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HomeMy WebLinkAbout0040 ACRE HILL ROAD - Health 40 Acre Hill Road„ �arns��o[e. A 3 x. v a I COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3. A. Sig ■ Print your name and address on the reverse x''' ' Agent ` so that we can return the card to you. ❑Addressee ■ Attach this card to the back of the mailpiece, B• teceive4.by(Printe Name) ate of elive or on the front if space permits. D.is delivery address different from item 12 ❑Yes If YES,enter delivery address below: p No Donald Prouty I 40 Acre-Hill Road. Barnstal�Sl'e, MA 02630` II�IIII'II'IIIIIII II IIIIIII III I IitIIII'II'I III 3, Service Type ❑Priority Mail Express® ❑Adult Signature ❑Regiegistered MaiIT"' ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted El Certified Mail@ 9590 9403 0424 5163 7488 92 ❑Certified Mail Restricted Delivery ❑Return Receiptfor ❑Collect on Delivery Merchandise ti -— ❑Collect on Delivery Restricted Delivery ❑Signature Confirmationlm '014'1200 0001 0358 3537 ❑Insured Mail ❑Signature Confirmation ❑Insured Mail Restricted Delivery Restricted Delivery over$500) Form 3811,April 2015 PSN 7530-02-000-9053 10 Domestic Return Receipt UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 I I ' Sender: Please print your name, address, and ZIP+4®in this box' 9 Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 I s USPS TRACKING# iln I 9590 9403 .U424 5163 488 92 Certified Mail: 7014 1200 0001 0358 3537 Town of Barnstable Regulatory Services naxxsrABLE Ricahard Scali, Director 'v MAC. Public Health Division t63q. �0 �fD MP't A Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 `October 13, 2015 Donald Prouty 40.Acre Hill Road Barnstable, MA 02630 NOTICE TO ABATE VIOLATIONS OF TOWN OF BARNSTABLE CODE The property owned by you, located at 40 Acre Hill Road, Barnstable, MA was inspected on October 9, 2015, by Timothy B. O'Connell, R.S., Health Inspector for the Town of Barnstable, because of a complaint. The following violation of the Town of Barnstable Board Code was obse ed: § 353-1 Responsibilities of Owners: 1 , Observed large brush pile located on the Eastern side of property. You are directed to remove the brush from your property and dispose of it properly within (30) thirty days of your receipt of this notice. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Please be advised that failure to comply with an order will result in a fine of $100.00. Each day's failure to comply with an order shall constitute a separate violation. r PER ORDER OF THE BOARD OF HEALTH �mas McKean, CHO, RS Director of Public Health- Town of Barnstable Q:\Order letters\Refuse\945 rt 149.doc '-:Citizen Web Request Page 1 of 3 1AA5% < .. ..Logged A TOWN\ coon Citizen Request Management . Friday, October 92015 TOWN\ocannelt Route to Users Search Reauests Create Requests Request Information Request ID: 54337 Created: 10/9/2015 9:48:02 AM Status: Assigned To Staff Assigned To: O'Connell,Timothy Health Office Anonymous: Yes Request Category: Chapter II : Housing Substandard edit Routine work: No Estimate: No edit Date scheduled: edit Estimated 10/26/2015 Change Estimated Sep October 2015 Nov Completion Completion Date: Date: Sun Mon Tue Wed Thu Fri Sat 27 28 29 30 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 16 17 Created By: Sousa,Vanessa Priority: Medium edit Health Office Citation Numbers: edit A ILL Se.,J —�LX Requestor Information Requestor ! (� equest DETAILS: © 1OCATION: 40 ACRE HILL ROAD Barnstable, Ma 02630 Request Parcel Number Anonymous caller reports an Map: 298 Block: 13,!Lot: 000 ry infestation of rats being seen by day. Terminex says source of problem is Parcel Lookup coming from property. Says there is a. 10-12 foot brush pile, not easily seen, on side of garage. Describes yard as a "dump." Email: Edit Reauestor Information http://issgl2/intemalwrs/WRequest.aspx?ID=54337 10/9/2015 K citizen Web Request Page 2 of 3 Track Request Progress •Request Work History: Internal Note History: Entered on 10/9/2015 9:48:02 AM by Sousa,Vanessa Last modified on 10/9/2015 9:51:22 AM (H) 508-362-2882 (C) 508-246-3047 Says can view brush if walk in front of property #32, Look out to land, and to the left is brush. As we were on phone she put an orange cone in front of brush to guide inspector of pile. System entry on 10/9/2015 9:48:02 AM: Assigned to O'Connell,Timothy Enter work progress: Enter internal.note: (Viewed by everybody) (Viewed internally only) V _ i „N ,t4 Xl} Rn p� Spell Check SpellCheck Add document or image link: _( `Browse .. * You can also type in a folder name to see everything in the folder Current Links: Time worked on request: I2 Response time: 0 *Time entries are in hours. Examples of time entries: 1.25, 0.5, 0.75, 1, 3.5, 0.25, 0.10 * Response time: Measured from the creation date to your first actions on the request. * Do not include nights, weekends, and holidays in response time for most departments. r; Save changes r Check to notify town employee below to review this request. C Save changes and notify Health Office IC= citizen* ---_____.._ Crocker, Sharon i� C. Close request _.._ .