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HomeMy WebLinkAbout0128 CHESTNUT STREET - Health / 128 Chestnut St., Hyannis A=309-042 s TOWN OF BARNSTABLE LOCATION /�4F a4e s buVt S t— SEWAGE # VILLAGE ASSESSOR'S MAP & LOT O INSTALLER'S NAME&PHONE NO. t® 69 pe- S eo t-c, SEPTIC TANK CAPACITY Y De LEACHING FACILITY: (type) (size) NO.OF BEDROOMS g BUILDER OR OWNER PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility :Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by , t A Y .�•s� .t .... ' �� _.. ... /Y� V �N •� n� �� u l= i i7Rt✓e, �� � ��� � � I� �� _ r_ G V G Fee No. 3 t 4THE GbMMONWEALTH OF MASSACHUSETTS ' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pphration for 33iopoOt *pgtem Conotruction Permit Application is hereby made for a Permit to Construct( )or Repair( an On-site Sewage Disposal System at: Location Address or Lot No. Own Name,Address and Tel.No. Assessor's Map/Parcel �O 1 d Installer's Name,Address,and Tel.No. — w ,�� Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures �— gallons. Design Flow -�� gallons per day. Calculated daily flow 3� g Plan Date Number of sheets Revision Date Title Description of Soil Nature of Repairs or Alterations(Answer when applicable) __-00VSTW1 /sm S*01C_74C K 12 Q 0 DJ�- ©� Tr'�r�-� <-1 x�-- Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued Bo a Signe Date Application Approved by Application Disapproved for the following reasons Permit No. 91111 Date Issued 'o - -- ———————— ————--------------; No:' "�`!� _ ! Fee ` O - !T MMONWEALTH OF MASSACHUSETTS Y PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,MASSACHUSETTS 01pplicatiou for Mtoo d 6potem.. Construction Permit Application is hereby made for a Permit to Construct( )or Repair( . an On-site Sewage Disposal System at: Location Address or Lot No.I,-4FG �T5T_ Owne' N`ame,Address and Tel.No. Assessor's Map/Parcel _ Installer's Name,Address,and Tel.No. Q a r ,VP _Designer's Name,Address and Tel.No. a Type of Building: Dwelling No.of Bedrooms Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow 3 3 gallons. Plan Date Number of sheets Revision Date Title Description of Soil ✓�'17C S�rw Nature of Repairs or Alterations(Answer when applicable) Date fast inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b Bo a `� Signer Date _ b Application Approved by Date e'-' Application Disapproved for the following reasons 17, _. Permit No. 6n J Date Issued Z.!r 9� ------------ - -------------------------- THE COMMONWEALTH OF MASSACHUSETTS , BARNSTABLE, MASSACHUSETTS Certificate of Compliance _ IS�jO CER t the On-site Sewage Disposal System install id( repaired/replaced( )on by ,_NHL ISO t _e Installer at 1,t r ✓-- has been constructed in accordance with the provisions of Title_ and the for Disposal System Construction Permit No.. dated Date Inspector r THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRIOD AS A GUARANTEE THAT THE SYS- TEM WILL FUNCTION SATISFACTORY. ————// ——————— —————————— —————————— j No. t� — _ � Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS mig aljo � tem n�truction Permit Permission is herebyanted to a �- v ✓ to construct( )repair( n-site Sewage Sy em located at No.# ►`vT'-` s ' Street and as described in the above Application for Disposal System Construction Permit. No. Date The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. A All construction must be completed within three years of the date below. Date: k Y /S 6 Approved by (may Board of Health e— t CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) `} hereby certify that the application for disposal works construction permit signed by me dated �- S , concerning the property located at J�� G h-es�'�S� meets ell of the following criteria: s' . • There are no wetlands within 300 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system i • The observed groundwater table is 14 feet or greater below the bottom of the leaching facility • There is no increase in flow and/or change in use proposed z r • There are no variances requested or needed. { SIGNED: DATE: LICENSED SEPTIC STEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system.Also if the licensed installer popes a ce tified plot plan, this plan should be submitted]. E ,5 { a d S �� . % i `F I 0 d (�' . _ 651, 002 Receipt for Certified Mail No Insurance Coverage Provided uRTEo Do not use for International Mail POSTILL SERVILE . (See Reverse) cl) Sent to m Street and No. zd- 2 Y 2 P. to and ZI ode ` O Postage C* E Certified Fee 6 O L Special Delivery Fee fi�3tffEtetlf D�k'�eiy�Pe� NR'etilrn�ReL'2ipttSfibTNiiig7 - _ III to Whom&Date Delivered Return Receipt Showing to Whom, Date,and Addressee's Address TOTAL Postage &Fees w i Postmark or Date � _ STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front). d 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attached and present the artice at a post office service window or hand it to your rural'carrier(no extra charge). CC `. 