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HomeMy WebLinkAbout0041 ADMIRAL'S LANE - Health 41 Admiral's Lane Osterville P A = _118 .132 4 :e,, Osterville No. 4210 1/3 BGR cy Pndia-]Q ESSELTE C 0 0 O 0 TOWN OF BARNSTABL�E LOCATION 41 Admirals Lane SEWAGE # 3/3/03 VILLAGE— )sterville,Mass. 02655 ASSESSOR'S MAP & LOT l ie 132. 'INSTALLER'S NAME & PHONE NO. T U jvja(-Qmher�Jr SEPTIC TANK CAPACITY 1000 gallon + Box LEACHING FACIL=: (type) 1 -T-R-1 000 (size) l s n n qa 1 1 nn c NO. OF BEDROOMS 3 BUILDER OR OWNER Paul Fazio PERMITDATE: 3,/31 2 COMPLIANCE DATE: Inspection 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 o le hin acility) Feet Furnished by c Foo rif ` o d(yt u--,,I, s Lo, . Ode fv"c I l e DATE : 3/3/03 PROPERTY ADDRESS:41 Admirals Lane Osterville,Mass_-_----- 02655 On the above date, I inspected the septic system at the above a-d-d-re�ss. �'��® This system consists of the following: ME 1 . 1 -1000 gallon septic tank. 2. 1 -Distribution box. MAR 17 2003 3 . 1 -1000 gallon ,precast leaching pit. TOWN OF BARNSTABLE Based on my inspection, I certify the following conditions: HEALiHDEPT. 4. This is a title five septic system. (78Code) 5 . The septic system is in proper working order at the present time. 6. Pumped the septic tank at time of inspection. Heavy scum & solids layers were present. 7 . The leaching pit is presently dry. 8. The house is presently vacant. SIGNATU R Name ; _ J ._ _P . Macomber Jr . Company :24jgph 2J- Son, Inc , A00r.eSS :__@Qx _�-8------------ __C.e_nSfrYLU_e,_tia -22-632- 0066 Pn one :__508- 775_ 3338 -- THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR-WARRANTY. TY IOSEPH P. MACOMBER & SON, INC. , Tanks•Cesspools•Leachflelds Pumped & Installed Town Sewer Connections P.0 Box 66 Centerville. MA 02632.0066 775.3338 775.6412 COMMONWEALTH OF MASSACHUSETTS = EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION i TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR.VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 41 Admirals Lane Ost rville.Mass. Owner's Name:paul Fd7.i o Owner's Addresssame Date of Inspection: 3 3 0 3 Name of Inspector: (please print) Joseph P.Macomber Jr. Company Name: 7_P_Macomber & Son Inc. Mailing Address:Anx r ti Mass-.02632 Telephone Number: SoS_775_3_ 3g CERTIFICATION STATEMENT I certify that 1 have personally inspected the sewage disposal system at this address and that the information repotted below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my rraiping 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: . f��Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority _ Fails Inspector's Signature: �d� Date: The system inspector shall mit 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. Notes and Comments ****This report only describes conditions at the time of inspection and under the condition3-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 1 I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART A CERTIFICATION (continued). Property Address:41 Admirals Lane Osterville,Mass. Owner:Paul Fazio Date of inspection: 111103 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A'<�masses- 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: _ tic system is in proper working order at the present time. B. System Conditionally Passes: F 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 statemen explain. ts. If"not determined"please Wl� The septic tank is metal and over 20 years old'' or the septic tank(whether metal ornot) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the exisIL4 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 indicatirr�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 pipc(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 s stem will pass inspection if(with approval of the Board of Health): y broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of I I ,r OFFICIA-L INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 