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Home My WebLink About0047 FARM HILL ROAD - Health 47 FARM HILL, CENTERVILLE A �//// JAaOcuo `� ® UPC 12534 No.2_15_ N,�,,�s� HASTINGS, MN TOWN OF BARNSTABLE BAR-W Ordinance or Regulation WARNING NOTICE Name of Offender/Manager Address of Offender MV/MB Reg. # Village/State/Zip Business Name am/pm, on 20_ Business Address Signature of Enforcing Officer Village/State/Zip Location of Offense Enforcing Dept/Division Offense Facts This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WfII aFi ^D�� A LA Y 'J1il� SF� ='rl_'i_; F'NK -.COLD _`IFif •S U Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental W1111am F.WeldGQVWW Trudy Coxe A��r Paul Celluoci 8—� David B.Struhs comm"Gow ee SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION PropertyAddresa: 47 Far ill Road Address of Owner. Date of In$Peotjon: 3/2 5/96 (If difierent) Name of Inspector. Joseph P. Macomber Jr. '9�0 'Pee, Company Name,Address and Telephone Number. ► �;r J.P.Macomber & Son Inc. Box 66 Centerville,Mass . 02632 d, �® 508-775-3338 - �99 CERTIFICATION STATEMENT .. A_ I certify that I hive personally inspected the sewage disposal system at this address and that the information reported below�s.true, 1 and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper to ction and i;cif maiatenance of on-site sewage disposal systems, The system: Passes v. _ Conditionally Passes Needs Further Evaluation By the Local Approving Authority rails Inspector's Signature: Date: '—`�o . The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspectiom If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer,if applicable and the approving authority. INSPECTION SUMMARY: Check A.B.C,or D: Aj SYSTEM PASSES: __1/_ I have not found any information which indicates that the system violates any of the failure criteria as derived in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. BJ SYSTEM CONDITIONALLY PASSES: �. One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair,passes inspection. Indicate yes,no,or not determined(Y,N,or ND). Describe basis of determination in all instances. If"not determined",explain why not) /r 4,04—O The septic tank is metal,cracked,structurally unsound,shows substantial infiltration or exaltration,.or tank failure is Imminer:t. The system will pass inspection if the existing septic tank is replaced with a ponforming septic tank as approved �J by the Board of Health. (revised 11/03/95) 1 One 1Mnter Street • Boston,Massachusetts 02108, Is FAX(617)556-1049 • Telephone(017)292-SW i Printed on Recycled riper , SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 47 Farmhill Road West Hyannisport,Mass . Owner. Roger Shermont Date of Inspection: 3/2 5/9 6 B)SYSTEM CONDITIONALLY PASSES(continudd) e 06—X(: Sewage backup or breakout or hA static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken,settlad or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times g year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipes)are replaced obstruction is removed C1 FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Na Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health,safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: d�p Cesspool or privy is within 60 feet of a surface water 4& Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER,IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENM b10 The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. dW The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. 40 The system has a septic tank and soil absorption system and is within 60 feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility,and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 6 ppm. 8) OTHER 1 (revised 11/03/95). 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(oontiaued) Property Address: 47 Farmhill Road West Hyanni sport,Mass . Owner. Roger Shermont Date of Inspmuon: 3/2 5/9 6 • • D) SYSTEM FAIISs • AM I have determined that the system violates one or more of the following failure criteria as defined in 310 CMIi 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be aeoessary to corred the failure. L10 Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. &P Discharge or ponding of effluent to the surface of th*ground or surface waters due to an overloaded or clogged SAS or cesspool. NIAT45 Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. 4L Liquid depth in cesspool is less than 6"below invert or available volume is less than IN day flow. Gd�l Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped /Ln Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 foot of a surface water supply or tributary to a surface water supply. 