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HomeMy WebLinkAbout0077 WOODLAND AVENUE - Health 77 Woodland Avenue Hyannis A = 269 060 i� k i Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments :f ,M 77 Woodland Ave Property Address ,^+ Juan Marichal Owner Owner's Name M. information is 4 required for every Hyannis Ma 02601 3/6/18 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. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not Michael DiBuono use the return Name of Inspector key. DiBuono Sewer and Drain r� Company Name 35 Content Ln Company Address r Cotu it MA 02635 City/Town State Zip Code 508-364-9587 SI 13522 Telephone Number License Number B. Certification 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 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluati pproving Authority /r 3/6/18 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 is a shared system or 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 should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 77 Woodland Ave Property Address Juan Marichal Owner Owner's Name information is required for every Hyannis Ma 02601 3/6/18 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: System contains a 1500 gallon septic tank. As well as a concrete distribution box and 2 500 Gallon chambers in stone 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 77 Woodland Ave Property Address Juan Marichal Owner Owner's Name information is required for every Hyannis Ma 02601 3/6/18 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): F1, 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): 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M ,• 77 Woodland Ave Property Address Juan Marichal Owner Owner's Name information is required for every Hyannis Ma 02601 3/6/18 page. Cityfrown 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 r n in f effluent sc e o o d o e uent to the surface of the round or surface waters 9 p 9 9 ❑ ® 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 1/2 day flow t5ins•3/13 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 �,M 0 77 Woodland Ave Property Address Juan Marichal Owner Owner's Name information is required for every Hyannis Ma 02601 3/6/18 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 77 Woodland Ave Property Address Juan Marichal Owner Owner's Name information is required for every Hyannis Ma 02601 3/6/18 page. City/Town 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 CM 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•3/13 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 77 Woodland Ave Property Address Juan Marichal Owner Owner's Name information is required for every Hyannis Ma 02601 3/6/18 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: Vacant 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 Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage d NA 9 ( Y 9 (gP ))� Detail: Sump pump? ❑ Yes ❑ No Last date of occupancy: Date 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 77 Woodland Ave Property Address Juan Marichal Owner Owner's Name information is required for every Hyannis Ma 02601 3/6/18 page. Cityfrown 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: Not provided Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 77 Woodland Ave Property Address Juan Marichal Owner Owner's Name information is required for every Hyannis Ma 02601 3/6/18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 6/28/02 Were sewage odors detected when arriving at the site? ❑ Yes ❑ No Building Sewer(locate on site plan): Depth below grade: 2 feet Material of construction: ® cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Tee's are in place Septic Tank (locate on site plan): Depth below grade: 1.5 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 1500 If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: t5ins•3/13 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 ,M ,•°'y 77 Woodland Ave Property Address Juan Marichal Owner Owner's Name