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HomeMy WebLinkAbout0194 BISHOPS TERRACE - Health 'y 194 Bishops Terrace Hyannis A = 251 173 R k i I t No. 43501/3 RED r Pend � OEM�� e 10% ' � � � ' � � �� �� � �, � o � �� o = � � � � � , 'i 0? Commonwealth of Massachusetts / �3 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 194 Bishop terr. Property Address Domingo's Owner Owner's Name information is annis Ma 11/19/19 H required for every y page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Imngoutforms A. Inspector Information filling out forms on the computer, use only the tab Chad hathaway key to move your Name of Inspector cursor-do not HPS use the return Company Name key. P.O.Box 151 rah Company Address Forestdale Ma. 02644 Cityrrown State - ,' Zip Code 774 274 2581 412866, Telephone Number License Numbed B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails r� 11/19/19 nspectors Sign re Date The sy em inspector shall submi copy of this inspection report to the Approving Authority(Board 11 of Health or DEP)within 30 day of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the insp an'd the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 194 Bishop terr. Property Address Domingo's Owner Owner's Name information is Hyannis Ma 11/19/19 H required for every y page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® I have not found any information which indicates that any of the failure,criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: This inspection is not a guaranteeand applies no warrantyof the described septic components in this report including but not limited to piping structual intergrity oflcomponents and life exspectancy of leaching and described components. This inspection is to describe conditions witnessed at time of inspection only. Regular tank maintenance and water conservation can prolong life of septic systems Information on care and do's and don't's can be found at town health dept or mass.gov 2) 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. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. 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. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 194 Bishop terr. Property Address Domingo's Owner Owner's Name information is Hyannis Ma 11/19/19 H required for every y page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes(cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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 ❑ Y ❑'N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ® Y ❑ N ❑ ND(Explain below): ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ 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. a. 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: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 194 Bishop terr. Property Address Domingo's Owner Owner's Name information is Hyannis Ma 11/19/19 H required for every y page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. 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: ❑ 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. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 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 fecal coliform bacteria indicates absent 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. c: Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No El ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form � Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 194 Bishop terr. Property Address Domingo's Owner Owner's Name information is H annis Ma 11/19/19 required for every y page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® 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 water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any 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. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent 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 and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® 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 Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system 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 II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 194 Bishop terr. Property Address Domingo's Owner Owner's Name information is Hyannis Ma 11/19/19 H required for every y page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered"yes" to any question in Section C.5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes"or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® 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, excluding 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: ® ❑ 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(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 194 Bishop terr. Property Address Domingo's Owner Owner's Name information is Hyannis Ma 11/19/19 H required for every y page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): min. 2 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): min. 220 Description: 6'x6' pit with 2' stone no engineering on file. 2 bedrooms on main floor basent finished as 1 large open room Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection information in this report.) El Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): Detail Sump pump? ❑ Yes ® No Last date of occupancy: unknown Date t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 194 Bishop terr. Property Address Domingo's Owner Owner's Name information is Hyannis Ma 11/19/19 H required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes. ❑ No. Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: pumped 2018 on file at town hall BOH Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 194 Bishop terr. Property Address Domingo's Owner Owner's Name information is Hyannis Ma 11/19/19 requiredd y for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: 1983 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 1.5 feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: 24' + see asbuilt feet Comments (on condition of joints, venting, evidence of leakage, etc.): none t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 194 Bishop terr. Property Address Domingo's Owner Owner's Name information is Hyannis Ma 11/19/19 H required for every y page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 1' Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 8'x5' lit Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 30" 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 0 How were dimensions determined? tape and sludge judge Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage,,etc.): baffles in place no major decay or cracks visable in tank. liquid level to bottom of outlet pipe. t5insp.doc-rev.7/2612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 194 Bishop terr. Property Address Domingo's Owner Owner's Name information is Hyannis Ma 11/19/19 required for every Y page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 cam, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments � 194 Bishop terr. Property Address Domingo's Owner Owner's Name information is Hyannis Ma 11/19/19 H required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 0 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.): Db3 with riser box is newer with no decay present D133 H10 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments VV ,b 194 Bishop terr. Property Address Domingo's Owner Owner's Name information is Hyannis Ma 11/19/19 H required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 194 Bishop terr. Property Address Domingo's Owner Owner's Name information is Hyannis Ma 11/19/19 H required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding; damp soil, condition of vegetation, etc.): 6' precast pit dry at time of inspection with a stain line 2'off bottom of pit. Concrete clean above stain line. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No I Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 cam, Commonwealth of Massachusetts p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 194 Bishop terr. Property Address Domingo's. Owner Owner's Name information is Hyannis Ma 11/19/19 H required for every Y page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 13. Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): l5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 Commonwealth of Massachusetts ry Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 194 Bishop terr. Property Address Domingo's Owner Owner's Name information is Hyannis Ma 11/19/19 H required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below drawing attached separately coUer 1 0 a Air a� B2 - 3af S� �L t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 Commonwealth of Massachusetts �a Title 5 Official Inspection Form �= Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u 194 Bishop terr. Property Address Domingo's Owner Owner's Name information is H annis Ma 11/19/19 required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 37'feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: You must describe how you established the high ground water elevation: lot el. 70 lake wequaquet el. 33' seperation in el. 37' bottom of SAS 7.5' below grade Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 194 Bishop terr. Property Address Domingo's Owner Owner's Name information is Hyannis Ma 11/19/19 H required for every y page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria)and 6 (Checklist)completed i ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included 4 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments =u- 194 Bishops Terrace -. Property Address i Sybil Mooney ' Owner Owner's Name information is r t• required for every Hyannis ✓ MA 02601 7/3/2019 ' page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. Inspector Information 61 (39IS filling out forms on the computer, use only the tab Douglas Brown key to move your Name of Inspector cursor-do not Cape Cod Septic Services Inc. use the return Company Name key. 350 Main St. Company Address West Yarmouth MA 02673 City/Town State Zip Code � 508-775-2825 S15016 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: J 1. ® Passes ` � r 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority ( on d`jv�-c•r �� Sf 4. ❑ Fails 1.2 C4 l � — - --,--- . 