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0108 LONGFELLOW DRIVE - Health
108 LONGFELLOW DRIVE, CENTERVILLE A=189-109 �' I No. 42101/3 ORA p ESSELTE 10% 0 0 0 0 1 Postal CERTIFIED MAILT. RECEIPT D, m D. Provided)m informationFor delivery ms Fc, .. .:: , ` m Postage $ E '"7 Im 1 0, 80 Po2sor O Certified Fee O O Retum Receipt Fee d—N �ry�y f/� (Endorsement Required) t� ere - Restricted Delivery elive Fee I� ri (Endorsement Required) p Total Postage&Fees $ j J ' rD Sent To �• ........... ` rw obeet,Apt:No.;. . �)j. © ...... or PO Box No. City,State,Z/P+4.... ®D 6 PS Form :00 June 2062 Certified Mail Provides: fas�aney)aooz eun�'ooBE uuod Sd o A mailing receipt « o A unique identifier for your mailpiece al A record of delivery kept by the Postal Service for two years Important Reminders: 11 Certified Mail may ONLY be combined with First-Class Maile or Priority Mail& ■ Certified Mail is not available for any class of international mail. = 91 NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. • For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt servfoe,please complete and attach a Return Receipt(PS Form 3811 to the article and add applicable postage to cover the fee.Endorse mailpiece'Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required:i - .4 - ■ For an additional fee; delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery"r_ e If a postmark on the Certified Mail receipt Is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt.and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to AM and.FPOs.. SENDERDELIVERY ■ Complete items 1,2,and 3,.Also complete A. Signature Item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse X ❑Addressee so that we can return the card to you. B. Received by(Printed Name) C.Date f Deiive ■ Attach this card to the back of the mailpiece, �,�! � � � or on the front if space permits. 6AO �`�" (4 1. Article Addressed to: D. Is delivery address different from Item 1? ❑Yes If YES,enter delivery address below: ❑No 4 . �'2e I 30d Ig V 3. S�eryIce Type C c 4� �t I Ga Certified Mail ❑'Express Mail Q 3 a Q Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number : ` i _ ,: :: _- , (fransfei from ser`vicellabeq ` t 7 0 0 5 116 0 9 3 5 9 PS Form'3811,1Febr6ary 2004 1 1 1 1 1 1 1D6mesticReturn Receipt 102595-02-M-1540 :w UNITED STATOU-� k ��L' 04-4',. .;. y. J'UN 2--LX'1M5 Iit 0 • Sender: Please print your name, address, and ZIP+4 in this box • I d W xJ e 7 01 I I f P• Er m •. • . . . Er n r information •I , r-q C3 Postage $ c C33 O Certified Fee 7� OReturn Receipt Fee Z Here Z (Endorsement Required) C3 Restricted Delivery Fee ..D (Endorsement Required) r-q a Total Postage&Fees $ to L 092 O 1�1 Sent To n O n�a 14 r' Sheet ApE No.; ------------------ ....- ----------- ---- or PO Box I Form :rr2002See Reverse for Instructions Certified Mail Provides: ■ A mailing receipt (GSJ-Gy)aooa a-r'ooee-0=1 Sd e A unique identifier for your mailpiece • A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Mail®or Priority Maile. in Certified Mail is not available for any class of International mail. • NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a LISPS®postmark on your Certified Mail receipt is required. •For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". • If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. tw 'J1 � Town of Barnstable CF THE t Regulatory Services Barnstable do Thomas F. Geiler, Director ;mericaCity Public Health Division * AMASS. # Thomas McKean Director I I 9�Ar 2007 1639. a`�� 200 Main Street ED Mp`t f Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 r; June 16, 2009 Carol A. Groh P.O. Box 308 Centerville, MA. 02632 RE: Assessors (map-parcel) 189-109 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 108 Longfellow D.ri�-ve Centerville, MA. 02632. 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.bamstable.ma.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 2009 fees included. Please contact me or the Division Assistant to schedule inspection of the property as soon as possible. If there are tenants presently occupying the property please provide the contact information being sure to include a daytime phone number for all tenants. For your use an occupant's permission form has been included to allow for inspections to be performed in the tenant's absence. Failure to comply with this ordinance will result in the issuance of a non-criminal ticket citation in the amount of$100. Each day of non-compliance is considered a separate offense. Should you have any questions, please feel free to call 508-862-4072. Thank you in advance for your cooperation. Teresa Wright Division Assistant Health Division Direct#508-862-4072 +, - 1oosll(o � c� Qoe� 0150 935 r - 'E He?..�lth Master Detail Page 1 of 1 Health Master A we Logged In As: TOWN\wrightt Health Master Detail Monday, )ur t Application Center Parcel Lookup f E - i Parcel Septic Perc Well Fuel Tank s Parcel: 189-109 Location: 108 LONGFELLOW DRIVE, CENTERVILLE Owner: GROH, CAROL A k , Business name:]---- Business phone: ' Rental property: [i Deed restricted: ❑ Number of bedrooms : 0� Contaminant released: r Fuel storage tank permit: (J T Save Parcel Changes { ! Return toLookup Parcel Info Parcel ID: 189-109 Developer lot: LOT 36 Location: 108 LONGFELLOW DRIVE Primary frontage: 100 Secondary road: Secondary frontage: Village:CENTERVILLE Fire district:C-O-MM Sewer acct: Road index:0918 Asbuilt Septic Scan: 189109_1 Interactive map td F Town zone of contribution:AP (Aquifer Protection Overlay District) State zone of contribution:OUT Owner Info Owner: GROH, CAROL A Co-Owner: Streetl: PO BOX 308 Street2: City:CENTERVILLE State: MA Zip: 02632 Countr Deed date:07/15/1996 Deed reference:C141336 Land Info Acres: 0.24 Use: Single Fam MDL-01 Zoning: RD-1 Neighborhood: 011 Topography: Level Road: Paved Utilities: Public Water,Gas,Septic Location: Construction Info Building No ear Built Effective Area Bedrooms Bathrooms 1 1970 1589 3 Bedrooms2 Full Buildings value:)x160,500.00 Extra features: m25,900.00 Land value: x165,600.00 http://issgl2/intranet/healthMaster/HealthMasterDetail.aspx?ID=189109 6/15/2009 oFTHE rot Town of Barnstable Department of Health, Safety and Environmental Services BA MASS. * public Health Division. 