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2051 MAIN ST./RTE 6A(W.BARN.) - Health
u {- 2051 Main Street/Rte 6A (B _ M36rnstable �0 �' Y a t I A = 216 076 r I L y4 A i f 't " 4 ! a 3 ; N !r' 1• I y3.y'a st �ty,4`� i$j x'' n s`3"k�t��e�`C�a C3 !Er 0 I 40 Certified Mail Fee Ir $ •� Extra Services&Fees(check box,add tee as appropriate) ❑Return Receipt(hardcopy) $ ❑Return Receipt(electronic) $ � Postmark O ❑Certified Mail Restricted Delivery $ Here r3 ❑Adult Signature Required $ ❑Adult Signature Restricted Delivery$ Postace JPMORGAN CHASE BANK NA U 3415 VISION DRIVE rq COLUMBUS, OH 43219 r� r r r r•r•r• -�«� Certified Mail service provides the following benefits: •Areceipt(this pbrtiori of the Certified Mail iabel). for an electronic return receipt,see a retail ■A.unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS&postmarked Certified Mail receipt to the ■A record of delivery(including the recipient's retail associate. signature)that is retained by the Postal Service" Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent. Important Reminders: Adult signature service,which requires the •You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mail®,First-Class Package Service®, available at retaiq. or Priority Mail®service. Adult signature restricted delivery service,which •Certified Mail service Is notavailable for requires the signee to be at least 21 years of age international mail. and provides delivery to the addressee specifle. •Insurance coverage is notavallable for purchase by name,or to the addressee's authorized agen , with Certified Mail service.However,the purchase (not available at retail). t� of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark.If you would like a postmark on f •For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for the following services: postmarking.If you don't need a postmark on this Return receipt service,which provides a record. Certified Mail receipt,detach the barcoded portion of delivery(including the recipients signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.C r electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt;attach PS Form 3811 to your mailpiece; IMPORTAt1T.Save this receipt for your records. Ps Fore,3800,April 2015(Reverse)PSN 7530-02-000.9047 a. 1 • • COMPLETE THIS SECTIONON DELIVERY ila:romplete items 1,2,and 3. A. Si nature IIlt, 0 Adrat your name and address on the reverse � Addressee so that we can return the card to you. Addressee ■ Attach this card to the back of the mailpiece, A. Refbelve'd (Pri��Name) C. Date of Delivery or on the front if space permits. l�- 1. Article Addressed to: D. Is delivery address different from Re _ - If YES_enter delivery address bel :�� A ..! JPMORGAN-CHASE,:.BANK NA c N' .5 VISION DRIVE =�� a Cl -T BUS OH,4>3219 ❑Prlon ` ress® II �III�I IBII ICI I III I I II II I III III III�I IIII'll ❑Adult Signature ❑Registered Mail ❑/�duR Signature Restricted Delivery Restricted Mail Certified Mail® Air, 9590 9402 7037 1225 8089 84 ❑Certified Mail Restricted Delivery Signature ConfirmatlonT ❑Collect on Delivery ❑Signature Confirmation 9—Artinle_Number_(rfdrlsfer from service label) ❑Collect on Delivery Restricted Delivery Restricted Delivery r - . t s i t A; f t s ;r-n_ir,�v�gMail .. 70115 1�7 3`0 sp 0 p 1 '4 9 8 9 0 4 7 2 ' Ij l Restricted Delivery PS Form 3811,July 2020 PSN 7530-02-000-9053 Domestic Return Receipt USPS TRACKING# N �. 30 First,Gloss Mail Postage&Fees Paid USPS j11 IN 7 L Permit No.G-10 j 9590 9402 7037 1225 8089 84 I United States •Sender:Please print your name,address,and ZIP+4®in this boxO Postal Service TOWN OF BARNSTABLE HEALTH DIVISION ! 200 MAIN STREET HYANNIS, MA 02601 l i ��._,: -+_.� rl, il iui I i 1i i liii iJ'11i i .I ►� I Town of Barnstable Regulatory Services �OFIHE A Thomas F. Geiler,Director yP Public Health Division BARNSFABLE Thomas McKean, Director MASS. . 200 Main Street iOrEn i„�r s Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 May 24,2007 Dr..William Fenney 2071 West Main Street Barnstable,Massachusetts 02630 Dear Dr.Fenney: On May.23, 2007 at 3;30 p.m.,.Thomas McKean viewed the horse stable site at the property lines from several different locations and observed the following: -Entrance(iron) gates were closed tight -Compost bins with manure piled inside covered with tarps -Corral with no dust being discharged into the air Also I did not detect any odors.of manure..north, west, east and south of the property. In addition, there were no.loose horses. Therefore at that particular time r,I did not observe any health violations. A site visit will be.conducted by the