41 Admirals Lane Owoer: Paul Fazio Date of Iaspechoo:3/'1/01 C. Further Evalustioo is Required by the Board of Health: Conditions exist which require Nnher evaluation by the Board of Health In order to determine if the system , is failing to protect public health,.safcty or-the environment. I. System %ill pass unless Board of Health determines In accordance with 310 CMR I5.303(1)(b) that the system is not functioning in a maooer wbich will protect public bealtb, safety and the envirooment: 1(.b Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 5o feet of a bordering vegetated wetland or a salt marsh 01 5%stem will fail unless the Board of Health (and Public Water Supplier, If any) determines that the s,,stem 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 I of a public water supply Nv The system has a septic tank and SAS and the SAS is within SO 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 et or more from a prig-ate eater supple well Method used to determine distance This s>stem passes if the well water analysis, performed at a DEP eenifted laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nirrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other I failure criteria are Triggered. A copy of the analysis must be anaehed to this form. 3. Other: 3 Page 4 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Add ress41 Admirals Lane cisterville,Mass. Owner: Paul Fazio Date of Inspection: 3/3/0 3 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No/ NV up 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 outletinvert due to an overloaded or clogged SAS or cesspool j.i 12 11466 CAp �squid depth inte%peol is less than 6 below invert or available volume is less than 1/2day flow equired pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped/. VAae elko 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 V/water supply. _ /any portion of a cesspool or privy is within a Zone 1 of a public well. y portion of a cesspool or privy is within 50 feet of a private water supply well. l.� 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 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.] (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as I 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 now 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 �`ihe system is located in a nitrogen.sensitive area(Lnterim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public water supply well 4 If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered ' es"y to 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 w'pgr y o dance with 3 IO CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of I I OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:41 Admirals Lane Osterville,Mass. Owner: Pa u 1 Fa 7.i c) Date of Inspection: -i-/,i f n- 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 2were any of the system components pumped out in the previous two weeks? d Has the system received normal flows in the previous two week period? ZHave large volumes of water been introduced to the system recently or as part of this inspection ? 4/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 ? occluding the SAS, located on site? Were all system components, 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: Yes no / I' 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)] 5 Page 6 of 1 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 41 Admirals Lane Osterville,Mass . Owner: Paul Fazio Date of Inspection: 3/1/0 3 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): �* Number of bedrooms(actual): _ DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): %X�JO= � •� Number of current residents: Does residence have a garbage grinder(yes or no):iLh Is laundry on a separate sewage system(yes or no):-06 (if yes separate inspection required) Laundry system inspected(yes or no):,KeS Seasonal use: (yes or no):AIP Water meter readings, if available(last 2 years usage(gpd)):2 0 01 —1 2 0, 0 0 0 ga 1 l ons=3 2 8. 7 7 GPD Sump pump(yes or no):" 2002-119, 000 gallons=326 . 03 GPD Last date of occupancy:1TAZe. cJ CuW­*4�2 Sprirriler system is present COMM ERCIAL/INDUSTRIA L Type of establishment: Design flow(based on 310 CMR 15.203): 40 gpd Basis of design flow(seats/persons/sgft,etc.): .� Grease trap present(yes or no):,dZj Industrial waste holding tank present(yes or no):yid Non-sanitary waste discharged to the Title 5 system (yes or no): 4.V Water meter readings, if available: Last date of occupancy/use: /L OTHER(describe): 11�4 GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or no): s If yes, volume pumped: / gallons--How was quantity pumped determined? 1?M4S:41'_ML Reason for pumping: FtJy 2a"" )eys TYPE OF SYSTEM I/Septic tank,distribution box,soil absorption system L 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) , I LL Tight tank 'ep_Attach a copy of the DEP approval ,��Other(describe): Approximate aee of all components,date installed(if known)and sodree of information: I Were sewage odors detected when arriving at the site(yes or no): 6 Page 7 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:41 Admirals Lane Osterville,Mass , Owner: Paul Fazio Date of Inspection: 3/3/0 3 BUILDING SEWER(locate on site plan) Depth below grade: /T Materials of construction:_cast iron /0 PVC mother(explain): d/�, Distance from private water supply well or suction line: Comments(on condition of joints, venting, evidence of leakage, etc.): ,Joints appear tight No evidence of leakage The system is vented through the house vents. SEPTIC TANK: (locate on site plan) leA53'OW AV.S Depth below grade: � Material of construction: �Eoncrete 4/Dmetal.40 fiberglass.0 polyethylene N©other(explain) �— If tank is metal list age:,_ is age confirmed by a Certificate of Compliance (yes or no)��(attach a copy of certificate) l Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined: /7/r4 7Y w Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,,evidence of leakage,etc.): Pump the septic tank every 2-3 years Inlet & outlet tees are in place The tank is stucturally sound and shows no evidence of leakage.Pumped tank at time of inspection. GREASE TRAI)4�5(locate on site plan) Depth below grade: r&Y Material of construction;,�concretedmetaWo fiberglass4/Xpo lye thy]en�z1 other (explain): 4)�4 Dimensions: A14 Scum thickness: 4,-X7 — 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.): Grease trap is not present. 7 Page 8 of 1 I OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:41 Admirals Lane w Owner: Paul Fazio Date of Inspection:3/3/0 3 TIGHT or HOLDING TANK(tank must be pumped at time of inspection)(locate on site plan) Depth below grade: AA Material of construction:�0 concreteA,�j metal fiberglass,y,9 Polyethylene,.a4 other(explain): Dimensions: Capacity: gallons Design Flow: J1,4 gallons/day Alarm present(yes or no): Alarm level: 4),4 Alarm in working order(yes or no): Date of last pumping: �L4 Comments(condition of alarm and float switches, etc.): Tight or holding tanks are not present. DISTRIBUTION BOX: Zif preseni'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.): pi_s_tri hni-i nn hnx has ane 1 atpra1 -No evi deep of sr)1 i ds carry Q"cY NO Q3zi donne of laak;ago into or- ®tlt of the box .. PUMP CHAMBERd&t- 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.): Pnmi Chamhar i c nnt- =rpsent i 8 Page 9 of 1 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 41 Admirals Lane Osterville_,Mass. Owner:pa u 1 pa7.i Date of inspection: 3/3/0 l SOIL ABSORPTION SYSTEM (SAS):locate on site plan,excavation not required) -1 -1000 gallon precast leaching pit If SAS not located explain why: Located- SPA page 10 Type leaching pits, number: / ,00 leaching chambers, number: 6 ;D7T leaching galleries,number: �5— leaching trenches,number, length: d NVleaching fields,number, dimensions: d overflow cesspool, number: L� innovative/alternative system Type/name of technology:j1pa Svc e,2 Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Lcmmv sand to medium fine sand.No signs of hydraulic failure or ponding Roils are dry-Vegetation is normai.The iaecHing is presently dry. CESSPOOLSf,��(cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: ('> Depth-top of liquid to inlet inven: Depth of solids layer: M 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.): LPs__Srx�olG a e not present PRIVY,rj4locate 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.): Privy is not present 9 Page 10 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 41 Admirals Lane Osterville,Mass . Owner: Paul Fazio Date of Inspection: V-i f n-i . 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. FConf ` o ' r Ci rt Lr-" s Lo_ (0,3ty i Ili 10 Page 11 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:41 Admirals Lane Ost ryill .,Mass. Owner: Paul Fazio Date of Inspection: 3/3 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: No Obtained from system design plans on record-If checked,date of design plan reviewed: NA yyS Observed site(abutting property/observation hole within 150 feet of-SAS) p0—Checked with local Board of Health-explain: N A s Checked with local excavators, installers-(attach documentation) YESAccessed USGS database-explain:http: /town.barns table.ma.us. You must describe how you established the high ground water elevation: sed: Gahrety & Miller Model. 12/16/94 Ground water elevations above sea level. sed: USGS--Observation well data. June 1992 sed: USGS- Technical bull Ptt-i n 92-non-1 plate #2 Annual ranges of around -;6pAi60n- January 992 V. Leaching Pit ;eet 7 Groundwater: feet Below Bottom of Pit High Groundwater Adjustment 1.8 ft per Frimpter Method Therefore, the vertical separation distance between the bottom of the leaching it and the adjusted P ) groundwater table is feet. I 11 •nrslrw.-nt•t+�•t,-trnrm+n+sn�-nrtrnrr�rarnw+++nri�n+n.rn n�rws++�n�st�+ .rR-rrr�r-:..^ , TOWN OF Barnstable BOARD OF 11EALTII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D •- CERTIFICATION IJ •••T!'t^T•••:•1-�fif.^.�TT4TIf•.TI'IT.'t'f►I TIRifT1I39'IT7'1'T4'I nt1l'Tt71R7�f-9••A.A1Af/�1A7R7 t�... !.•n1"T'T•1 +..fit -TYPE OR PRINT CI.EARLY- PROPERTY INSPECTED STREET ADDRES$ 41 Admirals Lane Osterville Mass . ASSESSORS MAP, BLOCK AND PARCEL # OWNER' s NAME Paul Fazio- . PART D - CERTIFICATION I NAME OF INSPECTOR Joseph P.Macomber Jr. COMPANY NAME J.P.Macomber�A Sorf Inc. COMPANY ADDRESS Box 66 Centerville,Mass. 02632 Street Town or CSty State LIP COMPANY TELEPHONE ( 508 ) 775 - 3338 FAX ( 508 1 790 - 1 578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposaj system at ID his address and that the information reported is true , accurate, and omplete as of the time of -inspection . The inspection was performed and any ecommendations 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 System: PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15 . 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 acted has found that the system fails to protect the public health and the environment in accordance with Title 45 , 310 CMR 15 ..303 , and as specifically noted on PART. 0 - FAILURE CRITERIA of this inspection form , Inspector Signature Date ' I ne copy of this ce tificatioh must be provided to the OWNER, the BUYER ( where applicable ) and the BOARD OF HEAL711, * If the inspection FAILED, the owner or.).operator shall u within one year of the date of the inspection, unless allowed dortrequiredm otherwise as provided in 3.10 CMR 16 . 306 . partd .doc /? 