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0048 NORTH PRECINCT ROAD - Health
48 NORTH PRECINCT RD. CENTERVILLE A = i llll o UPC 12534 No.2_ 153LOR HASTINGS,UN Town of Barnstable Barnstable RegulatoryServices Department 11 I.F 59. Public Health Division 2007 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL # 7012 1010 0000 2851 3559 May 22, 2014 Mr. &Mrs. Tighe R Jensen .% Bank National Association,TR % Wells Fargo Home Mortgage 3476 Stateview Blvd • Fort Mill, SC 29715 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 48 North Precinct Road, Centerville, MA, was last inspected on 3/10/2014, by Robert Paolini, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system" Fails" under the guidelines of the 1995 TITLE'S (310 CMR 15.00) due.to the following: • Leaching chambers in hydraulic failure.. You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH c ean,�SCHO Agent of the Board of Health Q:\SEPTIC\Sample Failure Ltr\48 North Precinct Rd Cent May 2014.doc A Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments • °¢ 48 North Precinct Rd. Property Address Lisa Burgess Owner Owner's Name information is required fo every Centerville MA 02632 3/10/14 r page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms I on the computer, use only the tab 1. Inspector: TTVV)) U�YJn key to move your cursor-do not Robert Paolini use the return key. Name of Inspector Robert Paolini Septic Service Company Name 17 Playground Lane Company Address Yarmouthport MA 02675 City/Town State Zip Code 508 362-3555 S 14454 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ❑ Passes ❑ Conditionally Passes 0 Fails ❑ Needs Further Ev luation by the Local Approving Authority 4 3/10/14 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. 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 DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of.inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. V� I , t5ins•3/13 Title 5 Offtc n Gon Form:Subsurface Sewage Disposal System•Page 1 of 17 w Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 48 North Precinct Rd. Property Address Lisa Burgess Owner Owner's Name information is required for every Centerville MA 02632 3/10/14 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. * A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments • °M 48 North Precinct Rd. Property Address Lisa Burgess Owner Owner's Name information is required for Centerville MA 02632 3/10/14 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N FIND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): • ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N FIND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: i ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c 48 North Precinct Rd. GSM Property Address Lisa Burgess Owner Owner's Name information is required for Centerville MA 02632 3/10/14 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool • ® ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 'h day flow t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments • ,a''�e 48 North Precinct Rd. Property Address Lisa Burgess Owner Owner's Name information is required for every Centerville MA 02632 3/10/14 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ❑x Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ❑x Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ❑x Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ❑x 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. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered..A copy of the analysis and chain of custody must be attached to this form.] ❑ ❑x The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. Z ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ 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 If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate I regional office of the Department. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments • 48 North Precinct Rd. Property Address Lisa Burgess Owner Owner's Name information is required for every Centerville MA 02632 3/10/14 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No 0 ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ 0 Were any of the system components pumped out in the previous two weeks? ❑ 0 Has the system received normal flows in the previous two week period? ❑ 0 Have large volumes of water been introduced to the system recently or as part of this inspection? 0 ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) 0 ❑ Was the facility or dwelling inspected for signs of sewage back up? 0 ❑ Was the site inspected for signs of break out? 0 ❑ Were all system components, excluding the SAS, located on site? 0 ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? 0 ❑ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ❑ 0 Existing information. For example, a plan at the Board of Health. ❑ 0 Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 t5in3-3113 TNe 5 Official Inspection form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments • w 48 North Precinct Rd. Property Address Lisa Burgess Owner Owner's Name information is required for every Centerville MA 02632 3/10/14 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: na Does residence have a garbage grinder? ❑ Yes ❑x No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes x❑ No information in this report.) Laundry system inspected? Fx_1 Yes ❑ No • Seasonal use? ❑ Yes ❑X No Water meter readings, if available last 2 ears usage d na 9 ( Y 9 (gP ))� Detail: Sump pump? ❑ Yes 0 No Last date of occupancy: 3/7/14 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No I Water meter readings, if available: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 48 North Precinct Rd. Property Address Lisa Burgess Owner Owner's Name information is required for every Centerville MA 02632 3/10/14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ❑ No If yes, volume pumped: gallons � How was quantity pumped determined? Reason for pumping: Type of System: ❑x Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. i ❑ Other(describe): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments • .� 48 North Precinct Rd. Property Address Lisa Burgess Owner Owner's Name information is required for every Centerville MA 02632 3/10/14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Were sewage odors detected when arriving at the site? ❑ Yes 0 No Building Sewer(locate on site plan): Depth below grade: 1 feet Material of construction: ❑ cast iron ❑x 40 PVC ❑ other(explain): Distance from private water supply well or suction line: 10+ feet • Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of Ieakage.System vented through the building vents. Septic Tank(locate on site plan): Depth below grade: 18" feet Material of construction: 0 concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No ` Dimensions: 1000 gl. Sludge depth: 6" t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments • 48 North Precinct Rd. Property Address Lisa Burgess Owner Owner's Name information is required for every Centerville MA 02632 3/10/14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 32" 7-1 Scum thickness Distance from top of scum to top of outlet tee or baffle 4" Distance from bottom of scum to bottom of outlet tee or baffle 7" How were dimensions determined? Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pump tank every 2 years.Inlet and outlet tees are in place.No evidence of Ieakage.Tank appears structurally sound. • Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle • Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments • "~ 48 North Precinct Rd. Property Address Lisa Burgess Owner Owner's Name information is required for every Centerville MA 02632 3/10/14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: • ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): • *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No I t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments • ,M 48 North Precinct Rd. Property Address Lisa Burgess Owner Owner's Name information is required for every Centerville MA 02632 3/10/14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert No Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Box is level.Box has one outlet lateral. Evidence of solids carryover.No evidence of leakage. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: • t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments . 48 North Precinct Rd. Property Address Lisa Burgess Owner Owner's Name information is required for every Centerville MA 02632 3/10/14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: 0 leaching chambers number: 2 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system • Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Sandy soil.Leaching Chambers are in hydraulic failure. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 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 ❑ Yes ❑ No t5ins•3/13 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments • "Y 48 North Precinct Rd. Property Address Lisa Burgess Owner Owner's Name information is required for every Centerville MA 02632 3/10/14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): • t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 48 North Precinct Rd. — Property Address Lisa Burgess _ Owner Owner's Name information is required for every Centerville MA 026.32 3/10/14 page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ❑ drawing attached separately • d bq -dq iE � -T.V � t _r f�C� "fig / L21 � t5ins•3113 Tiee 5 Offciallnspedon Form:Subsurface Sewage Dsposal System Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 48 North Precinct Rd. Property Address Lisa Burgess Owner Owner's Name information is required for every Centerville MA 02632 3/10/14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑X Check Slope Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: Bottom of leaching 10' feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: As-Built ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: USED:USGS observation well data.USED:Technical bulletin 92-0001 annual ranges of groundwater elevations. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.3/13 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 48 North Precinct Rd. Property Address Lisa Burgess Owner Owner's Name information is required for every Centerville MA 02632 3/10/14 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ❑x Inspection Summary: A, B, C, D, or E checked R Inspection Summary D (System Failure Criteria Applicable to All Systems) completed Fx] System Information—Estimated depth to high groundwater Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file • t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 TOWN OF BARNS.T-ABBLE LOCATION g Itl®ll-i 9 SEWAGE # VILLAGE c.,ew /`yiIJe-- ASSESSOR'S MAP & LOT 1 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACII,ITY: (type) (size) ,-NO.OF BEDROOMS '',BUILDER OR OWNER PERMITDATE: ! ! COMPLIANCE'DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the 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 leaching facility.) Feet Furnished by ft e- z, c TOWN OF BARNSTABLE LOCATION yg ZV eAA 07 ee"K k . SEWAGE#ALOty- 3OG VILLAGE If eji , ee&*,fl-y ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. �l ,;Ic,s A 2nfcu T Nc SEPTIC TANK CAPACITY LEACHING FACILITY: (type) },- �4�/r�Ch,,--kels (size) NO. OF BEDROOMS ] OWNER LA-2e(I S ':o, PERMIT DATE: S 19 COMPLIANCE DATE: � t 1`� l 9 Separation Distance Between the: Maximum Adjusted Groundwater Table to the 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 leaching facility) Feet FURNISHED BY _�jlC�w n� AOVT r D - NU,7 00 -� H 7 ✓ D � 2 00 No. W ILA OIW©d � 't FEE COMMONWEALTH OF MASSACHUSETTS Board of Health, 1 75 2,N Lt, ,MA. APPLICATION FOR DISPOSAL,SYSTEM[ CONSTRUCTION PERMIT Application for a Permit to Construct( Repair(' Upgrade( Abandon( - ❑Complete Syste1*dividual Components Location ti Owner's Name C&S W Map/Parcel# L/ } Zi J Address Lot# Telephone# Installer's Name GS 1 ..�g� Designer's Name Address '�'®�3 CerV 4j% P Aci Address Telephone# S� ®(( Telephone# Type of Building Lot Size sq.ft. Dwelling-No.of Bedrooms 7 Garbage grinder ( ) Other-Type of Building No.of persons Showers( ),Cafeteria( ) Other Fixtures Design Flow (min.re uired gpd Calculated desiign flow 3U Design flow provid d ;3CJ gpd Plan: Date ( Number of sheets 1 Revision Date Title �, Fi Description of Soils) Soil Evaluator Form No. Al Name of Soil Evaluator Q�����Date of Evaluation C, 1 q DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date tv, -,Z&-/g Inspections r No.ZO ILA- 30(0 _ FEE /W 000 COMMONWEALTH'OF MASSACHUSETTS ~ Board of Health, :`rr r < •4 MA. - APPLICATION FOR DISPOSAL SYSTEM/C NSTRUCTI®N,_PERMIT ti Application for a Permit to Construct( Repair({ Upgrade( Abandon( - ❑Complete System/` individual Components Location L ' G o Owner's Name (:5L S yt�GU Map/Parcel# L4 , �� Address A �"`�--r' 1 C Lot# Telephone# Installer's Name � Tl Designer's Name Address ?,o _)36 1- P Address 26 Le V Telephone# S l Telephone# J - (� Type of Building �--1 {{ Lot Size sq.ft. Dwelling-No.of Bedrooms J 1 Garbage grinder ( ) Other-Type of Building No.of persons Showers ( ),Cafeteria( ) Other Fixtures e Design Flow (min.re uired) gpd Calculated design flow �G a Design flow provided 3U gpd Plan: Date (��? y �' Number of sheets 1. Revision!Date -21-4 Title r ' Description of Soil(s) Svc l-R p Soil Evaluator Form No. 11 ) Name of Soil Evaluator c� A oDate of Evaluation L DESCRIPTION OF REPAIRS OR ALTERATIONSE The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date'(; -rZG-/!V Inspections NoZp1 y 30 C COMMONWEALT14 OF MASSACHUSETTS FEE i Board of Health, j7)A?_ S—rA(3l.0 , MA. CERTIFICATE OF COMPLIANCE Description of Work: Q-Individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired (,Upgraded ( ),Abandoned ( ) by: n c a..3Y1 at c( A jag:r if. 1? VLy!"C has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. Pr,. LI D(c dated 5� 6 9 i ArVY Approved Design Flow (gpd) Installer m Designer: ,_"U Inspector: \ Date: The issuance of this permit shall not be construed as a guarantee that the system will function as designed. No. !U 1 y- 3 0(p FEE COMMONWEALTH OF MASSACHUSETTS Board of Health, !Q/4 elt)'Mc-z e MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is herebygranted to; Construct( ) Repair( Upgrade( ) Abandon( ) an individual sewage disposal system at y8 /I)gi2T1t �91,�_C'_7AV r as described in the application for Disposal System Construction Permit No.ZDlLl-306 dated °' ZS z Provided: Construction shall be completed within three years of the date of this 1 local c itions must be met. i Form 1255 Rev.5/96 A.M.Sulkin Co.Charlestown,MA Date/ Zr7 Board of Health Town of Barnstable Regulatory Services Richard V. Sc �i,Interim Director t BAMSrneU, � , �� � � Public Hbaith Division ,bey. Thomas .f_4 CKi any Director 200 Main Stree ,Hyannis,AIA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Cerb- cation Form Date: ' 4�l�� Sewage Permit# ,.2COZ y 30,C._Assessor's Map\Parcel � Designer: D MG, A;ioc�es Installer: 175 A, _�?r6w It 1 AC- -Address; Zo Thd �S (�,( Address: P Q 13 6y 14s, �e ri.c►may MA rV, l On g-2 S^ VA , T3r0 W A 1,1 L I was issued a permit to install a (date) (installer) • t septic system at ncve c-""`+ � C��` 's'1 based on a design drawn by (address) v G- A-ss ac'c_l-e� dated (designer) p, 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 tank. Strip out (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 coraponeal.. of the septic system) but in accordance v Ath State & Local Regulations. Plan.revision or certified as-built by designer to follow. Strip out (if required)was inspected and.the soils were found satisfactory. I certify that the system referenced above Was constructed rn compliance frith the terms of the IAA approval letters (if applicable) stallleerr's Signature) ;arc+ g��o 3;31U 's Signature) tn= s; fa Q i y (�:.DA - p Nere) PLEASE RETURN TO BA:I2NSTABLE PUBLIC BEALTH DIVISION. CERTIFICATE OF COWLIANCE. WILL. NOT BE .ISSTJ UI TIL-BOTH TIi�S �OR14� AND.AS; BUILT CARD ARE RECEIVED BY TET,,BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. I QASepticlDesiper Certification Form Rev 8-14-13.doc Town of Barnstable P# Department of Regulatory Services Public,Health Division Date 200 Main Street,Hyannis MA 02601 0 Date Scheduled Time _ Fee Pd. Soil Suitability Assessment for Sewage Disposal Performed By: Witnessed By: LOCATION_&GENERAL INFORMATION Location Address Owner's Name r SRC 1�► \b`�t'�G Jv \ •�^"" Address Assessor's Map/Parccl: '"f 1 Engineer's Name 13') NEW CONSTRUCTION EPAIR 2 Telephone# 1" Land Use G Slopes 1%) © � J Surface Stones Distances from: Open Water Bodyft Possible Wet Area ��ft Drinking Water Well /60Lft t-� � t Drainage Way V ft Property Line 4 L.> ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&Pere tests,locale wetlands in proximity to holes) Parent material(geologic) Depth to Bedrock Depth to Groundwater: Standing Water in Hole: N� l+ � �eping from Pit Face Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used:Depth Observed standing in obs.hole: in. Depth to soil mottles: P43 14'0�16 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 Date Time Observation Hole# ' Time at 9" 1♦ Depth of Pere 3 _ Time at 6" Start Pre-soak Time C ��ry�� Time(9"-6") End Pre-soak �cyw RateMin./Inch Site Suitability Assessment: Sitc Passed � 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 a DEEP OBSERVATION HOLE LOG Hole# I Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel 'A 9 -z' � S GZ s SAD Co c_3 kATA �- ty DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil r Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) to iq I. I0HfLz,1, ` ) LS J e n L� 1M� 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 (Stmcturc,Stones,Boulders. Consistency.%Gravel) Flood Insurance Rate 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 aterial exist in all areas observed throughout the area proposed for the soil absorption system? ___ If not,what is the depth of naturally occurring pervious material? Certification I certify that on 9 (date)I have passed the soil evaluator examination approved by the Department of Envir ental Protection and that the above analysis - s performed by me consistent with the required traini , pertise an erience described in 310 15.017. Signature _ Date_ 1 Q:\SEPTIC\PERCFORM.DOC i Town of Barnstable 41 Department of Health, Safety, and Environmental Services `BAM � Public Health Division �EDMA'�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 May 28, 1999 William E. Dacey, Jr., Trustee P.O. Box 721 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 RENTAL ORDINANCE,ARTICLE 51 The property owned by you located at 48 North Precinct Road, Centerville, was inspected on , June 17, 1999 by Glen Harington, R.S., Health Inspector for the Town of Barnstable, because of a complaint. The following violations of 105 CMR 410.00, State Sanitary Code II, Minimum Standards of Fitness for Human Habitation were observed: 410.300: Evidence of breakout of sewage effluent to the surface of the ground over leaching pit due to hydraulic failure. REGULATION 310 CMR 15.02 (207) AND 105 CMR 410.300: Overflowing sewage onto the ground. This violation is a serious public health hazard. 1) You are directed to hire a licensed septage hauler to pump the overflowing cesspool within twenty-four (24) hours of receipt of this letter. 2) You are also directed to keep the on-site sewage disposal system pumped as many times as necessary to keep from overflowing onto the ground. 3) You are further directed to contact and hire a licensed Disposal Works Installer within seven (7) days of receipt of this letter in order to repair this system or connect to town sewer. 410.481: No posting of owners name, address or telephone number on durable, 20 inch square material. 410.482: No smoke detectors were observed. dacey/wp/q/ls t 410.351: Chronic dampness in basement due to to leaks in plumbing. Plastic stapled to basement ceiling was full of water along with full buckets of water below plastic on floor. 410.351: Cracked and chipping plaster observed on kitchen ceiling. 410.351: Kitchen sink drain line drips into full bowl of water. 410.351: Refrigerator is broken. Defrost water drains into meat drawer. 410.500: Chronic dampness in bathroom. Ceiling is covered with mold. There is no plaster left on ceiling. It was all peeled off. Dampness due to leaky roof. You are directed to correct the violations of 410.481, 410.482 and 410.351 within twenty-four(24) hours of receipt of this notice. You are also directed to correct violation 410.300 within sixty (60) 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, these violations 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 $500. Each separate day's failure to comply with an order shall constitute a separate violation. PER ORDER OF E BOARD OF HEALTH Thomas A. McKean Director of Public Health dacey/wp/q/Is i • The Town 'of Barnstable �_ Health Department 1 "" out 367 Main Street, Hyannis, MA 02601 1659. �F �r A, Office 508-790-6265 Thomas A. McKean FAX 501-j7PL3344 � Z Z) 1 q9 9 Director of Public Health o,c -7-2-1 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY CODE II, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATIONvl�� The property owned by you located at `-1 ff-,,'Vv r �`'� 41lecj�cf(l�was inspected on 5vv4- LI) 199q by, C(Q,, tkricK92-&—j 0=L, Health Inspector for the Town of Barnstable, because of a complaint. The following violations of 105 CMR 410.00, State Sanitary Code II, Minimum Standards of Fitness for Human Habitation were observed: `f 1 `� OD .�c(R,k C�. ✓t LcUv� d`� �-2�c�c C�fi Wes- Vv Y4,j- Su v .oL d Ale_ 4 t z V d -ow/(;-6- 14 1 0 ° (4?' 1 : �t/o_ r o 1 t� 0 w1—s lti&A,.,R , a�d,6,e """"`ct'h�•L , ZO SQ V a..%k 0-.a, - 41 dot,,-e.. 4o (eti,k.s 910 , 3 S' I : �twSG S led ba5ew.�.�.-t ceit�►y w� s {:,I(01 c,ra utcw� .s ^ b 1 b✓ s Lq wo-4,L- l L4-L� , You are directed to correct violations within twent \ G four (24) hours of receipt of this notice. a c�.,d �ft0. S� � VVV �$�lo, 48 You are also directed to correct V r c(a�c v� 1�• 3 a within S f K4-7 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, these violations 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. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health CoG be d &,wA, WvoA,:�,f tkv�,, ct, C�r we�ro Is cou��v'' u, .vtdl�✓o l,,,o la.-t e,'!� . Leg �i/y ��• l 199,1 NOTICE TO ABATE VIOLATIONS OF 310 ' CMR# 15.00 THE STATE ENVIRONMENTAL CODE TITLE V: MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF SANITARY SEWAGE AND 105 CMR 410.00 STATE SANITARY CODE II - MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION. The property owned by . you located at listed as Parcel on Assessor's Map , was inspected on 1991, by , Health Inspector for the Town of Barnstable because of a complaint. The following violations of 310 CUR 15.00, the State Environmental Code, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage and 105 CHR 410.00 State Sanitary Code II - Minimum Standards of Fitness for Human Habitation were observe 105 CMR 410.300: p<r' :u � Overflowing sewage onto the groun a ion is a 0 S -6 serious public health hazard. j J4 1) You are directed to hire a licensed septage hauler to � 47 pump the overflowing awl within twenty-four (24) hours 0 F of receipt of this letter._ SY4'c SyS � 2) You are also directed to keep the on-site sewage disposal system pumped as many times as necessary to keep from overflowing onto the ground. 3) You are further directed to contact and hire a licensed Disposal Works Installer within seven (7) days of receipt of this letter in order to repair the system. You may request a hearing before the ' Board of Health if written petition requesting same .is received within seven (7) days after the date the order is served. Non-compliance could result in a fine 'of up to. $500.00. Each day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH Thomas-A. McKean r5`., Director of Public Health . F(iR 0 CAW HosssaWnaRev'" THE COMMONWEALTH OF MASSACHUSETTS , .1 F H 1�;,�47 � BOARD O HEALTH ) � -4 61e - CITY/TOWN d DEPARTMENT' ADDRESS T TELEPHONE Aj 1 rec't"t"I� tu! �' V; El,by axd LAY O/V►'� Address „Occupan Floor Apartment No. No.lof Occupants No.of Habitable Rooms No.Sleeping Rooms No. dwelling or rooming units -Lt. No-Stories Name and address of owner._ R.0.k .41! ORc Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation,Rats or other: STRUCTURE EXT. Steps,Stains, Porches: . Dual Egress:and Obst'n-: El B, ❑ F ❑ M Doors,'•Windows: ' Roof.5. 3 jot6+tA'401ae. PfLkt" dA4.. {o' ka W. 444,[ 7 �- Gutters, Drains::. ' Walls:' Foundation: Chimne BASEMENT Gen.Sanitation: Dam ness:CtA ro-t^i�r-�,'dthX' <b jO lvimlasps — l V Stairs:' GtdS Li htin : STRUCTURE INT. ....Hall'-Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: ' Hall Lighting: t Hall Windows: HEATING Chimneys: Central ❑ Y ❑,N. E ui . Re air TYPE: Stacks, Flues,Vents. PLUMBING: Supply Line.: ❑ MS- ❑ ST ❑ P. Waste Line: �"A"r-0 e7 b Yeo ka1.-1 (01 bott,/i,. , ?0o 1>C H.W.Tanks.Safety and Vents ``. ELECTRICAL Panels, Meters Cir.: ❑ 110 11220 Fusing,Grnd , A10 .s`01014 de4C—(ry S AMP: Gen. Cond. Distrib. Box:.Gen. Basement Wiring: DWELLING UNIT Ventil. L to Outlets Walls "Ceils. Wind. Doors Floors Locks Kitchen I '"GLG -- hn 3S Bathroom (Ar y Pantry Den j Living Room Bedroom 1 ` Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas;Oil,.Elect.: Stacks,Flues,Vents,Safeties: Ij Kitchen Facilities Sink _ 2 _f r`t4 Ur 0J'10UI t /Nr. A f 0 U4" X Stove l? Qcil�+- rc. 4.w it 44- h ./c% c t!"��S iH s l Bathing,Toilet Facil. Vent.., Plumb.,Sanit'n.: Wash Basin,Shower or Tub:0010 fAiL CJOA-t� ,.�,1-lre�(/H3�U7.�u�'l�✓�d Infestation Rats, Mice, Roaches or Other: ' < V 1a(541 61LAGL,,CPr`�k, Egress . Dual and Obst'n: General, Building Posteds Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE.IS A CONDITION WHICH MAY:MATERIALLY IMPAIR THE HEALTH.OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR 'THE AUTHORIZED INSPECTOR.(See Over) 1 'THIS INSPECTION REPORT IS SIGNED AND.CERTIFIED UNDER THE PAINS.AND PENALTIES-OF PERJU� ." INSPECTOR &-JTITLE Ct;A� G ,.. q A.M. DATE 1 TIME " 'Z', C7 P.M A.M. THE NEXT SCHEDULED,REINSPECTION 4,211 / P.M. . 4 r - ems• '�'"'��- 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health,or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for i human habitation, any other violation has the potential to fall.within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by'105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting,or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. JANE F. DAVIS Attorney at Law June 8, 1999 Thomas A. McKean Town of Barnstable Department of Health, Safety and Environmental Services Public Health Division P.O. Box 534 Hyannis MA 02601 RE: WILLIAM E. DACEY, JR. (NOW DECEASED) JOHANNA DACEY Dear Mr. McKean: My client Johanna Dacey received your Notice dated May 28, 1999 some days later as she was out of Town. She is working on abating the conditions listed in your letter. Please be advised that the tenants in the property are being evicted and reported the property after being served with the eviction papers. The tenants have greatly damaged the property and are responsible for much of the damage that is listed in your letter. Notwithstanding that, be assured my client is working on correcting everything mentioned in your letter. I will be in touch as soon as repairs are completed. Sin ely, ane F. avis JFD:rlp P.O. Box 1887 • 712 Main Street • .Hyannis,Massachusetts 02601 • (508) 771-4551 • Fax:(508) 790-4050 .t: 9 f0 JANE F. DAVIS Attorney at Law °D J U L 2 8 1999 N July 23, 1999 BY FACSIMILE ON JULY 23, 1999 TO 790-6304 Glen Harrington Town of Barnstable Department of Health, Safety and Environmental Services Public Health Division P.O. Box 534 Hyannis MA 02601 RE: WILLIAM E. DACEY, JR. (NOW DECEASED) JOHANNA DACEY 48 NORTH PRECINCT ROAD, CENTERVILLE Dear Glen: Enclosed are copies of the Septic Report on 48 North Precinct Road showing that the septic system tank was full of rags and plastic bags. Notwithstanding this, Ms. Dacey has contracted with Bortolotti to fix the system. We continue to have problems with the tenant allowing access. The septic contractor has asked that all debris, nails, etc. , in the yard be cleaned before the trucks will enter to do the system. 1 have requested the tenant to clean up the yard and he has refused. He actually hung up the phone on me and threatened to sue everyone. I informed him. that Ms. Dacey or her agents would do the cleanup themselves and that the system would then be installed. I attach herewith the estimate/contract with Bortolotti. P.O. Box 1887 • 712 Main Street • .Hyannis,Massachusetts 02601 • (508) 771-4551 • Fax: (508) 790-4050 Last week, Ms. Dacey was refused entry with a plumber and electrician. I myself requested entry for Saturday, July 24, 1999 for the Electrician to fix the smoke detectors and was refused. I asked for appointments for next week and was refused. The tenant said he would call me next week. This is the continuing problem. I enclose a copy of a Winslow Plumbing report showing tenant damages to plumbing and a copy of the Eviction Judgement. I will be in contact today with Ms. Dacey to stress the need to fix the septic system, per your call to my office. Sincerely, J0 Jane F. vi JFD: rlp cc: Johanna Dacey BORTOLOTTI CONSTRUCTION INC. DRAINAGE LAND DEVELOPMENT SEPTIC SYSTEMS Johanna Dacey 7+ 18 P. O. Box 339 Centerville, MA 02632 06 Telephone: 508-362-5878 RE: 48 North Precinct Road Centerville, MA Bortolotti Construction, Inc.,proposes - - `72;t k�q. ►ystem Repair as per the Town Of Barnstable