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HomeMy WebLinkAbout0212 HARBOR HILLS ROAD - Health 212 HARBOR HILL RD., CENTERVILLE A= i - Town of Barnstable P#_/ aP� Department of Regulatory Services ►a�►.t� Public Health Division Date Met Y V 200 Main Street,H nnis MA 02601 LID � Date Scheduled Time Fee Pd. �(/ CD Soil Suitability Assessment for Sewage Disposalsw Performed By:-b kJ /t�(7G►)Z L� Witnessed B � . LOCATION G NERAL INFORMATION b s : Location Address 21 Z {10 1100V 1 (�S ,�.� Owner's Name Address 'Ll 16er H fif 0) Ut Map/Parcel: ?�7 Assessor's Ma l: Engineer's Name V l �d��j1�Bar NEW CONSTRUCPION REPAIR Telephone# �4 " Land Use Slopes(46) Surface Stones Ht` Distances from: Open Water Body 0 0 t ft Possible Wet Area ��d ft Drinking Water Well L�o t t: Drainage Way t ft Property Line L 0 fi ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) a GROUNDWATER ADJUSTMENT ` EXISTING GROUNDWATER LEVEL BASED ON TOWN OF BARNSTABLE GIS DEPARTMENT RECORDS. INDICATED GW MIW INDEX WELL CIW-29 i ZONE READING DATE 8.2 2007 11-00 READING 00m F ADJUSTED ADJUSTMENGW 14.3 I Parent material(geologic) ` W' � Depth to Bedrgclt Depth to Groundwater. Standing Water in Hole: tv Weeping from Pit Face e Estimated Seasonal High Groundwater See ii W s e DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: See Depth Observed standing in obs.hole: __ _ in. Depth to soil mottles: In. Depth to weeping from side of obs.hole: In. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level..�,,,,,•�, Adj.hictor— Adj.Groundwater Level PERCOLATION TEST Daty G Z6l1V- Thne 11L3©!tt4 Observation Hole# Time at 9" Depth of Pent G6C 4L Time at 6" 14 14 Start Pre-soak Time @ Time(9"-6") End Pre-soak 14 1 3 Z Rate MinAnch t . ?f ",Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division - Observation Hole Data To Be Completed-on Back----------- lJi S , **If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. `! Q:\.SEPfIC1PERCFORM.DOC SOIL- TEST LOG DATE OF TEST: JUNE 20. 2006 APPROVED SOIL EVALUATOR: DAVID D. COUGHANOWR. #461 WITNESSED BY: DON DESMARAIS. HEALTH DEPT. PERC NUMBER: 12228 TEST PIT 1 PAARENT MATERIAL:GROUNDWATER ENCOUNTERED AL OUTWASH PERC AT 64 in - 2 MIN/INCH IN C SOILS ` + ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSELU MOTTLING 44.70 0-10 Ap SANDY LOAM 10 YR 3/2 NONE FRIABLE 41.37 10-40 B LOAMY SAND 10 YR 4/6 NONE FRIABLE 40-13B C MEDUIM SAND 10 YR 5/4 1 NONE ILOOSE 33.20 NO GROUNDWATER NCOUNTERED TEST PIT 2 PARENT MATERIAL:E PROGLAC AL OUTWASH 2 MIN/INCH IN C SOILS ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSELU MOTTLING 44.00 0-12 AP . SANDY LOAM 10 YR 2/2 NONE FRIABLE 12-36 B LOAMY SAND 10 YR 4/6 NONE FRIABLE 41.00 s 36-138 C MEDUIM SAND 10 YR 5/4 NONE LOOSE 32.50 "- Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) l r DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munselp Mottling (Structure,Stones',Boulders. onitn t Flood Insurance Pate Map: / Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? q eS _— If not,what is the depth of naturally occurring pervious material? �._. r Certification I certify that on r10J LKq s (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent a� tN OF the required trainin ,expertis a d experience described in I10 CMR 15.017. o DAVID oG Sept 2 ?.80� P o D. • � � � Date .� Signature " COUGHANOWR /CENS�� 0 . EVA1.uP Q:\.S.Ep nC1PERCFORM.DOC TOWN OF B,AR/NSTABLE LOCATION did Ra,6 Rib f/.-d SEWAGE# C?065� VILLAGE C^enicrr,dle ASSESSOR'S MAP&PARCEL 137 7 f •- epgq INSTALLER'S NAME&PHONE NO. L.