HomeMy WebLinkAbout0127 HIGHLAND DRIVE - Health 127 Highland Drive
Centerville
A= 190 —056
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/// SMEAO
No. 53LOR
UPC 12543
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TOWN OF BARNSTABLE
LOCATION SEWAGE #r" ��►5 "��
VILLAGE ASSESSOR'S MAP & LOT t S o - - L S 5
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) 2 ` c-~ 7 o (size) -5-u"
NO. OF BEDROOMS
BUILDER OR OWNER
PERMITDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 7. 7 ' 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—'r c,J;L 1,
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b` � -�'
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SENDEQ: COMPLBTE THIS'SECTION COMPLETE THIS SECTION ON DELIVERY
0 Complete items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. f ' u ❑Agent
■ Print your name and address on the reverse X t a, �� C- . �� ❑Addressee
so that we can return the card to you. B. Received by( Rnted Name) C. D e o Deli ry
■ Attach this card to the back of the mailpiece, G'-.
or on the front if space permits. //
D. Is delivery address different from item 1 ❑ 5/
1. Article Addressed to: If YES,enter delivery address below: ❑No
3. Service Type
0 Certified Mail ❑Express Mail
E ❑Registered W Return Receipt for Merchandise
❑Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes 1
2. Article Number _
i liri 006`0 ,Qp;pp ;1911638
(Transfer from seMce/abeQ [75 11 PS Form 3811,February 2004 Domestic Return Recelpt to2sss-o2-M-164o j
E UNITED STA7!.;k?Q TAIL SERWC . ,• ;,.�^ aY.:.. ....',,;
z
cad*.
• Sender: Please print your name, address, and ZIP+4 in this box •�
I
Town of Barnstable
' r Health Division
O n Street
I 200 Mau
}_I van❑is._N4A,02601t
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Town of Barnstable Barnstable
THE
OF Taw
Regulatory Services Department AD-Am�'�ac
ft
'Ni
Regulatory
Public Health vision
�90���6�q. ,gym b Hl Di 11 ..
f0 MAMA' 200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
January 3, 2008
Mary & James Hayes
127 Highland Drive
Centerville, MA 02632
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 127 Highland Drive, Centerville, MA was inspected on
September 27, 2007 by Troy Williams, certified Title V Septic Inspector for the State of
Massachusetts.
The inspection of the septic system showed that the system NEEDS FURTHER
EVALUATION under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the
following:
Cesspool blocks are corroding creating a high potential for a collapse.
You are ordered to repair or replace the septic system within Two (2) years from the date
of this notification.
Failure to repair/replace the septic system within the deadline period will result in future
enforcement action.
r
PER ORDER OF THE BO RD OF HEALTH
T omas McKean, R.S., CHO
Agent of the Board of Health No oil P q � Y{
Q:\SEPTIC\Letters Septic Inspection Failures\127 Highland Drive.doc
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TROY 'WILLIAMS
SEPTIC INSPECTIONS
Certified by MA Department of Environmental Protection (508) 3b5-1300
19 Hummel Drive
South Dennis, MA 02660
COMMONWEALTH OF MASSACHUSE'I"I'S
EX[,,CU'I'1VF; (OFFICE OF, ENVIRONMEN'FAl. AFFAIRS
1)EPARTMEN'1' OF F.NVIRONMEN'I'AL PRO'17FC1I0N
rlTi_.r 5
OFFICIAL INSPEC"HON FORM -- NO -1- FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL. SYSTEM FORM
PART A
CVAU'l FICA7'ION `
Property Address: 127 Highland Drive
Centerville
0%%n e i s Na nt c: Mary Francis Hayes Estate `w
c/o Terence Hayes
1 ti
Owner's Address: Y '
590 Slough Road,Brewster, MA 02632 -'
September 27 € ` -
Date of Inspection: Se p 2007
s N
Name of Inspector: Troy M. Williams
Company Name: Troy Williams Septic Inspections cal w
Mailing Address: 19 Hummel Drive i
I ✓
South Dennis,MA 02660. .,
Telephone Number: (508)385-1300 :t7
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal systern at this address and that the information reported
below is true, accurate and complete as of the time of the inspection. "file inspection x%-0-perfonned based on my
training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP
approN ed system inspector pursuant to Section 15.3.10 of Tille 5(310 CM12 15.000). f he syslenr
Passes
Conditionalls Passes
Needs further Evaluation b) the Local Approving Aulhorit)
Fails
Inspector's Signature: �J Date: _ o
l he system inspector shall submit a copy of this inspection report to the Approving Authority(Board of I lealth or
DEP)within 30 days of completing this inspection. If the.systein is a shared systern 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 off ice of the
DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving
authoritY.
