HomeMy WebLinkAbout0503 STRAWBERRY HILL ROAD - Health E
RAWBERRY HILL, CENTERVILLE
48 021
1l ifad,
UPC 12543
Mo,53LOR
�--_- - - °�T cc
HASTINGS, PIP!
Page 1 of 1
Town of Barnstable Health Dept.
From: Town of Barnstable Health Dept. <health@ town.barnstable.ma.us>
To: <CRDAY5476@aol.com>
Sent: Thursday, January 11, 2001 3:00 PM
Subject: Answer to Your Question
The site is located within a zone of contribution to public water supply
wells. Therefore, the property is limited to 330 gallons per acre per day.
A septic system inspection report conducted by Joseph P. Macomber Jr. dated
May 10, 1995 reports there are three (3)bedrooms in the house.
Also, the disposal works construction permt application, dated June 7, 1995,
has three (3) bedrooms listed on it. This is the official record used by
this office for establishing the number of legally allowed bedrooms in a
house, as required by the Massachusetts Department of Environmental
Protection (DEP).
Therefore, this property is limited to three (3)bedrooms.
[NOTE: There are no
engineered plans on file.
g
What would you like me to FAX to Charlene Day, this response?
----- Original Message -----
From: <CRDAY5476 @ aol.com>
To: <health@town.barnstable.ma.us>
Sent: Wednesday, January 10, 2001 9:11 AM
Subject: request for as built
> address: 503 Strawberry Hill Road, Centerville
>Map: 248 Parcel: 021
>I would like to know how many bedrooms this septic system provides for.
> I
>Please fax this to Charlene Day as soon as possible at
> 508 362 1313
>Thank you.
1/11/01
f
Page 1 of 1
Town of Barnstable Health Dept.
From: <CRDAY5476@aol.com>
To: <health@ town.barnstable.ma.us>
Sent: Wednesday, January 10, 2001 9:11 AM
Subject: request for as built
address: 503 Strawberry Hill Road, Centerville
Map: 248 Parcel: 021
I would like to know how many bedrooms this septic system provides for.
Please fax this to Charlene Day as soon as possible at
508 362 1313
Thank you.
1/11/01
y TOWN OF BARNSIABLE
LOCATION �3 `-S ' > i� SEWAGE# 4� y
VILLAGE ��� ASSESSOR'S MAP &LOT-: �—RXI
INSTALLER'S NAME&PHONE NO.00AS 2"77 C-tl N�ri-- y-;1" 44
SEPTIC TANK CAPACITY /,s5-0-0,sft�
LEACHING FACILITY: (type)�/'Y (size) /°L �/ I
NO.OF BEDROOMS
BUILDER O OWNE �y
PERMITDATE: ��/�� COMPLIANCE DATE: /—a
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 's.
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
s°3 'Air
�3
4� TOWN OF BARN STABLE
LOCATION ,125,3 SEWAGE #
VILLAGE CY1�rr/�,QG ASSESSOR'S. MAP & LOT
INSTALLER'S NAME & PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) (size)
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER '
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
• ti
0
-- \t c�c.
.L
t .
No __... . Fps.... d.. .....
THE COMM, ONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABL.E
Appliration fur Mij-putial Wor1w Tomitrnr#iun rami#
Application is hereby made for a Permit to Construct ( ) or Repair (o< an Individual Sewage Disposal
System at:
._ 3 /lA vJ Q�2lt / t l,� �0,�p fi1
( .........................
I , _^U Locilt�l-Address y •____._._._-_ � I� � //�.�]]_%...................
��_/�._____..or________-O: ......................
. ...................................... ..........................
" ddress
M I I,L.S
Installer Address
UType of Building Size Lot............................Sq. feet
Dwelling— No. of Bedrooms--------------_
------------------------ ----Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building _--.______________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
Q' Other fixtures -------------------------- -
------------ --------------------------------------------------------••-•-
W Design Flow---------------=- ..._-_-___..._••_.gallons per person per day. Total daily flow.......... d._......__..
........�, -_---
WSeptic Tank—Liquid capa6ty/-540---gallons Length---L(!<_�_ Width.._ • Diameter................ Depth................
x Disposal Trench—No. --------- --------- Width---S4_-------- Total Length-----CW_'---- Total leaching area....................sq. ft.
