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HomeMy WebLinkAbout0020 GREGOIRE CIRCLE - Health (3) 20 Gregoire. Mcre Centerville A = 273 012 1 y UPC 10259 No.H� 16_ NASTINOS. ON i o: Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for DtqpogaY *p5tent Cottgtructton Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. ��' OwP Q� ����°-le Own s Name,Address,and Tel.No. Assessor's Map/Parcel o {! Installer's Name,Address,and Tel.No. �Ct�} Desiger's Name,Address and Tel.No. n Type of Buildi Dwelling No.of Bedrooms Lot Size to,Syn sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures �t Design Flow(min.r uire ) 3 �� gpd Design flow provided v Y gpd Plan Date �3 ��' Number of sheets Revision Date A.)I Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 t ' Board of Health. Signed Date O Ilk Application Approved b A Date Application Disapproved by: Date for the following reasons Permit No. Date Issued f Fee _ THE COMMONWEALTH OF MASSACHUSETTS Entered incoinputer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE MASSACHUSETTS Yes RppYtcatton for ��tgpoaC *pwtu Congtructton Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components L Location Address or Lot No. (Zc act p\t-me— Q x T_C�f' Owner's Name,Address,and Tel.No. // Mocks i dV1 IX Assessor's Map/Parcel P O r Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Buildin Dwelling No.of Bedrooms Lot Size !O,5- Z� sq. ft. Garbage Grinder (V)`✓ Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.r uire ) I —ao gpd Design flow provided j y/ gpd Plan Date Z3 0 Q Number of sheets�_ Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 r] O' i f Application Approved by jr Wj Date Application Disapproved by: e V Date j for the following reasons Permit No. '"'` Date Issued THE COMMONWEALTH OF MASSACHUSETTS' BARNSTABLE, MASSACHUSETTS Certificate of Compliance I� THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ' ) Repaired ( ',) ,Upgraded ( ) Abandoned( )by atn (lP-4-ery,I�e has been c struc e '� ccordance with the provisions of Title 5 and the fo Disposal System Construction Permit No. '� dated Installer Designer #bedrooms Approved design fl wt D gpd The issuance of this erm' shall not be construed as a guarantee that the system will 'nnti-n as designed. �!( Date Inspector ) • . I No. J Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS �Bigool 6p,5tem Con,5truction permit Permission is hereby granted to Construct ( ) Repair ((/)/Upgr de ) Abandon ( ) System located at `c��c Q p�„-� C«e�e,,, r i and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty 1 to comply with Title 5 and the following local provisions or special conditions. Provided: Con ncction ust e completed within three years of the date of this Date Approved b pp Y :moo w el -C 13 �} �C, = n of H EET 1 o F Z APPLICANT: _ A ,�•p ADDRESS:. DESIGN FLOW: gpd REVIEWED BY: DATE: aJ� GENERAL SEPTIC TANK Legal al boundaries denoted 310 CMR 15.220(4)a 51" e OK? 310 CMR 15.223 1 Street,Lot,tax parcel number and lot number noted on plan[310 et tee located ten inches below flow line 310 CMR 15.227 CMR 15.220(4)(u tlet tee 14"or 14"+5"per foot for increase ft depth[310 CMR i" ' Locus Provided f 310 CMR 152204(t) 5.227( _ Plan proper scale?