Notes and Comments
Although system meets the minlmum requirements set forth by the Massachusetts Department of
Environmental Protection,certification is not 10 be construed as a guarantee of future working condition
of systern,piping or components. This Inspection represents the conditions of the system on the Date of
Inspection noted above.
"'Uhis report only describes condilionskaf the time of inspection and under the conditions of use at Ihal
time. -1;his inspection does not address how the system will perform in the future under the same or different
conditions of use.
Title 5 Inspection Form 6/15/2000 paee 1 of 11
"Vilge 2 tit
FORM — NOT !"Olt 'V01,11IN'ARY A�S EN'l('S
S(IIISIIIzPA(,E sl!"Wii (,W �VSTJ
NVII rN ITC"M ION :M+'01tivl
i'l ul►cjlY gtltlressi 127 Highland Drive
Centerville
Mary Francis Hayes Estate
11;uc u!luspcc(iu1l: September27,2007
Insllcclioo Sonl4uary: Cilecit r1,11,C,1) ill- IL/ AI.Wi S collllllcic l►II tlI Sccllull I)
A. System Passes:
IulvC nol found any inliliillilliuu w1iiell iullicalcs shill . ny of illc Ii11111iC GI'licilil IICSI jillCll III to LNIit
15.�03 or iu ]III CMIZ -S.30,1 exist. Ally lililujc Cjilcji;l I cvilillaicil aie indwilletl below.
Conuuellls;
Il. sysicol ('uulliliuuillly I'asses;
Uue ur nlol-C syslclll cmillloilcills its llescllbctl ill Ilse "Colµlllional l'ilss"seclloll need Io Ile jCplllced of
icllaiicll. TJIG system, kilmll.colnItirliUn lll'lbe iclllacel(Iilu u1 lellair, as appiovetl ily isle lloilnl ill. tills►, will pills.
Ailswel yes, kill W llol (1ciciillinctl(Y,N,Nl)) in ill( it rbe fIllow6%slalel►tcki(s. It'' kill ileleiluiticil" please
cicplain.
SC1111i: look is iuClill and ovCi 20 years lilil" ur IIIC sejllii: idol. (whet i iiiCllll of fish) is sliuclu(ally
uusnunll, cxllibils subsl;ulliill inlillielion of exlillialillll of lank i;lilui(; is ills I1will. sysitlll will Ililss itisl)CCl(oll it IIIC
exisolig lame is iClilai:t;d wills it ctlilylyikig scplic lanl; its allpjovell by Ill ,loilld of lleallli.
to inelill sel)lic lank will pass ikisl)cc(ioil il*ll is sliocllljlllly sotloll, n Icakiug anti If it ( CjliliciUe u(Lnlnplinncc
ilillicalikig Ilwl Oil; Imik is Icss Ihnu 20 yca js oltl is avlliJal,ll;.
NI-) exl)loo:
obse1villilll1 ol'scwllgi I)iiGlillll tit Musk oil „(sirs!sliliie willti (Cvcl Ill IIIC ilisljlblllloll l)ox disc 10 hlukell of
obs'lillcl.ul piec(s)Qi lisle]p it i)lakell, scilletl nj ,nevell l.lis(iibillinn box. syslcui-wlll III►Ss Illsl)eclli?)1 11(wish.
al)I)(ovili of I�ui►jtl t'f llCill(Il):
f - ---'—' h(ll� II;I)Illp(s) fill; il'.l)Ii1CCll
---- , sljuililll! is (4;I�luvell
lllsliil)tllioll llux i Icycictl llr icillacell
NO Cxl)lililk:
-- fllC sys(cill iluiiCLI l)twilling jlloiit lllail el U11!OS it yl:ilj dill: Ili lliokcki tit obsliuclul pi,p (s), '►'Ile syslelri will
l)tlss inslWelion (Willi itl)pjoval of jjl c Boiljtl lll,Jlelllll!): � �
_.._._._l)4llliCll llil)l(s)ill I-eldilecll
- =obslillcltiotl►is iCli nvei)
. 2 1i
011.11 It DIAL INSPECTION MiORIVI - N(),I, It'(' VOr.ONTtMY ASS1t:SSIVIEN 1 S
S1113S11rt1�ACT, S1�WA(1011� 1)1S1,0SAI., SYSTEM INS
Ili;CTI0N 'I 01tM
('I��t'1'111'��:t1'�'r(.l'N (cunlinuctl)
1'I t�perlY AtItL t si 127 Highland Drive
Centerville
Mary Francis Hayes Estate
Hate of lnspeclilto: Septem6er27,2007 -
(:. /I urll,el I valitaliu,i is Itctluil cil l,y like lloiij 41 411-lll::t1411:
v� Cuntliliol,s cxlsl which lquiic hlitlic}.cvilltliiljoll by !lit; �lu;li(I tlI'il(;itItIt ill ill del Ill ticiril)1ille (1 lilt,sysirril
is fiuling In piolccl public Itcalili, sa(cly of tl,l cilvilomilenl.