Board Of Health Requiremenis p,, _hree Bedroom Appli- cation: Furnish and Install a Distribution Box, and 2 (H-10) 500 Gallon Leaching Chambers with Wrished Stone surrounding and between (Leaching Area: 12' W x 26'L x 2'D) connect to the Exisfii)K Septic Tank at the.Rear of the Dwelling. INC. Permit Fee, Sketch Plan Design, Tree Trimming and Removal as necessary, Pumping and Filling of the Existing Leach Pit, All Materials and Labor, Backfill and Grade, Removal of Excess Fill, Re-Woodchip the Disturbed Wooded Areas. NOTE: Soil Conditions are assumed to be Suitable and will be varifted at tittle of Installation. If Loandug and Seeding are desired, it call be performed at an Additional Cost at a more suitable time of year. The Total Price for the above stated work will be$2,975.00, with Payment Terms as follows: 50% Upon Acceptance, Balance Upon Completion or Other Suitable Arrangements Call Be Made. Thank you for the opportunity afforded its in offering this Proposal. JCCE,,PT CE: Sincerely, Ro e t J. ortolatti ._ .lohanna Dacey President 'i Bortolotti Construction, Inc. it in agreement with this Proposal ILLS, MASSACHUSETTS 02648 • (508)428-8926 sign both copies - keep one for your records, send one back to us. Thanks BORTOLOTTI CONSTRUCTION yr 01. W,.�iw•r �r•rn�l.+a �'�sl�.+fi rMrry Ilr'W{r , !PI 0 Reartior'r C�t41v 30uth Yarrnuuth, MA A?AAd Sl;lrrylulrrd 7� Z w�1414 9 = �O @61ribICl(1AII) 104 711D ruo(r"u) uVv I4au I1QCQl�ed /kdc/99 14 a 4ta zone CIEN Work Address Contact In llr Y y ipl-f wia �°9 hIS�F1 rrt f�RC•C"I Nf^T F711 Prnnvur ur Oro tri`ti t t=1�V lL,l_<T Mai Phorie Alt Et,one 5013-'36 -5878 �m(�IvyB6. jEr ,' cLppK mm 8 Terms 10 BE BILLED Nork Requested MOKl� PLUMPING REPPIPC CLL� mpS. DAGtV FOR DtTAILG AS CLOSE T© 9:00 IF POSSIBLE CALL, WHEN ON THE WAY 1 -r61-9 711,-.a'5 45 ❑ ESTIMATE. LAY W011K. ❑ SERVICE CONTRACT T f ❑ WARRANTY C; COM"R.ACT EXTRA TIME APiRIVEO: _? f —^-- -, --_—� TIME1�AARTE.h: TRAVEL. TIME:. _ --= — _ �t7UANT�4 —„_.� .�—�,..,._--,,...—DES -- -�.., _ ..,. ! _ 1_�_F11i 0rt pF MATERIAL uSFn —_ —�_ "-,—=w = :. •--- L� f%Rt�E _- nMt)llhlY 11 - --`3-�- _w --���.�—,..DN �,., (/�(.I J� fx��'?'1�0✓�' �'anlscnr_7' o� �w � ��--- /�1.I_l.`t'fl^c.�h � (►ifF — 11.�...,. Mr1 l��n�Q �-._. - __ r -- —flll�l) IT�IIIIII��IIIIII I it �V^ ,..r �: '.f� .,1'Y ..fir, I���.,�1�,�r�.�� ! s•�i�9 , r�'-�.�..' , 4�-� m m niIn I Innn Iowa i t Irinr III u��n ` I I) tl�llllllll I Illllll,llllllllllllfilll�llll 1111111 II I'�IIT eun� re _ Alf'A n15 1nr t"'I rrrrlr hnne nr ]djuCir%lpnt0 MUCI b Kjadd M�vR$ — � a _nenQ / --------- - AMo TOTAl MECHANICS �v - —� MATERIALS , — HELp RS TilrAl .� —. LAE T - oamptnra�of IffQ.Dove tl9acnp�won. �rAl l,.At3DR � y 'SAY � �---�--- Warm.. E. Robinson, Sir. IVAiept�c See P.O. Box 1089 MA 02632 Cente�� �^1 xy/�11 9 77 Pax 90-1694 I DATE pEsCRIPTION f 0 r tin I TOTAL AMOUNT RETURNEn CHEC fc-t2 ' .. BALANCES OVER 90 DAYS SUFJJ�CT Tb 1'/."/o SERVICE CHARGE. ------------------------------------------------ CONNECTION TO I I TOTAL PAGE = 1 RESULT - I SUCCESS I COMMONWEALTH OF MASSACI{USETTS DISTRICT COURTS OF MASSACITUSE•TTS BARNSTABLE, SS: DISTRICT COURT DEPARTMENT SUMMARY PROCTSS : �? PLAINTIFF VS DATE: nerEND N f AGREEML•NT FOR JUDGMENT It is hereby agreed that judgment may be entered in thi.s Summary Process. action for POSSESSION as of .EXECUTION FOR POSSESSION TO BE ISSUED ON MONEY EXE UTION I SUED TOTAL, RENT DUE: COSTS: OTHER TERMS & CONDITIONS: -03 Jq NTI DE ANT k TTY FOR A FOR. DEF: (,(�� APPROVED BY MEDIATOR: APPROVED BY THE COURT: JUSTICE EJECTMENT E*CUTION REQUESTED: / MONEY EXECUTION REQUESTED: JANE F. DAVIS Attorney at Law August 11, 1999 Thomas A. McKeon Town of Barnstable Department of Health, Safety and Environmental Services Public Health Division P.O. Box 534 Hyannis MA 02601 I RE: JOHANNA DACEY 48 NORTH PRECINCT ROAD, CENTERVILLE Dear Mt. McKeon: I am writing to follow up on the above property. I will respond item by item to your letter of May 28, 1999. Regarding 410.300: Septic was pumped and evidence of rags and plastic bags were found in it. Nevertheless, all necessary work to be done September 9, 1999 by Bortolotti. Enclosed is estimate and work . order as well as pumping receipt and report of items found. Regarding 410. 481: A sign with the owner' s name, address and telephone number will be installed on August 11, 1999. As you know, the tenant well knew the owner and has called her repeatedly as well as you and me. Regarding 410.482 : Smoke detectors are being repaired/installed on August 11, 1999. It took me many, many telephone calls (more than 10) to get dates that the tenant would allow entry for the electrician. I confirmed date and time by telephone after 2 letters and all the telephone calls. I requested and got assistance from Inspector McNeeley of the Centerville, Osterville, Marstons Mills Fire Department who also contacted the tenant at my request. P.O. Box 1887 • 712 Main Street • .Hyannis,Massachusetts 02601 • (508) 771-4551 • Fax: (508) 790-4050 �A +f " JANE F. DAVIS Attorney at Law August 12, 1999 Thomas A. McKeon Town of Barnstable �EIUE� Department of Health, Safety co. AUG 1 3 �.ggg i and Environmental Services Public Health Division T"gF8gNMW W P.O. Box 534 Hyannis MA 02601 I 1 �1 RE: JOHA4NA IDACEY 48 NORTH PRECINCT ROAD, CENTERVILLE Dear Mr. McKeon: Enclosed is a receipt for work done at 48 North Precinct Road, Centerville. The smoke detectors are done and per the receipt the tenant admitted removing the smoke detectors and would not give them back. Also per the receipt, the tenant had installed an external jumper on the hot water heater. And the electrician reports the refrigerator freezer is working. I will report to you when the septic is finished. Sincer ne vis JFD:rlp cc: Johanna Dacey P.O.Box 1887 • 712 Main Street • .Hyannis,Massachusetts 02601 • (508) 771-4551 • Fax:(508) 790-4050 jA 237 �o COLEMAN COSTELLQ INVUIC N<�- 2 52 ! Licensed Electrician 49 Indian Trail,Centerville,MA 02632 DATE -: 7- —/-119— Telephone (5�)8)771-2143 CU57OMER _..� ADDRESS - -- . CITY & STATE JOB LOCATION ADDRESS CITY & STATE 4. Amount Quantity Description i -r S 9 � i 1 •' I , � o i� 1 I ry rrn�' f i 1 ' r I- 1 j i. i (, $UB TOTAL i n TAX TOTAL ------------------------------------------------------------------------------------------- ` , CFCs l = TOWN OF BARNSTABBLE �f y-� �°�1Ylli7�Y SEWAGE # Z �"�7y LOCATION _ J VILLAGE C-e.,�w%//e-- ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) -$-OD y,¢�C 4 � (size) NO. OF BEDROOMS 5 BUILDER OR OWNER pG� PERMITDATE: l 7�p( COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the 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 leaching facility) Feet Furnished by A � a L-Z C 3 No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: � Ves PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for Mtgooal bpztem Construction Permit Application for a Permit to Construct( )Repair(✓)Upgrade( )Abandon( ) ❑Complete System 2 ;dividual Components Location Address or Lot No. LlV IL1077- wner's Name,Address and Tel.No. Assessor's Map/Parcel ceelein,11/le. , 1®4111161? Aece Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Go �Ge&51y,-. 77/- Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder Other Type of Building 25 e4reNo.