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HomeMy WebLinkAbout0006 GENERAL PATTON DRIVE - Health 6 General Patton bri e Hyannis ,P '_._,._..-- j A = 292 l24 r, I a s i 0 ,: T""n"�,i- :... ^+•.y.r-". rsl .k v"1!` ;:,r'P x s r^fi. '.^vy-., -Tni -�".,r,•j"--a f7'._^.-,-Y v '.-^sw ; TOWN OF BARNSTABLE' BAR-W 3993 Ordinance or Regulation , WARNING . NOTICE Name of Offender/Manager �n,f'+ G Ca Address of Offender l MV/MB Reg.# Village/State/Zip ;atv , t (1:2 �0 .1 " Business Name Y•/. am/, on q/ll'l 20/1 (/ Business Address ` Signature of Enforcing Officer Village/State/Zip Location of Offense_ /ter, r tom. A t .r , ,r E,-{;lt )p r4,;7 Enfo1rcing ," 'P t/Division De f Offense . Facts ;M kJAU Id Arld he dr4r/7016 This will iAWe only a"s'"a Ewarping. At this time -no legal action. has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK ENFORCING OFFICER GOLD-ENFORCING DEPT. ,. ,..;.: .,-..._^^"�±e-v"—.-"'.v^,+."."Y�}*go+..ii^a...."*'.t"e`E •'.,v.. :•,,y�. r �„¢ -t :"�+r-�e'^r--yr;x,.' �;,4^.syr,"""M s x _ uTOWN OF BARNSTABLE BAR-W 33 `. Ordinance or, Regulation WARNING NOTICE Name of Offender/Manager ,•e^fr , CA Address of Offender ' ., � w. MV/MB Reg.# Village/State/Zip '11. A_; - , 1 i,, Business Name am/pm:, on 1 20/' V Business Address <... Signature of Enforcing Officer Village/State/Zip c Location of Offense Enforcing ;Dept/Division Offense f .f _t '€t' `~ ,, f =r`r-, .xr 4 of f o Facts ie"14 ItV This will srve $only as`a iwarn;ing. At this time 'no legal action has` been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. 71,- 'TOWN• OF ' BARNSTABLE BAR-W.W539 Ordinance or Regulation WARNING NOTICE C / Name of Offende /Manager � 1�,G�� � ` r1(3ff to i Address of Offende -/ A 15 Vill14a0 qd My/MB Reg.# Village/State/Zip t^ (0r� A (43v Y Business Name r l ./�am/p i on / 12Q V *. Business Address ; �. /►A Signature of,Enforcing Officer Village/State/Zip } Location of Offense 6.6cottin rF P nkc /�o de- dio4/I4NA( �ra cllr;7� f W /414 7�',�n J/ / Enfohrcing�Ddpt%Division Zrol OffenseT6 . Avv"11, tu_ 0 �r� �Ot, c_kd, UV Facts Ja �. I U blfri (J I'A.1.4 G►r �'nc �,.rl,:, r, .ra k l�l�Tl.. . t�Fvl Qe C(P�r,ecl i � d # q ri r tP (I0 i'a 14 �',C W i ev LioV.. This wi'11 'serve ' my asp a wazni °g. At this time no legal ac on hasbeen taken. It is the goal-.of Town agencies to achieve voluntary co lance of Town Ordinances, Rules and Regulations. Education efforts and warnin notices are attempts to gain voluntary compliance. Subsequent violations will esult in appropriate legal action by the Town. WHITE OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER _GOLD-ENFORCING DEPT. -7— 7-, 77-7 77, 7 77 77 7 TOWN, OF BARNSTABLE 3639 BAR-W Ordinance or, Regulation WARNING NOTICE Name of Offende /Manaqer C 1 1) t f 5' 1(� 1 V Address of Offen\de Rd ZMVIMB Reg.# Village/State/Zip r tlllql20j V Business Name a m/0; on Business Address Signature Officer Village/State/Zip Location of Offense Enf oi�:cing/Ofpt/Divis ion Facts Offense. T03 - 44 r4 hA '006 iltArfj ir%r , e c Ir Abe V f le CA/ � 4 r,V This wkll 'serve /only as'a wakni At this time no legal act�iwon haqjbeen taken. I . I pfl c �:L It is the goal of Town agencies to achieve voluntary om Lance of Town Ordinances, Rules and Regulations. Education efforts and warninFNgotices are attempts to gain. voluntary compliance. Subsequent violations will result in appropriate propriate legal action by the Town. WHITE OFFENDER . CANARY-ORD./REG.-FROG. PINK-ENFORCING,OFFICER GOLD ENFORCING ENFORCING DEPT. ... ,-�•s'm`:^^�sz--'!'4--- ° ^T""' .�;=. 'w""f+f�'' ,-rr^ z •,^.�r s �-��{"r'.A'y"-�''-�.—T ,-�- .-..._-.` f- ;r. r TOWN OF BARNS TABLE BAR-W `! 39 .-f Ordinance or Regulation WARNING NOTICE �,,,} 0 Name of Offende /Manager y f lot i pz' [\ Address of Offende f / +1...� t Z/MB Reg.