tiU
1. System will bass uuiess Illtaltl of !!call!! ticferutiucs ill accaltlancc will! 31Q CNllt 1531}3(l)(b) Illt►1 lllc
syslelu is lilt( fuucliolkilkg Ill a uuy►oel- wllicll will pi'(11ccl pill,lil; Ilcallh,sift y aptl the cuvl►olluwnl:
____ l'csspuul ui lit ivy is within M) fucl of a sill lau; watci
(_'cssipold ui pi ivy Is wlthiu jU tccl lit it Ikolticiing vcgclaicil wcllaiul o f it sill 11wish
2. Sysle!o will fail uulcss Ills illtartl of heal!!! (illitl 1'ilblic Walcr Slippliel-, 11;iilly) fielel-lltil►es Ihal (l!c
sysleili is tlll,Ctiltllillg ill it l,lilllllel ililil „l'alects like plil)l1C l,eillfll,safely ailll CiIVIIU11111Ll11:
----- c systum Ilas it septic lack alid still iihstlipiluu sysicol(SAS)aotl tlic SAS is wllliio 161) Iccl of it
suilacc eviller supply ili (I ibillaly to it sm mike wtilci supply.
----- i be syslt;ut has it scl]lic iauk and SAS itiltl !)ic SAS is wilililt it Lune I of a public walcl supply.
he syslcn]has it scplic link liwl SAS ii.ad Ibc.;AS is wilhilt Stl lccl of i,'Illlvitic wit lei supply well.
___-- Tbv syAcul has it septic Tank awl SAS ailti tilt; SAS is less Than 100 feel hill 511 fl;el m ludic Goill a
wivatc walt;i supply well". Mclboti used lit ticicillkii,c dislancc
s slt,ni ,,lssl,s it' well willt;i iwal sis, hcifoiliicl ill a PEP ccilihed hilluiilloiy, fol.cttlifilltit
Y . ' 1 . "' Y' I
ililciglju i111ti volatile illG?ItIC Cliltlillltiutis intlicilics Iltai lilt; well is Iice fio111 i allltllt]l} �1l]l►.t Iltill l`tl( lily t►litf
lilt i]lesc1lct of auuuupiil piligl;(1l all(! 1]i/lalt. tliliu¢cit is t,tluiti to tli less !hall S hpllt,h1-11vid"I !hill on plllel
(�ailllt�crilcliu rill; (11g1jL'ICIi. A cnpy(]f lilt, anillysis uulsl l,i;allacllcli lu IIUS Iu1i11�
/Uo c ram_
o c' r.�- '- l,h. Wu-Tav 1'.c J.t (• t t� �(a.,h L'."�f pU0' Ww� Jl< <+..�10v< 1 N I'A -
aul' ILt ihkv—V1S cf`A`. 4-b pD v- "1�(a �y v(/``'��/G�Do✓ C'1` SSpoo (,
()Vc►71d� A- n,
�la
t,
'1'agc �l ul
Slllisllltl-'ACI!, Sl!:'WA(A" j)ISII'(.)51k1. S'ys'J'Ji Nl INS IM c 1 wrq tiY)121YI
4It'll' A
127 Highland Drive
I'I'opcily Atltlk tJS; Centerville
Mary Francis Hayes Estate
Owner; September 27,2007
1)nIC ul Ifispccllnn;
D. Sysickil Failure ('I lick iu applicable Ili all syslelu�;
you ifiusl ilidwale "yes" or"nu" lu each ul•Il,e lullowillt; fat.!II_I,isl,t tuns:
Yes Nil
- �/ Liiiekup ui sewage into Iticllily iti syslcltt co!ulwucul title to i,verluatictl Ili cluggntl SAS o►cesspopl
✓- l)iscbiII8c ui liuotli,ig of cl ducal ill file sill Bice ill lbc 81-oluld of surface walers flue(q an ovtrlttadetl or
cluggctl SAS of cesspool
,/ Slalic litluitl level in like tiislribfilion l,ux ubuve utlllcl iuverl title lit im ovclloittictl of dogged SAS fit
ccsspoul .
Luiuitl ticptb ill cesspool Is less thikil b' I,cluw iliveit fir available vnluulc.is. less lloill ''A dily I'low
Ruiluircil pufitpiug lilure 111an41 Blues ill llle last year N(_Ill'_title It,clt]ggetl ni ol,slikwicil pil,e(4). Nlinibel
uC lima puuyictl_..__..._
Any pullieu of tic SAS• cesspool or IIIlyy is below Itigb ground wales cicvaliro. �
Any poiliun ufccsspool or privy is wilbirl I00 Ice( ufa surb,cc walei supply ill lril,ulalY lu it suifucC
walci supply.