(1"=40'for plot plans,i"=20'or fewer for utlet tee with gas baffle or approved filter 310 CMR 15.227(4)] components) 310 CMR 15.220(4)] lote regarding installation on stable compacted base[310 CMR Easements shown 310 CMR 15.220(4)(b) 15.228(1) System located totally on lot served[310 CMR 15.405(I)(a)for eparation between inlet and outlet tees(no less than liquid s/ up es-f/'not,a variance is required 310 CMR 15.412(4)] lepth 310 CMR 15.227(2 Location of impervious surfaces(driveways,parking areas etc.) �. let/Outlet elevations at least 12"above high groundwater / 310 CMR 15.220(4) - except as described 310 CMR 15.227(5))or permitted for l/ Location all buildings existing and proposed 310 CMR -upgrades under LUA 310 CMR 15.405 1 ] 15.220(4)(c)) Minimum cover 9"(Tanks buried more than 9"must have risers Location and dimensions of system components and reserve areas. on all openings and on the d-box)[310 CMR 152228(1)and 310 kol 310 CMR 15.220(4)(a CMR 15.232 3 f) System Calculations 3.10 CMR 15.220(4)( Three access covers(inlet and outlet must be 20"or greater)- n/ /� dail flow If middle access at least 8"(b 7/07 310 CMR 15228 2 6 IS. /0pd 64 septic tank capacity1required andprovided) Access to within 6"of grade -one port for systems<1000gpd, soil absorption s tem(required and rovided) two for systems>1000 gpd 310 CMR 15.228(2)] whether system deli ed for arba a der All at-grade covers secured to unauthorized access? [310 CMR N�/g North arrow 310 CMR 15.220(4)(g)] 15.228(2)] Existing and ro osed contours 310 CMR 15.220(4)(g) >10 ft from building foundation 310 CMR 15.211(I Location and log of deep observation holes(existing grade el.on _ Buoyancy calculation Required/Done 310 CMR 15.221(8)] each test) 310 CMR 15.220(4)(h)l H-20 Where appropriate? 310 CMR 15.226(3)] Names of soil evaluator and BOH representative[310 CMR ✓ Setbacks from resources 310 CMR 15.211 {/ 15.220(4)(h)and(i)] Multi-Compartment Tanks Location and date of percolation tests(performed at proper (/ Required when other than single-family dwelling or flow>1000 elevation?)[310 CMR 15220(4)i d 310 CMR 15.223(1) A,/I Percolation test results match loading rate? 310 CMR 15.242 First compartment 200%daily flow;Second compartment 100% Certification statement by Soil Evaluator 310 CMR 15.220 4) ON uy it flow 310 CMR 15.224(2)and 3 l/} Observed and Adjusted groundwater(method for adjustment "U"pipe through or over baffle,outlet of each compartment with A)1A given or indicated)(310 CMR 15.103(3)and 310 CUR gas baffle or approved filter 310 CMR 15.224(4)] 15.220(4)(n)] Location of every water supply,public and private,[310 CMR BUILDING:SEWER AND OTHER PIPING.` 15220 4(k)] Located at least ten feet from any water line?[310 CMR within 400 feet of the proposed system location in the case .15.222(2) of surface water supplies and gravel packed public water su 1 /$ Disposal piping at least 18"below water line(when water and N/ within 250 feet of the proposed system location in the case q q sewer cross,see 310 CMR 15.211 I 1 within 150 feet of the proposed system location in the case Cleanouts required/provided rovided 7 310 CMR 15.222 8 /U of private water supply wells Njo� Thrust blocks specified in force mains?310 CMR 15.221 (c Location of all surface water;and wetlands located up to 100 ft. Slope of sewer line not less than 0.01(1/8"/ft) 0.02 preferable beyond setbacks listed in 310 CMR 15.211 and any catch basins 01A [310 CMR 15.222(6)) located within 50 ft. 310 CMR 15.220(4)(1)1 per pitch on all runs?