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0027 HORSESHOE LANE - Health
_27 Horseshoe Lane, Centerville _ A= 206-081-003 i I No. 42101/3 ORA ESSELTE 1096 O 0 O O A I k r S SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTiOjV ON DELIVERY ■ Complete items 1,2,and 3.Also complete A ature Item 4 if Restricted Delivery Is desired. Q- 4 , ❑Agent ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. a eived��. Printed fJ ' ate Vi ery ■ Attach this card,to the back of the mailpiece, C� or on the front if space permits. } D. Is delivery a_ different from Itern-11 ❑Yes 1. Article Addressed to: ] If YES,enter d ivery addre"sa belo4 ❑No 3. Service Type da I a — 3913 lk Certified Mail ❑Express Mail E3 Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number - - )(Transfer from service I �`u cam,O 41 9 0 6 ` PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box • gs� Town of Barnstable Health Division F 200 Main Street i Hyannis,MA 02601 I Him 111111111 Ins)11111f 1.1111.l1�11fIi31111i1-�1'I to F�l l.a a 111111 Health Master Detail Page 1 of 1 €,y„ I,": r,5: :�'iv 1.3:.`.,,.C;t177E'.: ra.3.. ..CE I?_ha PM �'�-- .au �C ) e�LS_.��..c?I. �'..:::'"!�S �r,3 f 4 er Parcel Septic Perc � %Jell F L'�- n Parcel: 206-0 1-0 Location: 27 HORSESHOE LANE, C NT RVILLE Owner: KAIN, MARTIN 3 Business name: Business phone: Rental property: Deed restricted: Number of bedrooms : 0' Contaminant released: Fuel storage tank permit: Satre Parcet'Changes :Return to Lookup Parcel Inns Parcel ID: 206-081-003 Developer lot:l...OT 3 Location:27 HORSESHOE LANE Primary frontage: 124 Secondary road: Secondary frontage: Village:CENTERV1LLE Fire district:C-O MM Sewer acct: Road index:0742 R Interactive map: ^ AP (Aquifer Protection Overlay Town zone of contribution: State zone of contribution:OUT District) Owner Infer Owner: KXIN, MARTIN 3 Co-Owner: Streetl:327 ASHMON'1 S1 Street2: City: BOSTON State: US Zip: 02124-3813 Cou Deed date: 3/3/1998 Deed reference: 11258/220 Land Yates Acres: 0.23 Use: Single Fam MDL--01 Zoning: RC Neighborhood: 0107 Topography:Level Road: Paved Utilities:Public Water,Gas,Septic Location: Construction Info E Ic'i s Wcar'nuiltlEffcctive Arlea edrpoms 8attjrou s 1 1981 1506 Bedroom 1 Full + 1H Buildings value:$144,000.00 Extra features: $0.00 Land value: $180,400.00 http://issql/intranet/healthMaster/HealthMasterDetail.aspx?ID=206081003 6/5/2008 I Cape Cod Vacation Rentals—Kinlin Grover GMAC - Property Page Page 1 of 4 t f I N L I N GA&Ac I Horne >> Properly List» Property Owners>) -Gape Cad>> • Links» •Homes for Sale» ROVER Vacation Rentals Property Search >> Ofice Locations >> About),) Contact» eNews» Properties '7 Property Details TKAIN 27 Horseshoe Lane (V), Barnstable-Centerville ' CENTERVILLE: Absolutely pristine and nicely decorated r 4• rental home with distant water views and only 3/10 mile le home has from Crai ville Beach. This upside-down style 9 P Y c� two bedrooms and a full bath with washer/dryer on the first floor. and a kitchen with breakfast bar. dining area. half bath. living room and deck on the second floor. Beds: 2-Q. Maximum Occupancy: 4. GUESTS BEDS BEDROOMS BATHS RATES 4 2 Queen Bed(s) 2 1.5 $1800/wk 1 Sleeper Sofa(s) send inquiry >> Calendar Reserve Online Now June 2008 July 2008 Reserving online is fast, easy, and S M T W T F S I I S M T W T F S secure. The calendar on the left 25 26 1 27 1 28 29 30 31 291301 1 1 2 3 4 5 shows the days that this property is 1 1 2 3 4 5 6 7 6 7 8 9 10 11 12 currently available as blue on white, 8 9 10 11 12 13 14 13 14 15 16 17 18 19 and days that are not available as 15 16 17 18 19 20 21 1 20 21 22 23 24 25 261 gray. To make a reservation for 27 28 29 30 31 1 2 this property now, select an available 22 23 24 25 26 27 28� I � P P Y , 29 30 1 2 :EE4 5 13 4 5 6 7 8 9 arrival date for the first night of your --- ---- stay by clicking on the calendar on PLEASE NOTE: All properties are available Saturday to Saturday with a 7 night minimum unless otherwised noted. the left. First Night Last Night Town Barnstable- Centerville Pictures http://www.vacationcapecod.com/viewproperty.aspx?PropertyID=4509 6/5/2008 y,.,�rr� b�P �. -.,.4Y�t �.ryt.. r $ :,, P_i. ryh•rT -t. �—�� ICI �•""� � f $� M , t i r . N J M� ti r wy �A OL i Cape Cod Vacation Rentals—Kinlin Grover.GMAC - Property Page Page 3 of 4 ,t t i:,;,;. till ' r . x a � (click picture to enlarge) (click picture to enlarge) r�rw� y L, a rRRR t t _Il r.y X�- (click picture to enlarge) (click picture to enlarge) (click picture to enlarge) Amenities Business Entertainment Outdoor Convenience • Answering Machine • VCR • Picnic Table • Clothes Washer • LD Phone Block • CD Player • Outdoor Furniture • Dryer http://www.vacationcapecod.com/viewproperty.aspx?PropertyID=4509 6/5/2008 r Cape Cod Vacation Rentals—Kinlin Grover GMAC - Property Page Page 4 of 4 Living • Stereo • Grill(Gas) • Iron (Clothing) • Heat • Color TV • Beach Chairs • Iron Board • Cable Channels • Deck Kitchen • Porch • Dish Washer • Microwave • Electric Coffee Pot • Toaster • Lobster Pot ® COPYRIGHT 200% GMAC HOME SERVICES •: LEGAL .. PRIVACY ASSOCIATES ONLY EQUAL HOUSING OPPORTUNITY Information Policy Site Usage Agreement © 1999-2007 Escapia, Inc. Kinlin Grover GMAC Vacation Rentals is powered by Escapia Vacation Rental Software ClearStay Vacation Rentals ib Barnstable Vacation Rentals I Centerville Vacation Rentals I Cotuit Vacation Rentals I Cummaquid Vacation Rentals Hyannis Vacation Rentals Hyannisport Vacation Rentals I Marstons Mills Vacation Rentals I Osterville Vacation Rentals I Cataumet Vacation Rentals Grey Gables Monument Beach Vacation Rentals I Pocasset Vacation Rentals I Brewster Vacation Rentals Ocean Edge Resort Vacation Rentals I Chatham Vacation Rentals I Dennis Vacation Rentals I Eastham Vacation Rentals Falmouth Vacation Rentals E. Falmouth Vacation Rentals Falmouth Hts Vacation Rentals I N. Falmouth Vacation Rentals Teaticket Vacation Rentals W. Falmouth Vacation Rentals I Woods Hole Vacation Rentals I Harwich Vacation Rentals I The Belmont Vacation Rentals I Mashpee Vacation Rentals I New Seabury Vacation Rentals I Popponesset