Loading...
HomeMy WebLinkAbout0550 CRAIGVILLE BEACH ROAD - Health 550 Craigville Beach.Road Centerville A= 246-036 k 0 OPendafleYp' a Esselte 4210113 ORA 10% P4, No. ° Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipphrattou for aigonl *pgtem Cougtructiou permit Application for a Permit to Construct( ) Repair(ce Upgrade( ) Abandon( ) Z Complete System ❑Individual Components Location Address or Lot No. S S® e nt4,)v;tLe +3e4cfv Rp. Owner's Name,Address,and Tel.No. w ,1r1 e 'S'sa3 - Assessor's Map/Parcel 2 3 L Qia,ra-n_at a J4" Installer's Name,Address,and Tel.No. CVtW-_ , ei k r)t' > Designer's Name,Address and Tel.No. 5,C� t -)► tA--'- P a . PTax ZC3 -L£Sy t:r4N4k—&I >f C.�trn*try 11c fYl W �.%hr tv�rai�q✓+� �2,�`3 Type of Building: Dwelling No.of Bedrooms Lot Size � sq.ft. Garbage Grinder ( ) Other Type of Building 4-4 r 0+Pr, "-, No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided S 79f gpd Plan Date 6_ S ZGog Number of sheets I Revision Date Title S J Size of Septic Tank 2 o 0 12) L v r Type of S.A.S. Description of Soil t Jo j a i Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Z0 O 7 Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Uealth. Signe Q Date 2 O Application Approved by 17F Date O Application Disapproved by: Date for the following reasons Permit No. Date Issued k ":y;.,,w;�:z.-�C.Y'` .+: 4�.m-,...1 .-:. �.�..!.-, .w?:; ,�.,.:-.i+,r.^+..w. .,*ir`..,,v'x.'lY"�`.+a'.,..-+-....:.,.�,,:L..-..,+.,..'-*.++-•r+,Y:...w'-`,. 4 �.,. ,,,,o,u.. .--..; No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2[pplication for Iigpo$at *pgtem Congtruction'vermtt Application for a Permit to Construct( ) Repair(4) Upgrade( ) Abandon( ) �]Complete System ❑Individual Components 4ti ' Location Address or Lot No. 5 S O C/lW y v�%I-* i3e4CJ- R 7. Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 2 t j�,, 3(;, 4 e•1 ran.-1( Installer's Name,Address,and Tel.No. C,4p -_et, O1 �C��''>r� Designer's Name,Address and Tel.No. S.C. e-) f: o . rtz.rt 7t; ZFSS`) CrraNbea� 44y C.�,Jsj"t•..:ll< M 1�1 ��sr wq.G�l,4v� b2 Type of Building: Dwelling No.of Bedrooms Lot Size SU p(,.O+ sq.ft.: Garbage Grinder ( ) . Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 5�� gpd Design flow provided S 7� gpd Plan Date (a- 5 —2 0 o SS Number of sheets Revision Date Title 5),J Lyul.,�.( -r Size of Septic Tank 2 5o o Z) [vvv, 4n Pv ,,+ Type of S.A.S. P,�� � S 1 one t lc�o o ejq / ✓/vt'�^C�Y�»' - Description of Soil — k.t A 1 eno� — Nature of Repairs or Alterations(Answer when applicable) Date last inspected: 2.0 O-7 l k Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signe , f/-377 a Y'a r~� Date �d 2-9 0 rr Application Approved by Date 45?�r v t " Application Disapproved by: Date for the following reasons + Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (� ) Upgraded ( ) Abandoned( )by L.�d2w��e [:�31 �✓i�t� (,t_ at ��So C { V,c(< I�r,��, /1c has een cons;ucted in dance with the provisions of Title 5 and the for Disposal System Construction Permit No. "' dated Installer 1f4A2Z„1ra-t ,0✓i Designer Z -C• +11 #bedrooms Approved design_low Al gpd The issuance of this permit shall n e nstw d ss a,gtlghritee that the system wi=11. unction s designed. �> Date ) j Inspector //[/ � ,� Zk---No. (J�r�� ------------------ G-- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS liq gal &pgtem Congtruction Vertnit FF Permission is hereby granted to Construct ( ) Repair ) Upgrade ( ) Abandon ( ) System located at S S u 6 w. til tle ill—AA,. L,r2 v i�inj "4z 14 and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this pe 3t 14 e S Date 9 Approved by / / own of 15arnstaame Regulatory.Services i ux $m F ThOnias F. Geller. Director b �. PlIblic Health Division °-. Thomas McKean,.Director 200 Main Street,Hyannis,MA 026,01 Office: 50$-862-4644 Fax: SUF 79U•63ti4 :Installer &Dgsigner Certification FREM .pate: Uesier: L nu trig e.r�r� 5.��C Installer: Ca�� 3e. ac: G�f �Pl�c:{• �fl Address- aE , 1t Co nv _ �.. Address, Z L2— WQnA® was issued a permit to install a (date) (installer) septic system at 550_ G 4 (3 C. �onc based on a design drawn by ..�, (address) . aS.•n c. dated "Su e- 51 7,00.8 C IC& muk5oc1 ( esigtter �! I, certify that the septic system refercriced above'was install ed substantially according to the design, which may include minor: approved changes su{-.h as lateral relocation of the distribution box and/or septic tar k. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any componcrtt of the septic system) but in accordance with State &:Local 'Regulations, Plan revision or certified u-built by designer to follow. tH[1M 4f.