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Home My WebLink About0290 BAY LANE - Health Bay Lane, Centerville., A= 9 i Sl1/ o��.cvc`F°�y UPC 12534 �q No.2-153LOR HASTINGS. MN -_ — _ .:..:,.... �...Wn....,..m...Wr:._._. � ..:.:�.,.,._.�_ -- ... ,...._...........sue_... _ 10 I DATE: PROPERTY ADDRESS:Z8z 3.ay-L ,nQ-___________ 1996 --lute -y-illa-Uu� ------- _—QR •32------------------ On the above date, 1 Inspected the septic system at the above address. { This system consists of the followin 1 . 2 6x8,. .ce.aspools (25+years old?. I - Based on my Inspection, I certify the following conditions: 1•:=-Thj,s is not a Title Five Septic System. 2.•Split .System. The cesspool that is partially under .the garage takes the kitchen sink & 1 bath. The 2'nd pool on right hand corner handles the other bathroom. i • I i SIGNATURE: _ __ i Name:Jose2h P Macomber Jr____ - - I i Company:_Jg,.a,l�h_pji�LUULb_Qr_&_Son Inc. i ' f i Address._Box 66 Centerv_ille ---------- Phone:SL9-8 L-rLrLrL-333 8-------- --- i THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY JOSEPH rP MACOMBER & SON, INC. .Tanks-Cesspools-LeachfIeIds Pumped & Installed Town Sewer Connectlons P.O. Box 66 Centerville, MA 02632-0066 775.3338 775.6412 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION PORN , Address of property '282 r�vJP,--/ � p tuE C�� LLB Owner 's name l..iS►9 's/W re4ry Date of Inspection PART A CHECKLIST Check if the following have been done: y Pumping information was requested of the owner, occupant, and Board of Health. •None of the system components have been pumped for at least"two 'weeks and the system has been receiving normal flow rates during that period. Large volumes -of water have not been introduced into the system recently or as part of this inspection. A- As built plans have been obtained and examined. Note if the are not available with N/A. y The facility .or dwelling was inspected for signs of . sewage back-up- The p The site was inspected for signs of breakout. All system components, ' -excluding the SAS;; have been site. located on the The septic tank manholes were uncovered, opened, and. the interior pf the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of. liquid, depth of sludge, depth of scum. The size and location of the SAS on the site has been determined on existing information or a thods based approximated by non-intrusive methods. - The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance Of SSDS. N.o" c o.,,.t.Fo��i vt)1�_ TU 71_1 E 14OV-1 E;\l�E 2 T4 E�_/ A<(ZG X10- - fx P—ou v DS T=6 r2 -;7At L,c ►'l.) �'� �`� �c..(o►z+L 1S t�P.��S� �'�-TZ�tS -�O�S� �l.`aC• - . A 8u t LSD 1 C �wt t i l op: }� Z110111C_i 3_1 'bra t C.C_ Z ' es A, A.ZZNE>G C tz i tv Q�. 'Fc7(z rr W t w kz-E)4TL_Y ►Z-E=- oLX-,G " L t PG 0 F 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION FLOW CONDITIONS If residential Z+L number of. bedrooms enumber of current residents ES garbage grinder, yes or no laundry connected to system, yes cr no y seasonal use, yes or no If nonresidential, calculated flow: ,. Water meter readings, if .available: Last date of occupancy GENERAL INFORMATION Pumping records and source of information: O SOc�dLCG V v�-t ?OUT �CC_O♦2.ps � ) 1 F S ♦ Q.0 - System pumped as part of inspection, yes or no if yes, volume pumped Reason for pumping: Type of system Septic tank/distribution box/soil absorption system --)L_ Single cesspool 'T1v.4p SYsj--E%_„S Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) Other (explain) Approximate tion age of all components information: . Date installed, if known. Source of �O Sewage odors' ; - , 9 detected when arriving at the. site, yes or no 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SEPTIC TANK: 0toG (locate on site plan) depth below grade: material of construction: V concrete metal FRP of er ex lain � ( P ) 1 dimensions:„: �s sludge depth distance from top of sludge to bottom of outlet tee or baffle scum. thickness distance from top of scum to top ofoutlet tee or baffle ' distance from bottom of scum to bottom of outlet tee or baffle. ; Comments: (recommendation for pumping,, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity,._ evidence of leakage, recommendations for repairs, etc. ) DISTRIBUTION BOX: (locate on site plan) depth of liquid level above outlet invert Comments: (note if level and distribution is equal, evidence of solids- carryover, .. ... evidence of leakage into or.