+i+l o ,os� SrF'/-,e Sid►�e� 7�S Q�fit$ SEPTIC TANK CAPACITY /cam LEACHING FACILITY:(type) _6-.x Ci i�er 33a (size) NO. OF BEDROOMS OWNER C I b PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility a �� 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 L,aching Facility(if any wetlands exist within 300 feet of leaching facility). feet FURNISHED BY Pei 1C., plc,;, q � -e s� 9� Pk �C-A 1. ` G ± D C_3 r �� '1 1 3 ®,3r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Applicattou for �Dtgo!gal *pgtem Cougtructiou 3permit Application for a Permit to Construct( ) Repair(YJ Upgrade( ) Abandon( ) ❑.Complete System ❑Individual Components L icationtA�`�sP or A� oI�)IS J �� _VI 1 � Owner's IVameaAddrls�Address, Tel.No. — �r�� Assessor'ssMav/PaYr �a � v� �h�t5 KaG��� Jl P l Installer's Nam Address,and Tel N.oI . Desi ner's Name Address and Tel.No..5®r 36 4—0 9qq 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(min.required) 3 S n, gpd Design flow provided 3 Q (� gpd Plan Date Number of sheets Revision Date 2006 Title Size of.Septic Tank 1000 Type of S.A.S. �� �( $ 'yC 7- l..Q/ae to I n�'At,�.�,C� Description of Soil S L x pt-At N 1 Nature of Repairs or Alterations(Answer when applicable) r0s (SEX A-® Plus 0-F A 0 , &9,24o 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 yofflelth. - Signed .c Date 9 6 Q Application Approved by Date �— S — —006 Application Disapproved b Date for the following reasons Permit No. 2—n Q A^ 3 6, Date Issued zoel ---------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS .CDC Certificate of Compliance +. THIS IS TO CE,RT}IFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ()C ) Upgraded ( ) Abandoned )by t�JM �- t�U�'J\(�Sc��n �r ✓ C... at' i a Y' t S �Z ` � � 1 has been constructed in accordance 2aoy- 3G_r - Zoe with the provisions of Title 5 and the for Disposal System Construction Permit No. dated I Installer Designer 2.a g► N Su N I C6 #bedrooms 3 Approved design flow 3 3U gpd The issuance of this permit shall not be construed as a guarantee that the system will func'on.as desi d. Date f 1 Z — o Inspector V� No. � 0 0,r� — �j(-0-1 Fee ©� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS Migpont 'patent Con5truction Permit Permission is hereby grantedto Construct ( ) Repair (K ) Upgrade ( ) Abandon ( ) System located at P k a `�`{Q.�b N 1 � s C� O�c C�, Q�� V► e , —' and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this perm Date 2 b C� �j Approved by No. LO tJ 3�s T .b Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: SPUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for �Digo5ar ,�)p 5tem Cou0tructf ou,:permit Application for a Permit to Construct( ) Repair V) Upgrade'( ) Abandon( ) ❑.Complete System ❑Individual Components + Location,Address or Lot No. Owner's Name Address,and Tel.No. (Oct yv Assessor's Map. rcel '7 AlpAy 7_D t91' k(4'Y- 4 j 1 I i!> t�C�e���C a l+_C J 1 Installer's Name Address,and Tel.�1 o. i� Designer's Name,Address and Tel.Nos �M (C.p r�S� `mil" �O- T2C " u» PO $ci so ov\a Type of Building: Dwelling\ No.of Bedrooms Lot Size sq. R. Garbage Grinder Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided �'� gpd Plan Date Number of sheets Revision Date 9 - 6' 2 0 05 Title Size of,Septic Tank p Q C) Type of S.A.S. '�f_7 X �► ��C Z.z Z n C k t Description of Soil s o s Pc LN N Nature of Rep irs orAlterations(Answer when applicable) cT�-( ecb - y t,l 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 Signed �t Date j G Y4, Application Approved by Date ' _ Z006 w kr i` f s,Application Disapproved•by/ Date for the following reasons � Permit No. �--' 1 -� � " -- S Date Issued � '13 % dUIF - - ToWwo Barnstable- - ' o Regulatory.-Services- Thomas.-F.-Geller,Director BARNsrABsa; MAS . PublicAlealth:DivisioII :a6g9. �® Thomas-McKean,Director 200 Main Street;Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&.Designer Certifieation Form Dater 0�� ..Sewage.Permft#___ Assessor's Mapu'arcel Designer: D f C Installer: U do 1n �t' - v i e. Address. LA�`16 G_,V-\QkC_ �i CCU C Address: T'D Si a was issued a permit to.install a (date) : OnsWler}� septic system at }_ - `r �` lS '" ' based on:a desigg drawn by (address). : ' c dated---- ( '� ) deer er I.certify that.the septic system--referenced above was-installed substantially according to'. the"design, which may-include-minor-approved changes-such":as-lateral-relocation-of the _. distribution box and/or:septic I certify that-the s tic. . septic.