9$ MASS. 0 1639. �m i°ren Htn t a 200 Main St. Hyannis,MA:02601 Office: 508-8624644 Thomas A. McKean,RS,CHO FAX: 508-790-6304 Director of Public Health f : Carol Groh January 6, 2010 PO BOX 308 ° Centerville, MA. 02632 The property owned by you located at 108 Longfellow Dr., Centerville, was inspected on December 31, 2009 by Donald Desmarais;RS, Health Inspector for the Town of Barnstable, after receiving a call from the Barnstable Police Department. Based on the-results of that inspection, the Barnstable Health Department found that the dwelling was unfit for human habitation. Based on my verbal direction you were . allowed to clean the.property. Upon subsequent inspection I have found the domicile once again fit for human habitation. Donald Desmarais RS Health Inspector Town of Barnstable CC: Carol Groh, occupant COMM Fird Department Barnstable Police Department TOB Building Department Q:/health/order letters/Condemnations\ 108 Longfellow Dr.Centerville TOWN OF BARNSTABLE LOCknON e �e�%d cy SEWAGE # e l3 W, _e . ASSESSOR'S MAP &LOT �'- I©C INSTALLER'S NAME&PHONE NO. �Y'�- &gCOI'V? Z l C-- SEPTIC TANK CAPACITY 1000 Of-P 1 ve, LEACHING FACILITY: (type(`coo t� l�Ll�r'c a c e flr size) v NO.OF BEDROOMS tttt BUILDER OR OWNER PERMIT DATE: !� -"a-'�€`-SSG COMPLIANCE DATE: '7 ^D-3 �'X- 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 . I 7 ��� On 12/31/09 at 3:30 I responded to a police call for a health inspector at 108 Longfellow Dr. Centerville. Upon arrival I was met by the Police and escorted into the property. They had gained entry under the execution of a search warrant. I photographed instances of filth, feces and egress obstructions. I also saw and photographed a dead rat in the front yard. Today, January 4, 2010 I condemned the house with a KEEP OUT sticker, sent a certified mail to the owner Carol Groh and sent copies of the Condemnation to the TOB Building Dept., the Barnstable PD and the COMM Fire. Once Ms. Groh contacts me I r will guide her through the process enabling her to get back into the house. Donald Desmarais RS � I YY\ 116//P ell, OrA."VY, tAo tj 1 a OF THE Toi:, Town of Barnstable Department of Health, Safety and Environmental Services BA LE MASS. , Public Health Division � MASS. � '. 1639. �ArFD MAC A,0 200 Main St.Hyannis,MA 02601 Office: 508-862-464.4 Thomas A. McKean,RS,CHO FAX: 508-790-6304 Director of Public Health Certified mail: 70060810000035253398 Carol Groh January 4, 2010 PO BOX 308 Centerville, MA. 02632 EMERGENCY CONDEMNATION AND ORDER TO VACATE Finding of Unfitness for Human Habitation and Determination of Immediate Danger The property owned by you located at 108 Longfellow.Dr., Centerville,was inspected on December 31, 2009 by Donald Desmarais, RS, Health Inspector for the Town of Barnstable, after receiving a call from the Barnstable Police Department. Based on the results of that inspection, the Barnstable Health Department finds that the dwelling is unfit for human habitation. Pursuant to M.G.L c. 127B and 105 CMR 410.831 (D), the Health Department further finds that the conditions within the dwelling are such that the danger to the life or health of the occupants of the subject dwelling is so immediate that no delay may be permitted in making this finding. The following violations of 105 CMR 410.00, State Sanitary Code 1I: Minimum Standards Of Fitness For Human Habitation were observed: 105 CMR 410.750: Conditions Deemed to Endanger or Impair Health or Safety (I) "Failure to comply with any provisions of 105 CMR 410.600, 410.601i or.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. There was a large accumulation of garbage,rubbish, filth and other causes of sickness present at the location, including feces. There was a dead rat on the front lawn. Based upon these findings any and all,occupants are hereby ordered to vacate and the landlord/owner is ordered to secure the subject dwelling within 48 hours of receipt of this order. If any person refuses to leave a dwelling or portion thereof,which was ordered vacated,they may be forcibly removed by the local Board of Health (M.G.L. c. 127B), or by local police authorities at request of the Board of Health. Q:/health/order letters/Condemnations\108 Longfellow.Dr.Centerville Furthermore, anyone who fails to comply with any order of the Board of Health may be subject to fines of not more than $500. Each day's failure to comply with an order shall kF constitute a separate violation. Once vacated this dwelling may not be occupied without the written approval of the Board of Health. Note: This is an im ortant legal�document. It may affect your rights. Si ne Thomas A. McKean Director of Public Health CC: Carol Groh, occupant COMM Fire Department Barnstable Police Department TOB Building Department Q:/health/order letters/Condemnations\ 108 Longfellow Dr.Centerville Parcel Detail Page 1 of 3 r7_ balm n�Ff,+.I' S'Ce1S LF_rj W—e-1 i�r✓t �_ ,�- .ems Logged In As: Parcel Detail Monday,January 4 2010 Parcel Lookup Parcel Info Parcel ID 189-109 I DeveloLoo� LOT 36 Location 108 LONGFELLOW DRIVE I Pri Frontage 100 Sec Road Sec; Frontage L village.CENTERVILLE Fire District is-O-MM Sewer Acct — 1 Road Index 10918am N Asbuilt Septic Scan: Interactive , i 189109 1 Map3:`r Owner Info owner GROH, CAROL A Co-owner Streeti PO BOX 308 Street2 City CENTERVILLE State rMA zip i02632 j Country{USA -- Land Info Acres 0.24 I Use Single Fam MDL-01 Zoning jRD-' 'I Nghbd 0107 I Topography Level — - Road Paved —- — Utilities Public Water,Gas,Septic Q Location i I Construction Info Building 1 of 1 Year 1970 Roof Gable/Hp i ExtlWood Shingle Built Struct -... Wall ---- - .