___ha_..____ ___ Brief message to reviewer: C Close request and notify citizen* http://issgl2/internalwrs/WRequest.aspx?ID=54337 10/9/2015 r 1h/13/20-16 Health Master Detail G a - i�sa�uti lrrX;11 Logged in As: TOb' N\health Health Master Detail Tuesday, October 13 2015 AQolication Center Parcel Lookup Selection Items j Parcel Septic Perc I Well Fuel Tank Parcel: 298-113 Location: 40 ACRE HILL ROAD, BARNSTABLE Owner: PROUTY, DONALD N & KATHLEEN Business name: Business phone. ........... -------------—- -- Rental property: Deed restricted. Q Number of bedrooms : 0 Contaminant released: ❑ Fuel storage tank permit: Q FSa� Parcel Changes] Return to Lookup Parcel Info Parcel ID: 298-113 Developer lot:LOT 19 Location:40 ACRE HILL ROAD Primary frontage: 131 Secondary road: Secondary frontage: Village: BARNSTABLE Fire district:BARNSTABLE Town sewer exists at this address: No Road index:0005 Asbuilt Septic Scan: 298113 1 Interactive mapR!, ,A. GP (Groundwater Protection Overlay Town zone of contribution District) State zone of contribution:OUT Owner Info owner: PROUTY, DONALD N & KATHLEEN Co-Owner: ROUTY,.DO'NALD N w Streets: PROUTY FAMILY TRUST OF 2015 Street2:40 ACRE HILL RD city:BARNSTABLE state:MA zip: 02630 Country: Deed date: 5/31/1996 Deed reference: 10229/272 Land Info Acres: 1.02 use: Single Fam MDL-01 Zoning:RF-1 Neighborhood: 0106 Topography: Level Road:Paved Utilities:Septic,Gas,Public Water Location:Rear Location Construction Info Building No Year BuilC Gross AreaLiving Area Bedrooms Bathrooms 1 1978 II4132 2164 2 Bedrooms0 Full-0 Half 1 2010 14132 2164 0 Full-0 Half Buildings value:$155,600.00 Extra features: $51,700.00 Land value: $127,400.00 http:/fiissq 12/i ntranet/healthM aster/H ealthM asterDetai I.asp)OlD=298113 1/1 +r AV K T .: v R i ci 7 Off pl t t rf i ::•y r ....1 i r f 1�.,� A, l iy �+.p"L •�af�"S a �• 3�."`• + '' � !� 4� r. o-ta¢,r- r cr t Xc c J:..5;, '3° �tl} C. tr Y P �•- s• 4 tr rr. ,. 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Ml NV � L� 3063 R O t\....� EXP. DDINING '�l 3'66IB' C. 9�8 T6k8' EXISTING ATTIC STAIRS W - I Cti CENTEREDO WALL ...., W yy Q i MIIrA) .�. Cl Ll R N TO BE NEW KITCHEN I @ BY OTHERS 3'CASED OPENING . V-0UT TO BE : h DETERMINED • . li .. `�� .' CENTERED ON WALL r y$ yy p@p R ''�k� .. NEW COVERED PORCH - . STONE 5 ON WALLCENTERED t 4' SS FRENCH DOORS CENTERED ON WALL - - s1E . . 'FOR NEW FAMILY ROOM: . 5 I ...FRENCH _ - rr�� INSWING � "• TCq DOORS...... . kjj r Y• jMiD42x2W/DOUBLE D . POCKET CENTERED ON WALL si datc: �E€E Page 7 of 1 o - - Lr Y. .i..�,. ,.,t5, t� €. ., V y, ILING S R - 21t10 LINO 31B'OC : 'o ROOM EXTENDED DINING 8 6ATH - N Fr1� C I to Lo CD OUfLOOKERS/ ..MtTS TO Br DETERMINED . HANG ROOF t - �. �i x as I -•_ I i .. i t CEILING JOISTS 19'OC®PORCH ��RRu - "'BBB CCC I 1 1 CEILING JOIST 16-OC®190- ' FROM FINISH FLOOR. f E I Al O j.. ti date scale: Page 8 Of 10 - ;t. L •t �1.�5 Y� a}�- � #�.&'�'ii'ka!' ql k} o � . i E VER-FRAME C NEW BAY i M . 1 f/ .. •�'... Y!' 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TVP.FOUNDATION DETAILS: LI G RUCTION: y -10'xB'MIN.FOOTINGS®ALL -SISTER EXISTING 20 CEILING JOISTS O NEW FOUNDAT10WROST ERE NEEDED - ti f ' _ "•ALL STRUCTURAL BEAMS/ ACO MIN.4'BELOW GRADE {+,/B'10'ANCHOR BOLTS FRAMING TO BE DONE BY OTHERS"' S �.. r INSTALL 2x LEDGER WHERE NEEDED - (J11.T xior PLATE WASHERS _1x3 STRAPPING 18'OC - >L: SPACED 3V OC MAX. -1/2'GYPSUM W/SKIM COAT PLASTER ' I� r 2xS PLATE 0 ALL - •mm RPENDIOCULAR BL FROM END .lu .. .. FGINSULATION IN FROM V -ADD Vr RIGID INSUL. SLOPED — . CEILING OF NEW FAMILY RM. '.'Nr FOUNDATION TO FRAME �\ fr�i� .. _ CONNECTIONS k : co 11( . ./ TYP.FL OR FRAMING: ALL STRUCTURAL BEAMS/ P.ROO NS TI POSTS OS O 1 ED0OTHERSBV OTHERS•^ -SISTER EXISTING w RAFTERS JOISTS Q EX TIN MAIN HOUSE MERE NEEDED NEW G-PERPENDICULAR 4'R BLOCKING� ALL STRUCTURAL BEAMS/ - L NEW GABLES 4'OC 2 SAYS IN FROM FRAMING TO BE DONE'BY.O-,HERS W .. END. NEW 2.10 RAFTERS 10'OC — P` SW'SUBFLOOR GLUED _ 12'SHEATHING(PATCH EXISTING LDS ROOF WHERE NEEDED) PERPENDICULARBLOCKING®NEW ¢ GABLES C OC 2 BAYS IN FROM END - ICE WATER'0 EAVES&VALLEYS :.... - -,:.....:._ ......