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HomeMy WebLinkAbout0067 LUMBERT MILL ROAD - Health E-7-1 . SMEAD No. H163OR UPC 10259 smead.com • Made in USA i '1 TOWN OF BARNSTABLE LOCATION 6 L.Vr-U - n�( 1. SEWAGE# VILLAGE Ce k 1-e(_"O l e- ASSESSOR'S MAP&PARCEL le,' INSTALLER'S NAME&PHONE NO. S�e4,tl"4'� S u� Ll 3 SEPTIC TANK-CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS OWNER J G`n eJ Are; PERMIT DATE: COMPLIANCE DATE: 'Z Separation Distance Between the: Maximum Adjusted Groundwater Table to'the Bottom of Leaching Facility �,a J_ ' 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 f 4-?'6�+ ll a c b huuSL Health Complaints 20-Dec-06 Time: 9:30:00 AM Date: 1/23/2006 Complaint Number: 18632 Referred To: DONNA MIORANDI Taken By: ELLEN WADLINGTON Complaint Type: NUISANCE CONTROL REG. 1 RUBBISH Article X Detail: UNSANITARY CONDITIONS Business Name: Number: 67 Street: LUMBERT MILL ROAD Villager CENTERVILLE Assessors Map_Parcel: . Complaint Description: multiple families noted living in house; lots of boards piled beside fence; lots of plastic trash barrels upside down; lawn mowers inside and outside building; suspected illegal use of premises ( Building Dept. has pictures). Actions Taken/Results: Talked to him regarding the problems at length. He is complaining about#39 Lumbert Mill Road, Centerville. He states there are 10 men living there and they work all night coming and going with noisy cars and loads of lumber. He also states that they micturate in the backyard. After talking with Mr. . --- - DZM went to the correct house of the complaint and started taking pictures. I was then invited inside by two women. One of them being a daughter named Atlla Coelho, cell phone(508)-367-4131. She was most cooperative and stated that her parents bought the house in October 2004 as a 5 bedroom house. She states that there are only 5 people living there. DZM walked 1 Health Complaints 20-Dec-06 through the house and there are two bedrooms on the main floor with another room as a potential bedroom being used as an ofice and two completed bedrooms in the basement.Thel assessor's has it listed as a 3 bedroom house and there are no permits to go from 3 to 4 or 5 bedrooms for that matter. Previous septic inspections and permits have it stated as a 4 bedroom . On another note, the vans shall be removed in a week and they ask for a month for the unusable debris to be removed. 01/27/2006- Much debris cleaned up and fence has been put up. DZM took pictures. Investigation Date: 1/23/2006 Investigation Time: 2 r i No. � � Fee l!/�d ` THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 4plitation for Disposal 6pstem Construction permit Application for a Permit to Construct( ) Repair(�_Upgrade( ) Abandon( ) ,�omplete System ❑Individual Components Location Address or Lot No. Cpl LV r��,r i;/M'\\ Of\Ve Owner's Name,Address,and Tel.No.3-twN Cstn�-exv%\�X $O Mavn-�rAN^ Aue.Y'VA. PO Assessor's Map/Parcel 05A Pe A D�3 � � �8\- �13-`•ya0 Installer's Name,Address,and Tel.No. 9e0kttr G h EkCs�A�%IY) Designer's Name,Address,and Tel.No. So 8 y3a-SS fo S iS s 'S„W l C�xw Bch rn%A oa(U45 Dc,.v-, S, C�Y,5�NG4��r Dc�V 2�Gson a- S 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) X3 gpd Design flow provided gpd Plan Date N OCi2 rn1Def CD a,0\S Number of sheets Revision Date I� Title (z V_) cc5 J 6- 6-1 LQrv.Veri Size of Septic Tank r 5 O6 C ;3m(3n Type of S.A.S. Description of Soil S0,r1d . Nature of Repairs or Alterations(Answer when applicable) �1 C ,1 �f� J Vl G cY)y' lnstcOk \oc', _yln \r . ,, �r�, nn��1 -Rnx ��C"Y-i �`A a � FAY Y� sanSwct,�n �� aT 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 Environment and not to place the system in operation until a Certificate of Compliance has been issued by this d of alth. S• e Date Ar Application Approved by