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HomeMy WebLinkAbout0005 GENERAL PATTON DRIVE - Health 5 General Patton Drive Hyannis A= 292 —098 i i i No_7-153CR UPC 17'734 smaadxom Made in USA N ti v o C1 ti � ti w 3 0 ZI h i w � W ' a � 2 1 v I I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5 General Patton Property Address Ronald Bourgeois Owner Owner's Name information is required for every Hyannis MA 02601 03/15/15 page. City/Town State Zip Code Date of Inspection 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 forms A. General Information on the computer, use only the tab 1. Inspector. JI ID1 LS key to move your cursor-do not Trevor Kellett use the return Name of Inspector key. TK Septic Company Name 38 Vacation Lane Company Address �—�— West Yarmouth ma 02673 City/Town State Zip Code 5085795502 S113744 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 2S& 3/17/15 Inspector's Signature Date 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. t5ins•3/13 Title 5Official Inspection Fomr.Subsurface Sewage Disposal System-Page 1 of W Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments W 9 P Y Y 5 General Patton Property Address Ronald Bourgeois Owner Owner's Name information is required for every Hyannis MA 02601 03/15/15 page. City/Town State Zip Code Date of Inspection B. Certification (coot.) 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 exfiftration 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): t5ins•3113 Title 5 Offidal Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 it Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5 General Patton Property Address Ronald Bourgeois Owner Owner's Name information is required for every Hyannis MA 02601 03/15/15 page. City/Town State Zip Code Date of Inspection B. Certification (coot.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurfaoe Sewage Disposal System.Page 3 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments w 5 General Patton Property Address Ronald Bourgeois Owner Owner's Name information is required for every Hyannis MA 02601 03/15/15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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 coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal 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 No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than %day flow t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5 General Patton Property Address Ronald Bourgeois Owner Owner's Name information is required for every Hyannis MA 02601 03/15/15 page. Cityfrown State Zip Code Date of Inspection B. Certification (Cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain 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 fails. 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 11 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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts - Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 5 General Patton Property Address Ronald Bourgeois Owner Owner's Name information is required for every Hyannis MA 02601 03/15/15 page. CitytTo`^n State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has 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 ® El information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been 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): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 t5ins•3113 Title 5 Ofidal Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5 General Patton Property Address Ronald Bourgeois Owner Owner's Name information is required for every Hyannis MA 02601 03/15/15 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 4+ Does residence have a garbage grinder? Q Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: current Date Commercial/Industrial 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: t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments w 5 General Patton Property Address Ronald Bourgeois Owner Owner's Name information is required for every Hyannis MA 02601 03/15/15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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 System: ® 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): t5ins-3113 Tite 5 Ottidal Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 i Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5 General Patton Property Address Ronald Bourgeois Owner Owner's Name information is required for every Hyannis MA 02601 03/15/15 - page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed(if known)and source of information: 