25%Credit Reduction) - .. . .:,.. 69598.9 mg/day Loading ... . . .. ... - LAWN 1,371;451 -.Lawn area(sf) ' ..0.003 - Fertilizer concentration(3 Lbs/1000 sf of lawn) :: '_(Per Cape Cod Commission TB 91-001 Table 1) _ - 1,243.84 - Conversion factor(1:yr/365.days.x 454,000 mg/lb)- - - 0.25 - - Percent of flow leached into soil - -. - (Per Cape.Cod Commission TB 91-0017able 1). 1,279,394.7.mg/day -Loading - - NATURAL 4,619,012 - Natural area(so. - - 1.50 :Recharge for natural area(ftlyr) - _(Per Cape Cod Commission TB"91-001 Table 1) - - - 0.0776. Conversion factor(28.32 liter/cf x.1:yd365 days). - - - - - - ,537.577.09-Uday Recharge SUMMARY- Title V Total Loading= -- 2,165,380.74 mg/day�`'_ -Title V To al Recharge 612,413.75.Uday - - Tile V Nitrogen Loading Concentration. -- 3 54'Ppm �5 ppm'(milligram/liter)NQ�-N ��- Target Concentration per Cape Cod Commission.T8.91-001 Table 1 - .. Actual - - - - - - - FINAL-CALCULATION.: (Title V flow+.Actual/2 C©mmonwealth of Massachusetts 9 Executive Office of Energy&Environmental Affairs Department. of Environmental Protection One Winter Street Boston, MA 02108•617-202-5500 DEVAL L PATRICK RICHARD K.SULLIVAN JR. l Governor, - Secretary, TIMOTHY P.MURRAY <ENNETH L.9CINiMELL Lieutenant Governor Corn rn issinner GENERAL USE CERTIFICATION Pursuant to Title'5, 3-10 CMR 15.00' Name and Address of Applicant Presby Environmental, Inc. 1.43 Airport Road Whitefield,NH 03598 Trade name of technology and models Presby Enviro-Septic®Wastewater Treatment System (hereinafter called the"System"). The "Massachusetts Enviro-Septic® Wastewater Treatment,System Quick Reference Guide.. including schematic drawings of typical Systems, an inspection checklist;-and.a System Installation Form are:part of this Certification. Transmittal Number: X233394 Date of Issuance: Revised March 19, 2013: Authority for Issuance Pursuant to Title.5 of the State.Environmental Code, 310 CMR 15.000,the Department of Environmental, Protection hereby issues this Certification for General Use to:Presby . Environmental, Inc."1,}43 Airport Road; Whitefield,NH 03598 (hereinafter"the Company") certifying the System described herein for General Use in the.Commonwealth of Massachusetts- The sale,.design; installation,and use,of the,System are conditioned on compliance by the : Company,the Designer, the Installer and the System Owner'with the terms and conditions set forth below. Any noncompliance with the terms or conditions of this Certification,constitutes a violation of 31,0 CMR 15.000. . March 19, 2013 Davin Ferris,Director Date Wastewater Management Program Bureau.of Resource Protection This information is available In alternate format:.Call Michelle Waters-Ekanem,Diversity Director,at 617-292-5751.TDD#1-866-539-7622 or 1-617-574-6868' MassDEP Websde:www.mass.gov/dep Printed on Recycled-Paper Revised General Use Certification Page.2 of 3 Presby Enviro-Septic Wastewater Treatment System Revision Date: 3/19/2013 - Technology Description The System is an alternative subsurface Soil Absorption System(SAS):that replaces a conventional SAS designed in accordance with.310 CNM 15.0,00. The System.consists of an 11 5/8-inch diameter corrugated;high-density plastic pipe with a 9.5-inch interior:diameter.-and a standard length per unit*of 10 feet.The pipe is perforated with eight holes equally distributed- around its inner.circumference at each corrugation.Each hole has a plastic skimmer extending inwards. The exterior of the pipe has ridges on the peak of each corrugation and is wrapped with two layers of fabric material. The inner layer is a thick layer of coarse, randomly oriented polypropylene fibers. The outer fabric layer is,a thinner non-woven geo-textile polypropylene. The System includes required connectors designed to connect-pipe units together: The System also includes six inches of sand; specified as concrete sand meeting.ASTM C-33 (also called `System sand'), surrounding the pipe on,,all sides. Conditions of Approval The.term"System"refers to the Alternative Soil Absorption System in combination with the other components of an on-site.treatment and disposal'system that may be required to serve a ' facility in accordance.with 310 CMR 15.000. The:term"Approval"refers to the technology-specific Special Conditions,the Standard Conditions for General Use Certification of Alternative Soil Absorption.Systems, the General Conditions of 310 CMR 15.287, and any Attachments. For Alternative'Soil Absorption Systems that have been issued General Use.Certification for the installation of Systems to serve facilities where the site meets:the requirements'for.new construction,the Department authorizes reductions in the effective leaching area(3.10 CNM 15.242), subject to the Standard Conditions that apply to all Alternative Soil Absorption Systems _ with General Use Certification and subject to the Special Conditions below applicable to this Technology. Special Conditions 1. The System is an"approved Patented Sand Filter System for use as an Alternative Soil Absorption System. In_addition to the Special Conditions contained in this Approval, the System shall comply with.all Standard Conditions for Alternative Soil.Absorption Systems; except.where stated,otherwise in these Special Conditions: 2. The System is approved for facilities where-a conventional system with a reserve area exists or can be built..on-site in full compliance with the new construction requirements of 310 . CMR 15.000 and has.been approved by the local approving authority. 3. This Certification shall not be used for the installation of a System to upgrade or replace an existing,failed or nonconforming system, unless the facility meets.the siting requirements for new construction,including a reserve.area. X233394 Revised General Use Certification Page 3 of 3 Presby Enviro-Septic Wastewater Treatment System Revision Date:3/19/2013 . 4. The separation.distance to the estimated seasonal high groundwater elevation shall be . measured from the bottom of the System sand below the:Enviro-Septic.Wastewater Treatment System., 5. The System shall only be installed in bed or field configuration, as described in 310,CMR 15.252. The System shall not be installed in trench configuration and no sidewall area shall: be considered in the total effective leaching area provided.. The effective leaching area shall be the bottom area only (length times width)of the sand bed: 6. Systems shall be installed with differential venting for aeration.and inspection access at end of each run of pipe, section or serial bed and-whenever the System is installed under impervious surfaces. 