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Home My WebLink About0063 OST.-W.BARN. RD - Health 63"O`st VV.BarnT 'RW Y Gsterville r A - 120 - 61 - 16 G r { 0 1 , w ••,'r,Vyr- .ry,�, w...v..... ...`�-�..... .. '1,v`+y'w"Yw:�,,,;,t�..;,,.�.,�,,�ti.,'Y.N:,.yT„n.�-. + .r -wl.r«.t�.i\. ,. F�N�' �t� ® 7 Fee �t� i THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION--TOWN OF BARNSTABLE, MASSACHUSETS Yes T Zipplication for Oigpogal i§pgtem QCootruction Permit , Application for a Permit to Construct O Repair 0 Upgrade O Abandon O ❑.Complete System 2 Individual Components Location Address or Lot No. to 3 0,s� Owner's Name,Address,and Tel.No. G 17—510 " 8186 �S-r.(3A RNls7I�t3 LE T"bNw � yN� /1 Assessor's Map/Parcel p 3 Q STZ RV I L Ltr W ti36► 5 (aI—E 0 ¢„ w. r. 50 l;r . Installer's Name,Address,.and%Te1.jNo. Designer's Name,Address and Tel.No. R*N C ON sTR V cm oIJ Type of Building: Dwelling No.of Bedrooms ., a Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures. ` Design Flow(min.required) gpd Design flow provided gpd Plan Date `" Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil i Nature of Repairs or Alterations(Answer when applicable) — p bx 6P Pl R _ .y Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions o T41e-5 of hvironmenta Code and nog?place the system in operation until a Certificate of Compliance has been issued b this Board„afIe th. Sign d7j'* ! p Date 313, I(o Application'Approved by t Date ^ Z3 Application Disapproved by: Date for the following reasons ' ' Permit No. Qo '©� Date Issued 3 O� THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance :uz THIS IS TO CERTIF at t/e/On-ssi Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( ) Abandoned( )by 'H en 14:3 at Fi onstructed in accordance.. >- with the pro ' 'ens o itle 5 and t for Di osal System Construction Permit No.(9C —O� dated 3 Installer S r 0 C D G(� Designer ! #bedrooms Approved design flow p / /� gpd II ,- - The issuance of this ermit shall not be construed as a g Y guarantee that the s stem will un ion as desi n.d. P g Date Inspector i; ——————————————— —————————— ——— ————————-- No. V I �l Fee THE COMMONWEALTH OF MASSACHUSETTS 1 PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS wigool *pgtem Congtruction Permit Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( ) Aban in ( /) System located at �� , r S f4 L c r and as described in the above'Application fo Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following localprovisions or special conditions. Provided: Construction must'be co pleted within three years of the dat�,of this pe I Date p Approved by -'' 1Q -4'A of B MA LOCATION LdT-4 16 05q, �V, ��4I�J4 N, SEWAGE # q-S— (az7 VILLAGE 0-4f ASSESSOR'S MAP 6z LOT 1)6_86t-0 INSTALLER'S NAME & PHONE NO. a,�S, G)�;SCa�� 771 10gQ SEPTIC TANK CAPACITY 1,SOU yry�(ots LEACHING FACILITY:(type) (size)000 jawr NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATER BUILDER OR OWNER �a�S + '77/ �4�f DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED VARIANCE GRANTED: Yes No Q ' y i��rb„ AsBuilt Page 1 of 1 LOCATION Le)T'4 0,,4, lv, ��:�ns7�hl�Rd SEWAGE Lt 9_�— 017 VILLAGE C�StQCd ��G ASSESSOR'S MAP & LOT ))6.161-� INSTALLER'S NAME & PHONE NO. Oc•,56Al 771—(0�6 SEPTIC TANK CAPACITY � 1 LEACHING FACILITY:(type) ��^ �� 1 (size) 1,000 at/1ewr NO.OP BEDROOMS 3 PRIVATE WELL Old PUBLIC WATER_ BUILDER OR OWNER 6 AYS'G u.14 "5 Co r 271"OSq� DATE PERMIT ISSUED: I 's �y -DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No d I t y A F 39` 3S �(o a i http://issgl2/intranet/propdata/prebuilt.aspx?mappar=120001016&seq=1 3/3/2016 rCommonwealth of,Massachusetts v W Title 5 Official 'Inspection Form Subsurface Sewage DisposalSystem Form - Not for Voluntary Assessments 63 OSTERVILLE W BARNSTABLE ROAD Property Address f,. JOHN LYNCH Owner Owner's Name information is required for every OSTERVILLE - MA -h02655 12/23/2014 _ page. City/Town State Zip Code Date of Inspection > ' inspection results must be submitted on this form. Inspection forms may not.be altered'in any way. Please see completeness checklist at the end of the form. f Important:when filling out forms A. General Information ' s on the computer, /n use only the tab 1. Inspector: key to move your ° cursor-do not JOHN P GRACI SR use the return key. Name of Inspector ; GRACI SEPTIC INSPECTIONS LLC. Company Name PO BOX 2119 - -Company Address TEATICKET. i MA 02536. Cityrrown State Zip Code 508-641-6694 S1468 Telephone Number= ; 'v' License Number B. Certification I certify that I have personally-inspected-the sewage disposal system at this`address and that the +. information reported below is true;accurate and complete as of the time of the inspection. The inspection was performed based.on,my training and experience in the proper function and maintenance of on site sewage disposal systems. I am.a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: `Z Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further valuation by.the Local Approving Authority w 12/23/2014 . +. Inspector's Signature Date r The system inspec shall submit a copy of this inspection report to'the"Approving Authority(Board of Health or'DEP) hin 30`d6ys of completing this inspection. If the system is a shared system or has a design flow 0,000 gpd or greater, the inspector and,the system owner shall submit the report to the appropriate regional office of the DER The original should be,sent to the system owner and copies sent to the buyer, if applicable, and the approving authority.-. ****This report only describes conditions at the time of inspection and under the conditions of use ` at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins-3h 3 Title 5 Official Inspection r :Subsurface Sewage Disp sal System Page 1 of 17;: Commonwealth of Massachusetts Title 5 Official, Inspection Form° Subsurface Sewage Disposal System Form -'Not for Voluntary Assessments °M 63 OSTERVILLE W BARNSTABLE ROAD'.. Property Address JOHN LYNCH Owner Owner's Name information is required for every OSTERVILLE Y f MA 02655', ' 12/23/2014 page. City/Town - State Zip Code' : Date of Inspection B. Certification (cont.) Inspection Summary: Check.A,B,C,D or E C always complete all of Section b A) System:Passes: ® I have not found any information which indicates that any of the failure,criteria described in 310 CMR 15.303 or in 310 CMR:15.304 exist. Any failure criteria not evaluated are indicated below. Comments: ; _SYSTEM PASSES TITLE WNSPECTION B) .System Conditionally Passes: _ ❑ One or more system.comp rients as described;in the "Conditional Pass" section need to be ' replaced or repaired.The system, upon,completion.of the replacement or repair; as approved by the Board of,Health, will pass. Check the box for"yes", "no" or"not determined'-(Y, N, ND) for the following statements. If"not determined," please explain.' The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure-is imminent. System will pass inspection if the existing tank is*replaced,with a,complying septic tank as approved by the Board of ..Health. *A metal septic tank will pass inspection if it is;.structurallysound, not leaking,and if a Certificate of Compliance indicating that the tank is less than 20'years old is'available. 'ElY ❑ N ❑ ND(Explain'belowNA )k' n , t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17' a - - ; Commonwealth of Massachusetts. W Title 5 Official= Inspectionfoem- PA Subsurface Sewage Disposal System Form - Not for Voluntary Assessments' °M 63 OSTERVILLE W BARNSTABLE ROAD Property Address s JOHN LYNCH: e Owner Owner's Name information is OSTERVILLE ' MA 02655 r required for every 12/23/2014 page. City/Town State Zip Code. Date of,Inspection • B.' Certification (cont.) Pump Chamber pumps/alarms not operational System will pass with Board of.Health approval.if pumps/alarms are repaired. ` '. B) System Conditionally Passes (cont ): ' ❑_Observation of sewage backup or breakout 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): El broken pipe(s) are replaced ❑ .Y ❑ N ❑ ND (Explain below): El obstruction is removed ❑ Y ❑ N ❑ ND'(Explain below): ' ❑ distribution box is leveled.or replaced ❑ Y. ❑ N ;.❑ ND-(Explain below): ` NA ❑ The system required pumping more than 4 times ayear 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" ❑' NO (Explain below): ❑ obstruction is removed Fes -Y ❑ N ❑ ND (Explain below):: � NA . C) Further,Evaluation`is Required by the Boardof Health: •Conditions.exist which require further evaluation,by the Boardf of Health in*order to determine if the system is failing to protect public health, safety or the"environment: 1. System will pass unless Board of Health determines in accordance with 310.CMR - 15.303(1)(b)that the system is not functioning in a'manner Which will protect public health, safety and the environment: F Cesspool r privy i within o s thin 50 feet f surface o ❑• p p y e o a u ace water -Cesspool.or privy is within 50 feet of a bordering vegetated wetland or a salt marsh, t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of M h assachusetts Title 5 Official Inspection Form - s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 63 OSTERVILLE W BARNSTABLE ROAD Property Address JOHN LYNCH ` Owner Owner's Name information is , required for every OSTERVILLE MA 02655 12/23/2014 page. City.Town • ,State' Zip Code Date of Inspection ` - B. Certification (cont.) z . . 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in,a manner that`protects the public health', safety and environment: 0 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 w_ ater;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 5O'feet.of.a private water ' supply well. w The system has aseptic tank,and SAS and the SAS is Iess.than 100 feet but 50 feet or • more from a private water supply well**,: Method used to determine distance: NA a ** This system passes if the well water analysis, perfo`rmed'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 pf,.the analysis must be attached,to this form. , 3. Other: NA D) System Failure Criteria Applicable to All Systems:. : "You must indicate"Yes" or"No"to each of the following for all.inspections Yes No - Backup of sewage into yfacility,or systemV component due to overloaded orYe ® clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface'waters due to'an overloaded or clogged SAS or cesspool ® Static liquid level in the distribution box above outlet'invert due to an overloaded or clogged SAS or cesspool Liquid depth in cesspool is less than 6" below invert or available volume is less fi ® than '/2 day flow Y ; t5ins-3/13 4` Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 K Commonwealth of Massachusetts W Title 5 Official inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 63 OSTERVILLE W BARNSTABLE ROAD Property Address JOHN LYNCH r Owner Owner's Name i information is OSTERVILLE x MA s02655 12/23/2014 required for every page. City/Town State Zip Code Date of Inspection B. Certification cont: f.., Yes No Required pumping more than 4.times in the last year NOT due to clogged or ® ,obstructed pipe(s). Number of times pumped: ® s> -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. ❑ ® Anylportion.of a cesspool or privy is within a Zone 1 of a public well. ..® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ - ® Any portion of a cesspool,&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 systermis a cesspool serving a facility with a design flow of 2000gpd-'-' 10,000gpd. r El ® The system fails. I have determinedthat one or more of the above failure w criteria'exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board"of Health to determine what will be necessary`to correct the failure: E) Large Systems: To be considered a large system the system:must serve a facility with a ' design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either-"yes" or"no"to each of the;following, in addition to the questions in Section D: , Yes No h ❑` 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 If of.a public water supply well r If you have answered "yes".to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any-large system considered a significant threat under Section E or failed under Section D shall upgrade the . system in accordance with 310 CMR 15.304. The system owner should contact the appropriate ' regional office of the Department. l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 , Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage.Disposal System Form - Not for Voluntary Assessments ` M 63 OSTERVILLE W BARNSTABLE ROAD -' Property Address JOHN LYNCH _ Owner Owner's Name information is required for every OSTERVILLE '' MA I 02655 12/23/2014 page. CityrFown State Zip Code Date of.Inspection C. Checklist , • Check if the following have been done. You must indicate"yes"or"no"-as to each of the following: Yes No ; ® ❑ Pumping information was provided by the owner, occupant, or Board of Health • ❑ ' N . .Were any of the system components pumped out in the previous two weeks? ® ❑ 'Has the system'received normal flowsin the previous two week period? ❑ ® Have,large volumes of water been introduced to thesystem recently or as part of this inspection? ' N 0 . � 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 forsigns of break out? . ®• ❑ Were all system components,.excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened,.and the interior of the tank inspected for the condition of the baffles or tees'material-of construction, • dimensions, depth of liquid, depth of sludge and depth of scum? ® Was the facility owner(and occupants if different from owner),provided with information on the proper maintenance of subsurface sewage disposal systems? The size and•location of the Soil Absorption System (SAS) on the"site has � z been determined based on: -® ❑:" Existing information. For example, a plan at.the Board of Health. a Determined'in the field (if any of the failure criteria related to Part C is at issue E approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: a� ' Number of bedrooms (design):- Number of bedrooms (actual): . DESIGN flow based on 310 CMR•15.203 (for example: 110 gpd x#o bedrooms);. 330 f e •t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 6 of 17 • _ Commonwealth of Massachusetts Title 5 Officials-Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments ; 63 OSTERVILLE W BARNSTABL'E ROAD 5 - Property Address ti ` JOHN LYNCH , Owner Owner's Name information is required for every OSTERVILLE , MA 02655 -12/23/2014 � _ • page. City/Town State Zip Code Date of Inspection D. System Information .Description: ' 1500 GALLON SEPTIC TANK;DISTRIBUTION`BOX AND 1000 GALLON LEACH PIT- Number of current residents: Does residence have a garbage grinder? '_ { , ❑ Yes ® .No Is laundry on a separate sewage system? (Include laundry system inspection - information in this report.) Yes N. 'No- 'Laundry ,. M - � ' - M .. system inspected? ® Yes ❑ . No. Seasonal use? ❑ Yes .® No TOWN; Water meter readings,.if available;(last 2 years usage (gpd)):� Detail: 2012 150,000 .2013. 185,000 x. Sump pump? ❑ Yes N No Last date of occupancy: OCCUPIED: Date Commercial/Industrial:Flow Conditions:. f t Type of Establishment: NA _ Design flow(based on 310 CMR 15.203). NA Gallons per day(gpd) Basis of design flow.