Board of Health members in the near future. Very truly yours, <f3�Ilvb Thomas McKean,R.S.,CHO Director of Public Health 00 q:\wpfiles\fenneycornplaintresponseltr05.24.2007.doc f r WEST BARNSTABLE FIRE DEPARTMENT 2160 Meeting house Way West Barnstable Ma. 02668 westbarnstablefiredept@verizon.net Chief Joseph V. Maruca Emergency: 911 Business 508-362-3241 Fax: 508-362-3683 16 February 07 Brenda Tri DIAMOND EDGE FARM 2051 Main Street West Barnstable, MA 02668 RE: AGRICULTURAL BURN PERMIT Dear Ms. Tri: In accordance with your request of 2/15/07 you are hereby granted an Agricultural Open Burning Permit pursuant to GL Chapter 111s Section 142L. This permit is valid for 2007 and must be renewed annually. This permit allows you to burn brush(limbs of less than 4".diameter).The burning of leaves, hay, straw, stumps or building materials are not allowed. Burning may only take place on days with good atmospheric ventilation and.s_moke must not cause a nuisance to your neighbors. Fires must be at least 75' from any residence. There must be an adult present at all times and a charged hose at the fire. Each time you want to burn please give us at least 2 days notice and call in the morning you are burning to confirm that weather conditions are appropriate for burning. You will be allowed to burn between 9:00 a.m. and 4:00 p.m. This permit is valid only on that portion of your property that is within the West Barnstable Fire District (roughly west of your house). If you have any questions, please feel free to call me. Respectfully, - Joseph V. Maruca, Chief cc: Barnstable Fire Department: ',. Barnstable,-Board of Health.. David&Pamela Troutman�Mary Anne Fenney Christopher&Lynne Mason Chef Philip-Ryan,_CCCC Police jvm/jkk f r ( j +C ugh i Town of Barnstable �: ��� ��� Regulatory ServicesMAM - ('�a^►^ �- A Thomas F. Geiler,Director �� � f -5744e-- ibra *. Public Health Division e . Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 ' www.town.barnstable.ma.us Telephone: 508-862-4644 Fax: 508-790-6304 February 9,2004 Ms.Leigh-Anne Souza 3715 Falmouth Road Marstons Mills,MA 02648 Dear Ms. Souza, I am in receipt of a copy of your letter addressed to John Klimm dated January 9,2004. I was sorry to hear about the way you felt during the January 8'h meeting. As the appointed agent of the Board,and acting in my capacity as the Director of Public Health Division,I was also present at that hearing. I also reviewed the videotape of that meeting in it's entirety this morning. In my opinion,the three Board of Health members did act most professionally and were courteous to those present. Perhaps there was some confusion in regards to who are the actual appointed Board of Health members. There are only three Board of Health members; Dr.Miller,Susan Rask,and Sumner Kaufman. None of the Board members left the room during the entire meeting as you alleged. Late into the hearing,the Chairman did instruct a staff-person.to go to an adjacent meeting room to inquire about the availability of the room. Then a staff-person did leave for that purpose. Please be advised that health agents and health inspectors are not voting members of the Board. You also stated in your letter that you observed a female health inspector passing notes to opposing witnesses. I did not observe her passing notes to any opposing witnesses. The Board of Health members did listen to your testimony during the meeting. You stated in the second paragraph of your letter that you were not allowed to finish your thoughts. Then in the third paragraph of your letter,you indicated that you were not"able to speak." Please recall that you did speak,all of your spoken sentences were completed,and that you were allowed to return to the podium a second time to provide additional testimony. I did not notice or observe any of the Board members rolling their eyes or snickering as you alleged in your letter. Their thoughts and discussions were seriously focused upon the facts and discussions pertaining to the manure piles. As to your allocations regarding their decision making,I review matters with Board members on a weekly basis and I've never known them to make decisions based on anything other than the protection of the public health interests in the Town of Barnstable. The Board of Health acted responsively and decisively when they voted to revoke the horse stable license, in my opinion. Accumulating large piles of raw manure on top of the ground is a direct violation of the Health Regulation,PART X,paragraph 7. The stable owner continued to violate this section five months after the written cease and desist order was received by her in July. I do believe this letter answers the questions contained within your letter and I hope it clarifies for you the issues which you presented. If you should have any questions,please feel free to call me at 862-4644. Sincerely, r Thomas A.McKean,RS,CHO Cc: John Klimm y. ; t The Town of Barnstable *.suc�cai .