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0001 BETH LANE - Health
t � v 1 { eth Lane 44 273-200 Hyannis i oc UPC 17734 No` 2 eta,. NASTIN09.UN 0 1 u j i TOWN OF BARNSTABLE LOCATION 1 -� d. n-.<_, SEWAGE# VILLAGE ASSESSOR'S MAP.&PARCEL INSTALLER'S NAME&PHONE NOde�.aaeJ" c Q SEPTIC TANK CAPACITY "( Off �, - LEACHING FACILITY:(type) �,.� -e „r,,t ��,(size) S n, Z�x NO.OF BEDROOMS a OWNER ' _. PERMIT DATE: Co( ot 3�1 �_ COMPLIANCE DATE: /O Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on, site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED Byz•+• WZ ���,�,L.. n� �c�lJs `e t _. ® 4 �� � v a3,6 .� � � as � 1 a o � o � � ��,��, � a � � ,. ® � Y 1 1, �� l r `�` No. Fee OU THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 1 O Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS y 01ppYication for Disposal bpstem (Construction 3permit Application for a Permit to Construct( ) Repair( ) Upgrade( /Abandon( ) ❑Complete System Wndividual Components Location Address or Lot No. li Q7E—\r,., `—.=.,.t!� Owner's Name,Address,and Tel.No.S�`�' 63-� kcT Assessor's Map/Parcel a-7 44 Z Installer's Name,Address,and Te.No. SZ7SK- "J Des!Yner's Name,Address,and Tel.No.Sb�'= Type of Building: /�— Dwelling No.of Bedrooms Lot Size .. I G 4QPC.Jq.ft. ` Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required)t Z 3 (n gpd Design flow provided 3 Y�% gpd Plan Date Vd e) (3 Number of sheets Revision Date Title Size of Septic Tank C7 �o� 1+ Type of S.A.S.Cc'�vg-- C. GV.t��,�,GJ'j Description of Soil 4a V;PQae,� Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Si ne Date `v Application Approved by Date Application Disapproved by Date for the following reasons Permit No. 2-0 13— y/2 Date Issued POW ^No. 3 ' I / - _ Fee /6U THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yam% O PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS es Yitation for -Mis osar & stem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade(,—.Abandon( ) ❑Complete System []Individual Components Location Address or Lot No. L.bw Owner's Name,Address,and Tel.No.,�Z-`�63-b X4 �2- Assessor's Map/Parcel vZ C I c pvti �tom. . Installer's Name,Address,and Tel.No. S©"Z—"� '-�75 S Designer's Name,Address,and Tel.No. J;:�a Type of Building: --.5� A_ Dwelling No.of Bedrooms Lot Size .. , (.�rC q.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) h - s- Other Fixtures Design Flow(min.required) gpd Design flow provided ? gpd Plan Date (� ( ( ( '� Number of sheets Revision Date r i Title Size of Septic Tank CD , Type of S.A.S.Qc v-C Description of Soil �..✓� Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Si a Date i Application Approved by , n4 -01 'Date Application Disapproved by Date for the following reasons Permit No. ..U 13 L/%2 Date Issued i - •. TI F;COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded(� Abandoned( )by at has been constructed in accordance t: with the provisions of Title 5 and the or Disposal System Construction Permit No..),u/3- V,,2 dated 104,711.7 i Installer Designer #bedrooms l c Approved desi flow 330 1 gpd " The issuance of this permits all not b cons ed as a guarantee that the system will fiction a designed C) t /�� Date /0 //o Inspector �f (,� - �Y�• I r /111 P - ------------ -----/------- ---------------------------------------------------------------------------------------------------- No. )-U ( � I 2. Fee l UU THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Disposal *pstem Construction 3permit Permission is hereby granted to Construct( ) Repair( ) Upgrade(� Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit.f Date I o ? // ? Approved by .,. L a o,o DEED RESTRICTION Whereas, Wells Fargo Bank,N.A., a national association duly established under the laws of the State of Delaware;is the owner of property located at 1 Beth Lane, Hyannis, Barnstable County, Massachusetts,by deed dated July 12 2012 and recorded in the Barnstable County Registry of Deeds on November 16, 2012 in Book 26860,Page 189, said land being shown on the Town of Barnstable Assessor's Map'as Map 273,Parcel 200, and more particularly described on Exhibit"A".attached hereto and incorporated herein. Whereas,Wells Fargo Bank,N.A., as the'owner of said Lot, has agreed to a restriction as to the number of bedrooms which can be included in any'dwelling existing or constructed in the future on said Lot-as a pre-condition to obtaining,a permit for the installation of a new septic system; ' Whereas, the Town of Barnstable Board of Health, as a pre-condition to granting the permit a; for the installation of a new septic system iri accordance with 310 CMR 15.000: The State Environmental Code,Title 5, is requiring that the agreement for the restriction of the number of bedroomsin any dwelling existing or to be constructed on the Lot be put on record with the Barnstable County Registry of Deeds by recording this document. Now Therefore, Wells Fargo Bank,N.A. does hereby place the following restriction on the above referenced land in,accordance w16this agreement with the Town of Barnstable Board of.Health,which restriction shall run with the land and be'binding upon all successors in title: , ^0The property located at 1 Beth Lane, Hyannis,Massachusetts, and described on the attached Exhibit"A",may have a dwelling,containing no more than three (3)bedrooms. Wells Fargo Bank,N.A.;hereby agrees that this shall be a permanent deed restriction affecting the above described premises. } w FOR TITLE, see deed recorded with the Barnstable County Registry of Deeds in Book ' 26860, Page 189. WITNESS the execution by said national association this--"") day of 2013. W is Fargo Bank,N.A. By: am A�QQW _ \ Title: STATE OF TEXikS County of On this c� day of 2013, before me, e undersigned notary public,personally appeared the within named L�.fq M't'r , to me known and known by me to be the/a/an of and the person executing this instrument, and acknowledged tome that he/she executed it on behalf of Wells Fargo Bank,N.A. as the free act and deed of Wells.Fargo Bank,N.A. oq� a P-MM W0 OTON(a Notary, b is amWwcn Number 763568 ° -My Commission cif o� June 21,2016 My Co fission Expires: J� � Exhibit«W' Property description' The land, together with the buildings thereon,-situated in Barnstable (Hyannis), Barnstable County Massachusetts, bounded and described as follows: Containing 15,586 square,feet of land,more or less, and being LOT 51 as shown on a plan entitled `-`Plan of Land in Hyannis, Barnstable, Massachusetts for Cape Investment Trust," dated January2, 1973 recorded in the Barnstable County Registry of Deeds in Plan Book 271,-Pages 83 and 84: r STABLE REGISTRY OF DEEDS Town- Of Barnstable �.� Regulatory Services Thomas F.Geiler,Director ' BARNMBM Public Health Division MASS Public � _Thomas McKean,Director 200 Main Street, Hyannis,MA, 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: ' n Sewage Permit#�c� =4j Q Assessor's Map/Parcel 73/_;2c> Installer&Designer Certification Form Designer: S,Q rnftaller: .. .F Address: Qe\ Address: 'VP..<�-- 0l.4 on G a 3 3 t��„ �a�;'Yr" V_qm;L�was issued a permit to install a (date) T�(installer) septic system at I bt-N.. u. VA'N v►n n t s - based on a design drawn by , (address) pin dated J n, k.6 77-., ° (designer) I certify that the septic system referenced above was.installed substantially according to the design, which may.include minor approved changes such as lateral relocation of the distribution box and/or septic tank:', Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation.of the SAS or any`vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer,to,follow. Stripout(if required) ected and the soils were found satisfactory. FA ,o UNDA J. G Ppf (Installer's Signature) v C Vy' P _ " - �e ( n (Designer's Signature) (Affix Desi r.. � Here) PLEASE RETURN TO BARNSTABLE PUBLIC,HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH- THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. q:\officeforms\dcsignercertificationforTn.doc ',; Town ®f Barnstable r �pb Department of Regulatory Services SAMSTABU& Public Health Division Date MARS, 200 Main Street,Hyannis MA 0260 Date Scheduled_ a, Ti me I' '€ ✓ p.-. ee Pd. 6 Soil Suitability Assessmentfor Se Dis os b Performed By: Witnessed By: LOCATION& GENERAL EVI ORMA,TION Location Address 'Owner's Name Address VAC Assessor's Map/Parcel: � �'X'� Engineer's Named cQ� � NEW CONSTRUCTION REPAIR Telephone# 1,25/7 �O �� Land Use.-_ V t8 l a to A ASV I", Slopes(`fo) � � 'VLb .Surface Stones `�,O__ Distances from: Open Water Body it 'Possible Wet Area NIA .ft Drinking Water Well �ft Drainage Way N i/1 ft Property Line ft Other ft SIaTCLIs(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands(n proxintity to holes) TP- 'L 4: ry 1..-�t1►-�5 c cis cx� „ e Parent material(geologic) I GIGt(a' 1)4A ash Depth to Bedrock > 00 1 Depth to Groundwater. Standing Water in Hole: Y�' Weeping from Pit Nee Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL,IIIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: lu, Depth to soil mottles: ln. Depth to weeping from side of obs.bole: Ill. Groundwater Adjustment ft. Index Well# Rcading Date: Index Weil level Adj.factor- Adj.Groundwater'Level e IERCOLATION TEST watt Zl `liana_ %bDarn Observation A Hole It � 'CLne at 9" Depth of Pere tt Time at 6" Start Pre-soak Time @ ,OO Time(9"-6") End Pre-soak �ti 00 I.RateMin./Inch L m`� ck Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) f] Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Consel;vatiou Division at least one(1) week prior to beginning. Q:\S EPricwE1tCFORM.DOC DEEP-OBSERVATION BOLE LOG Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Molilia g (Structure,Stones;Boulders. onsistencv.%Gravel) 01 A (11 LS I -71z S- ►o �' F LS o 2 L I.