# Village/State/Zip r (..qJ ) f Business Name 41 20 '� . �5 �am/ ; on E . V t Business Address /� <,. � iA., s - • Signature of .Enforcing Officer L Village/State/Zip Location of Offense cyst lJV f, i1c, � 11t:o/4-,�Jr ktri—/ Enf9tcing/n 6pt/Division f Offense. L � . tvj, jjnfr- ( ,zl 'oj pry j °i r r Facts t 4 , t" �";� r .s tt r r , r; .. :. t "* e+ + 1 ;. t' ' c IrAll rt 4lf) q .fi tp III, VV I �'1 ( a 1. L'f^T •• �-/ i.:j P yw ' This will serve only as' a warning. At this time no legal action has been taken. It is the goal- of Town agencies to achieve voluntary comp-liance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will"result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG._ PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. Health Complaints 27-Apr-04 Time: 10:52:00 AM Date: 4/12/2004 Complaint Number: 17360 Referred To: DAVID STANTON Taken By: DENISE WITTER Complaint Type: NUISANCE CONTROL REG. 1 RUBBISH Article X Detail: UNSANITARY CONDITIONS Business Name: Number: 6 Street: General Patton Drive Village: HYANNIS Assessors Map_Parcel: Complaint Description: Caller said the house has trash in the yard. Caller said she saw rats. Has a pile of k' mattresses and trash from the house being gutted. ON 4/21/2004 1 RECEIVED A CALL FROM THE PRIOR OWNER.. SHE SAYS IT IS NOW OWNED BY MARCIA HUFF AS OF FEBRUARY. Actions Taken/Results: DS WENT TO SAID LOCATION. DS OBSERVED MATTRESSES AND OTHER WASTE IN YARD. WARNING NOTICE BEING MAILED. DS MAILED A NEW WARNING, OWNER CHANGED, AND TOB ASSESSORS IS WAY BEHIND, SO DS WILL USE BARNSTABLE COUNTY REGISTRY OF DEEDS TO TRACK DOWN NEW OWNER. DS DID A FOLLOW UP INSPECTION ON 4/27/2004 AND THE VIOLATIONS HAVE BEEN CORRECTED. Investigation Date: 4/14/2004 Investigation Time: 4:15:00 PM 1 3+ 2?� T 4- g- LRECE'VED L 3 0 2003 COMMONWEALTH OF MASSACHUSETN OF BARNSTABLE EXECUTIVE OFFICE OF ENVIRONMEEAF-DEPT. r d DEPARTMENT OF ENVIRONMENTAL PROTECTION OqM SJev 350 MAIN STREET WEST YARMOUTH,MA 508-775-2800 TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM_ FORM PART A CERTIFICATION MAP 292 PAR 124 Property Address: 6 GENERAL PATTON DRIVE HYANNIS,MA 02601 Owner's Name: FLORES,HELEN Owner's Address: 74 NORTH EAST VILLAGE CONCORD,MA 03301 Date of Inspection JUNE 23,2003 Name of Inspector:(please print) JAMES D. SEARS Company Name: A& B Canco Mailing Address: . 350 Main Street West Yannouth,MA 02673 Telephone Number: 508-775-2800 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 CMR 15.000). The system: ./ Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: �M-�sy,lLa� Date: 9 - 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 tot he 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 1 Page 2 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 6 GENERAL PATTON DRIVE HYANNIS,MA 02601 Owner: FLORES, HELEN Date of Inspection: JUNE 23,2003 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: ✓ I have not found any infonnation which indicates that any of the failure criteria described in 310 CM 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: N/A 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 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: 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: Title 5 Inspection Form 6/15/2000 2 Page 3 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: 6 GENERAL PATTON DRIVE HYANNIS,MA 02601 Owner: FLORES,HELEN Date of Inspection: JUNE 23,2003 C. Further Evaluation is Required by the Board of Health: N/A Conditions exist which require further evaluation by the Board of Health in order to detennine 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 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: 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 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 detennine 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: Title 5 Inspection Form 6/15/2000 3 Page 4 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: 6 GENERAL PATTON DRIVE HYANNIS,MA 02601 Owner: FLORES,HELEN Date of Inspection: JUNE 23,2003 