-- DK 24 Effect 1557 Roof Asph/F GIs/Cmp AC None — t4 i_ Area Cover Type HAS 3 - HMT t• 2 Int - Bed Style Raised Ranch I Wall Drywall __� Rooms 13 Bedrooms w 13 44 Model Residential I I Bath J2 Full Fl000 rr Rooms 24, aMT Grade Average Heat Hot Water Total 1 Type Rooms r 9 Rooms I - --_ - - -_ - t6 1 2a Stories 1 Story Heat I Fuel Gas I Found-iTyplcalation I Permit History Issue Date Purpose Permit# Amount Insp Date Comments http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=13033 1/4/2010 Parcel Detail Page 2 of 3 Repair Work 43026 $300 1/1/2000 12:00:00 AM I9 17 1/9989 I Remod l/Renov I334011 I$10 600 I7/1/1999 12:00:00 AM - Visit History Date Who Purpose 12/19/2008 12:00:00 AM Paul Talbot Cyclical Inspection 1/28/2000 12:00:00 AM Martin Flynn Meas/Listed-Interior Access 7/1/1999 12:00:00 AM Andrew Machado Meas/Est - Sales History Line Sale Date Owner Book/Page Sale Price 1 7/15/1996 GROH, CAROL A C141336 $109,400 2 7/15/1996 VIESKALNIS,ANTANAS& ELENA C141335 $1 3 6/15/1994 VIESKALNIS,ANTANAS& ELENA C134243 $1 4 3/15/1988 VIESKALNIS,ANTANAS& C113675 $1 5 VIESKALNIS,ANTANAS C48690 $1 6 VIESKALNIS,ANTANAS C48690 $0 7 VIESKALNIS,ANTANAS C48690 $0 8 VIESKALNIS,ANTANAS 9276/113 $0 9 VIESKALNIS,ZOFIJA M792 5294/027 1 $0 - Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2009 $160,500 $25,900 $0 $165,600 $352'000 2 2008 $144,400 $25,900 $0 $181,200 $351,500 4 2007 $143,500 $25,900 $0 $181,200 $350,600 5 2006 $128,800 $25,900 $0 $142,800 $297,500 6 2005 $120,300 $25,500 $0 $160,800 $306,600 7 2004 $97,700 $25,500 $0 $128,700 $251,900 8 2003 $93,900 $25,500 $0 $42,100 $161,500 9 2002 $93,900 $25,500 $0 $42,100 $161,500 10 2001 $97,100 $26,500 $0 $42,100 $165,700 11 2000 $62,100 $17,200 $0 $31,000 $110,300 12 1999 $62,100 $17,200 $0 $31,000 $110,300 13 1998 $62,100 $18,000 $0 $31,000 $111,100 14 1997 $92,000 $0 $0 $24,800 $116,800 15 1996 $92,000 $0 $0 $24,800 $116,800 16 1995 $92,000 $0 $0 $24,800 $116,800 17 1994 $85,900 $0 $0 $33,400 $119,300 18 1993 $85,900 $0 $0 $33,400 $119,300 19 1992 $97,900 $0 $0 $37,200 $135,100 20 1991 $103,700 $0 $0 $49,500 $153,200 21 1990 $103,700 $0 $0 $49,500 $153,200 22 1989 $103,700 $0 $0 $49,500 $153,200 23 1988 $71,100 $0 $0 $21,700 $92,800 24 1987 $71,100 $0 $0 $21,700 $92,800 25 11986 1 $71,100 $0 $0 $21,7001 $92,800 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=13033 1/4/2010 Parcel Detail Page 3 of 3 Photos fR http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=13033 1/4/2010 a t I ' r h j r f r w, H1��;,���i �: �.W __ _ ICI`,' ., r.. �. �a, ..�..su { I ` � � 1 � - !, ' F I l �r: i �; ? a ��� � o �•�. � r i A � l .i�w r __ = _. � 14 �� I . _ '�' � �.. ,, ,.�� _ �� �' I � b { ... i I Iwo .. .. Air. s i 1 i w �� •a;=.a •�=eS a` e I t;1f�1 �� y ktiY� I :_ . . -: �� _�_�.<.aE:. -�:. , �. 4 .,.,,_ . _, .. ,� r`r ,4� .-,:.- .�;, k 1 9 1' ` k '„� �f i a .�. ffi �:� y ' •, i�• � a • � � . ` i'(� �. ♦�J �� ��a ��'t�Wun � ., � � ,�. 04• ;A , \. .1 Tyc �4 A I vJ ti A J 0 f "°- � i i • ' � M • or � r �M 1t 4� s, F.; Ff fllo _ Y I SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION . ■ Complete items 1,2,and 3.Also complete A. SignatufalI item 4 if Restricted Delivery is desired. X �` Q Agent I ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. R�elved by(Printed N e) C. Date of Delivery ■ Attach this card to the back of the mailpiece, /V A �L p or on the front if space permits. s del D. Is delivery address different from Rem 1? ❑Yes 1. Article Addressed to: f kk 4` If YES,enter dbilyery,ad�dr)cal)s below: 0 No o i Gul�—c cc 3. gervice�hype--�...�� Syy � ai" ti1 IaT�Certified�Ntaii,i0 Express Mail c) Al A ❑Registered )kRetum Receipt for Merchandise ❑Insured Mail ❑C.O.D. d 4. Restricted Delivery?(Ed a Fee) ❑Yes 2. Article Number 'ti% ,7006``0810` 0000 '.3525 3398". (Transfer from service labeq PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 ' rim.-•:�._• .'; _ y:M, .'l.. r.. ."Ya.. UNITED STATES POSTAL SERVICEcC193s. elf "�• .. � aid • Sender: Please print your name, address, and ZIP+4 in this box • Or , 1jr1an 1\,3 , r I - Health Complaints 08-Aug-06 Time: 11:00:00 AM Date: 11/24/1997 Complaint Number: 1106 Referred To: DONNA MIORANDI Taken By: K. Complaint Type: CHAPTER II HOUSING Article X Detail: UNSANITARY CONDITIONS Business Name: Number: 108 Street: Long Fellow Dr. Village: Centerville Assessors Map_Parcel: Complaint Description: is renting the appartment downstairs. Everything is dump. had humidifier but the landlord took it out. Windows are leaking. does not have a heat from Sunday morning. Actions Taken/Results: DZM went to house on evening of November 24, 1997 and spoke at length to owner of house, Carol Groh (771-1947). To return on the 25th but ill.Called tenant Cecile Pierce on 12/1/97 (771-7807)to call for a follow-up and left a message. Received a phone call on 12/4/97 from owner, Carol Groh stating she received a letter from Ed Barry today(12/4/97) to correct in 24 hours but unable to gain access. DZM shall call Cecile Pierce again today. Called and left a message again. Cecile Pierce called on 12/5/97 at 9:45 am and has a death in the family and shall call me on Monday 12/8/97 when she has returned from off Cape. TM reinspected the rental unit on 12/10/97. Both the landlord and the tenant were present. The bedroom temperature were satisfactory (72 1 f -T Health Complaints 08-Aug-06 degrees F). However, the other violations were not corrected yet. The landlord was originally given 14 days after receipt of the certified order letter. It was received by Ms. Carol Groh on 12/4/97. Therefore, the landlord has until December 18, 1997 to correct these violations. Also, the tenant stored excessive amounts of debris and boxes throughout the rental unit including the rear porch entry-way room, causing an obstruction to any person who would attempt to repair the woindows at the rear porch entry-way room. The tenant agreed to remove the debris before December 30, 1997. The landlord then agreed to correct the window violations before January 14, 1998. A letter was mailed to the landlord, with a copy to the tenant, on December 10, 1997 detailing the above DEcember 10th findings and agreements. Investigation Date: 11/25/1997 Investigation Time: 2 --'Z 203 499 103 US Postal Service Receipt for Certified Mail No Insurance Coverage Provided. Do not use for International Mail ee re erne Sent t 01 Stregt�IVu ber Pos!Ri6e,State,&ZrKCode Postage $ Certified Fee Special Delivery Fee Restricted Delivery Fee Return Receipt Showing to Whom&Date Delivered Q Return Receipt Showing to Whom, �+ Date,&Addressee's Address O TOTAL Postage&Fees $ p� i1 Co ¢h Postmark or Date o /�—le- 9 u- co Stick postage stamps to article to cover First-Class postage,certified mail fee,and charges for any selected optional services(See front). 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 y window or hand it to your rural carrier(no extra charge). m T, 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the mPC -;� return address of the article,date,detach,and retain the receipt,and mail the article. LO 3. If you want a return receipt,write the certified mail number and your name and address on a return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space permits. Otherwise,affix to back of article. Endorse front of article a RETURN RECEIPT REQUESTED adjacent to the number. Q 4. If you want delivery restricted to the addressee, or to an authorized agent of the O O addressee,endorse RESTRICTED DELIVERY on the front of the article. 