The URL can be used to link to this page

Home My WebLink About0038 OLD EAST OSTERVILLE ROAD - Health 38 Old East Osterville Road Osterville A = 145 - 052 �I I�� TDWROP BARNSTABLE; SAGE 11 �5ES50 'S MAP: Lcff � x AST�Xi'S IdAil� `PIYQIJE Id0 / S$PUC TAH&CAPACITY f--- AC ER:OR D R.,,,, PHIMT-DA'M. S�stratian>i�ts Bstvieen tba: ,, . :. Ivl xiun►tmAd�ustetl'CrauaiiwaterTableistheBattotnofL 9.108 ►Gib+ Pl ate .titer:;u iy yYc[aria L.eoiaiain ?acdety.S€�anY et1s mist 0eitc.ctie within 2A0 feet pFeet f wit bin f�cs ). ft ►Jeftd an Lea >hln pacaliiy euny wetlands exist Feet Atlia MG fi.e� icx�dl ip�laGiliry} s,.,.. D4JK o � oa C-( 6-1- ' A .q- Of 6-Y-,3cl- Commonwealth of.Massachusetts _ 0S A. f ,w Title 5 Official Inspection Form ill Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 38 Old East Osterville Rd Property Address Pauline Healey Owner Owner's Name / information is required for every Osterville MA 02655 10-17-19, page. City/Town State Zip Code Date of Inspection h k.. IT 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. A. Inspector Information Shawn Mcelroy Name of Inspector Upper Cape Septic Services 1 Company Name P.O. Box 73 Company Address E. Falmouth MA _ . 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification I certify that:l am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000);1 have personally inspected the sewage disposal system at theproperty address listed above;the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes r 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 10-17-19 spec or'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 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form i i► Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 38 Old East Osterville Rd Property Address Pauline Healey Owner Owner's Name information is required for every Osterville MA 02655 10-17-19 pace. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® 1 have not found an information which indicates that an of the failure criteria described Y Y in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System is in good working order with no sign of failure. 2) 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 ore i t ation or tank failure is imminent. System will ass unsound, exhibits substantial infiltration xf I r y p 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 El ❑ ND (Explain below): t5insp.doc•rev.7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 Commonwealth of Massachusetts ;.; Title 5 Official Inspection. Fora i� w:' Chi Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 38 Old East Osterville Rd Property Address Pauline Healey Owner Owner's Name information is required for every Osterville MA 02655 10-17-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) € . 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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): ❑ distribution box isleveled 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 ON ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health:. r ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if r the system is failing to protect public health,safety or the environment. a. 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: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts r� Title 5 Official Inspection Form bl Subsurface Sewage Disposal System Form -Not for Voluntary Assessments V, / 38 Old East Osterville Rd Property Address Pauline Healey Owner Owner's Name information is requ red for every Osterville MA 02655 10-17-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. 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. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No I ` ❑ ® 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 t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form iFI Subsurface Sewage Disposal System Form =Not for Voluntary Assessments 38 Old East Osterville Rd Property Address Pauline Healey Owner Owner's Name information is required for every Osterville • MA 02655 10-17-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No 0 ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool isrless than 6" below invert or available volume is less than Y2 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. ❑ ® 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 water supply 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 2000 gpd- 10,000 gpd. ❑ . ® 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. 5) 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. i For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts a Title 5 Official Inspection Form i�l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 38 Old East Osterville Rd J- Property Address Pauline Healey Owner Owner's Name information is required for every Osterville MA 02655 10-17-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) p rY If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered yes to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: 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? ® El available 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? ® ❑ Wasthe 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 CMR 15.302(5)] t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts 3 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments' . 38 Old East Osterville Rd Property Address Pauline Healey Owner Owner's Name information is required for every Osterville • MA 02655 10-17-19 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Description: Number of current residents: - , 2 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes [ No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ .Yes ® No Last date of occupancy: 10-2019 Date ' t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form i� wa i�l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 38 Old East Osterville Rd. Property Address Pauline Healey Owner Owner's Name information is required for every Osterville MA 02655 10-17-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. 