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HomeMy WebLinkAbout0152 MARSTONS LANE - Health 117 1 =�2 TMaistons Dane -� Barnstable J 3 JT's L ^LsaY;nb r I. I� f, III I i A U G i N V 2 Aso-oao i < Commonwealth of Massachusetts Title 5 Official Inspection Form r . "a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Jyy 152 Marstons Lane "J Property Address Demetrios Tserp_es ` Owner Owner's Name information is required for every Cummaquid Ma 02637 9/09/2020 page. Cityrrown State Zip Code Date of Inspection , Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. Inspector Information filling out forms on the computer, use only the tab Jeffrey M. Wall key to move your Name of Inspector cursor-do not Wall Septic Service use the return Company Name key. P.O. Box 771 r� Company Address Harwichport Ma 02646 Cityrrown State Zip Code rmrn 508 432 4980 673 Telephone Number License Number B. Certification m I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails Inln p s Si ature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments �? 152 Marstons Lane Property Address Demetrios Tserpes Owner Owner's Name information is required for every 20 Cummaquid Ma 02637 9/09/20 page. CitylTown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 7IePasses: ve 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: One or more system components as described in the"Conditional Pass" section need to be laced or repaired. The system, upon completion of the replacement or repair, as approved by the and of Health, will pass. Check the box "yes", "no"or"not determined" (Y, N, ND) for the following statements. If"not determined," plea xplain. The septic tank is metal a over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial 'Itration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is re ced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it I ructurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 2 ars old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rev.7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 • Commonwealth of Massachusetts Title 5 Official Inspection Form .' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 152 Marstons Lane Property Address Demetrios Tserpes Owner Owner's Name information is Cummaquid Ma _ 02637 _ 9/09/2020 required for every State Zip Code Date of Inspection page. City/Town C. Inspection Summary (cont.) 2) stem Conditionally Passes (cont.): ❑ mp Chamber pumps/alarms not operational. System will pass with Board of Health approval if pu s/alarms are repaired. ❑ Observation sewage backup or break out or high static water level in the distribution box due to broken or ob ucted pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if ith approval of Board of Health): ❑ broken pipe(s) replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is remove ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled o eplaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due t roken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Hea ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ D (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND ( lain below): Co dit o"Trs-eau t which require further evaluation by the Board of Health in order to determine if ❑ the system is failin tect public health, safety or the environment. a. System will pass unless Boar�" 4 Ith determines in accordance with 310 CMR 15.303(1)(b)that the system is not functions manner which will protect public health, safety and the environment: 15insp.doc-rev.'7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 18 Commonwealth of Massachusetts 63 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 152 Marstons Lane Property Address Demetrios Tserpes Owner Owner's Name information is Cummaquid Ma 02637 9/09/2020 required for every page. City(Town State Zip Code Date of Inspection C. Inspection Summary (cont.) Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. Syste ill fail unless the Board of Health (and Public Water Supplier, if any) determines t the system is functioning in a manner that protects the public health, safety and env nment: ❑ The system has eptic tank.and soil absorption system (SAS) and the SAS is within 100 feet of a surface w r supply or tributary to a surface water supply. ❑ The system has a Sep tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tan nd SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and S and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: "*This system passes if the well water analysis, perform at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of am ia.nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are iggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: each of the following for all inspections: You must indicate Yes or No to ea _ p Yes No Backup of sewage into facility or system component due to overloaded or El clogged SAS or cesspool El � Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form I� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 152 Marstons Lane _ Property Address Demetrios Tserpes Owner Owner's Name information is Cummaquid Ma 02637 9/09/2020 required for every State Zip Code Date of Inspection page. City/Town C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ [g/ Static liquid level in the distribution box above outlet invert due to an overloaded / or clogged SAS or cesspool ❑ / Liquid depth in cesspool is less than 6" below invert or available volume is less than 1h day flow ❑ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ [�. Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ [ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ L!d' Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] The system is a cesspool serving a facility with a design flow of 2000 gpd- El10,000 gpd. ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. low of 10,000 gpd to 15,000 gpd. For large sy ou must indicate either"yes" or"no" to each of the following, in addition to the questions in Section Yes No ❑ ❑ the system is within 400 feet of a s drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface water supply ❑ El Area system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well l5insp.doc•rev.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 i Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 152 Marstons Lane Property Address Demetrios Tserpes _ Owner Owner's Name information is Cumma uid Ma 02637 9/09/2020 required for every q ._. page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered"yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following for all inspections: Yes No ❑ Pumping information was provided b the owner, occupant, or Board of Health P 9 P Y P , ❑ [� Were any of the system components pumped out in the previous two weeks? ❑ [� Has the system received normal flows in the previous two week period? /No US-0 C ❑ Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) i ❑ Was the facility or dwelling inspected for signs of sewage back up? ❑ Was the site inspected for signs of break out? in LV, i7G ❑ Were all system components, a ing the SAS, located on site? UYI ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ Was the facility owner(and occupants if different from owner) provided with j information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ❑ Existing information. For example, a plan at the Board of Health. ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] CC.nGGi t C�tgfie,/) t5lnsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form <P' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 152 Marstons Lane Property Address Demetrios Tserpes Owner Owner's Name information is required for every Cummaguid Ma 02637 9/09/2020 — page. Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: �2 -7 Number of bedrooms(design): —v Number of bedrooms (actual). DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 3 3 Description o � I,,,C '7"`SAG S / ►� �� _ v 171 - o Number of current residents: Does residence have a garbage grinder? ❑ Yes B No Does residence have a water treatment unit? ❑ Yes No If yes, discharges to: ---L�1 - Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes Rr"'No information in this report.) Laundry system inspected? ❑ Yes Ef"No Seasonaluse? ❑ Yes VNo I_d2� Water meter readings, if available (last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes No Last date of occupancy: Date t51nsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 152 Marstons Lane Property Address Demetrios Tserpes Owner Owner's Name information is Cummaquid Ma 02637 9/09/2020 required for every -- page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type of Establishment: Desi flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of des flow(seats/persons/sq.ft., etc.): — — Grease trap presen . ❑ Yes ❑ No Water treatment unit prese ❑ Yes ❑ No If yes, discharges to: - Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 syste ? ❑ Yes ❑ No Water meter readings, if available: - Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: e� Source of information: Was system pumped as,part of the inspection? ❑ Yes &KNo If yes, volume pumped: �g gallons / How was quantity pumped determined? Reason for pumping: -- t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 152 Marstons Lane `J Property Address Demetrios Tserpes Owner Owner's Name information is Cummaguid _Ma 02637 9/09/2020 required for every --- - page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 4. Type of yytem: Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age ofall components, ate installed (if known)and source of inform tion: Were sewage odors detected when arriving at the site? ❑ Yes M/No 5. Building Sewer(locate on site plan): Depth below grade: feet _— Material of construction: cast iron 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): t5insp.doc-rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form e Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 152 Marstons Lane Property Address Demetrios Tserpes Owner Owner's Name _ information is Cumma required for every uid Ma 02637 9/09/2020 q page. Cityrrown . State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): , 7S Depth below grade: feet 7Mate ial of construction: concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) years -4�age®+ai +a�ec#-byt�fate�ef ©w�a falicare?