1 oFtN Town of Barnstable • BARNSTABLE, • MASS. Board of Health �pr 039. ``� P.O. Box 534, Hyannis MA 02601 ED MA'S A Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Ralph A.Murphy,M.D. Sumner Kaufman, M.S.P.H. To: FAZIO,PAUL A&MARINA L TRS Date Monday,March 05,2001 %AMAIL REALTY TRUST 41 ADMIRALS LN OSTERVILLE M 02655 RE:Underground Storage Tank at 41 ADMIRALS LANE Map Parcel: 118132 Tank NO: 01 Tag NO: 00758 Our records indicate that your underground fuel(or chemical)storage tank is over 20 years old,and has not been removed as required by section 03: subsection 2 of the Town of Barnstable Health Regulation regarding fuel and chemical storage systems. You are directed to remove this tank sixty(60)days from the date of this notice. After your tank is removed, please furnish this office evidence in the form of a permit from your local Fire Department within ninety(90)days of the receipt of this notice. You may request a hearing provided a written petition'requesting same is received by the Board of Health within ten(10) days after this order is served. Per Order of the Board of Health Thomas A.McKean,RS,CHO Health Agent 03-27-2001 11:34AM CENT OST FiREDEPT 508730-2385 P.02 Make application to local Fire Department Fire Department retains original application and issues dupficate as Permit- 6 �\ 7 w�e n�a�c�n�4 C:ftir.;�XW{ eb- 13 17WIX a/cJ��x� ✓ xevdreCc�ya�,_ F.._::....,.._ APPLICATION and PERMIT if.ee: $25�(lfr _ for storage tank remcv:J and transportation to approved tank dispcsal yard in accordance with the provisions of M.G.L. Chapter 1.8. Section 38A, 527 CMR 9,00, application is hereby snare by: Paul Fazio x Tank Owner Name(pt,E,-'print) _ __ -�'gnaTurcr;,�ayrh7rcxP�'n,:,�Address —.- 41 Admira16 Lane, Ost:e:ville, KA l ----- ----- -------- sate z;Fz;F, 1 Company Name Artyaxtcpd. ,Yo rime tnal _ ! Co.o:individual_ AdvancevircnmenCal Kni # Address P.O. Box 472, S. Dennis„ MA Address emnt Sicnat ap yinc`�r=e Signature -Pi n .cr_emit) i i - _ Other IFC!CzrcisE_ Other ____ ..: IFCI Certrtted _ ,. -- _ Tank Location 41 Admirals Luna:., Osterville �--- - S�e-r h7Cras —" fTank Capacity(gaflcr-. - 2,000 Substance Last Stcr<____ #2 Fuel Oil } 'ar*Dimernsions fotaryi len lI j - Firm transporting wastes Advanced Environmental State Lic. # MA50g385°100_ Hazardous waste mzrr.<=- ; " - c'.P,A.# ---- -- - i Approved tank di5pcse � I.G. Grant Tank and 0 03501,i'i_ - y - Type of inert gas TP,r,k yard address Re4dvi.11e, MA Centerville 0192D City or Town - FUIa�.# Permit# marchL.6, 2001 April 9, 20U1 Date of issue ___ _ ___ --Date of expiradon-�M 20011201.028 -wi Oig safe approval number D' Safe Toil -fel, Number-800-322.4c444 i Signature/Title of Of`cer;ranting permit After rerncval(s)send =?•290R signed by Local Fire Dept.to UST Regulatory Compii Jnit,One Ashburton Place, Rocm 1310, 3cston. . TOTAL P.02 ...................... Fug. ......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 75 v /..............._.oF..,,� /y.(���el-..e-............................. Appliration -fur M ooal Workii Tow0rurtion Vanift Application is hereby'made for a 'Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: y ---- Loc 'on•Address �, or Lot N . � }L. caner a ���.... . - -- ...._....__.._.. -------------------•--------............- ,/v!/ !mot.._... Installer Address d Pq Type of Building Size feet Dwelling ' No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ------ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOther fixtures ../1' t'N � -----••---•-------------------------------------------------------•-- W Design Flow.............. .......--....--..gallons per person per day. Total daily flow__73..(-----..------- ..gallons. WSeptic Tank—Liquid capacity :f--gallons Length................ Width................ Diameter------_------_ Depth..-.---.--...... x Disposal Trench—No- -------------------- Width. ---------------- Total Length-------------------- Total leaching area.........._---------sq. ft. Seepage Pit No......./...-------- Diameter../�3..--.------- Depth below inlet-------------------- Total leaching are:0.46.7-.----sq. ft. Z Other Distribution box ( ) Dosin tank ( ) Percolation Test Results Performed by.