Vacation Rentals I S. Mashpee Vacation Rentals I Orleans Vacation Rentals I Provincetown Vacation Rentals I Sandwich Vacation Rentals I Wellfleet Vacation Rentals I Yarmouth Vacation Rentals I Truro Vacation Rentals Disclaimer: All information deemed reliable but not guaranteed.All properties are subject to prior sale or rental,change or withdrawal. Listing broker's) and information provider's)shall not be responsible for any typographical errors, misinformation,or misprints and shall be held totally harmless. http://www.vacationcapecod.com/viewproperty.aspx?PropertyID=4509 6/5/2008 r Town of Barnstable oFt Tea. Regulatory Services _''` �P` o Thomas F. Geiler, Director°�. " Public Health Division * * • BARMSTABLE, v NAS.S. �, Thomas McKean, Director i63q. ArF p 39.E A 200 Main Street Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 June 4, 2008 Martin Kain 327 Ashmont Street Boston, Ma 02124 As of October 1, 2006 a new rental registration ordinance was put into affect requiring all property owners of rental units to register their rental units with the Town of Barnstable Health Division. According to our records, you own the rental property at 27 Horsehoe Lane , Osterville Enclosed is an application. Please use a separate application for each rental unit you own. Should you need more applications, they are available online at www.town.barn.stable.m.a.us. Go to the Health Division page by looking in the Department Menu. There is a link to the Rental Registration information on the Health Division page. You may print out as many as you need, and return them to the Health Division with the appropriate 2008 fees included. Failure to comply with this ordinance will result in the issuance of a non-criminal ticket citation in the amount of$100. Each day of non-compliance is considered a separate offense. Should you have any questions, please feel free to call 508-862-4644. Thank you in advance for your cooperation. C � Timothy B. O'Connell Health Inspector Health Division Direct#508-862-4646 t u � ti 1 w?/ r .I DATE.,,: , PROPERTY ADDRESS F27 horseshoe Lana,_, 3 az� ff s er Masa AUG o 199t 0265 5 H66,11 DEPT �WN.OF RARf�BT'ABf On the above date, l Inspected the septic system at the above,address. This" system .cons1sts of the ioilowing: "1 1-100.0 gallon:.s.epti,c tank. .•s' • f -�Z. ' 1—Distribution bax 1, 3,• T-1000 gallon leaching pit. Based bn my Ins oactlon; I certify the following con dlttons: i 1 This is a title `five; sepiaa vs ode rstain. (: �$ C ) J SORSMApNt� , 'D 2. The septic s3�stem is 3n failure.`' ; 3. Must be upgraded to the ;95 ( Code ) ELNO• C f' ; SIGNATURE: Name: J_P_M_ac'omber Jr_, i -,— --- l Company• •P_Macomber & Son Inc• r -- — Address: r 4 ` { { N Cente_rvilleLMass_: Phone:--=5Q8.JJ_5:.3338— THIS CERTIFICATION' DOES NOT. CONSTITUTE A GUARANTY, .OR 1NARRANTY -IM • i JOSEPH K.MACOMBER & .$ON, INC• r 4 Tanks-Csupools-Leschfleid:'' ' Pumped-& Installed Town Sewer Connection: P.O. Box 46 Centerville, MA 02632 0066. j 775.3338' r 7�3-8412 �{ sj „ , Ul Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection WUILAM Governor F.Weld Trudy Cox* Aryeo Paul Celluccl swaary LL Gawmor David B.Struhs C.onunlealoner e SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 27 Horseshoe Lane Centerville- MasSAddressof owner. 652 University Avenue Date of Inspection: 8/9/9 6 (If different) Los Al t o s, C A Nameoflnspector. Joseph P. Macomber Jr. 94022 Company Name,Address and Telephone Number. J.P.Macomber & Son Inc. Box 66 Centerville,Mass . 02632 508-775-3338 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of inspection. The inspection was performed based on nay training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: _ Passes Conditionally Passes eeds Further Evaluati n By the Local Approving Authority ,�/ Fails Inspector's 9fgnat &111dla'_ Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: Check A,B, C,or D: A) SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B) SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair,passes inspection. 'Indicate yes,(po,or not determined(Y,N,or ND). Describe basis of determimtion in all instances. If"not determined•,explain why not) The septic tank is metal,cm:ked,structurally unsound,shows substantial infiltration or exfiltration,.or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a ponforming septic tank as approved by the Board of Health. (revised 11/03/95) 1 One Winter Street a Boston,Massachusetts 02108 a FAX(617)556-1049 a Telephone(617)292•SW �� Printed on Recycled Pape r t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (oontinued) PropertyAddresa: 27 Horseshoe Lane Centerville,Mass . Owner. Norma Fox Date of Inspection:8/9/9 6 7 B)SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or hOh static water level observed in the distribution bout is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(&)are replaced obstruction is removed distribution box is levelled or replaced �11 The system required pumping more than four tirr a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed C] FURTHER EVALUATION IS REQUIREI) BY THE BOARD OF HEALTH: VO Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM 119 NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water d�e) Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER,IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: �Q The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. 12 The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. ZO The system has a septic tank and soil absorption system and is within 60 feet of a private water supply well. Iaj The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. 3) OTHER r (revised 11/03/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 27 Horseshoe Lane Centerville ,Mass . Owner. Norma Fox Date of Inspection: 8/9/9 6 DI SYSTEM FAILS: !