5/20/96 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 1.8 feet Material of construction: ❑cast iron ®40 PVC ❑other(explain): 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): Depth below grade: f e Material of 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 Dimensions: 1000 g Sludge depth: 3 t5ins•3/13 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5 General Patton Property Address Ronald Bourgeois Owner Owner's Name - rnformation is Hyannis MA 02601 03/15/15 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 30" Scum thickness 1 Distance from top of scum to top of outlet tee or baffle 91, Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? measured Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Septic Tank is water tight and structurally sound with both tees intact and water at the outlet invert, no sign of back up or failure 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 Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5 General Patton . Property Address Ronald Bourgeois Owner Owner's Name information is required for every Hyannis MA 02601 03/15/15 page. City/Town State Zip Code Date of Inspection 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.): Tight or Holding Tank(tank must be pumped at time of inspection)(locate 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 t5ins•3113 Title 5 Offidal Inspection Form.Subsurface Sewage Disposal System•Page 11 of 17 r Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5 General Patton Property Address Ronald Bourgeois Owner Owner's Name information is required for every Hyannis MA 02601 03/15/15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert even 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.): The d box is level and water tight with no signs of carryover 1 inlet, 3 outlets, 2 knockouts Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order,system is a conditional pass. Soil Absorption System(SAS)(locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3113 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5 General Patton Property Address Ronald Bourgeois Owner Owner's Name information is required for every Hyannis MA 02601 03/15/15 page. City/Tom State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 3 ❑ 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.): This leaching consists of 3 leaching pits 1 full(pit 1) 1 with 21"of space between the pipe and liquid (pit 2)and the last one is dry(pit 3) 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments w 5 General Patton Property Address Ronald Bourgeois Owner Owner's Name information is required for every Hyannis MA 02601 03/15/15 page. City/Town State Zip Code Date of Inspection 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.): t5ins•3113 Title 5 Offidal Inspection Forth:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5 General Patton Property Address Ronald Bourgeois Owner Owner's Name information is required for every H annis MA 02601 03/15/15 y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately B 7-] � a (IVD9- t5ins 43 •3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5 General Patton Property Address Ronald Bourgeois Owner Owner's Name information is required for every Hyannis MA 02601 03/15/15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 40+ 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 ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board 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: USGS shows groundwater at 40 feet Before filing this Inspection Report,please see Report Completeness Checklist on next page. t5ins•3/13 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 f Commonwealth of Massachusetts Title 5. Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ., 5 General Patton Property Address Ronald Bourgeois .Owner Owner's Name information is required for every Hyannis MA 02601 03/15/15 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3113 Title 5 Oftldal Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 r i Commonwealth of Massachusetts. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments y 5 General Patton Drive Property Address James Walker -Owner Owner's Name information is required for every Hyannis MA 02601 04/22/11 page. City/Town State Zip Code Date of Inspection 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 A. General Information filling out forms on thethe computer, use onlymythe tab 1. Inspector: -key to move your cursor-do not Michael Kellett use the return Name of Inspector key. Aardvark Environmental Inspections �y Company Name P.O. Box 896 Company Address low East Dennis MA 02641 Cirylrown State Zip Code 508-385-7608 SI 3742 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails "= ❑ Needs Further Evaluation by the Local Approving Authority .