(seats/persons/O t., etc.): f+lA 3 Grease trap present? w . ❑ Yes ❑ No Industrial waste holding tank present? ' w ❑',Ye sr .No Non-sanitary waste discharged to the Title 5 system? ❑ Yes•❑ 'No Water meter readings, if available: NA r • t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7-of 17 - s Commonwealth of Massachusetts W Title 5 Official•.Inspection Form. R. , Subsurface Sewage Disposal System Form - Not for Voluntary Assessments - �M 63 OSTERVILLE W BARNSTABLE ROAD: Property Address JOHN LYNCH L Owner Owner's Name information is OSTERVILLE ` 4 MA 02655 • 12/2 required for every - 3/2014 • page. City/Town State Zip Code Date of.Inspection D. System Information (cont.) Last date of occupancy/use: ` ' NA s Date ' -Other(describe below): NA General Information Pumping Records: Source of information: Was system pumped as part of the inspection? i- ❑ Yes ❑ • No NA If yes, volume pumped: gallons How was quantity pumped determined? NA Reason for pumping: NA Type of System: ® Septic tank, distribution box, soil absorption system ❑ `Single`cesspool' ❑ Overflow cesspool ElPrivy n ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) El Innovative/Alternative technology. Attach a copy of the current operation and j maintenance contract(to be obtained from system owner) and a copy cf•latest. inspection of the I/A system by'system operator under contract ❑ Tight tank. Attach a copy ofthe DEP approval. . a; ❑ Other(describe): NA t5ins•3/13 " Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 y.J;:1, : a . . 1 '- y, ' ' 4-...^- • _ - Commonwealth of Massachusetts W Title 5 Official. Inspection Form r - Subsurface Sewage Disposal System Form - Not for Voluntary Assessments. 63-OSTERVILLE W BARNSTABLE ROAD Property Address JOHN LYNCH T Owner Owner's Name information is required for every OSTERVILLE `°' MA 02655 ' 12/23/201,4 • page. City/Town '. State ` .Zip Code Date of Inspection D. System Information ,(cont ) = Approximate age of all components, date installed (if known) and source of information: 03/25/1994 - Were sewage odors detected when arriving at the site? ❑ Yes ® No,, Building Sewer(locate on site plan): ` (2)'TWO°FEET k ` Depth,below grade;, feet yMaterial of construction: F❑ cast iron ® 40 PVC' ❑ other(explain): - . �10+ FEET Distance from private water.supply well or suction line:` Meet r , y Comments (on condition ofjoints, venting, evidence of leakage, etc.) NA Septic Tank(locate on site plan): Depth below grade: # V feet ' Material of construction:.' r ° ® concrete ,v 'El metal ' ❑ fiberglass ❑ polyethylene ❑ other°(explain) NA r 5 s If tank is metal, list age: ,t } NA w. Years Is age confirmed by a Certificate of Compliance? (attach a copy oftertificate) ❑ Yes No y. Dimensions: 1500 GALLON a. R _ 31 Sludge depth: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 9 of 17' ' zNIS Commonwealth of Massachusetts Title 5 Official Inspection . Form a a Subsurface Sewage Disposal System Form -.Not for Voluntary Assessments �M 63 OSTERVILLE W BARNSTABLE ROAD Property Address ;. JOHN LYNCH r . Owner Owner's Name. information is required for every OSTERVILLE `' _ MA 02655 '-12/23/2014 page. City/Town . ' State `Zip Code ' ' Date of Inspection D. System1fiformation (cont.) Septic Tank (cont.) z 4 R ' Distance from top of sludge.to bottom of outlet tee or baffle (31) THIRTY ONE INCHES - " s Scum thickness• (1) ONE INCH (6) SIX INCHES Distance from top of scum to top of outlet tee or baffle ' k Distance from`bottom of scum to bottom of-outlet tee or baffle a . r MEASURED How were dimensions determined? t Comments (on pumping;recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): - SYSTEM APPEARS`TO BE STRUCTUARLLY,SOUND AND FUNCTIONING PROPERLY AT TIME OF INSPECTION. RECOMMEND PUMPING EVERY TWO YEARS.,_, Grease Trap (locate on site plan): Depth below grade: J NA feet Material of construction:; ❑ concrete =El metal` 0 fiberglass ❑ polyethylene '`zEllother(explain): NA •' ` � r �4. ~�< '. � � "`• � - '• NA µ •• -' Dimensions: Scum thickness NA Distance from'top of scum to top of outlet,tee or.baffle NA Distance from bottom of scum to bottom of outlet tee or baffle NA Date of last pumping; NA . _ Date t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of;17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM °w 63 OSTERVILLE.W BARN STAB LE'ROAD Property Address JOHN LYNCH Owner Owner's Name s information is OSTERVILLE 4. MA` 02655 12/23/2014 required for every ' page. City/Town State' Zip Code bate of Inspection D. System Information (cost:) t Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc:): NA Tight or Holding Tank (tank must be-pumped.at time of inspection) (locate on site plan): , Depth below grade: NA „. Material of construction: ` ❑ concrete ❑ metal' ❑ fiberglass • ❑'polyethylene ❑ other(explain): NA , Dimensions: NA Capacity: - g A ns NA Design Flow: > , gallons per day ; Alarm present: El Yes. El No a,. NA' -`Alarm level: Alarm in working order: ❑, Yes ❑ No �, , Date of last pumping ? NA fn. . : Date Comments (condition of alarm and float switches;etc.) r F. NA s a Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 ' Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 i Commonwealth of Massachusetts ; Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �.M 63 OSTERVILLE W BARNSTABLE ROAD Property Address , JOHN LYNCH /.. Owner Y Owner's Name . . _ °•. • information is required for every OSTERVILLE MA 02655 12/23/2014., page. City/Town State -Zip Code Date of Inspection D. System Information (cont ) i Distribution Box (if present must be opened) (locate on'site plan),: { Depth of liquid level'above outlet invert BOTTOM OF PIPE , _ h u • b omment ` n e if box is level and distrib i`n to • u le u I an evidence of solids carryover, an, C s of o a ut o o f is e a e c ( Q YY evidence of leakage into or,out of box, etc.): DISTRIBUTION BOX APPEARS TO BE STRUCTUARLLY SOUND AND FUNCTIONING• PROPERLY AT TIME OF{INSPECTION. ,. Pump Chamber(locate on site plan): Pumps in working order: El Yes'. El'No* Alarms in working order: ❑ Yes 0 No* Comments (note condition of pump chamber, condition of,pumps and appurtenances, etc.-):Y NA :. * If pumps or alarms-are not imworking'order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located,'explain why: NA 9 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System?Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official:,Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments, M . 63 OSTERVILLE W BARNSTABLE~ROAD Property Address e JOHN LYNCH.- Owner Owner's Name information is required for every OSTERVILLE 'MA 02655 •12/23/2014 r page. Cityrrown State Zip Code Date of Inspection D. System Information (cost:) F .type: - ® leaching•pits : number: 1 ❑" leaching chambers number.".. ❑ leaching galleries- ;number. El leaching trenches, = number, length: - ❑ leaching fields number,,dimensions: k ` L ❑ overflow cesspool, number: - ❑ innovative/alternative system " Type/name of technology. ` Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil,condition of vegetation, etc.): 1000 GALLON LEACH PIT APPEARS TO BE STRUCTUARLLY SOUND AND FUNCTIONING , PROPERLY AT TIME OF INSPECTION. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration , • ' - NA iNA Depth —,top of,liquid to inletinvert u. Depth of.solids layer - NA Depth of scum layer NA Dimens ons,of cesspools f NA NA Materials of construction _ • -} Indication of groundwater inflow. ❑ Yes ❑ No t5ins•3/13 , Title 5 Official Inspection.Form`Subsurface Sewage Disposal System•Page 13 of 17 , Commonwealth of Massachusetts W Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form ;Not for Voluntary Assessments 63 OSTERVILLE W BARNSTABLE ROAD Property Address a JOHN LYNCH Owner Owner's Name information is required for every OSTERVILLE , MA 02655 12/23/2014 r _ .page. City/Town State Zip Code. Date of Inspection D. System Information (cont.)" ' Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): NA Privy (locate on site plan): w Materials of construction: Dimensions - NA Depth of solids _ NA 'Comments (note condition of soil, signs of hydraulic failure, level of,ponding, condition of vegetation,-• etc.): , r _ 't5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments. °M 63 OSTERVILLE W BARNSTABLE ROAD Property Address JOHN LYNCH „ Owner Owner's Name information is required for every OSTERVILLE MA 02655 12/23/2014 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately BAC- m o p P=14 AA I8$ BA vL CA 13 9 q-g 2t�9 cS 441 AC bt 40fo cG 2-( AD 3Pj t- BD 67 S GD 3 q 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts _ W Title 5 Official -Inspection .Form Subsurface Sewage Disposal System Form -.Not for Voluntary Assessments•: 63 OSTERVILLE W BARNSTABLE ROAD Property Address JOHN LYNCH * ` " Owner Owner's Name information is OSTERVILLE MA 02655, 12/23/2014 required for every ' page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check'Slope ' ❑ Surface water ❑ Check cellar R ❑ " Shallow wells t 12+ FEET: . Estimated depth,to high ground water. + `. feet' Please indicate all methods used to determine the.high ground water elevation: c. ❑ Obtained from system design plans'on record' ; If checked, date of design plan reviewed: ;pate ❑ 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 groundwater elevation: HAND AUGER = Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 -Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments" °v 63 OSTERVILLE W_ BARNSTABLE.ROAD Property Address . JOHN LYNCH Owner Owner's Name information is required for every OSTERVILLE MA 02655 12/23/2014 page. City/Town State Zip Code Date'&Inspection E. Report Completeness Checklist r Z Inspection Summary: A, B,°C, D, or E checked ® Inspection Summary D (System Failure*Criteria Applicable to All Systems) completed ® System Information;=.Estimated depth to high groundwater 1 ® Sketch of Sewage Disposal System either drawn on page 15 or.attached in separate file t5ins 3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 17 of 17 _ ARDITO, SWEENEY, STUSSE, ROBERTSON & DUPUY, P.C. ATTORNEYS AT LAW;, 25 MID-TECH DRIVE, SUITE C WEST YARMOUTH, MA 02673 ':(508)775-3433-Telephone (508) 790-4778 Facsimile y Edward J.Sweeney,Jr. Thomas P.Carpenters Michael B.Stusse Kelly S.Jason ' Donna M. Robertson Tracey L.Taylor Matthew J. Dupuy A Charles M.Sabatt \ Charles J.Ardito P.C. PLEASE REFER TO FILE NO. January 11, 2008 Town of Barnstable Board of Health Attn: Mr. Wayne Miller, Chairman 200 Main Street Hyannis, MA 02601 Re: John Lynch 63 Osterville-West Barnstable Road; Osterville,�MA-•, Dear Mr. Miller, I am in receipt of your letter dated December'l'2'2007»with a postmark of January 10, 2008. I am enclosing the proposed Deed Restriction for your review. Please let me know if this is satisfactory and I will then record same with the Barnstable County Registry of Deeds. Thank you for your attention to this matter. rely, , S M. ATT, ESQ. . CMS/tlb w r� Enc. /oFTKE rower Town of Barnstable Board of Health Itl* nARNSrABLE. ' r MASS. Ok 200 Main Street,Hyannis MA 02601 �O 03 9' plFb MA't a. Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi December 12, 2007 Charles M. Sabatt, Esquire Ardito, Sweeney, Stusse, Robertson & Dupuy, P.C. 25 Mid-Tech Drive, Suite C West Yarmouth, MA 02673 Peter Dawson Mirick O'Connell Attorneys at Law 100 Front Street Worcester, MA 01608-1477 Dear Mr. Sabatt and Mr. Dawson: You are granted permission on behalf of your client, John Lynch, to maintain four bedrooms at 63 Osterville-West Barnstable Road, Osterville. This permission.is granted because you demonstrated that four bedrooms were approved by the Building Division. Although a septic.construction permit was originally issued in 1993 for three bedrooms, you demonstrated that the house plans submitted along with the building permit were for four bedrooms and the septic capacity is adequate for the four bedrooms. Also, a building permit was obtained in 2000 to finish a room above the garage to be used as a playroom. You are ordered to submit a recorded Deed Restriction for a maximum of four bedrooms at this property. Please ensure that you submit the recorded Deed Restriction to the Public Health Division within 30 Days of this letter. Si erely you ay Miller Chai an Q:\WPFILES\Sabatt 63 Ost W B Rd 2007.doc • Public Health Division �— ^*w • BAMSTAZM� 200 Main Street _ _ _.: - Hyannis, MA 02601 02 1A $ 00.410 0004606238 J.AN 10 2008 MAILEDFROM ZIPCODE 02601 Charles. M. Sabatt, Esquire Ardito, Sweeney, Stusse, Robertson & Dupuy 25 Mid=Tech Drive, Suite C West Yarmouth, MA 02673 ••) 'F., •�r`�T.i'I�".".r `i'..r A Ell III?1013 i=?iid?iliAt?;*,t1 1 it(:tts iti!i.?.I i tihlil..it. J' � Deed Restriction Whereas, John F. Lynch, of 63 Osterville-West Barnstable Road, Barnstable (Osterville), Massachusetts, is the owner of property located at 63 Osterville-West Barnstable Road, Barnstable (Osterville), Barnstable County, Massachusetts, by Deed recorded as Document Number 929,769 shown on Certificate of Title Number 169811, said land being shown on Barnstable Assessor's Map 129 Parcel 1.16 and being shown as Lot 16 on Land Court Plan 7687-E filed in the Barnstable County Registry of Deeds Land Court Department. Whereas, John F. Lynch, as the owner of said lot, has agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in the home built on the existing said lot. Y L+ Whereas,The Town of Barnstable Board of Health, is requiring that the agreement for the restriction of the number of bedrooms in the house on the lot be put on record with the Barnstable County Registry of Deeds by recording this document. Now Therefore, John F. Lynch does hereby place the following restriction on the above referenced land in accordance with this agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title: 1. Lot 16, Land Court Plan 7687-E, house# 63 Osterville-West Barnstable Road, Osterville, Massachusetts, may maintain upon the lot a house containing no more than four(4) bedrooms. John F. Lynch hereby agrees that this shall be a permanent deed restriction affecting the above described premises so long as the premises are not serviced by a public sewer. If in the future the premises are serviced by a public sewer, then this restriction shall terminate. y For title see deed recorded in the Barnstable County Registry of Deeds as Document Number 929,769 noted on Certificate of Title Number 169811. Executed as a sealed instrument this ;FT4 day of „�._� 2008 o F. Lynch COMMONWEALTH OF MASSACHUSETTS Barnstable, ss ./ =y , 2008 9 l y On this $� day of 0GtYiu , 2008, before me, the undersigned notary public, personally appeared John F. Lynch, proved to me through satisfactory evidence of identification, which was a Massachusetts Driver's License, to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he signed it voluntarily for its stated purpose, c Notary Public: Lvo n rt-e (5r►'� 1 " Com Exp: .1 a- s w ` . BARNSTABLE LAND COURT REGISTRY Deed Restriction Whereas, John F. Lynch, of 63 Osterville-West Barnstable Road, Barnstable (Osterville), Massachusetts, is the owner of property located at 63 Osterville-West Barnstable Road, Barnstable (Osteiville), Barnstable County, Massachusetts, by