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0017 SOUTHWINDS CIRCLE - Health
17 SOUTHWINDSCIRCLE, CENTERVILLE A=226-159 i No. 42101/3 ORA ESSELTE 10% O O O O I 1 J ' CN COMMONWEALTH OF MASSACHUSETTSEXECUTIVE OFFICE OF ENVIRONMENTAL AFFA1j/-DEPARTMENT OF ENVIRONMENTAL PROTEONE WINTER STREET. BOSTON, MA 02108 617-292-5500j`9`9J/W1LLIAM F.11'ELD TRUDY XE Govemor Secretary ARGEO PAUL CELLUCCI DAVID B.STRUHS Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commissioner PART A CERTIFICATION ,,/ (Lot #3 ) Property Address: 1 7/Jn Sout�hwinds Cir, .�i, ass of Owner: Wm Schortman Date of Inspection: 7�-31-q // (If different) 72 BroadBrook Rd Name of Inspector: Wm E Robinson Sr BroadBrook, CT 06016 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: Wm E Robinson Septic Service Mailing Address: PO Box 1 089, C _n ervi 1 1 P r MA 02632 Telephone Numbers SOS ) 77 5_R 7 7 6 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: 's Passes _ Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ Fails Inspector's Signature: Date: ^3/ / 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. COMMENTS: BI SYSTEM CONDITIONALLY PASSES: One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. 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 tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, 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 conforming septic tank as approved by the Board of Health. (revised 04/25/97) Page 1 of 10 DEP on the World Wide Web: http:/twww.magnetstate.ma.us/dep 0 Printed on Recycled Paper i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Addresl".17/19 Souttwinds Cir, Craigville Owner: /_ ,Wm Schortman Date of Inspection: SYSTEM CONDITIONALLY PASSE$ (continued) Sewage backup or breakout or high static water level observed in the distribution box 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). Describe observations: 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 C) FU THEIR 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: Cesspool or privy is within 50 feet of a surface water 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 PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS 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 the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS 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. Method used to determine distance (approximation not valid). 3) O HER (revised 04/25/97) Page 2 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1 7/1 9 Southwinds Cir, Craigville Owner: Wm Schortman Date of Inspection: _3 _ D YSTEM FAILS: You m st indicate ei:,;er "Yes" or "No" as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis or this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct t e failure. Yes N Backup of sewage into facility or system component due to an overloaded or clogged SAS 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. Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available volume is less than 112 day flow. Required pumping more than 4 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. _ 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 coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: You must i dicate either "Yes" or"No" as to each of the following: TWfollowing criteria apply to large systems in addition to the criteria above: Th 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: I Yes No d 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 r 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 04/25/97) Page 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 1 7/1 9 Southwinds Cir, Craigville Owner: Wm Schortman Date of Inspection: .) 9 Check if the following have been done: You must indicate either "Yes" or"No" as to each of the following: Yes No Pumping information was provided by the owner, occupant, or 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. _ As built 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. The system does not receive non-sanitary or industrial waste flow. _ The site was inspected for signs of breakout. VW'- _ All system components, excluding 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 tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. Iles _ Existing information. Ex. Plan at B.O.H. Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) (15.302(3)(b)J (revised 04/25/97) Page 4 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 1 7/1 9 Southwinds Cir,: Craigville Owner: Wm Schortman Date of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow:1�11/6 g.p.d./bedroom for S.A.S. Number of bedrooms:L Number of current residents: Garbage grinder (yes or no):/-o Laundry connected to system (yes or no): +-- Seasonal use (yes or Water meter readings, if available (last two (2)year usage (gpd): 1995 — 9 5, 0 0 O.ga 1 s Sump Pump (yes or no):,6-d 1996 — 8 9, 0 0 0 ga i s Last date of occupancy: COMMERCIAUI N D USTRIAL• Type of establishment: Design flow:_gallons/day Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Non-sanitary waste discharged to the Title 5 system: (yes or no)_ Water meter readings, if available: Last date of occupancy: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source ot information: .0- 1 /`ZQ �I I`� 5S ) 996 System pumped as part of inspection: (yes or no)/1-0 If yes, volume pumped: eallons Reason for pumping: TYPE OF S TEM Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) I/A Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: I//—S' 6� Sewage odors detected when arriving at the site: (yes or no)�L V (revised 04/25/97) Page 5 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1 7/1 9 Southwinds Cir, Craigville Owner: Wm Schortman Date of Inspection: �7 BUILDING SEWER: (Locate on site plan) Depth below grade: Material of construct' n: _cast iron _40 PVC_other (explain) Distance fr/( ndition ate water supply well or suction line Diameter Comments: of joints, venting, evidence of leakage, etc.) SEPTIC TANK:_ (locate on site plan) Depth below grade: Material of construction: d/concrete _metal _Fiberglass _Polyethylene _other(explain) If tank is metal, list age _ Is age confirmed by Certificate of Compliance _(Yes/No) L a a Dimensions: g Sludge depth: ZT" Distance from top of sludge to bottom of outlet tee or baffle: 4�0 � Scum thickness: 41 s- i a Distance from top of scum to top of outlet tee or baffle: 11 Distance from bottom of scum to bottom of outlet tee or baffler How dimensions were determined: %d g ' .,v, j7n a. Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles depth of�l.i9.uid level iim relation to outlet invert, structural integrity, evidence of leakage, etc.) (G >� "" A ! n'ttl r M ;'7 GREAS RAP: (locate on *te plan) Depth below rade: Material of co struction: _concrete _metal _Fiberglass _Polyethylene —other(explain) Dimensions: Scum thickness: Distance from t p of scum to top of outlet tee or baffle: Distance from b ttom of scum to bottom of outlet tee or baffle: Date of last pu ping: Comments: (recommendation r pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence f leakage, etc.) (revised 04/25/97) Page 6 of 10 a SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1 7/1 9 Southwinds Cir, Craigville Owner: Wm Schortman Date of Inspection: ,_3 o q TIC OR HOLDING TANK: (Tank must be pumped prior to, or at time, of inspection) (locateyne n) Depth e: Materiauction: _concrete _metal _Fiberglass _Polyethylene —other(explain) DimensCapacigallons Design gallons/day Alarm I vel: Alarm in working order _Yes; _ No Date of IN,evious pumping: Comment : (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: 0 Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.)_4 PUMP CRAM ER:_ (locate on site Ian) Pumps in worki g order: (Yes or No) Alarms in work ng order (Yes or No) Comm') condition f pump chamber, condition of pumps and appurtenances, etc.) (revised 04/25/97) Page 7 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1 7/1 9 Southwinds Cir, Craigville Owner: Wm Schortman Date of Inspection: 9-7 i g-1 / SOIL ABSORPTION SYSTEM (SAS):i/ (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number: leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: ! 2- 'k z j 'k, leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level o!y_onfling, condition of vegetation, etc.) _ C✓U e�vz. �i w� � ^ � 1 yr t; � � ✓+'� � ✓U f� `� t �! .t. :s ® L PITT, j-ucI / is CESS OLS: _ (locate n site plan) Numbe and configuration: Depth-t p of liquid to inlet invert: Depth f solids layer: Depth f scum layer: Dime ions of cesspool: Matey als of construction: Indi tion of groundwater: inflow (cesspool must be pumped as part of inspection) Comme ts: (note c(ndition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY: (locate o ite plan) Materials f construction: Dimensions: Depth of olids- Comme s: (note c dition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (reviaad 04/25/97) Hags a of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1 7/1 9 Southwinds Cir, Craigville (Lot #3 ) Owner: Wm Schortman Date of Inspection: )—3 6`4 /7 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) a. Lt • l3 f � 02 (revised 04/25/97) Page 9 of 10 a SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1 7/1 9 Southwinds CIr, Craigville Owner: Wm Schortman Date of Inspection: 1 -9 1-07 7 Depth to Groundwater Feet Please indicate all the methods used to determine High Groundwater Elevation: _L/Obtained from Design Plans on record Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators, installers Use USGS Data Describe in your own words how you established the High Groundwater Elevation. (Must be completed) V3 o L�l (revised 04/25/97) Page 10 of 10 jWo 'y 7o) g� i i G�2�� �o jut 1 I997 j TO: BOB AND MARIA PARELLO '000THo Ae(T 86�BAR/Vs fPT i FROM: BILL SCHORTMAN A July 8, 1997 E �' We received partial payment of your June rent on July 5, 1997. The balance of your rent is $126 for June. This includes the $20 late charge. The Dyer Electric bill is not our bill . We discussed this at an earlier time and you were .told since you called the electrician any bill would be your responsibility. If you paid the bill on time you would not have had the added late charges. We are on a water meter. Sprinklers and water hoses cannot be running for extensive periods of time. Outside faucets will be capped if this continues to be a problem. Also attached is another copy of a letter sent to ALL our Southwinds tenants regarding a rent increase as of June 1 , 1997. You were not singled out as the only tenant with a rent increase. If you recall , at one time your rent was $600. 00 a month. When times got tough in 1991 we decreasd your rent to $500.00 a month. For six years we have not increased your rent . Taxes, increased water rates and road assessment has necessitated a $50. 00 a month increase in your rent . You will be contacted for someone to enter your apartment Monday, July 21 , 1997 to correct any violations pending from the Board of Health letter. Unfortunately, we cannot talk with you because you have an unlisted number and have not given it to us . Your co-operation would be greatly appreciated . Bill Schortman CC: Board of Health S . 6 `L P 339 578 767 Ow US Postal Service z Receipt for Certified Mail No Insurance Coverage Provided. Do not use for International Mail See reverse Sent to WILLIAM SHORTMAN Street&Number 72 BROADBRE10K RD. Post Office,State,&ZIP Code BROADBROOK CT Postage $ 1.67 Certified Fee 1. 10 Special Delivery Fee Restricted Delivery Fee LO Return Receipt Showing to Whom&Date Delivered Return Receipt Showing to Whom, Date,&Addressee's Address 0 TOTAL Postage&Fees $ 2. 77 Cq Postmark or Date € 9/8/97 12 rn 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 m window or hand it to your rural carrier(no extra charge). m 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the m return address of the article,date,detach,and retain the receipt,and mail the article. N 3. If you want a return receipt,write the certified mail number and your name and address on a return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space permits. Otherwise,affix to back of article. Endorse front of article RETURN RECEIPT REQUESTED adjacent to the number. 4. If you want delivery restricted to the addressee, or to an authorized agent of the C 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. ti 6. Save this receipt and present it if you make an inquiry. t f L` Town of Barnstable Department of Health, Safety, and Environmental Services BARNSTABM MUM PublicHealth Division i6S9• ♦� ArFD jA°�A 367 Main Street, Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health September 8, 1997 William Shortman 72 Broadbrook Road Broadbrook, CT 05016 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 17 Southwinds Circle, Centerville, was inspected on August 2.5 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: 410.500: Water stains on ceilings of the kitchen, living room and small bedroom. You are directed to correct the above listed violations within fourteen (14) 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, 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 Q. kz� Thomas A. McKean Director of Public Health rr[, The Town of Barnstable Jy Health Department t out 367 Main Street, Hyannis, MA 02601 riva Office 508-790-6265 r d '� Thomas A. McKean FAX 50b-i7pe344 -7,�, 13-y`e,,47d/->7-40 k' If - Director of Public Health _NOTICE TO ABATE VIOLATIONS OF 105 CHR 410.00, STATE SANITARY CODE II1 MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION The property owned by you located at l'7 sv -1-4 inspected on ,lase v,�"� , 199 by x�V � '�a'��41" Health Inspectof for the Town of Barnstable, because of a complaint. The following violations of 105 CHR 410.00, State Sanitary Code II, Minimum Standards of Fitness for Human Habitation were observed: 97 = c You are direct "o correct se vi ' ons wit n--t'" y- four ours of r pof' th notice You are also directed to correct within 7��4�' ,e y� days/hours of receipt of this notice. You may request a hearing if written petition requesting same is received by the Board of HealtTi 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 m SENDER: 'o ■Complete items 1 and/or 2 for additional services. I also wish to receive the Z ■Complete items 3,4a,and 4b. following services(for an N ■Print your name and address on the reverse of this form so that we can return this extra fee): 2 card to you. ai j ■Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address 0 permit. y ■write'Retum Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery N ._. ■The Return Receipt will show to whom the article was delivered and the date a delivered. Consult postmaster for fee. 3.Article Addr Sped to: 4a.Article Number E 4b.Service Type 0 ''7� ❑ Registered Certified � ❑ Express Mail ❑ Insured 5 e_ ❑ Return Receipt for Merchandise ❑ COD 0 7.Date of D ive I� 0 5.Re eived t Name) 8.Address e's ddr s(Only if requested w / ' l� ' p` and fee is paid) 3 n 6.Si ture: (Addressee or Age t) (A y� X, PS For,3811, December 1994 102595-97-a-01.79 Domestic Return.Receipt ust- lass Mail UNITED STATES POSTAL SERVICE Postage&Fees Paid USPS Permit No.G-10 • Print your name, address, and ZIP Code in this box• I Public Health Division ,_, j Town of Barnstable P.O.Box 534 Hyannis,Massachusetts 02601 ' I ' I ' I 40 _ e �CXA r, 7 ) f - 3l ?(, kfCe.��, �i�Ks©� October 25, 1996 William Schortman 72 Broadbrook Road Broadbrook, CT 06016 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 17 South Wind Circle, Centerville was inspected on October 21, 1996 by , 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 State Sanitary Code were observed: 410. 55 2� The self closing device is missing from the side entrance storm door. 1� 0.500: The ceiling in the kitchen/livingroom was water damaged and water was found inside the globe of the kitchen light fixture and also inside the � kitchen cabinets. ti,,®1 I eawty� v.S� 04,4,t vk o v'( dOc"410.500�- The ceiling area above the bay window in the livingroom was water .�Aained and dripping water. - K ( .f,&At t '`a `' LOV A-" �&--r- I Q�J�4j5�00- The ceiling in the masterbedroom was water stained due to a past leak. 1^� p' 410.500-�' The ceiling in the child's bedroom was water stained due to a roof leak. 410.500: There was mildew on the ceiling in the bathroom. ' ' 0 17 10.501(A): e window in the bathroom had a cracked pane of glass. ()r4 410.501(A): The storm window on the left side of the masterbedroom had a cracked ���, pane of glass. �1 OV`L 410.501(A): The rear window of the masterbedroom was missing a pane of glass. 6 h 4 01 The storm window frame of the livingroom bay window was rpt tight against the window frame on the left botton edge. - , 60,tJ4jA.50181: The side entrance door was not weather tight as there was a large gap between the left side of the door and the prime door frame. �C�40.500: The threshold for the side entrance door loose. , You are 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 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 Thomas A. McKean Director of Public Health cc: Bob Payello ' per electrical Co. INVOICE N0. PAYMENT ADDRESS 009969 Since 1910 DYER ELECTRICAL CO. 325 Stevens Street INVOICE HYANNIS,MA 02601-5127 P.O.BOX 1775 (508)775.2525 HYANNIS, MA 02601-6775 Master Elect.Uc.#A6231 STAFF 2 CM Tax Exempt # SOLDTO: Robert Parello SHIPTO: 17 Southwind Circle 1 17 Southwind Circle 1 Centerville, MA 02632 Centerville, MA 02632 DUE UPONAECEI M ACCOUNT NO. SnMNO. PURCHASE ORDER NO. SHIP VIA COL PPD DATE SHIPPED TERMS INVOICE DATE PAGE -A009968 Truck/Coen Car 10/21/96 C.O.D. 11/05/96 10, CITY. CITY ORDERED SHIPPED BA K ITEM NO. DESCRIPTION UNIT PRICE DID' EXTENDED PRICE ORDERED October 21, 1996 Removing Kitchen Light Due To Water Damage. 1.0 1.0 R-1 1-MALT PER HXR-ELECTRICAL 39.00 $39.00 Thank You Flor Your Business. I i i SALES AMOUNT 39.00 Interest on overdue amounts at the rate of 1'A%per month or a maximum of 18%per year (minimum of$2.50). Customer agrees to pay all costs of collection Including attorney fees not MISC.CHARGES $.00 to exceed 50%. Dyer Electrical Co.reserves the right to revoke any charge privileges if your SALES TAX account becomes past due. $.00 Payments Can Now Be Made With The Following Credit Cards: Discover, MasterCard&Visa. FREIGHT .00 Call Office To Make Payments. f7 ,, nkYou TOTAL► $39.00 oao Z 348 659 757 Receipt for Certified Mail No Insurance Coverage Provided SUMS Do not use for International Mail • vosru SERVICE (See Reverse) Obi Sent to � � Q L Street and � t .,State and IP Code 1 I O Ili nnn OCO Postage co E Certified Fee J� 8 U LL Special Delivery Fee rn a e�triLn4�Cd�De,—f vte��y I�e I eW541RtcipLRt owing to-Whom&Date Delivered O Return Receipt Showing to Whom, Date,and Addressee's Address TOTAL Postage &Fees p�A• 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). 1 Z 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 j your rural carrier(no extra charge). Cr S 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return c.) address of the article,date,detach and retain the receipt,and mail the article. L 3. If you want a return receipt,write the certified mail number and your name and address on a return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT REQUESTED adjacent to the number. C 4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, M endorse RESTRICTED DELIVERY on the front of the article. I—= 0 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If LL return receipt is requested,check the applicable blocks in item 1 of Form 3811. W a 6. Save this receipt and present it if you make inquiry. 105603-93-13-0218 i The Town of Barnstable AHa�TAffi� Department of Health, Safety and Environmental Services i D • ib39• �' Public Health Division � 367 Main Street,Hyannis,MA 02601 Office 508-790-6265 Thomas A.McKean FAX 508-775-3344 Director of Public Health October 25, 1996 William Schortman 72 Broadbrook Road Broadbrook, CT 06016 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 17 South Wind Circle, Centerville was inspected on October 21, 1996 by, 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 State Sanitary Code were observed: 410.552: The self closing device is missing from the side entrance storm door. 410.500: The ceiling in the kitchen/livingroom was water damaged and water was found inside the globe of the kitchen light fixture and also inside the kitchen cabinets. 410.500: The ceiling area above the bay window in the livingroom was water stained and dripping water. 410.500: The ceiling in the masterbedroom was water stained due to a past leak. 410.500: The ceiling in the child's bedroom was water stained due to a roof leak. 410.500: There was mildew on the ceiling in the bathroom. 410.501(A): The window in the bathroom had a cracked pane of glass. 410.501(A): The storm window on the left side of the masterbedroom had a cracked pane of glass. 4 J 410.501(A): The rear window of the masterbedroom was missing a pane of glass. 410.501(A): The storm window frame of the livingroom bay window was not tight against the window frame on the left botton edge. 410.501(B): The side entrance door was not weather tight as there was a large gap between the left side of the door and the prime door frame. 410.500: The threshold for the side entrance door was loose. You are 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 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 T E BOARD OF HEALTH Thomas A. McKean Director of Public Health cc: Bob Pavello 2 a 6 /V/9 0roo..)b rwel C7- 0 6 o 14" NOTICE TO ABATE VIOLATIONS OF 105 CMR 410,00, STATE SANITARY CODE lI MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN Oh BARNSTABLE RENTAL ORDINANCE ARTICLE 51 The property owned by you located at I-) ?0,.-kIL)k � 0'1 /was inspected on t by N 2P Health Agent for the Town of Barnstable because of a complaint. I,he following violations of the Town of Barnstable Rental Ordinance Article 51 and the Sanitary Code If were observed: �C i�► deoice is vh(sj fmo r1 b^ t v1 d oo P- -rev wu �.e cer l�n r� {�tFeOepti �lr yr �- r- /tL-PrS r� s,de k��,- JP oil V(0, ,--C)o �"�,2 cat rc.� a�H- ems ,¢ ev- MaS y/v, 500 �� der(,�.. t-v; � ".`/,d ``S'yl(�. sot (4) me)oLD t,, 4C-e. Wo. Sol(lq) `j ke_ S40r m v l e- sro�p o� f W &�-azk cd Pare C9-f- 0 Lis �iy�{e/i �ee/az7dvr Cc�Q.s' VYt�SS(4110, 5 a r(w) '�"lz e r��v w c�ow o-( a Pa ©vie lE Lh-, eon /elf 9(d e a-r 4-4 e abe.- 4-4 %o y�e, soo Tom. M�-,ti/,,Q b�, 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) days after the date order is received. However, these violations must be corrected regardless of any request for a hearing. I'lease be advised that failure to comply with an order could result in a fine of not more (liar, $5oo. Fach 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. 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 FORM3o HOBss&WARREN,INC.NOV.1979-1983 THE COMMONWEALTH OF MASSACHUSETTS / '7; BOARD OF HEALTH CITY)TOWN o DEPARTMENT`�t °t ADDRESS �y Jr/C( TELEPHONE /� ' � nCIO Gl/ f Address 7-)U �rLli} 1 �rN' � Occupant �� "� � / Floor Apartment No: No.of Occupants No.of Habitable Rooms No.Sleeping Rooms �— No.dwelling or rooming units No.Stories 1 Name and address of owner II /�, /// n�r(�,ve-41, )j 124 Remarks Reg. Vlo. YARD Out Bld s.: Fences: / Garbage and Rubbish Containers: Drainage Infestation Rats or other: , STRUCTURE EXT. Steps,Stairs, Porches: � ,A, , rr., , , Dual Egress:and Obst'n.,: 40 �,, �)� ,r r A(i r• r,>L /,� ❑ B ❑ F ❑ M Doors,Windows: C_t�r1 l . �` ;ya , Roof .�r -C.�tr I to Gutters, Drains: Walls: - Foundation: S.0 t.,tr L0 A V-r1n Chimney: Y I/a(1/ ) �� •.r _(. L L .I BASEMENT Gen.Sanitation: ^1^, A,f f Dampness: Stairs: Lighting: tr k Aj " STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: YV -A Hall Windows: C HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair .. C7F'1 r K4,4_ ttl, E-T &7 jf r r TYPE: Stacks,Flues,Vents: PLUMBING: Supply Line: l) ❑ MS ❑ ST ❑ P Waste Line: T V a t5 - I H.W.Tanks Safety and Vent s /"1 , , /_ , ) .✓ r c%/;.��' . `�� ,ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: ,rr, c , r i. Gen. Basement Wiring: r ,,,tArO Ok4A-)) — ` ; 77v6 ,- Toex j-ir DWELLING UNIT . Ventil. L to . Outlets Walls `,-ails 5 /Wintl. 906orr§r Flo"ors Locks Kitchen Bathroom 6- Pantry t v , Den `/�1-G"rlr._C� 77TO Living Room Bedroom 1 " 7 a ,�,. 6 ,r n 10 A .,4 C 7 Bedroom 2 C �i 22 G �— /h Ya`, Bedroom 3 / , Bedroom 4 --, `.i' (7 Hot Water Facll. Sup.Ten.,Gas,Oil,Elect.: ,Jo �, ;�,- ,,,,,rn, 1 Stacks,Flues,Vents,Safeties: i Kitchen Facilities Sink Stove Bathing,Toilet Facil. Vent.,Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats Mice Roaches or Other: Egress Dual and Obst'n: General BuIldina Posted , Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY." INSPECTOR�/'"'w1 " /- /G� TITLE t1 ull --�VIi�2� 1 >r A.M. '- -. DATE / � / / TIME P.M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. y 410.750: Conditions Deemed to Endanger or Impair Health or Safety r The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of these items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.000 through 410.499 state minimum requirements of fitness for human habitation, any violation has the potential to fall within this category in any given situation but may not do so in every case and therefore cannot be included in this listing. Failure to include shall in no way be construed as.a determination that other violations may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of the violation(s) pursuant to 410 CMR 410.830 through 410.833 nor shall it affect the legal obligation of the person to whom the order is issued to comply with such order. _. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 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 105 CMR 410.450 -and 410.451. (H) Failure to comply with the security requirements of 105 CMR 41b.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. (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health -or 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. Health Complaints 24-Oct-96 Time: 11:00:00 AM Date: 10/21/96 Complaint Number: 494 Referred To: CHRISTINA KUCHINSKI Taken By: L.S. Complaint Type: CHAPTER II HOUSING Article X Detail: Business Name: Number: 17 Street: SOUTHWINDS CIRCLE Village: CENTERVILLE Assessors Map-Parcel: Complaint Description: COTTAGE CEILINGS ARE LEAKING ALL OVER THE HOUSE. HE HAD A WIRING INSPECTOR THERE ALSO. HE IS A TENANT AND THE OWNER IS NAMED BILL SHORTMAN WHO CAN'T BE REACHED . THEY HAD TO TURN ELECTRICITY OFF. CHRIS WAS BEEPED. Actions Taken/Results: CK observed water damaged/stained ceilings in dwelling unit and other housing code violations (see file). Order to correct sent to landlord. Investigation Date: 10/21/96 Investigation Time: 1:25:00 PM 1 ] PAR- ] Real Estate System - General Property Inquiry] Help [ ] Parcel Id: 226 159- - Account No: 13672 Parent : Location: OFF CRGVLE BCH RD CENT Neighborhood: 46AD Fire Dist : CO Devel Lot : 3 Lot Size : . 14 Acres Current Own: SCHORTMAN, MAXINE R State Class : 104 72 BROAD BROOK RD No. Bldgs : 1 Area: 1350 Year Added: BROAD BROOK CT 6016 Deed Date : 070196 Reference : 10323174 January 1st : SCHORTMAN, WILLIAM A Deed MMDD: 1085 Deed Ref : 4735/001 Comments : Values : Land: 53000 Buildings : 76000 Extra Features : Road System: 17 Index: 1923 (SOUTHWINDS CIRCLE ) Frntg: 84 Index: ( ) Frntg: Control Info: Last Auto Upd: 090896 Status : C Last TACS Update : 090596 Land Reviewed By: Date : 0000 Bldgs Reviewed By: Date : 0000 Tax Title : Account : Taken: Account Status : Hold Status : Cancel [ ] Press XMT for more data Next screen [PAR ] Action [ ] Owners Name [ ] Road Index [ ] Road Name [ ] Parcel Number [226] [160] [ ] [ ] [ ] 1 d SENDER: M ■Complete items 1 and/or 2 for additional services. I also wish to receive the rn ■Complete items 3,4a,and 4b. following services(for an H ■Print your name and address on the reverse of this form so that we can return this extra fee): a) card to you. ai 4) ■Attach this form to the front of the mailpiece,or on the back if space does not 1. El Addressee's Address d permit. d ■Write'Return Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery to « ■The Return Receipt will show to whom the article was delivered and the date a delivered: Consult postmaster for fee. 0 3.Article:Addressed to: 4a.Article Number d '. C )_ `Z 3 -? G m c� t O c omen E 4b.Service Type. ��`- (`pGa� (00 p Rege?frd Certified C ❑ Express Mall ` .` ..".. ❑ Insured E- / ❑ Return Receipt for Merchandise ❑ COD 0 0 i CP 7.Date of Deliv ry 0 1 '9:, :. 0 ILMU 5.R cei d : (P ' ) 8.Addressee's Address(Only if requested A and fee is paid) t Signa re- (Ad es or t ~---MPS Form 3 ' B " f`nber 1994 Domestic Return Receipt I-1 . 11ea1th Department, ; Town of Barnstable. 0 0,Box 534 riyannis,MassachusefSs 02601 Fax(50$)775-3344 F,.;one(508)790-6265 xoq sigl ui apoO dIZ pue `ssaappe `9weu anon(IuPd of-E.oN l,.- pied seed e6 �o Not'Pr®ce�s On Automated Equipment A I I!BV4 SSel' LOCATION SEWAGE PERMIT NO. G fZ V"%\�-e L9' " # 3 YIL GE INSTALLER'S NAME i ADDRESS I R UILDE R OR OWNER 1 e DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED 1 ;00 5.4 Avvk a � 7r' ®icr I AWw- —14 '�� W ��V t fi�� Q if fw L G`4p Qvtc,)x-ce*� .`i •1 cv y�J No......`a�a.:. nci F>cs!...:� r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r .. ...... ...............OF..... !rw.5 . . ................................... .Appliration for Uiopooal lVorkii C ontitrur#inn ami# Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: etc' �`t� �r a��+ ----• ...............................AA�.----......-•-•- -...-•-•-.•...... \ (� Location•Add r ss D —y or Lot No. 1 ......... l4bL LZ.1GXa_... �2.� �w.. -�!�_� T. .^�i t........... f....: J.�.�. ..ln �..... /... 108 h =1 ` Ow *� Address a �se :o.IQ.P� o e ................. . ........13 aS a�+ +.C.S......F to T 1r�• Installer Address dType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms____._____................................Expansion Attic ( ) Garbage Grinder ( ) 04 a Other—T e of Building No. of persons____________________________ Showers — Cafeteria a' Other fixtures __________________________________ W Design Flow............... ................gallons per person per day. Total daily flow_______k4'' ...................gallons. t� Septic Tank—Liquid capacity(. Qt?gallons Length_: _�__�_._ Width._�.4�_____._ Diameter_________________De th______________.. xDisposal Trench—No. ____�.............. Width___.S_........... Total Length....�:5__�__._ Total leaching area....... 7_._sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet_;_._.._......._.__ Total leaching area..................sq. ft- Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-•---------------------------••-----...------•----•---•..._......•-•---_. Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ L% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ C4 ...................................................-•.......................... ....... ---........................................................... 0 Description of Soil........ ..........1;;L _______�. v`- r............................................................. ------•--•---•- ------------ ----------------------------------------------•----••---•-•-..._..---•••-------- ---- --- .. U Nature of Repairs or Alterations—Answer whe applicable._____.1_ ......�}(, n..... `c `fan ............ �J --------•------------&--:5......... T n-1;� '.,5................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with _ the provisions of iITL% 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Complian bee�Ith(�boar of healtSigne �. 3.�'� Date Application Approved By............ .-- -•..............•...------...----- Date Application Disapproved for the lowing reasons:.............................................................................................................. - .................................•----•-•---••••-•--------••---•-•-••--•-••-----.........._._......_._.....•••-•-••--•---•-------------------•--•-•----•----•------••--•---•••---••-•----•••--•••-------- Date PermitNo.......................................................... Issued....................................................... Date No....... `.,z_._Sc°L -Fes$ . ........... _`. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r+ .� lirttti�art fur jBispusttl Works Tonstrurtiun Vrrmit Application is hereby.;made for a Permit to Construct ( ) or Repair (' an Individual Sewage Disposal <1 System at: .t.a:.... v 06^ ...... ................................:* -�►... .................................. j Location-Addre s b or Lot No. �y, y� .Gd : .^. :l f .............fit..4....:W..�r d...�.�4�!..rt. Ow Address G r" ,�-�_+ .�p_s .> .!? ..+( ' �Ca• ,' . -----....-- t �� r ° .."� y . My ...... .......................................... q. Installer Address Type of Building Size Lot............................S feet Dwelling—No. of Bedrooms.......................a....................Expansion Attic ( ) Garbage Grinder ( ) C4Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ... -------------------------------------•---•-..-•--...--•---------.....--------------•--•... ------------------------------ p q r .. gallons per person per day. Total daisy flow....... "" gallons. L' 4 Septic Tank—Liquid Design Flow.._.... � capaclty��Callons I�ength...�..�:...... Width..�s?_........ Diameter.............:.De th ...._..._..... �[ Disposal Trench—No. .............. Width....tk........... Total Length....49. ..... Total leaching area... ---sq. ft. r; Seepage Pit No.............. Diameter.................... Depth below inlet.................... Total leaching area.......... ft. r ,� Other Distribution box ( ) Dosing tank ( ) 0.4 Percolation Test Results Performed by-----•-•......................................•----........ ......... Date........................................... Fy Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water......................... L'4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....... Cd ..................................................... �� Description of Soil.......... .j1 st_ a ra s� x. • ...:. '----- �aC-4, its:�r............................................................. C� -- ----------- -------•--................-•--•---------•---------------•....-• .........................•---•----•---•--.-• --.....---------•----........_:........----.._..... ►4 .................................................................'---.._.........._._....._.._.......__ j Nature of Repairs or Alterations Answer whe applicable - .;�.. ........... ..... ram►. .. :. ............................... : The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate.of Complian s e"�en is�ueEi.,, e, oard of healtli. ' c,,.�.R. . . _. Signe Applicatio&,;—p proved By....- . . .. ........................................Hate - --•• - -- ..