-, t ) -n 05/02/11 ---: Inspector's Signature Date The system ins ector'shall submit a copy of this inspection report to the A� oritY(O, pard�2 rrs of Health or DEP)within30=days of completing this inspection. If the system is a shared systeymor has a design flow of 10,000 gpd oT-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. t5ins•.09M Title 5 Official Inspection Form:Subsurface Sewage Disposal S m•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection. Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 5 General Patton Drive Property Address James Walker Owner Owner's Name information is required for every Hyannis MA 02601 04/22/11 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 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: 13) 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): i t5ins•09/08 Title 5 Official fnspection Form:Subsurface Sewage Disposal System•Page 2 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 5 General Patton Drive Property Address James Walker Owner Owner's Name information is required for every Hyannis MA 02601 04/22/11 page. City/Town State Zip Code Date of Inspection 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 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 r . Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 5 General Patton Drive Property Address James Walker Owner Owners Name information is required for every Hyannis MA 02601 04/22/11 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) 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 coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal 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 No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool El ® 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 1/2 day flow t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 5 General Patton Drive Property Address James Walker Owner Owner's Name information is Hyannis MA 02601 04/22/11 required for every y page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain 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 fails. I have determined that one or more of the above failure criteria exist as described in 310 CM 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. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts f TRM��, Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 5 General Patton Drive Property Address James Walker Owner Owner's Name information is required for every Hyannis MA 02601 04/22/11 page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has 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 been 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): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•09/08 Tdle 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 I . Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments. 5 General Patton Drive Property Address James Walker Owner Owner's Name information is required for every Hyannis MA 02601 04/22/11 page. Citylrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: current Date Commercial/Industrial 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: t5ins-09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 5 General Patton Drive Property Address James Walker Owner Owner's Name information is Hyannis MA 02601 04/22/11 required for every y page. Cdy/Town State Zip Code Date of Inspection D. System Information (cont.) 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 System: ® 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): t5ins•02/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 5 General Patton Drive Property Address James Walker Owner Owner's Name information is required for every Hyannis MA 02601 04/22/11 page. Citylrown State Zip Code Date of Inspection. D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 05/20/92 per BOH Were sewage odors detected when arriving at the site? ❑' Yes ® No Building Sewer(locate on site plan): Depth below grade: 1.8 feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): 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): Depth below grade: 1.1 feet Material of 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 Dimensions: 1000 gal Sludge depth: 3" t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 5 General Patton Drive Property Address James Walker Owner Owner's Name information is required for every Hyannis MA 02601 04/22/11 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 28" Scum thickness 2" Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? measured Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tank was sound and tight with tees in place and liquid at outlet invert. 