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 Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Owner---pumped 2yrs ago Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Maintenance t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 I ' Commonwealth of Massachusetts r� 3,� Title 5 Official Inspection Form ��I' _Icl Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 38 Old East Osterville Rd _ Property Address Pauline Healey Owner Owner's Name information is required for every Osterville MA. 02655 10-17-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: I ® 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): Approximate age of all components,,date installed (if known) and source of information: 1987 Were sewage odors detected when arriving at the site? , ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 24"feet Material of construction: El cast iron r ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. Lt5,..p.d,oc•rev.7/26/2018 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form C�'l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments v >�` 38 Old East Ostefville Rd Property Address Pauline Healey Owner Owner's Name information is required for every Osterville MA 02655 10-17-19 pagE. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank (locate on site plan): Depth below grade: 18"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal 611 Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 26" Scum thickness 0 Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? 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.): Tank is in good condition with baffles installed and no sign of leakage. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form , Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 38 Old East Osterville Rd - Property Address Pauline Healey Owner Owner's Name information is required for every Osterville t, MA 02655 10-17-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. 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 j Date of last pumping: I Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): ' 8. 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 • t5insp.doc•rev.7/26/2018 Title 5 Official Inspecton Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form C�ll Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 38 Old East Osterville Rd Property Address Pauline Healey Owner Owner's Name information is required for every Osterville MA 02655 10-17-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cont.) 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 9. 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.): Good condition with water at working level and no sign of back-up from pit. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 Commonwealth of Massachusetts r� 3 Title 5 Official Inspection Fora I� w_� �Z) Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 38 Old East Osterville Rd _ Property Address Pauline Healey Owner Owner's Name information is required for every Osterville MA 02655 10-17-19 page. City/Town State Zip Code Date of Inspection D. System Information (cone.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ -Yes ❑ No* Alarms in working order: 4 ❑ Yes ❑ No* i 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. 11. Soil Absorption System (SAS) (locate on site plan,-excavation not required): if SAS not located, explain why: Type: ® leaching pits number: 1-1000 gal ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ,� wa r► Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 38 Old East Osterville Rd Property Address Pauline Healey Owner Owner's Name information is required for every Osterville MA 02655 10-11-19 page City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach pit in good working order and holding 12" of water with stain line at 30" below inlet invert. 12. 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 Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev..7/26/2018 Tile 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form i�t wSubsurface Sewage Disposal System Form Not for Voluntary Assessments r 38 Old East Osterville Rd Property Address Pauline Healey Owner Owner's Name information is OSterville ' required for every MA 02655 10-17-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): r t5insp.doc•rev.712 612 01 8 Title 5 Official Inspection Form:Subsurface 9 Sewage Disposal System-Page 15 of 18 P Y L < Commonwealth of Massachusetts w Title 5 Official Inspection Form i-'I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 38 Old East Osterville Rd Property Address Pauline Healey Owner Owner's Name information is required for every Osterville MA 02655 10-17-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. 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 19 1 f ., r P �y r: a , A � 63. l.c -Y . t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 i Commonwealth of Massachusetts Title 5 Official Inspection Form I;I Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 38 Old East Osterville Rd Property Address Pauline Healey Owner Owner's Name information is required for every Osterville , MA 02655 10-17-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope , ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 20 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: 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: USGS and town maps show groundwater at greater than 20'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 18 Commonwealth of Massachusetts 3 Title 5 Official Inspection Form -i' ri Subsurface Sewage Disposal System Form Not for Voluntary Assessments 38 Old East Osterville Rd Property Address Pauline Healey Owner Owner's Name information is required for every Osterville MA 02655 10-17-19 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 oFTHE, Town of Barnstable Regulatory Services + BARNSTABLE, MASS. Thomas F.