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow l/01 gallons per day. Calculated daily flow 3 3 e gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank /®®® Q G 'S 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 Certifi- cate of Compliance has been issue by t 's oardof Health. Signed �� -Date Application Approved by Date 7 g 9.4 Application Disapproved for the folio ing reasons Permit No. Date Issued % ,I :It v No., �� — Fe e ee�.— . r 4 .. :THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ites r PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS Zippfication for Mitpoml *pgtem Construction Permit Application for a Permit to Construct( )Repair,�/ Upgrade( )Abandon( ) ❑Complete System �'J Individual Components Location Address or Lot No. /wCJ`/ wner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's,NQa"me,Address,and Tel.No. Designer's Name,Address and Tel.No. t 7-7 -93 Type of Building: � /J Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(_ � Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow // gallons per day. Calculated daily flow 3 3 gallons. m Plan Date Number of sheets Revision Date F ` Title Size of Septic Tank lewd peel exl:5 7`l�l�' Type of S.A.S. Description of Soil / Nature of Repairs or Alterations(Answer when applicable) 7-//4-le 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 Certifi- cate of Compliance has been issue by this oard of Health. Signed Date Application Approved by Date 7 - 9� Application Disapproved for th follo ing reasons f,t Permit No. Date Issued ----------------------------- -----. THE COMMONWEALTH OF MASSACHUSETTS g �L`�—�23 } BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( -)Upgraded( ) Abandoned( )by 4 d l0 /// - at 11571 ..G /9C C ell'IV1// etas been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. - c dated Installer Designer The issuance of this perRt sLall t strued as a guarantee that the4yej)w'll function as de i ne / 0, � Date � Inspector w A --------------------------------------- No. - S_ /41£r-I2-3 -- Fee l� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Migozal *pgtem -Construction Permit Permission is hereby granted to Construct ) pair(✓)Upgrade(/ )Abandon( ) System located at �/ /�OI'7►-� /�°.C,hG-�"' dpl' � '6j�`�`' j �/%/�E' and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date: Approved by-S� .'u t Y T.- :rin t`�ia/"u.a.-r� ��'i" ki k r.' ..*w��. �'w ti• � + `ti �< Uw79 yi5 NO1�lIi kOff•%^ K.*. ." A'x ig � ` CE: This Yorm Is T6 Be Used For the Repair'"'Of Failed k Septic Systems Only ��.. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) hereby'! certify, ce that rn/ / the application for disposal.works construction permit signed by me dated ; 1l311W , concerning the property located at y /1�1'9 ` -1 /�2°c/�C �e� �vlI`e meets all of the following criteria: • i The failed system is connected to a residential dwelling only. There are no commercial or business es associated with the dwelling. e soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. ere are no wetlands within 100 feet of the proposed septic system There are no private wells within 150 feet of the proposed septic system J/There is no increase in flow and/or change in use Po ro sed P b/There are no variances requested or needed a/The bottom of the proposed leaching facility will not be located less five P� g tY _ than a feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor when applicable] /ethod the S.A.S.will be located with 250 feet of any vegetated wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following. A) Top of Ground Surface Elevation(using GIS information) �Dr B) G.W.Elevation +the MA, High G.W.Adjustment. 7 _ �7 DIFFERENCE BETWEEN A and B G I a SIGNED: DATE: Sketch[ Lta of on bad]. PmP�P l q:>ah 0 9 4ss� I& LOCATION �S� WAGE P"MIT00 N0. VILLAGE INST LER'S__NA E i ADDRESS •-- o�2a' l v� Oc S UIIDE OR OWNER � , DATE PERMIT ISSU E D DATE COMPLIANCE ISSUED ,_ /� �/ �� 6�� � , ��� � a�� . , cpjd- Fss.....No......... .-- •---•- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF, HE TH � .......oF.....'.......Z.a . 1 ........_.............. Appliration for Disposal 10orks Tanstrurtion 1rrutit Application is hereby made for a Permit to Co nstruct ( ) or Repair ( ) an Individual Sewage Disposal System at* �. . 1'.0Y-.... ..._1 . .,�l. .._ ... v��� ----- --... , _. ........... ner Ci Address a .................... Installer Address Type of Building Size Lot.40.•••......- �..� Dwelling—No. of Bedrooms...._.... .. .................Expansion Attic ( j Garbage Grinder ( ) `4 Other—T a of Building LJP0�_U&..6No. of persons............. ......... Showers — Cafeteria. Ga YP g --- - P �9- � ) i d Other fixt es .. ---------------.........._...._..----------.--------..._.... = ===..:........ a Septic Tank—Liquid car gallons P Lengtherson per days Total daily f�w..............3.? _........`.......gallons.�----------- Design Flow........ .� . .. .�.,...__. loos er S p q ty.:�Oe.g ._-.���.. Width.�..la.... Diameter................ Depth-._.. W Disposal Trench—No. . . ___.. Widt .......- Total Length Total leaching area....................s ft. x P gt ••.......•-••i•_..., g � q• Other Distribution box Dos t inlet......[ ... ... Total leaching areaag....:.6....sq. ft. � Seepage Pit No............ ( ) Diameter......_....g_._. Depth)Uelo J' �--1 v a Percolation Test Results Performed by........ ..f&. ..l&L............f:.......f.!�...r1'... .. Date---.-: ,1 �......._... Test Pit No. 1...........—.minutes per inch Depth of Test Pit......../A ... Dept to ground water........................ (s, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ... • 5..... D ._... ?G.escrptonooil---.. - V --------------------- ----•-----•-------........-----........-•---......-•----------.........-•--._........ W ...................................... •` .......... ........ . P.............................................................................. Nature of Repairs or Alterations—Answer when applicable......................................................•.........................._._.._...._... --••-••-----....---•-----•-•------------------•-•---------------...------------....---..................._.......... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with ,the provisions of TITLE 5 of the State Sanitary Code The undersigned further agrees not to place the system in operation until a Certificate of Complian been'' su d by the boa d o ealth. fC S geed...... •= -/ � '._... - Z U �. (L.O✓�-. Date Application Approved B / PP PP Y t 1... - D z .e e Application Disapproved for the following reasons:_...................•---•-------•--••------•--.......--•---•----•-----------...-----•-----•---•--------------- ......-•-•-•...---•..............•-••......_..--•--••................-•••-•••-•--•-•-•---•--••---••-•••-.•--••--••••...-•-•-•.....--•-----------.............. ------- -••----------------- Date PermitNo........................................................: Issued........................................................ Date ... _ ! . _ 1y ri No ..ls q-...._ Fxs. ..�........... THE COM,,��pyy p M77��ONN ASS WEALTH OF M SACH�pUpS��EppTTS p�p�gqgq p1!J........OF......... ........................ M Appliration for Disposal Nods �vnsthwtw'n Prntit Application is hereby made for a-Permit to Construct ( ) .or Repair ( ) an Individual Sewage Disposal System at: .���':...�d1 � ,���Q Z � ...�� Location-Address / j �' /!+ A or Lot No. r t c �d dJ V (, . . .0 f � /�1i1 ,�1�✓ti` 9"� /��/��n//�/� W ..... '� _..... Owner...,. Address- f _ .._ .. ..........-_• ...__....... • _.. ...............•----....... ---......._,�............._....