HomeMy WebLinkAbout0060 OLANDER DRIVE - Health 60 Olander Drive
270-247 Hyannis
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a
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DATE : 12115103.
PROPERTY ADDRESS : .60 0.gande2 Dliive
-----------
-- 0.�601-----------------
On the above date, I inspected the septic system—at the a�b>aoove a'aa=ress,
Tms system consists of the loll.owing:
1, 1-1500 gai eon zept.ic tank.
j 2. 1-Dibt2-i9ut-ion &ox, JA� o 2�e�
3. 2-Rowz oZ 3 100 cuPtec.6. 28'X11 'X6" TOWN OFc ABLE
Baseo on my inspection, I certily the following condit4n•sl HEALTH DEPT.
4. 7hiz i,3 a t.itee yeive zept.i.c zyztem. (95 Code.)
7. The zept.ic zyztem .iz .in paope2 wo zk.ing oadea
at the paezent.t ime.
6. The two zow,3 o/ cu Qtee 100'z ate paeaent.ey d zy..
ztone a zound them .iz ciean & day.
SIGNATUR ,
Name ! P_ _Macomber_ Jr ._ _-- -
rompanY I4��Qh .P.,_ M�S4mtz� �_d_ Son, Inc . MAP
� voress : @Q,� _6 - _ PARCEL.
----------- LOT
- - -Qe-nj r YLLLp._ Ja - _QZ632-0066
?^one 508 . 715_ ) ) )8 _- - - - ---
ThIS CERTIFICATION OOES NOT CONSTITUTE A GUARANTY OR WARRANTY
JOSEPH P. MACOMBER & SON, INC.
Tinks•Cesspools-l.eschIIeIds
Pumped & instilled
Town Sewer Connections
P 0 Box 66 Centerville, MA 02632-0066
775-3338 775-6412
1
f
•\ COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE`OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
TITLE 5
OFFICIAL INSPECTION FORM-NOT:FOR.VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM.FORM
PART A
CERTIFICATION
Property Address:6.0 O eande z DA-iye
Kyanniz, (Nazis.
Owner's Name: C-ei f l o zd Rodd
Owner's Address:166 Academu S.t, #K3
l oughkee,?eie N. ?J. Z60I
Date of Inspection: 1 Z/1 5/0 3
Name of Inspector: (please print) o 3e12h l. (Nacom ea aa.
Company Name: �2. P.Aaco:mie2 (? Son Inc.
Mailing Address: Pox 66
Cen eav c e, E7 . 02632
Telephone Number: 5 0 8-7 7 5=3 3 3 8
CERTIFICATION STATEMENT
I 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 was performed based on my
training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP
approved system inspector pursuant to Section.15:340 of:Title 5(310 C.MR 15 000). The system:
,Passes
Conditional]),Passes
Needs Further Evaluation by the Local Approving Authority
Fails
Inspector's Signature: Dater
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 is.a.shared system or has.a design flow of 10,000
P g
gpd or greater,,the inspector and the system owner.shall'submit the report to the appropriate regional office of the
DEP.The original should be sent.to the system owner and copies sent to the buyer,if applicable,and the approving.
authority.
Notes and Comments
****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.
Title 5 Inspection Form 6/15/2000 page 1
Page 2 of 11.
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A '
CERTIFICATION (continued)
Property Address: 60 O eande2 172.ive
yann cs,
Owner: Ce-i?P_1ozd Rodd
Date of Inspection: 12115/0 3
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
r
A. System Passes:
I
d2b 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:
Zh.n AJZQJ-in 6J16 gm iA i;�QaQ,non mnl7k ng nnrlvn rli i&q-
/z2e�se"n.t
B. System Conditionally Passes:
1A 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.
Answer yes,no or not determined(Y,N,ND)in the 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.
ND explain:
AM 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
obstruction is removed
distribution box is leveled or replaced
ND explain:
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
obstruction is removed
ND explain:
2
Page 3 of I 1
OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION.FORM
PART A
CERTI.FICATION(continued)
Property Address:60 0.QanrLea [hive
yann7z, Nazz.
Owner:. Cti�load Rodd
Date of Inspection:. 12115103
C. Further Evaluation is Required by the Board of Health:
tII Conditions.exist which require further:evaluation.by.the Board of Healthdn 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:
d?b 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
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:
'(26— 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.