3 Seepage Pit No..................... Diameter..------------------ Depth below inlet__I-r. ..... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by_------------------ ----------------------------•------------------------ Date........................................
Test Pit No. 1----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water.....................
rX, Test Pit No. 2................minutes per inch Depth of Test Pit_................. Depth to ground water........................
W ._...---••••--------------------•-•--•---•-•----•-•--•---•---••-----•••-•--•••-•--•---•-•-•---••---........................... ......
-••--•-----------
0 Description of Soil......................................... ----•-•-•---------•-•-•--•-----•-•--••-----------•----•-----•------•--••-----••-•-------------------
x
U .............•-------•--••--•--••----•--•-•---•--•-•-----------•---•-•-••--•-----••-•--•-••••--•---------•-•-------•----••---------••---•--•----•--•....------•••-•-•--•----••---••--•---•-•--•-•--•--•-
w
U Nature of Repairs or Alterations—Answer when applicable.--_ A....... ---- .._ .____.___.
f S .
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compliance b en 'ss b e board of health.
Signed --- ------- ----
-----�-___-_...- ..- Dace
Application.Approved By -------- ---- -- ------- ------------ ------
Dare
Application Disapproved for the following i asons- ----------------- -- ----- _........ -.-.................................................
= - --------------._----
-� Dare
Permit No. -- Issued __..' .. �..
`... ... ........--- ------- ....------- ace
No.._ Fa$.... .o f
f
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
1
,TOWN OF BARNSTABLE
Allp iratiun for Di-tipaiial Works Tomitrurtiun ramit
Application is hereby made for a Permit to Construct ,O or Repair (pQ an Individual Sewage Disposal y
System at: ,.
.: .........----------------------- S j/La�,.1 p . ...... lZ��➢------. Cam.... �. I L�
- --------- - -------- ----
�/j� LLocation-:\d ress ��r'� --- -C,y-_•_--•-----t------/..................
� or Lot---o-----=-•---•t!/1!� .................
owner •---------
WQ!cil (�ih� 1�.L�
Address
,-�
Installer
% Address
UType of Building "�� Size Lot...........................Sq. feet
Dwelling— No. of Bedrooms______________._. pansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ------------------- No. of'persons___._---_.-_..--_-___-_._-- Showers ( ) Cafeteria ( )
Other fixtures ------------------------------------------------------
W Design Flow.................. -_-_____-_.-gallons per person per day.' Total daily flow..__._._..':?-.._.__:................gallons.
WSeptic Tank—Liquid capacity/ ...gallons r)j engtll.-&,�.T_r.�`Width_ ,S_ Diameter.-.___-._-_--- Depth____.___._....
x Disposal Trench—No. .....___r_.___ Width..._-•_..__.-__-_--_ Tota'1`Length-__-.�!5�i-.__ Total leaching area------- ...........sq. ft.
Seepage Pit No.---.-- Diameter...----------- Depth below inlet._-P!t -___. Total leaching area..../............sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
est
^" -a Percolation
Test Pit No.Results----_--1 Performed
inch Depth of Test Pit...._--____-_-_.- Depth to ground water........................
� P g
fS. Test Pit No.-2................minutes per inch Depth of Test Pit-------------------- Depth to ground water---:....................
---••-•--•--------------•----••--------•---•----•-•-••---•------•-•---•-•-------•---••--------------------------
------...._...........-•--•-•--•------------
xD '1 Description of Soil----------------------•---s---------------•-----•••----------•-....• ......------------------------------------------.....-------------------- '"�
,
c.� ��
t ny �°
x = -------------_------------------------------------------....--••.
Nature of Re airs or Alterations—Answer when a licable._._1.. "-�4-4/\___ •A_----.__
/ �j -10
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
-. system in operation until a Certificate of Compliance s b en ss e``= byi e board of health.
Signed -
Dace
Application.Approved BY -- --- -.0...$.`. . .- /Yl. ,l..... ............................................
Dare
Application Disapproved for the following ikasonr: . ..... - -. .............................
- .----- ...- r......
PermitNo. - ..... ------------------- Issued ..... ..... ...............
