HomeMy WebLinkAbout0457 OLD STAGE ROAD - Health (4) 4 i Old Stage Road
Centerville
A = 190_ 064 (?File#2)
- fI
,I
No. 4214 1/3 ORA
ESSELTE
10%
® O O O
a
9
� t
t)
/ �
cc
I,.q
rn
o
r
U
Z 15.71fied Mail Fee
I
Extra Services&Fees(checkbox,add teeas appropnate),x
[]Return Receipt(hardcopy) $
❑Return Receipt(electronic) $ tmark
r3 []Certified Mail Restricted Delivery $ 9 1 Here
C:3 []Adult Signature Required $ •3 . C
❑Adult Signature Restricted Delivery$
0 Postage
rn
Total Postage and Fet
rq
SHERMAN, CARL F
` $
e"tT°
-q 457A OLD STAGE RD
9treetandApENo.,oi CENTERVILLE, MA 02632
City State,ZIP+4�
r. r r r rrr•r.
Certified Mail service provides the following benefits:
■A receipt(this portion of the Certified Mail label). 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 s
for a specified period. delivery to the addressee specified by n4me,or
to the addressee's authorized agent '
Important Reminders: Adult signature service,which requires the y
■You may purchase Certified Mail service with signee to be at least 21 years of age(not r'
First-Class Mail®,First-Class Package Service®, available at retail). `
or Priority Mail®service. Adult signature restricted delivery service,which
r 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 specified'
■Insurance coverage is notavailable for purchase by name,or to the addressee's authorized age-fit.
with Certified Mail service.However,the purchase (not available at retail).
of Certified Mail service does not change the s 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 n
■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 recipient's 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.
electronic version.For a hardcopy.retum receipt,
complete PS Form 3811,Domestic Return
Receipt,attach PS Form 3811 to your mailpiece; IMPORTANT.Save this receipt for your records.
PS Form 3800,April 2015(Reverse)PSN 7530-02-000-9047
SECTIONSENDER: COMPLETE THIS •MPLETE'HIS SECTION ON DELIVERY
■ Complete items 1,2,and 3. A. ignature \
N Print your name and address on the reverse X ❑Agent
so that we can return the.card to you. Ad a see
■ Atta6h this card to the back of the mailpiece, B. Received by(Prin d Name) C. D e ve
or on the front if_space permits. _
1• { D. Is delivery address different from item ? ❑Yks
If YES,enter delivery address below: ❑No
i
SHERMAN, CARL F
L457A OLD STAGE RD
CENTERVILLE, MA 02632
II I II�III IIII OI I II I I II II I Ili II I�III I I II II III 0 Priority Mail Express@
�AdultSignature. Service eRestricted Delivery 0 Reg stered Mail Restricted
I� 9590 9402 4116 8092 9362 03 Certified Mail® D
elivery
I Certified Mail Restricted Delivery eturn Receipt for
❑Collect on Delivery erchandise
��n+t le A6.mhcr Trnnefnr frnm_enn r�hen n Gallant fin Delivery Restricted Delivery
�. a r tI 0-Signature confirmation
7 01`5 17 3 0 10[!01 j!4:.9 8 7=: 5 318:. c Pal]Restricted Delivery Restricted Delivery
PS Form 3811,July'2015 PSN 7530-02-000-9053 Domestic Return Receipt
USPS TRACKING#
First-Class Mail
e
Postage&Fees;Paid
USPS ..
Permit No.G-10
9590 940 11,6" 8092 9362 03
United States •Sender:Please print your name,address,and ZIP+4®in this box• ,
Postal Service
1
d"
Town of Barnstable
It q Health Division
I f 200 Main Street I
Hyannis,MA 02601
I I
I
I
i��ie►��f��ilfl���fe� ,��>>ijj�i� ii1fi1t{1,r)1ipilfl)e1J IJ11,
J
'rt .
ru SWIM
io 0 F F ' — . L U S E--\l
c0 Certified Mail Fee
Q' $ a
Extra Services&Fees(check box,add fee�es app•
❑Return Receipt(hardcopy). $ C` r `I'"
❑Return Receipt(electronic) $ Postmark
❑Certified Mail Restricted Delivery $ Here
oO []Adult SignatureRequired i $
❑Adult Signature Restricted-Delivery$
0 -
m
KADOLKAA-,,ALIAKSANDR A p
"n 606 OLD STAGE ROAD r
o CENTERVILLE, MA 02632 +
Certified Mail service provides the following benefits:
■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail
■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate
rs 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 r.,
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 L
Y P ry signee to be at least 21 years of age(not
First-Class Mail®,First-Class Package Service®, available at retail).
or Priority WHO service. �Y '
.• -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 specified 3
■Insurance coverage Is notavailable for purchase by name,or to the addressee's authorized agent..
with Certified Mail service.However,the purchase (not available at retail).
of Certified Mail service does not change the is 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 rr
•For an additional fee,and with a proper this.Certified Mail receipt,please present your _
endorsement on the mailpiece,you may iequest 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'pardon,,
of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply r�
You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.G�
electronic version.For a hardcopy return receipt,
complete PS Form 3811,Domestic Retum
" Receipt attach PS Form 3811 to your mailpiece; IMPORTANT.Save this receipt for your records.
