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HomeMy WebLinkAbout0564 FLINT STREET - Health 564 FLINT STREET, M. MILLS A=102-055 i�. '�I _ COMMONWEALTH'OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AF I . �— DEPARTMENT OF ENVIlRONMENTA.L PRO Y"11 °N '9` ONE WINTER STREET, BOSTON MA 02108 (617) 292 Y y+ 40 ,9 o, 2 'fo DY CORE 1A S y9 Secretary 19.Q ARGEO PAUL CELLUCCI "�l/� _ DA' STRUHS Governor SUBSURFACE SEWAGE.DISPOSAL SYSTEM INSPECTION FORM ommissioner PART A' Gro CERTIFICATION Property Address: 564 Flint Street/Marstons Mills(Barnstable) Name of Owner: Greg O'Donnell Address of Owner: 171 O'Grady Street Ant.20 Date of Inspection: 15 May 1999 _Fall River,MA 02720 Name of Inspector:(Please Print) Nelson B. Cabral 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) Company Name: Samiotes Consultants,Inc. Mailing Address: 10 Central Street,Wayland,MA 01701 Telephone Number: a08)877-6688 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: J Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: Date: June 22, 1999 The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. NOTES AND COMMENTS (revised 9/2/98) Page 1 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:564 Flint Street/Marston Mills(Barnstable) Owner: Greg O'Donnell Date of Inspection: 15 May 1999 INSPECTION SUMMARY: Check A, B, C, or D: A] SYSTEM PASSES: d I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not evaluated are indicated below. COMMENTS: NO FAILURE CRITERIA OBSERVED. 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 repair, as approved by the Board of Health,will pass. Indicate yes, no or not determined(Y,N,or ND). Describe basis of determination in all instances. If "not determined",explain why not.) The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank,whether or not metal,is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). broken pipe(s)are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four 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 (revised 9/2198) Page 2 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 564 Flint Street/Marstons Mills(Barnstable) Owner: Greg O'Donnell Date of Inspection: 15 May 1999 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 the public health,safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OFHEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 15.303(1)(b)THAT THE SYSTEM IS NOT FUNCTIONING IN!A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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 THATTHE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I or a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 Feet but 50 feet or more from a private water supply well, unless a well water analysis 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. Method used to determine distance (approximation not valid). 3) OTHER o revised 9/2/98( ) Page 3 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 564 Flint Street Jr Marstons Mills(Barnstable) Owner: Greg O'Donnell Date of Inspection: 15 May 1999 D] SYSTEM FAILS: You must indicate either"Yes"or"No"as to each of the following: I have determined that one or more of the following failure criteria exist as described in 310 CMR 15.303.The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No d Backup of sewage into facility or system component due to an overload or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet or a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No the system is within 400 feet of a surface drinking water supply _ the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area(IWPA)or a mapped Zone II of a public water supply well) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of the Department for further information. (revised 9/2/98) Page 4 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 564 Flint Street/Marstons Mills(Barnstable) Owner: Greg O'Donnell Date of Inspection: 15 May 1999 Check if the following has been done: You must indicate either"Yes"or'No"as to each of the following: Yes No _ Pumping information was requested of the owner,occupant,or Board of Health. d _ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. As built plans have been obtained and examined. (Note if they are not available with N/A.) d _ The facility or dwelling was inspected for signs of sewage