(.005 within gravity-distributed trenohes Water lines and other subsurface utilities located(310 CMR �• and beds) 310 CMR 15.251 9 and 310 CMR 15.252(2)(c !� 15.220 4 m) (if water line cross see 310 CMR 15.211 1 1 Siphonproblem/(leachfield below pump chamber) Profile of system showing invert elevations of all system Endca s or vent manifoldspecified? com onents and the bottom of the SAS 310 CMR15.220 4 o �- Size and orientation of discharge holes specified?(not smaller Stamp of designer 310 CMR 15.220 1 and 310 CMR 15.220(2)) than 3/8"not larger than 5/8")[310 CMR 15.251(8)and 310 /lr/ Stamp of Registered Land Surveyor(required if construction ✓ CMR 15252 2 activities within 5 ft.of lot line 310 CMR 15.220(3)] Materials specified (310 CMR 15.251(5)specifies various pipe Test Holes adequate(two in each of the primary and reserve / es allowed unless trenches as permitted in 310 CMR 15.102(2)or as V approved for an upgrade under LUA at 310 CMR 15.405 1 (k)] DISTRIBUTION BOX. Test hole adequate to demonstrate four feet of suitable material? k- Stable compacted base[310 CMR 15.22](2)and 310 CMR 310 CMR 15.103(4)] 15.232 2 a Test Holes adequate to confirm adequate groundwater separation? / Splash plate or baffle tee required on inlet/provided?(when 310 CMR 15.103(3)] ✓ pressure sewer to d-box or steep pitch of gravity sewer)[310 /U/, Benchmark within 50-75'of system 310 CMR 15.220(4(q) CMR 15.323 3(a Materials specifications noted?[various sections of 310 CMR Riser if deeper than 9".[310 CMR 15232 3 15.000 Inside minimum dimension I T' 310 CMR 15232 2 System components not>36"deep(unless Local Upgrade Minimum sum 6" 310 CMR15.232 3(e) A roval or LUA uested 310 CMR 15.405 1 Watertight cover if<1000gpd);waterproof manhole if>2000gpd N/� 310 CUR 15.232(3)(d)) ,/ e 10 W 0) Of BhO 5TA-9 lit K cc- r 2 O F 2— APPLICANT: ADDRESS: PUMP CHAMBERS Capacity(emergency storage above working—design flow)?(310 DID THE"PLAN;INVOLYE CMR 231(2 Pressure Dosed System? Provided pump and piping Proper setbacks 310 CMR 15.211 same ass tic tanks calculations as uired 310 CMR 15.220 4 r N Watertight 20-in minium access manhole at least 20"MUST BE Pressure dosing required on all systems>2000gpd or alternative TO GRADE 310 CMR 15.231 systems under remedial approval[310 CMR 15.254(2)and I/A Service components accessible(not too deep with piping, Remedial Use A rovals disconnects accessible :If used in gravelless system-make sure jet is directed as not to Alarm floats-alarm on circuits arate from pumps specifiedT scour soil interface Guidance Document Exceeds two units must have two pumps operating in lead4ag Inspections once per year(system s<2000 gpd)or quarterly mode. 310 CMR 15.231 and 8 (>2000 dgood to note on plan 310 CMR 15.254 2 d Stable Compacted Base 310 CMR 15.221(2)1 Construction in fill-Did the plan specify that the fill shall meet ,^ Buo. c calculations needed?Provided?[310 CMR 15.221 8 the specification of 310 CMR 15.255 3 7 R SOIL ABSORPTION SYSTEMS(SAS)GENERAL Impervious barrier and/or retaining wall? Guidance Document Impervious barrier installation must be supervised by ect?Calculations corr 4 feet of naturally occurring material demonstrated?