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt. If return receipt is requested,check the applicable blocks in item 1 of Form 3811. ti 6. Save this receipt and present it if you make an inquiry. 102595-97-B-01 as D • a; SENDERo v ■complete items 1 and/or 2 for additional services. I also wish to receive the ■Complete items 3,4a,and Alb. following services(for an ■Print your name and address on the reverse of this form so that we can return this extra fee)' card to.you. ai i ■Attach,this forth to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address permit $ ■Write.'Retum Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery d! ■The Return Receipt will show to whom the article was delivered and the date .. o delivered. Consult postmaster for fee. c 0 v 3.Articl Addresse 4a,Article Num er d ? �3 E E 4b.Service Type A� ❑ Registered IP Certified °C rn rr W ❑ Express Mail ❑ Insured S Ic V/��✓�,�� //��(' ❑ Return Receipt for Merchandise ❑ COD a (.�/d'► y `� 7.Date of Delivery_ A / °a� n 5.Rec 8.Addressee's Address(Only if requested (iL G and fee is paid) i g 6.Signature: dd ee or Agent ,x C� � -PS Form 3811, December 1994 102595-97-13-0179 Domestic Return Receipt UNITED STATES POSTAL SERVICE O• Mq _ q as it P �% es 1�8 (�M W h Mi jc��'�'. Print your name, ` dr ,qan ZIP Coftin, Public Health Division town of Barnstable P.O.Box 534 , finis,t�assachuseas 0260 11l�tri�.i€Itlltttl�t�111IIH tl�l .f .' A`= �tHE Town of Barnstable • Department of Health,Safety,and Environmental Services '"R'ASS.`�' MASS. ` Public Health Division 'OtEp 3� P.O.Box 534,Hyannis MA 02601 Thomas A.McKean,RS,CHO Office: 508-790-6265 Director of Public Health FAX: 508-790-6304 December 10, 1997 Carol Groh 108 Longfellow Drive . Centerville,MA Dear Ms.Groh, On December 10, 1997,a follow-up inspection was conducted at 108 Longfellow Drive Centerville,inside the basement rental unit. Multiple violations of the State Sanitary Code,Article II,were originally observed by Health Inspector Edward Barry on November 2, 1997. f The air temperature was satisfactory,measured at 69 degrees Fahrenheit in the bathroom and 72 degrees Fahrenheit in the bedroom. The air temperatures were determined at 1:35 p.m.on December 10, 1997. However,the following violations of 105 CMR 410.00,State Sanitary Code 11 remained uncorrected: 410,35k Uncapped gas line observed in the kitchen. 41 Wall light fixture was loosely mounted on the porch entry-way room. 1LQ3Qk Two east windows of porch entry-way had no window sashes. Also,wood rot was observed on the window frame most likely due to chronic dampness. 41 : East and south windows of the porch entry-way room were not weatherized. You,the owner,are responsible for correcting these violations. The uncapped gas line and the loose wall fixture violations must be rectified before the deadlines originally established in the order letter to you dated December 2, 1997. You received this certified order letter on December 4, 1997,which indicated that these violations must be corrected within 14 days. Therefore,these violations must be corrected on or before December 18, 1997. It was noted during my inspection that the tenant failed to maintain the porch entry-way free from an excessive amount of debris(boxes and usable items)which would obstruct any person from attempting to make the necessary repairs. Today,the tenant agreed to remove these items from the porch entry-way room before December 30, 1997. Thus,you agreed to correct these remaining violations regarding the porch entry-way room windows on or before January 14, 1998. Sincerely yours, 4L Thomas A.McKean ~ CENTERVOLLE-OSTER99OLLE-MARSTONS MOLLS FIRE DEPARTMENT . INCIDENT REPORT Type of Call:_iv Z4',o j - j__Alarm No:-E-la-:071rM Brief Narrative Required on all Calls _Location: 108-* _ szQ ��!_�� -----Date:_II1 - �1��- 1ZLgZ_ � �f LA-t- Called b Tel.#: � 0.- 97<-�-Tlme rec'd s- _`ry _ IC — Dispatcher: Comments: c _ �l Apparatus response: _309 Total Manpower: _ W �1C7 On the Air: (SqP- On location: ISL4& Ret. l(or In Service 06 12 `— c.v wC�S Weather: O- ecA-e, Temp: �z_ Z Wind: k-�' At:JO—/S- — y 3 itF.Ji LUtiJ G� Other Agencies Notified - _ _ Name/Agency Tele No. By ldlle.S+( � L/n_Orc.�.. 1 / �T Buildings Tye f Occupancy: Tele No. 7)1 a 4 ,1 _ I�trtwt6C.,J�r Owner: T _Address:_S c,�� n cis— _ u.. �J 2 �✓ c� clLkA Tenant:--- -1- '�1�— (.- ,A ----- U(A 2E1L�S cett , Gt OS Equipment/Type: -- ---__Location:_--------- -- le �SLu-�--� Year: Make: Model:_ _C,0 Serial No. _ i CLI-e LA _ e� Motor Vehicle - Year: Make/Model: (,�: ti�_� _ Color:— —VIN:_ --- Reg.#: — ;ram _ 1 Owner: Address: a _ — Operator:— Address: ------------- — L1 Brush Fire======Class: Area/size: --- �-- a Automatic Alarms - Classification/Code: Items needin Follow Up: — �i,.-tea -- —`'—�--------- Form #62 left at: 777/ ---- -- -- B` � Report b C-O-MM Form #19A Chief Rec'd: Date: r ' 'E Z , 203 499 105 US Postal Service Receipt for Certified Mail No Insurance Coverage Provided. Do not use for Interna1ional Mall See reverse) Sentto Stre mbar Post ce; ZIP Postage Certified Fee Special Delivery Fee Restricted Delivery Fee u) Return Receipt Showing to Whom&Date Delivered a Return Receipt Showing to Whom, Q Date,&Addressee's Address 0 TOTAL Postage&Fees is M Postmark or Date 0 U. Cl) a Stick postage stamps to article to cover First-Class postage,certified mail fee,and charges for any selected optional services(See front). 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). 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return address of the article,date,detach,and retain the receipt,and mail the article. LO _ 3. If you want a return receipt,write the cerlified mail number and your name and address rn on a return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space permits. Otherwise,affix to back of article. Endorse front of article a RETURN RECEIPT REQUESTED adjacent to the number. Q 4. If you want delivery restricted to the addressee, or to an authorized agent of the O y O addressee,endorse RESTRICTED DELIVERY on the front of the article. M 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt. If return receipt is requested,check the applicable blocks in item 1 of Form 3811. to 6. Save this receipt and present it if you make an inquiry. 