7/18/2019 Inspector's Signature Date The system inspector shall submit 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 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. l5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 I ' Commonwealth of Massachusetts _--,,p Title 5 Official Inspection Form Subsurface Sewage Disposal.System Form - Not for Voluntary Assessments ;V 194 Bishops Terrace Property Address Sybil Mooney Owner Owner's Name information is required for every Hyannis MA 02601 7/3/2019 page. CitylTown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System in working condition. 2) 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. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. 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. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 I ' Commonwealth of Massachusetts Title 5 Official Inspection Form 'T lI Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ., � 194 Bishops Terrace Property Address Sybil Mooney Owner Owner's Name information is required for every Hyannis MA 02601 7/3/2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): .ti 3) Further Evaluation is Required by the Board of Health: ❑ 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. a. 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: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Form N for Voluntary Assessments Subsurface Sewage Disposal System of y 194 Bishops Terrace Property Address Sybil Mooney Owner Owner's Name information is required for every Hyannis MA 02601 7/3/2019 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. 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: ❑ 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. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 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 fecal coliform bacteria indicates absent 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. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 ' Commonwealth of Massachusetts e Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 194 Bishops Terrace u° Property Address Sybil Mooney Owner Owner's Name information is required for every Hyannis MA 02601 7/3/2019 page. CityFrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 'h day flow El ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® 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 water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any 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. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent 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 and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CM 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000-gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system 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 II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u— 194 Bishops Terrace Property Address Sybil Mooney Owner Owner's Name information is required for every Hyannis MA 02601 7/3/2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes" to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304, The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? El ® 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, excluding 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: ® ❑ 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 El ® approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts �x ,p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 194 Bishops Terrace Property Address Sybil Mooney Owner Owner's Name information is required for every Hyannis MA 02601 7/3/2019 page. CityTTown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): Unknown Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 110x2= 220gpd Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonal use? ® Yes ❑ No pd 137g= Water meter readings, if available(last 2 years usage (gpd)): 2012017137gd Detail: Sump pump? ❑ Yes ® No Last date of occupancy: UnknownDate t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 J Commonwealth of Massachusetts Y Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments r; 194 Bishops Terrace Property Address Sybil Mooney Owner Owner's Name information is required for every Hyannis MA 02601 7/3/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: No Records Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts �r ,p Title 5 Official Inspection Form to Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 194 Bishops Terrace Property Address Sybil Mooney Owner Owner's Name information is required for every Hyannis MA 02601 7/3/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: 1983 Per BOH Records. Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): 19" � Depth below grade: feet Material of construction: - ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: +10' feet Comments (on condition of joints, venting, evidence of leakage, etc.): Line was checked with sewer camera and found to be clean, properly pitched with no sign of root intrusion. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;V 194 Bishops Terrace Property Address Sybil Mooney Owner Owner's Name information is required for every Hyannis MA 02601 7/3/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank (locate on site plan): Depth below grade: 10"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ® No Dimensions: 1000Gal Sludge depth: 2-3 Distance from top of sludge to bottom of outlet tee or baffle Scum thickness 1-2 Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Estimated Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 1000Gal tank in good condition. Concrete baffles in place and clean. Tank at normal operating level. Covers 10" below grade. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 194 Bishops Terrace Property Address Sybil Mooney Owner Owner's Name information is required for every Hyannis MA 02601 7/3/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 9 p Y Y 194 Bishops Terrace Property Address Sybil Mooney Owner Owner's Name information is required for every Hyannis MA 02601 7/3/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" 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.): H-10 DB-3 with 1 line in and 1 line out in good condition. Box is clean and level with minimal solids carryover. No sign of overloading or hydraulic failure. Cover 6" below grade. I t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts :. Title 5 Official Inspection Form , Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 194 Bishops Terrace Property Address Sybil Mooney Owner Owner's Name information is required for every Hyannis MA 02601 7/3/2019 page. City(Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 1-6x6 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts -,, Title 5 Official Inspection Form 1 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 194 Bishops Terrace Property Address Sybil Mooney Owner Owner's Name information is required for every Hyannis MA 02601 7/3/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): 1-6x6 Pit with stone. Pit found dry during inspection. No evident stain. No sign of overloading or hydraulic failure. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth —top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts ,rsp Title 5 Official Inspection Form 1. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 194 Bishops Terrace Property Address Sybil Mooney Owner Owner's Name information is required for every Hyannis MA 02601 7/3/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): / t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 Commonwealth of Massachusetts �x Title 5 Official Inspection Form �1. Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 194 Bishops Terrace Property Address Sybil Mooney Owner Owner's Name information is required for every Hyannis MA 02601 7/3/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments V 194 Bishops Terrace Property Address Sybil Mooney Owner Owner's Name information is required for every Hyannis MA 02601 7/3/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: +12' feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers=(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation:. Hand auger did not encounter water at 12'. Max bottom of leaching T6". I Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form �1� Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 10 194 Bishops Terrace Property Address Sybil Mooney Owner Owner's Name information is required for every Hyannis MA 02601 7/3/2019 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank— Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 Assessing As-Built Cards Page 1 of 2 LOCATION SEWAGE PERMIT N0. dam/—1'7_5 VILLAGE /7 f1Gt /VS f INSTALL 'SS M rADDRESS 3ty _g c5'K t BUILDER OR OWTm/_/v In DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 12- 5' 2 Z i 3Z z� 3y z 7 3Z i I r https://townofbarnstable.us/Departments/Assessing/Property_Values/HMdisplay.asp?mappa... 5/1/2019 n r .: '• .gam � S '�` -!i al` ..a j � yM.., a. y fro`�°=•S' „•; ?f- �,C+t w.,r',r• � � 't �a+�'�"�i'r• r fir• s •^" P+ .''y I: �,,ayw, �-,,� •t;.:+/�i«�9.fi',�. f"`,,.M• r ,C .F�.,r"•.fr �' .:�; i Y.�, r �•i�Jt:�S.°r<{s� dyr t� ,t'r'`� _ }� �''�''..�Tr±!a'�`_i'�i ., 1 �.,�� f� �q��•r..i.'��t- '4Y > 1'r i �' �.k✓s � „., ,•y�,i(ri .47fii f PwY'tF y/s ix�i ` j ,.i �•-�9 ti .�k #. �.y�yA41r' "("��. �4s T •� 4. s• ��".�� •n t' _ 4 r 12 Tq- • � � rtf ..i.. '"gym. ` —..� 4� �' y N �w:ki >f'rty.� ' .a.0'�.4 ���.�F-..jrT= :a 7 � �' � • .'�%u.«�9��..���iar' �T,�p".$4�"3 �� ���] ,p. ( <��}4. � A'.1.� , •w..•xy Via#3F_: r 1 .�� 4 '� '#fiir 7• v it it •ttf # ,i. ,� a ��. f. •#Fg4�4.. � ,. • `.$�,�t 4.�)��i s_;,t�� �r�Jj!�i .v' ,. � �°F�'�'F r� ,5' ,� a i*b i ��.�`. k'.'�;rb}.i ._ r•.�r:R�rj�J,.t' � � ter+- �r�/*' � �-��� �:< ,i�k.ks.# �,ir. t?S' ���'.. '� .*A'f �i}.ate � .� i +ice�.,. ^.,t',. �,,,, �S }_• c.� •�� ,Y a yr. ,�,1� y ,i. ..r�y }��"t.""^. ,,,+, '� ���.* '`y o � �'�z "x'�,'i}Rol. `\,�;�•3 t ��'�l.. ,1a �.