D. System Failure Criteria applicable to all systems: N/A You must indicate"yes"or"no"to each of the following for all inspections: Yes No J Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in pit is less than 6"below invert or available volume is less than '/z day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation N/A Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply N/A Any portion of a cesspool or privy is within a Zone I of a public well N/A Any portion of a cesspool or privy is within 50 feet of a private water supply well N/A 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 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 or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this fonn.) NO (Yes/No)The system fails. I have detennined 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 detennine what will be necessary to correct the failure. E. Large Systems: N/A To be considered a large system the system must service 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 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 11 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 is 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. Title 5 Inspection Form 6/15/2000 4 Page 5 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 6 GENERAL PATTON DRIVE HYANNIS,MA 02601 Owner: FLORES,HELEN Date of Inspection: JUNE 23,2003 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 nonnal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection? J 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 scan ✓ Was the facility owner(and occupants if different from owner)provided with infonmation on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)has been determined based on: Yes No ✓ Existing information. For example,a plan at the Board of Health. ✓ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] Title 5 Inspection Form 6/15/2000 5 Page 6 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 6 GENERAL PATTON DRIVE HYANNIS,MA 02601 Owner: FLORES,HELEN Date of Inspection: JUNE 23,2003 FLOW CONDITIONS RESIDENTIAL Number of Bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 1 10 gpd x#of bedrooms: 330 Number of current residents: 3 Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): YES Seasonal use(yes or no): NO Water meter readings,if available(last 2 years usage(gpd)): 2003 301 cu.ft.—2003 273 cu.ft. Sump pump(yes or no) NO Last date of occupancy: PRESENT COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CM 15.203): Basis of design flow(seats/persons/sqft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of infonmation: JUNE 3,2003 Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: gallons—How was quantity pumped detennined? 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) Tight tank Attach copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: 1987 PERMIT#87-735 Were sewage odors detected when arriving at the site(yes or no): NO Title 5 Inspection Form 6/15/2000 6 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 6 GENERAL PATTON DRIVE HYANNIS,MA 02601 Owner: FLORES,HELEN Date of Inspection: JUNE 23,2003 BUILDING SEWER(locate on site plan): ✓ Depth below grade: 2' Materials of construction: Cast iron _ 40 PVC _ other(explain) Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK(locate onsite plan): ✓ Depth below grade: I' Material of construction: ./ concrete metal fiberglass polyethylene other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1,500 GALLON Sludge depth: P, Distance from top of sludge to the bottom of outlet tee or baffle: 29" Scum thickness: 0" Distance from top of scum to top of outlet tee or baffle: 12" Distance from bottom of scum to bottom of outlet tee or baffle: 18" How were dimensions detennined: ASBUILT AND TAPE Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): MAIN TANK AT WORKING LEVEL.TANK AND COVERS 1' BELOW GRADE.INLET AND OUTLETS HAVE BAFFLES.NO