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Home My WebLink About0028 MANNI CIRCLE - Health (4) 52 NA7A DR, CENTERVILLE A= 169-1.25 No. 42101/3 ORA (3im cui ESSELTE o a o 0 l t , U�, 1zS� No..,l�.1r--J633 FIns..7��..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN. OF BARNSTABLE Appliratinn for �1ijpn!3 a1 Wnrlui Cnnntitrnr#inn ramit Application is hereby made for a Permit to Construct ( ) or Repair (� an Individual Sewage Disposal System at: --'•(!!��!�! Location•:\ddress A,/,"_/ ------- f or Lot No. ........ _... Owner Address w CI��G c.UT 1 nl S•-----------------� ...... ---r-=`Ya-K ,lS A ./C,---/ Installer Address Type of Building Size feet Dwelling— No. of Bedrooms----------1-2..-.._-____--_------.-.Expansion Attic ( ) Garbage Grinder aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a Other fixtures .. _.._._._ W Design Flow_________________....._._....gallons per person per day. Total daily flow-------------------3�d----------------------......__gallons. WSeptic Tank—Liquid capacit,VAR�....gallons Length---------------- Width-----.---------- Diameter.--------------- Depth................ x Disposal Trench—No. .................... Width-_-----(------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No----------/..-.-.-- Diameter-------lQ........ Depth below inlet..... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by.......................................................................... Date.--.----------- ---------------------- - ,� Test Pit No. I................minutes per inch Depth of Test Pit.-.-_---_-----..__-- Depth to ground water_.----.----.-_--------. (X4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ---••-----•--•------------- -•----•-•-•---•--...--••-----•••---•------•-.....---•--------.......---'......................................................... 0 Description of Soil...............................................................................................................................................................:........ x w U Nature of Rep irs or Alterations—Answer when applicable.-._-,4�----�......,,o v�---�'-._.._ �`f=� .._.� �:. �'7c.........W ..........................................S 1✓(�Sf�llJ�__A ......---/--------------------�Cl�---!----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmenta Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance s een iss d the board of health. Signed --------- ---------- - ------- -- ----- 7 �-Y/�� Date Application.Approved By ............... .:. ............. ,.�,.� ......:.:.::......:.... ... . 7-. .� .- Application Disapproved for the ollowing reasons- ------------------------------------------------------------- ---------------------- -------------------------------------------- ----------------------------------------------------------------------------- -----------...---....----...--- --- .... .._.... --- -------- ----------------..._------...__.....-- ----- ----------D.. ....... ........ • � a tere Permit No. ,� - -11�9---33............. Issued . ............................----------------------------- Uate J No----Z . .. 7Fics. ...........- THE COMMONWEALTH OF MASSACHUSETTS r BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiutt for Di-npiml 3I or1w Tattritrurtiun autit Application is hereby made for a Permit to Construct ( ) or Repair (�)• an Individua Sewage Disposal System at: ....� .......�" ..... �.�................ (., ........... LocatioJ ' ` t Address S-QL w 1�� ' ) or Loft No. ..--•-•----•.-•.-/--(-......J....................••----...........--...----•------------------•/v �t J r -- w a% e.o o« ^�s '- 7 a a 1'.1�iL ?`............................. D .%titi Z...r z,� --o ---....... a Installer Address PQ UType of Building Size Lot_/(,-*/`n._k_�....Sq. feet Dwelling— No. of Bedrooms----------�__________________________Expansion Attic ( ) Garbage Grinder aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOther fixtures -------------------------------------------•-•--------------------------------- W Design Flow................. �-------------gallons per person per day. Total daily flow....._._.....___J��__��_.�....__........__gallons. WSeptic Tank—Liquid capacity R ____gallons Length________________ Width---------------- Diameter---------------- Depth................. x Disposal Trench—No- -------------------- Width__;-------------------- Total Length-------------------- Total leaching area--------------------sq. ft. Seepage Pit No........../-------- Diameter----_Z0........ 