_.,:,._...... _, _.,_ ,...m _ .. .. ALL ACC HURRICANE TIENE NEW ASHP TSHINGLES -. (REPLACE EXISTING) ATT.. RAFTER TO PLATE CONNECTIONS W . .. - INSTALL RIDGE STRAPS®ALL NEW .F � RAFTER TO RIDGE CONNECTIONS 77 (RAFTER TO RAFTER OVER RIDGE) TYP. CONSTRUCTION: a -SINGLE 2x4 BOTTOM PLATE . . 2x4 STUDS IS-OC(MATCH - T EXISTING CEILING HEIGHT) 6 V.. -DOUBLE TOP PLATE .-_..__ ....... __.._. ......_._..._._... _.... _ .......... .. 1IC COX SHEATHING �. a_ .3 FG INSULATION - 'T R'YPA HOUSE WRAP TAPED - >�. SEAMS ���eQeQnnTT1 R. .4i NEW ADDITKIN - - - 124 RC CLAPBOARDS®FROM k �' ?+! ADDITION(MATCH EXPOSURE OF yB O _ -WC SHINGLES @ REAR ADDITIONS PAT EXISTING EXPOSURE) CH WHERE NEEDED - 12'GYPSUM®INTERIOR W/SKIM d COAT PIASTER +o� >� . 4 N., -�L Lf3lo 1 1 . m ! b � to NEW PORCH f8 (p LIZS�I.NG FAMILY RM/OFFICE:GATIONA30 4YI g:IN T sc4k: T;k 10'SONOTUBE9 W21' 10'SONOTUBES W,2 )p s Page 10 of 10 , , 7._. _ .. �V...,.'t.. ..i,1.,.. .aF";� :'1�..�..:t..�. .,_..':t....,z3.�?_. y +f 000 0' 10 zll \ , \� G t - Eck LOT 18 ; LOT 13 •. h`OTE. IT :a l'Pf.:-lf:s ;VE ACCF S DIr'/Vfs'wA}` CIrCISSE LAND OF 0'1'HEfiS' RES. ZONE 'RFI This MORTGAGE INSPECTION' '2r is For �L00D ZONF,. ,.0 Bank Use Onl , TOWN: _Jh1ti:sT �G ____ REGISTRY OWNER- MA Y F__CASSEh'LY'__ DEED REF 1��1J 4y `�J _ = -- -- - - DATE 3t+I 1 D_1 P ��) }'-- -- - 1'ER - :AN RFF� 1 1 � L 1 — 50 i' d i HEREBY CERTIFY TO . :JJ 1&h1'� 4I0�,'L!JGL _THAT .THE BUILDING SHO'ATI ON THIS P1,AN IS LOCATED ON THE GROUND AS V'/ '� �_�.�L `�N]\ ,I SHOWN AND THAT ITS POSITION DOES ___ GONFOi;M A. t .;y CO CIS U LTA N l TO_THE ZONING LAW SETBACK REQUIREMENTS OF THE 40I3 INDUSTRY ROAD TOWN�OF. DAI?NST4BLE ___ -__AND THAT � "fc. 3�U b �,, A; IT DOES�_! OT _ LIE' WITHIN THE SPF,CIAL—FLOOD MARSTONS MILLS, MA O�fi48 HAZARD �r TEL. 428-00 AREA AS SHOWN ON THE H U.D. MAP DATE:;i?_f�: �_ FAX: �l_'0- 555", ` e l{ii it t' .} � :` � ..<::.. I'I:t� Ivry 1s AItE h l�C5 t1M ! . f�lJA9 ;..:; Lllarllt.y, NOT O BE. t gEb VOR WiNetti. V M Rfcf Commonwealth of Massachusetts q y Executive of E nvironmental Af f airs �. l �� 96 i DEP Department of Environmental Protection SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 40 Acre H ill R oad. B arnstable, M a. Address of Owner: Mary Casserly (if different) 63 Poplar Street. Bangor Me 04401 Date of Inspection: 04/30/96 Name of Inspector: Michael DeDecko Company Name, Address-and Telephone number: Atlantic Environmental P.o Box 2384 - M ashpee Ma 02649. Tel : (508) 4771420 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection . The inspection was performed based.on my training and experience in the proper function and maintenance of on site sewage disposal systems. The system -X-- Passes ---- Conditionally Passes ---- Needs further evaluation by the local Approving Authority ---- Fails Inspectors Signature: y Date: 05/01/96 The system Inspecto all s bmit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office or the Department of Environmental Protection. The original should be sent to the system owner and copy sent to the buyer, if applicable and the approving authority. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 40 Acre Hill Road. Barnstable Ma. Owners: Mary Casserly Date of Inspection : 04/30196 INSPECTION SUMMARY: Check A, B, C,or D A)SYSTEM PASSES: --x-- I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CM 15.303. Any failure criteria not evaluated are indicated below B)SYSTEM CONDITIONALLY PASSES: ---- One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair, passes inspection. .Indicate yes, no, or not determinate (Y,N,or ND). Describe basis of determination in all instances. If "not determinated", explain why not. ---- The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or exfiltration , or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. ---- Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. The system will pass inspection if (with approval of the Board of Health). ----- broken pipe(s) are replaced ----- obstruction is removed ----- distribution box is levelled or replaced ---- The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if (with approval of the Board of Health): ----- broken pipe(s) are replaced ----- obstruction is removed 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address : 40 Acre H ill R oad, B arnstable M a. Owner : Mary Casserly Date of Inspection : 04/30/96 C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: ---- Conditions exist which require further evaluation by the Board of Health in order to de- termine