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Home My WebLink About0031 KEELA ROAD - Health 31 KEELA ROAD, COTUIT i A= 018-063 Town of Barnstable Health Inspector oFt Office Hours Regulatory Services 8:30-9:30 Thomas F. Geiler,Director 1:00—2:00 • BAMSrABLE, 9� MASI- 039. ,0� Public Health Division 3 a� plFp �A Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT— SEPTIC QUESTIONNAIRE 1. General Information: Size of Property: Address: Map Parcel 0�03 Name: Phone #: vZD - /`7 xQ 2a. How many bedrooms exist at your property now? I 2b. Are you planning to add an bedrooms? y� y p g y /�a If yes,how many? 2c. How many bedrooms total are proposed at this property(including the amnesty unit)` 2d. Please include a copy of the floor plans for the entire property - showing the existing rooms in the home plus the proposed amnesty apartment and/or addition. Please label . each room clearly on the plans. 3. Is the dwelling connected to public sewer? YES or NO Tf the dwelling is connected to public sewer,skip„questions#4°through#9;below _ , =x 4. Location of dwelling is INSIDE or OUTSIDE a Zone of Contribution to public supply wells? � 5. Is the dwelling connected to an ONSITE WELL or to PUBLIC WATER? 6. Is a disposal works construction permit on file? YES or NO 6a. If yes,how many bedrooms were approved according to this permit? Bedrooms. 7. Were any building permits obtained for construction of additional bedrooms? YES or NO .8. Is there an engineered septic system plan on file at the Health Division? YES or NO 9. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO -------------------------------------------------------------=------------------------------------------------------ FOR OFFICE USE ONLY The Public.Health Division has no objection to bedrooms at this property. Special Conditions: Signed: Date: S Q;/health/wpfiles/amnestyapp x �a � cJ --a� �J s �� - � �l ', '� 3i �'�tta �, Ca7uir ro,� /�zma�% �/zrJrrr✓� �'azEv A� y fiy f Message Page 1 of 1 McKean, Thomas From: McKean, Thomas Sent: Tuesday, March 15, 2005 4:39 PM To: Dillen, Elizabeth Subject: AMNESTY APPLICATIONS RECEIVED-31 Keela Road/324 Nye Road/200 Oak Neck Road 31 Keela Road, Cotuit- OK-The septic system was permitted on 9/13/95 for three bedrooms.The appl;icant is requesting three bedrooms.. 324 Nye Road- PROBLEM: The submitted.floor plan shows five rooms with privacy afforded for sleeping (bedrooms). This site is located within a nitrogen sensitive area and the lot size is only 0.49 acre. Therefore, no additional bedrooms are authorized. Please inform the applcant that she will be required to remove the doors to the"massage room"and to the"office/den" and provide miunimum five feet openings to these rooms. Also, the Health Division does not have a record of a Title 5 septic system at this prperty. Please have the applicant hire a septic inspector to submit an 11 page inspection report. 200 Oak Neck Road-PROBLEM: There were several housing vioations including mold, insufficient heat, leaking water from the refrigerator, and a cracked ceiling during October 2003. At this time, it is unknown whether or not these violations were corrected. These violations shall be corrected before occupancy. 3/15/2005 TOWN OF BARNSTABLE LOCATION C C �V t SEWAGE# VII,LAGE 31 k600 ROOD ASSESSOR'S MAP'&LOT • 0 INSTALLER'S NAME&PHONE NO. W C gotoLo Sbti Sr-pfIc 775-g774 SEPTIC TANK CAPACITY 1500 4 iA S - LEACHING FACILITY: (type) (CAC F iC�cY (size) X Y.�("Y.Ly, NO.OF BEDROOMS 3 BUILDER OR OWNER - } PERMIT DATE: 9�!3 95 COMPLIANCE ATE: 411�5 5 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 1, t BA Ic ok 4FoJ5E TOWN OF BARNSTABLE LOCATION C O� V-%i- SEWAGE# S- 1-1 2,15 VII,LAGE 3I ��1 i2oW� ASSESSOR'S MAP&LOTC INSTALLER'S NAME&PHONE NO. W - C' . 'Ro bL uJ SbrJ SC--p F(c 775 sg 7 7L SEPTIC TANK CAPACITY Q Soa g1 rA k SA- LEACHING FACILITY: (type) I CACVN ��CA (size) ;t,AY-.4�X(.0 r NO.OF BEDROOMS ;3 BUILDER OR OWNER PERMIT DATE: 9/1 S 14 S COMPLIANCE DATE: 9II 5Z9 S 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 jo -A?vg o 1y� 0 f No. Fee 3 0.0 0 THE COMMONWEALTH OF MASSACHUSETTS 3 PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 0(pplication for Migool *pgtem Cow5tructfon Permit Application is hereby made for a Permit to Construct( )or Repair( x)an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 31 Keela RD Cotuit Christina Kelly Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. W.E. Robinson Septic Service P.O. Box 1089 Centerville Type of Building: Dwelling No.of Bedrooms 3 Garbage Grinder( nQ Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Description of Soil sand Nature of Repairs or Alterations(Answer when applicable) install a 1 , 500 gal tank, d-box and Title V leach-trench 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 issue by this�ar Health. p Signed il 1 C i `/ Date Application Approved by < - Application Disapproved for the fo owing qasons Permit No. /s"' 1 7 Date Issued ——————————————————————————————————————— Fee 30.00 i THE COMMONWEALTH OF MASSACHUSETTS j I PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS .. . 01pprication for Miopogal *pgtem Congtruction Permit Application is hereby made for a Permit to Construct( )or Repair( X)an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 31 Keela RD Cotuit Christina Kelly Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. W.E:. Robinson Septic Service P.O. Box 1089 Centervillef yy; J yi' Type of Building: Dwelling , No.of Bedrooms 3 Garbage Grinde`r1_n�---- __' rs Other Type of Building No. of Peons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow, gallons. Plan Date Number of sheets Revision Date Title Description of Soil sand Nature of Repairs or Alterations(Answer when applicable) install a 1 500 gal tank, d-box and Title V leach-trench r Date last inspected: "' -' Agreement:,, The uddersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordancelwith the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance ha�,been issue b this ar Y Health. P Y .� Signed Date Application Approved by Application Disapproved for the fo owing 4asons ' i q ,l Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Certificate of Compliance - f THIS IS TO CERTIFY that the On-site Sewage Disposal System.installed( )or repaired/replaced( 7C)on by W.E. >'tobinson Septic for Christina Kelly as !?1 has bee constructed"ri accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Use of this system is conditioned on compliance with the provisions set forth below: �'F r No. � Fee . 30.00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 'Wi0po0ar.6p5tem Con.5truction Permit Permission is hereby granted to W.E. Robinson Septic Service to construct( )repair(X )an On-site Sewage System located at 31 Keela RD Cotuit 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. All construction must be completed within two years of the date below. Date: Approved by a CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) I, G o / �✓�- hereby certify that the application for disposal works construction permit signed by me dated J"l ,� 9 , concerning the ,�. property located at l �L' r b meets all of the following criteria: • There are no wetlands within 300 feet of the proposed septic system • There are norprivate wells within 150 feet of the proposed septic system • 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 r. • There are no variances requested or needed. SIGNED,: DATE: LICENSED 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]. a, 6 p isd o a. 'jo s r I