�Geiler, Director �p 1639. Public Health Division Thomas McKean, Director 200 Main'Street,. Hyannis,MA 02601- Office: 508-862-4644 Fax: 508-790-6304 Bar(s): 80334 Name of Offender: Pauline Healy, DOB Location of Violation: 38 Old East Osterville Road, Ostervilie Date(s) of Violation: August 8, 2010 Violation(s): Town of Barnstable Board Code § 353-1 Storage of garbage and rubbish, responsibilities of occupants_ Facts: On 6/28/10, Health Division received its-third complaint regarding a trash problem at said location. Health Inspector Timothy.B. O'Connell, RS went to said location on 6/28/1D: Inspector O'Connell did.observe a large red dumpster approximately half full with yard debris (branches, leaves, ect.). This dumpster did-not have a cover as required by Town of Barnstable Ordinance 353-2. On same day I left said offender a phone message to either remove dumpster; or cover it. I did not here back from said offender. This dumpster was left on this property for over two (2)months. Due too many past complaints (12-4-2009 and 2-23*2009) and warnings (BARW5539). I issued said citation BAR(80334). - Respectfully Submitted, Timoth O'Connell, R.S.— Health Ipector Town of Barnstable 200 Main Street Hyannis, MA 02601 (508) 862-4644 r 4, >a, Citizen Web Request Page 1 of 4 g ' k Y f. P� R :. z mr- Log:l Cd In)'ir3. y �� N-, V�L�EF e l Ct}1 ,�._ out' 'to i.;sers `+e, -rc R,e,,,t,£s'.a t,i'c"": to Request Information . ___..._..__._ .......____ . ..._._...... Request ID: 24625 Created. 2/23/2009 1:25:19 PM _� . ..� _ Cabot, Jaime Status: Closed Assigned To: Health Office Anonymous: Yes Request Category: Section 353-1 Garbage and Rubbish Routine work: No Estimate: No Date scheduled: ........ .....9 _.v._ -- - -------- Estimated 3/16/2009 Chan a Estimated Completion Completion Date: 6 r Date: _ .are Mon Tu � 'ed ,hu �,i t 22. 23 24 m5 jC 2i .F 12 � f a ,2 3 -14 22 23 24 2 6 2.7 2.8 3J 3 a. 3 Created By: Crocker, Sharon P.riority:., Medium Health-Office .........._.__.__...._.................._..::_..._ _ _ ....._...... Citation Numbers: . BARW5539 Requestor Information _ _.__. __..._..._..._...._._. . .........._..... ...._..__. Requestor Request DETAILS: _ LOCATION: 38 OLD EAST OSTERVILLE ROAD Osterville, Ma 02655 Request Parcel Number Map 145 Block: 052 Lot: Continue of prior complaint: Dumpster has been there two months and trash is falling out onto ground.. Parcel._Lookup No activity in awhile.The building dept had put a stop order for bldging a shed without a permit. Requestor http://issgl2/intemalwrs/VVRequest.aspx?ID=24625 10/20/2010 Citizen Web Request Page 2 of 4 1 called again to report that dumpste`r had not been removed on 3/16/2009 12/04/2009 - Red Dumpster back on property and full. , Email: Track Request Progress Request Work'History:;. Internal Note History: Entered on 2/25/2009 4:31:22 PM System entry on 2/23/2009 1:25:19 PM: by Cabot, Jaime 'Assigned to Cabot, Jaime. JAC inspected complainton 2/25/2009. A deck W being built on grade was observed in the back yard, System entry on 3/16/2009 8:18:53 AM childrens toys were piled up against the fence, debris rubbish;furnitue and brush were observed in Estimated completion changed-from., the yard. A'30'Cubic yard dumpster was in the fronts i �3/9/2009 to„3/16/2009 yard. JAC contacted Judy at Casssova 508 563-5070" - -- - and inquired as to the situation. i System entry on 3/17/2009 3:27:07 PM. - i Entered on 2/26/2009 3:19:21 PM Request Closed by cabotj by Cabot, Jaime- _- System=entry on 12/4/2009 11:18:04 AM Warning notice issued to: Pauline Healy 104 Y Academy Rd. Brighton, MA 02135 Certified Mail # Request Reopened by wadlinge 7007 3020 0001 3429 7847 .......... s System entry on 12/4/2009 11:38:26 AM: Entered on 3/9/2009 8:32:49 AM by Cabot,,Jaime -Please Review- email sent to,Cabot,Jai. Last modified on 3/9/2009 8:36`:08 AM System entry on 12/4/2009 3:30:14 PM: JAC recieved voice mail from Pauline Healy who I say's she does not,know why the dumpster is still Request Closed by cabotj thereas she has called for a pick up.-Left,tel. number, of 857-225-1051. Entered on 3/9/2009 8:37:20 AM by Cabot, Jaime E JAC spoke to Pauline Healy say' s she will take care violations this week. Entered on 3/12/2009 4:20.24 PM Y ' by Cabot, Jaime JAC re-inspected complaint violations still present 2 45p 3/12/09 citation to issue. ' Entered on 3/16/2009 8:18:53 AM http //issgl2/intemalwrs/WRequest.aspx?ID=24625 10/20/2010 Citizen Web Request Page 3 of 4 by Cabot, Jaime JAC needs to speak to Tom Mckean regarding issuance of citation for rubbish. Entered on 3/17/2009 3:26:59 PM by Cabot, Jaime JAC inspected complaint dumpster had been i remove from property. No violations were observed l '' from the road, however there was junk(golf bag w clubs, basket, boards and other items) piled up w against the side of the house. ' l Enter work progress:. I Enter internal.note: (Viewed by everybody) I (Viewed internally only) I- l � S ell Check ; Self Check Add document or image link: . .. '. You can also type in a folder narise to see everything in the folder , Current Links: ...3L3„i.l€s.. Ea SIT,t}F7�.e��I in '.;: 53�4't: Time worked on request: 3.00 Response time: 12.00'. Time entries are in`ho€_€rs. Examples of time entries: t..2 , .5, 03 , t}v.3.5, 0,25, 0.10 Resoonse time: Measured from the creaflon date to y ur fi st actions can the i-eq lest, Do not include nights, weekends, n ho ida . its --s ense ime for most departments, ._. ........................ ....._. ....................... _e_._ Reopen C- Reopen and notify citizen . Reopen http://Issq 12/intemalwrs/WRequest.dspx.ID-24625 10/20/2010 NAME OF OFFENDER L , B p R 80334 TOV*IY N•O� IT ADDRESS OF OFFENDER to,{ �- BARS`I ADLE CITY,STAT,ZIP CODE yf prr7 ►q,. ( MV/Me REGISTRATION NUMBER OFFENSE ItAN 1.%flI.E. Ir,�•,�-,'�LJLw ��p-�.q,•�.f/ - 1�*��VV`r+,��is'' w'F ✓ ✓ a TIME AND DATE OF VIOLATION V LOCATION OF VIOL -ION. Z NOTICE OF =0 an P .pow ,�} 201Q Cif nS"� � cgVfIle LLJ f VIOLATION SigurIRFOrENFORTO/ ONf2 ENF RCINGDE . b BADGE NO. Cl) OF TOWN ~ I HE�EBY ACK OWLEDGE RECEIPT OF CITATION X a ORDINANCE 111°Nnable to obtain signature of offender. r�-..IV_F� THE NONCRIMINAL FINE FOR THIS OFFENSE IS S t� Date mailed tLu OR YOU HAVE THE FOLLOWING ALTERNATIVES WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTION(1)OR OPTION(2)WILL OPERATE AS A FINAL 0. REGULATION DISPOSITION WITH NO RESULTING CRIMINAL RECORD. ti (1)You may elect to pay Clark fine,either by appearing in person between 8:30 A.M.and 4:00 P.M.,Monday through Friday,legal holidays exceppted, before:The Barnstable Clerk,200 Main Street,Hyannis,MA 02601,or by mailing a check,money,order or postal note to Barnstable Clerk,P.O.Box 2430, Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE DATE OF THIS NOTICE. a ((2))If you desire to contest this matter in a noncriminal proceeding,yyou mayy do so by making written request to DISTRICT COURT DEPARTMENT,FIRST BARNSTABLE DIVISION,COURT COMPOUND,MAIN STREET,BARNSTABLE,MA 02830,Attn:21 D Noncriminal Hearings and enclose a copy of this citation for a hearing. (3)If you fail to pay the above offense or to request a hearing within 21 days,or If you fail to appear for the hearing or to pay any fine determined at the hearing to be due,criminal complaint may be issued against you. ❑ I HEREBY ELECT the first option above,confess to the offense charged,and enclose payment In the amount of$ Signature Citizen Web Request Page 1 of 3 'e^�PRIM Fps Ile 5 r wSy'` 5 l I q TOV , ._. Citizen �- q � t :, _ _- �..;.. Route try.= sees "'e•,`-- R_ .au ie>:S Qe to Re .'S Request Information ____ ....................................................._......__.._...._......_._.._.._................__.---,__-._...__._.._.__-_-.-._.__._....__._..._..._..�__—_—___—____.._ Request ID: 31387 Created: 6/28/2010, 11:38:39 AM Status: Assigned To Staff Assigned To: O'Connell,Timothy -Health Office Anonymous: No Request Category: General Routine work: No Estimate:' No _......_................. _, . Date scheduled: ..-. Estimated 6/29/2010 Change Estimated 9 June 2010 Jul Completion. Completion Date: Date: Sun Mon Tue Wed Thu Fri Sat 30 31 1 . 2 3 4 5 . 6 7 8 9 10 11 12 _13 14 15 16 17 18 19 .20 21 22 23 24 25 26 27 . 28 29 30 . 1 2 3 4 5 6 7. 8 9 li�_o Created By: Wadlington, Ellen Priority:' �mmMedium Health Office — _.. _.............. _.--_................__-__ .. --............. ___ Citation Numbers:"` BAR80334 , Re west®r Tnf�lrn�a�i®n� q . _ _. .......... .................... ....................::_ -- --...................... —._..._.. t Requestor . Request i i _ , DETAILS: = LOCATION: 38 OLD EAST OSTERVILLEyROAD Osterville, Ma 02655 Request 'Parcel Number MaP 1.. Block: 052 Lot 01 i Another large red dumpster was put into this yard and filled; no cover and animals are coming and going Parcel Lookup inside the dumpster. http://issgl2/intemalwrs/WRequest.aspx?ID=31387 8/10/2010 Citizen Web Request Page 2 of 3 j Email: Edit.._Requestor Information .... ........ ..... _ _ ............... ...............- -- ............ -_._-_-._...__--- Track Request Progress [ _. Request Work History Internal Note History: j Entered on 6/28/2010.2:53:10 PM '' ,, System entry on 6/28/2010 11:38:39.AM: by O'Connell, Timothy F ; Assigned,to Stanton- David . On 6-28-10 went to said property and did observe dumpster.,Dumpster about 1/2 full. Most of , System entry on 6/28/2010 11:42:55'AM: i contents was yard waste (brush and leaves).i did observe about 4-5 bags. They'were not torn open so 'Estimated completion changed from it did not appear that they were household.trash. 7/13/2010 to 6/29/2010 Will continue to"monitor. update delete System entry on 6/28/2010 11 43:54 AM:_ -Please Review- M1 email 'Connell ,._.- _ 0 e a sent to Timoth I.Entered:on 7/20/2010 8:48:27 AM � Y by O'Connell,Timothy System entry on 6/28/2010 1.06.48 PM. ` On 7-19-10 dumpster still present. I have left -numerous messages. Will issue citation if not Assigned to O'Connell;Timothy E •. removed or cover on 7-27-10 €update delete Entered on 6/28/2010 5:07:57 PM by O'Connell; Timothy Entered on 8/10/2010 2:01.21 PM' ` by O'Connell, Timothy ' i update delete On 8-10-10 dumpster still present. Will issue I citation. Long history of trash problems at property. l ] i Many prior warnings. I update delete Enter work progress:. i Enter internal note: (Viewed by everybody) (Viewed internally oral r 1 f 1 f ( , http://issgl2/intemalwrs/VYRequest.aspx?ID=31387 8/10/2010 .Citizen Web Request Page 3 of 3 [ Spell Check ._�iSpell``Cfieck<F Add document or:image link: J Browse � ( YOU cian also type in a foider nnarrfe to see eveny&,hing in t ie folder.... Current Links: Time worked on request: 5.00 Response time: 2.00 TTi- e e t-ieq are in hours . xamples of tinje,entries 1,25, O? 5, O? 75 1, 3.5, 0,25, 0.10 y, e� i ti.,"t c r €;tr(�m he C€ atit311'-tt<I e o fit 5 ii E:S on heC E? fit. _P� got include nights; v-jee ends;'and Iholid s in response timefor most departments, _..._ ....._. _._ Save Changes 4-. � Check to notify'town employee below v �: . to review this,request. Save changes and notify Health Office ;.citizen* _ ' Crocker, Sharon ' _: . Close request _. - Brief message to reviewer z :Close request and notify citizen* x Update � - . :• � .� .