back-up. d _ The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. d _ All system components,excluding the Soil Absorption System, have been located on the site. The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees, material of construction,dimensions,depth of liquid,depth of sludge,depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: Existing information. Ex. Plan at B.O.H. d _ Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) [15.302(3)(b)]. The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub-Surface Disposal System. (revised 9/2/99) Page 5 of 11 I` + SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 564 Flint Street/Marstons Mills(Barnstable) Owner: Greg O'Donnell Date of Inspection: 15 May 1999 FLOW CONDITIONS RESIDENTIAL: Design flow: 440 g.p.d./bedroom. Number of bedrooms 4 Number of bedrooms(actual): 4 Total DESIGN flow 440 GPD Number of current residents: 0 Garbage grinder(yes or no): YES Laundry(separate system) (yes or no): NO ; If yes,separate inspection required. Laundry system inspected (yes or no): NIA Seasonal use(yes or no): NO Water meter readings,if available(last two year's usage(gpd): 1999—348 GPD; 1998—474 GPD Sump Pump(yes or no): NO Last date of occupancy: FEBRUARY 1999 COMMERCIAL/INDUSTRIAL: Type of establishment: NIA Design flow: gpd (Based on 15.203) Basis of design flow Grease trap present(yes or no): Industrial Waste Holding Tank present: (yes or no): Non-sanitary waste discharged to the Title 5 system: (yes or no): Water meter readings, if available Last date of occupancy: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: - SYSTEM HAS NOT BEEN PUMPED SINCE INSTALLATION OF NEW GALLEYS IN AUGUST OF 1998. System pumped as part of inspection(yes or no): NO If yes,volume pumped gallons Reason for pumping: TYPE OF SYSTEM d 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) I/A Technology etc. Attach copy of up to date operation and maintenance contract. Other APPROXIMATE AGE of all components,date installed(if known)and source of information:SEPTIC TANK&OVERFLOW PIT INSTALLED IN AUGUST 1998. DISTRIBUTION BOX AND LEACHING GALLEYS INSTALLED A094&T.W& Sewage odors detected when arriving at the site: (yes or no) NO (revised 9/2/98) Page 6 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 564 Flint Street/Marstons Mills(Barnstable) Owner: Greg O'Donnell Date of Inspection: 15 May 1999 BUILDING SEWER: (Locate on site plan) Depth below grade: 10" Material of construction: d cast iron_40 PVC_other(explain) Distance from private water supply well or suction line N/A Diameter 4" Comments: (condition of joints,venting,evidence of leakage,etc.) NO ODORS DETECTED. NO EVIDENCE OF LEAKAGE. INTERIOR PLUMBING IN GOOD CONDITION SEPTIC TANK: (locate or site plan) Depth below grade: 20" Material of construction: d concrete metal _Fiberglass Polyethylene_other(explain) If tank is metal, list age_ Is age confirmed by Certificate of Compliance (Yes/No) Dimensions: 1,000 GAL.VOLUME Sludge depth: 4" Distance from top of sludge to bottom of outlet tee or baffle: 32" Scum thickness: 1" Distance from top of scum to top of outlet tee or baffle: 18" Distance from bottom of scum to bottom of outlet tee or baffle: 6" How dimensions were determined: MEASURED INFIELD WITH STEEL TAPE Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage,etc.) TEES IN PLACE. TANK IN GOOD STRUCTURAL CONDITION. LIQUID LEVEL BELOW OUTLET(11 INCHES BELOW). MORE THAN LIKELY DUE TO LACK OF REGULAR USE(FLOW) NO EVIDENCE OF LEAKAGE OBSERVED WATER STAINING OBSERVED IN TANK INDICATE LIQUID LEVELS CONSISTENTLY AT OUTLET ELEVATION OF TANK GREASE TRAP: N/A (locate on site plan) Depth below grade: _ Material of construction: concrete metal _ Fiberglass Polyethylene _ other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: _ Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage,etc.) (revised 9/2/98) Page 7 of I f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION,(continued) Property Address: 564 Flint Street/Marstons Mills(Barnstable) Owner: Greg O'Donnell Date of Inspection: 15 May 1999 TIGHT OR HOLDING TANK: N/A (Tank must be pumped prior to,or at time,of inspection) (locate on site plan) Depth below grade: Material of construction: concrete _ metal _ Fiberglass_ Polyethylene_ other(explain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm present:_ Alarm level: Alarm in working order:_ Yes No— Date of previous pumping: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: OUTLET INVERT Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) EQUAL AND LEVEL DISTRIBUTION OBSERVED(ONLY ONE OUTLET). BOX IN GOOD STRUCTURAL CONDITION. NO EVIDENCE OF LEAKAGE OBSERVED. NO SOLIDS CARRYOVER. PUMPCHAMBER: N/A (locate on site plan) Pumps in working order(Yes or No): Alarms in working order(Yes or No): Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) (revised 9/2/98) Page 8 of 11 } SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM PART C SYSTEM INFORMATION,(continued) Property Address: 564 Flint Street/Marstons Mills(Barnstable) Owner: Greg O'Donnell Date of Inspection: 15 May 1999 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods) If not located,explain: Type: leaching pits,number: 1-600 GALLON LEACH PIT (NOT BEING USED) leaching chambers, number:_ leaching galleries, number: 3—500 GALLON CHAMBERS 0 33.5'L X 12'W X 2'D leaching trenches, number, length: leaching fields,number,dimensions: overflow cesspool, number:_ Alternative system: Name of Technology: Comments: (note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.)SOIL CONDITION NORMAL FOR SEASONALCONDITIONS. NO LEVELS OF PONDING OBSERVED. VEGETATION CONSISTED OF HARD WOOD. NO SIGNS OF GROUNDWATER INFILTRATION. NO SIGNS OF HYRAULIC FAILURE OBSERVED. EXISTING LEACH PIT CONNECTED TO TANK BUT OUTLET IS CAPPED TO LEACH PIT. LEACH PIT NOT PART OF CURRENT SYSTEM. CESSPOOLS: N/A (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow(cesspool must be pumped as part of inspection) Comments: (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.) PRIVY: N/A (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments: (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.) (revised 9/2198) Page 9 of 11 SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM PART C SYSTEM INFORMATION, (continued) Property Address: 564 Flint Street!Marstons Mills(Barnstable) Owner: Greg O'Donnell Date of Inspection: 15 May 1999 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house). blSsy r'� I I C�efiC I LXI'S i �0 Li s (revised 9/2/98) Page 10 of 11 • SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM PART C SYSTEM INFORMATION,(continued) Property Address: 564 Flint Street/Marstons Mills(Barnstable) Owner: Greg O'Donnell Date of Inspection: 15 May 1999 NRCS Report name SOIL SURVEY OF BARNSTABLE COUNTY, MASSACHUSETTS Soil Type MERRIMAC SANDY LOAM Typical depth to groundwater >6.0 FEET USGS Date website visited — Observation Wells checked N/A Groundwater depth: Shallow Moderate Deep SITE EXAM Slope � Surface water Check Cellar Shallow wells Estimated Depth to Groundwater: 10+ Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record d Observation of Site(Abutting property,observation hole, basement sump etc.) �1 Determined from local conditions d Checked with local Board of Health Checked FEMA Maps _ Checked pumping records Checked local excavators,installers Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) USGS DATA&SOIL SURVEY INFORMATION NOTES THE EXISTENCE MERRIMAC SANDY LOAMS IN THE LOCATION OF SITE. THIS SOIL IS CHARACTERIZED AS A DEEP,GENTLY SLOPING,WELL DRAINED SOIL COMMONLY FOUND IN BROAD AREAS AND ON LOW HILLS ON OUTWASH PLAINS. MERRIMAC SANDY LOAMS ARE ALSO FOUND IN AREAS OF GLACIAL LAKE DEPOSITS. GROUNDWATER IS TYPICALLY FOUND TO BE AT A DEPTH OF 6 FEET OR GREATER. FURTHERMORE,WITNESSED SOIL TESTING CONDUCTED IN JULY OF 1998 ESTABLISHED AN ESTIMATED HIGH GROUNDWATER ELEVATION AT A DEPTH GREATER THAN TEN(10)FEET. (remised Page 11 of 11 } TOWN OF BARNSTABLE LOCATION �� /��n S SEWAGE # VILLAGE/lj ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. A & B CANCO 775-6264 _SEPTIC TANK CAPACITYIAZ 4/�U�'D LEACHING FACILITY:(type)�.. Gov ize)33•f�/���2 NO.OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No 1. a�� o i No. .. Fee M THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01ppffcation for Migool 6pgtem Congtructfon Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components 1 Location Address or Lot No. 57 09 I t �. Owner's Name,Address and Tel.No. j 1 Assessor's Map/Parcel /D(:)L — O , Installer's Name,Add re A,�pda ft-NCO Designer's Name,Address and Tel.No. 0 f 35e1'f Main Street i Type of Building: / Dwelling No.of Bedrooms L Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank lOZTn Type of S.A.S. 0 !