�•2'..." T..it. ```.N i��f}�. ''f''t j„y•. �sf •'S `6' ��4 `t"1• ld � T?' T �y� •'. �.y 1 Ys .. - a h' R ,fie j'F > 'IKE Town of Barnstable Barn Regulatory Services Department cap i BARNSCAHM ' MAft i6 Public Health Division J9, `0� m FDMA'�A 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7015 1730 0001 4988 0282 April 30, 2018 ` MOONEY, SYBIL A 184 BISHOPS TERRACE HYANNIS, MA 02601 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 194 Bishops Terrace, Hyannis,MA was inspected on 04/11/2018 by Nicholas Geneseo, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Conditionally Passes" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: C Distribution box needs to be replaced. You are ordered to repair or replace the septic system within two (2) years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas �cKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mail ing\Conditionall y Passes Letters\194 Bishops Terrace Hyannis.doc Inspection Form sewage Disposal System Form -Not for Voluntary Assessments -dam 194 Bishops Terrace Property Address Ellen Mooney Owner Owners Name information is required for every Hyannis MA 02601 04/11/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 0" 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.): The distribution box is 18" below grade with one outlet taking flow. The box is not level and has extensive corrosion to the walls. The box needs to be replaced Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No' Alarms in working order: ❑ Yes ❑ No` Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 FtKE T Town of Barnstable Barnstable Regulatory Services Department OftedcaCfir � IARlV5fAB1.E. g rY p 1 1 MAC. Public Health Division �. 16;q. ♦4i Alf� �A 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO THIRD NOTICE CERTIFIED MAIL# 7015 1730 0001 4990 0225 July 3, 2018 MOONEY, SYBIL A C/O MOONEY, ELLEN 194 BISHOPS TERRACE HYANNIS, MA 02601 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 194 Bishops Terrace, Hyannis, MA was inspected on 04/11/2018 by Nicholas Geneseo, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Conditionally Passes" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Distribution box needs to be replaced. You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF HE B ARD OF HEALTH o e HO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mai ling\Conditionally Passes Letters\194 Bishops Terrace Hyannis THIRD NOTICE- Copy.doc Town of Barnstable Barnstable AlAmedcaCft Regulatory Services Department 1639. Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: - 508-790-6304 Thomas A.McKean,CHO SECOND NOTICE CERTIFIED MAIL# 7015 1730 0001 4988 0565 May 31, 2018 MOONEY,SYBIL A 194 BISHOPS TERRACE HYANNIS, MA 02601 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 194 Bishops Terrace, Hyannis,MA was inspected on 04/11/2018 by Nicholas Geneseo, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Conditionally Passes" under the guidelines of 1995 TITLE V (310 CMR 15,00) due to the following: • Distribution box needs to be replaced. You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health I Q:\SEPTIC\Title V Inspection Report Letters Mailing\Conditionally Passes Letters\194 Bishops Terrace Hyannis SECOND NOTICE.doc 1 t j Town of Barnstable Barnstable THE T(}� °^ Regulatory Services Department "�ca� ®, sAatvseAUtae. : ' I 9q� t" : ,,� Public Health Division �ON'A�A 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7015 1730 0001 4988 0282 April 30, 2018 ( ✓��` `�`',�j Y, SYBIL A 184 B HOPS TERRACE HY NNIS, MA 02601 p ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 194 Bishops Terrace, Hyannis, MA was inspected on 04/11/2018 by Nicholas Geneseo, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Conditionally Passes" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Distribution box needs to be replaced. You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas cKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mail ing\Conditionally Passes Letters\194 Bishops Terrace Hyannis.doc I � , Town of Barnstable SARNSfASL& MASS 639• A`�� Regulatory Services Department FD MA'S Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 5/11/16 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An"x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1) YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). WO 2 YE DLINE CRITERIA ❑ Single Cesspool VAny"conditionally passed systems" (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components, etc) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER )e- 7DRCX A" � Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts Title- 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments i M 194 Bishops Terrace r„) Property Address h Ellen Mooney Owner Owner's Name / u5 information is required for every Hyannis ✓ MA 02601 04/11/2018 � page. Cityrrown State Zip Code Date of Inspection• t:5 Inspection results must be submitted on this.form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not Nicholas Geneseo use the return Name of Inspector key. Wind River Environmental sW Company Name 46 Lizotte Drive Company Address Marlborough MA 01752 City/Town State Zip Code (973)830-6126 S113988 Telephone Number License Number B Certif Canon 1 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 wasF performed based'on my training>and experience in the proper funs#ion and ritaintenance of on site sewage•disposal`systerri. A am a D.EP"approved system inspector pursuant to Section 15:340 of title 5:(:310 CM. R 15`.OQ0}..The system:. [�. Passes Conditionally Passes [ Falls T ❑, Needs.Further Evaluation by the Local Approving Authority � . lnspe.- ors .igrsature: Date - The:system inspector stiatt submit"a cop}r of this Inspection "report tolt a"Approving Authority(Board of Health or'DEP)within 30 days of completing this inspection. If the.Oystem'has a design flow of 10,000 gpdor greater,the inspector and:the system owner shalt submit"the report to the appropriate. regional office of:the DEP:The original should tie sent,to the systerrr.owner and copies sent to-.the buyer,if applicable;and the approving adthoritj 444't h Is report only describes conditions at the,time of inspection and under the conditions of use at that#ime Thts'Inspection does not;addiress how'the system will perform in the future"under the same or di#feron. conditions of use. tsins4oc•rev;4116 7die 5 Offici4W Insgection,Forin:.SUbwrfaee Sewage 0isPOWSystem•Page 1 oE:17. ,C� VS f r r Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 194 Bishops Terrace Property Address Ellen Mooney Owner Owner's Name information is required for every Hyannis MA 02601 04/11/2018 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 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. Check the box for"yes", "no" or``not determined" (Y, N, ND)for the following statements. If"not determined," please explain. 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. ❑ Y ❑ N ❑ ND (Explain below): t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 t Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 194 Bishops Terrace Property Address Ellen Mooney Owner Owner's Name information is required for every Hyannis MA 02601 04/11/2018 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ® 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ® distribution box is leveled or replaced ® Y ❑ N ❑ ND (Explain below): The distribution box is not level and has extensive corrosion. The box needs to be replaced. ❑ 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 ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ 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: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 194 Bishops Terrace Property Address Ellen Mooney Owner Owner's Name information is required for every Hyannis MA 02601 04/11/2018 page. City/rown State Zip Code Date of Inspection B. Certification (cont.) 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: ❑ 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. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 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 fecal coliform bacteria indicates absent 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: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge 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 cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 194 Bishops Terrace Property Address Ellen Mooney Owner Owner's Name information is required for every Hyannis MA 02601 04/11/2018 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® 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 water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any 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. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent 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 and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® 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 Board of 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 flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system 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 II 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 "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 194 Bishops Terrace Property Address Ellen Mooney Owner Owner's Name information is Hyannis MA 02601 04/11/2018 required for every y page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® 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, excluding 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: ® ❑ 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(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 2 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 220 gpd t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 194 Bishops Terrace Property Address Ellen Mooney Owner Owner's Name information is required for every Hyannis MA 02601 04/11/2018 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ® Yes ❑ No Water meter readings, if available last 2 ears usage d 157 gpd 9 ( Y 9 (gpd)): Detail 6700 cu.ft. (2016) + 8600 cu.ft. (2017) = 15,300 cu.ft. x 7.5 = 114,750 gallons/730 days = 157 gpd Water consumption quantities provided over the phone by the Water Department. Sump pump? ❑ Yes ® No Last date of occupancy: CurrentDate Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 194 Bishops Terrace Property Address Ellen Mooney Owner Owner's Name information is required for every Hyannis MA 02601 04/11/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Wind River Environmental -See attached record. Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1,000 gallons How was quantity pumped determined? The quantity was measured by the pump truck. Reason for pumping: To check the structural integrity of the septic tank. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 194 Bishops Terrace Property Address Ellen Mooney Owner Owner's Name information is required for every Hyannis MA 02601 04/11/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 1984 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 18"feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: N/A feet Comments (on condition of joints, venting, evidence of leakage, etc.): The plumbing is PVC with no leaks and all joints look solid. Septic Tank(locate on site plan): 1' Depth below grade: feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 8'x5'x4' Sludge depth: 8" t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 194 Bishops Terrace Property Address Ellen Mooney Owner Owner's Name information is required for every Hyannis MA 02601 04/11/2018 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 23" Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 3" Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? The dimensions were determined by sludge judge, rod, and ruler. Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The liquid level is at the outlet invert and both tees are in place. The tank appears to be in good condition and watertight. Recommend installing a filter on the outlet and pumping annually. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 194 Bishops Terrace Property Address Ellen Mooney Owner Owner's Name information is required for every Hyannis MA 02601 04/11/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 194 Bishops Terrace Property Address Ellen Mooney Owner Owner's Name information is required for every Hyannis MA 02601 04/11/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 0" 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.): The distribution box is 18" below grade with one outlet taking flow.The box is not level and has extensive corrosion to the walls.The box needs to be replaced. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No" Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System(SAS)(locate on site plan, excavation not required): If SAS not located, explain why: t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 194 Bishops Terrace Property Address Ellen Mooney Owner Owner's Name information is required for every Hyannis MA 02601 04/11/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 @ 6'x 6' ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The leach pit has 4.5' of space between the liquid and inlet pipe. There is no staining on the walls of the pit and there are no signs of hydraulic failure. Cesspools (cesspool must be pumped as part of inspection)(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 I Indication of groundwater inflow ❑ Yes ❑ No t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 194 Bishops Terrace Property Address Ellen Mooney Owner Owner's Name information is required for every Hyannis MA 02601 04/11/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 194 Bishops Terrace Property Address Ellen Mooney Owner Owners Name information is required for every Hyannis MA 02601 04/11/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system,including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ' ® hand-sketch in the area below ❑ drawing attached separately +fit A t5ins doc•rev.BL18 Tide 5 OrfidaE lgsoction r-onn:subsurface Selvage Dispasal System•.Page 15 of t:7 Commonwealth of Massachusetts IL W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 194 Bishops Terrace Property Address Ellen Mooney Owner Owners Name information is required for every Hyannis MA 02601 04/11/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 10, feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers -(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Dug observation hole 15' away from the leach pit with no water encountered. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 194 Bishops Terrace Property Address Ellen Mooney Owner Owner's Name information is Hyannis MA 02601 04/11/2018 required for every y page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Mrk Order# 0217064064 Cust# 10 3 3 3 61• Customer Since: 2 0 0 0 Tax: 6 .2 5 0 0 0 Job Comments Tech Comments 04/11/2018 Title V inspection, customer will have as built, 52018131846 consent form as well as water records. No closing date yet. Home/CC on file (SCL) System Owner System Location Ellen Mooney Primary Home 194 Bishops Terrace 194 Bishops Terrace Hyannis, MA 02601 Hyannis, MA 02601 (508) 775-6508 Mooney (508) 775-6508 Service Date: WED 04/11/2018 07:oo AM Frequency: Call to Confirm: Service Type: standard Previous Service: 03/30/2018 Approx. Gals: o CCLS: Location Details: Depth Below Grade:o Custom Clean ._:.. Cust Home: No Filter Township: Inspectian/�TS. County: Barnstable X 0%0% Budd Up:._... WK 11i ROOM, Inspection Title 5 (riot anclud ng umpi gr? 1 A011, <$ 365 "0000 365 k' -'� Inspection (Labor/Expoauze Fees}per hr 1 04 $ 189990 18a„5 0 y Inspection Title 5 BOII Rees'" k 0E} $ 5 '00!)0 $ 25 0 i Pumping 1001 - 15001.00 :-$- ., Environmental Compliance Residential 1.00 $ 21.9500 $ 21.95 S x v« .. We suggest these 3 keys steps to keep your system healthy: .:• Subtotal $ 951.07 T $ 0.00 • Regular servicing • Use CCLS bacteria additive Total $ 951.07 • Use a filter Disposal Site: Disposal Volume: Payment Detail: Waste Code : 0.0000 Master xxxxxxxxxx4131 09/2019 Sales Rep : CSR : Steven Lan Due on Receipt Truck :sloo Technician : Nicholas Geneseo On Site : 08:27 AM P 0 Number: Tech Notes : Normal water level. Moderate top solids. Heavy bottom sludge. Both baffles are intact. Main line Clear. No filter is present on the tank; current tank can be \ outfitted with a filter. Recommended Installing a filter,Installing a riser. Cover(s) secured. Repairs needed: D-box is 2' below grade with one outlet . Box is not level and has extensive deteriation. Box needs to be replaced. Title 5 I is `a Conditional pass due to d-box needing to be replaced. Tank is in good condition with baffles intact Leach pit has 4.5' of available space. All Customer Signature covers secured. NG. ENVIRONMENTAL .r- a Remit payment to 46 Lizotte Dr Suite 1000,Marlborough,MA 01752 Town of Barnstable BAR AS& Regulatory Services for�nr°' Richard Scali,Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 March 1, 2018 Ellen Mooney Thayer 205 Mitchell's way Hyannis, MA 02601 NOTICE TO ABATE VIOLATIONS OF TOWN OF BARNSTABLE BOARD OF HEALTH REGULATIONS,NUISANCE CONTROL REGULATION NO. 1 The property owned by you located at 194 Bishops Terrace, Hyannis was inspected on February 28, 2018 by Timothy B. O'Connell, R.S., Health Inspector, because of a complaint. §54-3 (A) Outdoor Storage Multiple items are being stored outdoors on this property which are not screened from public view and are not within an enclosed structure as required by above ordinance. These items include but are not limited to: automobile tires, furniture, cabinets, wood scraps and other assorted debris. You are directed to correct the violations listed above within (15) days of your receipt of this letter by removing said items from property or storing them in an enclosed structure or disposing of them properly. 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. Please be advised that failure to comply with an order could result in a fine of$100.00. Each day's failure to comply with an order shall constitute a separate violation. : PER ORDER OF T BOARD OF HEALTH omas A. McKean, R.S. Director of Public Health Town of Barnstable Q:Health/orderletters/refuse/194 Bishops Terrace.doc Q izen Web Request Page 1 of 3 p� 90 7— k it s ;�1 E� iy � 77 14 Logged In As: Citizen Request Management Thursday, March 1201S TOWN\oconneit Route to Users Search Requests Create Requests Request Information Request ID: 59316 Created: 2/16/2018 8:49:49 AM Status: Assigned To Staff Assigned To: O'Connell,Timothy Health Office Anonymous: Yes Request Category: Chapter 54-5 : Rubbish and Garbage edit Routine work: No Estimate: NO edit Date scheduled: edit Estimated 3/2/2018 Change Estimated Feb March 2018 Apr Completion Completion Date: Date: Sun Mon Tue Wed Thu Fri Sat 25 26 27 28 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 t202122 23 24 25 26 29 30 31 1 2 5 6 7 Created By: Crocker, Sharon Priority: High edit Health Office Citation Numbers: edit Requestor Information Requestor Request DETAILS: LOCATION: 194 BISHOPS TERRACE Hyannis, Ma 02601 Request Parcel Map: Chief Paul MacDonald/ Email: Richard Gentlemen. May we bring your attention to a blatant safety issue http://issgl2/intemalwrs/WRequest.aspx?ID=59316 3/1/2018 Citizen Web Request Page 2 of 3 Z. at 194 Bishops Terrace, Hy. The house has been abandoned since November 2017. Piles of tires, refuse, everywhere and a refrigerator (with door unsecured)!! left in the middle of the driveway- very dangerous for small children. (anonymous) Edit Requestor Information Track Request Progress Request Work History: -Internal Note History: Entered on 2/16/2018 9:02:48 AM System entry on 2/16/2018 8:49:49 AM: by Crocker, Sharon Assigned to O'Connell,Timothy Addtil note: Building Dept will be going out to make sure building is secured as it is abandoned. Entered on 2/21/2018 9:00:29 AM by O'Connell,Timothy Officer Gallant is looking into contacts for owner. Waiting to hear back from her. I did go to dwelling and did observe debris. No one answered the door. update delete Entered on 2/28/2018 4:03:02 PM by O'Connell,Timothy Last modified on 3/1/2018 8:58:55 AM I have placed call to owner with phone number that was provided to me by office Gallant. No answer left a message to remove debris. I will also send an order letter.The refrigerator has been removed. update delete Enter work progress: Enter internal note: (Viewed by everybody) (Viewed internally only) http://issgl2/internalwrs/WRequest.aspx?ID=59316 3/1/2018 I I O'Connell, Timothy From: Gallant,Therese Sent: Thursday, February 22, 2018 2:54 PM To: O'Connell, Timothy Cc: Anderson, Robin Subject: 194 Bishop Terrace Hey Tim, I wanted to update you on this property. So as we had discussed, Sybil Mooney did pass away, as confirmed by her daughter, Ellen Mooney Thayer. I spoke with Ms.Thayer yesterday(2/21), she identified herself as the property owner now and