_.... _>/ Ally potliuu ul'a cesspuul fit privy is willti,i :t `Lune I ofa publit: well.
✓, Any poitiuu ufa ccsslxwl ui privy is willlili all fccl tifit Ill ivalt: waici supply well.
-.. / Ally pulliuti of a i i ssliuul ui privy is less (Rita I M) feel bill grt alci Ilion SO fro (Iol))it III Walt i
supply well Willi fill itceel,litblc water tltuilily itilitlysls. 1'11tis sysIt:tlk IIiIsSe'S 11 llkC Vycll IYiktin alkitlysis,
l,cl lul'tuctl al a lil!:l' cc►lilicil Jabal allily, Ii,r culili,l-ut I,aclt ria ulltl volitlilc ul'l;aulC l'0111pb1,II11S
intllcaics Ihal like well Is It (Iv,tlt Ilul,l)llt,lt lrauk Iliul facility and llte Ilrescltcc uI anknionla
till l,gt:fi and skill ale fiiii-ageu is eilllal lit Ill. Icss Ilan S ppfi,, lu ovitlell Thal till ailker failure ct llerla
ill c if iggcretl. A cagy a(lilt: alullysbs Itulsl Ile allikOwtl lit ihis Iaru1.)
(ycs/Nu)'I'l,c sysicul litils. I have ticiclntiliUl (lull uile tli n,tiic ill lift: above fuillirc crileria exist its
ticsciibetl ill 310(.Ivllt 0.303, Illcitai,tt, lilt; syslelll fails. 'I'll(;syslcok uwucl sbolltl culllacl lilt: liouni ill'
l lcalllt lu ticicinlioc wbal will be eicccssafy lu cuirccl ilic Inillart:.
Il:. l.ul�l;c Syslcuks:
'I'll lie colisillcl ctl a likl gc syslctn like sysicllt nlusl s/Olit-itilkilig.
iy wills a csign flow If 10,0110 bpi) In 15,086
gI►tI.
you luusl ifitlicale cillicl"ycs"nt"fill" In cuclt ill'the
Iiillowltlt;cillellit apply to I:U'ge systems Ilk i1lltlllill 'la itbtive)
Yes nu
111C syslcty is within t100 Feel oFu suil•ut:c tll' r supply
_-- _,-- lilt sysicltl is wilbio 200 feel o1,a wbiZ1lIVy,;.,iiIci1
Ill
tlt-ifilCing walci sfipply
_-_- life s slclli is loculct Ili a nitro Gli sc liner to Wcllbcitil PI-o t:c io
Y I b ( I. I II ll Area -IWl A) u(it ijtahpcll
`Loth 11 01 a public walci supply
ll,ytiu Ittive illiswcictl "yes" to arty titic lull ill Seciiotl I- [Ile syslclii is conslticictl it siUlllllc11111 Illlcal, of ilnswel'pt)
"yes"lit Seciigll 13 ubovc file lal8c Slctit Ito kilcll.'�,llc t,wu�j ill.ol,cfaltti t�l ilt!Y i'1(bri tYslClll Oositle'l-0 a
sll;l?Il)c4t111 41,rcill tllitlei St clji,lt r' I (itjle!,tuttict St t lltlli 'l slial� I►Ilbrltlt: file syslClll lit opgllli)Ilcc Willi I 10 FMIt
I�.Sllt,..'�lie syslclp pwl,ej slit , tl ctillpit"I le itITIuh(iigku milli: lO office I]I Ille � c('11f1111.t 11�,.;
. l
( 1"FICIAL INS144"I'ON I'61tlyl - NOT Je011t V4_)I.l<IN"JARV ASSI SSM�i�N"l'S
SUBSURFACE S��.W����r�; 1!)ISVOSAJ- S'�S I Mi:l�1 �NS�'I?�`�'�()N I�c�i2M
I'l"lie'1Y Iltltlrtas: 127 Highland Drive
Centerville
Mary Francis Hayes Estate
Dille c)1 I11SI)C Bull: September 27,2007
l.'11cck if llic fulluwiui; have been (luuc. Ynll 1uus1 lµliculc "Yc5"i)r it its lu cacll ill'IIIC lullilwiu :
Ycs No
-., -......_ l ulul)lilg nllulYnilllutl wag i)tuVltlt:t) by IIIG UWIIL'r, liCClll)illll, Ui Boalil of 11calill -
Wcre any of Ibe sysicio colul)iillclih pillul)ct! ol)1 ill Ilse i)reviuus Iwo wccks
Jz Ilas lilt; sysleol icccivctl not111ill flows ill lilt Illcviolis two week licl ioll '?
have large vulilulcs'u(wulci bcCll inlro(Iticctl Ill Owsyslcol iu:eotly dli as Marl of lllis lusl)cclitiil'?