* Office of Town Manager ` 367 Main Street,Hyannis MA 02601 www.town.barnstable.ma.us. Office; 508-862-4610 John C.Klimm,Town Manager Fax: 508-790-6226 Email: john.klimm@town.barnstable.ma.us MEMORANDUM TO: Tom McKean,Director of Public Health FR: John C. Klimm, Town er M DT: 2/4/04 RE: Board of Health Complaint Please respond to the enclosed letter from Leigh-Anne Souza regarding the January 9th Board of Health Hearing. Thank you. JCK:mpt Enclosure JAN-17-04 03 :05 A.M NORMAN BARRETT 508 428 7870 P. 01 k '�t,1'l', ��.84:.,•;:y'4• ' ••Y•�Y;��y:-•I��,... ,,J,'�A,�ipj• �Y' h IJenusiiy A, !9004 ',fir•`• '�' '}�.'''1,�•. .' ,. i, '• J''• •.ri,i;0''�=;'�� it a311j8I7t.r� YlA S113fOrtL>pg `� � .k +il '.a•• BQ,$11+d.�4 fi1fd4C'Eh 2IIAot hP qp,�O°� -W.li rok ad d+L 8P �}yp� p(•p�7� .:j�;. ..3� (� .•.Y-• ;•,�, a,; . :moo '1 ). .sina�that date;it 1 lm ain,tO x ":++ �$?a.vdid disc to ' Yflon.t#saE thatpotlar ' , << ii av etght Xt><�oatryig the would U6'to F r.l tt91'dtcgust t1" 6 W6ty I WAt4 frOGtted 60 t igf'th again �i: by to'board �*?ll Margo i ice, W ,�.}�,8 t4.�e�C •: ' ":J I „ ye roaeftedulad I Ce a 4p, tl'io `. pro�ser;ioallsm d2d'f2is,4 ,Qoaing yelp hop . �ot> ve;vlssi,• Q UAana'd to b3'. rd-121eT1�b@Z I •:::• .. 1 't-f,u,F,:�l,: 'ov by tti�i ` a o; ws�>sot R ►ed to ,�+a$r�.'� 'ttoboexddidm' ' ," . 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' •'"�•: '•�': ,i'G.: :!i:.r4• .CI �y *bAtia ,Ilkwhilsiu t17 t}1H�oBY`at_-} '7 1toad .Dy the elate tcuwd am ' Q r '+ "•�'.', ,;,T'^ w go :KJ•MC! 1i�L3 T• �]'^','II�^Hci 1 ,�JAL( ,a�T .-`',` .•f;:;i °`N' "� i.'• I r1v. � •Y!'�•F'.�. YAi il Q.: Aro tho hnraea,dfae�d,or T T. 7�.D. •f�.)nwPl'},.!'. �.� ott :t3> ,.a.triteh hunt bVlAi .� .:`.F'• t I r t:f.�,:;., .. ,' ^iti tom!✓%:. �'I:.�r' ••'!`:•' ,.!...:�? 5'.' . Boll mQmbeR' v 9 rsPpwdnt tha,towp:, `f'. cI"3ni'Yiay r �Oeelona]e ate orkuxi ' Ytnb�e raw.en1�:i�a alit -41 t'1 -r :�'• 5 2. Vn � J.1' 1• �]d/�p ,, •.• "l� Ir'' 1 'R.,fit.: Y ', wf..;• 1•,�•77r,kk'' ' ''..,•, •,• Of7v�i U 1.4 r ' '',j ,�'''wi .i• '' ` .. f.:J.� i 3+� PAGE 1 OF 3 pUTHEToq, Town of Barnstable Regulatory Services • sAaNMBI.E. 9 MASS. Thomas F. Geiler,Director 039. 10 p'Ep3,�A Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 November 3,2006 Mrs. Brenda Tri Diamond Edge Farm 2051 Main Street West Barnstable, MA 02668 NOTICE OF HEARING ON STABLE PERMIT You are scheduled to appear before the Board of Health at their meeting scheduled on Tuesday November 14, 2006 at 3:00 p.m. due to complaints received in regards to keeping of horses at 2051 Main Street West Barnstable. During recent months, we received complaints regarding loose horses, dust, and manure odors. The Board has decided to hold a preliminary hearing to allow the complainants to present the complaints to the full Board. The hearing will be held in the Town Hall, second floor Hearing Room, 367 Main Street Hyannis. During the hearing, you will be given an opportunity to provide testimony, to present documentary evidence, photographs, and to present witnesses on your behalf. You are invited to the hearing to attend and respond. The hearing will be held on November 14th at 3:00 p.m. The Board may schedule a further hearing to consider action if deemed necessary, and the information presented on November 14th may be used if there is a further hearing. I Sincerely, Tho s A. McKean, RS, CHO Triletter3 I cFTHE ram, Town of Barnstable Regulatory Services * BARMSfABLE, 9 MASS. Thomas F. Geiler,Director �prED MA'S A,� Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 November 27,2006 Mrs. Brenda Tri Diamond Edge Farm 2051 Main Street West Barnstable, MA 02668 NOTICE OF HEARING ON STABLE PERMIT i You are scheduled to appear before the Board of Health at their meeting scheduled on Tuesday December 5, 2006 at 3:00 p.m. due to complaints received in regards to keeping of horses at 2051 Main Street West Barnstable. At the previous meeting held on November 14, 2006, the Board voted to schedule and hold a hearing. Complaints were received regarding loose horses, dust, and manure odors. During the hearing, you will be given an opportunity to provide testimony, to present documentary evidence,photographs, and to present witnesses on your behalf. The hearing will be