information is required for every Hyannis Ma 02601 3/6/18 page. CitylTown 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 24" Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 42" Distance from bottom of scum to bottom of outlet tee or baffle Sludge stick How were dimensions determined? Tape Measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 77 Woodland Ave Property Address Juan Marichal Owner Owner's Name information is required for every Hyannis Ma 02601 3/6/18 page. CitylTown 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M ,•''t 77 Woodland Ave Property Address Juan Marichal Owner Owner's Name information is required for every Hyannis Ma 02601 3/6/18 page. Cityrrown 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 Level and at normal level 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.): 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•?age 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 77 Woodland Ave Property Address Juan Marichal Owner Owner's Name information is Hyannis Ma 02601 3/6/18 required for every y page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 2 ❑ 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.): System is working as designed 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 t5ins•3/13 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 GSM ,•''r 77 Woodland Ave Property Address Juan Marichal Owner Owner's Name information is required for every Hyannis Ma 02601 3/6/18 page. Cityfrown 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•3/13 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 77 Woodland Ave Property Address Juan Marichal Owner Owner's Name information is required for every Hyannis Ma 02601 3/6/18 page. City/Town 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 77 Woodland Ave Property Address Juan Marichal Owner Owner's Name information is Hyannis Ma 02601 3/6/18 required for every y page. CityrFown 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 + Ft 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: 6/26/02 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: Test hole data on plan Before filing this Inspection Report, please see Report Completeness Checklist on next page. l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 3/6/2018. Assessing As-Built Cards TOWN OF BARNSTABLE E LOCATION_ 7 �.kd[�S y„D ��SEWAGE A_ —26 7 VILLAGE. } 1,wr►.S ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY ,Sc70 LEACHNG FACILLTY:(type) oZ iU -per fize) 25 x IS NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: 6 Separation Distance Between the: Maximum Adjusted Groundwater Table to the 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 a 0 0 C! � I 1500 ,� Gtf11i o,J 5CST t C.�fl�/l �r,►t�r A='z5'S: g=17 our�r_'f W a Y�43 4'tio r ` http://Www.townofbarnstable.us/Assessing/H Mdisplay.asp?mappar-269060&seq=1 1/2 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 77 Woodland Ave Property Address Juan Marichal Owner Owner's Name information is required for every Hyannis Ma 02601 3/6/18 _ page. Cityrrown 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 l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 '� p1 Health Complaints 08-Aug-05 Time: 11:45:00 AM Date: 8/4/2005 Complaint Number: 18324 Referred To: DAVID STANTON Taken By: Judith Flynn Complaint Type: NUISANCE CONTROL REG. 1 RUBBISH Article X Detail: UNSANITARY CONDITIONS Business Name: Number: 77 Street: Woodland Ave Village: HYANNIS Assessors Map_Parcel: Complaint Description: Large amounts of trash and numerous vehicles on property -caller states that there may be some work going on inside- seems to think that there are no permits issused permits issued. -this property has had the trash problem for some time. Actions Taken/Results: DS WENT TO SAID LOCATION AND SPOKE WITH OWNER. WE HAVE NO REGULATIONS ON THE NUMBER OF VEHICLES. WE DO NOTISSUE BUILDING PERMITS. WE DO ENFORCE TRASH VIOLATIONS, HOWEVER, THERE WERE ONLY TWO BAGS OF TRASH OUTSIDE, THAT HE HAD JUST