-S a `i fz. S/fir )S- 13o C , M -C sw)j !u DEEP OBSERVATION HOLE LOG Mole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsisten %Gravel) 0 A -M L S l0 '9 LS o Iz C1 - 30 13 I_S t o `I 2 sl - DEEP OIBSERVATION MOLE LOG Bole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,.Stones,Boulders. Can i tc c .O c i - DEEP OIBSERVATION DOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color 5o11 Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, 6 ciravell a Flood Insurance Date Map: ` Above 500 year flood boundary No_ Yes Within 500 year boundary No '+ Yes Within 100 year flood boundary No v Yes _ Depth of Naturally Occurring Pervious Material d Does at least four feat of naturally occurring pervi us material exist in all areas observed throughout the area proposed for the soil absorption system? e•S If not,what is the depth of naturally occurring pervious material? Certification l I certify that on J 04 1,0011 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required rai ing,expertise and experience described in 10 CNM 15.017. Signature ` Date b ( 3 Q\SEPTIC\PERCPORM.DOC • *Town of BarnstableBarnstable ��z�Teti Regulatory Services Department AllAm e9`aCity ``'R Public Health Division � D• Public 200 Main Street, Hyannis MA 02601 2007 SECOND NOTICE Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2851 0886 October 15, 2013 Wells Fargo Bank,NA 4101 Wiseman Boulevard San Antonio TX 7825.1 RE: 1 Beth Lane, Hyannis ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE. TITLE 5 The septic system located at 1 Beth Lane, Hyannis MA was last inspected on.2/03/2013 by Mark Poselli, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines. of 1995 TITLE 5 (310 CMR 15.00) due to the following: • System is in hydraulic failure. You are ordered to repair/replace the septic system within sixty (60) days from the date you receive this notification.. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OFT BOARD OF HEALTH a l3 Thomas McKean, R:S. CHO Agent of the Board of Health i Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\I Beth Ln Hy Mar 2013.docQ:\SEPTIC\Letters Septic Inspection Failures or Future Eval\l Beth Ln Hy Mar 2013.doc *Town of Barnstable Barnstable �, r - "°� Regulatory Services Department 1 e``aCitv HAM BAjWSrA8L& Public Health Division �• FG MAI a�� 2007 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2843 9217 June. 10 2013, 2013 . Wells Fargo Bank,NA 4101 Wiseman Boulevard San Antonio TX 18251 RE: 1 Beth Lane, Hyannis - ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE. TITLE 5 The septic system located at 1 Beth Lane,..Hyannis MA was last inspected on 2/03/2013 by Mark Poselli, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: r • System is in hydraulic failure. You are ordered to repair/replace the septic system within sixty (60) days from the date you receive this notification.. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean,R.S. CHO \ � Agent of the Board of Health 9, t Q:\SEPTIC\Letters Septic Inspection Failures or Future Evahl Beth Ln Hy Mar 2013.docQ:\SEPTIC\Letters Septic Inspection Failures or Future Eval\I Beth.Ln Hy Mar 2013:doc i �I •. f - Town of Barnstable Barnstable Regulatory Services Department A&AmW=Cft + tAMSTABI�. • I MABB. Public Health. Division FD MAI �� 2007 200 Main Street, Hyannis MA 02601 Office: 508862-4644 homas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO p CERTIFIED MAIL# 7012 1010 0000 2843 2188 March 14, 2013 David Holt ,Today Real Estate 487 Station Avenue South Yarmouth, MA 02664 RE: 1 Beth Lane, Hyannis -^ ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE.'TITLE 5 The septic system located at 1 Beth Lane,Hyannis MA was last inspected on 2/03/2013 by Mark Poselli, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Fails" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • System is in hydraulic failure. You are ordered to repair/replace the septic system within sixty (60) days from the date you receive this notification.. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE OARD OF HEALTH McKe R.S. CH s O Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\I Beth Ln Hy Mar 2011doc Tow ofBarnstable Barnstable ` J v��oFr °h o L L Al Amedca City Regulatory Services Department li IARNS'rAQLE, : - 7 .�. , �• � MASS. 0 Public Health Division 1639. DMa�A 200 Main Street, Hyannis MA 02601 2007 ,S10 - Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Certified mail 7006 2150 0002 1042 1054 Samuel C. Traywick P.O. Box 216 West Hyannisport, MA 02672 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000 STATE SANITARY CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you located at<1`;;Beth°Lane,Hyan—i!Wwas inspected on August 21, 2008 at 10:05 a.m. by Thomas Perry, Building Commissioner, Robin Giangregorio, Zoning Enforcement Officer and Jaime Cabot, a Health Inspector for the Town o p P f Barnstable. This inspection was conducted on the basis of a rental inspection. V�� The.following violations of the State Sanitary Code, 105 CMR 410 and 310 CMR 15.00 Title 5 of the State environmental code were observed: 105 CMR 410.552—Screens for Doors:. No Screen/Storm door was present on the kitchen door. 105 CMR 410.500- Owner's Responsibility to Maintain Structural Elements: Rotten wood was observed on the windowsills, cover missing from electrical outlet. 105 CMR 410.551- Screens for Windows: Screens Missing from Windows. 105 CMR 410.482- Smoke and Carbon Monoxide Detectors; Smoke Detector in basement and first floor hall not working.No carbon monoxide detector in room being used as.a studio apartment on first floor and no Carbon Monoxide Detector in second floor bedroom. 105 CMR 410.480(A) -Locks: No lock on front door of house, building not capable of being secured against unlawful entry. 105 CMR 410.100- kitchen Facilities: Studio on first floor and bedrooms on second floor have no kitchen sink or suitable space to.store prepare and serve foods in a sanitary manner. F , 105 CMR 410.300 and 310 CMR 15.00: There were a total of Four-(4) bedrooms observed in the dwelling. However the existing septic system was not designed for four bedrooms. It was designed for three bedrooms. You are ordered to correct the violations listed above within twenty-four (24) hours of your receipt of this notice by installing.smoke detectors, in accordance with Massachusetts Fire Codes. You are ordered to correct the following violations with in thirty (30) days of receipt of this notice by installing screens on windows designed to be opened, installing.a storm/screen door on the kitchen door, repairing the rotten wood on the window sills installing a lock on the front door to the dwelling and removing the door to the kitchen area You are ordered to.correct the violations listed above within sixty (60) days of your receipt of this notice by pulling any required building permits to restore the property to a three bedroom home. You are ordered to remove the bedroom by removing entrance doors and by opening door-way entrance.to the room to a minimum of five feet wide openings. This will bring the total bedroom count down from four (4) to the appropriate three (3) as designated by your septic permit. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable *Town ,of Barnstable. Barnstable Regulatory Services.-Department ;edtaC ft B' �' Health Division039�- 2007 m Public 200 Main Street, Hyannis MA 02601 SECOND NOTICE Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2851 08,q s October 15, 2013 Wells Fargo Bank,NA 4101 Wiseman Boulevard San Antonio TX 78251 RE: 1 Beth Lane, Hyannis ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE. TITLE 5 , The septic.system located at 1 Beth Lane,Hyannis MA was last inspected on 2/03/2013 by Mark Poselli, a certified septic inspector for the State of Massachusetts. . The inspection of the septic system showed that the'system"Fails" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • System is in hydraulic failure. You are ordered to repair/replace the septic system within sixty (60) days from the date you receive this notification.. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF T, BOARD OF HEALTH Thomas McKean, R.S. CHO Agent of the Board of Health 0 Q:\SEPTIC\Letters Septic Inspection Failures or Future Evahl Beth Ln Hy Mar 2013.docQ:\SEPTIC\Letters Septic Inspection Failures or Future Eval\1 Beth Ln Hy Mar 2013.doc o y TOWN OF BAR 3 xv K : ; -- w 1 CD w I i I a c;L , a �7 `I k .1 4 Y F��r Town of Barnstable "b Regulatory Services Department ;e1C8C j ESARNSrABLE. IMAM r63q•. Public Health Division . �0 ArEDM`Asp 200 Main Street,Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Certified mail 7006 2150 0002 1042 1054 0 Samuel C. Traywick N 0 C.1M*aC0L P.O. Box 216 West Hyannisport, MA 02672 PULA&- NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you located-at-l'Beth_Lan l', Hy nnis',as inspected on August 21, 2008 at 10:05 a.m. by Thomas Perry, Building Commissioner, Robin Giangregorio, Zoning Enforcement Officer and Jaime Cabot, a Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of a rental inspection. The following violations of the.State Sanitary Code, 105 CMR 410 and 310 CMR 15.00 , Title 5 of the State environmental code were observed: 105 CMR 410.552—Screens for Doors: No Screen/Storm door was present on the kitchen door. 105 CMR 410.500- Owner's Responsibility to Maintain Structural Elements: Rotten wood was observed on the windowsills, cover missing from electrical outlet. 105 CMR 410.5517 Screens for Windows: Screens Missing from Windows. 105.CMR 410.482- Smoke and Carbon Monoxide Detectors; Smoke Detector in basement and first floor hall not working. No carbon monoxide detector in room being used as a studio apartment on first floor and no Carbon Monoxide Detector in second floorbedroom. 105 CMR 410.480(A) -rLocks: No lock on front door of house, building not capable of being secured against unlawful entry. 105 CMR 410.100- kitchen Facilities: Studio on first floor and bedrooms on second floor have no kitchen sink or suitable space to store prepare and serve foods in a sanitary manner. Y f 105 CMR 410.300 and 310 CMR 15.00: There were a total of Four(4)bedrooms observed in the dwelling. However the existing septic system was not designed for four bedrooms. It was designed for three bedrooms. You are ordered to correct the violations listed above within twenty-four (24) hours of your receipt of this notice by installing smoke detectors, in accordance with Massachusetts Fire Codes.You are ordered to correct the following violations with in thirty(30) days of receipt of this notice by installing screens on windows designed to be opened, installing a storm/screen door on the kitchen door, repairing the rotten wood on the window sills installing a lock on the front door to the dwelling and removing the door to the kitchen area You are ordered to correct the violations listed above within sixty (60) days of your receipt of this notice by pulling any required building permits to restore the property to a three bedroom home. You are ordered to remove the bedroom by removing entrance doors and by opening door-way entrance to the room to a minimum of five feet wide openings. This will bring the total bedroom count down from four (4) to the appropriate three (3) as designated by your septic permit. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of$100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the.above violations, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable T f Town of Barnstable Regulatory Services BARN STAF3LE Thomas F. Geiler�Director > • � _ . MAS 039. Publie Health Division plEO MAI A Thomas McKean, Director 200 Main Street,Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 August 21, 2008 Attn: Hyannis Fire Health Inspector Jaime A. Cabot conducted a rental.-inspection in accordance with Chapter 170 of the Town of Barnstable-Code. In accordance with the State Sanitary Code, 105 CMR 410.482, the Health -Department is required to notify the Fire Department if there is a smoke detector violation,or possible.smoke detector violation. The following property had possible smoke'detector-(and\or CO detector) violation(s): I Beth Lane, Assessrrs Map- Parcel: (273-200) Carbon Monoxide detector missing second and first floor bedrooms - Smoke detectors not wor `ng in basement; r` a Jai A. Cabot, Health ns ector Q:\Order letters\Housing violations\Rental ordinance\\Fire ViolationsTIRE TEMPLATE.doc Health Master Detail Page 1 of 1 Parcel Septic Perc Well Fuel Tank Parcel: 273-200 Location: 1 BETH LANE, HYANNIS Owner: TRAYWICK, SAMUEL C Business name:l Business phone:i � Rental property: [—j Deed restricted: r- Number of bedrooms Contaminant released: f- Fuel storage tank permit: ' Save Parcel Changes �) � Return to Lookup Parcel Info Parcel ID: 273-200 Developer lot: LOT 51 Location:1 BETH LANE Primary frontage: 125 Secondary road:` Secondary frontage: Village: HYANNIS Fire district: HYANNIS Sewer acct: Road index:0119 Interactive map Town zone of contribution:GP (Groundwater Protection Overlay District) State zone of contribution:IN Owner Info Owner: TRAYWICK, SAMUEL C. Co-Owner: Streetl: P O BOX 216 Street2: City:W HYANNISPORT State: MA Zip: 02672 Deed date:4/18/2001 �. Deed reference: 13738/109 Land Info Acres: 0.36 Use: Single Fam MDL-01 Zoning: RC-1 Neighborhood Topography: Road: Utilities: Location: Construction Info Building NoYear Built Effective Area Bedrooms Bathrooms 1 1980 1613 5 Bedrooms2'Full Buildings value:$150,200.00 Extra features: $0.00 Land value: $148,400.00 http://issgl/intranet/healthMaster/HealthMasterDetail.aspx?ID=273200 8/21/2008 FORM30 &W HOBBSBWARREN'" THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH f�>m,%(ZN S-r.N,5�)Lr CITY/TOW N W a.ulm a DEPARTMENT 2-Go V6k% tJ s Vi AN ADDRESS G^M Sye�e O TELEPHO E Address ' ZN LixV-�,g Occupant Floor Apartment No. V � No.of Occupants No. of Habitable Rooms No.Sleeping Rooms No.dwelling or rooming units �__�No,Stories Z. Name and address of owner �p Y�1v fst. b • t"1 V\S oz, ".4-- J 'L(� Remarks Reg. Vio. YARD Out BI 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:; o K-C t o4. c 2 Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: /' brio ac,&IrVt z4to Dampness: VS g c L Stairs: Li htin : STRUCTURE INT. Hall,Stairway: muponeic 4 lQ Z Obst'n.: Hall, Floor,Wall,Ceiling: S r (7 Hall Lighting: Gov Hall Windows: HEATING S Chimneys: Central �Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floor L CAJ Kitchen Tv %Z Z O uv LG t? Bathroom R A /a. Pantry Den Living Room Bedroom 1 .: Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Elect.: Stacks, Flues, ents, eties: Kit en Facilities Sink Stove Bathing,Toilet acl . Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: . S Apr Egress _ _ Dual and Obst'n: U -(940 AE4 General Building Posted Locks on Doors: I£ 1r,►0r- ►.�L. !p k A, ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDI ION WHICH J 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 PERJUR INSPECTOR TITLE � �-7(e A. DATE 2 �� TIME ICJ • G G P.M. A.M. THE NEXT SCHEDULED REINSPECTION 7 ,84 P.M. 0 410.750: 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 those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such vialation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold,to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstrLcti0h of any exit, passageway or common area caused by any object, including garbage or trash,which prevents egress i-i case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. -(See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or cond tions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting,or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or pro-.ective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(E). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. J' &W HOBBS&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS FORM$O C BOARD OF HEALTH CITY/TOWN W _ DEPA TMENT a ADDRESS L. GSM SVey`mW r� Q TELEPHON Address I J L�N tL _ Occupan i�/�i�L-�„�A_..✓ ?e5 Floor_Apartment No. No. of Occupants No.of Habitable Rooms—`— No.Sleeping Rooms- -No.dwelling or rooming units No.Stories Pame and address of owner t, �e 2 (". Remarks Reg, Vio. YARD Out Bld s.: Fences';' \ Garbage and Rubbish Containers: 4,11 Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: ./ Dual Egress:and Obst'n.: ,S` ❑ B ❑ F ❑ M Doors,Windows: X'10 b N / $ Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen,Sanitation: Dampness: A4 J9CT4C T o(, tip Z Stairs: & Li htin : U O er STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICA Panels, Meters,Cir.: ❑ 110 EW20 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Lo s Kitchen ZO AJ 2 z JQ1w Bathroom lDp Pantry Den Living Room Bedroom 1 . Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten. ', Elect.: Sta lues,Ven s,Sae' s: Kitchen Facilities 101nk Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin, Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress - Dual and Obst'n: General Building Posted CST G Locks on Doors: Al vA 12c, ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH J 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 PERJURY." INSPECTOR TITLE Ar4 L%Y TQ2 DATE TIME ` ��, o P.M. A.M. THE NEXT SCHEDULED REINSPECTION —r Q- P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions,when found to exist yin 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 those items which are deemed to always have the potent al to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to call within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obst-uction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation, or other structural defects-hat may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to We, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector requirec by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroacie3, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. •ti FORM30 &W HOBBS&WARREN TM THE COMMONWEALTH,OFMASSACHUSETTS BOARD OF HEALTH CITY/TOWN a DEPARTMENT 'q 2 �v M�.� N �� . 1-�1r A��►;s. � 02��� ADDRE S TELEPHONE Address I gjr-TH LAP-jr. Occupant V AGkNil Floor Apartment No. No. of Occupants_ 1 No. of Habitable'Rooms 2 No.Sleeping Rooms No.dwelling or rooming units No.Stories Z. Name and address of owner S A Tel vt_._ YL/>� l.-�Ck -j �d �C? 2 t �9{FS't �1 �s Remarks Reg. Vio. YARD 1 Out Bld s.: Fences: Garbage and Rubbish Containers: 1 Drainage $ Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: U 2,rM l® s'Z Dual Egress:and Obst'n.: I t-4 vtl -t ; ❑ B ❑ F ❑ M Doors,Windows: 4pew- S f Roof o ." Gutters, Drains: 11 Aj i 0 Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Lighting: GAL &--oAA9664. 8 2 STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: .Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: 13110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to Outlets Walls Ceils. Wind. Doors'l Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Stacks, Flue ents,Sa ties: Kitchen Facilities!` Sink Ve tov Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other.- Egress Dual and Obst'n: General Building Posted w n•ChC �C ticjl GS P�/J Locks on Doors: '1 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 REPO IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES-7RJU I , INSPECTOR TITLE l�f_4( zn Z� X- A.M. DATE ZC 6 TIME /0 ', TU P.M. n A.M. THE NEXT SCHEDULED REINSPECTION � P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions,when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-,being of a person or persons occupying the premises.This listing is composed of those items which are deemed to always have the poten-ial to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such Violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B),410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash,which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 AMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Preventio-i and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns,shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns,shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector require) by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing o-heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting,or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or prDtective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents,cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair:he 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. M *Town of Barnstable Barnstable Regulatory Services Department ;edcac'1 i 'ARNSrABM MAM � Public Health Division 2007 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2843 9217 June 10 2013, 2013 Wells Fargo Bank,NA 4101 Wiseman Boulevard San Antonio TX 78251 .RE: 1 Beth Lane, Hyannis ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE. TITLE 5 • The septic system located at 1 Beth Lane, Hyannis MA was last inspected on 2/03/2013 by Mark Poselli,a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails".under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • System is in hydraulic failure. You are ordered to repair/replace the septic system within sixty(60) days from the date you receive this notification.. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S. CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Evahl Beth Ln Hy Mar 2013.docQ:\SEPTIC\Letters Septic Inspection Failures or Future Evahl Beth Ln Hy Mar 20.13.doc Parcel Detail http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=21045 L 1 y ( y 017 a 4 " . IE A. xq�y amass �� �, ,�. Zq �` `" r Logged In As: Parcel Detail Monday,June 10 2013 Parcel LookuD Parcel Info Developer Parcel ID 273-200 I Lot LOT 51 Location 11 BETH LANE I Pri Frontage 1125 Sec Road I Sec I Frontage��� I Village I HYANNIS I Fire DistrictlHYANNIS Town sewer exists at this address No I Road Index 0119 Interactive Map r . Owner Info Owner IWELLS FARGO BANK, NA Co-Ownerr --.—. ..._._._ __ ._ _.. Streetl 4101 WISEMAN BOULEVARD Street2 City ISAN ANTONIO � State TX Zip+78251 Country - Land Info _ Acres 30 6 I Use Single Fam MDL-01 I zoning IRS C-1 Nghbd 0105 Topography I Road I Utilities I Location� � I Construction Info Building 1 of 1 Year Roof Ext �� Built 1980 Struct Gable/Hip I Wall{Wood Shingle I Living Roof AC 1440 As ph/F GIs/Cmp ( None _ I Area Cover Type w Int � Bed r__ 41 Style f Cape Cod Wall Ro Drywall i5 Bedrooms. ° �' oms . w IntBath 4 #FttB`x "t Model Residential Floor Carpet ( Rooms 12 Full ' - Y �> _.. _ He Total Grade(Average I Type Elec Baseboard Rooms Rooms V-, V Heat Found- stories I—, , Stories I Fuel lElectrlc i ation.Poured Conc. Gross 2880 Area Permit History http://issgl2/intranet/propdata/ParcelDetaii.aspx?ID=21045 6/10/2013 •ter Town of Barnstable Barnstable Regulatory Services DepartmentOftedcaft • "B`Er Public Health Division 16 Ec M►. p 2007 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL # 7012 1010 0000 2843 2188 March 14, 2013 David Holt Today Real Estate 487 Station Avenue South Yarmouth,MA 02664 -RE: 1 Beth Lane,Hyannis ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE. TITLE 5 The septic system located at 1 Beth Lane, Hyannis MA was last inspected on 2/03/2013 by Mark Poselli, a certified septic inspector for the State of Massachusetts.. The inspection of the septic system showed that the system"Fails" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • System is in hydraulic failure. You are ordered to repair/replace the septic system within sixty (60) days from the date you receive this notification.. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF.THE OARD OF HEALTH s McKe , R.S. CHO Agent of the Board of Health QASEPTIC\L.etters Septic Inspection Failures or Future Evahl Beth Ln Hy Mar 2013.doc: Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal S teem/Form-Not for Voluntary Assessments Property Address �e v�i e✓- � �SSe� S2✓vl�e S Owner Owner's Name - Information is b a 3 3 required for _ every page. Clty/Town State Zip Code Date of In e n Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: When filling out A. General Information forms on the computer,use 1. Inspector: only the tab key to move your G✓/� /S� �� ti cursor-do not Name of Inspector �` ^ use the return ,�i v� 0 key. /v Company Name 0 dig> Company Address I z:-as 4 Aa V'� •�' 0� 6 qc� City/Town State 7Jp Code I Uqv-) — ? 04 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this add s"s and thaT information reported below is true, accurate and complete as of the time of the irfis fiction.The inspe'8tion was performed based on my training and experience in the proper function and mamtenance:rzf on sl sewage disposal systems. I am a DEP approved system inspector pursuant to Section 16, 40 Title 5(310 CM 16.000).The system: =' ❑ Passes ❑ Conditionally Passes F411� ❑ Needs Further Evaluation by the Local Approving Authority 143 i3 Inspe or's Signature —�-- Date ' ran The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 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 DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ""This report only describes conditions at the time of Inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. tSlns•11110 Title 5 afB W Inspecdon Form:Subsurkm Sewspa DWpwal Syd em•PW 1 or 17 Commonwealth of Massachusetts lugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form•Not for Voluntary Assessments Property Address / vice Owner Owner's Name ,/ �1� / Information is G✓r✓1�t _ / l r 6P 6 b required for -`-� State Zip Code Date of to pe on every page. Cityfrown B. Certification (cunt.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) 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. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old" or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. "A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): Sins•11110 Tltlo 6 OWWW Inspoctlon Form:Subsudew Sowspo Disposal Sydam•Pop 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form 19 Subsurface Sewage Disposal System Form•Not for Voluntary Assessments ��t g90 -- U - Property Address / _e _/ - J�PWC,e, Owner Owner's Name e l Information is QNh�S /�� _ 2 6 c) o 3required for c�yrto StateZip Code Date of I every page. wn B. Certification (cont.) B) system Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): The system required pumping more than 4 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 ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) 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 public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance-with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, 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 TM*B Official Inspection Form:Subsufte Sewape DISPoeN 8Yabm•Pape 9 d 17 lana•11110 f Commonwealth of Massachusetts Title 5 Official Inspection Form lug Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address /— & <;� Owner Owner's Name Information is f �0 required for C�y�o State Zip Code Date of In ectl every page. wn B. Certification (cunt.) 2. System will fail unless the Board of Health(and Public Water Supplier,if any) determines that the system Is functioning In a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: _— ""This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal s absent and the presence of ammonia nitrogen and nitrate nitrogen is equal conform bacteria indicate to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Elischarge 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'/s day flow Me 5 MWI kopsdnon Form:subsumes"SewdP Ohpssd 8y"bm•P*P,or 0 Ons•r vro f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address /�v✓J/2✓ G�Yy�GG Owner owners Name V. Informatlon Is An s required for state Zip Code Date of I*eodon every page. Chyfrown B. Certification (cunt.) Yes No Required pumping more than 4 times in the last year NOT due to clogged or IILLJJJJ obstructed pipe(s). Number of times pumped: ❑ � Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ 2// Any portion of cesspool or privy is within 100 feet of a surface water supply or ll�� tributary to a surface water supply. ❑ [ ny portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ortion 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. (This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence a to or less than 5 m of ammonia nitrogen and nitrate nitrogen is equal Pp 9 provided that no other failure criteria are triggered.A copy of the analysis a ain of custody must be attached to this form.] ❑ The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ The system!Wis. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a, design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ 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 If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. tuns•11110 Title 5 Offblal Wopectlon form;Subw0aos Sw"V Dhpoeal Pidw•Pepe 5 of 17 Commonwealth of Massachusetts IL Title 5 Official Inspection Form Subsurface Sewage Disposal System Form•Not for Voluntary Assessments Property Address --- Owner Owner's Name information Is Nor f /� U;)bOJ required for every page. CilyR own State Zip Code Date of I ecti C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ❑ 211 ping information was provided by the owner, occupant, or Board of Health ❑ e any of the system components pumped out in the previous two weeks? ❑ the system received normal flows in the previous two week period? ❑ Have large volumes of water been introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined?.(If they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? Were all system components, excluding the SAS, located on site? ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has :en determined based on: ❑ Existing information. For example, a plan at the Board of Health. ❑ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): -- — Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): Oro•1 Wo Title 5 offl w wopxtbn Form:Subsudwe Sewepe DIsPMI Syd bin•POP 8 Of 17 Commonwealth of Massachusetts 19 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form•Not for Voluntary Assessments / & GI A Yl-e_- _ Property Address / Owner Owner's Name 3 information Isa N r ��b ov OZ- required for State Zip Code Date of insp4c6orl every page. Clty/Town D. System Information Description: ��a� �lu� + �/G 7�"4" 4" owl Z-C 0 Number of current residents: Does residence have a garbage grinder? ❑ Yes O/No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes 2/No Laundry system inspected? ❑ Yes ��N Seasonal use? ❑ Yes No Water meter readings, if available(last 2 years usage(gpd)): Detail: Sump pump? ^` ❑ Yes No Last date of occupancy: oate CommerciallIndustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: uu�� Ons•11110 Me 5 Oftal Inspection Form:Subsurfwe 5"Ve Dbpwel SyMM•Pape 7 of 17 Commonwealth of Massachusetts • ion Form Tale 5 Official Inspect t Subsurface Sewage Disposal System Form•Not for Voluntary Assessments Property Address /1eU�ce l/ Owner Owner's Name Information is a1 _ro�-f;6 _ vZ required for every page. citY/Town �--�—State Zip Code Date of lr4ecgn D. System Information (cunt.