SIGN OF OVERLOADING OR LEAKAGE. GREASE TRAP(located on site plan) N/A Depth below grade: 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: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Title 5 Inspection Form 6/15/2000 7 f Page 8 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 6 GENERAL PATTON DRIVE HYANNIS,MA 02601 Owner: FLORES,HELEN Date of Inspection: JUNE 23,2003 TIGHT or HOLDING TANK: N/A (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/day Alarm present(yes or no) Alarm level: Alarm in working order(yes or no): Date of last pumping Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ./ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: 0 Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.,): DISTRIBUTION BOX IS 20"BELOW GRADE.ONE LINE IN,ONE LINE OUT.BOX IS CLEAN AND SOLID. NO SIGN OF OVER LOADING OR SOLID CARRYOVER. PUMP CHAMBER: N/A (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Title 5 Inspection Form 6/15/2000 8 Page 9 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 6 GENERAL PATTON DRIVE HYANNIS,MA 02601 Owner: FLORES,HELEN Date of Inspection: JUNE 23,2003 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ./ leaching pits,number: 1 leaching chambers,number: leaching galleries,number leaching trenches,number,length leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) LEACHING IS ONE 1,000 GALLON PRE CAST PIT.PIT AND COVER 18"BELOW GRADE.6"WATER. STAIN LINE AT 3'.NO SIGN OF SOLID CARRYOVER OR OVERLOADING. CESSPOOLS: N/A (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 or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation etc.): PRIVY: I N/A (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.) I Title 5 Inspection Form 6/15/2000 9 Pa,-e 9 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 6 GENERAL PATTON DRIVE H)'ANNIS,MA 02601 Owner: FLORES,HELEN Date of Inspection: JUNE 23,2003 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. I i O I Title 5 Inspection Form 6/15/2000 10 a . r Page I I of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 6 GENERAL PATTON DRIVE HYANNIS,MA 02601 Owner: FLORES, HELEN Date of Inspection: JUNE 23,2003 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to groundwater 22.3 feet Please indicate(check)all methods used to detennine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observation site(abutting property/observation hole within ISO 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: USGS WELL DATA WELL AIW 230 22.3' ZONE B 1.9' Title 5 Inspection Form 6/15/2000 11 HYANNIS FIRE DEPARTMENT 95 HIGH SCHOOL ROAD EXTENSION HYANNIS, MASS. 02601 PAUL D.CHISHOLM,CHIEF FIRE PREVENTION BUREAU LT. DONALD H. CHASE, JR. LT. ERIC HUBLER Inspector Inspector Sept. 2, 1997 Board of Health Town Hall Main Street Hyannis, MA 02601 6 General Patton Drive (m292 p124) �S Called to this address by the rescue company & Lt. who were on site treating an elderly woman who had fallen. She was reported to have been on the floor for about two days. Upon looking around the home, I noticed a large quantity of trash bags throughout the home and piles of debris consisting of clothes, boxes and personal effects. It was evident, from the odor present, that fecal material was around the house as were a large quantity of house flies. I am not sure if there were any health code violations at this location, but I thought I should notify you. The smoke detector was in the proper place and operational. It was signaling the need for a new battery, but was in service. Contact: Drena Perry daughter 771-3188 Enclosed please find a copy of our current info / owner for this location. Thank yo ,Lt. .Do ald•H; Chase,°Jr. Fire,Prevention Officer Business 508-775-1300 Emergency 9-1-1 Fax 508-778-6448 � -.HYANNfS .