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1927 FALMOUTH ROAD/RTE 28 - Health (2)
11927 FALMOUTH 'RD. , CENTERVILLE UNIT r jf A=189-067 A 6 II No. 42101/3 ORA ESSELTE 10% ® 0 0 0 OWN OF BARNSTABLE k— % 0 — 11 r LOCATION 15 �'�(„��,����` Q, SEWAGE#g -I m �.g 1 VILLAGE C��n��s ur�� ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. s> �r�J-' G,fit✓ , SEPTIC TANK CAPACITY LEACHING FACILITY:(type) ksize) K NO.OF BEDROOMS OWNER PERMIT DATE: iTt �� COMPLIANCE DATE: \ Q 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) / Feet "P FURNISHED BY -� Tca^�.lr �,per� GS� F�U•�• Q•� a6 0013 , �a � 3� � n :�e- 3 e � s a.3 01 No. 166; . Fee - , THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 4plication for Disposal A*pstrm Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade X Abandon( ) ❑Complete System Individual Components Location Address or Lot No. 1�a� T�,(,✓wca v��, ��5� Owner's Name,Address,and Tel.No. s�g-5'a`� `? 2 P -17 Assessor's Map/Parcel �•-7 WN A dQ C S5 Installer's Name,Address,and Tel.No. 's- roc�s3 Designer's Name,Address,and Tel.No. Type of Building: ?c Dwelling No.of Bedrooms Lot Size -z GY og p Garbage Grinder( ) I Other Type of Building No.of Persons Showers( ) Cafeteria( ) i Other Fixtures Design Flow(min.required) gpd Design flow provided 3 7 a I gpd i Plan Date 1,7D �7 Number of sheets_ Revision Date Title Size of Septic Tank J5'<0cn--r 6C<Z> Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) `:Z—j,s % 5� s � � S'nv �y�n ldo..�. -�,nc.,t.�, �1,...a�,.,�b�.r� �% S' r©� S��w•2 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date 77 Application Approved by Date Application Disapproved by Date for the following reasons r' Permit No. Date Issued 8z:tpo�ld LT GZ V03 4 L- No. s' ` , ,� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ftplication for Misposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade(4 Abandon( ❑Complete System 0 Individual Components Location Address or Lot No. --r- ��� d:�S?y Owner's Name,Addreess,and Tel.No. -1 7 O fJ —a .ram S -• �'r G o,a tea` y04� Assessor's Map/Parcel `ce d -7 C�c;`� ;� w\� CjA C s s I' Installer's Name,Address,and Tel.No.s -z��' Cosy Designer's Name,Address,and Tel.No.<d Z-_3,S(�-'33�l F�� '��k8'� ronacs��•d�ety-�...fa b�t'sYS/ �o S�3>c �f`? ( r"���1z..rr-t So�5.�'�C` t Type of Building: Dwelling No.of Bedrooms Lot Size o Y pQ ey§fl"fl' Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( Other Fixtures Design Flow(min.required) 7)-7 Q gpd Design flow provided -� 1 � gpd I. Plan Date t ( ( "c �7 Number of sheets Revision Date Title l Size of Septic Tank 5C)c2�r JJr.� b�-� Type of S.A.S. D 1 cription of Soil Y o -,a Nature of Repairs or Alterations(Answer when applicable) -'::V- i., `l_ \ �( S _�(�O.l�, .5, j ✓� S� 3- < z!-,5C%sS ,',c l �pllc,✓� 1.av \C. �.�. Ott �� © So y Date last inspected: 8Z:Poi+, a I0Z 170 DIG 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. - Signed Date �i� Date 1 Application Approved by NOW-`/ (�1,.-,/1,�,,. �i S Date Application Disapproved by Date ! .w for the following reasons Permit No. Date.Issued f Jp� 1 / f 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 at ��� f-a��,,c, ,� Q,�Q �k1 Ott has been constructed in accordance with the provisions of Titles 5 and the for Disposal System Construction Permit No. dated InstallerZ� `��; � -a „��,�-�",� Designer Cs c>>v�s Inc^ #bedrooms Approved design flow-- :3 3� gpd The issuance of this permit shall not be.construed as a guarantee that the system will,,fun on as degned. Date J /0 �� Inspector --------------/----- ---------(---------------=--------------------------------------------------------------------------------------------- No. �� ( ) (-! -- l�� / Fee D6 4 THE COMMONWEALTH OF MASSACHUSETTS , PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposat *pstem Construction Permit Permission is hereby granted to Construct( ) Repair( ) c—Upgrade(r_( Abandon( ) System located at I, and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. ` i Provided:Construction must be completed within three years of the date of this permit. 1' 1 Date ( Approved by yv` 1 I , b Town of Barnstable Regulatory Services * Richard V. Scali,Interim Director • anxivsena[.e. MAS& ��$ Public Health Division gft659. p Thomas McKean,Director i 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: (+� Sewage Permit#Q<)o -`Yr Assessor's Map\Parcel V alb, �. . S6n� L; Designer: e� S Installer: I Address: !�� �1�f f Address: Cs le) Ind t (9, IVA a,;� a 5 On . -�� ,;; was issued a permit to install a (dat v installer) septic stem at based on a design drawn b p Y � Y (address) �6. ry�e.t�,. M dated (d sig r) I certify that the se tic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. 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 component of the septic system)but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(iT required) was inspected and the soils were found satisfactory. I certify that the system referenced above was construct e with the terms of the IAA approval letters(if applicable) 7T nstaller's Si ature� r : 99 �4 signer's&,gnature) (Affix Designer -amp Here) r �E—T'URN TO B SWABLE PUBLIC HEALTH DIVISION. CERTIFICATE IANCE WILL BE ISSUED UNTIL BOTH THIS FORM AND AS- ARE RECEIVEh BY THE BARNSTABLE PUBLIC HEALTH DIVISION. .ertification Form Rev 8-14-13.doc T ' c) MEYER & SONS, INC. A . PO BOX 981 E.SANDWICH. NAA 02537 508-352-2922 BEDROOM SUMMARY 1.927 FALMOUTH ROAD, C:'ENTERVILLE, MA. 3 BUIL.DINGS (A1..l.. PRE EXISTING BUILDINGS) : B UI1:,I)I NG BREAKDOWN: E.N1TS 2-� BEC)ItOC)�-15 LNITS 6-8 3 BEDROOMS UNI"I'S 9-1 1 3 BEDROOMS ITB BREAKDOWN: k x L NI"I' 2: 1. BEDROOM t NIT 3: 1 BEDROOM t NIT 4: 2 BEDROOMS I..NIT 5: 1 BE::DRt:OTVI I. N11' G: S"I`C IDIO U N IT 7: S`I'C:D I O I N[`I` 8: ST111 DIO (. N1,.1, 9: S'I"I_;IAO :NIT 10: STUDIO L.NI`I' 11: S'FUDIO TOTAL, BEDROOM CO(JNI' FOR PROPF-R'I'Y: 19BI.,,I)IZOOMS TOTAL,: AL., (NO PROPOSED INCREASE IN FI..,C)W) i !► ro `J (p i ��r C• e , � 1 VVII LZI a S t� AK 5 f L c31'ti tl`�'='xcl`.sT•' � S� tc��'� ,+. ;y�A—.�. �3'x �t F f r l YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town(which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. U DATE: l-3 Fill in please: APPLICANT'S YOUR NAME S t F�G1 iz_doso USINESS YOUR HOM ADDRE S: ,A LM Ov fl (5�) 134 GYq CEti TELEPHONE # Home Telephone Number NAME OF CORPORATION: V f= J u E NAME OF NEW BUSINESS TYPE OF BU ESS - 1ti IS THIS A HOME OCCUPATION? YES NO ADDRESS OF BUSINESS I I � MAP/PARCEL NUMBER (Assessing) Cer ry i 0,: ,6 3 a-,, When'starting a new.business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S FFICE UST COMPLY WITH HOME OCCUPATION This individual has been in r d f any per a uirements that pertain this type of busineULES AND REGULATIONS. FAILURE TO Authorized Sin OOMPL.Y MAY R€OULT IN PINtk CO MERITS: t1t4"e 44 2. BOARD OF HEALTH This individual har n informed of erm' requirements that pertain to this type of business. M,.I �eQ�111PLW)TFI�1L A, tt'4110A kfAZ11DO1� lAA►7EflAl3 REd1It�JS Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: Date: TOWN OF BARNSTABLE OXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: C Ou �'L� rJ,' BUSINESS LOCATION: v2 C Can INVENTORY MAILING ADDRESS: ct Len rv'� TOTAL AMOUNT: TELEPHONE NUMBER- CONTACT PERSON: AR. 0S'J r EMERGENCY CONTACT TELEPHON NUMBER: MSDS ON SITE? TYPE OF BUSINESS: INFORMATION / RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes D()Si t Laundry soil &stain removers (including bleach) Spot removers&cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials Town.of Barnstable P# j 7 ' Department of Regulatory Services 1 F Public Health Division ]0 ' Date Ia sd7p• 200 Main Street,Hyannis MA 02601 Date Scheduled ---t`—= Tf'rne _ tee Pd._ Oil )Suitabil'ty Assess ent for a Dispos l hh � Performed By: l�. Witnessed By: P LOCATION&.GENERAL INFORMATION Location Address . Q-PD, -pp�oez Name �'��"�k r`__S, (e l as C V"'" O'�6ss Asaoasor'e Map/Parcel: r` �� 1©�7 Engineer's Name NEW CONSTRUCTION REPAIR Tele.hone# S'O 3 CC.) 33 Land Use 1��� t•� iV � I Slopes Surface Stones Distances from: Open Water Body> U0 lt possible Wet Area-�J* aft . Drinking 1'Vatcr Well ft ',-.t�. `) 4 Dmihage Way ft Property Line / D ft Other ft SKETCH:(street name,dimensions of lot,exact locations of test holes&pare tests,locato wetlands in proximity to holes) KY Sff,A— oo c Mai\ JQkj 11 13011 Parent material(geologic) Depth to Bedrock Depth to Oroundwater. Stan ng Water in Hole:l Weeping from Pit Paca Bstimated Seasonal High Oroundwater_ 1 DETERMINATION FOR SEASONAL'HIGH WATER TABLE Method Used: Depth Observed standing In obs.hole: In, Depth to sell mottles. Jn, Delith to weeping from aide of obs,hole: In, Cimundwater Adjustment }t, Index Well-0 - Reading Date: Index Well Ievol� � AdJ4hotbr•, Adj.GroundwaterLavel..._. PERCOLATION TEST' Date Thne, Obaervadon � / ' Hole# y Time at 9" Depth of Paro 1 Time at 6" Start Pre-soak Time® (6) Time(91141) End Pro-soak to Rate Mlh./Inch , Site Sultabillty Assessment: Site Passed _ Site Failed: Additional Testing Needed(YIN) 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 t"irst notify the Barnstable Conset}vation Division at least one(1)week prior to beginning. Q:%EPTICIPBRCFORM.DOC DEEP•OBSERVATION HOLE LOG Hole# Depth from Soli Horizon Soil Texture Shcl Color Sall. Ftb.r Surface(in.) (USDA) (Munsell) Mottling (Structure,Stoned;Boulders. Corialstency.% 3ravgll I 1 3 . &�vl 3Z DEEP OBSERVATION HOLE LOG Hole# Z/ Depth from Sall Horizon Sall Texture Soil Color Sall Other Surface(la.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, 6 -40 LD a- DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Sall Color Sall Other Surface(in.) (USDA) (Munsell) Mottiing (Structure,Stones,Boulders, Consistency, Oravell DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Sol[Texture Soil Color nail Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders, Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes y__ Within 500 year boundary No= Yes Within 100 year flood boundary No.-, Yes Depth of Na turgUy Occurring Pervious MaterigI Does at least four feet of naturally occurring per 1 us;t-0rator,"',,, axles in all areas observed thrpughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pe to ,.. Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department o nvlronm ntal Protection and that the above analysis was performed by me conslstant with . the required. aln arose nd experience descr bed in 10 CMR 15.01? Signature Date , D Q.xS.BPTIC\PBACPORM. 00 Miorandi, Donna From: Miorandi, Donna Sent: Wednesday, December 13, 2017 11:42 AM To: 'Meyer And Sons' Cc: 'pts@readyrooter.com'; Heath DeptMailbox Subject: RE: 1927 Falmouth Rd Hi Darren; Just had our staff meeting and we all looked at the plan including the floor plans. It is agreed that units 2- 11 have a total of 11 bedrooms so you don't have to do an I/A. This does not include Unit 1. However,you do have to submit a plan showing all buildings on the lot including septics, water lines, etc. in order for me to move forward on approval on this repair permit. Any questions feel free to contact me. Donna Miorandi -----Original Message----- From: Meyer And Sons [mailto:meyerandsonstitle5@gmail.com] Sent: Wednesday, December 13, 2017 8:19 AM To: Miorandi, Donna Subject: 1927 Falmouth Rd 7, Miorandi, Donna From: Miorandi, Donna Sent: Tuesday, December 05, 2017 8:39 AM To: meyerandsonstitle5(§gmail.com' Subject: 1927 Falmouth Road, Centerville Hi Darren: Your plan for this property requires that we have an accurate floor plan showing all the bedrooms in all 3 buildings. There seems to be a discrepancy in bedrooms from what you present,what the town has and what a 1993 engineered plan shows. Tom McKean states that it may kick in the 1650 rule or due to the fact that it is in the Saltwater Estuary the BOH may want an I/A system. It is a relatively small lot for all those bedrooms. As you know today on that size lot it would only have 3 bedrooms total. Talk soon I am sure. 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UNIT APARTMENT 8 / APARTMENT i/ /�� i �•.� BUILDING/ �; ��'�FF Ems. 5 ?_8�/. j% [tQjs ,Wt T i l FF' EL.. 53.48// T 1 \ / - �.;.;i� s _� j � NVER7 3 INVERT 4 .w Citizen Web Request Page 1 of 1 Citizen Request Management Request ID: 53007 Created: 6/22/2015 3:15:55 PM Status: Assigned To Staff Assigned To: Parziale, Jim Health Office Anonymous: No Category: Chapter II : Housing Substandard E.C. Date: 7/7/2015 Created By: Crocker, Sharon Citations: Health Office Time Worked: 0 Response Time: 0 Request Location: 1927 FALMOUTH ROAD/RTE 28 Centerville, Ma 02632 Parcel Number: Map: 189 Block: 067 Lot: 000 Request: Caller said they are in a rental and have bedbugs(bites and hives). Just threw mattress away. Also, dog is trained rat terrior and has now been going crazy with the closet. There are rats at the neighbors next door. Request Work History: http://issgl2/IntemalWRS/WRequestPrintPub.aspx?ID=53007 6/26/2015 MEYER & SONS, INC. PO Box 981 • E. SANDWICH, MA02537 508-362-2922 BEDROOM SUMMARY 1927 FALMOUTH ROAD, CENTERVILLE, MA 3 BUILDINGS (ALL PRE EXISTING BUILDINGS) : BUILDING BREAKDOWN: UNITS 2-5 5 BEDROOMS UNITS 6-8 3 BEDROOMS UNITS 9-11 3 BEDROOMS UNIT BREAKDOWN: UNIT 2: 1 BEDROOM UNIT 3: 1 BEDROOM UNIT 4: 2 BEDROOMS UNIT 5: 1 BEDROOM UNIT 6: STUDIO UNIT 7: STUDIO UNIT 8: STUDIO UNIT 9: STUDIO UNIT 10: STUDIO UNIT 11: STUDIO TOTAL BEDROOM COUNT FOR PROPERTY: 11 BEDROOMS TOTAL (NO PROPOSED INCREASE IN FLOW) ARCHITECTURE ENGINEERING SURVEYING v Cal— i kc� CS l �_ 57 ej +3 MICA- I, kay- 9 Y 1 SAV 14 e L- -Z-"a���--7> 'a'l t. , rxc i • b p Q Rax W I 1 4, 1 1 L 19 M Pi 1121 t T Ll 9 2 A "RVH L 131111 Ol%A il; i Al I PRI I-A"ISTI"NO 141,111.1)l N,i4 I 1 1 N't P B R K I-K AV\ I'NI TS 2-5 5 111.1)RC1,,ONO, I N1 IN ij x ; ail 'I*f,(10,0,,%;N I N I I'S ')-1 1 3 111 ;1 HUX K\I I'M V I 1 1.4 Fll),R(x P.\I I iN I I A o III I TROP")XV. 1 1101 1 1 11 M 10 A F I I)k i )U 1% 11 14 )R(A ONV% I r 0 1 Ar, 1IN't)P(),sl"D VNOfll. vd* IN I L�AV) V 4111H 11,911 1..,% a N 1,1 ho\1 i Town of Barnstable Page 2 of 2 Stories 1 Story Interior Drywall Walls Living Area 484 Exterior Wood - sq/ft Walls Shingle Gross Area Roof sq/ft 484 Structure Gable/Hip Roof Asph/F Cover GIs/Cmp I http://www.townofbarnstr.bte.us/Assessing/printsketch.asp?mappar=189067 12/4/2017 Town of Barnstable Page 1 of 2 Go Back Building Details Land Building $488,400 Bedrooms 5 USE 1120 value Bedrooms CODE , Replacement Lot Size $186,154 Bathrooms 5 Full 0.64 Cost (Acres) MA Total .Appraised$ *_, t Model Residential 7 Rooms Value 76,300 Style Family Heat Fuel Gas Assessed $ Conver. Value 76,3001 ' Grade Average Heat Type Hot Air w [{p Year Built 1949 AC Type None Effective 15 Interior Carpet et Units#6;8 u mt'#9-10 depreciation Floors k. Stories Interior Drywall Walls Living Area 612 Exterior Wood sq/ft Walls Shingle Gross Area 2,425 Roof Gable/Hip sq/ft Structure Roof Asph/F Cover GIs/Cmp Building Details Land Building $488 400 Bedrooms 4 USE 1120 value Bedrooms CODE Replacement Lot Size fl $239,192 Bathrooms 4 Full 0.64 n 4 Cost (Acres) x Total Appraised$ 1, + 4 'Q;- Model Residential 8NJ Rooms Value 76,300 I � i Style Family Heat Fuel Gas Assessed $ tt ail Conver. Value 76,300 Grade Average Heat Type Hot Aire .' Year Built 1949 AC Type None , Effective 15 Interior p Car et ..: U,mt#2•,' depreciation Floors Units#3;5 Stories Interior Drywall Walls Living Area 2,337 Exterior Wood sq/ft Walls Shingle Gross Area 3,210 Roof Gable/Hip sq/ft Structure Roof Asph/F Cover GIs/Cmp Building Details Land Building $488,400 Bedrooms 1 USE 1120 value Bedroom CODE Replacement$67,987 Bathrooms 1 Full Lot Size 0.64 Cost (Acres) Model Residential Total 4 Rooms Appraised$ Rooms Value 76,300 Style Cottage Heat Fuel Gas Assessed $ Value 76,300 Grade Average Heat Type Typical Year Built 1949 AC Type None Effective 21 Interior Carpet depreciation Floors P f http://www.townofbamstable.us/Assessing/printsketch.asp?mappar=l8%6 7 `,r`j 12/4/2017 h SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. S' nature item 4 if Restricted Delivery is desired. '>_ Agent ■ Print your name and address on the reverse X ❑Addressee so that we can return thecard to you. eceived by(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. 11bin t D. Is de very address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No (i d Centerville Village Realty Trust � 3. Service Type 770A Main Street ,Certified Mail ❑Express Mail I Osterville, MA 02655 ❑Registered ❑Return Receipt for Merchandise, ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes ?` (Transfer from servicelabel) 11 } ' 7 012'1 o 10' a'o o rj 2 8'S o F8 6 21--- —� I I P.S Form 3811. February 2004 Domestic Return Receipt 102595-02-M-15401 L. UNITED STATES,?.QS.TAL_SERVICE First-Class Maio .;} Postage&Fees Paid : �. ' _4 uses Permit No.G-10 P-14SL • Sender: Please print your name, address, and ZIP+4 in this box • i Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 ` T f Certified Mail#7012 1010 000 2850 8821 VET°wti Town of Barnstable Regulatory Services BARNSTABLF, v�. =b M Richard Scali, Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 October 21, 2014 Centerville Village Realty Trust 770A Main Street Osterville, MA 02655 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II — MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION (( AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you located at 1927 Falmouth Road Apt. #10 Centerville, was inspected on October 21, 2014 by Timothy O'Connell, R.S., Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of the rental registration in accordance with Chapter 170 of the Town of Barnstable Code. The following violations of the State Sanitary Code were observed: 105 CMR 410.500—Owner's Responsibility to Maintain Structural Elements: Back exterior door located within bedroom leaks; is in disrepair and must be replaced. Steps leading into dwelling unit are loose and in need of repair. You are directed to correct the violations listed above within 30 days of your receipt this letter by repairing steps as mention above and by replacing said door. 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. Non-compliance will result in a fine of$100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. ER OF THE BOARD OF HEALTH QZ McKean, R.S., CHO Director of Public Health Town of Barnstable Q:\Order letters\Housing violations\Rental ordinance\1927 Falmouth Road Apt. 10 10-21-14.doc COMPLETES ENDER: •N COMPLETE THIS SECTIONON DELIVERY ■ Complete items 1,2,and 3.Also complete A. I ature item 4 if Restricted Delivery is desired. bcagent ■ Print your name.and address on the reverse ❑Addressee so that we can return the card to'you. Received by(P'nted Name) C. Date of Delivery ■ Attach this card to the back'of the mailpiece, U6 e C 1 U I or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1, Article Addressed to:, '-- If YES,enter delivery address below: I;No• I I jCenter`ville Village Realty Trust 770A Main Street 3: Spice Type 1 Osterville, MA 02655 certified Mail ❑Express Mail I f ,� ❑Registered ❑Return Receipt for Merchandise I ❑Insured Mail ❑C.O.D. I - 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Rrtic.a Number ! I j (Transfer from service labe) { 7a21''2 I .. 1�;;t 0 0 0'0 ;2 i``5 2 r_8 8 H ,� f o I PS Form 3811. February 200d Domestic Return Receipt 102595-02-M-1540 :. � UNITED SPAT .�i�; TR11.YSr1G19u � ,_ • Sender: Please print your name, address, and ZIP+4 in this box • ^9 Town of Barnstable L Health Division 200 Main Street `-----„- nnic_4A_W)601_----- --� � I I Certified Mail#7012 1010 000 2850 8807 ��tT°wti Town of Barnstable o� Regulatory Services BARNSraat,E, M^S& Richard Scali, Director Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 October 15, 2014 Centerville Village Realty Trust 770A Main Street Osterville, MA 02655 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II — MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you located at 1927 Falmouth Road Apt. #1 Centerville, was inspected on October 14, 2014 by Timothy O'Connell, R.S., Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of the rental registration in accordance with Chapter 170 of the Town of Barnstable Code. The following violations of the State Sanitary Code were observed: 105 CMR 410.351 —Owner's Installation and Maintenance Responsibilities. Window observed within bedroom that was lacking a lock. Multiple outlets within kitchen area either not working or shorting out when used. You are directed to correct the violations listed above within twenty four (24) hours of your receipt of this notice by repairing locks. You are directed to correct the - violations listed above within 30 days of your receipt this letter by hiring a MA Licensed electrician'to repair or replace outlets so they work as intended to.. 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. Non-compliance will result in a fine of$100.00'per violation. Each day's failure to comply with an order shall constitute a sep ate violation. R ORDER F THE BOARD OF HEALTH omas A. McKean, R.S., CHO Director of Public Health Town of Barnstable QAOrder letters\Housing violations\Rental ordinance\1927 Falmouth Road Apt. l.doc. �I � VE Town.of Barnstable r 41 Department of Regulatory Services Public Health Division Date MA8.4 0.19 m� 200 Main Street,Hyannis MA 02601 ,All lft)AAA � Date Scheduled— D Time Fee Pd. "" Soil Suitability Assessment for Se e Dis ®s Performed B /�/• �/ �rJt'�L y'- Witnessed By: LOCATION & GE1 NERAL INF ORMATIOaT Location Address 0wncr's Name /-/c Address o 72c>4 ,t, 4.1 U F7 Assessor's Map/Parcel: Engineer's Name NEW CONSTRUCTION REPAIR �� �S !!JJ Telephone# Land Us..C�l l j�{G -^�� Slo es 90 W P ( ) Surface S ones _than.� Distances from: Open Water Body 2:�o ft Possible Wet Area>Z Sd ft Drinking Water Well zl�_ ft Drainage Ways Lw ft Property Line ft Other It SIMTCH:(Street name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands in proximity to holes) Parent material(geologic)Cf�'�"' �t_ O JJ Depth to Bedrock, Depth to Groundwater. StandingWater in[-Tole: Weeping from Pit Reee Estimated Seasonal High Groundwater DETERARNATION FOR SEASONAL HIGH WATE R TABLE Method Used: Depth Observed standing in obs.hole: _ In. Depth to soil mottles: ln. Depth to weeping from side of obs.hole: In, Groundwater Adjustment ft. Index Well# Rcading Date: Index Well level Adj.factor- Adj.