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......................... fs. Test Pit No. 2................minutes per inch- . Depth of Test Pit-------------------- Depth to ground water........................ Phi ....._-----•----------------------------------•--••••--•---------••-------------•-----------•-------:----------•-----------------------•----------....- 0 Description of Soil..-----••..........--•- -•-••............ ... ... ... ...•- ••----•--..--- ------------------••••------......---------........------......---••----•--------•--- x U ---------------------------•-------••-•--•-•------•---------•-----•----------•-•--------•-------------••---------------•-••---------------•------------•-. --•••--••-•--•-------•-•-••••-•--•-------•-- �- w -------------------------------------------------------------------------------------------------------------- -----------------------------•----------� '1 --�-�---( V Nature of Repairs or Alterations—Answer when applicable.-_. 1•�`4._.-A_-__--_j.!V U_..4• .. ..----... `� ��--s--•--5� �...... �fc..f/W� a1L. ....... -�bt 5c� 1 -....5 F/?77 ,S S%t.•✓� 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 been iss f d,bly the board of health. Signed .. .......... ------- Application.Approved BY ----- .... ..^ ' 1....._.._.............._..............._..........-.............. Dace Application Disapproved for the ollowing rearonr: ... .................. .. ............................... .................. .. .. ..._ ...... ... ......_....... ----------------------------------- -_------------------------------------ IDace PermitNo. ... ..R....-/�a... , Issued ..............................................Dace THE COMMONWEALTH OFIy1ASSACHUSETTS 4� BOARD OF HEALTH TOWN OF BARNSTABLE C erttf rate of C�ampliance THIS IS TO CWgY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( per ) bya1�Ci-�cs>�.........-.0 e?� 5.7.7{.�.-c riu>•------------------------------------------------------_....-------------------_----------- ----_ Insedler SN -r-MCA---...at ................................................ v.t_t, c. has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. dated ..... .... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE AS A GUARANTEE THAT TAE SYSTEM WILL FUNCTION SATISFACTORY. DATE-----... ... ``....`'" .`_..... ...... ... _ Inspector . .. .................:..._ --------------- ._-_ _.----_-_-.-_-.-_,-----_ THE COMMONWEALTH OF MASSACHUSETTS ^�— BOARD OF HEALTH TOWN OF BARNSTABLE No....!-'5V 33 FEE- -`-�G Mips ua1 Workii Tunutrudiun rrrntit Permission is hereby granted O c�a�. . ........../.... U!J------•---•--------------------------- to Construct ( ) or Repair (->4-) an Individual Se rage Disposal System at No. 5 .�-i� GA- -C-�••------ l.*-Jt t�� Street 31 /I// as shown on the application for Disposal Works Construction Permit No. . l�__� Dated...... �..�.-.. /�... (� Board of Health DATE .- ---------------------• v FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS i CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANSI hereby certify that the application for disposal works construction permit signed by me dated 7��y�� , concerning the property located at _ _S�- Aj -7 l�J ,�2�� meets all of the 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 SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. ,..r, 1 , „ S✓�/ 3 G.P.rJ. \l .. �x j''•: 32 Ise O � � � 87 • � \' , �-,ice 40 877 M Aw. P/r k /• •��tkofM,, �L,4A/ .e �C-,A/C- Mom ..I .�. � MORAN ,. _-. ,._ _T- `v^r � .. -i1.1-w,...L. .j. .� .,_I .'ram."'_ •-�.—�.�1_1.... a. � r•Li'_. —i TOWN OP cBARNSTABirB w - LOCATI 'SBWAGB # -� ' 'ILLAGB e'N1 , - R'8 ASSB3S0 MAP LOT �&STA I* j3R'S NAME 6t PHONE NO. VC► tAw.�, 4SEPTIC TANS CAPACITY. v t LEACHING- AGILITY'.-( (size) s NO' OF B- QROOM3 3 ,PRIVATE WELL.'OR PUBLIC.WATBR j BUILDER:Glt:OWNER �� A NAj DATE PRIYT ISSUED.--r� -5� '. t DATE .01.1 ANCE ISSUED: VARIANCS...01tANTED: Yes ,.� No - . ........ . . r e 'y h t AOtI'� ` r • ' ' • :ti f ti4 t �� ys �x : rf J m DATE:_7/13./95 1®I AAA PROPERTY AODRES S: 52 Matka Drive Cb _..._Centervi_1.L.e C) � y _P1ass . 02632j:q ,N On the above date, I Inspected the septic system at the above a This system consists of the following: 1 . 1-1000 gallon leaching pit racked in stone . 