Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0029 FRESH HOLES ROAD - Health
29-31 Fresh Holes Road _ Hyannis ` A = 292 149 a. I I . a i s a TOWN OF BARNSTABLE LOCATION` 3! )�5,f 410/e-5 SEWAGE #,A®®e VXAGE -,Z 1V,0 Al'✓J, P ASSESSOR'S MAP & LOTZ INSTALLER'S NAME&PHONE NO.A2 f/ 4.v.s 1 S® S' "7�S r �2 SEPTIC TANK CAPACITY 5 8 ST LEACHING FACILITY: (type (size) V'ka® X S NO.OF BEDROOMS // BUILDER OR OWNER f d&, 9Ad�2 1 w /L PERMIT DATE: 3 6 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by T 9 00 , lift Y. 4 No. aQp ! — )go Fee m er: l/ THE COMMONWEALTH OF MASSACHUSETTS Entered in co put Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Diopogal bpztem Con!gtruction Permit Application for a Permit to Construct( . )Repair( /)-,upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address Lot No. ` A n Owner's Name,Addressr d Tel.No. 2�' .3/ ��� �o �s �%��2 l� 41 Ass sor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow G1;Z12 gallons per day. Calculated daily flow T gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank / S'aD R y/sri Type of S.A.S. Description of Soil Nat of Re�ai or Alter do s(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 n t to place the system in operation until a Certifi- cate of Compliance has been iss this o ealth. Signe Date 11 Application Approved by Date u Application Disapproved for tiv following reasons Permit No. eZ V o y- 5 o Date Issued t No l F 4 A Fee THE COMMONWEALTH OF MASSACHUSETTS,% Entered in computer.Pk Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLEs MASSACHUSETTS ZfppltLatton, for �Dtopoml *pgtem Con5tructton Vermtt Application for a Permit to Construct( )Repair Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address 9a6t No.' Owner's Name,Address Md Tel.No. Assessor's 4 p/Parcel 02 Installer's Name Address,and Tel.No. Desi er's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 7 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow ��� gallons per day. Calculated daily flow �� • 33 gallons. Plan Date Number of sheets Revision Date Title _ Size of Septic Tank S ad y S Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) J/ IJ Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued-by,thi Bo .d-of ealth. / Signed Date/ / �! Application Approved by v "� Date �l/�3/0V Application Disapproved for the following reasons Permit No. a DO I Date Issued IN_?1(J t/ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certiftcate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( ) Repaired ( ) Upgraded( ) Abandoned( )by I)ILC '41 'G., 5f at 5�3/ � S' cl 'cS /� ��/�.�'-� has been constructed i accordance with the provisi ns of Title 5 and the for Disposal System Construction Pe t No. a CX L�-1'90 dated Installer ����"� �"�S i Designer /`l�/I The issuancg of this ermit shall not be construed as a guarantee that the system will function as designed. Date 4 �l ���® Inspector �a � r. ———————————————————————————— No. 1V�Gl� I r� ------ —Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLEs MASSACHUSETTS 7igoga1 *p5tem c.on5truction vermit Permission is hereby granted to Construct _ )Repair/� �T_ rade( )Abandon( ) System located at c� ' 3� r" �� and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction 'u�stt be completed within three years of the date of thitpeermiio Date:_._ L//a U 1 Approved by rh--�`l ,' '\ � Town of Barnstable P��fj"E TOww Regulatory Services Thomas F.Geiler,Director snWSTAsr a.KAM • 4� i6s�. �• Public Health Division '�TFo. a Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: AF W t,, Z j 200 4 Designer: � �� RJS • Installer: AlLc t/ co g. Address: . . o - i` X Address: 1�y,49 •✓w 15 On 3116 A4 G,r �.+�sT was issued a permit to install a (date) (installer)septic system at YOZ65 /'/�O a based on a design drawn by (address) e dated o2 8� 0 . (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State&Local Regulations. Plan revision or certified as-built by designer to follow. OF DAR (Installer's Signature) R No. 1140 I C'/STE�1O M �gNItARIPN /A. (Designer's Signature) (Affix Designer's tamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND-AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. . Q:Health/Septic/Designer Certification Form .,�,� TOWN OF BARNSTABLE LOCATI0N�.3/ r;*@ 4-5'� '410 02.5 Pl d� SEWAGE el— I O VILLAGE_ /,4 A/4/1,5 /ASSESSOR'S MAP&LOTI INSTALLER'S NAME&PHONE NO.Aa C& 4-S7 5- SEPTIC TANK CAPACITY f 5 S� LEACHING'FACILITY: (type) /1,e-i9.0 ..<,,,;c1 r4A'o,2t (size).V`xo20 X A NO.OF BEDROOMS BUELDER OR OWNER A4�1 gg -lva avi n/$ �L PERMITDATE: 6 COMPLIANCE DATE: 02 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and L aching Facility (lf any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility'(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by 1 y 3q,j'� -- OP t-f3I5' Town of Barnstable P# �pFTHE Tpk� ` Department of Regulatory Services �� snarisrABM Public Health Division Date v 6 m° s63q 200 Main Street,Hyannis MA 02601 �p . ♦�' , prfD!AA'�b i I /�, Date Scheduled � � v Time I f)I M Fee Pd. Soil Suitability Assessment for Sejafe Disp sa Performed By: Witnessed By: OCATI N & GENERAL INFORMATION Location Address Owner's Name W rt8,r '1- Address 1 r4A✓I/1 Assessor's Map/Parcel: Engineer's Name��� y y 1� NEW CONSTRUCTION REPAIR Telephone# S'!i'j lv`� �. Surface Stones /VD Land Use �Qi�/ov,���- • Slopes(/o) ./ Distances from: Open Water Body .J' ft Possible Wet Area 500 ft Drinking Water Well N ft ft Drainage Way ft Property Line J ft Other — SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to,holes) Parent material(geologic)d t,]-W�� 1 1� Depth to Bedrock I"1A Depth to Groundwater: Standing Water in Hole: IVlA Weeping from Pit Face 1A/ 0 Estimated Seasonal High Groundwater 'v/ DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: in. Depth Observed standing in obs.hole: in. Depth to soil mottles: Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level— PERCOLATION TEST Date Time Observation Time at 9" Hole# rl— Depth of Perc �j � Time at 6" Start Pre-soak Time @ Time(9"-6 End Pre-soak ` + µ Rate Min./Inch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back--------- ***If percolation test is to be conducted within 100' of wetland,you must first no the Barnstable Conservation Division at least one(1)week Prior to beginning. Q:HEALTH/WP/PCRCFORM DEEP OBSERVATION HOLE LOG Hole# Depth.from Soil Horizon Soil Texture Soil Color Soil Other Surtltce(in,) (USDA) (Munsell) Mottling '(Structure;Stones,Boulders.,, Qnsigton4%ON,a avel).. )46& DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistencv %Gravel) DEEP OBSERVATION HOLE LOG Hole# Other Depth from Soil Horizon Soil Texture Soil Color Soil Surface(in.) (USDA) (Munsell) Mottling Cons stepre,Stones,Boulders. Consistencv %Gravel) Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes Within 100 year flood boundary No Yes De th of Naturall Occurring Pervious Material Does at least four feet of-naturally occurring pe ious material exist in all areas observed throughout the r area proposed for the soil absorption system? tali If not,what is the depth of naturally occurring pervious Certi_ fication I certify that on 10�� (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 " ing,expertise a d experience described in 310 CMR 1.5.0 '{ ��✓ Date '[ Q� Signature 4 Q:H EALT1-l/W P/PERC FORM F Ii x TOWN OF BARNSTABLE '. LOCATIONS ` 3 r � �S/� �v lF5 Pe CO SEWAGE VILLAGE �/-/A Al y ASSESSOR'S MAP & LOTS-��' INSTALLER'S NAME&PHONE NO. a e,'y l .7 SEPTIC TANK CAPACITY S' 1� S vim• '" A..,3,tr e i..3 r�/�;6 -x Q LEACHING FACILITY: (type) .