Deed recorded as Document Number 929,769 shown on Certificate of Title Number 169811, said land being shown on Barnstable Assessor's Map 129 Parcel 1.16 and being shown as Lot 16 on Land Court Plan 7687-E filed in the Barnstable County Registry of Deeds Land Court Department. Whereas, John F. Lynch, as the owner of said lot, has agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in the home built on the existing said lot. Y i Whereas, The Town of Barnstable Board of Health, is requiring that the agreement for y the restriction of the number of bedrooms in the house on the lot be put on record with the Barnstable County Registry of Deeds by recording this document. Now Therefore, John F. Lynch does hereby place the following restriction on the above referenced land in accordance with this agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title: 1. Lot 16, Land Court Plan 7687-E,house#63 Osterville-West Barnstable Road, Osterville, Massachusetts, may maintain upon the lot a house containing no more than four(4) bedrooms. John F. Lynch hereby agrees that this shall be a permanent deed restriction affecting the above described premises so long as the premises are not serviced by a public sewer. If in the future the premises are serviced by a public sewer, then this restriction shall terminate. Y a For title see deed recorded in the Barnstable County Registry of Deeds as Document Number 929,769 noted on Certificate of Title Number 169811. Executed as a sealed instrument this V-4 day of / 12008 o F. Lynch 17 COMMONWEALTH OF MASSACHUSETTS Barnstable, ss :/ =y , 2008 5 On this ?' day of �Gt�, 2008,before me, the undersigned notary public, personally appeared John F. Lynch, proved to me through satisfactory evidence of identification, which was a Massachusetts Driver's License, to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he signed it voluntarily for its stated purpose, c� Notary Public: Ljo n ri-e (Srn 1 ` Com Exp: I I d-6 I J y t y I� ARDITO, SWEENEY, STUSSE, ROBERTSON & DUPUY, P.C. ATTORNEYS.AT LAW '25 MID-=TECH DRIVE, SUITE C WEST YARMOUTH, MA 02673 (508) 775-3433 Telephone (508) 790-4778 Facsimile Edward J.Sweeney,Jr. - Thomas P.Carpenter Michael B.Stusse Kelly S.Jason Donna M.Robertson Tracey L.Taylor Matthew J.Dupuy Charles M.Sabatt Charles J.Ardito P.C. PLEASE REFER TO FILE NO. G6545X February 28, 2008 Town of Barnstable Board of Health Attn: Mr. Wayne Miller, Chairman 200 Main Street Hyannis, MA 02601 Re: John Lynch !: ` 63 Osterville-West Barnstable Road, Ostervtlle, MA Dear Mr. Miller,, v. , With regard to the above matter, please find enclosed for your records a copy of the deed restriction recorded with the Barnstable County Registry of Deeds as Document Number 1,082,905. Thank you for your attention to this matter. Sincerely, ARLES M. SABATT, ESQ. CMS/tlb Enc. $ST. CENTERVILLE-OSTERVILLE-MARSTONS MILLS FIRE DISTRICT DEPARTMENT OF FIRE-RESCUE&EMERGENCY SERVICES - M 1875 Route 28•Centerville, NIA 02632-3117 1926 508-790-2375 x1 • FAX: 508-790-2385 John M.Farrington,Chief Martin O'L. MacNeely, Fire Prevention Officer Craig E.Whiteley,Deputy Chief Francis M. Pulsifer, Fire Prevention Officer August 17, 2007 Mr. Thomas McKeon Director- Board of Health 200 Main Street Hyani is, MA 02601 Dear Director McKeon: Pursuant to MGL Chapter 148 Section 28A, I am making you aware and request your interpretation of an undersized septic system at: 63 Osterville- West Barnstable Road Osterville, MA The fire prevention office received fire alarm plans indicating a total of five bedrooms at this address. There.was a note on the plans relati�!e to additional bedrooms with a three- bedroom septic design. After placing a call to your office, your staff indicated that your files indicate a three-bedroom septic and I confirmed a total of five- bedrooms during the fire alarm inspection. Please call my office with any questions or concerns with this issue at 508-790- 2375 Ext.l. Thank you. Sincerely, i Francis M. Pulsifer ° Fire Prevention Officer rQ Co. i.' "Commitment to Our Community" I August 17, 2007 Mr. Thomas McKeon Director- Board of Health 200 Main Street Hyannis, MA 02601 Dear Director McKeon: Pursuant to MGL Chapter 148 Section 28A, I am making you aware and request your interpretation of an undersized septic system at: 63 Osterville- West Barnstable Road Osterville, MA The fire prevention office received fire alarm plans indicating a total of five bedrooms at this address. There was a note on the plans relative to additional bedrooms with a three- bedroom septic design. After placing a call to your office, your staff indicated that your files indicate a three- bedroom septic and I confirmed a total of five- bedrooms during the fire alarm inspection. Please call my office with any questions or concerns with this issue at 508-790- 2375 Ext.1. Thank you. Sincerely, Francis M. Pulsifer Fire Prevention Officer 1 EXCERPT FROM BOH MEETING NOVEMBER 13, 2007 A. Charles Sabatt, Attorney, representing John Lynch — 63 Osterville W. Barnstable Road, Osterville, number of bedrooms and septic size, 1.06 acres. Mr. Sabatt said he was not able to see our file as the health division had trouble locating it. He stated the Ellis Brothers installed the septic system and the permit was issued for four bedrooms. Mr. Lynch upgraded his alarm system. As that time, the fire inspection reported an illegal fifth bedroom. The as-built shows it as a three bedroom and shows it as 1500 gallons. The original permit can not be located but it is believed to be for four bedrooms. Mr. Sabatt presented the floor plans. The Building permit was issued for four bedrooms. A fifth bedroom (over the garage) was permitted in 2000 which can not be closed off for privacy. It was designed as a play room. Upon a motion duly made by Dr. Canniff, seconded by Mr. Sawayanangi, the Board stated that this is and always has been a four bedroom, the septic is adequate to handle four bedroom, and the Board will require a four-bedroom.deed restriction be recorded. (Unanimously voted in favor.) 'c 1 ARDITO, SWEENEY, STUSSE, ROBERTSON & DUPUY, P.C. ATTORNEYS AT LAW 25 MID-TECH DRIVE, SUITE C WEST YARMOUTH, MA 02673 (508) 775-3433 Telephone (508) 790-4778 Facsimile Edward J.Sweeney,Jr. Thomas P.Carpenter Michael B.Stusse Kelly S.Jason Donna M.Robertson Tracey L.Taylor Matthew J.Dupuy Charles M.Sabatt Charles J.Ardito P.C. PLEASE REFER TO FILE No. G6545X November 15,2007 Ms.Sharon Crocker Barnstable Board of Health 200 Main Street Hyannis,MA 02601 Re: John Lynch 63 Osterville West Barnstable Road,Osterville,MA Dear Ms. Crocker: Pursuant to the request of the Board of Health made at their hearing of November 13, 2007 with reference to the above entitled matter,I am enclosing herewith photocopies of the documents that I submitted to them at the time of the hearing that include the following: 1. Photocopy of report from Peter Sullivan with Reid C. Ellis report attached. 2. Photocopy of September 27,2000 Building Permit. 3. Collection of photographs showing loft room above garage. 4. Original construction plans. I am in the process of preparing a deed restriction as required by the Board of Health and as soon as the same has been executed I will forward it to your office for review. Thank you for your attention to this matter. Sincerely, Charles Sabatt CMS:eah Enc. Sullivan Engineering Inc. 7 Parker Road,P.O. Bog 659 OsterviRe,MA 02655 Peter Sullivan P.E.Mass Registration No.29733 phone 508-428-3344 fax 508428-3115 peter@sullivanengin.com October 31,2007 Attorney Charles Sabbit 25 Mid Tech Drive Suite C West Yarmouth MA 02673 RE: Mr. John Lynch 63 Osterville West Barnstable Road, Osterville Dear Attorney Sabatt I have reviewed the following information as provided by your office: Ellis Brothers Construction Letter report dated October 30,2007 2 pages (copy attached) Based on this report, it is my opinion that the existing septic system that is presently in the ground and properly functioning has a Title 5 flow capacity of 550 gallons per day as per the regulations that were in effect at the time of installation. This capacity can readily accommodate the flow from a 4 bedroom dwelling. I trust that this meets your present needs. If you have any questions once you have review the above information please feel free to call V truly yours Peter Sullivan PE Sullivan Engineering, Inc. Members of American Society of Civil Engineers and Boston Society of Civil Engineers Section 23 Enterprises Road Yarmouth Port,MA 7-1 ELLIS BROTI- ( ONSTO October 30,2007 ARDITO,SWEENEY,STUSSE,ROBERTSON&DUPUY,P.C. 25 Mid—Tech Drive,.Suite C West Yarmouth,MA 02673 Dear Charles Sabitt: The Property of Mr.John Lynch at 63 Osterville-West Barnstable Road,Osterville;MA 02655 was inspected by Reid C.Ellis On October 4,2007. The inspection found a 1500 gallon septic tank with H-10 Loading,Standard Distribution box with H-10 Loading and 1000 gallon leaching pit of H-10 loading with 2 feet of stone around it.The Leaching area is 6 feet deep by 10 feet wide with 6 x 6 pit and 2 feet of stone around it.The septic tank was pumped at this time and taken to the Yarmouth and Dennis treatment plant on 47 Workshop Road,South Yarmouth,MA.The discharge of this load at the Y-D treatment plant was for accuracy. The total received at the plant was 1510 gallons Ticket# 108769.Please see copy of ticket. Sincerely, Reid C.Ellis sfe . . . . . . . . . . . . . . . . . . . . . . . . . . . . �Ft:•! 'YC�)i..ii INVOICE !•'iAt.i9...9::aR TICKET 'T•OIWN OF `('•(•'1RI,.lOU..i.H >:?A T'I:m :l.i:°i.''s.;?":;f`t•'7 :i', t'T•1..9{;:i:aAY T:C9`1E :I:mn 08::5,,' r. r., i::•..._. 1::o BOX ;`.'?6 �l'�::t9'•�:l�r9t:l�.l..i.l..If::�1:19�`.T {•r9A (?D Si:r•:5 :.91.0 ELL IS d:ROS. �..:Ol-,1,.,i f,t.1(::•i :I:�.T1-•9 1.,1ATERI[af... a.:9. RESIDENTIAL i:SEP T•At•E `:?t.iT.11'4(.,f::.`:::: .l. 1:,9'•f ODOR;, T c.i:;:: (1DDI T ANAL: ACC. r' F't{:::•:1':: A ..'r...S 05 5 0 .........................................................._.... .... hfl•::•'i';, 12590 �• 8. 34 Pf:::F 1510 GALLONS PROPERTIES ............................................................. ...................................................................... TRANSn ADDRESS:: 63 IJ:C9...f...{:::"•'Wf::: :S•T' BARNS TABLE E F4I)Bi'iR9'-•1: ..i.A:l•• 9...f::: REASON FOR Ai::••i'1:T;f'••1:: I W:I:NTl:::!''•IAl'••ICk: ... r, ;` 1.�:,:9.f>i (:•T(•�t9...f...(:1r••9s:S 0 0, 11 f�9�:R :: :9.f:,t::,: :9 0 fY9��t"i'I:::i��::{:s��li...:; .{.:1. I•�:1:::-`::i.l:I�{:::I'••I"i':f:�•lf... n{:::1�'i•flt.:;9::. , irJ{ii::C(al-d{•r1i�1f:S'T'I::R '<:S:I:C:�i-i r::. �:.. ............................._ DRIVER s.f. 7N;: OIN OF BARNSTABLE BUILDING PERMIT APPLICATION 1 Map 4 P cel '� 01- 016 Permit# Health Division << ��; � � �� Date Issued �� . t a, Conservation Division Tax Collector rp S'PTIC SYS,TE �iUST IBA: Treasure 1 U INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMIENTAL CODE AM!D TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address b s I t oc)j Le - GCS(pS,4t2 Q'S7, A(n 12 6 Village CS TE12[JiLC Owner (4LISF/2l 1-- - W edrgr2Th Address 63 63Tc: (L01LC L-j - 13(AA rAS1Ig Ie-40D- Telephone Permit Request F vt i S 4, r 0c V-, v'*V bane (S 19L) %0 D� r of i Square feet:�lt floor: existing proposed 2nd floor: existing proposed Total new Valuations Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size r Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family 0- Multi=Family(#units) Age of Existing Structure Historic House: ❑Yes ❑ No On 0ld King's Highway: Cl Yes ❑ No . Basement Type: )0 Full ❑Crawl ❑Walkout ❑.Other - Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel:'16 Gas ❑Oil ❑ Electric Cl Other Central Air: �d Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes 64 No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:0 existing ❑new size Attached garage:' ]existing ❑new size Shed:❑existing.❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded 0: Commercial ❑Yes ❑ No If yes, site plan review# Current Use `Proposed Use BUILDER INFORMATION Name °i+ �� S �� l�S Telephone Numbeklzo Address �I a ' 6ekE"c --Pp"4Q k Q_02�-a License# CAS , a 3—� 6 2 6`k c- V-'-A - 6 6 S"S- Home Improvement Contractor# Worker's Compensation#Cv e,�31 S 3 i 6S cs 1 �134�,azr wcuTur-C, ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �n2�_ C'. rnLA -As 12e �v 6� SIGNATURE,w de DATE 9 �. _ �' .�..r- ...� � �j� �=` _ � � .Q�� .� �, _ ,., i _ � v � + � - r -_ e v �� ICI , �� ' �3 i416F� _ F' A� W�� ti� .ap Ir - �� C-_ T` r i i I'": .. - _� Ni !�{�';: �� .5 � '�, ,� �, f - . r.� _'�. �. � .. - I T, ® ter � orw i M In — _. r^ P° Tom,o -a � as =:0 PTR � 77. _ U— i _ -- Fii C 4 I —'--- —.�--i— — - -—--'-- - _ 15AYS 10 E FbU I Ln I NCB Go INc CENTEP-U I LL.E arE 9 3 F FZD I.IT ELEVAT tot" AL AN N IA.C1L2rdY ��3��49 ,ort�e.aie - 0 ---- _- r _ i • I I � I � L 5AYSI0E P,>UILOIN[. 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I ---'- _�AYStgE e,-�111LnIN6C•l.oc —.65n'o 'CENTE2V11_LE may oruww ry SD-e. .. oa•wroo wuueen ' L11. � 4NIJ /nc GArt T4Y 93- �j I 4(D-\ @ Im a n 4 y ly pf J � ul41 .In -ape" Tvqlv 14 _ — 5 'aq oLp II c o I0 .__.-. /1i9' /� 1' •i 1 4'O' I eta• O ; MATLN. • 1 ! f I ` (A a . r • � R _BAY910:E' 9UIl.�ING Co lwG . CENT.E R.LJ{E_LPEI AhS / • - - r ecu[:1 4,••_ •_p ,vnnovw Bv o�uwN M R •• • o•�e: Nov 9 S • - OIUWiNo MUYYU ANN pl[CA(Z-N-C 9 oc B - G,•o� 1I — - I,eiC I ,_ �' _ Df�* p ` -J �Dt } i � P:nn � _ mt•1 � � CD 6 Z W LZ 1 n - 011 �y Pca•vnc Sfai25, I 24�a' _.— I � c if — f,. P _gAYSI0E 3uILpWG C.14c C.EIaT�Rv I CLE //�G65 - - - ec.u: .I ervnoveo er �yASEf�ENT �0�.1NS]GTIaw • AL q AN N WUW MuwW .a of =•SAL-TAA, Asp"At-r 5µ Wr-"r.S 1�1'o r.//<:� 1/1"Gnx StitEATNrNcw - JYL. 'F10�meGL,.AS pl_Yboon CATtJAUt IYB FASCIA AWM.GUTTER% Z LCA06 QS : 1 t VFN•T1"G Ora 1n - .� rtb.w v NOC\ HCpn7 - T` F02 OIW A/nE.uTA.,. 'CAph / 1/ SN E. 1 ln�< -:lr to SRJ/J S.a'lv... 10 4,. .. ' to r fLc»hv �.AP o.0t.RJ.7S �} = PJCt GeK W-C.SIJ 1N6L`ah ANT) ROAR tt 1 t65- - .S/g Ff.:dldCLigpCJ<-- v � - 1�5�r i �1vt� r I` � - tii. 14'•ct_ CowiPN 4�_o, �, � Ho n Y S'/L-CONC Ib- _.__-- 14�.•1<uo .FGOTI w�4�j_..._ � _ 6AY9'IOE C'SUII.gING .CafN�— CBNTERViI-LE /LASS eC..�[:1 6:a 1_p^ <vvnovao av ouwv.w SECTION.. . - AL AN N I&C CA4.T Hd puwma to e rort luau 4 0►6. 1 . ,f Town of Barnstable . Board of Health i RAIINSTARLE, ''t 9 MASS. m 200 Main Street,Hyannis MA 02601 i639. ArFb MA1 A, Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi December 12, 2007 Charles M. Sabatt; Esquire T _ 1,26—b/6 Ardito, Sweeney, Stusse, Robertson & Dupuy, P.C. / 1 25 Mid-Tech Drive, Suite C West Yarmouth, MA 02673 Peter Dawson Mirick O'Connell Attorneys at Law 100 Front Street Worcester, MA 01608-1477 Dear Mr. Sabatt and Mr. Dawson: You are granted permission on behalf of your client, John Lynch, to maintain four bedrooms at 63 Osterville-West Barnstable Road, Osterville. This permission is granted because you demonstrated that four bedrooms were approved by the, Building Division. Although a septic construction permit was originally issued in 1993 for three bedrooms, you demonstrated that the house plans submitted along with the building permit were for four bedrooms and the septic capacity is adequate for the four bedrooms. Also, a building permit was obtained in 2000 to finish a room above-the garage to be used as a playroom. You are ordered to submit a recorded Deed Restriction for a maximum of four bedrooms at this property. Please ensure that you submit the recorded Deed Restriction to the Public Health Division within 30 Days of this letter:' Si erely you ay Miller Chai an Q:\WPFILES\Sabatt 63 Ost W B Rd 2007.doc e P�ppSHFTp�y Town of Barnstable y� Board of Health 1 BARNSTABLE, y MASS. m 200 Main Street,Hyannis MA 02601 �p 1679. 