�!. ...................................................... Installer Address Type of Building { Size Lot. a d..�. ......Sq. feet Dwelling—No. of Bedrooms._....:-3..............................Expansion Attic ( . ) Garbage Grinder ( ) Other—Type of.qBuilding ...W u ea.� ?�`N0. of persons.............U.......... Showers ( ) — Cafeteria ( ) d Other fixtures ._.... ...-----•-•-------------------------------------•-------_-........ ....----------- .....______•---- W Design Flow........S.� _..6�L n!1t'_P.....gallons per person per dal Total daily flow..............����P......_.._._....gallon WSeptic-Tank—Liquid ca,p,a�city_J64g_.gallons Length.... ,___ .. Width.�._L.U.... Diameter____ _______ Depth.._. ........ x Disposal Trench—NO..!el�._..__.._.. Width.......--__-_....... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.........._.a.__.... Diameter.......... ...�._ Depth below inlet......r e.... Total leachin area P /L� P g ea sq. ft. Z Other Distribution box ( ) Dosing tak ( ) Jai 2 a Percolation Test Results Performed by......._ . _ ......................t.... ___ Date....__._r_..__......................... Test Pit No. I....-...........minutes per inch Depth of Test Pit........Z*.?=.... Depth to ground water........................ 44 Test Pit Noi,2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ...................................................... O Description of Soil.: fit'1-;77 ...--lr=' �t-r,. �.._.��-.�?_ �?.t................. ............... t �t J \ --- .................................. -`, 12........... ---•--••2!-�^'V )••----•--••---•-•••--••-......----•-•--••......-•--------•--•-......-•-------- U Nature of,Repairs-or l t&ations—Answer when applicable............................................................................................... -------------------------------••-••--_...---•--••-•••-•---....----•---•------•-•-•-•--...---......-----•----------•-•---•••-•---•-=_•---•:--•-------•'-•---•-•-..................--•-•-----••----•-. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place"the system in operation until a Certificate of Compliance--has been.is'sUd by the board of health! Y .s \.•__ ..........................f'i'DL. lji�l �l DVe ~ Application Approved By........ Application Disapproved for the following reasons:.........................:.:.. . . ... D ........................•----•-•-•-------••----------------••--•-•---••-----•----------.._..-•--------._..--•-•-•--•----•-----............--•---............----•-............•.._...........----•--•--- Date PermitNo................................................. Issued--------------------•--•••-••-•• ...................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF A,LTI=G ,. - :.... . . O F................. . ..... .............................. a}. .. . w_ Trrfifiratr of TH IS O C RTI , That the Individual Sewage Disposal System constructed ( or Repaired ( ) by..... s.�� - �'^_'•_.............. --..._..-. _. ................. -•--------�^_........_.. P' w�l.:'... `� • � In lief _ S has been insiallea'°in• accordance with the provisions of T 5 of The State Sanitary Coe s des ib din the ....................................... �application for I)issposal Works Construction Permit No -_-._____-/ ?_ ______________ dated.._.... . THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTIONS TISFACTORY }. DATE .r �... G.��� � Inspector �'�� � F � :�# F L9* •"" ... ^'` ,.,t..., k .,..} - .................... • .s.�s2.�.. THE COMMONWEALTH OF MASSACHUSETTS { BOARD g HEALTH c�/ __. F ? No.•••-•••l J FEE........................ - - Di ns or i��i mitr rat... amit Permission i herebygranted.__.. ,(_. .._. �tII ------------------------------- --- ................................... to Constrn or air ) :Mdivid;u�a�I.Se;,a otem•.atNo.. - ��f .......... .. .,--- ----•--- -- ........................... Street' /`�/^� / as shown on the application for Disposal Works Construction P No. ..:... .... .. Dated.......,1._._............................ a. � • Board of Health DATE........- ............. i................................................. FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS f; , µ r� " : s ,ri , r,, x ., ' t aC , de r,1 -" t J V, } x F d '+ ' -<.� .I t:., � ,it ti n dtr 4:s ,, , r I, nt r t - r ,ry y nS 'r i"okf ,i,,T�r ,, J { i. j i I ,"'�..ilr ,, J,.,: 4' •,�} • �+--a.uk.�t-"Z * . i qq� i p yC„- d Ir t'� t'o1 1 � ,is a ,, I, 7' ', d, a � .. { t s b A I M , 5 r , ,aI�as 1 rt I ''�s ry r�'n `? k r t 'Iz It� '.F y F- ' ,, �}It, r e " " Y �� Ip',: r' m t N i. N, , ,n. 'gi 1 r t d ,;I ar r ,t ° { c xt� y t S, f ' J �I t s `x� r y �,, �'tk;,.",' 2 2. y 1 F t ... a u 'u r - ? " 6Y �' i .— .. .. S 6 - r. F . _1 0'5.,III I 1I,.��II.:.-_�1_,f 1,4I�-_".,..j�—..'-�,�_�.I.1 o.I�*7II,0,1.I.I fI,Z�,�._-�.�--r�,�,-.*.)I q,-�1_I�I,,,-..1-1 II I./I.,..,,.....I�.: Vi I.,,I,j" '. - I' JF VkeYr , f , 11=r .i . U I f 1 } r j,' 4(' ( h r d' n t.. n I '`V 1 .) }, ry Pd,'t Yn t 1 �. )A ' `'` tl Yl tilt Jr # t .�� t I , U t�a 1'3 k 6 e>e/!d ,. r l 1 � _s e � ', L ,{i p a r } ... r( t t,. i tfx � I t El'7 fC: tsj' r� L` iir4 1 l Y N I , TAB e//'4:' -.y k , •, r;' i , �k f; ! I t Y + r rt y s d�� H ! : ,, 5 bf� eh (• c /4V.*I _ g 1 tN I I j tnA ;S_E'e '.d rf r' k :"r t\.-• ~ '�"'.. +. rr. - _1: ..` y r rii ,5' tr 6 'eI 3 Yx �r 1 {J''" a> r tpr a /4'I 3 t' ' n �d r +r . ',i yY( I ,fir f I a 7t1. . J SE' 4 ! t .� { t i.. J , t )" x+ P t t"q y R tl V` i aw N'1't 4 , j..,n , 0 4 4 �,�!F� , i tt�{ 4)r'" e,,.� �f,�Lk p q'1 " .`' v7 b.V si.', 4 i 2, 1 I - ..e�, .r J ..m v ..mwa+ -,.�ry:.nr...,re .«...../.-,e..r.�.�j� _ ,!—.....� _ 1 i f S,I x , o- I .„„,.,V �`-'�_ / "Y"t J 1/V e' �, t w t x4t F; }�, a. K� j— I'A l� I 4 - .t E - Y r} �, X , 1 f_,1 C"; `k }I 'li" �. r I /'I},� POSFR t 'G� s x NSP 2 C'�Q/ ,, x rr #\\„\P 7� � VI a r Y i n I .�.�yt•�.� G x, rJ f r1� .uct.'fAL / , r, s, ,F 1` t '#, LEGEND i 1ST"' SPOV ELEVATION Ox0 ;a . CERTIFIED PLOT PL`APf T1NQ .;CONTOUR --- O — W fi ' .t _a., %G v F c a. cT f4P � 10 8POT.' ELEVATION /1 ? '.. �r�''e /I ,V�:, . t lHEt� CONTOUR , 0 xi, ;: INt , tom, bYED;r 80ARD OF HEALTH !. "�' ' `IIE '�' AGENT '. SCALE: / '(--:-4 �,' DATE t" II 7 .1, ENGINEERING Cat IN -� y "4 i;, CLIENT I CERTIFY THAT THE PROPOSED TER REGI,BTERED JOB NO. �' Z" BUILDLG SHOWN ON THis' . PL AWE` �' r '",,,``CIY1L' .. LAND CONFORMS TO THE ZONIN® lAW$ r URV Y R OR.BY� �41 /1 ,�1'f. OF ® RNS A8 E , E ' , 1 �l r o 4, .. , :'� t T' MAIN 3T. CH. BY t -f' ,`� . i�f�krw« *rAa,{ , : HYANNIS,'MASS: �. - � SMEET_..OF DA E' E0. LAND SU .V , wv y- 9 .^"' t ti a fix'% t ;.•-" r 's= _,.-' "'' :r, -roc. :a a - > °` . . T . -.; v� .: :i4-...�:" ii' •�+�y"�g' � �� 3"w WORD c_ y4 C:: :ram^ = -'s_ "' MY - Fk A •.. - •= , AF 40 • o • • • •• • I •• AN M ' �lo�► dilR l G=�3lJ 611t: � ,. � •� . WAs 4 w D/ST • • • • o •o • • • � ��C BOX .. • . - x - •��' -. ;. •• A O<� r , �/'1•Cl'7•�_• • •,: yVi43JNED s'TOXE��.. -• • • • �, • • •• • O • PIREL'AST 5jmm46E • '• r• . I . ♦ P/7 DR !/1/rRR /1/8 T L E EYAT/0 �' Gv.,Ir1• t /MYd"'RT AT Ov/tD/wG- 9? D FT !o P7 DRAM• C Cie /%�r�o/v� /NLET PTAC TANK fT r I ONTLE:'T BdPTIC TANK ��'3 f7. GRO(/ND WATER Ti OLE i //vLFT O/1TRidvrloN Box 946 .97: vF I i®N 15- fT .§'Ej4/,q��s O/SISi�t SY.ST�A9 Ti1&✓LAT/DiV Ot/TTiti/. �!!I/J' _l I/1lC�T ZXACN/A/lr /2 VT _LS—S fT - - - LC�/N6► . P/T Af'T. DfSl6/V CRITERIA C, NM� AER of AWDR04"s SO/L. LOG E1T G�t/R0.46E p/3fAosllL vN/T T07iAt �r//y tT�O F40&V 3 GAL.IA4V 'SO/L TESTT / SOIL TFST 2. 