�•C`ii/> 1��•/r2A'c (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: leCOMPLIANCE DATE: 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) Feed Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by i C-nLIP � I v— - R� �� 3cf -f-1 FORM30 Ilr�w HOBBSB WARREN'" THE COMMONWEALTH OF MASSACHUSETTS y� ARD F H ALTH CITY/70 W Q O PA NT AD RESS {^�' TELEPHONE � C Address_ � g Mod Occupant / VG Floor_ A artment No. No.of Occupants P p No. of Habitable Rooms No.Sleeping Rooms ___ ¢� No.dwelling or rooming units''._./I©_ _ N S ies _ o �n fi4Fj4j1efiP0rName and address of owner�V� p �;�j 7-- - Remarks i Reg. Vio. //!/1 YARD Out Bld s.: Fences: OA% Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B E] Fi ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs.- Lighting: STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N E ui . Repair TYPE: Stacks, Flues,Vents: j 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 Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink Stove Bathing,Toilet Facil. Vent.,Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rais,Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE I OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION REPO T IS SIGNED AND CERTIFIED UNDER THE PAIN ND PENALT F PERJURY G/ n INSPECTOR /TITLE M. DATE TIME _ _ P.M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. �Y�FTHEI Town of Barnstable ins Department of Health, Safety, and Environmental Services BAM 9�p 1 A•�� Public Health Division TFO MA't 367 Main Street, Hyannis MA 02601 FAX Date: Number of pages to fo low: To: From: p Phone: Phone: 508-862-4644 Fax phone 06 1. Fax phone: 508-790-6304 CC: -- REMARKS: Urgent For your review Reply ASAP Please comment i e CID I ^! y 3 i SSE!-14-98 02:44P HOUSING-ASSISTANCE CORP 508 775 7434 P.01 Tel. (508)771-5400 HOWLING INSSIVMWANWAWM u (508)255-5507 m V (508)477-0301 r T_ 460 West Main Street,Hyannis,MA 02601-3698 FAX(508)775-7434 Senator Edward M. Kennedy United States Senate Washington, D. C. 20510-2101 Dear Senator Kennedy: In response to your inquiries regarding the family of Marlene and Dennis Devine, I want you to know of our work with this family in their most difficult situation. The family is presently a guest in one of our scattered site shelter units which is a two bedroom apartment located in Hyannis. While we are well equipped to deal with the family's need for shelter and have the skills to work with them to locate housing,their special housing needs as related to their medical conditions are beyond our expertise. After numerous inquiries we were finally given medical information which we addressed as best we could. Since the presence of carpets and gas cooking were among the problem areas,we offered the family a three bedroom apartment which had carpet in only one room (and we could remove it) and electric cooking. This was turned down because of the family's lack of transportation though we were willing to work with them to meet those needs. lt is, of course,the province of the Department of Transitional Assistance to locate shelter space across the state for families. Even working together and contacting shelters closer to the family's doctors does not better address the medical issues and would likely place the family in a congregate setting (one or two rooms at best) rather than the apartment setting we can offer. We are, therefore,open to suggestions from any resource and in the meantime are doing our best to serve this family. We,too, are hopeful that through efforts such as yours this family can get on with their lives leaving behind the issues that they presently face. Sincerely, Allison A Cook Program Director: Family Housing Services Post-it"Fax Note 7671 Date AlPages► To From R-M". Co. Phoee N tl Fax g Fax N Sep-14-98 02:44P HOUSING ASSISTANCE CORP 508 775 7434 P.03 nq F� HOUSHIG ASSIrMnCIE Tel. (508)771-5400 (508)255-5507 RR (508)477-0301 _:.� ....._.mod�... .. , 460 West Main Street,Hyannis,MA 02601-3698 . -- FAX(508)775-7434 June 11, 1998 Marlene & Dennis Devine 29 Fresh Holes Road Hyannis, MA 02601 Dear Marlene & Dennis: Today, Joan was dropping; off mail at your unit and noticed cockroaches on the walls and Floors. During your shelter stay you have repeatedly refused to allow Terminix to enter the unit to exterminate or even put traps around. I understand that you have stated health reasons for this, but it is at the point that we must exterminate or allow the unit to become infested. The extennination will take place on Tuesday, June 16,1998 at 2PM you must leave the unit for at least 3-4 hours. I will place your family in another unit for the night if you wish, so please let its discuss this. Joan will discuss the preparations required for this. If you have any questions please feel free to call. Sinc ly, Dolores Barbati Facility Director A foca(housing partnership organization Sep-14-98 02:44P HOUSING ASSISTANCE CORP 508 775 7434 P_02 ConTel. (-well pe508)771-5507 (508)477-0301 ..'r 460 West�Main Street,Hyannis, � �H a , MA$..�. 02601-4 FAX _ .__.._...,_, �......_ _._.. .�.� (508)775-7434 April 27,1998 ' Marlene&Dennis Devine 29 Fresh Holes Road Hyannis,MA 02601 Dear Marlene&Dennis: Lane i week ending April 10,19)8 your etnartager,Joan Bassett,showed you bosh a unit on Brassie Lane Dennis. Tltis unit better suited your medical needs than our there is only one room with carpeting,the livin Y Present unit. The cooking is electric, heat,but the furnace is in the g vented. h could be removed. The unit does have gas basement and well vented. It is my understanding ihal your family has refused this wtit. I understand the unit would have transportation more difficult but at lltis time Brassie Lane is the only ade unit that meets mmedical requirenls. involved at yourr req copy of his ,,ter willuest,be given to DTA,your doctor,and Senator Kennedy's office,who have become Sincere ; oloMS Barbati , FadhtY Director A loeal housing partnership organization r f'�ti/GY`�Y.t�^'A�'��3-iY'r,r-..:�J��...,.-f'.'ay���7.+^.w,43�-^�7�,.�A�.+�•i"tS.ny,'�f`�.'.�c�.+y�y�-!!"�4 rl:r-j � •��......,�_rwF�'r�`L-.1„~" f,.�,��.,'Vi.w-... .•^l„^'ti E ! THE COMMONWEALTH OF MASSACHUSETTS ' FORM 30 C&W HOBBS 8 WARREN M ;_._�.. .._. , B D O HEALTH CITY/TO' 6 4 -OrL] AM ADDRESS ,M 5 0 yeW � •, ttt,��t/// I1J TELEPHONE TELEPHONE ' Address VN®C Occupan A "� °• Floor Apartment No. No.of Occupants t ry No.of Habitable Rooms No.Sleeping Rooms f?t No. dwelling or rooming unit o. t ri s r' t?