-system SYstem referenced above was uistalled with major.changes (i.e:.:.. greater than-.1.0' lateral relocation of the SAS or any vertical relocation of any component_.: of the septic systefnj but m a6tbidaiice with State&Loca1-Regulations: Plan Tevision or:: certified as built by designer to follow. � �ZNaFAq c q AV yG �� o D. (Installers Signature) COUGHANOWR No. 1093 STSk vsr'V sgN)rWP� (Designer's:Signature) '. (Affix.Designer's Stamp.Here) PLEASE RETURN TO- -:BARNSTABLE PUBLIC HEAL`i'H: DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE. ISSUED. UNTEL BOTH THIS "FORM AND:AS-BUILT CARD ARE. RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVLSION. THANKYOU. -- - Q:Health/Septic/Designer Certification Form 3-26-04.doc... Hazardous Materials Inventory Sheet Checklist 1156 c/ .Date -Physical Street Address-Check database to ensure it exists Working Phone Number --Actual Amounts-(le.gas being used to fuel machines,thinner to glean brushes all count as hazardous materials) C/ Storage Information-location of storage,,how long is storage for? If none,note.that. 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 disrnsePo u ith oti YOU WISH TO OPEN A BUSINESS? 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, 1-FL., 367 Main Street, Hyannis, MA.02601 (Town Hall) xsx emwa ewaj mvwas oa rim, APPLIGANT'5 YOUR NAME:-ft ,> 60 Cp Q' T: '" BUSINESS YOUR HOME ADDRESS: 'A (� BOR .,i Ll-� fZ. way ow TELEPHONE # Home Telephone Number NAME OF NEW BU­�;i NEZuS- I lVriP& TYPE OF 6iJSINESS: 1 Cti IS THIS A HOME OCCUPATION XEs. IVO . Have you been given app #Fi3r�-t` ild' Ives NO ADDRES'S'OF'BUSINESS 2 2 0�2 r�� :MAP/PARCEL NUMBER_ . c �. 0—r--:> 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 o Barnstable. This form is intended to assist you in obtaining t y g he information you [nay need. You MUST GO TO 200 Main St. — (corner of mouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your usiness in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed.of any permit requirements that pertain to,this type of business. Authprized Signature** COMMENTS: 2. BOARD OF HEALTH This individual has b n infor ed of the ermit requir ments that pertain to this type of business. thorized Signatur * MUSTCOMPLy WITH ALL COMMENTS: . HAZARDOUS MAMMA IONS 3: CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has.been informed of the licensing requirements that pertain to this type of business. Authorized Signature.** COMMENTS Date: IQ / S / o1 TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: tffQ1jn iDg' f1f;rqV6 BUSINESS LOCATION: 912 6 RR d02 h i Log R..D 65417LAL L1-5 INVENTORY MAILING ADDRESS: �9/2 Gr_iv/Fri v�'�c E TOTAL AMOUNT: TELEPHONE NUMBER: .5©f 2 SO 90 �P CONTACT PERSON: 1�iA60 191\1PR,42L EMERGENCY CONTACT TELEPHONE NUMBER: 509 280 ?d r2 MSDS ON SITE? TYPE OF BUSINESS: fAi T"A/�- 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) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine 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 Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, 2 Lacquer thinners (inc. carbon tetrachloride) 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 may be toxic or hazardous (please list): Laundry soil & stain removers (including bleach) Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-.BUSINESS s `� < .s L,:sztt•far„;r ? t. a: S s ♦. ♦ � -vr.r rd �11 . L —r - Date: tm / S / 0-1 TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: /tNP2 A 1q( I'H'77N6 _ BUSINESS LOCATION: g12 �'�'���'� h ��� D G�''� fi2U��� INVENTORY MAILING ADDRESS: /2 G"9�1 �" G G '� D 6T,v F TOTAL AMOUNT- TELEPHONE NUMBER: 50 9 2 go 10 CONTACT PERSON: ifL 61\'1P2AA6 EMERGENCY CONTACT TELEPHONE NUMBER: 50 9 O ?0D 7 MSDS ON SITE? TYPE OF BUSINESS: f4 Ti NG 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) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Misc. Combustible Jr Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt & roofing tar PCBs. Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) __._ NEWS USED- Any_othe.r.pr_o_ducts wi#h -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 may be toxic or hazardous (please list): Laundry soil & stain removers M �� 44 (including bleach) '� c GA `�)U C.� Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents a,w jj a06 Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS TOWN OF BARNSTABLE ,,,LOCATION L.�i r O H �'.git�(L l�1 LLS 1Zc�SEWAGE # `��- fa` � Cf 0.v►�� O 9 VILLAGE �'Sr�tL,�IS` ��3 — �SSESSOR S MAP LOT L�= •� `J INSTALLER'S NAME PHONE NO.* ° � SEPTIC TANK CAPACITY ► 000 LEACHING FACILITY:(type) L (c I_, (sue)10 100 0 NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER Pv �KT-W. NBUILDER OR OWNER /rsterJ CAL a DATE PERMIT ISSUED: -' —� DATE COMPLIANCE ISSUED: � VARIANCE GRANTED: Yes Now. �jr � �. e � �r �� � � c ` a 1� = / �� ��©w ti 'vLi,T'�!� �� Town of Barnstable 0 Department of Health, Safety, and Environmental Services aattx , : � Public Health Division AIED"A°�A P.O. Box 534, Hyannis MA 02601 Office: 508-862-4644 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health February 8, 2000 Mr. Kevin Colly 212 Harbor Hill Rd. Centerville, MA 02632 , NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY CODE II,MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE BOARD OF HEALTH'S NUISANCE CONTROL REGULATION NUMBER ONE The property owned by you located at 212 Harbor Hill Rd., Centerville was inspected on February 4, 2000, by Jerry Dunning Health Inspector for the Town of Barnstable, because of a complaint. The following violations of the Nuisance Control Regulation Number One Regulation and the Sanitary Code II were observed: 410.062 Uncovered dumpster located at front yard and bags of garbage observed on the ground. You are directed to correct these violations within 3 (three) days of receipt of this notice. You may request a hearing if written petition requesting same is received by the Board of Health within seven(7) days after the date order is received. However, this violation must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order could result in a fine of not more than $500. Each separate day's failure to comply with an order shall constitute a separate violation. You are also subject to non criminal citations of$40.00 for the first violation and$15.00 for each additional violation. Tickets will be issued daily until the violations are corrected. PE ER OF THE BOARD OF HEALTH c ean Director of Public Health KS:q/wpfiles.order.jerry ke, a.6 3 a- NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00. STATE SANITARY CODE II. NUNINIUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE BOARD OF HEALTH NUISANCE CONTROL REGULATION NUMBER ONE The property owned by you located at a(l Ir ,r was inspected on � _ q- 6o 1997, by fr gr Health Inspector for the Town of Barnstab e, because of a com Taint. The following violations of the Nuisance Control Regulation Number One Regulation and the Sanitary Code 11 were observed: You are directed to correct violations within of receipt of this notice. You may request a hearing if written petition requesting same is received by the Board of Health within seven(7) days after the date order is received. However, this violation must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order could result in a fine of not more than S500. Each separate dav's `allure to comply with an order shall constitute a separate violation. You are also subject to non criminal citations of 540.00 for the first violation and 515.00 for each additional violation. Tickets will be issued daily until the violations are corrected. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health No.... , �...... ' Fias...................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..il.............OF...�J�`'r.1NT ..........--r -...... Appliratinn for Diipnsal 'Works TonstrWiun rrrmit Application is hereby made for a Permit to Construct , or Repair ( ) an Individual Sewage Disposal System at; .� ............................................................. ......... ....................................� }.. ,o. Local Adess r Lol No O r Address Installer Address Type of Building Size Lot.. �_15......Sq. feet U Dwelling—No. of Bedrooms--- ..........................