held on Tuesday December 5th at 3:00 p.m. at the Town Hall, second floor Hearing Room, 367, Main Street, Hyannis, Massachusetts. Sincerely, mas A. McKean, S, CHO Message Page 1 of 1 McKean, Thomas From: McKean, Thomas Sent: Tuesday, September 19, 2006 3:23 PM To: Geiler, Tom Cc: Houghton, David Subject: Pictures From Dr. Fenney/Complainant FYI I attempted to view any violations at the Brenda Tri/Diamond's Edge Farm this afternoon at 2:30 p.m. First, I walked from the Cape Cod Community College soccer field to the edge of the Farm. It was too difficult to see anything. Then I attempted to view any violations from Dr. Fenney' property but could not see any violations from there. I did not observe any dust violations or any loose horses. I then went up the driveway and stopped before the iron gates. A few seconds later, Ms. Tri arrived there behind me. We then briefly discussed the complaint received yesterday morning (regarding loose horses , dust, and manure piles, over this past week-end). Ms. Tri stated there were no loose horses over this past week-end. She further stated there hasn't been any loose horses there for at least six months. I observed that the front iron gates were closed tight. I requested permission to enter the property to view the manure storage areas. Ms. Tri then informed me that she has an appointment and would rather see me come back tomorrow. Here are five photographs (out of 39) provided to us from Dr. Fenney today. Dr. Fenney claims the horses were loose again this past week-end, that there was dust, and manure piles adjacent to a vernal pool. As you can see, it is a bit difficult to see the problems in these pictures. David Houghton and I will be reviewing them at 3:30 this afternoon. -----Original Message----- From: Wadlington, Ellen Sent: Tuesday, September 19, 2006 2:41 PM To: McKean, Thomas Cc: Houghton, David Subject: Oops, you probably could not open the other e-mail attachments. Let's see how this works. 11/14/2006 Message Page 1 of 1 McKean, Thomas From: McKean, Thomas Sent: Tuesday, September 19, 2006 3:23 PM To: Geiler, Tom Cc: Houghton, David Subject: Pictures From Dr. Fenney/Complainant FYI I attempted to view any violations at the Brenda Tri/Diamond's Edge Farm this afternoon at 2:30 p.m. First, I walked from the Cape Cod Community College soccer field to the edge of the Farm. It was too difficult to see anything. Then I attempted to view any violations from Dr. Fenney' property but could not see any violations from there. I did not observe any dust violations or any loose horses. I then went up the driveway and stopped before the iron gates. A few seconds later, Ms. Tri arrived there behind me. We then briefly discussed the complaint received yesterday morning (regarding loose horses , dust, and manure piles, over this past week-end). Ms. Tri stated there were no loose horses over this past week-end. She further stated there hasn't been any loose horses there for at least six months. I observed that the front iron gates were closed tight. I requested permission to enter the property to view the manure storage areas. Ms. Tri then informed me that she has an appointment and would rather see me come back tomorrow. Here are five photographs (out of 39) provided to us from Dr. Fenney today. Dr. Fenney claims the horses were loose again this past week-end, that there was dust, and manure piles adjacent to a vernal pool. As you can see, it is a bit difficult to see the problems in these pictures. David Houghton and I will be reviewing them at 3:30 this afternoon. -----Original Message----- From: Wadlington, Ellen Sent: Tuesday, September 19, 2006 2:41 PM To: McKean, Thomas Cc: Houghton, David Subject: Oops, you probably could not open the other e-mail attachments. Let's see how this works. 11/14/2006 Message Page 1 of 1 McKean, Thomas From: McKean, Thomas Sent: Tuesday, September 19, 2006 3:23 PM To: Geiler, Tom Cc: Houghton, David Subject: Pictures From Dr. Fenney/Complainant FYI I attempted to view any violations at the Brenda Tri/Diamond's Edge Farm this afternoon at 2:30 p.m. First, I walked from the Cape Cod Community College soccer field to the edge of the Farm. It was too difficult to see anything. Then I attempted to view any violations from Dr. Fenney' property but could not see any violations from there. I did not observe any dust violations or any loose horses. I then went up the driveway and stopped before the iron gates. A few seconds later, Ms. Tri arrived there behind me. We then briefly discussed the complaint received yesterday morning (regarding loose horses , dust, and