-'l'"' Name and address of owner �1 1 r� D _,t✓' t,.: ! Remarks Reg. Vio. ` + YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof ;• Gutters, Drains: ' Walls: Foundation: Chimney: _.., BASEMENT Gen.Sanitation: Dampness: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: ' Obst'n.: / Hall, Floor,Wall, Ceiling: Hall Lighting:, Hall Windows: HEATING Chimneys: j 1 Central ❑ Y ❑ N Equip. Re air V 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 Wirin : DWELLING UNIT r Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room A. _ A Bedroom 1 U/V a0bo Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: Stacks, Flues,Vents,Safeties: 1 `� Kitchen Facilities Sink _ }. Stove U CI� Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.:, / ' Wash Basin, Shower or Tub: Infestation Rats, Mice,,Roaches or Other: Egress Dual andQbst'n: General Bui1din Posted ' Locks on Doors: ONE OR MORE OF-THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE" AUTHORIZED INSPECTOR.(See Over) ,a "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAIN AND PENALTIES-OF PERJURY 41, G INSPECTOR �' R � :,�J � r �•�' TITLE t, DATE TIME P.M ter: X.M. THE NEXT SCHEDULED REINSPECTION J 410.750: Conditions Deemed to Endanger or Impair Health or Safety 1 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 violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash,which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation,or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. • 11981 y t El aabeth. 0 Jones, Trustee,. . Quaker Vialage; Assn. - a - c/o. Dolben' Tnc;.;,Agests 40 Court St. . .' . 'Boston, Ma. . 02108 NOTICE TQ ABATE .A PUBLIC HEALTH ,=ISANCE ' - The property owned by .you at 30 F-eshh Holes .Roast; Hyannis, was' 'in.* spected on April 29, 1981, by -Ronald Gifford, ' Health" Inspector 'for. the .Town of Barnstable, because of- a' complaint,by. .the tenant, ,. Mary X ou Edwards, The full ming violations.of State Sanitary .Code, Chapter II O5 CMR 41Q 0U4 wer®_found:' - REGULATION- 410..351' (. ) : ' Wall .--witch.-for 'light, ,in front~. `bedroom defective - light will; ,not stay ,en, .sometimes switch sparks REGULATION' 410. y(B) s: I3irige on to�.�et seat` broken. . REGULATION .4.0.553: Screens misoirig. , n windows in both f ront` and rear bedrooms, ' You are directed t0 ;correct• all4,.V' iola:tic;ns within f ivee(s') days<` of ter the receipt,bf ,-this order. { . s• You may requests hearing'before. the ,Board -of: Health if,written petition• requesting same ,ih rece ved.'se'ven 9) • day$ after the L . date •order. served.: .•.. ,. i ` Non-►co npli arise: 'could result in a'1ine'' of up to 5500. each "day''s. failure`:to Caiply with..an order•. shall contitiite .a .separate` Viol a_ PER ORDER OF t THB. BOARD."OF HEALTH John M. Kelly Di.rector cif Pub3.ic;He'alth cc: Mr -Grover. Martin «i;. Mso Mary Lou Edwards, Y a BOARD OF HEALTH Town of Barnstable P.O. Box 534 Hyannis, Massachusetts 02601 This is an important legal document. it may affect your rights. You may obtain a translation of this form at the Town Office. ARTICLE II STATE SANITARY CODE Address: . . . .--F.Q. . . .l .E.:S.h!. . . . . . //a<-FS. . ./Z.. . . . . . . .L/Y,4.Iv./. . . . . . . . . . . . No. Occupants . . . . . . . . . . . . Occupant: . . . . ./31112-Y. . C o.U. . . . . .E..1�60"9/z. h.5 . . .p . . . . . . Floor: . . . . . . . . Apt. No. . . . . . . . . No. Dwelling Units: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . No. Rooming Units: . . . . . . . . . . . .` . . . . . . . . . . . . . . . . . . . . . . . . No. Stories: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Basement: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Type Structure: . . . . . . . . . . Frame: . . . . . . . . . . . . Brick: . . . . . . . . . . . . Semidetached: . . . . . . . .. . . . . Detached: . . . . . . . . . . . . No. of Habitable Rooms: . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . No. of Sleeping Rooms: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Owner: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X=VIOLATIONS REGULATION LIVING ROOM YES NO 7.1(a) Is there sufficient natural light? 7.1(b) Are there two separate electrical outlets in good repair? 7.1(b) Is there one outlet and one light fixture in good repair? 8.1A,8.1B(e) Is there proper ventilation? 1.3.1A Are the windows in good repair, weathertight and fit for the use intended? 13.1 Are the walls in good repair and fit for the use intended? 13.1 Are the ceilings in good repair and fit for the use intended? 13.1 Are the floors in good repair and fit for the use intended? 14.5. Are the exterior openings screened? REGULATION SLEEPING ROOM #1 (identify), 7.1(a) Is there sufficient natural light? 7.1(b) Are there two separate electrical outlets in good repair? 7.1(b) Is there one outlet and one light fixture in good repai 8.1 A,8.1B(e) Is there proper ventilation? ,� T 13.1A Are the windows in good repair, weathertight and fit for the use intended? 13.1 Are the walls in good repair and fit for the use intended? 13.1 Are the ceilings in good repair and fit for the use intended? 13.1 Are the floors in good repair and fit for the us intended? 14.5 Are all exterior openings screened? �� 11 Is there adequate space for the number of occupants? REGULATION SLEEPING ROOM #2 (identify) 7.1 (a) Is there sufficient natural light? 7.1 (b) Are there two separate electrical outlets in good repair? 7.1 (b) Is there one outlet and one light fixture in good repair? 8.1 A, 8.1 B(e) Is there proper ventilation? 13.1 A Are the windows in good repair, weathertight and fit for the use intended? 13.1 Are the walls in good repair and fit for the use intended? 13.1 Are the ceilings in good repair and fit for the use intended? 13.1 Are the floors in good repair and fit for the `se intended? 14.5 Are all exterior openings screened? , -A 11 Is there adequate space for the number of occupants? REGULATION BATHROOM 3.1A(a)3.113(a). Is,toilet with seat available? 3.1A(b)3.1B(b) Is washbasin available? "4 3.1A(c)3.18(c) Is shower or bathtub available? 3.1D 3.2 Are the facilities in a clean, smooth, impervious and sanitary condition? 4.1 (9.1 &9.2). Is cold water for facilities available (with sufficient quantity)? 5.1 (9.1 &9.2) Is hot water for.facilities available (120 F- 140 F)?. 9.1 &9.2 Are the facilities properly connected to drain line? 7.3&9.3 Is there at least one light fixture in good repair? 7.4& 9.3 Is there an electrical outlet in good repair at washbasin? 13.1 & 13.1A Are the windows in good repair, weathertight and fit for the use intended? 13.1 Are the doors in good repair and fit for the use intended? 13.1 &13.6 Are the walls in good repair and fit for the use intended? 13.1 & 13.6 Are the floors in good repair and fit for the use intended? 8.1A&8.18 Is there proper ventilation? 13.6 Are the floors and walls of nonabsorbent material? 14.5 Are the exterior openings-properly screened? X-VIOLATIONS REGULATION KITCHEN YES NO 2 Is the room suitable? Is the sink available and of sufficient size and capacity? 4.�1(9.1 &9.2) Is cold water for the sink available (with sufficient quantity and pressure)? 5.1(9.1 &9.2) Is hot water for sink available (120 F- 140 F)? 9.1 &9.2 Is sink properly connected to drain lines? 2.1(b) Is there a working stove and oven? 9.3 Is the stove and oven properly connected and vented? 2.2 Are the facilities clean, smooth, impervious, nonabsorbent? 7.2(a) Is there one light fixture in good repair? 7.2(b) Are there two electrical outlets in good repair? 