—T --- _-.esd.". .................... Date..�,� �_ __.-..:.... o. 1— —? m nutes er inch Depth of Test Pit:IV _ ------- Depth to round watefAi+�vF-. y G+✓ ,GF,� Test Pit N � p p � p a LL, Test Pit No. 2................minutes per inch Depth of Test Pit..----.--.-----.---- Depth to ground water...-...-.--------------- ------------------- --------------- ----•--••----------------------------•--- ............----.._..-•-•-------------...............----------------------- Description of Soil. �t = � iYl ' �� :.r'CJ -.J_a_11 ..3.a-- ��------ W ---------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------- VNature of Repairs or Alterations—Answer when applicable----------------...:--------------------------...-.--....-.--...-.-.-.. - -------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued y th board of health. ,� Si g = --- D '� 7 = Application Approved By----- f------------------------ 7= . Date Application Disapproved for the following reasons:--------- --------------------------------------------------------------------- -----------•----------------------------------••-------------------------------•-------------------------...---------------------------------------------------------------------- Permit No......................................................... Issued....V-'�f�1 Date ;D ....................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH oF..,���.f��r �%�'.�" `-............................. Application -for Mapos al lVarkii Tono#rur#inn Vrrutit Application is hereby'made for a Permit to Construct (,)<) or Repair ( } an Individual Sewage Disposal System at: ------....-e----------------------------------------------------••••---------- ••--- . ..... Location-Address or Lot T— ......................................... ..........................r -r% ✓,' 'f-3 1-_-------------.............4/....................... . ' �caner Sd'dress/ %1..... /`,/ e'/r�!7r( !w � r ............................................. Installer Address d Type of Building Size Lot_4n e.TA�a`Sq. feet Dwelling -'No. of Bedrooms.--_- 3.................__ . _....Expansion Attic ( ) Garbage Grinder ( ) Other—Type of BuildingNo. of persons .................. Showers — Cafeteria Q' Other fixtures __-....... f✓-"' -`__-_.__.__ d ------------------- ------------------------------------ -------------------------------------------------------- W Design Flow.............. .-��-_--_-__.-gallons per person per day. Total daily flow__ _.p.___--_-__---_--_-_-.......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_2�4------------- Depth below inlet.................... Total leaching areal ......sq. ft. Z Other Distribution box ( ) Dosin&tank ( ) Percolation Test Results Performed ................... Date............. �_l t:f.f 7�-.9!- Test Pit No. 1......e......minutes per inch Depth of lest Pit-/:q_y_�____. Depth to ground water�`s nti -_�'---- '. 44 Test Pit No. 2________________minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ ---------------------- ....................................................---------:.... 0 Description of Soil-&Y.0: ./ fr!�..r�..�� _J-0/o 5�✓! _ ra �......-._C' .0 .. z ------- nZM_!Si/ x W -------------------------------------------------------------------------------------------------•----------------•-------•--------•-•-•-•--------•----•----•-•--•-------•---•---•-------------•------ UNature of Repairs or Alterations—Answer when applicable..---------------------------------------------------------------------------------------------. ...._..-•-------•...................•------------------------------------.......---•----•------------ ------•--------------•-----••-•--•--•------------------------------------------------------------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article \I 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. r Sig a......