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return V) address of the article,date,detach and retain the receipt,and mail the article. L 3. If you want a return receipt,write the ce,tified mail number and your name and address on a >' return receipt card,Form 3811,and attach i!to the front of the article by means of the gummed ends if space permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT REQUESTED adjacent to the number. O O O 4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, M endorse RESTRICTED DELIVERY on the front of the article. r 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.It LL return receipt is requested,check the applicable blocks in item 1 of Form 3811. W 0- 6. Save this receipt and present it if you make inquiry. 105603-93-8-0218 Town of Barnstable • Department of Health, Safety, and Environmental Services NAM � Health Division 367 Main Street, Hyannis MA 02601 Office: 509-790-6265 Thomas A.McKean FAX: 508-775-3344 Director of Public Health October 5, 1995 Arnold Wininger 128 Chestnut Road Hyannis, MA 02601 SECOND ORDER TO COMPLY WITH 310 CMR 15.00, THE STATE ENVIRONMENTAL CODE, TITLE 5. The septic sytem owned by you located at 128 Chestnut Road, Hyannis was inspected on June 15, 1995 by J.P. Macomber a Massachusetts licensed septic inspector. The inspection of your septic system showed that your system has failed under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: Cesspools overflowing On July 5, 1995, you are directed to hire a licensed Town of Barnstable septic system installer to submit a sketch diagram of a proposed system to the Town of Barnstable Health Division Office (Town Hall, 367 Main Street, Hyannis) that will bring the septic system into compliance with 310 CMR 15.00, The State Environmental Code, Title 5 within (14) days of receipt of this notice. You were also directed to bring the septic system into compliance within thirty (30) days of receipt of this order letter. Hoever, the system was not upgraded as ordered. You are further directed to maintain the system by hiring a licensed septage hauler to pump the septic system to prevent discharge of sewage or effluent into the buildings, onto the surface of the ground, or in to surface waters. You are again directed to upgrade the septic system within thirty (30) days of receipt of this letter. Any person aggrieved by any order issued by the local approval authority may appeal to any court of competent jurisdiction as provided for by the laws of the Commonwealth. PER ORDER OF THE BOARD OF HEALTH T o as A. McKean, R.S., C.H.O. Agent of the Board of Health Town of Barnstable • � Department of Health, Safety, and Environmental Services .uruvSTABU "'" Health Division 367 Main Street, Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean FAX: 508-775-3344 Director of Public Health July 5, 1995 Arnold Wininger 128 Chestnut Road Hyannis, MA 02601 ORDER TO COMPLY WITH 310 CMR 15.00, THE STATE ENVIRONMENTAL CODE, TITLE 5. The septic sytem owned by you located at 128 Chestnut Road, Hyannis was inspected on June 15, 1995 by J.P. Macomber a Massachusetts licensed septic inspector. The inspection of your septic system showed that your system has failed under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Cesspools overflowing You are directed to hire a licensed Town of Barnstable septic system installer to submit a sketch diagram of a proposed system to the Town of Barnstable Health Division Office (Town Hall, 367 Main Street, Hyannis) that will bring the septic system into compliance with 310 CMR 15.00, The State Environmental Code, Title 5 within (14) days of receipt of this notice. You are also directed to bring the septic system into compliance within thirty (30) days of receipt of this order letter. You are further directed to maintain the system by hiring a licensed septage hauler to pump the septic system to prevent discharge of sewage or effluent into the buildings, onto the surface of the ground, or in to surface waters. Any person aggrieved by any order issued by the local approval authority may appeal to any court of competent jurisdiction as provided for by the laws of the Commonwealth. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., C.H.O. ASSESSORS MAP NO: Agent of the Board of Health PARCEL N0: [Installer letter] TO: V/ 1 � � �` (Date) Hyx AIA ORDER TO COMPLY WITH 310 CMR 15.00, THE STATE ENVIRONMENTAL CODE, TITLE 5. The septic system owned by you located at Vi�VP as inspected on y Massachusetts licensed septic inspector. The inspection of your septic system showed that your system has failed under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: 0 L v` b r You are directed to hire a licensed Town of Barnstable septic system installer to submit a sketch diagram of a proposed system to the Town of Barnstable Health Division Office (Town Hall, 367 main Street, Hyannis) that will bring the septic system into compliance with 310 CMR 15.00, The State Environmental Code, Title 5 within (14) fourteen days of receipt of this notice. You are also directed to bring the septic system into compliance within thirty (30) days of receipt of this order letter. You are further directed to maintain the system by hiring a licensed septage hauler to pump the septic system to prevent discharge of sewage or effluent into the buildings, onto the surface of the ground, or in to surface waters. Any person aggrieved by any order issued by the local approval authority may appeal to any court of competent jurisdiction as provided for by the laws of the Commonwealth. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.-S., C.H.O. Agent of the Board of Health Town of Barnstable i ASSESSORSIWA,Na PARCELN DATE: 6/19'/95 PROPERTY ADDRESS: 128 Chestnut Road Hyannis,Mass . W- 02601 ,I ------------------------ t On the above date, I Inspected the septic system at the above address. `ii This system consists of the following: A. Three block cesspools . Based on my inspection, I certify the following conditions: A. This is not a title five septic system. B. .System is operating at full capacity. C. The sewage -system is in failure. I SIG NATURE:__r Name: J•P•Macomber Jr. ' Inc. ' Company: J.P.Macomber & Son I------------------- i Address; Box 66 Centerville,Mass__0263_2_ Phone: 508-775-3338 THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY jc� SUN 2 f/Vf® i LCOMBER & SON, INC.spools-LeachfIelds ed & Installed wer Connections enterville, MA 02632-006638 775-6412 i I 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM , Address of property Q_'b C+-AEc3-TtJv i (�„yp �,-Iwo(xa S Owner ' s name Arnold Wininger Date of Inspection �I�NC l51 l `J PART A CHECKLIST Check if the following have been done: Pumping information was requested of the owner, occupant, and Board of Health. -----t None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. As built plans have been obtained and examin ed. Note if they are not available with N/A. The facility .or dwelling was inspected for signs of sewage back-up. L/ The site was inspected for signs of breakout. All system components, excluding the SAS, have been located on the site . The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the SAS on the site has been determined based on existing information or approximated by non-intrusive methods. r The- facility owner (and occupants, if different from owner) were provided with information on. the proper maintenance of SSDS. 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION FLOW CONDITIONS If residential number of. bedrooms L number of current residents .lamgarbage grinder, yes or no laundry connected to system, yes or no Mo seasonal use, yes or no If nonresidential , calculated flow: Water meter readings, if available: /ki2(L%�T7���-L '4 Z Ca 3/3/D'�S--rc> (,l6�/9s Last date of occupancy GENERAL INFORMATION Pumping records and source of information: �"`�,vP1L EP• c2T£�� l�vtiti� Lr� 3 C ,2S AGC) r System pumped as part of inspection, yes or no if yes, volume pumped Reason for pumping: Type of system Septic tank/distribution box/soil absorption system Y _ Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) Other (explain) Approximate age of all components. Date installed, if known. Source of information: lc:c 35 �c_.i� Less►�c�� 3 5--rO 2O� -5 Sewage odors detected when arrivingat the site, yes or no a 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued ,SEPTIC TANK: (locate on site plan) depth below grade: material of construction: concrete metal FRP other(explain) dimensions: sludge depth distance from top of sludge to bottom of outlet tee or baffle scum thickness distance from top of scum to top of outlet tee or baffle distance from bottom of scum to bottom of outlet tee or baffle. Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, recommendations for repairs, etc. ) DISTRIBUTION BOX: (locate on site plan) depth of liquid level above outlet invert Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, recommendation for repairs, etc. ) PUMP CHAMBER: (locate on site plan) pumps in working order, yes or no Comments: (note condition of pump chamber, condition of pumps and appurtenances, recommendations for maintenance or repairs,etc. ) 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SOIL ABSORPTION SYSTEM (SAS) : (locate on site plan, if possible; excavation not re approximated by non-intrusive methods) gaited, but may be If not determined to be present, explain: Type leaching pits and number leaching chambers and number leaching galleries and number leaching trenches, number, length leaching fields, number, dimensions overflow cesspool , number Comments: (note condition of soil, signs of hydraulic failure, level of pondirig, condition of vegetation, recommendations for maintenance or repairs,etc. ) CESSPOOLS (locate on site plan) : l 2 VF 3 number and configuration -:i Le s; n)1�cG �... depth-top of liquid to inlet invert x x depth of solids layer x I;b depth of scum layer dimensions of cesspool materials of construction Ga�roG g L indication of groundwater Co,vc 6;,cc_iG inflow (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level 'of ponding, condition off vegetation, recommendations for maintenance or r )�2 E �(U l C,.U� — " pasty PRIVY: i�2 VAY L F= am( 1� 22U .