BROUGHT OUT AND WAS LOADING INTO HIS VAN TO TAKE TO THE DUMP. HE SAID HE NEVER LEAVES TRASH OUT, AND THAT THEY HAVE DUMP STICKERS ON BOTH HIS AND HIS WIFES VEHICLE, SO HE DOESN'T UNDERSTAND WHY SOMEONE WOULD CALL AND COMPLAIN. THERE ARE A LOT OF KIDS TOYS IN THE YARD, HOWEVER, THIS IS NOT A VIOLATION. THE OWNER DOESN'T UNDERSTAND WHY ANYONE WOULD CALL 1 Health Complaints 08-Aug-05 AND COMPLAIN, HE IS A GOOD NEIGHBOR NO EVERYONE AROUND. I TOLD HIM HE DIDN'T HAVE TO WORRY, I DID NOT OBSERVE ANY HEALTH VIOLATIONS. NO FURTHER ACTION REQUIRED. Investigation Date: 8/4/2005 Investigation Time: 2:20:00 PM 2 �1NE Town of Barnstable Regulatory Services • BARNSI'ABLE. 9 MASS. �* Thomas F. Geiler,Director 1639n. 39nr Aim Public Health Division Thomas McKean,Director 200 Main Street,Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 May 29,2002 77 Woodland Avenue Hyannis, MA 02601 Dear John&Leslie Goyette: On Tuesday May 28, 2002, Health Inspector David Stanton conducted a septic inspection at 85 Woodland Avenue. This was a routine final inspection for the installation of a new title V septic system. The owner of the property at 85 Woodland Avenue said that your sewer pipe was tied into his old septic system. Claiming he had no agreement with you on allowing this, he did not connect your sewer pipe into his new septic system. Therefore you need to have your own septic system located on your property. Because your sewer pipe is not connected to his new septic system, the septic waste from your property may back up into your basement or onto the ground,which is illegal. Please have this problem corrected as soon as possible. Raw sewage is a public health hazard, and you may be fined if raw sewage becomes present on the ground at your property. Sincerely, David W. Stanton Health Inspector, Town of Barnstable I TOWN OF BARNSTABLE �. LOCATION / L)mx2on4Q _ J c, SEWAGE # 200—a26�7 VILLAGE h S ASSESSOR'S MAP & LOT 2 0- a6 o INSTALLER'S NAME&PHONE NO. rt SEPTIC TANK CAPACITY ysD U LEACHING FACILITY: (type) of t1*222 6A Dr,u,-Il3(Size) 25 x X,z.L NO. OF BEDROOMS BUILDER OR OWNER rr 3' cSlit .� lT c PERMITDATE: COMPLIANCE DATE: 6 2 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet a 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 - G r • rt 3�+Y: r�I" � I W } r J x r .-r • No. Fee THE COMMONWEALTH OF MASSACHUSETTS ` Entered in computer: Yes ✓/ PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Zippfication for �Digogar *pgtem Congtruction Permit Application for a Permit to Construct( )Repair(>4 Upgrade( )Abandon( ) >Complete System O Individual Components Location Address_or/�of No. Owner's Name,Address and T 1.No. ��S�1i Assessor's Map/Parcel u3octo ,j V N L Install is Name,Address and Tel.No. Design s Name,Address a, qd Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size L1g4- sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date 6 Z Number of sheets 0hA Revision Date \ Title Size of Septic Tank CACzo.J 1a%,,Ic Type of S.A.S. �3 x AS l' Description of Soil Nature of Repairs or Alterations(Answer when applicable) :Jc -, C i S e 1-N 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 by this Board of He th. Signed DateveOl�aZ Application Approved by Date 2 Application Disapproved for the following reasons Permit No. 1� c�lp� Date Issued Cot ¢t Y :No- �-t"J Fee -. � �.;,. S?`rat �-f��wue.. �• - THE COMMONWEALTH OF MASSACHUSETTS,,u Entered in computer, q Yes ' PUB IC HEALTH DIVISION -TOWN OF BARNSTABLE. MASSACHUSETTS i Application for Mi5pool *p!tem Congtructton Permit Application for a Permit to Construct( )Repair(Upgrade( )Abandon( ) [Complete System ❑Individual Components ' Location Address or/ of No. Owner's Name .M2 s apd TI1.Nl. 77 w-t�GX�G�y�� 2. lAY1Y11 r - �� ►r,� FS 1t Assessor's Map/Parcel .7Alim r M f}1 a Q e 1c Installer's Name,Address,and Tel. o. Design Qs Name,Address and Tel.No. i i F p y )0�3 '� S-35�� 3 v' si _7�!,ems- c),Q9 Type of Building: Dwelling No.of Bedrooms Lot Size UL'14 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 