7.2(c) Are the windows(if kitchen exceeds 70 sq.ft.)equal to at least 10% of the floor area? 13.1 & 13.1A Are the windows in good repair, weathertight and fit for the use intended? 14.5 Are the exterior openings properly screened? 13.1 Are the doors in good repair and fit for the use intended? 13.1 Are the walls in good repair and fit for the use intended? 13.1 Are the ceilings in good repair and fit for the use intended? 13.1 Are the floors in good repair and fit for the use intended? 13.6 Is the floor impervious and easily cleanable? 2.1(c) Is there adequate space and facilities for installing of Refrigerator? 8.1A,8.1B(a) Is there sufficient ventilation? 9.3(a)9.3(b) Are all owner installed appliances properly installed? 9.4 Are all occupant installed appliances properly installed? REGULATIONS COMMON AREA AND EXITS 7.5 Are interior common areas properly illuminated at all times? 7.7 Are there operational and sufficient and properly located light switches and fixtures? 13.1A Are the windows in good repair, weathertight and fit for the use intended? 13.1 B Are the doors in good repair, weathertight and fit for the use intended? 14.5 Are all doors screened as required? 13.1 Are the ceilings in good repair and fit for the use intended? 13.1 Are the walls in good repair and fit for the use intended? 13.1 Are the floors in good repair and fit for the use intended? 15.8& 15.9 Are all common areas clean? 13.1 Are the stairways in good repair and fit for the use intended? 13.3& 13.4 Are handrails in good repair and fit for the use intended? 13.5 Are all required balusters or other devices in place? 18.4 Is every entry door of a dwelling unit fitted with a proper lock? 18.3 Does the main entry door of a dwelling close and lock automatically? 18.6 Is the building properly posted with the name of owner? 3.2 Are the common bathroom facilities clean? 12.1 & 12.2 Are there sufficient and properly maintained exits? REGULATIONS EXTERIOR Are light fixtures and switches properly located? 13.1 Is the chimney in good repair? 13.1 Are the porches in good repair? 13.1 Is the foundation in good repair? 13.1 Are the stairs in good repair? 13.1 Are the structural elements in good repair? 13.3, 13.4& 13.5 Are all required hand railings and balusters in place and in good repair? 13.4 Are there walls or protective railings as required? 15.4 Is"the storage of rubbish and garbage proper (occupants)? 15.3 Are there sufficient and properly located receptacles? 15.10 Are the private passageways or rights of 'way clean and sanitary? 13.1 Are the gutters and down spouts in good repair and fit for the use intended? REGULATIONS GENERAL 10.1 Are all required services available and working? 6.1 Are the heating facilities in good repair? 6.2 Is heat being supplied at proper temperatures. (68 F-78 F)? 5.1 Are hot water heating facilities in good repair? 9.3(a) Are all required facilities properly=.installed and vented? 6.5 All space heaters in use meet the ,proper requirements? 7.9 Is there no temporary wiring in use? Location? 7.8 Is the electrical service safe and adequate? 14.1, 14.2& 14.3 The dwelling is free of insect rodent"presence? 15.7 Is the dwelling unit maintained in a clean and sanitary condition by the occupants? REGULATION OTHER 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 Regulation 29.2 of the code or the Authorized Inspector. A.M. INSPECTOR TITLE ��` A.M. DATE ` TIME _ U THE NEXT SCHEDULED REINSPECTION IS: DATE TIME HYANNIS PEDIATRIC GROUP, INC. • Py 140 YARMOUTH ROAD HYANNIS,MA 02601 GERALD W.HAZARD,M.D. HOURS BY APPOINTMENT ONLY HERBERT O.MATHEWSON,M.D. LEIF R.NORENBERG,M.D. Tel.(508)775-3727 RICHARD D.BLOOM,M.D. Fax:(508)778-9308 EILEEN N.HANSBURY,PA-C October 5, 1998 RE: Devine family, Dennis and Marlene Devine and children: Joshua, Rebecca, Tanya and Tanisha To Whom It May Concern: Please be advised that Mr. &Mrs. Devine spoke to me about their housing situation. They are very concerned about possible exposure to asbestos insulation wrapped around the furnace piping and visible mold growth inside the home. It concerns me that asbestos would be in the house and certainly removal seems appropriate. Unfortunately, their situation is complicated, as Mr. and Mrs. Devine by history have chemical sensitivities according to their specialist, Dr. LaCava. Please try to remedy this situation or provide alternative housing as photos they presented in the office appear to show substandard housing conditions. Sincerely, / Richard D. Bloom, M.D. Please see the enclosure from the Board of Health. �- �a Town of Barnstable oFt, , Regulatory Services Thomas F. Geiler,Director ST" Public Health Division Ai1639. s � Thomas McKean, Director FD Mp`l 367 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 November 6, 2001 Howard Winer P.O. Box 434 Harwich Port, MA 02646 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00,STATE SANITARY CODE II,MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE BOARD OF HEALTH NUISANCE CONTROL REGULATION NUMBER ONE The property owned by you located at 31 Fresh Holes Rd., Hyannis wasi`inspected on -- October 31, 2001,by Donna Z. Miorandi, R.S., Health Inspector for the Town of Barnstable,because of a complaint. The following violations of the Nuisance Control Regulation Number One Regulation and the Sanitary Code II were observed: 410.501: WEATHER TIGHT ELEMENTS Rear storm door is not weather tight. Front bottom storm window is missing. You are directed to correct above violations within ten (10) days of receipt of this notice. You may request a hearing if written petition requesting same is received by the Board of Health within seven (7) days after the date order is received. However, this violation must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order could result in a fine of not more than$500. Each separate day's failure to comply with an order shall constitute a separate violation. You are also subject to non criminal citations of$40.00 for the first violation and $15.00 for each additional violation. Tickets will be issued daily until the violations are corrected. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director'of Public Health Tenant: Debbie Coddington, 31 Fresh Holes Rd., Hyannis. CC: Mr. Robert Hooper, Barnstable Housing Authority, 146 South St., Hyannis, MA 02601. Qi Health.,4VpfiIes/Donna%1s The Town of Barnstable DesasTAn Department of Health, Safety and Environmental Services rasa Public Health Division 367 Main Street,Hyannis,MA 02601 Office 508-790-6265 Thomas A.McKean FAX 508-775-3344 Director of Public Health January 3, 1997 Howard A. Winer P.O. Box 741 South Yarmouth,MA 02664 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00,STATE SANITARY CODE II, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE BOARD OF HEALTH'S NUISANCE CONTROL REGULATION NUMBER ONE The property owned by you located at 31 Fresh Holes Road,Hyannis was inspected on December 31, 1996 by,Edward F. Barry,Health Inspector for the Town of Barnstable,because of a complaint. The following violations of the Nuisance Control Regulation Number One Regulation and the Sanitary Code II were observed: 410.351: Wastewater backing up in the toilet and bathtub. You may request a hearing if written petition requesting