PS Forth 3800,April 2oi5(Reverse)PSN 7530-02-OW-9047
y
1 • 1 • • • I
TI
A. Signature
■ Cofiipfetd.itemsAt;2,and 3. ❑Agent �
■ Print your a;riarii hd address on the reverse X ST7-7—
Addressee
so that we can return the card to you.
■ Attach this card to the back of the mailpiece, B. Received by(P d NO' C. f Delivery
or on the front if space permits.
1. Addressed to: D. Is delivery address d int front em 1?
ess below:
%ABOLKA,ALIAKSANDF2
?Q6==OLD STAGE ROAD--
< RVILLE, MA 02632 fi
❑Priority Mail Expiess®
II I�III� II I�) III�I I'I I I I III I'll _o au ro y,m.o� ❑Registered Mailva Re
Adult Signature Restricted Delivery Registered Mall Restricted
rtifled Mail® elivery ' '
9590 9402 5357 9189 1905 79 Certified Mail Restricted Delivery etum Receipt for
❑Collect on Delivery Merchandise
9 Article Numher?ransfer_frnm_service_lahelf, ❑Collect on Delivery Restricted Delivery' Signature ConfirmatlonT"'
•• ail ❑Signature Confirmation
7 0`15 17 3 01 0 0 01' 418 : '14 2 5 ," ail Restricted Delivery Restricted Delivery
PS Form 3811,July 2015 PSN 7530-02-000-9053 "_ Domestic Return Receipt`
USPS TRACK NG#
First-Class Mail
Postage&Fees Paid
USPS
Permit No.G-10
9590 9402 fM."489 1905 79
United States •Sender:Please print your name,address,and ZIP+4®in this box*
Postal Service
Town of Barnstable
y � Health Division
200 Main Street
Hyannis,MA 02601
I I I
I
_ i�iij,�;1�►j�i��ij'!"lllj'tllll�l�ljij�,tl,i;l,ll,;jl;,ij��.l�jj;l I
I
I
! t
°p THE T
Town of Barnstable Barnstable
Regulatory Services Department j miGac j
fAftNSWM '
"�: ,�� Public Health Division m
`bprF0�,,�e, 200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Richard V.Scali,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
SECOND NOTICE
CERTIFIED MAIL#7015 1730 0001 4987 5318
August 2, 2018
SHERMAN, CARL F
457A OLD STAGE RD
CENTERVILLE, MA 02632
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 457A Old Stage Road, Centerville,MA was inspected on
04/21/2018 by James D. Sears, certified Title V Septic Inspector for the State of
Massachusetts.
The inspection of the septic system showed that the system "Fails" under the guidelines
of 1995 TITLE V (310 CMR 15.00) due to the following:
• Backup of sewage into the house due to an overloaded or clogged SAS or
cesspool.
You are ordered to repair or replace the septic system within sixty (60) days from the
date you receive this notification.
Failure to repair/replace the septic system within the deadline period will result in future
enforcement action.
PER
T E BOARD OF HEALTH
Thomas McKean, R.S., CHO
Agent of the Board of Health
Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\457 A Old Stage Road Centerville-
SECONG.doc
v ?�
t Town of Barnstable
Inspectional Services Department
p DAMETABM 4Public Health Division
rfD 200 Main Street, Hyannis MA 02601
Office: 508-862-4644
FAX: 508-790-6304 Thomas A.McKean.CHO
FINAL NOTICE
CERTIFIED MAIL#7015 1730 0001 4988 1425
February 21, 2020
KADOLKA, ALIAKSANDR A
606 OLD STAGE ROAD
CENTERVILLE, MA 02632
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 457A Old Stage Road, Centerville,MA was inspected on
04/21/2018 by James D. Sears, certified Title V Septic Inspector for the State of
Massachusetts.
The inspection of the septic system showed that the system "Fails" under the guidelines
of 1995 TITLE V (310 CMR 15.00) due to the following:
o Backup of sewage into the house due to an overloaded or clogged SAS or
cesspool.
The original order letter to repair or replace the septic system was mailed on April 30,
2018. A second notice was mailed on August 2, 2018. A third notice was mailed on
November 27, 2018. A fourth notice was mailed on August 22, 2019 to the new owner in
our records, in which you were ordered to repair or replace the septic system within sixty
days from the date you receive this notification.
You are ordered to repair or replace the septic system within 6 months from receiving
this notification.
Failure to repair/replace the septic system within 6 months will result in scheduling this
issue before the Board of Health at a public meeting. Please contact the Public Health
Division at 508-862-4644, to rectify this issue.
PER ORDER OF THE BOARD OF HEALTH
T� h- o a McKean, R.S., CHO
Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\457 A Old Stage Road Centerville
Final Notice.doc
w Town of Barnstable-
Public
OF THE 7p
U.S.POSTAGE>>PITNEY BOWES
Health Division +
aaaNnANLE. ` 200 Main Street
NA
°'eo MPS P 0� Hyannis,MA 02601
�!� 00,
7015 1730 0001 4987 9422 �' 2 4w o260'1
0 .$ 006.670
0000.3.36455 NOV. 28. 2018.
rV
e;
HERMAN� S , CARL F
606 OLD STAGE ROAD
A1T�R\/1.1el^�,RAA (1'�Fi'17
T:a:i Y �e"r:w s c. �,.r.���• a cy.
f RETURNJ TO SENDER' ,
p MOT DELIVERABLE AS ADDRESSEDT.