VQ The system has a septic tank and SAS and the�SAS is.within a Zone I of a public water supply.
A)0 The system has a septic tank and.SAS and the SAS is within:50 feet of a private water supply well.
,( 1 The system has a septic tank and SAS and the-SAS is less than 100 feet.but 5 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 coliform
bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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:
3
Page 4 of 11
OFFICIAL INSPECTION FORM--NOT FOR.VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address:6 0 O eaade2 D t ive
yaaai,3, a.6,3.
Owner: Cii�,Zoad Rodd
Date of Inspection: 12115103
D. System Failure.Criteria applicable to all systems:.
You must.indicate"yes"or"no"to.each:of the.followingfor all inspections:
Yes NVDischarge:or
ackup of sewage into facility or system component due tto overloaded,or clogged SAS.or cesspool
ponding.of eifluent.to the surface of:the:.ground or.surface:waters due to an:overloaded or
ogged SAS or cesspool
Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or
cesspool —L-,tD® -4tvA-C
_ tquid dep&inseaspuais less than 6"below invert or available.,volume is less than'h.day flow
Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number
of times pumped .
_ y portion of the SAS,cesspool or privy is below high ground water elevation.
_ :!(/ty portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface
water supply.
rtion of a cesspool or:privy is within a'Zone l of a:.public well..
y 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.5.0...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 coliform bacteria and volatile organic compounds
indicates that the well is free from pollution from:that:facility 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.]
dL�D (Yes/No)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•
You must indicate either"yes"or"no"to.each of the following:
(The following criteria apply to large systems in.addition to the criteria above)
yes no�
the system is within 400 feet of a surface drinking water supply
e system is within 206 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. '
4
Page5of11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE:SEWAGE RISPOSAL-SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 60 O.C¢nd.e? D z ive
yann.tz,
Owner:CX-ic� o2 i o dd
Date of Inspection: 12115103
Check if the_following have been done.You must indicate"yes"or"no°"as to each..of the;foilowing:
Yes No
Ll::
P mping information was provided by the owner,occupant,or Board of Health
Were any of the system components pumped out in the previous two weeks?
_ H s 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,-emeluding 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,depthof 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:
Yes/no
— _ Existing information.For example,a plan at the Board ofHealth.
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(3)(b)J
5
Page 6 of I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION lot
Property Address: 60 Uande2 D z ive
fluann,L3.
OwperC�,i,e ennr/ /?ndd
Datc of Inspcctlon: Z 4/L 5-/0 3
FLOW CONDITIONS ,...
RESIDENTLAL o
Numbcr o(bcdrooms(design):� Number of bedrooms(actual): �/
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x it of bedrooms):
Number of current residents: &
Does residence have a garbage grinder(yes or no):
Is laundry on a separate sewage systevyes or no):70 (if yes separate Inspection.requ'ved)
Laundry system inspected (yes or no);
Scuonal use: (yes or no):
Water meter readings, if av ilable (last 2 years usage(gpd)): 2002=99, 750 ga-e-eon3=273. 29 G%D
Sump pump(yes or no); 10 = gateon s=232. 06 qPD
Last date of occupancy: rdakr
COMM ERCLAULNDUSTRIAL
Type of esublisbment:
Design now(based on 310 CMR 15.203): d
Buis of design now(scats/persons/sgR,etc.): AI
Grease tnp present (yes or no):41—U
Industrial waste holding tank present (yes or no): '
Non•saniury waste discharged to the Title 5 syst n) (yes or no):AU o )
Water meter rcadirsgs, i(available: Ali
Last date of occupancy/use:
OTHER(describe): ,xz&
GENERAL INFORMATION
Pumping Records
Source of information: wa,1 w&A'
Was system pumped as pan of the inspection (yes or no):•_
If yes, volume pumped: `1 gallons •• How was quantity pumped°determined? .0.4
Rcuon for pumping: )A
T OF SYSTEM
jrSeptic unYti distribution box, soil absorption system
Single cesspool
Overflow cesspool
Privy
1S Sharcd system (yes or no)(if yes, attach previous inspection records, if any)
6 Innovative/Alternative technology, Attach a copy of the current operation and maintenance contract (to be
VLned 6'om system owner)
ight tank AA6 Atucb a copy of the DEP approval
090t.her(describe): Nlt
App roximate age of all c=ponent , date in WpwrtInd source of inf ation'
Were sewage odors detected when arriving at the site(yes or no): •(�
6
Page 7 of I I
OF'FI.OI:AL INSPIE ` 'IC�T� FORM. NOT FOR VOLUNTARY ASSESSMENTS
SUSS;V`�FACE SEWAGE]DISPOSAL SYSTEM INSPECTION FORM
PART C '-
SYSTEM INFORMATION(continued)
Property A.ddress:6 D�U-eande2� 1-)A _p
Qwuc.r:
Date of Ins:pc'cflow 721751.03
BUILDING SEWER(Locate on site plain)
Depth bclgw g7a4c; /
Ma<tcnals o,�con.strtiction:;,,,,,cast Iron T„44 PVC�o,therr(cxplatn):
Di.Stincc&0m privity watFr supply wati or suction.lips✓D �
Comments(cn condition of joints,venting,ovidctee of Feaitage,ete.):
ie vented
.thzough .th�e/ oo� ven.tz.