(attaehr acry. E"3 Yes El Na— /S GA' Dimensions: n � OD /f��S� Sludge depth: -- Distance from top of sludge to bottom of outlet tee or baffle Scum thickness --— Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc,_..�' a eGfr� 1N N o?" /�E2�cu( GC S' G�o S c:?/fit... -7 .� A'y-_lg�v A `� �1--C T n Tic 406e• h u-e1<T7 000 a J.4:11 e, 44f c t5insp.doc•rev.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 i • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments of 152 Marstons Lane — — Property Address Demetrios Tserpes Owner Owner's Name information is Cummaquid Ma 02637 9/09/2020 required for every — — page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) epth below grade: feet Mated f construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee affle Distance from bottom of scum to bottom of outlet tee affle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or b e condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Depth w grade: — -- Material of construc i ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day I 15insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form 1 i Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 152 Marstons Lane v Property Address Demetrios Tserpes Owner Owner's Name — W information is Cummaquid Ma 02637 9/09/2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Alar resent: El Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: mate Comments (condition of alarm an at switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence f leakage into or out of box, etc : t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form <la Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 152 Marstons Lane Property Address Demetrios Tserpes Owner Owner's Name information is Cummaquid _ Ma _ 02637 9/09/2020 _ required for every Date of Inspection page. Cityrrown State Zip Code D. System Information (cont.) Pu in working order: ❑ Yes ❑ No` Alarms in wor ' order: ❑ Yes ❑ No` Comments(note conditio ump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: �a ✓BOA 6 /tan leaching chambers number: /,���p•� �2�,,,�e ❑ leaching galleries number: y ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: F ❑ overflow cesspool number: — ❑ innovative/alternative system Type/name of technology: l5insp.doc•rev.7126120,18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 r Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 152 Marstons Lane Property Address Demetrios Tserpes _. Owner Owner's Name information is required for every Cummaquid Ma 02637 9/09/2020 — page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.); 3570)c cr .�'ri G tA _. A o ji"vc L An r.—Peels ber and configuration Depth—to f liquid to inlet invert —�--� Depth of solids lay Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, lev f ponding, condition of vegetation, etc.): t5insp.doc•rev.712612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 152 Marstons Lane Property Address Demetrios Tserpes Owner Owners Name information is required.for every Cummaguid Ma 02637 9/09/2020 — — page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Mated construction: Dimensions Depth of solids — Comments (note condition of soil, signs of hydra ilure, level of ponding, condition of vegetation, etc.): N � 15insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts p Title 5 Official Inspection , Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 152 Marstons Lane Property Address Demetrios Tserpes — — Owner Owner's Name information is Cummaquid _ Ma_ 02637 9/09/2020 required for every — State Zip Code Date of Inspection page. Cityrrown D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the b 'ding. Check one of the boxes below: hand-sketch in the area below ❑ drawing attached separately 6t#04Z 6 e oKT �a T TO 6 o7 3-7 y s l5insp.doc•rev.7I262018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments' 152 Marstons Lane Property Address Demetrios Tserpes —. Owner Owner's Name information is Cummaquid _Ma 02637 9/09/2020 required for every - page. City/Town State ' Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: U/Check Slope IB/Surface water [uf heck cellar Shallow wells OJT Estimated depth to high ground water: f ,S/ &5 3 ,S 6Fe- Please indicate all methods used to determine the high ground water elevation: Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established t e high ground water elevation: �j .T.�Ste!/cal . ��� c,�r�r� (�► 40 L R y'•eyn Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5lnsp.doc-rev.7/28/2010 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 18 Commonwealth of Massachusetts p Title 5 Official Inspection Form t Subsurface Sewage Disposal System Form - Not for Voluntary Assessments y' 152 Marstons Lane Property Address Demetrios Tserpes Owner Owner's Name information is required for every Cummaguid Ma 02637 9/09/2020 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: �A. Inspector Information: Complete all fields in this section. []/ . Certification: Signed & Dated and 1, 2, 3, or 4 checked C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate (Failure Criteria) and 6 (Checklist) completed D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev,7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 i Tablo 3-2 Do's