AE, �
� m
11TF I E.lbn 02681400290 8369 051339—2 8—4 2
- .- ••�a�..1..� 0:2 . �i�lr��il�i�i'll''���11'��4�1f$'i��'°�99� r't����ioial9�3'�9l��rrio�
■ Complete items 1,2,and 3. 7Receive�d
j
® Print your name and address on the reverse ❑Agent
so that we can return the card to you. ❑Addressee
s Attach this card to the back of the mailpiece, B. y(Printed Name) C. Date of Deliveiv
or on the front if space permits.
1. .Ari D. Is delivery address different from item.i? ❑Yes
If YES,enter delivery address below: ❑No
1 SHERMAN, CARL F
666 OLD STAGE ROAD
C NTERVI LLE, MA 02632'
3. Service Type ❑priority Mail Express® 1
' �' / j I I Illlil ill)III I I II I i I I I III I I IIII I I I i I III El Adult❑Adult Signature Restricted Delivery ❑Register d Mal Restricted)
j 9590 9402 3759 8032 3744 63 5certifid Mal® Delivery
ertifid Mail Restricted Delivery `ll'�Retum Receipt for i
❑Collect on Delivery Merchandise !
?__Artir[A Numher_?ransfer-from-service_label) ❑Collect on Delivery Restricted Delivery El Signature ConfirrriationTm
lil O Signature Confirmation
7-015 1730 0001 4987 9422 lil Restricted Delivery Restricted Delivery
a 's . PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt
Barnstable
Town of Barnstable
Regulatory Services Department ;'e"aN j
BARN5fAB1F.
039. Public Health Division
200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Richard V.Scali,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
THIRD NOTICE
CERTIFIED MAIL#7015 1730 0001 4987 9422
November 27, 2018
SHERMAN, CARL F
1y'5'Y696.OLD STAGE ROAD
CENTERVILLE, MA 02632
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 457A Old Stage Road, Centerville, MA was inspected on
04/21/2018 by James D. Sears, certified Title V Septic Inspector for the State of
Massachusetts.
The inspection of the septic system showed that the system "Fails" under the guidelines
of 1995-TITLE V (310 CMR 15.00) due to the following:
• Backup of sewage into the house due to an overloaded or clogged SAS or
cesspool.
You are ordered to repair or replace the septic system within sixty (60) days from the
date you receive this notification.
Failure to repair/replace the septic system within the deadline period will result in future
enforcement action.
PER ORDER OF THE BOARD OF HEALTH �9
Thomas cKean,
Agent_of the Board of Health
Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\457 A Old Stage Road Centerville
Third Notice.doc
0
cO Certified Mail Fee ,..•-
Er '
$ t
Extra Services&Fees(check box,add fee as appropriate)
❑Return Receipt(hardcopy) $
C ❑Return Receipt(electronic) $ {f V Pia
C3 ❑Certified Mail Restricted Delivery $ 1 C>
p ❑Adult Signature Required $ �( f�
[]Adult Signature Restricted Delivery$
—
r- 9
� 1
s SHERMAN, CARL F
Ln
a 457A OLD STAGE RD
r- ` CENTERVILLE, MA 02632
Certified Mail service provides the following benefits:
■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail
■A unique identifier for your mailplece. 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 f-.
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 -D
First-Class Mail®,First-Class Package Service®, available at retail). _
or Priority Mail®service.`` Adult signature restricted delivery service,which
•Certified Mail service is notavaiiable for requires the signee to be at least 21 years of age,
international mail. and provides delivery to the addressee specified
■Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent-
with Certified Mail service.However,the purchase (not available at retail). 7
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
"Insurance
Priority Mail items. USPS postmark.If you would like-a postmark on
For an additional fee,and with a proper this Certified Mail receipt,please present your ,
endorsement on the mailplece,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 recipient's signature). of this label,affix it to the maiipiece,apply
1 You can request a hardcopy return receipt or an appropriate postage,and deposit the maiipiece.
electronic version.For a hardcopy return receipt, 1
complete PS Form 3811,Domestic Return
Receipt,•attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records.
Ps From,3800,April 2o16 fnevww)PSN 7530-02.000•aoa7
Town of Barnstable Barnstable
u4mmi
° �ck"Regulatory Services Department
saFvsrnst�
1
39. �' Public Health Division
i6 �0
200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Richard V.Scali,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
CERTIFIED MAIL#7015 1730 0001 4987 7404
April 30, 2018
SHERMAN, CARL F
457A OLD STAGE RD
CENTERVILLE, MA 02632
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 457A Old Stage Road, Centerville, MA was inspected on
04/21/2018 by James D. Sears, certified Title V Septic Inspector for the State of
Massachusetts.
The se inspection of the tics stem showed that the system stem "Fails" under the guidelines
p P y
of 1995 TITLE V (310 CMR 15.00) due to the following:
• Backup of sewage into the house due to an overloaded or clogged SAS or
cesspool.
You are ordered to repair or replace the septic system within sixty (60) days from the
date you receive this notification.