same is received by the Board of Health within seven(7)days after the date order is received. However,this violation must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order could result in a fine of not more than$500. Each separate day's failure to comply with an order shall constitute a separate violation. You are also subject to non criminal citations of$40.00 for the first violation and$15.00 for each additional violation. Tickets will be issued daily until the violations are corrected. ;PER ORDER OF THE BOARD F HEALTH —7 5F 7 T om as A.McKean Director of Public Health cc: Debra Coddington cdBany/q The Town of Barnstable • Health Department out 367 Main Street, Hyannis, MA 02601 Office 508-790-6265 Thomas A. McKean FAX 50b-WL, 344 `? - 6,�%" 7�l Director of Public Health �� Y,0 Z if ezi� NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY CODE II, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION The property owned by you located at,�/ Y�.,gx `i t" l� w inspected on / �-- �1 , ' 1994 by, Health Inspector for the Town of Barnstable, because of a complaint. The following violations of 105 CMR 410.00, State Sanitary Code II, Minimum Standards of Fitness for Human Habitation were �o�b,,sseerved: L C-Y-ou are directed to correct these violations within�t"snty- four (24) hours of recei t of th' notice. You are al dir ted t orrec within days/ho rs of recei of i notic . You may request a hearing if written petition requesting same is received by the Board of Health within seven (7) days after the date order is received. However, these violations must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order could result in a fine of not more than $500. Each separate day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health i s i Town of Barnstable " 1 � I Health Department Nam367 Main Street, Hyannis, MA 02601 2 Office 508-790-6265 Thomas A. McKean FAX 508-775-3344 Director of Public Health March 6, 1996 Winer Realty Trust Howard A. Winer, Trustee P.O. Box 434 Harwichport, MA 02646 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY CODE II MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE, ARTICLE 51 The property owned by you located at 31 Fresh Holes Road, Hyannis was inspected on March 6, 1996 by Christina Kuchinski�Health Inspector for the Town of Barnstable because of a complaint. The following violations of the Town of Barnstable Rental Ordinance Article 51 and the Sanitary Code H were observed: 410.201: Ambient air temperature of 58 degrees in child's bedroom at 10:00 a.m. 410.280: Window near closet in child's bedroom would not open. You are directed to correct the violation of 410.201 within twenty-four (24) hours of receipt of this notice by supplying sufficient heat to the child's bedroom. You are also directed to correct the remaining above listed violation 410.28 within seven (7) days of receipt of this notice by repairing the window near the closet. You may request a hearing if written petition requesting same is received by the Board of Health within seven (7) days after the date order is received. However, this violation must be corrected regardless of any request for a hearing. I Please be advised that failure to comply with an order could result in a fine of not more than $500. Each separate day's failure to comply with an order shall constitute a separate violation. You are also subject to non criminal citations of$40.00 for the first violation and $15.00 r corrected. ill issued daily until the violations are co Tickets w be for each additional violation. y PER ORDER OF THE BOARD OF HEALTH 11 orn A. McKean Director of Public Health cc: Donna Jones, tenant f k 3 A 1 I' ref lP-Y Mr./l Q cuc L/3 14&4 P NOTICE TO ABATE VIOLATIONS OF 105 R`41000:'STATE SANITARY CODE II. MINIMUM STANDARDS OF FTTNESSIOR"HUMAN HABITATION AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE,ARTICLE 51 The ro ert owned b you located at 3/ p Y Y Y was inspected on 199 by CYh KI r2Health Agent for.the;Town of Barnstable because of a complaint. The following violations of the Town of Barnstable Rental Ordinance Article 51 and the Sanitary Code II were observed: y/o.aol pm.b(c�-f air - uke v ,°)C: Ghcl� s y10. vr ow ✓�e� c lased �vc�uI by f- ©P e*1 F . Al Xyll- 1 r Fa f .sir Y y'F4 s { - p , '� `[ISt✓ +�y'yg Doi ' 4 ff y I ��'l Tl { 44 r` I , Y You are directed to correct the violation of within 24 hours of receipt of this notice by (b kgA f s au w-ee +-t) : f l (s in You Are also directed to correct the remaining above listed violations within seven (7)days of receipt of this notice. You may request a hearing if written petition requesting same is received by they Board of Health within seven (7) days after the date order is received. However, these violations must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order couid result in a fine of not more than $500. Each separate day's failure to comply with an order shall constitute a separate violation. You are,also subject to non criminal citations of$40.00 forthe first'violation and $15.00 for each additional violation. Tickets will be issued daily until the violations are corrected. Enclosed are citation numbers due to violations observed on PER ORDER OF THE BOARD OF HEALTH k {0. Thomas A. McKean , r��' % {, Director of Public Health { S t Town of Barnstable z fy %iafi�a"�",tse aya,X . s , t 1 f# r y Ysy�. y al a f rk N 4 ' .xa-.. rtr i . h{x"k!iy 'yx� V kit! 'f•,. ,,> ,' e7 Fi.` i 'i x' , tt � 4 FA .w'"f '• ` w ' FORM30 HOBBS6 WARREN,INC.NOV.197&1983 THE COMMONWEALTH OF MASSACHUSETTS �s BOARD OF HEALTH CITY/TO��� 4\ a DEPARTMENT ! f I ADDRESS/ TELEPHONE Address Z/ F—dzk -� ' `-� l a4V Occupant + I Msl� �l^-Q_f Floor Apartment No: No.of Occupants No.of Habitable Rooms No.Sleeping Rooms No.dwelling or rooming units No.Stories Name and address of owner /-�n� A• k)i cis T k -f1W- kAk,-e-i, 10- d' t3 4k y3 V o I44 i9 Remarks Reg. vlo. YARD Out Bld s.:/Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: 1A h 0 A j ► Dual Egress:and Obst'n.: ,1A%W ❑ B ❑ F ❑ M Doors,Windows: 1 O t 14 Roof f Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Lighting: STRUCTURE INT. Hall,Stairway: Obst'n.: Hall,Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Is Central ❑ Y ❑ N Equip. Repair �` V 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 Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Su .Ten.,Gas,Oil, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink Stove Bathing,Toilet Facil. Vent.,Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats,Mice,Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY." INSPECTOR �Y�f,/.� iTITL'E ��i�'/ DATE / �� TIME P.M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. a 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of these items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.000 through 410.499 state minimum requirements of fitness for human habitation, any violation has the potential to fall within this. category in any given situation but may not do so in every case and therefore cannot be included in this listing. Failure to include shall in no way be construed as.a determination that other violations may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of the violation(s) pursuant to 410 CMR 410.830 through 410.833 nor shall it affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to •meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 01R 410.201 or improper -ventink or use of`s 'space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shut-off and/or failure to restore electricity or gas. (D). Failure to supply the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253(A), 410.253(B) and the lighting in common area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. .