[310 CMR designer 310 CMR 15.255 2 15.240(1)1 Retaining wall must be designed by Registered Professional Required separation togroundwater? 310 CMR 15.212 Engineer 310 CMR 15255 2 a Aggregate specified as double washed 310 CMR 15.247(2 Side slo a not exceed 3:1? 310 CMR 15.255 2 System Venting r uired/ rovided? Breakout requirements met?[310 CMR 15.252(2)and Y g eq p (system under driveway or Guidance Document >36"de 310 CMR 15.241 N Inspection ports specified and within 3"final grade?[310 CMR At least 5 ft.from impervious barrier t=edge SAS (10 ft. 15.240(13)] recommended 310 CMR 15.255(2)(e Breakout requirements met? Gravelless S teen 111A A roval Letters) 1 req (No violation of breakout elevation / Check DEP Approval letters for credits and deli conditions within 15 ft of SAS unless barrier)[310 CMR 15.211(1)[4]and [/ If used with pressure dosing do not allow pressure discharge Guidance Document to scour soil interface. GALLERIES,PITS,CHAM.BERS 310 CMR 35.253. Altcriratrve Sepik Systeurll/A Approval Letters] Chambers and Gal.in trench configuration supplied with inlet every 20 ft. 310 CMR 15.253 Was DEP Approval Letter provided and/or have you 1 t Each structure with one.inspection manhole(if>2000 gpd must i reviewed the letter for conditions? 1V be to de 310 CMR 15253 2 v Is the technology being properly applied and does it meet all DEP A roval Conditions? Aggregate I'minimum-4'maximum. 310 CMR 15.253 1 Is there a note on the plan regarding the requirement for 2'sidewall credit maximum 310 CMR 15.253 1 a perpetual maintenance agreement? In bed configuration,inlet every 40 sq.ft. 310 CMR 15.253( An alarms involved on separate circuits aintenanc TRENCHES 310 CMR 15 251:. .::" Did the applicant submit an operation and m e Width 2'minimum T maximum 310 CMR 15.251 1 manual? 100 feet-maximum length 310 CMR 15.251 1 (a) Has a licant submitted a co of a maintenance Minimum separation 2x effective depth or width whichever ter 3x ifreserve between trenches 310 CMR 251 1 d Varimiees" Situated along contours P10 CMR 15.251 2 Are the variances listed on the plan?[310 CMR 15.220 Breakout OK? 310 CMR 15.211(l)[4)and Guidance Document 4 ) N 1 BED SAS(Maximum size of tied or field 5000 gpd)..' RLS Stamp necessary on plan if a component is within five 1 minimum 2 distribution lines[310 CMR 15.252C2 a ) feet of pro line 310 CMR 15.412 4 Maximum separation between lines 6' 310 CM R15.252 2 d) New construction or increased flow proposed-[Refer to 310 ( Maximum separation between lines and outside of bed 4'[310 CMR 15.414 / CMR 15.252(2)(e)] Nitrogen SensitiveAreas \ Aggregate depth below discharge pipes 6"minimum,12" Is the system in a Designated Nitrogen Sensitive Area("Lone 11 for- maximum.maximum. 310 CMR 15.252 2 a jublic supply well)?(310 CMR 15.214,310 CMR 15.215 and ' Separation between beds IV minimum. 310 CMR 15252 2 310 CMR 15.216-also refer to Policy regarding upgrades of such Bottom area used in calculations ont 310 CMR 15252(2)(i)] existing systems] 7 'dt Is the system proposed on the same lot as served by private well? 310 CMR 15214(2 Are the nitrogen loads proposed in compliance?