if the system is failing to protect the public health , safety and the environ- ment. 11 SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETYAND THE ENVIRONMENT: ---- Cesspool or privy is within 50 feet of a surface of water ---- Cesspool or privy is within 50 feet of a bordering vegetated wetland or a small marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNC- TIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT. ---- The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. ---- The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well ---- The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. ---- The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analy- sis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate notrogen is equal to or less than 5 ppm. D) SYSTEM FAILS: -- I have determined that the system violates one or more of the following failure criteria as defined in 310 CM 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to cor- rect the failure. --- Backup of sewage into facility or system component due to an overloaded or or clogged SAS or cesspool. 3 . SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 40 Acre Hill Road. Barnstable Ma Owner: Mary Casserly Date of Inspection : 04/30/96 D) SYSTEM FAILS (continued) -- 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 over- loaded or clogged SAS or cesspool. --- Liquid depth in cesspool is less than 6" below invert or available volume is less than 1 l2 day flow. --- Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). number of times pumped --- Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. --- Any portion of cesspool or privy is within 100 feet of a surface water supply ortributary to a surface water supply. ---Any portion of a cesspool or privy is within a Zone I of a public well. --- Any portion of a cesspool or privy is within 50 feet 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 ana- lysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 40Acre Hill Road. Barnstable Ma Owner: Mary Casserly Date of Inspection : 04/30/96 E) LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above : The design flown of system is 10,000 gpd or greater Large System and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist : --- the system is within 400 feet of a surface drinking water supply --- the system is within 200 feet of a tributary to a surface drinking water supply --- the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area - IWPA) or a mapped Zone 11 of a public water supply well. The owner or operator of any such system shall bring the system and facility into full compli- ance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please, consult the local regional office of the Department for further information. f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 40 Acre H ill R oad. B arnstable M a. Owner: Mary Casserly Date of Inspection: 04130/96 Check if the following have been done : -x Pumping information was requested of the owner , occupant and Board of . Health. -x None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during the period. Large volumes of water have not been introduced into the system recently or as part of this inspection. --x As built plans have been obtained and examined. Note if they are not available with N/A. --x The facility or dwelling was inspected for signs of sewage back-up. --x The system does not receive non-sanitary or industrial waste flow. --x The site was inspected for signs of breakout. -x All system components, excluding the Soil Absorption System, have been located on the site. ---x The septic tank manholes were uncovered, opened and the interior of the sep- tic tank was inspected for conditions of baffles or tees, material of construc- tion, dimensions, depth of liquid, depth of sludge, depth of scum. ---x The size and location of the S oil Absorption System on the site has been deter- mined based on existing information or approximated by non-intrusive methods -x The facility owners and occupants if different from owner were provided with information on the proper maintenance of Subsurface Disposal System. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 40 Acre Hill Road. Barnstable Ma. Owner: Mary Casserly Date of Inspection: 04/30/96 RESIDENTIAL: Design flow : 330 gallons Number of bedrooms : 03 Number of current residents: o Garbage grinder (yes or no) : 00 Laundry connected to system (yes or no):�eS Seasonal use (yes or no) : No Water meter readings, if available: N`A Last date of occupancy : i9yy COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow : gallons/day Grease trap present: (yes or no) Industrial waste holding tank present (yes or no) : Non-sanitary waste discharged to the Title 5 system (yes or no) : Water meter readings, if available : Last date of occupancy : Other: (Describe) ............................................................................................................ Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information : �gsT.�,scn...nl�.�ntc��.:oQ..�..�b���,.s..(3� da.�..� laoe�nr��•� System pumped as part of inspection (yes or no) ........... if yes, volume pomped : .................... gallons Reasonfor pumping :...............................................:............................................................ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 40 Acre H ill R oad. B arnstable M a. Owner: Mary Casserly Date of inspection: 04/30/96 TYPE OF SYSTEM X Septic tank/distribution box/soil absorption system --- Single cesspool --- Overflow cesspool -- Privy --- Shared system (yes or no) (if yes, attach previous inspection records, if any) --- Other (explain)........................................................................................... APPROXIMATE AGE of all components, date installed (if known) and source of information �Qp0X.IAlo t..h4 t-'a...�ryn� ........................................................... ................................................................................................................................................. Sewage odors detected when arriving at the sle : (yes or no)...u.�?... SEPTIC TANK : .. �s..... (locate on site plan Depth below grade: .. Material of construction: ...k concrete ......... metal ........ FR P ........ other (explain) ................................................................................................................................................ Dimensions: S w o L a 5 a�. Sludge depth :.. ........ Distance from top of sludge to bottom of outlet tee or baffle:.....3.y................:... Scum thickness :...a..'`............ Distance from top of scum to top of outlet tee or baffle: ...;....... ;�........................ Distance from bottom of scum to bottom of outlet tee or baffle :...ky:�............... Comments : (recommendation for pumping , condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.)...................... ..... %'.4.... .WTV. --.... SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 40 Acre Hill R oad. B arnstable M a. Owner: Mary Casserly Date of inspection: 04/30/96 GREASE TRAP : ...... (locate on site plan) Depth below grade: ............... Material of construction: ........concrete.........metal........FRP........other(explain).... ............................................................................................................................................ Dimensions:............................... Scum thickness:........................ Distance from top of scum to top of outlet tee or baffle:....................................... Distance from bottom scum to bottom of outlet tee or baffle:............ .................. Comments: (Recommendation for pumping condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.)........................ ................................................................................................................................................ ................................................................................................................................................ TIGHT OR HOLDING TANKS:...Q.a... (locate on site plan) Depth below grade:............... Material of construction:........concrete........metal.........FR P......... other (explain).......... ................................................................................................................................................ Dimensions:............................ Capacity:....................gallons Design flow:...............gallons/day Alarm level:............................. Comments: (condition of inlet tee, condition of alarm and float switches, etc.) . ....................................:........................................................................................................... ................................................................................................................................................ 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 40 Acre H ill R oad. B arnstable M a. Owner: Mary Casserly Date of inspection: 04/30/96 DISTRIBUTION BOX:.. .5. (locate on site plan) Depth of liquid level above outlet invert:..C".. .