stated that the male party the PD encountered there is in fact her son, Clayton Palmer. According to Ms. Thayer, it took about two years to remove problematic tenants and that her son is living there to prevent future squatters and assist with the clean-up. She explained that they are working on cleaning up the property with the intention of selling it. I drove by there today(2/22) and there is no refrigerator on the property, however,there was a stack of tires on the side of the house,visible from the roadway. Her contact information is as follows: Ellen Mooney Thayer 205 Mitchell's Way Hyannis, MA 02601 508-360-5768 Thank you, Therese Therese M. Gallant Barnstable Police Department Consumer Affairs Officer (508) 862-4667 1 1 Chief Paul MacDonald Barnstable Police Department 1200 Phinney's Lane P.O .Box B Hyannis, MA 02601 August 1,2008 Chief MacDonald, Sir,this is yet another appeal for your attention to 1�94"Bishop's-Terrace,Hya is (There are no house numbers displayed) There are still 3 unregistered vehicles with mix&match license plates on the property. It is still an operating junkyard. The owner of record is Ellen Mooney. She does not live there. She has not lived there for years. There is a man living on the property who has been there for 5 or 6 years. If he is renting the house, does the town have a responsibility to ensure the dwelling meets minimum safety&health codes? We realize there are more urgent matters that you must attend to at this busy time of year, but the neighborhood would appreciate any assistance. Many thanks for your time. i/cc. T.McKean Public Health Department cc. T. Perry Town Building Department C JG+ h' -o X un rn ,.r a a1 r „... �..a.,.,-.a.. r � � m4ss, Citizen Request Management - Internal Use Request ID: 20576 Created: 12/5/2006 9:02:04 AM Status: Assigned To Staff Assigned To: O'Connell, Timothy f Health Office 2' Anonymous: Yes Category: Section 353-1 Garbage y and Rubbish E.C. Date: 3/10/2007 Created By: Fontaine,Tina Citations: Health Office Time Worked: 1.50 Response Time: 4.50 ► Requestor Details: Email: Request Location: 194 BISHOPS TERRACE Hyannis, Ma 02601 Parcel Number: Map: 251 Block: 173 Lot: 000 Request: a letter came to the department saying that at this location there's a lot of garbage up against the fence. There's a half buried toilet in the front yard. The letter states that the owner of this rental property comes back periodically to add to the collection of junk in the yard. Request Work History: Entered on 12/6/2006 9:56:17 AM by Stanton, David Last modified on 12/6/2006 10:17:15 AM On 12/05/06 DS went to said location. Spoke with occupant. Many legal issues going on at said property. Property has been an issue for over 4 years with multiple Health Inspectors and Police Officers dealing with the property. DS will try to find time to consult with TM as to our next step to find a resolution to the issue. It is not a rental property. It is one of those fine lines in the Board of Health regulations, and the Town does not have a junk collectors ordinance for these types of properties (multiple around, and the Town has been told they cannot enforce, i.e. Old Stage road property with double decker bus...) DS did not observe a buried toilet, but again, there are other properties in Town that have toilets in their yards for various reasons, and we cannot enforce any clean up as there is no regulation against it. DS did see a sink and we think that might be what the complainant thought was a toilet. Entered on 1/29/2007 10:58:01 AM by Stanton, David 1/29/07: TM wants DS to pass all housing on to TO so DS can just focus on restaurant catch- ups only. Internal Note History: Entered on 12/5/2006 9:01:34 AM by Fontaine, Tina check street file for letter. System entry on 12/5/2006 9:01:34 AM: Assigned to Stanton, David Entered on 12/6/2006 10:02:15 AM by Stanton, David Last modified on 12/6/2006 10:08:58 AM This is a family estate. A lot of legal issues going on. The father died over 20 years ago.The mother committed suicide a while back (around 1993) and the estate was left to the children, Guinan "Guy" Mooney, and Ellen Mooney. Ellen is the executor to the estate. Ellen lived in the property for a long while with her children and boyfriend. Her boyfriend is an alleged junk collector. The daughter moved somewhere else with her boyfriend. Guy is living in the house now. Guy is paying the back taxes and has worked out a deal with the Town Assessor for a payment plan. Guy wants to clean up the property, but the police came out and ordered him to stop the last time as they called the police on him and he cannot get rid of another persons property. Guy tried to seek legal help, but the attorney said he could not help as it is illegal as he was the attorney that helped write the will for his parents and it is a conflict. There are a couple unregistered vehicles onsite, but the police have not done anything with it yet. Guy would like to buy out his sister on her half of the house and settle the estate, but he cannot afford to do that at this time. He has asked his sister to try and sell the house and split the money, but she has refused the idea. Entered on 12/6/2006 10:21:13 AM by Stanton, David Guys contact info is (508) 776-5895 or his cell (508) 280-0526. He would like to know if we can help him in anyway, as he is legal tied up and cannot do anything. System entry on 12/6/2006 10:21:35 AM: -Please Review- email sent to McKean, Thomas System entry on 1/29/2007 10:58:01 AM: -Please Review- email sent to O'Connell,Timothy System entry on 1/29/2007 11:14:09 AM: Estimated completion changed from 12/7/2006 to 3/10/2007 System entry on 1/29/2007 11:19:42 AM: Estimated completion changed from 12/7/2006 to 3/10/2007 System entry on 1/30/2007 9:12:19 AM: Assigned to O'Connell,Timothy Town of Barnstable Regulatory Services Thomas F. Geiler, Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 October 23, 2006 Ellen Mooney 194 Bishops Terrace Hyannis, MA 02601 NOTICE TO ABATE VIOLATIONS OF TOWN OF BARNSTABLE BOARD OF HEALTH REGULATIONS,NUISANCE CONTROL REGULATION NO. 1 The property inhabited by you located at 194 Bishops Terrace, Hyannis was inspected on September 1, 2006 by Donald Desmarais, Health Inspector,because of a complaint. The following violation of the Town of Barnstable E-Code Regulations, Chapter 353: NUISANCES were observed: 3� 53-1:Responsibilities of owners and occupants: Numerous piles of building materials and other rubbish. A rat was observed in the waste. You are directed to correct the violations within seven days of receipt of this order letter. 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. Please be advised that failure to comply with an order could result in a fine of$100.00. Each day's failurOean, R.S. order shall constitute a separate violation. PER ORDRD OF HEALTH s A. Director of Public Health Town of Barnstable Q:Health/orderletters/refuse/274 South.doc Health Complaints 17-May-04 Time: 3:00:00 PM Date: 5/17/2004 Complaint Number: 17426 Referred To: DONNA MIORANDI Taken By: DONNA MIORANDI Complaint Type: NUISANCE CONTROL REG. 1 RUBBISH Article X Detail: Business Name: Number: 194 Street: Bishop's Terrace Village: HYANNIS Assessors Map_Parcel: Actions Taken/Results: Letter came into office on 5/17/04 which was postmarked 5/13/04. This property has been an on-going problem. Family is moving at the end of June to an undisclosed confidential address in Centerville. Spoke to Ellen Mooney today and they shall try to have it cleaned up by the end of June. DZM shall make a site visit. Police have been to the property and walked it and have allegedly told the Mooney's that they only need to remove one vehicle. All others are registered and insured according to Ellen Mooney. Investigation Date: 5/17/2004 Investigation Time: 1 Miorandi, Donna From: McKean, Thomas Sent: Tuesday, October 21, 2003 9:43 AM To: Lomba, Lois; Miorandi, Donna Subject: RE: Sybil Mooney FYI- I telephoned the Clerk's Office this morning to request a copy of the death certificate (left a message on Leslie's voice mail and also spoke with Diane D'Agostino. ) The research could take some time at the Clerk's Office because the date of death is not known. -----Original Message----- From: Lomba, Lois Sent: Tuesday, October 21, 2003 9:36 AM, To: Miorandi, Donna Cc: McKean, Thomas Subject: Sybil Mooney Donna - this date I received a phone call from Det. Rick Morse, Barnstable Police Department. He was informed today that an officer from the Barnstable Police Department tried to serve a warrant last evening to Sybil Mooney, who has been deceased for quite some time. Det. Morse has made several requests. First, he would like you to go to the clerk's office and get a death certificate for Sybil Mooney and get a copy to him. (Please make sure you give me a copy also for the file) . (I can get the death certificate to him if you wish) . Once he has the death certificate he will be able to get the warrant and other violations out of the court system. You will need to void all citations written in her name. Please give me your pink copies and I will void all your violations. You will need to re-issue the violations to the person now living in the home. h 1 r. Health Complaints 09-Sep-03 Time: 2:55:00 AM Date: 6/3/2003 Complaint Number: 4076 Referred To: DONNA MIORANDI Taken By: JOAN AGOSTINELLI Complaint Type: NUISANCE CONTROL REG. 1 RUBBISH Article X Detail: Business Name: Number: 194/ 19 Street: BISHOPS TERRACE Village: HYANNIS Assessors Map_Parcel: Complainant's Name: ANONYMOUS Address: Telephone Number: Complaint Description: ALL KINDS OF TRASH IN YARD INCLUDING OLD WASHING MACHINES, CAR PARTS ETC. Actions Taken/Results: DZM investigated and found much debris on property. The same if not worse from when David Stanton was there on April 10, 2002. DZM shall issue tickets daily due to this problem. There is an AirStream on site , many old bikes and toys, old doors and windows, old saws and much scrap metal, old cars, old lawn mower, old wheelchair, etc. etc.c. DZM has issued four(4)$40 tickets as of 6/26/03. If they don't pay this will end up in court obviously. Investigation Date: 6/3/1903 Investigation Time: 4:00:00 PM 1 Health Complaints 11-Apr-02 Time: 8:25:00 AM Date: 4/9/2002 Complaint Number: 3357 Referred To: DAVID STANTON Taken By: DANIELLE ST.PETER Complaint Type: NUISANCE CONTROL REG. t.RUBBISH Article X Detail: Business Name: Number: 194 Street: BISHOPS.TERRACE Village: HYANNIS Assessors Map Parcel: Complaint Description: THERE IS.A STRONG SEPTIC ODOR COMING FROM THIS PROPERTY AND THERE ARE CHILDREN LIVING HERE. SHE ALSO SAID THEY DO.NOT HAVE GARBAGE PICK UP THEY.USE A DUMPSTER OR BURY IT. SEE ATTACHED. Actions Taken/Results: THERE WERE NO.SEPTIC ODORS PRESENT, NOR SIGNS OF HYDRAULIC FAILURE TO THE SEPTIC SYSTEM. THE PERSON THERE CLAIMS HE HAS.A DUMP. STICKER FOR THE TRANSFER STATION.. THERE WAS A LOT OF.RUBBISH PRESENT AT THIS.LOCATION. RUBBISH INCLUDED WOOD (PALLETS, FURNITURE PIECES...) VARIOUS METAL SCRAPS...ETC_ A NOTICE TO REMOVE THE RUBBISH WAS GIVEN ON 4/10/02 TO REMOVE IT WITHIN 30 DAYS (MAY 10, 2002) 2 PHOTOS.ON FILE. 