[310 CMR f 15.216 1 Miscellaneous l Pumping to septic tank? 310 CMR 15229 U Shared System 310 CMR 15.290 I r Town of Barnstaible ' Regulatory Services Thomas F. Geiler, Director • snxwsTnst.e. MAS& : Public Health Division 039. ♦� "rEonnAi5. Thomas McKean, Director 200 Main Street, Hyannis,h`IA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: 71_�Lo Designer: R .3 ,C LL�t 5 Installer: Address: �• © � k. 2-cs�Q_ Address: " q _ _N k C��6�� On l C lN_ was issued a permit to install a (date) nstal ler) septic system at 20 G reA6)j re, `_t based on a design drawn by (address) ,J • )A_0 i L j, y dated 6125 ��01 (designer) _ I certify that the septic 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. 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. ,wOFMAs RONALJAMES D �yc lInstaller's Signature) CADILLAC v 9 #1060 o y Ar /S'T t �NITAVO" (Designer's i ature (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q: Health/Septic/Designer Certification Form V TOWN OF BARNSTABLE LOCATION oW 1q),ec4i.e SEWAGE# /79 VILLAGE J' ,ATev V,11e ASSESSOR'S MAPy&PARCEL MU 1001'Z INSTALLER'S NAME&PHONE NO. � SEPTIC TANK CAPACITY 10060 LEACHING FACILITY:(type) S`` ! j�(refD�J, (size) ��x y® NO.OF BEDROOMS -0 ) OWNER , J v vk-S M /-40'XS I ka ALWI PERMIT DATE: r716 /69 COMPLIANCE DATE:9 9 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 FURNISHED BY N 'P .(S ... .� i ���q 1, .� y�, Z 3� '� l9 ``l�`�a oF mown of Barnstable P# G �- Department of Regulatory Services BAMSTABIA : Public Health Division Date XAftft z6J9 ,6� 200 Main Street,Hyannis MA 02601 Date Scheduled rJ Time , (� Fee Pd. 272- 7 Soil Suitability Assessment for Sewage isposal Performed By: RU ,4� V- �.C�D l LL,,,(� Witnessed By: �'V�` 5 A- LOCATION& GENERAL INFORMATION Location Address 2D G' ^r° 1�G Owner's Name C�/V7Gy/Gv/I,L Address I 1_9I/7h —7 '�i'1/L*� Assessor's Map/Parcel: 2 !3/12 Engineer's Name RatU - DELL NEW CONSTRUCTION REPAIR Telephone# 5 7�7®d—/ /Y g 70 o Land Use YI-)/—d Slopes Surface Stones nQ Distances from: Open Water Body ft Possible Wet Area 41 ft Drinking Water Well Drainage Way 137 ft Property Line 71ft Other y/ ft } SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlan proximity holes) i 37 Parent material(geologic) Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Weeping from Pit FAce /g Estimated Seasonal High Groundwater 6t,,, '�/j P 75 / DETERNHYATION FOR SEASONAL HIGH WATER TABLE 61�e Method Used: _See A Ab,,O 61_<1A/6 7_?PW ll Depth Observed standing in obs.hole: NG4 -in, Depth to soil mottles: in. Depth to weeping from side of obs.hole: N/•4. in, Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj,factor— Adj.0roundwaterbevel PERCOLATION TEST bate '1hne Observation Hole# / Time at V Depth of Perc Time at 6" Start Pre-soak Time @ Time(9"•6") _ End Pre-soak Rate Min./Inch Zh�tilY Site Suitability 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 first notify the, Barnstable Conservation Division at least one (1) week prior to beginning. Q:\SEPTIC\PERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole#. Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency,%Grvel 0-./© " /7 G 3 0 7� "r,Wel 32/' /F7" C /nec),J'onj Z'S e 6 v N. DEEP E OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) LLImL Aim. 