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building No.. of persons............................ Showers fir YP g •--------------------------- p ( ) — Cafeteria ( ) p' Other fixtures W Design Flow........P.C7...........................gallons per person er day. Total daily flow......a3 ?____.............._gallons. WSeptic Tank—Liquid capacity/00Pgallons Length.9�6". Width.4.'.l O. Diameter................ Depth25_'4-`' x Disposal Trench—No..................... Width.................... Total Length............. I........ Total leaching area....................sq. ft. 3 Seepage Pit No..424. . Diameter......J.Q__2. Depth below inlet......H_........ Total leaching area_4?�4_r�sq. ft. Z Other Distribution box Dos' tank ( ) '"' Percolation Test Results Performed b :t. // y......._ Fa:l.? F-3a: .. .......-•---- Date.... 2-�R.l.g.'.r�....... Test Pit No. I...-<.e..minutes per inch Depth of Test Pit.....J.0_........Depth to ground water..../.111Q,t1a. Lz. Test Pit No. 2...E_2.minutes per inch Depth of Test Pit.....f-.0_!..... Depth to ground water._.,.-�./-//e_ 04 ti fF.......................... ............r......-- O Description of Soil.T:�-_- _...... . 4 .._ !�!H.._ ....6�...�._... ..-j0 t o -GL '4rRC C O.a.�`SrE � . -7y..1N��.....��'..�►�lD Tv l=/�1�,. G l�.d►-l1EC_ x j�_ � ao :-• �s-�-� :::::::::::.._........ �r� --._ V Nature of Repairs or Alterations—Answer when applicable..._.. 11�- .......................... ............... ........... .... ......---........---------....--•-----------,--------...--------....._..-•--•--•--•--...-•-------------..._.................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of LITL:,-: 5 of the State Sanitary Code—The undersigned f ther agrees not to place the system in operation until a Certificate of ompliance has bee issued th o rd o lth. gned ... ' ......... ............................... ..`� � ••6 /�/t�• `_ ate PPlication A roved B ----•.................... ..... :................ PP Y ..__.. �._ ........... .. ................................ Date Application Disapproved for the following a ons:.............:.................................................................................................. ...........................................................................•-•---....---•--...........-•----:_.............._....---......................_...............---••-............--•-•-•••-- Date PermitNo.......................................................... Issued........................................................ 1� Is N, 96- ioG4 'If FEB.................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............OF... ...................................................................... 'Appliration for. Disposal Works Tonstrudion 11rrmit -Application is hereby made for a Permit to Construct (Y),or Repair an, Individual Sewage Disposal System at: 4L .................. .................... Location-Address C or Lot No. . .. ....... LI-1), M...... 0 Address------------------------------ p. "Installer Address Type of Building Size Lot..Z'2!? .......Sq. feet U 0­4 Dwelling—No. of Bedrooms._........ ...........................Expansion Attic Garbage Grinder Other—Type of Building ............................ No. of persons............................ Showers Cafeteria Other fixtures Design Flow_.......UC-72........................gallons per person per day. Total ow......7"! 5 C ....................gallons. Septic Tank—Liquid capacity,�d4Z (4 lions Lengthj��'6_"_. Width I ty-,-)fl ............. Diameter................ Depth.f'5.'.4-.'.' Disposal Trench—No..................... Width................... Total Length......___-_-........ Total leaching area....:------­......sq. ft. Seepage Pit Diameter_ Depth below inlet.....!?......... Total leaching area.? :5sq. ft. Z Other Distribution box 01-1) Dosing tank Percolation Test Results Performed by..11! , F':Al 1 1=F24, �J ......... Date_.L�Z2 /af5 Test Pit No. L.A5��._�'...minuteis per inch'"....D`e'*p"t`h­'o"i"*Ti­e's­t....Pit_.... Depth to ground water_......i*1"'c'?t­.:*,"'"E" . .... Test Pit No. 2..