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Home My WebLink About0450 PINE STREET (HY - Health (2) 450-DINE STREET, CENTERVILLE A= 228 020 �� =J�tiECYC(fOc�m O 2 UPC 12543 NO �`�Srco�sa HASfiiNG9.MN TOWN OF BARNSTABLE LOCATION �d / ' SEWAGE # 'VILLAGE �o�r� _:�-�� ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: 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 Furnished by Y 0 DATE:_7/25/95 PROPERTY ADDRESS:_4.50 Pine Street-, _. Centerville Mass . 02632 On the above date, I inspected the septic system at the above address. This system consists of the following: 1 . 1-1000 gallon leach pit . 2 . 1-distribution box. 3. 1-1000 gallon leaching pit , gn . 4 . 1-6 'x6 ' block cesspool . ( Grey water Based on my Ins section, I certify the following conditions: Cb 1 . This is a title five septic system ( 78 ) Code) �E� D 2 . The grey water cesspool is in failure . JUL 4— 3. The septic system is in proper working order at aD �� 8 19$5 I� the present time . co 8 ff, 5 SIONATURr: Name: J_P( Macdm_ber_Jr COm an T,:P.Kacgipber & San;In4 , Py -------,- ----------�= Address: ' �ni ] M � Q2,6��'Cent��v�il �e�! sI Phone:_ 5p8_775_'33�8;----�--' THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY s JOSEPH P. MACOMBER & SON, INC. Tames-CesspoolrLeachf lelds Pumped ` Installed Town Sewer Connections P.O. Box 66 Centerville, MA 02632-0066 775-3338 775-6412 111 Big ,. 7 1^^":CE SEWAGE DISPOSAL SYSTEM ills PEC12 *2: , 4ddf6ss Of Prope' fty 450 Pine Street Centerville ,Mass . Owner' s name Michael T. Munhall Date of Inspection 7/25/95 PART A CHECKLIST Check if the following have been done: Pumping information was requested of the owner, occupant, and Board of Health. .� None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. _ZAs built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. 4Z The site was inspected: for signs of breakout. All system components, excluding the SAS, have been located on the site. The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the SAS on the site has been determined based n existing information or approximated by non-intrusive methods. The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance '.of SSDS.' RECOMMENDATIONS 1 . Grey water cesspool pumped and filled in with sand . 2 . Grey water changed in cellar. Tie into existing soil pipe . 3 . Septic tank must be pumped annually due to the garbage disposal being present . SUBS '- r ACE SEWAGE DISPOSAL SYSTEM It�SPECT.ION FORM PART 8 SYSTEM INFORMATION FLOW CONDITIONS. If residential 4- number of bedrooms number of current residents garbage grinder, yes or no laundry connected to sr°stem, yes or no seasonal use, yes or no If nonresidential , calculated flow: Water meter readings, if available: 1993=88, 000=GPD=241 . 09 1994=64, 000=GPD=175 . 34 r Last date of occupancy GENERAL INFORMATION Pumping records and source of information: _ System pumped, .as part of inspection, yes or no if yes, volume pumped i Reason for pumping: i Typ of system Septic tank/distribution .box/soil •.absorption system ;I Single cesspool _///0 Overflow cesspool OPrivy Shared system (yes or no) (if yes, attach previous inspection it records, if any) _Ab Other (explain) II . Approximate age of all components.. Date installed, if known. Source of informs ion: •_ -- .... ..-. _._... . . I uJ S A Sewage odors detected when arriving at the site, yes or no 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued . SEPTIC TANK: �Ait1k, (locate on site plan) ' , depth below grade � u'.. material of construction: �oncrete metal _FRP _other(explain) dimensions: ,� ~ �� ! ��' '7/'l�`� !r sludge depth distance from top of sludge to bottom of outlet tee or baffle scum thickness distance from top of scum to top of outlet tee or baffle distance from bottom of scum to bottom of .ou.tlet tee or baffle Comments: (recommendation for pumping, condition of inlet and outlet tees or baffler., . depth of liquid level in relation to outlet invert, structural integrity,., eviden a of leakage recommend tons for re irs et . ) k 1 DISTRIBUTION BOX: (locate on site plan) depth of liquid level" above outlet invert Comments: (note if level and distribution is equal, evidence 'of solids carryover, evidence of leakage into or out of box, recommendation .for repairs, at ti PUMP CHAMBER: (hocate on site plan) pumps in working order, . yes or no Comments: (note condition of pump chamber, condition of-pumps and appurtenances, recommendations for maintenance or repairs,etc. ) 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM IN8P • ECTZON FORM PART B SYSTEX INFO TION eoatiaued SOIL ABSORPTION SYSTEM (SAS) : (locate on site plan, if