%,*L L Description of Soil dAN4YT�P Nature of Repairs or Alterations(Answer when applicable) t✓1.5 W i 3' S� a C.L C hhmm e/'s Lj VV Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of Heal h. Signed t) (vu�„,� Date 7— 36-T i% Application Approved by Date Application Disapproved for the ollowing reasons Permit No. Date Issued TOWN OF BARNSTABLE LOCATION_,5�I/ C14 SEWAGE # VILLAGE�j/��f ASSESSOR'S MAP 6z LOT_'6 INSTALLER'S NAME & PHONE NO. A & B CANCO 77 6264 SEPTIC TANK CAPACITY LEACHING FACILITY:(tnx)3. Soo gdlC�ly�o5ea (size)33•s' e/a eoZ NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER71 DATE PERMIT ISSUED: 4/— DA'rE COMPLIANCE ISSUED 7j VARIANCE GRANTED: Yes No -ef ,00 o g� INC 1 .j. No. Fee / THE COMMONWEALTH OF MASSACHPSETTS Entered in computer: �Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Z(pp tratton for Wzponl *pgtem Congtrurtton 3perrntt Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ;) ❑Complete System ❑Individual Components Location Address or Lot No. S F n Owner's Name,Address and Tel.No. G1�� Assessor's Map/Parcel AU,-) _ Q O , Installer's Name,Address,A&W.CANe0 Designer's Name,Address and Tel.No. 350 Main Street W. Yarmouth, MA 02673 Type of Building: Dwelling No.of Bedrooms Lt Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank /0OO Type of S.A.S. ._QQ 1,4/, 4 C. Description of Soil Nature of Repairs or Alterations(Answer when applicable) !i1 S(A a oo G AL (v n A f hAm d e15 urr Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of Health. Signed Date 7- .30`F F Application Approved by Date '7-3t9 -?E Application Disapproved for the ollowing reasons Permit No. 9 g ' V 73 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certtftrate of Compltanre THIS IS TO CERTIFY that the On-site SewageDisposal tsposal System Constructed ( )Repaired ( Upgraded( ) Abandoned( )by _ �l�iU�G at C"G 6/ C-�✓/l �74. fa`Ji4/s 1�A,, //'1-//h has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. Cl -Ll!-3 dated Installer Designer The issuance of this permits all not bepjonstrued as a guarantee that the system will function as designed., Date Inspector I-, C�J No. �' Fee S U THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS 'Wtg ogaf gtem Congtrurtton Vermtt Permission is hereby granted to Construct( )Repair(✓'Upgrade( )Abandon( ) System located at f /%.1 f .j�X- ./Z'/ ,/I and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date: "7 — 0 `9a Approved by 10/9/97 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) I, S b e ask"y" , hereby certify that the application for disposal works construction permit signed by me dated concerning the property located at 544 F t+ Sf .. Otalsfn,,Ak;t(, meets all of the following,criteria: There are no wetlands located within 100 feet of the proposed leaching facility There are no private wells within 150 feet of the proposed septic system c/. There is no increase in flow and/or change in use proposed • There are no variances requested-or-needed. �./ If the proposed leaching facility will be located within 250 feet of any wetlands,the bottom of the proposed leaching facility will n2l be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation. Please complete the following: A)Top of Ground Elevation(according to the Engineering Division G.T.S.map) B)Observed Groundwater Table Elevation(according to Health Division well map) SIGNED : DATE: LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. q:health folder:cert v^ ,�easIr 0 o O THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA i vvvN -vr- T �Ht�NS IHt�L�� ➢r�r�a�a� . nz7f urz - -- - . Qsatisfacto� l 2. PrintersBOARD OFHBALTH 3. Auto.. rody Shops ' O unsatisfactory- 4. ' Manufacturers COMPANY (see"Orders") S. Reta).1 Stores e -ADDRESS 6. Fuel Suppliers �j;�j�; " � T. � f�J.'