�, . .._ . ._.. .a. �� Check 1st ,a+7 aP Pub U lic se: P Inter.Friien l Versl n d o Internal'_Use: Printer.Friendlv_Version http://issgl2/intemalwrs/WRequest.aspx?ID=31387 8/10/2010 Citizen Web Request Page 1 of 2 P, ffil im R Citation Information s Contact:' Address L1, > Address L2: - „ti City,State,Zip: - - - --- Memo: i w� Citation #: 5539 i Ordinance: Chapter 353: NUISANCES -I- Storage of Garbage and y; Refuse y, Legal Description: Responsibilities of owners and occupants: Offense: 30.,Cubic Yard dumpster full_of debris has been left on lot over 30 days Violation Date/Time: 2/25/2009'1123 *' Offense Location: 38 Old East.Osterville Road, ......__....__....-.._..:_...............:_..._..._._._. . Offense Village: Hyannis Enf. Department: Public,Health Issued By: Cabot, Jaime ~: Badge.#: � - __ _----__— Fine: 0 Balance Due: 0 Payment Disposition: Voided.By: Pre-Co Arraign/Report Generated on Date: r Clerk's Hearing Request Date: C tl Hearing Date: ........_.-._........._....._................._....._......_......---...-.............................._......._......._...._......._..........:.............__......... .....__....._._.................................................._.._.._..........._......__.........._.... Docket #: I _....._........ _.__....-.._.......--- Hearing Disposition: http://issgl2/intemalwrs/citation.aspx?ID=5539 8/10/2010 Citizen Web Request Pagel of 3 fir' x a nErs " ' s [§1 . 8 ✓.�A`'v�R� �. _ k 'S, P10cam'ez " Loggedfn As: _.d , e Request Managerhent I•o to to Uses Se:£9':C.. R.ei ue§',s fcxeate Requests Request Information Request ID: 27889 Created: 12/4/2009 11:49:46 AM -._............_ _____---- ___._�. Status: Closed Assigned To: O'Connell,'Timothy Health Office Anonymous: Yes -„Request Category: Section-353-1 Garbage and.Rubbish Routine work: No Estimate: No Date'scheduled: ....... _ ....._........-....__.............. .. ._ Estimated 12/18/2009 Change Estimated N , t tp , an Completion Completion Date: Date: 'i fvion .i. . eb,' 'Th-U Sat 19 30 is 2 3 r i? :.2 13 13 "#9 C 2 ,i � 2 i %o � u a. 2 3 5 . 7 8 .g Created By: Wadlington,Ellen Priority: Medium Health Office __ .......... -- ----- Citation Numbers: Reques or Information Requestor Request DETAILS: LOCATION: 38 OLD EAST OSTERVILLE ROAD Osterville, Ma 02655 Request Parcel Number Large red dumpster full of trash., Map: 145 Block. 05? Lot: ........................... ............ ......... . ............._........ _.........._ Parcel Lookup Email: http://issgl2/intemalwrs/WRequest.dspx?ID=27889 10/20/2010 t; Citizen Web Request Page 2 of 3 Track Request Progress Request Work History: Internal Note History: Entered on 12/4/2009 3:36:52 PM System entry on 12/4/2009 11:49:46 AM: by O'Connell, Timothy Assigned to O'Connell, Timothy On 12-4-09 went to said property and did - observe a dumpster at property. It was filled will System entry on 12/15/2009.12:00:11 PM: brush, old furniture,and other debris. None of it was house hold garbage. Although.I did call;.dumpster Request Closed by oconnelt Co. (Cavossa)They told me dumpster has been at site since Sept 22, 2009. I then tailed owner.;of,. property and she was not home.1left a message for her to call me: Entered on 12/14/2009 3:47:59 PM by O'Connell, Timothy On 12-14-09 went to said property and met with. owner who said she is in the process of'getting dumpster removed.° Entered on 12/15/2009 12:00 11 PM by O'Connell, Timothy On 12-15-09 observed dumpster has been removed. Enter work progress: Enter internal note: _ (Vievied by everybody) ' (Viewed interilally,only) � Spell Check,��' 3 S eI1�Check �� A Add document or image link .y y http://is'sg12/internalwrs/WRequest.aspx?ID=27889 10/20/2010 Citizen Web Request Page 1 of 3 a a._ - rya ' f y -- g p .o-a1 .'r .. yj $ Loacod In As: �ze' n Request � Wednesday, Cto0 anagement- kou-t to U`Sers `JCar":h f'ecaezes c_` C e:-te Requests Request Information ...._.._.._........_._._._.._____.......,__..._._�_e.__ _ Request ID: 31387 Created: 6/28/2010 11:38:39 AM ...........--- --_ Status: Closed Assigned To: O'Connell,Timothy Health Office Anonymous: No Request Category: General Routine work: No Estimate: No Date scheduled: ._.. ......._........._._ __ _ _._._....._............_..._.__ Estimated 6,/29/2010 Change Estimated May 1-Ine- 2010 Jul Completion . Completion Date; Date: Sun �,� T e v red Thu F'N Sat 30 5 4, .: 16 1 18 19' 2 3 23 24 25 26` 27 28 29 30 2 3 i P 1. Created By: W'adlington, Ellen Priority: ` Medium Health Office - Citation Numbers: BAR80334 Requestor Information .._................_..........._...-----..._ ----- Requestor Request DETAILS: LOCATION:. 38 OLD EAST OSTERVILLE ROAD Osterville, Ma 02655 Request g - P _ -� ...Parcel Number., ["'Map: � �,.�" __ �,�, Another large red dum ster was 145 Block: 052 i Lot 01 ._._ put into this yard and filled; no cover and animals are coming and going Parcel.__Looku.p. inside the dumpster. http://issgl2/intomalwrs/VVRequest.aspx?ID=31387 10/20/2010 Citizen Web Request Page 2 of 3 * ' Email: Track Request Progress Request Work History: .Internal Note History: Entered on 6/28/2010 2:53:10 PM System entry on 6/28/2010 11:38:39 AM: by O'Connell, Timothy Assigned to Stanton, David On 6-28-10 went to said property and did observe dumpster. Dumpster about 1/2 full. Most of System entry on 6/28/2010 11:42:55 AM: contents was yard waste(brush and leaves). I did observe about 4'S bags.,They were not torn"open so Estimated completion changed from it did not appear that they were household trash: 7/13/2010 to 6/29/2010 Will continue to monitor. System.entry on 6/28/2010 11:43:54 AM: Entered on 7/20/2010 8:48:27.AM ' by O'Connell; Timothy -Please Review-email sent to O'Connell, Timothy On 7-19-10 dumpster still present. I-have left numerous messages. Will issue citation if not System entry on 6/28/2010 1:06:48 PM: removed or cover on-7-27-10 -- - Assigned to O'Connell, Timothy. Entered on 8/10/2010 2 01:2,1 P.M by O'Connell,Timothy Entered on 6/28/2010 3:07:57 PM r by..O'Connell, Timothy On 8-10-10 dumpster still present.Will issue citation. Long history of trash problems at property. - Many prior warnings. ., . _ .. .... System entry on 8j16j2010 3:15:12.PM. Entered on 8/16/2010 3:15:12 PM ` by O'Connell, Timothy Request Closed by oconnelt As of 8-16=10,dumpster has been removed. Enter work progress: . Enter internal note: (Viewed by everybody) (Viewed internally only) m p, http://issgl2/intern.alwrs/WRequest.aspN?ID=31387 10/20/2010 _ TOWN OF BARNSTABLE BAR-W 551 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager. 41.0 .l T!, , I' �a��.