�d4 �l vat1 w az,�k�s� Comment: (note if level and distribution equal evidence of solids carryover, evidence of leakage into or out of bpx etc .7D.-%Qk.. 'sv. �, . ... �.....�� . PUMP CHAMBER::...h::4 . (locate on the site) Pumps in working order: (yes or no)............... Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.).................... ................................................................................................................................................. . ................................................................................................................................................ SOIL ABSORPTION SYSTEM (SAS):....:� 5...... (locate on site plan, if possible; excavation not required, but may be approximated by non- intrusive methods) if not determined to be present, explain: ................................................................................................................................................ ................................................................................................................................................ Type: leaching pits, number: ...l.l leaching chambers,number:........ leaching galleries, number:........... leaching trenches, number ,length:...... leaching fields, number, dimensions:................... overflow cesspool, number:.......... Comments: (note condition of soil, signs.of hydraulic failure, level of ponding, condition of vegetation, etc ) Cim �. ..p. -...��r �.,..1LC:` r-..� i'^�rr� ,... sz`rr. .a.....R: >....ci,�.GrEy�� C � Wit , SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property address: 40 Acre H ill R oad. B arnstable M a. Owner: Mary Casserly Date of inspection: 04/30/96 CESSPOOLS:....��.... (locate on site plan) Number and configuration: .................................... Depth-top of liquid to inlet invert: ........................... Depth of solids layer: ............................................... Depth of scum layer: ............................................... Dimensions of cesspool: ...................... Materials of construction: ..................... Indicator of ground water: .................... inflow (cesspool must be pumped as part of inspection) ................................................................................................. Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) ................................................................................................................................................ ................................................................................................................................................. PRIVY : .... C�... (locate on the site) Material of construction: ................................... Dimensions: ...................... Depth of solids: ................ Comments: (note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.) . ................................................................................................................................................ ................................................................................................................................................ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address : 40 Acre Hill Road. Barnstable Ma. Owner: Mary Casserly Date of inspection: 04/30/96 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate at wells within 100'. I_ kb -----, SIN"0VA � f � a A3 �3 cal A �t S Oy DEPTH TO GROUNDWATER: Depth to groundwater: a .feet Method of determination or approximative: W�\ .. rL..`:.e'C'�. . ...a:4.`................................................................. ........................................ .t�9 TOW F B RNSTAI3LE LOCATION �- c _ '. r �c f-d- SEWAGE # VILLAGE�2 -c`2�� ASSESSOR'S MAP & LOT INSTALLER'S NAME PHONE NO. V� SEPTIC TANK CAPACITY 1,000 LEACHING FACILITY:(type) `7c (size) '=\i =5 j OM A-AA,�v NO. OF BEDROOMS c�- PRIVATE WELL O PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE G NTED: Yes No �-- I �Ot j: No..- FRiz..B..................... ........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 4)6t ...... . ._..__....OF.......�� �`3 _�..................................... Appliration -for Bhipoiial Workii Tomitrurtion Vrrnift Application is hereby'made for a Permit to Construct (Z—or Repair an Individual Sewage Disposal System at: (-ICAA.� � - ­2.