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Home My WebLink About0062 AUTUMN DRIVE - Health 62 AUTUMN DR., CENTERVILLE A=168-052 No. 4210 1/3 ORA ESSELTE 10% O O O 0 ,r Health Complaints 29-Mar-02 Time: 10:30:00 AM Date: 3/28/02 Complaint Number: 3177 Referred To: LEE MCCONNELL Taken By: FLORENCE SMITH Complaint Type: ARTICLE XXXIX HAZARDOUS WASTE Article X Detail: Business Name: Number: 62 Street: Autumn Drive Village: CENTERVILLE Assessors Map-Parcel: Complaint Description: There is a car at this property leaking fluids. This car was in an accident and was towed to this house, it belongs to the owners son. This property is beside wetlands and to the right of the driveway there is a town right of way with two catch basins and an underground tank. Mr. Gunnery does not want you to give out his name. Actions Taken/Results: LM investigated complaint 3/28/2002. Spoke with owner of house Jack Threldeld about vehicle. He explained that the vehicle was just in an accident and was towed to his property. The car had appeared to have leaked a small amount of fluids but was mostly caught in a container. There is already one unregistered vhicle on property, which I explained was his limit. Jack explained that once the insurance adjuster is finished the car will be removed. There was nothing in the backyard which I could see that would concern the health or safety of the public. Investigation Date: 3/28/02 Investigation Time: 3:00:00 AM 1 Health Complaints 29-Mar-02 2 i (Pg— OS-), TOWN OF BARNSTABLE LOCATION � �Vy� O� -P SEWAGE # VILLAGE (f-e ASSESSOR'S MAP& LOT INSTALLER'S NAME&PHONE NO. n,u c442e_S'gOC2 SEPTIC TANK CAPACITY S-U LEACHING FACILITY::(type) 4,✓7 iL fit'.$ 7d (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by Nl 1�xisrirl� N 10 341- /3 TOWN OF BARNSTABLE LOCATION SEWAGE # —' VILLAGE_ -ei I ASSESSOR'S MAP & LOT — INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY S o U LEACHING FACILITY: (type) 16"Z I W,4%d/r�' (size) NO.OF BEDROOMS -!!� BUILDER OR OWNER X PERMITDATE: ^ COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by - - I O o JZ j G 42154 " 19 L17 No. !i M Z Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS ZippYication for 3igpogaf 6pgtem Con!5truction permit Application for a Permit to Construct( )Repair( )Upgrade(i/<Abandon( ) ❑Complete System DKJjtdividual Components Location Address or Lot No. (g a A*L-CU1N\ Owner's Name,Address and Tel.No. Assessor's Map/Parcel 1 f (a_O� Installer's Name,Address`,and Tel.No. Designer's Name,Address and Tel.No. Vh Type of Building: Dwelling No.of Bedrooms_ Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 1_5711 0 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank /'6V Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) �T \� � "A tQ 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 th Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has be-. o ealth. Signed Date 3 Application Approved b Date :51 P;Z Application Disapproved for the following reasons Permit No. Date Issued g MM No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pplication for Migo0al,*pgtem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade(VrAbandon( ) El Complete System Individual Components Location Address or Lot No. , �0-�X)w\ Drh Owner's Name,Address and Tel.No. G =rLCr Div Assessor's Map/Parcel �( L�_Os�)_ (�-'gU T=-Lc- t_ Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms_ Lot Size sq. ft. Garbage Grinder( ) Other Type of Building f No. of Persons Showers( ) Cafeteria( ) Other Fixtures >t Design Flow 0 gallons per day. Calculated daily flow ` gallons. Plan Date Number of sheets Revision Date Title - 'Size of Septic Tank. tc I VvC r- . QCU Type of S.A.S. �- Description of Soil �VIC� C.01a��_ Nature of Repairs or Alterations(Answe/w hen applicable) G-W'c, Cl :. r Date last inspected: r' ,r 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 t e Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has bggo,48s�t®d-ley-t ' a1'd ofHealth. `r Signed Date Application Approved b ii Date Application Disapproved for the following reasons Permit No. Date Issued ——————————————————————————————————————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 ��--C_Aae V C , at 0 A�tiW� C f �C7 thasl been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ,_ dated, Installer Designer C' The issuance o 's e 1 not be construed as a guarantee that the s e will function as desned. c Date Inspector — r�————————————————————————————-— No. l / Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS ligozal *p! tem Construction Dermit Permission is hereby granted to Construct( )Repair Upgrade Ve-)'A' bandon( ) System located at wn (1 C