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 Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of W 4 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 5 General Patton Drive Property Address James Walker Owner Owner's Name information is required for every Hyannis MA 02601 04/22/11 page. Cityrrown State Zip Code Date of Inspection 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.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate 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 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 111 of 17 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 5 General Patton Drive Property Address James Walker Owner Owner's Name information is required for every Hyannis MA 02601 04/22/11 page. Cityrfown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Even 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.): The box was level and tight with no sign of carryover. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 5 General Patton Drive Property Address James Walker Owner Owner's Name information is required for every Hyannis MA 02601 04/22/11 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ 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.): This system has a 6'x6 precast pit surrounded by 2'of stone. There was 4' between the liquid and the inlet invert. 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 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5 General Patton Drive Property Address James Walker Owner Owner's Name information is required for every Hyannis MA 02601 04/22/11 page. Cityrrown State Zip Code Date of Inspection 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.): t5ins•09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 14 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 5 General Patton Drive I:� Property Address ?� James Walker Owner Owner's Name information is Hyannis `) MA 02601 04/22/11 required for every State Zip Code (Date of Inspection page Citylrown ! D. System Information (cont.)t I f� Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all.wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: hand-sketch in the area below ❑ drawing attached separately I i a Ij f1 - 1 I � i i TNe 5 ofiaal gmcfjon Form:SuWWfXe SewaW� tem Sys '�e 15 of 17 ► t5ins•09108 q i 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 5 General Patton Drive Property Address James Walker Owner Owner's Name information is required for every Hyannis MA 02601 04/22/11 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: 20.0 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 ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board 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: USGS maps show an elevation of over 20.0 feet. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-09/08 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 5 General Patton Drive Property Address James Walker Owner Owner's Name information is required for every Hyannis MA 02601 04/22/11 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 I b I X iy a 1 -4 I •- �IT 14 y'rr► + n z Wl ,� � x�.a,?�'3 �� t„' '�'. + � eC�'�i'". `'•'�„� .t,�!S Y��_i� i1�` f' ':y S .aF� # J 'M '! � s � a � w -. � . v.. '� �L°* ;'� ay, ,.. a+i', F r fi - (} ;• "a:;}, - ,�'t �` ... '� er.'1. ., y a' 4 � �T�• - �� - `Y o p a y fi d r g , 1 e p e i s . y 4.4 r e :. yG �n�"t:J .�• Y�+t.�'} �,j�•, p �, �fig, ,�' t .. Tx df fir }• .� c # r k, �7 tr i r e. ,icy t '`•al ;5.7 z. }rty {^aa.,t,'" ,� ,Y' 1 '�� ,,_ "1t lv Y, t ' - -: ' }':. �. 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Xr�A•--.,a'b.i..s�ww�wr�wsy r..� .a,�� w.W� -�.+.r.. ..; .ty F 4 �:.i je ."� � ��t,�Y � ,>,+M�w ._-r'�'""'A" „ '� "`�'"-_.s fir... "'-�� •' -� _ F - ^*,� �.. �_� '',,, 41 Fj I ..i up t` A; 9 Y •.� �C � ,�W 1. � R �6" �ice' -}+p' Y G7 r 4� JV 'fir• � $ � � � , it,gil {y Y Y 5 AV Av 1 k. ' 4.'.�. �A, .; +� 4rfr ;..: s h-. � °�,.�^iF�i♦ � „e:fi,dx; i� =- �a�- i' y.r ,_. ;} �r ) fir. �,,1.. J A x'a ,'•'.� wx„�rra 7"'' ^* .