(F) Failure to provide a toilet and maintain a sewage system in operable condition as required by 105 CMR 410.150(A)(1) and 410.300. (GI Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by an object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450 and 410.451. (H) Failure to comply with the security requirements of 105 CMR 4110.480(D). (I) Failure to comply with any provisions of 105 CMR 410.600 through 410.602 which results in any accumulation of garbage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of lead-based paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regualtions for Lead Poisoning Prevention and Control 105 CMR 460.000. (B) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health -or dafety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilities as are required by 105 CMR 410.351 and 410.352 so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any of the following conditions which remain uncorrected for a period of five or more days following- the notice to or knowledge of the owner of said condition or conditions: (1) lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either operable. (2) failure to provide a washbasin and a shower or bathtub as required in 105 CMR 410.150(A)(2) and 410'.150(A)(3) and any defect which renders them inoperable. (3) -any defect in the electrical, plumbing, or heating system which makes such system or any part thereof in violation of generally accepted plumbing heating,• gas-fitting, or electrical wiring standards that do not create an immediate hazard. (r)" failure to maintain a safe handrail or .protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A) and 410.503(B). (5) failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (N) Amy other violation of Chapter II not enumerated in 105 CMR 410.750(A) through (M) shall be deemed to be a condition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered'by the board of health. L C A f 1.0N (0,7 p ff eLE5 PoAP S E W A G E PE R M I T M0. ' } _e © vAll�lZ V, l�stU P ISS VILLAGE I INSTA -LLER'S NAME i ADDRESS d U I L D E R OR OWNER '1- DATE PERMIT ISSUED id 4l DATE COMPLIANCE ISSUED Z - g � E fj q � is ` No. 1.. `..� Fss...........fV THE COMMONWEALTH OF MASSACHUSETTS BOARD F H E T Appliratiun for Bhip al Workii Ton. .otrur#iun Frrmit Application is hereby made for a Permit to Construct ( ) or Repair (�an Individual Sewage Disposal Syst t: :�... .1 � .�. ..._... _?Vie.�/..� .. ................................... Location-Add or or Lot No. - ......... •... ...-•-•.......................................................................................... ne Address U�..,.. .. ... .� ... -A .:.........c� . --••----•.............•-••--•.._... ._....------•-••••......•...._............. Installer Address Type of Building Size Lot.................... .....Sq. feet U Dwelling No. of Bedrooms...........................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No. of persons............................ Showers — Cafeteria R, 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 leachingarea.................... ft. 3 Seepage Pit No-----------------_- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution.box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date....................................... . Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water........................ 0 ._.. -- . --- --•--•------------------------------------------------------------------------- 0 Description of Soil-----......S • --••• -----------------•---------........................------•-----•............--• x x -----•...--•--------------------------•---------•-----------------------•---•-------------••--••--•----•--••---•------------ .: .... U rgr r Repair or Alterations—Answer en applicable-- =. h�..�.._ �� -•--......... . ---- --.� - -----�---M'--------------------_ ement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITL% 5 of the State Sanitary Code— The undersig ed further agrees not to place the system in operation until a Certificate of Compliance has bee ssued by the oar oM- th. Signed ••.... •-•-- ........ t ApplicationApproved By................................................... --- ......--•-•-•---•--•----•-- ........................................ Date Application Disapproved for the following reasons:------•-------••--......----•--•---•-•------•---------•---------------------•---------------------...........-- .................. •---------- •------------------------------------------------------------ --------------------------------- ----------------------------------- ---.--•---- ••------- Date Permit No....••---�.....---� `fig.. Issued..--•----------•------------•-----...:---•- ...... Date Ar No. ... Fizz.................. . 6HE r _Z9 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF�...... -................................... ................... ........................... .................................... Appliration for Dispaiial Marks Tonstrudion Prrmit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal —System at: ........................ .......................... Location-Address or Lot No. ................................................................................................ . ............................................ /Owner. 2 ................................................................................................. . .................................................................................................. Installer Address U Type of Building,,,, 44 Size Lot............................Sq. feet aDwelling---f No. of Bedrooms............................................Expansion Attic Garbage Grinder Other—Type of Building ............................ No. of persons............................ Showers Cafeteria P4 Other fixtures ......................................................................... < ----------------------------------------------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gAlons. 9 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter............_... Depth.........._..... W Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ 0.4 Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit..............._._.. Depth to ground water.............._......... ............................................................................................................................................................. 0 Description of Soil.....................:.................................................................................................................................................. ------------- --------------------------------*"*---------------------------"........... -------------------- ------ ---------".......""