�_ ace°
}
f'
THE COMMONWEALTH OF MASSACHUSETTS
SOARD OF HEALTH
TOWN OF BARNSTABLE
Qxr#tf rate of Tontyliance
THIS IS TO CERTIFY at the Individual Sewage Disposal System constructed ( ) or Repaired kl-NI, ) ,
by ........... ........... - - �-° -C.G ,S [ c "io).l
--: -
at ........................................... 6.�1 iP£RA—y /0i+.L � ,p C_
_. --- -----------------------------------------------
has
been installed in accordance with the provisions of TITI. he State ironmental Code as described in
the application for Disposal Works Construction Permit No. . ....�� ,r�-..�.� L_.;....... dated ._......
............_...............
........
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT 'CONTRUE AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE ."""�......2=` '`.--/�'��.----__---- -- Inspect ��% �..
-�-
�+�+4-�: .. .wo.r.�+�v r�.-a�.w.�r.�.s�f wr.r� r •+r n..�r-<r-.u ate-w n.a,tee�f r,�.++:r r_.._r��.-rn�n>s�+a.r u r.�+..wrri.�.�,�,u.i-a r�...,�.�.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH [ Q
!� TOWN OF BARNSTABLE
No._... ...... ... FEE.... Q
�i �rns�tlr�� Tunitrutiurt Frrmit
Permission is hereby granted...............
� _1-0 '.._.----------e -SJ. U•�__________ ______ __ _
to Construct ( ) or Re air (�) a Individual Sewage isposal System
at No............................... 3 �F'-7�(i4tiJi Z� -
1 •-
Street ,,
- --- a 1 - �
as shown on the application f Disp sal Works Construction P mit •� ----
-....... --------- -- - C
t..............
Board of ealfli
DATE..............................
FORM 36508 HOBBS h WARREN,INC PUBLISHERS
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS)
I, hereby certify that the application for disposal works
construction permit signed by me dated (p/z AIz-- , concerning the
property located at 5733 Cl LZ meets all of the
9AJ-1-
following criteria:
• There are no wetlands within 300 feet of the proposed septic system
• There are no private wells within 150 feet of the proposed septic system
• The observed groundwater table is 14 feet or greater below the bottom of the leaching facility
• There is no increase in flow and/or change in use proposed
• There are no variances requested or needed.
SIGNED : DATE:
LICENSED SEPTIC SYSTE M INSTALLER IN THE TOWN OF BARNSTABLE NUMBER -76
[Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan,
this plan should be submitted].
DATE:_ 5/i-195
PROPERTY ADDRESS: 503_S�trawberry Hill Road
CEI
Centerville,Mass., 02632
------------------------
MAY
_-02632 ----------------- 70WNFAr ..0 i
6'
On the above date, I Inspected the septic system. at the above address.
• This system consists of the following: ,
A. Two* 6x_$-,block cesspools. 40. years old +
Based on my Inspection, I certify the following conditions:
A ;:This is'-not a-tit-le five septic system.
B. The system is in failure.
C. -Rumping history during occupation.
• i
SIGNATURE:
• I
Name:J.P.Macomber Jr. '
Company:
. J.P.Macomber & Son Inc.
-------------------
i
. Address: Box 66
Ma.a._.Q26 3 2
.. i
Phone•_5o8_775 3338_________
i
t THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY:
a -
JOSEPH P. MACOMBER & SON, INC.
Tanks-Cesspools-Leachfields
Pumped & Installed
Town Sewer Connectlons
P.O. Box 66 Centerville, MA 02632-0066
775-3338 775-6412 -
SUBSURFACE SEWAGE ,DISPOBAL SYSTEH %NSPECTION FORM
Address of property Sb'3 fir. Q6R-�2. t�� �Ap
Owner's name U..ajVeX- Moce,\e,� Y n{ec�lIe
Date of Inspection toy
PART A
CHECKLIST
Check if '°
the following have been d✓ .one:
-
Y
yPumping information was re.qested of ,Healt the"..Owner,,.,,.. ccu an t, and Board of
r� 'None of the system components .have:,been um `e
Ieas
and the system has been receiving normalpflowdratesadu+ringtthat^ weeks
period. Large volumes of water have not been introduced into the
system recently or as part .,of,-this inspection.