'low /0' r - CIU � G ��rc� -r---. • � DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. ` Consistency. Flood Insurance Rate Map: 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? _— If not,what is the depth of naturally occurring pervious material? Certification ` I certify that on /VD(/ Z IW(date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the requi training, xper'se nd x ie c d ibed in 310 CMFt 15.017. Signature �'L Date 6 Z3 D�� •. ,•c Q:\S.EPTIWERCFORM.DOC Telephone(508)771-7222 Barnstable Fax(508)778-9312 Leased Housing Dept. (508)771-7292 Housing Authority y 146 South Street•Hyannis,Mass.02601 January 15, 2003 Thomas McKean, Director Public Health Division Town of Barnstable 200 Main Street Hyannis, MA 02601 Re: 20 Gregoire Circle, Centerville Dear Mr. McKean: This letter is to update you on the status of the BHA's response to the Notice to Abate Violations Order which your office issued on the above noted property in a letter dated December 18, 2002. This is a state funded property under the Chapter 705 Family Conventional Housing Program. Upon receipt of your letter, the BHA notified the Department of Housing and Community Development (DHCD)via fax. On December 30, 2002,_Tom Hackenson, Construction Advisor for DHCD visited the site and reported recommendations to his office. At an emergency funding meeting this morning in Boston, DHCD allocated $17,000 in modernization money for roof and window replacement as well as vinyl siding at 20 Gregoire Circle. Mr. Hackenson will be coming to Barnstable the week of January 27`h, 2003,with contractors to view the site with the intent of assisting the BHA with the project. The BHA maintenance department replaced the locking device on the window which was broken and did the repairs to the tile and grouting, once we had been notified by your office on 12/18/02. These are repairs for which the tenant should be calling the BHA Office to issue a work order, so the repairs can be scheduled. Please feel free to contact me at 508-771-7222 should you have further questions or concerns with respect to this property. Sincerely, Thomas K. Lynch Executive Director Equal Housing Opportunity Agency ` Town of Barnstable XAft' Regulatory Services Thomas F. Geiler,Director Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 December 18, 2002 Barnstable Housing Authority 146 South Street Hyannis, MA 02601 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II - MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION The property owned by you located at 20 Gregoire Circle, Centerville, was inspected on December 16, 2002 by Sam White, Health Inspector, and David Stanton, RS, Health Inspector for the Town of Barnstable, because of a complaint. The following violations of the State Sanitary Code was observed: 105 CMR 410.150(D): Broken/missing tile in bathroom. Grouting in shower tiles in disrepair. 105 CMR 410.480(E): Window in dining/kitchen area not lockable. 105 CMR 410.500: Ceiling not free from chronic dampness. Stains from possible water damage on ceiling of living room. 105 CMR 410.500: Window in dining/kitchen area (same window as mentioned above) not weatherproof. 105 CMR 410.551(2): Screen for window not tight fitting as to prevent the entrance of insects and rodents around the perimeter. 105 CMR 410.552(2): Screen for front door not tight fitting as to prevent the entrance of insects and rodents around the perimeter. You are directed to correct the violations within thirty (30) days of your receipt of this notice, by repairing/replacing the tile and grouting, repairing/replacing the locking device on the window, by repairing or replacing the roof, and by making the window weatherproof. 