10 ArED MPt A. Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi December 12, 2007 Charles M. Sabatt, Esquire Ardito, Sweeney, Stusse, Robertson & Dupuy, P.C. 25 Mid-Tech Drive, Suite C West Yarmouth, MA 02673 Peter Dawson Mirick O'Connell Attorneys at Law 100 Front Street Worcester, MA 01608-1477 Dear Mr. Sabatt and Mr. Dawson: You are granted permission on behalf of your client, John Lynch, to maintain four bedrooms at 63 Osterville-West Barnstable Road, Osterville. This permission is granted because you demonstrated that four bedrooms were approved by the Building Division. Although a septic construction permit was originally issued in 1993 for three bedrooms, you demonstrated that the house plans submitted along with the building permit were for four bedrooms and the septic capacity is adequate for the four bedrooms. Also, a building permit was obtained in 2000 to finish a room above the garage to be used as a playroom. You are ordered to submit a recorded Deed Restriction for a maximum of four bedrooms at this property. Please ensure that you submit the recorded Deed Restriction to the Public Health Division within 30 Days of this letter. Sincerely yours Wayne Miller. Chairman Q:\WPFILES\Sabatt 63 Ost W B Rd 2007.doc �/► `� °' L qVP C� I tY ti � A 1 I � 7 I i to- � S% l i too-05-or 10:33am From-MIRICK O'CONNELL 508-752-7305 T-5004 P.002 F-05? MIRICK O"CONNEEL - ATTOIKNEYS AT LAW M IRIc... O'C0—ELL 0rM AI In• $, Lou uiE. LLP Its t�liQ 3 Direct Line(508)929-1626 Direct lax(508)983-6241 _c o v q/Clcql, pjdawson@modl.com September 5, 2007 VYA FAQ.- (508) 790-6304 lho3nas A. McKean, R.S., CHO Director of Public Health Towii of 33arnstable 200 Main Street Hyani,t s,MA 02601 cxi Re: John F- Lynch 63 Ostervillc W. Barnstable Road, Osterville Dear Mr. McKean: � M Tease be advised that this office represents John,Lynch of 63 Osterville W.,Batnstable-� Road. Mr. Lynch received your letter of August 22,2007 on August 28. Suffice it to say that Mr. Lynch was significantly surprised by the content of your letter_ We are currently reviewing various materials in comiection with this matter,and respecifally request a hearing before the Board of Health regarding these issues. Attached for your information is a copy of the septic ir:spection received at the time of acquisition reflecting the system was designed for a four <<<;droorn home. i will telephone you early next week to follow up regarding these issues. Very truly yours, d Peter J. Dawson PJD/1J L Enclosure cs : M,"_ John F. Lynch i— W- TBOR ) i "kFFT BUSION.MAOUGH Mq lUU tK:ON l3l b6-1.)1-F�X 50�-898 1502 wi kCCSTER.Mn 016gg-I s77 602612-117• 617261.2416 SOTS=iyl-d5U0•FAX 503791-8502 //// (!Y\P�LUIIa?3aI;5003Ai1bi73a,llU<) ( /C / + wwvv.M iri ck0Conndi.com i Slip-05-07 10:34a71 From-MIRICK O'CONNELL 508-752-7305 T-564 P-003/013 F-01;2 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AI'rAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address; 63 OSTERVILLE W. BARNSTABLE RD. OSTERVILLE,MA 02655 Owner's Name: ALBERT MCCA;RTIIY (Dwtter's address: 63 OSTERVILLE W.BARNSTABLE RD.OSTERVILLE,MA 026 Date of Inspection: 5/1.2/03 Name of Inspector: (please print) JOIiN GRAC1,INC. Co,inpany Name: SEPTIC INSPECTIONS Mailing Address: P.O.BOX 21.19 TEATICKET,MA.02536 Telephone Number: 508-564-6813 FAX 508-564-7270 CERTIFICATION STATEMENT I certiflr thaa 1 have personally inspected the sewage disposal system at this address and that the information reported below i tnle, accurate and complcte as of the time of the inspection.The inspection was performed based on my training and , experience in the proper function and maintenance of on site sewage disposal systems. I am a IDEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: X Passes _ Conditiot liy asses Needs F h Evaluation by the Local Approving Authority _ Fails r Date: 5/12/03 Inspector's sip-nature: l' The system inspector shall sub' a copy of this inspection report to the Approving Authority (Board of Iealth or DEP)within 30 days of completing this inspe ion,If the system is a shared system or has a design flow of 10,000 gpd or greater,the bispcctor and the systcm owner all submit the report to the appropriate regional office of the DEP.The original should bts sdsat to the system owner and copies sent to thc:buyer, if applicable, and the approving authority. 'Notes and Comments SYSTEM PASSED TITLE V INSPECTION.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG'1HI: SYS`fEM'S USEFUL LIFE, "I"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.. F •,-o , ,, .,oacoe rw� �ninnnn 1 see-05-07 10:34am From-MIRICK O'CONNELL 508-752-7305 T-564 P.004/013 F-M ➢-age z of s OFFICIAL I.NSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL. SYSTEM INSPECTION FORM PART A i CERTIFICATION (continued) Property Address: 63 OSTERVILLE W-BARNSTABLF RI).OSTERVILLE,MA 02655 Owner: ALBERT MCCAkrHY .Date or Inspection: .5/32103 >leaspection Summary: Cbeck A,B,C,D or E/ ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates That any of the failure criteria described in 310 CMR 13.303 or in 310 CNIR 15.304 exist.Any failure criteria not evaluated are indicated below. M Comments: SYSTEM PASSED TITLE V INSPECTION.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTE-MIS USEFUL LIFE. B. System Conditionally Passes: Ole or more sys -m components as described in the"Conditional Pass" section need to be replaced or repaired.The systE m, upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the_.for the following statements, If."not determined"please explain. n/a The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound,exhibits subsTaatial im iliz ation or exfiltration or tank failure is hriminent- System will pass inspection it the existing tank is replaced with a cc)trplying septic tank as approved by the Board ofHeahb. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certiticate of Compliance indicating meat the tank is less than 20 years old is available. ND nplain: n/a n/a Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipes) or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced _ obstruction is removed _ distribution box is leveled or replaced ND explain: n1a n/a 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): f _broken pipes)are replaced _obstruction is removed ND explain: n/a sap-05-07 10:34am From-MIRICK O'CONNELL 508-752-7305 T-564 P.005/013 F-UF2 ljagc 3 of 11 OFFICIAL. INSPECTION FORM - NOI'FOR VOLUNTARY ASSESSMENT$ SUBSURFACE SEWAGE DISPOSAL, SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 63 OSTERVILLE W. BARNSTABLE RD_ OSTFRVILLE,MA 02655 Olmm'.,,: ALBERT MCCARTHY Date of Inspection: 5/12/03 C. Further)Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Boars of Health in order to determine if the system is failing to }protect public health; safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment_ Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment, _ The system has a septic table and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ 't'ne system has a septic tank and SAS and the SAS is within a Lone 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 wel.] *.Method used to determine distance n/a t **This system passes if the well water analysis,performed at a DEL?certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of anwionia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: i .( . k ssp-05-07 10;34am From-MIRICK O'CONNELL 506-752-7305 T-564 P-006/013 F-U52 4 01 11 OFF rCIAL INSP ECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACESEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property address; 63 OSTERVILLE W.BARNSTABLE RD.OSTERVILLE,MA 02655 Owner. ALBERT MCC ARTHY i ]date of Inspection: 5/12/03 D. System Failure Criteria applicable to all systems: You taus indicate"yes" or"no"to each of the following,for alLiuspections; a Yes No X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent Lo the surface of the grouted or surface waters due to an overloaded or clogged SAS or cesspool X Static liquid level in the distriburion box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is Icss than C" below invert or available volume is less than 'A day flow X Required pumping more than 4 times in the last year NOT chic to clogged or obstructed pipe(s).Number of time.: purnped PITME VNYR. .X 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. X Any portion of a cesspool or privy is within a Zone 1 of a public well. _ X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with -oo acceptable water qualiry analysis. (This system passes if the well water analysis, performed at a DEP . certified laboratory,for coliforrn bacteria and volatile organic compounds indicates that the well is frcr 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 forma NO (Yes/No)The system fails.I have detennir)ed that oue 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 wih he necessary to correct the failure. U. Large Systems: To he considered a large system the system trust serve a facility with a design flow of 10,000 gpd to 15,000 gpd. Yott tirL nt i!.l.dicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply _ "X the system is located in a nitrogen sensitive area.(Interim Weltliead Protection Area IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question ui Section E the system is considered a significant threat, or answered `yes" in Section D above the large system has failed.The owner or operator of any large system considered a significant(beat under Section E- or failed under Section D shall upaTade the system in accordance with 310 CMR 15.304. The system ov;ner. ,hoaild contact the appropriate regional office of the Departnnem t Q Sep-05-07 10:34am From-MIRICK O'CONNELL 506-752-7305 T-564 P.007/013 F-Ori2 ) a e4� of11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 63 OSTERVILLL W.BARNSTABLE RD. 0STERVILL9,MA 02655 Owner: ALBERT MCCARTHY Oahe of Inspection: 5/12/03 t Check—if the following have been done.You must indicate"yes" or"no" as to each of the following_ Yes No X _ 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 Tile previous two week period? i i X Have large voltunes of water been introduced to the system recently or as pan of this inspection? Were as built plans of the system obtained and examined?(If they were not available note as N/A) _ Was the facility or dwelling inspected for signs of sewage back Lip ? . 1 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 was,material of construction, dimensions,depth of liquid, depth of sludge and depth of scum? _ Was life 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: '1"es no _ Existing information. For example,a plan at the Board of Health. Determitned in the field(if any of the failure criteria related to Pan C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(h)3 S , 7 1 sap-05-07 10.34am Prom-MIRICK O'CONNELL 508-752-7305 T-564 P-008/013 F-W �a � 6ofII OFFICIAL INSPECTION FORM-?�;OT FOR VOI,UNTARY ASSESSMF,NTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION ]Property Address. 63 OSTERVILLE W. BARNSTABLIE RD.OSTERVILLF,MA 02655 Owner., ALBERT MCCARTHT Date of Inspection: 5/12103 FLOW CONDITIONS RE JIID>ENTIAL Number of bedrooms(design): 4 Number of bedrooms(actual*: 4 l:ESION flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 548 Nhunber of current residents:3 Docs residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Lxmdry system inspected(yes or no);NO Sersonal'ase: (yes Or no NO Water meter readings,if available(last 2 years usage(gpd)): n/a Slurp pump(yes or no): NO Last'date of occupancy:n/a C'Ol`blMIERCIAVINDUSTRIAL '. Type of establishment: n/a Design flow(based on 310 CMIt 15,203): n/agpd tasis of design flow (seats/persons/sgft,etc.): n/a Grease trap Present(yes or no):NO Industrial waste holding tank present(yes or no):NO Non-saniiary 1Nas.te discharged to the Title 5 system(yes or no): NO water_meter readings,if available: n/a Last date of occupancy/use: n/a OTHER(describe): n/a GENERAL INFORMATION #umpis g Records Source of information:PUMPED IN SEPTEN113ER BY OWNER Was system pumped as part of the inspection(yes or no):NO If ycs, volume ptarnped:n/agallons--How was quantity pumped deternnined?n/a Reason for pumping: n/a T`V'PE OF SYSTEM X Septic tail,distribution box,soil absorption system _dingle cesspool _Overflow cesspool Yriary _ _Shared system(yes or no) (if yes,attach previous inspection records,if any) _1-novative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from systena owner) _.righi tan-1c Attach a copy of the DEP approval 1 Otlier(describe): n/a Approximate ape of all components, date installed (if known)and source of information: 1994.'BY OWNER Were sewage odors detected when arriving at the site(yes or no): NO t • sap--05-07 10:34am From-MIRICK O'CONNELL 508-752-7305 T-564 P.009/013 F-052 Para;of I OFFICIAL INSPECTION FOIE—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address. 63 OSTERVILL;E W. BARNSTABLE RD_OSTERVILLE,MA 02655 Owner: ALBERT MCCARTHY i Date of Inspection: 5/12/03 3 111-J1LlDI.NG SEWER(locate on site plan) Depth below grade: 13" Materials of construction: _cast iron X40 PVC_other(explain); n/a _ Distance from private water supply well or suction line; n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER S'l PTIC T,.,NX: X(locate on site plan) Depth below grade: 12" lvlaterial of construction:%concrete_metal fiberglass_polyedrylene other(explain)n/a Tf tank is metal list age: n/a Is age confirmed by a Celtifncate of Compliance(yes or no): NO(attach a copy of ccrrificate) Dir::ensi0n3: 1000 GALLONS" Sludge depth: 2" Distance from top of sludge to botLOrn of outlet tee or baffle: 32" Scum thiclmess:T' Uistauce 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" 1 ow were dimensions determined; MEASURED ; Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid lCVC15 as relaxed to ouY1ei.invert,evidence of leakage,etc.): ;.1RPTI C TANK AND ALL COMPONENTS AIDE STRU(:Ti RALLY SOUND AND FUNCTIONING PROPERLY. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. GREASE TRAP: —(locate on site plan) i Dexh below grade; n/a iviateti�al of construction: concrete metal_fiberglass��olycthylene_other(explain): n/a Dimensions: n/a -Scam thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance n-om bottom of scum to bottom of outlet tee or baffle: n/a :Date of last pumping: n/a Comments(on pumping recommendations,inlet and outlet tee or baffle condition, svuctural integrity, Jiquid levels as related to oird(kc invert,evidence of leakage,etc.): n/a 7 Sep-•05-07 10:35am From-MIRICK O'CONNELL 508-752-7305 T-564 P-010/013 F-OU Pagz, b of 1 I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address. 