As built plans have been obtained and examined. Note i
available with N/A. f they, are- not
The facilit g .: , . .b _ _ . . . . . . . _.� _..w._...__. ___.
y .or dwelling was inspected for signs of sewage back-up.
The site was inspected° for signs of breakout.
All system components, excluding the SAS," have .been .
site.___._ ... w._ .
_....... located` on the
The septic tank manholes were uncovered the septic tank was inspected for condition of.baffles or• tees, ,
..opened, and the iriterior pf
material of construction, dimensions" ',- -depth o.f, ;-
sludge, depth of scum. quid; depth •of
<.__. .The. size and -location of the SAS on 'the"site has b.._een determined base
on existing information or approximated by non-intrusive methods. d
The facility owner (and occupants, if 'different from owner) ' w
provided with information on the proper maintenance* of SSDS. -.ere 'MX.
t. c�s:tis Atu u�tv� . vU ...w � c TT�-l�npcc
Y'a` T 'FO Y i c.us O.
v u F-sT MT t t_ 1 vet PQ_Ck/C wt f�
4U 1 L-L- 12C—Q u t e_6 UPC�(�A'p f iVlo G 5"
a
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
SYSTEM INFORMATION
FLOW CONDITIONS
If residential •F .-
number of. bedrooms
number of current residents
garbage grinder, yes or no-
laundry; connected- to system; yes or ,-no
seasonal use, yes or no
If nonresidential, calculated:-'flow } t . .....
t;
WaterTmeter readings, if.ravailable.'` y
Last date of occupancy
GENERAL INFORMATION
Pumping ecords and �s"ur a ofnf rmation• ,
Ad System pumped as pant of inspection, es: or no
if 'yes, pumped ; y
Reason :.for pumping••, ,. ,. .a.b.i :i 1., t Sa .S .i
-----------------
Type of. system;
Septic tank/distributi
Single on box/soil absorption system
.cesspool
Overflow cesspool-, . . .
Privy
Shared system (yes or no°)r (if yes, , attach previous inspection
records, if- any)
Other (explain)
Approximate age .^of .all, components.; Date ..installed; '!'if. known: Source''of
information: `
_ Sewage_ odors detected'1�hen arr,i�ing... at the, site,.. yes,.. no t i °•.
r
9
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART 8
SYSTEM INFORMATION` continued '
SEPTIC TANK: +►�(51..I E
(locate on site plan)
depth below grade:'
material of construction: concrete „_metal. . FRp �_ _ other.(explain)
dimensions:
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 orbaffle
distance from bottom of scum- to bottom.. o.f, outlet.tee:. baffle
-Comments.
(recommendation for pumping;, condition of inlet and outlet tees .or baffles,
depth of liquid level in relation to outlet invert, structural integrity.,::
evidence of leakage, recommendations_.for repairs,
DISTRIBUTION BOX: �0" _Cff
..(locate on site plan).;:
depth of liquid level above outlet invert _
Comments: :..{
(note if level and distribution is equal, evidence o.f ,solids carryover,'
evidence of leakage into or out of box, recommendation,..for-.repairs, etc.')`
PUMP CHAMBER: '%AOKi L
(locate. 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. )
10
ti-
SUBSURFACE SEWAGE DISPOSAL. SY,STEM INSPECTION FORM
.,
SYSTEX INFORKATION continued
SOIL ABSORPTION SYSTEM (SAS) :_
(locate on site plan, if possible; excavation not required.
but,,,.;�cjy,
approximated by non-intrusive methods)
If not determined 'to' be pies'ent,,,-,explai,h",: 1.11.1111--'..
Type
Q X
leaching pits and number
leaching chambers and number
leaching galleries and numb&r"-`
leaching trenches# ,, number',,-` length ' -"--
leaching fields, .number, dimensions
overflow cesspool, number Ira—
Comments:
(note condition of
soil':, signit ':61 hydraulic failure; levef'of- ' po'ndi fi g
con4.ition of, vegetation recommendations for -maintenance"'brrepairs,e
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 groundwaiter -
inflow (.cesspool must: be 'pumped 'as •
part of. inspection) ....