(Jroundwaterlevel PEIRCOLATION TEST Thne � Observation Hole It Time at 9" ZZ a �. Depth of Pere W-5 Time at 6" Start Pre-soak Time @ Time(9"-6") End Pre-soak Rate Min./Inch / Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***jf 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. qns EfffCArERCFORM.DOC r DEEP.OBSERVATION HOLE LOG Hole# .Z Depth from Soil Horizon Soil Texture .Sdil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones,,Boulders. onsi tenc ravel Z y �s Faye 7- s 7 DEEP OBSERVATION HOLE, LOG Hole# y Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mmrsell) Mottling (Structure,Stones,Boulders. . onsisten % ravel 2 '- v DEEP OBSERVATION HOLE LOG Mole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stricture,Stones,Boulders. Consistency,9n Graven DEEP OBSERVATION DOLE LOG hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consi ten a x -Moo 1 Ynggrance Rate Mnj,: Above 500 year flood boundary No + Yes Within 500 year boundary No '� Yes Within 100 year flood boundary No✓ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? VCR_ If not,what is the depth of naturally occurring pervious material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Envlron ental Protection and that the above analysis was performed by me consistent with the reqiliraylng,ex ertise and experience described in 10 CMR 15.017 Signatur ` Date QAS EPTIC\PERCPORM.D OC Hazardous Materials Inventory Sheet Checklist 3 Date 1__ Ptrysical Street Address-Check database to ensure it exists Working Phone Number Actual Amounts -( ie. gas being used to fuel machines, thinner to clean brushes all count as hazardous materials) Storage Information - location of storage, how long is storage for? If none, note that. isposal Information -where and who? If none, note that. Applicant Signature - understand what is listed and noted Staff Initial -any questions, know who to ask Vehicle Washing/Rinsing? -provide a vehicle washing policy and e plain it- note that it was given Attach the Business Certificate with your sign off and comments **The inventory form should explain what the business consists of and the procedures fhpv are rininn Nntas naari +n ha Icft+r_o ..i^i^ ..:L_1,.... . _i . YOU WISH TO OPEN A BUSINESS? For Your Information:, Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.- it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to time Town Clerk's Office, 1st. FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. ri vk - 1 ;, DATE: t) In 13 Fill in lease: { qh4, APPLICANT'S YOUR NAME/S: 3�6 S �L. I BUSINESS YOUR HOME ADDRESS: rC.L r—ov dApti� Y hY6T XI A7!4 • .I l S3 - t TELEPHONE # Home Telephone Number o Ac71 NAME OFCQIiPARTi@N NAME OF NEW BUSINESS � C TYPE.OF-BUS[NESS Cr= jA, Z r.,> +� IS THIS A HOME OCCUPATION? YES NO ADDRESS OF BUSINESS MAP/PARCEL NUMBER; (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST,GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. A. BUILDING CO MISSI ER'S OF E MUST COMPLY WITH HOME OCCUPATION This individ al n infer e o an er it requirem nts that pertain to this type of business. YK� F#UI�ES ARID REQU�TIONS.. FAILURE TO ` 'Au homed na ar COMPLY MAY. RESULT IN FINS . OMMENT 2. BOARD OF EALTH This individup a e infor 4'e �he p r iOequI hts that pertain to this type of business. `. -7 Authorized ti af'urg`** MUST yOMPLY WITH ALL COMMENTS: HAZA 3. CONSUMER AFFAIRS LICENSING AUTHORITY) This individual ha een ' r of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: TOWN OF ABLE BARNS T Dater /a� /� TOXIC AND HAZARDOUS MATERIALS ON-SITE4,1 NAME OF BUSINESS: ` BUSINESS LOCATION: a INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON: EMERGENCY CONTACT EPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: INFORMATION/RECOM ENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum r Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes , Laundry soil &stain removers TVA (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Appli�,' Si ature Staff's Initials r Bazar ous Materials Inventory Sheet Checklist Date ysicalStreet Address-Check.database to`ensure.it y Working Phone-Number �- Actual Amounts -<( ie. gas being used to fuel machines;.thinner to w. ... clean brushes all count-as.hazardous:materials=no%blanks) Storage Information.-:location of"s.torage,.how7long.is storage for,? If none; note that.. . .; Disposal.Information;-where and:who?lf:none;-.note that.; s,,i Applicant Signature;- understand.what�is listed=and noted ,• . Staff Initial—any who-.to asks:, rIn Vehicle Washing/Rinsing?:-,give a vehiclewashing.:policy and ex lain.it ._ y, ttach the Business Certificate•with your-sign-off and,comrnents '*The inventory form should explain what the business consists of and-theprocedures they are doing. Notes need to be left to explain what you discussed with them. Date: 1 /2Y / � TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: @ ACif e) eo, BUSINESS LOCATION: 7 U 1k cod t INVENTORY MAILING ADDRESS: ._O . 6 oX o2 02 S S t4 02,0-a-) I"s TOTAL AMOUNT: TELEPHONE NUMBER: 7 .� 14 CONTACT PERSON: L9�Oln„� EMERGENCY CONTACT TT LEPHON NUMBER: S DY 0 ,l MSDS ON SITE? TYPE OF BUSINESS: IN Fire District: Waste Transportation: A1114 Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts(Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals(Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt&roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes A z rn9 Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Q Windshield wash WHITE COPY-HEALTH DEPARTMENT I CANARY COPY-BUSINESS Applicant's Signatureo Staffs Initials YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for,4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this farm at 200 Main St., Hyannis. Take the completed form to the Down Clerk's Office, 1 st. FI., 367 Main St., Hyannis, MA 02601 Clown Hall) and get the Business Certificate that is required by law. DATE:D Id 113Fill in p se: APPLICANT'S YOUR NAME/S: -5- L BUSINESS YOUR HOME ADDRESS: l 9 `� TELEPHONE # Home Telephone Number NAME OF CORPORATION: NAME OF NEW BUSINESS TYPE OF BUSINESS. .sv-\ 925 Q r ✓•` S IS THIS A HOME OCCUPAT Q,N� YES NO ADDRESS OF BUSIN MAP/PARCEL NUMBER (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. —(corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your usiness in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. .`� Authorized Signature* COMMENTS: 2. BOARD OF HEALTH This individual h been inf' e of permit requirements that pertain to this type of business. Authorize Signature** V w MUST 4MPLYWITHALL COMMENTS: 117ARDQUS MATFRIAi gEni'`'T 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* .COMMENTS: w i F: i I BEr]NE�rr I+ NvmONMENTAL . ASSOCIATES INC. LICENSED SITE PROFESSIONALS Q ENVIRONMENTAL SCIENTISTS GEOLOGISTS®SANITARIANS TODD M.EVERSON,PWSO Senior Project Manager teverson@bennett-ea.com P.O.Box 1743,Brewster,MA 02631 0. i .. , r 1 f 4. I p�Av _ i k t lid k t A MM DD YYYY Delete NFIRS -1 01920 U 02 11 2012 11 112-0000346 000 ❑Change Basic i FDID * State* Incident Date * Station Incident Number * Exposure �h ❑No Activity ❑Check this box to Indicate that the address for this incident is provided on the Wildland Fire Census Tract $ Location* Module In Section a "Alternative Loc iEicati ation 5. on". Use only for Wildland fires. ®Street address 1927 " I I I I I 1 FALMOUTH RD IJ L_J❑Intersection Number/Milepost Prefix Street or Highway Street Type Suffix [:]In front of �'`� ❑Rear of 1-12 1 CENTERVILLE I (Llh 1 02 632 -1 ❑Adjacent to Apt./Suite/Room City State Zip Code [:]Directions Cross street or directions, as applicable Incident T * Midnight is 0000 C Type E1 Date & Times E2 Shift & Alarms 413 IOil or other combustible liquid Check boxes if Month Da Year Hr Min Sec Local Option Incident Type dates are the I' 1')'' same as Alarm ALARM always required �� (�� COM13 Aid Given or Received* Date. Alarm * 02 11 20 12 11:46:07 I3 1 (I 011 D Shift or Alarms District Platoon 1 ❑Mutual aid received ARRIVAL required, unless canceled or did not arrive IuI ® Arrival 1 021 1 111 1 2012 11:46:46 2 ❑Automatic aid recv. Their FDID Their E3 3 ❑Mutual aid given State CONTROLLED Optional, Except for wildland fires Special Studies 4 ❑Automatic aid given _ I I ❑Controlled " " 11 1 local Option 5 ❑Other aid given Their LAST UNIT CLEARED, required except for wildland fires }{ None Incident Number Last Unit Special1 t Special ❑ © Cleared �J 1 111 2012 16:08:06 Study l N D$ Study Value F Actions Taken * G1 Resources * "G2 Estimated Dollar Losses & Values Check this box and skip this LOSSES! Required for all fires if known. Optional section if an Apparatus or Personnel form is used. for non fires. None ri (Information, $I I � I ❑ Apparatus Personnel property Ll 000 11000 Primary Action Taken (1) r f 48 (Remove hazardous Suppression Contents $1 �� 0001 ,1 000 ❑ I Additional Action Taken (2) EMS PRE-INCIDENT VALUE: Optional 82 (Notify other agencies. Other 1 0001 1 00011 Property $I '� ElLJ 000 000 Additional Action,Taken (3) ❑ Check box if resource counts include aid received resources. Contents $1 , 000 ,L 000 ❑ Completed Modules Hl*Casualties❑None H 3 Hazardous Materials Release 2 Mixed Use Property ❑ ❑Fire-2 Deaths Injuries N None NN Not Mixed ❑Structure-3 Fire I I 1 0 Assembly use L� I � 1 ❑Natural Gas: �1°w leak, no e.,anatinn or xar�at actions 2 Q Education use ❑Civil Fire Cas.-4 Service 1 _J 2 ❑Propane gas: <21 lb. tank (a, in home BBq grill) 33 Medical use Fire Serv. Cas.-5 C1V111aE1iJ 3 ❑Gasoline: vehicle fuel tank or portable container 40 Residential use ❑EMS-6 4 ❑Kerosene 51 Row of stores H2 Detector fuel burning equipment or portable storage 53 Enclosed mall ❑HazMat-7 Re eseueue o :.,ehicle fuel tank or Required for Confined Fires. 5 ❑Di l fuel/fuel portable 58 Bus. & Residential ❑Wildland Fire-8 ❑Detector alerted occupants 6 [:]Household Household solvents: home/office spill, cleanup only 59 Office use 1 x- Apparatus-9 60 Industrial use 7 ❑Motor oil: frnm engine or portable container 63 Military use QPersonnel-10 2❑Detector did not alert them $ ❑paint from paint cans totaling< ss gallons 65 Farm use ❑Arson-11 U Unknown O Other: spe°ial H,r at actions req°ired or spill >ssgal., ❑ ❑ Hlease c molete the Hare�at form 00 Other mixed use J Property Use* Structures 341❑Clinic,clinic type infirmary 53 9 ❑Household goods,sales,repairs 3 42❑Doctor/dentist office 579 ❑Motor vehicle/boat sales/repair 13 1 ❑Church, place of worship 3 61❑Prison or jail, not juvenile 571 [:]Gas or service station 161 ❑Restaurant or cafeteria 41 9❑1-or 2-family dwelling 599 ❑ Business office 162 [:]]Bar/Tavern or nightclub 42 9®Multi-family dwelling 615 ❑Electric generating plant 213 ❑Elementary school or kindergarten 439 Rooming/boarding house 62 9 Laborato❑ ❑ ry/science lab 215 ❑High school or junior high 449❑Commercial hotel or motel 700 [:]Manufacturing plant 241 ❑College, adult education 459[:]Residential, board and care 819 ❑Livestock/poultry storage(barn) 311 ❑Care facility for the aged 4 64❑Dormitory/barracks 882 ❑Non-residential parking garage 331 ❑Hospital 519❑Food and beverage sales 891 ❑Warehouse Outside 936❑Vacant lot 981 ❑Construction site 124 ❑Playground or park 938 ❑Graded/care for plot of land 984 ❑ Industrial plant yard 655 ❑Crops or orchard 946 ❑Lake, river, stream 669 Forest (timberland) Lookup and enter a Property Use code only if 951 ❑Railroad right of Way you have NOT checked a Property Use box: 807 ❑Outdoor storage area 960 ❑Other street Property Use 1429 919 Dump or sanitary landfill 961 ❑Highway/divided highway 931 ❑Open land or field 962 ❑Residential street/driveway JMultifamily dwelling NFIRS-1 Revision 03 11 99 COMM Fire District 01920 02/11/2012 12-0000346 t K1 Person/Entity Involved Local Option Business name (if applicable) Area-Code I Phone Number c u iuL � � ❑Check This Box if Mr.,Ms., Mrs. First Name same .This as MI Last Name Suffix incident location. u I u Then skip the three duplicate address h Number Prefix Street or Highway Street Type lines. vp Suffix Post Office Box Apt./Suite/Room City u I -u State Zip Code More people involved? Check this box and attach Supplemental Forms (NFIRS-lS) as necessary K2 Owner Same as person involved? Then check this box and skip The rest of this section. u Local Option Business name (if Applicable) Area Code ?hone Number uI I " L � u ❑ Check this box if Mr.,Ms., Mrs. First Name MI Last Name Suffix same address as incident location. I I I I I I I Then skip the three duplicate address Number Prefix Street or Highway Street Type Suffix lines. Post Office Box Apt./Suite/Room City u u-u State Zip Code L Remarks Local Option Follow-up to incident #12-0000341 on 2/10/12. - 0921hrs Received call from Adam Hostetter property owner informing me that he has contracted with Tank Removal Services for site clean-up. He stated they will be there before 1200hrs. - 1035hrs Received call from Marcello Barboza who works for Adam Hostetter checking on status of situation. - 1140hrs 329 on location at site with owners agent Marcello, still waiting for Tank Removal Services. Reminded Marcello of smoke detector and carbon monoxide issues that are also pending for building. - 1210hrs Received call from Adam Hostetter stating Tank Services will be on site within 30 minutes. - 1235hrs Rick Mahoney from Tank Removal Services on site after looking at situation he stated he needs LSP on site to evaluate health and environmental concerns. Mr. Mahoney contacted property owner then Bennett Environmental Associates. Tank Removal Services left site to obtain more equipment and additional help. - 1315hrs. Spoke with David Bennett from Bennett Environmental Services explained situation to him, he had about 30 minute travel time to site. L Authorization 18350 I IMACNEELY, MARTIN 0. ISR. INSPEC 02 1 LLlj 1 2012 Officer in charge ID Signature Position or rank Assignment Month Day Year Chesoxcif XJ 18350 I [MACNEELY, MARTIN 0. I I SR. INSPEC j 1, 021 U 2012 same g Position or rank Assignment Month Dav Year as Officer Member making report ID Signature in charge. COMM Fire District 01920 02/11/2012 12-0000346 MM DD YYYY 01920 U 21 LU1 1 2012 1 12-0000346 000 complete FDID * State* Incident Date Station * Narrative Incident Nunber * Exposure �b Narrative: Follow-up to incident #12-0000341 on 2/10/12. - 0921hrs Received call from Adam Hostetter property owner informing me that he has contracted with Tank Removal Services for site clean-up. He stated they will be there before 1200hrs. - 1035hrs Received call from Marcello Barboza who works for Adam Hostetter checking on status of situation. - 1140hrs 329 on location at site with owners agent Marcello, still waiting for Tank Removal Services. Reminded Marcello of smoke detector and carbon monoxide issues that are also pending for building. - 1210hrs Received call from Adam Hostetter stating Tank Services will be on site within 30 minutes. - 1235hrs Rick Mahoney from Tank Removal Services on site after looking at situation he stated he needs LSP on site to evaluate health and environmental concerns. Mr. Mahoney contacted property owner then Bennett Environmental Associates. Tank Removal Services left site to obtain more equipment and additional help. - 1315hrs. Spoke with David Bennett from Bennett Environmental Services explained situation to him, he had about 30 minute travel time to site. - 1355 hrs Both Bennett Environmental and Tank Removal Services on site working - 1420 hrs initial air quality tests showed units 3, 4, and basement failed test, unit 5 ok and no access to unit 2. With property owners permission doors and windows in units 3, 4, 5, and basement opened for ventilation. Tank Removal Specialits pumped oil from plastic containers in basement to 55 gallon drum on side C of building. They also removed all containers from the site that were contaminated with fuel oil. - 1430 hrs verified properly operating smoke and CO detectors in common areas and all units except #2 - 1445hrs Bennett Environmental cleaned up all basement areas coverd with speedy dry and garden hoses that apparently were used to transfer oil from tank to plastic bins. All of these materials are stored in a separate 55 gallon drum on side C of the bulding. Additional ventilation fan set-up in basement to help with odor removal. - 1510hrs. After initial basement clean- up additional preliminary soil testing done on low spot in basement near base of chimney. Testing showed some additional contamination further testing will be done next week to determine extent. - 1545hrs apartments (except unit #2) and basement re-tested for air quality and all tested ok. Contaminated area in basement was isolated from rest of area with plastic and evacuation fan will be left running to help minimize vapors. Consulted by phone with Dave Stanton BOH and advised him of findings and results. He agreed that tenants can re-occupy the building, I notified Adam Hostetter and Marcello via phone that tenants are allowed back into units COMM Fire District 01920 02/11/2012 12-0000346 MM DD YYYY 01920 U 1 2 1 LL1j 2012 1 12-0000346 000 Complete FDID * State* Incident Date * Station Incident Number Narrative * Exposure * Narrative: - 1600hrs doors and windows secured to all units. Additional follow-up on site will be needed with property owner and Bennett Environmental. - 1609 hrs 329 cleared scene without further incident 02/11/2012 16:56:42 mmacneely COMM Fire District 01920 02/11/2012 12-0000346 A MM DD yyyy ❑Delete 101920 U 1 02 1 1 101 1 2012 11 112-0000341 000 NFIRs -1 FDID * State* Incident Date * Station Incident Number * Exposure ❑Change Basic ❑No Activity ❑Check this box to Indicate that the address for this incident is provided on the Wildl and Fire CeRBllS Tract ' 1 BLocation* Module In Section B "Alternative Location Specification". Use only for Wildland fires. ®street address 1927 " I FALMOUTH RD ❑Intersection Number/Milepost Prefix Street or Highway Rear of � Street Type) Suffix ❑Re ❑ front of 1-12 LCENTERVILLE l � 02 632 ❑Adjacent to Apt./Suite/Room City State Zip Code l [:]Directions Cross street or directions, as applicable Incident T �k midnight is 0000 C Type E1 Date & Times E2 Shift & Alarms 413 `Oil or other combustible liquidl Check boxes if Month Da Year Hr Min Sec Local Option Incident Type dates are the Y same as Alarm ALARM always required 14 1 � ��� Aid Given or Received* Date. Alarm * 02 10 2012 21:23:08 `—� I --I COMB D Shift or Alarms District Platoon ARRIVAL required, unless canceled or did not arrive 1 ❑Mutual aid received ❑ IuI ® Arrival * 02 10 2012 21:24:50 E3 2 Automatic aid recv. Their FDID Their State CONTROLLED Optional, Except for wildland fires 3 []Mutual aid given � P Special Studies 4 ❑Automatic aid given l l ❑Controlled " " II I Local option 5 ❑Other aid given Their LAST UNIT CLEARED, required except for wildland fires N None Incident Number Last Unit Special. t Special J ❑ ® Cleared 2J �� 2012 22:48:48Study ID4 Study Value F Actions Taken* Gl Resources * G2 Estimated Dollar Losses & Values Check this box and skip this LOSSES: Required for all fires if known. Optional section if an Apparatus or P Personnel form is used. for non fires. None Primary Action Takeenn (1) 8 lInve (1) e l Apparatus Personnel property $1I , 000 , 0001 El Suppression I IJ Contents $1 000 1 0001 El85 lEnforce codes l I I Additional Action Taken (2) EMS I I PRE-INCIDENT VALUE: optional 84 lRefer to proper Other 1 0002 1 0005 Pro pert y $1 —J ' 000 J , 000 J El Action Taken (3) ❑ Check box if resource counts include aid received resources. Contents $1 f 000 000 ❑ Completed Modules Hl*Casual ties❑None H 3 Hazardous Materials Release I Mixed Use Property ❑Fire-2 Deaths Injuries N ❑None NN Not Mixed ❑Structure-3 Fire 1 0 Assembly use I I I I 1 ❑Natural Gas: slow leak, n°evauation or Hauat action, 20 Education use ❑Civil Fire Cas.-4 Service 1 u 2 [-]Propane gas: <21 lb. tank (as in home BBQ gill) 33 Medical use F_JFire Serv. Cas.-5 I or portable contain: Residential use Civilianu �J 3 Gasoline: vehicle fool tank 40 ❑EMS-6 4 ❑Kerosene: fuel burnin 51 Row of stores H2 Detector g egnipmenc or portable ,torage 53 Enclosed mall QHazMat-7 5 ❑Diesel fuel/fuel oil:vehicae fuel tank or Required for Confined Fires. portable 58 Bus. 6 Residential ❑Wildland Fire-8 ❑ 6 ❑Household solvents: home/offices ill, cleanu 1❑Detector alerted occupants p� P only 59 Office use QApparatus-9 7 ❑Motor oil: from engine or Portable container 60 Industrial use X Personnel-10 2❑Detector did not alert them [:]Paint: 63 Military use 8 from Paint oan, totaling<BS gallons ❑Arson-11 65 Farm use U❑Unknown 0 ❑Other: special HazMat actions required or spill >SBgal., 00 Other mixed use Please co=lete the HazMat form I Li J Property Use* Structures 341❑Clinic,clinic type infirmary 539 ❑Household goods,sales,repairs 342❑Doctor/dentist office 579 []Motor vehicle/boat sales/repair 131 ❑Church, place of worship 3 61❑Prison or jail, not juvenile 571 ❑Gas or service station 161 ❑Restaurant or cafeteria 419❑1-or 2-family dwelling 599 ❑ Business office 162 ❑Bar/Tavern or nightclub 42 g Multi-£amil dwelling® Y g 615 []Electric generating plant 213 ❑Elementary school or kindergarten 43 g❑Rooming/boarding house 629 ❑Laboratory/science lab 215 ❑High school or junior high 449❑Commercial hotel or motel 700 ❑Manufacturing plant 241 ❑College, adult education 459❑Residential, board and care 819 ❑Livestock/poultry storage(barn) 311 ❑Care facility for the aged 4 64❑Dormitory/barracks 882 ❑Non-residential parking garage 331 ❑Hospital 519❑Food and beverage sales 891 ❑Warehouse Outside 936❑vacant lot 981 [:]Construction site 124 ❑Playground or park 938 ❑Graded/care for plot of land 984 ❑ Industrial plant yard 655 ❑Crops or orchard 946 ❑Lake, river, stream 669 ❑Forest (timberland Lookup and enter a Property Use code only if 951 ❑Railroad right of way you have NOT checked a Property Use box: 807 ❑Outdoor storage area 960 Other street ❑ Property Use 1429 919 ❑Dump or sanitary landfill 961 ❑Highway/divided highway en land or field Multifamil dwelling ,., 931 ❑Op 962 ❑Residential street/driveway NFIRS-1 Revis� n 03 it 99 COMM Fire 01920 02/10/2012 12-0000341 K1 Person/Entity Involved I I 1 J _1 J_1J Local Option Business name (if applicable) Area Code Phone Number �J® IWilliana �� �Menezes I U Check This Box if Mr.,Ms., Mrs. First Name MI Last Name same address as Suffix incident location. I I u Then skip the three 1927 �J I FALMOUTH RD lines.lic address LJ Number Prefix Street or Highway Street Type Suffix I 1-12 ICENTERVILLE Post Office Box Apt./Suite/Room City IMA 1102632 State Zip Code More people involved? Check this box and attach Supplemental Forms (NFIRS-1S) as necessary K2 Owner Same as person involved? Then check this box and skip The rest of this section. u u Local Option Business name (if Applicable) Area Code Phone Number (Cynthia H. TR LCallahan ❑ Check this box if Mr.,Ms., Mrs. First Name MI Last Name Suffix same address as incident location. 