1� IYtlMdER GF 4rACglAW P/73_ LEY. z IFtI�Y._1 `� G44TE OF do/L TEST `'0`; f`f<:� V. N/Nib AIR/a/T PT. R�'�//LT8 h//TN/iS'fED d1' /KCN Dpr79DM L,04CN/Nd PON P/T 7. so. AT ` ��. rn"p!�' rq/N. lNCM Per/Wos.AT/ow RA'7'.v lidTAL 44A' C! "4'0VF AREA . a-C> G fT. a5'c�=r' , ' 77 yr_ a ROBERT Tj v �UNIK1S r TOP FND ELEVATION = 100.0 USE RISERS TO BRING ZABEL FILTER IN FG 98 MAXIMUM COVER OVER FIELD IS 3' OBSERVATION TEST PITS COVERS WITHIN 6" .0 OUTLET TEE ANYTHING GREATER WILL REQUIRE VENTING OF FINISH GRADE FIN. GRADE EL. � 2" MIN THICK LAYER TP 1 TP 2 INSTALL MAGNETIC TAPE ON COVERS MIN. OF FIRST 2 FEET OF 1/$" - 3/8" WASHED ELEV= 98.0 ELEV= 98.0 BRING D-BOX TO WITHIN 6" OF OF OUTLET PIPES TO BE 25, PEASTONE FG 98.0 L A JOYR211 L A 10YR2/1 FIN. GR. WITH RISER. MARK LEVEL „ " 3 MIN COVER WITH MAGNETIC TAPE 4 SEE DET. 4 3/4 - 1 1/2 DOUBLE 10 10 WASHED STONE INFLOW PIPES LS B GRADE AT DYR5/4 LS B OYR5/4 4" PVC sCH.40 96. 1 4' TEE FROM D. BOX 4' 4.8' 4' 34" 34" ' T 6" INV= 96.35 INV= 6' 4" PVC SCH.4o 2� MIN S= 29, � �L6 �' �� S ND Cl 2.5Y5/3 �� SANS Cl 2.5Y5/3 _14_ TEE S= 2% INV.= INV.= 7 GRADE AT 78SILT INV= 10" TEE 95 7 95.58 TOP OF PEASTONE 2% MIN SAND C2 2.5Y5/4 78 SAND C2 2.5Y5/4 f o°o°o°o°c 07 o 0 0 '�°�oa EL. = 96.0 " 96.5 4' LIQUID 1000GAL. f >„o„or,o„or, 0 0 0 0° MED SEPTIC TANK / DISTRIBUTION88 88MED DEPTH GAS EL = 93.33 ElMIN SAND C3 2.5Y5/3 SAND C3 2.5Y5/3 EXIST BAFFLE �' 24' o`� ,'0o0 136" 136" LEVEL STABLE NTS 6.68 PERC. TEST PERC. TEST BASE OF -o-o-o YES t� FT. E�____---FT. )o°o°o°o°c 6 CRUSHED STONE WjBAFFLE WATER ELEV PERC 14836 SEPTIC TANK 3°o°o°o°o° A # __�2_MIN/IN -----MIN/IN NTS a?o°c°i°oo°c - = 86. 7 WATER EL= WATER EL= 500 GAL LEACHING DRYWELL TRENCH ___NONE ___NONE___ ALL STONE TO BE DOUBLE WASHED SOIL TEST PITS AND PERC. TEST PERFORMED BY.• PROFILE OF LEACHING CHAMBER SEWAGE DISPOSAL SYSTEM BILL GOTTWALD DATE 6/9/14 WITNESSED BY. BARNSTABLE BOH - DONNA TYPE OF BUILDING EXIST 3 BDRM HOUSE DESIGN FLOW 3 x 110 GPD/BDRM = 330 GPD SEPTIC TANK GENERAL NOTES: 2007 OF DESIGN FLOW= 330 x 2.0 = 660 GALLONS USE EXIST GALLON SEPTIC TANK (1000 GAL) 1. THE SEPTIC TANK SHALL BE 1500 GALLONS MINIMUM, UNLESS OTHERWISE SPECIFIED ON THIS DESIGN PLAN, AND FITTED WITH SCHEDULE 40 PVC TEES OF PROPER LENGTH INSTALL MAGNETIC TAPE ON ALL COMPONENETS SEPTIC TANK CONSTRUCTION SHALL CONFORM TO 310 CMR 15.226. THE SEPTIC TANK GARBAGE GRINDERS OUTLET COVER SHALL BE BUILT UP TO WITHIN 6" OF THE FINISHED GRADE UNLESS NOT ALLOWED! OTHERWISE SPECIFIED.. 2. SEPTIC TANK ANF DISTRIBUTION BOX SHALL BE PLACED ON A 6" MINIMUM COMPACTED GRAVEL BASE. 3. ALL JOINTS MUST BE WATERTIGHT, SEALED WITH SUITABLE CEMENT FOR THAT SPECIFIC COMPONENT. LEACHING FIELD 4. SOIL PREPERATION FOR THE LEACHING AREA SHALL CONFORM TO 310CMR 15.246 & LEACHING DRYWELLS BY SHOREY PRECAST 15.247 DESIGN PERC RA TE = 2 MIN/IN PERC #14836 OR APPROVED EQUAL 5. ANY EXCAVATION OF UNSUITABLE MATERIAL DESIGNATED ON THE PLAN SHALL CONFORM SOIL CLASS l TO CONSTRUCTION IN FILL REQUIREMENTS AS OUTLINED IN 310CMR 15.255 (1-6) 6• FILL MATERIAL FOR SYSTEMS CONSTRUCTED IN FILL SHALL BE COMPRISED OF CLEAN EFFLUNT LOADING RATE = 0. 74 GPD/SF GRANULAR SAND, FREE FROM ORGANIC MATTER AND DELETERIOUS SUBSTANCES. . ` 4 GRANULAR SAND, FREE FROM ORGANIC MATTER=AND DELETERIOUS SUBSTANCES. 330 GpD 0. 74 GPD SF = 446 SF OF LEACHING AREA AGGREGATE SPECIFICATIONS SHALL CONFORM TO 310 CMR 15.247. _ 24 HOUR NOTICE REQUIRED FOR INSTRUCTIONS w ANY ALTERATIONS, MUST BE REPORTED TO THE DESIGN ENGINEER-PRIOR TO 12.8 25' - 320 SF LIMIT OF 5' OVERDIG PROCEEDING WITH CONSTRUCTION. BOTTOM AREA = x - R&R ALL UNSUITABLE SOIL 2 LEACHING DRYWELL CHAMBERS w/4' STONE SIDEWALL AREA SEE NOTES 5&6 ALL AROUND 7. NO HEAVY EQUIPMENT SHALL BE RUN OVER THE COMPONENTS OR LEACHING BED DURING = 75.6 x 2.0 + 151.2 SF C2 LAYER CONSTRUCTION. TOTAL = 471.2 SF 98 INSTALL 1 INSPECTION PORT CONSISTING OF A PERFORATED 4" PIPE 8. DEEP TEST HOLE INFORMATION INDICATES SOIL CONDITION, PERCOLATION RATE AND / PLACED VERTICALLY DOWN INTO THE SAND TO THE NATURALLY OCCURING WATER TABLE ELEVATION AT THE TIME AND LOCATION OF ACTUAL TESTING ONLY. IF SOIL OR SAND FILL BELOW THE CHAMBERS, THE PIPE SHALL BE CAPPED w/ UNSUITABLE MATERIAL OR A HIGHER GROUNDWATER ELEVATION IS ENCOUNTERED, THE 471.2 > 446 // N 5222'16"E A SCREW TYPE CAP & ACCESSIBLE TO WITHIN 3" OF FINISH GRADE. MARK BOARD OF HEALTH AND DESIGN ENGINEER SHALL BE NOTIFIED. 138.QO w/ MAGNETIC TAPE. Lo 9. AREAS DISTURBED DURING CONSTRUCTION SHALL BE STABILIZED TO HELP PREVENT \44' �_ INSPECTION EROSION. THE AREA OVER THE SYSTEM SHALL BE GRADED TO A MINIMUM OF 29. SLOPE, TO PROVIDE POSITIVE SURFACE DRAINAGE. MANHOLE (ryP) 10. NO STRUCTURE MAY BE CONSTRUCTED OVER THE RESERVE AREA. EXISTING 1000 GAL SEPTIC TANK 11. THE SYSTEM SHALL BE VENTED IF THE TRENCH LENGTH EXCEEDS 50' OR IF IT IS ro • • • •• • • •• . •• • •• MAY REMAIN IF COVERED BY IMPERVIOUS SURFACE. ALL PUMPED SYSTEMS ARE TO BE VENTED. N STRUCTURALLY SOUND DESIGN O ° 12. IF ANY COMPONENTS OF THE PROPOSED SYSTEM ARE SPECIFIED AS HEAVY DUTY, ELEVA TION SCHEDULE ELEVA TI ON ' '' ' '' ''''' ' THOSE COMPONENTS SHALL CONFORM TO ALL STATE AND LOCAL REQUIREMENTS FOR AASHTO H=20 LOADING. TOP OF FOUNDATION 700. 0 13. THE SYSTEM MUST BE INSPECTED BY THE BOARD OF HEALTH AND THE DESIGN SEWER INVERT AT FOUNDATION 9 6. 6 -�► i--- i C ENGINEER, PRIOR TO BACKFILLING. SEWER INVERT INTO SEPTIC TANK 95.35 EXISTING LEACH AREA TO BE PUMPED i L___1 __J 14. UNLESS SPECIFIED IN THE BASIS OF SANITARY DESIGN, THIS SYSTEM IS NOT 95 I AND ABANDONDED AS PER TITLE 5 L______ --- \\ DESIGNED FOR THE USE OF A GARBAGE GRINDER OR OTHER HIGH WATER USAGE DEVICE SEWER INVERT OUT OF SEPTIC TANK o - - - - - - - 98 p 15. IF THE D-BOX IS DOSED OR THE INLET SLOPE EXCEEDS 8q, AN INLET TEE OR -- BAFFEL IS REQUIRED. SEWER INVERT INTO DIST. BOX 95. 75 16. ALL CONSTRUCTION SHALL CONFORM TO 3 tO CMR 15.00, TITLE V AND THE SEWER INVERT OUT OF DIST. BOX 95.58 to REGULATIONS OF THE LOCAL BOARD OF HEALTH. � o DECK SEWER INVERT INTO CHAMBERS 95.J 3 � (zi O 17. IT IS THE CONTRACTORS RESPONSIBILITY TO SECURE ALL NECESSARY PERMITS PRIOR :� o � TO ANY SITE ACTIVITY. A STAMPED COPY OF THE APPROVED PLAN SHALL BE KEPT BOTTOM OF CHAMBER 93.33 .. .. . ... .. . ... . . .. .. . . ... . . . .... ... ... .. .. ••••, � . .. .. . ... . ... .... . ... ... .. . .. .. .. .. . . .... . .. .•. � ►� ON-SITE. ELEVATION OF GROUND WATER TABLE 86. 7 z :•:•:•:•;•;•'•'•'• •:•:•:•#48 •'•'•'•'•'•'•'•'• " '� 18. ANY EXISTING UTILITIES SHOWN ARE APPROXIMATE ONLY. CONTRACTOR TO VERIFY .'•'•'•EXIST 3 BEDROOM'• z PRIOR TO EXCAVATION. .................... HOUSE:;',....::..... 19. ALL KNOWN PUBLIC AND PRIVATE WELLS PER 310 CMR 15.220(k) ARE SHOWN. BENCH]�T�+j� �j �3 20. CONSERVATION COMMISSION APPROVAL MAY BE REQUIRED. MARK.-1.�111Y1A1 K. 21• FOR OPTIMUM PERFORMANCE, THE SEPTIC TANK SHOULD BE INSPECTED ANNUALLY AND TOP OF FND WHEN THE SOLIDS AND SCUM DEPTH EXCEEDS 113 OF THE LIQUID DEPTH, THE TANK EL. = 100. 00 AP 148/123 SHOULD BE PUMPED. LOCUS (ASSUMED 24030 SF o _ ; 96 - - - - - - _ _ REPAIR N. PRECINT ,-96 138) ON-SITE SEWAGE DISPOSAL SYSTEM HADRADA LN N 52'22'16"E AP 1 48/1 23 W W L10 QF 48 N. PRECINT ROAD WILL M' E. CENTERVILLE, MASSACHUSETTS NORTHE CINT ®A 0 C V J ;� PREPARED FOR: JOHN ORLANDO OW NWLLLS FARGo HOME MORTGAGE is 284 FORT MILL S.C. MAP � L SCALE: 1"=20' DATE: 6/12/14 REV 8/24/14 CONTRACTOR TO CONTACT DIG-SAFE D M DMG ASSOCIATES TO VERIFY UTILITY LOCATION 40 THOMAS RD. BERKLEY, MA 508-951-1169