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: - Was system pumped as part of the inspection? ❑ Yes ❑ No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: —Type of of Syst 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) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): tlfins• 1no TWe s 0*101 kopecfbn Form:subwdow sowee owpow sysom•Pape a a 17 Commonwealth of Massachusetts Title 5 Official Inspection Form 0 Subsurface Sewage Disposal Syst m F rm-Not for Voluntary Assessments Property Address Owner Owner's Name / 0 6 ) J ' Information Is A��,S required for C State Zip Code Date of nsp ctlon every page. hYn o D. System Information (cont.) Approximate age of all components, date installed(if known)and source of information: �2 — awl p, )L a�Ido 1 Were sewage odors detected when arriving at the site? ❑ Yes No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron 40 PVC ❑other(explain): 1 Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): f I Depth below grad feet Mated construction: concrete ❑ metal ❑fiberglass ❑polyethylene ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No x Dimensions: Sludge depth: ono 11/10 Tide 6 official Inspwibn Form:Subsurface Sews po Die 0W SYatem•Pop 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal Sys m Form-Not for Voluntary Assessments a Property Address / �e✓�l�t�.f, Owner Owners Name / - /WW U�6 0� 3 ; information is �N H/r �� required for C Rown State Zip Code Date of Inap cd every page. dy D. System Information (cunt.) Septic Tank(cunt.) Distance from top of sludge to bottom of outlet tee or baffle ---�/— 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 How were dimensions determined? Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): S/44 C� I --1 Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle T Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date TN*6 0ftW1 Inspodm Form:subsurface saww 0 spy SY+Um-pegs 10 a 17 Cara•11/10 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal SystelA Form-Not for Voluntary Assessments d Property A dress /�i/✓�!-Pit/ i� /J ___ e- Owner owner's Name Information is a�N�s !/✓, Uo�6 oZ 3 required for - State Zlp Code Date of Insp Roff every page. C1ty/Town D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet Invert, evidence of leakage, etc.): d at time of Inspection) Tight or Holding Tank(tank must be pumpslocate on site plan): Depth below grade: Material of construction: ❑concrete ❑metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order. ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No tSine•11110 Title 5 OMCW Inapeetlon Form:Subaurfa0e Sewage Dlawaal System Pape 11 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments -�4;Ltl- Property Address Owner Owner's Name L11V �l We Information 1s �_required for state Zip Code Dection every page. CMyrrown D. System Information (cont.) Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc,): A0 r locate on site plan): Pump Chamber( p ) P Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump chamber, condition of pumps and appurtenances,eta): Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Too S o0clol mspacuon Form:subwRaa Swrayrr o 08W SY*M•POP 12 0117 e+ns•wto f Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form•Not for Voluntary Assessments Property Address ��N�4�✓ �� / --5&0C� — Owner Owner's Name Informabon Is 0/S 0 required for C �roWn state Zip Code Date of I spe on every page. KY D. System nformaition (cont.) 6x b Skl("V _ Type: leaching pits 0D2/ number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): vzer 4�7�7 Cesspools(cesspool must be pumped as part of Inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No L41ns•11/10 Me 5 of dal InspeeWn Form:SubwRaea Sewape Disposal System•Pepe i of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal S tem/ Form•Not for Voluntary Assessments Property Address Owner Owner's NameInform /��? �l��Ol / required Is Q441S C/ required for state Zlp Code Date of In ectlo every page. CflylTown D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions - — Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Vre-11no . Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal S stem Form-Not for Voluntary Assessments Property Address /,leW1l-PI/ x!� Owner Owner's Name information Is required for Cily/Town State Zip Code Date of limpAtIon every page. D. System Information (cont.) Sketch Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at leas o permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate wher public water supply enters the building. Check one of the boxes below: as in the area below ❑ drawing attached separately G �/T i 5 Al -f3- 36 y tSins•11H0 Title 5 Oftel inspection Fow SubsuttWe Sewage Dbpossl SYatem•Pape 18 d 17 • , Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal Syi1tem/ Form•Not for Voluntary Assessments Property Address �/lG Owner Owner's Name Information is L2 G Q l required for State Zip Code Date of I p n every page. CnylTown D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ served site (abutting property/observation hole within 150 feet of SAS) Checked with local PcArd of Health-explain: _ ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: ��✓1/� (r/t ,LTG -� /'"`✓� �Cf ' Before filing this Inspection Report,please see Report Completeness Checklist on next page. t5ins•11110 Tms 5 omam mswtw Form:subsurrae seyAW DWposar system•Palo 18 of 17 f - Commonwealth of Massachusetts Title 5 Official Inspection Form i Subsurface Sewage Disposal SS stem Form•Not for Voluntary Assessments 7 Property Address Owner Owner's Name /i��T U601, OZ �� Information is ����f required for State Zip Code Date of a on every page. City/Town E. Report Completeness Checklist Inspection Summary: A, B, C, D, or E checked nspection Summary D (System Failure Criteria Applicable to All Systems)completed ketecMhof t In ation—Estimated depth to high groundwater Sewage Disposal System either drawn an page 15 or attached in separate file i ins•11/10 TMo 5 oftW Inspection Form:Subsufte 8swap DhPeW Sy*m•Pape 17 of 17 SENT BY: 6-23-95 9:49AM 5087786448-► 5087753344i# 1 I HYANNIS FIRE DEPARTMENT 96 HIGH SCHOOL ROAD EXTENSION HYANNIS, MASS. 02601 PAUL D.CMSHOLM,CHIU FIRE PREVENTION BUREAU LT. DONALD H. CHASE,JR. LT. ERIC HURLER Inspector Inspector r AGENCY NOTIFICATION Healt BuildingWiring Consumer Affairs [ ] � � 9 L ] ( ] Gas ", Pur nt to Mass. General Law - 527 CMR 1 ,03 - Enforcement Authority Section, 1 .03 (2) requires notification of any other agency whose codes or laws are observed to have been violated. The following violation/s has been observed during an inspecti n o 1995 at the property located on 2) 3)� — Owner of record: phone (if known) &0�7k-5:7 Fire Prevention ,Office Hyannis Fire Department nc- File I i f AM HYANNIS FIRE DEPARTMENT " S 95 HIGH SCHOOL ROAD N EXTENSION h, /• '''�� HYANNIS MASS.S. 02601 � ,�IE PAUL D.CHJ8HOLM,cH1P.P ( , u �., FIRE PREVENTION BUREAU "� 4 C� PRE.%ENT*lO 0 9�0P LT,ERIC HURLER LT, DONALD H. CHASE, JR: " ' LJ Inspector Inspector ADDRESS: 1 BETH LANE OWNER: RON POMYKALA MAP/PARCEL: 273/200 221 Five. Corneas Rd. Centerville, Ma 02632. DATE: 6/21/95 ' , 508-420-4285 INSPECTOR:' LT. ERIC HUBLER } On 6/21/95, acting upon a complaint, I went to the property known as 1 BETH LANE. At approximately 1545, 1 arrived on location and was able to inspect the entire property. The property use appears: RESIDENTIAL. The building use appears: LODGING HOUSE, (REF: Letter of 6/15/93 to T. Geller cc: W. Rutherford) " Building Description: 1 1/2 story Cape with dormer on full foundation. BASEMENT: is unfinished with bulkhead access and is being used as laundry and storage. FIRST FLOOR .consists of an apartment with kitchen and a room with bath. SECOND FLOOR: consists of 2 room's - each with a bathroom. Inspection, shows 5 unrelated tenants in the building. P , I ........... ._...._. ----....._... FINDING: OUTSIDE: Discarded: 1 : couch .& furniture & combustibles against the building ` 2: unregistered motor vehicle (2 motor vehicles) BASEMENT: 1 : smoke detector missing 2: excess combustible storage with flammable6 -and propane stored in basement 3: motorcycle stored in basement 4: washer & dryer ,in disrepair may be electrical hazard FIRST FLOOR: '1 only one exit from apartment 2 no working electric smoke detector 3: hole in ceiling from water leak with electric wiring involved 4: single room unit missing electrical smoke detector 5: cooking appliances not allowed 6:' common hallway smoke detector disconnected 7: no emergency lighting 8: no;exit signs 9: no fire extinguisher SECOND MOOR: 1 : no fire 'extinguisher 2: no emergency lighting: all smoke detectors were working 3: left hand unit - no cooking appliances allowed 4: excessive use of extension cords (removed during inspection) Photo o en tion on file with Hyannis Fire Prevention Office. LT. ERIC BLEB FIRE PREVENTION OFFICER • ..r TOWN OF BARNSTABLE LO 'ANON 2 �3,- I-& SEWAGE # VILLAGE ASSESSOR'S MAP LOT a/3_ ac9P� INSTALLER'S NAME & PHONE NO. 19' SEPTIC TANK CAPACITY r LEACHING FACILITY:(type) Legc.�w /:/� r (size),:24 NO. OF BEDROOMS-PRIVATE WELL OR PUBLIC WATER BUILDER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: !:i VARIANCE GRANTED: Yes No { �� i fvwj f�� {�{ �� Y� II O CW v� �ZS` �� ������ j � � a 6 �- _. � ASSESSORS MAP ✓���No... PARCEL N0: Fimic THE COMMONWEALTH OF MASSACHUSETTS h B' f®AR® OF HEALTH � N ....OF................ .TI. N..S/-..- ..... Appliration for Dispos�al orks Toustrurtion Frrutit Application is hereby made for a Permit to Construct ( ) or Repair V an Individual Sewage Disposal System at: // .... --------•-------------------------------------------------------•-•. --•-- ------------•-----------.................. Lo ation-Addr ss vc� .vat .................. � 1--G�l!. Lot No �VN!. ......... Owner Address a -•--• C . __ Installer /,�Z V S feet � Type of Building � Address Size Lot---------,----------•�-- q• Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (P6) aOther—Type of Building ---------------•._______•--_-No. of persons............................ Showers ( ) — Cafeteria ( ) a 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........................................ a Test Pit No. 1----------------minutes per inch .