�—1 I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the �failure. G Backup of sewage into facility or system component due to an overloaded or clogged 3A3 or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. S Static liquid level in the tribution box above outlet invert due to an overloaded or clogged SAS or cesspool. ��K7- 7B Liquid depth in cesapeol is less than 6"below invert or available volume is less than 1/2 day flow. Required pumping more than times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. �Q Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for ooliform bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen. El LARGE SYSTEM FAILS: The following criteria apply to large'systems in addition to the criteria above: The system serves ajacility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: �Q9 the.system is within 400 feet of a surface drinking water supply LIT the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area(IWPA)or a mapped Zone II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information, (revised 11/03/95) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 27 Horseshoe Lane Centerville ,Mass . Owner. Norma Fox ' Date of Inspection: s s/9/96 Check if the following have been done: Pumping information was requested of the owner, ocFjgwut, and Board of Health. _LlNons of the system components have been pumped for at least two weeks and the system has been receiving normal ilow rates d that period. Large volumes of water have not been introduced into the system recently or as part of this inspection, ZAs t plans have been obtained and examined. Note if they are not available with N/A , The facility or dwelling was inspected for signs of sewage back-up. ZThe system does not receive non-sanitary or industrial waste flow ZTha site was inspected for signs of breakout. All system components,,excluding the Soil Absorption System, have been located on the site. ZThe septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baMu or' tees, material of construction, dimensions, depth of liquid,depth of sludge,depth of scum. ; The size and location of the Soil X.*orption System on the site has been determined based on existing information or approximated by non-intrusive methods. ,, The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub. Surface Disposal System. (revised 11/03/95) 4 a , l� SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Prop�ortyAddreax 27 Horseshoe Lane Centerville ,Mass . Owner. Norma Fox Date of Inspootiuu: 8/9/96 FLOW CONDITIONS RESIDENTLU- Design Bow:_ _ gallons ve.*— Number of bedrooms: -71 Number of current residents: Garbage grinder(yes or no):,� f�}� Laundry connected to system(yea or no):/�S Seasonal use (yes or no): � _ Water meter readings, if available: (7or- cam- c Last date of occupancy: COMMERCIAL INDUSTRIAL: Type of establishment: Design flow: gallons/day Grease trap present: (yes or no)AJ9 Industrial Waste Holding Tank present: (yes or no)A& Non-sanitary wasto discharged to the Title 5 system: (yes or no)&29 Water meter mar, if available: "VO9j Last date of occupancy: OTHER. (Describe) Last date of occupancy:- �L GENERAL INFORMATION PUMPI RECO Sand source f information: System p as part of inspection: (yes or no)X-6 If yes, volume pumped 0. Reason for TYPE OF SYSTEM Septic tank/distributioi box/soil absorption system Single coaspool Overnow cesspool Privy ' Shared system(yes or no) (if yes, attach previous inspection records, if any) Other(explain) APPRO)GMFAP A0 of all components, date in.riallod (if own) and source of information: e!�—� Sewage odors detected when arriving at the site: (yes or no) (revised 11/03/95) 6 JOSEPK P.DACOWWR&SON,INC. P.O.BOX 66 CENTERVILLE,PA 02632-0066 14l 1 Name: Norma Fox 4157941-8855 Customer Code: Address: 27 Horseshoe Lane nfo Town: CenteryiHe, SteAe: Zip: Mailing address: 852 Uniyersik} Aire Les Altos CA 94022 i Notes: 119187 sear insp pump 145.00 316187 2128190 pump 1 105.00 3127190 3127190 system 2500.00 4119190 3,13192 pump T 135.00 3117192 11124193 pump T repl line 327.10 12J719 3 , F 10127195 pump T 145.00 11110195 C C f 1 s { IIIII ' I i i I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C• • • SYSTEM INFORMATION (continued) Property Address: 27 Horseshoe Lane Centerville ,Mass . Owner: Norma FOX Date of Inspection: g/9/96 ' SEPTIC TANK: !cM yAZ_V /A10—K . (locate on site plan) Depth below grade:Material of constructin:o concrete _metal — —FRP other(explain) Dimensions:_ Sludge depth:_. �iludl'ge , Distance from to �� ottom of outlet tee or baffle:, Scum thickness:_ t Distance from top of scum to top of outlet tee or baffle: Distance•from bottom of scum to bottom of outlet tee or baffle. �) Comments: (recommendation for pumping, condition of inlet and outlet tees or baffle. depth of liquid level in relation to outlet invert, structural 7.rity, evidence of leakage, etc.) Pump tank every two years;Inlet and outlet tees a • - 1 nk i cum ewa e above the iniet invert andithe ou et invert• S stem muAl be upgrade d. GREASE TRAP. (locate on site plan) Depth below grade:'40 Material of constrtlrti6n,44 y�zoncrete —metal _FRP _other(explain) > Dimensions• Scum thickness: Distance from top uf scum to top of outlet tee or bafile: .t;)/ Distance from bottom nt <rum to honnm of outlet tee or 661e� /G'' Comments: (recommendation for pumping, condin of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.i:„�• (revised 9/15/95) 6 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 27 Horseshoe Lane Centerville ,Mass . Owner. Norma Fox Date of Iuspeotloa: g/9/9 6 TIGHT OR HOLDING TANK A (locate on site plan) o Depth below grade: J" Material of constiuction4 '/,concrete_metal_FRP_other explain) Dimensions:_ }(} Capacity: XlP =11ons Design flow: ' gallons/day Alarm level: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) --_A) 7drkjl y 1PJtC3r� DISTRIBUTION BOX-X. (locate on site plan) Depth of liquid level above outlet invert:_ Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) D-Box has equal flow:No evidence of solids carry over;No=ge in or out of the die ri hiiM on hex PUMP CHAMBER:_-& (locate on site plan) Pumps in working ordar:(yes or no)/L% Comments: (note condi '' n of pump chamber, condition of pumps and appurtenances, etc.) L-J vH�7E'A_.�T s (revised 11/03/95) 7 '" "' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) PropertyAddreas: 27 Horseshoe Lane Centerville ,Mass . Owner. Norma Fox Date of Inapootlon: 8/9/9 6 , SOIL ABSORPTION SYSTEM (SAS)u�gtl�j��.