Failure to repair/replace the septic system within the deadline period will result in future
enforcement action.
o�
PER ORDER OF THE BOARD OF HEALTH '
omas McKean, R.S., CHO
Agent of the Board of Health
Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\457 A Old Stage Road
Centerville.doc
Town of Barnstable
BUMS Regulatory Services Department
Public Health Division
200 Main Street,Hyannis MA-02601
Offica: 508-862-4644 Richard SrA Director
FAX 508-79D-6304 Thomas A McKean,CHO
Feb 6,2007
Rev. 5111116
DEADLINES TO'REPAIR FAILED SYSTEMS
(Town Code §36044 and Title V: 310 CMR 15.000) _
'An`Y'marked in the ❑is the failure criteria and associated repair deadline
60 DAY DEADLINE CRITERIA -
❑Discharge or ponding of effluent to the surface of the ground
❑Pumping more than 4 times during the last year not due to clogged of obstructed
pipe. :.
ackup of sewage into the house dne to an overloaded or clogged SAS or cesspool
ONE(1)YEARDEADLINE CRITERIA• .
❑Static liquid level in the distribution box above outlet invert due to an overloaded or
clogged SAS or cesspool '
❑Any portion of the-SAS, cesspool, or privy below high groundwater elevation
❑Any portion of the cesspool within a Zone 1 to a public well
❑Any portion of a cesspool within 50 feet of a private water supply well with no
acceptable water quality analysis.(This system passes if the wafer analysis
indicates the well is free from pollution).
TWO (2)YEAR DEADLINE CRITERIA
q Single'Cesspool
❑Any"conditionally passed systems" (broken cover,relocation of a pipe,relocation
of a d-iveway due to H-10 components, etc) -
o Leaching pit or cesspool with high liquid level,<12"below inlet(per Town Code
§360-9.1)
❑Leaching facility with standing liquid level at or above the invert pipe (per Town
Code §360-20 h)
OTHE+R
Repair deadline:
Q;\SEPTIC\DEADUNES TO REPAIR FAILED SYSTEMS.doc
c Commonwealth of Massachusetts
p Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
457 A Old Stage Road
•V
Property Address Q
Estate of Carl F.Sherman '
Cwner Owner's Name
irformation is
required for every Centerville MA 02632 4-21-18 t :
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.
Important:When ng out forms A. General Information
clnl the computer, ,,,,,,° OFrA4,16.
use only the tab 1. Inspector: ��'• • 9�y�
key to move your �moo: G
cursor-do not ? JAMES
James D.Sears
use the return Name of Inspector — Qr:-A- Q
key. * *r
Jim The Inspector Man �,'•;oFT,� °:
Company Name rF"� S:IN.... �
P.O.Box 784 �n�nnnummta``�`�
Company Address
West Yarmouth MA 02673
Cityrrown State Zip Code
508-364-4398 S 1623
Telephone Number 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:
❑ Passes ❑ Conditionally Passes ® Fails
❑ Needs Further Evaluation by the Local Approving Authority
oaola,j-P,-,ja� 4-28-18
nspector's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority (Board
of Health or DEP) within 30 days of completing this inspection. If the system has a design flow of
10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate
regional office of the DEP. The original 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.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
W Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
s
457 A Old Stage Road
Property Address
Estate of Carl F.Sherman
Owner Owner's Name
information is required for every Centerville MA 02632 4-21-18
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
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:
Failed system. The system is two old block c pool's w/orange Burge pipeing. Note: Block's old
structural not sound.
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.
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 structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 2 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
u
457 A Old Stage Road
Property Address
Estate of Carl F.Sherman
Owner Owner's Name
information is required for every Centerville MA 02632 4-21-18
page. CityTTown 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 break out or high static water level in the distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y . ❑ N ❑ ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
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
t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17
r
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
457 A Old Stage Road
Property Address
Estate of Carl F.Sherman
Owner Owner's Name
information is required for every Centerville MA 02632 4-21-18
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
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:
**This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must
be attached to this form.
3. Other:
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 facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ❑ Static liquid level in the distribution box above 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
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
u a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
457 A Old Stage Road
Property Address
Estate of Carl F.Sherman
Owner Owner's Name
information is required for every Centerville MA 02632 4-21-18
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
® ❑ 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.
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
❑ ❑ 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
El El 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.
t5ins.doc•rev.6116 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
w 457 A Old Stage Road
Property Address
Estate of Carl F.Sherman
Owner Owner's Name
information is required for every Centerville MA 02632 4-21-18
page. Cityrrown 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
❑ ® Were any of the system components pumped out in the previous two weeks?
® ❑ Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
❑ ® 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?
iiZ ❑ Was the site inspected for signs of break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the manholes uncovered, opened, and the interior
inspected for the condition of the AIMMM tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
❑ ® Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System(SAS) on the site has
been determined based on:
❑ ® Existing information. For example, a plan at the Board of Health.
❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)1
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): NA Number of bedrooms (actual): 2
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
,a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
457 A Old Stage Road
Property Address
Estate of Carl F.Sherman
Owner Owner's Name
information is Centerville MA 02632 4-21-18
required for every
page. City/Town State Zip Code Date of Inspection
D. System Information
Description:
Two Block c pools w/orange burge pipeing.