manure piles, over this past week-end). Ms. Tri stated there were no loose horses over this past week-end. She further stated there hasn't been any loose horses there for at least six months. I observed that the front iron gates were closed tight. I requested permission to enter the property to view the manure storage areas. Ms. Tri then informed me that she has an appointment and would rather see me come back tomorrow. Here are five photographs (out of 39) provided to us from Dr. Fenney today. Dr. Fenney claims the horses were loose again this past week-end, that there was dust, and manure piles adjacent to a vernal pool. As you can see, it is a bit difficult to see the problems in these pictures. David Houghton and I will be reviewing them at 3:30 this afternoon. -----Original Message----- From: Wadlington, Ellen Sent: Tuesday, September 19, 2006 2:41 PM To: McKean, Thomas Cc: Houghton, David Subject: Oops, you probably could not open the other e-mail attachments. Let's see how this works. 11/14/2006 KAM. 1619. f0 MA'S A STABLE INSPECTION FORM Name: Owner: Date: �/L®L96 Address: 20v i MQW SY Time: �tao l W 1-4s b&. Phone: ►400 0011 ]Y aN Comment Current license Number of Horses Two Window/Stable Adequate Ventilation Adequate Size 2 EF-1 Adequate Flooring Drainage Sufficient 0 ] �u4- e�es�'. A'-,_^C- '^ C-0ITo f b N aced u� e� �cstn PaS�s Fencing of Property 0 E$a Q-'X q' a-e9 o r= %+ l`dh J. Ne..• 50' Setback Requirement Manure Storage Sanitary Condition [ �0 Troughs Clean of Debris Food Stored Properly Area Rodent Free Additional Comments: avl -Q b -S _ evcr (W0-,1;::- n "A i n� a as v aj.Ks Inspector's Signature: JOwner's Signature: > p *NOTE: Waste matter shall be disposed of in a sanitary manner and shall not be accumulated on the property. o Teq { FIN PlaElt �� r't4gq $rene$ NO ���' V c.o fonS a�� �Tio� S J eniwsrABM MASS. � i639. `0� �FD MA'S s STABLE INSPECTION FORM �} e, �� s �e,c-� idri CalName: Owner: '�)reAJ,a- Date: Address: I mst��,�, $-� Time: d ®IAr`1 West' �rY..S 266$ Phone: 3 6 2 SG Z, i�G) 0 D D D!f DY ON Comment Current license F-1 0 Number of Horses 0 Two Window/Stable 0 0 Adequate Ventilation 0 a Adequate Size 0 Adequate Flooring 0 Drainage Sufficient 0 0 Fencing of Property 50' Setback Requirement r\4i CO \'e.�-e- -,I- r►1 f -e Manure Storage 0 �o rsP-f a S v� br 3d o bl Sanitary Condition 0 � m Troughs Clean of Debris a a Food Stored Properly 0 Area Rodent Free 0 Additional Comments: Inspector's Signature: AStable Owner's Signature: *NOTE: Waste matter shall be disposed of in a sanitary manner and shall not be accumulated on the property. Photos of fencing repair completed: Diamond Edge Farm (Brenda Tri) 2051 Main St., West Barnstable Please note under footing of the small barn in the photo. N ,�,�'"'7eulII` •*'@,...PiS 3 C�'� ,*�+7s7'��y�,.rcYE�..yv'"E��'ya �6� i"�;�' -•'�".��pFr„�5 ��xsv � "' '°"'r'-+` 1 } Irv- 'Oii .�1 � h...� � • t 'x.. .. rc n �$�c w 'vrt 'F :^ET,.rt � 4�5:� f•'i�b h att �`� Ak- .a s' ,e 5 71 rot 0 il z t' t�. + 1W � ,.; . 1<'k Rom!' '7+p"<- ✓����`w-•.. � i�` ,y 7 .,..� � a"` �4'3Y. Sr �.. � ,j� f� ��y..�`� w -. '.e -k,+�,,K"',.. 3,. n '.t� �'y :,. 't,+�;b y�.'+r3'°.+•„y,_' � �� .�' • q 'Y 1 W�A } �R of ° w �. 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"*:SA�T �r+,rir `�T, ��,r}•m y. .y p �\4\ a^.. r',z 4�i 1'•a:r y f' rt.'S.]l +s'" A� �, men`;, ?�� �` '"1i . �` t,ti*.,Z ti:� ��� s�t ,..E x�A.t;,; `Kym...,,? � i $- 'YYY�Y7����i�"t��� ;4 ^i' 1/dL �`yt f��.l�i Ll .�a ���• � +. * ���, �„ ;r� .a'�F` r �l� .� � ` S\ .fig",�, M s 11 •\ r+f_. ,�/ry4 g♦ T w y_,, �.,y.# ,�.=` �' '� <4 •♦ �+*�ryi..il,�h aryl^, �� .7 V�+. r �1 Y' ktt'�lp� � ��.i +ir� ,-'-"aC.� � ,°". � '� +:R ti'' ry�' •���. e. ' YY ,,r l .�01'�, f .'1.��i..l. '*A ::-. w< k _ fi4a•�♦. ._�,,,,.. '..�,p µ ,y 24 e /. la,. rl �}t Al'1'LlCA'P1UN vow 1'EI�COLATION TEST AND OBSERVATION ITS LOCATION �n - �� VILLAGE % NO. .. APPLICANT {j� ;•G�,s' ,`� �y l DATE . {T — FEE ADDRESS TELEPHONE NO. (Non_ refunds le ENGINEERr TELEPHONE No. DATE SCHEDULED i!pp E p••p _�!J !p *� Applicant's signature ' AUUAN�d,\' VAP14 LbWb= .. . ._. C . . . Y Y Y . . . . . .. . . . Y . . . . . . . . .. .. . . . . . . . . . ... . . . . . . . . . . . . 240'7$-00/ SOIL LOG SUS-DIVISION NAME . DATE �— TIME ��- �, EXPANSION AREA: YES NO A4 ENGINEER 1� // ENGINEER ...I.L TOWN WATER_ PRIVATE WELI,� BOARD- OP HEALTH F t?