�:v�'l�r<.:95 (locate on site Plan,U poaaible;excavation not squired, but MAY be approximated by non-intrusive met hods) . If not dstermiaad to be present, explain: s Type: leaching Pits, number: leaching chambers, number leaching galleries,number: leaching trenches, number,length: �> leaching fields, number, dimensions— overflow cesspool, number: Comments: (note condition of soil, signs of dr�u i um, level of pon , conditio Loam sand to medium sand: sere are signs oaf°f e f aoVe i a L 11 uTt— level of ondin veppe a ion is WajZP d water over _ 1 CESSPOOLS:4':& (locate on site plan) Number and configuration: /1 t4 Depth-top of liquid to inlet invert: A>� Depth of solids layer._ Depth of scum layer. i Dimensions of cesspool: I Materials of constriction: 11, Indication of groundwater:_ inflow(cesspool must be pumped as part of inspection) Cowmen : (note condition of soil,signs of S hydraulic failure,level of ponding,condition of vegetation,etc.) PRIVY; (locate on site plan) Materials of construction:_ Depth of so": 2'r/ Dimensjons: Coau nts note condition of soil, signs of hydraulic failure, level of �>((// p°ndin&condition of vegetation,etc.)_�,,,,j y (revised 11/03/95) 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION ,FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE L_SPOSAL SYSTEM: include ties to at least two permanent references landmarks. or benchmarks locate all wells within 100 ' Centerville Osterville Marstons Mills , 'dater Company 4?8--6691 �J. DEPTH TO GROUNDWATER depth to groundwater m';k.thod of Y - Ty encounter T. 77 I f ' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No... ........ Di FEE..�...30.00 ,��u,��Z 3�ur1;,� �un,�trurtiun �rrntit J P MacomberJr Permission is hereby granted........ --'--••'•-•--•......................-.�.---....._..........._..................................................................... to Construct air X� an Individual Sewage Disposal System . � or Repair at No.....27.----o.rseshoe ne Centerville Street ••••••• .......... _ ass own on the application for Disposal Works Construction P �it �. DATE. Board of Health-`�rr/:� . ...................................... FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE L'Lerfi1ICMfP Df (fomplian e J g M TO CURTIFY That the Individual Sewage Disposal System.constructed b ae om e r J ( ) or Repaired XX ........................:....................... 27 Horseshoe Lane Centerville . ...........................................................................................................e.'d"..... as been installed in accordance with the provisions of TITLE of The Sta a Environmental Code as described in the application for Disposal Works Construction Permit No. „��`�..^,--. dated�'.-'Ze4F ..... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTR AS A GUARANTEE THAT THE SYSTEM WILL FU CTION S TISFACTORY. 7�� �' DATE............. ..... Insp cJ ec ?.F.ALTY 775-7.133,'71 7.13. 5,0 '771 12D2 4-19. 1G 1996 10:46--41 P UST PRICE r 119 900 ..ST.REET# 27 ADD-,- �r.-).RSESHOE LANE 70WNCenterville RMS 8CIRM 6THS TYPEi$I-YLE Carriage House 4 2 11 LR 1 424 Sf aVATRtown o OR 10 , 000Sf S,E � R private SSMTLD)j 1`00 LU KT A EAT ISSNITBLD 5'6100 renovate8 (gas "DAI slab SPATslab 'N NTAX $11.3 6 Cr Mu LUC no none ILI --IPEPL none B3 r /VTR ACC 1 /4 mile B 4 LDY Disp D!,,,h h kL:A co Aj.jsh cxmnpr! D1,V C01111C W P"01 7171—r(ne C XTRAS Ford, Full,, F;m, IWAterviews/Craigville Beqach LW PON Feud Put Feixc! c) REMARKS two bedrooms and bath on first floor and living room/dining,kitchen,lbath second floor CD 2 DiR Craig�lille Beach Road to Waterman Farm and GVUP,E�Iorseshoe Lane, 1st drlve on right HUA F ' ox cc TITLE RE 'INFO 6641 /095 IVIAP/PARCL fl/ contact 206-081 -003 broker LST OFF walsh Realty PHCNE# 775-7330 LSrA3T irJdr7ie T. Walsh PHONEd COFEE 3% LIST PAIL'E 5 119, 000 m),r.Ffi ALL TO,'. '. -1C VILE-k KNC.,.,, ;AT eACK;N:. MAKV. NQ 30, SEPRE et4';A :C.N RF;.ARDINII: Ell;," PJFN ,A r P,.OM ;:J iLSH REALTY ?7 5—?, � H� q ?� `•��� �,� ='H=edE !J. :;a'_' 17� 1� q_:g. 1E. 13 6 10:42AM e• •r �• ��S i�✓�`F1 I{ �l• 5� ,- a'- y .iy ;�W � 'T�l,� �.. � ..r:T�t� :.17'�'� C�� f � r Y'y�'� '�ti 1, .r /• '\ /vim`�69 Y t 1 c ,i \� � ,�,~ y, V •. 1, NO ir Zo le .o \ r a • � ... ... m 4N All 1 5 W V • JCS �C`' THE COMMONWEALTH OF MASSACHUSETTS, DEPARTMENT OF ENVIRONMENTAL PROTECTION BE IT KNOWN THAT Q pseph P. Macomber, Jr. Has satisfied the Department's qualifications as required and is hereby authorized to use the title CERTIFIED TITLE 5 SYSTEM INSPECTOR as provided in 310 CMR 15.340 and Section 13 of Chapter 21A of the General Laws. Issued by The Department of Environmental Protection. June 8, 1995 Acting Director of the ' ion of Water Pollution Control •••rn�rr,-r.•..r. -r-r- T-rr_-•nT-r_-nr..Ts-.r.r.:-:—a=Tr:.r..—. -*--�,=r:.r.. ........-Tr-.-c _.. _ . . .. .. .. _ vs-rraTTTzrrsz.Tn-r-�•��s-.r.,.--.r-..F 4 BOARD OF HEALTH 1 TOWN UN Barnstable I SUBS1111FACF SEWAGE DISI'USAL SYSTEM INSI'FCTION FORM - PART U - CERTIFICATION v F.•••T••!�T".".:T—T'.Irk••.�TT 'T'l::T.TiT-T.�1T.:T'T-T'.T�•.'1�t.�TS TTT.T�TtTR.•>CRfRYi-CTTR4 i�TTI1S'RRTTR29'T *rrrrrrr•.-rrr•r-.•y •-. -TYPE OR PRINT C1.EARL1'- PROPERTY INSPECTED STREET ADDRESS 27 Horseshoe Lane Centerville .Mass . ASSESSORS MAP , BLOCK AND PARCEL # 206-081 -003 OWNER' s NAME —Norma Fox' PART D - CERTIFICATION T NAME OF INSPECTOR Joseph P. Macomber Jr. COMPANY NAME J.P.MAcomber & 9,1Cn' Inc. COMPANY ADDRESS Box 66 Centerville ,Mass . 02632 Street Town or City State LIP COMPANY TELEPHONE ( ) - FAX ( ) - .—..---50 8 , 775 3338 508 790 1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true , accurate , and complete as of the time of :inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one : Systeui PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or, the environment as defined in 310 CMR 15 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form , XXXXXXXYYXSystem FAILED* The inspection which I have conducted has found that the system fails to Protect the public h1ealth and the environment in accordance with Title 5 , 3.10 CMR 15 . 