�.2...minutes per inch Depth of Test Pita..?..;,:: :........ Depth to ground water... ..... .................__ % - ......................... ....................................................... -=—, 0 Description of Soil.:T'.:,� ­T /- 2 . . ....................................................................... . 4 A............................................................ ................................................ ------------------------------ .............................................. ........... ............ ... .............7......................................................1....... ........................................................... .......................... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ....................................................................................................................................................................................................... AgTeement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System iWaccordance with the provisions of'AI TLU 5 of the State Sanitary. Code—The undersigned further agrees not to place the system in operation until a Certificate of,Compliance has bee4,-issued by', the-h-o'Ard o Ith. gnedA ... i.. .......6.1..7... ................................... ...... Da te.. Application ication Approved By................................z.... ............................... .................... .................... Date Application Disapproved for the follouling reasons:.....................................I........................................................................... .......................................................................................................................................­­.......................................................... Date PermitNo................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS 'y 1 BOARD,, OF rHEALTH .......................................... ..... ....................................... ........................ Trrfifirati-lof f�11 Unxr , THIS IS TO CERTIFY That thg�nd'vidual( ,Sewage Disposal'}System constructed ( ) or Repaired ( ) by...............................•---•._........................ .. ................................................... �-x!`a�:.... . -. ..:............... ............. install« at............................................�:�.... b......._....i... o. ....�.`..............----•--•-•-......................._. ............................................ has been installed in accordance with the provisions of T1TIy 5 of The State Sanitary Co �a� Described in the application for Disposal Works Construction Permit No.. 6:!j q 4................. dated..... ... .............?..................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..................,�' ............................................ Inspector...... ........ ........................................... fj = zQ7 — OlS • - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH y ► � f`-' �I � o� �tj�L} ........... ..................OF.........................,................................_.......................... 7-S No... ...... Fes........................ �is ,asttt urks %ans r tan, rrmii Permissionis hereby granted------•-----•.............••-•••................ ..............`......................................................................-- to Construct (�) or Repair ( ) an Individual Se age Di , sal Systeg 2 (c3� Ib f(rl Re 5 r� tI� 1�'I VI at No................... ;......_.._.... .................._...._.._... ...... ...--•.......... } Street ` i KJ T I bG t . as shown on the application for Disposal Works Construction Permit No.....................Dated........... . ....J.. ,............. -� .......................................... ..................................._...................._ „-._. Board of Health DATE.............. •--- ...