SEPTIC TANK: p!(locate on site plari) �S'' ®�
DV.th below grade:.,,_;,_
M.a.tcritiiofeonstruction: concrete,,rnetalfrberglasars'',,,polyethylene.
��othcK:cxplain) ,
If tutJc is metal list.arc; is age conClrme.4 by atsr3lfiot�te of Compl.ance(yes or noj.d (attach a copy of
certiftcste) ,9 ,� 7 J
Oimcnsionr ¢f^� `1
Slud.gcdcpth: r
Distance from top o�ludge to botiorn O outlet tee or baffle:
Scum thickness:
Distance from top or scum to top of outlet tee or baffle:
Distance i in bottom of stun to bottom of outlet tee or baffle:_Z
H.ow w.cre dimensions determined:
Co-mrncnes.(on.pit rtping re.cortuncr,da<taorss, :,:Ict and butte tee or'ba.Pfle.condition, structural integrity, liquid levels
,Ls relitsdas outlet-in�rert,cvi:dcnee Qf.lcakage,ete;):
a m , ,the z e .t.i'c.
ate in e tank iz 6 i-'a u , . .
ev-idence , V ieakage?-Liquid ieupg-e_ a.t� ,h j Q�t •et' -inve2t iz 51„
GREASE TRAPfL41ocate on site plank
Depth b.clow grader
Material of¢onswation: concrete / ,mt tal,p ,fiber glass.{�palycthylenc�othcr
D:tmcnsians; .
Scum thic!;;Cs:s:
Distance lrom top of sCIUrn to top of outlet fee or baffle':"'.
Disunce from bottom or scum to bottom or outlet tee or baffle: .�
Date or Last pum,piog:
Comments(on pumping recommendations.,.inlet and outlet tee.or baffle condition,savcmnl Integrity, liquid levels
as related to autkt invert,evidence oricakage,etc.):
aea�e .t2a� .ie no.t '�ae�sen�_
Page 8.of 1 I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSME
NTS
9 SU'RF A►CE SEWAGE DISPOSA
L SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property.Address:47 Qt2hk,
977'77nTe. lee
Owner 12LAnna.,k fakk .
Date of Inspection:/—L/2 7 y
TIGHT or HOLDING'TANK (tank must be pumped at time of inspection)(locate on site plan)
Depth below grade: IN
Material of construction:n4concreteAld—metal,0�0 fiberglass,c?,!I._polyethyleneother(explain):
Dimensions.
Capacity: gallons
Design Flow: /,(f gallons/day
Alarm present(yes or no):
Alarm level: 4)A Alarm in working order(yes or no):
Date of last pumping:
Comments(condition of alarm and float switches,etc.):
=r- - h o2yrh. 6,ed 9e ,4 6A,aLliao��e¢ar�
DISTRIBUTION BOX: Z(if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert:
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.):
iplu.t.ion &ox haz .two ia.te2aiz. No ev-idence o/ Aso eidz
caa/zu oven. No evi ence o ea age -cn O 02 ,
PUMP CHAMBER,(locate on site plan)
Pump's in working order(yes or.no): 41A
Alarms in working order(yes or no):�.X
Comments(note condition of pump chamber,condition of pumps and appurtenances, etc.):
uma r.h LznPP_a ib n0t R11ebent
8
I
Page 9 of 11
OFFICIAL INSPECTION FORM—"NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued),.