102595-97-B-0145 CO Town of Barnstable LUMErrA8LE : Department of Health, Safety, and Environmental Services 019 ,m� Public Health Division P.O. Box 534, Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health December 2, 1997 Carol Groh 108 Longfellow Drive Centerville, MA 02632 ORDER 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 108 Longfellow Drive, Centerville, was inspected on November 25, 1997 by Edward Barry, Health Inspector for the Town of Barnstable, because of a complaint. The following violations of 105 CMR 410.00, State Sanitary Code II, Minimum Standards of Fitness for Human Habitation were observed: 'Flo p� w s7 / 410.200: Bathroom air temperature was only 62 degrees fahrenheit. o,� G9Dr i2�i0 C Z jF 1 Z U47 /3 P Bedroom temperature was only 54 degrees fahrenheit. 6h5 d ` ti No thermostat provided in apartment. —V-A,t) 6 y L.A,,,9LON 14t! IP4 0?4 WA 410.351: Uncapped gas line in kitchen. Wall light fixture loosely mounted. �.,tll �i �� � W 2�Prrea rz(�o�7 Y ' per 410.500: Two east windows of entry have no window sashes. Also, wood rot was 4,0 I -gc.AJ obse d at the on window frame due to chronic dampness. e. 410.501: East and north side windows of the entry room were not weatherized. _P( a i l.. •e Sec .e� w��ti 1r 4- The violation listed as 410.200 insufficient heat.is also listed under 410.750 and is eX � deemed a violation which may critically impair the health and/or safety of the occupants. ,P �� If This violation shall be orrected within twenty-four (24) hours of receipt of this order letter. You are also directed to correct the remaining violations within fourteen (14) da s of �"St receipt of this order letter. I tnfi 0�nR� ► Q7WfA N .Lj�� R_7 t 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, 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 day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH mas A. McKean Director of Public Health cc: Cecile Pierce The Town of Barnstable • - Health Department 1 } 367 Vain Street, Hyannis, MA 02601 �r►� w � Office 508-790-6265 60Z 674 �>�.11 'ry'�-� Thomas A. McKean FAX 50b-kV0344 A0 �d'�Sf` ��c "�� ` � �(,;< d:r '7/�' Director of Public Health NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY CO_D_E II,_MINIMUM_S_TANDARDS OF FITNESS FOR HUMAN HABITATION The property owned bY-pu located at/d46��Ify,; 4�w�/� � was inspected on / Iel � , 1997 by,j5: wO ' 2 Health Inspector for the Town of Barnstable, because of a complaint. The following violations of 105 CMR 410.00, State Sanitary Code II, Minimum Standards of Fitness for Human Habitation were observed: • '��C>' :AGO = r�t� .� /�...����'r,�'`��r�.� f'���'' �,.��4-���-gin -�.� •,���„e •,�'��',� lug�� �<<��� �=x'�"-�ir� .���:�•��� i��-�a�•�-� Grp t/.� /!/'� t �.��d' .� 5d �✓� %7, You are ) ' ected o cor P the viola i on"rith' are0 fou 4 ho of Fee i t o his tp ice,,,-'' You are also directj,d to correctAh&b'e within $ '" � L=�`� days/hwaT-s• 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, 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 $500. Each separate day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health ' t FORM 3o HOBBS&WARREN,INC. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH C,ITTWTOWN 01 DEPART ENT -27 Ax ADDRESS TELEPHONE Address Ja�A"�` %� �� ���-� Occupant Floor Apartment No. No.of Occupants No.of,Habitable Rooms No.Sleeping Room No.dwelling or rooming units —�1o.Stories Name and address of owner C-. 4 'eyo ,Gr �-7 y krr,, `7-e �l� Remarks Reg. Vim YARD �_ Out Bld s.: Fences: } Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: ' Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: WsWd aW 5 AK/ r—;,q 'ram ,4/cvj-7-h . ,1" � Lighting: '7` STRUCTURE INT. Hall,Stairway': Obst'n.: S<>m A sA-1wo V twry zroz Allo Hall, Floor,Wall,Ceiling:,. „ Hall Lighting: A40 /iVC(a �$j' A/V "7_iv, f ly ej joFb 5 =0 Hall Windows: pIHEATING Ghimne s: A—Z Xer-yd9Al Voa/Pl, � OVIn Central El ❑ N Equip. Repair /f C -4 '7',,cs .f^ ..� 7Y'rlT TYPE: Stacks, Flues,Vents1-4- 4zL*k*10,W ,•lrjx/� 4� V/0 PLUMBING: Supply Line: Sh b ❑ MS ❑ ST ❑ P Waste Line: IgA,Id' •5 9ZJ'T H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.- ,4/, 1 T :47,-, ❑ 110 ❑ 220 Fusing,Grnd.: M 0 v ,4d /0 s AMP: Gen.Cond. Distrib. Box: .O 7 .0-y- 4'1,43 JR` /47 ?n J lv 74t5 Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry _ Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. 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: G jdl ::dr' 1G ��✓l,� General Building Posted 4 Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY." INSPECTOR �xOe� T)��"t2-4 TITLE Wy 4 A.M. DATE �j� 77 TIME ��.' P!M; A.M. v THE NEXT SCHEDULED REINSPECTION P.M. �1 f Jr 410.750:: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to. exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of these items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.000 through 410.499 state minimum requirements of fitness for human habitation, any violation has the potential to fall within this category in any given situation but may not do so in every case and therefore cannot be included in this listing. Failure to include shall in no way be construed as.a determination that other violations may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of the violation(s) pursuant to 410 CMR 410.830 through 410.833 nor-shall it affect the legal obligation of the person to whom the order is issued- to comply_with_such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and- temperature, both hot and cold, to -meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 fora period of 24 hours or longer. -- - - -- e S f - - - -(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. t - . (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. '(B) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a. sewage system in operable .taddition as required by 105 CMR 410.-150(A)(1) and 410.300. ' (C) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by an object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450 and 410.451. (11) Failure to comply with the security requirements of 105 CMR 4110.480(D). (I) _ Failure to comply with any provisions of 105 CMR 410.600 through 410.602 _ ;.'