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A06�0 W1Hit$ PNI YOtJE(2�1, AYS�O aT'gy"6(ED zm T€30F HIS QTIC � . - -r AD D "xl�i a nort�ri`'i,al roceetlin ,you ma'ado so;bq pork eii regJest two DIS,Tg c 000p DEPAR MENT�FIRST _ , _ -, z: a ;12)°tf ryou� ,sl e o cor�tesRt Ftatte7,.r y._._,, !)r t - yr ., 4tD*Nan lml•aleanp s dl'enc anlose aopYRof this �'�^"�' �"`� ��.�'�r' tB'��•T�A`BL=sDIUIS1Q�r� ®�1RTr".,CEO„P®4J�1D.�AI �Ti EEf`BNSFAB E,�MA�02 30, A n 9 4, . s t �u�'`�,>, e �«•'��{' ,�� �k ,I�� ����. 1 ��rd-w.��� `�a �� ram"'`;��1� ���"Fu`` s� "':T� A"`?� t��m� �'��` ""�� �' '`y y^, ''`v� -.*s-2". �,1� �• *e,. �'x is is �" G �as a -� $4r+�� �v:,i s�°.aYt�`'�^i sa...'�3N,.� ''V �: �+„ t ., R$ edattonto a earth ar " tl n o-..._. K —_ ' '� RYA r = ? `, "s,+ .re•17es .heann wdtim 21days-or I)ryou;fa Irt appearbr the,heanng of to pay any tine determmed�at-the tleanng a ��ms-.�{k m If'•you t drto,pay�jl�above+otfense or;to q �? 9 -� ,. �x�.e. S•,r. p .-, w � sS �'r rft .r`^• w ar C r nn+ ',. �>K +�'` �„�•r~nth h � uto berdug�rllmtma corn laultat� bealss_uedta amst ou",:�.f� `' `'�`+� :�`"f'emu���''��:z�•'F" .�",,:<§..:s ,� zj` :' ���h�^.:"=�3` �,i.y;• "i',nr!f x.�� '�O+'3 �y�-�7.t�;&..,."�xA"�'`trsatl i'"�f'��,.[ ��i" ��'�i�3�Y��'�'���� ��si,�Aar.�1};F,��'"�{'✓� Sr,. g� �:��� �'� ' ���''�`� � � =t ' '-��'tiusio tro'r•above';contess�tathe�offe'nse OhS`rged and eneljosexpaYment rn the amount nf$�'�'�t� ��• f F�§'%� 4 Y . _,lv�>F s���t ktER€BY,ELECT the Q �,•z �.;�.� "• � r�.�,� ,., w> � ry u�•sr•= w -��'#•r � �f' t+, r-5� �� >-�Ta{ +�;C?�Ar� '►. ,,, . � �rai�t� `��" � ��•�'t' T'F3-��ry��� '�'+��?` �� �e�� ,'�:� ��, �''�,s'"t`S�� ��i�>�N �rya:: y i -� � �.�` gh'�l'�d ''' � P4 x+ht3!'p y„r. F' "� ✓y F �.�iR y+k� r ?L4�.e-r"�',%4�,t`6 5.ft j, y-rt d 5 �rz' 's.ajl:a'k_�!. .V, t"'" x� Z� h� ca r`"t,�„A arw.��S�-,x {}.. S1' y .F'tz2-'*r ',�x`ti ��z•'��i +. � ?, +� Y-i'� s �i 4 .;G.•*=..••.� .� A�,�..,.t�1 �� r� afi"♦z� � -.7., ,,,t'7,+. a.,.- r a ,S - r fi � �. o- a^1�r - `a�,��•'py^S.�t+".,7...,y a,wfc NAME OF OF 7 ' tt��. <• R'<.�` fl�'x:iri.r Sa." �f. °�° xr t}` 1 f�t rvY �.- '}�,•4sM d��'♦♦its` '*�^h "�'� l e�s t ��^Gta��`� 7 � re's-y�a „� ,i � � uro,�a s3��z�'��,^�r4,y,; €i`a���� +r�'s�"r�lh�v�`� a xT01NN�OF Jfi4 A)DRESSDFOFFEN I � i?+."rw• , �5, +• "�, t -c+�`S"', �, r 3r- ,;� +�-f� 2 { 'it, Y#� �' ��;aBAR�NSTABLE���TM,S�A�E ZIP CD � ,� � �� ,� _ �• _� �k.� > -� ; �5 ;'.,,;oF ENE raY. uL•TP*' ??;;„a"�'�{.1"� ,� r�����. �`r�ts+rt� 'fit .0 OFFENSE 1: pn�pnu � � ,��e� ��� ��+ a. _ �' :r,..�•�Y a �x r�' � ���C�-�`St ��r)c ,Wmg 1 y�raDEFi3w t TIME'AND NOTICE - � ,gam t� C OFrR 7 , �M" �v' ``'fi�,.trt {.v �'-' RC PE$ON y'-•;r +7' ''S;;' s r"`` EN T ,�'e ,S`a' y s. ��\�B u W • t7' �?` J v+'•N g",. r •d'._.?' S, TL°,irs, 8a =fit -'4,+rN i. x, a�:a ., r p ; s tt[. OFTO WN�x,,..�la�l Fig' EBYACKNOVIIL"E REGEIPT�OCITATION`X "' � � ,y � ��F1 I a "�.,'v { � I' �0 RD;INAN�C:EM z :Unable�to*obtarn tune offe er,LL� �"�r 4 ` � y 'HEzNOMCRIMIkNAL4FINE FOR THIS O F,ENSE ISM,$_ �V- Y .'` :^, �Ta..xr•. .:t)ateRla:l�,edtr - .,s.,,,, : .,m:=*�d" -eZ.:2�n'1a,e-`.�: 34`k.„"-`..Ga1 .?`± �.t,,v..,s.:�G� r.a '. 4 ::�P _-.'" :;.;-:7 -:ew. w:•::: ^ri�tR� � �1G.OUNHAUETHEtFOLLOWON : Li ERN GTI;VES+WJT�M,�REGARD�TODISPOSNIIUN50Fa�T IS+MATaTrE♦j-i�EITHERs`OPTI©N(1)109tQ,PTsIONi2�W�ILLOPERAT�AS,A�FI '`A'L � '' DbHSeyfaonrenel rflsT 0 hM eA WB 0a2IaT6 H0 1N OW RITEHS{IUt—i: ouep(1) tLe TTIaWNGoEv NCeTRYIM OINNeAEiL,{¢2f?1ErCDOARXD n yappea n QpA ��O.�Faa�l h� �ir exo uto;hB ar��nd stab lle,e�;kC�le-h rkMhP a"s_�Be oxxc�e2�p4 t3e krn k 230 SbUth Street.,Hyannis W260y rbymailing ached none ortleHrorP TES OFSHE TSNOTC wlJai , _ f � k ,r ., r� � � ,(2),It you desi„e to contest-his matter;in a noncrlmmal,proceeding you may dotso by nakng Wifterr,request;to,DISTRCCT,COURT DEPARTMENT�'FIRST+ l a � �^�',„ �,+�: �fB'ARNSTABC�r-DIV,ISiON"COUtRT OMPOUND�MA;I �STfiEET±MBARNSTABLE:MA�02630,�Attn 21D Noncrlmmal Heanngs�and.;•enctose a copy of�thls� -�_ :� I t bV��++ eµ�"�:�:�"k calon torah anng +,�1�'f��'a�ry4,�{47�'�tl'i���,.�.�+�'�.+"Sa�# "-�e��, t�u� � zk-:ti�'*2a�'� t�P�,Y�.'LN£a�iY�^..�K�x"�a✓i5,k"'a}rT��.�}7U.f.;:�4�'���ap.�s�s (3);It you tall to pay the abdve offense or to request a hearing wtthln 21 days or Itkyou fall to appear for the hearing or to pay.'any bne determined at the hearing. due cnmmal con laRjf ma be+Issuowa a4if out t d,3So r`, x x Y "�'�tN bu�C & ,''n,"'-.:`�'''' p x•a,z -W'S�'°>' )-`^' nt :x• w i �""% ^.�n3S td1 [-h Yt.iti ^# d.,'hffwh• HY:t� f > l t �.. hHEREByr ELECT,fhe,fust`optloR above co6fesl1s to th offe e nse charged and enclose payment n,the amount of$' ''.£4,t _:, 4 `nl!'r rrl tx 4�4kr f rSignature .. ,. ti a DOCKET NO. tt h f M t l C o Massachusetts Trial our RECORD OF CRIMINAL CASE' 0325 CR 002997 Tr District Court Department DEFENDANT NAME OURT NAME&ADDRESS SYBIL A MOONEY BARNSTABLE DISTRICT COURT DEFENDANT ALIAS(ES) ROUTE 6A, P.O. BOX 427 BARNSTABLE MA 02630-0427 (508) 375 6600 c y DEFENDANT ADDRESS CITY/TOWN VATE ZIP CODE 184 BISHOPS TERRACE HYANNIS MA 02601 SEX CITY OF BIRTH STATE OF BIRTH MOTHER'S MAIDEN NAME FATHER'S NAME PCF NO. SID NO. LICENSE STATE CASE INFORMATION NO.COUNTS POLICE DEP POLICE INCIDENT NO. OFFENSE LOCATION ARREST DATE MV CITATION NO. 2 BAR BARNSTABLE BAR66322 CURRENT DEFENSE ATTORNEY ATTORNEY TYPE CURRENT PROSECUTOR COMPLAINANT MORSE, DETECTIVE RICHARD S. OFFENSE AN'D JUDGMENT INFORMATION COUNT: 1 OFFENSE DATE: JUNE 3, 2003 666666 MISCELLANEOUS MUNIC ORDINANCE/BYLAW VIOL COUNT: 2 OFFENSE DATE.: JUNE 4, 2003 666666 MISCELLANEOUS MUNIC ORDINANCE/BYLAW VIOL ------------------------------------------------------------------------------------------ DOCKET ENTRIES ------------------------------------------------------------------------------------- DATE CODE DOCKET ENTRY JDG/MAG ACTION DATE 9/15/03 AC APPLICATION FOR COMPLAINT FILED 9/15/03 ZCI COMPLAINT ISSUED WFE 9/15/03 ARR ARRAIGNMENT SCHEDULED FOR 10/16/03 9/15/03 PI PROBATION INTAKE FORM PRINTED WFE 9/15/03 SUM SUMMONS ISSUED FOR DEFENDANT WFE rev P PAGE DATE RECORD PRINTED CLERK-MAGISTRATE A'TRUE 1 10/16/03 COPY ATTEST' CRF21A10/16/03 3:08PM DOCKET NO. RECORD OF CRIMINAL CASE 0325 CR 003336 Trial Court of Massachusetts District Court Department DEFENDANT NAME COURT NAME&ADDRESS SYBIL A MOONEY BARNSTABLE DISTRICT COURT DEFENDANT ALIAS(ES) ROUTE 6A, P.O. BOX 427 BARNSTABLE MA 02630-0427 (508) 375-6600 DEFENDANT ADDRESS CITY/TOWN STATE ZIP CODE 184 BISHOPS TERRACE HYANNIS MA 02601 SEX CITY OF BIRTH STATE OF BIRTH F MOTHER'S MAIDEN NAME FATHER'S NAME PCF NO. SID NO. LICENSE STATE CASE INFORMATION. NO.COUNTS POLICE DEP POLICE INCIDENT 7FFENSE LOCATION ARREST DATE MV CITATION NO. 3 BAR BARNSTABLE BAR66324 CURRENT DEFENSE ATTORNEY ATTORNEY TYPE CURRENT PROSECUTOR COMPLAINANT MORSE, DETECTIVE RICHARD S. OFFENSE AND<JUDGMENT`INFORMATION COUNT: 1 OFFENSE DATE: JUNE 25, 2003 666666 MISCELLANEOUS MUNIC ORDINANCE/BYLAW VIOL COUNT: 2 OFFENSE DATE: JUNE 26, 2003 666666 MISCELLANEOUS MUNIC ORDINANCE/BYLAW VIOL COUNT: 3 OFFENSE DATE: JULY 8, 2003 666666 MISCELLANEOUS MUNIC ORDINANCE/BYLAW VIOL ------------------------------------------------------------------------------------------ DOCKET ENTRIES ------------------------------------------------------------------------------------------ DATE CODE DOCKET ENTRY JDG/MAG ACTION DATE 10/15/03 AC APPLICATION FOR COMPLAINT FILED 10/15/03 ZCI COMPLAINT ISSUED WFE 10/15/03 ARR ARRAIGNMENT SCHEDULED FOR 11/13/03 10/15/03 PI PROBATION INTAKE FORM PRINTED WFE 10/15/03 SUM SUMMONS ISSUED FOR DEFENDANT WFE PAGE DATE RECORD PRINTED CLERK-MAGISTRATE A TRUE 1 10/16/03 copy ATTEST CRF21A 10/16/03 3:07 PM I 1 Miorandi, Donna From: Lomba, Lois Sent: Monday, October 06, 2003 12:06 PM To: Lavoie, Debbie; Mattos, David; Miorandi, Donna Subject: Request for Court Reports At your earliest convenience please submit a written incident for an upcoming arraignment at Barnstable First District Court for the following: Patricia Dimaggio/BAR 65372 & 65373/Dog/Everett Steven Florette/BAR 66619 & 66620/Dog/Lewis David Horan/BAR 65251/Shellfish/Murray Peter=K1-u'skey'J2f/BAR 4-98-52 49854;"&_4-9-8-5-5/-Zoning/Mattos Lena Kittle/BARBAR 66621/Dog/Lewis Sybil Mooney/BAR-6-6324;66325,& 66551%Health/Mro-rand Nathanial Smith/BAR 66651/Sandy Neck/McAbee Thank you, Lois 4672 r. ` � 1 « -,... .,.,,��.,.r«en .';;r+.` ...p M..••^.-•:"`r..y'!:.. .:��,:s:.�- rr �:.s¢•"°"3�r'''a'�`�y*i°uT�r�r^a"' M;:�. :�y-� sib+. „'.'?"�rrxs Er,,c�'j.¢�w � �5+^"'r•Fr-�n-sxe pc ta•':"".�`T �.n'� i •fr.:rr ` TOWN OF BARNSTABLE BAR-W '6d Ordinance or Regulation WARNING NOTICE Name of Offender/Manager r � r ( (�+ r Address of Offender 91( tjo l p rr-,o r e MV/MB Reg.# Village/State/Zip 'A ` f) 'AtjJ Business Name 'tK am/p'—m, on t r",7 V 20t}l Business Address Signature of Enforcing Officer Y Village/State/Zip �.t f / Location of Offense '? r te',R:sr � ftpt r r"'1'j4y1 +Ft% 114 oPpr� ,. _ q i Enforcing Dept/Division Offense H ;fir A44,tt t �.r�s�+�01 e v/;. �1 t P rir' 1777 Se r`A of) Facts t # /` i C r'�".A , A T /1 Zo E 7` r !