\c.V."d t'j EXCAVATOR SKETCH: (street name,'etc. ,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes) . :NOTES: ' M k^' .w Eu 30 f, N • PERCOLATION RATE: TEST HOLE N0 � • ELEVATION: T ST HOLE NO: ELEVATION: 2 1 '� 3 3 a _ 5 � 5 � 5 � 6 6 7 y e.A-rj 9 9 t6 10 Sit-ty 10 11 �°'►'�� 11 1 12 12 13 13 14' 14 A 15' 15 � •s 16 16o SUITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD +EACHING PITS LEACHING TRENCI' S� UNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS: NOTE: ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC `PEST APPLICATION ORIGINAL: • COMPLETEp IN EHT,TRETY AY P, �;. pj� �p TO BOARI) OF HEAI.`I'II COPY: RETAINED BY APPLICANT '"—'-- Town of Barnstable P# R (01 S 1 Eti° Department of Regulatory Services B Public Health Division Date � 3 v� MASS. `0 200 Main Street,Hyannis MA 02601 prFD MP'i� Date.Scheduled Time M Fee Pd. (�lU Soil Suitability°Assessment for:Sewage Disposal 2. 1 a. . � Witdessed ci s Performed By:�a� J By: _sim ;� '2: f r & yam/ xe 1 �F � .,����' � � !:k6'i�3�"^ !rb 5 �� s.,..352� 'r,�.,�. •�SaE.,�;r ri Location a Owner's Name L L! S Location Address �,,` (Z�FMS—( AZ ( AZL�= Address 2p —j 2J W V W.-Z A si essor's Map/Pa mR rcel: O r1(p Engineer's Na Q 19 o NEW CONSTRUCTION V/" _ REPAIR Telephone# Se S 398 sail Land Use eeS .7 t-!Q Slopes C/o) Surface Stones yeS Distances from: Open Water Body 2 b o ft'-Possible Wet Area ft Drinking Water Well /,11-,q ft Drainage Way ft Property Line ft Other ft SICETCH:(Street name,dimensions of tot,exact loc S ere tests,locate wetlands in proximity to holes) O fi ..2:'� � �. .tip.. �..`d "' �..� F, s,: �'t>�:X,..,, Fr .....� i "'y.3` .5. i �• `i.a, TA . f J=78 2&2r Parent material(geologic) Q G Depth to Bedrock l �,/ o-7 c Weeping from Pit Face Depth to Groundwater: Standing Water in Hole: Estimated Seasdnal High Groundwater 1!� F � � � ° N 911 2k . ewx a:u e.e 'u_�e,.v, ri..J n sr'k,.sxs w w•71.e4.„d: Method Used: 6' in. Depth to soil mottles: in. Depth Observed standing in obs.hole: p Depth to weeping from side of obs.hole: __ in. Groundwater Adjustment ft- Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level— { ,',� Nff MERIT Iii afip„ '�u' R�.$ e�r: .m .Amm Observation Time at 9" Hole# ' Time at 6" Depth of Perc } e -6„ Start Pre-soak Time Q Trm (g„ . ).. t p End Pre-soak i RateMin.Mch Z iN ti /h If el-;es� i Site Suitability Assessment: Site Passed t� Site Failed: 'Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back------ Q:HEALTH/WP/PERCFORM ...... ... ...,: r.+ 1!IIgYIY NHY,'t�9A !yk - p�^ti.i�.H s:;@-RE W�T:i� ' ,L , 'o , pR.din a a'Sn I man a yY"'r� y�'y s�I - r JT 'F ry NINT-4.; ,51.L_' 1 f '�lk9 ���171'�,1 �d� - rL 'u!p_� " r'i-. - u�.�......: ,.�d� 55y��r '. .d ��„:y, Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel Y. Lam'--�f8'. � '> ,� �•u�8. 'l7., I L 2-Z t o C 2 .s '� �`jy�'GF 4 I .f � :F, i l i 1-� I tN:•.: -'3.` ,�i'' �y, T,�rytf M'�'Gy 11 1�`.�yy� -� a �4uyi 6iaa,�::t�:�;;t£�'?tft:sa�;.._. >as„vPiti,*J'g. .::J.�,Vk+b'fi»d. Y„n •'. .d .�K.. '.� s �i�"m.d.ut Ia 'lu...,.�' z .%z ��--�+: Depth from . Soil Horizon . Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel # i fg �•... I M r� ,t n r,N A y IR.!,:�aCif':,r IrVF�»,u�;�•:,,�I .a.�'i.,�S'�'d yti��T 1 L�����F„P� X5"""6�7�� .r!I J .- '' .-&. '�a 5 I d- �ar'k1� rx4GA a v:uyl M+rR�RIR' c�: r1'1 a y#�s YI I'Yx •etU. 1 'rE71� .X 54 ..'ih;` :,. ..5.." 'i31i I '_ .? !x�:ev r•n u 1 "L:' m� r.,:,x�d,'' ..d�i x 1�1,7�'.,m,» Depth from _._ _.__Soil Horizon- -., Soil Texture _ Soil Color . Soil Other Surface(in.) (USDA) (Munsell) Mottling' (Structure;Stonesj Boulders. Consistenc .%Gravel II'MLI��2'I Iyx'hJ I r 9111 .. I Y r I 'Fy - �t {�'r J•'!I' l''°� �rNf1 �T'ay��u� ,•, Depth from Soil Horizon. Soil Texture Soil Color Soil Other Surface(in.) (USDA) ~(Munsell) Mottling :Structure,Stones,Boulders:- J Consistency,"/o Gravel -... .i,. : - Y Flood Insurance Rate Map: Above 500 yeai flood'boundary No— Yes 14 Within 500 year boundary No_ Yes Within 100 year flood boundary No— Yes Depth,of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? �S _ If not,.what is the depth-of naturally occurring pervious material?- - F -- - a . 6 Certification w- r , J'cetttfy that.on- t i --9 -;(date)I-have_passed-the*soil evaluator.examination approved by the Department of Environmental Prt tectlon and that the aboO'Ahalysis was-performed by me consistent with the required training,expertise and experience described-in 310 CMR�1l 5:017.