and Don'ts of Private Suptic syst,um Management DO.,. DON'T.,, Do have the on-site system Inspected and pumped by. Do not use the toilet or sink as a trash can by ~, u Ilcunt:ed professional approximatoly ovory 3 to 5 dumping non-biodegrudable material (cigare(te burs. years. Failure to pump out the sepUc tank can cause diapers, feminine products, etc.) or grease oryvvn U)-j system failure.If the tank fills up with an excess of sink or toilet. Non-biodegradable material can clog solids, the wastewater will nct have enough Ume to the pipes,while grease can thicken and clog the settle in the tank.These excess solids will then pass on pipes. Store cooking oils, fats, and grease in a can to the leach field, where they will clog the drain linos for disposal In Vie garbugu. _-- and soil, Do know the location of the on-site system and drain Do not put paint thinner, polyurethane, any fre6ze, pesticides, some dyes, disinfectants, water Field, and keep a record of all inspections, pumping, u0flunuru, and uUtur stronrJ chemicals inlo 'J,n repairs, contract or englnuoring work for ruturu references. Keep a sketch of it handy for service visits. system. 'fhusu can cause major upsets in tnu tank by killing the biological part of the on-site system and polluting the groundwater. Small amounts of standard household cleaner,, drain: cloansurs, dulurgunls, ulc. v:ill b(j dlluluu Iri Utu W1)A and should cause no damage to the system. rabove w grass or small plants (not trees or shrubs) Do not use a garbage grinder or disposal, Which the on-site system to hold the drain field in feeds Into the on-site tank. If tr,ere is one, severelyWater conservation Ulrough creuUvu limll Its use Acid IrxxJ wo stus ur oUlur so ids aping is a areal way to control excess runoff. need to pumpystcni lhe on-site lank. if a grinder is of , the system must De pumped more often Y Do install water conserving devices in faucets, Do not plant trees within 30 feel of the system or showeMeads and toilets to reduce the volume of water park/drive over any pan of Vie systern. ,rae running into the on-site system. Repair dripping faucets clog pipes, and heavy vehicles may cause tr,e orain and leaking toilets, run washing machines and field to collapse. dishwashom only when full, and avoid long showers, Do divert roof drains and surface wafer from driveways DO Ilut ullow unyu+tu W rup,419 pr, purer) Utu oyslurt, and hillsides away from the on-site system. Keep sump without first chocking that they are licensed system pumps and house footing drains away from the on-site professionals. s stem as-well Do (Like loflovor hazardous chornluls to on approvod Do not polforrn uxcossivq laundry loads v. to a hazardous waste collection center for disposal. Use washing macninu. Doing load after load Cori not bleach, disinfectants, and drain and toilet bowl cleaners allow the on-site tank time to adequately treat wastes sparngly and In accordance with product labels. and overwhelms the enure on-site system v;;C"i excess wastewater. This could flood Ux, drain field wiUlout aliowlny suffiucnt rucuvory time r:o�suit rr', an on-site tank professional to determine in, ;a!Icr capacity and number of loads per day t,:at can su`E,y t o into the system. _ D_0_a_se only on-site system additives that nave twun Do not usu cnunlic0l gglvertls tU rleUrt Ylv allowed for usage in Massachusetts by MA DEP. or on•sito system. "MiroGe" chemicals vn.l F=1I Additives that are allowed for use In Massachusetts microorganisms that consume harmful wastes. have been determined nct to produce a harmful effect These products can also cause grouno..vster lu tno individual syslom or Its componenla or to Ulu wntarninuUcn environment at large. n11V Iti^�"mwr povroop'waarlreao.rca✓mppWCa.40C , Message - Page 1 of 1 Stanton, David From: Stanton, David Sent: Friday, November 18, 2016 8:23 AM To: Heath DeptMaiIbox Subject: 152 Marstons Lane, Barnstable FYI, I received a call from Installer Kevin Quinn to.please hold issuing any copies of the Certificate of Compliance (he has the original) because the owner is refusing to pay and he is taking legal action against the owner of the property. I let him know I would notify everyone, however it may come down to a legal issue should the homeowner request a copy of the certificate of compliance. Should'the homeowner request a copy, please refrain from doing so at that time and let them know that we will consult with the Town Attorney regarding it. Contact the Town Attorney about the case and also Kevin Quinn should the request come in so he can notify his lawyer as well. Kevin's number is 774-392-0098. Thanks, David 11/18/2016 TOWN OF BARNSTABLE LOCATION &(S J'6nS " SEWAGE# 20 t � -37� VILLAGE CLt JM Q 4;& ASSESSOR'S MAP&PARCEL 3�ID--030 INSTALLER'S NAME&PHONE NO. utwiw+`s Argave-)kb, 7;?Y 392 0678 SEPTIC TANK CAPACITY I50' 6 LEACHING FACILITY. (type) (,,S"6O �1 f�;tb (size) /3�' NO.OF BEDROOMS 3 'v OWNER D ,4 1 1;�S PERMIT DATE: COMPLIANCE DATE: I` Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) IVA Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of le eet FURNISHED BY A�3=37g from,. A4zS;► ASS so Ab= 'Fill 37 B6= 38.2 f No. l6 (v Fe �O�� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS. Yes 