Number of current residents: NA
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ® No
Seasonal use? ❑ Yes ® No
Water meter readings, if available last 2 ears usage d NA
9 ( Y 9 (gp ))�
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: Present
Date
Commercial/Industrial Flow Conditions:
Type of Establishment: '
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow (seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
l<F' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
F 457 A Old Stage Road
v
Property Address
Estate of Carl F.Sherman
Owner Owner's Name
information is required for every Centerville MA 02632 4-21-18
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
Source of information: NA
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
❑ Septic tank, distribution box, soil absorption system
® lcesspool
® Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
457 A Old Stage Road
Property Address
Estate of Carl F.Sherman
Owner Owner's Name
information is required for every Centerville MA 02632 4-21-18
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:
NA
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 2'feet
Material of construction:
® cast iron ❑ 40 PVC ® other(explain):
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
Pipeing is cast iron and orange burge. Note: Orange burge pipeing main pool to over flow ,Blocked
line and comeing apart- pipeing no good.
Septic Tank(locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions:
Sludge depth:
t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17
-- l
Commonwealth of Massachusetts
Title 5 Official Inspection Form
F5 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
457 A Old Stage Road
Property Address
Estate of Carl F.Sherman
Owner Owner's Name
information is required for every Centerville MA 02632 4-21-18
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank (cont.)
Distance from top of sludge to bottom of outlet tee or baffle
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
How were dimensions determined?
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Grease Trap (locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping:
Date
t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17
Commonwealth of Massachusetts
n Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
457 A Old Stage Road
Property Address
Estate of Carl F.Sherman
Owner Owner's Name
information is required for every Centerville MA 02632 4-21-18
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity:
gallons
Design Flow: gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
*Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
457 A Old Stage Road
Property Address
Estate of Carl F.Sherman
Owner Owner's Name
information is-equired for every Centerville MA 02632 4-21-18
oage. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box (if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert No Box
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.):
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No*
Alarms in working order: ❑ Yes ❑ No*
Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.):
* If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
i
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
457 A Old Stage Road
Property Address
Estate of Carl F.Sherman
Owner Owner's Name
information is required for every Centerville MA 02632 4-21-18
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
❑ leaching chambers number:
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
® overflow cesspool number: 1
❑ 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.):
Leaching is block 10' Deep w/small steel cover at grade. 2'water w/stain line at inlet. Note: Cover
not a good fit. Note: Old Block's structural not good.
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration 1
Depth —top of liquid to inlet invert 1'
Depth of solids layer
4"
Depth of scum layer 311
Dimensions of cesspool 8' Deep
Materials of construction Old Block
Indication of groundwater inflow ❑ Yes ® No
t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
457 A Old Stage Road
Property address
Estate of Carl F.Sherman
Cwner Owner's Name
information is required for every Centerville MA 02632 4-21-18
page. Citylrown 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.):
Main pool 8' deep- 16" below grade w/cover at grade. Pool at outlet level. No in Tee, Brocken outlet
sweep. Note: Block's are old structural not good.
Privy (locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
Commonwealth of Massachusetts
p' Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
457 A Old Stage Road
Property Address
Estate of Carl F.Sherman
Owner Owner's Name
information is required for every Centerville MA 02632 4-21-18
page. Cityrrown 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
I�R s M-f
�t o
� o
I �
54
MA11' 90011-
v""
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17
� I
c Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
457 A Old Stage Road
1_0 9
Property Address
Estate of Carl F.Sherman
Owner Owner's Name
information is required for every Centerville MA 02632 4-21-18
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check Slope
❑ Surface water
❑ Check cellar
❑ Shallow wells
12'+
Estimated depth ti fMigh ground water: feet
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from system design plans on record
If checked, date of design plan reviewed: Date
® Observed site(abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health - explain:
❑ Checked with local excavators, installers- (attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
Auger T.H. 12' no G.K. Bottom of over flow at 10' below grade. Bottom of over flow at 2'above
T.H. Depth.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17
I
c Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
457 A Old Stage Road
Property Address
Estate of Carl F.Sherman
Owner Owner's Name
information is required for every Centerville MA 02632 4-21-18
page. CityrTown State Zip Code Date of Inspection
E. Report Completeness Checklist
® 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
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
i
l5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
�flg ray Town of Barnstable
Regulatory Services
nnnxrisrna� Thomas F. Geiler, Director
MASS
Public Health Division
Thomas McKean, Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
January 11, 2007
Mr. Robert Jordan
Department of Social Services
500 Main Street
Hyannis, MA 02601
Re: 457A Old Stage Road, Centerville, MA
Dear Mr. Jordan:
The Barnstable Public Health Department is in receipt of complaints of the above mentioned
address concerning property owner, Carl F. Sherman's son, being Keith A. Sherman and his three
children residing in a camper on the Sherman property.
Health Inspector, Donna Miorandi has been to the property on December 11 and 27 of 2006 and
most recently on January 9, 2007. During these site visits it is obvious that people are living in
this trailer due to the illegal connection of blackwater waste emanating from the trailer via a PVC
pipe ,that terminates somewhere unknown on the property underground. In addition, there is a
hose for greywater waste (shower and kitchen sink) discharging directly to a five gallon bucket
on the ground which has overflowed to the ground surface. Both of these connections are
violations of the State of Massachusetts Title V regulations, 310 CMR 11.00— 17.00.