------- - Signature Date Q;HEALTH/WP/PERCF i A TOWN OF link-'. NSTABLE CIPLOCA M b, 3 e ` . SEWAGE # %4- ) -Z 7 Cg0 VILLAGE I �I,�' ASSESSOR'S MAP & LOT) / ,INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY 1, 5-ec) ®j a C(e)"S LEACHING FACILITY:(type) Z te°lc�" 11v Q �S (size) 1 O®Dye, !S NO. OF BEDROOMS _PRIVATE WELL O PUBLIC WATER BUILDER OR OWNER S 1V% CG DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED VARIANCE GRANTED: Yes No �, A/14 s�z i4t f i 7� TOWN OF BtM NSTABLE r- 1Y �ZLOCATION -o+(- 5 Z 3 Oo AG VILLAGE w: Q�hS h 1'}'►hh ASSESSOR'S MAP & LOT �§3NSTALLER'S NAME & PHONE NO. T Q. SEPTIC TANK CAPACITY I, 57eO 11 t.IvviS i © LEACHING PACILITYi(type)_Z. Le-1 �I (size) I NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATER BUILDER OR OWNER t, i�. �0", DATE PERMIT ISSUED: i DATE COMPLIANCE ISSUED:_ VARIANCE GRANTED: Yes No 1 CL� i� • � I zir , N Y4 6� 3 i 1 j f 1 A i < i �. 44 . No....��... .:l � y Ra t FEB...., ...... "` THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Toc1uJ...........OF........... �{-'ds ....- Appliration for Dispersal Works Tnnitrurtiun "rrmit Application is hereby made for a Permit to Construct (x) or Repair ( ) an Individual Sewage Disposal System at: / `` is 1...._.... Q : ..3 ... zB.•.. .. ...: ----------------"=r=- _.... =......................... .. p Location-All dr/essss / or Lot No. ................_... :`-:�::VeM:....c. ..^k.114e�...•........ ...................--.......... ...................•...............-»...••.^ Owner Address •....................... ..'.....ei5.w.u-.-....-.-.•-------•-----.--------------- --...----...--------•-----•-•---...............----............................---................ Installer Address Type of Building Size Lot?.57.3 4.QYQ..Sq. feet a Dwelling—No. of Bedrooms...........................................Expansion Attic gyp ) Garbage Grinder (ko aOther—Type of m No. of persons............................ Showers ( ) Cafeteria ( ) I l© •-•--•---.-••----•---•-------------------------••------.........c........o..-----...-----•-•-•-----.... W Design Flow............................................gallons per per day. Total daily flow....................----___.........._......gallons. WSeptic Tank—Liquid capacity I'0U-gallons Length.1 8...... Width:.'D. .._..... Diameter................ Depth.-_5..C.o...... x Disposal Trench—No........ Width_- !7 —..--.. Total Length_:''....... Total leaching area....!!.......sq. ft. 3 Seepage Pit No......Z--------- Diameter.......!P....... Depth below inlet................ Total leaching area...r,.'. Q.sq. ft. Z Other Distribution box (,O Dosing tank ( ) � Percolation Test Results Performed by...K:-F t?:�=......... Date--:rE9:.:.�a{1g E).Q....... if.................. Test Pit No. I.......e....minutes per inch Depth of Test Pit...._J.r..z(o.u._. Depth to ground water.KDKG. . .,_.. 14-Lt. Test Pit No. 2.......�_...minutes per inch Depth of Test Pit......UP&.... Depth to ground water... �....: Ri ................................................ `t • Description of Soil. . ....Q.- �. ?>1M. SVi1 _4&y. T�LL_.. .F��! !�... 141`�. .......... Sllr .. ......�to L I_ �GA.�1~1. U .......................... •-------•----•--•--------•----------.....-----------...-----••-------....----••--•-----------------=-•-------------------••------......-•----•-•••-•......_..........•---.... 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 LITLZ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Complianc been issue the oard of health. Signe ........ . •..... ........... .......... ................ Date Application Approved BY............. -'-� 1 .................. Date Application Disapproved for the following reasons:.........................................................................:...................................... --••--•-------....-•..................................................•-------.........---......-•---................-------------••----•-•-----•-----•--..........-•-•-...---.... ............ Date ... PermitNo...........U .:-- ----••-------------- Issued------------....-•-•----.....•••......--•............... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - OF................. Appliration for Disposal Works Tonstrurtion Permit \ Application is hereby made for a Permit to Construct IV or Repair ( ) an Individual Sewage Disposal System at: o si .... .........__..L._o--r5 3 A Kt o zB t2tn. rF &p ud, -k A� ---••----- ..._ F -••-...--•--. .. s-r • .., Location-Address or Lot No. ........................ .rdat. ......................cr al..::•..•..........-------------- ..................................................................................................-------•------•----•----•--.....------...... ......--•------............................--- Owner Address a -...: . D t S o.L L:-....................................... .......................................................................•------.....