� : ^ivit a (T7esigner's Si e) ( esi,�ner's amp Here) PLEASETU STA13LI USLIC IiE TH T.ITVT.QTnN. CERTIFICATE OF COMPLIANCE N AND -~ BU C RECEIVEDE E H U N 4. Q:Health/Septic/Designer Certification Form 1 0 'd 49£0 2zz .809 DN I N33N I`_aN331^ wv a£: o T 8oez-8r.-!3na t TOWN OF BARNSTABLE LOCATIONU 3ecte6 12c� SEWAGE# $'3 3 VILLAGE Cec�1 pfc,S �lA ASSESSOR'S MAP&PARCEL jq6 ^ 3b INSTALLER'S NAME&PHONE NO. Z r`k 4 Zg 9 U ;t$ SEPTIC TANK CAPACITY .1Sc)o No l oo V Q.,r7 6 0-(-e/ )0 LEACHING FACILITY:(type) (size) \-1 y, 6-0 NO.OF BEDROOMS S OWNER ne— PERMIT DATE: 9'14- O$ COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility $� feet Private Water Supply Well and Leaching Facility(if any wells exist on site or within 200 feet of leaching facility) feet Edge of Wetland and Leaching Facility(if any wetlands exist within 300 feet of leaching:facility). - p- feet S Liar FURNISHED BY ( i Cho �� 1 �Drf �2 .� . . . . .. A b Iq 32.n Al 13 2z.sue .3 3 ae,o �a a A,o �b 35•0 y�.S Town of Barnstable P# Department of Regulatory Services • r►srrarwara. Public Health Division Date ,arras. ��� 200 Main Street,Hyannis MA 02601 Date Scheduled Tfine Fee Pd. 00 Soil Suitability Assessment for Sewage Disposal Performed By: ,0�'O L 1 Qnuc6ni(i, ZY(. C. Witnessed By: V6 tC! LOCATION& GENERAL INFORMATION Location Address V Owner 's Name n I efie� tU_ Address j jo CZ 4 ti'�\.0 ",A_ t2evt-J Assessor's Map/Parcel: 2 q G103(. Ccfs Engineer's Name C-v��CL -c`l4yyw)s-c5 NEW CONSTRUCTION REPAIR Telephone# �0, 't 156 9 e2 Land Use GVtgA m f nk �out'L [!f S Slopes(g'o) 2 -6 Surface Stones ` Distances from: Open Water Body 7 t 50 ft Possible Wet Area y��© ft Drinking Water Well Nl A ft Drainage Way 7 i O O ft Property Line /U ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pen;tests,locate wetlands in proximity to holes) SCe_ C4Q-c�A eA 64 5,/5 k4n" Lie 3 or GGt c Q(oil d4 kC� 5une-. 51 Zoo 8 V e-pi e-d boy' i t lc � Parent material(geologic) 6L*W,,`'�n Depth to Bedrock 'U 1O5s 4 Depth to Groundwater. Standing Water in Hole: 6 7 2 105 S Weeping from Pit Face Estimated Seasonal High Groundwater (a DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: D(Ce.0- 0PSaluOii-6Y) Depth Observed standing in obs.hole: 72- _ id. Depth to soil mottles: y in. Depth to weeping from side of obs.hole: in, Groundwater Adjustment -ft. Index Well# Reading Date: _ Index Well level A4I.Factor Adj.Groundwater Level, PERCOLATION TEST Date 1;12-08 Thne ki-H Observation Hole# 3 Time at 9" 'y Depth of Perc 2 ® Time at 6" Start Pre-soak Time @ ii,>12 Time(9"4") 2 End Pre-soak Rate MinJlnch 7 � t Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) AJ Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTICWERCFORM.DOC r_ DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, Gravel) 311 d �� ��£�• L S I f�.Yr sly �7l�`` '7.5 �� _ . Fib 406 C. -N sated Z, 5 1 6/ h�C� _ I It DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell), Mottling (Structure,Stones,Boulders. Consistencv.%Gravel) DEEP OBSERVATION HOLE LOG Hole# 3 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%a vel '2.-(40 LS )0Try/6 (od -too L LS 10`lr 716 ro 4 7.5 If 516 Sl-�•..t 72`` DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones',Boulders. Consi ten Flood Insurance Rate Man: Above 500 year flood boundary No_ Yes Within 500 year boundary No✓ Yes Within 100 year flood boundary No 1/ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? y GS _— �( f-fair allows {4,6 e use o( If not,what is the depth of naturally occurring pervious material? _. ;' " �'°r t zv� Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Envir mental Protection and that e,above ysis was performed by me consistent with . the required traini ,e pertise an e i ce e 0 CUR 15.0177.. Signature Date C� Q:4S.EPTICVERCFORM.DOC >✓Sr CENTERVILLE-OSTERVILLE-MARSTONS MILLS FIRE DISTRICT DEPARTMENT OF FIRE-RESCUE&EMERGENCY SERVICES 1875 Route 28•Cen.terville, MA 02632-3117 1926 508-790-2375 x1 FAX: 508-790-2385 John M.Farrington,Chief Martin O'L.MacNeely, Fire Prevention Officer Philip H. Field,Jr.,Deputy Chief Michael G.Grossman,Fire Prevention Officer December 12, 2011 TO: Mr. Thomas McKeon Director, Health Department Town of Barnstable 200-Main Street Hyannis, MA. 02601 In accordance with 527 CMR 1.06(6), the Centerville-Osterville-Marstons Mills Fire/Rescue Department brings to your attention the following potential health code violations for your review and/or interpretation of same. NAME/BUSINESS: Residence ADDRESS: 550 B Craigville Beach Road, Centerville . ; s -�- OBSERVANCE: During a recent emergency response, responding crews "==� observed the dwelling full of storage and debris and possible unsanitary conditions. C:) era Michael Grossman 4e), L==Z ire Prevention Officer C.O.M.M. Fire District CC: Donna Miorandi "Commitment to Our Community" >✓Sr . CENTERVILLE-OSTERVILLE-MARSTONS MILLS FIRE .DISTRICT DEPARTMENT'OF FIRE-RESCUE&EMERGENCY SERVICES. 