�' Address of Offender c* ► .s C. MV/MB Reg.# Village/State/Zip ► ,!. i , M A. # Business Name ;. /pm, on 20 1 Business Address z Signature of Enforcing Officer Village/State/Zip i g �jtG» . � � Z Location of Offense c�, i . a •�+ t �d;, �` Enforcing Dept/Division Offense 4 +Q �x IE I1�b �,i + Facts C> 1-3 Lz�"�` 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 compliance of Town Ori'inances, 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. Ir o !l_I Postage $ x,: N m o Certified Fee , rq ReturnReceipt Fee 0 (Endorsement Required) SptS C:3 Restricted Delivery Fee (Endorsement Required) 17 ru Total Postage&Fees CO m ant To r U L r1�- .----��/�1 t No.; Street,AP Ao �._. 0 �or Po Box No. ,Q, ••-.. -- r- ---------zia+a [a - � b 13 11 N� VIA o SENDER: COMPLETE ■ CofMMf gems 1,.2,and 3.Also complete A. Signatu ..�'^� ��anw�y 'gem.s^.. item 4 if Restri6t&fl4KAg)kQ;d&G� ■ Print your on the revers our n e AaZrfW e. Y so that we can return the card to you. B. Recei Yb - ■ Attach this card to the back of the mailpiece, Y( Hied Name) Date of Delivery or on the front if space permits. -il 9 1. Article Addressed to: D. Is delivery addres)r"diffe ? ❑ es If YES,enter d ive ad w: No N$. C, \ /"�` t }jT Q to MA 3. Service Type Certified Mail ❑Express Mail i�'� ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes z. Article Number 7007 3020 00111 3429 7847 (Transfer from service label) - - -- -- PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1544) 1 NAME FF E,_/ 0 Me ]BAR 69180 TOW OF -�Q ADDR�SS,OF�OFFElV vvsr/N ROM CITY.STAY,ZIP C D�'' tl// l/{S� ��F._pr! Ei.�/) BARNSTABLET :W f rot M1� Q J IKE t MV/MB REGISTRATION NUMBER -, xneMSIexi.r.. MASS. OFFEN„$EI Vr/ / jy I"-I �r�� 1/l /R.,,,.aG r. W g e 639. ♦e - ''�) {1,^,.j� ��/✓�(j�j`'� 7y� tZ tf0 +�. r t r�� " '` 'l A •�#/ J ! V"' ..�7��C � 1� F I '"i V LU O TIME AND D E O D TION rr / l,0 ATI N O VIOLS N ,�p�� w Z NOTICE OF �` (A.M./ P, - (N loll ,20 3g.b rO [ i eUJI SI6 ATUflE.OF ENFORCING PERSON ,�J�$ ERE NG DEQT,t 1 BADG,E�+D! j N VIOLATION a �� VT OF TOWN Uj .LHEREBY ACKNOWLEDGE RECEIPT OF CITATION X a 15-Unable to obta�l'l igna ure of o Mender. f� ORDINANCE / Date mailed / r/�1 THE NONCRIMINAL FINE FOR THIS OFFENSE IS $ �0( � w LU OR YOU HAVE THE FOLLOWING ALTERNATIVES WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTION(1)OR OPTION(2)WILL OPERATE AS A FINAL a DISPOSITION WITH NO RESULTING CRIMINAL RECORD. uu REGULATION (1)You may elect to pay the above fine,either by appearing in person between 8:30 A.M.and 4:00 P.M.,Monday through Friday,legal holidays excepted, w before:The Barnstable Clerk,200 Main Street,Hyannis,MA 02601,or by mailing a check,money order or postal note to Barnstable Clerk,P.O.Box 2430, a Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE DATE OF THIS NOTICE. (2)If you desire to contest this matter in a noncriminal proceeding,you may do so by making written request to DISTRICT COURT DEPARTMENT,FIRST BARNSTABLE DIVISION,COURT COMPOUND,MAIN STREET,BARNSTABLE,MA.02630,Attn:21 D Noncriminal Hearings and enclose a copy of this citation for a hearing. (3)If you fail to pay the above offense or to request a hearing within 21 days,or if you fail to appear for the hearing or to pay any fine determined at the hearing to be due,criminal complaint may be issued against you. ❑ I HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$ Sianature Health Complaints 20-Dec-05 a Time: 1:05:00 AM Date: 12/5/2005 Complaint Number: 18566 Referred To: DONNA MIORANDI Taken By: JUDITH FLYNN Complaint Type: NUISANCE CONTROL REG. 1 RUBBISH Article X Detail: UNSANITARY CONDITIONS Business Name: Number: 38 Street: Old East Osterville Road Village: OSTERVILLE Assessors Map_Parcel: Complainant's Address: Telephone Number:,- Complaint Description: No occupants, trash left and animals have scattered it. Actions Taken/Results: DZM investigated and took pictures. Shall send a warning to owners of house. DZM mailed warning on 12/9 to clean up by 12/16/05. 12/16/2005-DZM re-inspected and found nothing done. Therefore, a ticket will be mailed. Ticket being mailed on 12/21/2005. Investigation Date: 12/7/2005 Investigation Time: 1 s n n . Y E ii s y g • y Y'� .... M E. y 6 200 TOWN OF BARNSTABLE BAR-W 4857 ordinance or Regulation WARNING NOTICE Name of Offender/Manager 41A VI f P/j A r--A tc- Address of Offender —MV/MB Reg.# Village/State/Zip Akl r, 1,1--rolv ffif'l - Business Name P M, on` 20 105' Business Address Sig-n1ature of - forc"'ifig Officer Village/State/Zip Location of Offense'V OX 16-evu-c- ell), 0j: Enforcing Dept/biZvisicn 0 PON 01:� 57bl,6LE' Offense -f rAA ffa 0 F rl-� Factsm/)r# /Vto /2� P y'fAr-014 41VI of loldly IrIlk This _willserve only as a warning: At this' time nonlegal action has been taken. 1 . 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,y- appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. TOMg,OF 'BARNSTABLE ' BAR-w 450 - Ordinance or Rdgulation,. WARNING NOTICE Name of Off ender/Manager Addres's of Offender MV/MB Reg.# ' Village/State/Zip J ,. Business Name -on '7 2 0 0-/ Business Address Signature of Enforcing Officer Village/State/Zip Location of Offense (. Enforcing Dept/Division Offense Ic It P 1) 5. Facts Lori If L 714 ril/V zci di // 1416 r; This willserve only as a warning. 