Comments:
(note condition. of soil, . signs of -hydraulic failure, level-of -'Pon' di I ng,
condition of vegetation, recommendations for maintenance or repairs .etc
PRIVY:
(locate on site plan)
materials of construction
dimensions
depth of solids
----------
Comments:
(note' condition -of soil, signs.,of hyd=aulic- failurei level of-Ponding*, -
condition. . of vegetation, recommendations, for .maintenance or, re a
P irs,etc" —.),
-------------
SUBSURFACE SEWAGE;, DISPOSAL` SYSTEM INSPECTION -FORM
�..: .0 PART.°B—,,.-
SYSTEM INFORMATION;continued l ^`
SKETCH OF '-SEWAGE' DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
• 3
locate,,.,a11 wells within -;O, ' •.,>�,r v - 2S ,-- 1 ` ? ,� �i
r
o
r
1
i
DEPTH TO "GROUNDWATER
depth to groundwater
method of determination or approximation: t
xlb /.l 3` L���-L. .1 �vt-l•� 'I.C..l �� t��� .
Z�' i
- 12
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
m . . FAILURE `CRITERIA . ._. . . ti
Indicate yes, no, or not.determine&' (Y;� N, or ND
determination in all instances. If "not determined Describe basis of
.�, ;Oxplain.•.wh not
Backup of sewage into facility?
Discharge or ponding of,, effluent to the 's -
surface 'waters?. urface of the ground or`' '
Static liq
uid. level in. the distribution bo,x above outlet invert?
Liquid depth in cesspool <6" below invert; or flow? :".available volume< 1/2 day
Required pumping 4, times or more in the last-`year?
number of times pumped
Septic tank is metal? cracked? structural) uns
infiltration? substantial exfiltration? tank failure imminent?
"=DIs an y portion of the SAS,,. cesspool or privy:
below the high groundwater g g undwater elevation?
IT'D within
50 feet of a surface water?
within . 100 fe
et of a surface water suppl
water supply? y or tributary to a surface
. ,
p�Q within a Zone I of a
public well?
.� within 50 feet of a bordering
ring vegetated wetland or. salt, marsh..-.
(cesspools and privies only, Lot the SAS) ? , a,
within 50 feet of a .pri `, .. • ,.... . .. �. .,1._,. ... i
vate water supply well? . ..
.less.-
than _ _10 0
supply well wit henobacceptable water50 alieett .fr6m,.a-private water
has been analyzed to be, acceptable attach- copy-.-ofnal well If the -well"'"
for. coliform bacteria, volatile grganic compounds. ammonia-watnitroalysis
and r to 9en
I
05/16/1995 13:11 508-428-3508 C.-.O.MM. WATER DEFT FAGE 02
KEY NUI4BER <1056 >
NAME <GIBBS, CHESTERF EST OF > B-C 1 B-C 2
C/O ROADWAY MOTOR INN, B-C 3 B-C 4 ZOC
STREET 1157 ROUTE 132
CITY HYANNIS ST MA ZIP 02601-1832 REF 1 REF 2 OFF
PHONE ( ) - REF 3 REF 4
METER NO.< 1021> DATE READING CONS
STREET <STRAWBERRY HILL RD NO. 503> 12/31/94 1016 0
CITY CEN L ST LOC 06/30/94 1016 0
PHONE (14 ) - 12/31/93 1016 0
06/30/93 1016 0
ROUTE NUMBER 23 12/31/92 1016 0
SERVICE DATE 09/21/48 06/30/92 1016 399
METER DATE 03/05/49 12/31/91 617 0
CAPACITY 7 06/30/91 617 2
STYLE T8
SIZE 1 RATE SCHEDULE
KEY PIT PLASTIC
NOTE LS OF DOOR OFF NON-PAYT 6/92 ADDITIONAL CONS 0
ALTERNATE MIN 0
• a
SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM
PART D
CERTIFICATION
Inspector : Peter Sullivan PE
Location 503 Strawberry Hill Road Centerville
Date : May 10,1995
Certification Statement
I certify that I have personally inspected the sewage disposal 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 regarding
upgrade, maintenance and repair are consistent with my training and experience in.
the proper function and maintenance of,on-site sewage disposal systems.
I have 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.
Please note the summary of recommendations as presented in this form.
V truly yours
Peter Sullivan PE
Distribution:
Original to system owner
Buyer
Board of Heath
PMR G,
SULLIVAN
No. 29733
0�►At E '�
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5 . 01 ' E
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