1875 Route 28-Centerville, MA 02632-3117 1926 508-790-2375 x1 - FAX: 508-790-2385 John M.Farrington,Chief Martin O'L.MacNeely,Fire Prevention Officer Philip H.Field,Jr.,Deputy Chief Michael G.Grossman,Fire Prevention Officer December 12, 2011 TO: Mr. Thomas McKeon Director, Health Department Town of Barnstable 200 Main Street Hyannis, MA. 02601 In accordance with 527 CMR 1.06(6), the Centerville-Osterville-Marstons Mills Fire/Rescue Department brings to your attention the following potential health code violations for your review and/or interpretation of same. NAME/BUSINESS: Residence ADDRESS: 550 B Craigville Beach Road, Centerville OBSERVANCE: During a recent emergency response, responding.crews observed the dwelling full of storage and debris and possible unsanitary. conditions. (77 Michael Grossman C Fire Prevention Officer C.O.M.M. ire District fi a CC: Donna Miorandi , "Commitment to Our Community" TOWN OF BARNSTABLE BOARD OF HEALTH l ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION Date Owner IP 2h5nn0 Tenant Address Address 5�5�Crvw- Compliance Remarks or Regulation# Yes No Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 0-t� 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal �- 16. Sewage Disposal 17. Temporary Housing /v PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here TOWN OF BARNSTABLE,UN 2 6 20O �3 ? S b BOARD OF HEALTH J ARTICLE 11:MINIMUM STANDARDS FOR HUMAN HABITATION Date - 6(W 16:3 Owner Tenant c-3m,S�1- 1 Yao� �osQ— <j Address Address 550 C"r'0A!N'J'It-IV Complionce Remarks or Regulation# Yes No Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities V 8. Ventilation ' 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements '►'1 14. Insects and Rodents _ �� 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing PART 11 37. Placarding of Condemned Dwelling; 1� Removal of Occupants; Demolition G��9�V--", Q--��Person(s) Interviewe 4 Inspector ?c--eo- e1 C\At'--,_. If Public Building such as Store or Hotel/Motel specify here Y .N7,r ...r- ..K- r.r.'9�".c?�--�yYp••(.'41�iiT:�F'L'Vil33�kF'ti:.FA`�Rr-'mx_M�,Ri•Y+�sali;:IFs+ii:L+Yx'p�.-. .....�.�c� �wrr�yJ-"V.►�Y"Y�s�-. .s-•-v .. - wv n 11 , i �Y• Y� �i Yp 4 yy 1 1 I ....�- � � I i t i•tl A It I `� F 7 I I (� J I � v r 1 .,..,� qqe �, S+ 'd� � J/Y 6 �.� �+ / i — �. .--f ,o-�_ �,� �) ��. SECTIONSB41DER: COMPLETE THIS SECTION COMPLETE THIS ON DELIVERY ■ Complet@ items 1,2,and 3.Also complete A. Received by(Please Print Clearly) B. Date of Delivery tem 4 if Restricted Delivery is desired. W Print your name and address on the reverseALL so that we can return the card to you. C. Si ure ■ Attach this card to the back of the mailpiece, X ❑Agent I or on the front if space permits. Addressee D. Is d livery address different from item 1? Yes M 1. Article Addressed to: If YES O" ivery address below: ❑ No p. o. 60x 021 W. (��A nn�s�or / Ml� 072 3.%R, :�VRxept ress Mail urn Receipt for Merchandise 11 ❑ Insured Mail ❑C.O.D. '10 0o I lJr7o 00(3 0ro 0 1352 4. Restricted Delivery?(Extra Fee) ❑Yes 21.to{{rticle Number(Copy from service label) 111 11 1 11 IiliF f PS Form 3811,July 1999 Domestic Return Receipt 102595-00-M-0952 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.0-10 • Sender: Please print your name, address, and ZIP+4 in this box • I Z00 5"r �yo,�K;s� Mr4 02601 I r °FZHE T° Town of Barnstable ti Regulatory Services B" `� ' Public Health Division y MUSS.s. 0a t6;q. ♦0 iOren neat° 200 Main St.,Hyannis,MA 02601 Office: 508-862-4644 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health July 30, 2002 Mr. Peter Dunn `'O"� P.O. Box 450 2 WSJ )�t W. Hyannisport, MA 02672 4 , 5 X zo ou NOTICE TO ABATE VIOLATIONS OF THE TOWN OF BARNSTABLE BOARD OF HEALTH'S NUISANCE CONTROL REGULATION NUMBER ONE The property owned by you located at 550 Craigville Beach Road, was inspected on July 26, 2002 by Sam White, Health Inspector for the Town of Barnstable, because of a complaint. The following violation of Nuisance Control Regulation Number One Regulation was observed: Refuse from Commercial Buildings,Lodging Houses, Multiple Family Dwellings, Municipal Buildings and other Business Establishments (excluding single family dwellings): The dumpster is not screened from the neighbor's view and from public view. You are directed to correct this violation within thirty(30) days of receipt of this notice by screening the dumpster with fencing or year-round bushes, trees, and/or other plantings. You may request