• `_ � ""-tea � r ICA rH°y A;N , I S F j�R E p l T R hC� �R O ''E R TI���"N CAR D p yy .FDAAMSIF X 't ' 4pa re`°'3 "% d y §� �"� 6 GEN PATTON DR 'AM 292124 , 1' MAP\P RC 34 * HY FLORES MELECIO ,2 fir /FIRE .1,8 lCT � k VILLAGE CEDE ` r/tea% CURRENT©WNER �, ' S rt y '� CO�R\ADDRESS // s ADbRESS� 742NEIL. G4ERD� C�NCOyRD NFHa �®33Oi ST;4TE Om- Z1I� / 101 RESIDENTIAL SINGLE FAMILY USEGROIJP� C®[)EDESCRIPTION� or A lip t iy T®TAL�ACR S BUILDING "WAR, lFRONTAGEf / $36;700 £ �'�NiVLANDUALUE/ BUIL®1NG R TUALl1E pOTi4L UALUTIOfV " FE 4T ES M p AC / �7 q 9 'pL, RM:y°,r MELD��' 7 HBO a 3:1 / j l' 0N000 / a / lAN1 O DEED REFERENCE't JAf�1REPERENC;E�DATE w s, TOWN OF BARNSTABLE COCATION G C,F1V Et AL SEWAGE # VILLAGE ASSESSOR'S MAP & LOT o'I /� f.NSP£c Gies �3 NAME&PHONE NO. � S��° �7S`oZ ode SEPTIC TANK CAPACITY, LEACHING_FACILITY--,(type)' —.,(size) i•. � °k N0'OF BEDROOMS BUILDER OR OWNER )tiSP£c icy- PEDATE: 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 ..NV•... M�M D �A r [W� O �� v-t . o J` y _L.O-"C.A,T ION SEWAGE PERMIT .NO. . 6&Ac, P wc;ro.-� btu . 7- -7 3:5 VILLAGE F ` + \ , Ifs INST. A LLER'S NAME A ADDRESS e U I L D E R OR OWNER DATE PERMIT ISSUED 4, ` ATIE COMPLIANCE ISSUED /Z_ F-17 _, , �,S . � ,� ;�� �� �� � ���� �: , . . ri - � No....d�.1.... � � Fps. .. ..... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH / �.............OF........FX 7../�Ph ................................. Appliratilan for Mipoiia1 darks Cnnn,strnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: - ..__ r .... =- --------------------------------- � --•---------------- ssLocation-Ad or Lo ......................—......................................................................... ••-------•---------•-•--------•----..........---------------•-....•-•---.......r....•............- Own Address Installer Address Q Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............. .......•...................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures -------------------------------- . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid"capacity............gallons Length................ Width................ Diameter---------------- Depth................ 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........................................ a Test Pit No. 1................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-._________-____-____- ODescription of Soil----------, `=- ............ '�. � .......r'A--- --------------------------------------------------------------------------- x ---------------------------------------------------------------------------------------------------------------------------------------•---------------------- U Nature of Repairs or Alterations=Answer when applicable------- �_�� t ___t� x <_...- �(I! . .......................-......... o va ------- �''�`� -��' :.�.. ..................o�-Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'T''ice ;of the State Sanitary Code—The undersigned further agrees not to piace the system in operation until a Certificate of Compliance has been ' ed by the board of health. &ned �� P Application Approved .. .... al.------•----•..................•-- 6G! 'e te Application Disapproved for the following reasons-------------------------------------------------•-•------•----•-------------•--•---------------------........._ ...--•--------•-------------•---••----•-----•--......---•-----•-•-•---•---...-••------.......•--•-----••-•••----•-•-•-•-••-•----•-••----•••-----------••••-•••--••---•••••----•-----••••-••-•--•--.••--- Q Date Permit No.---Q 7p-----`�--`3 ............... Issued......................................................._. Date _ Y / '1 - No..�;...1.... Frost-......(,.............._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ------. ..............................OF....... 1 iY�':1 �w�i------.-.-•---....__...._....---------------- Appliration for Uispaaal Works Tomitrurtinn Vrrmit Application is hereby made for a Permit to Construct ( ) or Repair X) an Individual Sewage Disposal System at: C %Win, /;,i% ,., % r; -•-----•---....._.......f,........;.