��cr�S� C-E5S (locate on site plan) materials of construction dimensions depth of solids Comments: (note fond fveget.of soil, signs of hydraulic failure, level of . ponding, ` condition of vegetation, recommendations for maintenance or repairs,etc. ) a 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100 ' k.) ?mil 011,.,E(Z-T L-AN C) S J � DEPTH TO GROUNDWATER 2Q� depth to groundwater method of determination or approximation: US f5 Gx0�D �L � + �A Z0VL� G C f ��4 f 4 wd 12 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C FAILURE CRITERIA Indicate yes, no, or not determined (Y, N, or ND) . Describe basis of determination in all instances. If "not determined" , explain why not) Backup of sewage into facility? — --- OV ciZ C 0\1e42-5 _ Discharge or pond'ing of effluent to the surface of the ground or surface waters? Static liquid level in the distribution box above outlet invert? Ytl--5 Liquid depth in cesspool <6" below invert or available volume< 1/2 day flow? "------ - M Required pumping 4 times or more in the last year? "• number of times pumped talc Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank failure imminent? t )1 ' ( Is any portion of the SAS, cesspool or privy: O below the high groundwater elevation? within 50 feet of a surface water? within . 100 feet of a surface water supply or tributary to a surface water supply? within a Zone I of a public well? within 50 feet of a bordering vegetated wetland or salt marsh (cesspools and privies only, not the SAS) ? within 50 feet of a private water supply P pp y well? p less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis? If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile grganic compounds, ammonia nitrogen and nitrate nitrogen. u TOWN OF _—.—.----------- BOARD OF HEALTH—------ ----------=_.; �. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D - CERTIFICATIONI -TYPE OR PRINT CLEARLY- PROPERTY INSPECTED STREET ADDRESS IZ� U7 QQAQ ASSESSORS MAP, BLOCK AND PARCEL 4 309-42 OWNER' s NAME Arnold Wininger PART D - CERTIFICATION NAME OF INSPECTOR COMPANY NAME L)4U&u4.-TArV t To j�MA-C-C> JOB COMPANY ADDRESS Box 66 Centerville,Mass . Street Town or City State ZIP COMPANY TELEPHONE_( 508 ) 775 - 3338 FAX ( 790 ) 15 -78 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposa`1 system at this address and that the information reported is true , accurate, and complete as of the time of inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one . + t a System PASSED The inspection which I have cond c--t'ed has: noa,!found any information which indicates that the system a.1'1, "to".ade;quately protect public health or the environment as defined in'-,TO``CMR 15 . 303 . Any failure criteria not evaluated are as stated in'' t`tIe FAILURE CRITERIA section of this form. System FAILED* The inspection which. I have conducted has found that the system fails to protect the public health and the environment in accordance with Title 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . S ® '\Inspector Signature Date One copy of this certification must be provided to the OWNER, the BUYER ( where applicable ) and the BOARD OF HEALTH. * If the inspection FAILED, the owner or operator shall upgrade the system within one year of the date of the inspection, unless allowed or required otherwise as provided in 310 CMR 15 . 305 . partd.doc SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM PART D CERTIFICATION Inspector : Peter Sullivan PE Location :128 Chestnut Road, Hyannis Date :June 15,1995 j Certification Statement I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true, accurate and complete as of the time of inspection. The inspection was performed and any recommendations regarding i upgrade, maintenance and repair are consistent with my training and experience in the proper function and maintenance of on-site sewage disposal systems. I have determined that the system fails to protect public health and the environment p p t as defined in 310 CMR 15.303 . The basis for this determination is provided in the FAILURE CRITERIA section of this form. ruly yours eter Sullivan PE �� � I �- _--•'` f � '' Distribution: " Original to system owner •" .:r;- ,s" Buyer Board of Heath