Property Address: 60 Qiande2 Dlt-ive
yanniz, Nazz.
Owner: C.ULO Rodd
Date of Inspection: 7 2/15/0 3
SOIL ABSORPTION SYSTEM(SAS): {locate on site plan,excavation not required)
6 1'00 cui ec aechaageni 7wo 2owg5 o-1 th�cee
If SAS not located explain why:
Lo cr ed See Page 10
Type
,eP leaching pits,number: 0�- r0�
is
leaching chambers,number: &4
WD leaching galleries,number:
leaching trenches,number; Qth:
leaching fields,number,dimensions:
overflow cesspool,number: ��----
A-FoF innovative/alternative system Type/name of technology:71116
Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,
etc.):
Loamy Sand .to medium sand No zi1cnh o hyd2 aon lag.
So.iiz aae dzy. Syz.tem .in da.iveway
CESSPOOLsikc►(cesspool must be pumped as part of inspection)(locate on site plan)
Number and configuration: _
Depth—top of liquid to inlet invert:AW
Depth of solids layer:
Depth of scum layer:
Dimensions of cesspool:
Materials of construction:
Indication of groundwater inflow(yes or no):
Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
PRIVY2k4locate 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.):
P,zivy .i z not zezen.t
9
Page 10 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY.ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 60 Q-Prz n d a a�>;o
H14 rn n n_A a- A A
Owner: ( Oi PGonr/ /?nr/r/
Date of Inspection: 12 LCL3
SKETCH OF SEWAGE•DISPOSAL SYSTEM
Provide a sketch 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.
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TOWN OF Barnstable BOARD OF HEALTH
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSUCTION FORM - PART D •- CERTIFICATION I
..•-....T.•,•..: -T.11'^�.T.T..�TII•R:1T1 T•111.T.Ti1STr11'.r-'.'I r11T1'Y iTT1TrR�•'C RT.RIRtRtCTRT'� i'Rf1ItTRRITiiTTT7'T`fR.•,�.I'.'r• A
-TYPE OR PRINT CLEARLY-
i
PROPERTYGINSPECTED
STREET ADDRESS 60 Oiandea DILive fiyann.iz, Nazz.
ASSESSORS MAP , BLOCK AND PARCEL # 270-247
OWNER' s NAME C-ei)e�oltd -Rodd
PART D - CERTIFICATION
NAME OF INSPECTOR Joseph P. Macomber Jr
COMPANY NAME Joseph P. Macomber &-ton Inc
COMPANY ADDRESS Box 66 Centerville Mass 02632
Street Town or City Stat• 11P
COMPANY TELEPHONE ( 508 ) 775-3338 FAX ( 508 ) 790-1.578
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system nt
AlQkkthis address and that the information reported is true , accurate , and
Ar in
omplete 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 :
��Systevi PASSED
The inspection which I have conducted has not found any information
which indicates that the system fails to adequately protect public
health or Lhe environment as defined in 310 CMR 16 . 303 , Any failure
criteria not evaluated are as stated in the FAILURE CRITERIA section of
this form ,
System FAILED* \
The inspection which I have con ' rcted has found that the system fails to
Protect the 1"ublic health and the environment in accordance with Title
5 , 310 CMR 15 , 303 , and as specifically noted on PART C - FAILURE
CRITERIA of this inspection, form.,
Inspector Signature 101
a II•ate
614-
*One copy of this cification must be provided to the OWNER , the BUYER
( where applicable ) and the DOARD OF HEALTH.