-Depth of Test Pit.................... Depth to ground water-..-_---__-__.____.__... f� Test. Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ------------------------------------------ ................................................................................................................... 0 Description of Soil.................................................--•---•-----.....-•---•----...-----------------------•---------------------•--------------------------...------------. x V ---------------------------------------i--'-----•-------------------...----------•----------••-------...--------------------------•--------------------•---------------------------•---•-------=------- --------•-- --- ----• -------------t-=--;;--------------- ----- . ---------- •-------------- U Nature of Repairs or Alterations—Answer when applicable.__-_-----ADZ......................��L__._ ---ff._/�� ------------------------------------------------------------------------------------•--.....--------•--•--•--------•--------•----------------•-•-••------------•-•------•-•--•-•--•-••........_-------•• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of J i L% , p 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has ben issued by/ e bo d It . Sign ����A�- ate Application Approved BY '-'. ... --------------------------- 7 Application Disapproved for the following reasons:......................... Date PermitNo.--Q.�::7Q(�1- -----------•--•-----------. Issued........................................................ Date No- 3--- 1.41 ;U9 FEs........................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........ .. ....... . ...........OF.......................-•------........ -----------------............... ApplirFation for Uhipaii al Works Toustrurtiun lirrutit Application is hereby made for a Permit to Construct ( ) or Repair V an Individual Sewage Disposal System at:- / /�� 8 /L�v- L /-.__._. ... - ---- 4 -------------------------------------------------------------------------------------------------- /�7� T ccalio/n-Address K7� / or/Lot�Noo' 'y/�/e// i.//l..l!.`� ........./..C..L!.13 L� l......�tl.[!:.......C_/...C..!1aiC /. ... Alleell Owner Address Installer Address Q Type of Building Size Lot. -Sq. feet V Dwelling—No. of Bedrooms.............................. .. .Expansion Attic ( ) Garbage Grinder V,6 a. Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Pa Other fixtures -------------------------------- - . Design Flow............................................gallons per person per day. Total daily flow............................................gallons. R4 Septic Tank—Liquid capacity_.___.__....gallons Length................ Width................ Diameter---------------- Depth................ ,r 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......................................... W Test Pit No. 1................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---________•___•--_-___. R4 �- 0 Description of Soil........................................................................................................................................................................ x U •--••••••---•-••--•-----•-••••••-•-•-••...-•----••-•-------••--•-•••----••-----•-•--.._......-••-•-•----•----•-••••--•-----•--------••••--•-••--•-•••--••-•••-•-•---••-••-•----•--------------------•--- W ------------------------------------•----------------------•-----------------'-----------------------•......• ........................................................... - -j V Nature of Repairs or Alterations—Answer when applicable._.._: ._ . ..../_�bU... }L..._... �}...,1�.� Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T"' r of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b n issued by board f heal Si ne �f .. Application Approved B V -�..._,.....� ................................................................... .........A# Application Disapproved for the following reasons---------------------------------•--...-----------•-----------••----------------•-----------••-•••-----••.....I- ..-•••••-•-•--••••••----•-......••-----•-•--•-•-•---•-•--•-----••-•-•---•...--•-•..................•---•--••--•-----•-•-----••--••--------•-.--•---------............................................. Date - Permit No.?..I b ..15r----------------------- Issued...-----------------Dat ee-_------------------------- • THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................/.... )1116..OF................ .................... Trrtif iratle of Toutpliattrr THIS IS TIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ) bY------- -------/--Z- 77............................................................................................................................................................... at..................... ` / /.a�-.G-Installer � /Y . ......... ............................-........................... has been installed in accordance with the provisions of T1TIE j of The State Sanitary Code as described in the application for Disposal Works Construction Permit ......... dated-.. ... -. .-- THE ISSUANCE OF THIS CERTIFICATE SHAI ��t9'�dSTRUED AS A G8JlK1€'Ae" YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................................................•--......-------_._. Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Q Teti.........OF.............. � /1lL�,l.lI �G.........------........ �r� ����� ............. .. ... ..... FEE........................ Disposal nrkii Tonstrurtion rrutit Permission is hereby grant,��-------------��.a#.-•---•---.--- •-----------...-•-------••----•----••---------------••---.........-•-•-•-•-•--•----...... to Construct or Repair an Individ 1 Sewa DisposalS st at No...........I-.O-.�.....31=------.....�-, T �---- y /5. Street as shown on the application for Disposal Works Construction Permit N .___•--r.__ Dated.._ •--•-.----•---••--.... ---- Board of Health DATEf `� 0j--------------------------------------- FORM 12S BBS & ARRE INC.. PUBLISHERS r . .rl 1-7 .tune 22, 1995 To Whom Tt May Concern - This letter is to document tennant complaints against Ron Pomylaka, 1-andlord; 1 Reth Lane Hyannis MA , An. apartment on the r premises is rented to myself (Julie Moran) , and to William Pecha for the sum of 650 . 00/month . In May 1995, we had a problem with the hot water. heater . The landlord (Mrs Pomylaka) was nestifted, a.nd. she sent out a plumber. . The immediate problem was repaired, however, I told the plumber the toilet was broken ( it will not flush) , and the faucet in the tub was broken (you could not adjust the hot and cold water, and the flow was diminished) . The plumber Raid he would inform the landlord, and come back to complete the job on Friday of the same week . We never saw him, again. We strongly believe it is because of an incident with a former. tennant of the same building. A few weeks prior to the hot water problem, Ron Pomylaka came by the house . He cut the lock on the basement door, and took an electric power tool belonging to the tennant . He told Billy he was taking it , and him. " When this former tennant asked R1.l.ly to sign a statement witnessing what occured, .he felt legally and morally obligated to do so . This former tennant then took_ the landlord to r.nirt and the document was presented. Around the same time, the plumber was told not to return to complete our repairs . Tn the mean time, we decided to withhold our rent until the repairs were made ( $65O . 00 is a . lot of money for no working toilet the plumber, she said she told the pli mber not to name hack . Flea i then spoke with Mr. Pomylaka about the rent and the plumber, and explained that the broken faucet had gotten T/,gorse, and now we have no cold water in the tub. He was told, the plumber was cancelled, and we must pay the rent before he comes . At the time we requested the plumber, our rent was up to date . We feel this is blatant retaliation against Billy' s legal. rights to report the illegal actions and statement of this landlord against the former tennant . We have also received a notice to quit , with the amount in errs incorrect . There are other complaints that we have spoken to the landlord about , and he refuses. to attempt any cooperate effort to resolve . They are : *Inconsistent trash pick up- the dumpster is not emptied until the trash overflows for weeks (their are now skunks out by the dumpster) *Numerous junk in the yard (broken glass window panes, an old couch, T.V . , motorcycles, ) *Numerous junk in the basement (old furniture, appliances, paint , ) *No working `smoke detectors anywhere in the apartment or basement We have offered to make dump runs, and deduct rent , to no avail . Addendum problems; *No screens (other than what we bought and installed) We requested a plumber numerous times to Mr . Pomylaka when he �.aas here in person . We also reminded him we would regiame payment �r 3 *Coakroaches ! ! ! *We have to turn the toilet water on and off by hand to flush the toilet *We have only scalding hot water in the shower, the only way to shower is to let all the hot water run out , and then take a cold shower, or else get burned. *light fixture in the kitchen has been hanging loosely from the ceiling since .,we moved in *electrical outlets in the bathroom don't work, ? faulty wiring *their is a hole in the kitchen ceiling with water stains and wires exposed. We feel these are serious problems, that not only violate our rights, but also endanger our health and. safety. We rented this apartment in good faith, and expect to be treated fairly. Lt . Frir_ Hubler from the Hyannis Fire Department came to the house on June 21 . He inspected the premises, and found numerous complaints, which he said will. he on file at the fire department . He also said he would be notifying the building department about violations he observed. ADDENDUM: on July, 3:-4 Mr . Pomylaka removed the Junk from the yard miner hha OMMOMdmt , Inmto lijerl a RMOke dQtar:tor (we also bought one) , and repaired the. hole in the kitchen ceiling, per order of the Hyannis fire department . We requested a plumber numerous times to Mr . Pomylaka when he was here in person . We also reminded him we would resume payment 4 of rent once the problems were -repaired. However, on July 4th we were told by him that the only way he would send a plumber would be if the board of health ordered him to . At this time, we are requesting a board of health inspection, and any advice available . ' F Sincerely, (Julie Moran tennant ) (William Pecha, tennant ) LOCATION SEWAGE PERMIT U0. VIiI LAC E S 1 W S T A LLEA'S WAME b ADDRESS JOHN A. AAL_TO B SERVICE !Nest,Barnstable, Mass. 02668 0 UILDE R OR OLUER j DATE PERMIT ISSUED y-7�d - DATE COMPLIANCE ISSUED ,, ` ,v ''v �� .9 M' �� � �®� �� � � / i � � .� `� � � . �i�i � 1 :' �„s ,' � +t f. No.........l(� .... Fr+s ...... THE COMMONWEALTWbF MASSAtHUSETTS BOAR® OF HEALTH �1'!i./!�.-.....OF........�R 441.1 /. /T -----------------------•---- Apli iration for Bhipoiia1 Morks Towitrurtinn Prrutit Application is hereby made for a Permit to Construct (\Z or Repair ( } an Individual Sewage Disposal System at: .................... ....., -. _..... _---------..-.........---. .................................. ..:---._......._...____..._..... ......................................................... L Add re s ion• or Lot alX-...__./.f.:. y V �!�!I/"!1 `--- .....Addre�s ,.�1�!/I! 4/ ... � Installer Address Q Type of Building Size Lot---,l-✓c_ �...Sq. feet V Dwelling—No. of Bedrooms________________________________ _Expansion Attic ( ) Garbage Grinder ( ) Pk Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ...................................................... W Design Flow...................... ............gallons per person per day. Total daily flow----------------- _�0............. WSeptic Tank—Liquid capacity__/aka_gallons Length__.._8._____ Width____ ________ Diameter................ Depth___! ......... - x Disposal Trench—No_ ____________________ Width.................... Total Length-------------_----- Total leaching area____________________sq. ft. Seepage Pit No-_._____-_..)........ Diameter...../A'6_''__ Depth below inlet... _............ Total leaching area__ _�__9_.___sq. ft. Z Other Distribution box (h) Dosing tank (� I Percolation Test Results Performed by____C._`_t_ r_.___ _. _ ___ Date____e_8t__&�___79__.__.. ,al Test Pit No. 1----�z....minutes per inch Depth of Test Pit___1_2..._.._._ Depth to ground water___--------:'^.._--_. f� Test Pit No. 2.......9!......minutes per inch Depth of Test Pit-------------------- Depth to ground water_________°--________--. - ..O Description of Soil ---------- ---------------- '- o •--�='-"'„ •- - •-•-•-•-----� V .._.••-••-••---- . . . • • •----•-•-•-•. ............•.------------•-•---.....-------•---•--••-----._.._.._.---------------•--••--••------••--•-•-•-••--•--•--------------••--••...--•-••---•-••--- V Nature of Repairs or Alterations—Answer when applicable______________________________________________________________________________________________ ..-------•-•--•---------------•-----------------•---------•--•-•---•-•••-•--•--•-------•--........----•--------••-•--------------•-•--------------------------•-----•--•--•--•••---------••---•._...---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of I i p 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be"issued by the bo-rd f health. Sign _ - . ..... Date Application Approved By-••• ---•-• ...... ..................... ----•-••••-••--•------------•--•------•- Application Disapproved for the following reasons:-__._••••---•-•---- -•-------•`-•---••-----•--------•--•-•-----•---•-•-•••-----Date P .............. ---•----------•-----•--------•••------•------•--....-•••-•--------------------------•------••------------•-••••--•••----••-•-•---•-•---------•=-••--._...•-•----•-•__._••••--.......................... Date PermitNo......................................................... Issued----•-{•� 7/ _----------•------- Date No.........X 0..... F.R .. ........ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ..............7,11 l/.---.0 F........ '�, /l S/ L = ............................ Appliratiou for Uh4posal Works Tomitrurtion tirrutit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: --'- ZZE<f� ��.....--•------------------ •......--•-- .. -----•--... ..--------........----- Location-Address `ter Lot ........................ ..................................................� O ner Address ........... ....... .....%%✓.. f't f` r ............................... ------•rll ,tf T 5 .......r�....�r�l..S_/.. S-•-- Installer Address Type of Building Size Lot___lc -�'�� �....Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building No. of persons............................ Showers G� YP g --------•------------------- P ( ) — Cafeteria ( ) QI Other fixtures ---------------------------------- ------ w� �✓ Design Flow...................... gallons per person per day. Total daily ._flow____ _..____.........._ ___gallons. WSeptic Tank—Liquid capacity.. 0 tigallons Length------ ______ Width___.'. .`....._ Diameter................ Depth...'5_-........ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area.................... sq. ft. Seepage Pit No............)_....... Diameter___-_ Depth below inlet.......:............ Total leaching area..: sr- .....sq. ft. z Other Distribution box (, ) Dosing tank ( c 0-4 Percolation Test Results Performed by.._�n_:_.a-------- _...._............................. Date....... .............................f Test Pit No. 1...:2�_2-....minutes per inch Depth of Test Pit.......2.......... Depth to ground 1=4 Test Pit No. 2�':_-;.'_......minutes per inch Depth of Test Pit.................... Depth to ground water-..__-____`------------- ....................... .•--------- -•-•••••.----- .-- ................................. ------------ Description of Soil..... ... •• r - ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- .... U Nature of Repairs or Alterations-Answer when applicable._--__.......................................................................................... _ ----------------------------•---------------------------------------------►--------------------------------------------------------------------•-----------------------------_-------------------------- Agreement: The undersigned 'agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of 11T4E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of.Compliance has be5n;issued by the board of health. Sign -= ---- -- --------------- --------•-----------•-- -•---' ----- ........----. Date Application Approved. •- .. � _-------. --•------ .�:d��Y";,<-, Date Application Disapproved for the following reasons.:�t,_' ----;----•---•--------•----------------------------------------------------------------••--------• Date PermitNo.............................. ---------------------- Issued....................................................... Date E THE COMMONWEALTHOF MASSACHUSETTS l BO^RD O HEALTH r- .. d/ - ........0F..... ................. &rfifiratr of Tnntpil anrr T S I TO CE IFY t the Individual Sewage Disposal System constructed ( or Repaired ( ) ..--- ._............................................ by-- -� ...->� -----•-- .. .----------------... ....-------- -' at �r Installer i . ...... - - 0.- ------------------- -----------------------•--•------------- --------•---•---- _ has been installed in accordance with the provisi ns"of T I r. 5 f The State Sa ltary"Co as des ib�i m tlae„ application f'nr Disposal Works`Construction Permit No. __ -:---_. .. :__......, dted_... _� �: `"_ _(�._. ......... THE '.ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CONSTRUEMAS A GUARANTEE THAT THE A SYSTEM WILL-FUNCTION SATISFACTORY.' DATE......- -.�.�� .................... ------.--•-.. Inspector...... ............................. ........... THE,%COMMONWEALTH OF MASSACHUSETTS BOARD OF EALTH ........................................ No.---••- •- - ----....: ........... .. . . FEE....�............. Mops ork � ��rttr#ilan .erani� Permission i h by granted-...- - to Constretla-, e air an ndiv al p Sewa lsposal System °» at _.. .........-.. � ................ ---------------- ...-------- Street as shown on the application for Disposal Wbfks' Construction"Construction"P60ylit N .24--------- ----- Dated..... ` lJ -- . • .................................. �V oard of V DATE---------- ., ----------------•- -----------•-•----•-----•..---•- FORM 1255 HOBBS & WARREN. INC_ _P..UBLISHERS - • '-^,;� 1 Hyann15, MA Sg, LOCUS 6 ed Lot 5 I a Area =0.3G Acres± a 3 S o INSTALLER TO VERIFY THE LOCATION OF ALL N N UNDERGROUND AND OVERHEAD UTILITIES Y PRIOR TO THE START OF ANY EXCAVATION ACTIVITIES AND RELOCATE A5 NECESSARY (5EE NOTE#15) LU COI 4° `}rifle I SITE LOCUS iLO n O 0 N / tVA NOT TO SCALE 2 qe. . .5 ,,, 7 2 f s " 1.)Assessor's Map 273 Parcel 200 ,clump.I O° 48'' O 2:.) Deed Book 13738 Page 109 1P, 3.) Plan Book 271 Page 84 tHn 4° �h�' � � ' t O Existing 5eptic Components to s 4:)This property is in a Zone II of a ` cv he Abandoned(5ee Note#22) Public Water Supply r O 5) Flood Zone: C .pine N (v 1 CERTIFY THAT I AM CURRENTLY APPROVED BY THE DEPARTMENT OF ENVIRONMENTAL PROTECTION PURSUANT TO q s �_� r`F� BENCHMARK 31 O CMR 15.017 TO CONDUCT 501L EVALUATIONS AND THAT Fxisbng 5eptic Tank to be }a9 p THE SOIL ANALYSIS HAS BEEN PERFORMED BY ME CONSISTENT Utrlized(5ee Note#2/J 1 °pine To of concrete O EL=50.0(Assumed Datum i a o WITH THE REQUIRED TRAINING, EXPERTISE, AND EXPERIENCE / DESCRIBED IN 3 10 CMR 15.017. 1 FURTHER CERTIFY THAT THE LEGEN qas t RESULTS OF MY SOIL EVALUATION AS INDICATED ON THE Existm ATTACHED SOIL EVALUATION FORM, ARE ACCURATE AND IN .t 12.3 EY15TING SPOT GRADE ACCORDANCE WITH 3 10 CMR 1 5.100 THROUGH 1 5.107 - I g 3 Bedroom . i 24x5 ° PROPOSED SPOT GRADE Dwe11ng 1 2q— EX15TING CONTOUR Top of Foundation / 3 a EL=50:5± r Q�-t �)-3 )13 —24— PROPOSED CONTOUR y a „ —W WATER SERVICE LINE Lin a J. Pinto, Certified Soil Evaluator o— OVERHEAD UTILITY LINES. —U UNDERGROUND UTILITY LINE5 * - :E = G GA5 SERVICE LINE EDGE OF CLEARING �. jN OF�y '--'--'- — FENCE o J� 48 a R° 1 f� TEST HOLE LOCATION c) \off LINDA J. 5T SEPTIC TANK PIN DB DISTRIBUTION BOX c 1 25.0CV I. 1 CI IL � 5A5 SOIL ABSORPTION SYSTEM N 87°08'45"W 50 ¢ 4 • �O�F�f Gt S FE��G�� ' �10NAL EN Beth Lane 40' Public Way Prepared for: WC115 Fargo Bank C'SN DD SITE PLAN pQQ" = 4 101 Wiseman Blvd., San Antonio, TX 7825 1 SCALE: I 30' Engineering O 30 60 90 Proposed Sewage Disposal System 1 Beth Ln., Hyannis, MA P.O.Boxiol Phone:(508)299-3250 PAGE I OF 2 Brewster,M 02631 Far:(508)896 1783 SCALE 1 "=30' CACSN\RR-Beth\RR-Beth -5D5 Plan.dw 9 Date: 10/01/13 Scale:As Shown 6y: L)P Check: MLA Project No. C5110393 TOP OF FOUNDATION 24"diameter concrete coueis CONSTRUCTION N O I �.J EL=50.5 raised to wrthm 6-of hnesh grade (or as noted) » 1.)ALL WORK SHALL CONFORM TO THE STATE ENVIRONMENTAL CODE,TITLE 5(3 10 CMR 15.000):STANDARD REQUIREMENTS FOR THE SITING,CONSTRUCTION,INSPECTION,UPGRADE,AND EXPANSION OF ON-51TE SEWAGE TREATMENT•AND DISPOSAL SYSTEMS AND FOR Cxisbn EL=49.5# 5!