- out of box, recommendation for repairs, etc.) . PUMP CHAMBER: f�10l.9� (locate on site plan) t pumps in working order, yes or. no Comments: (note condition of pump chamber, condition of pumps and appurtenances, recommendations for maintenance or repairs,etc. ) 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMAT ION "N continued SOIL ABSORPTION SYSTEM (SAS) : (locate on site plan, if possible; excavation not re approximated by non-intrusive methods) quired, but. may be If not determined to be present, explain: Type _ . . .. leaching pits and number leaching chambers and number leaching galleries and number leaching trenches, number; length leaching fields] number, dimensions overflow cesspool, number 25YSTwLs 6 SIDE T��-� Comments: (note condition of .soil, signs of hydraulic failure, level of pondifig, co dition of. .vveggetation, recommendations for maintenance or repairs,etc. ).,_ uL l_0e CESSPOOLS (locate on site plan) : number and configuration g E E g��--r�,.� depth-top of liquid to inlet invert �� + depth of solids layer -.-� depth of scum layer dimensions of .cesspool r, materials of .construction indication of groundwater inflow (cesspool must be pumped` as ►40 4K-kp�L ,o,�-�� part of inspection) . , Comments: (note condition of soil, signs of hydraulic failure, level •of ponding, condition of vegetation,n,�recommendations for ma ' tenance o repairs etc. l-oo tG a-- CO AD iJ (-t18 � ��5 T��" � VU �o I D F�wt PRIVY: 'ROUT 'P4 ►�n (locate on site plan) Q0 KA materials of construction dimensions depth of solids Comments: (note condition -of soil, signs of hydraulic failure, - level of.ponding, condition of vegetation, recommendations for maintenance or repairs,etc. ) ' SUBSURFACE SEWAGE DISPOSAL_ BYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within loo ' �BUTT�e.S AeG O,rv-T�'c�.i,.tN f i .7 8R .c4•g y L DEPTH TO GROUNDWATER depth to groundwater r 2.0� TUC)S 0o—,;rA c.� a`. AT L Ea:xST l b r FV OM V OQ f77a O'k p P S-?ST A.4, TQ 12-00 UU QNvQ method of deteim.ination or approximation: i 12 SUBSURFACE ,-SEWAGE .DISPOSAL SYSTEM INSPECTION FORM PART C ;FAILURE CRITERIA ) � Indicate yes, no I , or not determined (Y, N, or ND determination in all instances. If "not de ter mined�'Describe basis''of"'J �O _ explain ,why.,noty Backup of sewage into facility? Discharge or ponding of effluent to the surface of the ground or surface waters? ' Static I' liquid level in the distribution box above outlet invert? Liquid depth in ��cesspool < flow? P 6 below invert or available volume< 1/2 day1 ..� � Required . q pumping 4 times or, more in. the last year? number of times pumped Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank failure. imminent? koIs an y portion of the SAS, cesspool or privy: ) below the high groundwater elevation? within 50 feet of a 'surface water? within 100 feet of .a. water supply? surface water supply or tributary to a surface within a Zone I of a public well? '•a:�:'.�" • within 5 0 feet of a bordering vegetated wetland or -salt marsh (cesspools and privies only, not the SAS) ? , ; within 50 feet of a private water suPP1Y well7 r less than 100 feet but greater than 50 feet from a private -water -_ supply well with no acceptable water ter has been analyzed to be acceptable, attachtcoanalysis? If the -well'-- for coliform bacteria, volatile Qrganic compoundspy , ammoniatni ' and nitrate nitrogen. analysis. gen f' 06/06/1995 12:07 508-428-3:�08 C.-.O.MM. WATER DEPT PAGE 03 i • 13 r KEY NUMBER <1728 > NAME <HAGERTY, HARRY, MRS > B-C 1 B-C 2 B-C 3 B-C 4 STREET 8 PINE TERRACE CITY BRONXVILLE ST NY ZIP 10708-5007 REF 1 REF 2 PHONE ( ) - REF 3 REF 4 METER NO.< 1650> DATE READING CONS STREET <BAY LN N0. 282> 12/31/94 682 175 CITY CEN P ST LOC 06/30/94 507 4 PHONE (508) 775-2677 12/31/93 503 102 06/30/93 401 18 ROUTE NUMBER 21 12/31/92 383 132 SERVICE DATE 08/14/89 06/30/92 251 31 METER . DATE 08/14/89 12/31/91 220 113 CAPACITY 7 06/30/91 107 14 STYLE T10 SIZE 2 RATE SCHEDULE KEY PIT PLASTI� X NOTE RS BACK DOOR PARENTS AT A/C#1711 ADDITIONAL CONS 0 ALTERNATE MIN 0 1 5 f i f None: Mrs Lisa Haggerty 775-2677 914-793-6865 Customer Code: t Address: 282 Bay lane shag To■n: Centerville . stare: Zip: Mailing address: 8 Pine Terrace Bronxville KY 10708 74 87 Arthur Ormsby . Notes: 8112193 pump 1 pool 145.00 . 913193 .413195 pull permit 50.00 515195 '..._Ormsby;-. Arthur T. . . ......775-26?7... 282 Bay_-Lane .- ............ '�Ox..� Cen. erville 0 _� -- �8/20/74-Pumpin.g-2_acid=$46.00-Pd.�f,3/ . -- ---- t 6/28/76-Pum in - 22.00-TPF- 4. -O-Aci.d-_ 26..00-Pd- 11/1 /78-Pump ing-$32...-oo-Aci-d-$26_..00.-P_d,-// .7 ___.____.___.__._--___._-_ 1J 14 �30- um�n :-'��_.Jo�.cid-26 0J-Pd�..)..I_...�.