* If the inspection FAILED , the owner or operator ehalI upgrade • the eye tem
within one year of the date of the inspection , unless allowed or required
otherwise as provided in 3.10 CHR 16 - 305 ,
partd . doc
r _
j TOWN OF BARNSTABLE
LOC:ATTO&V' (S:^ ®1"asnF k_ SEWAGE # l S -Y 7l
VILLAGE ygd4 �.s o5 ASSESSOR'S MAP &LOT_ ,),7a.d, 7
-ISTALLER'S NAME&PHONE NO. IU&�dm GF-d_ `7:ZS--3 57re 7
SEPTIC TANK CAPACITY
VLEACHING FACILITY: (type)a go.-gi o a (size) Lck`ire ;66
NO.OF BEDROOMS _
BUILDER OR OWNER
PERMTTDATE: - COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
g 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 farility) Feet
Furnished by
O,
► n
s THE COMMONWEALTH MA A H Entered in computer:
OF SS C USETTS Yes
`PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
2ppliration for Zi.5po$at *potem Cowarurtion Permit
Application fo'r a Permit to Construct( )Repair( )UpgradeXX )Abandon( ) DOComplete System ❑Individual Components
Location Address or Lot No. 0 Olancler Drive Owner's Name,Address and Tel.No. 60 Academy ST
Hyannis,Mass. 02601 Poughkeepsie New York
Assessor's Map/Parcel 12601 0"
Installer's Name,Address,and Tel.No. J.P.Macomber & Designer's Name,Address and Tel.No. 5 0 8—7 7 5—3 3 3 8
Son Inc. Box 66 Centerville,NIass. J.P.Macomber & Son Inc.
02632 508-775-3338 Box 66 Centerville,Mass. 02632
Type of Building:
Dwelling XXNo.of Bedrooms 4 12, Lot Size sq.ft. Garbage GrinderlRO )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 3 3 0 gallons per day. Calculated daily flow 3 x 1 10 gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank 1 500 Type of S.A.S.6-1 000 cultec
Description of Soil Sand & Gravel
Nature of Repairs or Alterations(Answer when applicable) 1 -1 500 gallon septic 1 -Distribution
box 6 100 cultec rechargers packed in stone with 6 ' between
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 iss d by this B 'ard�Hea th.
Signed Date 7 12 2 9 8
Application Approved by - Date
Application Disapproved or the following reasons
Permit No. 7,ef- -517!Z Date Issued r7' Z -9
N. r v Fee $ 50 .00
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Yes
Application.-for Migonl pgtem Con.5truction Permit
Application',for a Permit to Construct( )Repair( )Upgrade(X )Abandon( ) complete System ❑Individual Components
Location Address or Lot No. O an er Drive ". Owner's Name,Address and Tel.No. 60 Academy OT
Hyannis,Mass. 02601 Poughkeepsie New York
Assessor's Map/Parcel � 12601
Installer's Name,Address,and Tel.No. J.P.Macomber & Designer's Name,Address and Tel.No. 5 0 8—7 7 5—3 3 3 8
Son Inc. Box 66 Centerv3(11L Mass. J.P.Macomber & Son Inc.
02632 508-775-333P ( Box 66 Centerville,Mass. 02632
Type of Building: 4`f
Dwelling XXNo.of Bedrooms _ ) of Size f G� sq.ft. Garbage Grinder NO )r —
Other Type of Building " '. > No. of PeJrsons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 330 gallons per day. Calculated daily flow 3x1 1 0 gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank 1 500 Type-of,S.A.S.6-1000 cultec
Description of Soil Sand & Gravel
Nature of Repairs or Alterations(Answer when applicable) - 1=1'500 gallon septic 1 —Didtribution
box 6 100 cultec rechar ers packed in stone with 6 ' between.
Date last inspected:
Agreement: k
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 iss d by this B and Health.
Signed • Date 7/2 2/9 8
Application Approved by Date 2
Application Disapproved or the followinIMg reasons
Permit No. 9 — Date Issued
9
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( )Repaired( )UpgradecKXX)
Abandoned( ))by J.P.Macomber & Son Inc.
at 60 Olander Drive Hyannis,Mass. has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. '9 9-y W dated T— Z 3-9 Pr .
Installer J.P.Macomber & Son Inc. Designer J.P.Macomber & Son Inc.
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
Date Inspector
t
No. /9 Fee $ 50 .00
THE COMMONWEALTH OF MASSACHUSETTS
} PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
lwigogal *proem Construction Permit
Permission is hereby granted to Construct( )Repair( )UpgradeXXXAbandon( )
System located at 60 slander Drive H)4anni s ass
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title's=,and the following local provisions or special conditions.