There are additional violations of the State Sanitary Code, 105 CMR 400.000.,one of which
includes temporary wiring. There is an extension cord going from the trailer across the ground
outside to the main house on the property. The other violation is 105 CMR 410.602 which
requires that the land shall be maintained in a safe and sanitary manner. There is much debris on
the property including old washing machines, old propane tanks, other scrap metal as well as old
toys, carriages and old grill. Mr. Carl F. Sherman, being the owner of the property has been sent
a warning notice to have the latter violation cleaned up by January 15, 2007.
These above stated conditions pose a concern for the children residing in the trailer on this
property. There are concerns of sewage violations, temporary wiring violations and possibly a
lack of adequate heat and natural ventilation (windows). The windows are all blocked from
ventilation by either sheeting or some form of aluminum covering.
Finally, under 105 CMR 410.430 of the State Sanitary Code no temporary housing may be used
except with the written permission of the board of health.
QAOrder letters\Sewage violations\457A Old Stage Road,Centerville.doc
This department is aware of the family's hardships but this letter is expressing our deep concern
for the health and safety of the children.
Please feel free to contact me directly if you need further assistance. Thank you for your time
and attention to this matter.
Sincerely,
Donna Z. Miorandi, S.
Health Inspector
Cc: Robin Giangregorio, Zoning Enforcement Officer
Lt. Martin McNeely, COMM Fire Department
Officer Mark Delaney, Barnstable Police Department
QAOrder letters\Sewage violations\457A Old Stage Road,Centerville.doc
{
I
J 010
I
Town of Barnstable
Regulatory Services
DARNSTAa.M Thomas F. Geiler, Director
MASS.
Public Health Division
Thomas McKean, Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
January 11, 2007
Mr. Robert Jordan
Department of Social Services
500 Main Street
Hyannis, MA 02601
Re: 457A Old Stage Road, Centerville,MA
Dear Mr. Jordan:
The Barnstable Public Health Department is in receipt of complaints of the above mentioned
address concerning property owner, Carl F. Sherman's son, being Keith A. Sherman and his three
children residing in a camper on the Sherman property.
Health Inspector, Donna Miorandi has been to the property on December 11 and 27 of 2006 and
most recently on January 9, 2007. During these site visits it is obvious that people are living in
this trailer due to the illegal connection of blackwater waste emanating from the trailer via a PVC
pipe ,that terminates somewhere unknown on the property underground. In addition, there is a
hose for greywater waste (shower and kitchen sink) discharging directly to a five gallon bucket
on the ground which has overflowed to the ground surface. Both of these connections are
violations of the State of Massachusetts Title V regulations, 310 CMR 11.00— 17.00.
There are additional violations of the State Sanitary Code, 105 CMR 400.000.,one of which
includes temporary wiring. There is an extension cord going from the trailer across the ground
outside to the main house on the property. The other violation is 105 CMR 410.602 which.
requires that the land shall be maintained in a safe and sanitary manner. There is much debris on
the property including old washing machines, old propane tanks, other scrap metal as well as old
toys, carriages and old grill. Mr. Carl F. Sherman, being the owner of the property has been sent
a warning notice to have the latter violation cleaned up by January 15, 2007.
These above stated conditions pose a concern for the children residing in the trailer on this
property. There are concerns of sewage violations, temporary wiring violations and possibly a
lack of adequate heat and natural ventilation (windows). The windows are all blocked from
ventilation by either sheeting or some form of aluminum covering.
Finally, under 105 CMR 410.430 of the State Sanitary Code no temporary housing may be used
except with the written permission of the board of health.
QAOrder letters\Sewage violations\457A Old Stage Road,Centerville.doc
This department is aware of the family's hardships but this letter is expressing our deep concern
for the health and safety of the children.
Please feel free to contact me directly if you need further assistance. Thank you for your time
and attention to this matter.
Sincerely,
Donna Z. Miorandi, S.
Health Inspector
Cc: Robin Giangregorio, Zoning Enforcement Officer
Lt. Martin McNeely, COMM Fire Department
Officer Mark Delaney, Barnstable Police Department
QAOrder letters\Sewage violations\457A Old Stage Road,Centerville.doc
i
�'T l Town of Barnstable
HE
Regulatory Services
Thomas F.Geiler,Director
BARNSTABM ' Building Division
y MASS.
1639• Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
January 10,2007
Mr.Robert Jordan
Cape&Islands Area Office
Dept.of Social Services
Hyannis,Ma
Re: 457A Old Stage Rd,Centerville,Ma
Dear Mr. Jordan:
This office was recently called to investigate a zoning complaint at the aforementioned address concerning
the property owner,Carl Sherman's son,Keith and his three young children residing in a camper on the
Sherman homestead.
Local Inspector Jeff Lauzon confirmed this arrangement with Keith Sherman sometime in Nov.2006.At
that time,the parties were advised to file for a temporary permit which would allow the occupation of the
trailer for twenty days under Zoning Code Chapter 240 Section 9(B). Mr. Sherman was to utilize that
timeframe to fmd other accommodations for his family.
