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HomeMy WebLinkAbout1120 OLD STAGE ROAD - Health 1120 OLD STAGE RD. , CENTERVILLE A=173-021 No. 42101/3 ORA ESSELTE 10°/® ® o 0 0 7 TOWN OF BARNSTABLE LOCATION I `"'� 0 0 T_ SEWAGE # VILLAGE �', t K- I ASSESSOR'S MAP &LOT 2 3 -61 INSTALLER'S NAME&PHONE NO.e _2 �� -7 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) lei—47 C NO. OF BEDROOMS BUILDER OR OWNER 29ZAc �- 1L PERMITDATE: ,!� "J/_7 COMPLIAN DATE: C Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist . on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet 'I Furnished by �b 36 �v No. A Fee$5 0 •0 0 1 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN, OF BARNSTABLE., MASSACHUSETTS Yes ZIppYication for XDigpogaf' Azpgtem Corigtruction Permit Application for a Permit to Cons ct( )Repair(x )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Old Stage Rd Owner's Name,Address and Tel.No. 4 2 8—6 6 8 3 J Assessor'sMap/Parcel Centerville, MA Lance MacEnerney MA CeI1159-N'61 Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. WM E Robinson Sr, Septic Sry PO Box 1089 , CEnterville, MA 0263 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(no Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil sand Nature of Repairs or Alterations(Answer when applicable)_ Title 5 septic repair c o n s i s t i n g of a 1500g tank, d—box, and 3 stonepacked infiltrators. 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 issued by this oar f Health. ? n Signed � B ,i Date Application Approved by Date Application Disapproved for the following reasons Permit No. 7 2W7 Date Issued TOWN OF BARNSTABLE LOCATION f 1 "'� U [�ice' � SEWAGE # _lam S VELLAGE_C =r- 1 _ II ASSESSOR'S MAP&LOT -INSTALLER'S NAME&PHONE No. SEPTIC`TANK .CAPACITY b� LEACHING FACILITY: (type) TA-S J'' (size) NO.OF BEDROOMS Z BUILDER OR OWNER ' A- PERMITIATE: oZ '�! COMPLIAN DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private'-ater Supply Welland 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 G� �b .,� 36 J I I iT✓t'n,? '.,wr '.�,. .,..�; r � - cs-s :t.,, .r. ..ly,�.r,.,.,�� ri:.}: -= y M,;..:�✓S...r� '.tip, :'t(,�.°%;. .-3„ .. _ .e A�No: Fee$5 0.0 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: YesV/ PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Application for Mi,5 wal *p5tem Con!6truction Permit Application for a Permit to Construct( )Repair(x)Upgrade( )Abandon( ) El Complete System O Individual Components Location.Address or Lot No. Old Stage Rd Owner's Name,Address and Tel.No. 4 2$—6 6 8 3 j Assessor's Map/Pazcel li Centerville, MA Lance Ma@Enerney Ce4Eg f�I i Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. j WM E Robinson Sr, Septic Sry PO Box 1089, CEnterville, MA 0263 ! Type of Building: Dwelling No.of Bedrooms 3 Lot Size n a sq.ft. Garbage Grinder(nc) Other Type of Building Nof Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date _. Title ,": I Size of Septic Tank Type of S.A.S. Description of l/ sand Nature of Repairs or Alterations(Answer when applicable) Title 5 septic reapir consisting- of a 15,0,Gg tank, d-box, and 3 stonepacked infiltrators. 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 issued by this oaz f Health. . Signed �> 1 I � i_ Date �• — Application Approved by Date 'Application Disapproved for the following reasons Permit N c- te�ss}�e�d ------ t ——— — -- --- --- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS MacEnerney Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded ( ) Abandoned( )by at 1 120 Old Stage RN Centerville ha b e constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. "' ated Installer Wm E Robinson Sr Sept Srv. Designer The issuance of this pe t shall not be construed as a guarantee that the system will function as designed. Date ' ,t ; / Inspector ——— /— ———————————————————— -—————— No. Fee $5 0.0 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS.. :, *acEnerney - Migogal 6p.5tem Construction Permit Permission is hereby granted to Construct( )Repair,( x)Upgrade( )Abandon( ) System located at 1 120 Old Stage Rd Centerville, MA Installer: Wm E Robinson Sr Sept Sry 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:Copstr Etion ust be completed within three years of the date of t is p it. o Date. Approved by f' 9 NOTICE: This form is to be used for the r0air of failed septic systems only CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) I,William E. Robinson, Sr.,hereby certify that the application for disposal works construction permit signed by me dated � —.2 , concerning the property located at 1120 Old Stage Rd Centerville, MA meets all of the following criteria: 4ere,are no wetlands within 300 feet of the proposed septic system. * ere are no private wells within 150 feet of the proposed septic system. * bseved groundwater table is 14 feet or greater below the bottom of the leaching facility. here is no increase in flow and/or change in use proposed. V * There are no variances requested or needed. SIGNED: ,� 1 �, �^-•� DATE LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER 60 (Attach a sketchplan of the proposed system. Also if the licensed installer proposes a certification plot plan,this plan should be submitted). 