-49,0± EL=48.0-49.0 THE TRANSPORT AND DISPOSAL OF SEPTAGE,AND THE LOCAL BOARD OF HEALTH REGULATIONS.' F/77X7 2.) ANY SEPTIC SYSTEM COMPONENT INSTALLED IN A LOCATION WHERE THERE I5 POTENTIAL FOR VEHICLES OR HEAVY EQUIPMENT TO PASS OVER IT SHALL BE DESIGNED TO WITHSTAND AN H-20 LOADING, IF UNDER AN IMPERVIOUS SURFACE,SYSTEM SHALL BE VENTED TO THE ATMOSPHERE. 46.5± Z 3.)TO MINIMIZE UNEVEN SETTLING,SEPTIC TANKS SHALL BE IN5TALLED ON ASTABLE MECHANICALLY-COMPACTED BASE ON SIX INCHES Lxisbng �'0+ 46.6tt OF CRUSHED STONE. m GEOTIXT/LEPABRIC 4.)COVERS OVER THE INLET AND OUTLET TEES OF THE SEPTIC TANK,THE DISTRIBUTION BOX,AND THE SOIL ABSORPTION SYSTEM SHALL a pNPLACEDF BRJC 2°PEASTONq BE RAISED TO WITHIN G°OF FINAL GRADE. LEACHING FIELDS,TRENCHES,AND OTHER SOIL ABSORPTION SYSTEMS WITHOUT ACCESS Exrstm 47.3± n MANHOLES SHALL HAVE AT LEAST ONE(1)INSPECTION PORT CONSISTING OF PERFORATED 4"PVC PIPE PLACED VERTICALLY TO THE w 47.0E 46.47 46.00 3/4 !-//2.9TONf ixistmg a ; fxrstm N 46.30 N N BOTTOM OF THE SOIL ABSORPTION SYSTEM WITH A CAP,TIED WITH MAGNETIC MARKING TAPE,ACCESSIBLE TO WITHIN.3°,OF FINAL _ g GRADE ti. Gag Baffle ".00 ` �, 5.)PIPING SHALL CONSIST OF 4°SCHEDULE 40 PVC OR EQUIVALENT. "PIPE SHALL BE LAID ON A MINIMUM CONTINUOUS GRADE OF NOT TWO 0 5HOREYPRECAST 5O0 I LESS THAN 2%,FROM THE BUILDING TO THE!SEPTIC TANK,AND NOT LE55 THAN I%OTHERWISE. Longest Run I GALLON LEACf/CHAMBERS W/TH { /0' --} -26' /2'--# 4'OFSTONEALL AROUND 3'± G'.)DISTRIBUTION LINES FOR THE SOIL ABSORPTION 5Y5TEM SHALL BE 4"DIAMETER SCHEDULE 40:PVC(OR EQUIVALENT)LAID AT 0.005 Existrrrg DB-6 (END VIEW) FT/FT.UNLESS OTHERWISE NOTED.LINES SHALL BE CAPPED AT END OR AS NOTED. 5(1STING.7.000 GALLON .. (H-20 Rated) / / . r L AC/ f ' I t 7•)LINES FROM THE DISTRIBUTION BOX TO BE LEVEL FOR THE FIRST TWO(2)FEET BEFORE PITCHING TO THE 501L ABSORPTION SYSTEM. i DISTRIBUTION BOX SHALL,BE WATER TESTED TO ASSURE EVEN DISTRIBUTION. 5fMC TANK D-BOX CH AMBERS'` &=37.7±Bottom of Te9t Hole 8.)GROUT TO BE USED AT ALL POINTS WHERE PIPES ENTER OR LEAVE ALL CONCRETE STRUCTURES IN ORDER TO PROVIDE A WATERTIGHT y SEAL. r FLOW PROFILE L 9.)HEAVY EQUIPMENT.SHALL NOT BE ALLOWED TO OPERATE OVER THE LIMITS OF,,THE SEWAGE DISPOSAL FIELD DURING THE COURSE OF 25.0� ` :NOT TO SCALE a CONSTRUCTION OF THE SYSTEM. 10.)IN ACCORDANCE WITH 3 10 CMRJ 5.22 1,ALL SYSTEM COMPONENTS SHALL BE MARKED WITH MAGNETIC MARKING TAPE. 4' «g J;).)THERE ARE NO KNOWN WELL5 WITHIN 100-OF THE PROPOSED SOIL ABSORPTION SYSTEM, a„ a SYSTEM DES I G N CALC U L! 1TI O NS * 12.)FROM THE DATE OF,THE INSTALLATION OF THE SOIL ABSORPTION SYSTEM UNTIL RECEIPT OF THE CERTIFICATE OF COMPLIANCE,THE PERIMETER SHALL BE STAKED AND FLAGGED TO PREVENT USE OF THE AREA THAT MAY CAUSE DAMAGE TO THE SYSTEM. O R SEWAGFD€S1GN t1OWRPOUIRED:3 BE9900ML74tEWNG&T //OGPD+/BEDROOM 1 3.) THE DESIGNER WILL NOT BERESPONSIBLE FOR THE SYSTEM AS DESIGNED UNLESS CONSTRUCTED AS SHOWN ON PLAN,. ANY Chambers' N` - =330GPDREQUIRED CHANGES SHALL BE APPROVED IN WRITING BYTHE DESIGNER. r SEWAGE DES/GN FLOW PROVIDED: TWO(2)500 GALLON LEACH CRAM y ., A s_`r BERS W/TH 14. THE BOARD OF HEALTH REQUIRES INSPECTION OF ALL CONSTRUCTION BY AN AGENT OF THE BOARD OF HEALTH AND THE DESIGNER.° ' N 4`OFSTONEALL AROUND THE DESIGNER SHALL CERTIFY IN WRITING THAT THE SEWAGE DISPOSAL SYSTEM WAS INSTALLED IN ACCORDANCE WITH THE TERMS OF D-BOX' THE PERMIT AND THE APPROVED PLANS: 48 HOURS ADVANCE NOTICE 15 REQUESTED. I; ' - - Ix21x.74 P At-!(25.Ox/2.83J t 2(25.0 t lZB3J '• � n ' ' PLAN VIEW 349.3 GPO PROVIDED` " 5.)LOCATION OF UTILITIES IS APPROXIMATE AND CONTRACTOR SHALL BE RE5PON515LE FOR DETERMINING THE LOCATION OF ALL ,j UNDERGROUND AND OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF ANY WORK.THIS INCLUDES,.BUT IS NOT LIMITED TO,REQUESTS a RDREQUIR59 i TO DIG5AFE,ANY PRIVATE UTILITY COMPANIES,AND THE LOCAL WATER DEPARTMENT. NOT TO SCALE .. ,.. ...x' 349 GPD PROV/DED>33D G SEP17C TANK CAPAC/TYREQUIRED: 330GPDX200%-660GALLON.5 REQUIRED 16.)'CONTRACTOR SHALL VERIFY THAT ALL WASTELINE5 ARE CONNECTED BY WATER TESTING WITHIN.THE DWELLING PRIOR TO SEPTlC TANK CAPAC/TYPROVIDL�: IX/ST/NG/OOO GALLON SEPTIC TANK T F ANY SEPTIC COMPONENTS.INSTALLATION O NTS 17.)CONTRACTOR SHALL VERIFY EXISTING INVERT ELEVATIONS PRIOR TO INSTALLATION OF ANY SEPTIC SYSTEM COMPONENTS. .' A GARBAGE DISPOSAL 15 NOT PERM177F0 wm TH/S DES16N FLOW _'.. • ' TESTI-I O LE. LOGS t. •_ �. r• °(N OF lolls�.'+` 18.)INSTRUMENT SURVEY CONDUCTED FOR PROPOSED WORK ONLY. SITE PLAN SHALL NOT BE USED FOR STAKING,OR ANY OTHER � S,gCy PURPOSES: Test Hole#1 (EL=48.5±) �� LINDA J. G� 19.)THI5 PLAN DOES NOT CERTIFY,GUARANTEE OR WARRANTY COMPLIANCE WITH DEEDED OR ZONING BYLAWS,SPECIFICALLY,BUT NOT Bth Bth PINTO LIMITED TO,SIDELINE SETBACKS AND BUILDING HEIGHT RESTRICTIONS.OWNER 15 RE5PON51BLE FOR OBTAINING SUCH A DETERMINATION Depth layer 5a1 Cla55 Sod Color Comments FROM THE APPROPRIATE AUTHORITY. _ U ( ' .. to 0°-5" C/A Fme-MedlueLoamy Sand •1 OYR 2/2 Bdrm. Bdrm . 4 5 20)�IF SOILS DIFFER FROM THOSE SHOWN IN THE SOILS LOGS, DESIGN ENGINEER IS TO INSPECT THE SOILS PRIOR TO PROCEEDING 51-10" E 'fine Loamy Sand I OYR 4/2 #I 4 #2 9 d4J ; • WITH INSTALLATION, ti 10°-25" B fine Loam Sand 1 CYR 5/8 O 25'-130° C I Medium-Coarse Sand I OYR 5/6 40%Gravel �tC GtS Q 2I.)EXISTING 1000 GALLON SEPTIC TANK TO BE UTILIZED, PVC TEES TO BE INSTALLED ON INLET.AND OUTLET PIPES IF NECESSARY,AND Perc @ 53", 2nd Floor gSIONAL N A GAS BAFFLE INSTALLED IN.THE OUTLET TEE. Test Hole#2(EL=48.7-±')> 22.)EXISTING SEPTIC COMPONENTS TO BE LOCATED,PUMPED DRY,FILLED WITH CLEAN SAND AND ABANDONED IN PLACE. AREA TO BE Kitchen Bth Den COMPACTED TO MINIMIZE SETTLING Depth Layer Soil Class Soil Color Comments t mm ! O°-G° C/A Fine-Medium Loamy Sand I OYR 2/2 Bdrm Prepared for: G"-9° ` E fine Loamy Sand I OYR 4/2 Llvinc� #3 B fine,Loamy Sand I OYR 5/8 30°-130' Cl Medum-Coarse Sand I OYR SIG 40%Gravel WC1I5 Farrjo Bank CSN' y, I st Floor 4 10 1 Wiseman Blvd., San Antonio,TX 7825 1 DATE OF TESTING: 0912GI13 P#14140 p �Q �® Engineering SOIL EVALUATOR: LINDAJ.PINTO,P.E.,CSN ENGINEERING 1=LOO1� FLAN PrOpOSed SeWa9e DISpOSal System BOARD OF HEALTH AGENT: DONNA MIOKANDI,BARNSTABLE HEALTH DEPARTMENT NOT TO SCALE I Beth Ln., f1 annl5, MA PERCOLATION RATE: LESS THAN 2 MIN/INCH IN°C I°LAYER Y P.O.Bos201 Phone:(508)299-3250 NO GROUNDWATER ENCOUNTERED . ' PAGE 2 OF 2 Brewster,NISI 02631 Far.-(508)896-1783 C:\CSN\RR-Beth\RR-Beth -5D5 Plan.dW9 Date: 10/O I/13 Scale:As Shown, By; LIP Check: MLA Project No.CSN0393 57S TY P I C AL ,; SYSTEW PROPILE EA., �'PL AN, F NISH GRADE= 'SCALE AR NOT�JO FDN TOO I N I S H'F'30 SCALE : I F INISH GRADE OV E R:TA N K GRADE .' OVER PIT=L D T B E.T.H S,:'. L ANE( 0,� 0 P,y C OR, 167 Cl -TEES 'IBSMT�:� GAL.FLR' B 0—D REINFO D I S T-�R C T CRETE -�B E ANstALLED"'N 0 I ., -,A: LEVELI'STABLE BASE 'S E P T I'C, , ANK-,Ohl�NSTALLED ' A tl.-TO 'BE,,l EVE �j-',STABLE'.`BASt` ),7 D'PEASTONt AILL-�2 -1/8I' 1/2 "-WASHE _R 0 N S,.Fl N E S�BRICK INAORTARCOURSE'S AROUND FREE 017o I RtOUIRED TO ,,8RING',,.COVE,R...'70'GRADE,��. 'AND DUSTIN PLAC E LEACHING PIT-�3 ED,CRUSHEI I BASE TO LEVEL' DET L SEt STO N E ROUND F BE D/4, TO�,l-1/2-!�WASH ANHO E VER 8k 2 4 L CO' FRAME A I ALL A EE OF AND DUST�IN IRON S 'T I N ES PLACE FOR;FIN.. .GRADE��:SEE-SYSTEM PROFILE� � O LAT 10 N SOIL, : AND, �, PERC DATA PERC RATE : M IN./I N.IFIO R I N V. E L E V1. S E C;:D.,KEN BY�.' TA SPOHR 407 INLET v , — , I . : zo SYSTEM"�PRO:Fi LE-"I NE -WITNESSED BY: 8,4112t0S�rAeik,r 6i OPEN INGS'W/4'o 1/8 'OC7 9 79 OUTER_DIA.�;8, 1 -3/14 DATE ' TEST, PIT-GND ELEV_INSIDE DIA�,' 6 �' AREA r ,Q� /V�� �O VS7,.22 0 0 0�4' 1 A'._6 .6. I-D BOT. PERC. HOLE�F�,E C T I Y�F` I A EF DOWN I' SECTIOt EA,C iN G JR-17 HI DESIGN DATA INO ,:SCALE�u � DO T RUNIHEAVY EQUIPMENT;OVER SYSTEM NOTE* NO N 0. 0 F BEDROOMS DISPOSAL . ,EST. TO ILY EFFLUE LEA C H I N G '-: P1 T NOTES: ',., T4L DA NT : GALS. SEPTIC�Co NC-TO -BE; 4000 P.S.I 2 8 , DAY S% TAN k G A L.6:� G A-::W.� M.::2 R E I N.F. W x I �rl 4EP-rF)'r 74 SECTIONS ARE AVAILABLE.TOR 3.":Z'AND 4 RAL NOTES GENE GREAT ER DEPT H,,�R EQU I R EMENTS 1 . ALL SYSTEM COMPONENTS SHALL BEINSTALLED I N' ' ACCORDANCE WITH TITLE5,OF,THE STATE SANITARY CODE NOTE. 1 XCAVATE TO ELEV. 6 L E St. DATED JULY 1, 1977,&,ANY LOCAL RULES APPLICABLE. CONTAfN IN RE,OUIRED TO REMOVE ALL LOAM AN b CLAY G -.2. ANY CHANGE-TO THIS PLAN MUST BE APPRD. IN_�MATERIAL BENEATH PIT. REPLACE EXCAVATED MATERIAL ,� WR I t ING BY M R. CHARLES D. SPOH.R.WITH �-CLEAN CLAY FREE :,GRAVEL MEcHA NICALLY 3. WHEN CONSTRUCTION IS COMPLETED, PRIOR.TO BACKFILLING COMPACTED IN .PLACE. F./GAL I GALS NOTI FY, THE, ENG I NEER AND, BOARO-OF HEALTH,FOR I NSPECTION.D�5E )5 Al -s.F. S 4. FOUNDATION ELEV. MUST BE CHECKED WHEN COMPLETED..R A- S. F/GAL GALS ;BOTTOM A E = , 87 Sg:Q DER OWNERS )Ul-L 5. THESE ELEVS. MUST NOT BE CHANGED WITHOUT WRITTEN OTAL AREA 285-S.'F TOTAL GALS �'�ppRovAL By CHARLES D.:SPOHR.0 LEGEND 6. FOUNDATION INSPECTION REQD. WHEN EXCAVATED. -7 +50.0 EXIST. GROUND . ELE.V',,,Bo M. -'NOT Eo 50.0' FINISH GROUND ELE V�'UNDERLIN ED, REV D A T E, D E S C R I P T I 0 N) PIPE INVERT. ELEV,;'TEST PIT LOC ATI ON SEWAGE DI SPOSAL SYSTEM R AREA SEPTIC TANK - BU I LDERS NN CLARK �F:L ION BOX E] DISTRIBUT NOTE * 4 0,7' /5, A107-- A r HjF �1"191�e"-160�.se.�,:C"�gpo--,* /so' LOT BETH S : LA 4 C- I � P I P E a 9 A?A45 rlA 4 A 64 I e, FLOOD P/_1119 Al IS-,.it ' 4"BIT. FIBER P.IPE�-TIGHT JOINTS WAY) Hy(P ITCHERS ' 'AN DESIGNED: C�D.SPOHR D AT t.25 A�4k'l ec D RAW(-N G 40.7R T R. D PROPERTY LINE 2-7 3 2-00 DRAWN: SCALE:ASSHOWN KAIN. CODE DISTANCE I PCL I LOT IHOUSE I CHECKED: C. D. S . 9K