-•--•---•--.... Installer Address Type of Building Size Lot;.a2?.,D.n CLSq. feet Dwelling—No. of Bedrooms............................................Expansion Attic (\,V ) Garbage Grinder (NO) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures- --------------------------------------------------------------- ........................ ..._... WaW Design Flow.............. ......gallons per der on per day. Total daily flow..............��__.U...___..........gallons. WSeptic Tank—Liquid capaciity!. ?M.gallons Length.l.n.. Q..._.. Width.!4....... Diameter................ Depths?.(:�.".... x Disposal Trench—No. ............ Width__- _... Total Length.:77: .....• Total leaching area....:!!!!� -.......sq. ft. 3 Seepage Pit No......Z.___-__-- Diameter.......l 9....... Depth below inlet................ Total leaching area..-`-.5.��4 :U.sq. ft. Z Other Distribution box ()() Dosing tank ( ) Percolation 'Test Results Performed by...E F,&! t`� ,�' ............... Date........................................ -3lQ a .......... ............•••. -- Test Pit No. I.......�----minutes per inch Depth of Test Pit.....1.�.(n...... Depth"to ground water.K�leI�.e:......... 44 Test Pit No. 2....... ?....minutes per inch Depth of Test Pit......1.ka"... Depth to ground water...IJv��...._.. _ - = --------•-•-•------------------------•-••.-•--- r•--•-6' ...................... ..........._.... O o c�,_?4 ta)l�r�l t Sti '11E 44� �t l.T �' " w TiL(. l` Nr"12�, l T Description of So11.�1� - ... �_..... c ••••-•••--- ---..J - 1 ._U..� ..lW�t.-f ...SU6.7.4`-- ` "-�a-fLT... ')....._Y12(.-•T_i ts1_:_._( "YZ .It`l..f�t✓L.� VW --•--•-•-----------------• •-----......----•-•....-••-•--••---•----•----•-•-•-----•--......-•---•-----•-------•------•--...........---•----•••--•---•.......•••-••....-•-•-•••----••----•-•••-:......... Nature of Repairs or Alterations—Answer when applicable......................................................................................i:::_... - y ..................................................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLW 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance-has been issuede board of health. Signed....\-............... .................. Date Application Approved By ..--•---•-•--•---------•-••-- '?---..i_ -. ... Date Application Disapproved for the following reasons:......................................................................:..................................... ......................................................•-----....----•---•------------...-------•----.....................•...._......--•-•...-.............................----...Date.....------•- Permit No.......... �l f .........-'7 Issued..-...-. 7.................... Date ........... at...... Imo^ .:Fa.=_ ., .. _.� _,_� .. . .. -•. ....«,.,....._....,..----- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..........................................................I.......................... Trrtif iratr of Tompliattrle THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) bY------------------ •--.. .... C. -•...........................•--------------•---------...-•---••----------•---••---........-----------.....................--•--- �e Installer at......... !-... ------`-L�...... .�.......... •-�..................t!C/,...... .................................................... has been installed in accordance with the provisions of TITLE, 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......... ... ..... dated................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS-A.GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. \� DATE--•-------------------�... ...._.... . ��..._......-•••••-•-•-..... Inspector.................. ... 1-- .......... .---------------------------- ------------------ .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH / ��� ............. , .v z ........OF............. No........................ FEE.--•-•-•---•--.......... Disposal Works Tonotrurtion Permit Permission is hereby granted........ ..... . . -------------•-----------------...................................... to Construct (X) or Repair ( ) an Individu'�al_p_S_ewage Disposal System tat No.............................. •--•----......-•----............ -------•---......_........--•---•-•------•--------•--•--...---..................--•--- Street as shown on the application for Disposal Works Construction Permit No..................... Dated.._._.....:._................ .j ----........•--••-••--------•-----•--...... --- =-. ............................................. DATE..... ....---�-.. 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