6LO Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E)LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: .J,!Q The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significaat threat to public health and safety and the environment because one or more of the following conditions exist: r . N� the system is within 400 feet of a surface drinking water supP13' the system fs within 200 feet of a tributary to a surface drinking water supply la the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area(IWPA)or a mapped Zone II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional once of the Department for Anther information., (revised 11/03/95) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 47 Farmhill RafLd West Hyannisport,Mass. Owner. Roger Shermont• Date of Inspeotion: 3/2 5/9 6 e Ch�if:"the following have been done: Pumping information was requested of the owner,occupant,and Board of Health. „j<ous of the system components have been pumped for at least two weeks and the system bas been receiving normal Clow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. AfA-As built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non4anitary or industrial waste flow' , The site was inspected for signs of breakout. . All system components,'"chiding the Soil Absorption System,have been located on the site. AJQN:L The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum. -41 U size and location of the Sots Absorption System on the,site has been determined based on existing information or apP ted by non-intrusive methods. The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of Sub. Surface Disposal System. (revised 11103/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 47 Farmhill Road West Hyanni sport,Mass. Owner. Roger Shermont Date of Inspection: 3/2 5 9 6 • FLOW CONDITIONS RESIDENTIAL: Design flow-_&2Q_jpMns Number of bedrooms-L& Number of current saidenb: Garbage grinder(yes or no): �� Laundry conned to system(yes or no)--2: Seasonal use.(yar°or no):•j Water meter•readinp,if available: a g•� — A r Last data.of.00cupa=7 COMMERCIAL/INDUSTRUII. Type of establishment:_— /Jl* Design flow-_A,$,_•gallon/day Grease trap present:(yes or no)_&4 Industrial Waste Holding Tank present:(yea or no)—A)-4 Non-sanitary waste discharged to the Title 6 system: (yea or no)& Water meter readings,if available:_ Last date of occupancy: OTHER(DescrU)_ Last date of occupancy: 4.W GENERAL INFORMATION PUMPING RECORDS and source of informatio - ^ �! —,Z- g �S'� ulr System pumped as part of inspection:(yes or no)Z,0_5 V If yes,volume pumped L o _ Reason for pumping TYPE OF SYSTEM Septic tank/distribution box/soil absorption system . Single cesspool _ - _L Overilow cesspool ` Privy Shared system(yes or sio) (if yes,attach previous inspection records,if any) NIT Other(explain) APPROXIMATE AGE of all components,date installed(if lmown)and source of information: Y Sewage odors detected when arriving at the site: (yea or no)ei l (revised 11/03/95) 5 b _J SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(oontinued) Property Addreaw 47 Farmhill Road West Hyannisplo: t,Mass. Owner. Roger Shermont Date of Inspection:3/2 5/9 6 SEPTIC TAN&� � . (locate on sits plan) Depth below grade:—VA Material of constructionwVA_concrets metal_FRP,�other(esplain) Dimensionii Sludge depth--.&A— Distance$nun top of sludge to bottom of outlet tee or baffle:,d2&— 4 Scum thickmess: A) Distance from top of scum to top of outlet tee or battle: Al Distance from bottom of scum to bottom of outlet tee or baffle:�l Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity, evidgace of leakage,etc.) GREASE TRAP: (locate on site plan) Depth below grade: fA W Material of construction• concrete_metal_FRP_other(explain) Dimensions: AA Scum thickness:JV A. Distance from top of scum to top of outlet tee or baffler Distance from bottom of scum to bottom of outlet tee or baffle:AZA 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,etc.) Vd cAl"Ae-7eeN T S I (revised 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(oontlnued) PropertyAddresss 4.7 Farmhill Road West Hyannisport,Mass . Owner. Roger Shermont Data of Inspeotlon:3/2 5/9 6 TIGHT OR HOLDING TAN&AbYe— • (locate.on site plan) • Depth below grade:,, Material of construction:&concrete metal FRP_other(e:plain) Dimensions A Capacity: ns Design flow: ns/day Alarm level: Comments: (coadit!