2 . 1—distribution box . 3 . 1-1000 gallon septic tank . Based on my !nR;�►r_.tlon, I certify the following conditions: 1 . This is a title five septic system . ( 73 Code ) 2. . The septic system is in failure . ',Dater above leach holes in p pit . The system is filled to capacity . Recommen.datiot,/s . ! L Add an addi.t:iona7_ ]_each:i_ng p:i. Cr to existing septic syst III . �_. SIGNATUR!-- : Name:_1-P-_MAL-D-mhar V- Company: J . P_Ma.eomber _._'Son_Tnc . Address: Box 66 . - Ceat�rvi ].� - U s-s_:_1)2 -32 Phone: 508_775-3333__THIS CERTIFICATIOk DOES NOT CONSTITUTE A GUARANTY OR WARRANTY 5"M JOSEP� P. M1ACO �ER SON, INC. Tanks-CersspoolwLeschflelds Pumped Z Installed Town Sewer Connections P.O. Box 66 Centerville, MA 02632-0066 775-3338 775-6412 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION .FORM Address of property 52 Natka Drive Centerville ,Mass . Owner' s name Chris Burgess Date of Inspection 7/17/95 PART A CHECKLIST Check if the following have been done: YPR Pumping information was requested of the owner, occupant, and Board of Health. NQ 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. YPG As built plans have been obtained and examined. Note if they are not available with N/A. Yp,. The facility or dwelling was inspected for signs of sewage back-up. Yes The site was inspected for signs of breakout. -Ye.s All system components, excluding the SAS , have been located on th site. e Yes 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. Ye_ The size and location of the SAS on the site has been determined based on existing information or approximated by non-intrusive methods. Yes The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance -.of SSDS. ' 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION 1 FLOW CONDITIONS If residential A number of bedrooms 4 number of current residents -NQ_ garbage grinder, yes or no YES laundry connected to system, yes or no _N_ seasonal use, yes or no If nonresidential , calculated flow: Water meter readings, if available: 1993-140, 000 gallons GPD 383 Centerville Osterville Marstons Mills Water Company . Last date of occupan y94-121 , 000 gallons GPD 331 Presently GENERAL INFORMATION Pumping records and source of information: No. Pumping record BaLnLitable Sewage Dlant . Bearses Way } Hyannis . Mass . Tank pumped 5 . ac'om er Son L NO System pumped as part of inspection, yes or no if yes, volume pumped Reason for pumping: Type of system YES Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy NO Shared system (yes or no') (if yes, attach previous inspection records, if any) Other (explain) Approximate age 'of all components. Date installed, if known. Source of information: 8 v e a r s -------------- N0 _ 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: 1 -1 00 gallon tank. (locate on site plan) depth below grade: 12" material of construction: XXXX concrete metal FRP other(explain) dimensions: L-8 ' 6" W-4 ' 10" H-517" 0 sludge depth Septic tank pumped 5/2/95 J.P.Macomber & Son Inc 0 distance from top of sludge to bottom of outlet tee or baffle 0 scum thickness _0 distance from top of scum to top of outlet tee or baffle 0 _ distance from bottom of scum to bottom of outlet tee or 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, etc.) Tanked Dumped once every 3 years . Tank condition is fine . Inlet4 'O' . outlet invert 4 ' 3" No repairs needed for the septic tan DISTRIBUTION BOX: YES (locate on site plan) NA 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, etc. ) s carry over • no leakaoe •Plo repairs needed PUMP CHAMBER: 110 (locate on site plan) 1101,1E 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 INSPECTION FORM PART B SYSTEM INFORMATION continued SOIL ABSORPTION SYSTEM (SAS) : YFS (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 1 1000 dallnn leaching i leaching chambers and number leaching galleries and number leaching trenches , number, length leaching fields, number, dimensions overflow cesspool , number Comments : (note condition of soil , signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or re airs, etc. ) Clean medium sand . no hydraulic failure or ponding ; vegetation nior mal ; Pit is filled above weep holes and wit in of rove . Leach pit is in failure . CESSPOOLS (locate on site plan) : i number and configuration depth-top of liquid to inlet invert NONE depth of solids layer depth of scum layer dimensions of cesspool materials of construction indication of groundwater inflow (cesspool must be pumped as part of inspection) Comments : (note condition of soil , signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs, etc. ) i PRIVY : ( locate on site plan) materials of .construction NONE dimensions depth of solids Comments : l' (note condition of soil , signs of hydraulic failure, level of ponding, 1 condition of vegetation, recommendations for maintenance or repairs, etc. ) rr� TF . 