Provided: Construction must be completed within three years of the date of this?rmjt.
Date: 7 , �,��1 Approved bye �� v2
10/9/97
NOTICE: This Form Is To Be Used For the Repair Of Failed
Septic Systems Only.
CERTIFICATION OF SKETCH AND APPLICATION FOR A
DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT
ENGINEERED PLANS)
I,Joseph. P Macomber Jr_ , hereby certify that the application for disposal works
construction permit signed by me dated 7/22/98 , concerning the
property located at 60 Olander Drive Hyanni stmass meets all of the
following criteria:
• There are no wetlands located within 100 feet of the proposed leaching facility
• There are no private wells within 150 feet of the proposed septic system
• There is no increase in flow and/or change in use proposed
• There are no variances requested or needed.
• If the proposed leaching facility will be located within 250 feet of any wetlands, the bottom of the
proposed leaching facility will=be located less than fourteen (14) feet above the maximum adjusted
groundwater table elevation.
Please complete the following:
.ram
A)Top of Ground Elevation (according to the Engineering Division G.I.S. map) � J
B)Observed Groundwater Table Elevation (according to Health Division well map)
1 NED : DATE: C
SG
LICE ' SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER
(Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan,
this plan should be submitted).
q:health folder:cert
F�
i
TOWN OF BARNSTABLE
LOCATION 6,N 1....,r,c o SEWAGE # 7�
VILLAGE XTv,_ 4Xa' ASSESSOR'S MAP & LOT 7
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
I
LEACHING FACILITY: (type),2 eo.hh d a (size)s'u.`4:£
NO.OF BEDROOMS
BUILDER OR OWNER
PERMITDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and LeachingFacility
ty (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
60 Oianden Da ive
11yann.iz, 17a,6,3.
O2601
1- 1500 gaeion zep ,ic tank.
2=,,1-Diztbz igut-ion Sox.
3-6- 100 cuitec 2echa2ye2-s.
l he zepz is z y-stem .i,6 .in /?2o/?e2
Wo2k.ing o zde2 at the /zne,3ent time.
— .� �
P
(�' a
'�' $
-- - - �
�`��� !�
`��
� ` h���
�/ e�� ! �.
j ��.i
i ��
TOWN OF BARNSTABLE
LOCATION_L6(j ffic ndp 0- bruit SEWAGE # 12
VILLAGEti��� ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO.S�
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) _ ',�' (size)
_J7"`��
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
.VARIANCE GRANTED: Yes No
q16
r
Fss.....30 Y...... ..
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
TOWN OF BARNSTABLE
Appliratiun for Di-sposal Works Tunutrnrtion ramit
Application, is hereby- made-for.•a-Permit to Construct ( ) or Repair �X) an Individual Sewage Disposal
System at:
60 Olander Drive Centerville
.
................__ ........- ................................................. ......... .....------•--.........----•--..._..........-----...............--------•--
Location Address or Lot No.
Cliff'Rodd'---"
......................-.......................................................................... ------------------------------------------------------------------------------------------------•-
Owner Address
W J.P.Macomber Jr .
Installer Address
Type of Buildin Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms......................_.....................Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building No. of persons____________________________ Showers — Cafeteria
P4 Other fixtures __________________________________
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter_______________ Depth................
x Disposal Trench—No_____________________ Width.................... Total Length.........._......... Total leaching area....................sq. ft.
Seepage Pit No..................... Diameter____________________ Depth below inlet____________________ Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by.......................................................................... Date......................................
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water_____________________-_.
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -
x
0 Description of Soil................ ------• :;--- --------------------------------------------------------------------------------•-••------_-----
x Sand $c Gra�re
U -----------------------------------•-...------------•------------------------------------------------•--•---------------------------•----------------------...--------------••----•••-------------------
W ------------------------------------------------------------------------------------------------------------------------------------- ------------
-----------------
•-----------------------------------
VNature of Repairs or Alterations—Answer wh licabi� __________
1-�1'�J nalon Ieach pig- ----------------------------------------------
-------------------------------------------•---------------------------------------------------.....--------------------------------------------------.................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Comphilrice hasibeo issued by the f health.
Signed ----f................................