63 OSTERVTLLE W_ BARNSTA.BLE RD,OSTERVILLE,MA 02655 Owner: A BERT MCCARTHY 1 Date of Inspection: 5112/03 TIGHT of HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Dept below grade: n/a hiaterial of construction, _concrete_metal_fiberglass_polyethylene_oflier(explain): n/a i Dimensions: n/a Ce.-pacify; n/a gallons Design Flow: n/a gallons/day Marm present(yes or Do): NIA Alarm level: Nl.� Alarm in working order(yes or no):NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): 1t/a DISTRIBUTION BOX. X (if present must be opened)(locate on site.plan) + Depth of liquid level,above outlet invert:LEVEL WITII BOTTOM OF PIPE }. Cnnments (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-): D-BOX VAS VIDEO INSPECTFD AND APPEARS TO BE STRUCTURALLY SOITND. 1?1'i1MP CHAMBER, _(locate on site plan) ;,.jznps in working order(yes or no):NO .P..Isams in working order(yes or no):NO Comments(note condition of pump chamber, condition of pun-ips and appurtenances,etc.): Wa i r Q sop-05-07 10:35am From-MIRICK O'CONNELL 508-752-7305 T-564 P-011/013 F-052 Page 9 of 11 OFFICIAL INSPECTION FORM®NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM I1VFORMATION(continued) f Property.LWdress: 63 OSTERVILLE W_BARNSTABLE RD.OSTERVILLE,MA 02655 Owner: A,LBE RT id CCARTRY Rate of Inspection: 5/12/03 SOIL A,.13SORPTION SYSTEM (SAS): _x (locate on site plan,excavatioti not required) i 14`SAS not located explain why: n!a Type . 10 00 G_1!,y`X 6' Teaching pits, number: 1 1Lb leaching chambers, number: n/a n/a leaching galleries, number: nla n/a leaching trenches, number, length: nfa n/a leaching fields, number: nla ;ta/1 overflow cesspool, number: n/a innovative/alternative system Type/name of technology: n/a Comments(note condition of soil, signs of hydraulic failure,level of ponding, damp soil, condition of vegetation, etc.): LEACH PIT IS STRUCTURALLY SOUND AND rUNCTIONING PROPERLY. SYSTEM SI4OWS NO SIGNS OF FAILURE.PIT HAS Y OF LEACHING LEFT IN IT.BOTTOM IS AT 716" ('F SPa)OLS: (cesspool must be pumped as part of impection)(locate on site plan) Number and configuration: n/a Deptlt—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depia,of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a :indication of groundwater inflow (yes or no):NO ' Co jnmiejas(mote condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.): n/a 1Yh IV is (locate on site plan) N(aterials of construction: tt/a 1 Dimensions: n/a Depth of solids: n/a Coinrnents,(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation, etc.): n/a i 4 SGP-05-07 10:35am From-MIRICK O'CONNELL 508-752-7305 T-564 P-012/013 F-0!;2 pag;= iU of 11 OFFICIAL INSPECTION FORM-NOT.FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C < SYSTEM INYORMAT1ON(continued) A t Froperty Address: 63 OSTERV'ILLE W.BARNSTABLE RD.OSTERVILLE,MA 02655 l'ywaer: A,BERT MCCARTRY Date of lnspeWon. 5/12/03 SKETCH 01P SEWAGE DISPOSAL SYSTEM } Provide a sketch of the sewage disposal system including ties to at leapt two permanent reference landmarks or benchmarks. Locate all wells wiihin 100 feet. Locate where public water•supply enters the building. 3' - q t • . 1 it sop-05-07 10:35am From-MIN CK O'CONNELL 508-752-7305 T-564 P-013/013 F-H2 P�gc 1 oC 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM: PART C i SYSTEM INFORMATION(continued) Property Address: 63 OSTERVILLE W. BARNSTABLE RD. OSTERVILLE,MA 02655 Owner: A SERT MCCA.RTHY Date on Inspection; 5/1.2103 g SITE (EXAM # Slooe _Surface water Check cellar Shatlow wells Estimated depth to ground water 10 i•feet 1 Please indicate(check)all metliods used to determine the high groundwater elevation; i YES Obtained[rom system design plans on record-If checked, date of design plan reviewed: n/a No Observed site(abutting propeny/observation bole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a tWO: Checked with local excavators,installers-(attach documentation) . NO Accessed USGS database-explain: n/a You rnnst describe how you established the high ground water elevation: GROUNDWATER DETERMINED FROM ENGINEERED PLANS SUPPLIED BY BOARD OF HEALTH NO GROUNDWATER AT 121" i., l sap-05-07 10:33zal From-MIRICK O'CONNELL 50E-752-7305 T-564 P.001 F_06;' { MIRICK OTONNELL ATTORNEYS AT LAW MTRICK,O'CONNELL,nE•MALLIE&LOUGEE,LLP FAY""K. Mate: Septa.niber 5, 2007 Time: � Client Number: 99999-22222 _ Nutmt3er of pagvi including cover sheet: 13 To: Thomas A. McKean, R.S., CHO From: Peter J. Dawson, Esq. Director of Public Health Mirick, O'Connell, DeMallie& Lougee, LLP Town of Banistable 100 Front Street MO Main Street Worcester, MA 01608-1477 "Hyannis, MA 02601 Telephone: -(508) 862-4644 Telephone: (508) 791-8500 _ Fax: (508) 790-6304 Fax: (508) 790-6304 mm CC: E-mail: jdawson modl.com _ Return fax confirmation page to: Lora E 03 iginal Will Follow F7 Original Will Not Follow REMARKS: Urgent For your review F7 Reply ASAP F__] Please coxrynent CONFIDIENTL4.11TV NOTICE: TH1E INFORMATION CONTAINED IN THIS FAX MESSAGE AND ANY A°I LCI ENT 'S ATTORNEY PRIVILEGED AND CONFIDENTIAL INFORMATION INTENDED ONLY ]FOR Talc; INDI`T[DUAL OR ENTITY NAMED ABOVE. IF YOU ARE NOT THE INTENDED RECIPIENT, YO'U' ARE H36Rf,'BY NOTIFIED TILkT ANY DISCLOSURE, DISSEMINATION OR COIPYING OF 1THS COMMUNICATION IS STRICTLY PROITMITED. IF YOU HAVE RECEIVED THIS COMMUNICATION IN 1EI"MOR,PLEASE U"MEDIATELY NOTIFY US BY TFLEPRONE. THANK YOU. WT-MOROUCT-T,MA 100 FRONT MEET ROSTON,MA 5U8 89K 1501>TAX 508-898-1502 worcr,=-R,MA 016U8-1477 617-261-2417<FAX 617-261.2418 508-791-8500•FAX 508-791-8502 c.�aw.M irickC)Connall.com ILd4�A�Ll�hcyrt;iigol,al 1^.n TIK nqC • I F Lul - -- - --- ._ ..... ... .--Elm CLOP Pso4n.gti _ .. .. __.._ ... .. —._ . ........... . .. _. _..-. . __ .. i - ---- --._--__.—... - -- - ------1 - 5AYS10E P�.U1Ln[we- Go lrlc GEN-rep-u I LLF- wn: i FQ-0WT ELEVATION } AL >R AN N IhG Ge.RTLIY °X"�3NUYBFN 1` w.r,uB,e 49 _ c I f y - r I I E>AY51gE FbUILOINC. C 1we- - ' --C ENTE2V f LL.L /hC.Sh e: Nou 93 L•C.FT SIpC AL- $ ANN /he—C1+rGTAY 9�3�u4-e9 ro.r rasa . F_- - _ _.BAY_S.IDE PSUILDINC, Co1Nc C.EN T E:QV t 1..1.E /h[�rrj5 _ RJ G.I-�ZSI.Q E_.,�LE.VfiT.IGN CAM THE( wuw'9�°e4�J I R LE � - -- I I I I -14 I.B A:Y S 10 E 6 U I LD 1 N G Co I N'C. -.CENTS FLViI LL.E. /nA SS ogre: 1�1 DJ 9$ .lZEAR. .EL.E�/OTIO N ' A L. 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I°I �•O'• G`-F Iw MCC.LAI i/�P-:ICLG4K FPLY.I W-e-S111NGLG4_.�i 1�7GS �% MrAm reP,f. _. ....._._.--- v .. 7 F.C.-sYGLTROpt-- Inr ai \4'-d 14..o.. i m�} _ E 1 - - 1�------ h,l I •' j ,,vC� �5'Ii...OQAN r r " Ni IQ-d' COLUiI-Nh ' .8"Y'1'•9"L'OHC.I!VJALIs •y. _ •tLsP acirp pnoovl ua - _.,.. �...- 3�IL"LONG • 6AY9'IO.E 6UILgING Col.w\c CErlTE2VILt_E `/MASS EC�IE:I 4%L I-O" MPROVEp EY Olt �j SE C-r I ap rort usu 4 OT e. Certified Mail#7006 0810 0000 3525 2988 ��j tati Town of Barnstable o� Regulatory Services BARN STABLE. MASS. Thomas F. Geiler, Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 August 22, 2007 John Lynch 63 Osterville W. Barnstable Rd. Osterville, MA 02655 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.300 and 310 CMR 15.00,AS WELL AS TITLE V. The property owned by you located at 63 Osterville W-.-Barnstable Rd."in Osterville was. 'j inspected on August 16, 2007 by Francis Pulsifer, Fire Prevention Officer for COMM Fire Station. The following violations of the State Sanitary Code were observed: 105 CMR 410.300 and 310 CMR 15.00: There were a total of five (5) bedrooms observed at this property. However, the existing septic system (permit# 93-627) was not approved for five (5)bedrooms. It was approved for three (3)bedrooms only. You are ordered to correct the violations listed above within thirty (30) days of your receipt of this notice by pulling any required building permits to restore the property to a three bedroom home. You are ordered to remove two of the bedrooms by removing entrance doors and by opening all door-way entrances to each room to a minimum of five feet wide openings. This will bring the total bedroom count down from five (5) to the appropriate three (3) as designated by your septic permit. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of $100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the above violation, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. Q:\Order letters\Housing violations\Rental ordinance\55 betty's pond.doe PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable Cc: Meredith Morgan Q:\Order letters\Housing violations\Rental ordinance\55 betty's pond.doc l_ f Certified Mail#7006 0810 0000 3525 2988 sKE Tati Town of Barnstable IIA LE, Regulatory Services M^�� x ASS.. ]J V � � Thomas F. Geiler,Director 039. PlF°""AAA Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 August 22, 2007 John Lynch 63 Osterville W. Barnstable Rd. Osterville, MA 02655 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.300 and 310 CMR 15.00,AS WELL AS TITLE V. The property owned by you located at 63 Osterville W. Barnstable Rd. in Osterville was inspected on August 16, 2007 by Francis Pulsifer, Fire Prevention Officer for COMM Fire Station. The following violations of the State Sanitary Code were observed: 105 CMR 410.300 and 310 CMR 15.00: There were a total of five (5) bedrooms observed at this property. However, the existing septic system (permit# 93-627) was not approved for five (5)bedrooms. It was approved for three (3) bedrooms only. You are ordered to correct the violations listed above within thirty (30) days of your receipt of this notice by pulling any required building permits to restore the property to a three bedroom home. You are ordered to remove two of the bedrooms by removing entrance doors and by opening all door-way entrances to each room to a minimum of five feet wide openings. This will bring the total bedroom count down from five (5) to the appropriate three (3) as designated by your septic permit. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of $100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the above violation, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. Q:\Order letters\Housing violations\Rental ordinance\55 betty's pond.doc PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable Cc: Meredith Morgan QAOrder letterMousing violations\Rental ordinance\55 betty's pond.doc - - , or AAa 6AllaA[,.c--- L�Kjfl�Ef� "ol i 'PA I Lam( 5E'[�-1 C �'AN�, 33o X/5o ��49SG?p i � � �� • r lYi le /oop GAL 4Z 1Ol DlSPoSA L PIT '51DEMLL AR A =108 S B07TOM .� 78 SF 44 ~ x I.O a. .`1 gGPD. 41. ID AL De61614 = 546 as -- TOTAL , VAIL- MIV 3 O ZM/f alL So :� ' 10� PE2GaLAT7oN � z I iu Z,c,L►N�<.� SZ \ � � � � �a •_ � � I� N I.7OF it OF�9 131 I RICHARD o SULLIVANER — - / S A. N °AX4FR M No. 2913.3 `'ido.2aoae L EN6�� E 164 T M6Ir F 814to !•I•o��-` �o-z�-93 �47/=.s/ 'G L dL TF=5o SdQso�� k 1w.. Z `t'" I�� 1t11C 4� DKT I d �Ild GAL 1000' IW 4S2 OCK q �i�b SepT'IC g GAS,.' ?"AN L C`�'g'J \N. I IrA, Sl= LSo=�S ok .; saw /Z Z1,11`4Va WA696P kS:. Au--5rzL.mze3 sr-T TouE ' S titofZF 'f1LAnj 4 viaep �$ �Sga1.. BE 14'Z.0 ZohfE fLF•-� lIS I51P 12n FCL 1-1 -palSLOPED I l�I® Pt�- FaN 40 SGALE-: �' �D DATE przgV6I3a PLAN i GExT1fi( 1�AT T►{E Dwc44,1 JG Eft.�JCE 1 low tJ NErZEaN CoM'P__L�yyS, WrrA A-41fir-WM LO l 'i 5 �1�r !-o�T� 4v►t 1u E zaoa M,aIa � � G• ��$' � . $dxTE�Z NYE (W- CIS FtAW lS fJOr BASED 0;4 AN t�1S'Ti'�LJktELJT p 55�or ldL AIJD Su>?s✓ yoeS Sugwc-y MjJ > T� e oF�SeT" 41-OOL.,'� u or Be o �`'L L �Gt LJ LEL5 U' cI� 'TO �STaB�Kt� L=QTy �.,uEg. STrzviu.a MAC , APPLICANT-, -9Ay51DE TI)IL-DIil/_ /_ � o t y ! fl t;,6" i LOCATION i II ff �T� 16 o5�, �1/. 7=-:v►s7��7��0 SEWAGE # R'�- OZ7 VILLAGE 0'4'ec\,lh ASSESSOR'S MAP & LOT fJ6.661-01 INSTALLER'S NAME & PHONE NO. �.-5: QCRA1 771 10gj) SEPTIC TANK CAPACITY �� _00 51 t6's LEACHING FACILITY:(type) C��j^ Pj (size) 1,006 aill a r NO. OF BEDROOMS 3 PRIVATE WELL O PUBLIC WATER ' BUILDER OR OWNER Co, -27 DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No i E -- i , s�. s 1� , F ! • : 1 , , : , : t I , , 1 : , : ( I -F , , T" I i ! 1 I t � 1 � � of►7"e��i � — — — t —+,_—' 1 ` I {— , i � -i- _7_—- , : : i 1 I I •Y , ' 1 , .--r---�---=r- a �- --- -- ---- --" - , ---- - r 1 : 1 y� _ t , 1' i , , , , , t r , : • _ - I , �_... t off Ye • , p : , I r ""►va`-�-�...�sm""e.°'T-•-_'�- ! --- - -i-- - - -- • I gent�S - - : , : --, - # • : : ^ T i t , 1 1 a- 1 1 � : i i : 1 E : ---r I •! I i i r - _- , f , I 1 : : : i_. _: : , //♦♦yyam� / 1 , 'r i r-- : i : f 1 i i. 1 - L A FLOO , I , ! t t �i rai . ram+. , ' , I • r p, „� Y T I ! : , , 1 ' t , I —....- --- t f : I : r _ T Ly j a 7 I i 29 1 , _r , — r r' i I I •. I-—'�I�-1-----� --� -rya S� �.. :. �._....-- --- : -------------------- i ' I T 1 1 I i I •t I t , , 1 . � ;_...-- , IN , ' I .....1..---1 , , i i 1 I : .... .....mo .. , -70 , • _ I - , , f : , Message Page 1 of 1 Morgan, Meredith From: Fontaine, Tina Sent: Friday, September 28, 2007 1:16 PM To: McKean, Thomas; Morgan, Meredith Subject: 63 Osterville W Barnstable rd The attorney.representing John Lynch of 63 Ost WB road came into see the original permit that was stated in the letter sent out in August. They're going to the board this month and want to see the permit that states it's a 3br system. I couldn't locate the permit. Tina C. Fontaine Town of Barnstable Healtlti Dlvlslon f 10/2/2007 ISIe�-0!S-0 10:33am from-MIRICK O'CONNELL 508-752-7305 T-sod P.002 F-0!i2 MIRlCK O'CONNELL - o.TT0KN.EYS AT LAW M IRiCK. O'CONNELL DEMAI IIr $ LuuBfE. LLP �/s �l-i Direct Line(508)929-1626 �- )7 ' W' Direct Fax(508) 983-6241 �.,ort o v4- pj dawson@a)tno dl.com September 5, 2007 VIA ETA- (503) 790-6304 Tho3na-s A. McKean, R.S., CHO .7 D;in actor of Public Health io,vv,n of Barnstable 200 Main Street -- t yarni i s,MA 02601 cl, Re: J ohn F. Lynch 63 Osterville W. Barnstable Road, Osterville =- Dea-Ivir. Mclean: Please be advised that this office represents John.Lynch of 63 Osterville W. Barnstable Road. I& Lynch received your letter of August 22, 2007 on August 28. Suffice it to say that Ms. Lynch was significantly surprised by the content of your letter- We are currently reviewing oarious mate:i'ials in comiection with this matter and respeCtfully request a hearing before the Load of health regarding these issues. Attached for your infonnation is a copy of the septic D-:spec-rion received at the time of acquisition reflecting the system was designed for a four i'�edtoom 1:.ome. ' i will telephone you early next week to follow up regarding these issues. Very truly Yours, J Peter J. Dawson-- PJD/lj: 1✓nclosure c_: Mi-. John F. Lynch W_STBCROUGH.MA IVU MON l STREET BUS IUN.MA °O8 IS9tl-Eiji-FNC 508-898-1502 Wi RCES T ER.Mn 01606-14 61726)2-117 0 rnKE17 2 61 2416 S[1h=91-SSuO-EqX SG9791-0,502 �7 %} i!•Y1Px.LNI-:?3»u5003W:17A734.00<1 wvvw-MirickOConnell.cvm Q�t�• � i S.ep-ob-a F 10 34cii From-MIRICK O'CONNELL 508-752-7305 T-564 P-003/013 F-11I2 COMMONWEALTH OF M.ASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS 1 J.