- cm ASS yw cn ru ink 4"T r Y r w - Certified Mail#0000 0000 0000 0000 0000 Town of Barnstable Regulatory Services BAMSTABLS, w MASS. � Thomas F. Geiler, Director Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 A (Date) ,,(Name) l� (Street Address) e a-0 4�• (City,Stat ,Zip) 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 .5 Tab& was inspected (Address) on / / 06 by ` $-l�C'oNy✓e�I_ , Health InsDector for the Town (date) (Inspector's name of Barnstable, beeansc-ef— '�� � - WA6 Reason fosinspection) wdJ, 1-70 Theiollow ng vi""oIation*) of the State Sanitary Code were observed: State code violation number-violatio de ri tion 105 CMR 410. 4 - R p zj��� IWF (q3c) .-J A�,f 130OF 54 nc 105 CMR 410. - 105 CMR 410. - Q:\Order letters\Housing violations\Rental ordinance\template.doc • 105 CMR 410. - The following violation(s) of the Town of Barnstable Code were observed: Town code violation number-violation description) §170- '7 - 170- - You are directed to correct the violations listed above within 5 O days (written#) (#) _ of you receipt of this notice by (p�,,"rV � E P 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. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable Cc: -&04 A44,:�. (Name,tenant,o er,Fire Depot.,Uuqding Dept.... T ) Cc: ._ �- 0 1�4/V 2 th inspector's)4 ov `5 QAOrder letters\Housing violations\Rental ordinance\template.doc FORM30 C&W HOBBS&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CITY/TOWN ^ V _ 0 DEPARTMENT - mA �c`�M Vey`ee AD RESS I C50 t" _. ,g6q _I TELEPHONE Address_ " �`^�' Occupant. Floor Apartme t No. No. of Occupants ' No. of Habitable Rooms No.Sleeping Rooms 3 No. dwelling or rooming units No.Stories_— Name and address of owner __A_ 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.- Lighting: STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vent PLUMBING: Sup ly Line: r 2-p ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: 11110 ❑ 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 Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted ' S 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 NSPnCTIOR REPO T IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIE O JURY." I,, INSPECTOR )kv TITLE T r a�DATE I � TIME A.M. THE NEXT SCHEDULED REINSPECTION Ostt��� P.M. .. _..... ........ . ..a_, t a5 .P.,M1 :i,.i n*,y\u �+.C":F:T:S14T,+'Tf'.;fi Mr L. t'!�.'Yr�'r')'YX'C �M � 'S f ViYi'J uLh�hI ..i.t'S.hiPJ`•T. :1.W y�..:. 5v ... � 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 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 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. Parcel Detail Page 1 of 3 � MASS' ' :oE A -f rz q ' Logged In As: Parcel Detail Friday, Octob, Parcel Lookup Parcellnfo Parcel ID 292-098 Developer _LOT 4 Lot Location 15 GENERAL PATTON DRIVE I Pri Frontage`56 Sec Road Sec i Frontage Village EYANNIS _ Fire District;HYANNIS Sewer Acct Road Index i0595 Interactive p Owner Info Owner WALKER, JAMES A I Co-owner Streetl 1726 FALMOUTH RD I Streetz �� City I HYANNIS I State .A. zip j02601 Country FUS Land Info Acres 10.44 use l Single Fam MDL-01 zoning RB _ J Nghbd 0105 Topography Level � � I Road�Paved�mm Utilities ISeptic,Gas,Public Water Location Construction Info Building 1 of 1 Year Roof Ext _. Bunt J 1945 I Struct!Gable/Hip Wail,Vlnyl Siding .I Effect 975v._..... _. .__.� Roof Asph/F�Gls/Cmp AC None Area Cover Type Style Ranch , wall Drywall �� Bed 3 Bedrooms I Rooms Int Bath Model I Residential Floor I Rooms€1 Full I Heat Total Grade Aeraga Min Type Rooms 5 Rooms I http://issql/intranet/propdata/ParcelDetail.aspx?ID=22969 10/13/2006 Parcel Detail Page 2 of 3 H ea t _ Found-r- , stories j1 Story Oil �Conc. Slab Fuel` ation ...... --- Permit History Issue Date Purpose Permit# Amount Insp Date I Comments Visit History Date Who Purpose 3/1/2001 12:00:00 AM SM Meas/Listed'.; '.' " 9/15/1987 12:00:00 AM ML ----- - w Sales History - Line Sale Date Owner Book%Page Sale P 1 4/15/1993-''> WALKER, JAMES A 8523/:144 2 WALKER,JAMES A 1826/146 _ Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parce 1 2006 $80,900 $0 $0 $113,400 2 2005 $74,500 $0 $0 $84,900 3 2004 $60,300 $0 $0 $84,900 4 2003 $44,400 $0 $0 $25,400 5 2002 $44,400 $0 $0 $25,400 6 2001 $40,400 $0 $0 $25,400 7 2000 $29,500 $0 $0 $25,300 8 1999 $28,400 $0 $0 $25,300 9 1998 $28,400 $0 $0 $25,300 10 1997 $18,000 $0 $0 $21,600 11 1996 $18,000 $0 $0 $21,600 12 1995 $18,000 $0 $0 $21,600 13 1994 $19,600 $0 $0 $26,000 14 1993 $19,600 $0 $0 $26,000 15 1992 $22,400 $0 $0 $28,900 16 1991 $30,400 $0 $0 $46,900 http://issql/intranet/propdata/ParcelDetail.aspx?ID=22969 10/13/2006 Parcel Detail Page 3 of 3 17 1990 $30,400 $0 $0 $46,900 18 1989 $30,400 $0 $0 $46,900 19 1988 $27,200 $0 $0 $23,100 20 1987 $27,200 $0 $0 $23,100 21 1986 $27,200 $0 $0 $23,100 ► Photos r http://issql/intranet/propdata/ParcelDetail.aspx?ID=22969 