770 �J ISO Main I ST u Then skip the three duplicate address Number Prefix Street or Highway Street Type Suffix lines. I 1 1 1 ICENTERVILLE I Post Office Box Apt./Suite/Room City IMA J 0266332_�-�� State Zip Code L Remarks Local Option Capt. 321 dispatched w/ engine 306 to a report of a CO detector sounding. Upon our arrival of a wood frame multi-resident apartments we found the carbon monoxide detector sounding in Apartment 3. There were no CO readings however there was a strong smell of paint or fuel. Investigation by Lt. 306 finds a large spill of diesel fuel in the basement. It appears thta an oil tank was illegally moved from the basment. The oil spilled all over the basement and large amounts of speedi-dri had been applied. We also found three large (est 18-20 gallon) tubberware container containing additional fuel oil. Upon the discivery the following notifcations were made: Requested a Fire Prevention Officer to the scene. Inspector MacNeely responded. Requested the Town of Barnstalble Board of Health - Dave Stanton responded Requested D.E.P. , spoke with Dave Grafton for advice and he said because it was the interior it came under the jurisdiction of the Board of Health. Upon Inspector MacNeely's arrival he was able to notify a caretaker of the building, Marcello (spelling) . After consulting with the DEP, and the Baord of Health, along with Inspector Macneely, the following actions were taken. Occupants were evacuated from the building due to the strong smell of diesel fuel throughout the building. Consulting with the WISER programs and the DOT guidebook both recomended that people exposed be moved into fresh air. No one was complaining of any symptoms, the actions were taken proactively. Additional fire prevention concerns regarding smoke detectors in the building would be followed up with C-O-MM Fire Prevention. No one would be allowed back into L Authorization 18390 IJFrRGERS, D. BRADY ICAPT I II.C. I 02 1011 2012 Officer in charge ID In ture Position or rank Assignment Month Day Year Check Box if 0 18390 I RO E(' S/ D.' BRADY I I CAPT I I 1.C. 021 u 1 2012 same + Position or rank Assignment as Officer Member making report ID gnaFure gnment Month Day Year in charge. fi COMM Fire 01920 02/10/2012 12-0000341 MM DD YYYY 01920 U 1 21 LLOJ 1 2012 1 12-0000341 000 Complete FDID * State* Incident Date * Station Incident Number * Exposure * Narrative Narrative: Capt. 321 dispatched w/ engine 306 to a report of a CO detector sounding. Upon our arrival of a wood frame multi-resident apartments we found the carbon monoxide detector sounding in Apartment 3. There were no CO readings however there was a strong smell of paint or fuel. Investigation by Lt. 306 finds a large spill of diesel fuel in the basement. It appears thta an oil tank was illegally moved from the basment. The oil spilled all over the basement and large amounts of speedi-dri had been applied. We also found three large (est 18-20 gallon) tubberware container containing additional fuel oil. Upon the discivery the following notifcations were made: Requested a Fire Prevention Officer to the scene. Inspector MacNeely responded. Requested the Town of Barnstalble Board of Health - Dave Stanton responded Requested D.E.P., spoke with Dave Grafton for advice and he said because it was the interior it came under the jurisdiction of the Board of Health. Upon Inspector MacNeely's arrival he was able to notify a caretaker of the building, Marcello (spelling) . After consulting with the DEP, and the Baord of Health, along with Inspector Macneely, the following actions were taken. Occupants were evacuated from the building due to the strong smell of diesel fuel throughout the building. Consulting with the WISER programs and the DOT guidebook both recomended that people exposed be moved into fresh air. No one was complaining of any symptoms, the actions were taken proactively. Additional fire prevention concerns regarding smoke detectors in the building would be followed up with C-O-MM Fire Prevention. No one would be allowed back into the building until the problems were rectified. The Red Cross was called to the scene to assist in relocating The building owner would work with Inspector MacNeely and the Board of Health in having all hazadous materials removed from the site. (It was recommended by both myself and Inspector MacNeely that a number of old paint cans and thinner be removed at the same time) . Nothing was to be removed and/or cleaned until Inspector MacNeely and the Board of Health approved of the company (environemtal clean up company) and methods. In addition any smell from the product was to be removed. Inspector MacNeely would also enforce fire prevention codes (i.e. smoke detectors) before any occupants would be allowed to move back in. Inspector MacNeely would also coordinate housing issues from peopke evacuated from the home with the building owner and the American Red Cross. With all parties satisfied with any actions that could be taken at this time. Fire line tape was put over the entrance to the basement to discourage people from entering it without prior approval. Inspector MacNeely left his cell phone number with the building representative so that he could be contacted as arrangements were being made. The incident is on going pending Inspector MacNeely's follow up. COMM Fire 01920 02/10/2012 12-0000341 MM DD YYYY 3'1,920 j U 1 21 10 2012 �� 12-0000341 000 complete FDID * State* Incident Date * Station Incident Number Exposure Narrative * * Narrative: 02/10/2012 23:43:53 dbrogers COMM Fire 01920 02/10/2012 12-0000341 A MM DD yyy.y 920 I IMA 1 121 1101 1 20121 1 1 1 1 12-0000341 1 1 000 1 L 11 ❑Delete NFIRS - 7 FDID * State* Incident Date Station Incident Number * * Exposure * Haz No* ❑Change HazMat B HazMat ID Chemical * Diesel 1202 000 Name UN Number DOT Hazard CAS Registration Number Classification Physical State 1 Container Type C2 Estimated Container Capacity Dl Estimated Amount Released F'1 When Released I 1 , 11 11 101 1 ❑Solid Capacity: by volume or weight Amount released: by volume or weight 2 ®Liquid Container Type 3 ❑Gas C3 Units: Capacity Check one box D2 Units: Released Check one box U ❑Undetermined VOLUME WEIGHT VOLUME WEIGHT 11 ounces 21 ounces 11 ❑ounces 21 ❑ounces E Released Into More hazardous 12 ❑Gallons 22 ❑Pounds 12 ®Gallons 22 ❑Pounds 2 Materials? Use 13 []Barrels: 42 gal. 23 Grams ❑ 13 []Barrels: 42 gal. 23 ❑Grams additional sheets. 14 ❑Liters 24 ❑Kilograms 14 ❑Liters 24 [:]Kilograms L 8 1 15 ❑Cubic feet 15 ❑Cubic feet Released into 16 ❑Cubic meters 16 ❑Cubic meters F2 Population Density G2 Area Evacuated❑None H HazMat Actions Taken Complete the remainder Enter up to three actions taken of this form only for the first hazardous material 1 ❑Urban 1 ❑ square Feet L IJ involved in this incident. 2 ❑ Suburban 2 ❑ Blocks Enter Measurement Primary Action Taken (1) 3 Rural 3 ❑ square miles Estimated Number of I� Fl Released From: G Additional Action Taken (2) Check all applicable boxes C�1 Area Affected 3 People Evacuated ' I I I I Below grade 1 ❑ Square Feet Additional Action Taken (3) ® 2 ❑ Blocks C74 Estimated Number of I If fire or explosion is involved with a 1 Inside/On structure release, which occurred first? Storyof 3 ❑ square miles Buildings Evacuated Release I I 1 ❑Ignition U-❑Undetermined 2 ❑Outside of structur None 2 [:]Release Enter Measurement J Cause Of Release * K Factors Contributing to Release L Factors Affecting Mitigation Enter up to three contributing factors Enter up to three factors or impediments that 1 ❑Intentional affected the mitigation of the incident 2 ®unintentional release 46 1 Ilmproper movement of hazardousl ( N I (None I 3 ❑Container/ Factor Contributing To Release (1) Factor or impediment (1) containment failure 4 ❑Act of nature 5 ❑Cause under investigation Factor Contributing To Release (2) Factor or impediment (2) U [:]Cause undetermined after investigation Factor Contributing To Release (3) Factor or impediment (3) M Equipment Involved In Release N Mobile Property Involved ❑ None 0 HazMat Disposition* ❑ None In Release 1 [:]Completed by fire service only I I 1 2 [:]Completed w/ fire service Mobile property type present ❑Released to local agency Equipment involved in release 4 ❑Released to county agency Mobile property make 5 ❑Released to state agency Brand 6 ❑Released to federal agency Model L i IMobile property model Year II � 7 ®Released to a private agency g ❑Released to property owner Serial l I I U or manager I Number Q License Plate Number State HazMat Civilian Casualties Year �� I I IDeathsl Injuries DOT Number/ ICC Number I I NFIRS-7 Revision 5/6/99 COMM Fire 01920 02/10/2012 12-0000341 l 01920 �` U 1 21 10 2012 1 12-0000341 000 Responding FDID State Incident Date Station Incident Number Exposure Units/Personnel Unit Notify Time Enroute Time Arrival Time Cleared Time 306 Engine 306 21:23:40 21:24 :19 21:25:39 22:48:48 Staff ID\Staff Name Activity Rank Position Role 8235 DALBEC, EDWARD J Incident Respons Firefighter 8280 GALLO, RICHARD M. Incident Respons Firefighter 8405 SABATINELLI, ERIC J. Incident- Respons Lieutenant Unit Narrative Responded for a CO alarm activation. Upon arrival investigated first floor apartment, found strong unknown odor thru out residence. Metered the residence, zero readings found. Further investigation of basement area, found large amounts of absorbant material spread across the basement floor. Also found three large rubber containers containing heating oil. 321 notified of situation. Assisted with evacuation of occupants from the residence and scene security. Cleared to quarters. 02/10/2012 23:17:02 esabatinelli 321 Shift Commander 21:23:40 21:24 :04 21:24:50 22:48:37 Staff ID\Staff Name Activity Rank Position Role 8350 MACNEELY, MARTIN 0. Incident Respons Senior Fire 8390 ROGERS, D. BRADY Incident Respons Captain COMM Fire Page 1 01920 02/10/2012 12-0000341 A' "S .s M , r. Y � a a q' , . . r ^ �+ rr lav, : t+�, na e.: s a,nti• •�' „'. 4e' �" '..� d u- t r t� a, h � 1 r d � r :r '*`a.X"� ,i, _,- ."t.,;. .::, ....x. �;: 3++�.�. �+74^� , pa,gy.Ytl'�'a d��3 * � fir'• aq If �� d � '"`"ids' .���, " �:: •t � .r ,�r � r "t �""µ �,+,'a �,`�`��"'e$ � s� , y h"`s`.� ,. ' ,��.�?=� _:>� ,, r • �.,y r. Ux�"i `s �d i `��" y= etc ,:�, r o- ��'' 'w.,n a f!.'',., -:""'�. ..A. ,.. �' ,°a - r. � "� ♦ -x 'Yy.� � a :,,y,,,,.. �^ �, e:Y it ;C' I �.Fq<ri,. w �F� .rry�.. .�' ,.,.. �. „�", ° >.,,.. .. , a:C'""3'° k x +1 ,o � x-s�• _ ..h`:c�� ta°,�:; { y !3,'F �., 1 ,.:t..:m k�. ,may F. 77 x"'w�,t•c:+:'4 "1"µi�,hn,� it'd ,,,r. <���4����^., .�., i '. '1 ;1 �;';: '�"`' ,, "d" � i..� � �° .xi�;f"'�,i'�"V 1^d`k �, w ��M t�f� S�-'{x�sa+'t¢-,r� �v''a�ir�i �'"�� x• ry c *"'�"�'�er. v - t . r rot " Official Website of The Town of Barnstable - Property Lookup Page 1 of 4 Select Language Assessing Division Property Lookup Results - 2012 367 Main Street,Hyannis,MA.02601 <<BACK TO SEARCH << Owner Information - Map/Block/Lot: 189 /067/ - Use Code: 1120 i Owner Owner Name as of 1/1/12 CALLAHAN,CYNTHIA H TR Map/Block/Lot GIS MAPS 770 S MAIN ST 189/067/ OSTERVILLE,MA.02655 Property Address Co-Owner Name CENTERVILLE VILLAGE REALTY TRUST 1927 FALMOUTH ROAD/RTE 28 i i Village:Centerville i Town Sewer At Address: No L_ ' Assessed Values 2012 - Map/Block/Lot: 189 / 0671- Use Code: 1120 2012 Appraised Value 2012 Assessed Value Past Comparisons Building Value: $506,900 $506,900 Year Total Assessed Value j Extra Features: $0 $0 2011 -$904,500 Outbuildings: $6,400 $6,400 2010-$957,700 Land Value: $316,900 $316,900 2009-$963,200 I 2008-$938,500 2007-$938,500 j 2012 Totals $830,200 $830,200 2006-$966,900 1 Tax Information 2012 - Map/Block/Lot: 189 / 067/ - Use Code: 1120 ITaxes C.O.M.M. FD Tax(Residential) $ 1,187.19 Fiscal Year 2012 TAX RATES HERE Community Preservation Act Tax $209.71 Town Tax(Residential) $6,990.28 $8,387.18 Sales History - Map/Block/Lot: 189/ 067/ - Use Code: 1120 i History: Owner: Sale Date Book/Page: Sale Price: CALLAHAN, CYNTHIA H TR 7/21/1993 8688/243 $115000 BBX REAL ESTATE CORP 6/15/1993 8614/143 $122000 SAURO, DAVID A&JANICE L 3/15/1987 5590/001 $225000 COLBATH, CHARLES P 6/9/1980 3107/266 $0 Sketches - Map/Block/Lot: 189/067/ - Use Code: 1120 This property contains multiple sketches. Please use the navigation below the sketch to browse sketches. http://town.bamstable.ma.us/Assessing/propertydisplayscreenl 2.asp?searchparce1=189067... 2/10/2012 Official Website of The Town of Barnstable - Property Lookup Page 2 of 4 i { i c Units#6-8 Units 29-10 1 I { i Additional Sketches 1 1 213 1 Click Here for print version that displays all sketches at once AsBuilt Card N/A Constructions Details - Map/Block/Lot: 189 /0671- Use Code: 1120 I Building Details Land I Building value $506,900 Bedrooms 5 Bedrooms USE CODE 1120 Total Improvements Value $186,154 Bathrooms 5 Full Lot Size(Acres) 0.64 1 Model Residential Total Rooms 7 Appraised Value $316,900 Style Family Conver. Heat Fuel Gas Assessed Value $316,90( Grade Average Heat Type Hot Air Year Built 1949 AC Type None Effective depreciation 15 Interior Floors Carpet j Stories Interior Walls Drywall Living Area sq/ft 1,612 Exterior Walls Wood Shingle Gross Area sq/ft 2,425 Roof Structure Gable/Hip Roof Cover Asph/F GIs/Cmp I Outbuildings & Extra Features - Map/Block/Lot: 189/067/- Use Code: 1120 lCode Description Units/SQ ft Appraised Value Assessed Value j FOP Open Porch-roof-ceiling 365 $8,900 $8,900 WDCK Wood decking 448 $4,600 $4,600 w/railings WDCK Wood decking 80 $ 1,800 $ 1,800 w/railings http://town.bamstable.ma.us/Assessing/propertydisplayscreenl2.asp?searchparcel=189067... 2/10/2012 Official Website of The Town of Barnstable - Property Lookup Page 3 of 4 UST Utility Storage-attached 25 __w $000 $600 BMT Basement-Unfinished 768 $ 16,700 $16,700 Sketch Legend Property Sketch Legend AOF Office, (Average) FTS Third Story Living Area(Finished) SFB Base, Semi-Finished I BAS First Floor, Living Area FUS Second Story Living Area(Finished) TQS Three Quarters Story(Finished) BMT Basement Area(Unfinished) GARGarage UAT Attic Area(Unfinished) CLIP Loading Platform GRN Greenhouse UHS Half Story(Unfinished) CAN Canopy MZ1 Mezzanine, Unfinished UST Utility Area(Unfinished) FAT Attic Area(Finished) MZ2 Mezzanine, Semi-finished UTQ Three Quarters Story(Unfinished 1 FBM Finished Basement MZ3 Mezzanine,finished UUA Unfinished Utility Attic FCP Carport PAT Patio Outbuilding Listed UUS Full Upper 2nd Story(Unfinished) FEP Enclosed Porch PTO Patio WDKWood Deck FHS Half Story(Finished) REF Reference Only WKO Wood Deck Outbuilding Listed FOP Open or Screened in Porch SDA Store Display Area k Contact Director of Assess Jeffrey Rudziak P 508-862-4022 F 508-862-4722 8:30a.m.to 4:30p.n Helpful Links to I Abatements Department of R Exemptions Parcel Consolide Questions about Town Tax Rates Town Land Use Helpful Maps All Town Maps Flood Insurance Property Maps Contact Director of Assess Jeffrey Rudziak P 508-862-4022 F 508-862-4722 htt ://town.barnstable.ma.us/Assessin r/ o e dis la screenl2.as .search arcel-189067... 2/10/2012 p g p p �Y P Y p p Official Website of The Town of Barnstable - Property Lookup Page 4 of 4 8:30a.m.to 4:30p.n Related Boards Board of Assessors Owned and Operated by The Town of Barnstable-Information Technology Home Departments&Services I Boards&Committees I Residents&Visitors I Doing Business I Town Calendar I Phone Dir Employment I Email Town Hall http://town.bamstable.ma.us/Assessing/propertydisplayscreen 12.asp?searchparcel=189067... 2/10/2012 CENTERVILLE-OSTERVILLE-MARSTONS MILLS EST. DEPARTMENT OF FIRE-RESCUE&t EMERGENCY SERVICES 1875 ROUTE 28 CENTERVILLE,MA 02662-3117 1926 TEL.-508-790-2375 NEWS RELEASE FAX—508-790-2385 FOR IMMEDIATE RELEASE Type of Incident: Hazardous Materials Incident Date/Time of Occurrence: 02/10/2012 at 2123 hours. Location: 1927 Falmouth Rd.Centerville, MA Contact person: Capt. D. Brady Rogers E-mail: d brogers@commfi red istrict,com Incident Commander: Capt. D. Brady Rogers E-mail: dbrogers@commfiredistrict.com Statement(Facts upon arrival): C-O-MM Fire was dispatched to a report of a CO detector sounding. Upon arrival, investigation found a large interior fuel oil(home heating oil)I spill from an illegal tank removal.There was an undetermined amount of fuel spilled and an estimated 30 gallons of fuel was found illegally stored in plastic bins in the basement of the apartments.There were no injuries or illnesses but three people were re-located,with the assistance of the American Red Cross,from the building due to the strong smell of fuel oil throughout the building and additional fire prevention concerns. C-O-MM Fire Inspector MacNeely was going to coordinate with the Town of Barnstable Board of Health to rectify all problems before the residents would be allowed back into the building. Investigation and mitigation is ongoing. Property Owner: Listed by Barnstable Assessors as Cynthia Callahan Trust&Centerville Village Realty Trust Type of Damage: Minor:XX Moderate: Heavy/Severe: Cause: Illegal removal of fuel oil tank. Assisting Agencies: Fire Departments: Hyannis: Cotuit: Barnstable: W. Barnstable: Barnstable Police: State Fire Marshal's Office: Mass.State Police: _ American Red Cross: XX Others: Town of Barnstable Board of Health, Dept.of Environmental Protection Estimated#of emergency personnel on scene: 6 Injuries to emergency personnel: Yes:_ No: XX_ Injuries to citizens: Yes: No:XX (However 3 occupants were relocated). HIPAA regulations prohibit C-O-MM Fire from releasing the name(s)of people treated and/or transported. ENDS C-OMM Fire Form#23 07/01/06 I r 7 MRVr # Assessors Office (1st Floor) Assessor,s Map and Parcel # % G L 7 Building Department (4th Floor) Zoning INSPECTION FEE $5 0 60•G7) RE-INSPECTION FEE $15.00 Request For A Housing Inspection For Certification Under the I MA Rental Voucher Program Your Name Jv A Affiliation (Circle One) Owner Real Estate Agen Tenant Your Address 776)9 try I!e£tr Telephone Number (Day) �`lic� ZG -01 y (Night) Address of Property Where Inspection is Requested Unit/Apt.# 7 tf /hA ,Name of Owner ��/y� f/lviG�`t Address 776/V Mailing Address (if,different) Telephone Number (Day� )yz�-ol�S� (Night.) Will there be any children under the age of six (6) wh ' 11 .: be occupying the rental unit? (circle one) Yes No Was. the dwelling constructed prior to 1979? Yes No ' DEC 1 1 2002 xa TOWi,!OF BARNSTV" __ �T - — --- --- ---�-�a��.sasaaa:os-:sQ-aaa�'--acc—.—.-----3 8--------. - .- YFOROFFICEt'-USE:'ONLY: - a ciL+rvfi — dw*• i Y 3 Certification Th' 3edwelling; dwel - -ng nit; or rooming unit located at was• inspected on ' 1,2 �,302� b �a f N. W Healthy he k�;= � , " sInspector wfort t ,r u f; • , Town of. Barnstable and was found to be in "' F :c°mp¢1)i�an with the provisions contained ;within ' '105 CMR StSanitar Code II: Minimum Standards of ;Fitness. Habta�ton Y: Sowever this. certification' does: not. ana ex_ nation as `to whether thia:'unit, contains any h because# ,r# - � ,�; under 760 CMR 49 02 'Massachusetts "Rental ., uPro ram separate lead :.paint inspection must be yy � f TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE 11:MINIMUM STANDARDS FOR HUMAN HABITATION Date �3 Gam. d�'l le y 1 e J�( Owner --oA V +�� 1f.R I k-px� Tenant Address 92-7 Address Complionce Remarks or Regulation# Yes No Recommendations 2. Kitchen Facilities 3. Bathroom Facilities L O! 6� yv1 i SS r� AY,, S 4. Water Supply -IV LIP— V- ICLG� " Ae-eag D�/ 5. Hot Water Facilities `l �` Q, sr 6. Heating Facilities J tQGtiC-b`. ,�°d' r�') y` c 7. Lighting and Electrical Facilities J 8. Ventilation ✓ c 6 �� c r'� 9. Installation and Maintenance of Facilities SL"Y rt�nSs i r a r �-. 10. Curtailment of Service lC( 5;c-ZTi- 11. Space and Use jJ`l1551 n 12. Exits . 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents (�S C �C 15. Garbage and Rubbish Storage and Disposal `✓ � � 7_ c� c G . 16. Sewage Disposal -�`C, 17. Temporary Housing p iL ' ,41 PART II t. 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition 'Person(s) Interviewed Inspector f If Public Building such as Store or Hotel/Motel specify here _H �i HOBBS&WARREN,INC. MRVP # ' Assessors office (1st Floor) Assessors Map and Parcel # 189-129 Building De tment (4th Floor Zoning INSPECTION FEE $61 . 00 RE-INSPECTION FEE .$15. 00 Request For A Housing Inspection For Certification Under the MA Rental Voucher Program Your Name Judy McNamara >: Affiliation (Circle. One) Owner Real Estate A entl Tenant Your Address 770A Main StrPPt, 0stPrvillPP MA Q2699 Telephone Number (Day) (508)420-0644" (Night) Same Address of Property .Where Inspection is Requested Unit/Apt.# Unit- 1 { 1A27 Fa1month Road , CentPrvi11a, MA Name of Owner Centerville Village Apartments Address . 770A Main Street , Osterville. MA 02655 Mailing Address (if different) Telephone Number (Day) (508)420-0644 (Night) Same Will there be any children under the age of six (6) who will be occupying the rental unit? (circle one) : Yes No ) Was the dwelling constructed prior to 1979? ( Yes ) No FOR OFFICE USE ONLY: _ .. Certification The dwelling, dwellin unit, or rooming unfit located at h, / Z 4. c .o v.� 12d fieolety llt was inspected on Aa Y zy J by /e" rrr�, *v, P ,S. Health Inspector for the Town of Barnstable and was . found to be in compliance with the provisions contained within 105 CMR 410.00, State Sanitary Code, II: Minimum' Standards of Fitness for Human Habitation. However, this certification does not include a determination as to whether this unit contains any lead paint because under 760 CMR 49.02 Massachusetts Rental Voucher Program, a separate lead paint inspection must be conducted. Inspector's Signature . Date �� sW HOBBSB WARREN irn THE COMMONWEALTH OF MASSACHUSETTS FORM C BOARD OF HEALTH CITY/TOWN DEPARTMENT 4-ox imp ;M ADDRESS J16 I 6 q 4( i !��J TELEPHONE Address V,_; / 1 P 2 '/ �-ice"ot�" �` Occupants� Z— 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: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual E ress: and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: s'L"ak' rr-0- '— SM Roof wl �� 6✓ G roc R f bcC� �? Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: ® Pe_-lv%_aA-4 SyS,I r Lighting: STRUCTURE INT. Hall,Stairway: 4f Obst'n.: Hall, Floor,Wall, Ceiling: Hall Lighting: Hall Windows: HEATING / Chimneys: Central N Equip. Repair TYPE: S Stacks, Flues,Vents: PLUMBING: Supply Line: „v` ,tom ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent s - ELECTRICAL Panels, Meters,Cir.: &'I._ `B1'10 1�r'220 Fusing,Grnd.: AMP: 16-0 Gen.Cond. Distrib. Box:. Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 - Bedroom 4 Hot Water Facil. Su .Ten., as il, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink is S ie- Stove - r �7 --'-'�_-- %i-._. n6,...L. Q.,.,f+'r, t),(_ .... �'�i/�/1 .�,.v. /0�-1�..-.a t�.