�.. . __f i nn _. a �17 /'lacy I i SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM PART D CERTIFICATION Inspector : Peter Sullivan PE Location : 282 Bay Lane, Osterville Date :June2,1995 Certification Statement I certify.that I have personally inspected the sewage disposal system at this address and that the information reported is true, accurate and complete as of the time of inspection: The inspection was performed and any recommendations regarding upgrade, maintenance and repair are consistent with my training and experience in the proper function and maintenance of on-site sewage disposal systems. I have not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15.303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. Please note the summary of recommendations as presented in this form. Lastly please note 310CMR:15.302 Criteria for Inspection(1) "The inspection is not designed to provide information to demonstrate that the system will adequately serve the use to be placed upon it by the new owner. " e ruly yo 0 eter Su Ivan PE Distribution: ki Original to system owner Buyer ° P"UER G . Board of Heath suu.:VAN NO. 29733 +sTsab t ��. FEs.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Di-nVniittl lVorkii Towitrnrtion Famit Application is hereby made for a Permit to Construct ( ) or Repair (>�) an Individual Sewage Disposal System at: 282 Bay Lane Centerville,Mass .......-•--•......................•--------••----------.....-----------.....---......•-----------. ------------------------------•-•-----•-•-------....---------------•-••-••••-••••----•••......•--- Location-Address or Lot No. .......... '------------------------------------------------------------------ ---------------------------------------------------------••-•-----....•-•-..................------ Owner Address J.P.M I acomber Jr,. ------------------------------------------...Adddresres- - 's------------•------------------------------- � nstaller UType of Building Size Lot............................Sq. feet Dwellin*X-XNo. of Bedrooms.___-___--3______________________---__---Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures _______________________________ __ W Design Flow--------------------------------------------gallons per person per day. Total daily flow--------------------------------------------gallons. GY Septic Tank—Liquid capacitv._____._..-gallons Length---------------- Width________________ Diameter__-..__.__--- Depth................ W Disposal Trench—No. .................... Width-------------------- Total Length-------------------- Total leaching area--------------------sq. ft. x Seepage Pit No__________ __________ Diameter-------------------- Depth below inlet.................... Total leaching area..................sq, ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water__._--_.----____-____.-. fi, Test Pit No. 2................minutes per inch Depth of Test Pit-_.____.________-__. Depth to ground water---_--_._._..__.______-. a -------------------- ---------------•.._.....---------..............------------------------------------------------------•-----............................ 0 Description of Soil........................................................................................................................................................................ v -----------------Sand. x.ay. l ----------------------------------..........-----------------------------------------------------------------------..........---------••-------. W ------------------------------------------------------------------------------------------------------------------------------------------------------------------- UNature of Repairs or Alterations—Answer when applicable----Omit-_-CeSap-0_9.],.S......Install__-1_-_9_.z`Q.0...... gallon tank, 1 -distribution box- and 1 -1 000-__cia-llon--_leeach.._pi-ir.-_-.-••.•••---. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complia ce has be it-ed y the bo d o health. Signe /�✓ `�- 3.L.3O.L95...... .:...... Date Application.Approved By .............. /(�//(�/��/ i( � -�'� f-r%�.... .. .........._......--------------.........._.......-...-----._............... -----...-.......Dace-------....... Application Disapproved for the following reasons- ------------------------------------------------------------------------------------------------------- .. ' ........... .............................................--------------------._-------------------- ----------------------------------------------------------------------- ........................................ Permit No. )s..-...� 2 _ e Issued 3— 3 S Dace No. _....... Fizz..$....3.0..-..00... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratinn for Di-aipn3ul Mirks TnnMrnrtinn Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (�) an Individual Sewage Disposal System at: 282 Bay Lane Centerville,Mass ........................................................