.4hich.results in any accumulation of garbage, rubbish, filth or other causes -`of: sickness which may provide a food source or harborage- for rodents, insects •.".ior other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence-of lead-based paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regualtions for Lead'Poisoning Prevention and Control 105 CMR 460.000. - ;(K) Roof,'-foundation, or other structural.defects that may expose the occupant or anyone else to fire," burns, shock, accident or other dangers or f Aftbant to health -or dafety. (IL)" Failure to install electrical, plumbing, heating and gas-burning -� facilities in accordance with accepted plumbing, heating, gas-fitting and - olectrical_ wiring standards or failure to maintain such facilities as ` ore'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. _QQ 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: . " , _ lt)' "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 . - E plumbing heating,, gae-fitting, or electrical wiring standards that do not create an immediate hazard. .14) 'faiiuie .tf 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 ai'required by i05.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 fir the health or safety and well-being of an occupant upon the failure of tho.owner to remedy said condition within the time.so ordered by the board of health.. L ✓ J TOWN OF BARNSTABLE •�• LOCATION <d� , AX� U� /CII�'G !O VILLAGE ASSESSOR'S MAP&LOT 9_NAME&PHONE NO. I: INL0Y14" ' --I-1: SEPTIC TANK CAPACITY 2alb LEACHING FACILITY: (type) 0 �X7 ' (size) 11Wd NO.OF BEDROOMSVVEM�tcW OWNE�/RJ,ATE: G��Z'�� DATE: c�A `1!!� 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 e ' t within 300 fee f leac ' f ty Feet Furnished : — r - ram ,1�,9., ` OF� d SENDER: o ■completwitims 1 and/or 2 for additional services. I also wish to receive the 1; complete items 3,4a,and 4b. following services(for an 0 ..■Print your,name and address on the reverse of this form so that we can return this extra fee): card to you.:r.: ' ■Aettac`this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address `■Wrifa'Retum Receipt Requested'on the mail piece below the article number. d P 4 a 2. ❑ Restricted Delivery N ■The Retum.Receipt will show to whom the article was delivered'and the date a r delivered.' Consult postmaster for fee. 0 -0 3.Article Addressed to: 4a.Article Number E 4b.Service TypcV A m 0 ❑ Registered OP Certified of W^ ❑ Express Mail ❑ Insured .E- o , ❑ Return Receipt for Merchandise ❑ COD fate of Delivery 6 5:R ceived By :Mdr tftm S;Artldressee's Addre s(O y if requested u . Y m nW and fee is paid) t t— g 6.Sig Ore:(Addressee or Agent) X l PS Form 3811, December 1994 102595-97-6-0179 Domestic Return Receipt First# it UNITED STATES POSTAL SERVICE QO• �� Class Mail ' j "} � I?p ye& es i-al' o • Print your name,addr's an ZIP Codo1s it r I Public Health Didislon v I jown of Barnstable P.O.Box 534 ® � Hyannis.Maswh ,. I • I D ..YJ ',� 6!4/96 DATE:__ .: PROPERTY , ADDRESS: ,108 -i,-ongfel•low Drive QECEOWED Centerville,Mass . SUN 7 1996 •0 2 63 2 HEALTH DEPT. ?CpWN OF BARNSTABLE On the above date, I Inspected the septic system at the above address. This system .consists of the'following: 1-;1-1000 .gallon septic tank. ASSESSORS MAP Na 2,;.1-10.00' gallon leaching pit. PARCELNO: 4 01_:�; 6 based on my Inspection, I certify the following conditions: fig' T-h1s is. a title five. septic system- ( 78 .,Code ) 2.. The .:sept.ic system is in failure . Tank and leach pit have water ov�r..the _,inlet inverts and outlet invert of- .the -septic tank .. 3, .. System .1n_ust. be upgrad0,d 'to, a tit-le five septic system. i SIGNATURP: Name: J. P.Racomber Jr... i 7------- Company:* J•P.Macomber. & Son' 'Inc • ; -------.- ----------- ------ Address: - --Centerville Agps__0.2.632 ` t.. Phone:---5Q8.:Z7�-�3338-----_- j THIS CERTIFICATION DOES'NOT CONSTITUTE A GUARANTY OR WARRANTY ROX&Y"" .pOSEPH P. MACOMBER & SON,. INC. Tan�;s-Cesspools-Leachfle1 $ Pumped & Installed Town Sewer Connections P.O. Box ' . Centerville, MA 02632-0066 77.5-3338 , 77"4.12 U Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of • Environmental Protection William F.Weld Trudy Cox* Govwnor Y A��Pfaul Celluoci David B.Struhs coovnb,tomr • SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION PropertyAddresu 108 Longfellow Drive Centerville 6�4�96 Address of Owner. /+7 Clark Street Date of Inspeotion: (If different) Newton,Mass . Nameoflnspeotor.Joseph P. Macomber Jr. 02159 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 my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: _ Passes _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signet/ �C/yG� Date: —4�4C� 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 oMce 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: ZJ D 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 nsod to be replaced or repaired. The system, upon completion of the replacement or repair,passes inspection. Indicate yes, no, or not determined(Y, N, or ND). Describe basis of determination in all instances. If"not determined",explain why not) The septic taak is metal, cracked, structurally unsound, shows substantial infiltration or exflitration,.or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a-Conforming septic tank as approved by the Board of Health. (revised 11/03/95) I One Winter Street 9 Boston,Massachusetts 02108 • FAX(617) 556-1049 0 Telephone(617)292.55W Date of Inspeotion: B)SYSTEM CONDITIONALLY PASSES(continued) NAG Sewage backup or breakout or hoh static water level observed in the distribution boa is due to broken or obstructed pipes) or due to a broken,settled or uneven distribution boa. The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed Cl FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: _& 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 IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: &LA Cesspool or privy is within 50 feet of a surface water AN 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: The system has a septic tank and soil,absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. 'f The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. �Q 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 (revised 11/03/95) t 2 Owner. 108 Longfellow Drive Centerville,Mass . ( x Date of InsPeotlon: K.J. Kevicius �`JJ D] SYSTEM FAILS:6/4/96 I have determined that the system violates one or more of the following failure criteria as defined in 310 ChM 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. !es- Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. �0 Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. A..