A114 Weic its I)oill l)laus of dw syslcio oblllincil;lull exati)ilictl?(11 lbcy wcltc uol avililal)IC ntilc as N/A)
✓. Was.Ilic Iln:ilily ul Ilwcllillg inspcoetl lt)(signs of st wage blu:k till '?
- _-- Was Ibc silt insl)ccictl fni signs ol'bicai; ou1 Y
V/. 1Ncrc all syslcliiCwlil)tluculs, cxclutliug lllc SA lulallctl tillsllc '?
NIA Wcic tilt;sclilic lank owubulcs Ililcuvciul, i)1)cllctl,.au41 the intciiur of liin oink iosl)Ccicil ltii IIIC COIIIIIiIOII
of Illc bafllcs tw ices, tilalcltill ofcunsiroclion, tllluellsipus, Ile)111 ill lit uit tic pill o sbu e ilia tie Itll o seoiti
I 1 1. , f . le I , ( ,
Was Ilw lacilily uwilci(ilpil occill)aills II tlil1cicnl Bail uwuci)I)iovlticil Willi IllltwilulllOn pit Ille Illopei
Wiillitclialicu ill'subsul face scwagc.tlislulsal syslculs ?
'I'lle sire Gilt, Incaliorl u(file Soil 411sol lllilip Syslcill jSAS) oli Ibc silt lids bull lIt;lgpIiIIC() jusetl Oil;
Ycs till
— i?xisling infillilialtun. I:or exatly1c, 11 Iplall ill IIIC (lo;lrtl of I Icallll.
_-- I)ciclmillctl in lbc lichl(if any til`dit; fillllliP ciilcriit I:Oillctl ill fall C is ul issue apl7iaxillllllio11 o(tllsfalice
is nnaccel)wI)Ic)(i l h('wilt 1 S.102(i)(l))l
Oli'I�'I('1AI. INSI'�!:("M')jUN I (WIVI - NOT I,00 V6LI1N`I Aj1Y ASSJI SSIVIENT1
SII Its IIIt1iACl!: 'sP"WAGJ!; PIS M'OSA1, S)(,s'IT:IVI IN51'I4`1'NUIy Ifi'OItM
I'ruper(y Atltb t s: 127 Highland Drive
Centerville
Mary Francis Hayes Estate
1)alc u(Insl,ccliu,,; September27,2007.
1i1..0w ("ONI)I'1'IONS
Nuutbci t,I'bctli tit ulis(t It,Sig II): Y Nuull,ci of lieilitiotits (aclttal): -Y 1 wiY(ty v f G(„yc.1
M'Sit N IYuw based tilt 110 Clvllt I5.261 (l'oi exaoti)Ic; I Ib gptl x 11 of l,ctli41411ils): D
Ntmibci t,l'cimcul icsitleuls:
lhtt tusiticlu.c I,nvr,a gail,agt: giiutlei(yes ui dui): n/p
Is Imlildiy tilt it s;paialc sewage sysictit(yt:s of tilt): -/p fit'yes scl,aiale iusliccliuii(cilulieil!
l.:lufitliy syslcut luspcc(ct1(yes ui fill): _/t//A
Seitsutial use: (yes of tilt). /Jo
Walci lucici Iuildifigs, it Wvailable(Ills( 2 ycais usage(8I1'1)) -0§'._y.&�0UJ
Sunil, I,ttuy,(yes lit tit!): No
y o00
L.:isl Halt: ufuct:uiiaut:y: Qc.�.y___(3t.�Jt
COIVIIVI l!:It(:1:11./IN1)US'f1I IA L,
'I�ypc ul cslablisbu,citl:
1)esigu Iluw(b:isctl till _i it)(lvllt I 1 263): Glut
Oasis t4 design flow(seals/Iicisuus/stlll,cic )
Gicasc if fit uscul (yes tii lit)):
lutlttsUutl waste Iwltliug liutk picscitl (yes Ui tilt):.