possible; excavation not required, but :may •be • approximated by non-intrusive- methods) If not determined to be present, explain: Type leaching pits and number leaching chambers and number 4 leaching galleries and number leaching trenches, number, length leaching fields, number, dimensions overflow cesspool , ,number Comments: (note condition of soil , signs- of hydraulic failure, leyel 'of ponding., condition of vegetation, recommends ions for maintenance or repairs,etc. S. CESSPOOLS (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 I inflow (cesspool must be pumped as part of inspection) a Comments: (note condition of soil, signs of hydraulic failure, level •of ponding, c ndit.i nsof vegeta ion ecomendations for maintenance or repairs,etc.) � PRIVY S�OT[G y 1G ji1; I _.. Jlocate -on site--plan)---- -- -------= ---- -. _ _. -• ,,. _ �. ,. fit. _„ materials of construction dimensions ' - 1 depth of solids i Comments: (note condition of soil, signs of hydraulic failure, • level of.pondinq, condition of vegetation, recommendations for maintenance or repairs,r- 1 f Il ACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ' SUBSURFACE - FART B SYSTEM INFORMATION continued SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or„benchmarks i locate .all, wells within 100.' .,Town ' Water Y IN. , r .\X i DEPTH TO GROUNDWATER depth to groundwater . . G fl [ i I method of determination or approximation: Tnc o sep is system in i . , 12 SUBSURFACE ;SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C FAILURE CRITERIA Indicate yes, no, or not determined (Y, N, or ND) . Describe basis of determination in all instances. If "not determined",. explain why not) N� Backup of sewage into facility? Discharge or pondin of effluent to. the surface. of the ground or surface waters? �j( y d� �,�y W�q.�e- yOOD4 ��, ;,"Ae_. G Tv Static liquid level in the distribution box above outlet invert? ' _ j Liquid depth in cesspo�ol <6" elow i me vert or available volu < 1/2 da flow? �/ lul je�Q NODS. T. D,/6 y jZ Required pumping 4 times or more in the last year? number .of times pumped _LVQ Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank failure imminent? Is any portion of the SAS, cesspool or privy: .rd)D below the high groundwater elevation? within 50 feet of a surface water? ! M5 within 100 feet of a surface water supply or tributary to a surface water supply? A10 within a Zone I of a public well? I ' within 50 feet of a `bordering vegetated wetland or salt marsh• (cesspools and privies only, no the SAS) ? 4 within 50 feet of a private water supply well? less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis? If the well orm bacteria,. volatile organic compounds, ammonia nitro " analyzed to be acceptable, attach copy of*well water anal, for colifgen-% and nitrate nitrogen., i TOWN OF Barnstable BOARD OF HEALTH i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D - CERTIFICATION �iSs'GIILae1iL'tT�iltT tIIST.M1Ti� • ttQiRE�OaaTCmss^ivSsmiifn(issa aeats+seasdsTxcrosnaelt�i�}nea-t�.r i:tunr•V'i.:� -TYPE OR PRINT CLEARLY- PROPERTY INSPECTED CEO STREET ADDit7US45D pine CtrPPr Lenz Prville .Mass , ASSESSORS MAP, BLOCK AND PARCEL # OWNER' s NAME r.4; rliac1_ T Mnnhall PART D - CERTIFICATION NAME OF INSPECTOR J P Macomber Jr COMPANY NAME J.P.Macomber & Son Inc. COMPANY ADDRESS Box 66 Centerville,Mass . 02632-0066 Street Town or City State ZIP COMPANY TELEPHONE (508 ) 7,75 - 3338 FAX ( 508 ) 790 1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposa-1 system at this address and that the information reported is true, accurate and complete as of the time of inspection . The inspection was performed and any recommendations n regarding upgrade , maintenance and repair are consistent � with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one: XXXXXSystem PASSED The inspection which I have conducted has not found any information which indicates that . the system fails to adequately protect public health or the environment as defined in 310 CMR 15 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. System FAILED* i i The inspection which I have conducted has found that the system fails to protect the public health and the environment in accordance with Title i 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form. Inspector Signature Date- �. o 2 95 _ i :�-- -•�� a �� , One copy of this ce fication must be pro4ided to the OWNER, the BUYER (where applicable ) and the BOARD OF HEALTH. i I * If the inspection FAILED, the owner or operator shall upgrade the system within one year of the dat6, of the inspection, unless allowed or required otherwise as provided in 340 CMR 15 . 305 . I partd.doo Ccmmcnwearrr c; MCSS=7;;SeTTS -ExecuTrve Office cr EnvircnmerlTCi Department of Environmental Protection ' Water Pollution Control Tecnnicel Assistance and Training Sections VAUL&m F.Weid Goy.e�•r Trudy Cox• sea•wr.eon► Thom"&Powwv 06/12/95 ATTN: Joseph P. Macomber, Jr. Joseph Macomber and San PO Box 66 Centerville, MA 02632- i Dear Joseph P. Macomber, Jr. , _ I am pleased to inform you that you have attended training, met the experience qualifications,". and have passed the Title 5 System Inspector exam, pursuant to 3i0 CMR 15 .340. The passing grade for the exam was 39/52 or 75%. This is an official notification that you .are a Certified Department of Environmental Protection System Inspector pursuant to 310 CMR 15. 340. You will receive a System Inspector certificate at a later date. If you have any futher. questions, please write to me at the following address : Kimball Simpson D.E. P. Training Center 50 Route 20 Millbury, MA 01527 Thank you very much for your time and consideration in this matter. I i Sincerely, I I - I Kimball T. Simpson, DEP Training Center Director (2405) Route 20 • Millbury, MA FAX •5-ep8-755-9253 .E nt7n• 508-756r7Z8 1 Water , Conservation SAVE Tips . . . ME! p CHECK FOR LEAKS Water Loss in Gallons Due to Leaks Leak this Loss Per Day Size . Loss Per Month 120 3,600 350 10,800 • 693 ' 20,790 • 1,200 36,000 1,920 57,600 3,096.• 92,880 0 41,296 .128,980 ® 6,640 199,200. 6,9.84 '• 200,520 8,424 252,72.0 9,888 296,640 ® 11,324 339,720 12,720 381,600 14,952 448,560 I y-669 LOCATION,-- SEWAGE PERMIT NO. VILLAGE �c A & B CESSPOOL SERVICE 128 BISHOPS TERRACE, HYANNIS, MA 02601 BUILDER OR OWNER DATE PERMIT ISSUED t� DATE COMPLIANCE ISSUED `Z -AC�$/ �a ,. . �� ,b , a�� `� � � a No.&!: 6 - 1 00 x.l'... Fss............ ....... y THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH Town Barnstable ..........................................OF............... Appliration for Elhipas al Warks Tonstrnrtinn antic Application is hereby made for a Permit to Construct ( ) or Repair ( xj an Individual Sewage Disposal System at: 4: 11..Pina..Stx .,...Centexvi11e_,-•-MA-----02,632...... .................................................................................................. Location.Address or Lot No. dDhn..�rrl�x or�.............•----•---••--------....................-----•--------- �. Q._ i1 ... t et. o3�tervillel MA .026 2. Owner Address ................................... - ? ogs Terrace,...H -annis M 02601 ---• Installer Address d Type of Building Size Lot............................Sq. feet U DwellingNo. of Bedrooms.................2...._..._......_........Ex anion Attic— p ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons................. .-_-_-_-_ Showers ( ) — Cafeteria ( ) dOther fixtures -•----=•-••-•••--•-••-•---•••......••---------...••--.----•---•----•--•--•--•--•-----•...•--•...-------•-•-••-••..................... W Design Flow.............................................gallons per person per day. Total daily flow............._..............................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth...._...__...... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area-----_---•__------sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water..................-----. 44 Test Pit No. 2................minutes per inch Depth of Test Pit..............._.... Depth to ground water........................ 94 ••••--•----•-----------•-----------------------•.....-••-------.....----.........------------•--•--....._...----•-----...........----------------••----...... 0 Description of Soil............Sa.nd................................................................................................................................................... W U Nature of Repairs or Alterations—Answer when applicable_....dYLStylcation... f.•a__1,,000_.A.__septic tank, dis tributi on...box..a.nd_a..1,00.-gaa-.---lei�}a.-�a�-►---�t one_-Packed.-------•-------- 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 furtja es not to place the system in operation until a Certificate of Compliance has i sued by the board of I01 t �i- 'gned _. ._. .... :.. 26 84 Application Approved By...'�...-•-------------------------------•----•--.........---.......................... 7!2�l e`+ -••---------------- -----••--•------ Date Application Disapproved fo th ollowing reasons:................................................................................................................ ...............•-•-•---------•------•-----------......••-----•••-•--•--------.....-•----...--•--------•--•----•---•---•-•-••-----••--•-•-•---••••-•-•••--•-•----------••••••••-••----------••-----•----- Date Permit No. 84- --------------------------------------- Issued...........21261�.......................... Date Fizz.......$...15.00 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....................Town ...------.OF..........Barnstable. Appliration for UiopooFal Works Tonotrurtion rrntit Application is hereby'.made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal System at: I65II..P.irta.Stre�t.,.._Ce:nte u3l.ler 1 .....02632-------- .................................................................................................. Location.Address or Lot No. John..And-ersca--------------------------------------------------------------------- 4,50...am... � I<��_.G�erter!alp.,.- Owner Address aA B Qes .................................... 1.?_?L 5_shops._TQ? ee.,.._H !annia:.. ._.:..42601... Installer Address Type of Building Size Lot.................... .....Sq. feet Dwelling—No. of Bedrooms............ ....•.........._..............Expansion Attic ( ) Garbage Grinder ( ) aOther Other—Type of Building __-_----•-•--------------_ No. of persons.....__.._...._2---_______ Showers ( ) — Cafeteria fixtures W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid*capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length-------............. Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) . aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water................... fZ.I Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....._.................. r............•..............••...........••--••-•---•--•••--------••-----•-••-••---••--•-••._.............----••-••...._...._--_............................ O Description of Soil..........' and-•---•..............•--••---------........-------••••---•-••••-••-----•----•----•------•--•-•••--•-•••-----•-----•----------------•--•----......_.. x W x -•--•••-•---------------•--------•-••------••-•----...-•------------•--•---•---------•----•.-••--•-----------•••----------••------------•-•------•----•-•••-••-•----------••-•---•--••-.........••••- U Nature of Repairs or Alterations—Answer when applicable___.installation_-Of--a•-1,000 _ septic tank, distribution...box..=d•_a... ,Q00---g 1,-t---beach--Pita--stca�e._packed.--------------- --•... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIE 5 of the State Sanitary Code—The undersigned further a des not to place the system in operation until a Certificate of Complianc as,09ssued by the board of h altrlY � Application Approved By..`�_.. . 7�2eJ 94 ------------- Application Disapproved fo the ollowing reasons__________________________________________________ ..---•-----------------•--...............Date•------••••-.. -•-•-----............................................. 84 Permit No.............. ..................................... Issued_----•-•-•-7/26/ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................T..awn..............OF...............Barnstable........................................... Grtifiratr of Tnntph aurr THIS IS TO CERTIFY, That the Indiv'd 1 Sewa e Dis oral Seem constructed ( o Repaired (X ) by.....A..& B Cesspool Service, Inc., 12 Bish ps Terrace, Hyann. NA 0 01 - --- ------- - -- ------------------.......................--•-.........---•-- stall 450 Fine St., Centerville, 02632 - Jo Fi. Anderson at --••--• ---•--•-• ----•.. -•---••--••--••--------. •--------------- ----•--•----- . ----------•---- has been installed in accordance with the provisions of &TIE o he State Sanitary Ccr_._._.___..d/&s�5cribed in the application for Disposal Works Construction Permit No.._._._.. ... ,.-_____----_ dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® A UARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE. .7�26..84 .......-•-----•................•-•-••-•••••-•-••-. Inspector...�j- •-...................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Rt�_ �............� ` .°wn..............OF..........Parnstable N_ �, 15.00 0..........- FEE.......................t Disposal 10orkv Tonotrnrtion antit Permission is hereby granted.........A & B Cesspool. ..Service, I.nC. ...... . ._. .---••--•-••••-•. •---••- to Constr ct ( ) or,Re air (X ll an Indiv .ual San osal AVM. ` 50 Pine Sheet, Centerw . e, 9I� — Jt�hn M. Anderson atNo....... --••-•-•-----••••----•--•-•-••......•-••-•--•-•----- Street as shown on the application for Disposal Works Construction Permit N68_......... _=_ ated......_7�26�8'.................. ........................... ..:•• -••----•---------•••--•-•••---•------••--•-•-••----...---•-•..... 7/26/&► Board of Health DATE. FORM 1255 A. M. SULKIN, INC.. BOSTON