�t//n �'Y•r l/��/A,°Y'CIL� l w BENNETT ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (508)896-1706 Brewster,MA 02631 fax(508)896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: Hostetter Realty Trust 3/22/2012 BEA 12-10408 Adam Hostetter,Trustee 770 Main Street Osterville,MA 02655 REGARDING: FUEL OIL RELEASE INVESTIGATION SHIPPING METHOD: Regular Mail X❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ ;7 ' --1 r C" f Certified Mail ❑ Green Card/RR ❑ COPIES DATE DESCRIPTION ", i0- 1 3/15/2012 Fuel Oil Release Investigation -- Oak Tree Village ,'r 1927 Falmouth Road-Centerville,MA ! r j( C For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: ❑ REMARKS: cc: Fire Prevention Officer Martin MacNeely,COMM Fire Department David Stanton,Inspector-Barnstable Health Department FROM: DCB If enclosures are not as noted,kindly notify us at once n , t BENNETTENVIRONMENTALASSOCIATES, INC. LICENSED SITE PROFESSIONALS 0 ENVIRONMENTAL SCIENTISTS 6 GEOLOGISTS 6 ENGINEERS 1573 Main Street-P.O. Box 1743, Brewster, MA 02631 508-896-1706 Fax 508-896-5109 www.bennett-ea.com BEA12-10408 March 15, 2012 Hostetter Realty Trust Adam Hostetter, Trustee 770 Main Street Osterville, MA 02655 RE: FUEL OIL RELEASE INVESTIGATION Oak Tree Village 1927 Falmouth Road—Centerville, MA Dear Mr. Hostetter, BENNETT ENVIRONMENTAL ASSOCIATES, INC. (BEA) has'prepared the following narrative to document environmental conditions and appropriate remedial response actions at the subject property towards meeting regulatory requirements to support project closure in accordance with the provisions of 310 CMR 40.0000,the MA Contingency Plan(MCP). On February 10,2012, the COMM Fire Department investigation of petroleum odors reported.by tenants within the living units of the subject property found a minor release of fuel oil to the basement floor with open containers of#2 fuel oil that had been left by the tank removal contractor. These conditions were reported to the MA DEP and a Release Tracking Number was assigned. You were subsequently contacted by the MA.DEP as the property representative and advised to engage an LSP to oversee cleanup, evaluate potential exposure risks and determine the appropriate remedial response actions for cleanup. Based on concerns for the occupants, the Barnstable Health Department and COMM Fire Department ordered the dwelling vacated and the occupants were placed in temporary housing. BEA was contacted by you the following day and responded to the property to evaluate environmental impacts and exposure risks associated with the spill. On arrival,a distinct petroleum odor was noted in the basement[7.5 ppmv] and within each of the first and second floor living units [0.9 to 2.6 ppmv] with detectable concentrations recorded on the photoionization detector (PID) above the guidance threshold of 1.0 ppmv.1 The heat was temporarily shut off and windows opened in each of the living units to ventilate. In the basement, the open containers were pumped into a DOT drum outside the building and spent absorbents were removed from the basement floor and also drummed outside the building. A minimal area of concrete floor staining was revealed on the removal of the absorbents in the vicinity of a sump-like depression in the floor nearest the chimney. Soil in this area was obviously impacted. A crack in the floor was also identified as a potential route of infiltration into the environment. Subsequent to the removal of the remedial waste from the basement as a source of odor,a vapor barrier was constructed in that portion of the basement affected with the placement of plastic sheeting on the ceiling and as a curtain to the basement floor. A commercial fan was used to actively ventilate the isolated area and air quality improved immediately I MA DEP BWSC"Standard Operating Procedures Indoor Air Contamination"(2008) 1 EMERGENCY SPILL RESPONSE & WASTE SITE CLEANUP 6 SITE ASSESSMENT 0 PERMITTING & SEPTIC DESIGN&INSPECTION WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE 6 WASTEWATER TREATMENT,OPERATION&MAINTENANCE MARCH 15,2012 HOSTETTER/BEA12-10408 PAGE 2 OF 3 FUEL OIL RELEASE INVESTIGATION:1927 FALMOUTH ROAD,CENTERVILL,E with all areas reporting PID concentrations as<0.1 ppmv. As based on engineering controls and the absence of odor or detectable PID concentrations of organic vapors, BEA indicated that re- occupancy could be allowed wherein under the aforementioned SOP, no short term exposure risk was apparent. BEA contacted the MA DEP (Bob Murphy) to review remedial response actions and environmental conditions relative to a Reportable Condition and applicability to the MCP regulations, It was noted in such communications that the Department would require this additional information to make such a determination. Subsequent to authorization, BEA returned to the property on February 15, 2012 and met with Representatives of the Barnstable Health Department (David Stanton) to continue investigation of environmental impacts and evaluation of potential exposure risks. PID reading reported no detectable concentrations of organic vapors(<O.1 ppmv)in the basement or living areas. The concrete floor around the sump and crack in the floor were broken up to advance additional soil sampling and field testing to determine any significant infiltration through the floor and the vertical and lateral extent of such impacts [Refer to Field. Log and Site Plan]. Such testing indicated that infiltration had occurred in the area of the sump as resulting in significant soil impact vertically restricted to a depth of 2' below the basement floor. As such,it was determined that such materials would be removed and managed as remedial waste as a potential source of organic vapors and impact to indoor air. Soil removal was accomplished within the affected sump area in a 3' x 2' x 2' (D) area as placed into drums outside the building. Approximately 0.3 yards of soils were generated as remedial waste and placed in drums at the exterior of the building. Endpoint soil samples were collected as representative of sidewall and bottom of hole areas and submitted for laboratory analysis of Extractable Petroleum Hydrocarbons(EPH)with target analytes(PAH)as representative of fuel oil impacts under MA DEP Policy WSC-02-411. BEA received analytical results for the sidewall and bottom of hole samples wherein all fractional EPH compounds and PAH target analytes were reported as Non-Detect. Wherein the detection limit concentrations are less than the RCS-1 standards, this data demonstrated that there was no Reportable Condition as defined by release to the environment of more than 10 gallons of fuel oil or more than 2 yards of contaminated soils exceeding the RCS-1 standards. This information was communicated to the MA DEP that issued a BWSC-101 form.to close out the project within the MCP as a"less than" reportable condition. On March 1, 2012, BEA returned to the Site to remove equipment and to manage the remedial waste generated by the spill as including one(1)drum of virgin fuel oil and three(3)drums of petroleum impacted soils and absorbents. These materials were picked up from the property, transported and disposed of by licensed haulers to appropriately licensed facilities[Refer to Enclosed Uniform Hazardous Waste Manifests]. At the time of this work, the active ventilation and vapor barrier were removed and indoor air was allowed to equilibrate without engineering controls. No petroleum odor was noted and PID screening reported organic vapors as Non-Detect (<O.1). As consistent with the noted SOP and MA DEP policy, no degraded indoor air quality was noted following cleanup and all significantly impacted soils have been removed and properly managed as remedial waste. MARCH 15,2012 HOSTETTER/BEA12-10408 PAGE 3 OF 3 FUEL OIL RELEASE INVESTIGATION:1927 FALMOUTH ROAD,CENTERVILLE In conclusion, these actions document appropriate remedial response, management of remedial waste and evaluation of potential exposure risk associated with the incident,albeit outside the MCP as a Non-Reportable Condition. No additional actions are required under the regulations and the incident should be considered closed. A copy of this letter is being provided to the COMM Fire Department and Barnstable Health Department under local jurisdictional authority as part of the public record. If you have any questions or need additional information,please contact me directly at your earliest convenience. M IRONMENTAL ASSOCIATES, INC. e SP., CGWP., LPG. Encl. Site Plan entitled"Fuel Oil Release Investigation.....",Dated March 15,2012, and Prepared by BENNETT ENVIRONMENTAL ASSOCIATES, INC. Field Response Log Laboratory Analytical Results [ESS 2/27/12] Uniform Hazardous Waste Manifest [#008520499JJK(oil)# 67541 (soil)] Cc. Fire prevention Officer Martin MacNeely, COMM Fire Department David Stanton, Inspector—Barnstable health Department r i A PAGE 1 OF 4 FLOG/BEA12-10408 FIELD RESPONSE LOG RTN4-23798 Oak Tree Village BEA12-10408 Potentially Responsible Party: Hostetter Realty Trust Adam Hostetter, Trustee 770 Main Street Osterville, MA 02655 Property Location: Oak Tree Village 1927 Falmouth Road (Route 28) Centerville, MA Background Conditions: • Call from Rick Mahoney(TRS) at approximately 12:15 PM. Release of unknown volume of #2 fuel oil from an unpermitted AST removal. Oil spilled to concrete floor. The COMM Fire Department and Dan Crafton of the MADEP were notified. Inspector MacNeely of the COMM FD is onsite. • Dwelling serviced by natural gas, tank had been abandoned. • Speedi-Dry spread along release. Sump area and crack noted under absorbents • Fuel oil odor throughout the residence (one structure comprised of four living units). • COMM Fire Department and Barnstable BOH notify MA DEP (RTN#4-23798) and require temporary evacuation of tenants over air quality and odor/vapor concerns. Environmental Conditions: • Subject property is a multi-family residential dwelling in a mixed residential-commercial use area. The area of release in the basement is partially restricted with children potentially being present. • The property is within a Potential Drinking Water Source area although the property and surrounding area is serviced by municipal water and there are no known private potable wells within 500' of the property. • Based on environmental conditions and site features, the RCS-1 and RCGW-1 Reportable Conditions apply as would the S-1/GW-1, Method 1 — Risk Characterizations standards as defined within the MCP, 310 CMR 40.0000. r r PAGE 2 OF 4 FLOG/BEA12-10408 Remedial Response: 2/11/12 1:00 pm Receive call and dispatch to office for response. 1:25 pm Leave office with trailer. 2:00 pm Met by Inspector McNeely. Enter units for ambient air screening as follows: Location P.I.D. Unit#3 first floor 1.9 max Unit#4 upstairs 2.6 Unit#5 first floor 0.9 Basement 7.5 Open window to ventilate. Tank Removal Services uses fuel transfer pump to remove open containers of oil in basement and secure outside house. 2:30 pm Set up active ventilation fan in basement to exhaust under deck. Sweep Speedi-dry off floor and drum to remove any sources of odor. Install plastic vapor barrier around release area for isolation and active ventilation (fan exhausts from release area). 3:00 pm Collect soil sample from apparent sump area within area of former Speedi- dry for screening as follows: Location P.I.D. 0-1' 95 ppmv 1-2' 45 ppmv 3:30 pm Unable to advance to depth due to cobbles. Collect sample for analysis as may be appropriate. Base our additional testing to depth and testing along crack in floor. 4:00 pm Conduct indoor air screening with P.I.D. as follows: Location P.I.D. Basement 0.0 1 PAGE 3 OF 4 FLOGBEAI2-10408 Unit#3 0.0 Unit#4 0.0 Unit#5 0.0 Discuss results with Inspector Martin McNeely about re-entry. Based on BDL and no persistent odor, opine on policy that it is safe to re-occupy dwelling. Contact owner to discuss additional work. Clean up and leave site. 2/15/2012 9:10 am Arrive at Site. Greet Dave Stanton (Barnstable Health Dept). Review site, release area, and SOW for assessment. Enter basement, note faint fuel oil odor. TOV=BDL (outdoors/indoors). 9:20 am Begin to break up concrete around `sump' at chimney base and around unsheathed copper feed line (sub-slab). Note distinct fuel oil odor upon breaking hole in concrete. Continue to break up concrete within—3-4 sq ft area towards assessment and qualification of 2 cubic yards of significant impact(or greater). Note buried cinder block underlying the abandoned feed line. Unknown purpose. Break-up additional portion of concrete floor and discover that cinder block was part of abandoned drywell/cistern/sump (?) as approximately 60"L x 40"W x >2'D. No staining or odor reported as within or emanating from the found cavity. No staining or odor to exterior of found cavity. Note: Concrete slab z; 5' BGS. Cistern=concrete block and mortar with poured concrete cap. Collect soil samples from HB's for field screening as follows: Location P.I.D. Dexsil (from 2/11/12) HB-1: 0-2' ss 95 24' ss 1.3 HB-2: 0-2' ss 3.8 22 24' ss BDL <0.1 Review findings with LSP. Decide to excavate small area and collect end- point samples. PAGE 4 OF 4 FLOG/BEA12-10408 Plan to run active ventilation until lab report received. Will rely on P.I.D. for air quality (without ventilation)to confirm no significant risk to I.A. 12:30 pm Finish excavation. Collect BOH and SW-comp from approx. 3' x 2' x 2'D area of soil removal. Location P.I.D. BOH at 2' ss BDL SW-comp 5.0 12:40 pm Drum soils. Place planks over excavation and broken portion of cistern cap. Restore vapor barrier. Depart at 1:00 pm. 2/27/12 Receive analytical data for endpoint soil samples collected at the extent of soil removal. All fractional EPH and target analyte concentrations reported as Non-Detect wherein the detection limit concentrations are less than the RCS-1 standards. Contact MA DEP to report findings wherein less than 10 gallons fuel oil was released to the environment and less than 2 yards of contaminated soils generated as substantiating a non-reportable condition as framed in BWSC-101 form. 3/1/12 9:00 am BEA personnel arrive at property to sign manifest for drum pickup, remove vapor barrier and ventilation equipment and make final screening of ambient air quality. Enter basement and no petroleum odor noted nor PID response (<0.1 ppmv). Remove fan and vapor barrier. Transporter at another location with signatures already provided under Agent For. Leave property to allow air to equilibrate without ventilation of vapor barrier. 10:45 am Return to property and enter basement with no noticeable odor and no PID reading (< 0.1 ppmv). Contact owner and advise to have hole backfilled and concrete floor restored in area of former sump excavated. Leave property at 11:30 am. Submitted by: BENNETT ENVIRONMENTAL ASSOCIATES, INC. This Field Response Log is a compilation of field observations, interviews with individuals familiar with the project and a review of public record. As such, it is intended to be an accurate and complete record of pertinent information. However, based on the reliance on third party and hearsay information included, no guarantee or warranties of the accuracy and completeness of that information is expressed or implied. i f J ESS Laboratory BAL Laboratory j Division ofThielscb Engineering,Inc. The Microbiology DAision l + ' ofThielsehEngineering,Inc. CERTIFICATE OFANALYSIS Todd Everson Bennett Environmental Associates P.O. Box 1743 Brewster,MA 02631 RE: Hostetter(BEA12-10408) ESS Laboratory Work Order Number: 1202252 This signed Certificate of Analysis is our approved release of your analytical results. These results are only representative of sample aliquots received at the laboratory. ESS Laboratory expects its clients to follow all regulatory sampling guidelines. Beginning with this page, the entire report has been paginated. This report should not be copied except in full without the approval of the laboratory. Samples will be disposed of thirty days after the final report has been delivered. If you have any questions or concerns, please feel free to call our Customer Service Department. REVIEWED Laurel Stoddard By ESS Laboratory at 4:39 pm, Feb 27, 2012 J Laboratory Director Analytical Summary The project as described above has been analyzed in accordance with the ESS Quality Assurance Plan. This plan utilizes the following methodologies: US EPA SW-846, US EPA Methods for Chemical Analysis of Water and Wastes per 40 CFR Part 136, APHA Standard Methods for the Examination of Water and Wastewater, American Society for Testing and Materials (ASTM), and other recognized methodologies. The analyses with these noted observations are in conformance to the Quality Assurance Plan. In chromatographic analysis, manual integration is frequently used instead of automated integration because it produces more accurate results. ESS Laboratory certifies that the test results meet the requirements of NELAC and A2LA, except where noted within this project narrative. 185 Frances Avenue,Cranston,RI 029 1 0-22 1 1 Tel:401-461-7181 Fax:401-461-4486 httn://wwNv.ESSLaboratory.com Dependability ♦ Quality ♦ Service Page 1 of 13 ESS Laboratory BAL Laboratory Division of Thielsch Engineering,Inc. vk=z The Microbiology Division l�i a of Thielsch Engineering,Inc. IA OR CERTIFICATE OFANALYSIS Client Name: Bennett Environmental Associates Client Project ID: Hostetter ESS Laboratory Work Order: 1202252 SAMPLE RECEIPT The following samples were received on February 17, 2012 for the analyses specified on the enclosed Chain of Custody Record. To achieve CAM compliance for MCP data, ESS Laboratory has performed and reviewed all QA/QC Requirements and Performance Standards listed in each method. Holding times and preservation have also been reviewed. All CAM requirements have been achieved unless noted in the project narrative. Each method has been set-up in the laboratory to reach required MCP standards. The methods for aqueous VOA and Soil Methanol VOA have known limitations for certain analytes. The regulatory standards may not be achieved due to these limitations. In addition, for all methods, matrix interferences, dilutions, and %Solids may elevate method reporting limits above regulatory standards. ESS Laboratory can provide, upon request, a Data Checker (regulatory standard comparison spreadsheet)electronic deliverable which will highlight these exceedances. Lab Number Sarn leName Matrix Analysis 1202252-01 SW-Comp 0-2ft SS Soil MAEPH04-1 1202252-02 BOH 2ft SS Soil MA EPH04-1 185 Frances Avenue,Cranston,RI 02910-2211 Tel:401-461-7181 Fax:401-461-4486 ham://wwNv.ESSLaboratory.com Dependability ♦ Quality ♦ Service Page 2 of 13 ESS Laboratory BAL Laboratory Division of Tbielsch Engineering,Inc. The Microbiology Division fThielsch Engineering,Inc. BAAL :;� CERTIFICATE OFANALYSIS Client Name: Bennett Environmental Associates Client Project ID: Hostetter ESS Laboratory Work Order: 1202252 PROJECT NARRATIVE MADEP-EPH-04-1.1/8270D Extractable Petroleum Hydrocarbons 1202252-01 Aromatic Range result has been corrected for identified cartridge contaminant. 1202252-02 Aromatic Range result has been corrected for identified cartridge contaminant. CB22122-BLK2 Aromatic Range result has been corrected for identified cartridge contaminant. CB22122-BS2 Aromatic Range result has been corrected for identified cartridge contaminant. CB22122-BSD2 Aromatic Range result has been corrected for identified cartridge contaminant. No other observations noted. End of Project Narrative. DATA USABILITY LINKS Definitions of Quality Control Parameters Semivolatile Organics Internal Standard Information Semivolatile Organics Surrogate Information Volatile Organics Internal Standard Information Volatile Organics Surrogate Information EPH and VPH Alkane Lists 185 Frances Avenue,Cranston,RI 02910-2211 Tel:401-461-7181 Fax:401-461-4486 htto://www.ESSLaboratory.com Dependability ♦ Quality ♦ Service Page 3 of 13 ESS Laboratory BAL Laboratory - Division of Thielsch Engineering,Inc. The Microbiology Division lrt ♦ ofTbielschEngineering,Inc. AALLABO;RA;T�04RY CERTIFICATE OFAIVALYSIS Client Name: Bennett Environmental Associates Client Project ID: Hostetter ESS Laboratory Work Order: 1202252 MassDEP Analytical Protocol Certification Form MADEP RTN: This form provides certification for the following data set:1202252-01 through 1202252-02 Matrices: ( )Ground Water/Surface Water QQ Soil/Sediment ( )Drinking Water ( )Air ( )Other: CAM Protocol(check all that apply below): ( ) 8260 VOC ( ) 7470/7471 Hg ( ) MassDEP VPH ( )8081 Pesticides ( ) 7196 Hex Cr ( ) MassDEP APH CAM II A CAM III B CAM IV A CAM V B CAM VI B CAM IX A ( ) 8270 SVOC ( ) 7010 Metals (X) MassDEP EPH ( ) 8151 Herbicides ( ) 8330 Explosives ( ) TO-15 VOC CAM II B CAM III C CAM IV B CAM V C CAM VIII A CAM IX B ( ) 6010 Metals ( ) 6020 Metals ( ) 8082 PCB ( ) 6860 Perchlorate ( ) 9014 Total Cyanide/PAC CAM III A CAM III D CAM V A CAM VIII B CAM VI A Affirmative responses to questions A through F are required for Presumptive Certainty'ktatus A Were all samples received in a condition consistent with those described on the Chain-of-Custody,properly Yes(X) No( ) preserved(including temperature)in the field or laboratory,and prepared/analyzed within method holding times? B Were the analytical method(s)and all associated QC requirements specified in the selected CAM protocol(s) Yes(X) No( ) followed? C Were all required corrective actions and analytical response actions specified in the selected CAM protocol(s) Yes(X) No( ) implemented for all identified performance standard non-conformances? D Does the laboratory report comply with all the reporting requirements specified in the CAM VII A,"Quality Yes(X) No( ) Assurance and Quality Control Guidelines for the Acquisition and Reporting of Analytical Data"? E a.VPH,EPH,APH and TO-15 only:Was each method conducted without significant modification(s)?(Refer Yes(X) No( ) to the individual method(s)for a list of significant modifications). b.APH and TO-15 Methods only:Was the complete analyte list reported for each method? Yes( ) No( ) F Were all applicable CAM protocol QC and performance standard non-conformances identified and evaluated Yes(X) No( ) in a laboratory narrative(including all"No"responses to Questions A through E)? Responses to Questions G,H and I below are required for Presumptive Certainty'§tatus G Were the reporting limits at or below all CAM reporting limits specified in the selected CAM protocols(s)? Yes(X) No( )* Data User Note:Data that achieve Presumptive Certainty'Ratus may not necessarily meet the data usability and representativeness requirements described in 310 CMR 40.1056(2)(k)and WSC-07-350. H Were all QC performance standards specified in the CAM protocol(s)achieved? Yes(X) No( )* I Were results reported for the complete analyte list specified in the selected CAM protocol(s)? Yes(X) No( )* *All negative responses must be addressed in an attached laboratory narrative. I,the undersigned,attest under the pains and penalties of perjury that,based upon my personal inquiry of those responsible for obtaining the information,the material contained in this analytical report is,to the best of my knowledge and belief, accurate and complete. Signature: Date: February 27,2012 Printed Name:Laurel Stoddard Position:Laboratory Director 185 Frances Avenue,Cranston,RI 02910-2211 Tel:401-461-7181 Fax:401-461-4486 httn://www.ESSLaboratory.com Dependability ♦ Quality • Service Page 4 of 13 ESS Laboratory BAL LaboratoryLi t c � Division of Thielsch Engineering,Inc. The Microbiology Division ofThielsch Engineering,Inc. CERTIFICATE OFANALYSIS Client Name: Bennett Environmental Associates Client Project ID: Hostetter ESS Laboratory Work Order: 1202252 Client Sample ID: SW-Comp 0-2ft SS ESS Laboratory Sample ID: 1202252-01 Date Sampled: 02/15/12 12:30 Sample Matrix: Soil Percent Solids: 98 Units:mg/kg dry Initial Volume: 25.4 Analyst: SEP Final Volume: 1 Prepared: 2/21/12 13:53 Extraction Method: 3546 MADEP-EPH-04-1.1/8270D Extractable Petroleum Hydrocarbons MA-S1GW1 Analyte Results(MRL) Limit DF Analyzed Sequence Batch C9-C18A1iphaticsl ND(15.1) 1000 1 02/23/12 6:03 CVB0133 CB22122 C19-C36Aliphaticsl ND(15.1) 3000 1 02/23/12 6:03 CVB0133 CB22122 Cll-C22 Unadjusted Aromatics ND(15.1) / 1000 1 02/24/12 11:44 CVB0157 CB22122 C11-C22 Aromatics l,2 ND(15.1) 1000 02/24/12 11:44 [CALC] 2-Methylnaphthalene ND(0.20) 0.7 1 02/24/12 11:44 CVB0157 CB22122 Acenaphthene ND(0.40) 4 1 02/24/12 11:44 CVB0157 CB22122 Naphthalene ND(0.40) 4 1 02/24/12 11:44 CVB0157 CB22122 Phenanthrene ND(0.40) 10 1 02/24/12 11:44 CVB0157 CB22122 Acenaphthylene ND(0.20) 1 1 02/24/12 11:44 CVB0157 CB22122 Anthracene ND(0.40) 1000 . 