�------ -------- ..... ......... ..........................................."t-1.9...................................... ............... . .....2 Location-Address No. �.1 r _ .or Lot .....mx�....)6��...%VVU\Xl� _ X�� . ..... . . ...........I............................................ .......... .......... ----------------------------------.._.........-------- Owner Address Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—.I No. of Bedrooms-------------------- ....................Expansion Attic Garbage Grinder ( ) -1 a4 -Other—Type of Building ............................ No. of persons....-_---------------- Showers Cafeteria ( ) PL4 'Other fixtures ........................................................... ---------------------------------------------------------- ----------------------------_ Design Flow.:----------------55---------------------gallons per pet-son per day. Total daily flow.........5�?_Q-------------------------gallons. P4 Septic Tank iLLiquid capacityAQQQ__ga1lons Length....._`-_--___ Width__5_------- Diameter--.._-._.__... Depth---._-.---.-_. Disposal Trench—No. .................... Width__:-__--_-------__-- Total Length_.-___-____ Total leaching area--------------------sq. f t. Seepage Pit No-------/--------- Diameter--------- ---------- Depth below inlet...... ....... Total leaching area.A_4�/----S(1. f t. Z Other Distribution box (V Dosing tank Cl/ ­ 77. Percolation Test Results Performed by------------ ............................................................. Date---------------------------------------- Test Pit No. 1...2n--------minutesperinch Depth of Test Pit.................... Depth to ground water w.----------------- Test Pit No. 2................minutes per inch Depth of Test Pit.--___-_--________-- Depth to ground water--.------_----.-----.--- �� �' --•-------------------------------------------------------------•--------------•------•---------•--•--------------------------------------------------------- 0 Description of Soil---- ...... ---------------- U ------ --------------------------------------------- W Z ------------------------------*-------------------------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable---------------------------------------------------------------------------- _----------- ------------------------------------L----------------------------------------------------------------- ----------------------------- ........ ...........w Agreement: The undersigned agrees to install the aforcdescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. _ --------- -------------------------------- Date Application Approved By---- ---------------- X-7-.1-7-77-------- v� V11,L_ Date Application Disapproved for the following reasons:................................................................................................................ --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Date PermitNo........................................................ Issued....................................................... Date ---------- - - THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I M A�C(, I DATA No.......... ... Fks./.:J•'........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH b - ....! ..............OF....... ....... ............`'�... ..... ....... Appliration -fur Bhipagttl Workii Tvnutrurtinn Vrrmft Application"is hereby'made for a Permit to Construct (I/) or Repair ( ) an Individual Sewage Disposal System at: ...... L.. ......£.• l.. ;.. '1Cc.. . ......:!L!L_ .................................................. ...................................... LocatiQo'n�.Address T or Lot No. •...J.i.t i'Lx.�;N � A��q"S..�yx ��4�- i.�...ti.ti.f .................................................................................................. t Owner Address Wi ...ks.�.�^a..c.... t` �!..........r�� ... ..................................................... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures -----.----------------------- - W Design Flow__ _______________......-..................gallons per person per day..Total daily flow_____-___ ............................gallons. Septic Tank L Liquid capacity� __gallons Length____'':_______ Width..__•--.......... Diameter_.............. Depth-----.--_.----- xDisposal Trench—N�°..................... Width-_ ---------------- Total Length---------- Total leaching area-__--__--..-___-_sq. ft. o Seepage Pit N .. _ + Diameter______ ------- De th below inlet__ F ........ Total leaching trea.X -_ sc ft. z Other Distribution box (1.') Dosing tank ( ) Qj• 1,41c Percolation Test Results Performed by--------------- -------------------------------------------------------- Date-.