� DEPARTMENT OF ENVIRONMENTAL PROTECTION :;� ,mi IRK TITHE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION PRop.rty address: 53 OSTERVMLE W. BARNSTABLE RD.OSTERVILLE,MA 02655 Owner's Name: ALBERT MCCARTI YY Clwner's Address: 63 OSTERV.LLLE W.BARNSTAI3LE RD.OSTERVILLE,MA 026 D121te of Inspection: 5/1.2/03 Name of Inspector: (please print) JOHN GRACI,INC, allow Company Name: SEPTIC INSPECTIONS 141.ailing Address' P.O.BOX 21.19 TEATICUT,MA.02536 Te^lptihone Number: 508-564-6813 FAX 508-564-7270 CERTIFICATION STATEMENT I cerd_R/tl�.a-I have personally inspected the sewage disposal system at this address and that the information reported below;s true, accurate acid complcte as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I-am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). Tbc system: X Passes Condivot lly asses Needs F 1. ation by the Local Approving.Authority Fails l(tfl I� stox's Sign,s<tttrc: 1' Date: 5/12/03 lall Thfu ystein inspector shall subma copy ofthis inspection report to the Approving Authority(Board of Health or DEP)within 30:ays of completing this inspeion.If the system is ashared system or has a design flow of 10,000 gpd orineater,the aispcctor and the systcm owner submit the report to the appropriate regional office of the DEP.The original should b sFBat to the systcm owr_er and copies sent to tha buyer, if applicable, and the approving authority. Notes and Comments 5,Y5'1'F�M1 PASSED TITLE V INSPECTION:RECOMMFN- D PUMPJNG LVERY TWO YEARS TO PROLONG THE SYSTl M'S US.EFUJ_LIFE, t;`,'This report only describes conditions at the time of inspection and tinder the conditions of use V that time.T115; ins cc-don does not address how the system will perform in the future under the same or different conditions of its�.. 5aP-05-07 10:34.am From-MIRICK O'CONNELL 508-752-7305 T-564 P.004/013 F-M Page 01 1! OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION I OR t PART A CERTIFICATION (continuer!) lroper-ty Address: 63 OSTERVILLE W.BARNSTABLF RD.OSTERVILLE,MA 02655 Owner: A-LBE)h T MCCARTHY rig[e or Inspection: 5/12103 Inspection Summary: Cbeck A,B,C,D or E/ ALWAYS complete all of Section D A. SySlern P255as: I have not found aT.y irtfbrmation which indicates That any of the failure criteria described in 310 CMR 15.303 or in 310 CM 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: SI STEM PASSED TITLE V INSPECTION.RFCOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SIN' TEMIS USEFUL LIFE. H. Systern Conditionally Passes: 0:1e ar m.ore s:/stem components as described in the"Conditional Pass" section need to be replaced or repaired.The sys'tc in, upon completion of the replacement or repair,as approved by the Board of Health,will pass. Ans,xer ves,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. n/a T"ac septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally unsound,exhibiu subsiantial infill'u-ation or exfUtration or tank failure is i rninemi. System will pass inspection it the existing tank is replaced WAi;:ccimplying septic tank as approved by the Board of Healib. ma41 septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicatinE diax ilie tank is less than 20 years old is available, NI)uxplain: n/a n/:a -0b_ervanon of sewage backup or break out or high static"water level in the distribution box due to broken or obstructe!; pipei;s) or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of broken pipe(s)are replaced obsn-uction is removed _ distribution box is leveled or replaced 1T.I�explain: n/G n/a The sys-,gym.regti_�ed pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inS}5ectloTi if(with approval of the Board of Health): _broken pipes)are replaced _obstruction is removed ?JL�explain: n/a jlap-05-07 l Cl:3dam From-MIRICK O'CONNELL 508-752-7305 T-584 P.005/013 F-0E;2 1pa�c a ; '_ 1= OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SE WAGE DISPOSAL SYSTEM INSYECTION FORM PART A CERTIFICATION (continued) Prop riy Address: 63 OSTERViLLE W. BARNSTABLE RD_ OSTERVILLE,MA 02655 Ow-im-'-: AL BERT MCCARTHY I9ate of Inspection: 5/12/03 C. Further Evaluation is Required by the 13oard of.H.ealth: _.Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to rirotect T)uh iir health; safety or the environment. -!. Systek-n will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within SO feet of a bordering vegetated wetland or a salt marsh 2. Svstem 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 thbutary to a surface water supply. _ T'ne sy:aem has a septic tank:and SAS and the SAS is within a Lone 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 wafer supply well*"'.Method used to determine distance n/a l his 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 anunonia niT ogen and nitrate nitrogen is equal to or less than 5 ppm,provided That no other failure criteria are triggered.A copy of the analysis must be attached to.this form. 3. Orher: Z kp;a-05-G7 10:34am From-MIRICK O'CONNELL 508-752-7305 T-564 P.006/013 F-IM OFIrYCIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION>FORMM_ PART A CERTIFICATION (continued) :Property Address- 63 OSTERVILLE W.BARNSTABLE RD.08TERVILLE,MA 02655 Owner- ALBERT 1MCCARTHY Date of lnspection: 5/12/03 D. ,system .failure Criteria applicable to all systems: Y au_r{utsB indicate"yes" or"no"to each of the following,for al.Limpections: Yes No X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent to the sin-face of the ground or surface waters due to an overloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than 'A day flow N Required pumping more than 4 times Lithe last year NOT due to clogged or obstructed pipe(s).Number of tiMLU pwrLped ETTIVIP VNFTZ, _ X Any portion of the SAS, cesspool or privy is below high ground water elevation. X Any;portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supp.y. _ 9 Any portion of a cesspool or privy is within a Zone l of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well N Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private wa'XT 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 frcc: froth pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to cir less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.1 NO (Yes/No)The system fails.I have detennined that one or Mori:of Lee above failure criteria exist as described in 3 l 0 CNIR i 5.303, therefore the system fails.The system owner should coZtact the Board of Bcalth to determine what wW be s:,cessary to correct the failure. 1% 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. you tTru:-,t_,J i„ate either"yes"or"no"to each of the following: (Tlie folloviina criteria apply to largo:systems in addition to the criteria above) yes no N the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply _ X the system is located in a nitrogen sensitive area(Interim Wellllzad Prozcction Area IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any ilucsuon in Section E the system is considered a significant threat,or answered -yes".in Section D above the large system has failed.The owner or operator of any large system considered a significant fueat ar.der Section L- of failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system ov.ner should contact the appropriate regional office of the Departnnem. n I Sao-V-0i' 10:34,t From-MIRICK O'CONNELL 506-752-7305 T-564 P-007/013 F-V2 P La = of 11 _ OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE)DISPOSAL SYSTEM INSPECTION FORM PART S CHECKLIST Prop rty Address: 03 OSTERVILLE W. B.kPUNSTABLE RD.OSTEIRV1LLL,MA 02655 Owner: A-LBERT MCC_4RTHY 1).ate oflaspcction: 5/12/03 if the following have been done.You must indicate"yes"or "no" as to each of the following_ 'Yes No _ purtm;ag in.fonnation Was provided by Lhe owner,occupant, or Board of Health Were any of-lie system components pumped out in the previous two weeks _ :Has the system received normal flows in the previous two week period 9 _ X Have large volumes of water been introduced to the system recenLly or as pan of this inspection? WCTe 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 ir_spec-ed for signs of break out _ Were all system componenrs; excluding the SAS, located on site i; Were the septic lank manholes tuicovered, opened, and the interior of die tank inspected for the condition of thc baff' o;tees,material of construction, dimensions,depth of liquid, depth of sludge and depth of scum? _ Was Coe facility owner(and occupants if different from owner)provided with information on t.e 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- Wes no Existing information.For example,a plan at the Board of Health. l;; _ DeLermined 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)(h)] s I 581--05-07 10:34wn From-MIRICK O'CONNELL 508-752-'7305 T-56C P-008/013 F-Ub2 OFFICIAL INSPECTION FORNNI—NOT FOR VOg,UNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Pi roper.y Address. 63 OSTERVILLE.W.BARNSTABLE RD.OSTERVILLF..,MA 02655 Owner: ALBERT MCCARTHY Date of Inspeet4on: 5/12103 FLOW CONDITIONS RES BENT IAL Number of bedrooms(design): 4 Number of bedrooms(actual): 4 DF,SICGN flo•v,ba::ed on 3.10 CMR 15.203 (tor example: 110 �*pd x#of bedrooms): 548 Niunber of current residents:3 r OCS Tesidence have a garbage grinder(yes or no): NO Is 137sr.f-y on a separate sewage system(yes or no): NO (if yes separate inspection required] La-�udry system inspected(yes or no):NO SeSonal use: (yes or no): NO b51atrr meter readings,if available(last 2 years usage(gpd)): n/a Stur.p pump(yes or no): NO Last date of occupancy: n/a ('O:'vl',-16]-RC IA I,/FNDUS TRI A L Tyre of establisluient: n/a Design flow(bzsed on 310 CNM 15,203): n/agpd Basis of design flow(seats/persons/sgft,etc.): n/a Grease-crap Present(yes or no):NO Industrial waste holding tank present(yes or no):NO . ,inn.-53rit3y'U3 to discharged to the Title 5 system(yes or no):NO - INaier--meter readings, if available: n/a Last date oi'oc;;upancy/use: n/a OT':1'1ER(describe): n/a GENERAL INFORMATION P' mphig Records S0 1.1rc of ufornmation:lPUWED IN SEPTEMBER BY.OWNER 'ras system pumped as part of the inspection(yes or no):NO - If yes, volume pwnped:n/agallons--How was quantity pumped determined? n/a Reason for p*mping; n/a T'V'P1`,OF SYSTEM! X Septic tank,distribution box, soil absorption system _dill-le cesspool _Overflow cesspool ::hared system(yes or no)(if yes,attach previous inspection records,if any) _h-Movative/Altemative technology.Artacb a copy of the current operation and maintenance contract(to.be obtained from systetll o'wIlctr) 'l igkat t43LIc •Attach a copy of the DEP approval. On?lcr(describe): n/a fi1)proximate,age of all components,date installed(if known)and source of information' 1994 BY OWNER Were sewaae odors detected when arriving at the site(yes or no)` NO r; "'ap-`03-07 10:34am From-MIRICK O'CONNELL 508-752-7305 T-584 P-009/013 F-1152 Paf a; of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Pro[ °rty Address. 63 OSTERVILLE W. BA INSTABLE RD_OSTER'VILLE,MA 02655 Owner- ALBERT MCCARTHY Date of Inspection: 5/12/03 ItIRLDING SFIVVER(locate on site plan) Depth below grade: 18" Tdav�rials of construction: _cast iron X40 PVC_other(explani); n/a Dstancc from.private water supply well or suction lirie; n/a C;)malems (on condition of joints,venting, evidence of leakage,etc.): TU�'IVN VVA.TER °',.1E PTIC TP.NK: X(locate on site plan) T3ep t•,below grade: 12" NIaYtrial of construction:Xconcrete_metal_fiberglass_polyediylene other(explain)n/a if twak is metal list age: n/a is age confirmed by a Certificaie of Compliance(yes or no): NO(attach a copy of certificate) 1000 GALLONS" 51tt:i�e d:;pti�: 3" Distarice from top of sludge to bottom of outlet tee or baffle:.32 ..Curt thicllies 2" Distauee from top of scum to lop of outlet tee or baffle: 6" Do's Ace from bottom of scum to bottom of outlet tee or baffle: 16" Ilow were dimensions determined: MEASURED Comments(on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity,-liquid levels as related to oadazz invert,evidence of leakage,etc.): SIRPTIC TANK AND ALL COMPONENTS ARE STRU[:TORALLY SOUND AND FUNCTIONING PROPERIL'Y.. RECO_LMIEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. ACRE a SE TRAP: _(locate on site plan) Dcoth bcicw grade; n/a -'Vjatee lai of construction: _concrete metal_fiberglass_polyethylene_other(explain): n/a Di.rnensions: n/a Scum thickness: n/a Distance from top of setam to top of outlet tee or baffle: n/a 1.1)i3tance from bottom of scum to bottom of outlet fee or baffle: n/a .Dzie of last puanping: n/a Coi,.Lments(on pumping recommendations,inlet and outlet tee or bafte condition, structural integrity, liquid levels as related to 11_)ll'ik:C ir..vect,evidence of leakage,etc.): 7 sao--H-Ci 10:35am From-MIRICK O'CONNELL 508-752-7305 T-564 P-010/013 F-0!:2 CIFFICIAL I- SPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS . SUBSURFACE, SEWAGE DISPOSAL. SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 63 OSTERVILLE W_BARINSTABLE RD. OSTERVILLE,MA 02655 Owner: ALBERT MCCARTHY Date of Inspection: 5/12/03 TIGHT or R.OLDiNC TANK: (tank must be pumped at.time of inspection)(locate on site plan) th below Grade: n/a 1,5at� ia1 of construction:_concrete_metal_fiberglass_polywh.ylcne_other(explain): n/a DiPrls_-nsions: n/a Cana-iTy : n/a gallons Design Flow; n/a gallons/day _ lilarm present(yes or no): NIA ��l.arn� teval:N/. Alarm in working order(yes or no):NO Date of last purnoing: n/a Cr.=nents(condition of alarm and float switches, etc.): 11/.a 1)ISTRjEU>i`1ON BOX: X (if present lmusL be opened)(1_ocate on site.plan) Deptb of liquid level.above outlet invent LEVEL WITH BOTTOM OF PIPS; Comments (note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out ofbox,et:.): D-VOX WV__�S VIDEO INSPECTFD AND APPEARS TO BE STRUCTURALLY SOUND. Lp1U vEP CHAMBER, _(locate on site plan) Puri ,s in working order(yes or no):NO t F1�tns in v)orlring order(yes or no):NO C'oj:LrnEr;ts(note condition of pump chamber,condition of pumps and appurtenances,etc.): r,!a 5e -H-07 10:35am From-MIRICK O'CONNELL 508-752-7305 T-564 P-011/013 F-0r2 i>agz of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) ;Prct�erty Ldj ess: 63 OSTER'VILLE W_BARNSTABLL RD. OSTERVILLE,MA 02655 lbw �acr; A,LBE.-.1T 1vfCCARTHY Il:at,e of'tnspection: 5/12/03 SCK.'l,A.13SORPTION SYSTENI (SAS): X (locate on site plan,excavanon not required) l''.5AS not located explain why: n 1a INO GAL 6'X 6' leaching pits, number-. � leaching chambers, number. nla Ida leaching galleries, number: nla n/a leaching trenches, number, length: n/a ttla leaching fields, number: n/a ryf.3 overflow cesspool, number. ri/a n/a innovativelalternative system Type/name of technology: n/a Com—picots(note condition of soil,signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): I..Ejd,C.II PTT IS STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. SYSTEM SHOWS NO SIGNS O FAILURE.PIT HAS I' OF LEACIIING LEFT IN IT.BOTTOM IS AT 716". (, SpCiOL,S: (cesspool must be Pumped as part of inspeciion)(locate on site plan) Number and configuration: n/a J)epth—top of liquid to inlet invert: n/a Dep-h of solids layer: n/a 1.)eptlt of scum layer, n/a Diruensious of cesspool: n/a terials of constructiot: n/a lndicadon of groundwater inflow (yes or no):NO Coetits(note condition of soil,signs of hydraulic,failure,level of ponding,condition-of vegetation,etc.): ,it/t, c hVl/: (locate on site plan) )6aerials of construction: 1 1a Dinxensions: n/a Depth of solids: n/a Commens(note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation, etc.): W 4 l�a;n-•05-07 10.35am . From-MIRICK O'CONNELL 508-752-7305 T-564 P.012/013 F-flf'7. Y�[c i0 Of i'I OFff,ICIAL INSPECTION FOR-M—NOT-.FOR VOLUNTARY ASSESS_l'LENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION-FORM PART C . SYSTEM L-NFOF—MATION(continued) 1?rci;perry Addi-ess. 63 OSTERVILLE W.BARNSTABLE RD.OSTFRVILLE,MA 02655 Gv 31er: ALBERT MCCARTHY I3a'te of lnspec on; 55 12/03 S!:Kj:C�.j O>F SEWAGE DISPOSAL SYSTEM Prnvide a skcich of the sewage disposal system including ties to at least two permanent re ference landmarks or benchmarks. Locz,?e all wells within 100 feet. Locate where public water supply enters the building. 