-•...................:.............................. NOTES CONTOURS o EXISTING LEACH PIT IS TO BE PUMPED. EXISTING - - - - - - - 50 N ° HILLS ROAD Q D COLLAPSED AND FILED. MINIMAL GRADING PROPOSED = OP INSTALLER MAY MOVE VENT PIPE TO °mL A A DIFFERENT LOCATION. w INSTALL A 40 MIL POLYETHYLENE BARRIER °Z� BETWEEN THE LEACHING GALLERY AND LOCUS o z w THE FOUNDATION AS SHOWN ON PLAN. O o W BUJ e 4 Z d O W Q GARBAGE GRINDER m \ CENTERVILLE. MA rwm m-icD e c> `n �� IS NOT ALLOWED LOCUS M A P j i �\ \Oct WITH THIS DESIGN. NOT TO SCALE ww< O m = 0 z zw LEGEND o w~,j � U) o< r TP-1 �� �. W m wo w°C c� m W BENCH MARK m;=D� �� ��3 EXISTING _ 1000 GALLON ucn Ju°z ~ ? �' 3 w° TOP OF FOUNDATION �2 z <cn Z w z cn cD / s \� SEPTIC TANK z �3 = W ° �= ELEVATION = 46.35 i `aa mZ m 43 w �0 U J o � '- o� BARNSTABLE GIS DATUM 4�/ ' LOT 1� EXISTING\`� > L EACH PIT O Z z 4 m N Q � z < ao Qz \ =o in Ln F = W Q w w \ —1 0 0 AREA = 7500 sf+- v >W w 3¢ /P-2 UTILITY POLE DRAIN 09 Wz < O° w \ _ / t ®� O F-- O I�� WATER/INE�WATER O TEST PIT D-BOX O 43 GATE W �0 �^ j �� \\ C JED ( DECIDUOUS CONIFEROUS W � a� X w c��` OR � O ��� P�J��P TREE oho TREE m \O�j d�b 12-M 12-P w IY�11 � � � 1 A-�\ �/ ¢I- (� (-a W N (n L` \ 1�£t O �q INCHES. LETTER DENOREFERS TO TES ETYPE .TER IN �ZIw Wz OI m in \ S v^ 3 _ ` k 2 �1 / O-OAK M-MAPLE P-PINE C-CEDAR ch- X Z Q �z W ` OZ� /' �ZN OF Mgssq CN OF MASS z F z z CD o m a� ��44 o� DAVID cyGN �o` DAVID a0 //�mm COUGHANOWR " COUGHANOWR e o I- J No. 1093 z W Z' o � `�\� o S t, 0 2 wo cnw i m � 33 f L X 7 FL x 2 f L / F01STS o, CENS� �O W m zo + 0 m w w m � m m LEACHING GALLERY �m Fti � e TAR a o m X 1 VEN J X w w PIPE P-e k1 S Cad ' PeP4 �, Z6d�_ <Ln FLAN AN W z \1 G®- Ted SEWAGE DISPOSAL SYSTEM PL z J z SCALE: 1 in = 20 f L � �j -TO SERVE EXISTING DWELLING � z 20 0 20 40 EST. RUTH ANNE COLBY L 0- 30 0 m < ~ VARIANCES REQUESTED OWNERS OF RECORD 0 z f , r� MAY BE GRANTED IMMEDIATELY BY HEALTH AGENT OR HEALTH INSPECTOR. 1 2� �C� Igg5 212 HARBOR HILLS ROAD 0LL �J r ° m �'' X 310 CMR 15.221(7) - COMPONENT � �� CENTERVILLE. MA ¢ i LLJ l9 W DEPTH TO FINISH GRADE. 36 in IRON PROPERTY ADDRESS cl + MAX REQUIRED - VARIANCE TO .� U) ASSESSORS MAF_13_ I PARCEL 2 4$" 6�7 in OF COVER REQUESTED. ( 43 TRIANGLE CIRCLE LL 31k7 CMR 15.211(1) - SOIL ABSORPTION SANDWICH MA 02563 PLAN BOOK 1t�3 PAGE 127 �, Z 508 364-O8J4 DATE SEPTEMBER 2. 200B 0 p Z Z SYSTEM TO CELLAR WALL. 20 ft MIN 0- W N X ' W REQUIRED - VARIANCE TO 11 f t JOB #E T E-2 J 2 6 PAGE I OF 2 VERSION: w w SEPARATION REQUESTED. THIS PLAN IS BASED ON AN INSTRUMENT SURVEY AND IS INTENDED SOLELY FOR INSTALLATION OF THE PROPOSED SEPTIC SYSTEM DEPICTED HEREON. FOR ANY OTHER CHANGES TO'PROPERTY INCLUDING PLACEMENT OF ADDITIONS. SHEDS, FENCES OR SWIMMING POOLS. OWNER SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR. SOIL TEST LOG DESIGN CALCULATIONS DATE OF TEST: JUNE 20. 2008 APPROVED SOIL EVALUATOR: DAVID D. COUGHANOWR. #461 DESIGN FLOW: 3 BEDROOMS X 110 GPD = 330 GPD WITNESSED BY: DON DESMARAIS. HEALTH DEPT. SEPTIC TANK: 330 GPD X 2 DAYS = 660 GALLONS PERC NUMBER: 12228 USE EXISTING 1000 GALLON SEPTIC TANK IF IN SOUND STRUCTURAL NO GROUNDWATER ENCOUNTERED CONDITION. IF NOT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) TEST PIT 1 PARENT MATERIAL: PROGLACIAL OUTWASH DISTRIBUTION BOX: USE 3 OUTLET D-BOX. PERC AT 64 in - 2 MIN/INCH IN C SOILS SOIL ABSORBTION SYSTEM: A 38 Ft x 7 ft x 2 Ft LEACHING GALLERY CAN LEACH ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER A6ot = ( 38 x ? ) = 266 sF 44.70 (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING Asdw = ( 38 + 38 + + 7 ) x 2 = 160 sF 0-10 Ap SANDY LOAM 10 YR 3/2 NONE FRIABLE Atot. = 446 sF Vt 0.74 x 446 = 330.04 GPD 41.37 10-40 B LOAMY SAND 10 YR 4/6 NONE FRIABLE 40-138 C MEDUIM SAND 10 YR 5/4 NONE LOOSE USE A 38 Ft x Ft x 2 ft GALLERY. Vt = 330.04 GPD > 330 GPD REQUIRED 33.20 L EACHING G�L L ER Y SOCAT TO LE 1000 GALLON SEPTIC TAW DIMENSIONS AND DETAIL NOT TO TEST PIT 2 NO GROUNDWATER ENCOUNTERED PARENT MATERIAL:ENCPROOUNTERED OUTWASH USE CULTEC RECHARGER 330 CHAMBERS OR EQUIVALENT usE EXISTING H-10 UNIT SCALE 2 MIN/INCH IN C SOILS CROSS SECTION VIEW SEPTIC TANK IS TO BE PUMPED DRY ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER AT TIME OF INSTALLATION AND IS TO (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING 2 to 41n 2 1n PEASTONE IN EXAMINED FOR STRUCTURAL 44 00 IN EXAMINED INSTALL NEW PVC OUTLET 0-12 Ap SANDY LOAM 10 YR 2/2 NONE FRIABLE 24 In 3/4 In TO TEE EOUIPPED WITH A GAS BAFFLE. 