Neu suti(Wiy was(c tliscbaiGctl Ili lilt;Tilic ) sysl t(yes of titi);
WWlci mcwt Icatlitigs, it available:
L.;ls1 bale of ut:cupailt:y/use: ---------------------------
OTIll'It (tltacribc):
1 J1�:N1�11r1I. IN1�(11tA'1:1'1'1ON
1'uutpinl; Itt:curtls Was sysit-m I,uuipctl its pall tit lbc ifispuction(ycs tit Ito): �yO
II yes, vulutlit I,uutl,cti: :. .___...Galluus .. (Itiw was t1!Itlulily putilliud delciu,iuctl'1
---- --- -- --- ---
ltcastln (oi puuiltiug' -
I Y1'1 l)1 SYS'!'>Ilv1
_-Scliiic iil(tk, ilisoilit lam box, soli absoiltlion syslclii
Single cessl,otll
Oveillow cessl,00l
V,ivy
-Situ(eil system(yes ui fill)(iiyes, attach I)ieviuus itispCcimll iccuitls, it ally)
- IIII ovalive/AIIgI lit livu Iccluutltigy. AIIWch W copy o(Ibc cuiicol npcialitni Will (kill iuiellup(u contract(lo be
OblillilL'l' llY)111 syslcili uwrtei) -
_... I'igltl lark _._ Allucb it coley o(Ibc 1)1=1' ,ippioval
Ulltei(lIi st iibt);
Alil�iuxirlrllc al;e ol'all colu(,ollcltls, dale tnslalletl(II'hllowN) t!!lt,source i,l'Iuliiiljlillln(i:.
W1;ic scwil to utlo15 t►ciccictl when ail iviug lit Ill(;silo(yes of Iuo): /Vo
INSI'!:C'I'!(aN +'()121yr
Sr11ISl11il+'At•:!!: SYi�'�'�f1Cyl+� �)!��'��Sr1l. S'��'!'�?IYI llyS!'!!:�`!'l�.I,N 1�1.)IlIVI
�Y��I�liN►YI rN�+�4�lc��l�,�M�l�)N (t;titllititlt:�l)
1'l ppcl 1y ltltlress; 127 Highland Drive
Centerville
Mary Francis Hayes Estate
Dale of luspct tut►: September 27,2007
IIIJ11.1)INt,SEWER (locale on site plan)
I)ta,lb below glade: -.__f'..8
Malciials of coosotickow ,/ it till -`I(1 I'VC
t)islauce lititii piivalc wale+ supply well Ili suclitill lI+)t,:
Conuticuls(till ctilitlilitin of juinls, vt ulinl;,/cvlticut c of Icakagt, cli ).---- {� L_U!'Ga.rs.t�..�._.�✓_r..y__�i ..�_...1N_�'-S.....Til.�.t tn. �_.fb]�._1`+!S 7'�+t;
(lot:alc tin Silt plan)
Ocpll, I,t:luw gliltic:
Nlalclial til,consliuchow collcicic ulclal Ijbcil;l;lss polycll,ylcl
till�cr(explaiu)
IPIal1k is ultaal list ikgc: lS tlgc ci,nliri►lctl I,y a Ccililjcalti of Cru1 l;ulct (yes pi till): -(allucll it copy Of
ccllilic;llc)
1)I,ucusitius:
Slutlgt ticplb: .._..........
l)islal,t:(; 111ou,lop of stooge It) btilluiu ul'tiullcl lee ill.bill'
Scum Il+ickucss. __ 'I
I)ISltlucc 11'on,lop of scuiu to lop of t,ullct Ice tit I,; c:
1)Islaucc IYoul bolltitil ofx:ul+l to bulbul ill*ow lcc tii lril'Ilc:
I low writ: tlillwlisions ticicioiioctl: ._.____..:
Ctiottllcols (till pillolutig iccon,ttic+itlalill Into aotl iilillcl Icc Ili l)alllc t.tiutllllr,il, sllut:luii,l iulc8lily, Iltluitl levels
us tclalctl to uullul jltvcil, t:viticnce of -altgac, (;tc.).
G1Zl::e�SI! '1'I�AI'; — (►tit alp ou Sllc Iilan)
l�eplll(,tauw I;iatic� -----
Nl�ilcljal ul�cphslillcllu+l: ct,ucicfc iMltaal__ _-Ill,pihlllss..._..._.polycll t:ut: ulliei
-
l�iulcusionS:
Scllnl II+ILkness:
I)Islaucc (l'i,l11 lop ul scuff,lu lop ul uullcl Ice u(I,alllt: -
l)(slauce (11i111 lxiUolti i,1 Sc,liil lti btilltilli nl oullcl lec ti iIilllc: - ---
1)tllc tiI I�ISf l>lllllpll,l; .---------- -
(-,Olnnlcills(till pulllpwg icctilluocutlaliuns, 1111c 1111 t)llticl ltc tii I,al'llc Condition, slt4clllo1 Iplcl;lily, lltlilltl leyejs
as lelalctl to outlet io-11,cvlticllcc ul"lcaka tat:,):
�I'al;c tS ul I l
SYS'1 V Vy MNSPI CT ION 1`010V!