<3rC1AL"- , 4 f i+V/J 1 ¢ t:!"J io R Sf #k.)111 f i*, i' i d /4 4 1 3 6 , .to",}/ - ! ' "I RC' 4L This will serve only as a warning. AC- this t :m4 no/legal/action has be&n taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. NAME OF OFFENDER ILgN M©OM, BAR 66558 TOWN OF ADORES OFO FF�JO R /�'��ap�^ * ./f��/ BARNSTABLE CITY,STATE, I c ,/� �� ` ) M!! [L. " /J✓ `SINE t°w MV/MB REGISTRATION NUMBER bi P O OFFENSE U J HARNNTANLE.. LLI Y lIA55. d C6 1679. PrFD MPS A, C7' O A/ M ft �Ir, > TIME ANDTiSTT 0 I L-ATION / L�gAy10 F VIOL•TIOy�' V u Z NOTICE OF '� (A:rui- _ ON !ram 200 '7 l�i�__'p� TI SI ATII E'OFENFO�CI�Nc PER ° EN Q CI D v` `/ g,'A�D9GE,0� Er, w VIOLATION Lu l : ° ,nI! t� 1Y fT ��l o OF TOWN I BEBY ACKNOWLEDGE RECEIPT OF CITATION X a Unable to obta�p si'natuy�ef f nder. J ORDINANCE 1 'f THE NONCRIMINAL FINE FOR THIS OFFENSE IS $ l � Date mailed— LU LU OR YOU HAVE THE FOLLOWI G'AL_lfRNATI ES WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTION(1)OR OPTION(2)WILL OPERATE AS A FINAL DISPOSITION WITH NO RESULTING CRIMINAL RECORD. w Cn REGULATION (1)You may elect to pay the above fine,either by appearing in person between 8:30 A.M.and 4:00 P.M.,Monday through Friday,legal holidays excepted, J before:The Barnstable Clerk,230 South Street,Hyannis,MA 02601,or by mailing a check,money order or postal note to Barnstable Clerk,P.O.Box 2430, a Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE DATE OF THIS NOTICE. (2)If you desire to contest this matter in a noncriminal proceeding,you may do so by making written request to DISTRICT COURT DEPARTMENT,FIRST BARNSTABLE DIVISION,COURT COMPOUND,MAIN STREET,BARNSTABLE,MA 02630,Attn:21D Noncriminal Hearings and enclose a copy of this citation for a hearing. (3)If you fail to pay the above offense or to request a hearing within 21 days,or if you fail to appear for the hearing or to pay any fine determined at the hearing to be due,criminal complaint may be issued against you. ❑ I HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$ Signature JEFER . DAD 6[A►557 TOWN OF E DnnV4i VBARNSTABLE MODE f3 '" �f , J '/ 111E fp � � ��� y w 7 �IA55. g. r./ (I. CD �pff0 MPS • _S + I..JE. r6Zfto W TIME AND D F VfOLATION L C7vTOW "VIO N' +' w .NOTICE OF �. `� (a.M P Mr)o4N _ 20 0 q }�C�t� �J VIOLATION S)G ATURE.OF ENFORCIN PERs$N EN CII� B D E N . w" OF TOWN I.H,EREBY ACKNOV&EDGE RECEIPT OF CITATION X a ORDINANCE [ Date maile Unable to obtai Sig atur of o(,ender. /� ,r THE NONCRIMINAL FINE FOR THIS OFFENSE IS S ka�at�(1 W d _ w OR YOU HAVE THE FOLLOWIN ALT RNATIVES WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTION(1)OR OPTION(2)WILL OPERATE AS A FINAL a DISPOSITION WITH NO RESULTING CRIMINAL RECORD. w REGULATION J (1)You may elect to pay the above tine,either by appearing in person between 8:30 A.M.and 4:00 P.M.,Monday through Friday,legal holidays excepted, before:The Barnstable Clerk,230 South Street,Hyannis,MA 02601,or by mailing a check,money order or postal note to Barnstable Clerk,P.O.Box 2430, Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE DATE OF THIS NOTICE. (2)If you desire to contest this matter in a noncriminal proceeding,you may do so by making written request to DISTRICT COURT DEPARTMENT,FIRST BARNSTABLE DIVISION,COURT COMPOUND,MAIN STREET,BARNSTABLE,MA 02630,Attn:21D Noncriminal Hearings and enclose a copy of this citation for a hearing. (3)If you fail to pay the above offense or to request a hearing within 21 days,or if you fail to.appear for the hearing or to pay any fine determined at the hearing to be due criminal complaint may be issued against you. ❑ I HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$ Signature NAME OF OF B/lR{ �V �� TOWN OF ADDRESS 0 FPEND AIEq{_I y, ,./f' /� BARNSTABLE CITY,STATE ZIP OD. '` _ !/ 111 !••+ Or IKE rpw 1MV ' MV/MB REGISTRATION NUMBER O; OFFENS LJ 13 4.-VV.k.J)y� +��+. l� 1 1 llYl.�ij 'lCD !�- CL f / l/ .J� A M/rr 'Cl lMgM �/��� LU Z NOTICE OF E AND DATE�OF�VIOLATION �' u J /� LI TI NOFVIOLAZIO�I� �+/"' � rr �f w "1i ( M ( P.M,)zON IJ 20 bJ1/ , /Y) J{/J,ff /( A'/Yj J VIOLATION d FIATU IEOPE ER NFOHCING PSON y f(y +� 0 EN F RCIr� DEPT. B LU A�j o OF TOWN `IHEREBY ACKNOW EDGE RECEIPT OF CITATION X CUj L ORDINANCE V IH Unable to obtain si ,ature of of ender. d ♦ ♦ THE NONCRIMINAL FINE FOR THIS OFFENSE IS $/ 0 W Date mailed �,,cc.,[c w OR YOU HAVE THE FOLL�(=}wI.NG ALTE NATIVftS WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTION(1)OR OPTION(2)WILL OPERATE AS A FINAL DISPOSITION WITH NO RESULTING CRIMINAL RECORD. w REGULATION (1)You may elect to pay the above fine,either by appearing in person be tween 8:30 A.M.and 4:00 P.M.,Monday through Friday,legal holidays excepted, J before:The Barnstable Clerk,230 South Street,Hyannis,MA 02601,or by mailing a check,money order or postal note to Barnstable Clerk,P.O.Box 2430, a Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE DATE OF THIS NOTICE. (2)If you desire to contest this matter in a noncriminal proceeding,you may do so by making written request to DISTRICT COURT DEPARTMENT,FIRST BARNSTABLE DIVISION,COURT COMPOUND,MAIN STREET,BARNS yABLE,MA 02630,Attn:21D Noncriminal Hearings and enclose a copy of this citation for a hearing. (3)If you fail to pay the above offense or to request a hearing within 21 days,or if you fail to appear for the hearing or to pay any fine determined at the hearing to be due criminal complaint may be issued against you. ❑ I HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$ Signature NAMED FFrEND � ,. "' BAR 66555 TOWN OF ADD IS`_F0E- D 'n ��, 1 �C✓ � r 11JC BARNSTABLE CITY,ST E Z A , MA on o 1ME rO�i / ' - MV/MB REGISTRATION NUMBER 9e gp' OFFENSE V/ !(( �l/)�'A�� ~�I[••• •I.`Jy �.. J(lj'(� J1/.1� _ i y / / , ( UC { LU OtAN\SlANlk, 1+639 V V NNOS 0042S W{" / M l LU Z TIME AND DATE l�"V OLATION L C SIO VIOLATION / w NOTICE OF (�-�►-i oN ,20 � i uopt g •AT RE OF ENfO CI G PE9S,ON � � ¢ EW�)WaozY BAO E 0 r � w VIOLATION . / "� rr�°' V��/ r � � �� CD OF TOWN I EREBY ACKNOSEDGE RECEIPT OF CITATION X CL ORDINANCE Unable to obtain si na df off 'der. r9 w� THE NONCRIMINAL FINE FOR THIS OFFENSE IS $/00,!0701 Date mailed— _ LU t w OR YOU HAVE THE FOLLOWING ILT tATIVES WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTION(1)OR OPTION(2)WILL OPERATE AS A FINAL °- DISPOSITION WITH NO RESULTING CRIMINAL RECORD. w REGULATION (1)You may elect to pay the above fine,either by appearing in person between 8:30 A.M.and 4:00 P.M.,Monday through Friday,legal holidays excepted, J before:The Barnstable Clerk,230 South Street,Hyannis,MA 02601,or by mailing a check,money order or postal note to Barnstable Clerk,P.O.Box 2430, a Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE DATE OF THIS NOTICE. (2)If you desire to contest this matter in a noncriminal proceeding,you may do so by making written request to DISTRICT COURT DEPARTMENT,FIRST BARNSTABLE DIVISION,COURT COMPOUND, MAIN STREET,BARNSTABLE,MA 02630,Attn:21D Noncriminal Hearings and enclose a copy of this citation for a hearing. (3)If you fail to pay.the above offense or to request a hearing within 21 days,or if you fail to appear for the hearing or to pay any fine determined at the hearing to be due,criminal complaint may be issued a ainst you. ❑ I HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$ Signature Violation History AcctNo 1469 Mooney Sybil 10-21-2003 184 Bishops Ter Hyannis Issue Date Cit No Fine Date Paid Amt Paid Dlso Total Due Notice2 Final Hearing Arraign 06-05-2003 66322 40.00 Cleared 0.00 07-07-2003 08-05-2003 -10-16-2003 06-05-2003 66323 40.00 Cleared 0.00 07-07-2003 08-05-2003 10-16-2003 06-26-2003 66324 40.00 Cleared 0.00 08-05-2003 09-11-2003 11-13-2003 06-26-2003 66325 40.00 Cleared 0.00 08-05-2003 09-11-2003 07-10-2003 66551 100.00 Cleared 0.00 08-05-2003 09-11-2003 260.00 0.00 Health Complaints 11-Apr-02 Time: 8:25:00.AM Date: 4/9/2002 Complaint Number: .3357 Referred To: DAVID STANTON Taken By: DANIELLE ST.PETER Complaint Type: NUISANCE CONTROL REG. 1 RUBBISH Article X Detail: Business Name: Number: 194 Street: BISHOPS TERRACE Village: HYANNIS Assessors Map Parcel: Complaint Description: THERE IS A STRONG.SEPTIC.ODOR COMING,FROM THIS PROPERTY.AND THERE ARE.CHILDREN.LIVING HERE. SHE ALSO.SAID THEY DO.NOT.HAVE GARBAGE PICK UP THEY USE.A DUMPSTER OR BURY IT..SEE ATTACHED. Actions Taken/Results: THERE WERE NO SEPTIC ODORS PRESENT,.NOR SIGNS.OF.HYDRAULIC FAILURE TO.THE SEPTIC SYSTEM.. THE PERSON.THERE.CLAIMS.HE HAS A DUMP. STICKER FOR THE TRANSFER STATION.. THERE WAS.A LOT OF.RUBBISH.PRESENT AT.THIS.LOCATION..RUBBISH INCLUDED WOOD.(PALLETS,.FURNITURE PIECES...) VARIOUS METAL SCRAPS...ETC...A NOTICE TO REMOVE THE RUBBISH.WAS.GIVEN.ON 4/10/02 TO.REMOVE.IT WITHIN 30 DAYS (MAY 10, 2002) 2.PHOTOS.ON FILE. Investigation Date: 4/9/02 Investigation Time: 3:00:00.PM 1 LOCATION SEWAGE PERMIT NO. t' a VILLAGE 14,0114 INSTAALL 'S NAME & rADDRESS 6UILDEIII OR OWNED �f/t 1�r, � &44Ytzf DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 2 Q �� i 2� z Z ,�� bZ 2� �z h� S s z.� ,�a f�q J /73 No.D.3." ... _ - FR$.........`f�.............. /^ THE COMMONWEALTH.OF MASSACHUSETTS BOARD OF -HEALTH Tovin Barnstable .................0 F......................................................................................... Appliration for Disposal Works. Tonstrurtion Prrmit Application is hereby made for a Permit to Construct (X ) or Repair { ) an Individual Sewage Disposal System at: .... Lot_ 25 -....-.... Bis hop 's ferrate,: Hyannis ,hiA ............................ .........................•-------. ..........--•---...-----------------.................----------- - ..._... ... -Ad rust ora Capricorn ReLa'Ay 765 Falmouth Rod No..14,annis ..--•-------•-----•---- -••..............................••......---......Owner Address W Steve Label .................................•------......----•.....•-••...••------....... .... .. ...... -•---.........--------•---.................-••-•----•..................---- Installer Address d Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms._.3 ------ _-----:_-:.Expansion Attic ( ) Garbage Grinder ( ) No. of persons..........................:. Showers 2 — Cafeteria p., Other—Type of Building ranch............. p ( ) ( ) a Other fixtures ----------------------••••- W Design Flow.........55..............................gallons per person per Total daily flow---------330..........................gallons. WSeptic Tank—Liquid*capacity100@gallons Lengths.-_6._'...__. Width...10..... Diameter................ Depths._.8.-..__. Disposal Trench—No..................... Width.................... Total Length......._........... Total leaching area___.._...._.._......sq. ft. 3 Seepage Pit No--------------------- Diameter.....6.#..._..... Depth below inlet.._....�..._...... Total leaching area...2.�.........sq. ft. Other Distribution box ( ) Dosing tank ( ) z Percolation Test Results Performed by....Eldredge Engineering 11-2�-81 ---.... ... Date----...