1 ) gallons per day. Calculated daily flow gallons. Plan Date t,� 1�2 Number of sheets Revision Date 1 Title Size of Septic Tank 1 500 C-at_`a,-j -f , k Type of S.A.S. �3 x 2 S 1.1iVL_ oQ 6 Description'of Soil i *" Nature of Repairs or Alterations(Answer when applicable) ��'� a�.,r�—n.silcl 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 by this Board of Health. Signed Date � �Q,2 Application Approved by- d Q Date 7 2 Application Disapproved for the following reasons t Permit No. Date Issued ---------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS - I .r BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired Upgraded( ) Abandoned( )by at '7 d has been constructed in accor�dance with the provisions of Title 5 and the for Disposal System Constructi n Permit No.:r-� elated G Installer .: k,,2( .,-Designer L ✓74,r— �Yl�,v�� The issuance o this�ermit shall not be construed as a guarantee that the syst will function as d '.ne . �0 !f Date- , 1. Inspector SIN Date _ --------------------------------------- NO. Feej THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS . isspogal by.5tem Construction Permit Permission is hereby granted to Construct( )Repair(_>•)Upgrade( )Abandon( ) System located at i and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Cons Z i n must be-completed within three years of the date of this pet {'� Date: rG7 I\ - Approved by `-' �� - TOWN OF BARNSTABLE f C.— LOCATION SEWAGE # 2&2—�b`) VILLAGE_ s ASSESSOR'S MAP& LOT 2 49-06 0 INSTALLER'S NA &PHONE NO. ,� A.-' ME s SEPTIC TANK CAPACITY 9 LEACHING FACILITY: (type) .071 (size) 0✓l5 k l X r� a NO. OF BEDROOMS BUILDER OR OWNER I PERMITDATE: COMPLIANCE DATE: �6 i Separation Distance Between the: i Maximum Adjusted Groundwater Table to the 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 0 4 3 `c CQ Cn J 9 � � sran j t ASSESSORS MAP: Z6R TEST HOLE LOGS NOTES: PARCEL : 060 1) THE INSTALLATION MUST BE IN SUBSTANTIAL COMPLIANCE WITH SOIL EVALU TOR ; LAOZEN I�l• ���•,(�•S HIS PLAN, 1995 MASSACHUSETTS TITLE V & TOWN OF FLOOD ZONE: WITNESS A- I�! BOARD OF HEALTH REGULATIONS. REFERENCE: N IA DATE: U �_ 7 1002- 2) THE INSTALLER SHALL VERIFY THE LOCATION OF UTILITIES, fsr PERCOLATION RAC E• <- ^^�N 1JGkt SEWER INVERTS AND SEPTIC COMPONENTS PRIOR TO � L►1.�1 a� � So u•- LT�t'12 � 0,7� � �,,_} INSTALLATION. C� ou TH- I TH'2 3) THIS PLAN SHALL B T B SYSTEM INSTALLATION ONLY, AND SHALL NOT USED FOR PROPERTY LINE �rN O'/ IOC �3 DETERMINATION. AA 4) ALL PIPING TO BE 4 SCHEDULE 40 Q 1/$ / FOOT. (UNLESS �"� INV% SPECIFIED OTHERWISE) 31" S 27,6 t LOCATION MAP 'f-S) MEt�tV+� ( 5) THE DESIGN OF THIS SYSTEM DOES NOT ALLOW FOR THE USE OF A E GARBAGE DISPOSAL. c. zl.o 6) SEPTIC TANKS AND DISTRIBUTION BOXES (WHEN INSTALLED) evienl VAl MUST BE PLACED ON A MECHANICALLY COMPACTED BASE OR ON S }J� A BASE OF 6"OF CRUSHED STONE. 7 2a5 y/ EY1577N4_se n s s'r _ v_�_ �y _Pam.. 140 4 af)lJDw 4TcL 0p5- - S E P T I ;" SYSTEM DESIGN FLOW ESTIMATE �j BEDROOMS AT 110 GAL/DAY/BEDROOM - 33o GAL/DAY i =3tZ Auc-TU Al— 3 &le— D C S c t4 f�l f3ov�D SEPTIC TANK '• 'Let,(o"1 SuMJ r3U SAL/DAY x 2 DAYS - C�ro0 GAL ,� ups D A'Dom hs 6Z• 1J vG A 1.L t/ll/3��i/ TU U t.�USE 1 GALLON SEPTIC TANK ,NCEt� 14© 3a SOIL ABSORPTION SYSTEM 7 x, l �12� 5�'Gkuvl,t Pe�cST LEE�Gbf £�tAM `,.,rl .. ate` .'f�.. . /h/ tfLl.� J! 'G a� O 4 2� I �WA� S_ 0 � 31DE AREA: 2�)2•+- '..�. _ 30TTOM AREA: 25 x 13 X�l T•f ZYa. So o ia' �x1Sn�N�i 73�0rl,lo� ray SEPT I :.. SYSTEM SECT I ON -�z Sena FM� 10 I p 13 �C'^' to w/h 7d to ZBa - gl 2 < S Z'-�8" ov(�le Wpsl�ol. Sv1e 12 ZI 'ZS y�S'v' ie l3as e:? 6"'shine �'I � a D-BOX 2-7,q-7 550 GAL �7,61, ( ks4- \ r�.�� 1= � Z�. 2 7, / STD SEPTIC TANK l� 4rs / 30 Y �y Z i�.- �/Lqq L41to 1�t3-3 Washed YY►e -' a j R 750-ra , OF -FE S I N bE L• l9, / -- poof SITE AND SEWAGE PLAN LOCATION : 7w w60DcAA)0 i}vC—. PREPARED FOR : `/attN G�S�tC �0LIF Z- ol 13 0 DARREN M. MEYER, R.S.tu SCALE: ZU o 43 VINE STREET DATE: - 12-0 2. DUXBURY, MA 02332 J U DATE HEALTH AGENT (781) 585-0293 Lu