1'A ITT C
I'rolii rly Adlll css: 127 Highland Drive
Centerville
Owner; Mary Francis Hayes Estate
));llc li(luslicclioll: September27,2007
1'lGll'I'or MMjtl 1�INc� 'I'AN�i: _--(lank uiiisl lie (Ilin111til al lilac ill' Oil un Silt;plan)
I)cplll l�clow grallc:
IVl illell;ll oi•uinslruciion: ._....--_coma Olt_._.._..._likelil)
-._
I)Wltusk�na: ---.-
C ikpeclly. -gallons
Dcsigu flow. -------- gallonshlay
Alaiin piescol(yes of lul): ._...____.
Alaiol ill woikilig oitici es of no):
i)illc of lasl plimpilig
(;oiuuicills(aonliliuu ofahoill aud Iloal wilcllcs,
I�1 "('ltllill'1'1ON ItOX: - (II lirescul ilulsl lie opcllcil)(lociili:fill silt ao)
1)tplll o(lii)uill IcVel al.love uullcl iuvclY: _._. _.._
('Ululiwills(pow il"luix is Icvcl ,kill ilisliil,nliun to olillcls cilua ally cviticncc ofsoliili calryuvei, ally(;VIllellcC of
Icilkagc iolo (ii oil of box, etc.):
ITIVII, ('11AIV11001: -.; (locale on situ Blau)
I'illlips ill wtilkilig iiillcr(ycs fii po): -
-
A(q(iils in w(iiking oitici(ycs ilk ilo): —
l;ululllepls(luilt coliililiuo ol,liuulp cliaulbcl, coullllioll ill, uulis i mil appul'luuiiilci;s, cic.):
t
i
i
Tikgc 9 (it' I 1
OI�I�1('IAI. INSVIWTION 1`0ItIyl --- Nll'I' FOI2 VOI.r1N'I'ARV ASSI!SSIYIVN'I'S
S lilts ltliA(:T O SS1 I I I -4- IC)N Ir(Mly!
S'YSTVIyI MNI( M MA11ON (cuilliillied)
I'l ullcl ly A lltll esst 127 Highland Drive
Centerville
(llv"L1` Mary Francis Hayes Estate
1)altul�nsl,telinu' September 27,2007
s(�}(. Al}SOItl''1'}ON SYS'►'ILIVI (Sr1S): ✓_(lnc;14!%�f!�j(c 1!Iill!, cxkiiyullull Miu} lctlui►etl)
if SAS not lociuctl cslllitio why:
.l,yltc
__-.- Icacltiug Mils, luooltci: ._..____
- __ Icaialing cluuul�cis, nuoillci:
-_._- Icaclting galleries, uund�ci: -_ -
Icaclting Iicnclics, uuu,lltei, Icnglll: --
Itacltiug Iicl l,, nuuiltcr, tliutcusious.
uvcillow ccsSltool, uunilicl. I -
i000valivc/allcn lilt ivc syslcoi Typ011ilnit: of Icclwo1(lj,Y.
011llllellls(l1oIG ellllllllltlll Ul'5UIl, ......._. _.._......_. . .__._..
sigiis ofit til-illiG Iilllillb, luvcI oflolitilib. dallip.. Still, c-o—l—ltlil—ion--o-
f Vu8claiioli,
cic.):
Svt. � l..Jc>-5 _..��+�Vl-.rl.� L44)�.aJ. J._ wv-S.._.-�5..!^.!�_...12_..�1 l,/ _ w. c. ✓L_.Ls.._// l.�_..s>�-�_.a
(.�.ti�-.,_��H,.Y,�,..... .l ....Ea_clJ_� !_�+.:..i!_G_✓_ �.. Ct-_4a��;�..1.....(�_.�o�-1t._ c.�.t_.._s..�sa✓Co_
j---
l_;I SSI'OQI.S: ✓ (cesspool nutsl lw Inu!ipt it its pilil of iltsticcliwl)(localt on silt; plan)
Nuiltlwiiloticooligolalioo: _(af►c�.__I+.wr..5....__�..>✓.t_�_p.��.t .
PcIlth-- loll of litlojtl to io1cl iuvcil:
fleplllofsolitlslaycr: .....f3''.._..... - -....__-
Oc(lillll(sCno'llityci: A(p.N� ........._,
sc -
NialeiialsofCollstiucliuil: �aI_ alp�lC_...--- -- - - - -
ltllllL'.IIIU11of g1011ntlWillel 6016W(YCS tli Jill):
C'oolowcllls(ilnlc colitlitiuu o f sojl,signs( ('liyillaidic I lililic, level o f iwntliug, colitliliull of vogelaligll, e}r..):
w•�_5.._la �.y.�r.�._ _ C1�_�l r_.l. r� .._;_i_.__.��t S�v(1 ;�b 10 l�s
1!Sri ._..:�.CL�✓ _3(_,_ _a+/a....... f�t�✓hr�_.-._w-wl r.�- .�_tN.Y�. -.�<v<.5 -�_< <.60
�` I/ �(� - - —_SLR � ►. 1 �,.