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. Q:Health/WP/BamstableHousingAuthority f Non-compliance could result in a fine of up to $500.00. Each day's failure to comply with an order shall constitute a separate violation. PER ORDER OF BOARD OF HEALTH omas A. McKean, R.S. Director of Public Health Town of Barnstable Q:Health/WPBamstableHousingAuthority FoRM30 °Iixw HOBBS&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CITY/TOWN j MAP PARC DEPARTMENT LOT � 2v� � _ �,� ADDRESS ) d 6 2 M ELEPHONE _ Occupant_, r"Address I Floor Apart rnt No._ - _. No. of Occupants_ -3. No.of Habitable Rooms _ No.Sleeping Rooms __ __ No.dwelling or rooming units No._ No.Stories A Name and address of owners 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:,qnd Obst'n.: ❑ B ❑ F ❑ M ,--[j-007rrW__indow­sN,, lrrorA cc r pA o4oxty n�,, a Ap t,J i A d rv ,.,s r A-r ,rm Gutters, Drains: I Walls: Foundation: Chimney: BASEMENT Gen. Sanitation: Dampness: Stairs: Lighting: STRUCTURE INT. Hall,Stairway: Obst'n.: _ Hall, FloorCW_. ',Ceiling: �,'-� xw,,,c ArAw, pu55; bk/ tascv- Hall Lighting: Z ;Q0, CQ,;`� �t i�. lA r r,4 Y,66W H�hl°Windows: � � � Y HEATING Chimne s: Central ❑ Y ❑ N Equip. Re airs, e TYPE: Stacks, Flues,Venl'S. PLUMBING: Supply Line: `"" WiA(Yow J)YkA^_ ❑ MS ❑ ST ❑ P Waste Line: LA- lac 1cc bl't -- H.W.Tanks Safety and Vent(s)r ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220' Fusing, Grnd.: AMP: - Gen.Cond. Distrib. BQx:_ k roken I wa 11 Ji k Gen. Base V/rrirr °�----�vo,�F,�,R r`G,ews� 1rP01ACQ_NW.,n4 DWELLING-'UNIT -V ntil. L to Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen (Bathroom '�i _Pantry, 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 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"ERJURY ' INSPECTOR TITLE diS 2 A.M. DATE 12 l G, V1 TIME J© ­"P.M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions,when found to exist in residential premises, shall be deemed conditions which may endanger or impair the heaith, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 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 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. ALWAYS DIG SAFE PRIOR TO CONSTRUCTION--UTILITY LOCATIONS SHOWN INCOMPLETE. JOB No. B09-03 NOT To NOTES BHA._d_wg SCALE BENCH MARK--TOP WOOD STAKE SET FLUSH=49.93 ASSIGNED 1. LOCUS IS A.M. 273, PARCEL 012. , �e�5� O NOTE; CALL R.J.CADILLAC TO (2'-»' TO NEAR CORN. HOUSE do 7'OFF FENM 2. ELEVATIONS SHOWN ARE ASSIGNED. \r 0_ r 3. LOCUS IS IN FLOOD ZONE C ON FIRM DATED AUGUST 19, 1985. Qr N INSPECT PRIOR TO BACKFILL. 4. ALL PIPES TO BE 4" SCH 40, AND PITCHED AT 1/4" PER FOOT. (UNLESS NOTED) n N/F 5. MUNICIPAL WATER IS AVAILABLE. LOTS WITHIN 100' ARE ON TOWN WATER. a Cr VAZQUEZ °'0 6. COMPONENTS TO BE AASHTO H-10, UNLESS NOTED. „ d 7. INLET TEE TO PROJECT DOWN 13 , OUTLET TEE DOWN 14 . 8. IF TWO OR MORE LINES, WATER TEST D-BOX FOR EQUAL FLOW _z (16 a N/F D-BOX EXIT PIPES TO BE LEVEL FOR FIRST TWO FEET. ` 9. DEPTH OF COMPONENTS NOT TO EXCEED 3', OR VENTING MUST BE PROVIDED. a „ x 50,1 COVERS: BUILD UP COVERS TO 6" BELOW GRADE--1 ON TANK, 1 ON D-BOX, 1 ON LEACHING GREGOIRE 5°,6 '°�° LOT 6 10. STONE TO BE DOUBLE WASHED 3/4 TO 1 1/2" WITH 2" MIN. 1/8 TO 1/2" PEA STONE ON TOP. A6 h NSF 11. IF UNSUITABLE SOILS, OR SOILS DIFFERING FROM THE SOIL LOG ARE FOUND, LOCATION MAP 118 O,57Of S F CARBONELL CONTACT THE BOARD OF HEALTH, OR R.J. CADILLAC. 