-------------------------------------- a Test Pit No. 1...1----------minutes per inch Depth of Test Pit____________________ Depth to ground water-------:................ Test Pit No. 2................minutes per inch Depth of Test Pit...................... Depth to ground water._.-..- ___-_._-.-_-.-. ------------- W �� O Description of Soil.... - _c5�.rn a'� 1J DI L t> Ctkc. btu _ j ----------- x 97t, 1 _LLz'+ C-k•c i 2 � _ 1 1 1�tc u�.„ `��c-.t, 5 - £`''`` v - -- ----------------------------- -- - --I. ;, ...... -------------------------- -------------- W U Nature of Repairs or Alterations—Answer when applicable..---------------------------------------------------------------------------------------------- ----------------------•--------------------------•..--------------------------------------------------------------------------------------------- ------------------------------------- --------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signe ._ ArWICAV.. ate. ------ ----------- Date Application Approved BY LzG� ='= '� s ��� Date Application Disapproved for, the following reasons:_..._._. ------------------------------------------------------ ---------------------------•--••• -----------------•------------------------------------------------------------------------------------•--.. -------------- Date PermitNo......................................................... Issued---------------------- ---------------------------••••-- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Q.,prtifirttte Lif T""nutplittttrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (✓ ) or Repaired ( ) -Installer at ------`-- 1' 4 ---- tr.�. 1.-------. ��'� ---------��c.-- -����.�L_h.s ....................................................... has been installed in accordance with the provisions of : XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit N % /07- dated--f-�_' _ .-.Z..T................ 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 �j BOARD OF,. HEALTH o. '... � ...OF. ............................................. C..... at'G3 N F ! ,l EE.. ..- ................ �i��n,�ttl nrk,� �nn���nrt �n �rruti# Permission is hereby granted......L-_-:" '-`--- "J-----e -.-,--u-"-_-=--'---------------•---------•-----------•-••--•-•-------•--••--.-•---------•---•-•--. to Construct . A or Repair ( ) an Individual-Sewage Disposal System at No.----'=:; I_-�• ._t c tX - `� L :,,F L ............................................... --------------------------------------------------------'................ Street as shown on the application for Disposal Works Construction Pe it N ..............�..____ Dated____ .'_ 7"'7�..______..... � = -------------------- -------- Board of Heal/ DATE------------------------------------------------------------------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS LO-C PAT ION ` S , E.. PJ RMIT NO. VtIL G-E . INS LLER'S ,- 'NAME & ADDRESS 0 U I E R OR OWNER : . Y aD� DATE PERMIT ISSUED DATE COMPLIANCE ISSUED + r 11v. n. D 0.0 LOT 4 HOL 1 f' TEST /fib PROP PAUL 'MItRY SNSE `�L34 1043 iqoLE PROP. LINE' r2,t9 � r i- y S - �'DRIYEtiJRY EX ITi= fix d=•36 LOAM AND RESElPVE to+� a— /4J; © SdJBSL ? 10 36. 96 . MfD/11�? - 'f y J6t2 LEACH SA 311, f1fl? �. ( , s P/T is P3- .testy"4�• '" rY` ;._ - LOw- tr r 96 /16.'. C L.�y 8+ /z f7` a Lo r ..F,�; - ,. ems• E. .S/li (d 3�7 ���� ELEV. 3 3.� S. Z C LOTN.0 WigTF EN'CD(17€RED ' 4 TOGUN 1NA .TER 'l'S AVAjLfr04.E ' - �3"u%c:D�ivG S ETE3;�1C . ? gUeE. v7 w S .A . .._: � oX;loS RooM SEP T/G 5"ys 7 M con/. T�2 uG 'iv�v 5/ 5/'/ AFL 0W GAL.JflDA Y EN1f 0ia/MZ-A/ GG3D 'Ti�6. EX/4 irl V! Ems' '7`= / ? IfA z -4.44Ox '.r1 r .� Qs /3rrl" A 336 .4 /l ' TOP OF .� T �.6CJGA �"/ONS. $rr / O D` _ 4r, nil a/vN oLL rox.T TN/N I' �• 3" _ .� •�/2ona /nfF/LT_eAT/n!6 AA CaJ/E2` v� 4nca _ Sr s`�4 ._ G"nA,AJ :M/,v p rcw oT lQ"Mi v / �4 /foot '�2 iiv• rrc k" :✓ •R/T , �/G¢�-`�21 b1A. ,. .: DoiVQ Oil ytiAs HEo GA G 4- :0&/ /NVE.2T CA )L'AC/�TY . :F Al2Dun/[Q 7 '*D/ r /NVE ZT cr ,,, e�-;5 a S/ T pL r x r a I�EF'E2EnYCE IN f3Qx C ,�'AND" L E.4G.!•//.vG 'Fes/7 �2E/A/ o;eCE1D GdNC.�E7` . .ems �• x C n�C,Qi_=•T� S7;e�AA5rx/ 5000 ps/ Miiv. 20000 Y' 3C3Ca7"'`i" ,! T` q � OT TO BE .LOCATED �* '�s 0VE•e 5'`�S.TEM UnitE55 f�- ZQ x HEREVY CE PFY THAT THE Exisr1ltI:6M L:4.ctLD/NG FO UIVO;47l6N LOCAT`/oN IS CORR,FCT­ AS: S#014l.R AND DOES CoN FO R M . U-1 f rW 7WE [��J/G lN6 SE7'I�'R AP T Eau/R 'M,Fl�1.3" `�°sT OF UHF 7' Iv of. . 3Al,'N5 TfI k.. DA TE f� L!L,ice/ �t GE.ciT Z:>,�477 LZ'Z <t pa�OValL . _ .. .. _ _. ...,.. '6. _ .- .,.. ,✓. e!•`rr a_,iy"...... .• '.Y1.. t. .- - `,e