a hearing if written petition requesting same is received by the Board of Health within seven (7) days after the date order is received. However, this violation must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order could result.in a fine of not more . than $500. Each separate day's failure to comply with an order shall constitute a separate violation. PER ORDER OF T BOARD OF HEALTH r Thomas A. McKean Director of Public Health CC: Mr. UG�.n 5ol,�ts� sw CAPE COD HOSPITAL ' IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII (508) 771-1800 43751585 DUNNE;PETER DISCHARGE INSTRUCTIONS & M3 M3.3522-B 07/16/02 .PATIENT CARE REFERRAL FORM MRN 054239 DOB oDR.M. F0001 D.O. GENERAL DATA SECTION Discharge Date: Proxy: ❑ Yes ❑ No Referred for care to: PT Marital Status ❑ S ❑ M ❑ W ❑ D ❑ SEP. 1st Insurance Type: Policy No.: Patient Address: 2nd Insurance Type: Policy No.: Patient Phone: Next of Kin/Guardian: Address: Phone: PHYSICIAN SECTION DIAGNOSIS (S) Surgery Performed and Date, Infections or Allergies: PHYSICIAN'S ORDERS: (Include specific orders for Diet, Lab Tests, Speech, and O.T.) MEDICATION STRENGTH AND FREQUENCY DATE &TIME OF NEXT DOSE Alb r"T z Speiser Z—SFo 6tt, ` r�rsa 02 'k u'�''� ✓ems air rg TREATMENTS & FREQUENCY: DIET: if Wi-8 2- REHABILITATION ORDERS: Restrict Activity ❑ YES IV NO Sensation Impaired ❑ YES Al NO RECOMMENDATIONS . Precaution Weight Bearing Status - Non-Weight ❑ Partial-Weight ❑ Full-Weight YES NO SPECIFIC TREATMENT & FREQUENCY: Shower ❑ ANTICIPATED GOALS.• Bathe (] Stairs 1 ❑ Drive ❑ The above services require Level of Care: ❑ SNF ❑ ICF M.D. If chronic, �wh ? - nature) y• Tel. Will fooW ❑ YES^�/N If rio, who? M.D.. F/U APPT. Zkl-cA� Tel: I Date & Time: HOME HEALTH PHYSICAL OCC. SPEECH SOCIAL H.H. OTHER Not A Referral SERVICES: ❑ NURSING ❑THERAPY ❑ THERAPY ❑ THERAPY ❑ WORK ❑ AIDE ❑ Specify: ❑ For Services I have reviewed and understand the above i rmation and have participated in the development of my discharge plan and have received a copy of the plan. My signature d s n QessarilyJ dicate total acceptance of the plan. 1 have received a copy of my DISCHARGE RIGHTS. Patient Signat e: Date: CCH A 103 A Rev. 2/96 WHITE COPY to ent(Agency! cility) CANARY COPY to MR PINK COPY'to MD GOLDENROD COPY to Patient(Agency/Facility) t� Health Complaints 06-Aug-02 Time: 9:30:00 AM Date: 7/24/02 Complaint Number: 3612 Referred To: SAM WHITE Taken By: Complaint Type: NUISANCE CONTROL REG. 1 RUBBISH Article X Detail: ILLEGAL OPERATIONS Business Name: Number: 558/5-gb Street: Craigville Beach Rd. Village: Assessors Map Parcel: 1 1• Health Complaints 06-Aug-02 Johnson and Mr. Dunn on 8/6/2002. Trash containers on 558 Craigville Beach Rd. will be moved halfway from property line to condo building. Dumpster will be fenced and or shielded with greenery. Investigation Date: 7/24/02 Investigation Time: 11:00:00 AM 2 . FORM30 Caw HOBBS&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � 5 CITY/TOWN b DEPARTIIR,y "0d� /( ADDRESS TELEPHONE Address --Occupant PCj44,-1-A4"f Floor Apartment No. No. of Occupants No.of Habitable Rooms No.Sleeping Rooms _ No. dwelling or rooming units__ No.Stories Name and address of owner Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish j Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows_: ' al/' I�l lam S Roof e/ C C Gutters, Drains: Walls: /'vw1 a •f l _A,.&c-d rw r� sty Foundation: S i. a Chimney: S 14e r &Ud BASEMENT Gen.Sanitation: Dampness: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.`. Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N E ui . Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: z is Cx L .fj "j 1 H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks V- Kitchen C61AA W-CN-1 ` Q K Bathroom Ftsvv+ c�— Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,6ffsj%l, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink 10 q±71 r 0 ec:Vfq A.�N Stove 3y­",-t_ C-a4 AI � Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: a✓F,- s¢ Egress Dual and Obst'n: General Building Posted Locks on Doors: •♦ t/ e' ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE �I OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE �i AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES PERJU, ' _/ INSPECTOR e Fl TITLEtl/w� / A. DATE e� / `� TIME d , P.M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. Z�II s m' j r F 9 " ' ;..' t'` .4,�'.�. ja'k1�74.liavr� -�� '�:,, '.., ' �;i �.di�,,p�tlf,�,rY• ,. .. i. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (I) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so,as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that,do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 4'10750(A)through (0)shall be deemed'to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. FORM30 H&W HoB&&WARREN'M THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH A SA-y (ns, 6 b CITY/TOWN /OVI o DEPARTMENT �1 c^M SVr ep S�O J� ADDRESS Y l' 7 TELEPHONE GR� a Address - .----Occupant Occupant vQT"�� H�-�yN� Floor _Apartment No.____— __ No. of Occupants__ No. of Habitable Rooms_-----No.Sleeping Rooms __—__ No.dwelling or rooming units----- No. Stories Name and address of owner______ Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: r Drainage J Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: / ❑ B ❑ F ❑ M Doors,Windows: vd(1.Q.v^ ) Ili" le !M V4 Roof C a A Gnr d t +-R to L-l/O Sty / Gutters, Drains: t 'LAn &r,lS Walls: pvv►j I r, rv,^ e d I4a W­'k- Foundation: S IV- Chimney: oo-S J 1 ArCr d. BASEMENT Gen.Sanitation: Dampness: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING S Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: FHA Stacks, Flues,Vents: PLUMBING: Su I Line: v` (�!A ❑ MS ❑ ST ❑ P Waste Line: c. (3 a l ( Ce/S "/ 1 ; H.W.Tanks Safety and Vent(s)i ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen. Cond. Distrib. Box: Gen, Basement Wiring: DWELLING UNIT Sd(J�C Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen i 0 K Bathroom F� j r-r - Pant Den Living Room Bedroom(1) Bedroom 2 Bedroom 3 l Bedroom 4 Hot Water Facil. Su .Ten., as il, Elect.: t Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink o cc v A'"Vl Stove it/edrv�au • � Bathing,Toilet Facil. `��Ve.nt.,.P-bu,mb.,-Sanit'n-:�,,:_-, Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: I General Building Posted ram; Locks on Doors: (,e f Ye ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH ~ MAY MATERIALLY IMPAIR THE HEALTH OR,SAFETY AND.,WELL-B,EING-OF THE c " OCCUPANT AS DETERMINED BY 105CMR '410.750 OF'THE CODE OR. THE tiCAUTHORIZED INSPECTOR.(See Over) +CTHIS INSPECTION REPO T IS SIG ED AND CERTIFIED UNDER THE PAINS ANDS s PENALTIE F PERJUF� INSPECTOR ,,,TITLE + `A. r t� DATE} ` / 4 ;TIME _ P.M. A.M. ` THE NEXT SCHEDULED REINSPECTION P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the heaith, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local repair or correction of such violation pursuant to 105 CMR 410.830 through 410.833 nor shall failure to health official to order p (s) p 9 include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. r provide a smoke detector required b 105 CMR 410.482. (N) Failure to p o de q y (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR410.750(A)•through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. FORM30 Caw HoessaWna ENtM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �HJ CITY/TOWN "- DEPARTMENT r ADDRESS I G,,M s0y`0 r z- /// OAC V TELEPHONE Address's-70 C ;""V,6 T7 � � _ - occ(uupant _ ( Floor Apartment No. No. of Occupants Q No. of Habitable Rooms No.Sleeping Rooms___ -S No. dwelling or rooming units No.Stories G� �� �• Name and address of owner Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish.A c-cvtAA, Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Z ( GOi.avw-wt, >4u G✓cw SD Dual Egress. and Obst'n.: —�(/ SGr ❑ B ❑ F ❑ M Doors,Windows: Attzd Ala u, ,eo-7 Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Vl&i Dampness: Av Stairs: Li htin : STRUCTURE INT. Hall,Stairway: .� Obst'n.: Hall, Floor,Wall,Ceiling: ✓ Hall Lighting: Hall Windows: HEATING C-> Chimneys: Central VI:Ql( ❑ N E ui . Repair TYPE: F" Stacks, Flues,Vents: PLUMBING: Supply Line: ?- � ❑ MS ❑ ST ❑ P Waste Line: S H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: t10 V220 Fusing,Grnd.: MP: '2100 Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. Lgtng. Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: Z /to --170 [Cot I Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink Stove >� Bathing;Toilet Facil. Vent., Plumb.,Sanit'n.: I•,.w Y14 t zd �,2�• Wash Basin, Shower or Tub: , Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY." INSPECTO "TITLE �� A DATE TIME �®% �-� P.M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. 1. .;. _ .,�,�,y. y�r�:. r y ..- .. -a'fk"a^1:+^-.�%:r�£''• ,.,It•;,:yi 1: ^r;,,,T tY _ Via. � ., .;;� r fY.;�_. y' t 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall.within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair'or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) . Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair,the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. !, FORM 30 CH&W H.. WnR eNTM THE COMMONWEALTH OF MASSACHUSETTS R BOARD OF HEALTH CITY/TOWN TVA PEPARTME Tr�t�. //V�''�A Ill'fa�%�-, J ,�/G+ A44-a w ADDRESS C,� V. qq TELEPHONE14, AddressS� Crgrf�i .. cG ti Occupant r ✓ Y Floor Apartment No, No. of.Occupan s_ , u r �G � e' No. of Habitable Rooms—No.Sleep in Rooms 7 1 , D No.dwelling or rooming units No. Stories ,!. Name and address of owner .f r,. ,Remarks Reg., Vio. t YARD Out Bld s.: Fences: - Garbage and Rubbish/0 c v Containers: Drainage Infestation.Rats or other: , STRUCTURE EXT. Steps,Stairs, Porches: �; CAwwcv+� . a Z✓�`1 S k Dual Egress: and Ob%'n,: doA14Acf 3Cre�ETT.c.�.. ❑ B OF ❑ M Doors,Windows: •VGA ce 3z Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: V C-CQ C-- Dam ness: Stairs: Li htin ; STRUCTURE INT. Hall,Stairway: Obst'n.: Hall,Floor,Wall,Ceiling'. Hall Lighting: ✓; Hall Windows: HEATING '> Chimneys: Central Y ❑,N E ui . Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: Tile— vw ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent s ELECTRICAL Panels, Meters Cir:: 110 19 220 Fusin ,Grnd AMP: �7 o Gen.Cond. Distrib: Box: Gen..Basement Wiring: I,... ... DWELLING UNIT Ventil. . " Lqtng. Outlets Walls :Ceils. Wind. Doors Floors Locks Kitchen - Bathroom Pantry Den , Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.',Gas,Oil, Elect.: z Q Stacks,.Flues,Vents,Safeties:V f Kitchen Facilities Sink Stove G-4S ✓' Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: / C471*'k-r" 14&-Y104 uy7.3 *'r Wash Basin, Shower or Tub: Infestation Rats, Mice, Roaches'or"Other: `��'CA-t.J j J 0-J OVA t 4(/ Egress Dual and Obst'n: General Building Posted t Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE.IS A.CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND'WELL--BEING OF THE OCCUPANT AS DETERMINED BY .105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJJU Y ' INSPECTO �'' TITLE DATEr A Z� TIME ID is P.M. 1. A.M. THE NEXT SCHEDULED REINSPECTION P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises.This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall.within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash,which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. f r I i i I i i I� t i — — ILA f t H ---7e I} II I y BEDROOM APT*Q r G L — Ilk Oc 1 J LvC.) ?Dom aF Y;ITc}�EN Kt�H oRMM Ktu4i N `� r3�aRoots � ° 5 K ITG�I EN J LVG R06M o 0 o O 3 00 , A FPL * , L\/G ROOM PT 3 / - I" Cl�A�1�C� �f�Nr LI/G ROW) APT*Ll NOISIAtO 3 UL s '/s OS .£ Hd 61 Sf1V 8�1O�' r - _DEW N p. ►=Est ss?M C 3&ERNE N`�" SLAB = 16.3' ± PROVIDE PRECAST CONCRETE EXTENSION FINISH GRADE OVER LEACHING FIELD= 15.5' - 15.9' GENERAL NOTES RISER WITH CONCRETE COVER TO WITHIN 5"DIA. OUTLET(S) SLOPE @ 2% MIN. OVER SYSTEM REMOVABLE COVER w/RISER 6"OF F.G. OVER INLET, CENTER 8 OUTLET COVER 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION FINISH GRADE OVER D-BOX= 15.8'± 4"SCHEDULE 40 PVC MIN. SLOPE 1% METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE FINISH GRADE @ FND. EL.= 24" MIN.ACCESS COVER , , 2"SCH.40 INSPECTION PORT w/ACCESS ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. 16.0± (TYPICAL FOR 3) F.G. OVER S.T. &P.C. EL.= 15.0 - 15.7 TO D-BOX 3/4"TO 1-1/2" DOUBLE WASHED STONE TO CROWN OF PIPE BOX AND COVER TO GRADE 13.33'� s"MIN. � 2"OF 1/8"TO 1/2"DOUBLE WASHED STONE (SEE NOTE#22) 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD 36"MAX. 12.70' 36""MAX. 9"MIN. OF HEALTH AND THE DESIGN ENGINEER. PROPOSED PROP. " 36"MAX. " 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL 4"SCH.40 PVC " 3" q"SCH. 2 PVC TEE 4 PVC OUT TO 4" PVC PERFORATED PIPE SLOPE @ 2%min. cfl 3 3" " 40 PVC ! LEACHING FACILITY ° BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. 2"MIN/3"MAX 9" 9 SLOPE @ t%min. - SLOPE AT 0.50 /o TOP OF S.A.S. = 14.75 - 14.50 9"MIN. - _ _ 36"MAX. 4. TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE LESS THAN « « 19" L-2 14.00' ELEVATION = 14.75' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS T 60 19 11.75' ALARM ON END CAPS 1 A 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF 12.00' T LIQUID 1 ' \ O ° UT ELEVATION. --� S NOT LESS THAN HE BREAKOUT 19± LEVEL f_j MP ON ;n THE LINER 11.70 .. PIPE LENGTH I INLET TEE ` -- -�-------- - - -� "' ', ° 5 SLOPE ALL SOLID PIPE AT 1 0°/ MINIMUM 1500 GAL.COMPARTMENT 1000 L.C T 6.25' OUTLET ' I 14.35, E::� -0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. 