10/13/2006 NSI APO Home I Help I sign In Track&Confirm FA Qs Wrack & Confirm Search Results Label/Receipt Number:7006 0810 0000 3524 7557 -- Status: Delivered r 01"'Fr�t 0 Enter Label/Receipt Number. Your item was delivered at 11:45 AM on November 24,2006 in HYANNIS, MA 02601. Not Cation Options. Track&Confirm by email Get current event information or updates for your item sent to you or others by email. POSTAL INSPECTORS site map contact us government services jobs National & Premier Accounts Preserving the Trust Copyright©1999-2004 LISPS.All Rights Reserved.Terms of Use Privacy Policy Asbestos Page 1 of 3 COYLE HOME INSPECTION `z ENGINEERS, Inc. -2 t> Asbestos Cow Asbestos BI091 Please refer to Carmela's http://www.cdphe.state.co.us/ap/asbestos/index.html#Program% glop 20Description for detailed information regarding the history of asbestos, bans, types of materials, regulations regarding removal, Thea Blo9 health department contacts, etc. Employees Asbestos has long been known for its excellent insulating qualities Sign in and resistance to heat. Contrary to popular belief, asbestos is still allowed in certain building materials and applications. Products manufactured in Canada and Mexico are unregulated and available for purchase in the USA. Therefore it is impossible to say that homes built after a certain date do not contain any asbestos. Some sources state that asbestos was banned in 1979, and others say 1989, but in fact some of the bans were overturned. There are currently 6 materials that are prohibited from containing asbestos, if manufactured in the USA. For a list of dates and banned materials, see http://www.cdphe.state.co.us/ap/asbestos/AsbestosBan5.pdf Also see, http://www.cdphe.state.co.us/ap/asbestos/AsbestosGeneralInfo.pdf for general information. Perhaps the following generalizations can be made: Homes built after 1989 have a lesser likelihood of containing asbestos, followed by increasing probability for homes built between 1979 and 1989; then greater yet possibility for homes built between 1950 and 1979; and homes built prior to 1950 have a the greatest probability of having asbestos materials. The presence of asbestos materials in a home is generally not considered a hazard unless the material becomes damaged or disturbed. Damaged or disturbed asbestos material can release fibers and/or dust into the air that may be inhaled. . Inhalation of asbestos fibers and/or dust can cause several http://www.coyle-inspect.com/asbestos.htm 10/22/2007 Asbestos Page 2 of 3 f diseases, including "asbestosis a disease similar to emphysema, and several types of cancer. • The likelihood of developing an asbestos related disease increases with the amount of asbestos inhaled and the length of time exposed to breathing asbestos fibers. • Smoking, when combined with breathing asbestos fibers, greatly increases the risk of asbestos related diseases. • The risk of asbestos related diseases seems to be greatest for workers who manufactured, handled, installed and/or removed asbestos containing products. Asbestos comes in several forms, and is found in many different products, such as: • Insulation for piping, boilers, ductwork, etc. • Automobile brake and clutch linings • Asbestos mineral shingles • Siding products, such as "transite" and asbestos siding • Floor tile and adhesives. Much of the older 9" x 9" resilient floor tile used in homes and businesses in the past contains some asbestos, as does some of the adhesives used to secure the tile. Asbestos can be classified as either "friable" or non-friable. Friable asbestos is asbestos that can easily release fibers into the air, such as pipe insulation or duct insulation that is in poor condition. This type.asbestos when handled, bumped or touched, may release fibers into the air which can then be inhaled into the lungs. • Non-friable asbestos is asbestos which will not easily crumble, abrade, or otherwise easily release its fibers into the air. Examples of this type asbestos are: asbestos floor tiles (in good condition), asbestos siding, and asbestos shingles (sometimes referred to as mineral fiber shingles). • Asbestos in a non-friable state is not harmful as no fibers are being released into the air for inhalation. • Asbestos in a friable state is a health concern. When disturbed it releases asbestos fibers into the air. These fibers are very -small and can stay airborne for long periods of time. Asbestos in the home should be treated in different ways, according the type of asbestos and degree of friability. • Asbestos floor tiles (or