7. Serial distribution laterals or sections shall be limited to,no more-than 500 gpd with each lateral a maximum of 100 feet,and must be laid fevel.:Multi-level systems shall riot be allowed:, . A. System component material specifications for the pipe, plastic components, fabric and sand= shall comply with the specifications identified in the initial.I/A technology approval. Prior approval from the Department for any change from these specifications shall be requested in „writing: 9. Any changes to the approved-plans must receive prior Local Approving Authority(LAA) approval.Before a Certificate of Compliance can be issued by the LAA the System.Designer must include any changes to the approved plan into the.as-built plans'. sa X233394 Message Page 1 of 1 McKean, Thomas From: Miorandi, Donna Sent: Thursday, January 30, 2014 8:44 AM To: 'Stephen Matson' Cc: McKean, Thomas; Heath DeptMailbox Subject: RE: Cummaquid Golf Course Plans Hi Steve, Yes and you realize that the grease trap sizing will also have to be modified. Then you also need the whole Presby manual. Now, for more bad news because it is over 2000 gpd it is required to have pressure distribution and on page 13 of the Presby manual pressure distribution lines are prohibited. Donna -----Original Message---- From: Stephen Matson [mailto:smatson@baxter-nye.com] Sent: Wednesday, January 29, 2014 4:38 PM To: Miorandi, Donna Subject: RE: Cummaquid Golf Course Plans Donna, You are correct the seat count is 179.This will make to design flow for the new clubhouse 7193 gpd.The total with the maintenance building will then be 7253 (see attached pdf). I will also revise the drawing C5.0 and send you-a new PDF copy. Will the new spreadsheet and revised plan have to be resubmitted? Thanks Steve From: Miorandi, Donna [mailto:Donna.Miorandi@town.barnstable.ma.us] Sent: Wednesday, January 29, 2014 4:19 PM To: Stephen Matson Subject: Cummaquid Golf Course,Plans Hi Steve: Just started reviewing the plans for Cummaquid Golf Course and right out of the gate there are problems. Cummaquid is currently permitted for 243 seats and on your summary as well as your design plans you call out only 67 seats. The floor plans that were presented in the package clearly show 179 seats ( 14-8 tops), (12-4 tops) and 19 seats at the bar for a total of 179 seats. Why are you not designing for 179 seats per title V? Donna Miorandi 3/4/2014 Message Page 1 of 1 Miorandi, Donna From: Miorandi, Donna Sent: Thursday, January 30, 2014 8:44 AM i To: 'Stephen Matson' Cc: McKean, Thomas; Heath DeptMailbox Subject: RE: Cummaquid Golf Course Plans Hi Steve, Yes and you realize that the grease trap sizing will also have to be modified. Then you also need the whole Presby manual. Now, for more bad news because it is over 2000 gpd it is required to have pressure distribution and on page 13 of the Presby manual pressure distribution lines are prohibited. Donna -----Original Message----- From: Stephen Matson [mailto:smatson@baxter-nye.com] Sent: Wednesday, January 29, 2014 4:38 PM To: Miorandi, Donna Subject: RE: Cummaquid Golf Course Plans Donna, You are correct the seat count is 179.This will make to design flow for the new clubhouse 7193 gpd.The total with the maintenance building will then be 7253 (see attached pdf). I will also revise the drawing C5.0 and send you a new PDF copy. Will the new spreadsheet and revised plan have to be resubmitted? Thanks Steve From: Miorandi, Donna [mailto:Donna.Miorandi@town.barnstable.ma.us] Sent: Wednesday, January 29, 2014 4:19 PM To: Stephen Matson Subject: Cummaquid Golf Course Plans Hi Steve: Just started reviewing the plans for Cummaquid Golf Course and right out of the gate there are problems. Cummaquid is currently permitted for 243 seats and on your summary as,well as your design plans you call out only 67 seats. The floor plans that were presented in the package clearly show 179 seats ( 14-8 tops), (12-4 tops) and 19 seats at the bar for a total of 179 seats. Why are you not designing for 179 seats per title V? Donna Miorandi 2/5/2014 BAXTER NYE ENGINEERING & SURVEYING_ Registered.Professional Engineers and Land Surveyors 78 North Street, 3`d Floor,Hyannis,MA 02601 Tel: (508)771-7502 Fax:(508)771-7622 January 28,2014 Dr. Wayne Miller Barnstable Board of Health Mr.Thomas McKean_ Barnstable Health Department 200 Main St. Hyannis,MA 02601 RE: 35 Marstons Lane—Cummaquid Golf Club,Informal Review BN Job#2013-072 Dear Dr.Miller,Board members,and Mr.McKean: We are pleased to submit plans and.additional information for a proposed I/A septic system for the Cummaquid Golf Club 35 Marstons Lane, Cummaquid,.MA for an informal review and discussion. A new club house is proposed for the site along with a new on-site septic system.The daily flow will be in excess of 6000 gpd.According to Barnstable Code Article XIII,flows.over 1650 gpd requires.an I/A system. We are proposing a Presby Enviro-Septic Wastewater Treatment System as the /A system. The following items are included: 1. Application Form 2. A preliminary plan showing the-proposed Presby Enviro-Septic Wastewater Treatment System. 3. Massachusetts Department of Environmental.Protection Approval Letter for Presby Enviro-Septic Wastewater Treatment System 4. Design Flow Calculations 5. . Nitrogen Loading Calculations We would like to discuss the proposed IYAsystem with.the Board to obtain their comments. We-appreciate the Boards consideration of this information:. Very truly yours, �. .. Baxter Nye Engineering.&Surveying C7- r Stephen_ D.Matson,:P.E. { Project Engineer a j t Cc: File Y , 0:\20I3\2013-072�ADMIN\LETTERS\2013-072 L1 BOH SUBMITTAL 1NFORMAL.doc r— Land Surveys 4 Site Design 9 Subdivisions 9 Septic Design w Wetland Filings o Planning . ; f .. . . : .: . . . ;. I I 1. :, OVERALL GOLF CLUB SEPTIC SYSTEM DESIGN FLOW SUMMARY CUMMAQUID GOLF CLUB . . , - . ' . .. January H, 2014� . BN.PROJECT#,2013-072 .; PROPOS ED CLUB HOUSE,: t. ,` ., :: FLOW FACTOR . F ' - W.GENERATOR QUANTITY UNIT. GPD UNIT. FL01N - L UI lz m. COUNTRY CLUB, DINING ROOM.SEATS 176 SEATS 10;'. GPD/SEAT " 1760 GPD 1 . COUNTRY CLUB, LOCKERS ;. 26 , . 6 LOCKERS 2 0 GP 100 PD/1000 ER 5750 GPD RETAIL SPACE SF ..:;: 50 GPD/1000 SF 36 . GPDII . T OTAL FIOW 7191 . GPD 5 ; , .. , - ... . . EX_`: ,,, 1,0 • ISTING MAINTENANCE BUILDING (7,620 SF) - . FLOW FACTOR : FLOW GENERATOR ;: QUANTITY ' UNIT,; GF?.D UNIT; FLOW EMPLOYEES' 4 ° , " M.f'LOYE,E 15 GPD/SEAT 60 GPD ' . .. . TOTAL GOLF COURSE.FLOW 725T,: GPD . .: ;: ; ; \.Y .. ... rf ., r .. n.: r.. -. . ,. .. -. . ...is ::: .. �:. .. t. - - 5 ., Cl ' . . ". ,.4,.. 1. ".: :.: i c ', % r '. .. i:' r .: r '� ,:,. ". - �- , .. . .. r . .- ..' Project:, CUMMAQUID CLUB HOUSE: Date -2:/18/2 014' 2.4 0:0 GPD:,.:PER SAS.BED '(see II 1) Daily.Des'ign:Flow- Bedrooms or.GPD, :Perc Rate 2 Q' MPI Soil Class notes) ' A).Presby Pipe.Required from Table (below) 2400/ioo x`so Zoo ft -Mir imum'AES Pipe Re uirement§ _ tBedroomS - Perc.Rate Commercial d (MPI) 2: 3 4 5 6 I per 100 GPD ditiona Room `?1 6U 1 I'100:; 150 i,200 If 25D'g3 I`, RE 61-90` 160 240 320 1400' 480-1 80 85 . AES.Pie Required min. ft', *Note::61-90 MPI beds:limited:to'500=GPD each 1200 2 4 '(USE 3) B) Daily-:Design-Flow(if over 500) GPD= 500= Sections (round_up.to whole number) Note multiple beds required wheni.flow is greater-than 500 GPD for61=90 M:PI 120b� 3 40:0 C) Pipe Req'd (from 1A) ft Number of Sections ft/section min 2) System Sand-BeddrArea (SSBA) 0'. 8 83 A)"Idnd Term Acceptance Rate GPD/sq ft(1-60 MPI use Table:B, 61 90 MPI use 0 25): x Viable B::Long Term Acceptari66:Rate.(1-60 Pe�c. Rate:' Soil` Soil :Soil Soil (MPI) -Class'I Class'II .:Class ill".`.'Class.IV 6 4.166 1.000 k alx t t 11.33° K p 0;00 8. 1.T00. -1.000 011 95-19 0:933 0.616 " .25-29 0.666 0:550, 3039sMOREW0,:55Mzx '0r483s' 40-49 0.416 60. -0:250 . 0.250 LTAR MaAmum<GPD/s .ft. ..114X24=2736 .;(ROUND.UP TO.,, y ( ) 2soo PEx BED) aq ft(1-60 MP.I use Table�C,"61=90 M`PI use:•Table F.)'. B .S stern Sand-Bed Area SSBA Table C:S stem Sand'Bed:AreaRe dire Minimum 9 -60 MPI Numberof Bedrooms. '. Additional LIAR :^'Commercial , 2 Bedrooms 3 Bedrooms 4 Bedroom'.. 5 Bedroom 6.Bedroom . Bedroom (GPDlsg ft.) - Per 100 GPD . 220 GP.D 330'.GPD) 440'GPD : 550'GPD 660 GPD "(110.GPD) 1.233 400 400`; 400 447 536 :. 90 82 a :1;166 =tawmaww Waftwoosv"',._t aw"Oww cW472W { M567�a�`4;:.?e "All.w a8Q? h_ 1:..133 400 400 400 486 :583• 98: 89 '..;fir 1 1 ffm�r4 A- 40.0� i y -�r��a 40o�k�r �c�N17014 0�r`.���t FIRM u` 500 g�"�� � F ��G00��f°k u�G r�s 1.00e� �.: � ?�d 91 A�s�� , 1.000:, 400 400 440 : 550. - 660 1,10 - 100 r0 933n1 �e _ 400x1� 400 s ,4 s4721 ' . ',.r 45590� 4 _ 708 .v1tigak 0:883 400 : 400, : 499: 623 748 125 1.1.4. 0 666 C 1F 1110 e496s, R - t 66.1 fi .. 826 a F 9,91't � ,�a 156d a z A '5n1�' 0.61.6:... 400 536 715, 893" 1;,072 1,79 163 e rfi tY 5 i t3 584a �a a...h778"u k °i9 972r�:.=�a s1c,16r7 `"y$ 1f95s c a7 .ob177 5 , 0:550 - 400 . . 600 800. 1;000 1,200 ' :.. 200 182 0 EZ Of483V .:h456xxz y 7n 684 s`. 1, _. 911 "' (krahullkkl'39 r_ � 1,36a7,. ti h223 r.: r208 : .�.. ,, o.wntrrt �. 1058 1323 1 587 265 241529 794 �E�� 7 32M WWr62=. 982AW 3 ft 30 5�' ,-r- 0.250':'._ 880 1,320 1,760 2,200 2,640. 440 400 ,. .. •; System:Sand`Bed Area:Minimom:(sq ft) Massachusetts AES pesign Worksheet(Presby Man October 2013.edi ion) Page 1 of 3.... Table F."S stem Sand Bed Area(61-90 MPI) Dail Design`Flow '. System Sand Bed-Area Min.s ft E EBedroomM.F-_- 8!8D '3 Bedrooms 1;320 I4{Betlrgoms $ "� Yt1r 750S "?� -' Each Additional Bedroom 440 i ComnaeraalF"eri100RGPD 4.OD , Note:Tables C and.F already,.include the state.approved bed size reduction. 3) System2 Slope NA % (1-60 MPI`=,25% max ,'61-90'MP1 systems per.T.able E requirements) Table E:AllowaLile System Slope 61-90 MPI r Perc.Rate Ran a MPI S stem.Slo a Max: 6.170�' {tome 1t5 � u 71-80. 5�ry 8x1:90 e in a Kk 5 �a 4A) Presby Pipe Row Length to.be,used NA ft(1'7.�60 M.P1 100 ft max.; 61 90 MP.I per,Table G) - ...: 4....: Table'G:rRow Len th Miniinurn"(61-90'MPI)` : Pe rc.Rate: Bedrooms„ Commercial ` Range(MPI) 2 `3 : 4 Each Add l per 100 GPD 71 zo-';r'81 9©IA '. 80h90R,A it00; 110fi2rsua. q 45$ . Row Length Mm ft. B);Pipe.Used (> 1A) 12r00 ft •,.Row Length 100 ft 12 Rows (note:•number,of rows must be whole:number when divided by nurnber•of serial sections-re dired,frorn 1 C); ;. C) Row;Length 100 ft_- 2 ft 1'02 ft-°System Sand Bed Length(SS.BL) , D) (<10% 1-60 MPI) SSBA 2B - ,2.800 sgft SS"BL 4C F102 `ft 2 ft= 27 :45 Pipe Layout Width min ;(>10% 1=60 MPI)SSBA 2B sq:ft , SSBL 4C77777777 ft 5 ft Pipe Layout Widtt -min 'E) Pipe Layout Width from Table D 17 5 ft when using', l 5 ft Row Spacing (USING 12 ROWS & 1 5' :S.PAGING) ' Table.D Numtie'r of R"ows and Pi e`La out Width Length ft. Total Linear Feet of Enviro=Se tic 30 60 90 1'20 ' 150 180 210'" ''240' 270'' 300- 330 360 390 420 450 "3'5 � 70 1:05 1:40 ?1:75' ,_2'1iO4 24.5::�Y-11R 80�3r.� 315 350?i°`:f 385•.€.;,`h420� i455 . ..4.9© lie,5251- �' 4:i) a 80 l fi12D WONi6A'- 200 a 240 280 .- .320 360: 400 440.' 480 520 "560, 600 s'4.51ra _�9013'S0 1,&0` 22 a.270 : 31.5x360•e;' 405.t t�.45D 95.t, 50 400 150 200 ft25M. 300 350 400` 450 500` 550: ' 600 650 '700 750 _. 55:" sT 11!O .r385.M 440.: -4,4. 5'[ r 550.+3;:'4 05rS. 660 60 120 180 1 240 420 480' 540' 600 '660 : : 720 780 840 ,'. 900 ' - ,,.+u 650.. .E ,-1,30V..ZAT9.0 0,260M, 325 80 1i 70 140 210 280 "3+50 420_' 490' S60 630 700 770 840 910 ::'980 1050 150u�:3 22'5 MOMS. 3T' _`,.450: 525`i' r600.M-: T6.75' t��7.5MIA'".825"..r;a 9DOr "� 975 ,J;1050. ;1!125h. 80 160 240 320 4'0� 480 560 640 720 800 880 960 1040 1420 1200 F_F 8`5 f�s�� 1'r7.0 25'S ,€:340ti• 47 c -5101t a595.i F 680c+Pa .765.:`i 850P`'a.935:1_tK 1020yk 1.105 ,:T1`90.-IMA12,7 90 -180 270 360 45( 540 630: .,:720 810 900 990- 1080 1170 ' -1260 s1350 .9Sr,'^F z 19D..,x-:28'5k (r.3$0: !75 ..570r "665 760., 855 950r :c 1E095:k 1P40 0 S,1t2,96- ,:,i)330 100 200 300- '4000© 600 700 800- 900 ;1000 �1TOO 1200 1300 ;''1400 1500 #of Rows 2. 3: 4 " �6 7 B 9 10:'-.i 11 12 13 14 15' Spacing. --4 � 1 SO dux 2 SOS - R' E 7 QO� 8.501 10.00 1:1.50 13.00 14.50 ` 16:00' 1 Z:50 19'00 •20.50'.22.00 t . 1,:75 7!}:2:75 ..-4'50r MW25f.. t8::00 i�9:.7.55 .111.5M(,1,3.25�.�1i5:06 :'.1": )1`8j' �r F162 25, 22£OOi;4&23% "'125 50.v 2.00 300 . .5.00 7.00 8:00 1:1.00` 13.00 15.00 17,00 19.00, 21.:00 . 23.00 25:00 .':27:00 29:00 25 .. 3:25.„s5 50 l�7x:75 1 O On`. 12:2'6 e.1.4:50' r '6.75' `19 00 .21i.25:;M 23.50: 1x25.7.5.<l 28 00:, 30 25<,. 3250Ka 2.50 3.50 6:00 8;50 11.:00 13.50; 16 00 18.50'= 21.00 23.50 26.00 28.50 31:00 '33.50 36.00 P� V751�, 3 ,3.75 a._;6:50 ,t 9 25 t 1:2.O.Ot .,14.:75 a'�17.503k .2M. 5 :23 00�1,-,2 75 4" 28,5O:wi)N31.25,14 34.D0 .'=36 761A!=h39.50 3s00 4.00 7.00 10 00 1'3.00': `16.00 19.00 22.00 ''_25.00 28.00 31.00 34.00 37.00 '.40.00 43.00 )`k, 3.25=�r�9 ift 51�600 V 110:75.r 14.:QO a 1a7,2'5r :' 5C�23.75.-h 27..00 5&25: `,33 50 f36.75r ,40�00�:t 43.25:(4.6.50 a %3.50 4:50' "8;00 11:50 `75:00 18.50 ` 22:00 25:50` . 29.00'' 32:50 36:00 39.50 43:00 46.50 .`50.00 PF 3t.7.5O ''u4 75 1r2.25�'r 1,6 0`0,.,, T9.75s 23:50 , 27f22 :1331,.00? ,34..7,5 z38-5a a�42r2'5 E146.00x11 49..7.5,E 53.50 A. 5 00 9.00 T3;00 "''17.00" 21.00 25i00 29.00 .:33.00 37:00 `' 41.00 r 45.00 -''49 00° 53.00 57:00 25w " 5 2 0 9?50.-, { ]r3:>ZS,.,mom .2225 ba r26?50L 30r..75ag 35?00? 39 25 43,50=4 4.7..7,5F,,��52.003 0!56 25. 60�50 4:50 5.50 10.00 14.50 19.00: :23:50' 28.00 32:50 "37.00: `41:50 46:00 : 50.50. 55.00 59.50' 64.D0 1 ti4 75�1 G [5,z5 :YO 50 95.25 3..20,_0:0 �24?75 29 50,`134.25 i 3951 n'�4?3 75� t48'.5O'Gr53�25 w 58 OOws(6275e )6r7-50.r1 3:00 . 600' 11 s00 16:00 21:00 26.00 31.00 "36i00 ` 41:00 46.00 51:00` 56.00: '61;00 6600 71.00-: Pi e'La outlNidth ft. outermostedges of rows g kshee#('Presby Manual October"201'.3 e'dluon) Page`2:of 3 y Massachusetts AE:S-Desl ri Wor - 4 _ l , .. . , 1. . -�'.:, :,- :,,.. . . t�.- :.- ,.: : ; , :_ �:,. �- --4'.."--, i.'-�. , ., ,,,��,�,;,.-.,�. - v -- - I I y, IC- I - -: � . " : . :-�. . I , . - .;7 . --, �-, . ---�c-- -1 - - � .: ISA)-C41culate System Sand Bed Length (SSBL): :, �. 1. :Row Length 10 0 ft+2 ft 10.2 ft System Sand;Bed Length (SSBL) B)-Calculate System'Sand-Bed Width (SSBW) 27 45.. (USE.28)' 1).SSBA(from 2B) : 2 8 0 0 sq ft 102 ft.'SSBL ft SSBV min 2) Pipe Layout Width 17 --5 ft+ 2A 19 5 ft SSBW,neededlo coverall Presby Pipes . - - . 3),Beds >1.0% Slope:'.PLW .ft+ 5 ft SSBW with System Sand Extension . .4).System Sand Bed Width used "2 8 ft,(B1,`.B2 or B3 above-whichever is larger) ;a . - C) System:Sand Bed Area Provided (SSBA) 2856 `PER :BED . { SSBL (from A) 102 ft:x 28 ft SSBW (from�.B4) = sq ft SSBA provided ;; . ., Notes:. . •�CALCULATIONS. ARE�.PER BED.;' .TOTAL DESIGN .FLOW USED ,= 7 2 0 0' :'GPD 7200 :GPD%3`' BEDS:. 2400 'GPD . 283,E ;SF PER`. BE.D: X: 3,,:BEDS: 8568 SF TOTAL:'PROVIDED, > .8208 SF,REQUIRED - . ,,- - . ,;: . System Illustration.(optional):: 1 . , v .. I�]� II .-. _ . - Q Massachusetts AES.Design=Workshe t(Presby,Manual October 2013 edition), Page 3 of 3 II ,. . . - �... .��,' , r. I-:-'.-.,��'.,'--,,-:.�':, � , I .- . . � � — .d I I , - . - : ��.-1-,�.'-.1 .,"."," 1.'11-,. .�::, �. _. Barnstable Town of Barnstalble BARNgrABMg Board of Health 039• pr f p►�'�°' 200 Main Street, Hyannis MA 02601 Zoos Office: 508-8624644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi November 25, 2012 Mr. John K..Holmgren J.K. Holmgren Engineering, Inc.. 942 West Chestnut St. Brockton, MA RE: Variance Decision/ Cum maquid=Golf Club ,a4� .A= 350 001 35 'Marston's Lane,,Cummaquld j " , A Dear Mr. Holmgren, You are granted conditional variances, on behalf of Cummaquid Golf Club, to construct an onsite sewage disposal system at 35 Marston's Lane, Cummaquid. The variances granted areas follows: 310 CMR 15. 221 (7): To install the two soil absorption systems in areas where the depth of soil cover ranges from 5.35 feet deep to 2.45 feet deep, in lieu of the maximum 36-inches of soil cover.allowed. 310 CMR 15. 240 (7): To install the two soil absorption systems underneath impervious areas. These variances are granted with the following conditions: (1) Charcoal filtering shall be added to the'three above-ground SAS vents. (2) Additional test holes shall be excavated at the propsed reserve area(s) prior to construction of the septic system. (3) The System Owner shall strictly adhere to all ten conditions contained within the Presby Enviro-Septic Leaching System approval letter from the Department of Environmental Protection (DEP) entitled `Certification for General Use-Revised' dated October 24, 2011, ar. Q'\WPFILES\Cumaqu idGol fSeptic2012i doc i (4) The Company (Presby Environmental; Inc.) shall strictly adhere to all twelve conditions contained within the Presby Enviro-Septic Leaching System approval letter from the Department of Environmental Protection (DEP) entitled `Certification for General Use-Revised' dated October 24, 2011. (5) The Installer(s) of the System shall strictly adhere to all seven conditions contained within the Presby Enviro-Septic Leaching System :approval letter`.from the Department of Environmental Protection (DEP) entitled `Certification for General Use-Revised' dated October 24, 2011 (6) The septic system with innovative technology components (Presby Enviro- Septic Leaching System) shall be installed in strict accordance with the engineered plans,dated June 29, 2012. (7) The Designer shall strictly adhere to all.three conditions contained within the Presby Enviro-Septic Leaching System approval letter from the , Department of Environmental Protection (DEP) entitled _`Certification for General Use-Revised' dated October 24, 2011.; s (8) The designing engineer shall supervise the..construction_ of the ensite sewage disposal system with innovative technology components and shall certify in writing to the Board of Health that the system was installed:in substantial compliance with the plans dated June 29,.2012 These variances are granted:because the designing engineer stated that it.is-- extremely difficult to provide less than 36 inches of cover over a large system (that is effectively 154 feet by 72 feet in area) and design grading that is. functional for the site'at the same time which. is gravity fed. Also, the engineer testified that the area selected for the SAS, beneath an impervious area, is the most logical location based .on the layout, of the proposed club. house and topography of the surrounding area. Sincer ley yours, L/ . Wa: ne iIIer, .D. Chairma Q;\VJPFILES\Cumagp dGoOepti62012,doo i I !. I ;� i 33� i 61-7 IKE DATE: lte� FEE: 26 ' $� BARNSfABLE, 039. ,0� s REC. BY T .: n Barnstable s , , 1 own 0� SCHED': DATE: Board ofRealth 200 Main Street;Hyannis MA'02601 Office: 508-862-4644 Wayne A.Miller,M.D: FAX: 508-790-6304 Junichi Sawayanagi Paul J.Canniff,D.M.D. VARIANCE REQUEST FORM LOCATION Property Address: 35 Marston's Lane Assessor's Map and Parcel Number: 350/001 Size of Lot:110.62 acres Wetlands Within 300 Ft. Yes Business Name:.Cum_ maouid Golf Club ' No X Subdivision Name::. APPLICANT'S NAME:Curnmaauid Golf Club` Phone 508-362-8008 Did the owner of the property authorize you to represent him or her? Yes X No PROPERTY OWNER'S NAME CONTACT PERSON Name: Cummaquid Golf Club ,Name: John-K: Holmgren Address: 35 Marstnn's I anP, Rarnstahla MA Address: 942 West .h .ctn it t_, Brockton, MA Phone: 508-326-8008 Phone:.508-583-2595 VARIANCE FROM REGULATION.(List Reg.) . ` REASON FOR VARIANCE(May attach if more space needed) 310 CMR 15.221(7) Depth of cover See attached 310 CMR 15.240(7)System under paved area- See attached Approval for alternative technology system Proposing to use'a'Presby.Enviro-Septic alt.tech.system NATURE OF-WORK: House Addition House Renovation ❑ Repair of Failed Septic'System ❑ (Construction of a new clubhouse building after tearing down the existing building) Checklist (to be completed by office staff-person receiving variance request application) Please submit copies in 4 separate completed sets. , Four(4)copies of the completed variance request form _ Four(4)copies of engineered plan submitted(e.g lwptic system plans)'_ Completed seven(7)page checklist confirming review of engineered.septic system plan by"submitting engineer or registered sanitarian _ Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans,or restaurant kitchen plans), _ Signed letter stating that the property owner authorized you to represent hin-/her for this request _ Applicant understands thatthe abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) _ Full menu submitted(for grease trap variance requests:only) _ Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/lessee only], outside dining variance renewals(same owner/leasee only],and variances to repair failed sewage-disposal systems[only.if no expansion i6the building proposed]) .' Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Wayne Miller,Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Paul J.Canniff,D.M.D. C:\Users\decollik\AppData\Local\Microsof.t\Windows\Temporary Internet' Files\Content:Outlook\BAJ9P9B7\VARIREQ.DOC r J.K. HOLMGREN ENGINEERING, INC. Registered Professional Engineers and Land Surveyors 942 W.Chestnut Street,Brockton,MA 02301 Tel:(508)583-2595 Fax:(508)588-7518 Toll Free:(800)439-2595 June 29 2012 To: Barnstable Board of Health RE: Title 5 Variances for Cummaquid Golf Club The following is a list of.Title 5 variances and reasons for such requests. This document is intended to accompany the Town of Barnstable Board of Health Variance Request Form.' 1. 310 CMR 15.221(7) Depth of Cover The provided depth of cover over the system ranges from 5.35' deep to 2.45'. This variance is requested due to the size of the system, which consists of two Soil Absorption Systems (SAS) that are 72.20' long by 70.20' wide each. It is extremely difficult to provide less than 36-inches of cover over a system that is effectively a 154.50' by 72.20' area and design grading that is functional for the site at the same time. Furthermore, the Presby Enviro- Septic system that we are proposing is gravity fed (pressure=dosing is not required) and the additional depth is needed to get the wastewater flows into the system. 2. 310 CMR 15.240(7) Soil Absorption System (SAS) located under an impervious area The area selected for the SAS is the most logical location based on the layout of the proposed clubhouse and the topography of the surrounding area. The location is adjacent to the lower portion of the building and is close enough to be gravity fed. In addition; the Presby Enviro-Septic system is an aerobic system that requires venting, a requirement of the regulation for placing a SAS under an impervious area. E Land Surveys • Subdivisions 9 Septic Designs 9 'Wetland Filings 0 Site Designs r J.K. HOLMGREN ENGINEERING, INC. Registered Professional Engineers and Land Surveyors 942 W.Chestnut Street,Brockton,MA 02301 Tel:(508)583-2595 Fax:(508)588-7518 Toll Free:(800)439-2595 . June 29, 2012 JKHE Project#1998-1326 ` Board of Health Town of Barnstable °� v W" �G.r C? 200 Main Street Hyannis, MA 02601 u ; / `7 RE: Applicant: Cummaquid Golf Clubl;;d `a 4 35 Marston's Lane W Proposed Septic System. 'Assessor's Map 350 Parce1.001 To Whom It May Concern: On behalf of the:Applicant, J.K. Holmgren Engineering, Inc. is submitting this request for local upgrade approval from the Barnstable Board of Health and 310:CMR 15 (Title 5)'.for purposes of constructing a- new septic system ffor the new building at the above referenced property.'. The Applicant intends to tear down their existing-Clubhouse building and construct a new, larger facility it its place. The Applicant is requesting a variance from 310 CMR 15.221 (7) Depth of Cover as well as 310 CMR 15.240 (7) locating an SAS under an impervious area. The attached Variance Application and explanation of the requests explains the nature of the requests and the need for the variances. Furthermore; we understand that_the Board requires a hearing in the case of an innovative/alternative (I/A) technology being utilized. , We are- proposing. to use the Presby Enviro-Septic system for this project. The.proposed system is designed in full compliance with . the DEP Approval Letter for General Use aswell as the Massachusetts Design Manual for the product. We would like to request that the project be placed on.the agenda for the July 10, 2012 Board of Health hearing. Please do not hesitate to contact-me at 508-583-2595 if you have any questions or require additional information. Thank you; J.K. Holmgren Engineering, Inc. rego Driscoll, Jr., RE. Land Surveys .v Subdivisions • Septic Designs, e, Wetland Filings 0 Site Designs Town of Barnstable Pit d� Department of Regulatory Services u i Public Health Division Date/vT f I, MAM 200 Main Street,Hyannis MA 02601 Date Scheduled / I/p �/� Time / Fee Pd -Soil Suitability Assessment for Sew Me .Disposal Performed By:- J y` N C e Yl —) n C Witnessed By: LOCATION& GENERAL INFORMATION Location Address ,j 5 n Q r S t o n S 'Lan e. Owner's Name Lu m m-CCvt, CA G o�1 4 C.1 kn l�;.'' Q lUM_ M InA p2 � /+ q �' 3 Address 3 5 �'14 r 5 i onS L 3 Assessor's Map/Parcel: )rJ C, ?C L I n Engineer's Name 5,h n W o NEW CONSTRUCTION +/ REPAIR F Telephone# a 8 - 5 t3 3-2 6 9z <t . Sad C-) Land Use: C tly r s Slope's(96) Surface Stones )J Ivy- Distances from: Open Water Bod U u ✓k ' P Y�R Possible Wet Area � ft Drinking Water Well N �' ft ff n CD Drainage Way N/(+ ft Property Line /t)° ft Other ft SKETCH:(Street name,dimensions of lot„e ct locadons of test holes&pare tests,locate wetlands in proximity to holes) \ \��\.........'-`,� to o. f; . *Tp I Parent material(geologic)CEjar�p�kj_yw C 704K Depth to Bedrock Depth to Groundwater. Standing Water in Hole: l,NO Q. . Weeping from Pit Rice Estimated Seasonal High Groundwater . "I Il,5V t—lbatwm a[ DETERMINATION FOR SEASONAL HIGH WATER TABU Method Used: Depth Observed standing in obs.hole: In. Depth to soil mottles: Ndder In, Depth to%vecping from side of cbs:-hole: NQOi [m Groundwater Adjua.mcnt ft. - Index Well# Reading Date: Index Well level _ Adj.factor- Adj.droundwater Leval PERCOLATION TEST bate 10TS111 Tltnu !i�m Observation ' Hole# 3 Time at 4" J U.33 �?0'�cfo Depth of Perc 3z Time at 6" 1if 2 q • s Start Pre-soak Time @ I Time WI-0) r►^� �o w, i End Pre-soak 1 •is . �1 Rate Min.flnch i Site Suitability Assessment: Site Passed 'V Site Failed: 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. Q:\SEPTIC\PERCFORM.DOC r DEEP-OBSERVATION HOLE LOG Hole#-- 1 Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency.%Gravel) NMI c 6 L All— I20" ca J-01Z• 914 Ls DEEP OBSERVATION HOLE LOG Hole#_1-2-2 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. I I Consistency,%Grave 24�7 0" LS b. Ls Y ' 4/ DEEP OBSERVATION HOLE LOG Hole# -rP-3 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(iu.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,7g Gravel) "- Ztl Ct LS 25 Ys/# Na "- 2.0 Gz LS 1Z 414( DEEP OBSERVATION HOLE LOG Hole# TPA Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency, LS .514 20" UY24K _Flood Insurance Rate Man: Above 500 year flood boundary No— Yes ` 'Within 500 year boundary No V+ Yes.:. Within 1.00 year flood boundary No.—/— Yes _ 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? If not,what is the depth of naturally occurring pervious material? Certification 'f�'� I certify that on T 00,3 (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 trap 'ng,expertise and experience described in 310 CMR 15.017. Signature Date 201� . S'_22s1 6 Q:\S.EPTIC\PERCPORM.DOC S 4.9 Documentation to;Ehd User The Designer must provide the system owner with copies.of'the'State's Certification for Genera"Use:andtor Approval -for Remed-jal Use and an`Advanced Enviro-Septic`- astewater Treatment Operating'.Manual`The state approvals are available for download on the Massachusetts DEP website.The Operators Manual is available for dowrntoad on our website:www.PresbyEnvironmentat.com or call;t300-473 5296 to request:pnriied copies. 4.10 End-to-End Beds Preferred Over We-to-Side Beds If site conditions permit, End'to-End;mulfipie bed configurations are preferable;to Side-to.-Side::configua(ions(see: sect.8.1,ipage 10). 4.1.1 Fill Extensions: Fill extensions-are the materai used between the Peesby System Sand Bed and the beginning;of the Side Slope- Tapers(see fit.insect.5.3,page 8}..fill extensions-ate constructed on all foursides of:a Presty Bed,The Breakout' Elevation establishes the ele- 16 .at.the intersecUon<of the._F II Extension and;Side,Slope Taper(seeall in sect.5:3,, page 8) 4.12 Flow Equalizers Required. All distribution boxes used to divide efftuenf f#ow require flow equalizers in the r ou 1 is. Flow equalizers are timited,to. a Mwdinum of 20.GPM per:equalizer Flow equalizers are not required when.using only one D-Box:ouUet.Never place a flow:.equalizer on the_W16 reading to a vent: 13 Garbage Disposais_(a k.a.Gar659A Grinders a additional ES pipe is required when using a garbage disposa (grin er).tf a garbage diSposat:is utiliz follow e States requirements regarding septic tank sizing:_Muttiale compartment septic tantcs of multiple tank are referred and gtwuld be pumped as-needed) - 4A4 H-1 O:AND H-20 Depth of Cover Material vErsrria ialFOLli_; The:minimum total depth of cover on-AES rou`'s is 10; ` E>RE►aoFnaxres rtlreEroNn: " EDGE OF PIPE(ALLEOGES) inches: 6"of systemsa,nd plus 4 of topsoil. AES pipe. Z BANK RUNGIZAVEE with IT of:structural'coveris designed for H40 loading, it 'INOSTOr1ESOVER,2^01 f2 MIN(BELOI�RAVEMEHT) and AES pipe with 18'of stnictural cover and: i s-s r§sEni-iAi BOlff *Ai i RECObtb"DED MMEU Stabilizatio tFabrlcisdesignedforH2O AE6P1PEEIMSARE1NACCE6 Mt i loading(the:only soil compactidn'that'shou_ld: ! - ISO SAND VOIDSALIOVA:O.t'JALKBE'TblEEN:' IRSTALL"IL4ZATI"FABRICIATNA' take place i5..at the point of.:preparatibri4or ROtYSicb�leREs50lcsANO)TversuREs0.t,0 GRa9TE�7S1iES et`iq!NOFs1# e8S ERA An MOE pavement);., FIL4$ALLV010.4AROUNDAESPIPES: ASTMW4632'S1XjNC"ES'O.VEt2AESPIPE'.. 4.15 Inspection Ports At least one Inspection Port 4s,requi.red.in each Advanced En iro-Septica field.The inspection'Port]&.Construcled'.of`. perforated 4 in.diameter plastic and wrrapped`with geo4extile.fabnc#o;protect against sand infi1hr tion.The bottom of a the inspection Porf`must extend down to the;bottom of the System Sand Bed;Bottom,which is in.betowAhe.AES. pipes for 1-60 MPI and 12 in,.for 61-90 MP1.The top of the..i'shoUld extend to the final grade and use a threaded. cap for access.in beds with-.a less than or equal to 10%Syst6m Slope,d must;be paced_befwreen i- of the AES rows;preferably at the end of a sedal:_section:In beds with more than:a 10%System Slope,it mus(be ocated at tf'e toe of the.System Sand Extension(s'ee ill.in sect 5:3;_page, 4.16 Maximum and Minimum Rove Lengths To maintain efficient effluent cyciingwi In the AES plpe,the ma�uriium row length is R00 ft.and the recommended minimum ro»i length_is 30 ft: ;(For acceptabie;exceptions fb this,rule,refer to Rijn-Conventionaf:System Configurations;sect.112,page 11). 4.1T MinimumbispersalAr;i: To I meet m at Massachusetts'requireents notime may an Advanced Enwro Septac®system beldesigned to have a sand bed area less than 40%;of.a.gonventiona)T►ffe 5'aggregate system designed- n.accordapce with 310 CMR 15.00 for ihe-sameaite; 41& Pessure Di tnbution. a) The useof pressure distributiortwith AESSystems is not:pertnitted b) ;Pump systems to gain elevation are allowed(see`Pump System,R.equirenents,sect 25 O page 161; 419' Row Elevations for Sloping Sites Eleuaiions niusl be.proyided;`on the'con`s#rucfi}on drawing for eac"i Advanced Enviro-Septic.rbiv in.thesloping_betl. system AES:;Oesign 8 Installation Manual for;;MA,©Presby Environmental Inc: bctober2013 E.d(tion` 5 ' , No. 3 — Fee C./ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: s PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 3pplicatton for nigozar *pgtem Construction Permit Application for a Permit to Construct( . )Repair( )Upgrade(gAbandon( ) O Complete System ❑Individual Components Location Address or Lot No. -a S s J C n S Owner's Name,Address and Tel.N,q* / Gu-.6 rY,Qt&t a ' �ulrn"0�0► cFC Assessor's Map/Parcel ,-3 56 ®c Installer's Name,_Address,and Tel.No.5,�rX f-f a--a-—9 f a-1 Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other 1 pe of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. 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 pplicable) v QC a. ' � Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by oard of Health. n Date Application Approve Date 11 1 IT 10'3 Application Disapproved for the following reasons Permit No. G4QaQ " (oO Date Issued 10 '~ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: �.• PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Y� r application fok miobg;ar *pgtem Construction Permit Application for a.Permit to Construct pp' ( "'Repair( )Upgrade(Abandon( ) ❑Complete System El Individual Components t Location Address or Lot No. Owner's Name,Address and Tel.N/ G �. Co�m Gl/ n S �m"We 01 � Assessor's Map/Parcel � S6 Installer's Name,Address,and Tel.No. 51$- L1�o — Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 4 Lot Size sq.ft. `Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design`Flow gallons per day. Calculated daily flow gallons. 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 pplicable) F Date last inspected: `f Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by '.Board of Health. Signed----, ��n � � Date Application Approved-by Date 11 Q; G Application Disapproved for-the following reasons Permit No. — � _.9 Date Issued (\ , 1c, "? --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal Sys�m Constructed( )Repaired( )Upgraded ) Abandoned( )by u S1.„��� at� i/1,, K, ;n t f.. � ;_r,.1t7-/0f 0 has been constructed in accordanc, with the provisions of Title 5 and the for Disposal System Construction Permit No a -20J3'�a ed j PUP ? Installer Designer The issuan(e of this permit shall not be construed as a guarantee that the sy to wild unction designed. Date �1 k�JLI Inspector % , No. "-5 kc) ------------------- Fee "' THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE,, MASSACHUSETTS Migpooar *pgtem �Con.5truction Permit Permission is hereby granted to Construct( )Repair( )Upgrade)Abandon ur- ( ) System located at f tjA lk l r-'^.e 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 becompleted within three years of the da of thts, t. Date: 1 I Approved by COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION R EC EIVED W FEB 1 1 2003 TOWN OF BARNSTABLE HEALTH DEPT. TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION MAP F 5 Property Address: 35 MARSTONS LANE�' PARCEL NIMAQU11)02637 M35 P001 -- Owner's Name: CUMMAQUID GOLF 6,Y13 LOT - Owner's Address: MAINTENANCE BUILD-IN-G. Date of Inspection: 1/24/03 Name of Inspector: (please print) JOHN GRACI Company Name: SEPTIC INSPECTIONS- j=vA c_ Mailing Address: P.O. BOX 2119 TEATICKET,MA. 02536 Telephone Number: 508-564-6813 FAX 508-564-7270 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: X Passes Conditionall asses _ Needs Furd Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: 1/24/03 The system inspector shall submit copy of this inspection report to the Approving Authority(Board of Health or DEP) within 30 days of completing this inspec on. If the system is a shared system or has a design flow of 10,000 ;pd 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 THE SYSTEM PASSES TITLE INSPECTION. RECOMMEND PUMPING EVERY TWO YEARS TO PROLON( THE SYSTEM'S USEFUL LIFE. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.1 his inspection does not address how the system will perform in the future under the same or different conditions of i, e. Page 2,of I l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 35 MARSTONS LANE CUMMAQUID 02637 M35 P001 Owner: CUMMAQUID GOLF CLUB Date of Inspection: 1/24/03 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X 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: THE SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPING'EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. 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. n/a 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: n/a n/a 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: n/a n/a 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: n/a r Page 3,of I I OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 35 MARSTONS LANE CUMMAQUID 02637 M35 POOL Owner: CUMMAQUID GOLF CLUB Date of Inspection: 1/24/03 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 n/a "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: n/a Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 35 MARSTONS LANE CUMMAQUID 02637 M35 P001 Owner: CUMMAQUID GOLF CLUB Date of Inspection: 1/24/03 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all-inspections: Yes No _ X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than '/z day flow X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped nLa. X Any portion of the SAS, cesspool or privy is below high ground water elevation. X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone 1 of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X 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 4-6(Yes/No) attached to this form.] The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. 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 X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 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. a Page 5 of l l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 35 MARSTONS LANE CUMMAQUID 02637 M35 P001 Owner: CUMMAQUID GOLF CLUB Date of Inspection: 1/24/03 Check if the following have been done.You must indicate "yes" or"no" as.to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health X Were any of the system components pumped out in the previous two weeks X Has the system received normal flows in the previous two week period X Have large volumes of water been introduced to the system recently or as part of this inspection X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up? i A X _ Was the site inspected for signs of break out? X _ Were all system components,excluding the SAS, located on site X _ Were the septic tank manholes uncovered, opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid, depth of sludge and depth of scum?. X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no X _ Existing information. For example, a plan at the Board of Health. X _ 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 Page 6 of l l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 35 MARSTONS LANE CUMMAQUID 02637 M35 P001 Owner: CUMMAQUID GOLF CLUB Date of Inspection: 1/24/03 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): 0 Number of current residents: n/a Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO Seasonal use: (yes or no): NO Water meter readings, if available(last 2 years usage(gpd)): n/a Sump pump(yes or no): NO Last date of occupancy: n/a COMMERCIAL/INDUSTRIAL Type of establishment: MAINTENANCE BUILDING Design flow(based on 310 CMR 15.203): 50gpd Basis of design flow(seats/persons/sqft,etc.): 50 GALLONS PER PERSON/300 PER DAY Grease trap present(yes or no): NO 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: n/a Last date of occupancy/use: n/a OTHER(describe): n/a GENERAL INFORMATION Pumping Records Source of information: n/a Was system pumped as part of the inspection(yes or no): NO F If yes,volume pumped: n/agallons--How was quantity pumped determined? n/a Reason for pumping: n/a TYPE OF SYSTEM X Septic tank, distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes, attach previous inspection records, if any) _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): n/a Approximate age of all components,date installed(if known)and source of information: 1986 PERMIT 86-1108 Were sewage odors detected when arriving at the site(yes or no): NO Page 7,of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 35 MARSTONS LANE CUMMAQUID 02637 M35 P001 Owner: CUMMAQUID GOLF CLUB Date of Inspection: 1/24/03 BUILDING SEWER(locate on site plan) Depth below grade: 8" Materials of construction:_cast iron X40 PVC_other(explain): n/a Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): 100+FEET TO WELL SEPTIC TANK: X(locate on site plan) Depth below grade: 2" Material of construction: Xconcrete_metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: 2000 GALLONS" Sludge depth: 0" Distance from top of sludge to bottom of outlet tee or baffle:34" Scum thickness: I" Distance from top of scum to top of outlet tee or baffle: 12" Distance from bottom of scum to bottom of outlet tee or baffle: 11" How were dimensions determined: MEASURED Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): SEPTIC TANK AND ALL COMPONENTS ARE STRCTURALLY SOUND AND FUNCTIONING PROPERLY. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. GREASE TRAP: _(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): n/a I Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 35 MARSTONS LANE CUMMAQUID 02637 M35 P001 Owner: CUMMAQUID GOLF CLUB Date of Inspection: 1/24/03 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan). Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX: X(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE 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.): D-BOX IS STRUCTURALLY SOUND. PUMP CHAMBER: _(locate on site plan) Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.). n/a R r Page 9 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 35 MARSTONS LANE CUMMAQUID 02637 M35 P001 Owner: CUMMAQUID GOLF CLUB Date of Inspection: 1/24/03 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type n/a leaching pits, number: n/a n/a leaching chambers, number: 0 GALLIES leaching galleries, number: 7 n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: n/a n/a innovative/alternative system Type/name of technology: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): THE LEACH FIELD IS STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.THE FIELD SHOWS NO SIGNS OF FAILURE. CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scumIayer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of soil,signs of hydraulic failure; level of ponding,condition of vegetation,etc.): n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a A r Pq'C 10 of I OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 35 MARSTONS LANE CUMMAQUID 02637 M35 P001 Oil ner: CUMMAQUID GOLF CLUB Date of Inspection: 1/24/03 Sl<ETCH OF SEWAGE DISPOSAL SYSTEM Provide a ske(ch of the sewage disposal system including ties to at least two permanent reference laiidinarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. O A I Joe AC LLLILL�c) rx: jr �rrrefLS �p �tft�c� - r � .Page I I of'1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSE`fSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION ;FORM PART C SYSTEM INFORMATION (continued) Property Address: 35 MARSTONS LANE CUMMAQUID 02637 M35 P001 Owner: CUMMAQUID GOLF CLUB Date of Inspection: 1/24/03 ` SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 1_1,+feet Please indicate(check)all methods used to determine the high ground water elevation: YES Obtained from system design plans on record- If checked,date of design plan reviewer n/a NO Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain:n/a NO Checked with local excavators, installers-(attach documentation) NO Accessed USGS database-explain: n/a You must describe how you established the high groundwater elevation: GROUNDWATER WAS DETERMINED FROM APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT- 132" NO GROUNDWATER ENCOUNTERED. Town of Barnstable P# Department of Health,Safety,and Environmental Services CC1C60,;q. E ' Public Health Division Datea. 367 Main Street,Hyannis MA 02601 TABLE, Date Scheduled ry �y� ,O �W Fee Pd. /��a+" 4� / v�lf T Time a Soil Suitability Assessment for Sewage Disposal Performed By: ` !y ,f Witnessed By: LOC�T30N & GENERAL INFORIVIA'TIOl Location Address Owner's Name ' Assessor's Map/Parcel: �iS �' Engineer's Name NEW CONSTRUCTION i/REPAIR Telephone# Land Use Slopes(%) 4 Y& Surface Stones a/&ZT Distances from: . Open Water Body R Possible Wet Area it Drinking Water Well ft 1 Drainage Way .R Property Line 130 R Other It SKETCH: (Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) 03 �" �pGF Cou/Z�i'G 7 Parent material(geologic) Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Nq Weeping from Pit Face �q Estimated Seasonal High Groundwater ... 11E° EYNA`�YONR SEA.Sb1 �4L GHVA`rEY2;'r' I�LE Method Used. Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment tt, Index Well#_ _..._. .Rradiniz Date:.—_ _ Index Well level Adj.factor Adj.Groundwater Level PERCOI AT ON TEST ?Dafe: :+: .w/Time: Observation Hole# / Time at 9" :Depth of Perc 70 Tine at 6" Start Pre-soak Time @ /� ''� Time(9"-6") :End Pre-soak :Rate Min./Inch LDS ?t/AN N Site Suitability Assessment: Site Passed 1,1� Site Failed: Additional Testing Needed(Y/N) original: Public Health Division Observation Hole Data To Be Completed on Back j Copy: Applicant ........... .................... ........... . l DEEP OBSERVATION MO............ ............................................................... LE LOG YioIe Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.%Gravel p`l n SGrnJD�, GoAM /0 ter 4/Z 3l"-50" C ��Nso �a`/e �/G ... DEEP OBSERVATION HQL E LOG Hole ..... Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,%Gravel) Lg n'L $¢" G _.. DEEP OBSERVATION HOLE LOG Hole .:: - .. ._ . . Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(m.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,° Gravel 5;WDy Z,&Y', YZ ¢ z AEEP OBSERVATION HOLE LOG Dols Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency, ravel Flood Insurance Rate Man: _ Above 500 year flood boundary No— Yes Within 500 year boundary No_ Yes Within 100 year flood boundary No_ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? c-s If not,what is the depth of naturally occurring pervious material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310'CMR 15.017. Signature Date _ TOWN OF BARNSTABLE' X LO _ t9 • 1 a �d A WAGE VILLAGE ' Y' ASSESSOR'S MAP LOT INSTALLER'S NAME & PHONE NO. -4. ft e- SEPTIC TANK CAPACITY ".f .,t t LEACHING F,ACILITY:(type) _(size) yqe 9 " a NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: n" v► DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes to 8 � .y r y4 ' � n 7 ^, THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTf*n,, A a p �( 1....d�'"^ ..............0F.......: 0. .K.S.T ."� _.ably �9n R v Appl ration for Disposal Murks Ton rrm roo. s pp sioa Application is hereby made for a Permit to Construct ( ) or Repair ( ) n Individual ' age��o al System at: pate ..C:vl.2!M./ES�szl.Ci.._....... OL .cC vG....................... ...... . .sse..PcL... .................... Location Address or Lot No. .....G� .rr¢ J•..._......1!1!��4$.� • .................................•--•----......................._........ .... ••-Owner ��.,A'��. .......Address ............... .✓.................... ...... Installer Address Type of Building Size Lot...... U Dwelling—No. of Bedrooms................................ .....Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building ... No. of persons............................ Showers — Cafeteria a' Other fixtures ............................................. --------------.................. a W Design Flow............................................gallons per person per day. Total daily flow................a-0..9.0...............gallons. WSeptic Tank—Liquid capacityj✓ ..gallons Length................ Width:....;.......... Diameter............_... Depth................ x Disposal Trench—No. ......Al........... Width---1.a.......... Total Length...ZA.o....... Total leaching area_./Z'n....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........................................ 11 M Test Pit No. 1....7.......minutes per inch Depth of Test Pit...1.g 4_..... Depth-to ground water....&!M�C..-_. Lt. Test Pit No. 2................minutes per inch Depth of Test Pit..!4n8../L. Depth to ground water...." .... 04 .........--•............................................................................:...... ......................................................... P A l---••-... S., �� `i!�Q " / !q _0. '1 ..Description of Soi1......�YJ�.QFc�... .......... ............................ v �. `•-----..... 1 �2r�1 �.-•--•---., Sri ...� nr --------�'----/�...-E....2�Ma�I�J..................................... W U Nature of Repairs or Alterations—Answer when applicable. � TI. C�.......................... Sfz�........ L.y k �T! /l £.t_v.. ..... .....�� eg y T"!� Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of LITLZ 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b en issued by the boar f health. ned , -; ................................................... ..... ��l�... /> QQ a�- Application Approved By------/ :........s� �d� 1��'�' l.. � " Date Application Disapproved for the following reasons:......n................•-•--••----------------------...._....-•-•------------.........._...................... -•...............•--..................._......•----•-----.....•--•......---..............•-•--•--•--........................---•••----•-•---•---••-•-•-...............•••-•----............----........_ a��........_... ...... ��•-{------------- Issued----.��--�-- .... .-- ��...1.....Permit No..... ...._ -- arc