1 02/24/12 11:44 CVB0157 CB22122 Benzo(a)anthracene ND(0.40) 7 1 02/24/12 11:44 CVB0157 CB22122 Benzo(a)pyrene ND(0.40) 2 1 02/24/12 11:44. CVB0157 CB22122 Benzo(b)fluoranthene ND(0.40) 7 1 02/24/12 11:44 CVB0157 CB22122 Benzo(g,h,i)perylene ND(0.40) 1000 1 02/24/12 11:44 CVB0157 CB22122 Benzo(k)fluoranthene ND(0.40) 70 1 02/24/12 11:44 CVB0157 CB22122 Chrysene ND(0.40) 70 1 02/24/12 11:44 CVB0157 CB22122 Dibenzo(a,h)Anthracene ND(0.20) 0.7 1 02/24/12 11:44 CVB0157 CB22122 Fluoranthene ND(0.40) 1000 1 02/24/12 11:44 CVB0157 CB22122 Fluorene ND(0.40) 1000 1 02/24/12 11:44 CVB0157 CB22122 Indeno(1,2,3-cd)Pyrene ND(0.40) 7 1 02/24/12 11:44 CVB0157 CB22122 Pyrene ND(0.40) 1000 1 02/24/12 11:44 CVB0157 CB22122 %Recovery Qualifier Limits Surrogate.,1-Chloroocladecane 68% 40-140 Surrogate:2-Bromonaphthalene 92% 40-140 Surrogate:2-i1uorob1pheny1 88% 40-140 surrogate:O-Terphenyl 83% 40-140 185 Frances Avenue,Cranston,RI 029 1 0-22 1 1 Tel:401-461-7181 Fax:401-461-4486 htto://N%r%vw.ESSLaboratorv.com Dependability ♦ Quality ♦ Service Page 5 of 13 ESS Laboratory BAL Laboratory . f}^- Division of Thielsch Engineering,Inc. The Microbiology Division lr <.: ♦ ofTbielsch Engineering,Inc. CERTIFICATE OFANALYSIS Client Name: Bennett Environmental Associates Client Project ID: Hostetter ESS Laboratory Work Order: 1202252 Client Sample ID: BOH 2ft SS ESS Laboratory Sample ID: 1202252-02 Date Sampled: 02/15/12 12:30 Sample Matrix: Soil Percent Solids: 98 Units:mg/kg dry Initial Volume: 24.4 Analyst: SEP Final Volume: 1 Prepared: 2/21/12 13:53 Extraction Method: 3546 MADEP-EPH-04-1.1/8270D Extractable Petroleum Hydrocarbons MA-S1GW1 Analyte Results(MRL) Limit DF Analyzed Sequence Batch C9-C 18 Aliphatics I ND(15.7) 1000 1 02/23/12 6:54 CVB0133 CB22122 C19-C36Aliphaticsl ND(15.7) 3000 1 02/23/12 6:54 CVB0133 CB22122 Cll-C22 Unadjusted Aromatics ND(15.7) 1000 1 02/24/12 12:31 CVB0157 CB22122 l C I I-C22 Aromati.csl,2 ND(15.7) 1000 02/24/12 12:31 [CALCI 2-Methylnaphthalene ND(0.21) 0.7 1 02/24/12 12:31 CVB0157 CB22122 Acenaphthene ND(0.42) 4 1 02/24/12 12:31 CVB0157 CB22122 Naphthalene ND(0.42) 4 1 02/24/12 12:31 CVB0157 CB22122 Phenanthrene ND(0.42) 10 1 02/24/12 12:31 CVB0157 CB22122 Acenaphthylene ND(0.21) 1 1 02/24/12 12:31 CVB0157 CB22122 Anthracene ND(0.42) 1000 1 02/24/12 12:31 CVB0157 CB22122 Benzo(a)anthracene ND(0.42) 7 1 02/24/12 12:31 CVB0157 CB22122 Benzo(a)pyrene ND(0.42) 2 1 02/24/12 12:31 CVB0157 CB22122 Benzo(b)fluoranthene ND(0.42) 7 1 02/24/12 12:31 CVB0157 CB22122 Benzo(g,h,i)perylene ND(0.42) 1000 1 02/24/12 12:31 CVB0157 CB22122 Benzo(k)fluoranthene ND(0.42) 70 1 02/24/12 12:31 CVB0157 CB22122 Chrysene ND(0.42) 70 1 02/24/12 12:31 CVB0157 CB22122 Dibenzo(a,h)Anthracene ND(0.21) 0.7 1 02/24/12 12:31 CVB0157 CB22122 Fluoranthene ND(0.42) 1000 1 02/24/12 12:31 CVB0157 CB22122 Fluorene ND(0.42) 1000 1 02/24/12 12:31 CVB0157 CB22122 Indeno(1,2,3-cd)Pyrene ND(0.42) 7 1 02/24/12 12:31 CVB0157 CB22122 Pyrene ND(0.42) 1000 1 02/24/12 12:31 CVB0157 CB22122 %Recovery Qua/frier Limits Surrogate:1-Chloroodadecane 70% 40-140 Surrogate:1-Bromonaphthalene 94% 40-140 Surrogate:1-Fluoro&phenyl Bg% 40-140 Surrogate-O-Terphenyl 76% 40-140 185 Frances Avenue,Cranston,RI 02910-2211 Tel:401-461-7181 Fax:401-461-4486 http://xvww.ESSLaboratory.com Dependability ♦ Quality ♦ service Page 6 of 13 I ESS Laboratory BAL Laboratory Division ofTbielsch Engineering,Inc. The Microbiology Division w - ofThielsch Engineering,Inc. RALIABORMW CERTIFICATE OFANALYSIS Client Name: Bennett Environmental Associates Client Project ID: Hostetter ESS Laboratory Work Order: 1202252 Quality Control Data Spike Source %REC RPD Analyte Result MRL Units Level Result %REC Limits RPD Limit Qualifier MADEP-EPH-04-1.1/8270D Extractable Petroleum Hydrocarbons Batch CB22122-3546 Blank C19-C36 Aliphaticsl ND 15.0 mg/kg wet C9-C18 Aliphaticsl ND 15.0 mg/kg wet Decane(C10) ND 0.5 mg/kg wet Docosane(C22) ND 0.5 mg/kg wet Dodecane(C12) ND 0.5 mg/kg wet Eicosane(C20) ND 0.5 mg/kg wet Hexacosane(C26) ND 0.5 mg/kg wet Hexadecane(C16) ND 0.5 mg/kg wet Hexatriacontane(C36) ND 0.5 mg/kg wet Nonadecane(C19) ND 0.5 mg/kg wet Nonane(C9) ND 0.5 mg/kg wet Octacosane(C28) ND 0.5 mg/kg wet Octadecane(C18) ND 0.5 mg/kg wet Tetracosane(C24) ND 0.5 mg/kg wet Tetradecane(C14) ND 0.5 mg/kg wet Triacontane(C30) ND 0.5 mg/kg wet Surrogate.1-Chlorooctadecane 1.60 mg/kg wet 2.000 80 40-140 Blank CC 2-Methylnaphthalene ND 0.20 mg/kg wet Acenaphthene ND 0.40 mg/kg wet Acenaphthylene ND 0.20 mg/kg wet Anthracene ND 0.40 mg/kg wet Benzo(a)anthracene ND 0.40 mg/kg wet Benzo(a)pyrene ND 0.40 mg/kg wet Benzo(b)fluoranthene ND 0.40 mg/kg wet Senzo(g,h,i)perylene ND 0.40 mg/kg wet Benzo(k)fluoranthene ND 0.40 mg/kg wet C11-C22 Unadjusted Aromaticsl ND 15.0 mg/kg wet Chrysene ND 0.40 mg/kg wet Dibenzo(a,h)Anthracene ND 0.20 mg/kg wet Fluoranthene ND 0.40 mg/kg wet Fluorene ND 0.40 mg/kg wet Indeno(1,2,3-cd)Pyrene ND 0.40 mg/kg wet Naphthalene ND 0.40 mg/kg wet Phenanthrene ND 0.40 mg/kg wet Pyrene ND 0.40 mg/kg wet Surrogate:l-Bromonaphthalene 45..2 mg/L 50.00 90 40.140 Surrogate:l-Fluomblphenyl 41.8 mg/L 50.00 84 40-140 Surrogate.,O-Terphenyl 1.66 mg/kg wet 2.000 83 40-140 LCS C19-C36 Aliphaticsl 14.8 15.0 mg/kg wet 16.00 93 40-140 C9-C18 Aliphaticsl 11.1 15.0 mg/kg wet 12.00 92 40-140 Decane(C10) 1.1 0.5 mg/kg wet 2.000 57 40-140 185 Frances Avenue,Cranston,RI 02910-2211 Tel:401-461-7181 Fax:401-461-4486 littp://Hryviv.ESSLaboratory.com Dependability ♦ Quality ♦ Service Page 7 of 13 ESS Laboratory BAL Laboratory x<<� Division ofThielsch Engineering,Inc. The Microbiology DAisiou 1 a oMidscb Engineering,Inc. CERTIFICATE OFAIVALYSIS Client Name: Bennett Environmental Associates Client Project ID: Hostetter ESS Laboratory Work Order: 1202252 Quality Control Data Spike Source %REC RPD Analyte Result MRL Units Level Result %REC Limits RPD Limit Qualifier MADEP-EPH-04-1.1/8270D Extractable Petroleum Hydrocarbons Batch CB22122-3546 Docosane(C22) 1.8 0.5 mg/kg wet 2.000 90 40-140 Dodecane(C12) 1.4 0.5 mg/kg wet 2.000 68 40-140 Eicosane(C20) 1.7 0.5 mg/kg wet 2.000 85 40-140 Hexacosane(C26) 1.8 0.5 mg/kg wet 2.000 89 40-140 Hexadecane(C16) 1.6 0.5 mg/kg wet 2.000 79 40-140 Hexatriacontane(C36) 1.4 0.5 mg/kg wet 2.000 69 40-140 Nonadecane(C19) 1.6 0.5 mg/kg wet 2.000 82 40-140 Nonane(C9) 0.8 0.5 mg/kg wet 2.000 40 30-140 Octacosane(C28) 1.7 0.5 mg/kg wet 2.000 87 40-140 Octadecane(C18) 1.7 0.5 mg/kg wet 2.000 83 40-140 Tetracosane(C24) 1.8 0.5 mg/kg wet 2.000 89 40-140 Tetredecane(C14) 1.4 0.5 mg/kg wet 2.000 72 40-140 Triacontane(C30) 1.7 0.5 mg/kg wet 2.000 86 40.140 Surrogate:1-Ch/orooctadecane 1.59 mg/kg wet 2.000 79 40-140 LCS CC 2-Methylnaphthalene 1.50 0.20 mg/kg wet 2.000 75 40-140 Acenaphthene 1.56 0.40 mg/kg wet 2.000 78 40-140 Acenaphthylene 1.59 0.20 mg/kg wet 2.000 79 40-140 Anthracene 1.77 0.40 mg/kg wet 2.000 89 40-140 Benzo(a)anthracene 1.82 0.40 mg/kg wet 2.000 91 40-140 Benzo(a)pyrene 2.08 0.40 mg/kg wet 2.000 104 40-140 Benzo(b)fluoranthene 1.82 0.40 mg/kg wet 2.000 91 40-140 Benzo(g,h,l)perylene 1.81 0.40 mg/kg wet 2.000 91 40-140 Benzo(k)fluoranthene 1.86 0.40 mg/kg wet 2.000 93 40-140 C11-C22 Unadjusted Aromaticsl 37.4 15.0 mg/kg wet 34.00 110 40-140 Chrysene 1.84 0.40 mg/kg wet 2.000 92 40-140 Dibenzo(a,h)Anthracene 1.82 0.20 mg/kg wet 2.000 91 40-140 Fluoranthene 1.77 0.40 mg/kg wet 2.000 88 40-140 Fluorene 1.66 0.40 mg/kg wet 2.000 83 40-140 Indeno(1,2,3-cd)Pyrene 1.72 0.40 mg/kg wet 2.000 86 40-140 Naphthalene 1.39 0.40 mg/kg wet 2.000 70 40-140 Phenanthrene 1.74 0.40 mg/kg wet 2.000 87 40-140 Pyrene 1.83 0.40 mg/kg wet 2.000 92 40-140 Surrogate:2-Bromonaphtha/ene 44.7 mg/L 50.00 89 40-140 5urrogate:2-f/uorobiphenyt 44.0 mg/L 50.00 88 40-140 Surrogate:0-Terphenyt 1.75 mg/kg wet 2.000 87 40-140 LCS 2-Methylnaphthalene Breakthrough 0.0 % 0-5 Naphthalene Breakthrough 0.0 % 0-5 LCS Dup C19-C36 Aliphaticsl 12.3 15.0 mg/kg wet 16.00 77 40-140 18 25 C9-C18 Aliphaticsi 10.2 15.0 mg/kg wet 12.00 85 40-140 9 25 Decane(C10) 1.1 0.5 mg/kg wet 2.000 55 40-140 3 25 Docosane(C22) 1.7 0.5 mg/kg wet 2.000 84 40-140 7 25 185 Frances Avenue,Cranston,RI 02910-2211 Tel:401-461-7181 Fax:401-461-4486 http://xvww.ESSLaboratory.coi Dependability ♦ Quality ♦ Service Page 8 of 13 ESS Laboratory BAL Laboratory o-51 s<.. 9Division of Thielsch Engineering,Inc. Tbe Microbiology Division +.- of Thielsch Engineering,Inc. BALLABORATORY CERTIFICATE OFANALYSIS Client Name: Bennett Environmental Associates Client Project ID: Hostetter ESS Laboratory Work Order: 1202252 Quality Control Data Spike Source %REC RPD Analyte Result MRL Units Level Result %REC Limits RPD Limit Qualifier MADEP-EPH-04-1.1/8270D Extractable Petroleum Hydrocarbons Batch C622122-3,146 Dodecane(02) _ 1.3 0.5 mg/kg wet 2.000 65 40-140 4 25 Eicosane(C20) 1.6 0.5 mg/kg wet 2.000 82 40-140 5 25 Hexacosane(C26) 1.7 0.5 mg/kg wet 2.000 83 40-140 7 25 Headecane(C16) 1.5 0.5 mg/kg wet 2.000 73 40-140 7 25 Heatriacontane(C36) 1.3 0.5 mg/kg wet 2.000 64 40-140 7 25 Nonadecane(C19) 1.6 0.5 mg/kg wet 2.000 78 40-140 6 25 Nonane(C9) 0.8 0.5 mg/kg wet 2.000 39 30-140 3 25 Octacosane(C28) 1.6 0.5 mg/kg wet 2,000 82 40-140 5 25 Octadecane(08) 1.6 0.5 mg/kg wet 2.000 79 40-140 6 25 Tetracosane(C24) 1.7 0.5 mg/kg wet 2.000 84 40-14 9/9 0 6 25 Tetradecane(C14) 1.4 0.5 mg/kg wet 2.000 68 40-140 6 25 Tdacontane(00) 1.6 0.5 mg/kg wet 2.000 82 40-140 5 25 Surrogate:1-Ch/orooctadecane 1.51 mg/kg wet 2.000 75 40-140 III LCS Dup CC 2-Methylnaphthalene 1.52 0.20 mg/kg wet 2.000 76 40-140 1 25 Acenaphthene 1.50 0.40 mg/kg wet 2.000 75 40-140 4 25 Acenaphthylene 1.56 0.20 mg/kg wet 2.000 78 40-140 2 25 Anthracene 1.68 0.40 mg/kg wet 2.000 84 40-140 5 25 Benzo(a)anthracene 1.69 0.40 mg/kg wet 2.000 84 40-140 8 25 Benzo(a)pyrene 1.96 0.40 mg/kg wet 2.000 98 40-140 6 25 Benzo(b)0uoranthene 1.79 0.40 mg/kg wet 2.000 89 40-140 2 25 Benzo(g,hJ)perylene 1.72 0.40 mg/kg wet 2.000 86 40-140 5 25 Benzo(k)0uoranthene 1.73 0.40 mg/kg wet 2.000 87 40-140 7 25 C11-C22 Unadjusted Aromabcsl 36.4 15.0 mg/kg wet 34.00 107 40-140 3 25 Chrysene 1.74 0.40 mg/kg wet 2.000 87 40-140 6 25 Dibenzo(a,h)Anthracene 1.74 0.20 mg/kg wet 2.000 87 40-140 4 25 Fluoranthene 1.70 0.40 mg/kg wet 2.000 85 40-140 4 25 Fluorene 1.65 0.40 mg/kg wet 2.000 83 40-140 0.4 25 Indeio(1,2,3-cd)Pyrene 1.65 0.40 mg/kg wet 2.000 82 40-140 4 25 Naphthalene 1.39 0.40 mg/kg wet 2.000 70 40-140 0.06 25 Phenanthrene 1.70 0.40 mg/kg wet 2.000 85 40-140 2 25 Pyrene 1.75 0.40 mg/kg wet 2.000 87 40-140 5 25 511rrogate:2-Bromonaphthalene 44.3 mg/L 50.00 89 40-140 Sunogate:l-Fluorobiphenyl 44.8 mg/L 50.00 90 40-140 Surrogate:O-Terphenyl 1.67 mg/kg wet 2.000 84 40-140 LCS Dup 2-Methylnaphthalene Breakthrough 0.0 % 0-5 200 Naphthalene Breakthrough 0.0 % 0-5 200 I I 185 Frances Avenue,Cranston,RI 02 9 1 0-22 1 1 Tel:401-461-7181 Fax:401-461-4486 http:/hv\vw.ESSLaboratorv.001n Dependability ♦ Quality ♦ Service Page 9 of 13 rJ. . a ESS Laboratory BAL Laboratory Division of Thicisch Engineering,Inc. The Microbiology Division 1 r ti ofThielsch Engineering,Inc. BALLABORAT CERTIFICATE OFANALYSIS Client Name: Bennett Environmental Associates Client Project ID: Hostetter ESS Laboratory Work Order: 1202252 Notes and Definitions U Analyte included in the analysis,but not detected CC Aromatic Range result has been corrected for identified cartridge contaminant. ND Analyte NOT DETECTED at or above the MRL(LOQ),LOD for DoD Reports,MDL for J-Flagged Analytes dry Sample results reported on a dry weight basis RPD Relative Percent Difference MDL Method Detection Limit MRL Method Reporting Limit LOD Limit of Detection LOQ Limit of Quantitation DL Detection Limit IN Initial Volume FN Final Volume § Subcontracted analysis;see attached report 1 Range result excludes concentrations of surrogates and/or internal standards eluting in that range. 2 Range result excludes concentrations of target analytes eluting in that range. 3 Range result excludes the concentration of the C9-C10 aromatic range. Avg Results reported as a mathematical average. NR No Recovery [CALC] Calculated Analyte SUB Subcontracted analysis;see attached report 185 Frances Avenue,Cranston,RI 02910-2211 Tel:401-461-7181 Fax:401-461-4486 littp://Nvww.ESSLaboratory.com Dependability ♦ Quality ♦ Service Page 10 of 13 1 Apr. ESS Laboratory BAL Laboratory •� - Division of Thielscb Engineering,Inc. The Microbiology Division j r e ofThielsch Engineering,Inc. BALL CERTIFICATE OFANALYSIS Client Name: Bennett Environmental Associates Client Project ID: Hostetter ESS Laboratory Work Order: 1202252 ESS LABORATORY CERTIFICATIONS AND ACCREDITATIONS ENVIRONMENTAL Department of Defense(DoD)Environmental Laboratory Accreditation Program(FLAP) A2LAAccredited:Testing Cert#2864.01 http://vv%vNv.a2la.org/scopepdfJ2864-Ol.pdf Rhode Island Potable and Non Potable Water:LAI00179 http://,,v%v%v.health.ri.gov/1abs/i,vaterlabs-instate.])lip Connecticut Potable and Non Potable Water,Solid and Hazardous Waste:PH-0750 http://www.ct.gov/dph/lib/dph/environmental health/environmental laboratories/pdf/out state pdf Maine Potable and Non Potable Water: RI0002 http:/hvwNv.maine.gov/dep/blwq/topic/vesse]4ab list.pdf Massachusetts Potable and Non Potable Water:M-RIO02 http://public.dep.state.ma.usAabeert/labcert.aspx New Hampshire(NELAP accredited)Potable and Non PotableWater,Solid and Hazardous Waste:2424 http://-vvw%v4.egov.nh.gov/des/nlielap/namesearch.asp New York(NELAP accredited)Non Potable Water,Solid and Hazardous Waste: 11313 htti):Hiv,,vvv.wadsworth.orgilabcert/elay/conuii.html United States Department of Agriculture Soil Permit:S-54210 Maryland Potable Water:301 http://www.mde.state.md.us/assets/document/WSP labs-2009apr20.pdf CHEMISTRY A2LAAccredited:Testing Cert#2864.01 Lead in Paint,Phthalates,Lead in Children's Metals Products(Including Jewelry) littp:Hwxvw.A2LA.org/dirsearclinexv/newsearch.cfm CPSC ID#1141 Lead Paint,Lead in Children's Metals Jewelry http://w%vNv.cpsc.gov/cgi-bin/labqpplist.asox 185 Frances Avenue,Cranston,RI 02910-2211 Tel:401-461-7181 Fax:401-461-4486 http://Nvivw.ESSLaboratory.com Dependability ♦ Quality ♦ Service Page 11 of 13 Attachment B Sample and Cooler Receipt Checklist SOP 10_0001 Client: Bennet Environmental Association ESS Project ID: 12020252 Client Project ID: Date Project Due: 2124/12 Shipped/Delivered Via: ESS Courier Days For Project: 5 Day Items to be checked upon receipt: f 1. Air Bill Manifest Present? *No 10. Are the samples properly preserved": Yes I Air No.: 11. Proper sample containers used? Yes 2. Were Custody Seals Present? No 12. Any air bubbles in the VOA vials? N/A 3. Were Custody Seals Intact? NIA 13. Holding times exceeded? No 4. Is Radiation count < 100 CPM? Yes 14. Sufficient sample volumes? Yes 5. Is a cooler present? Yes 15. Any Subcontracting needed? Wess 1 Cooler Temp: 2.4 16. Are ESS labels on correct contai ers? Iced With: Ice acks 17. Were samples received Intact? 6. Was COC Included with samples? Yes ESS Sample IDs: 7. Was COC signed and dated by client? Yes Sub Lab: B. Does the COC match the sample Yes Analysis: 9. Is COC complete and correct? Yes TAT: 18. Was there need to call project manager to discuss status? If yes, please explain. Who was called?: By whom? Sample Number Properly Preserved Container Type #of Containers Preservative 1 Yes Glass Jar 1 NP 2 Yes Glass Jar 1 NP Completed By: t_ D q Date/Time: !i Reviewed By: �,.J Date/Time: a It I i Page 12 of 13 1 ESS Laboratory CHAIN OF CUSTODY Page_-of_� Division of Thielsch Engineering, Inc. Turn Time Standard Other Reporting Limits ESS IAB PROJL ID 185 Frances Avenue, Cranston, RI 02910-2211 If faster than 5 days, ri r roval by laboratory is required# S--{ I zo to where samples were collected from: J ` Tel. (401) 461-7181 Fax (401) 461-4486 RI CT NH N) NY ME Other Electronic Deliverable Yes No www.esslaboratory.com .2 i�CP t for an o the following Navy USACE Other Format: Excel_ Access— PDF, rher C .Name Project# Project Name(zo c-1—.or IM) Write Required Analysis :� � SSG .rA � �r� c�tact P rson A r .i y� ' State A 0 PO# �C j N �J a Telephone Fax# Email Address06 )1 c f. ESS LAB Date Collection x a Sample# Time ` u S Sample Identification(20 Chrr.or Im) Z F d it gL 1� s&J -CO��= o-Z 'ss 1 Container Type: P-Poly G-Glass S-Sterile V-VOA Matrix: S-Soil SD-Solid D-Sludge WW Waste Water GW-Ground Water SW-Surface Water DW Drinking Water, O-Oil W Wipes F-Filters Cooler Present �es GW /77.Internal Use Only Preservation Cod(I.NI 2-HCl,3-HMS,4-IINOe,5-NaOH,6-McOlf,7-Asorbic Acid,8-ZnAct,9- Seats Intact / Yes _No NA:��up Sampled by: rCn� G CD CooIerTemp: -r [ j Technicians Comments: w �••� fiIV n i e by:(Signature) atefrmeVved by: nature) Date/Time Relinquished by:(Signature) ateMme cc' d ate/TimeI c� ,c y:(S' n t re ate/Time Ic ' - Si at ) I WTI Relinquished by: Signature) Datemme Received by:(Signature) DatcMme *By circling MA-MCP,client acknowledges samples were collected Please fax all changes to Chain of Custody in writing. I(White)Lab Copy 2(Yellow)Client Receipt in accordance with MADEP CAM VII A 10/26/04 A rQ j Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-003f UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3 Emergency Response Phonz 4.Manrfest Tracking Number WASTE MANIFEST ('A,. ' ( JJK 5.Generator's Name and Mailing Address t a A , Generator's Site Address(if different than mailing address) e_. Generator's Phone 6.Transporter 1 Company Name U.S.EPA ID Number 7.Transporter 2 Company Name U.S.EPA ID Number 8.Designated Facility Name and She Address :;r;:;.t ' }+. `s._,1 ;. _; U.S.EPA ID Number - S�i,tr; ,i' , . t'�c 1•�: �. � � i�`s.`rrr Z ,; 3+.. s� �,. .�.., Facilitys Phone: oa. 9b.U.S.DOT Description(induding Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit HM and Packing Group(if any)) No. Type Quantity WUI.Vo 13.Waste Codes j '{ 1 :t .?r• =st;.'ri f !U, Z 2. w C9 i i 3. 4. 14.Special Handling Instructions and Additional Information )" •q,.g4rk:Y'•„ art J" t 1 tG2 N�{tti'+�N 15'i;Ci[ '.. �. .i.�y•r ♦ � ! r 15. GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged, marked and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations.If export shipment and I am the Primary Exporter,I certify that the contents or this consignment conform to the terms of the attached EPAAcknowledgment of Consent. I certify that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(if I am a small quantity generator)is true. GeneratofslOfferor's Printed)Typed Name _...•Signature. .. Month Day Year 16.International Shipments t-- ❑Import to U.S. ❑Export from U-3. Port of entry/exit: z Transporter signature(for exports only): 9 Date leaving U.S.: W 17.Transporter Acknowledgment of Receipt of Materials Transporter i Printedfiyped Name Signature, Month Day Year a s z Transporter 2 PdntedfTyped Name Signature Month Dayy y Year a t- 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity Type Residue Par ial Rejection on ❑Full Rejection Manifest Reference Number. F 18b.Alternate Facility(or Generator) U.S.EPA ID Number J U ram Fachitys Phone: w 18c.Signature of Alternate Facility(or Generator) Month Day Year z 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) G 1. 2. 3. 4. 20.Designated Facility Owner or Operator.Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a PrintedfTyped Name Signature Month Day Year PP4FnrmR711n.99fRov3-0.q1 Pravinu.garfitinnsaranhsnlafa 11GkIGDATnr3'01KIMIA1 rnD%J 1— Generato0r1 's3 US EIP_AI1D Noo.ja�� I� �Manifest Document No. 2,Pago i 14 0.Generator's Name and Mailing Address A. -' HflSTE'1'TER REALTY TRUST 770 MAIN STREET B,State Gen,ID ' "•? OSTERV I LL*`, MA 0265; SAME h,Generators Phone( r�t?g_!a S.Transporter 1 Company Name -- 6.US EPA ID Number -� G,State Trans.ID [LEAN V t ltREa INC. --- t =u:010i 010I 0121 'A 11 2A 7.Transporter 2 company Name 8.US EPA ID Number D.Tran_sporter's Phone { 1 _ E.State Trans,ID 9, rated Facility Name and Site Address 10.US EPA ID Number GENERAL CHEM I CAL:CORD:::.`;•,;:':;=:.:::, ::;.;,.:':':'; .::.`;'.;,':;..'-. F.Transporter's Phone { ) 133 LELAIdD G.State Facility's ID _ NOT REQLinED' Fit NGF{ MR 7t7 ''S 1 H.Fecil ty's Phone { (5f�38) 872-5! f3l9__ 11.US DOT Description Jncludlri•Pro"erShf'p/n`Name Nezaid.Claas aril/?R'Nurinti's :;;:::;! 1z.conbine. — P ( J , P pG B -- . .... ...!1_..... No, a Total _ wNi�i WASTEN6. a NON RCRA NOW DOT'REGLIERTED i`IATERTAL:.':t0I1`Y'HHNW; ;;;:: MA99 EXEMPT MATERIAL•)` ;,t>< US t4l N E R _ — `% A R Ufa d. - _- I'Yoe +tier 1 J.Addltlonat Descriptions for Materials UsledyAhoe Q•nudepX'I v., K.Handilnp Codes for•Wastas Listed Above y iT��G X a. - - u1 n l7 d. d I 16.Special Han(fling Instructions and Additional Information 24 Hour Emergency Number (50B) 872—Ji1f�J0 (!)III5-1 OILY SOLIDS 9 Y _ 16.GENERATOR'S CEFITIFICATION: I certify the materials described above an this manifest are not subject#Federal'Regulations for reporting-� oper disposal of hazardous waste, Date R ' - r r' J {(�11p (0O to - i R 17,Transporter 1 P.cknowledgement of Receipt of Materl Is _ _ _ Date N f5 _a S — � O *5-- .. -- 0, R 16.Transporter 2 Acknowledgement of Receipt,of Matenals w _ Date E PrOledTypedName r; Sig lure Dionih oay-yoar F 19 Discrepancy Indication Space A C > 20.Facility Owner or Operator: Cortiftratian of receipt of hazardous materials covered by this manifest except as noted in Item 19 T FrfntecbTyped Narne — y Signature `— o Year. ., �+ fF D CQPY�•�':•�: tl'Ij. rc J jj l ' Wig v T j rT ' .,•a 'sue .. r �� ty p v .0. f a ��'+�iW'..t2a. �,' ',"y.�' •,t v x'i"'a ., a �n� �t�.. • R�+� � �CS RR � 5 Y . i jt .st �W��W w c �t .•, ,,yam—. h,} i � *' + y= ,� Rs �'� ' ,w✓ R,.v�.� ,... �_'� .FAT'. ��f # C. R... S •'..t �~ v ; � , r fY � i�ys..." -'•'tea s�' � *` _j•' � C d t f v�'� � � r�T i":• � '{ '9�. Y ,;�•• �., '+w' ,- '�a*4r -,�x a 'v' `gala v a s ;. Yam' ♦ 1. �� J �YBMr A} y Y q d.a�� K �! +b`' q� •��. � ` i? ' �'r.T ,. .. �:»r + �.�'y,�,4 4,^s&, � x A`p'.3:.��� F`�R 1 IJ r rl `., '« °�W't'; .. .*. �n Y '•r� �. FEB* 1 61 ��`�;,�w�A... a Y'v� ♦ +`d t ' �� � � p �4 It � -:a • .. S 0 �. ._* +a r. +,� P +. � .�• _ � ,ate o'•'_ it a Health Complaints 28-Mar-03 Time: 11:00:00 AM Date: 3/28/2003 Complaint Number: 3972 Referred To: DAVID STANTON Taken By: JOAN AGOSTINELLI Complaint Type: Article X Detail: Business Name: OAK VILLAGE Number: 1927 Street: FALMOUTH ROAD Village: CENTERVILLE Assessors Map-Parcel: Complainant's Name: COMM FIRE Address: Telephone Number: 790-2375 Complaint Description: 15 GALLONS OF GASOLINE RELEASED FROM A VEHICLE. Actions Taken/Results: DS & DD VISITEDSAID LOCATION. WALKED PROPERTY, DID NOT SEE ANY EVIDENCE PHYSICALLY, BUT DID PICK UP SOME ODORS OF GASOLINE ON A SMALL AREA OF THE PROPERTY. SMELLED GROUND AND MUD, BUT DID NOT CONTAIN GASOLINE ODORS. VISITED FIRE DEPT. AND SPOKE WITH DEPUTY CHIEF WITLEY. SAID THE FIRE DEPARTMENT CLEANED UP MOST OF IT. "HELPING HANDS" NON PROFIT ORGANIZATION DELIVERED VEHICLE TO SAID LOCATION. THE UN KNOWN TOW TRUCK DRIVER, PEIRCED THE FUEL TANK, AND SPED OFF. IT IS UNKOWN WHAT COMPANY HE WAS FROM. FIRE DEPARTMENT TRIED TO LOCATE A NUMBER FOR THE HELPING HANDS TO SEE IF THEY KNOW WHO WAS CONTRACTED TO DELIVER VEHICLE. DEP WAS NOTIFIED BY COMM FIRE. RESPONSIBLE PARTY UNKNOWN, PERSON 1 I Health Complaints 28-Mar-03 RECEIVING VEHICLE CLAIMS IT IS NOT HIS PROBLEM. VEHICLE WAS REMOVED FROM PREMISES. Investigation Date: 3/28/2003 Investigation Time: 11:15:00 AM 2 Certified Mail#7006 2150 0002 1041 8337 TKe Town of Barnstable r " Regulatory Services ang Thomas F. Geiler, Director 9$� b A,a� Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 December 3, 2008 Richard Callahan 770A Main Street Osterville, MA 02655 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II — MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you located at 1927 Falmouth Road Apt #11, Centerville, was inspected on December 3, 2008 by Timothy O'Connell, Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of a complaint. The following violations of the State Sanitary Code were observed: 105 CMR 410.351 —Owner's Installation and Maintenance Responsibilities. Received call from tenant from above address that sewage had been leaking into basement. You are directed to correct the violations listed above.within twenty-four (24) hours of your receipt of this notice by correcting leaking sewage pipe so it works as intended to; by following best practices for sewage remediation which include cleaning and sanitizing any area within the basement which had contact with sewage. 