12-36 B LOAMY SAND 10 YR 4/6 NONE FRIABLE 26 In DEPTHrIVE 1-1/2 In GRAVEL 41.00 1 In 36-136 C MEDUIM SAND 10 YR 5/4 NONE LOOSE 32.50 16 to 52 1n 16 jr, Tf1 PER 84 1n C o 0 i INSTALLER MAY SUBSTITUTE AN APPROVED GEOTEXTILE o GROUNDWATER ADJUSTMENT FABRIC IN PLACE OF THE PEAS TONE LAYER SPECIFIED 4 LO EXISTING GROUNDWATER LEVEL BASED ON TOWN OF BARNSTABLE 1 GIS DEPARTMENT RECORDS. 6 INDICATED GW 11.00 In A INDEX WELL MI.W-29 INLET OUTLET ZONE C COVER COVER READING DATE DUNE. 2007 READING 6.2 , M �:�.wMIMC ' x'4 ADJUSTMENT 3.3 3IN^DROP —► Il FLOW LINE - ADJUSTED GW 14.3 — NBTES FROM BUILDING 10 to 14 - tn D-BOX 48 to LIQUID GAS LEVEL BAFFLE 1) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. 2) SEPTIC TANK TO BE PUMPED DRY AT TIME OF SYSTEM REPAIR AND CHECKED FOR STRUCTURAL INTEGRITY. INSTALL PVC OUTLET TEE FITTED WITH GAS BAFFLE. 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REOUIREMENTS CROSS SECTION VIEW OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15). 4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES BEFORE EXCAVATING FOR SYSTEM. SEWAGE DISPOSAL SYSTEM PLAN 5) EXISTING LEACH PIT TO BE PUMPED, COLLAPSED. AND FILLED. 6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST IN PLACE. -TO SERVE EXISTING DWELLING 7) ETECH ENVIRONMENTAL APPLIANCES. AND BIANNUAL PUMP ING OF THE SEPTICS THE ONK OW FLOW FIXTURES AND RUTH ANNE COLBY 8) SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT 42 HARBOR HILLS ROAD CENTERVILLE, MA .�( PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. ECO-TECH ENVIRONMENTAL 9) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH 43 TRIANGLE CIRCLE SANDWICH MA 02563 SIX INCHES OF CRUSHED STONE HAS BEEN PLACED TO MINIMIZE UNEVEN SETTLING. ETE-29261 SEPTEMBER 2. 2008 212 - SECTION — SEWAGE-, C rHyrJ--/y a 1 ••f _ .. .. - - - - C TANK �j — D BOX �j —LEACH O F FON T _ I { W OF I18TO)A" WASHEDSTONE t :> _. -t /� ., :... _- _-..__:: - _. -.- °.. ��- f•• USX', I - 31 � r 7 • OUT• IN• / I ( 1 OyT. 4-0I O 4A11 • TANK : ELEV. E V II LE ELEV. ELEV. • a ELEV. ELEV. fs•"' - ..• - ,{ yam'. s,�,.-S lFl l C ':�i� - _ . f — n Le OF VG". - 4V :' -WASHED STONE. - L30 TEST HOLE LOG. -P�513'? - }{ TEST BY Faatbor�k.PE. WITNESS TEST DATE 12-9-SS DESIGN. 3 BEDROOM HOUSE O'. �'-���E;6 r.t0i` r` T.H, a► 1 f1 T.H. 2 04 f71�11✓u_J►d� Q - _— ELEV. .% ELEv.46,,a NO PERC RATE.' �2.MIN/IN., DISPOSER DISPOSER IS c 40 IS , �� FLOW RATE I I C- {GAL-/DAY) coext SEPTIC TANK 3a 1 - 4qlq 5 ♦o REQ'DSEPTIC TANK SIZE C70t� LEACH FACILITY SIDE WALL �t7?7� =.I�75•� (Z5) 7 Ir..� G/D:. BOTTOM Pa;Y-7r� 78. (I,o) = 7g,s G/D: �� L--OT �� p:,xvr4 _ / s io. }� TOTAL 96�.� Ise '7- F_ I a ine � Oi.� I O • w I USE- LEACHING 144 '�i 14 3�i'� 1 ID 'F� �2 WATER ENCOUNTERED -- _ O NOTES-• (UNLESS,OTHERWISE NOTED) ir- 1.DATUM(MSU+TAKEN FROM rA N PI S QUADRANGLE MAP � -- - -- 2:MUNICIPAL WATERAVAILABLE 3.PIPE PITCH:Vs"PER FOOT 4.DESIGN LOADING FOR ALL PRE-CAST UNITS:AASHO- _I� -44 �� OF S.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES:(1)FT. 6:PIPE JOINTS SHALL BE MADE WATERTIGHT r _. ARNE H.- 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. STATE ENVIRONMENTAL CODE TITLES ALA _ �. T�-1tb Qt�►.+J FoL 'PY�?t �c a� :k�0`GIC C��L`C A�a� .5+iO�J�� - OF P LOCUS: - s -SITE PLAN _,. _ t RNE _. RE NGINEER ;+�� _ r a. ar LA. . .` h� I V07 - - e It _28R down cape engineering' PREPARED FOR: - y CIVIL ENGINEERS \��sj� r E �y rta 2./���;C�` - (EXISTING - �I)1$� R -YOR. Il a BOARD OF HEALTH' LAND SURVEYORS CONTOURS ).....:.--- IbC�f.l�Tl� �26 sCALF 1 ZOI IZ 6 542 REG DER (PROPOSED)—O—O—O-0-•: APPROVED DATE MA j Y Y� { ' r `GATE s .t _