9 AA 3 I 5813-H-07 10:35am From-MIRICK O'CONNELL 508-752-7305 T-U4 P.013/013 F-052 OFFICIAL INSPECTION FORM-NOT FOR VOLIJ TTARY ASSESSMENTS SL'RSU-RIFACE SEWAGE DISPOSAL SYSTEM INSPECTION FO.1ZM: PART C SYSTEM INFORMATION(continued) PI-operry Acdress. 63 FJ•STERVILLE W. BARNSTABLEI RD. OSTERVILLE,MA 02655 Owner: ALBERT MCCART'HY 11a1e of Inspection; 5/1.2/03 SITE EXAM Slope -_'Surface water Checl.cellex -Shadow wells F..stina ed depth to ground water 10 i•feet P lease hidicate(check)all methods used to detemine the high ground water elevation; YES Obtained from system design plans on record-If checked, date of design plan reviewed: n/a NO Observed site(abutting propwty/observation bole within 150 feet of SAS) NO Ch+ cked with local board of Health-explain: n/a NO Checked with local excavators,installers-(attach documentation) NO Accessed USGS database-explain: n/a Ycci rrjnst describe how you established the high ground water elevation: G'.R(JLINDWATER DETERMINED FROM ENGINEERED PLANS SUPPLIED BY BOARD OF HEALTH NO G].t+JtiNDWATJE:R AT 121" • tt 5g,p-•05—Cr 10.Skal From-MIRICK O'CONNELL 50e-752-7305 T-564 P.001 F—H; MYRICK OTOlO NELL ATTORNEYS AT LAW MiRICK,O'CONNELL,DEMALL1E&LOUGEE,LLr Mite: S--iAtmber 5, 2007 Time: Client Number: 99999-22222 _ :Cduratier of pages including cover sheet: 13 To: Thomas A. McKean, R.S.,_CHO From: Peter J. Dawson, Esq. _W Director of Public Health Mirick, O'Connell, DeMali-ie&Lougee, LLP Town of Barnstable 100 Front Street _ �MO _Main Street Worcester, MA 01608-1477 _ �;,gy3ririis, MA 02601 _ -- Telepho.ne: -(508) 862-4644 Telephone: (508) 791-8500 _ Fa:x: (SOS) 790-6304 Fax (508) 790-6304 CC: E-mail: pjdawson@modl.com _ Return fax confirmation page to: Lora Oi i,inal Will Follow F Original Will Not Follow �umuuuuti�i�ur ® RJEMAIUKS: ElUrgent For your review 0 Reply ASAP F_� Please corn ment CONFIDENTLgLITY NOTICE: THE JNFORMATION CONTAINED IN THIS FAX MESSAGE AND ANY ATTA+C[EVILPIe' Is ATTORNEY PRIVILEGED AND CONFEDENTIAL INFORMATION INTENDED ONLY FOR T:E>u+c; ENI)F)IDUAL OR ENTITY NAMED ABOVE. IF YOU ARE NOT THE INi TENDED RE,CIPIENT, YOU ARE HE R),"BY NOTIFIED TH.LT ANY DISCLOSURE, DISSEMINATION OR COPYING OF TINS COMNfl rNIC.ATION IS STRICTLY PROMBITCD. IF YOU HAVE RECEIVED THIS COMMUNICATION IN 1E1~'t:1R.OR,PLEASE IMMEDIATELY NOTIFY US BY TELEPHONE. TFLAINK YOU. WESTBOROUGH,MA 100 FRONT STREET F)O.STON,MA 5U€s-898-1501•PAX 508-898-1502 WOP.crsr=R,MA 01608-1477 617-261-2417 FAX 617.261.2418 508-791-8500•FAX 508-791-8502 t %v%~. .MHckOConnell.con: r, II Certified Mail#7006 0810 0000 3525 2988 ��Y Tayti Town of Barnstable Regulatory Services * nARNSTA6LE. 9� M U9_ ,�g Thomas F. Geiler,Director prF°MA�A Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 August 22, 2007 John Lynch 63 Osterville W. Barnstable Rd. Osterville, MA 02655 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.300 and 310 CMR 15.00,AS WELL AS TITLE V. The property owned by you located at 63 Osterville W. Barnstable Rd. in Osterville was inspected on August 16, 2007 by Francis Pulsifer, Fire Prevention Officer for COMM Fire Station. The following violations of the State Sanitary.Code were observed: 105 CMR 410.300 and 310 CMR 15.00: There were a total of five (5) bedrooms observed at this property. However, the existing septic system (permit# 93-627) was not approved for five (5)bedrooms. It was approved for three (3) bedrooms only. You are ordered to correct the violations listed above within thirty (30) days of your receipt of this notice by pulling any required building permits to restore the property to a three bedroom home. You are ordered to remove two of the bedrooms by removing entrance doors and by opening all door-way entrances to each room to a minimum of five feet wide openings. This will bring the total bedroom count down from five.(5) to the appropriate three (3) as designated by your septic permit. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days.after'the date the order is served. Non-compliance will result in a fine of $100.0.0 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the above violation, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. Q:\Order letters\Housing violations\Rental ordinance\55 betty's pond.doc PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable Cc: Meredith Morgan Q:\Order lettersMousing violations\Rental ordinance\55 betty's pond.doc Certified Mail#7006 0810 0000 3525 2988 P�oFs Tati Town of Barnstable O; Regulatory Services QDPV BAEMAS.S.LE,6s Thomas F. Geiler,Director Public Health.Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 August 22, 2007 John Lynch 63 Osterville W. Barnstable Rd. Osterville, MA 02655 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.300 and 310 CMR 15.00, AS WELL AS TITLE V. The property owned by you located at 63 Osterville W. Barnstable Rd. in Osterville was inspected on August 16, 2007 by Francis Pulsifer, Fire Prevention Officer for COMM Fire Station. The following violations of the State Sanitary Code were observed: 105 CMR 410.30.0 and 310 CMR 15.00: There were a total of five (5) bedrooms observed at this property. However, the existing septic system (permit# 93-627) was not approved for five (5) bedrooms. It was approved for three (3)bedrooms only. You are ordered to correct the violations listed above within thirty (30)_days of your receipt of this notice by pulling any required building permits to restore the property to a three bedroom home. You are ordered to remove two of the bedrooms by removing entrance doors and by opening all door-way entrances to each room to a minimum of five feet wide openings. This will bring the total bedroom count down from five (5)to the appropriate three (3) as designated by your septic permit. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of $100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any 'questions regarding the above violation, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. QAOrder letters\Housing violations\Rental ordinance\55 betty's pond.doc PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable Cc: Meredith Morgan QAOrder letterMousing violations\Rental ordinance\55 betty's pond.doc DE516 r.! -PA-FA" - da &AzaArz 6QOE>Z All Sept'!C TA�V- U4ig loop SAG 4z ,_, h' • _ / (•aG Qc i i 47041E SIt>r=w4 1. SFr r �. BMOM � - • 778 SF _ _ t �I'AL516tJ = 54$ 48 — 07 TOTAL RAIL 3 mil- a� So \ lo 'l S24e)LAT7oN QATE �I Iu Z,�,�W/l Z S 1 �R N OF�j I� RICHARD PETCr S ER BWER N VAN \ tom.2dQ48 No. 2913.3 IsTER�O �` +�4 •ass/ONA L V�'��C FI•oLtr` io-�93 , EL C& ` , TF Loary� ., -- y„ Tom- ---fin•—' =�r '.7r�'T!� SdQSorL M �, �O �D PVC 1w.. Z ` T. IQ� 6ALI S 4S2 SGK .4 �,d 4epric ll7aQ' Ir1J (i GAL T" N Z �lAV WMaEP Aw. 5rtucNvzn er-T 'STOtlE Mo¢F TW4 4''vsrEP I B !&4A4.L ME A-?A !i ICI to 1072F1 9-_ P-B13o Lore ��'' � �D D4-�'�-; TpD o�vs P1-AN Qe kr w u-1 G Rr1c.E �1ow�1 N�oN coMpc. 5 wl-tµ Ott: l� i� �Q' cv AWN or n�i rEE L� 5 Ike- l-OaT� WIT Ill E rtom MA,--------------- �,. �- G •c.. ��$? DAXTErZ ►�yE INc. 7r4IS F UW IS Not" T3A4m oN /114 .l�ti-iI'-c�4tE+JT' pZ0R-.`fl"L LAUD Su>?a/�yo2s SuP&-Y MD THE OFr- BETS 4;.tooty Ovr -aE o �►�+�- �Gi14EEt $ � 05e TD ESTQBUL-5 �. Fl?-Te :r\* lar�lEg. ST vtLLE MASS . I .I P P I -�r' A i(-r- , n ,c�,..- 1� i i 0 j F 26 3-9 i LOCATION 6)57, �V, &-'AJ04 FJ, SEWAGE VILLAGE oc ICJ%\� ASSESSOR'S MAP & LOT J6. 661- INSTALLER'S NAME & PHONE NO. 771 0q0 j. i SEPTIC TANK CAPACITY 1 f�� S ►llv�s LEACHING FACILITYAtype) ��G1^ �, I (size) � 000 Iz�j(a�,r NO. OF BEDROOMS ] PRIVATE WELL O �PUBLICWA TER BUILDER OR OWNER YS -27 DATE PERMIT ISSUED: �j / � - L i DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No : , 1 $D I n : 5m Wol i : ! � , , i � i of 3--- —•'—' "--I • ; , : r . : : I : `F � ! ! I i I j I j I ! i I -{--I�-. �' � .. i�3- i •---- -r--- --4----.L.._-• 70p i , I I I j � I "'_- / i-- i �� lea — -----•-- ---- ' -- - {-..__.,...:_.. .1.__.. _ '•i : I ; : - r— I , : I , 1- .. ... ......._ ._ - :.... :...._ Sr 610 , • I : f I •i : i --E---i--• -•-- .---j---i-• -i---- -,----'-i- '1- 1 ` 3R4'1iLS 'T'Li . � r L _ ...t -f- �-_-_f____-''-_•_•_T-•._�__.._.1._.__1--_�-_ 1�{ ._-j..-Y._ _-•-_ i -.I I-_ I �:i�--��- . i 1 _ : - I , - 1 I I.A : ! I i i I i I I --�_- i'-�-•_' I---i---l�- I- --,---�--t---r-�- _T---:---, -j---i_.__. I -C_'---1 I ._ _.. i I i I r / IToo : p / lit__ 1 I D --__ _..•_ -....... j MOO , i i __. _f_..._. - .. . .... .. .. .......... - _ eLOO: r : ITO r ;R' , it .._ :... ! - -- -•- ---- ------ -._ ....._ -'----.. _ . ._. .-• - art-•---...L__.._' . ' , I - " i ' g r 1. - -- - _ i 1 i I i .i $Z'T1tR..aS T r _r � y I _ i _ fc , r i ! • t , 1 i ! ! F t 1 , r - r L + r , ( : I ll _ � f- _......_ ._.. ..... r .4. r , I 1 1 __ ` .. _.. ...__ _..._ .. _._.. r , : .r. Message Page 1 of 1 Morgan, Meredith From: Fontaine, Tina Sent: Friday, September 28, 2007 1:16 PM To: McKean, Thomas; Morgan, Meredith Subject: 63 Osterville W Barnstable rd The attorney representing John Lynch of 63 Ost WB road came into see the original permit that was stated in the letter sent out in August. They're going to the board this month and want to see the permit that states it's a 3br system. I couldn't locate the permit. Tina C. Fontaine Town of Barnstable Healtk DMs�on 10/2/2007 r---- - - i - - Ja J 40 El D _ = - . / GLAD Q.AA2gt .:�: .._. BAYS 10 E R�U I L 0 I N C- Go I Mc . CENT FPLU 1LLE /AASS. Buie: 4- I=o .vraoveo er vn,er �'. ogre: 9 3 FQ2 WT ELEVATION DNA1YI O t..ee A //L A AN N .c GAM-64Y `�3 49 OF ron+esee - T. i s' r ,.. - _ i I I I I I I i I � 6AYSIOE FbUILOttJC. C.IweA CENT E2V I LLr- - ecnie:�4`�1'-0' �rmoven er oiuwn er R.- - 1.-e.FT SIpC yy AL AN I^e-4I+2THV 9'3MU4e9 "l of e } i hl,�l I — OEM I I j i � �:F _- i I I I - -- --- - -- --- - -_'-; $AY.S.IDE F�UILDINc. CoSr+c cf T ECLV I L.L.E /Ab,-S, - ec•�e 4 o i'-G- .—ROAD el Iwuw.er iZ AWN /h4C.IL'r"y oruw��u.uep' wu - o r ei r FT r -� =..BAYSIOE BUILDING Co Wc. -.CE NT E2.V ILL F— SS . 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AL $ AN�! /nc.C1.2'rHv 93-49 rorriw�a '1 of 6 • �, w s I . a a ono L rF _ � _ I y —i—--- -- --- —__ _�_.BAY_S1DE P�UIL-DIN6 Co INc .. CENTE4.VlLLE /h4<j/a RJ G.KZ9LD E_.�LE.V/aS.loN �p AL $t AN N /hG Cp2TN�! puw'V b•5 or A I LIE-] 54 E.._BUILDING. C. W.L. -.GENTER.V I LLE //�A.55 ecue: 4"91-o .vrnovFa�r ou.ww er 2. oere: N G�J 9$ —• REAR EL.EI/GT10 N AL � A N N ow.wwo wywu�yen ro m s • y o p, .. � � P �, ` 14:o'c- ' u c m I o c oo 0 J _} y Iq ca i I C to, u a'aI4 - J C D -Ip�?D o I _ yi;•• ,�. I sw�r r ,.y, Q _� c�-.p ,gyp "• 1 � c N 0 Ici"I ` p oe Rwr+ A (n too I• P . 'S'e Smayy S s r,+ un �.arG� !-V w '/H Gs.Ny' 1 / figx i a: I aeas 'V4." c-ruvc SMSAKFa Sr__—___. .__._._..;/1'•i•57uo.)--. '•• co uc�ci� a .con. I• 9.7�'.--._.� '2.4'. ._6G�o•• ^t'---- _. --------- ...._._ -CENTEIZVII_LE 2 P>"^J� ' Al A"W 1^4CAM-r11Y auwwo wuueen • 2e, •o 0 F000 lu A f 1 ..'7�•t, 4..y,c u. a IB R I y... _t.bF a- AZ`— p V JGN. Al s I061bg o "' p � av•y o — CIOEI L AA P i lab' a' •.� a'd•' �g..d•Y -w • '_BAY91 2E. SU I L-Wl 4 G C- toc i _ CENTS C2 J Il-l-r- Aha a: 1Jo�9S S.CCONm. FLA=m=rz . quwi o wum�x ':%iL•.>t L1 NN /Ac CL1.RTi1`( -- - I _ K r L J h L� I P n 1 6) OR cr I I ' o 0 �t,e• q,._o., W I I � -- -- -_aA-YSI0E 3UILC)kWGC..'IN, CEhtTCtZ'u1LL_E /AGSS art: - oU.ej BASEMEN-r -. FOuy"7.ATION ,. AL t dNN MGGan. Ny o"•`�a s3 ' of �� 2X to RI�Gr�_,PLAIv+e . . to I(4-0/ Al-'fad aepua�r 41aWG�lS . /.:/ G n x -sw EAT FI[[`I is . �F10 fLE Gla,S pLYrlcon CATtdAllt IX0 FAK1P (• 'i S, A.I.UM.GUTTCIRa, A LeA.00M, W - vs-WrI"C. On.lM Eq L.Q. - 'm _....� . I' `02 orW N�•+TM-�'capb / �V�D FY �uG 4LG' 11 II SNEC �• . ,. \ -•S.Y fe 3Rlr>S,OP IC.- 'Ps? ftoeRnS FttO�► \ -W-C.S1 % 6LC.4 OIr76S .y RCA 2 \ Joan Twha . 7 - � 10 M' l h ,ai \Q�•O <r�r ly 4��•• � m 1 \ u PYhY I Nba OM.®W oa. OCAM cr 1` ,, i Gowinrl5 1 B"Y'I'•9"G•o1lC![WA1.+LS w — idspu elr cicn`P pnoorl ua —_.... _.. Ib. - �-y-y- BAY'9"IOE 15UILDING C-INC CHhiTE2VIlLE MASS - acu[:1 b s 1.p` urnov[n ar SE GT IOVl rort luau AL 4 A 4 N IAC GA2T FIV n or a., j O jN OF BARNSTABLE BUILDING PERMIT APPLICATION ; j Map P�'rQ'el '� - Permit# Health.Division �� t � � � Date Issued (�O r� a• Conservation Division r PO Fee Tax Collector Treasure I AG E P TIC SYSTEMMUST ME Ir.! �LLE� 1� G®�r�PLIAN % Planning Dept. WITH TITLE 6 Date Definitive Plan Approved by Planning Board ENVIRONP�ENT�AL CODE AMD TC� N REGULATIONS Historic-OKH Preservation/Hyannis a Project Street Address 0. ICi2UrCCG- LUC- S(1S tqt2t7S7"A61e J2oe—, Village Owner (AL9Z /2l 14- W edrqt2Tk`r Address 63 650 lzdlLf LJ - 13 2n6ItAb le-P). Telephone 6- 0 — S� Permit Request s it i S t, i2oaV---� Y tooue (S A(2 ►M o v--vA I G 0,7e yo, `� 1Y ror)vir, Square feet: 1 t floor: existing proposed 2nd floor:existing proposed Total new Valuation `� + Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi=Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑ No Basement Type: )]Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half: existing new Number of Bedrooms: existing_ new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: 16 Gas ❑Oil ❑ Electric ❑Other - Central Air: 4d Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:q existing ❑new. size Attached garage:f' ]existing ❑new size Shed:❑existing.O new size Other: Zoning Board of Appeals Authorization O Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan.review# . Current Use 'Proposed.Use BUILDER INFORMATION 1 . Name S e a �� S "�r �c�S Telephone Numbe S y /; Address �/ � ��' �'�e o License# 0 S O ,.5 N?F c Home Improvement Contractor# u Worker's Compensation#Cc e.�31 S 3 i (76S"B a t &113 Tr we uTun-L ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO ink C.. nLA o- h) 1Js /Z-e v 6� SIGNATURE,w d- d, DATE a—` - 01 i COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS J U N 10 2003 DEPARTMENT OF ENVIRONMENTAL PROTECTION TOWN OF BARNSTABLE HEALTH DEPT. h , 11 F Y OV TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 63 OSTERVILLE W. BARNSTABLE RD.OSTERVILLE, MA 02655 Owner's Name: ALBERT MCICARTHY Owner's Address: 63 OSTERVILLE W. BARNSTABLE RD.OSTERVILLE,MA 026 Date of Inspection: 5/12/03 Name of Inspector: (please print) JOHN GRACI,INC. ' Company Name: SEPTIC INSPECTIONS p y � Mailing Address: P.O.BOX 2119 TEATICKET, MA.02536 Telephone Number: 508-564-6813 FAX 508-564-7270 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: X Passes _ Conditio Ily asses _ Needs F h Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: 5/12/03 The system inspector shall subm a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspe ion. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner all 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 SYSTEM PASSED TITLE V INSPECTION. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. ****This report only describes conditions at the time of inspection and under tie 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. r P4ge 2•of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 63 OSTERVILLE W.BARNSTABLE RD.OSTERVILLE,MA 02655 Owner: ALBERT MCCARTHY Date of Inspection: 5/12/03 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: SYSTEM PASSED TITLE V INSPECTION.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. B. System Conditionally Passes: _ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. n/a The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: n/a n/a Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): _ broken pipe(s)are replaced _ obstruction is removed _ distribution box is leveled or replaced ND explain: n/a n/a The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): _broken pipe(s)are replaced _obstruction is removed ND explain: n/a Pase 3•of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 63 OSTERVILLE W.BARNSTABLE RD. OSTERVILLE,MA 02655 Owner: ALBERT MCCARTHY Date of Inspection: 5/12/03 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance n/a "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free'from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: n/a f Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 63 OSTERVILLE W. BARNSTABLE RD.OSTERVILLE,MA 02655 Owner: ALBERT MCCARTHY Date of Inspection: 5/12/03 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all-inspections: Yes No X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than ''/z day flow _ X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped PUMPED IN SEPTEMBER BY OWNER. X Any portion of the SAS,cesspool or privy is below high ground water elevation. X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone 1 of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X 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.] NO (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. 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 X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply _ X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. d I Page 5 of l l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 63 OSTERVILLE W.BARNSTABLE RD.OSTERVILLE,MA 02655 Owner: ALBERT MCCARTHY Date of Inspection: 5/12/03 Check if the following have been done.You must indicate"yes" or"no" as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health _ X Were any of the system components pumped out in the previous two weeks? X _ Has the system received normal flows in the previous two week period`? _ X Have large volumes of water been introduced to the system recently or as part of this inspection? X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up X _ Was the site inspected for signs of break out X _ Were all system components,excluding the SAS, located on site X _ 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 ? X _ 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 X _ Existing information.For example,a plan at the Board of Health. X _ 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)] S Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 63 OSTERVILLE W.BARNSTABLE RD.OSTERVILLE,MA 02655 Owner: ALBERT MCCARTHY Date of Inspection: 5/12/03 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 548 Number of current residents: 3 Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO Seasonal use: (yes or no): NO Water meter readings, if available(last 2 years usage(gpd)): Sump pump(yes or no): NO Last date of occupancy: n/a COMMERCIALANDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR 15.203): n/agpd Basis of design flow(seats/persons/sgft,etc.): n/a Grease trap present(yes or no): NO Industrial waste holding tank present(yes or no): NO Non-sanitary waste discharged to the Title 5 system(yes or no): NO Water meter readings,if available: n/a Last date of occupancy/use: n/a OTHER(describe): n/a GENERAL INFORMATION Pumping Records Source of information: PUMPED IN SEPTEMBER BY OWNER Was system pumped as part of the inspection(yes or no):NO If yes,volume pumped: n/agallons--How was quantity pumped determined? n/a Reason for pumping: n/a TYPE OF SYSTEM X Septic tank,distribution box, soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank Attach a copy of the DEP approval Other(describe): n/a Approximate age of all components,date installed(if known)and source of information: 1994 BY OWNER Were sewage odors detected when arriving at the site(yes or no): NO F Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 63 OSTERVILLE W.BARNSTABLE RD. OSTERVILLE,MA 0265.5 Owner: ALBERT MCCARTHY Date of Inspection: 5/12/03 BUILDING SEWER(locate on site plan) Depth below grade: 18" Materials of construction:_cast iron X40 PVC_other(explain): n/a Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER SEPTIC TANK: X(locate on site plan) Depth below grade: 12" Material of construction: Xconcrete_metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions:H 10' 6" H 5' 7" W 5' 8"" Sludge depth:2" Distance from top of sludge to bottom of outlet tee or baffle:32" Scum thickness:2" 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: MEASURED Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. GREASE TRAP:_(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): n/a Page 8 of l l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 63 OSTERVILLE W.BARNSTABLE RD. OSTERVILLE,MA 02655 Owner: ALBERT MCCARTHY Date of Inspection: 5/12/03 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX:X(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE 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.): D-BOX WAS VIDEO INSPECTED AND APPEARS TO BE STRUCTURALLY SOUND. PUMP CHAMBER: _(locate on site plan) Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): n/a I R Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 63 OSTERVILLE W. BARNSTABLE RD.OSTERVILLE,MA 02655 Owner: ALBERT MCCARTHY Date of Inspection: 5/12/03 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type 1000 GAL 6'X 6' leaching pits, number: 1 n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: n/a n/a innovative/alternative system Type/name of technology: n/a Comments(note condition of soil, signs of hydraulic failure,level of ponding, damp soil,condition of vegetation,etc.): LEACH PIT IS STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.SYSTEM SHOWS NO SIGNS OF FAILURE.PIT HAS I' OF LEACHING LEFT IN IT. BOTTOM IS AT 716". CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction:n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.): n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a Q r Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 63 OSTERVILLE W. BARNSTABLE RD.OSTERVILLE,MA 02655 Owner: ALBERT MCCARTHY Date of Inspection: 5/12/03 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. f> 0 e g � �A 31 - � S 1 3� � 39 in Pa it of 11 c' OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 63 OSTERVILLE W.BARNSTABLE RD.OSTERVILLE,MA 02655 Owner: ALBERT MCCARTHY Date of Inspection: 5/12/03 SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 10+feet Please indicate(check)all methods used to determine the high ground water elevation: YES Obtained from system design plans on record-If checked,date of design plan reviewed: n/a NO Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators, installers-(attach documentation) NO Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: GROUNDWATER DETERMINED FROM ENGINEERED PLANS SUPPLIED BY BOARD OF HEALTH NO GROUNDWATER AT 121" t i0 r f I�D � - ' 4 • ............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE � plirtt i,a�t for i n tti 3 nrk Cnlnn.itxnr#inn Vamit Application is hereby made for a Permit to Construct (V) or Repair ( ) an Individual Sewage Disposal Sy /. ...a '_Lv /Ji G La- it dress ------------- ddt No. __--__ O ress .................... / •--•-----•------•-•--'•----•---.-.-.---••--------------••-•-•--..._........._..Installer Address / /�G S feet U - Type of Building Size Lot------°__________________ q. Dwelling—No. of Bedrooms .__.__..J _--_-__Expansion Attic WC) Garbage Grinder (Va aOther—Type of Building __� ___41%(�l iNo- of persons____________________________ Showers ( ) — Cafeteria ( ) d Other fixtur ------- ---------------------------••- W Design Flow............... per fat4m per day. Total daily flow............._%-__ _D___-_______------gallons. WSeptic Tank—Liquid capacitylXV.gallons Length________________ Width---------------- Diameter---------------- Depth................ x Disposal Trench—No_ ____________________ Width.................... Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No-------- ----------- Diameter..........---------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing to k Percolation Test Results Performed b ___- G- --d---------- --------- Date---- � 0/ �- 3_____-. ,.a Test Pit No. 1__�----_____minutes per inch Depth of Test Pit___ _______________ Depth to ground water........................ G% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -------------- -------------•------------•----....--'--------......................................................... 0 Description of Soil------------- --- ..---- ----- •--.._....------------------------------------_..---------------------------------------------•-•-------•--••- x w -----------------...................................................................................................................................................................... -------•------- U Nature 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 TITLE 5 of the State Environmental Code he undersig further agrees not to place the system in operation until a Certificate of Comph ce has b e u d by the o r of health. Signed - - ---- -------------- . ... .. ..................................................... Dace Application Approved BY ---------- - ------- ------ -b l — --- Dace Application Disapproved for the following reasons- ------------------------------------------------------------------------------------------------- ................................ . ....-............................................................. . . ............. .....................-- ............... f �ry Dale `Permit No. ...............7--- L` .1 --------... Issued ------------------------o�-e------------------_-----....- V. (� ��j /FiRZ......� ............ THE COMMONWEALTH OF MASSACHUSETTS f BOARD OF HEALTH TOWN OF BARNSTABLE f 1A,vOration for Di-tipuuttl Murky Tunitrnrtiun ramit Application is hereby made for a Permit to Construct (V) or Repair ( ) an Individual Sewage Disposal System at Location-iWdress o- Lot .. - ------ -•-•--... ------..... ------ ....................... ...... adress a -� ..... }- �. -_---•------•------- � - -•-- Installer Address s' �� UType of Building f Size Lot......:...............6..Sq. feet Dwelling—No. of Bedroom`�s�.__.......----------------------------Expansion Attic (V(;) - Garbage Grinder (1✓(�) aOther—Type of Buildiug/i`�l __-✓tGlct No. of persons____________________________ Showers ( ) — Cafeteria ( ) dOther fixtures ---------------------------------- - ------ -------------------- ------------------•---------••------••-----•---••--------•--. w Design Flow...............114-------------...-.gallons per person per day. Total daily flow.---__.____-._-'�.-3'4 ..................gallons. WSeptic Tank—Liquid capacitv�.�_..1_T_-gal Ions Length---------------- Width--.--_-_.___:... Diameter---------------- Depth................ x Disposal Trench—No. .................... Width-------------------- Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing to k '~ Percolation Test Results Performed by.__..__ . ....,. 'e"................... Date....1.. ---- ----9_�--.-_-.. Test Pit No.•I... '..__-----minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ fZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground, water........................ L� i ... .. .....................•-----•-- Description of Soil ..-f 1�/?-----� 1'!L'f------------------------- U ---------------------------------------•--..--------------------------------------•---------------------------------------------------------- w 1 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 TITLE 5 of the State Environmental Code The undersig ecll further agrees not to place the system in operation until a Certificate of Complince has b6en Issued by the be rd of health. Signed ... - ._. J.,i(% ....- . . .................... f% Dace Application Approved By ....... + �..... . .., ,.. v _... 1......`... � Application Disapproved for the following reasons: .................................................................................... -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------- ---------------------------------------- —7 Date Permit No. ..... - -7 � -.l .. ... Issued - _---- ------------ Date -. _— —_._.---_._----__,__.--. ----—_—---_____ —_,_. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE CITextifirate of C�ompltana THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( �) or Repaired ( ) by ------- j / .�5.( - �. . -... . Installer t -D.T.. � ...........�57... � 0 S7 Va _....... . has been installed in accordance with the provisions of TITLE 5 .f The State Environmental Code as described in the application for Disposal Works Construction Permit No. ....._7 -._. _`�t�. ..._. dated .....__------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE---------- 0.--- --a.. . ......7, ... ......__.... ...... Inspector ..........!......... ...... ....__-------------------------------------------------- V -------------------------------------- ---------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH C� / TOWN OF BARNSTABLE �tu�u�tt1 Turku C�un,�tr�rtiun �rrbtit Permission is hereby granted-----:sr to Construct (� or Repair ( ) an Individual Sewage Disposal System at No...L.0.T.....L-E......(a 5_7-.--!• tV. `-3-�-"t-R �� Te/?-- ✓. L StFeet ¢ �� / . as shown on the applicati n for Disposal Works Construction P init o.!//_ ._'_-_--__;.__ �ated�....................�..�.._........... - Board of Health DATE.................... C 5�. ---------------------- FORM 36508 HOBBS&WARREN.INC..PUBLISHERS s r7 . t•16L - FA114Y. _3.__..$EWWtilt CAI L-( FLoW S Xi/o _:�?r16f� 42, lSPoSA - PIT /pao..GpG z'sra�lE; �' sl�EwQIL MsA = I f,b SF BOTTOM Ate, - '8 SF ' 41. TOTAL VAIL 3ojD(,�'D:, o1L So PE¢Gaca-noN =I to Zmw/LEA sz --7 H s � xjofMq I r ¢ yv OF PETER RtcA RD SULLIVAN t 3 aWER No. 2973.3 n�.woks a \ _ yr�14t ass/pNA L EN _��c.p _ 1946 Trs r 8h�o t+oLE TF=50 Laayr P V•G' tM/ SdK5OiL , I000 We z M' PVT �• tiIJ 6AL B` ►NY. IOOQ lrN 4S2 Bt C .4 ' 4�i�b T�lNlr GAL' Cc44iJrrr o 1Nj1'i�, ' SL= 6 ctSo=tS OIL —1 — ' c.o. C�lAVE w,6ge,, i,�z:: Au_5racrviccn sr-r STotIE MWE PU14 4'•vrE-p rWALL Me A-Z•o ZofjE �F-1 �s 15 1wp 12a P�I-I PST' PLdIJ 60 DATC—; I tL as�� P-e�E R�JCE 1 CGMFk( I*T TEE�w l.Li n1G PLAN �. %0v/N ke2wN e-o y ru 5 wrrµ T4l� LttJE L� l fmof cc. ID" 0r''B,��y1'�3GE �+ID I S 4,-r l-D CATED -W T'LDOD M41 a, $? NYE lw.L p �ros,ldL L.WD 501-7✓eyc¢S (K !J t5 NOT" T3A5® OW AA Ei,161 N FPS 6L)fz `f Ml:> T' F- OF:5eT!S 44flap uor Be STEr?—/ILL,r-- MA44 , u5t rD eSTQBU59: uWC-5 APFLIcAWT, �A SIDG T014zlu(