and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date oft rmit. Date: '` c� Approved b , 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL e. WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) hereby certify that the application for disposal works construction permit signed by me dated concerning the property located at 1�1�`'��- r�� C=P w meets all of the following criteria: The failed system is connected to a residential dwelling only. There are no commercial or business ` es associated with the dwelling. :4 a LASS I and the percolation rate is less than ore equal to 5 minutes r inch. e soil is classified s C pe q pe There are no wetlands within 100 feet of the proposed septic system ; A /There are no private wells within 150 feet of the proposed septic system •/There is no increase in flow and/or change in use proposed -,-411ere are no variances requested or needed. The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] the S.A.S. will be located with 250 feet of any vegetated wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) B) G.W.Elevation 16t a +the MAX.High G.W. Adjustment.�� _ ' � � 14 DIFFERENCE BETWEEN A and B SIGNED : DATE: � �3 [Sketch proposed plan of system on back]. q:health folder:cert p r ............-.:_-- ........... THE COMMONWEALTH OF MASSACHU!§ETTS BOARD HEALTH 0 F........pll� ........... ....................... Application -for Uiiipviial Warks Towitrurtion Prrutit App ation is herebv/Sade for a Petinit to Construct or Repair an Individual Sewage Disposal S t ;)Is I Coe, 4.............. ............................................................................................. V. .... ocat n ress /of No. A 12 o/ of .... ...... -------- ------ --- ---------................................ 1, ...... ...........................it.,....... r Xot,ft. r - dres� ) 01P / k .. . .................. ................................................................ ..........................#•-----i111....... Installer Addr 6, ess pe of Building Size Lot ........Sq. feet Dwelling—No. of Bedro oms...*.. tm#-------------------Expansion Attic Garbage Grinder ( Other—Type of Building -------------------------- No. of persons.---.------_-_____----__--__ Showers Cafeteria ( Other-Lxt.Qres ------------------------------------------------------------------------------------------------------ ......................... Design Flo ....... ...........................11 � -gallons per person per day. Total daily flow_______4--Tb--------------------gallons. W Tank Liquid capacity_ arneter-------------- Depth.__.._._-_..... Septic �- -gallons Length_____________-- Width..........._...; Di, Disposal Trench—Vo..................... W�j ................. Total Length_-_---_-____-____-.- Total leaching area---------- .........sq. ft. let_....Seepage Pit No.-___-______________ Diamete .................. Depth below I t ............. Total leaching area----- ----------s(l. f t. Other Distribution-box Dosing to P Percolation Test Results Performed b - ------- ...... ........ ... .... Date.. ---------- Test Pit No. I----------------minutes per in Dept of est Pit_...._...._..___._.. Depth to ground water...___...._.._.__._.___. fi Test Pit No. 2----------------minutes per inch Depth of Test Pit------------------ Depth to ground water._.-.------.-_.--------- h i g ta f inch Dept 0es t ---------- ------- --- a k ------ 0 OST �--- ...... .... .. ........ . Description of Soi------------6-----7.k -------------------------- e,7�y----------- ---------- U /J----1 a-------------- ................. -----------0-4 -4 -------- - --- ----- ------------------------------------- 42 ------------------- --- ------------- Z - Z2��6� U Nature of Repairs or Alterations Answer when applicable._..----------------------------------- ------- ------------------- --------------------------------------------- -------------------------------------------------------------------------------------------------- --------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewag isposal System in accordance with the provisions of Article XI of the State Sani , y Co e—The un ersigned her agrees not to place the system in operation until a Certificate of Compliance has, issued by d of th. Sig 7— 7S` --- -------------------------------------------------------------------------- ................................ Date Application Approved By---- !... ..... .. .. . -tm- 7------------ Date Application Disapproved for the following reasons:----------------- - - --------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Date PermitNo......................................................... Issued....37 J........................ Date ---------- --—---------------------------------------------------------------- No.1.4if..------. Fmic.,...K.................. K THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEA�TH k' , Appliratiutt -fur 11-4 oiial Worku Tomi#rurtiott Vrrmft �17 App ation is her'eby'r ade for a Permit Ito Construct ( ) or Repair ( ) an Individual Sewame,-Dispbsal S IB t� � - � i �� Y 1 I.E Loca. �n ress t No. ..... ----• — o r e'r ,' dr s r Installer Address d e of Building Size Loth.......................Sq. feet U Dwelling—No. of Bedrooms.• _ ...................Expansion Attic ( ) Garbage Grinder ( )per.., Other—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a'' Other_.xt res ------------------------------------------------------- W Design Flow_ _______ ______________________ gallons per p.er'son per.day. Total daily flow_-_-__ '- --�------------._........gallons. WSeptic Tank Liquid capacity . -gallons Length-----------------width................ Diameter---------------- Depth.__----_.-.-.--. x Disposal Trench 0. .................... � _--__-_____-_--__- Total Length._............__.... Total leaching area--------------------sq. ft. Seepage Pit No......:.............. Diamete .......... Depth below •nlet... __...______ Total leaching t rea.___. -__...--____sq. f1. z Other Distributiot4ox ( ) Dosin to ) * - �'/i a Percolation Test Results Performed by. � . ...... ........ Date._r /t-X .' '..F""'_---.... Test Pit No. 1________________minutes per inch Dept of Test Pit-------------------- Depth to ground water..-.-.--.----.-.-----_.- ' fX4 Test Pit No. 2-----_----------minutes per inch Dep h of Test Pit.................... Depth to ground water--..-.--.---._----__---- - (� -�-r O.. Description of Soil-----------Q .I � -- .•. "' - � �!w _ -A. �'`.. } --- x ~..' ,e -,, ��. �- >,.�r�,� `- �;;��r's------------ V Nature of Repairs or Alterations Answer when applicable----------------------------------------------------------------------------..-_.--.-.-.---_-.... ---•----------------------------------•------- ----------------------------------------------------------•-----------------------•-------••---•------------•------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewa Disposal System in accordance with the provisions of Article XI of the State Sani ry Co e—The un ersigned her.agrees not to place the system in operation until a"Certificate of Compliance ha . issued b d of Sig d J. -------------------------------•--••---•--- .... -- Date A lication A "roves B -------------------------- ' �2 � -7=�PP PP Y -- ; Date Application Disapprov"ed for the following reasons:............................ ................................................. ......•--•--..._ ............. -------------•-----•----•=----...----------------•--•---------•-•---------••-------------•---•.•---•---•..•-••••------................---------.---------------------•------------•------••------••-•--- Date PermitNo......................................................... Issued........................................................ Date gr. THE COMMONWEALTH OF MASSACHUSETTS ' BOARWo F HEALTFL ............OF.... .. !•....... �rdifiraf Tomptiaurr IS IS TO ER , That e idual e e Dis al S� em ucted ) or Repaired ( ) t.,.E ----- ` --------------------------------•------- bY + staller at*!_ h i t. ' . --.. has been installed in accordance with the provisions of-Ar '��, XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit`No.•.(W- -----.(9---4""_-----_- dated---iJ-- .r7 - ......�"7-4- ........ w THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... ' THE COMMONWEALTH OF MASSACHUSETTS � BOARD F HEA H F .. .. ..................... .. No. .:-------- Biquul rki u r#iutt prruti# .� ` . . . .Permission is hereby granted�_._ ___� ..... . ......._ •..................................................................... to Con -'u ( ' > Repair ( Individ S ge Dis s 1 µSyst at NO. k! ."! 1,t,�.e•14. tri.e..�e *----- --- ------------------------------------- Street as shown on the applicationyfor Disposal Works Construction mit, Dated ________________ _....._._ - -- Board of Health DATE-------=-----------•----•--------------•--------•-------------•----------•-•-•• FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS LOC_AT1C)t-1 SEW6,C4 ; PERMIT 1JO. it�l.ST_L�LLER�S IJ�,ME_�_ADDRESS. __ __ _ f. -----DIN►TE_ PERNA17_ ISSUED � . i � ` . a � 9, ►i��. �I'� '" wr},M �j� I! Y. 1. � 1�, � 'f r _ , .' �1E. } ,M�},�yy �f�, F a _ ��} a �� £ ��' �. - 1�• 07 Lit oe to ql lee r## f -SZ 00 �'i a �1�} yI��I k,�•+�+ ` .. h r..' •t�•_ . ... ' � � I. , ��,�//¢ I � • t.. .. 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