303, and as specifically noted on PART C - FAILURE CRITERIA of this inspection f rm . Inspector Signature Date 8/1'6/96 One copy of this c 7ification must be provided to the OWNER, the BUYER ( where applicable ) and the BOARD OF HEAL'I'il. * If the inspection FAILED, th'e owner or"operator shall upgrade ' the ayatem. within one year of the date of the inspection , unless allowed or required otherwise as provided in 310 CMR 15 . 305 , ..4.a A r� r1-FOR_ ,L(�Y1 DATE 1o/iy TIME P.M. M OF ° PHONED'- ❑FAX ' ,. PHONE ❑MOB1Le "� �!`� 6yy 7,0UR' A YOtJFt CALL: AREA CODE - NUMBER + EXTEN ION x MESSAGE RSE CALL: 1' ALL, E. 1NAI�IX TD ,SEE YOU ' SI .NED ( FORM 4003 NOTES � Health Complaints 10-Oct-96 Time: 10:00:00 AM Date: 9/24/96 Complaint Number: 473 Referred To: CHRISTINA KUCHINSKI Taken By: CHRISTINA KUCHINSKI Complaint Type: CHAPTER II HOUSING Article X Detail: Business Name: Number: 27 Street: Horseshoe Lane Village: CENTERVILLE Assessors Map-Parcel: Complaint Description: HousingW complaints including rats, leaking ceiling, faulty electric outlets. Actions Taken/Results: CK observed many housing code violations (see file). Landlord is Norma Fox, 853 University Ave, Los Altos, CA.Order to correct sent to landlord. Investigation Date: 9/25/96 Investigation Time: 10:30:00 AM 1 Y :Z 3-48 659 914 r Receipt for Certified Mail No Insurance Coverage Provided MnT.S--1 Do not use for International Mail Po TAL SERN E (See Reverse) 0) t rn t t et an J 2 O P.O to an Code CID Po $ Certified Fee . /O O � LL Special Delivery Fee i ILL�f_�jcledil�v�rylFee ie.urn H ecelgt owl�g to Whom&Date Delivered To Return Receipt Showing to Whom, Date,and Addressee's Address TOTAL Postage &Fees ,��� Postmark or Date STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front). a 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier(no extra charge). CC `. 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. t 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 Co ends if space permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT REQUESTED adjacent to the number. O O O 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. € G 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If L 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. 1105503-93,13-0218 Town of Barnstable Health Department 367 Main Street, Hyannis, MA 02601 e�P Office 508-790.6265 Thomas A.McKean FAX 509-775-3344 Director of Public Health September 30, 1996 Norma Fox, Tr. Walsh Realty Jeffrey and Margaret Hall 610-A W. Main Street 853 University Avenue Hyannis, MA 02601 Los Altos, CA 94022 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 27 Horseshoe Lane, Centerville was inspected on September 25, 1996 by Christina Kuchinski, R.S. 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: The door handle for the sliding glass door was broken and held together with electrical tape., 410.500: The right side glass panel of the sliding glass door was not secured in frame (held in by metal hook installed by tenant) and not weather tight. 410.500: There were two large holes in the bathroom wall behind the washing machine. The tenant stated that rats/mice are coming into the house through these holes. 410.504: The floor tiles were lifting off the bathroom floor and were also worn in several locations exposing the plywood sub floor underneath. 410.500: The bottom surface of the first floor bathroom sink vanity was water damaged. 410.500: There was a hole around the hot water pipe that supplies the heat baseboard in the master bedroom. The tenant stated that mice come through this hole into her bedroom. 410.500: The living room ceiling was water stained and had peeling paint around an old stove pipe. The tenant stated that when it rains water drips through the ceiling around the stove pipe. 410.501(A)(4)(a): The ceiling in the children's bedroom was water stained. The top edge of the window frame in the children's bedroom was also water stained. The tenant stated that water drips through the top of the window when it rains. 410.501: The storm windows provided on the outside of the house did not have caulking installed along the bottom edge between the storm window frame and the prime window frame. 410.250 B : The electric outlets in the children's bedroom and first floor bathroom are not working. The outside light fixture for the main door was not working. 410.351: Three control knobs on the kitchen stove were missing and the two right burners were not working. 410.550 A : There were holes excavated on the left side and rear of the house's foundation. You are directed to correct the above listed violations within seven (7) days 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 $15.00 for each additional violation. Tickets will be issued daily until the violations are corrected. PER ORDER OF THE BOARD OF HEALTH McKean _The as A. Director of Public Health cc: Henrietta Green a� lr�&ho e- Now L6 s /,�o s CAI �yva a /� �.�►n S, Y11P 0 a-6 b 0 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410,00, STATE SANITARY CODE II, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE,ARTICLE 51 The property owned by you located at 1'1 Po-,5!eshoe b-v, was inspected on 9 M4 by C f-p / 12 S' Health Agent for the Town of Barnstable because of a complaint. The following violations of the Town of Barnstable Rental Ordinance Article 51 and the Sanitary Code 11 were observed: '//0, So `Fkz 1co,. C� ` O. 5vv cde l�s / as h (Aged day- y/v-Svv %J.�-,•-e c�-e f"'v ��,v�,e,, ����aM� 5��� � �"`�_ i LA, JI-e h,4) uje -e-k s� ` `z �li'f WO ^ ho(� Y,40 ` - roovv► C.P r li v, Gv� ���s�i� ot � �llb•500 .E �l vrv�s r - a 5v o � � -- av�v ) e � � Ipt Y/o,Soo 7-Ae q , c2e/rr� 1h 41-e CAI,1��, is ��x.