�� Class: 7, Misc llaneous 'i QUANTITIES AND STORAGE (IN=indoors; OU1•coutdooi Case lots Drums MAJOR MA AbgveTanks Unde t roued '[auks MATERIALS IN )UT ! g Fuels: I eIIons a fesi Gasoline, Jet Fuel (A) Diesel, Kerosene, 112 (B) Heavy Oils: — waste motor oil (C) new motor' oil transmission/hydraulic �t Synthetic Organics: degreasers r ' I' . Miscellaneous: 1 UISpUSAL kE-GJ1'I'IUN R):Pu�RKS: 1. Sanitary Sewage 2. Water Supplly . c_�t, �'' /'i�1 1 ��� .d C `C � ✓`-' QjTown Sewer �"� public: 0-On-site Private • J if 3. Indoor Floor Drains: YES C NO �� ► ,•--�1 , . �,� -��� L ' 1 ,�� f / — Q [folding iankt, MUC `-- O Catch basin/Dry well �U w OOn-site system -- 4. Outdoor Surface drains:YES NO _ Q Holdink• tank: MUC \ ; O Catch basin/Dry well 1 / QOn-site system S. Waste Transporter Licensed? Name of Hauler ,jZEst_Ina t ion illaste Product 1. Person(s) nt.ery ewe / Inspector Vate TOWN OF BARNSTABLE BAR-W 1238 Ordinance or Regulation t WARNING NOTICE . Name of Offender/Manager l 1NOtine14 Address of Offender A.2 /9#'Ik S 4- L MV/MB Reg.# Village/State/Zip Business Name w am/ m; on Cl � c,/ 19 Business Address 044.,yr c..E nA Signature of Enforcing Offi6er Village/State/Zip Location of Offense' ► S uP�✓li Enforcing Dept/Division Offense ! d l orclw/2 V16I &O.D. A Facts h y L�otM,o�Qf! ff+�'rh 1'ICrQ� ltrl This will serve only as a warning., At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. -238 ' TOWN OF BARNSTABLE BAR-W Ordinance or ,Regulation rY � -WARNING. NOTICE :. Name of 'Offender/Manager 41iwe' Address of Offender—. ly. fAve sltp� . rw/MB Reg # Village/State/Zip roek- r . .., ©d Business ..Name am/pm; one/ 19 Business Address ' Signature of Enforcing Offi6er Village/State/Zip Location of Offense ', y/ Put'/ S a-1 ma*,&nsh4l'I Ham' ,r,--t Enforcing Dept/Division Offenseu�.Sc lti►� tdr, ! /! �"C%91cJ�� o�. Facts J -�S� `C�C�t I VA v &410 411t 4f '1-frh rw 'b j-_r )-e'.��s t k j-, -t t y v This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. TOWN OF BARNSTABLE BAR-W 1238 � . Ordinance or Regulation WARNING NOTICE G -Pitt r �f• r+e� ,,>FC�n� 1 Name of 'Offender/Manager C sr �' I , ,, ,f Address of Offender / lt rct`•t' MV/MB Reg.# Village/State/Zip eo k4:1, 47 Business Name ' '' am/pm on y,& �,/` 19 Business Address � C .t .�:Cn t Signature of Enforcing Officer Village/State/Zip Location of Offense z + t0, .`; f , , ` /If f Enforcing Dept/Division Offense t C rK rjl '-/ar} . 4, 1 jylx ,C/are Facts .4 t`cy/, it 4�la� ` t� «s ! 7ry� a�, vlraer Fii'l . This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. ] PAR ] Real Estate System - General Property Inquiry] Help [ ] Parcel Id: 102 055- - Account No: 49511 Parent : Location: 564 FLINT ST MM Neighborhood: 20AC Fire Dist : CO Devel Lot : 29 Lot Size : .24 Acres Current Own: ODONNELL, TERRENCE P & State Class : 101 ODONNELL, ANNE L& GREGORY F No. Bldgs : 1 Area: 1536 142 ARTHUR ST Year Added: BROCKTON MA 2402 Deed Date: 080194 Reference: 9329/273 January 1st : ODONNELL, TERRENCE P & Deed MMDD: 0894 Deed Ref : 9329/273 Comments : Values : Land: 24800 Buildings : 96700 Extra Features : Road System: 564 Index: 551 (FLINT STREET ) Frntg: 108 Index: ( ) Frntg: Control Info: Last Auto Upd: 110495 Status : C Last TACS Update : 110195 Land Reviewed By: Date : 0000 Bldgs Reviewed By: AM Date: 0187 Tax Title : Account : Taken: Account Status : Hold Status : Cancel [ ] Press XMT for more data Next screen [PAR ] Action [ ] Owners Name [ ] Road Index [ ] Road Name [ ] Parcel Number [102] [056] [ ] [ ] ( T DaW46� 30 l� Health Complaints 09-Oct-96 Time: 9:25:11 AM Date: 9/6/96 Complaint Number: 414 Referred To: CHRISTINA KUCHINSKI Taken By: c.d. Complaint Type: NUISANCE CONTROL REG. 1 RUBBISH Article X Detail: Business Name: Number:§i64 Street: Flint Street Village: MARSTONS MILLS Assessors Map-Parcel: Complaint Description: The complainant has called in the past regarding the following matter. At the above location there is a large pile of brush/trash that is attracting rats in the area. This has still not been cleaned up and is an ongoing condition. Actions Taken/Results: CK observed brush/trash, landlord is Investigation Date: 9/9/96 Investigation Time: 4:30:00 PM 1 i ASSESSOR'S MAP.N6.` PARCEL L O CAT ON S A G E PERMIT NO. V I L L A GE INSTALLER'S NAME _j-} AcD'DR'ESS F. EDY T { KIN8 w YVILLUVV . ft j : 1 WEST 6ARNSTABLE, MASS. Q 6�" B UILDE R TEIO*2-3W*N ER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED r�i���ji � ��:�� I� +`, ;� ..� �� �P FJ s.cpa- v ... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....:.............OF..... / Appliratiun for I9iopuoal Worko Totuitrnr#inn Permit Application is hereby made for a Permit to Construct (V) or Repair ( ) an Individual Sewage.Disposal System at 2 L/•UE ation•Add ess ...............