�04)6 Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. �J Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow. A& Required pumping more than 4 tunes in the last year NOT due to clogged or obstructed pipe($). 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. 6j/ Any portion of a cesspool or privy is within 60 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 60 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. E] LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The system serves a facility 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: JLA the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply �� the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area(IWPA)or a mapped Zone 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 6.00 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 CHECICLIST Prop.,VAddress: 108 Longfellow Drive Centerville,Mass . Owner. K.J. Kevicius Date of Inspootlon: 6/4/96 Check if the following have been done: ,Pumping information was requested of the owner, occupant, and Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period Large volumes of water have not been introduced into the system recently or as part of this inspection. ZAs built plans have been obtained and examined. Note if they are not available with N/A ZThe facility or dwelling was inspected for signs of sewage back-up. Zhe system does not receive non-sanitary or industrial waste flow 27he site was inspected for signs of breakout. ZA,�Kygtem components,)Scluding the Soil Absorption System, have been located on the site. �/The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or Zmaterial of construction, dimensions, depth of liquid, depth of sludge, depth of scum. size and location of the Soil Absorption System on the site has been determined based on existing information or ZThe rozimated by aon-intrusive methods. facility owner(and occupwts, if different from owner)were provided with information on the proper maintenance of Sub. Surface Disposal System. (revised 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 108 Longfellow Drive Centerville ,Mass . Owner. K.J. KeviCius Date of Inspection:6/4/96 FLOW CONDITIONS RESIDENTIAL Design flow: z> gallons �/¢y Number of bedrooms: Number of Current residents: 41 Garbage grinder(yes or no):A Laundry connected to system(yes or no):ya_,� Seasonal use(yes or no):VP Water meter readings, if available: t,4d0 !¢21. 5=� / ,�'� 'V t4 A, dA Last date of occupancy:i Q� COMMERCIAL NDUSTRLAL: Type of establia ent: A74 Design flow: allons/day Grease trap present: (yes or no)&—.4 Industrial Waste Holding Tank present: (yea or no)jA) Non-sanitary waste discharged to the Title 5 system: (yes or no)A# Water meter readings, if available: A)A- Lest date of occupancy:�.. OTHER: (Describe) A)� Last date of occupancy: A GENERAL INFORMATION PUMPING OVS an f info 0 /J System pumped as par4, je'xe7 • ection: (yes or no) If yes,volume pumped:ReasonforP�P+ar. L�/Ap L!✓TjI TYPE OF SYSTEM __Septic tank/di"PRfttiea bo:/soil absorption system o single cesspool Overflow cesspool Privy N shared system(yes or no) (if yea, attach previous inspection records, if any) Other(explain) AP OXI TE AGE of all components, date installed (it known)and source of information: _y7,�,,er✓ ;. /9 ZO Sewage odors detected when arriving at the site: (yea or no) IV/ (revised 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C• • - SYSTEM INFORMATION (continued) Property Address: 108 Longfellow Drive Centerville,Mass. Owner: K.J. KeviCius Date of Inspection:6/4/9 6 SEPTIC TANK:L-/zV414.-bwv ZflAlk , (locate on site plan) a Depth below grade:._& Material of construction: concrete _metal _FRP —other(explain) Dimensions:' Sludge depth: 00 Distance from top of sludge to bottom of outlet tee or baffle:0 Scum thickness:_ 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 integrity, evidence of leakage, etc.) p»m d 0"Al at t0a a„p' g �--tr�nk_.evPru 2-3�S.e.T� I1�1.Rt � go =•ePalea 1aeeded- at tyna- present %J e: GREASE TRAP..1�ds (locate on site pian) Depth below grade:(/LI4 Material of constn!rtion Ozoncrete _metal _FRP --other(explain) Dimension;;, _ Scum thickness:_ Distance from top u t scum to top of outlet tee or bah'le:A))Oj Distance from bottom of !rum in bottom of outlet tee or baffle:_ r Comments: (recommendation for pumping, condi—ri of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) (revised 8/15/95) 6 • V V✓V V....♦.e...r✓..l.Vu✓.V�VVlL/4IaN•a'L.1•l.�J•�%V..V�• .'Vl4l.� PART C SYSTEM INFORMATION(continued) Property Add,... 108 Longfellow Drive Centerville,Mass . Owner. K.J. Kevicius Date of Inspection: '6/4/96 TIGHT OR HOLDING TANK�,f)C, (locate on site plan) • Depth below grade:, Material of constr u tion�oncrete_metal_FRP—other(explain) - Dimensions:_ AA Capacity: A4 gallons Design flow; gallons/day Alarm level: Comments: I, 1{ (condition�of inlet tee,condMn of alarm and float switches, etc.) —16 C dYY1H? ] TS DISTRIBUTION BOX, (locate on site plan) Depth of liquid level above outlet invert: A�11i Comments: (note if level and distribution is equal,evidence of solids carryover, evidence of leakage into or out of box,etc.) PUMP CHAMBER:!!�4Njf—., (locate on site plan) Pumps in working ordo -(yes or ao)_g/ Comments: (note ndi ' n of pump chamber, condition of pumps and appurtenances, etc.) a 7- k (revised 11/03/95) 7 PART SYSTEM INFORMATION (continued) PmpertyAddroas: 108 Longfellow Drive Centerville,Mass. Owner. K.J. Kevicius Date of Inipootion: 6/4/96 SOIL ABSORPTION SYSTEM (SA9):z (locate on sits,plan, if possible; excavation not mquirvd, but uwy be approximated by non-intrusive methods) c If not determined to be present, explain: Type: leaching pits, number: leaching chagalleries,bers, number: loachin8 g , number: leaching trenches, number,leagth: leaching fields, number, ions:_ _ overflow cesspool, numbe Comments: (note condition of soil, aigns of hydraulic failure. level of ponding, condition of vegetation,etc.) Loamy sand Sand & !navel-medium fine sand; Leaching nit filled to the cover. Water over the inlet invert Meat hA »j)grgdArj to n t; tlA f,ve AAYPt, C sa stem ` CESSPOOLS:"'V e (locate on site plan) Number and configuration: VA _ Depth-top of liquid to inlet invort: Depth of solids layer: 19 _ Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow(cesspool must be pumped as part of inspection) A)d: Comments- (note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation, etc.) .