12. IF AN OVERDIG IS CALLED FOR BELOW, FILL MATERIAL FOR 5' AROUND AND UNDER LEACHING TH 1 IS TO BE CLEAN GRANULAR SAND MEETING SPECIFICATIONS OF 310 CMR 15.255(3). TEST HOLE 1 TH 2 50,0 13. PUMP AND FILL ANY EXISTING CESSPOOLS. REMOVE ANY CLOGGED SOIL, BLOCK, AND STONE IN LEACH AREA, AND DISPOSE OF AS DIRECTED BY HEALTH AGENT. 49,9 DEPTH (inches) ELEV.(feet) 14. ALL CONSTRUCTION TO MEET TITLE 5 AND LOCAL REGULATIONS. 0 50.4 Fin 10, TEST HOLE DATE: June 23, 2009--P# 12602 10" NO GRADE CHANGES PERFORMED BY: Ron Cadillac, Soil Evaluator 50,0 ARE PROPOSED WITNESSED BY: David W. Stanton, Inspector B layery10yr 5/8 BENCH MARK---TOP, BACK, CENTER x 50,3 _ i o PERC RATE: <2'-00"/inch (C layer) sand loam SEPTIC TANK=49.92 ASSIGNED o g 50.98f SOIL SURVEY(1993): Eastchop loamy fine sand „ N N ,tea 4g' Top Foundation GEOLOGIC MAP(1986): Barnstable plain deposits 32 47.7 fl", �o BENCH MARK-*-NW CORNER CQNC. Invert 48.46f C layer 2.5y 6/6 N/F i Invert 48.11 5 HIGH CAPACITY1 � STOOP=50.27 ASSIGNED 50s BUCKO Exist. Cast Iron INFILTRATORS medium sand Use Gas Baffle Existing Invert 46.98 (30% gravel) �, 47.4=Toa Unit Z vsE 1 b %� o S=1/8"/ft+ Exist. 9 cover Proposed pea Stone/Filter Cloth 50,3 50.2 NG N� Spa h --- __--_- r-------- N Existing S=5/8"/ft 3" Max. 5°2 W EX,N©, N F Invert 48.30t 1000 Gal. 17�\ 1 inspection Port .'. asee� ` -.. 50. / Existing Septic Tank i ----------� �, b ONNEMBO �--------- 10 1/4 127" no water 39.8 SE .;�.. • 46.1 NOv 4 5 5 6" Stone or compactlnPro osedvert 5 Invert 46.95 6.3' Bottom N9, 1 x 50, 49� � p Proposed i TEST HOLE 2 20'---i Bottom TH1=39.8 50,1 x 50 DEPTH (inches) ELEV.(feet) o x 50,3° rn 0 A layer 10yr 3/3 50.8 9.6 49, a DESIGN DATA 14 „ sandy loam o BEDROOMS: 3 Y yr5/810 er B la LEACH AREA GARBAGE GRINDER: No sandy loam USE 5 HIGH CAPACITY INFILTRATORS WITH w 28'62° q p 49 REQUIRED CAPACITY: 330 GPD 3 1/2'+ OF STONE ON THE SIDES AND 3'+ 42" 47.3 5 13�1'ag 4 2 00+ EXISTING SEPTIC TANK: 1000 GAL. ON THE ENDS TO MAKE A 38' BY 10' WIDE ems. BOTTOM LEACHING AREA: 380 SF BY 10 1/4" DEEP LEACH AREA. C layer 2.5y 6/6 " W �048 66 p9 49'� N/F [(38' X 10')] medium sand 5 13y1'A0* 4 SIDE LEACHING AREA: 81.6 SF (30% gravel) 60. PEREIRA [2(10'+ 38') X 0.85' DEEP)] 7 DESIGN CAPACITY: 341 GPD 4g. 'GO [(380 SF + $1.6 SF) X .74 GPD/SF] 4g.26 BDRM DNRM KIT. 120" no water 40.8 46 2� ---- GAR. BDRM BDRM LVRM; NSF FLOOR PLAN KENNEDY NOT TO SCALE SITE PLAN FOR THIS PLAN IS A VALID COPY ONLY IF IT BEARS AN ORIGINAL RED STAMP AND SIGNATURE. BARNSTABLE HOUSING' AUTHORITY F�q ... LOT 69 20 GREGOIRE CIRCLE, CENTERVILLE, MA LEGENDq ' ��N V " ' TH 1 TEST HOLE LOCATION, NUMBER � ;� JU N E 23, 2009 SCALE: 1 =20 ILLA W WATER LINE MARKINGS C#D060 " °CAOILi�yC E OVERHEAD ELECTRIC WIRES (IF SHOWN) �k�l o 3S770 x 9.5 X8 7 EXISTING & PROPOSED ELEVATIONS ('X' MARKS POINT) sTF_ 6- .- EXISTING CONTOUR 'S RONALD J. CADILLAC, PLS, RS, P.C. 8 PROPOSED CONTOUR 4Z PROFESSIONAL LAND SURVEYOR & REGISTERED SANITARIAN 0 UTILITY POLE (IF SHOWN) P.O. BOX 258 ® EXISTING DRAINAGE CATCH BASIN WEST YARMOUTH, MA 02673 0 x --- FENCE (IF SHOWN, NOT ALL SHOWN) (5O8) 775--9700 TREE (IF SHOWN, NOT ALL SHOWN) HEALTH AGENT APPROVAL p DATE ©2009 BY R.J. CADILLAC PAGE 1 OF 1