*of inlet tee;condition of alarm and float switches,etc.) DISTRIBUTION BOX:f,�MQ (locate on site plan) Depth of liquid level above outlet invert:�Q Comments: (note if level and distribution is equal,evidence,of solids carryover,evidence of leakage into or out of box,etc.) ,No' C- mr»eor4 PUMP CRAMBER:AlNe, (locate on site plan) Pumps in working order:(yes or now)A Comments: .. . (note cond�i °a of pump chamber;condition of pumps and appurtenances,etc.) 1049 64*2 046ET-s (revised 11/03/95) 7 1� SUBSURFACE sEXAOE D19POSAL SYSTEM INSPECTION FORM SYST::"' I'': errs (oontinued) ProperVAddress: 47 Farmhill Road West Hyannisport,Ma.ss . owners Roger Shermont Date of Inspection: 3/2 5/96 ,;'� •,�: SOIL ABSORPTION SYSTEM(SAS?:2 gocate on site plan,if po"US;excav but may be approximated by noa•intrusiw methods) If not dstarnsiaed to be present,explain: ?' leaching Pits,numbes:Q„ . .. . . leaching trenches,utimber length: leaching fields,number,dime°ions: overflow cesspool,iumber._L Comments:(note condition of soil,signs o!hydraulic failure, 1�.r! o.' ^'.'^^ mnd lion of vegetationLetC.) Soils: Sand & gravel; No signs of_hydrau�ic failure• o eve o p , V m 1• Ce col is structural V soun o repairs nee e cL- at-this time. CESSPOOLS: .. .. ... . •.. ... ... (locate on site plan) r� Number and configuration, G Depth-top of liquid to inlet invert: Depth of solids layer. Depth of scum layer• Dimensions of cesspool: Materials of construction: Indication of groundwater. _ • inflow(oessWol must be pumped as part of Comments:(note condition of soil,signs of hydraulic failvo., lc�•^_1 cr c "^ condition of vegetatioN etc.) . • N i n of h draulic failure or pondin . All vegetat�ori • . , orma o cesspools are s• rizc�ura�l y soun . No rupu a t is time PRIVY:J�N� (locate on SW plan) . Materials of A119 _ Dimensions• fl 9 Depth of solids:cCAM Commen :(note condition of soil.Signs of hydraulic failure, .on of vegetation,itC.) (revised il/03/.95) 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) PropertyAddresa: 47 -Farmhill Road West Hyanni sport,Mass . Owner. Roger Shermont Date of Innoodon: 3/2 5/96 SKETCH OF SEWAGE DISPOSAL SYSTEM: • include ties to at least two permanent references landmarks or benchmarks kuate all wells within 100, Centerville Ostervills Magstons Mills Water Company' 428-6691 Qk 117 CaRM ///Z/ Rd DEPTH TO GROUNDWATER Depth to groundwater,I Ej— feet method of determination ora praximado Pumped main cesspool. Cesspool not in water table Installed sys�em No water encoun ere a (revised 11/03/95) 9 01 -1.OWN OF Barnstable BOARD OF HEALTH 1'"',1.,,....:,,_,„Rw.SUfISUItFACR SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART UR- CFI FICATIUN - I -wi -TYPE OR PRINT CLEARL1'- PROPERTY INSPECTED STREET ADDRESS 47 Farmhill Road West Hyannisport,Mass. ASSESSORS MAP, BLOCK ANU11PARCEL # OWNER' s NAME Roger Shai p nt PAIN'D - CERTIFICATION r NAME OF INSPECTOR Joseph P. Macomi,pr---Jr.. COMPANY NAME J.P.Macomber & Son Itc. COMPANY ADDRESS Rnx Ah rente << Ai l ig-r MaSs . 0?6�33?, Street Torn or City State LIP COMPANY TELEPHONE t 508 ) 775 - 3338 FAX (508 790 - 1578 .. Car 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 tithe of :inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with toy training and experience in the proper function and maintenance of on- site sewage disposal systems . • �� ire ��, Check one: XXXXXXXXSystem PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 16 - 303 . Any failure criteria not evaluated a,re as stated in the FAILURE CRITERIA sectioll of this form. System FAILED* The inspection wilich I have conducted has found that the system fails to Protect the public !health and the environment in accordance with Title 5 , 310 CMR 15 . 303, and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signature Date 3/27/98 ' One copy of this certification must be provided to the OWNER, the BUYER ( where . applicable ) and, the BOARD OF 11LrAL1'1I, If the inspection FAILED, the owner pr operator ehall upgrade - the eyetem wiChin one . year of . the date of t'he ! inspection , unless allowed on W THE COMMONWEALTH OF. MASSACHUSETTS . DEPARTMENT OF ENVIRONMENTAL PROTECTION BE IT KNOWN THAT Joseph P. Macomber, Jr. i Has satisfied the Department's qualifications as required and is hereby authorized to use the title CERTIFIED TITLE 5 SYSTEM INSPECTOR as provided in 310 CMR 15.340 and Section 13 -of Chapter 21A of the General Laws. Issued by The Department of Environmental Protection. June 8, 1995 Acting Director"of the ' '•ion of Water Pollution Control T TOWN OF BARNSTABLE L^CATION WAGE VILLAGE ASSESSOR"S MAP &LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS l BUILDER OR OWNER PERMITDATE:~` COMPLIANCE DATE: Separation Distance Between the Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leac 'ng facility) Feet Furnished by i I 117