Date Application Disapproved byywvl Date J for the f Il wing reasons J 1 Ibl �� Permit No. d i — �) Date Issued (� -- -THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by q at fQ� LV mbl ,�V �A\�1 UCA 5. kVV1`�k, has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 9 a i j' 0 dated 1 ( (�' Installer Y�(`C�nFxC � L.L Designer #bedrooms Approved design flow 330 gpd The issuance of thiqpertjt shall not be construed as a guarantee that the system wilLfunction as designed Date C V Inspector �• �C� l l 1 4 \\�F� ee 11 THE COMMONWEALTH OF MASSA- U'SE 1 F.Ittereli in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS., Yes ftpu ration for Misposal *pstrm Consort ctcon er i Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) '! 'CRomp eIe\Sy _ ?Ihdiid"ual Components Location Address or Lot No. (01 Lv rv\b,,r\- M%k\ O t \Ve Owner's Name;Address,and Tel No•��� Q v Assessor's Map/Parcel 05A mi \�'_ 21 ( p Installer's Name,Address,and Tel.NOgeawan EkcooAk�f—yj Designer's Name,Address andtT C o. %-' \SS Gl \\Gvvv.ch rr�AOa S pc,,� t� SP_ew`` ) &; -k4ZQk-CY5 L5 us a ` Ty J. of Building: Dwelling No.of Bedrooms Lot Size P t JA k 1"�sq:`t. ; fGarbag'e�"(r alArr Q# ) ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required)�1O X 7j0 gpd Design flow provided gpd { Plan Date ti J,,g r rnl ie� CD a,Q\S Number of shegts 4 A, Revision Date t TitleS�� P�n,n ��� �Y����.e�a C�nS��'�c-1-��r� 6-t L.•,rr.1�a-e� 1' Mk\� ,c�c� C4rkeyy{��,,M�A Size of Septic Tank�5 O6 Type of S.A.S. Description of Soil /Mt? \U S ar d 04 Nature of Repairs or Alterations(Answer when applicable) rs S�yr_���e ,5 �1 A I I J Y� 'St 0 C i q r( c OS \\ 0c,.Cyknr' kn18 and �) �i � x �c. N � IGYs \g\!4 Da0Al tC 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 previsions of Title 5 of the Environmenta Gode and not to place the system in operation until a Certificate of Compliance has begn issued by this Board o—fInkalth. S'gne / r Date // /,�, Application Approved by Date 1 I Cl / Application Disapproved by1 t _ Date ' for the following reasons - 'kad � f 1� ,Permit No. 2 04 — I Date Issued 1! J !h 17 ------------------------ -------------------------------------------------------- - --- -- -------------- THE COMMONWEALTH OF MASSACHUSETTS - BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by at ICT-1 �_U mhe r V {\1 l_SZ6 a(-kVV Ak . has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. _') d t j' � dated ( 1 Installer YY`G�1�`�C�1\ t 1 L.L Designer / #bedrooms � Q Q _ 3 Approved design flow 3 gpd The issuance of thisjpermt shall not be construed as a guarantee that the system will function as designed. p o G / Date � � 1( ! ) Inspector - ------------------------------------------------------------------------------------- ------------------- No. �.o () — y/) Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS misposal 6pstem Construction Vermit Permission is hereby granted to Construct( ) Repair( pp) `Upgrade( ) Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Constructio t must be completed within three years of the date of this permit. Date, 1 'Cl 1 Approved by a ; No. Cv (Co.(✓1 ' Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppliLatlon for Zisposal 6pstrm Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. .� M 0 / Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued f No. G{l (G r D Fee THE COMMONWEAL H OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 4plitatlon for bisposal *pstpm ConstrUrtion Permit Application for a Permit to Construct( ) Repair( ) Upgrade( .) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. f V / Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Col plialtre THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by l at _r has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. CH. V/1—dated 11 Installer S,PF t r-I-- t c C Designer #bedrooms I 11� rlu (?) Approved design flow 7 70 gpd The issuance of this ermit hall not be construed as a guarantee that the system wil �n de/signed. Date (� /�' ��� Inspector �(,.