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Home My WebLink About0007 WOODVALE LANE - Health 7 Woodvale Ave 190-175 Centerville No. 4210 1/3 O RA rPendaflexo 10% (i) . r u � / s v Town of Barnstable Health Inspector Office Hours Regulatory Services 8:00—9:30 Thomas F.Geiler, Director 1:00—2:00 BARNSTABLE, Only MASS. Public Health Division �En Mn+s Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT — SEPTIC QUESTIONNAIRE 1. General Information: Address: � QD �a �, Q,�10/Tl V t�(� Map �Ifl Parcel 1�S Name: IL'1 �(1 Kl�,rl 1G 1�}}' �7� Phone#: _ 6 2a. How many bedrooms exist at your property now? 2b. Are you planning to add any bedrooms? Q "fz��12 If yes, how many? _ 2c. How many bedrooms total are proposed at this property(including the amnesty unit)? 2d. Please include a copy of the floor plans for the entire property- showing the existing rooms.in the home plus the proposed amnesty apartment and/or addition. Please label each room clearly on the plans. 3. Is the dwelling connected to public sewer? YES or NO If the.dwelltng:is connected to publicsewer°: kip questions 4.-9 below 4. Location of dwelling is INSIDE or OUTSID �, a Zone of Cont ' on to public supply wells? 5. Is the dwelling connected to an ONSITE WELL or to PUBLIC WAT ? 6. Is a disposal works construction permit on file? YES or NO 6a .If yes,how many bedrooms were approved according to this permit? Bedrooms. 7. Were any building permits obtained for construction of additional bedrooms? YES or NO 8. Is there an engineered septic system plan on file at the Health Division? YES or NO 9. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO -------------------------------------------------------------------------------------------------------------------- FOR OFFICE USE ONLY . .. TO BE SIGNED BY A HEALTH INSPECTOR/AGENT ONLY e�(__ 1:2�12/v� The Public Health Divisio h no objection to bedrooms at this r ert . . oar I2(4 J p faOi` 517 V_Jr- Signed: Date: 2 �2. 8 -Art bum( Inspector(Print): 1'0•Kn MC C� �� ®R Q;/health/wpfiles/amnestyapp McKean, Thomas From: McKean, Thomas Sent: Thursday, December 11, 2003 4:21 PM To: Mcauliffe, Paulette Cc: Weil, Ruth Subject: Amnesty Applications F.Y.I. There were two amnesty septic questionnaire/applications forms received recently. The questionnaires/applications could not be approved due to the following reasons: • Roy and Nancy Brown, 34 Horatio Lane—REASON: Located inside a nitrogen sensitive area designated b DEP 9 9 Y , restricted per 310 CMR 15.214, State Environmental Code, Title 5, septic system capacity designed for bedrooms. Lot size is only 0.39 of an acre. However, counted six to seven bedrooms on submitted floor plan. Five rooms were labeled as"bedrooms"on the submitted plan, one room was labeled as"future guest room," and another room was labeled as"den." The homeowner was notified by telephone that the application could not be approved and I advised her of other options, specifically the options regarding removal of doors to rooms and widening doorways to five feet. The applicant responded that her husband is a contractor and that she will consider those options in the future. • Ann Condon, 7 Woodvale Lane- REASON: Too many bedrooms and rooms considered as bedrooms, according to bedroom definition with State Environmental Code, Title 5. Three rooms were labeled as bedrooms, one room was labeled as a"study" and another as an "office with a possible double opening." There is limited capacity within the existing septic system. The existing leaching pit is only 6'X 4' and was designed for a total of three bedrooms (not 5). This applicant informed of this information by telephone on December 11, 2003 and was provided the option of increasing the size and capacity of the septic system to accommodate the total number of bedrooms at her property. [NOTE: This property is not within a nitrogen sensitive area and is not restricted in regards to wastewater discharge.] 1 b T tr 1 no-q 5 6U Ps` ko &Uff �e Sep(i c trizz? 1� b c Cs.7 dead L& 'Ac- , a + ---------------- 0 0, l Ci V (,L, a i '� 1r [k a d h4J L V� a b. P _ e, cg/?/p70 Q � o L f c r;,kd ivy wit TOWN OF BARNSTABLE vV LOCATION' to 0 e-cj V /Z� SEWAGE VILLAGE l n-� V s ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. 40,� -�d =� ! l ,,> 1 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) G 1 (size) r �✓ NO. OF BEDROOMS-3PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER l r fs d "v DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED:!9`,Z VARIANCE GRANTED: Yes No xl� ✓�'f ' ,� �� t Y P� ,�, � 4 P 4Y v ^ p _+!f �, 6 '\�.. �1 1. re ............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Dig nittl Workii Towitrnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: '7 Iloodvale Ave Centerville . -•-•------•--•-...---•--••................:............. ................................................................................................. Ann Condon Location-Address or Lot No. ......................_.......................................................................... -•••••---•-•-•------••-------------•---------•--•-•---.......••---..............------.....---••- Owner Address aW.E.___Robinson.-_Septic___Sery_---_-___.__•____._ P.O. Box Installer Address Type of Building Size Lot-. --------. -_------Sq. feet Dwelling— No. of Bedrooms.--.....3..................................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............................................gallons. 04 Septic iameter x Disposal Trench Tank—Liquid o capacity..----..- gallons Length Total Lengthidth':..__.--._-ToDta1 leaching area.. Depth-..---aq..f�: W I Seepage Pit No...................... Diameter-----.--.-_--.---. Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-----•----------------•-•. -----------••-• Date........................................ W 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........................ a -•---•---------•.............•----•-•--•-•---•---•-------•-•---•-------------•-•-••---••---•••----•-......................................................... 0 Description of Soil............sand U .........................................................-............................................................................................................................................... W .---- --•-----------------------------•-------••-----•••---------•----•----------•••---------•----. ----------------- ------------------------•-----------••••-••----•-----•------•-••-----•---------- M. Nature of Repairs or Alterations—Answer when applicable--iastalI-...a---1--,.QQ-Q----gal...tank........................ ........ _-box.. &_. stonepacke.d..-leachp 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 under ' ed rther agrees not to place the system in operation until a Certificate of Compliance has been/sue" t oa of health. Signed --------------------------------- � y� Application Approved BY P r ............... 4 �-- �;e.................. 1�T Application Disapproved for the following reasons- ---------------------------------------- --=----------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------- --------------------------------------- Permit No. ....... � - .........._ Issued .......... .--��......... Z-.. ........ ........ Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .TOWN OF BARNSTABLE `' Certificate of C�nmylianee z X THIS IS TO CERTIFY, That_the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by .... W W.E. Robinson Septic- S• exv.------- -h-,--:-u-e------------- --------........-----._.....----------......---------------------------..._... - -.: at ---- Woodva l,e Ave Centerville. ..------t---------------- ----------------------------------------------------------------------------------------------------------------- .......................................................... has been installed in'accordance with thelprovisions of TITI.Er5 of The State—Enyironmental Code as described in the application for DisposakWorks Construction Permit No. .7 f��._.__'�J:�G��" dated THE ISSUANCE,OF TMIS'CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WI�LL9FUNCTION SATISFACTORY. J DATE . --.. f:...- �-,.....` `'' /- "' ../.....�`�.... - - Inspector '--- ,. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE 30.00 No........................... FEE........................ Rspaua1 lUvrkii Tountrudion rrntit Permission is hereby granted.......N-B. ....Robinscaxi_._ xat-1_c:`._.S ry................ �- to Construct ( ) or Repair (X ) an Individual Sewage Disposal System atNo. Woodvale--•t�ve---C�ntervil.le---•-.....-•--------------- --- ------------------------------•-------------------------------------•-----......•. Strce�/7��✓ ti GJ /' as shown on the application for Disposal Works Construction Permit �io;,a,,.,./__..____..-..__ Dated ...,./-..�J�-__/.yam ........... ......i.. .............................. f_.G1-1=:� `c V /.:. �`�—J <S._.... DATE---..... -•-•---------•-.----------••-•--• Board of Health FORM 36506 HOBBS&WARREN.INC..PUBLISHERS ��d r� �• .L sT ............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE App iration for Divi-pnittl Wnrkii ( ontitrurfiurt rnmit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: 7.•rOoodvale Ave Centerville ------------------------------------------- --------•---------------------------- .---- ------ •...... .... Ann Condon Location-Address i or Lot No. ..... r Address -----•................................... •---•---•---...............................• --••- .................. Owne a W.E. Robinson Septic Sery P.O_. Box 1089- Centerville MA ------------- Installer Address d Type of Building Size Lot... ......... ..........Sq. feet aDwelling— No. of Bedrooms._.....3..................................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............................................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 ( ) Percolation Test Results Performed by--------------------------------------- ---------------------------------- Date........................................ a Test Pit No. I----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water.......----............. Li, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 ......-•--••----------------------------------•----•--------•----••-----------•-••-------•---•-----.......................................................... 0- Description of Soil............sand.............................................................................------------------------------------------------------------------- W UNature of Repairs or Alterations Answer when applicable.-.install---- ....1_-,-00-0.... rAl---tank......................... d-box & stonepacked leachit -------- ---- ----------------•--......--------•------•------•-----..........---... 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 unders. ned fdirther agrees not to place the system in operation until a Certificate of Compliance has been issuedby the boa �ofjealth.�7 L Signed �� . -....`-.`-� ----------. ... �� ~� �f"" .........- .. Date Application Approved By .6�:...........Zo. ............................ - ---------- �-.............................. Date Application Disapproved for the following reasons: ......................................... ........................................................ . ................... ................................................................................................................. . . ........................................................ -- . . . --------------------------------------- Permit No. ......%...T...�J... :v�—..�................ Issued .........._Y....... ........��` Date