•_._-•------•-•----•.-----.or Lot No. ..... • -- ------ .......................•---------...-- ---..................•-•--.---.............--- owner Address k >Z�. f .......................................... ........................•-..... •----.------•--............... pgnstaller . Address Type of Build Dwelling ingNo. o Size Lot_ ,.7, .'..Sq. feet U f Bedrooms.............�..........____ .....Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons............................ Showers — Cafeteria a Other fixtures ................................... . W Design Flow................ ....................gallons per person per day. Total wily flow..............►130_. ....__......gallons. WSeptic Tank—Liquid',capacity/.000gallons Length.- _.L&._.. Width.-•.•_-/O.._ Diameter................ DepthS.'.7... x Disposal Trench—No..................... Width.................... Total Length............. Total leaching area....................sq. ft. Seepage Pit No........./.......�. Diameter../Z..: ..... Depth below inlet_o..-..7......... Total leaching area.... 4:5....sq. ft. z Other Distribution box (,i ) Dosin ank ( �t) '-' Percolation Test Rests Performed by... T._./c l VIJ � ���Date..... _ /�1�..._......... a / �` Test Pit No. 1................minutes per inch Depth of Test Pit...... .. _ Depth to ground water........................ fs, Test Pit No. 2.! z.......minutes per inch Depth of Test Pit.......dJ�..... Depth to ground water........ -..._. O � Sescr ton o Soi..l ------� l] .. U ----......-•--j---•-•---••--•-•-----•-....--•-..._...... ....................................... ----•-....---•-•--•---------------------------.......-----------.........-----------------------•-•-•=------......--•------......--•••--••-•-......-•----••--.... V Nature of Repairs or Alterations—Answer when applicable............................................................................................... ........•--•••-•-••..............•• -•--•---..............................................-•----.................---............-••------•--....-•-••-------••......_--••--- Agreement ��~ The undersigned,agrees to install the aforedescribed Individual Sewage Disposal System in accordance witill t provisions of iITIS 5 of the State Sanitary Code—The undersigned further agrees not to place the system in o eratio til a Ce 'ficate of Com fiance has been 'ssued by the board of health. J� Signed_ - ................................ ..............................-- I Date PPlication Appr ed B .....................••.............. 6(aZ j Date .._._._.._._ Application Disapproved for the following real s:................................................................................................................ ......................•----•---••--..............------•-•-•...............-•---•---•----•-•-......•-•-•-.---•-••-••---••-•------•--•--.....-••-••--•---•-----•-----•••...._.••-••---•--••---........._.. Date ' PermitNo.....:...........••-•--....................••------------ w - .tasued......................................................... . s 3 .�= No................_..!... F stf cpo THE COMMONWEALTH OF MASSACHUSETTS f.� BOARD OF HEALTH i Q11.� -----------------OF..... ��/ .r�jr��`.' �.----------.....-----.......---•----- Apliliration for Diiposttl Works Tonitrur#ion Verntit Application is hereby made for a Permit to Construct (/)"or Repair ( ) an Individual Sewage Disposal System at •.............�fJ T..:..2 1. .�:!lft/.1... ' T'� 1'. :......... ............................................. ........................_•----............ - Location-Address or Lot No. i .............� .J�.1.-•-- ���t,l2................-----............---.... .................................................................................... 1 Owner Address .l.� .............•----....................--......... --.......... • •-- .........._..... a •Installer Address Type of Building Size Lot./0, J.J6.._:._'_'...Sq. feet U Dwelling—No. of Bedrooms............----------------------.....Expansion Attic ( ) Garbage Grinder ( ) aa Other—T ype of Buildin g ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures ......... WW Design Flow...............6";_....................gallons per person per day. Total daily flow..............02..6................gallons. WSeptic Tank—Liquid capacityJ4200.gallons Length.P_::(j.: Width4._-/O. Diameter................ Depths-., x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......._�.......... Diameter.,/Z..,: ....... Depth below inlet„3...:..;1..._. Total leaching area...ZAa.....sq. ft. Z Other Distribution box (/)- Dosing-tank ( ) `-' Percolation Test Results Performed by..6,10e ::. :.., ��I�/.�,,e�.. �;�(�(,�>It!�71 .Date....�� �'l............. Test Pit No. 1.. L.......minutes per inch Depth of Test Pit..... Depth to ground water........................ r t>;. Test,Pit No. 2.--�.Z........minutes per inch Depth of Test Pit......f44."_.. Depth to ground water........ ...... pf � „ - - ._/.. 1�1...,' �A�/� 1 W................ /P -------•-- Description ofYSoi :: Z_..t1.--_--.-......._...._. ---------------------------------- ......................................................... w UNature of Repairs or Alterations—Answer when applicable............................................................................................... Agreement: I The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with thcf provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in t opl ration a Certificate of ComplialVe has been issued by the board of health. 1� Signed........ '-'` \ • --- D .... f ' Date Application Approved By-----•---•-••-••........................................ ............. .. ...................... Application Disapproved for the following re ns ..............................................................................6 a %....... •----••----------------........-------•--•----•-•--------•-----...•-•-•-......-•-•---•••.•... Date PermitNo....---•--..._.....-•••----•..................•-••---•. Issued.--------------•------------.........-•---••-------•-. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................................OF.......... C9rdif irtt#.r of Tontpliattre THIS ISIeTO RTIFY That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) JoC. 20heIt by .............. . -•---------.-........... -• Installer -+....._....ten fv� / at.......-•- -..----_.•-�=a------�,►n---•----5 t .........! °.^ C?�1 [:!!-�(S_.... ......----•..................................•--- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as d�scri ed in the 4 application for Disposal Works Construction Permit No.c .... .4Z.... dated....._....../_... Z............ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTIONS TISFA ORY. ---------- DATE .......•-•_.•---•............ ............ Inspector..................................:..••------........-•-•----....._................. A — 10:;..- ass 1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH NCA? iS _ 6 ..............OF........... 1\\�..,.......................................` 3Dio�roottl Turku (�nriu •nr#iun ."amif / ! Permission is hereby granted....�J0.L.-•--fie-A4e-4 k .................................................................................................. to Construct or Repair (�y.) an Individual Sewag Disposal System at No..............;Z ) F1.1.. 1.•. l.'.t� r • ..... A40././f...--•---------------------------------tbC!......... 64.................. Street as shown on the applic tion for Disposal Works Construction Permit _. -_-----• Dated.......................:................. 2. 01, ...................................... ---•---•••--••-•••... � r� _g ..._......_ DATE........................ ...................................................... Boar f H th FORK 1255 HOBBS & WARREN. INC.. 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Ep , ,_�'�5�___.--- __. �r >~�. w� .; - -SSG S4 ` BOUA.1 A //V57L-c _ 4 PPI-AfA A/ JOHN KEAME �•" � SN RSTOF�9s Ts xyz 51 ,r - J; r s FLINT STREET Jrt A ,c ,4,pPL C,Q,B/,,�F toy UNDEFINED MWAI WA �.�y) �y� s " R 'C'` ~, -5� lftlAcE S Y.STEM LD�,4714 '9N' D7"lS ' �A' , -� Lorg � 1mr srje ET r� - L E? A GARvAG� �'�Q�it/DER lft//LL„��T��' 2 ` IA/5TALI.ED DA/ 714f' SV5TEM. BAVI STAB1 , �N OF ,t_ ,_R L G At D �. ��� Mqs �c�L� / - 3a . �,��t�, , 6' is/e� �,4� i/V<r v J. s fi V , 3 K. D•�/. � �f���CEi� f3 y: �JO�it:/D_ �Xl57P'SPDT�L. �✓' - Sox3 No. ,, g14 s� � �o .�aL, 4fA P 561Rv . c01,15uL TA 7- TER . FJ' } r, _ - -.:.:. .. '.. .- ::.fi .+.,.« .a++s... s+.:...s-:. .....a,..a,:...sib:-,.w••,a..:.w..._.aa.,_3..._usm ']..y,.w !S.r.._,,:f. —,.a...:. -..rv,-.. --.-r w. ,:.. ... ., i .,;