Dace
Application Approved B ¢. . �- --� --- ----------------- '
PP pP Y U :. `"`ti-r..-,. ... - 1 Dare
Application Disapproved for the following reasons: --=- -----------------------------------------------------------------------------------...........---------------------------
------------------------------------------------------ ................................................... ............................................ ----------------------..--..-------- ----------------------------------------
Dace
Permit No. ..........�110-V-�.7-�....................... Issued .................
----------------------------......------
Dace
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH I
TOWN OF BARNSTABLE
Appliration for Disposal Works Tonotrnrtion thrmit +
Application is hereby made for a Permit to Construct ( ) or Repair (KX) an Individual Sewage Disposal
System at: i
r0 Olander Dri' e Center i Ile (�1 w(-k l ;i ►1
................__...._ -............ ....._..... --•----•..............•-- --•--...........-• w •-...................................................
Cliff Rod d Location-Address or Lot No.
- ----------••-------.. ...............• ---...-------••---•---••---•••............-----•• ..........--......................................................................................
Owner —Address
w J.P.Macomber Jr.
Installer Address
d Type of Building Size Lot............................Sq. feet
Dwelling X No. of Bedrooms..............2...........................Expansion Attic ( ) Garbage Grinder ( )
a`k Other—Type of Building No. of persons............................ Showers
yP g ---------------------------- P ( ) — Cafeteria ( )
d Other fixtures ......................................... r
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. ,
WSeptic Tank—Liquid capacity............gallons Length................Width................ Diameter---............. Depth................
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by.......................................................................... Date......................................-
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water................. __._.
ri, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...................
04 ----•--••---------------•-------•-...............____._____.___....._______..............._......•....................................................-n.....
ODescription of Soil........................................................................................................................................................................
x Sand & Gra�-el
v .-------------------------------------------------•--•------•--------. ----------.......---------....------------.......--------------------•-------•----........-----------•-•-••---------•--•----'
W
UNature of Repairs or Alterations—Answer when applicable................................................................................................
----------------------------•-------------------•----------•---------•--••.1-1000 :allon_ leach_.pj:........------------------------------------................
Agreement: ,
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with f
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compliance has been issued by the
�board
%of health. 41
Signed 14,0-, .0���,�!.r�rJ O1.fwe.c.. l,� -n/ _
----------------
Application Approved By .. v . _�_�^ -�' .....------...........
Date
Application Disapproved for the following reasons: ................................................... --................................................................... r°
...........................................--. -----'---.............----'-'----............---......------------------....--- "----"--------'--------'--------------...---.........-------"------.. "--'--".I......"---'--'----''''"--
Dnt
Permit No. ......... /..-...r.7 Issued -------------- r'
Dare J
l
THE COMMONWEALTH OF MASSACHUSE17S
f
BOARD OF HEALTH
TOWN OF BARNSTABLE
Q'Ie rtifiratP of (gomplianre
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( XX)
by J.P.Macomber Jr ,
................... . .................................... ' ' .................'....'----'-'-'...........-""....................'-----'----"-------------'-'---'......--.....................
Ins�aller
60 Olander Dri,Je Cebterville .
at ........................................ ."--"""'--'-'--"-"'-.......-............................ ------........----------'..."-----"'......'-""...................................................................................
has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in
the application for Disposal Works Construction Permit No. .... �5.-.., 7�/............. datedl................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE........1.. :--.. :-...` ------ ---------------------------'---""....'--'" Inspector i... �„ ... �..�-...,���.
THE COMMONWEALTH OF MASSACHUSETTS
' BOARD OF HEALTH
TOWN OF BARNSTABLE
. 7� FEE..::!?...
Disposal Works Tonotrudion "amit
Permission is hereby granted...._J.P:Ma e omb e r...Jr.
.......................
to Construct ( ) or RepairX(KX) an Individual Sewage Disposal System
at No..(g...0jander__Drive Center-Ille
. . ...........•--...._......----......... ...._..
1 Street
as shown on the application for Disposal Works Construction Permit No. .��,?r� Dated..........................................
c ............. � ------------------.--------------------------------
. Boar Health
DATE............................_.......................................•-•-..---
j FORM 36508 HOBBS&WARREN.INC..PUBLISHERS