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION •FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE L=SPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100 ' Town Water DEPTH TO GROUNDWATER 20 '+ depth to groundwater method of determination or approximation: Test *hole 9/19/86 Revised 4/5/88 13 ' no water . See Attached plan .- Martin & Moran jL ` � L -41 so s• �sib/ /�,eccx-4?•��/ ,P�4 � \ :��`�• 87 � z , Cb) /cam �c7 AXI moo E. MORAN 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) No Backup of sewage into facility? NO Discharge or ponding of effluent to the surface. of the ground or surface waters? Nn_ Static liquid level in the distribution box above outlet invert? 6N:O )Liquid depth in cesspool <6" below invert or available volume< 1/2 day flow? No Required pumping 4 times or more in the last year? number of times pumped Tank pumped 5/2/95 No Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank failure imminent? Is any portion of the SAS, cesspool or privy: Nn below the high groundwater elevation? .din within 50 feet of a surface water? mp_ within 100 feet of a surface water supply or tributary to a surface water supply? No within a Zone I of a public well? NO within 50 feet of a bordering vegetated wetland or salt marsh- (cesspools and .privies only, not the SAS) ? No within 50 feet of a private water supply well? NO less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis? If the well 1 has been analyzed to be acceptable, attach copy of well water anal, . for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. TOWN OF Barn2ta_blp BOARD OF HEALTH SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D CERTIFICATION -TYPE OR PRINT CT,EARLY- PROPERTY INSPECTED STREET ADDRESS 52 Natka Drive Centerville ,Mass , ASSESSORS MAP, BLOCK AND PARCEL # OWNER' s NAME Chris Burgess PART D - CERTIFICATION NAME OF INSPECTOR j-P mqrnmhPr COMPANY NAME J.P.Macomber & Sop Tpr _ COMPANY ADDRESS Box 66 Centerville ,Mass . 02632 Street Town or City State ZIP COMPANY TELEPHONE ( 508 775 - 3333 FAX (508 790 15 7 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. Check one: 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 15 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. 6 XXXXI System FAILED* ��_�_Sy 9 t The inspection which I have conducted has found that the system fails to protect the public health and the environment in accordance with Title, 5 , 310 CMR 15 . 303 , and as specifically noted on PART C FAILURE CRITERIA of this inspection form. Inspector Signature _._Ld' � aw/'Z' Date 7/18*/95 f One copy of this � rtifica'tion must be provided to the OWNER, the BUYER ( where applicable ) and the BOARD OF HEALTH. If the inspection FAILED, the owner or""o'perator shall upgrade ' the system within one year of the date of the inspection, unless allowed or required otherwise as provided in 310 CMR 15 . 305 . partd.doe Water Coris'ervation . SAVE Tips . . . ME! , . CHECK FOR LEAKS Water Loss in Gallons Due to Leaks Leak this Loss Per Day Loss Per Month Size 120 3,600 • 360 10,800 • 693 20,790 • 1,200 36,000 • 1,920 57,600 3,096- 92,880 ,0 4,296 128,980 ® 6,640 199,200. 6,9.84 '• 200,520 8,424 252,720 9,888 296,640 ® 11,324 339,720 12,720 381,600 14,952 448,560 Ccmmonwearn of Masscc^useUs ExecuTive Office of EnvironmenTal AffCrs Department of !Environmental Protection Water Pollution Control Technical Asswonce and Training Sections WUU&a F.Woid C.V-MQr Trudy Cox• Swmry,EOEA Thomas B. Powws rlur+g Corm...orw OG/12/95 ATTN: Joseph P. Macomber, Jr. Joseph Macomber and Son PO Box 66 Centerville, MA 02632- 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 310 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. Sincerely, Kimball T. Simpson, P DEP Training Center Director [2405) Route20 • Millbury, MA 01S27 • FAX 508-755-9253 • Telephone 508-756-7281 i k