After repeated attempts to get Mr. Sherman to cooperate,he remains noncompliant. Subsequently,a written
order was issued and on Jan.9,2007 a coordinated effort was made by the Barnstable Health, &Building
Divisions,COM Fire and the Barnstable Police Dept.to personally contact Mr. Sherman and assess the
situation.Although,it appeared that someone was home,no one responded to our attempts to communicate.
We are very aware of the sad circumstances leading up to this arrangement. Be assured that our staff has
afforded the Shermans every opportunity to correct the violation. You must,however recognize that we
lack the discretion to permit this use,as clearly the habitation of a trailer by nonpaying guests is limited to
twenty days and clearly the occupation far exceeded that limit,with or without a permit.Although we are
reluctant to impose an additional hardship on the Sherman family,we have no alternative but to enforce the
ordinance.Violations may result in citations of$100.00 per day.
Please feel free to contact me directly should you require clarification.
erely,
Robin C.Giangregorio
Zoning Enforcement Officer
Cc:Donna Miorandi,Health. er
Martin MacNeely,FP Officer,COM Fire
Officer Mark Delaney,BPD
JAComplaint Inv Reportsk157A Old Stage DSS Letter.doc
k
°FTME ta,, Town of Barnstable
ti
Regulatory Services
* snxcvsTABLE, * -
Musa �, Thomas F.Geiler,Director
i6gg. ♦�
Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
December 11, 2006
Carl Sherman
457A Old Stage Rd.
Centerville, MA 02632
RE: 457 Old Stage Rd., Centerville,Map : 190 Parcel : 064
Dear Mr. Sherman:
This letter shall serve as notice that you are currently in violation of the Zoning Ordinance
of the Town of Barnstable Section 240-9B. As you may recall, last month this office did
inform you of the violation and what needed to be done to resolve the problem. To date,
this office has seen no attempt on your part to resolve the violation. You are hereby
notified that you have until December 18, 2006 to comply or a ticket in the amount of
$300.00 will be levied against you for each day the violation continues.
Please call (508) 862-4034 with any questions. Thank you for your anticipated
cooperation.
By Order,
de 7auzon
Local Inspector
Q:zoning5
_..-.w...�- ,arm.--.,.r,;....,t..•.,.,-,...,,,r,,---*r-+S.�Y+.^..s-^Yyr.-�+s-,-,.mow•^-^-�'y-•`•rs;=tr �.,t.�^.... .r;�ss �;rn+�-';-�+.*,xr-mr*�--:.-„-�..n,...-�^-a„r..,.�,..F+�.^^-.-.^.<-e�..n��t_-........-,�. ,-,.,-:
TOWN OF BARNSTABLE BAR-W 349
Ordinance or Regulation
WARNING NOTICE
Name of Offender/Manager ,
Address of Offender J-7� Vl; My/MB Reg.#
Village/State/Zip f' } t .r (, '. - '
Business Name �- j m/pm oar/i/0� 1,4 �204
Business Address ,a, r ✓ ,r� /p t�' r#t./ ,
Signature o nforcing Officer
Village/State/Zip E
Location of Offense �Y///ex/
/� �y� 'W �"'Enfor'cfi�ng Dept'/Di/vision
Offense ()1A1�1� t' �1 ff G. C_. 'L� t � ! 1IL
Facts �� Ldll r r ....h"M r1i 7,4 -P k-7: :r7rk/77 JrIl �f 0L
f ' -
( 'Iloollw, v r11k-----
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.
WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT.
._ „-_....T2--r; -_- �- ^ter.-a- ,m ...«-,. =w�.T'r e*- sa. .e=,..._.......«,r--�-r-'^t----.-.+ems.•+ ,.�.r�-,.:-r+.--.t:..Yr^:--+...-..-�-, s...�..-.:�....-..�:.
TOWN OF BARNSTABLE BAR-W4 '-
Ordinance or Regulation
WARNING NOTICE
qraA
Name of Offender/Manager +. f #
L�f'7
Address of Offender g
r
Village/State/Zip t �i �� rr� ? ' _.`'' - '
w
V
Business Name - . /`pm., ono . 0
.14 f
Business Address 1 r"
Signature of.,`Enforcing Officer
Village/State/Zip
Location of Offense ,
Enforcing Dept/Division
0 f f e n s e �.1�t�� '��a ���{,+r�' j j/j@".� .`_j`fJ'• '°• {y�,� � �j{f, (j`�-• ,�, fr frj} �
Facts /'`l:. l; `t,I f if •,' j/ ' �+ /..� J �
+ y / r
ivA
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.
WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT.