►� -/74>P c 1 v �d 2 vJ (YA- vu$ � a+o�w) �h� Pe rms vL,4l o CA 1 � t k 7q^-e dwi- L�(lo , 3 51 -�-ham, Or4.47-6 0�7 m!'S-S/,r�i� 'v rt. bv� s /el'li srd-e i You are directed to correct the violation of within 24 hours of receipt of this notice by You 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 same is received by the Board of I lealth within seven (7) clays after the date order is received. However, these violations 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 (lay'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. Enclosed are citation numbers due to violations observed on PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health Town of Barnstable r r FORM30 Hoess&WARREN,INC.NOV.19MI983 THE COMMONWEALTH OF MASSAC}IUSETTS BOARD OF CHEALTH CITY/TOWN o DEPARTMENT ADDRESS / /TELEPHONE /(o Address ? 4 1'.f2-r�`tee Lh/ t�►�' Y�Occupant Floor Apartment No: No.of Occupants No.of Habitable Rooms No.Sleeping Rooms _m No.dwelling or rooming units No.Stories Name and address of owner f\)o V,.n [) I�f"f ►'`'1 L�' _ , �, !- lJ� `���m � � Remarks YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: �'1 cA p OAt. Gi n, )(� �• ., Dual Egress:and Obst'n.: -1-- V4, a4-4 _ C�lj-e p( 118 ❑ F ❑ M Doors,Windows: t,4p4 �n/ arm `y,� 4vtco 4- l,%mr4 ( Roof LA lea *�Ixv 4_/fi (,I' - ,o � Gutters, Drains: �-e k.)(o r, ` V , c� lC!` _GcJ Walls: 1,4)/� V Foundation: / C- �ccs '(�.�r ..44 �� ��c,�- 4 Chimney: `i ' A�l�� - pA BASEMENT Gen.Sanitation R �, ,� 14 4AAA4 Y /).o, Dampness: s-G�.�-,. �� c" �,,d.�1 / � � .� ✓- ,n.. -t.. v Stairs: .4- vO GU_ fe . .c-� / -c�,� ,c•_� STRUCTURE INT. Hall,Stairway: Obst'n.: ! = �VV (.vimt Hall,Floor,Wall,Ceiling: (Y-1I� ba V,,060, Hall Lighting: > DtP ,pi :,p Hall Windows: `�-hiranr c� c�..�na0 K.TF r'PF a 'VPs�' HEATING Chimneys: (�( Central ❑ Y ❑ N Equip.Repair TYPE: Stacks,Flues,Vents: (Wif (-Jv-6k ,! 've) In, - (x %ram PLUMBING: Supply Line: `C+4) INS Yj LlA�ev�-S - � 44.1) ❑ MS ❑ST ❑ P Waste Line: rr", A !'At, Y kN a H.W.Tanks Safety and Vent(s) ELECTRICAL Panels,Meters,Cir.: s A^AA4d , 4-4 Cd s cif/-{v ez_*A-,PS' .✓✓r�ra�.�. ❑ 110 ❑220 Fusing,Grnd.: K� � 1 i, l� I, - � vti^P ,, „ „ ;4, Ire, AMP: Gen.Cond. Distrib. Box: /.�✓ .Y i)�.aa��a�� 1�7 1411, C 07' � 5� Gen. Basement Wirir 1,� t~rl 1.� - ,a 1 .aL -err✓ r �.. 4,/W DWELLING UNIT` a �� 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.,Gas,Oil, Elect.: Stacks Flues,Vents,Safeties: Kitchen Facilities Sink -/ , - 1 Stove— K K/�11 W r y r � `✓ - d rr •,�i>�.° Bathing,Toilet Facil. Vent.,Plumb.,Sanit'n.: Wash Basin Shower or Tub: Infestation Rats Mice Roaches or Other: ���-' �rllr_�'- 1 (� c.o).n - f-ucb tel4k4 Egress Dual and Obst'n: ,_ ►, r��r., �_C /`,,., „ .)� t; General Building Posted r 't Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR,(See Over) I "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF���PERJURY." /jn INSPECTOR 1 t`I�L1� �� { ac � .TITLE 4 A P.M. DATE /� ` � TIME .� 3U C r + A.M. THE NEXT SCHEDULED REINSPECTION P.M. 4 a 410.750: Conditions Deemed to Endanger or Impair Health or Safety a 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 1I, 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 410,110 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 OIR 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 101 CMR 410.450 and 410,451, P 8 g Y (H) Failure to comply with the security requirements of 105 CMR 4171.480(D). (I) Failure to comply with any provisions of 105 CMR 410.600 through 410.602 which 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 impairment 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: (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 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. (,+)_ 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. o .t Health Complaints 03-Oct-96 Time: 10:00:00 AM Date: 9/24/96 Complaint Number: 473 Referred To: CHRISTINA KUCHINSKI Taken By: CHRISTINA KUCHINSKI Complaint Type: CHAPTER II HOUSING Article X Detail: Business Name: Number: 27 Street: Horseshoe Lane Village: CENTERVILLE Assessors Map-Parcel: Complaint Description: Housingh complaints including rats, leaking ceiling, faulty electric outlets. Actions Taken/Results: CK observed many housing code violations (see file). Landlord is Norma Fox, 853 University Ave, Los Altos, CA. Investigation Date: 9/25/96 Investigation Time: 10:30:00 AM 1 SENDER: = I also wish to receive the V-.P Complete items 1 and/or 21or additional services. H ■Complete items 3,4a,and 4b. following services(for an y ■Print your name and address on the reverse of this form so that we can return this extra fee): d card to you. ai ■Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address 12 permit. y ■Write'Return Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery N r ■The Return Receipt will show to whom the article was delivered and the date C delivered. Consult postmaster for fee. Z o �. 3.Article Addressed t : 4a.Article_Uurober 4b.Service Type «' ❑ Registered fl Certified °C Q rn ❑ Express Mail ❑.Insured c frl ❑ Rum Re iptfor erchan 'se q COD a / .D e of very 0 -v N1 9�Z 5. eceived not Name .Addressee's dress Only i requested W and fee is paid) 1°c Sig�Ature:'rAddresseej5rAgs01U I0 X N PS Form 3811, December 1994 Domestic Return Receipt + UNITED STATES POSTAL SERVICE ' First-Class Mail P-ostage-&-Fees Paid uses L F'IVI Permit No..G-10 • Print your name, ad ZIP Code in this box • �I Health 0®-pit*60-nt 'down of Ban tibia P 0.Box 534 Hyannis,Massachusetts 02601 Fax(508)775-33' Phons(508)790-?265 { t y No. _..��..' Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYitation for Mi000ar *Proem Construction Permit Application is hereby made for a Permit to Construct( )or Repair gX)an On-site Sewage Disposal System at: Location Address or Lot No. 27 Horseshoe Lane Owner's Name,Address and Tel.No./+1 5—9 4 1—8 8 5 5 Centerville,Mass . 02632 Norma Fox 852 University Avenue Assessor'sMap/Parcel Los Altos , CA 94022 Installer's Name,Address,and Tel.No.5 0 8—7 7 5—3 3 3 8 Designer's Name,Address and Tel.No.5 0 8—7 7 5—3 3 3 8 J.P.Macomber & Son Inc. J.P.Macomber & Son Inc. Box 66 Centerville,Mass. 02632 Box 66 Centerville,Mass. 02632 Type of Building: Dwelling xx No.of Bedrooms 3 Garbage Grinder N 0) Other Type of Building R R S No.of Persons 4 Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 3 0 gallons per day. Calculated daily flow 3 Q—3 3 n gallons. Plan Date Number of sheets Revision Date Title Description of Soil T,namr sand to medii1m. sans. Nature of Repairs or Alterations(Answer when applicable)_Adding 1—3 3 0 r e c h a r g e r s to an existing tank nad leaching pit. Minium of 2. 