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. Non-compliance will result in a fine of $100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. PER ORDER T E BOARD OF HEALTH TUmas A. Mc a S., CHO o Public Healt Q:\Order letters\Housing violations\Rental ordinance\1927 Falmouth Road Apt.7.doc ' Citizen Web Request Page 1 of 3 k '. 1 e , ��. r-� � �* ��� ag-m c ...oc;:N\ocanndt C Citizen u e zes rzy, G <:er Request Information Request ID: 23831 Created: 12/02/2008 09:31:32 Status: Assigned To Staff Assigned To: O'Connell, Timothy Health Office Anonymous: Yes Request Category: Title 5 : Section 353-7 Sewage Routine work: No Estimate: No Date scheduled: Estimated 12/16/2008 Change Estimated Nov 2008 December Jan Completion Completion Date: Date: Sun Mon Tue Wed Thu Fri Sat 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 1 5 1 6 7 8 9 10 Created By: Parvin, Lindsay Priority: Medium Health Office Citation Numbers: Requestor Information Requestor Request DETAILS: LOCATION: 1927 FALMOUTH ROAD/RTE 28 00 Centerville, Ma 02632 Request Parcel Number Requestor reports plumbing Map: 189 Block: 067 Lot: issues/septic backup in basement. Owner has sent maintenance but Parcel..Lookup requestor feels as though they aren't equipped to handle issues http://issgl2/IntemalWRS/WRequest.aspx?ID=23831 12/2/2008 Citizen Web Request Page 2 of 3 Email: Edit._Req.uestor_Information —..__...__ .._....._.. - ._........_..........--------_........_.........__..._..__—..._..----- —..........._.._.-.......-......................................-..........._._........................-- ---- Track Request Progress Req u est Work History: Internal Note History: .-----...-. _._........ _._ Entered on 12/02/2008 09 31:32 by Parvin, Lindsay i System entry on 12/02/2008 09 31:32 Assigned to O'Connell, Timothy Enter work progress: Enter internal note: Viewed by everybody) (Viewed internally Daly) E 3 € Spell Check^ Spell.Check.'< E _................ __............................ ............ ....._..._................................................ Add document or image link: 'Browse r " You can also type in a folder na= e to see everything in t ie folde- Current Links: Time worked on request Response time: 0 Tirne entries are in hours. Exaanples of time entries: '1,25, 1,.;:, 0 5, 1S, 025, 0.10 Response nse i::ne: i}`4easttUred froril the creation d..abe to your firs actions on till request, Do not include nights, weekends, and holidays in response time for most departments, _ Check to notify town employee below http://issgl2/lntemaIWRS/WRequest.aspx?ID=23831 12/2/2008 r ti Citizen Web Request Page 3 of 3 Save changes �: to review this request. Save changes and notify Health Office -; citizen* Cabot, Jaime C= Close request Brief message to reviewer: r' Close request and notify citizen* -*notif% °,,vc,r ks if email address�,v s given ___.... . � Spell Check�Z Public_._Use: Printer Friendl_y__Version Internal_Use:_.Printer_Fri.e...nd..ly__Version. http://issgl2/IntemalWRS/WRequest.aspx?ID=23831 12/2/2008 r V , i 4 1 i \ J J J J Citizen Web Request Page 1 of 1 MMI . r . ' Citizen Request Management Request ID: 23831 Created: 12/2/2008 9:31:32 AM Status: Closed Assigned To: O'Connell,Timothy Health Office Anonymous: Yes Category: Title 5 : Section 353-7 Sewage E.C. Date: 12/16/2008 Created By: Parvin, Lindsay Citations: Building Dept Time Worked: 1.00 Response Time: 5.00 Request Location: 1927 FALMOUTH ROAD/RTE 28 00 Centerville, Ma 02632 Parcel Number: Map: 189 Block: 067 Lot: 000 Request: Requestor reports plumbing issues/septic backup in basement. Owner has sent maintenance but eequestor feels as though they aren't equipped to handle issues Request Work History: Entered on 12/2/2008 2:56:18 PM On 12-2-08 I talked with owner of property. He told me that there had been a leak of water from toilet due to clogged toilet. When I talked to tenant she said it was from sewage line in basement due to line blockage and due to septic back up directly from tank. So there are two renditions of story.This being; was it water from clogged toilet leaking into basement or actual sewage from septic tank. I will go into basement on 12-3-08 to see what I can see. http://issgl2/IntemalWRS/WRequestPrintPub.aspx?ID=23831 6/26/2015 Citizen Web Request Page 1 of 1. .t - Citizen Request Management. Request ID: 53007 Created: 6/22/2015 3:15:55 PM Status: Assigned To Staff Assigned To: Parziale,Jim Health Office Anonymous: No Category: Chapter II : Housing Substandard E.C. Date: 7/7/2015 Created By: Crocker, Sharon Citations: Health Office Time Worked: 0 Response Time: 0 Request Location: 1927 FALMOUTH ROAD/RTE 28 Centerville, Ma 02632 Parcel Number: Map: 189 Block: 067 Lot: 000 Request: Caller said they are in a rental and have bedbugs(bites and hives). Just threw mattress away.Also, dog is trained rat terrior and has now been going crazy with the closet.There are rats at the neighbors next door. Request Work History: http://issgl2/IntemalVvRS/WRequestPrintPub.aspx?ID=53007 6/26/2015 �. TOWN OF BARNSTABLE_ ` S LOCATION I % �� �. l C��. _8 a 1 SEWAGE • VILLAGE LC�.,�1T• ASSESSOR'S MAP & LOT INSTALLER'S NAME &.PHONE NO. V ✓ s:,a:1 : �5, SEPTIC TANK CAPACITY. LEACHING FACILITY:(tyge) `< (size) , - NO. OF BEDROOMS i 3 PRIVATE WELL OR PUBLIC WATERJ BUILDER OR OWNER (fCN�C-Q- '�€ _ ( r : 3 DATE PERMIT ISSUED: i DATE . COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No tt i• ` _ ✓ X'k COMPLETE .N COMPLETE THIS SECTIONON DELIVERY ■ Complete items 1,2,and 3.Also complete A Si ure item 4 if Restricted Delivery is desired. M ■`Print your name and address on the reverse X ❑Addressee so that we can return the card to you. B. pReceived by(.P nted Name) C. Da of Delivery ■ Attach this card to the back of the mailpiece, Jrjr '�e_ or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No -e � O Z 5 S 3. Service Type 'C WXAntfied Mail O Express Mail ❑Registered- fiLReturn Receipt for Merchandise ❑Insured Mall ❑C.O.D. 4. Restricted Delivery?(Extra Fee) 0 Yes 2. Article Number (T►ansfeibomservice?abep' 700.6 0810 ='0000 {3524 93081, C, PS Form 3811,February 2004 Domestic Return Receipt 102595•02-M-is40 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid LISPS Permit No..6-10 I • Sender. Please print your name;}address and ZIP+4 in,this box.• O° Town of Bamstable"'' 4 Health Division f 200 Main Street Hyannis,MA 02601 v �6tlil1111liifllilll?lil��lStlill!!d!1!!t!?�!{'11I1�1!!ll�i�li Certified Mail#7006 0810 0000 3524 9308 �d4VETa Town of Barnstable Regulatory Services IIA.EtNS`rAF3LE, y MAS& $ Thomas F. Geiler,Director �O i639' Arf°^"A�a, Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 5 -790-6304 April 4, 2007 Richard Callahan 770A Main Street Osterville, MA 02655 " U NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II - MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you located at 1927 Falmouth Road Apt. 7 Centerville, was inspected on March 22, 2007 by Timothy O'Connell, Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of the rental registration in accordance with Chapter 170 of the Town of Barnstable Code. The following violations of the State Sanitary Code were observed: 105 CMR 410.100 (A2) —Kitchen Facilities. Inoperable burner on stove. ✓ 105 CMR 410.351 —Owner's Installation and Maintenance Responsibilities. Light switch at main door is missing face plate; light switch at main door not turning on intended light. The following violations of the Town of Barnstable Code were observed: 1§ 70-10—Smoke Detectors and Carbon Monoxide Alarms. No CO detector. Q:\Order letters\llousing violations\Rental ordinance\1927 Falmouth Road Apt.7.doc i You are directed to correct the violations listed above within twenty-four (24) hours of your receipt of this notice by installing CO detector. You are directed to correct the violations listed above within thirty (30) days of your receipt of this notice by installing face plate and fixing or replacing the light switch so it operates as intended. Note: Loft area in units 7 & 11 are not to be used for sleeping. Area is less then 70 square feet and has no second means of egress. 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. Non-compliance will result in a fine of $100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the above violations, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. ER OF TH BOARD OF HEALTH Thomas . McKean, R.S., CHO Director of Public Health Town of Barnstable Cc: Nicole Holmes, Tenant Cc: Timothy O'Connell, Health Inspector Q:\Order letters\Housing violations\Rental ordinance\1927 Falmouth Road Apt.7.doc r Certified Mail#0000 0000 0000 0000 0000 �t�r Town of Barnstable r3nxrrss�isr� Regulatory Services ; q Thomas F. Geiler, Director Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 91� � +�'L/ date 7 d /`_1' do y- O 04. .4ess 6)L*SS city,state,zip NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000 STATE SANITARY CODE H — MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPnnTEnnR 170. The property owned by you located at 1q 27 . �°`� - i 7 was inspected On?/��,/ 0-7 b TO (Address) y , Health Inspector for the Town (date) (Inspector' n ) of Barnstable, (Reason for inspection) The following violation(s) of the State Sanitary Code were observed: State code violation number-violation d scri on 105 CMR 410. 3 - AY_A — 105 CMR 410. - 105 CMR 410. - Q:\Order letters\Housing violations\Rental ordinance\temp late.doc f 105 CMR 410. The following violation(s) of the Town of Barnstable Code were observed: Town code violati n numb -viola 'on escri do §170-W §170-_ - You are directed to correct the violations listed above within "�"� ( ) d- of your receipt of this notice by O (Written y ^4 A)et ,4� 70 Af'` �— l�'v 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. Non-compliance will result in a fine of $100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the above violations, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable Cc: AA,, R, e- . (Name,tenant,owner,Fire Dept.,Building Dept....) Cc: 7o (Health inspector's name) (Generic codes located at QAOrder letters\Housing violations\Rental Ordinance\GENERIC CODES.DOC) Q:\Order letters\Housing violations\Rental ordinance\template.doc .FORM30 li w HOBBSBWARREN'" THE COMMONWEALTH OF MASSACHUSETTS BOARD EALTH I - CITY/TOVy a 1 DE ARTMENT c .r f ADD ESS r TELEPHONE Address ��1q 22— ---- ---- -Occupant-- Floor YA/1Y V Apartment No.__7 _. No. of Occupant _ / No. of Habitable Rooms-1 No.Sleeping Rooms_Q -- � No.dwelling or rooming units— —__ No.S ries.-,,_,�_�-___ Name and address of owner r 'N i/ 1 �` Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: 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 Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Ciri_ ❑ 110 ❑ 220 Fusing,Grnd.: 1)p�L�Q .- 3 / J AMP: Gen. Cond. Distrib. Box: -yt4i Gen. Basement Wiring: DWELLING UNIT Ventil. L to . O'utl is Walls geils. Wind. Doors Floors Locks Kitchen 4- Bathroom Pantry P _ Den Living Room Bedroom 1 , Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: 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 VIOl ATIONM 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 INSPECTIO ORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF P INSPECTOR TITLE DATE'J TIME _---- ""� A.M. THE NEXT SCHEDULED REINSPECTION �� '" P.M. 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 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 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). (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 Y 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. �� '��� Fc i Town of Barnstable Regulatory Services BAMSrAISM + Thomas F. Geiler,Director Public Health Division Thomas McKean, Director . 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 March 22, 2007 Attn: COMM Fire Health Inspector Timothy B. O'Connell conducted a rental inspection in accordance with Chapter 170 of the Town of Barnstable Code. In accordance with the State Sanitary Code, 105 CMR 410.482, the Health Department is required to notify the Fire Department if there is a smoke detector violation, or possible smoke detector violation. The following property had possible smoke detector(and\or CO detector)violation(s): 1927 Falmouth Road Centerville, Assessors Map-Parcel: (189-067): -No CO detector in unit. —Z4b �, 6(�* Timothy B. 'Connell-Health Inspector QAOrder letters\Housing viol A ons\Ren tal ordinance\\Fire VViolationsTIRE TEMPLATE.doc FORM30 HOBBS&WARREN,INC. _ THE COMMONWEALTH OF MASSACHUSETTS /-- BOARD O HEALTH C7 D U 1�I �� � .r� �A A CITY O!!WNA I ' p DEPAR"r1 0MENT l 1 ADDRESS' ( 7 JjTELEP ONE Address / 1 OccupantrC �/ N _, I floor Apartment No. No.of Occupants '� 0 No.of Habitable Rooms No.Sleeping Rooms No.dwelling or rooming units No.Stories Name and address of owner A ii�t, Remarks Reg. Vim YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Lighting: STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: - PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: 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 Kitchen Bathroom Pantry '_ -_Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Su .Ten.,Gas,Oil, Elect.: ` Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: MI S K I I / AJ1 /V Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: -/N t r I V V V Egress Dual and Obst'n: General Building Posted Locks on Doors: �f ONE OR MORE OF THE VIOLATIONS CH CKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH R 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�PE}RJUtRY�." 1�' it cy , INSPECTOR TITLE ��„ff" DATE �- TIME/ A.M. THE NEXT SCHEDULED REINSPECTION P.M. . o a 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 these 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 410.000 through 410.499 state minimum requirements of fitness for human habitation, any violation has the potential to fall within this category in any given situation but may not do so in every case and therefore cannot be included in this listing. Failure to include shall in no way be construed as.a determination that other violations 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 the violation(s) pursuant to 410 CMR 410.830 through 410.833 nor shall it 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) Shut-off and/or failure to restore electricity or gas. (D). Failure to supply the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253(A), 410.253(B) and the lighting in common 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 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 an object; including garbage or trash, Which prevents egress in case of an emergency 105 CMR 410.450 and 410.451. (g) Failure to comply with the security requirements of 105 CMR 41D.480(D). (I) Failure to comply with any provisions of 105 CMR 410.600 through 410.602 • .4hich results in any accumulation of garbage, 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 lead-based paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regualtions for Lead Poisoning Prevention and Control 105 CMR 460.000. =(B) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or , isnpBfrMent to health or dafety. (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 facilities 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 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: (fi) 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 operable. (2) failure to provide a washbasin and a shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3) and 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,. gas-fitting, or electrical wiring standards that do not create an immediate hazard. (r)_ 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. (N) Amy other violation of Chapter II not enumerated in 105 CMR 410.750(A) through (M) shall be deemed to be a condition 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. I M,N HOBBS&WARREN,INC. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT( 0 (Ad M H j UTY/TOWN o R`] DEPpF'taMENT ;15f- Address TELEPHONE*f '"l C t✓V ` � ° Occupant ` � 1 i✓ t t Floor A�artment No. No.of Occupants 7 No.of Habitable Rooms No.Sleeping Rooms No.dwelling or rooming units No.Stories Name and address of owner �. t��j lea f�I"�` ICIL Remarks Reg. Vlo. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: 4 Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: r4� Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: _ Roof - Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: i Stairs: Lighting: STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: f Hall Windows: f t; HEATING Chimneys: r Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vents 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 Kitchen Bathroorn D_en Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.: Stacks, Flues,kVents,Safeties: 7 Kitchen Facilities 4 Sink „ _. , Stove /`�, .J '` /`1 l /' ►��C l T I f (/ Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.:, f i 1 / " .- 1 _ I / I /�, `I 1,4' f 1,4j1 /1 9, ` - Wash Basin,Showero.Lub. Tw,_ `- Infestation Rats, Mice, Roaches or Other: 1 1't Y 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 REPORTIS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY." ! Lc INSPECTORTITLE Z A.M. DATE 1/ f I TIME �- —P M I 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 these 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 410.000 through 410.499 state minimum requirements of fitness for human habitation, any violation has the potential to fall within this category in any given situation but may not do so in every case and therefore cannot be included in this listing. Failure to include shall in no way be construed as.a determination that other violations 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 the violation(s) pursuant to 410 CMR 410.830 through 410.833 nor shall it 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) Shut-off and/or failure to restore electricity or gas. (D)� . Failure to supply the electrical facilities required by 105 CMR 410.250(B); 410.251(A); 410.253(A), 410.253(B) and the lighting in common area required " by 105 CMR 410.254. . (I) Failure to provide a safe supply of water. � .(F) Failure to provide a toilet and maintain a sewage 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 an object, including garbage or trash, which prevents egress in case of "an emergency 105 CMR 410.450 and .410.451. -(S) -Failure to comply with the security requirements of 105 CMR 41D.480(D). (I). Failure to comply with any provisions of 105 CMR 410.600 through 410.6.02 ..Aieh.results in-any accumulation of garbage, rubbish, filth or other causes 'lif, sickness which may provide a food source or harborage for rodents, insects Mr other pests or otherwise contribute to accidents or to the creation or ' spread of disease. (J) The presence of lead-based paint on a dwelling or dwelling unit in ::violation of the Massachusetts Department of Public Health Regualtions for Lead Poisoning Prevention and Control 105 CMR 460.000. ;(K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or is fftent to health -or dafety. , (LY IFailure 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 facilities 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. t (1Q 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: (`t) iack'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 operable. (2) ' falluce to provide a washbasin and a shower or bathtub as required in-105 CMR 410.150(A)(2) and 410.150(A)(3) and any defect which renders them inoperable. ; Q) any defect in the electrical, plumbing, or heating system which makes such system or any part thereof in violation of generally accepted plumbing heating,, gas-fitting, or electrical wiring.standards that do not create an immediate hazard. ( ) 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. (N) Amy other violation of Chapter II not enumerated in 105 CMR 410.750(A) through (M) shall be deemed to be a condition which may endanger or materially Im"*r 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 Z 348 659 966 Receipt for Certified Mail No Insurance Coverage Provided ®URITED STATES Do not use for International Mail POSTAL SERVICE (See Reverse) C0 "en i m � St et and to l6 P.0 oy,tate ZIP Code� O QPostage Cf) E Certified Fee O LL Special Delivery Fee U) a, Rest7ici6d%De7ivety;Fee' I RERllrfl-Rebeip7=S9io'wirig� to Whom&Date Delivered • Return Receipt Showing to Whom, Date,and Addressee's Address TOTAL Postage &Fees Postmark or Date r� �� STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front). m 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address La leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier(no extra charge), IC 1 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return rn address of the article,date,detach and retain the receipt,and mail the article. L 3. If you want a return receipt,write the certified mail number and your name and address on a >' return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT REQUESTED adjacent to the number. C 4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, M endorse RESTRICTED DELIVERY on the front of the article. E `o 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If return receipt is requested,check the applicable blocks in item 1 of Form 3811. a 6. Save this receipt and present it if you make inquiry. 105603-93-13-021e 1 The Town of Barnstable I 1Aw3TAm i Department of Health, Safety and Environmental Services rb �9 Public Health Division ON �` 367 Main Street,Hyannis,MA 02601 Office 508-790-6265 Thomas A.McKean FAX 508-775-3344 Director of Public Health November 8, 1996 Richard Callahan Trust 770A Main Street Osterville, MA 02655 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY CODE II MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE,ARTICLE 51 The property owned by you located at Unit 12, 1927 Falmouth Road, Centerville was inspected on November 8, 1996 by Jerome Dunning, Health Inspector for the Town of Barnstable because of a complaint. The following violations of the Town of Barnstable Rental Ordinance Article 51 and the Sanitary Code H were observed: 410.500: Rainwater was leaking through the roof into the bedroom, den and stairs, evidenced by marks on the ceiling. A plastic tarp was covering part of roof, but water also leaking in the area of the tap. You are directed to correct the violation of 410.500 within seventy-two (72) hours of receipt of this notice. 