10.8' " TEE w/BAFFLE TEE 14.52 7.12' 11 .45 ' 6"EFFECTIVE 7- LOCAL BOARD OF HEALTH TO BE NOTIFIED PRIOR TO BACK FILLING WHEN TO DWELLING INSTALL 22"ZABEL 6"CRUSHED STONE ' ,,C 6"CRUSHED STONE I I FILTER w/SUPPORT COVER MECHANICALLY NICALLY o tw OVER MECHANICALLY I ( DEPTH SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS NOT TO "INTER-CONNECTING TEE SHALL MODEL#A100 COMPACTED BASE 14.25' BOTTOM OF TRENCH TO BE LEVEL EL. = 13,rjQ' BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH. BE PLACED DIRECTLY UNDER CENTER COVER OPENING LENGTH 13'-0" WIDTH 7'-0" DEPTH 7'-1" LENGTH 8'-6" WIDTH 4'-10" DEPTH 5'-7" 5 OUTLET DISTRIBUTION BOX *2500 GAL. 2-COMPART. SEPTIC TANK *1000 GALLON PUMP CHAMBER TO BE INSTALLED ON A LEVEL STABLE 50.0' 4' 4.5' 4.5' 4' 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM OF 18.00' BOTH TANKS SHALL BASE. FIRST TWO FEET OF OUTLET 17.0' ESTABLISHED ON A NAIL IN A TREE AS SHOWN ON PLAN. BE WATER-TIGHT AND PIPES TO BE LAID LEVEL. GROUND WATER ELEV.= 9.47' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION WATER-PROOFED THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE TANKS SHALL BE INSTALLED ON A LEVEL STABLE BASE CROSS SECTION VIEW 4' MIN. AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY TYPICAL FIELD PROFILE FIELD END VIEW PROPOSED 2500 GALLON 2-COMPARTMENT SEPTIC TANK & DISCREPANCIES TO THE DESIGN ENGINEER.10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE —CONTRACTOR TO VERIFY AND PROPOSED 1000 GALLON PUMP CHAMBER DISTRIBUTION BOX DETAIL FIELD DETAILS STRUCTURES SHALL BE MADE WATERTIGHT. REPORT TO ENGINEER,IF DIFFERENT NOT TO SCALE NOT TO SCALE NOT TO SCALE 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH NOTE: MAGNETIC MARKING TAPE SHALL BE PLACED DESIGN DATA TEST PIT DATA TEST PIT DATA DETERMINATION FROM APPROPRIATE AUTHORITY. PROPOSED IMPERVIOUS 40 MIL. ALONG THE TOP EDGES OF ALL SEPTIC SYSTEM INSPECTOR: Donald Desmarais, R.S. INSPECTOR: Donald Desmarais, R.S. 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS GEOMEMBRANE LINER COMPONENTS. NUMBER OF BEDROOMS (ASSESSORS) 5 LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE SOIL EVALUATOR: John L. Churchill, Jr. SOIL EVALUATOR: John L. Churchill, Jr. NUMBER OF BEDROOMS (DESIGN) 5 THEY SHALL WITHSTAND H-20 LOADING. S,S°51,40"E DESIGN FLOW 110 GAUDAY/BEDROOM DATE: May 12, 2008 DATE: May 12, 2008 239.36, ' X-X TOTAL DESIGN FLOW 550 GAUDAY TEST PIT#: 1 TEST PIT#: 2 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. REMOVE AND REPLACE _ _13 X�X UNSUITABLE MATERIAL TO"B"SOIL X �' X�X DESIGN FLOW X 200 % = 1,100 GAUDAY i ELEV TOP= 15.60' ELEV TOP= 16.60' 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM AND WITH CLEAN, COARSE SAND = _ 14- USE PROPOSED 2,500 GALLON 2-COMPARTMENT SEPTIC TANK ELEV WATER= 9.27' ELEV WATER= UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF k�X X LEACHING FACILITY. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN PROPOSED 17'x 50' LEACHING FIELD .(7) -�`�' CVX_XX_X X (48 HRS. STORAGE IN FIRST COMPARTMENT AND 24 HRS. IN SECOND COMPARTMENT) PERC RATE= PERC RATE = COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN oa PROPOSED INSPECTION PORT = _ __��0' X`X X X X\J� INSTALL A 17' x 50' LEACHING FIELD DEPTH OF PERC= DEPTH OF PERC = 15. CONTRACTOR SHALL NOTIFY DESIGN ACCORDANCE IALL )ENGINEER OF ANY DISCREPANCIES FOUND IN /2, r- / TEXTURAL CLASS: 1 TEXTURAL CLASS: SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. PROPOSED DISTRIBUTION BOX .�: \ �--- _ - `_ _ (8) j SIDEWALL CAPACITY - 16. PROPOSED PROJECT IS LOCATED WITHIN: \ \ STO NE -'� NO SIDEWALL AREA CREDIT TAKEN 0 15.60 0 16.60 W z to PROPOSED 1,000 GALLON PUMP CHAMBER = � DRIVE o � ASSESSORS MAP 246 PARCEL 36 N BOTTOM CAPACITY Fill 17. OWNER OF RECORD: PETER DUNNE and NATALIE DUNNE o PROPOSED 2,500 GALLON o = `--: CO Z 2-COMPARTMENT SEPTIC TANK \ (LENGTH x WIDTH)x(0.68 GAL/SQ.FT.)= SQ.FT. ADDRESS. c/o ANNI DUNNE ' ( 1T x 50' )X(0.68 GAUSQ.FT.1= 578 GAL. LEACHING/DAY PO BOX 450 48 11.60 EXISTING CESSPOOLS AND p _- _ W. HYANNISPORT, MA 02672 LEACHING PITS TO BE PUMPED, ti _ A Loamy Sand FILLED WITH CLEAN, COARSE \ `J/�_ / a / DOSING & STORAGE REQUIREMENTS 56" 10YR 3/1 10.93' FEMA FLOOD ZONE C SAND, AND ABANDONED DESIGN FLOW: 550 GPD Loamy Sand AS SHOWN ON COMMUNITY PANEL# 250001 0008 D B 10YR 5/4 Benchmark fir. \� \ P _ - (5) / DOSING REQUIRED: 4 CYCLES /DAY f Nail in Tree �- ' Fill ; 18. PLAN REFERENCE: \ (6) / ' 550 GPD/4 = 137.5 GAUCYCLE 76„ Mottling L 76" 9 27' PLAN BOOK 151, PAGE 29 Elev. = 18.00 �� a Standing @ 84" A rox. M.S.L. \ a TP 06 3 (4 /4 DISTANCE REQUIRED BETWEE:.. ,NIP 79 (1 1f 84" 8.60' 19. DEED REFERENCE: \ 8 S ONEER/VE C] ON AND PUMP OFF FLOATS: 88" 8.27' BOOK 12993, PAGE 17 PROP. C/O O �1ro o _ Q 137.5 GAUCYCLE - 250 GAUFT = 0.55 FT/CYCLE 20. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. � 10 108' cv `o'� Q' (USE 0.58T TO PROVIDE FOR BACKFLOW) HC- (2 (3 a J C Fine to Med. Sand 21. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY / J STORAGE REQUIRED ABOVE WORKING LEVEL: 550 GAL. 2.5Y 6/4 FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY / � ry TP 2 = STORAGE PROVIDED ABOVE WORKING LEVEL: 625 GAL. FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. P rn / 16.6' 108" 6.60' 80" 9.93' 22. A 4" PERFORATED SCH.40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A �8001 1'45 1 ~ DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3 OF FINISH GRADE. A .i " \ w TOTALS: REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. 20.00 --- ' OTAL NUMBER OF LATERALS 3 j MAP 246 \� #550 w -� �S -CO - fn o \ 'BEY' TOTAL LEACHING AREA 850.0 SQ.FT. TEST PIT DATA 00 00 EXISTING HG \ LOT 36 \ � � � TOTAL LEACHING CAPACITY 578.0 GAL./DAY rn C 5-BEDROOM CY 50,060 S.F. ± \ \ I INSPECTOR: Donald Desmarais, R.S. - 0 4-UNIT APART. BLDG. Z / SLAB EL.=16.3'± \ - SOIL EVALUATOR: John L. Churchill,Jr. LEGEND 'I DATE: May 12, 2008 W Day \,o �\ \ o INSTALL 1-1/4" PVC TO HOUSE.JOINTS TO BE MADE -- -- 15 - - -- EXISTING CONTOURS o WATERTIGHT. WIRE PUMP AND FLOATS TO SIMPLEX TEST PIT#: 3 \ \ o 15 PROPOSED SPOT GRADE n o 0 ° Ui CONTROL PANEL No. 1-CC2 NEMA-1 MFG. HOOVER ELEV TOP= 14.80 0 o M \�y�Iv \ INSTRUMENTS. ELEV WATER- 9.47' 15 PROPOSED CONTOURS o M \\ \ HOISTING CABLE 7 x 19 STAINLESS STEEL Z NEMA 4 JUNCTION BOX CORROSION RESISTANT 8 ----- -- W --- EXISTING WATER SERVICE LIQUID-TIGHT CABLE CONNECTORS SUPPORTED 1/8"DIA. /1,760 LB. STRENGTH PERC RATE= 7 Min/ln �w ❑�H/W - EXISTING OVERHEAD UTILITIES J \ 6�4- CONNECTORS SUPPORTED BY 1-1/4"PVC CONDUIT, " DEPTH OF PERC- 42"-60" N83°47'S0"VI/ JOINTS TO BE MADE WATERTIGHT 2 BALL VALVE w/UNIONS SCH. 80 PVC ���\ I GEORGE FISHER CO. MODEL NO. 560 TEST PIT LOCATION 78.79' _ _ TEXTURAL CLASS: 1 \ 3" 2"SCH.40 TO D-BOX 0 14.80' O O O PROP. 2,500 GAL. 2-COMPARTMENT SEPTIC TANK • ,�, "• �" r 1 r• ' w W _ o "SCH.40 TEE w/CLEAN-OUT CAP ' • • m • _ #550-B UP 285/2 ALARM ON Fill • i` •' o EXISTING `n r •r r r • �- o O O PROPOSED 1000 GALLON PUMP CHAMBER • _ _o c� BUILDING UMP ON 36" 11.80' « ' �n �� • • 11 • ' � � Z � 3edr�,,,l pUMp � 2" BALL CHECK VALVE SCH. 80 PVC 100 A Loamy Sand I PROPOSED 4 SOLID SCHEDULE 40 PVC PIPE rt • 4* • / #550-A P.S.I. FLOWMATIC MODEL No. 208S 42„ µ 10YR 3/2 11.30' PROPOSED 2"SOLID SCHEDULE 40 PVC PIPE • EXISTING •a " ' �• !�• N79°42100"V1r BUILDING Perc B _r Loamy Sand - - PROPOSED 4" PERFORATED SCH.40 PVC PIPE • ' ' o # r►• 58.00. (2)WIDE ANGLE CONTROL FLOATS ►f) ao 1/4"WEEP HOLE IN DISCHARGE PIPE 60" `= 10YR 5/6 g 80, r �3 F�z,)rc,c til o ❑ PROPOSED DISTRIBUTION BOX •• ,• _ (BARNES 073618) 2"SCH. 40 PVC DISCHARGE PIPE `'. • ' • • j �; 1: PUMP ON/OFF 120 ACTIVATION 64„ Mottling @ 64" 9.47' • + ,. +*., � , ••••!' 7.5Y 5l6 1 6-16-08 MCP JLC ADDED EXISTING BUILDINGS ON PLAN + . •I •w • ,� • • 2: ALARM ACTIVATION REV. DATE BY APP'D. DESCRIPTION BARNES SE411 PUMP 0.4 H.P., 115 V,2 * •• •• w M . • DISCHARGE PASSING 1-1/2"SOLIDS OR EQUAL 72' 8 80' Standing @ 72" - - - - PROPOSED SEPTIC SYSTEM UPGRADE C PREPARED FOR: ' "• :• +; . Fine to Med. Sand • E7. �$ 1 • w • • it• i 2.5Y 6/4 •fit ►k'r - 1000 GALLON PUMP CHAMBER CAPEWIDE ENTERPRISES I t) II• �'. r SWING TIES w jl 1 �` • "' • _ _ LOCATED AT BUOYANCY CALCULATIONS 100" 6.47' 550 CRAIGVILLE BEACH ROAD ol( �( � 11 1 � s � • � DESCRIPTION HC 1 HC 2 SEPTIC TAN . �'`-�� �.°� it ' 1 �{�- .! � • '� K SEPTIC COVER IN (1) 13.5' 34.8' HIGH GROUNDWATER EL.=9.47'; BOTTOM OF SEPTIC TANK EL. =6.25' CENTERVILLE, MA -- ,��'�` �" � � �,, • WATER DISPLACED= (9.47'-6.25')x 13.0 x 7.0=293 C.F. WEIGHT OF DISPLACED WATER=293 C.F. x 62.4 LB/C.F. = 18,284 LBS. . . . SEPTIC COVER OUT(2) 21.T 29.4' WEIGHT OF H-10 2500 GAL. SEPTIC TANK=24,000 LBS. ' r •M " RESERVED FOR SCALE: 1 INCH = 20 FT. DATE: JUNE 5, 2008 1 * SOIL COVER=(15.00'- 13.33')x 13.0 x 7.0 = 152 C.F. J ' - PUMP COVER IN 3 27.T 26.T O WEIGHT OF SOIL ABOVE TANK= 152 C.F. x 120 LB/C.F. = 18,240 LBS. BOARD OF HEALTH USE o 10 20 ao 80 FEET 42,240 LBS. 18,284 LBS. (ACCEPTABLE) ems"°F"ems, PUMP COVER OUT(4) 29.6 32.4 �� JOHN L. c� .F° ��� `�. PREPARED BY: PUMP CHAMBER: o CHURCHILL C ENGINEERING, IN �\ \ _. '�' CORNER STONE(5) 47.4 46.5 JR. rl* HIGH GROUNDWATER EL.=9.47; BOTTOM OF PUMP CHAMBER EL. =7.12' c,�L J G C CORNER STONE (6) 35.4 49.4 WATER DISPLACED =(9.47 7.12)x 4.8 x 8.5=96 C.F. ° 41 °' 2854 CRANBERRY HIGHWAY WEIGHT OF DISPLACED WATER=96 C.F. x 62.4 LB/C.F. =5,991 LBS. LOCUS PLAN CORNER STONE(7) 81.5' 97.9' WEIGHT OF H-10 1000 GAL. PUMP CHAMBER=8,300 LBS. EAST WAREHAM, MA 02538 SITE PLAN SOIL COVER= (15.5'- 12.7')x 4.8 x 8.5= 114 C.F. 508-273 0377 SCALE: 1"= 1000' CORNER STONE (8) 874' 965' WEIGHT OF SOIL ABOVE CHAMBER= 114 C.F. x 120 LB/C.F. = 13,680 LBS. ----. - -- - - -- - - - - - - -- - - SCALE: 1"=20' . . 21,980 LBS. >5,991 LBS. (ACCEPTABLE) /;' Drawn By: MCP Designed By: MCP I Checked By:JLC Job No.:1424