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 GCJ D-ENFORCING DEPT. r Health Complaints 09-Dec-05 Time: 1:05:00 AM Date: 12/5/2005 Complaint Number: 18566 Referred To: DONNA MIORANDI Taken By: JUDITH FLYNN Complaint Type: NUISANCE CONTROL REG. 1 RUBBISH Article X Detail: UNSANITARY CONDITIONS Business Name: Number: 38 Street: Old East Osterville Road Village: OSTERVILLE Assessors Map-Parcel: qs- Complaint Description: No occupants, trash left and animals have scattered it. Actions Taken/Results: DZM investigated and took pictures. Shall send a warning to owners of house. DZM mailed warning on 12/9 to clean up by 12/16/05. Investigation Date: 12/7/2005 Investigation Time: 1 . i led • i y� � r r c r�" i � y ti K 5 d ` ► e S[ Ab 1.4 c SAWN r f ♦ ` w'7 r' • P A di 1 _ r i, r r • �i a c3ASSESSOR'S MAP_ NO. �j PARCEL 0 72 LO CATION OL1 4- SEWAGA PERT NO. VILLAGE C c- INSTA l 'S NAME ADDRESS40 R U I L D E R OR OWNER DATE PERMIT ISSUED DATE C0MIPLIANCE ISSUED t ;�'•�� ''� � �D � E�i o _� .� l �- r AS'FSSORS MAP NO: / PARCEL NO.: OS� a.Al Nocx. .'.:_l X0Cf Fes$ THE COMMONWEALTH OF MASSACHUSETTS -�— BOAR® Off' HEALTH --/o.-ii Ae.. .......OF... l�S .................................. Appliration for Bisvoiial Workg Tomitrurtinn Vamit Application is hereby made for a Permit to Construct (L_-�'or Repair ( ) an Individual Sewage Disposal System at: rim ..........................................................-z Lee n-Address or Lots Now. / �� G?_.................................... ....................... Owner Address i - ----------------------------------xnP ._�YI�1 Installer Address QType of Building Size Lot....� __��......Sq. feet aDwelling—No. of Bedrooms..........- ..............................Expansion Attic ( ) Garbage Grinder ( ) Q, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures .................................. W Design Flow.............-S._�_.�.......................gallons per person per day. Total daily flow.............. ....................gallons. WSeptic Tank—Liquid capacity.l�a4?.gallons Length___6_.... Width._4------ Diameter-___--__----_- Depths.�__... x Disposal Trench—No..................... Width_............... Total Length.................. Total leaching area....................sq. ft. Seepage Pit No----------- Diameter......./-.--_-..... Depth below inlet.................... Total leaching area..•-----__....t.sq. ft. Z Other Distribution box ( ) Dosingk ( ) 1.Percolation Test Results Performed by_..__...off.... ....G0 ...:........................... Date....... Test Pit No. 1_./—..Z-..__minutes per inch Depth of Test Pit....e� .... Depth to ground water----- .............. (z, Test Pit No. 2...G.7`....minutes per inch Depth of Test Pit---/`�...... Depth to ground water........................ R+' •--------------------------------------••---------------- -•-- Descriptionof Soil .........................' ? 5'v,,g_So�G-----------------------------••--••--------------•-•--•---------- x 6 �� e� ----------------------- -------------- -------------------------------------------------------------------------------------------------------------------------------------------------------•---•---- U Nature of Repairs or Alterations—Answer when applicable................................................................................................ •-•------------------------•--••---•----•-----------------•---------------------------•--•-------••--•----....--------------...••-•-------•--•-...-•-•---•--•-•-------------•--•----•-.......-••-.•---- Agreement: The undersigned agrees 'to install the aforedescribed Individual Sewage Dis osal System in accordance with the provisions of iIT .; 5 of the State Sanitary Code— he undersigne rther rees not to place tha ' operation until a Certificate of Compliance has been is d y the bo d f)cal ffSigned---- - ----- - ---------- -•-• ----- -- --- - -1------------- ----� Application Approved By. .................- - f Date Application Disapproved for the following reasons:---•--------------------------------•-----------••---•--•----------•------------•---......................... •-----•------•-•-•--••--------------•----------------------------•......-••------•-..........•---•----------------------•--•----.....--------------------•------------------------------•--•----------•. �f Date PermitNo.---•----•---- ..-•---�-Q..I--• Issued........................................................ Date No.................. oc F ...... THE COMMONWEALTH OF MASSACHUSETTS BOARD` OF HEALTH ...---- ..... ...... Appliration for Disposal Works Tomilrttr#iun "truth Application is hereby made for a Permit to Construct (L,,T or Repair ( } an Individual Sewage Disposal System at: / !!11 ................•-................................................................................ ..........__._.._......_..........._............................................................_. Location-Address _ or Lot No. ....................r✓...... -= f-' �� ........'�C 5�....._�./� ./� vTf�_.__.._....-•--••-•-••.............. f U Ow er Address ....................... . ---.._.. :.................�&He.Ei1 Installer Address _ QType of Building Size Lot....Z� ......Sq. feet Dwelling—No. of Bedrooms.........'3..............._..............Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons_________________________._ Showers — Cafeteria P4 Other fixtures ---------------------------••••• - W Design Flow............�_�_._______________________gallons per person per day. Total daily flow..____._____:33�____.._.__..__._____gallons. WSeptic Tank—Liquid capacity!�oq_gallons Length___rG.'�_. Width_.!?..6�/_ Diameter................ Depth_g_a8-v x Disposal Trench—No_ ____________________ Width.................... Total Length.........._......... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter....../-.a....... Depth below inlet........G........ Total leaching area_:. .......�f-.sq. ft. Z Other Distribution box ( ) Dosing 4nk aPercolation Test Results Performed by.___ fir/-__`-�'4 _________________ Date...... � .!_._...__.. a Test Pit No. 1__4______.__._minutes per inch Depth of Test Pit__./t ...___. Depth to ground water_._............... LTI Test Pit No. 2..4_Z_._._minutes per inch Depth of Test Pit...:!¢ Depth to ground water________________________ 9 •------------------------------------------------------•----------=--------•••••-•-----•--------•••-••••-•••........ _•••••-••-•------ ------------------------ D Description of Soil_.._----•.•.__ '• �-`--•--T`� G ot�. e 5��s - off/_ ._ d .. ............................................................. W ---------•----....................................-..................................................................................... ............................................................. U Nature of Repairs or Alterations—Answer when applicable............................................................................................... --------•------------------------------------------•-----------------------------------•---•----------------•------•--------------------------------------------------------------------..__........-••• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Di osal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— e undersigne durrtl er a rees not to place the system i operation until a Certificate of Compliance has been iss the boa- lth '/ _ -�. . ,--1r> 7/5 Slgned� ...........................r = �------------ Date Application Approved By- .___��' � ;�� _� ? ....._.: �� , / 6. _ �___�.�__4=•. _ ^- Date Application Disapproved for the f 7lowing reasons--------------------------------------------------------------------------------------- ----------------------_ --------------------------------------------•----------------.._..-•••--.....•. •-•••-•-•-•••------••--•••-••••••••-••••-••-----•----- -•••--•••-•-•••-•---•••••••---•-----•---------•-•••••••-••_--- Date PermitNo.._..--•.._.......^� :a. ........ _� Issued------------------------------------------------------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............7 .! �/..OF......./.�./ sTfl, e .0 :.......__................. Tntifiratr of ToutpliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (c.,.4-or Repaired ( ) a- --- --------------------•------___-------------------------------------------------______-__ Installer at.....................................'�.'1-p----- �iC --------oe-d----------------------------------------------------------------------------------- has been installed in accordance with the provisions of TITLE, 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit Ndl<___� __...... -__. 4; ___.____ dated.. ....._.. __" _.-�_eVA�T 4,----- THE ISSUANCE OF THIS CERTIFICATE SHALL ON STRUE® AS A GUARANTEE T THE SYSTEM WILL FUNCT ON /SATISFACTORY. DATE........................... {l.f_ L_�.......------.....---------- Inspecto�---------------------------------------------------------------.--. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...................J.......................0F.....= f............t/S7i�.."�.� No. Disposal Vorks TWun#rudinn Upumit Permission is hereby granted �°r•........r=l t j to Construct (t.� or Repair ( ) an�'IVldual Sew isposal System at No.. ... L v`� �-� rf ---------------•----•------------------•--------------------•••---•----- Pam, - .�. �" v i--Gl---- -- -..:�--�..__.� ",w.gyp.(; s�>� as shown on the application for Disposal Works Construction Permit No. XDated______ ,,,,, ^?r��l.YZ:. .._. vy�� Board of'fieal •'�"'^"�---- ...--•-•------ DATE------ .._ -------------------••••-••---------------- FORM 1255 HOBBS & WARREN. INC., PUBLISHERS SNE 'T / 06: Z SHOTS � l 1 LoT-A4?-:z vl �AS ivy 9 Rsv< ZOO o — — F v , a /o� LoT�Z?— o pftoposen ; �- O O Box sr c �a 0 V 4q ► , Sr —Zot Y 1 a �. flT _ 3 7. - 0 1 r'Zd'11.T>'p of �o I BGPP✓a/p C ✓d.0� �SSuy 6-D s/T .... . .. A/ . . LOCATION r• SCALE . .�. '. ��.... DATE .!� y Z3.l584 PLAN' REFERENCE / �7!�G ..La. . . ./ E. ft'KELLE`r° hlo. 2610J ��✓_''J/ I CERTIFY THAT THE ..... .. . . .. . .. SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON; DATE �OWLmS - /pe'777-/0,/Z;E- REGISTERED LAND SURVEYOR SH&z'T Z TOP OF FOUNDATION CONCRETE COVER CONCRETE COVERS 3,zZ' e a 4��CAST IRON 12"MAX. OR SCHEDULE 40 12"MAX. 4"SCHEDULE 40 PVC.(ONLY) P.V.C. PIPE PITCH 1/4"PER.F PIPE- MIN. LEACH T PITCH 1/4"PER.FT. PIT PRECAST ° 1� LEACHING o' `—INVERT °. � Q :.�• '0 EL. 47,7.8.. � R INVE T INVERT PIT OR v , SEPTIC TANK EL ,¢ ,ya DIET. EL°� �a • . >_ EQUIV. oc NV 7.. �oo.�.. .. GAL. INV 7 BOX INVERT G' ww a: :�: 3/4��T0 11/2� ° EL....•...7 4l.30 u_o WASHED EL... kii Lw STONE yoi6 C-z,46,a ' i /S — - --W DIA. o• . . �-- /2' DIA.--+- ovcio�..rrexeD PROFI LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE SOIL LOG WITNESSED BY : DATE /f'BSTIME. . . .. . . . . . . !9L:5. .C4^!�.^! . BOARD OF HEALTH TEST HOLE I TEST HOLE 2 )3 j / S, ENGINEER ELEV. . 48,Bo ELEV. .4yto . . . . . .DESIGN DATA : 3e." e2.4.S.Bo ' �'`'►° NUMBER OF BEDROOMS 3. . . . . . TOTAL ESTIMATED FLOW . . 330 , , GALLONS/DAY H6'D, MGm.Foo,eCy pdo2l y BOTTOM LEACHING AREA . . . SO.FT. /PITIC,/?D, 6,Q,e►vED G�u�D SIDE LEACHING AREA SQ.FT./ PITI.S-iB SLMIo GARBAGE DISPOSAL /Von/E (50% AREA INCREASE) TOTAL LEACHING AREA . -3Zo�� SQ.FT " PERCOLATION RATE MIN/INCH LEACHING AREA PER PERCOLATION RATE .. . . . . . SQ.FT. G'/'•D No.WATER ENCOUNTERED NUMBER OF LEACHING PITS-. v"/GrT /NiT» APPROVED . . . . . . BOARD OF HEALTH 77-/ALL-�. F'L•''7` O`.S7'DN�" Oni/�t� SiDEs. DATE . . . . . . . . . . AGENT OR INSPECTOR 11 �A� OF A,„c��'! ASH OF T" � ��a EDVV doT L/ o l` r- 1 0 0 a ELLEY a A y 25100 IST PETITIONER . STzp//16w C-