•--••-------•-•....•-•------•------------• ••-----•----•-----•----------------------•--------------•-•-----------•-•--•-••--...............-- Location-Address or Lot No. Haa qe r ty-•...............•...--•-•--------••••-•---•------•----•--------- Owner Address W J.P.Macomber Jr. Installer Address Type of Building Size Lot............................Sq. feet .� DwellingXXNo. of Bedrooms---------3--------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ____________________________ No. of persons--_______._-______.____.-__- Showers ( ) — Cafeteria ( ) Other fixtures -----------------•---------- ---------- -------------- W Design Flow--------------------------------------------gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity-_-.--______gallons Length---------------- Width________________ Diameter---...__._-_-_. Depth................ x Disposal Trench--No. .._________________ Width..............------- Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No______________________ Diameter____-___.-...__./-- Depth below inlet.................... Total leaching area............._-..sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ~' Percolation Test Results Performed by.......................................................................... Date........................................ a .l Test Pit No. 1________________minutes per Inch Depth of Test Pit_--_____--.._-______ Depth to ground water...................... LL, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ 9 ------------ ....---......................................................................................................................................... 0 Description of Soil------------------------------------------------------------------------------------------------------------------------------------------------------•-•-----------•. xSand ..ravel--------------•---------------------------------•-----------------------------------------------------------------------......-----•... UW ............................... ----------------------------------------------------------------- -------------------------------- -•-----------•--••--------•.....••-------•---------•-•----••--------- Nature of Re airs or Alterations—Answer when applicable.__PMi-t- Cesst000ls-.----Install---1--1.5Q0---•.. ga�lon tank, 1 -distribution box and 1 1000 gallon leech pit -------•---•- ----••••----•••---•------------•---•-•----•--••-••-•--•-••-••--- --------- --------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complia ce has be iss�Ied y the bo .d o health. J Sig ------------------ .. ..... 3/30/95 1 --------------—Date-----------... C-r ..3 -.20 �s Application.Approved BY ---------------------- -------- a------ --- -- ..-.. - - ------...--- ... .......... .....-----"--ire-'-'----------- Application Disapproved for the following reafonf- ------ ----------------------- ----------------..-------------------------------................................................. -----------------------_.........._.....----------------------------------------------------------------------------.:_--- -..._---------------------......------------------------------ ........ -- ........------------ ^ V^ Date Permit No. (u _ .. / -.... — Issued -3.'.....-�� c� l�..S Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C ertiftra e of C�nmytianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (XXX) J.P.Macomber Jr. -... - -- - - -by -------...--__..._ --- ----- ---------------------------------- --------- Instiller at --------------2.8.2....Bay Lane---.Centerville.-------------------------------------------------------------------- ----- ---- ------ ------------------- -- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ----------- dated ....3.....' --J.._`-- - ------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCJ10 A�TISF CTO RY. �� j /^ DATE--------/.. -------- -- ------------------_._..- .... --------------- - Inspector -- -E� .... f THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH S'- SS/7 TOWN OF BARNSTABLE Dispnoal Workii Tnnotrudion "rrntit Permission is hereby granted...J--P-aMaOomp)Qr T-r o----------•-----------------------•---....------•----------------•------------................ to Construct ( ) or Repair F4X) an Individual Sewage Disposal System at No...... 82 Ba-Y-..Lane••Cexlter�l _1.7.'----------------------- Strcet j7____� 'O as shown on the application for Disposal Works Construction Permit No______ __ ated/A:_.____ .__..___ r_'-._.-_-.------ Board of Health DATE---------------------J FORM 36508 HOBBS dt WARREN.INC.,PUBLISHERS N