�• No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstrm Construction Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. I Provided:Construction must be completed within three years of the date of this permit. Date Approved by Town of Barnstable °FtHE>a,, Regulatory Services ti °T Richard V. Scali,Interim Director BAR.NBfABLE. ' Public Health Division v�Ar t s`0� Thomas McKean, Director fD►iMy 200 Plain Street, Hyannis,NIA 02601 Office: 508-862-4644 Fax: 508-790-6304 Homeowner Certification Form for Alternative Systems Property Address: L -Vt TmLC Assessor's Map\Parcel: -tC ( c S� Property Owners Name: 0v-4 In accordance with Massachusetts DEP alternative system approval letters, the following certification information is required by the Owner of record. The Owner of record must place an "x" in the applicable box next to each line certifying the information. Yes ❑ I have been provided a copy of the Title 5 I/A technology Approval letters. (15 page Standard Conditions letter and the specific technology letter) �❑ I have been provided with the Owner's Manual �For e been provided with the Operation and Maintenance Manual ❑ 1ystems installed under a Remedial Use Approval, I agree to fulfill m pP g Y responsibilities to provide a Deed Notice as required by 310 CMR 15.287(10) and the Approval ❑ ;?"/For Systems installed under a Remedial Use Approval, I agree to fulfill my responsibilities to provide written notification of the Approval to any new Owner, as required by 310 CMR 15.287(5) ��❑ If the design does not provide for the use of garbage grinders, the restriction is understood and accepted iJ ❑ Whether or not covered by a warranty, I understand the requirement to repair, replace, modify or take any other action as required by the Department or the LAA, if the Department or the LAA determines the System to be failing to protect public health and safety and the environment, as defined in 310 CMR 15.303 I , ja,",e5 F- agree to comply with all terms and conditions above. Property Owners printed dame k)0\1 --1-0 15`� operty Owners Signature Date Note: This form must be submitted along with the septic system disposal works permit application for all I\A systems including new construction, repairs\upgrades, with and without aggregate (stone) and with conventional design criteria or credited design criteria. QASepticVA homeowner certitication.doc Town of Barnstable Regulatory Services ti Richard V. Scali, Director anxxseast.e. MASS.v� s6;9• �' '°1EpµplA Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: I'Z 71 i5 Sewage Permit# 201 S -41 S Assessor's Map/Parcel I V 106 Installer& Designer Certification Form Designer: -D'C'' A 5I7tVrl-<i—�iv Installer: SP(AV,1-0� Address: ) S OC'It< `)4" Address: 1-'s— K C-4,qc IIL41Z,A Calf , l^A )IAt'-JiCt--1 ; &4 On 1 h5 SC--Iu1141,1 i LY, uc was issued a permit to install a (date) (installer) septic system at G 7 (,U m f�6n7 A 1 based on a design drawn by (address) A VDV"Al dun 3yZLcl run, dated u )15 .115 (designer) I certify that the septic system referenced above was installed substantially g accordin to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Stripout (if require nspected and the soils were found satisfactory. OF DAV1D MASON (Installer s Sig&ur ), v �NO.1066 0 �� oISTE�'` SgNI TARIP (Designer Signature) (Affix Des amp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gAoffice forms\designercertification form.doc Town of Barnstable P# /7-0 Department of Regulatory Services IABNSCABLE. : Public Health Division Date D .' 