-----••- ------------- 14 04 Test Pit No. 1.2..0..._..minutes per inch Depth of Test Pit...12.......... Depth to ground water2I e...Q.MCQunter- 44 Test Pit No. �A......_._minutes per inch Depth of Test Pit11l ..........: Depth to ground water..NIA_____________ e P4 ••••--••••••--••-•--•---•---•••••••...._..•-•••---•-••••---•--•••-••................•-•--••......••..-•-................--•••.......--•--•-•------...---•••••. ® Description of Soil.......... .'.... ..-2' ' loam &-topsoil x 2' - 10 ' Medium yellow sand v ••-------------•---•-•-•.... ...........................................- U Nature of Repairs or Alterations—.Answeew when Pptceabl88ndltraCes of gravel�no:-water_at:: 12' -•-•--......---••••••••-••••...............••--•••--••••-•••-•••--•••-•••......-•-..................•-•••--•--••--•----•••••••••-•--••-•--•••---•••-•-•-•••--•••-•••-••-•••••-••.........---•--....•--•- Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of:iTLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Complianc eNhs be issued by the board of h lth. s ign: ........Pre. •--••• --2� - L: Application Approved By..... ............. ....-•---...------•--------- -�•-•L_6 3 Date Application Disapproved th f ollowing reasons:-----•------------------------------------------•-----••-------------------------------••--•......•--•••••.••-- --------------------•--•-----•-----•-------------------------•-•-•--------•-------------.......-------•---•-----••--••-•--•-•----•--•--••••-•---•••••••--••••---••-•-•-•-----•••-----••••••••-•-------•- Date PermitNo......................................................... Issued....................................................... Date t.No.!'. .� / FEs... .yya..........'. THE COMMONWE�LATH OF MASSACHUSETTS y BOARD OF HEALTH TOVM Barnstable ................._............-......0 F..........................._..-..._._.. Appliration for Bigpogttl lgorkii Tonoirurfion ami# Application is hereby made for a Permit to Construct (X ) or Repair.,'(` ) an Individual Sewage Disposal System at .mot # 25 - . Bishop's 1'errace, H�!anriss...r"A :.. .......T........................... .. ..................._.................._ .... .....__ ............. ....... ..... Loc 'o -Ad'rless or Lot No. Capricorn Realty ;rust 76,E Falmouth Road,._.Hyannis-••__--_„--_,,,-•• -----�--••.... ............•••--••-••----.._.......-----•-•-••-........ ... ......... -••--••......... Steve L b e t Owner Address •-----------------------------------------------•----------......-------•••----•--•---............ ............-•---------.._._...---•••---•--•...........----••.._................-•---••-•----•---- Installer Address dType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms--- ......................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of. Building 1'@J!Q 1.............. No. of persons............................ Showers (2 ) Cafeteria ( ) P4Other fixtures ------................................................................................................................................................ W Design Flow........55...I.....:....................gallons per person pe i day. Total daily flow__.__._._.330_..__._....._..__..__._....gallons. WSeptic Tank—Liquid`capacity�_00�_gallons Lengtl15___6._....... Width4: 10__.._ Diameter________________ Depth5---as,..... Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit Nol------------------- Diameter-____6.._..______ Depth below inlet____6..--..-_._.,_ Total leaching area...Z66......sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.._�ldredge ET1glneeY`lYlg -•-•--•--- Date.__11_-z5m81- Test Pit No. 1.2rr._0_.__.-minutes per-inch Depth of Test Pit---12_'__...._.. Depth to ground wateinane:___encounter- 44 Test Pit No. :1.A_._._._._minutes per inch Depth of Test Pitli/A............ Depth to ground water--N/A............. e R6 •--------------------------- -----------•------------------•------•---------._._._..._...................................................................... ® Description of Soil.......... 2' -1Oam...&._ QPS03,�....................................................................................... v 2;------].•0;........................ i ..y-ellow-•sand W 15.i -.............. .2 -- ••me .---white -_sand -traces---of--- rave . ....Water...at,12' UNature of Repairs or Alterations=Answer when applicable_________ ___________ _______ ______________________.................................... ...........-............................................................................................-•------•---••----••------••-•-••-••-------•--•--•---•-•---------•----••--•--•......---.....---- Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITS:;=. 5 of the State Sanitary Code-The undersigned further agrees not to place the system in operation until a Certificate of Compliance as been issued by the board of health. �.�Sig df of Pres 2��83 Oii..-•---- •�---- .. - ApplicationApproved BY l . ........................... •-----------•---•---......----- ......................................... � Date Application Disapproved r tla'e following reasons------------- =--------------------•-----------------------------------------------------.._.................. ..........................------•-••-•---••------•-------------•---•-•-------•-•-------•------•----------•----•--•------••••-----•----------•-••----•-•--••-••---•--•---••-----•----•---•--•------..... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD .OF HEALTH ..........T.own.............I....OF......�f.4'� .n.9.t.ab1.e._............................_...._........... %T.Urtifiratr of Tomplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (K ) or Repaired ( ) bY-•-----•----------------------------------------�Ieme...I ahe..-..--...----------------------.......---------•-------•--------------------------.._..----------••---------------•--. T ='5 - Bishop's i'errac ;tauer ; at........ '°t ---•-•-• Provisions of � -----------Hy ;ulis - ----•----•-•----•-------- has been installed in accordance with the T1 I r) ! The State Sanitary ,C d- , Peqscribed in the application for Disposal Works Construction Permit No------------_-------------............. dated--- ...... THE ISS ANC OF THIS CERTIFICATE SHALL NOT BE CONSTR AS A GUARANTEE THAT THE SYSTEId//lddl L F��CTION SATISFACTORY. DATE.... .•. -.......;,_---------•--------------- Inspector.----- -- ---------------------..._.._.....----------------•---•---.....---..... j i i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH <, Tovm OF..3srnstab,� ..................... .......................... y1.7.. ................. INo. ................ FEE ......-•........... �io�o��1 ork� �on�irion prnti� - Permission is hereby granted................ te-ve---?._ebel......-----------------------------------------------------------------------------•------- to Construct a ai diet Ta e Disposal System ' k ) o��P $ sY�O ' ' `_�4a.�,g P Y atNo._-?tS�t__:at----------------------------------------------------------------•-----••---.------ ------Hyas�s�1�-r---i� ............_.. f----- -• Street /` �� as shown on the application for Disposal Works Construction Permit No.,___—_.-_..7:�Daated__ __._•.__._________________________ ..............................................................---......-................................. 4 2 Board of Health DATE----- 0 ----------------•------- L FORM 1255 HOBBS & WARREN, INC., PUBLISHERS r i � y OF Mq GN i Ll::5T $ H Na 74 • @/ST�� pQ` a �HU SUM pD ,S 79 3 el- 4 . w _ LOT 2S�° M t /Iy U o L � �1 +'GnRAaE beIjEWA`( _ 11 gyp. 0 . J �Pkopo E-L N) b ~ M wA7rlieil"I= N Ipoo•6AL u I C ` / 50t i ..MIN a i t LEA[Ntub _ 0 1 PIT Z z p _ YcAA po�£9 ► J o wW pp i �tr • ZQ� LEGEND EXISTING SPOT ELEVATION Ox0 *� OFMq CERTIFIED PLOT PLAN EXISTING CONTOUR 0 -- q . FINISHED SPOT ELEVATION ��]Q �o ),,g FINISHED CONTOUR 0 ORS ti I N APPROVED s BOARD OF HEALTH ,pNo.10951�p Q sS/oNAl- DATE AGENT SCALE: / 3 v DATE< -L REDGE ENGINEERING CO. IN CLIENT""c'" I . CERTIFY THAT THE PROPOSED EGISTERE REGISTERED JOB NO. f3.O°7 BUILDING SHOWN ON THIS PLAN CIVIL LAND CONFORMS TO THE ZONING LAWS ENGINEER URVEYOR DR.BY� . `1,.._. �_.. '.� OF BARNSTABLE MASS. 712 MAIN STREET. CH. BY+ ��•7ZC ' a HYANNIS. MASS Z 0 2i 83 SHEET..�. OF ATE R G. LAND SURVEYOR NOTE /F 'E/TNER THE SEPT/C TANK OR 20 PT. °M!/V: iE,4CHinrG PiT ARE MORE 7HAA1 IZ"ASELOW '° /O fT.� MlN. F . -` :1RAOE� f� 24'D/AM ETER G'OiyCRETE OOiiE.p SWALL BE ,gROuGNT TO GRAoE. f+N EXTRA r GONGRCTB 4 PYC P/PL h+EAVY CA ST /RON C o V4c T S14-4 L L L3E US EO M N N TC /F VE1V.4 /N D / Y �' •= 10 f.& YERS � r R O L C �•.• IB PFR FT. - 2 MiN. C'o/VCR E TE a _ G .�oE CO VEft CLEAN SANG 2'LAYER 4OCAST . a e /R /V O/PE O d cat M�tiE-� o b M/IN.P/TtX GA'L.. o•o� f • . • . , •e WA SHFO 57-ONE i %`pcR fT, SEPTIC TAMX D/sT, • a, f • • . . / , �-� fl�.� INJEk�-T.{3ELOW 3�. � � 1 f f •� 3/ � � ��� - ..: '�usE ca+,.onci�ti 3avc . •� >s f 1 EFFECT/VL � . � 4 - I /2 , FER Go.of i4CA ,�4- • I � r • • DEPTl+� • f f � � v� N643t/ED STONE + 04 0r.-93 D I f • • • • • 1 1 O p • • a; � D • o f f • O • O • 1 � PRECAS T SEEPAGE ?c�:x /� 78 i a• • / f • • • o • • f p ••p INYERT CLEVATIONS P�� c�►P'4 r�� GAL/��j' e �. f 1 e p f . • . . P/7 OR E4L/!V, • s — EL= 9d,IL 91.5 FT D/AM. t/!L /NG F ,/NYERT ATE D T. JNLET SEPTIC TANK 9-7 F7 D/.�4!►�• C SEE TABULATION, OtJTGET SEPTIC TANK 9 1, t FT N DISTR/EUTION BOX 9G• 9 FT. / OF OROuNo /HATER TALE / GET SECT ON. O�JTLETD/STR/BtJT/ON BQX 7 FT Y.ST�M .4u / POrSA L S _G� �O S SE E W r c. G y N /NtF � c TABULATlD /4CH/IVC 0/ OMENS/ON A FT. »t F SCALE-. :D,ES/6/( CR/TER/A D/.iJ.ENs/aN S 6 FT. NUMBER OF BEDROOMS 3 � � D/HENS/ON C�-FT.M�'� _ �stQAGEDISPOs�L uvir 11OWC SOIL. LOG- TOTAL E.?T/M►A'TEG FLOAV 3 3 o 6.41..ADAY SO%L. TEST A/ SO/C TEST#2 SOIL TEST NUMBER OF 4eACX/N4 P/TS E[EK gg7 ELeY. ,DATE OP- S01,L TEST J�E )A�a i S/DE-LEACH/NG PER P/T f Sfrt !'T. p Z ' ' RESClLTS iv/TNESSED jy 4 16 14-^3 BOTTOM LElICN/NG PER P/T PERCGLe1T/ON AATE,#I Liss M/N,//NCN To/�sa TOTitL LEACH//vG AREA ESQ. FT. AERCOLA7'/ON RA7E16E2 RESBRVELEAC'H/N6AREA 2w �' SQ. FT. �`� revs �a � >r ��,` ,-e�•r P - 17 89 soar ,rr�,v tN OFM 3.Z, -' 9 40r !3/SNc�T's � fZ. t R s Q. a 6G o ti� /9 o CT� ^X- F . ,3 ilk H a RSf ; 4 No.10951 OREDGE EJI W IV.EPR/NG GO,IIIIC. IS.TI- �� , g.. x 7/2 l►lAaN ST. s HYANN/S. MASS. l �O SUt ONA1.E �. yO GROUNp kvom fP �NCoUNrE�eEo CL/ENT:.�tz�t arc_o DRTE40 Q GROUND Lti/�1 TER AT ELEf✓ _ JOB .ND: 3 o 07 SHEET' z OF z