TOWN OF BARNSTABLE 4�&
Health Division— 200 Main Street - Hyannis, MA 02601
g4HE l
�P O
Date:
-V`AX
BARNSTABLE,
mass• Number of pages inclu ing cover sheet: a
To From: SHARON CROCKER
I
t (3 Town of Barnstable
Health Division
Mail to: 200 Main Street
Phone: Hyannis,MA 02601
Fax honer ,Fax 1-508-862-4644
Fax phone: 1-508-790-6304
REMARKS: ❑ Urgent ❑ For your review ❑ Reply ASAP ❑ Please comment
'
P. 1
COMMUNICATION RESULT REPORT ( DEC. 8.2006 3:38PM )
` TTI BARNSTABLE BOARD OF HEALTH
FILE MODE OPTION ADDRESS (GROUP) RESULT PAGE
755 MEMORY TX 915089476557 OK P. 2/2
----------------------------------------------------------------------------------------------------
REASON FOR ERROR
E-1) HANG UP OR LINE FAIL E-2) BUSY
E-3) NO ANSWER E-4) NO FACSIMILE CONNECTION
Citizen Web Request t (-S' Page 1 of 3
Citizen Request Management
' Request ID; 20506 Created; 10/27/2006 9:56:56 A
Stanton, David
Status: Closed Assigned To: Heap Office
.�i
�
o Chapter II : Housing; Anonymous: Yes Category;
Substandard
E,C. Date: 10/31/2006
j Created By: Fontaine,Tina
Health Office
Time Worked: 2.00 Response Time: 7.00
Requestor Details:
.Email:
Request Location:
457 OLD STAGE ROAD
Centerville, Ma 02632
Parcel Number: Map: 190 Block: 064 Lot: 000
Citizen Web Request Page 2 of 3
if there is a no trespassing sign present at the property, however anything observed during the
visit on the property cannot be used as evidence, unless the owner grants permission to look
around the property. The only evidence that may be used is that which can be observed from a
location offsite. However, the Police Department said the Town Attorney would have to agree wit
his policy for other Town Departments. We still have not heard back from the Town Attorney as t
whether or not this policy is acceptable.) We went to the home of camper #1 (471 Old Stage
Road) No one appeared to be home at said location. We then went to the home of camper #2
(463 Old Stage Road) and again, no one home. We then looked in the Conservation field, but did
not observe any campers there. A truck then pulled onto the dirt road and went to 471 Old Stage
Road. We then went and spoke with him. From there, we went to another location, the site of
camper #3 (457 Old Stage Road) We went to the home at 457 Old Stage Road and spoke with
the owner of the house. We explained we received a complaint about sewage coming out of the
trailer onto the ground. He said that it was not true. DS asked if we could take a look, and he
agreed. He walked us over to the location and showed us that the trailers waste discharges into
his septic system, which DS observed. The owner wanted to know who complained, but we told
him we cannot divulge a complainants name by law. Other department will be notified of the
complaint that may have violations at said property.
Entered on 10/31/2006 10:28:00 AM
No further action required by Health.
Internal Note History:
System entry on 10/27/2006 9:56:06 AM:
Assigned to Stanton, David
Entered on 10/31/2006 9:19:50 AM
Last modified on 10/31/2006 9:59:46 AM
System entry on 10/31/2006 10:00:33 AM:
-Please Review- email sent to Giangregorio, Robin
Entered on 10/31/2006 10:28:00 AM
DS called DSS on 10/31/06 @ 10:15 AM and gave as much information on the case as he has
DSS's number is (508) 760-0200.
System entry on 10/31/2006 10:28:12 AM:
-Please Review- email sent to O'Connell, Timothy
System entry on 10/31/2006 10:28:26 AM:
Request Closed
http://issgl/lntemalwrs/WRequestPrint.aspx?ID=20506 12/8/2006
Citizen Web Request Page 1 of 3
57 '7
"S LV,f 3
Citizen Request Management
Request ID: 20506 Created: 10/27/2006 9:56:56 A
Stanton, David
Status: Closed Assigned To:
� Health Office
Anonymous: Yes Category: Chapter II : Housing
Substandard
E.C. Date: 10/31/2006
Created By: Fontaine, Tina
Health Office
Time Worked: 2.00 Response Time: 7.00
e
Requestor Details:
Ae}-
Email:
Request Location:
457 OLD STAGE ROAD
Centerville, Ma 02632
Parcel Number: Map: 190 Block: 064 Lot: 000
Request:
they are living in a camper at this properly and dumping the sewage straight into the
ground. Sewage is all over the place.
Request Work History:
Entered on 10/31/2006 9:19:50 AM
DS updated the request location with the correct address. The original location given to the
Health Division was 473 Old Stage Road, which does not exist.
Entered on 10/31/2006 9:46:14 AM
Last modified on 10/31/2006 9:56:35 AM
On 10/30/06 @ 10:00 AM DS and TO went to general area of complaint, as there is no
property in Town numbered 473 Old Stage Road, Centerville. We drove down the dirt road that
said private property, no trespassing. We did pass on to the property even though it may not be
approved by the Town Attorney (According to the Police Dept. training a while back, the Police
Department feels that it is OK for Town Employees to go onto a property for official business eves
http://issgl/intemalwrs/WRequestPn*nt.aspx?ID=20506 12/8/2006
s � �
._
..�,
�.
��� � i ; �,I� �
� —/ .�
r a
/ � .
L� u
i �
1
1 �, �' ci
i,
, \
� • ' / �
/ /
i � �. � ,
_ i � � _
`_ /, , -
� �
1 � _�.
�,, � �
'� - - „� /
� � �i � � /
t _ , .- .
� �
0
` E '
1
c
# R a
I
L �
,�-
r
. A ,
}y �
� ���A � � � � • � � r� � � � � � � �