9 MASS. 039. �0� 200 Main Street,Hyannis MA 02601 9--D RFD MAC A C.y Date ScheduledJ,- Time�,�� Fee Pd. �y Soil Suitability Assessment for Sew a Disposal Performed By: Witnessed By: V i clu. Gtn �rJ_ LOCATION & GENERAL INFORMATION Location Address Owncr'sNamc CPS lv`(Yliry2r� YYI��I: ��'�} o\ M'A d a 67J` Address`�6 VA.,4nAc,(n ',eYW'- P O qs� —)a.� pembYoEs.�(YMK'j 6a� Assessor's Map/Parcel: Engineer's Namc�� n NEW CONSTRUCTION REPAIR Telephone# 'j b%- Land Use Slopes(%) Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way It Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test es&perc tests,locate wetlands in proximity to holes) �I Z I Parent material - th to Bedrock (geologic) Depth Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater DETERMeINATION FOR SEASONAL HIGH WATER TABLE Method Used: 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.factor Adj.Groundwater Level PERCOLATION TEST: "bate 'Tune Observation Hole# Time at 9" Depth of Perc Time at 6" Start Pre-soak Time @ ` Time(9"-6") End Pre-soak Rate Min./Inch G 7 Site Suitability Assessment: Site Passed t V000, Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***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:\SEPTIC\PERCFORM.DOC / / /b VJ DEEP OBSERVATION HOLE LOG Ho1e# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel - lD DEEP OBSERVATION.HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) DEEP OBSERVATION HOLE LOG, Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) DEEP OBSERVATION HOLE LOG , y Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) Flood Insurance Rate Map: / Above 500 year flood boundary No_ es Within 500 year boundary No Yes Within 100 year flood boundary No v Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervjous erial exist in all areas observed throughout the area proposed for the soil absorption system? If not what is the dept hrally occurrin e ions material? pY g p — Certification I certify that on ID (date)I have passed the soil evaluator examination approved by the Department of Envirootection and that the above analysis was perf rmed by me consistent with the required training,expe ' e a ex rience described in 310 CMR 15VJ6 7 Signa Date Q:\SEPTIC\PERCFORM.DOC TOWN OF B_ ARNSTABLE LOCATION G Lv►^�U - Mi ( SEWAGE# VILLAGE C'e k der�I`i ie ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. S�e��r'`"`t �b� W J)-- ST 6 S� SEPTIC TANK-CAPACITY t, J L LEACHING FACILITY. (type) (size) NO. OF BEDROOMS 3 OWNER ;1 arlel rt!'111 PERMIT DATE: COMPLIANCE DATE: 1- Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility G,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 Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY 2 k, �Z,, .n s0 nUusc _ a -/..ap ®)p f, g el. - W6 /C-F-t 0 covers " c cc S 7&" i r-o n or �t� '`� � r"_"'-`---•-.. /tt y e r o f f✓ Sch -40 PVC- all Pipe u.1mirt. i ,rain. ,n washed pitch 114."per C ,� peasfone fo07L 4 sc vc h. .r�/p pipe rnir7. p+�c • 2 9",men. J ..• trPV. � 1 , qa /. a base E r + + r t _ K{/1 Tj{( + `- Cfl�/�-'I �,✓-( c+•CC,� �-_.. h Y y , f 1 / __..:.-- -_ __.� "ti•--.-_ ,^...,.-t"' '• Jr'�a 'f-I f L1 h!' '; 16 L f + Y L (! �,e _ __. 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T/TLE 5 "i Al/D 7--H& •7•'o Gt AJ OF ° F- ULES F9ND )eEGfJL qT/©AjS FoJE' :5Ly85UP-FACE DISPosA1 of - SAN/ TfgR2Y SEWRG�. �kk`C12� 1�+ 0 0 O 2� �l�MPL/R/VC� !�//TH 2DN/AJG JEEGULATIOAIS --i._ - -- _. - -- SH,gLl BE- DE-TE/2MIAJED BY BUILDING I NSPE CT•oP / C®MMIS3 IONE/2. — 3) EX/STiRJG I? A-ID FlNqL_ GRADES SNMLL j��E 1� -ram Pv6 ��-. 77f f ,4-0e--9 770 A-/ CC" v,�•\AIE'Z IKI V 5 �' �.5 IC Cr✓�jy�r�/�- B D. OF HE- A L T H ,9 G E /V 7T J i /j L C, N /C T-r°E TO a6O WC45-ZC /-6 g ,G] y `- 9 � C} S DAVIs�C' ��-' ��� '✓ L-E G C-1V G> DAB ��' � c`✓ r /e /Y� �D �D/.t I a 8, � f MASON y . Il�AI� -+� .k o.foss ex�sfJryq Gary f��+r �sBo c` t'i� 1 / u° � ✓ ' ., /C'1� s cis s esf hole l z r