---------"-------*-------------------- ................................................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable................L..................... ................ ............................................................................................................................................. ...........................................:............ . Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed............................ - 7.....*------------------------------------------------- -------------------- Da),I,, ApplicationApproved By....._._..... .... ................................................. ........................................ Date Application Disapproved for the following reasons:..........................................................................................................--- .............................................................................................................................................................................................. Date Permit No.......... IssuedL..................................................... Date THE COMMONWEALTH OF MASSACHUSETTS";", BOARD OF HEALTH OF................................................. .......................................................................... THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired . by_.........`................. ...............................ol................................................................................................................................... Installer, at............................................ ----------"....... -------------------...*------------- ------------*-----------------------------------*---------- ........- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Cod described in the application for Disposal Works Construction Permit No........... .... dated.......... .............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION-SATISFACTORY. DATE...............................Z ................................................. Inspector.......... ------------ am . ............................ x. THE COMMONWEALTH bF`_M"A`S'*SACHUSETTS BOARD OF HEALTH ..........................................OF.............................. .... ....'l.........I.............................. No......................... Fn...... R�Jlvsgl arks Tanstrurtion frrmft is-hereby granted ..V Permission A I I I ... _. // .......... . ........... . ... .............. 41, �ai ewase' O.Se , to Construct or Repair isp , Syst .......................... at No..... ..... .. ..............12 0� .......... ...... Street -70 as shown on the application f6r Disposal Works Construction Permit No................... Dated',. ...................................... rZ ......................................... ....... ................................................ Board of Health DATE. . ............................. FORM 1255 A. M. SULKIN, INC..zELQ§T6&I ✓ ` �.. � P � \�� � 1 Ste\ 999 A lll 47 ` V -- (� .c 287 Q- ,N<.Y 73'b/ 1.78 ►.0 2 1 4 1 140 jl AC .24AG Tl►C � `I 6 i' 1?.2 17 Lj� 1� .� 0 .'�1 H AC •14AC '� .19 AC, C\ �42 8►G "1 � ti � Q-O 47 azGG-5 2 -� 10 ON 99 LP 177 o c' 321c o 2tAC�1 R,o y ` 6 �.21 C Sp i o ` n 6z4C 183 m .<` 19 1 7 ZI AC Jo V W a 09 a e47 q,g � 1 •Z�74C 69 O ; C •29�s ` 158g •zoq�j - c 1V'} X 90 4 69 3 8 S �4 334 C 254C e�. 5/ qC19 r cn Tr T C a �r 1 1 j . J 0 LOCATION SEWAGE PERMIT NO. .tq 6 3 � VILLAGE IrSTA LLER'S NAME i ADDRESS .. Qo8ezr a. ©vR. Co . 1mc . e U I L 0 E R OR OWNER QyAV�0e V 4 t-�� bars V%YA L Mk DATE PERMIT ISSUED DATE COMPLIANCE ISSUED � �j � - R 70 /v N ls w� n is r i ti 'i F THE COMMONWEALTH OF MASSACHUSETTS BOARD PF HEALTH ........ ................OF.......................................`►' - .:t ... .................... Appliratinn for DiipnBal Works Tnnstrudiun ramit Application is hereby made for a Permit to Construct ( ) or Repair (X an Individual Sewage Disposal System at ...... -----�!� ......L. 1........ :�.....��t1�lt�.......... __........ .-...................--....._..__.... ---� Location• ddress or t No. ..... . Via . t1 ...__A ............._.. .> .... � N Owner �.............. - ...- :.. ! . o.. . 1G.................. .......:� ..4. �ddre,.X._.4 ......... . .................................... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.......................... .....Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building No. of persons............................ Showers — a YP g ............................ P ( ) � Cafeteria ( ) a' Other fixtures ................................. WW Design Flow...........................................gallons per person per day. Total daily flow.........__.._......__.._...._._._..........gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No .................... Wid h ..... Total Length.................... Total leaching area.._.a._..�_.._......:.sq. ft. 3 Seepage Pit No........... Diameter.._. z�.�...Depth below inlet..44............. Total leaching area..-SVt_lsq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by....................... ................... Date..................... Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Al •-----•----••....................................•-------............................._._._.....................................---.......................... 0 Description of Soil......................................................................................... Uw --•--------•------------••----------•-----•..............................•--•.......................------......---------------•-----•..--••-.•--- ,.._................ -- ature of Repairs or Alterations—Answer when ap licable..Ow Exc5rui iK_.'�`S_...8 Q ...............u?.�_ !......Via ° ...........l.r R4 tom» ..__... Agreement: The undersigned agrees to install the of a scribed Individ Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanita ode—The and s' ed fur her agrees not to place the system in operation until a Certificate of Compliance has issued th of heal Date ApplicationApproved By................. .............................•••--• .........•----•--...........-----..----. ........................................ Application Disapproved for the f ollounng reasons:...........................................................................................................--- .........••..........................................................................................._............................................... ............................................ Date PermitNo.............-...............-........_...._.._.._ Issued.............-. ....----......................_ y No is 7 . { THE COMMONWEALTH OF MASSACHUSETTS. s BO`AR;D OF HEALTH ".'t........................ j .. 1 . .t Appliration for 3�is nsttl�` nrk Tonotrurtion 'Itprmit Application is hereby made for a Permit to Construct• (;, -),,or Repair (X) an .Individual Sewage Disposal System at: _ ...... _____ -v.z . I.��� f .. ...................... •----............ ......................_......_...._- --.......- ................ __. a t20 A V3. D'u,T co I hJ.• .+ � t��) i�ddre,s�..,�� ......................................................................... ................... .......................................:...I...... ......._..................................... Installer Address.. Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms.............................. .. .Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building ...... No. of persons............................ Showers A.I YP g ...................... p ( ) — Cafeteria ( ) 0. Other_fixtures ...................................................... Design Flow...........................................gallons per person per day. Total daily flow............................................gallons. Dip Trench No... ••-• -•--_... Width..........:.......... Total -- - Depth W Disposal T Length ................. Total leaching area---.F_•--•--.-;---sq. ft. Septic Tank—Liquid capacitylons Len Width.............. Diameter.. - .......... ..._ 3 Seepage Pit No..................... Diameter......... t.�.. Depth below inlet../............... Total leaching area..`1.�.5....!.sq. ft. Z Other Distribution box ( ) Dosing tank ( ) )_4 Percolation Test Results Performed by......................... Date......................••............ aTest Pit No. I................minutes per inch Depth of Test Tit.................... Depth to ground water........................ Gil Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ �+ -•-•--••.........................................•••-••--.............................--•-•-.....---........................--•--............................. ODescription of Soil................................................•-•---------...............----•----•-••----•--....-----.....................-•-•---•-----•••........................... W .` U Nature of Repairs or Alterations—Ans er when applicable __�_ �.CI `(_.'F'...v u �1� t t3 r 3 -F 1C�a Gel! r""�( s 13i ci t �.+ Ilt . ..... ............. ............ ........ ... .................-------•----.... ....•••-•....-•-............._..-•---•••--....-----.........-----------•-•.................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b6en issued by the*board of health. —7� �, I27/ Signed.............r------.......... ---- -- / ........................_.... / Date ApplicationApproved By................• --......••-•--•---..............�•-..................................._ ........................................ / Date Application Disapproved for the f ollouiingreasons:........................................................------.......5..----•- --- ........................................................................................-.....-----..._..................... -•-•••••---•••--••-•-•--_...................................... --•-- Date PermitNo.................................._.....---........._ Issued--..................................... . ...._ Daft- THE COMMONWEALTH OF MASSACHUSETTS s "� BOARD OF HEALTH Tertifirib of Toutplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.............. ......��.�- i '. O t1► ......_. ....«!. ...,.........-•-•--------•--•--...--------------------•-•----•--....----.................--•--_...._ — Installer Aj Lat.................. ............ ............. .. ...........................------•-•-- -•--•-....••• ...... ..... has been installed in accordance with the provisions of TITLE j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED"AS A GUARANTEE THAT THE SYSTEM WILL/FUNCTION SATISFACTORY. ' DATE......:�i /%l`.�...................................................... Inspector.................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH NoO..y./ ..... .!`.....................OF....... t'�{'..:r.S.� .--�................................ FEE.. ....9.............. Disposal Works T n VZ_ Ca trurtion f rrmit Permission Is hereby granted �� ---•-------------•u...........--•-----.........---....-•--•-••-•--••-•----........................_........................... to Construct ( ) or Repair (A) an Individual ,Sewage Disposal System at No..... -k twz, E1 (fvt E�t?....F� .......�.. O.r.l�f-•------•---------------- ........ ................. Street w // as shown on the application for Disposal Works Construction Permit No... �T ate .. /....... ...... ------ Bd �. DATE................................................................................ oar of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS i ASSESSORS MAP : 2�2 NOTES: 4 G AN TEST HOLELOGS l PARCEL : 1;) THE INSTALLATION MUST BE IN SUBSTANTIAL COMPLIANCE WITH J SOIL EVALUATOR : �• e.( `R.`5 CS HIS PLAN, 1995 MASSACHUSETTS TITLE V & TOWN OF 'I LE BOARD OF HEALTH REGULATIONS. F1.00D ZONE: NvN ttA2.A,t2 WITNESS : 5. T�-1 EPT i ° { REFERENCE: C. (�„��S� � DATE: �l�L, �i- 2) THE INSTALLER SHALL VERIFY THE LOCATION OF UTILITIES, ` s " HY NNI PERCOLAT LON RATE: '""'^/ IN(.bl SEWER INVERTS AND SEPTIC COMPONENTS PRIOR TO ,w Pd� INSTALLATION. W► ,,,R w I br! TH- I ��; ,�,� .TH-2 3) THIS PLAN SHALL BE USED FOR SEPTIC SYSTEM INSTALLATION M ONLY, ` AND SHALL NOT BE USED FOR PROPERTY LINE A LDAMy DETERMINATION. I rn� _ 4) ALL PIPING TO BE 4" SCHEDULE 40 @ 1/8 "/ FOOT. (UNLESS Lr4AMt� ;;, s SPECIFIED OTHERWISE) spa r( 5) THE DESIGN OF THIS SYSTEM DOES NOT ALLOW FOR THE USE OF A LOCATION MAPCt� � •SF) GARBAGE DISPOSAL. MoIvM R b) SEPTIC TANKS AND DISTRIBUTION BOXES (WHEN INSTALLED) ` SafA D C sU MUST BE PLACED ON A MECHANICALLY COMPACTED BASE OR ON Fag 310 6M IL 15,40S 1 (6 V kRl A-Nl.F, FkyM 310.C,44 9- 15 .211 TO A'LW tn1 (� � A BASE OF 6 OF CRUSHED STONE. l.EACA+rN� 70 ►3F- 5 F-"M SLA-$ FovNOhi11W 0. VI 101. �., 7j i '5 1 (40 w,l 14e1-hyItAt Llner PrOp�J 1?l� 39 2 �irivtoy�n T'E��TLz. y�2�Pc���.� w����� No 6w 065�r-VEo �) �!NOWtJ ��V .� w � w7llru of ROPOS�D V-Af-,k J� SEPTIC SYSTEM DESIGN FLOW ESTIMATE (bJFt 941 POILI dt,qjeklP it-ley- QS SA•u00. BEDROOMS AT IdD GAL/DAY/BEDROOM -440 GAL/DAY f: SEPTIC TANK �. EXrsT1 4 P ITS (No767� 440 GAL/DAY ,x 2 DAYS - 9-W GAL r '�6 �'✓ USE,,I� GALLON SEPTIC TANK - Ntln1' SOIL ABSORPTION SYSTEM SS USE `1 Z"R'�F_tJGH: I-! CA'Pf1GrT lNF-/LTili �pr!LS W 3.79 iv a. o+v F.Ap5 -'� ° -% ` ��• �(�. �.x, � , /710Es gj _ SIDE AREA: �2v z +��)2 �.S�Z+�1 Zk2Xb,'?yw �70 ZU c; �rN Ip+ BOTTOM AREA: 2p'x -#- I(�,5`x 13' x 0 7L/ - 2-7-7, 13 1 I-2Ll' .2 7, ��ISTI 4� 4 82 Dt1 FLEX giyo r;pv re�'o(• __ UJuS�ed '{�r,-�e SEPTIC SYSTEM SECTION _ N 8L. �I•� Q j� "1"P,M ToF- h.S /y13 ` LPT '✓' / -"- I 1 i S�O o „S rr 1k j a d t I � Gas a ><F�� �' 47.zs 3►�e�0b1� S - ��•o' I. _...- �R,.�l�? �,,/ �� �' ne ase- v• (�6 �iD BOX 4w. /,SOO GAL 4 7 `lei -ft 6.2 , s jp � i e r /e vt/hC55 Was i �° SEPTIC TANK � r�t El. 4q,?S ran•� (,.'t�o,7S `Nt''� ��,3 I 261x g r i Ba7Tan� aF I CSTtfo L- �L 39 zs Ole 3, � p„�f�e Wash S I TE AND SEWAGE PLAN I e,, rc er kf ►� '1�z��y Ica ► `S LOCATION : 2 d 3/ F4ESVI /fO&Es Ab. Of -bo 1✓11�i�'Pf �+ C�4U,� Ylv'� - l-f A/AI S o?(2 6 co,t/ b.x GT7D P ql,,Ia L( PREPARED FOR : A&H ��/V57k-V P ! V ° H04 C I o � � 31�� ._._ —" •'rf _.._ "31" SCALE: a ®ARREN M. MEYER, R.S. 43 VINE STREET DATE: 4-�8 D UXB U RY, WA 02332 W DATE HEALTH AGENT (781) 585-0293 W 2