--- - --- --------------------------------------- ! � e+r Da�- ,,�' Application Approved B c'� Application Disapproved for the following reasons--------------- -------------------------------•-•--------------•------------------------- Date---------- -------•------------------------------------------------------------- ---------------------------------.----------------------------------------------------------------------------------------------- Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............... .. I f 1 i.......OF............. r-- .. ':1.. `i............................................... Trr#ifira#r of 1011,11mplianur THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed (�)or Repaired ( ) f � _ _ / ` rf I at.•-••-• =- ` (, - - ,/ }a ° j/ ` r'7./_t.:. v�"= fir !/ o-f f Get y1 "itf r L/ /°.."" has been installed in accordance with flie provisions of Ar -'XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No... �f__:�_—_s---------------- dated_..._--:�_-_"�--i' 7�' .•-- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL SATISFACTORY. DATE..........sj- -- a"--1 7 2....................................... Inspector--------- :l THE COMMONWEALTH OF MASSACHUSETTS BOARD OF --HEALTH /.....�`"I �......OF Nod`-= -�.2.... � FEE----•-----'---........ �i��o�ttl ork,��-���t�#raar#ion �rrnti# Permission is hereby granted =--------------------------------------------------------------------------------------- to Construct ,/- or Repair 3�(�)-' p ( -)�`an Individual Sewage Di 'oral System atNo / ---: ... ...., ......... ==- ----- -- ---- - - -•-- .'_ ..---�..---------------------------------•- Street as shown on the application for Disposal Works Construction Permit No----Z........ Dated------J'__- .!.% ... s, i s �. . DATE................................................................................ Board of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS p�1►���+ pab V. I I IV 4Lp 10 � a N Pi R 1/ � seYarrc 1 Qoh�r� ' t3 7Z n1`. 5 Wit' /G 1 Rip gF,� 'suwLy,q�a Iov S 76 6t,4. L `. /. Soo 88 0 3 /✓O t7.�'1isYf7o uS BAD rs ati L i H�p �jr CERTIFI ED PLOT . PLAN LOCATION SCALE . . e, PLAN REFERENCE Z'� WA/ on/ r'' Fi�i'Jr;t� t s/�Vi D �oivq p r 5/4vj,4 KE I CERTIFY THAT THER!S�!^!G... SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF S/ ✓i'� / � SLV/,i4 BA; !-sL . . . . . . . WHEN CONSTRUCTED. DATE !?Xf`7.9' - PETITIONER: f y�/,4,,vti/g /1/1 S, r REGISTERED LAND SURVE R N59345 SH&e'i- TOP OF FOUNDATION CONCRETE COVER CONCRETE COVERS e o 4"CAST IRON 12"MAX. PI PE (OR 12"MAX. '' 4"ORANGEBURG(OR EQUIV.) EQUIV.)- MIN. PIPE- MIN. � LEACH ° PITCH I/4"PER. PITCH 1/4"PER.FT. PIT oc PRECAST o' INVERT o a LEACHING EL..4c3. l. INVERT INVERT ? . e•a PIT OR. o'. SEPTIC TANK p DIST. ' Z s , • w EQUIV. o INVERT EL..�P5. BOX EL....... . ; >_ .•: /oco • . . GAL. INVERT 0CL 0. �°. y INVERT w w �' ';` 3/4"TO I I& EL'f?.7. •.• e �� D' .�• WASHED w STONE /L --�-s'D1A. o• ° , �+--- /p' DIA.---►-� NONE PROFI LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE LrPh R ILE L IM I N A V SOIL LOG WITNESSED BY : DATE Der. /Siy7 TIME�G%3o Ar-t p6?uG u �2. . . . . . .�. . BOARD OF HEALTH TEST HOLE I TEST HOLE 2 4nfA4 �' ALL � ENGINEER ELEV. .'544•8cl. . . ELEV. .. . . .Im w°oacoal,y a DESIGN DATA s�e_sa.c. 3 NUMBER OF BEDROOMS 33a TOTAL ESTIMATED FLOW GALLONS/DAY BOTTOM LEACHING AREA ?�:'g�. . SO.FT. /PIT Core„' SIDE LEACHING AREA �88' SQ.FT./ PIT 5 � GARBAGE DISPOSAL NP':W.(50% -AREA INCREASE) TOTAL LEACHING AREA . .24 7 O G. SO.FT PERCOLATION RATE �-E3 z' . MIN/INCH LEACHING AREA PER PERCOLATION RATE J�- �?. . SQ.FT. No .WATER ENCOUNTERED NUMBER OF LEACHING PITS .1 77v. .7-wo• /EZrr APPROVED . . . . . . . . . . . . BOARD OF HEALTH Is% 7D"s _. arc sT�/C AW2 Ai77 TROMAS E.KELLEY CO: ' DATE . . . . . . . .ENGINEERS—SURVEYORS �j 7 AGENT OR INSPECTOR 346 LONG POND DRIVE SOUTH YARMOUTH,MASS. '�4A02664 ���'(H OFMgss �y,� +�� THO E. rn SiLVi � t u' p No.24260 O y L/n/p'0q G�� EM " O� GISTEM A N 6� PETITIONER / /i`}�/^/j3 /1ifA3�• t= 3�'°;`�r' 0 1,