9ppl ration for Misposal *pstpm Construction Permit Application for a Permit to Construct(1�1 Repair( ) Upgrade( ) Abandon( ) IN/Omplete System ❑Individual Components Location Address or Lot No. I 2 /16 arS -'Z1h Owner's Name,Address,and Tel.No. Assessor's Map/Parcelj� Gum �� Installer's Name,Address,and Tel.No. 7�q)?f •� Designer's Name,Address,and Tel.No. bu(rlIA�s xc� i� (hc . � Type of B ding: a�49 C&0(10(A iKk 62 963 Dwelling No.of Bedrooms Lot Size 143 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.requ' ed) gpd Design flow provided gpd �1 Plan Date �aC Number of sheets k�z, Revision Date Ala Title Q Y Size of Septic Tank Type of S.A.S. Description of Soil g Nature of Repairs or Alterations(Answer when applicable) Date last inspected: v ;?o Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. S' Date 1� 7 e Application Approved by/' Date Application Disapprove Date for the following rea ons Permit No /6 "3-7Z- Date Issued ��&I�, i No. 9016 �� t a, Fee / 5y If Entered in computer: ,THE COMMONWEALTH OF MASSACHUSETTS Yes PUBLIC HEALTH DIVISION = TOWN OF BARNSTABLE, MASSACHUSETTS 2pplitation for BispoBal 6pstrm Construction Vermit Application for a Permit to Construct(1�Repair( ) Upgrade( ) Abandon( ) N/__omplete System ❑Individual Components Location Address or Lot No. ).521 1 r/"�,Cl' 1.(Z1h,-,/ Owner's Name,Address,and Tel.No. (� Assessor's Map/Parcel. s� `lavh d, Deky`'! �t f 7_vf J Csor�,)776— P?01 Installer's Name,Address,and el.No. (777N)�f -tX>9? Designer'"s'Name,Address,and Tel.No. 60011S wcvapbn t,(,, iS st�rvcy�hc . .?6/9 4 ls� Type of Building: OZ61& SG,cf a (A AmA 62 Y63 Dwelling No.of Bedrooms , Lot Size 2q, /0.3 sq.ft. Garbage Grinder( ) Other Type of Building h Cu" No.of Persons Showers( ) Cafeteria( ) . r Other Fixtures Design Flow(min.required) � ® gpd Des)gn flow provided � ! gpd Plan Date / 07 Number of sheets Revision Date /1 Ali( Title t 1 Y, Size of Septic Tank Type of S.A.S. �,� ,'� � 1� � Description of Soil b& i 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 not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Si Date 7 011 Application Approved by� Date Application Disapprove Date for the following rea ons + I Permit No. �`�V 3Z- Date Issued /Q &(6 ------------------------------------------------------------------------------------------- ------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( Upgraded( ) Abandoned( )by at �' ��t2_�10,0 5 &4 TAy4 K) "r"�3!.Cr has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No&6—37Z dated /®LI1LZd6 Installer Designer #bedrooms Approved design flow 7 7o gpd i The issuance of this permit shall not be construed as a guarantee that the system wily c o i as desigiRed. }n Date I H )e Inspector - ---------------------- ti---------� ------- No. �00 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS -Disposal &- pstem Construction jermit Permission is hereby granted to Construct( ) Repair(K) Upgrade( ) Abandon( ) ti System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must,be completed within three years of the date of this pe Yi . w Date �(�//Gf�7�( �j Approved by _ Town of Barnstable Regulatory Services } Richard V. Scali, Director BAM BLF' Public Health Division i639• ��� men►9+'' Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: 11-14 —Z01% ewa a Permit#. - Assessor's Map/Parcel3,Z Installer& Designer Certification Form i Designer: Installer: -A y9 'y � Address: Fa 7Z9 Address: XOn ���/Q v r iv 4/ was issued a permit to install a (date) 7 (installer) septic system at 16_04 -S 0'V5 Z✓ 6CJ PAy4,aU',poased-on a design drawn by (address) 1 dated (designer) l X _ I certify that the septic..system referenced above was installed substantial) according to the design, y g which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (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. Stripout (if required) was inspected and the soils were found "satisfactory, 0 I certify that the system referenced above was constructed in compliance with the terms of the approval letters (if applicable). DAVID x " (In aller's Si ture) FLAHERTY,JR. No. 1211 �C'/STS (Designer's Signature) (Affix Desi r'' = ere) 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. gAoffice formsWesignercertification form.doc i down cape engineering, inc.. SIEVE SOILS ANALYSIS 152 MARSTONS LANE BARNSTABLE,MA DATE OF REPORT: 9/5/16 .JOB : GRAIN SIZE ANALYSIS-SIEVE TEST SITE: 152 Marstons Lane, Cummaquid/Barnstable LOCATION: EAS Survey Test Hole SIEVE ANALYSIS weight Sample(Grams): 172.0 SIZE :WEIGHT RETAINED .; % RETAINED %PASSED -- --- -----sum)-------- ---- ------ -- 00: ------------- - --------------------------- - 0.0: 1/2" 0.0; 0.0%: 100.0% ------ ------- ------ - 3/8" ; ' 0 0 0.0% 100 0% 0.0: 0:0%' 100.0% --- - - '0------- ------,.- - 10 20 9: 12.2%: 87 8% 0 81.5 j 47.40/ 52.60 ------------------------- 5---------------------t---- ----------- 140.0: 81.4%; 18.6% --------------...---------------------- ---------------------,-.. --.- ------- 0 152.7; 88.8%: 11.2% ------------- ------------------------------------------------•------------------ _ 0 162.9' 9_4.7%: 5.3% 100--------------------------- 165.7;-------------96.3°101------------3.7% -------------1_-------------------------- j--- -'---------------A----------------- 00 169.9' 98.80/o; 1.2% -------------►-----------------------1-- --------------------------------------- AN: C 17 .Oc 100.0%: 0.0% SAMPLE: 172.0; NOTE:TEST ON PASSING44 ONLY,4.1%RETAINED ON#4<45% O.K. RESULTS: SOIL CLASSIFIED AS AASHTO A-1-b(GRAVEL AND SAND)(UNCOMPACTED) PERCENTAGE OF MATERIAL PASSING#4 SIEVE #4 100% (TEST ONLY MATERIAL PASSING#4) OK #5010%-100% OK.1 #100 00/6-20% OK #200 0%-5% . OK SAMPLE MEETS TITLE 5 FILL SPECIFICATION >98%SAND RESULTS: PERMEABLE MATERIAL-CLASS 1<2 MINAN.MATERIAL(0.74 GPMISF) NONCOMPACTED SOIL DESCRIPTION: MEDIUM/COARSE SAND. DANIE,LA. 7 o OJAt A v CNIL No.46502 TE 1 ASS L Town of Barnstable P# d -/3.3 ' Department of Regulatory Services a Public Health Division t Date C� rd79- 200 Main Street,Hyannis MA 02601 co Date Scheduled }. (P ' /u Time `l � Fee Pd._ Soil Suitability Assessment for Sew e Dispos r ��L !/ Performed By: Wltnessed By: N✓� (/ �u LOCATION&.GENERAL INFORMATION Location Address �5 cJ�2 �Ak 1zl js L-A K(l� Owner'a Name ( SFt2 PC� ' GJ'I'1��c+2v ESQ s,/,wt4 Address c�J Assessor's /Ma Parcel �4 p Engineer's Name S&a0Cj,-<- N ll,�g-�zSz 36�EW CONSTRUCTION REPAIR Telephone# -a a S, S L/VVQ- IR n _ / O Land Use. �'�� `I�" tom/ Slopes(%)� _ Surface Stones_ a>�Le Distances from: Open Water Body "� tt Possible Wet•Area ft Drinking Water Well t//.,+40 - ftCn��C �� Dmihage Way ' 'f 3 ft Property Line �� SS ft Other SKETCH:(Street name,dimensions of lot,exact locations of test holes&pore tests,locate wetlands-11n proximity to holes) n L, v� C�)c/L Parent material(geologic) GP�'T�tI�I �(�1/ Depth to Bedrook Depth to Groundwater. Standing Water In Hole: Weeping from Pit Fnee Estimated Seasonal High Groundwater DETERMINATION FOR SEASONALEIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: In. Depth to still mottles., Dcdth to ceping from side of obs.hole: 1'A4' In. Oroundwater Ad ustment Index Well Reading Date: d. Index Well level ActJ,fhctor Ark.draundwater•Level lZ PERCOLATION TEST , % 947 Observation/ Hole# Time at 9" Depth of Pero Time at 6" Start Pro-soak Time® tl v Time(9"-6") and Pre-soak Rate Min./Inch . L 2121 lGZ -�J C 2 . C'OD,'►�'�SEr 5 4A/!' Site Suitability Assessment:,51to Passed 51tF Fatted: Additional Testing Needed(Y/N) Original: Public Health Division'` - Observation Hole Data To Ba Completed on.Back------ ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conselrvation Division at least one(1)week prior to beginning. Q:ISEPTICIPBRCFORM.DOC ` �< DEEP,OBSERVATION HOLE LOG Hole#—L—>� 7 Depth from Sall Horizon Sail Texture Shcl Color Soil. Other Surfacc(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders. lsistency.%'araval) lye 3 7. d z�'�%DZ rr, Z dal- Z,7y 7 l Nth -QV Cl1L/yy C> O DEEP OBSERVATION HOLE LOG Hole# Z Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. // a �- -/ oZCe 17, l�L DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(In.) (USDA) (Munsel.) Mottling (Structure,Stones,Boulders., Consistency, DEEP OBSERVATION HOLE LOG ' Hole# Depth from Soil Horizon Soil Texture" " Solt Color Boll Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Slopes;Boulders, Flood Insurance Rate Map: / Above 500 year flood boundary No _ Yea Within 500 year boundary No _+ Yes ' Within 100 year Flood boundary No.,r- Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervlo s material exist in all areas observed thrpughout the area proposed for the soil absorption system? -e 5 If not,what is the depth of naturally occurring p vious material'?, _._._.�.. Certification I certify that on 0 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by ma consistent with the required trainin ,e or erience described in 410 CMR 15.017. Signature Date Q:WHrrlC\PanCFORM.DOC i Hazardous Materials Inventory Sheet Checklist Date _ t— , Physical Street Address-Check database to ensure it exists —Wor king Phone Number L _1cActual Amounts-(le.gas being used to fuel machines,thinner to clean brushes all count as hazardous materials) Storage Information-location of storage,how long is storage for? If none,note that. !�A4 77r7T+- � Disposal Information-where and who?If none,note that. Applicant Signature-understand what is listed and noted Staff Initial-any questions,know who to ask Vehicle Washing/Rinsing? -provide a vehicle washing policy and explain it-note that it was given Attach the Business Certificate with your sign off and comments "The inventory form should explain what the business consists of and the procedures they are doing. Notes need to be left to explain what you discussed with them. YOU WISH TO OPEN A BUSINESS? !l0 r) ($ For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. - it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1st FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) 3:" DATE: a..... }(, $.r, trr Fill in please: _ � 'x APPLICANT'S YOUR NAME: ,..I >r- t� BUbIINESS �y YOUR HOME ADDRESS tk� 9�ywa✓:s�-.a r3� a�, 4�'�.. sy,� �y � ,.j'sAs ���?1� 1,�--� �.> Y `�� il,,.�l;c.r.�a �il. �d.il���•A TELEPHONE # Home Telep one Number C 22)IL 1- 93 1 l NAME OF NEW BUSINESS I's 1. TYPE OF BUSINESS L j' �2.w s IS THIS A HOME OCCUPATION? YES ENO Have you been given approval from the building division? YES NO ADDRESS OF BUSINESS L oin a c;.0 MAP/PARCEL NUMBER When starting a new business there are several things you must do i1i order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. -(corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature" COMMENTS: . 2. BOARD OF HEALTH _ This individual ha b n info d o th perm' requiroWnts that pertain to this type of business. t rized i nat rep C MMENTS: . 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature" COMMENTS: ra Date: TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: M`-", 11+ASw-Te ej lLgs BUSINESS LOCATION: L3; +^�v..%j-1A :• /g;� s L• INVENTORY MAILING ADDRESS: �0 �dx 2S.\_ TOTAL AMOUNT: TELEPHONE NUMBER(S0g) 1,(2_ g�U1 CONTACT PERSON: \ati, Tseir-Ae % EMERGENCY CONTACT TELEPHONE NUMBERK-S-01 -I-)G 8101 MSDS ON SITE? TYPE OF BUSINESS: L LA c�j V�5 INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous.waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed/Maximum Observed/Maximum Antifreeze (for gasoline or coolant systems) Misc. Corrosive NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED Misc. petroleum products: grease, Photochemicals (Developer) q lubricants, gear oil NEW USED U for engines and metal Printing ink Degreasers g 9 Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine D Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Misc. Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt & roofing tar PCB's 6 Paints, varnishes, stains, dyes 0 Other chlorinated hydrocarbons, inc. carbon tetrachloride Lacquer thinners ( ) NEW USED Any other products with "poison" labels Paint & varnish removers, deglossers (including chloroform, formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor &furniture strippers Other products not listed which you feel Metal polishes r may be toxic or hazardous (please list): Laundry soil & stain removers (including bleach) Spot removers &cleaning fluids K QN (dry cleaners) Other cleaning solvents ��C' .5 C\t,U,0h A 0,^ Dr Pe., Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS YOU WISH TO OPEN A BUSINESS? IL For Your Information: Business certificates(cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. - it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1S` FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: ..Ma No go Fill in please: APPLICANT'S YOUR NAME: A e i BUSINESS YOUR HOME ADDRESS: 9ti_) 9`1L,r..�-?09S Lam• TELEPHONE # Home Telep one Number (54.. NAM 5OF NEW BUSINESS TT'S TYPE OF BUSINESS l;a. _CTt* IS THIS A HOME OCCUPATION? YES X_N.O. Have you been given approval from the building division? YES NO ADDRESS OF BUSINESS IS- L `r, MAP/PARCEL NUMBER n When starting 'a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St.-(corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING C MIS NER'S OFFICE This indi ' ual , a eE-PH m of any permit requirements that pertain to this type of business. A v.s O or' ignature* 7 MMENTS '' � $ ���� � " m . 2. BOARD OF HEALTH This individual ha b n info d o th perm' requir nts that pertain to this type of business. Qj,,, t rized i at re C MMENTS: vV ` �a 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual h of the li si r ements that pertain to this type of business. Authorized Signature'" COMMENTS: • I Town of Barnstable Regulatory Services SHE Tp� Thomas F.Geiler,Director Building Division swRArRrABi E 9 MUSS. $ Tom Perry,Building Commissioner rFp �!p1� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 F 508-790-6230 Approve Fee: �s- °r Permit#: HOME OCCUPATION REGISTRATION Date: Name: JOVr '� \buee,S Phone 4'508);�4a—gn a Address: 18,1 Village:-C, U,3 Name of Business:—n,S C Moe- S uil tL-t_ls Type of Business: (I%AASC-ty ' Map/Lot:`�,Sd 0 3 O INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pickup truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Applicant: Date: 3-a77-bC Homeoc.doc Rev.5/30/03 �y EXISTING SEPTIC COMPONENTS 6A LOCUS DATA TO BE PUMPED CRUSHED AND. / REMOVED FROM 4 SITE IN. / ACCORDANCE WITH TITLE 5. J m •, CURRENT OWNER D. TSERPES / / ��, ? _'PROPOSED 1500 BENCHMARK T SPYRIDOULA / ` / / / ` GALLON SEPTIC TANK CORNER OF ' N N m of / I CONCRETE STOOP. af LOCUS / ELEVATION 50.00 Q . , o � PLAN REFERENCE 221-17 DEED REFERENCE 5784-315 / •O T 5•, . • r.,. o . ZONING DISTRICT + RF-2 E [� - �. LOCUS MAP J / / �. NOT TO SCALE: FLOOD ZONE „X" -" .. c . ASSESSORS MAP -350 / vJ W" / k *. 16-.0130.._ 2 PARCEL 050 / OVERLAY DISTRICT NOT A ZONE` II I • -` - •' ° LOT AREA 24,183f S.F. q #152 EXISTN SITE �c _SEWAGE / a / \ \• DWELLING REPAIR PLAN 3, : / . 10 \ BOX \ 1�7 5215. \ \, MA RS TONS LANE CK N CUMMAQUID, ' MASS I DRIVEWAY DATE:.. • ,SEPTEMBER 12, 2016 �.; 7' r I I GARAGE LOT (IfN +ELECTRIC ; I I i f• ^v OWNER/APPLICANT: MAN OLE . - ;.t D:EMETRIOS TSERPES: I 1 '1 9 P.O. - BOX ELECT� I i CU M M AQU ID, M A 02637 ,I I i L O;T 6 508- 776-8907 HYDRANT I " a^ I I 2 i n 24,183t S.F. , SHEET 1 OF 2 PROPOSED w S:A.S, I PREPARED ,BY: 13.0'x25.0' ' 59•S6 20 W, E A S SURVEY, I N C �����ofs ,86 P. O. BOX 1729' ' °? EDWAARq STONE U' 0 20 30 40 L O T 18f , SANDWICH , MA, 02563 p �No. 28s8o 4 PH. (508) 888-3619 ; CELL (508) 527-3600 A GRAPHIC SCALE: L- O T 7 . EAS.SURVEY@YAHOO.GOM 1 INCH 20 FEET . � 7 SYSTEM DESIGN RAISE COVERS •TO WITHIN 6" OF FINISH GRADE •.END'RISER DESIGN FLOW TCF = 50.85 FINISH GRADE RAISE.TO WITHIN-6",: 3 BEDROOMS AT 110 GPB/D IN- GPD ' GRADE 49.6 ELEV. 49.2 FINISH GRADE :OF FINISH GRADE ELEV. 47.0 REQUIRED+ SEPTIC TANK /� //,C�� " GROUND ELEVATION' 46.0 ELEV. 47.0 36" COVER ___ _ 330 x_2" _ 660 `"GAL. s' 24" COVER 15' SEPTIC TANK PROVIDED 1500 _GAL. 13' ®S=0.07 ' 7' CADS= 0.02 TOP ELEV 44.00 ' 16'®5=0.124 IN. .y a IN 4 PVC SCH 40 - 4" PVC SCH 40 O O O . o o O OO OO o " INV.= " 2 MIN-3 MAX SIZE OF LEACHING.FACILITY REQUIRED ,�• V•= 48.25 " O O O �00 p p I 2" MIN 1/8'-1�4 _ 47.34 10"TEE 14 TEE INV.= 4 O Op 00 O O 00 DOUBLE WASHED ,DESIGN- PERC RATE __-----__MIN:/INCH 5'-7" INSTALL:' 47R14 6" 00001 o 0 0 00 00 PEA STONE LONG TERM APPL. RATE 0,74_GPD/S:F. " _ O OR FILTER;FABRIC H-20`D83; 4'-6 1 2, 4'-1 • LIQUID LEVEL BAFFLE . 3 OUTLET 0TW0' 4'-10"x8'-6"x3'-0" CHAMBERS ._ / " SIZE OF .LEACHING SYSTEM PROVIDED:' t• • H-20 > ; .3/4. DOUBLE 43.3.1 INV.=43.00• o WASHED STONE R` - _ 13.0' x` 25:0,) a i 330 = •0.74; SF/GPD 446 S.F. MIN. REQ. INV.-43.14_ m SAS ( D A TU M: BOT. 0' x 35.0')` a o I CH WITH 4' S x` o e e " 42.80 "T REQUIRED .. OVERDIG (23. NE VERTICAL DATUM: < NG-2 AMBERS WI 0 AROUND PROPOSED 1,500 GALLON • , - M$Lt / ,BARNSTABLE GIS .. H-10 SEPTIC TANK SET"ON- , ` . . 5".STRIP.=OUT TO � �. , '' "` ELEVATION- 34.5' y SIDEWALL,,.- 2(13+25.0) x 2 152S.F. • BENCH MARK USED:. LEVEL STABLE BASE C-2 HORIZON PER' NO GROUNDWATER 'ENCOUNTERED:, BOTTOM E = 13G 5 0' - _BO : x 2 325S.F. CORNER,OF CONC. STOOP f. ; . 310CMR 15.255♦3 _ TO LEACHING 477S.F. =' .F w 0.74 : AREA 353 GIRD EA ELEVATION 50.00 477S 16-0130 CONSTRUCTION NOTES. PROVIDED > 330 GPD•REQUIRED . :. ._. M' 353 GPD 1: .CONTRACTORS'/ INSTALLERS.SHALL VERIFY'GRADES AND - > NO • GARBAGE RESERVE GRINDER ALLOWED ' _• SITE CX. -SEWAGE ,ELEVATIONS AND SITE.CONDITIONS PRIOR TO COMMENCING _ � „, , �,' ` `' `. � . ( / ) , � . • WORK ON THE SITE. ` REPAIR PLAN 2.. NO DETERMINATION HAS BEEN MADE' AS TO COMPLIANCE w. WITH DEEDED OR ZONING REGULATIONS. OWN ER'/ APPLICANT cJ R IS TO OBTAIN SUCH DETERMINATION FROM'APPROPRIATE_AUTHORITY, 7SL 3. VEHICULAR TRAFFIC, PARKING OF VEHICLES AND PLACING' 1 CERTIFY THAT.1 "AM CURRENTLY.APPROVED-BY'THE D.T.H. #1 � ' MATERIALS OVER THE SEPTIC TANK,'DISTRIBUTION, BOX AND DEPARTMENT OF ENVIRONMENTAL PROTECTION TO CONDUCT SOIL .EVALUATIONS AND THAT.,THE,RESULTS,OF MY.SOIL DATE: 8- -16 S.A.S.'AREA IS PROHIBITED PROHIBITED ,: , , . GROUND ELEV. 47.0 � ��0N" EVALUATION ARE'ACCURATE AND IN' ACCORDANCE WITH 310' AA'' GENERAL NOTES: .. s< CMR'15.100 RO GH 1 7 " NO GROUNDWATER , . 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO°'D.E.P. ' C U'M M A Q U I D; . MASS TITLE V AND THE: TOWN OF BARNSTABLE RULES AND REGULATIONS __ _ _ _______ _ A _ FOR SUBSURFACE DISPOSAL OF SEWERAGE. < ED S N ERTI D.:SOIL*EVALUATOR r 10YR 4/3 2. AT. LEAST ONE ACCESS POINT OVER'TANK TEES SHALL BE LOAMY SAND' DATE: SEPTEMBER 1.2, 2016 ACCESSIBLE WITHIN 3" OF.FINISH GRADE,. WITH ANY REMAINING 6' `ACCESS PORTS,BROUGHT TO WITHIN 12 OF FINISH GRADE: `` "� INDICATES DEEP 1OYR 6 6 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE DTH #1A.« `. HOL E ,. LE a. ' OWNER%APPI:ICANT: :`;CAPABLE OF WITHSTANDING H-10 LOADING UNLESS. ` L_ �OAMY SAND ` OTHERWISE SPECIFIED. Mg tN� s 32" C-d1 " .:D E M E TR,l 0 S. TS E R P E S 4. THE EXCAVATION_ CONTRACTOR SHALL VERIFY,THE LOCATIONOF ALL P.O. BOX 252 5. ANY MASONRYUNIPTS�USED TO BR NG COVERS TO,GRADE s P-1 SIEVE INDICATES SILTY LOAM UTILITIES o D ID7/6 u „ BY DOWNSIEVE SILTY LOAM ' , OR WITHIN 6" OF GRADE SHALL BE MORTARED`IN.PLACE. F H �( � - C U M M A Q U I D, M A `0 2 6 3 7 6. FINISH,GRADE SHALL HAVE A MINIMUM OF 0.02 FEET PER N CAPE ENG. EL. 38.5 102 FOOT OVER THE S.A.S. AND.'DISTRIBUTION BOX. 5 0 8-7 7 6, 8907 7. SEPTIC TANK SANITARY TEE'S SHALL BE CONSTRUCTED OF GIST SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6". ABOVE,�',` NO MOTTLING., SHEET- 2 'OF 2' THE FLOW LINE-AND 'SHALL BE ON THE CENTERLINE'AND C_2 SIEVE LOCATED DIRECTLY UNDER THE CLEAN OUT MANHOLES . / NO' WEEPING 2.5Y 7/4 8. THE INLET PIPE INVERT ELEVATION SHALL.BE NO LESS THAN 'COARSE SAND , PREPARED. BY: 2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT m� 150" INDICATES ADJ. .GROUNDWATER. ELEVATION OF THE OUTLET PIPE. NO OBS. GROUNDWATER NO G.WATER 150" 9. THE SEPTIC TANK SHALL HAVE A MINIMUM COVER, OF 9 INCHES s • EL 34.5 EAS SURVEY, I N C 10. THE OUTLET SANITARY TEE SHALL BE EQUIPPED. WITH AGAS 0 D 0 B.O.H. BAFFLE, 4 INCHES IN DIAMETER AND CONSTRUCTED OF 4" PVC DAVE STANTON P. Q. BOX 1729 11. ALL PIPES SHALL BE SCHEDULE 40 PVC SEWER PIPE AND DEPTH.-TO BOTTOM OF HOLE 12,5' SOIL EVALUATOR SANDWICH' M A O 2 5 6 3 SHALL BE SLOPED 1/4 INCH PER FOOT MIN. EXCEPT FOR THE ED. STONE ,• FIRST TWO FEET OUT OF THE DISTRIBUTION BOX WHICH SHALL VARIANCES REQUESTED BACKHOE OPERATOR. PH. (508) 888-3619 12.6E LEVEL I • - REID ELLIS CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION NONE _ SOIL TYPE: 1 CELL. (508) 527-3600 TO EAS SURVEY INC,_FOR B.O.H. AND DESIGN ENGINEERS REVIEW. PERC RATE: <2 MIN. PER INCH AND APPROVAL. LOADING RATE: 0_74 GAL/SF/MIN EAS.SU R VEY©YAH 00:COM 13. MAGNETIC TAPE ON ALL COMPONENTS. q ,