fn�c♦ rS /o/, c_V'.0 r-��. t S C.�.� S�H�La
1'lt}VY: ----(locale oll silt Itliul)
Mil(eiials of consliuellun: Z11Y1111
�1 ✓w�, Ca(t��,y cf✓✓�.�S h�>✓
if
I)eplli of snlitls: _...._
Cotlwlculs(Bole contliliutt o f soil, siglinl,l,i,utlilig, ctilillilioli of (�l)litlllki, e(L.):
{
- 9 -
I"At►YI -- NOT FOR Y()IAJN'I'i1jty ASSI!SSIVIIWI'S
SIiIt I1MtI�f��:.Il: SI� V � yM� 41� 't)S�RI„SYS'I'I'-NI INSIII "I'ION N-Atlyy
Pik PTC
�Y,�'!'ll?I�N INI?�)IilYl�1'I'I(1N (couliuuc�i)
127 Highland Drive
I'l ul,erly A'I'll Centerville
Mary Francis Hayes Estate
September 27,2007
11a1c u1 luslu:clluu:
sr:I;ICII �,Ir sly VV��I:I�: I�ISpOst�l.s�rs•I•,i�m
Ill ovidcit skcicl,of Il,c sewage disposal syslclll incilµliyg lies to ill Icas1 Two I,CillllWcol rdclCou lalltlrllarks q(
heluauuaiks. Locale all wells wilhin 100 fcc1. 1..,lca1G wllcic I,Ulilic walcl sopl,ly culcis Ille lloiltliug.
t3c,
i
loot-'
� l
3Q
rh IA
.l
c)F11VAAl, FORM .... NOT FOR VOLUNTARY ASSP'SISMEN'r's
S�S'1''11:I�'1 IN�i'OItlY��1'�'ION (wunlinuctl)
Ill openly Address; 127 Highland Drive
Centerville
Mary Francis Hayes Estate
Date n{111SIICclioll; September 27,2007
SITE, FKAIVI
:�It,llw ✓
.,tn Iacc.walcr
Check cellar ✓
�Italluw wells
,
Iisluualwd/I4;11111 lu gluuutl walci 2 0 t Iccl AI)JuslCtl ►tlt,lt I;rouud tiwticl clev;tllult77 lcwl
Please liulicalw(dwA) ,111 luc!I,utls used to Ilciclouinc Ills high glokoltl walla cicvallun:
()l,laincel linnl sy;lc,u dt SI811►Mans uu !wCold - 11 cllcclictl, talc of dusil It pl;u, reviewed:
Ol,sclvcd silt(;lIn,llinl;'ltlulwily/oitscrvaliwl III& wilhill 00 Iccl
'I,ccked will, local Iluard nl l lcalil, cxl,l;till:
L Itcckwtl wills local excav;Uuls, iuslallcls (al,lawll tluculnwnlallull)
Acccsscd W)WU dMalr,Isc wxIdilio: 5:... V i(�-•l' 3- 3'
Yuu Lrtusl dcsctillc how you cSlaltilslu:d Ilw ltiglt I;I'utlud �ralct cicvalluu:
/5
6x ✓�.✓.r... Z V li___. i:CU....J-.C�✓.-d�-�.c.-.. .��.)U l!i-1_((w�__"��r :.t_ __. .a.r-'-
J
X-1 -'Ja-4i<o��
30-,1
3. 3
7 ,
Ibis lep011 (las L,een Iliopaiecl tend lho syslarrl Inspac.lO as 0 y!d data of p,s{,actio!!. Illls lol) Is Oql a
vvatfanly of)!uaral�lea It1a1 fire systul))w111 Noctlo!)J)wv lly ftl 11)e ftllula. l held 114vd uee{)hc)war{ l)llas of
pua{al!lees, ellher ux�,ressell, wllllen cx 19
1ft111!J 1110 )Y4101►1, 11!e Iusl uc;llQ{I €)11{11gl(Ills
! I
Town of Barnstable
F1HE T°�
Regulatory Services
anxxsrnsi a Thomas F. Geiler,Director
6 9 `0�
9 Public Health Division
ArE p Mai"
Thomas McKean, Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
This septic system inspection report was completed by a private inspector who is certified
by the State of Massachusetts, Department of Environmental Protection.
Although the Town of Barnstable Health Division received the original/copy of this
report; this Division does not warranty the functionality of the septic system in the future
nor does this Division agree with any technical observation s and interpretations
contained within this report.
In addition, by receiving this report the Town of Barnstable Health Division does not
automatically approve the number of bedrooms listed within this report. The actual
number of bedrooms approved at a particular property would-be listed on the "Disposal
Work Construction Permit".
If you should have any questions regarding this report,please contact the certified Septic
System Inspector who conducted the inspection.