suspected asbestos tiles) are generally http://www.coyle-inspect.com/asbestos.htm 10/22/2007 Asbestos Page 3 of 3 best left in place. Common practice is to install new flooring over the old tile. Removing the old tile would probably release asbestos fibers and is not recommended. . Asbestos siding is often left in place and new insulation and siding is installed over the old siding. "Look alike" products are available if you want to replace some of the shingle siding with a fiber-cement product. Try this link to the GAF web-site. . Asbestos shingles usually must be removed and properly disposed of in a landfill approved for this type asbestos disposal. Here is a link to a site regarding safe removal: UNL. There may also be some State and/or local regulations, so please contact your local building department for starters. . Some older duct, pipe, or boiler insulation may contain asbestos. This insulation is generally aging and often in need of repair. Repair is usually preferred over replacement of this insulation as replacement is expensive and should only be done by specially trained and equipped personnel. Repair should also be done by trained personnel but is much less expensive. Repair usually consists of placing the insulation in a stable condition. This may entail a process called "encapsulation" and/or wrapping with plastic or another approved method. . Experienced people may be able to identify certain products as likely to contain asbestos, but positive identification.of a material as containing asbestos can only be made by laboratory analysis. Please refer to http://www.cdphe.state.co.us/ap,asbestos/index.html#Program% 20Description for detailed information regarding the history of asbestos, bans, types of materials, regulations regarding removal, health department contacts, etc. [ Home ] [Up] [ Company Profile ] [ Services ] { Testimonials ] [ FA 's ] [ Friends of [ Search] [ Helpful Links] [ Privacy Policy ] [ Contact Us ] Copyright©2001 Coyle Home Inspection Engineers Last modified:August 31,2007 http://www.coyle-inspect.com/asbestos.htm 10/22/2007 TOWN OF BARNSTABLH Iq LOCATION �Cr-G��G�'Dl �.�� �i'131, SEWAGE # 1 VILLAGE U� v s ASSESSOR'S MAP � LOT J. CRAIG MEDEIROS INSTALLER'S NAME PHONE NO.7LINDF� o �i,YA,N.NIS, MA 0260T SEPTIC, TANK CAPACITY / l��I J J /U.n.a Stuff 1,EACIIING FACILITY:ttyP,e)t�?e C.'s L (size) NO. OF BEDROOAtS__ LPRIVATE WELL QR�UBLIC 6-R OWNER_ C e OLGq DATE PERMIT I.S.rQJ�J J� --oi G AlL / t'��''`' DATE COMPLIANCE ISSUED- 1 . VARIANCE GRANTED: Yes No i, / r I i � I I \ r� o .001 - I Town of Barnstable r cFTHE 1py, Regulatory Services Barnstable c Thomas F. Geiler,Director ;mericaCity Public Health Division III �y snxxsrnsi.e. 9 MASS. Thomas McKean Director 1639. a`0g 200 Main Street 2007 ED Mp`l Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Mr. James Walker October 10, 2007 726 Falmouth Road Hyannis, MA 02601 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 CODE CHAPTER 170. The property owned by you located at 5 General Patton Drive, Hyannis, MA was inspected by Health Inspectors Meredith Morgan on October 5, 2007 and David Stanton, R.S. on October 6, P g 2007. These inspections were conducted on the basis of complaints made by the Hyannis Fire Department. The following violations of the State Sanitary Code were observed: 105 CMR 410.500- Owner's Responsibility to Maintain Structural Elements: Observed rotten flooring in the bedroom area. 105 CMR 410.500- Owner's Responsibility to Maintain Structural Elements: Chronic dampness (mold-like growth) observed in bedroom area. 105 CMR 410.200 (A)-Heating Facilities Required: Observed floor heating pipe to have significant condensation and/or improperly maintained. 105 CMR 410.831(E)- Dwellings Unfit for Human Habitation: Hearing: Condemnation: Order to Vacate: Demolition: Until all violations have been corrected, the bedroom has been deemed unfit for human habitation and has been issued a condemnation. The condemnation only applies to the bedroom and not the rest of the house. You are directed to correct the violations listed above within fourteen (14) days of your receipt of this notice by pulling any required building permits (if applicable); by repairing the damaged flooring and by repairing or replacing the heating system so that it functions properly and maintains in good repair. All mold-like growth must be removed and the source of the chronic dampness must be identified and repaired. You are ordered to provide to the Barnstable Health Division a report from a licensed plumber and or HVAC contractor which identifies the problem. This report must be submitted within five (5) days of your receipt of this notice. :'4You may request a hearing before the Board of Health if written petition requesting same is j.received within ten(10) days after the date the order is served. Non-compliance will result in a fine of $100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH s . McKean, R.S., CHO Director of Public Health Town of Barnstable CC: Meredith Morgan, Health Inspector Mona Griffin, Tenant u i 411 4 ok,�t� � �' ,fj5 -y "�".a 1. � .4 ' .