---•----'--...... ------------------•-----..... .... .......--------------•-- �/Jti/?� ............................. Location-A dress or Lyf No. .................... —_._.................•.OwnS.......• ....._.`........•....._.... --....------------........_................. ........................_ ............. Address JA2Vif 3 a Lam/ s,��_s f = "4 , installer Address PQ UType of Building Size Lot____-••••-•---------••••-___Sq. feet Dwelling—No. of Bedrooms........."................................Expansion Attic ( ) Garbage Grinder ( ) A4 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) P 1 Other fixtures -------------------------------• . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 9 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter________________ Depth................ 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........................................ ..a Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water-______-_____-________-. LL, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ D Description of Soil......_.. __ :�...•...... 's'� ✓� !'�''?.__..:r4'f 'f x --••-•-••-•-•-••---•--•................................................................. U -•••----•-------•-••--•-......•-••-•.......----••••---••-••-------•-••••---•••-•••------•-----•-•-•-------------•---•------••-•----•-••------------•-•--•----•--••••-•••-•--•---•----••-•--•---------•- W --•-------------------------•-....----•------------••--••--•-----•-••-•--•-•..._...-•••-•••-------------•--•--•-•--•--••-••--•-•-•-............---•-••-•••-••-•=---- U Nature of Repairs or Alterations—Answer when applicable.______:--�� _ t' _..1? ! <------Z�<_ ---------------- . =-----••. l.�sr� `'' `r......5:1-/-----------f`�',- Z -'-�^ -- -5/r,: , �.�i' ••-••••••............. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with .T= the provisions of T r1-- 5 of the State Sanitary 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. .............. '¢ A• ___________.__.___ ___.....-----..._......._...___ _ _ _ �r Application Approved By-•-•- .............fT��:i ? C-==--•--•-----------•-------.-----•--- .... 7ae.............. Application Disapproved for the following reasons-----------------------------------------------------------------------------•--•----------------------•--••---- ----•-••-•-•••-•---•---------•--.._-•-••-•••---•----••-•----•-•----•-------------------------•-----....--••--•-••----•-------------•-•-•---•••••-•-••----•-----•--•----- ............................... Date Permit No.... j� �a >�------------------ Issued-........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OR HEALTH Tntifiratr of Tuntpliatta THIS IS TO,CERTIFY, That the I dividual ewag Disposal System construed. (- ) Repaired ( '} by----'---.---. ',-s .T /�,a s. •. Z/.V �J.... `" /'4'... ------ ---------- ---- c Instalp / 7 21 at r has been installed in accordance with the provisions of T i T IE j of Ts e State Sanitary Code as described in the application for Disposal Works Construction Permit No.._�_. ... . �j-•-------_ dated___..______-______--------------------------- f THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. gg DATE.................. ................................ Inspector..................... .........•- ......................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �f °........ ' ...OF..-.... t !f°t NO.. d �� FEE. ....... ipas1 Works �a�nirnimrn Merit t Permission is hereby granted•..._/. ________%7":4 - .._s'`�^'r �.....•. -•------••----------------------------•--.._....------.....--•-•-•................ to Construct ) �r Repair an Individual 9rwage Disposal Syst __. _. -•_ -- ....... 11 as shown on the application for Disposal Works Construction Permit _" �°'.� Dated_.__��__ �_- .--•___._.... r Board of Health DATE / - 7----------------------------------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS