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HomeMy WebLinkAbout0083 POND VIEW DRIVE - Health 83 Pond View Drive Centerville P A = 229 023 Slll OCY"&� UPC 10259 ' No.H� 1630R �s>` HASTINGS. YN Certified Mail#7006 0810 0000 3524 9247 �oFtH�royy Town of Barnstable Regulatory Services � BAELNS'rABLE, 9� ASS 1� Thomas F. Geiler,Director Alf°MA Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 April 4, 2007 Kevin Barnicle P.O. Box 769 AV- Centerville, MA 02632 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II — MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you located at 83 Pond View Drive Centerville, was inspected on March 27, 2007 by Timothy O'Connell, Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of the rental registration in accordance with Chapter 170 of the Town of Barnstable Code. The following violations of the State Sanitary Code were observed: 105 CMR 410.500—Owner's Responsibility to Maintain Structural Elements. Laundry sink does not drain; slider door does not open with ease. 105 CMR 410.481 & §170—7—Posting of Name of Owner. Owner's name and phone number not posted. You are directed to correct the violations listed above within thirty (30) days of your receipt of this notice by fixing sink drain; by fixing sliding door so it slides with ease on track. *Note: Once all the other violations have been corrected, you will be issued a certificate of registration for the rental property. The certificate of registration will have all the necessary information to satisfy the requirements of § 170-7 of the Town of Barnstable Code. Q:\Order letters\Housing violations\Rental ordinance\83 Pond View Drive.doc l You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of $100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the above violations, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. PER ORDER OF T E BOARD OF HEALTH Thomas A. McKean, R.S., Director of Public Health Town of Barnstable Cc: Deanna Talin, Tenant Cc: Timothy O'Connell, Health Inspector QAOrder letters\Housing violations\Rental ordinance\83 Pond View Drive.doc FORM30 �IKw HOBBSE WARREN THE COMMONWEALTH OF MASSACHUSETTS BOARD OF H ALTH CITY/TOWN w EPARTMENT o V �c -- --- A RES� C�0 O O�� 16yLI GSM Svey �,,,) TELEPHONE Address 83 v"___ Occupant b'VWV,- ._ Floor_ Apartment No. N - No. of.Occupants__ No.of Habitable Rooms--?—No.Sleeping Rooms _____ No. dwelling or rooming units------No.Stories Name and address of 1 N® �wner Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress: and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: j4AAq, G L410 5M) Roof ¢_ Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: L l� Dampness: Stairs: Li htin : T6 3— 2.7-c--f- nrML flu STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters, Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen. Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom —Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.: Sta4s, Flues,Vents, S feties: _ Kitchen Facilities ink S ove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted 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) "THIS INSPECTION REPO T IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJUR ' �- INSPECTOR TITLE A. DATE `L-7 i ® TIME S. A.M. THE NEXT SCHEDULED REINSPECTION 7j3? P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shali be deemed conditions which may endanger or impair the heaith, 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 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. DATE: 5/29/02 PROPERTY ADDRESS83 Pondview Drive Centerville ,Mass - p ------------------------ 02632 ------------------------ RECEIVED On the above date, I Inspected the septic system at the ab ve address. This system consists of the following: JUN 0 4 2002 1 . 1-1500 gallon septic tank. TOWINOFBARNSTABLE 2 . 1—Distribution box . 3 . 6—Infiltr8t;Qj;s . 49 ' X11 ' Based on my Inspection, I certify the following conditions: �� 4 . This is a title five septic system. 5 . The septic system is in proper working order at the present time . MAP " 6 . No water useage for 2000-2001 ©'Z PARCEL LOT SIGNATURE:,- _ Name ;_j_P ,_ Macomber _,Jr-______ Company ; Joseph_P _ Macomber_& Son , Inc . Address ; Box 66 -------------------- Centerville , Ma . 02632-0066 -------------------- Phone: 508-775-3338 --------------------- THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY JOSEPH P. MACOMBER & SON, INC, Tan ks•Cesspools•Leachflelds Pumped & Installed Town Sewer Connectlon: P.O. Box 66 Centerville, MA 02632.0066 775.3338 775.6412 ,per \ COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION i TITLE 5 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 83 Pondview Drive C _n e yill ,Mass . Owner's Name: Fred Hume Owner's Address:83 Pondvi w Drive CAntarvi 11 a ,Mac.c _ Date of Inspection: S f 9 glo2 Name of Inspector: (please print)Joseph P .Macomber Jr . Company Name: J. P.Macomber & Son Inc . Mailing Address: Box 66 Centerville ,Mass . 02632 Telephone Number: — — CERTIFICATION STATEMENT 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: ,/y Passes l j Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fai Inspector's Signature: Alt 2 Date: �.� The system inspector shall bmit 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. Notes and Comments 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. Title 5 Inspection Form 6/15/2000 page I Page 2 of 1 I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 63 Pondview Drive Centervi e , ass . Owner: Fred Hume Date of lospectioo: 5 29 02 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. S s Passes: 1 have not found any informatio hick indicates that any of the failure criteria described in 310 CMR 15.303`or m 3TU-C-ffR'13.7�4 exist. ny failure criteria not evaluated are indicated below. Comments: The septic system is in proper working order at the pr sent time r 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. Answer yes, no or not determined (Y,N,ND) in the for the following statements, lf.`.`not determined" please explain. ,,, t 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. ND explain: ,0 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 obstruction is removed distribution box is leveled or replaced ND explain: 4 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 _obstruction is removed ND explain: 2 Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 83 Pondview Drive entervi e , ass Owner: Fred Hume Date of Inspection: 5 29 02 C. Further Evaluation is Required by the Board of Health: 4", 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: e3 Cesspool or privy is within 50 feet of a surface water 7P Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 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: NO 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. /2 The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. I 10 The system has a septic tank and SAS and the SAS is less than 100 feet bu 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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: i i 3 i Page a of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) ProperryAddres$83 Pondview Drive Centervi e ,Mass Owner: Fred Hume Date of Inspection: 5/29/02 D. System Failure Criteria applicable to all systems: You must indicate "yes" or"no" to each of the following for all inspections: Yes N _ achp of sewage into facility or system component due to overloaded or clogged SAS or cesspool �ischarge 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 ,r cesspool 14/A47,-,,9T/r5 iquid depth in44+spoe+is less than 6" below invert or available volume is less than ''A day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped n' , r/_ 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 ysater supply. Any portion of a cesspool or privy is within a Zone I of a public well. ,y portion of a cesspool or privy is within 50 feet of a private water supply well. _ 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. jTbis system passes If the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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.) —� (Yes'No)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 Boare 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 now of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no" to each of the following: (T1te following criteria apply to large systems in addition to the criteria above) des no/ (/ the system is within 400 feet of a surface drinking water supply G/the ystem 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 11 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 es" to Section D above the large system has failed. The owner or operator of any large system considered a s:entFicant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 5 30- The system owner should contact the appropriate regional office of the Department. 4 Page 5 of I 1 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 83 Pondview Drive en ervi e , ass . Owner: Fred Hume Date of Inspection: 2 Check if the following have been done. You must indicate"yes"or"no" as to each of the following: Yes Pvuere mping information was provided by the owner, occupant, or Board of Health any of the system components pumped out in the previous two weeks /Has the system received normal flows in the previous two week period? Z/Have large volumes of water been introduced to the system recently or as part of this inspection ? Were as built plans of the system obtained and examined?(If they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? Were all system components,- luding the SAS,/located on site ? 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 ? 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: Yes no Existing information. For example,a plan at the Board of Health. 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(3)(b)J 5 Page 6 of 1 1 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 83 Pondview Drive en ervi e , ass . Owner: Fred Hume Date of Inspection: FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):1- Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 11,0,gpd x.#.rof bedrooms): A'd Number of current residents: / Does residence have a garbage grinder(yes or no): Is laundry on a separate sewage system ( es or no) 2 [if/yes separate inspection required] Laundry system inspected(ves or no): � Seasonal use: (yes orno): . 1998-18 , 000 gallons=49 . 32 GPD Water meter readings, if available.(last 2 years usage(gpd)): I ctgq- 9 Ono gallons-5 . 48 GPD Sump pump(yes or no): 2000-1000-gallons= 2 . 74 GPD Last date of occupancy: 2001-00 , 000 gallons= 0 GPD COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): �Jq Grease trap present(yes or no):AN Industrial waste holding tank present(yes or no):A�e Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records . Source of information: y Was system pumped as part of the inspection(yes or no):.l�� If yes, volume pumped: 0 gallons -- How was quantity pumped determined? AN Reason for pumping: TYPE OF SYSTEM Septic tank,distribution box, soil absorption system l Single cesspool Overflow cesspool Privy Shared system(yes or no)(if yes, attach previous inspection records, if any) 41) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) 41J Tight tank /4-V Attach a,/copy of the DEP approval 4 4 Other(describe): Approximate age of all components, date installed (if known)and source of information: Were sewage odors detected when arriving at the site(yes or no): 4d 6 Page 7 of 1 I OFFICIAL INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 83 Pondview Drive Centerville ,Mass . Owner: Fred Hume Date of Inspection: 5/2 9/0 2 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron AI'40 PVC�4other(explain): eb-0i- Distance from private water supply well or suction line: /'rj° Comments(on condition of joints, venting, evidence of leakage, etc.): Joints appear tight . No evidence of leakage . The system is vented through the house vents . SEPTIC TANK: locate on site plan) Depth below grade: "� Material of construction oncreteivp meta 4/Lfiberglass/,Lolyethylene 41—other(explain) If tank is metal list age:_D Is age confirmed by a Certificate of Compliance(yes or no)/d (attach a copy of certificate) a / Dimensions: Sludge depth%tom Distance from top of sLu dge 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 outlet tef or baffle: How were dimensions determined: W04� 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 the septic tank every 2-3 years .'Inlet & outlet tees are in piace . lKe tank is structurally sound and shows no evi ence ot leakage . GREASE TRAP�1.L(locate on site plan) Depth below grade: Material of constructi on: con crete/meta l/afiberglasse&o lye thy Ien*tO other (explain): _ 4449 Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: /Ji�/V Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): grease trap is not present . 7 Page 8 of 1 1 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 83 Pondview Drive entervi e , ass . Owner: Fred Hume Date of Inspection: 5 2 9/0 2 TIGHT or HOLDING TANK66jr� Jt; (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: 11d Material of construction:/ concrete d!Z metal,&�J-fiberglass .[/polyethylene ) other(explain): Dimensions: 10!)4 � Capacity: 11 gallons Design Flow: A117 gallons/day Alarm present(ye or no): Alarm level: Alarm in working order(yes or no): 4 4 Date of last pumping: Comments(condition of alarm and float switches, etc.): Tight- or holding tanks are nAt;—present= . DISTRIBUTION BOX: Zif present must be opened)(locate on site plan) Depth of liquid level above outlet invert: 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.): Distribution box has two laterals . In_let & outlet tees are in place . No evidence of solids carry over No evil n P of leakage into or out of the box . PUMP CHAMBER;�e(locate on site plan) Pumps in working order(yes or no): .tl,4 Alarms in working order(yes or no): Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Pump chamber is not present . 8 k `v Pane 9 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 83 Pondview Drive Centerville ,Mass . Owner: Fred Hume Date of Inspection: 5/29/02 SOIL ABSORPTION SYSTEM (SAS): (locate on site plan, excavation not required) 6—infiltrators . 49 'X11 If SAS not located explain why: Located ; See page Type Nd leaching pits. number: leaching chambers, number: leaching galleries, number: 0 leaching trenches, number, length: Q 410 leaching fields, number, dimensions: overflow cesspool, number: Q innovative/alternative system Type/name of technology://�`,1� 1017A Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.). l,namy sand to mediim fine sand .No signs of hydraulic failure or ponding - Soils are dry . Vegetation is normal . CESSPOOLSI,1StJL (cesspool must be pumped as pan of inspection)(locate on site plan) Number and configuration: 6 Depth —top of liquid to inlet invert: iLllf Depth of solids layer: Depth of scum layer: /(J Dimensions of cesspool: �J/9 Materials of construction: lU/4 Indication of groundwater inflow(yes or no): Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Cesspools are not present . PRIVY��Jlocate on site plan) Materials of construction: Dimensions: 144 Depth of solids: _AX Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy is not present . 9 Pagc 10 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM TNFORM.ATION (continued) Properry Addres,: 83 Pondview Drive en t ervi e , s . Owocr: Fred Hume Oil( of Inspecsim 5 29 02 SKETCH OF SEWACE DISPOSAL SYSTEM Pioride a sketch of the )cwafc disposal lystcm including tics to el Icut two pmnancnt rcrcrcncc lan(m4rks or ocnc"L/ka. Locatc all wclls within 100 (m. Locatc whcrc public walcr supply cnlcrs the building. a s 10 Page 1 1 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 83 Pondview Drive entervi e , ass . Owner: Fred Hume Date of Inspection:5 29 02 SITE EXAM Slope Surface water Check cellar Shallow wells i Estimated depth to ground water _-V feet Please indicate (check)all methods used to determine the high ground water elevation: Obtained from system design plans on record - if checked,date of design plan reviewed: bserved s abuttin roe bservation hole within 150 feet of SAS) Ali -Checked with local Board of Health-explain: Checked with local excavators, installers-(attachApcume Lion) Accessed USGS database-explain:h�j� You must describe how you established the high ground water elevation: Used ; Gahrety & Miller Model . 12/16/94 Ground water elevations above sea level . Used ; USGS : Observation well data Trine 199 USED: US • of gro nd water elevations . 6 NFL��)la Groundwateti: t"et Below Bottom of Pit High Groundwater Adjustment 1.8 ft per Frimpter Method Therefore, the vertical separation distance between the boa om t Of the leaching pit and the adjusted groundwater table is Y, feet. 11 y^•nrnrr.—ni•r�Tt—srn-A•r.•nrrrrrer.asn.rrr.:-.•R+'nmr:•rrr.e*rrneml'st Tra��rtr.r+t+ 7'errra-T•—.—...--.—..,F 1 TOWN OF Barnstable BOARD OF HEALTII 0 -.`-r••.-. '--.'-�SUf)SUf(FACF••9I:HAGF DISPOSAL SYSTEM IN�9f'FCTION FORM - PART D^�CEftTIF CATIONr�, '. -TYPE OR PRINT CI,EARLY- PROPERTY INSPECTED STREET ADDRESS 83 Pondview Drive Centerville ,Mass . ' ASSESSORS MAP , BLOCK AND PARCEL # OWNER' s NAME Fred Hfdme PART D - CERTIFICATION T NAME OF INSPECTOR Joseph P.Macomber Jr. COMPANY NAME J. P.Macomber & Son Inch COMPANY ADDRESS Box 66 Centerville ,Mass . 02632 Street Town or City State LIP COMPANY TELEPHONE ( 508 775 - 3338 FAX (508 790 _ 1578 A CER'rIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true , accurate , and omplete as of the time of .inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems , • n i Ili+ l, Check one :�L/1 µ System 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 16 - 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form . System FAILED* The inspection which I have cony -cted has found that the system fails to Protect the public health and the environment in accordance with Title 6 , 310 CMR 15 , 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form , Inspector Signature wry Date � !`�%� ne copy of thi rtfication must be provided to the OWNER, the BUYER ( where applicable ) and the BOARD OF HEAL1'1I. * If the inspection FAILED, the owner or"I'operator shall upgrade ' the system within one year of the date of the inspection , unless allowed or required otherwise as provided in 310 CMR 16 , 305 , partd .doc P- 2�-q —0 23 No. ' l Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipplic Lion for ]3i!5poga1 *p5tem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) El Complete System ❑Individual Components Location AdUress or Lot No. Owner's Name,Address and 9Tel.No. Assessor's ap/Parcel a �� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. J P 1 S Type of Building: Dwelling No. of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 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 Nature of Repairs or Alt e ations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensu he construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of itl 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b t s oard"ealtbl Signed Date Application Approved by Date Application Disapproved for We folg4ing reasons Permit No. �-- 9 Date Issued ( w. ,-i .r. .i,4;` 'emu.3e\� '•r: - ,.:2. .. . ...r. .. .. .. � r Y U'l 2;-9 —o �2-3 No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Application for 30igpool *p.5tern Construction Vermit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System O Individual Components Location Address or Lot No. (� Owner's Name,Address and Tel.No. i Assessor's 14Iap/Parce ` r ! /L Installer's Name,Address,and Tel.No. Designer's Name Address and Tel.No. Po o Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 1 o 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 :2,p- Nat r -u e of Repairs or Alt ations(Answer when applicable) / U � ` R x SE Date last inspected: Agreement: The undersigned agrees to ensu he construction and maintenance of the afore described oti=site sewage disposal system in accordance with the provisions of itl 5 of the Environmental Code and not to place the system in operation until a Certifi- cate cate of Compliance has been issued b th s oard o ealt rr Signed' a Date 7--10` b _ Application Approved by Date v Application Disapproved for t e folfaing reasons Permit No. - y� Date Issued ----------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On�site Sewage Disposal System Constructed ( ) Repaired( ) Upgraded( '{) Abandoned( )by at has been constructed in accordance with the.:ptovisions of Title 5 and the for Disposal System Construction Permit No._ - _dated - Ingfaller Designer The issuance of this permit shall not be construed as a guarantee that the system 'll fu ction as designed. Date - � Inspector .. --— —————————————————————————————————— No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mizpozal *pztem Construction Vermtt Permission is hereby granted to Construct( )Repair( )Upgrade(k)Abandon System located at -G 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: 2 _ 15 - �{ Approved by �� t TOWN OF BARNSTABLE L �>� TION � � \ � SEWAGE # VIA LAGE —� �� ASSESSOR'S MAP & LOT2: ` "®2 3 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILrrY: (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 Wed!and and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by i Eul=.L- , \II to TOWN OF BARNSTABLE1 LOCATION SEWAGE # 9F VILLAGE P o ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY v LEACHING FACILITY: (type) ., (size) NO.OF`BEDROOMS BUILDEROR OWNER P� /"L C /t/At PERMITDATE: .l b^ _COMPLIANCE DATE: =� v Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Z1 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 i(Ie,4, , 4� c v ,S - a _ _ _ _ _ _ _ -- w :, , 1. -� /,\I� l l I-z.�� .,.I-I.. � �... I I�,I�- I �I I I I- I I� I i. I� _. I :. i %' . IL1­, k- BENCHMARK , / t �QV : I T ;, - 4 --.�-.; , - � �. SOIL.:.. ST , � TOP OF FOUNDATION 20 FT. MINIMUM •FROM Cf1.LAR } 2 , c 10 FT. MMHMUM FROM SLAB OR CRAWL ', = y, . :EEV. . ! yr 10 FT. MINIMUM . ! 1 CLEAN SAND DATE OF SOIL"TEST , , a , t� /' • (ASSUMED) CONCRETE - WITNESSED BY Y•'r r_4 v nn#r1 q 4 0 N ; B ... ' COVERS i - qe.G j {" SCHEDULE 40 PVC PIPE ,,•, LOAM AND SEED OBSERVATION HOLE 7a .. • MIN. PITCH 1/>s" PERT. .- PERCOUTlON RATE MIN./INCH At 'g$-�o INCHES 08PERCOLATION RATER OLE 2 MiN. A ..' INCHES 2 _ . - -,__ .; 2 LAYER OF _ . . . 1/8" 'i0 1/2" DEPTH HORIZ E COLOR trIOTT. 0 DEPTH HORIZ COL MOM OTHER . WASFt STONE A.c cs.n 71 j o R ( E L 9 9.0,.. ,� ; 3 4 • CAST IRON PIPE M x• VENT - (OR EQUAL MWiMUM NOT REQUIRED q ; Loa.,,y l4 YR_ - . I PITCH_1/4 PER FT. X i 1 CU. FT. OF C o<s;n t . 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" . o . //.. , w ?6.2� "I0" 6 9-f. G 7 ',l - - ��'..-..�I II-I�,.1­�.'�"���'-.%,,.­._,I K��,:I.I.I'..�.�I.I�..I_�I�.-._--1:II.-,�1.�-I.L1I.I�­I I._:1..:,,'I�f.I,I.-I-�j II 1­_,I."IIi�..rI���1�1�II 1.,II-, . (O.JCJ - � Q e� by p 1 ELEV. s :, - I/ ,. I _ ._. t. �...,rT��1I I x�.�I�"--�..Lr.I.--3I,.�;�I���'I�.-,I,,II_"�'1�� ­-J i-1­,-­D�I:�I.�,v-1,.'-_�.,­,1..,_,I,-�-I.I-1,.o�:,_­-1­,"_"�1'-�,-. l I�L,.,I�,,7�-�I�I.,,r--I I 1*III--t �.,­�:II��­I_I,.,.p I-�I,.`1I..--�,r.I�--'!�,-­.1'-�-'q1I,I-I,_�1-:,--.�-,�1��r I.1I.­,"­��-­)_- r. �• 9 - ;;qq�� �y m..lar.8-/ �• - .r.rY O 3S /Q o �.t - _p - v. II­ AFFLE __�_ ( 6_ c bdv B c. . . ponel) . DISTRIBUTION 2© = ID OUTLET ,, G HI(#i CAPACITY WFILTRATORS i"ITH BDX 9S STONE W AN - , ,j (TO BE PLACED.ON FIRM BASE} z t\ Z 4 FEET 14 W TO BE WATER TESTED - ` r _ !3 :_ !x.4 9 x /0 TRENCH FORMA 10N 2 (] _ . 5 ,FEET 19 iN 1500 GALLON IF ktOltE 'fIIAN oNir ouTLET 6 4.IN : N0 WATER ENCOUNTERED AT I32 ELEN. _ 'b77 G' WATER ENCOUNTERED AT ELEV. -. 7 m ` . . , : tTO BE`PLACED ON FIRM` BASE) ,. SOIL ABSORPTION ; %n wELL A 8 , 'I S P TI C N zoNE - ' CHES E TA K • - ,- - S/4 -TO 1 :1/2 tNDEX SYSTE SA fi z M S t o W #' Asr STONE Ac.usT .. : ., , . - LEGEND. DESIGN.! CALCULATIONS .' ,USGS PROBABLE WATER TABLE ELEV.-_. ;�, EXISTING,SPOT ELEVATION 00„0 .' NUMBER OF BEDROOMS L' X%sTr�!or '¢ �0 4 p SEWAGE DISPOSAL SYS M PROFILE , • OBSERVE WATER TABLE:( / / ) £1,EV. m I EXISTING CONTOUR 00 GARBAGE DISAOSAt. i1Nlt . . - : _,NQ_ "• NOT TO SCiE . BOTTOM OF TEST HOLE q4v- _ FINAL SPOT ELEVATION ' TOTAL ESTIMATED FLOW *. , --_ . ,.., _. -flNAL"CONTOUR ( 110.1iM:/!#t.JbAY X BR.) CAL/lJAY t t 'SOL 7EST LOCATION , ., f�QUtRED sEPTic-TANK CAPACITY GAL. , 1 - . '.Uiit.ITY=POLE• -�- SIZE OF SEPTIC TANK� GAL' ­ _, ; A CTUAL _ - . y,r CATER -W SOIL CLASS�ICATION . CA K. - DESIGN PERCOU1TKk1 RATE ttAiN. . TC IlAS�1 • IN. - 4 : ;' , O GAS l. lE EFFLUENT LOADING itATE o CAL f DAY/S.F.' . . . ._w; MA OUT SQ. FT.'CHI -. s - .. . c G ,' l ..SPOOL . C.P. :, - t '��: _f ° `' - LEACI�+IG CAPAgTY, -AREA X RATE) � .i, GAL/DAY . - - - - - - - _ .. - 4- - - I � . RESERVE IEACHIFIG CAPAgTY . I GAL./DAY s R__ ,. -. ..I - :- Sox 7.1` . _ .. _ - - �(T;o w" 1 x I �.�,o 3Y I' _ rS A x �"'�' 44 ' - r :,. i h ,. .. . -,'. r 1 , , �t . - OTES. t .. ; - t . \ �, } . At.L`'W I"ANSHIP AND MA ALS SHALL CONFGRfrt TO D.E.P. . , - � -!': - -a► ! A N-.?Tr't lit�^ , �, _ f •P t TITLE AIVD TFiE TONM OF RULES AND' __ -._,' S - . + (h / - �.`�,: - ., Lt \ I , REGULATIONS FOR TW SUBSURFACE DISPOSAL_OF SEWAGE. , oa v Y. - :..c. . :• 2.ALL CO% , 0 SANITARY UNITS SHALL BIE BROUGHT TD . , . - t � • t ` r L. V .1YrTW Q'.4F , 1MS� GRADE. , , . - , y r - _3. ALL:'COI�APOI TITS. OF THE•SANITARY SYSTEM SHALL :BE CAPABLE-OF - „' ,A 1 , _ ,"� . - ; . k _. WITHSTANDING H-10 LOADING`UNLESS THEY ARE UNDER OR'11YITHIN � . , P f • O v' 5 .. ' ' --1 . . N - , s►g ., -, ,: i-. _ 'I4 FT. OF 'DRIVES OR PARKING AREAS H-20-LOADING"SHALL BE ,.,cc t . , ��,•� r- :.:.• . .-�' , ,._. USED MINDER OR`WIl} 1 1Q FT. OF DRIVES OR PARKING AREAS. cr, t �- � �. �- a � _-. , - �� w S +. - _�. : 4 ANY,MASONARY UNITS USED•TOBRING COVERS TO GRADE SHAH w, ; . � / �' �•_ ,: 1x , �,� � A fl 1 3._ � , _. Md?ARED..IN PLAC£. �,__- _.. ., - _ -__ ° G> �''` --,:,�_ .i._...�. -�-- _ _ ._�,": * -�,,_ S. NO �ATiON HASBEEN MADE`XS TO COMPLIANCE WITH I O I F �._._ ' �. - � - _ -:•._ L , .y i DEEDED 0!t ZONING REGUlAT10N5 OWNER APPLICANT S 'iu I - , , _. '^ OBTAIN 'SUCH'DETFRMINAT�N FROM -APPROPRIATE AUTHORITY. • o \ •; 6. UTtt1T1ES SHOwN I�RE APPROXIMATE-OI�,Y. EXCAVA11oN CONTRACTOR . - Q_,_ ,_� P , ti - . ' -,N .- : IS TO CALL 'DIG-='SAFE" AT .1-800-322-4a'344 AT LEAST.:72 HOURS �K I ,, o p t�l o. �. .- .,. / ..._ , .�--- y /./- � _ ,. � t �-' I N - - F '"- • :" -. PRRIOR:Tn COia�JC�lG:WORK ON�SITE' , '% .Q '� _ t . h c,o �' ,w. ».. -.7. CONTRACTOR:IS TO VERIFY-GRADES AND Ei.EVATIONS AS WELL AS t , __ _1 et . C3 • "., ., . �, SITE COND ONS"'PRIOR . WOW ON h I p _ , , tt s oaca '«�o , ",,,, r! ► . ' . >3. PARCEL IS IN FLOOD ONE . ' 2 t . ,. ! i , . , - 9. LOT IS SHOWN ON.A9SES�RS MAP � AS PARCEL .. vtfL ''f�� �A �- O . I • Qi Sy P .I( T! G 0 , :, ' �s _ " v - G E ,/� . n F' �. .. ' _: - ti ., , . 7 - f _ , _ 1D O .E M P . 1 t3 pV i 1 - , v cz �. _ a ,f- D . . I : �tl w A .. ., _ .._ ! 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