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. You are also subject to non criminal citations of$40.00 for the first violation and $15.00 for each additional violation. Tickets will be issued daily until the violations are corrected. PER ORDER OF E BOARD OF HEALTH homas A. McKean Director of Public Health cc: John Parent _ r r Health Complaints 07-Nov-96 Time: 9:16:47 AM Date: 11/7/96 Complaint Number: 517 Referred To: JEROME DUNNING Taken By: c.d. Complaint Type: CHAPTER II HOUSING Article X Detail: Business Name: Number: 1927 Street: Falmouth Rd. # 12 Village: CeNTERVILLE Assessors Map_Parcel: Complaint Description: The tenant is calling re: a leaky roof that is causing water damage throughout the house. Water is leaking through the light fixtures. Water& mildew damage in the bedrooms& livingroom. Water is dripping in approx 5 or 6 places in the house. Actions Taken/Results: Investigation Date: Investigation Time: 1 I 4r Mr./Mrs. f NOTICE TO ABATE VIOLATIONS OF to CM It 410,00, S'EATE SANIiI'ARX (;UDL lI, AIININIUM STANDARDS OF FITNESS FQR IV LN 11 WIT U AND 'I'IIE 'I'0�VNOI� IAAItNS'I'AIJLEItEN'I'ALORDINANCE ARTICLESI vn MAP igr9 047 The property owned by you located at 1-1 f?a 7 c,,a,,OA RA was inspected n 1994 G,bvh Ov;,v 0lealth Agent for the Town of Barnstable because of crnnpl,jint. fhc following violations of the Town of Darnstable Rental Ordinance Article 51 and the Sanitary Code II were observed: You are directed to correct the violation of within ohours of receipt of this notice by Yon are also directed to correct the remaining above listed violations within seven (7) days of receipt of this notice. You may request a hearing if written petition requesting some is received by the Board of I Icallh within seven (7) days after the date order is received. however, these violations must be corrected regardless of any request for a heating. Please be advised that failure to comply with an order could result in a fine of not more than $500. L:ach separate day's failure to comply with an order shall constitute a separate violation. , You are nlso subject to non criminal citations of$40.00 for the first violation and $I5.00 for each additional violation. 'tickets will be issued daily until the violations are corrected. Enclosed are citation numbers due to violations observed on 11ER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health Town of Barnstable h SENDER: :•22 ■Complete items 1 and/or 2 for additional services. I also wish to receive the rm ■Complete items 3,4a,and 4b. following services(for an H ■Print your name and address on the reverse of this form so that we can return this extra fee): card to you. ■Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address permit. y ■Write'Retum Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery N t ■The Return Receipt will show to whom the article was delivered and the date a delivered. Consult postmaster for fee. 0 m 3.Article Addressed to: 4a.Article Number d d -Z (a CL �J b.Service Type ` ❑ Registered A&Certified 2 W / 7JI ❑ Express Mail ❑ Insured S U) c ❑ Return Receipt for Merchandise ❑ COD 7.Date of Delivery Z 9C M ee ddress 5.Received By: (Print Name) f3.Address 's (Only if requested c W '':S and fee is paid) r 6.Signa e: dd es a en t) 0• X w PS Form 11,_Decemb r _ _ 4_ Domestic Return Receipt C pp` i�q _-' fit--Class Ma' UNITED STATES POSTAL SERVI j !_., 'gam N _ V P_.oStage a Fe -aid ' i c� m 0 Print your Kqa��rsl and ZIPZCL- nshis --- q q stealth De a 9 -rG'Ixn of Bamstable pa,-Bay,534 Hya"n s Massachusetts 025(" �/` , w/B a r fp. j �J ...i.*..!.:::.-.,....:;.�..--!%�:..,k�.::*�.,�,.,.:....I"�....z::.....'.a"..�.-;:-.;�:...:,—:.5.W:�.::..��.:A:1..�:....:.....-��,,...,,.���'i:..,,�&,�.,�,,.L:..,.\,*...��:...."m-.*:,.*:..:.;::'��.�..-$..",'��,.�..-.-:.':.-:..'.:...,.-:�.".-.::..,:..:...".,..,.�-.-..tV�-.;',—..::'.�.,....'..�\..;::�:.::��:.:.:::..;:x.:.�.�..4*."::..:I::��....,".�,.."....,�,,,.-.�..,:.I..,.N�.:--':":..�iI.;N 7......:...�:."...Y. ;x�:.—:�,-�.:�:]*,i:.*:.'.,.,�,:-i.:..�<.....�..'���"k*.,',::.�.;:S�......:,.:.:'",:.��...-*;;::,�:::�:.�:..'-:'..]::ii.::.,.:.,i���.-.,-,,�-,.:*-�,""-.j:"-;��:.:..".::,:...-�:.�.A..7-N 3�:��.:�--i..*�:.-'-..:*:��:.i.::...:�...:..ii:.-..,-�.,::-.; -',.*%..��-I,.,��ov,*,.�x,:�:::..,.;W,!.:.:.:.,l::-1.i�:..,:.:-.I....�:�.1:..—:.��.-�3%:���:,�.'. :--,-'!'..i:-...lA).�,.:,-��:%-..��:::��1.i���..::Q.i:..:....��.:.!! .-�.:.<-.,..:'�...-.:.:..:...�.:........�.....�i..-I"�:.....�.�.—..I...i:......��',.l,,:I�..—I-:�::"�,.--:.':,..,.4:.:..:.:i.'..�.:"..7.....:.....'.-.0.�-I!-Z:...�.,..�'.",.....�:�:..:;:,:�......:�....Dj..........A�.-.2.%1 v.�.�.�5��%:.�:..,-1-',.':.;-.-1ff,.-:.;'%-::1.—....i.::..:.....�....,-,-.,.��;3.��-..��.",.:.,..j:,::-:.-�.�.:.::,:.....i.�:..�..�-..-,.�l'Y.%..']/..�.�,..-�.,6�"....,:,.].-:...-.:.�..7.:..:�...61I..�.—.:.-..r-:.;l,,;I1\.:.,,3��:..-.,.,.1�',I,:,,..,,-���:..-:.-.:�..-.'..:.:....:�-.:.,.—,% 1..1:�:;:�.1;.:....::.....]�:�..-;.:/�..a:F—�.:.--�:,i:.,.:*...1..ii::.:.�i:....-I;11�.:-�?—.4��:--..I�A:..:�.;i5;*�-..:..:.:.,::,:.,�: :.. 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Sl \ R 50 ac ,�" \l \, /� ).03 �. ,. \ \ -f i ti 3 v fi — i i _ .'.•-:..:... % / 1. // _ [ / .,\ u y q w f r` / F ; :: - /� 3 /F E 1 J:::.::.is hJf /.�\ t f `1/ �% . - �� �•.. t/`'� �/ .x ; c ., \..k ...: . +. ,.. E '\ r \ E >: ._.. ...:.:::., .._.. , . :::..... 4 T ..... \ :.r..... f 1 _ .TT A[ 9F\'<>% / •;: /, Fa :::a "Y \.:a 0.T3A( 4a: 7, 934(C <``" -1 < i \ t�� ( 6�v ll�,.•; ).O # 0 0 �.,:' � ....::::....:::>:. i>. ;s. .... ... I > ., w,. < ; 3 5L 040At \ yi L rfb�v��—'��� LD�3ACE jy ... .:-.-..:..5. L' �RM30 � � HOBBS&WARREN M THE COMMONWEALTH OF MASSACHUSETTS 1 BOARD OF HEALTH CITY/TOWN W � o DEPARTMENT 1(7 , e ADDRESS M Z — ieGYq TELEPHONE Address 2'� �- ti ( � vJe�Occupant . Floor Apartment No.�� No. of Occupants No. of Habitable Rooms No.Sleeping Rooms___ No.dwelling or rooming units ( No. tories_/-S Name and address of owner ��.�°I.t��✓�'� �i_u_�-� Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish d Containers: © Gyt Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: —a I,,, C.Z,v.��, ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Lighting: STRUCTURE INT. Hall,Stairway: S a' Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING 6,04�k,$ Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: 4,6 N`V Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ;� k ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT SL�.ea Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks pt-4- Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,rasTil, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink All Cj e'c re .rv-4-' Stove ,•$ e{ •-0 C<- a (1 Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: 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 PERJU " INSPECTOR TITLE v�'➢""`. �vl S A.M DATE 1/ — TIME V " P.M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. ;.,�..7,,...� . ,. ,.,_. „ ,.,arw..,,.,- .•a• .. ,,. .. „�. . . .tom ,�t'w7^'#'.'!`+,p.1wa•tr'"-tee*..'vc'w^..... r. 1 410.750: 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 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. 1 MRVP # Z Assessors office (1st Floor) Assessor's Map and Parcel # Building Department (4th Floor) Zoning / F I /« INSP TION FEE . - RE—INSPECTION FEE $15.00 Request For A Housing Inspection For Certification Under the MA Rental Voucher Program Your Name JUb a-t°► Affiliation (Circle One) Owner Real Estat Agent Tenant Your Address ']7B OI&IN .TT2CC ., OS'T£12y11,L4 ZLS Telephone Number (Day) e1Lfi -oL Vy (Night) 4/2,0 -oC t,«/ Address of Property Where Inspection is Requested Unit/Apt.# // , / Z 7 G/ �?O G r7.l /1 G±:/2 C��f2 vi GL Name of Owner '£�rsT72 �/LG 1// L t,,y 7S Address "?a J9 1221 iIP J"T/f££i I)S7- Mailing Address (if different) Telephone Number (Day) 9�U-at <IV (Night) y ZO -OG Vc/ Will there be any children under the age of six (6) who will be occupying the rental unit? (circle one) Yes No Was the dwelling constructed prior to 1979? es No ------------------------------------------------------------- FOR OFFICE USE ONLY: Certification The dwellin , dwelling unit, or rooming unit located at 7 Z7 was 'nsppected on by J, Health Inspector for the Town of Barnstable an was found to be in compliance with the provisions contained within 105 CMR 410.00, State Sanitary Code II: Minimum Standards of Fitness for Human Habitation. However, this certification does not include a determination as to whether this unit contains any lead paint because under 760 CMR 49.02 Massachusetts Rental Voucher Program, a separate lead paint inspection must be conducted. Q Inspector's Signature U . Date IVIM UU y y y y Li Delete NFIRS -1 ( 101920 U 1 10 1 1 131 1 2009 11 109-0003052 000 ❑change Basic FDID State Incident Date Station Incident Number ' * * * * Exposure * r ❑No Activity Check this box to Indicate that the address for this incident is provided on the wildland Fire Census Tract I I $ Location* Module In Section B "Alternative Location Specification". Use only for Midland fires. 1 -LJ ®street address L�(�FALMOUTH-RD-n ❑Intersection _ Number/Milepost Prefix Street or Highway Street Type Suffix ❑In front of L �'` Rear of MA I� I CENTERVILLE i 1 102 632 I �� ❑❑Adjacent to Apt./Suite/Room City State Zip Code ❑Directions Cross street or directions, as applicable C Incident Type * El Date & Times Midnight is 0000 E2 Shift & Alarms 550 (Public service assistance, I Check boxes if Month Day Year Hr Min Sec Local option dates are the Incident Type same as Alarm ALARM always required 12 1 COMI 3 Aid Given or Received* Date. Alarm * 10 13 2009 123:12:40 I Shift olr Alarms District DPlatoon ARRIVAL required, unless canceled or did not arrive 1 ❑ I Mutual aid received �I I -I ❑ Arrival * 10 13 2009 I23:15:00 � E3 2 ❑Automatic aid reCV. Their FDID Their State CONTROLLED Optional, Et for fires Special Studies 3 ❑Mutual aid given ona Except or w anP 4 ❑Automatic aid given I I ❑Controlled " " I I I I Local Option 5 ❑Other aid given Their LAST UNIT CLEARED, required except for wildland fires Incident Number Last Unit Special - 1 Special N NNone ❑ I 1 OJ u 2009 23:26:38 Study IDn Study Value Cleared L __ F Actions Taken * Gl Resources * G2 Estimated Dollar Losses & Values ❑ Check this box and skip this LOSSES: Required for all fires if known. Optional section if an Apparatus or 86 l Investigate I Personnel form is used. for non fires. None Primary Action Taken (1) Apparatus Personnel Property $I I , 000 d 0001El Suppression Contents $I J 000 ,1 000 :additional Action Taken (2) EMS PRE-INCIDENT VALUE: optional Other I 0001I 1 �0001 Property 000 000- U u,; ElL� Additional Action Taken (3) ❑ Check box if resource counts - include aid received resources. Contents $�� 000 , 000 -❑ Completed Modules Hl*Casualties❑None H 3 _Hazardous Materials Release I Mixed Use Property ❑ ❑Fire-2 Deaths Injuries N None NN Not Mixed I ' I � I 10 Assembly use ❑Structure-3 Fire L� L� 1 ❑Natural Gas: slo,+leak, no evsbation or xa=Mat actions 20 Education use ❑Civil Fire Cas.-4 Service 2 ❑Propane gas: <u s¢lb. tank (as in hone s g=i u) 33 Medical use . . j [-]Gasoline: vehicle fuel tank o table container ❑Fire Serv. Cas -5 Civilian 3 or 40 Residential use � ❑EMS-6 4 ❑Kerosene: fuel burning equipment or portable storage ( 51 RO stmies Detector . 5e`�3 Eno$ sed 1 ❑HazMat-7 Required for Confined Fires. 5 ❑Diesel fuel/fuel oil:vehicle fuel tank cr portable1�58 Buses& Reential ❑Wildland Fire-8 1❑Detector alerted occupants 6 ❑Household solvents: home/office spill, cleanup only',.n59 Offde Its Q Apparatus-9 7 ❑Motor oil: from en table container Industrialse gins or portable QPersonnel-10 2❑Detector did not alert them 8 ❑ 6,�3 Mi111.@ary Paint: from paint cans totaling<55 gallons 6�5 Far$1�lse ❑Arson-ll s l xa:Mat actions a o U❑Unknown 0 ❑Other: Special require r spill>55gal., Q0 Other mixedl use Pleacomplete the H—Mst form W ^ ' J Property Use* Structures 341❑Clinic,clinic type infirmary 53 9 ❑Household goods,sa es,rWrs 342❑Doctor/dentist office 579 ❑Motor vehicle/boa sale repair 131 ❑Church, place of worship 361❑Prison or jail, not juvenile 57 1 ❑Gas or service steion 1 61 ❑Restaurant or cafeteria 41 9❑ 1-or 27family dwelling 599 ❑ Business office N 162 ❑Bar/Tavern or nightclub 42 9®Multi-family dwelling 615 ❑Electric generating plant 213 Q Elementary school or kindergarten_ 43 9❑Rooming/boarding house 629 ❑Laboratory/science lab 215 ❑High school or junior high 449❑Commercial hotel or motel 700 ❑Manufacturing plant 241 ❑College, adult education 45 9❑Residential, board and care 819 [:)Livestock/poultry storage(barn) 311 ❑Care facility for the aged 4 64❑Dormitory/barracks 882 [:]Non-residential parking garage 331 ❑Hospital 519❑Food and beverage sales 891 ❑warehouse Outside . 936:❑Vacant lot 981 ❑Construction site 124 ❑Playground or park 938 ❑Graded/care for plot,of land 984 ❑ Industrial plant yard 655 ❑Crops or orchard 946 ❑Lake,,river,. stream Lookup and enter a,Property Use code only if 669 ❑Forest (timberland) 951 ❑Railroad right Of way you have NOT checked a Property Use box: 807 ❑Outdoor storage area 960 ❑Other street Property Use 429 91.9 ❑Dump or sanitary landfill 961'❑Highway/divided highway 931 ❑ Multifamily dwellingOpen land or field Q62 ❑Residential street/driveway NFIRS-1 Revisj n 03 1 9 COMM Fire Department 01920 10/13/2009 09-0003052 1 Person/Entity Involved Local Option Business name (if applicable) - Area Code Phone Number Check This Box if I I I " I I 1� c El same address as Mr. Ms. Mrs. First Name MI Last Name Suffix incident location. I ' Then skip the three IL_JI duplicate address Number lines. Prefix Street or Highway Street Type Suffix Post Office Box Apt./Suite/Room City State Zip Code More people involved? Check this box and attach Supplemental Forms (NFIRS-lS) as necessary K2 Owner ❑ Same as person involved? Then check this box and skip The rest of this section. Local Option Business name (if Applicable) Area Code Phone Number Check this box if Mr.,Ms., Mrs. First Name MI Last Name _ Suffix same address as - incident location. I I u I I u u Then skip the three duplicate address Number Prefix Street or Highway - Street Type Suffix lines. I I I (Post Office Box I I Apt./Suite/Room City State Zip Code L Remarks Local Option . Caller Name ELVA COSTA Caller Phone NOT GIVEN Caller Address SAA UNIT # 4 OIC : CAPT. ELDRIDGE Pats. . 0 wmonroe ; 2009/10/13 23: 15:00 - 321 AT EVENT MANNING IS 1 wmonroe ; 2009/10/13 23:14 :27 RP HEARS AN ANIMAL INSIDE UNIT # 4, AFRAID TO GO BACK IN. wmonroe ; 2009/10/13 23:14 :54 PD SENDING CRUISER Responded in 321 (1) to 1927 Rt 28, #4, Cent. to assist the occupant with an animal prob. Upon arrival, occupant reports seeing what she thought was a lg. rat inside her apartment, also hearing noises last two nights. Checked area of kitchen, no sign of anything, hole in garbage bag on floor. Rp removed trash to exterior. BPD on loc. as well. Advised occupants the safest thing to do was leave for the night. They declined and with notify property owner of situation in am. Ret. to Qtrs. 10/14/2009 07:10:58 beldridge L Authorization 18260 JELDRIDGE, BYRON L. I :LCAPT i IShift Comm 101 1 141 1 2009 Officer in charge ID Signature Position or rank Assignment Month Day Year CheBox f Q 18260 I I ELDRIDGE, BYRON L. I I CAPT I I Shift Comm I L 101 U 2009 same Position or rank Assignment Month Day Year as Officer Member making report ID Signature in charge. :OHM Fire Department 01920 10/13/2009 09- 0003052 ' � � ! ' I + � � i ' � � i Fib,: o' I � ) I � � i ! f ( i TT I I a 1v UA � i I i I ! i I t i j ! ! ' ! ! t �� i:` F—P I —J ,\\ \\ •� r •:•1 , -Ci ��. *i� ,0--*x. l x �t-rti:lNs�,.dp•}r 1`e `.+'� py��: r � .. rt b Cn rTl ILI rTl 70. v }+} + 1 / -rSlk+a(�tP.s,,,. . 11 r-- •:�•� yi��.�''ti` "''N':`.. > ii�a�t;^14n`t'p.. 1i' o —— �� (- :.�ir+�y. ~. fiR a.M1 T F•Ti�Y-„�LYo`� :��::aG \ \ i \ a,rG r'�v tea k r,,.ti'.f „f'i 1�•S`"5'^a�i�i�� —— 1 \\, \ \ n r' \ - S� 1.g�r Sw is Y'+�•.S ?'f tea.::» — + �� J 1'1 I 1 r•yi�r�tlr-i�'j,: r•..�i� r 9 w + ' \ G+ , --- `\ \N V"� O �I� ` �i�1 �Y N'{''tc�'{"u1•�• $,y,� !�J,;t�Y�r.�. \r � w7.} ,�'�M�'Y�:s+_.CA'c Y.e '��fy.K,..•� Ln LP el rn Cn rgFr�� \ 1 ��, Y1 tit f ry 9✓e,�»�` •M IZ �W aC I; 3 y ti�•Y4��,�. / NVO y� / r Citizen Web Request Page 1 of 1 { y -x :l 1. Citizen Request Management r Request ID: 23831 Created: 12/2/2008 9:31:32 AM Status: Closed Assigned To: O'Connell,Timothy Health Office Anonymous: Yes Category: Title 5 : Section 353-7 Sewage E.C. Date: 12/16/2008 Created By: Parvin, Lindsay Citations: Building Dept Time Worked: 1.00 Response Time: 5.00 Request Location: 1927 FALMOUTH ROAD/RTE 28 00 Centerville, Ma 02632 Parcel Number: Map: 189 Block: 067 Lot: 000 Request: Requestor reports plumbing issues/septic backup in basement. Owner has sent maintenance but requestor feels as though they aren't equipped to handle issues Request Work History: Entered on 12/2/2008 2:56:18 PM On 12-2-08 I talked with owner of property. He told me that there had been a leak of water from toilet due to clogged toilet. When I talked to tenant she said it was from sewage line in basement due to line blockage and due to septic back up directly from tank. So there are two renditions of story.This being; was it water from clogged toilet leaking into basement or actual sewage from septic tank. I will go into basement on 12-3-08 to see what I can see. I http://issgl2/IntemalWRS/WRequestPrintPub.aspx?ID=23831 6/26/2015 MRVP # Assessors office (1st Floor) Assessor's Map and Parcel # Building Department (4th Floor) Zoning INSPECTION FEE $54=;*0 G0•(1� RE-INSPECTION FEE $15.00 Request For A Housing Inspection For Certification Under the MA Rental Voucher Program Your Name it, 5 4 �c iyA-m R-R A Affiliation (Circle One) Owner Real Estate Agen Tenant Your Address 776,4 11 /4try fi:eftr 0S'TCjev 1.1-1 /Y) ft Telephone Number (Day) ,�`Ii� LO -01'/ (Night) Address of Property Where Inspection is Requested Unit/Apt.# 7 /-191tnok ,-11 . j , C'£yTCf /hA Name of Owner 4:�[=F/1 va if `i�� f f�i°�/�Trv)rf r,s Address 77G/W MifInI .IT/lfj�/— 4S"r1411LL 4. /t) / Mailing Address (if different) ' Telephone Number (DayY )V4P-61l4/�1 (Night) Will there be any children under the age of six (6) wh ' ll be occupying the rental unit? (circle one) Yes No - °'7�'9.IVF© Was the dwelling constructed prior to 1979? Yes �• No DEC 1 1 2002 ---------------- TOWS!OF BARNSTAr v . . 4 tir.4.'w.-.r. •.....tlr.+w•.• w.r° +rt +. MRVP # w� Assessor's office (1st Floor) Assessor's Map and Parcel # 9 G 7 Building Department (4th Floor) Zoning Q. E n A.' i'j NSPECTIONZFEE RE-INSPECTION FEE $15.00 Request For A Housing Inspection For Certification Under the MA Rental Voucher Program Your Name JV +� a �c lyftm A R A - - ' -s"'Affiliation (Circle One) Owner Real Estate(Agent• Tenant 71 _,y_-.. [1 .v...:—_' -r_a.�. ,.-,-.� .'.:>-� �,...._.. ,.......c. _• »,,. � :.: `err-,�' __ ..�� ,..:_--�. _ _�- -.-z.. Your Address 7 7G O Te ephone. Number (Day) S'�S L Z 0 -of Y y(Night) Address of Property Where Inspection is Requested Unit/Apt.# // j,2 7 /-/�!rr�o�i 7-11 . CH%f,E v, ON Name of Owner Address `2 _rrl?-f'f 1 Mailing Address (if different) Telephone Number (Day)/-rr yzl-a441 1 (Night) } t lie Will there be any children under the age of six (6) whUNo ill occupying the rental unit? (circle one) Yes Was the dwelling constructed prior to 1979? Yes + " No FOR OFFICE USE ONLY: Certification The dwelling, we ng = nit; or rooming unit located at Q� Aervil'2 was inspected on � IZ-�3- o2 by ""Ski-"ucj H- Wh,4t Health Inspector for the Town of Barnstable and was found to be in compliance with the provisions contained ,--within, 105 CMR 410.00, State Sanitary Code If-i"'Minimum. Standards of Fitness F for Human Habitation. `However, this certification does,. not t include a determination as to whether this unit contains any lead paint because under 760,,CMR' 49s:02 Massachusetts Rental Voucher Program, a separate lead paint inspection must be k conducted. 1 Inspector's Signature Date 2-'1?3 2 MRVP # Assessor's Office (1st Floor) Assessor's Map and Parcel # 189-129 Building De tment (4th Floor Zoning INSPECTION FEE $60.00 RE-INSPECTION FEE $15.00 Request For A Housing Inspection For Certification Under the MA Rental Voucher Program Your Name Judy McNamara Affiliation (Circle. One) Owner Real Estate A ent. Tenant . Your Address 770A Main StrPPt, nGtPrvillp, MA n26-,,-, Telephone Number (Day) (508)420-0644 (Night) Same Address of Property Where Inspection is Requested Unit/Apt.# T1ni i- 1 , 1927 Fa 1 mnui-h Road , C'anf:arvi 1 1 a, MA Name of Owner Centerville Village Apartments Address 770A Main Street, Osterville, MA 02655 Mailing Address (if different) Telephone Number (Day) (508 )420-0644 (Night) Same Will there be any children under the age of six (6) who will be occupying the rental unit? (circle one) Yes No ) Was the dwelling constructed prior to 1979? ( Yes ) No ------------------------------------------------------------ FOR OFFICE USE ONLY: Certification The dwelling, dwellin unit, or rooming unit located at !n a` / Z � �+e�✓ �� `�h1ePL1/, was inspected on f IC t_ / by le," rrlH Yri, ,S. Health Inspector for the Town of Barnstable and- was -found to be in compliance with the provisions contained within 105 CMR 410.00, State Sanitary Code II: Minimum Standards of Fitness for Human Habitation. However, this certification does not include a determination as to whether this unit contains any lead paint because under 760 CMR 49.02 Massachusetts Rental Voucher Program, a separate lead paint inspection must be conducted. A Inspector's Signature Date J �'- FORM 3Q, HOBBSB WARREN TM THE COMMONWEALTH OF MASSACHUSETTS ��- BOARD OF HEALTH CITY/TOW N w I DEPARTMENT _ 'o ADDRESS G,M Svey`e �V V✓�V / 1 �i TELEPHONE Address( — �� 1 f / ��`� �`*�`Occupant--la ®0+4 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: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: w4,4- Roof w y-y4viv S G r&C Q i O-C& P S'S� bz- Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: O e,&o-annj4-,, i Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central [9 /❑ N E ui . Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ✓` ❑ MS ❑ ST ❑ P Waste Line: _ H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: 6(_ XB'1'10 220 Fusing,Grnd.: AMP: ,Lco Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT d Ventil. L to . 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.,eaas5il, Elect.: SV- 1/0--/300 Stacks, FI es,Vents,Safeties: Kitchen Facilities Sink �C S Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: eta levv Egress Dual and Obst'n: General Building Posted if 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 �w `G AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJUR INSPECTO � � TITLE c�.J 2 A.M.9 q , DATE TIME r 3 _ U� THE NEXT SCHEDULED REINSPECTION CO-641- P.M.des I kf��^ 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 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. g (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 to 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. own of Barnstable • Decz ament Qi ,Ecl CciE�/ cn 1rCnniEni21 —`�Cr/1C S Public Hiezith Division �c !Tin H �2nris i\jl G=�� FAX �- I ��u.:,cer ai_��s co ollo•.Y- io: 1 -.,m: i I ! 251-7 I I i I i 'i TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION �. Date �3 d m le y 1p Owner _ 1+''4-e- V LltA-4 Tenant Address 1 l2-7 � �n^-�'W`Ti� / - /l Address Compliance Remarks or Regulation# Yes No Recommendations 2. Kitchen Facilities 3. Bathroom Facilities < 2 s2® Yvt 15 S Y S 4. Water Supply 6e- 5. Hot Water Facilities VX- s or 6. Heating Facilities ✓ (iGG tJ aUI�ETw �3vt.