6 � ��� � � -0G x P 339 578 798 US Postal Service Receipt for Certified Mail No Insurance Coverage Provided. Do not use for International Mail See reverse Sen Stpej4 N iber P���t Offiyef ZIP Code Postage Certified Fee , 0 Special Delivery Fee Restricted Delivery Fee Return Receipt Showing to Whom&Date Delivered o Retum Receipt Showing to Whom, Date,&Addressee's Address 0 TOTAL Postage&Fees Cq Postmark or Date ' 0 U. rn a Stick postage stamps to article to cover First-Class postage,certlfled mail fee,and charges for any selected optional services(See front). 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attached, and present the article at a post office service 18, Window or hand it to your rural carrier(no extra charge). 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the m return address of the article,date,detach,and retain the receipt,and mail the article. 0 in 3. If you want a return receipt,write the certified mail number and your name and address rn on a return receipt card,Fort 3811,and attach it to the front of the article by means of the gummed ends 8 space permits. Otherwise,affix to back of article. Endorse front of article a RETURN RECEIPT REQUESTED adjacent to the number. Q 4. If you want delivery restricted to the addressee, or to an authorized agent of the C addressee,endorse RESTRICTED DELIVERY on the front of the article. M i 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt. If return receipt is requested,check the applicable blocks in item 1 of Form 3811. to 6. Save this receipt and present it if you make an inquiry. d Town of Barnstable • Department of Health, Safety, and Environmental Services R►tNAM. Public Health Division y NAM. i639. 367 Main Street, Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean FAX: 508-775-3344 Director of Public Health May 2, 1997 Mr. Lance Mcenemey 126 Mid Tech Drive West Yarmouth, MA 02673 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 CMR410.00 STATE SANITARY CODE II - MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION. The property owned by you located at 1120 Old Stage Road, Centerville listed as Parcel 173 on Assessor's Map 021 was inspected on April 30, 1997 by Jerome Dunning, Health Inspector for the Town of Barnstable, because of a complaint. The following violation of 310 CMR 15.00, the State Environmental Code, 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 was observed: 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. 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. P ERJOF T E BOARD OF HEALTH omas . McKean Director of Public Health 111i'! Z&f v-.2-s f r L a_ 0 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 /JAo Q l,� d,m, PAl Cs.Zn"SL listed as Parcel 17,3 on Assessor's Map Oa l , was inspectAd on 4 -30. 97 , 199 , by p �,,,r,,,, NG , Health Inspector for the Town of Barnsta5le because of a complaint. The following violations of 310 CMR 15.00, the State Environmental Code, 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 were observed: 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 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. pan ORDER or was BOARD OF HEALTH Thomas A. McKean Director of Public Health o ' PAR Real Estate System - General Property Inquiry Help Parcel Id: 173 021- - Account No: 103408 Parent : Location: 1120 OLD STAGE RD Neighborhood: 36BC Fire Dist : CO' Devel Lot : Lot Size : . 72 Acres Current Own: MACENERNEY, LANCE A State Class : 101 126 MID TECH DRIVE No. Bldgs : 1 Area: 1250 Year Added: WEST YARMOUTH MA 2673 Deed Date : 050188 Reference: 6255/144 January 1st : MACENERNEY, LANCE A. Deed MMDD: 0588 Deed Ref : 6255/144 Comments : Values : Land: 34300 Buildings : 60300 Extra Features : Road System: 1110 Index: 1174 (OLD STAGE ROAD ) Frntg: 112 Index: ( ) Frntg: Control Info: Last Auto Upd: 050695 Status : C Last TACS Update: 082290 Land Reviewed By: Date : 0000 Bldgs Reviewed By: Date: 0000 Tax Title : Account : Taken: Account Status : Hold Status : Cancel Press XMT for more data Next screen PAR Action Owners Name Road Index Road Name Parcel Number 173 022 RCV F (GE) 1 d SENDER: o ■Complete items 1 and/or 2 for additional services. I also wish to receive the H ■Complete items 3,4a,and 4b. following services(for an w ■Print your name and address on the reverse of this form so that we can return this extra fee): card to you. ai j NAttach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address permit. y ■Write°Return Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery N i r ■The ReturnReceipt will show to whom the article was delivered and the date ., 1I delivered. Consult postmaster for fee. ° 0 3.Article Ad essed to: 4a.Artic Number a0i E 4b.Service Type u va ❑ Registered Certified W I tz W /l [I Express Mail ❑ Insured M � Return Receipt for Merchandise ❑ COD 7.Date of D,liive 0 z ®a��/ V 0 p 5.Received By: (Print Name) 8.Addre see's,Address(Only if requested and fee is paid) 6 Signature: (Addressee or Age 0 � tll Re PS Form �811,Dec"ber 1994 �� rn i r UNITED STATES POSTAL SERVIC Mq I" =First-Class=Mail— ��• _ _ _ -�^ Postage-&-Fees-Paid USPS Na P M s Permit No.G-10 • Print you ryman`ie dCYdr4s, and ZIP Code in this box • I 1 I Public Heaith o Dfvtslop 1 wn Of Barnstable I P0•Box 534 Hyannis, Massachusetts 02601 I I i I I I I I,