511 of stone all arounr3 _ Drip pipe run through the rechargers. 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 Env' nmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issuedA this Boaz of Signed C Date 9/9/9 6 Application Approved by Date In Application Disapproved for the following reasons Permit No. Date Issued 9 —/0 —9 c No. 96 / y '. Fee$4 Q.Q Q THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Zip'pfication for 30i!gpogaY,bpgtem,Con!6truction permit Application is hereby made for a Permit to Construct( )or Repair KX)an On-site Sewage Disposal System at: Location Address or Lot No. 27 Horseshoe Lane Owner's Name,Address and Tel.No.415--9 41--8 8 5 5., Centerville,Mass. 02632 Norma Fox; $52 University Avenue Assessor'sMap/Parcel Los Altos ,CA. 94022 Installer's Name,Address,and Tel.No.5 Q 8—7 7 5—3 3 3 8 Designer's Name,Address and Tel.No.5 0 8—77 5—3 3 3 8 k J.P.Maco4ber & Son Inc. J.P.Macomber & Som Inc, ` Box 66 Centerville,Mass, 02632 Box 66 Centerville,Mass. 02632 Type of Building: Dwelling xx No.of Bedrooms 3 Garbage Grinder(JQ) Other Type of Building RES No.of Persons 4 Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 3 0 gallons per day. Calculated daily.flow 1 x 1 !,r)3 o gallons. Plan Date Number of'sheets "1 'Revision Date Title Description of Soil Loamy sn,nd. to mcar7Av1m Nature of Repairs or Alterations(Answer when applicable) Adding 3—310 r a c�h a r g to r a to n ( existing tank nad leaching pit. Minium of 2. 511 - of stone all around. Drip pipe run through the rechargers. E 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 Tide.5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued this Boar off Signed ' Date 9/9/9 6 Application Approved by G t Date 1�► `�� fG. Application Disapproved for_the following reasons u, t i Permit No. �' y S� Date Issued _ /D 77 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replacedT�-X)5 on by J.P.Macomber & Son Inc. Installer at 27 Horseshoe Lane Centerville,Mass. has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No, 9& -�✓5-0 dated ' Date t Inspector t THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYS- TEM WILL FUNCTION SATISFACTORY. ; .. No. �b —C/�v,----------------------------t Fee 40.00 1 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE., MASSACHUSETTS 'W71f6pozat *pgtem Congtruction Permit rr Permission is hereby granted to J.P.Macomber & Son Inc. to construct( )repair-X}fan On-site Sewage System located at No.# 27 Horseshoe Lane Centerville,Mass. Street r and as described in the above Application for Disposal System Construction Permit. 96- '05-0 No. Date r The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions.. All construction must be completed within three years of the date below. Al �] Date: _ /�P°` 6 Approved by Board of Health CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) 4 I Joseph P.Maeomber Jr., hereby certify that the application for disposal works construction permit signed by me dated , 9/9/'96 , concerning the property located at 27 HorQaahoe r'ne Centerville MA meets all of the following criteria: • There are no wetlands within 300 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system • The observed groundwater table is A feet or greater below the bottom of the leaching facility • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. SIG y DATE: 9/9/96 LICENS D SEPTI SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER certified lot plan, system. Also if the licensed installer posesses a p p , (Attach a sketch plan of the proposed y this plan should be submitted). ' 1-1000 gallon rC 1 -1000�Q gallon pit septic tank `O . 1-Distributio 3-330 Box RECHAR.OERS 27 Horseshoe Lane Centerville �X- TOWN OF BARNSTABLE ATION 115ADC 1.rr7 SEWAGE # P 6 Vi LAG ASSESSOR'S MAP & LOT__A6k_0& 663 INSTALLER'S NAME dt PHONE NO. SEPTIC TANK CAPACITY OC LEACHING FACILITY: (type) ?14 (size),3,30 /QrY2,l NO.OF BEDROOMS__ BUILDER OR OWNER Vim- — PERMTTDATE: �I — y —7& COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 .:: �- ',� � /-,C c � a� No.............. Fps... .....O.,2O_ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliration for Disposal Works Tonstrnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: 27 Horseshoe Lane Centerville ..... _........ •-------•-- .-.-•-•--•-------•-------------------------- Norma Fox - - - ..... - ............ Location-Address or Lot No. W J,P.Macomber Jr. Owner Address ,-� . ............................................................................................... --------•-----------------•---•-------•--........------••.......•-•-....------------•---------•--- Installer Address Q Type of Building Size Lot.................... .....Sq. feet DwellingX No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) per-, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ............................................. ................................. Q ------------------------------------------------------------ ------- -....... ------------------------------ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area____-_-------.__.---sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area........._........sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by-------------------------------------••----------------•...--------------- Date........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................ (i, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ I ----------------------------------------------------------------------••-•-----------•--•--•---•---•......................................................... 0 Description of Soil----•- ----------------- x Sand & Gravel W UNature of Repairs or Alterations—Answer when a licable------------------------------ --------------------------------------------------------------- 1-1�g0 gallon tank, -1 gallon pit -------------------------------- •------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliant has been iss d��byy the boar]of he h. Signed ... � lfr�c'-,!