---•----•--...... Dat s e Apphett'on Disapproved for the f l owing reasons:_.... ............... ..... ..................... ......... ....:..........._.._ r ... ':.................................................... ._ .............................. .. i �Ftit�. Date-------------- U -..... --..... Issued: Date _ THE COMMONWEALTH'OF MASSACHUSETTS BOARD OF HEALTH" F ..........................................OF..................................................................................... Trrtifiratr of (aumplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired,) by•---•----•--------------. .....----••-•----•.....:_ ------.......-----•-•----•----------------•--•-----•--.....................-•--•---......................................---.....:_......-•-- Installer at--- .................•-• . --........----•--•---------•-----••----•----•-•-------•• ---•-----.............--••---•-•-----.....----•••-•--.........--•-----...... ..------....._---••- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the i aplcation for Disposal Works Construction Permit No.__. .' ................... dated-----e 2•-�+.................. j ._ .... ' .THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A"GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.............. . 4 ................................ Inspector..... ... D-fs /AACj JEVGjtvrj R Kj vs FRI florria 14. ��c�+J6 1 F f THE COMMONWEALTH OF MASSACHU$ST�So t•v64 OV foL4ty TO LpNAr'*�pN$ 1''��,�^t 9�Vwo fj��// S tr' ►� BOARD OF HEALTH cJTItl c� V 21 A Nc�E © I`� L. ----- !�, � ..................OF.................................. ............................................. No.........�......... Fzz _ .: ...... . 3 tffp.ansttl irks Taustrudilan Vrrmi# Permission is hereby granted � 11�.. 1�S?� .I?. .. to Construct ( ) or Repair QC) an Individual Sewage Disposal System at No �1 1 S..c'?t1 .!L Le�la�!! ........-----------------••-- - .....-•---........ ..... ._ . ..-•--- Street `z S'_es Ca as shown on the application for Disposal Works Construction Permit No. ted:.. ......J.. .................. 66aof Health`. DATE..................61........................................................... .,� .. FORM 1255 A. M. SULKIN, INC., BOSTON UPPER CAPE ENGINEERING COMPANY 7 FERN AVE. E. SANDWICH, MA 02537 617.888.2027 SPECIALIZING IN: SITE PLANS SEWAGE DESIGN SUBDIVISIONS HOME INSPECTION PERCOLATION &SOIL TESTS Sept . 24 , 1985 Barnstable Board of Health - Town Hall Hyannis , Mass . R . E . Harold Moore The septic system designed by this company was installed by Capeland Construction in accordance with the plan with the addition of a vent at the distal end of the trench . Ta ou hn Jacobi 8 0. ----�/Z...... # _fir FES �.eQ�............. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH .............Town..................OF..............Barnstable Appliraiion for Mipviial Workii Tomitrurtilan Frrmit Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: 19 South Winds Cottages, Craigvi-lle. Beach Rd. ...Centerville .y...............---•----•---..t............... ..... ..............--••------•--------............-•-- hili ernick Location-Address or Lot No. Philip W -...................................•-•...----------•---------------•-- 4 5 C lie land Rd........Chestnut Hi Hill Own r Address a A & B Cesspool Servfce 128 Bishops_Terracg, Hyannis Ma,_____ Installer Address y Type of Building Size Lot................. .........Sq. feet Dwelling—No. of Bedrooms___..._....................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons__..._._.3................ Showers — Cafeteria Q' Other fixtures -------------------------------- . 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 ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water-____-__----__-_--_____. Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ ------------------------ ---- ---------------------------------------------- ......... •--•----........................ .........-----•----•--- •--.----------- 0 Description of Soil.....Sand-------•-••---••--------------•---•-----••---......---••------------------------------------------------------------------------------------------•--- x V •-•-------------•-•-------------------------------------------------------•---------...........--------------------------------------------------------------...----------------------------•-•--------- -------------------------------------------------------------------------------------------------------------------------........................................................................... U Nature of Repairs or Alterations—Answer when applicable__Instal.1.ati-on---of---2....(twa)-----------------_---__. Flowdif_fus.oxz..pan.kad._with---extra---aton.e..-----------................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iIT1.;,;, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued e b he igned.. ............ --- ........................................... -912-147.8------•---- Date Application Approved BY li .. 'ff::::......-- ---------9-/21l78----------- Date Application Disapproved for the following reasons:................................................................................................................ ----•---•------------------------------------------------------------------------------------------------..------------------....-----------------------------•--•.•---•---•.•---.... -----•---•--•- Date PermitNo......................................................... issued------9/2i1"?8............................. Date 0' ... ..................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town OF..............1!.arnstab Le........................................... .............................. ............................... if 'Appliratiou for Disposal Works Toustrurtion "rrmit V Application is hereby made for, a Permit to Construct or Repair (X) an Individual Sewage Disposal System at: I . I lQ South-xinds Cottages ,...g�.K�ti -ville Beach Rd . . Centerville ............;_............................................ ...6................ ................................................................................................ Location-Address or Lot No. Phil J_b:_-Werfi-ick 45 Olveland Rd . , CheStniit �:" a ... .......................................................... .....................................................I...................... s A & B ZeSSP001 Ser`VTce! 128 BiehOPS Terrace, Hyannis .................................... ................................................................................ lia :7 J......................Installer Address Type of,Building Size Lot........................,...Sq. feet Dwelling—No. of Bedrooms.:__.._._...2..............................Expansion ttic Garbage Grinder Other—. -Type of Building ............................ No. of persons_______.______________..._._ Showers Cafeteria P-I Other fixtures ......................................................................................................................m............................... Design%-•_Y,Gi.__".,.,.......................................gallons per person per day. Total daily flow..__._._________.____...______:: .._.___gallons. 1:14 Septic Tank—, Liquid'capacity............gallons Length________________ Width__.__.._.___._.. Diameter.___...__._.____ Depth._..___.___._... W — 7,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 Percolation Test Results Performed by- ______________________________________________________________--- Date__ __:__ ................... TeS't-Pit No..,1................minutes per inch �Depth of Test Pit______._________.___ Depth to ground water........................ Test,Pit;lNo.;.2......_..........minutes per inch Depth of Test Pit____________________ Depth to ground water........................ ........................................................................................................................................"-------------------- 0 Description .................................................................................................................... .... U .............................. ......................................................................................................................................................................................................... ........... ........................................................................................................................................................I------------------------------------- U Nature*,.6'f Repairs or Alterations—Answer when applicable-.ins-t-al.1-a-ti-or,....nf_2---f.txo.) Flowd1ffigpors...pp�ked...3M.1-11-4 Ile Ir ------------ a ....e Xt.r a...$10A ............................................................................................ Agreement: The'-undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions'of TME 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued e he 22/7 igned.. .... ............. . ........................................... ...1)j--- R........... D to Y F3A�ApplicationApproved PY................... ..V................ ............... . ....I............... Date Applicgti.o.' Disapproved for the following reasons:................................................................................. ...........;............................. ................................................................................................................................................................................ Date Permit,No.-........................................................ Issued.....91Z.... .......................... Date, THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH own B 0 F............Arn.-5.t4b.1P................................ .. ..................................... Tntifiratr of Toutpliaurr THIS JSJO'CERTIFY, That the Individual Sewage Disposal System constructed or RepairedL X) b 4.,fJess,pool Service , 128 Bishops Verrac.a, Hvannis ............................................................................ .............................................................................................. Ipla 19v.t6iAli W�inds Cottages , CraigVi-fte Beach Rd . , Centerville. at...........T."..'r.........................................................................................................................................................�r........................ has been.k�4kalled in accordance with the provisions of TIR-13 ' f Th State Sanitary Code as described in the ..g ....I.....a ................... applic�a.tio,nfdr.'I)i.sposaI Works Construction Permit No.0-11----- -1 _ ----- -- -----t ME. -- OF THIS CER�IFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE,THAT THE SYSTEM,VILL.FUN ON 16ATISFACTORY. ............7 _91 Inspector..... ............................................................................ t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 35 00 78' ......T.ow.n....................OF............R.arn............s.ta.........b.lj.................................................. ........ .. AmFEE..._._...__............. .t _ Disposal Works Clustrudivit rerntit Permission is hereby grantedk & R Cesspool Service,,... I:Ier......... s R i s h 0 DS =............................. it to Coftkruct'(., or Repair an Individual Se-,�,age Disposal System q9"South ;Minds Cottages , Cralgvilj'e Beach Rd . , Centerville atNo.t......................................................................................................... ---------------------------------------------------- ............................. Street ( 0- as shownon the application for Disposal Works Construction. BurnutNo-----------4...... D ated-.9- -------- ........................ ................................... .... Board of ]Vpdth D. ...................................... I.RM .1, BBS 0 WARREN, INC.. PUBLISHERS _ ,•^^<"'�'..°. ..,r„ ..�.a.-,...,,F•r.• +'Y. 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