� a r< ''� 7. Lighting and Electrical Facilities 8. Ventilation 6ve--55 d 9. Installation and Maintenance of Facilities J ,Sclf ryHSS i p11, tl 10. Curtailment of Service d �Clzc 5c�► S�e( . 11. Space and Use �55� n 12. Exits ✓ ��'s . 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents PAS � C 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing �4 PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Person(s) Interviewed Inspector a,kwil It If Public Building such as Store or Hotel/Motel specify here _ H1'c��� HOBBS&WARREN,INC. ASSESSORS MR NO: PARCEL NO: Q,6 , FnB- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH V ..TO.W.Al.. ....................OF......Z>ARIV! $r�.154n-E........................................... Appliration for Mqpaoal Workii Tomitrudion Vernat Application is hereby made for a Permit to Construct or Repair ( \/5-an Individual Sewage Disposal System at: RA414............................. .......... .... ..................................................... Loc.ti Addr S Z/ ......7 r Lot-IV ja- -------- ..... .. ......... ------ Address, ok 0. r ........... ..................................... ................................................................................................... Installer Address Type of Building Size Lot..-2,7 sEq.}......Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder ( ) Other—Type of Building ...U...................... No. of persons__._.._.._..__._..__.__.___. Showers Cafeteria ( ) Otherfixtures .................................................................................................................... Design Flow.............J1,0............'...00.........gallons per person per day. Total daily Septic Tank—Liquid capacity.1AA'q'..gallons Length./A'40..... Width.,5:. �,' Diameter..-�.'l... gallons. ..... Depth..... Disposal Trench—N ... Width....__....._._..__.. Total Length._._.....__......___ Total leaching area....................sq. f t. 't 9.................. Seepage Pit No._-C!t;�--------- Diameter.._..('............ Depth below inlet-....C........... Total leaching area33.%,2....sq. ft. Z Other Distribution box ( ) Dosing tank 0-.4 Percolation Test Results Performed ........... 1.4 Test Pit No. .....minutesperinch Depth of Test Pit..... .l......... Depth to ground water... 1-4 Test Pit No. 2................minutes per inch Depth of Test Pit.................._. Depth to ground water........................ .. ... .... ------------....... - 0 Description of Soil....O�-2....... ....... ... .... W R - .... ......"...*............. -------------*........*------------------"-----------------*----------- ------------------------------ ....*------------------- ............. .........**--------------- ........................................................................................................................................................................................................ 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 TL I TI LZ 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bb issued by the board of health.S1 . .... .......... 7 L--# .. ... . . ....................... ...........Signed .. . .................. t— 9 ae .......... Application Approved By.............. .......f ... .......t ... . . ... Z...... ....... Date Application Disapproved for the following reasons:.................................... . .............................. .................................. ..... ................... --------------------*.......... ---------------------- ........ ------- .............. ..............1........................... f Dale Permit No........�>......n ........... .. .. Issued..........Y ......... Date No... THE COMMONWEALTH '00 MASSACHUSETTS BOARD OF HEALTH _T0 klIV,. ....................OF........RIV rAISI-E :5.............................................................. Allpfiratiou for Uhipasal Work.6 Toustrurtion Itermit Application is hereby-made for a Permit to Construct or Repair ( fan Individual Sewage Disposal System at: ............................ ................... ........................................ .................................. Location-Addre s r Lot rya P "'Tr ...................... :EF --f...... -7-70 .94 e5�-O�—rA ny)..................................... ------------------------------------- .................................................................................................. �-4 Ina Address 4- U Type of Building Size Lot.2Z.(4:50.......Sq. feet Dwelling—No. of Bedrooms....._.3.................................Expansion Attic Garbage Grinder aOther—Type of Building ...NI...................... No. of persons............_........-_..... Showers Cafeteria Other fixtures ............................................. .......................**...............................................*..........--------*........ Design Flow.............Ar)........................gallons per person per day. Total daily gallons. Ono Septic Tank—Liquid capacity'.!s9.4'a..gallons Length. Width-7."-'...... Diameter..-�2............. Depth.... .......... Disposal Trench—No. .................... Width.................... Total Length.............._...._I Total leaching area....................sq. ft. (40 -%-. _' 't 3....sq. ft.Seepage Pit No..... ......... Diameter.....r-............ Depth below inlet.._C............ Total leaching area �,...-. Z Other Distribution box ( ) I Dosing tank Percolation Test Results Performed Date..Aj,<, -3 ,/17"t3 ?..,..�7............................. 1.4 Test Pit No. I .....minutesperinch Depth of Test .......... Depth to ground 4 Test Pit No. 2................minutes per inch Depth of Test Pit._............_...._ Depth to ground water.-_........._._......... ............................................................................................................................................................. 0 Description of Soil....n--2........_10/2 4- _'11"L() /-/, .F_o jAj.............. . �4 ........................... ... ....... ......... ............... -----------------------*---------*--------------------------------------"-----------------------------------------*---------------------*--------------------- .......*-------"--------- .............................................................................................................................................................I.......................................... U Nature of Repairs or Alterations—Answer when applicable............................................................................:---------*........ ........................................................................................................................................................................................................ Agreement: The tin*dersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 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. Signed.._.._. .._..- lo ................................ lq3 76�, - - e V .1 &a*?. Application Approved By..� ....... PV04- 911��10� _..J�....... ..................... ........... ....... Date Application Disapproved for the following reasons:............................................................................................................ ....................................................................................................................................................................................................... I( D`�'�. 140" Permit No........ ..................................... Issued.------ Date ------ --------*--------------------------------------- ------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ~...............OF........... .................. (9rdifirate of (foutphattrit THIS IS PTO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by....._.... -66 11?A2..........t3 Vit 11 v< .... ..►................................... ...................................................................................................... A- ............... ............... has been installed in accordance with the provisions of Tll-`�W 5 of The S ate Sanitary Code as described in the application for Disposal Works Construction Permit No dated.....- 'Of THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................hZ_n.1-13.................................. Inspector...-- _CD",--------------------------------*-------------------------------------- -------------------------------------------------------------------------------------------------------------------- THE C8MMONWEALTH OF,,MASSACHUSETTS BOARD OF HEALTH 17, .............. ...... .... eV'...OF...... FEE.... Disposal !�rka Tanstrurtion rrrmit Permission is hereby granted..._.,,_... ...................................................................................... to, Construct or Repair k;��an Individual Se g- ]Lisposal System at No........... ------- /P ee" ...... ------------------�_f.... ... - ............ - - -----......... Streeo t7 No qJD as shown on the application for Disposal Works Construction Permit (j� ated...... ----------------- r. NA-Z.......................................................... DATE..... 0 Board of Health -----------------------------------— ,�. TOWN OF STABLE `s , LOCATION /"1 �7 tiQ *' l Esr( . SEWAGE # ^ VILLAGE r tat. _ ASSESSOR'S MAP & LOT J Q� INSTALLER'S NAME & PHONE NO. e040) 3 - I SUa f SEPTIC TANK CAPACITY 1 LEACHING FACILITY:(type) �X 6 (size) NO. OF BEDROOMS 13 PRIVATE WELL OR PUBLIC WATER xit�t BUILDER OR OWNER �CaN rC%!C C VW*,rjt N DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: P i VARIANCE GRANTED: Yes No `�. 111 ti TOWN OF BARNSTABLE LOCATION" " r^ ��� iU!�ISEWAGE ## VILLAGE � �- ASSESSOR'S MAP LOT J 9- 6e.-7 INSTALLER'S NAME & PHONE NO. t ��i�d►r1'� � 9• 41, " J 6`f0 SEPTIC TANK CAPACITY 100 Ci f LEACHING FACILITY:(typef9 3 P4 GAL' (size) 6 Aln NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER, ' BUILDER OR OWNER 0 !/gyp_ �'l�f 1"I � r CA-1 DATE PERMIT ISSUED: m w 9 3 DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �F� f � �y k + ��+ � E , . r, �� t t�{�!j�,n T�.c a� ..�ddd"' ��� sy,a C����'�• �J�g l fy '�1.1 a? w a e F�j •/` •. { f A_ �. R � _ ��.�.� t� ;:. 1 ����„ '�� u: III nay,.,,�..���,.. '.•��+ �Y i �"" ,y . G � : a � ��} � . a � "� _ .. LEGEND � BENCH MARK CENTERVILLE TOP OF FOUNDATION 52.14 O PROPOSED CONTOUR O - __ 96.46' BARNSTABLE CIS.DATU �O ® PROPOSED SPOT GRADE UTILITY OLE (Y —— 98 -— EXISTING CONTOUR O °� a �CFO �'�,� • so I.i + 96.52 EXISTING SPOT GRADE �a u �7 �Q i� r W— APRX. EXIST. WATER SERVICE /\ !� TEST PIT `` QP / 4V �� o� r✓ �' N Rp• O& F,O ,GUJI SCALE: 1"=30' LOCUS OL J `�Q PROP 1 000c S LOCUS MAP " \ / , SEPTIC TANK / P , �, TP_2 a LOCUS INFORMATION Xz 20 ft % ' �(\ y �G ���' ° c f ' TITLE REF: BK 27960/PG 093 g PARCEL ID: MAP 189 PAR. 067 EbST. 1. ai LOT SEPTIC TANK / f {`�� 3 ¢ N FLOOD ZONE: "X" AREA = 0.64 oc+— �0 'gig o r r �'J TO}1/ —c 1 ' COMMUNITY PANEL: 25001CO563J DATED:07/16/14 PLAN BOOT: 48 PAGE 49 ASSR MAP189 PCL 67 ' ,.i �; �� to. SEPTIC SYSTEM T REPAIR PLAN LOCATED AT: <- ° 1" , EXIST. I 1927 FALMOUTH ROAD ' REMAIN) ,51 - (UNITS 9, 10 & 11 ) 51 CEN TERVI LLE, MA PREPARED FOR W y CALLAHAN /READY ROOTER c NOVEMBER 30, 2017 REV: DECEMBER 20, 2017 G OF ass` GENERAL NOTES: — — _ _ — A N n 1140 1• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL 8• ALL AREAS. DISTURBED DURING CONSTRUCTION SHALL BE RESTORED BOARD OF HEALTH AND THE DESIGN ENGINEER. TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR: qE�/ 9 �1NITAR . IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE �p� h 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING LOCAL RULES AND REGULATIONS. CONSTRUCTION. 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND REMOVED PER TITLE 5. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR REPLACE WITH CLEAN MEDIUM SAND PER TITLE 5. MEYER & SONS INC. TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE � DESIGN ENGINEER. 1 1, 48 HOUR NOTICE FOR ENGINEER CERTIFICATION P. O. BOX 981 4• ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING 12. THIS PLAN IS TO BE IISED FOR SEPTIC SYSTEM PURPOSES ONLY FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY E. SANDWICH, MA 02537 ENGINEER BEFORE CONSTRUCTION CONTINUES. PH:- (508) 362-2922 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 13. NO PRIVATE WELLS WITHIN 150' OF PROPOSED LEACHING. v FAX: (774) 413-9468 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 14. NO WETLANDS WITHIN 1100' OF PROPOSED LEACHING. THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF meyerandsonstitle5Qgmail.Com HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 15. ALL PIPING TO BE 4 SCH 40 ® 1/8 /FT (UNLESS SPECIFIED) www.meyerandsons.com 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. SHEET 1 OF 2 J 1735 ELEV. TOP NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS FOUNDATION (Existing) INSTALL RISERS W/IN 6' OF FINISH GRADE ON ALL COVERS 52.14 FINISHED GRADE (50.0) F.G.EL: 51.0 F.G.EL: 50.4 F.G.EL: 50.4 F.G. EL: 50.0 INSTALL RISERS W/IN 13' OF FINISH GRADE 4 MAINTAIN 2% MIN SLOPE OVER LEACHING AREA f EL:='49.52 ✓2" OF 3/8" DOUBLE WASHED 'EL= 26.6 STONE OR FILTER FABRIC 'A 3/4" - 1-1/2" _ DOUBLE WASHED STONE 101I t4 ' 4" SCH 40 PVC TEE'S ARE TO BE a EL= .50 4' SCH 40 PVC INV. 10' 14 6 Q EL= 48.15 TEE'S ARE TO BE ®®® ®®®®®®®®®®®®®® 4' SCH 40 PVC RtE:3®®®®®®®®®cAs lNv_ 25 lN . INv. 2 EFF. DEPTH ®®®®®®1®®®® v:.:::: INV. :•.•.A... BAFFLE /EXLEJ EL= 47.90 " EL.=, 47.70 L.= 47.50 Am IS-M amI 4 2X8.5 4 EXIST. OUTLET EXIST. 1,500 GALLON SEPTIC TANK PROPOSED DB-3 , PROPOSED 1,000 GALLON SEPTIC TANK IH-20 DISTRIBUTION Box EFFECTIVE LENGTH = 25 n INV. ELEV.= 46.50 v BREAKOUT NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING ELEV.= 47.50 PIPE INVERTS PRIOR TO CONSTRUCTION TOP CONIC. ELEV.= 47.50 2) ALL NEW COMPONENTS SHALL BE SET LEVEL AND INV. ELEV.= 46.50 ®® TRUE TO GRADE ON A MECHANICALLY COMPACTED ®®® SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN E ®®®®®®® E3 3®®®®® •. 310 CMR 15.221(2) BOTTOM EL.= 44.50 ®®®®®®® 3) INSTALL INLET & OUTLET TEES W/ 3.75' 1 5 FT. 3,75' GAS BAFFLE AS REQUIRED SEPARATION 5.58 FT. EFFECTIVE WIDTH = 12.5' SEPTIC SYSTEM P RO R LE BOTTOM OF TESTHOLE EL. 38.g2 I SOIL ABSORPTION SYSTEM (SECTION) (500 GALLON H2O LEACH CHAMBER) DESIGN CRITERIA SOIL LOGS P#: 15507 NUMBER OF BEDROOMS: 3 - 1 BEDROOM STUI00S = 3 TOTAL BEDRO S " DESIGN FLOW: RESIDENTIAL: 3 BEDROOMS ® 110 GPD/BR = 330 GPD DATE: OCTOBER 25, 2017 DESIGN PERCOLATION RATE: <2 MIN/IN SOIL TEXTURAL CLASS: CLASS 1 (0.74 GPD/SF) SOIL EVALUATOR: DARREN MEYER, CSE 1614 GARBAGE GRINDER: NO (not designed for garbage grinder) ✓ WITNESS: DON DESMARAIS, BARNS. HEALTH ���� OF SEPTIC TANK: 330 gpd x 200% = 660 gpd USE (2) TANKS (1,500 EXISTING/1,000 PROP.) IN SERIES **meets 2 compartment tank requirement** o D R�2EN /Elev. TP- 1 Depth /Elev. TP-2 Depth YER -� LEACHING AREA REQUIRED: (330)/.74 = 445.94 S.F. ✓ / 50.06 0" 7 J 49.92 0" DISTRIBUTION BOX: USE (H20) DB-3 DBOX L0 S LOB S�10 2 10YR �D 49.06 12" 49.09 10" RFC gj � USE TWO (2) 500 GALLON H2O PRECAST LEACH CHAMBERS B eNITAR�a� LOAMY W/ 4' STONE ON ENDS AND 3.75' ON SIDES: 25' L x 12.5' W x 2'D 10 SAND L10AOYR MY 5/1D 46.64 C 41" 46.59 C 40" BOTTOM AREA: 25 x 12.5 = 312.5 SF J MEDIUM MEDIUM SIDE AREA: (25 + 12.5) X 2 X 2 = 150 SF SAND PERC O EL. 45.2 SAND 2.SY 6/4 2.SY 6/4 PROPOSED SEPTIC SYSTEM UPGRADE PLAN TOTAL SQUARE FEET PROVIDED = 462.5 vs. 445.94 REQ'D 1 DESIGN FLOW PROVIDED: 0.74(462.5 S.F.) = 342 G.P.D. vs. 330 G.P.D. req'd 39.06 132; 38.92 132" 1927 FALMOUTH RD, (9,10 & 1 1 ) CENTERVILLE, . MA PERC RATE <2 MIN/IN. (-Cl- HORIZON) No GROUNDWATER OBSERVED Prepared for: Callahan/Ready Rooter Exc. Design and Topographic Plan by: SCALE DRAWN DATE MEYER&SONS,INC. N.T.S. DMM 11/30/17 1. Darren M. Meyer, R.S., CSE, hereby certify that 1 am currently approved by MADEP pursuant to 310 CMR 15.017 PO BOX961 to conduct soil evaluations and that the above analysis has been performed by me consistent with the EAST SANDWICH,MA 02537 REV- DATE CHECKED SHEET NO. requirements of 310 CMR 15.017.. 1 further certify that I have passed the Soil Eval. Exam in October, 1999. 508-362-2922 12/20/17 DMM 2 Of 2 TEST HOLE LOGS .- s y� I ENGINEER: JAMES C. JODICF- -% WITNESS: JERR Y DUNNING (B.0.H.) DATE: AUGUST 3. 1993 �j\ \ - - ,y �.� PERC. RATE: <2 MIN/INCH GREAT\\ - I q R S � AM 0' EL. 49.6 \I ST ATE H TOP AND SUBSOIL /��.:' \ 0' W/O 2' EL. 47.6 �J - / r� ���� �;�' EO?: \ �SS,gC BENCHMARK: IOC " MED. �. G� \ E ► - l SAND h TO CONCRETE BOUND / / �t-- --- J - - - -- --- -- - -- ---- - i \ 4OT t s / AT EL. 52.67 I -- ------- UTiL!'Y POLE \�_ LOCATION MAP (NO SCALE) N P� FLOOD ZONE C 13' -- O EL. 36.8 ,A \ 1 a -7,WATER Y r FOUND, -- ` '�-�17- N \ ONZ OF ��`'G 6A P +++ ++ +`+ /� GAS METER SEPTIC DESIGN (A / )_ SEPTIC_ DESIGN c { DESIGN FLOWS: DESIGN FLOWS: SECTION 1: 5 BEDROOMS 0 10 10 CPD) = 550 GPD SECTION 1: 3 --- - P S � BEDROOMS BEDROOMS (1 10 GPD) - 330 CPD P ° SECTION 2. ,I (1 GPD) - 330 CPD / 5 SEPTIC _TANK- DESIGN._ SEPTIC TANK DES. - -- --- - - - --- -_IGN__ TANK 1: 330 CPD (1.5) = 495 GALLONS 1 1� & �S��NG�MFN� �/ + `+ ++ `, ` + Nv 4 PR°P TANK 1: 550 CPD 1.5 = 825 GALLONS, / X R ct ( ) USE, A 1000 CALI,ON SEPTIC TANK Ppvp\NG �� 0) USE A 1500 GALLON SEPTIC TANK TANK 2: 330 GPD (1.5 = 495 GALLONS LEACHING DESIGN: o USE A 1500 CALLON SEPTIC TANK SIDEWALK: f 0-rr 6' 2.5 = 471.2 + ,?, PROP. 1500 1 ( ) - \\\ NG/ ,� C+ ` ?3' ;4,-,� 2 � , -'" � BOTTOM AREA: �25� 1.0 - 78.5GCPD '9 4� EX1`?� , - t►saK \-_---GAL. SEPTIC---"' /5 LFACHING DESIGN; --- ---- --- --�- --- ----- - -- TOTAL 267.0 S.F. ,549.7 CPD �C TANKS DF_, ffALL: 2(12 rr 6 (2.51 = 113> CPD �A7 Ue� `{' - BOTTOM AREA: 2 36-rr) (1.0) = 226.2 GPD USE, (1) LEACHING PIT (6'x6') WITH 2' OF j''�5 TOTAL 678.6 S.F. 1357.2 CPD 5IONI; ALL AROUND { U.'E (2) LEACHING PITS (6 x 6') WITH 3 OF r') s`1 � STONE ALL AROUND 4 ` 4�- SO- "J P�Z _-�- _C,--r J---G \_P 6 EACH PIT WITH R- °POS '48- -�4 - r c, 3' OF STONE e�Ov_ _G (2) PROP. 6'x�, RE e✓lv" 4�-_---- -_ _4 `� _ =-"'�t�; -- LEACH PITS WITH G-- --- - G - _ ''`--T O STONE 2 SEPTIC DESIGN _ DESIGN FLOWS: KE Y x 'HI SECTION 3: .3 BEDROOMS (1 10 GPD) = 330 GPI) EXIST. CONTOUR- �\ SEPTIC TANK DESIGN: WATER LINE. - - --w-- - ---- --w--_ 4.--a-24 �r�n i� f. = s(35 GALLONS -:-- PARCEL. 3 --- \ USE A 1500 GALLON SEPTIC TANK_- ---� LEACHING DESIGN. { r� --- --- --- ---- ------SIDEIFALL: (121-r fl' (2.5) = 565.5 CPD EXIST. TREE. \ BOTTOM AREA: J6r) (1.D) = 1 13. 1_CPD _ �r SEPTIC PROFILE (DESIGN B) TOTAL : 339.3 S.F. 678.6 GPD ---------- - -- -- -� USE (1) LEACHING PIT (6'x6') WITH 3' OF (NOT TO SCALE) STONE ALL AROUND TOP OF FOUND. AT ZL. 48.7 -FRAME AND COVER TO WIT.1Il.V i' OF URADE -- - -- SEI'TI C PROFILE A2) f EL. 47.0 MINIMUM 1 ' OF CUVi-P UVE� PRECAST \\ �� (NOT TO SCALE) - - --- -- P_ 48.0 EXISTING __ - - --- � --- -------- INVERT EL. 44.70 t ) I 1 TOP OF FOUND. AT B«_54._4 -FRAMA'S AND COVERS TO IFITHIN 11 OF cAADR PROPOSED I I 2 PEA S TOI\'I; - NO �]�T�� ~ 10u0 GAL. 44.07 - _ 1 I i SEPTIC TANK � - EL. 44.79T I'�IN!VUM 1 ' OF COVER OVER PRECAST -- L- - - --" - EL. 51.2 J L 44.32 �'Lr6p�-oC\ 43-� oo°° EXISTING =__- --- EL. 51.5 - 1. DATUM ,1Ctin TAKEN FROM HYANNIS QUAD MAP (ASSUMED). 44_01 n 0" ,0 0 0 - ('0 o I o 00 o LN b h'X T --- --- Q ( ) / °000 ' 6'-6' ao°o0 EL. 50.78t _.__ j L�_' ---� 2. MUNICIPAL. WATER IS AVAILABLE. 2 PEASTON �- DEPTH OF FLOW = 4' pppO o 00 �� I(�- 3. PIPE. PITCH TO BE 1 f' PER FOOT. 000o LEACH I �-- EL. 50.54 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO-H /0 . TEE SIZES: 43.7910°o 0 0 0 0 0 I PROP. 1500 -�'�" i l 0000 000o I GAL SEPTIC 50.05 -IT EL.F;' CRIIS'flf;'D PIT -504 1 ---- -J� _ 5. PIPE. JOI.ti'TS TO AF, MADE WATERTIGHT. INLET - ld ou0 I 000 TANK ourLET = 1�' ST01VI' U,ti'DI'R 00a -_ _ ob EL. 37.79 j! I o 0 00 � pO°° 0000 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE MASS. 21 D' BOX ----- - �� = --- --1 49.99 n o 0 0 0� 49_82 0000 000 - -1- 10. _ °°oo° 6 -6 °oo o ENVIRONhfE,ti'T�il. CODE TITLE L'. 3/4" TO 1-1/2"- -"� 00 DEPTH OF FLOW = 4 °°°° °pD0 7. THIS PLAN FOR PROPOSED WORK ONLY AND NOT TO BE USED CLEAN WASHED jEvdE IZI�s� 49_54 000 0 LEA o�ryO3 ENGINEER TO CERTIFY GOOD SOIL TO EL. 33.79 MIN. 6" CRUSHED °o a PIT o°�oo� FOR LOT LINE STAKING. STONE, ----IN E ------ -- - - TO EL. - ----- OL'TtET = 19' -STONE U.1 DER 000 ,°Oo0+ D' BOX goo EL. 43.54 8. SCII 40-4' P...0 TO IMF, USED THROUGHOUT SEPTIC SYSTEM. FOUNDATION - 19' - SEPTIC TANK -- 3' --- -- -D' BOX- -- 5' ----LEACHING FACILITY -� - 9. OWNERS F_NGt,4'IsF,R TO INSPECT ALL SITE WORK. 3/4- TO 1-1/2" 6, 4' 10. EXISTING CESSPOOLS TO BE REMOVED. CLEAN WASHED 11. D'BOX TO BE WATER TESTED FOR LEVELNESS. STONE NO WATER AT EL. 36.6 �_ 12. C'O,NTRA(:'TOR TO VERIFY LOCATION OF ALL SITE - ------------------ - - FOUNDATION- --24' - SEPTIC TANK ----- - 3'-- -D' BO,Y---- ---- 14' - - - -LEACHING FACILITYCTII•ITIF.S PRIOR TO CONSTRUCTION. �1) 1 P TI C PIS O FI L Ir, (D1rSl(:.v A I (NOT TO SCALE) TOP OF FOUND_ AT_NL. 53.9- __.- -- ---- -PRAMNS AND COVER TO WITHIN PA' CR,4:I ' i d wn cape engineering, inc. I j ZL. 12.7 (AVERACE)XXISTING MINIMUM 1 ' OF COVER OVER ?LCAs' 1 YVF R r -- - ll DB9 I 2" PEASTONE ----- - - .'LEV47'10NSt INVERT 1: 49.0 L�1 _ D'ROX !: 47.45 CIVIL ENGINEERS S i INVERT 2: 49.5 ( ( D'N0.1' t?.22 -=1 t , I I PROP. 1500 INVERT 3: 50.0 \- SEPTIC U ~ TANKS TIC PIT 2 47.35 UPGRADE LAND SURVEYORS � INVERT 4: ;�0.0 TANK ,: I7.6b �L._------J\- _ � I� - TANK 1: 47.9 + TAN.>4 X: 47.66 r -r- R e a TANK z: 47.9 _�-T D'I10,1 1: 47.28 A Y ARMO UTH, AIA �-- - D'BOX Z: 47.05 ti 000 --- 0000 (pOoo° FOR 1927 FALMOUTH ROAD IN THE TOWN DEPTH OF FLOW = 4' IOo°000aI 6 6 Poo°o°0 �F' TEX SIZES: PIT 1: 46.95 �ppO° � LEACH I o0000 °°°° b CENTER VILLF_ BAR S'TABLE, M l a INLF'I -- 1d PIT 2: 46.31 - °000 I PIT `0oa0 '`ps+r � ur!Tt.11'T = 19' 000 °000 PR 1: 40.95 � 1�� � � t � ARHE RIME °000 PR 2_40_31 '�, OJALA I PREPARF,D FOR: ALA VIL • WASHED --------- ---- -�-- STO,V'F. _ENGINEER TO CERTIFY GOOD SOIL TO EL. 38.31 r { i { + ----� -- -- - DA1� IE, L HO S 7 E. T TER X-P . 0 �., R.I,.S. DA TF 7 , . FOUNDATION T�iRIES SEPTIC TANK 6ARIF.S' - -- D' BOX - "- VARIES' ---- - --I,F.AC'IIINC FACILITY SCALE,': I" 0' DATE: SEPTEMBEZ 8, 1993 I REV: SEPTEMBER 13, 1993 93-269 RBFBRBNCB / /// C6NTBRVILLB, -Town of Bemstable Assessor's Map 189 Parcel 67 �/ MA -Septic Plan Eacept Pwvided By Barnstable Board of Health ���' �'�► PORMM 5lJMP AREA OF 501L RMOVAL NOTE: This Site Plan Was Not Prepared Fmm Any eAS MENT 31 x 2'x 2t B haf sinew Snmey And Under No Ciramsstaueee Should The CRACK IN I 2�3 (0°3 ' Distavices, Bearing AmYOr Other Featares Shawn Be Used rocx� CONCRETE To Bstabhah Propmiy Lines. N�OOR 1=M" LEGEND \ Urnrnr POLE AREA Or < ha z ®\\ A55ORBENT \ f Ty� \ HAND BORING APPLICATION \ DETAIL FORMER OIL SCALE I'�5' TANK , « h O R m d & 41 _ 4 fir^ 4 � {I I d s � E.3 '.: o COD c p � 4 r 4 �t t! A ,i-fig rc a A f RF RTN# 4-23798 Phdaft HOSTETTER REALTY TRUST =US 77i0 MAIlN SPRwr-OSIEItVELB,M&MW p. . q 1927 rALMOUTH ROAD T FUEL OIL REI:EASE INVESTIGATION IM7 M MO =ROAD-CBNMVHL$MA OM BENNETT ENVIRONMENTAL 51TE PLAN .,# ASSOCIATES, INC. A±L1Cm4m am ENVEtOlINMNITALOCENTNM (MOLOM%E S 0 20 40 60 IM MAN S'PB1i38T,P.O.BM 17A BREMMI M,MAW61 5EE DETAIL PlEMO M"M .a a.� mlv. FAMPON N SCALE V-2a 03/15/12 As Noted SRF DGB BEA12-10408 I