�a� 3�6�90 . 1 . . - --------------- Application Approved B ................................ L�(J ----' ........................................................ Date ... -. Application Disapproved for the following reasons- ...............................---------------------------------------------------------------------------------- --------------- ----------------------------------- i e Permit No. ��' Issued '" -te................. Date .... No............... Fss.. �f?....00.. THE COMMONWEALTH OF MASSACHUSETTS y BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Elispuiittl Warks Tonstrnrtinn Tirrutit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: 27 Horseshoe Lane Centerville ................_................................................................................ --•-•-......-•------•---•-•-----•-----...--•-----••-•......_...._...--•-.....-•-----------•---••-- Location-Address or Lot No. Norma Fox - - .....................: ... ----------.__-____--------------.....__-_----------- . Owner - � Address W J,P.Macomber Jr. .............................•-•----•-------......................- •-••-•••••-••-•••• --•---••-•---------------------------•••••••-:•---•...--•--........._•---._.....----.....•-•--•--- � Installer Address d Type of Building Size Lot............................Sq. feet U DwellingX-No. of Bedrooms....._..._._7.............................Expansion Attic ( ) Garbage Grinder ( ) a`4 Other—T e of Building No. of persons............................ Showers YP g ---------------------------- P ( ) — Cafeteria-(--->- dOther fixtures --------------------------------------------------•----------------------•----------------•---------...----------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid capacity.....--.....gallons Length......:......... Width................ Diameter---•............ Depth................ W Disposal Trench—No..................... Width.................... Total Length.....................Total leaching area....................sq. ft. Seepage Pit No..................... Diameter....----.---.--..... Depth below inlet..-................. Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank (( ) aPercolation Test Results Performed by.................�11!�-•-------.....-•-----------------•-•--------------. Date........................................ Test Pit No. I................minutes per inch IDepth of Test Pit.................... Depth to ground water................... GZ, Test Pit No. 2................minutes per in3 h ff e'pth of es Pit-------------------- Depth to ground water....................---. •--------------------- I....................... -- .............................................................................................. ODescription of Soil....................................�A-----------------------•--------- ------------------•----•---------.._...-•----------------------------------.........._----.. x Sand- & Grave l0-` v --------------•--•-•-•--------•---- __ . . . -- UW ............................................. ----•---• ......---------------......------------------------------------------------------ Nature of Repairs or Alterations—Answer when applicable............................................................................................... 1.....................1-1000...gallon--tank 1-10 0 - a17 417_._ i t. - Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with . the provisions of TITLE 5 of the State Environmental 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. E Signed �,�% , e ApplicationApproved By— .. .-..............................................I—..----------------- .�,.`��1� Date Application Disapproved for the following reasons- ------------------------------ ................... ........................................---------------------_--- ------------------- - ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---.................................... Permit No. .......-..��.�..�f�--------------------------- Issued ....t., ......`� .- DaceF�� Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE O'Llex#ifiratr of CgumpIinure THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired(CXXX) by J.P.Macomber Jr. ......................................---------------------------------------------------------------------------------------------------------------------------------------------------------------------_----_------------- Installer at ....Z7....librs.e.alioP.....Lar.1P.....e.n tarmi-.I_1.P-------------------------------------------------------------------------------------------------------------- --------------------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. qq1..�.....��....... dated ;. ----��r�...I THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE T IA THE SYSTEM WILL FU CTION/SATISFACTORY. DATE . . .... / ..................................I....... Inspedor ................. Y THE COMMONWEALTH OF MASSACHUSETTS --4- BOARD OF HEALTH TOWN OF BARNSTABLE No..................•_•••.. '. FEE-�...3n.10.0... µ Disposal Works Cnunotrnrtion 'pamit Permissioniis,hereby granted.......1.R-Mac,.nmhe r%!r.�....................•-•--•----•--......---...........----.................................... to Construct ( ) or Repairx(XX) an Individual Sewage Disposal System at No...2:7---joM5e55h E-'...Lame Q teru 1p...--•-••----•------------------•-----................----........-------•--.......--•---•---........... ............... Street as shown on the application for Disposal Works Construction Permit N,o.. .^..TLC Dated..... r ......... DATE--- ..................................... �ord of Health / ..._..---•--..........�.__._.� FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS if TOWN OF BARNSTABLE LCCATION1 ,rsr. 't�y�:® Lv� SEWAGE # �~ VILLAGE h7c, ASSESSOR'S MAP & LOT INSTALLER'S NAME 6z PHONE NO. SEPTIC TANK CAPACITY r1rLc:` LEACHING FACILITY:(type) L�ytY (size) / ' NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER B lb5ffi FOR OWNER �y �- DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: +% VARIANCE GRANTED: Yes No ( „ i 0 " " /