�(p LJIS�rY1PJUT$ ' PRIVY: (locate on site plan) ~ . Materials of construction: Dimensions: Depth of solids:_ Co ntxk(� condition ��nof soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.) (revised 11/03/95) b .ti SYSTEM INFORMATION (oontinued) Property Address: 108 Longfellow Drive Centerville,Mass, Owner. K.J. Kevicius Date of Inspection: 6/4/9 6 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or beachmarks locate all wells within 100, Centerville Osterville Marstons Mills Water Company 428-6691 DEPTH To GROUNDWATER Depth to groundwater. 1 6* feet method of determination or approximation: System installed in 1970. no water encountered (revised 11/03/95) g • , Y - sj LO I � z • I _ }''l-y 3�7 i THE COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION BE IT KNOWN THAT Joseph :P. Macomber, Jr. Has satisfied the Department's qualifications as regdire.d. 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 k.. TOWN OF Barnstable BOARD OF HEALTH SUBSURFACE SEWAGE; DISPOSAL SYSTEM INSPECTION FORM - PART D — CERTIFICATION ` A..._.. .. ..._.__.—rr..�._�_�...:—:.—........ -.--r!er.—rs--rsr.rrrr:��+�rasretrm rr•.rrr.r.r. rT.—rrr r. -. A TTT'.T —TYPE OR PRINT CI.EARLY— PROPERTY INSPECTED STREET ADDRESS 108 Longfellow Drive Centerville,Mass . ASSESSORS MAP , BLOCK AND PARCEL # OWNER' s NAME K.J. Kevicius ._- - -- PART D - CERTIFICATION Y NAME OF INSPECTOR Joseph P. Macomber Jr. COMPANY NAME J.P.Macomber Jr. COMPANY ADDRESS Box 66 Centerville Mass . 02632 Street Towti or Clty State LIP COMPANY TELEPHONE c508 ) 775 - 3338 FAX (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 ; System PASSED The inspection tghich 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 . XXXXXXXXXSystem FAILED* The inspection which I have conducted has found that the system fails to protect the public health 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 form . Inspector Signature Date 6/4/96 One copy of this /rtilfication must be provided to the OWNER, the BUYER ( where applicable ) and the 130ARD OF IIHAL7'I1. * If the inspection FAILED, the owner or"operator shall upgrade the system within one year of the date of the inspection , unless allowed or required otherwise as provided in 310 CMR 15 . 305 , _.... nn..i-a A-- No. 40�7 Fee $ 40.0 00 i THE COMMONWEALTH OF MASSACHUSE S PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppYicatiou for Mitmat 6wem Cow6truction 3dermit Application is hereby made for a Permit to Construct( )or Repair(XX)an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 1 7—5 2 7—21 31 108 Longfellow Drive K.C. Mitkevicious Centerville,Mass . 02632 47 Clark Street Newton Mass. 02159 Installer's Name,Address,and Tel.No. 5 0 8—77 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 Jr. J.P.Macomber Jr. Box 66 Centerville,Mass . 02632 Box 66 Centerville,Mass . 02632 Type of Building: DwellingXXXNo.of Bedrooms 4 Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow_ 440 gallons per day. Calculated daily flow ��x 1 1 0 gallons. Plan Date 6.127.196 Number of sheets Revision Date Title Description of Soil �S a n rl & Gr a v e l Nature of Repairs or Alterations(Answer when applicable) Adding four 330 re chargers to an existing 1000 gallon tan ,wand and 1000 gallon leaching pit. 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 Certifi- cate of Compliance has been iss d by this a o alth. 6�27�96 Signed Date Application Approved by Application Disapproved for the following reasons Permit No. Date Issued �b ' No. ..v" C.A, Fee $ 40,0i THE COMMONWEALTH OF MASSACHUSE S PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Application for Migog.aY *pgtem Construction Permit Application is hereby made for a Permit to Construct( )or Repair( X)an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 17�—5 2 7—21 31 10$ Longfellow Drive K.C. Mitkevicious Centerville,Mass. 02632 ,, 47 Clark Street Newton Mass. 02159 Installer's Name,Address,and Tel.No. 5 0$-77 5-=3338 Designer's Name,Address and Tel.No. 5 08—7 7 5—3 3 3$ J.P.Macomber Jr. , - J.P.Macomber Jr. Box 66 Centerville,Mass . 02.632 Box 66 Centerville,Mass. 02632 Type of Building: i Dwelling XXXNo.of Bedrooms L, Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 440 gallons per day. Calculated daily flow 4x1 1 0 gallons. Plan Date 6127196 Number of sheets Revision Date Title , Description of Soil Samd R. Greavel, Nature of Repairs or Alterations(Answer when applicable) Adding four 330 reeharger,s to an existing 1000 gallon tankkand and 1000 gallon leaching pit. 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 Certifi- cate of Compliance has been iss d by this °o o alth. Signed W !� t Date 6/27/96: Application Approved by , Application Disapproved for the following reasons Permit No. Kam" AV Date Issued �" 6 t THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( or repaired/replacedXX)o on by J.P.Macomber Jr. for K.C., Mitkevicious as 108 LongfellowDrive er y ivt has been constructed in accordance -- ,���� with the provisions of Title 5 and the for Disposal System Construction Permit No. 4 dated,7, ` 7,`` Use of this system is conditioned on compliance with the provisions set forth below: J,7 `7- l • No. Fee$ 40.00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 'Wi5pogarl6pztem Congtrutttori permit PLDate: isin i hereby granted to J.P.Macomber Jr. )repair SIX)an On-site Sewage System located at 108 LongfPl.l ow nri vA Centervi.l_l.e.MA.,gs. bed in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to Title 5 and the following local provisions or special conditions. ion musttbbe completed within two years of the date below. � 'f/ � 45�1� Approved PP -~ CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) Y I, Joseph P. Macomber Jr, hereby certify that the application for disposal works construction permit signed by me dated 6/28/96 , concerning the property located at 108 LonufP1 l ow nri�e meets all of the Centerville,Mass. following criteria: Y 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 Y The observed groundwater table is :4 feet or greater below the bottom of the leaching facility • There is no increase in flow and/or change in use proposed Y There are no variances requested or needed. SIGNED : DATE: 6/28/96 LICENS SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. Existing 1000 gallon' leach pit. New Distribution Box Install 4 330 Rechargers . Existing 1000 gallon Septic tank.