�•. IL 0 4 � . a ti or ,� v f e C .. 41 cm y � s � Y'n.r•..."'�r � �.- _ - - — - � .e .a .ice _ ,� — ..�. - n t ��p `�� 4�i --''9e _ '..s�C`,:`�-Y: "`. `at'z G• � � '�,.�.._�,+'•�.. �'•vt � i. " .'.fir} .�..� ; x , s i Ti �fv `��+jw�k5':�s �� � � '� .�� v� �_ 4• "`fit •d h<' � 4-: � y'6• �- r t �� Yy t.}''-iskr r Ad +d A. 7^ sl`'��'r --. a+ .Ei 9,,,eJ a"-"•V"v - r �� �',w ,c�. t«���"e 9 "`.r j4L�. �' � �' �. b.�.y1v w CT t¢ .� r+��y�� ;�. � � �?Q. � ,..,i �` ;�'�. O ...y,: � � � # . .._ jC.•.., is � dti NAI r �r 4 �1 �r I -* may('b .� �,' *,- -$�, •" f' t d r 1• •gyp� .fx � �',l'�,��.. C• �. a tY �~ �£ Y, y . �' ti �� Jy. f a^``tom �` � _ •' � -,,,y, �� W fF'"J p £ S a Po o' rati sa - <. "..� -xs+ •�'� �. es a�7". oa�jk s 5y �9. :p � '&-, ° pa 4:4 O i t� hok �I;o rt 'i� pby w'vqZVI Gi p . apt e ' a � .17 ~�� a � '•Yt.+...ds...`''�.I�%"� =r.,.A` " � 'v.►'' O�"�1�;`1 �rr4 ,-•4, ss.eP�4�r�r "�..�• F ," r �� a � w y 3 i .a ���I .• r � �l`f� {r- !�� I ..,.a�*1-!$p � n 4 ,�'+ �• '► Xr A''a '� + ef'�. -7 ,'�".�..� _r'- --�.��'� f K`��Wit.: Wro. 1 ""`.Ix, � �� .«•,r � x� � # � • ,t',w Gk�,x„ -- i. _3 '`.r �.•S r�. :. *A n.+f' {�'�� 5+� .lk,-, ,.. k i1�w. • ,xt rt '.r 1� r�.�' `,��'�... '�;T:L t •figg �� ` :3� pr, rJ rA Y a�:F 7 ,tx. ". ♦ 'r•rJc r,},,f SS :�>'�' "'+fi ?:�;:* Can �^`J �r7'Sa ;,�• i) ,f( ,f^ �S.tr - `���. 3�o e,,,'• ..,, s -S � yy Y .E '� xn � a?3 ; I 'a.4 f• �. a , "'`• -tin.. .y�` ,. _ - £.,�,.., 2 Tyr ®R+ h a"La. I t ..e'. M. C �` _ I Jfji ., • • � '1 R � 4lot t Y tr J2 •a T*f w 'A 1 n R 1 K� r fit, di T ,f r t � 1 i �Y t �i r( Invoice BOURQUE HEATING & COOLING CO, INC. October 18, 2007 P.O. Box 770 F Summary: SERVICE/C.O.D. Marstons Mills, MA. 02648 Invoice#: 26277 508.790.2887/Fax 771.9696/bourque.hcc@earthlink.net Tech: ' BOURQ/TYLE Due Date: 11/17/2007 Job Date: 10/18/2007 Bill To: Job Name: JAMES WALKER JAMES WALKER/PROPERTY 726 FALMOUTH ROAD 5 GENERAL PATTON DRIVE HYANNIS, MA 02601 HYANNIS, MA 02601 508-775-0100 HOME Item Code Description Hrs/Qty Price Amount HVAC SYSTEM INSPECTION 10/17- BOB/JAMES - UPON INITIAL INSPECTION FOUND MOST RETURN AIR VENTS BLOCKED OFF; WILL RETURN WHEN TENANTS CLEAR ALL RETURN AIR VENTS. RETURNED, CHECKED HEATING SYSTEM TEMPERATURE RISE AND OPERATION, RETURN AIR AND SUPPLY C.O., AND CHECKED OPERATION. SYSTEM IS WORKING WITHIN PARAMETERS. L-R1 LABOR REGULAR 1ST HOUR/ZONE 1 1.00 96.00 HR 96.00 (BARNST VILLAGES) 1--R LABOR REGULAR RATE 1.00 92.00 HR 92.00 OX F U r- --4 M Labor Subtotal Total 188.00 188.00 $188.00 All material is guaranteed to be as specified. All work to be completed in a professional manner according to standard practices. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon delays beyond our control. Purchaser agrees to pay all costs of collection, including attorney's fees. Terms: Payable Upon Receip Please pay promptly from this invoice -2% disc. before 10 days (service only) 13 A h 01922 MA 10/6/2007 001 A270983 I ❑ Change NFIRS 1 4 State Incident Date Station Incident Number Expostr ❑ No Activity 13asre w I ►? Check this box to indicate that the address for this incident is provided on the W ldland Fire i� Location I ❑ Module in Section B"Alternative Location Specification".Use only for wildland fires. Census Tract 40 ❑ Street Address r I I 5 - GENERAL.PATTON DRIVE DR ❑ Intersections u n front Of Number/Milepost Prefix Street or Highway R I . Street Type Suffix 'f I ❑ Rear of �� (Hyannis '` ,L,\�1VIA I 02601 ❑ Adjacent to Apt./Suite/Room City atate zip Code ❑ Directions IIBEARSES WAY ❑ Cross street or directions,as applicable C Incident Type E1 Dates&Times Mid 'fit goon E2 Shifts&Alarms L40� Hazardous_ condition, other Local Option r Check boxes if Month Da Fear'.; Hour Min Incident Type M ��' � � y - dates are the B I Still U same as Alarm ALARM always required p Aid Given Received Date. Alarm I 10 06 2007J 1.4:15 pShift or latoon No OfAlarm�istnct 1 ❑ Mutual aid received U I ARRIVAL required,unless canceled or did not arrive 2 El Automatic aid recv. r ® Arrival 10 06 2n07 14 21 Special Studies 3 ❑ Mutual aid give TheirFDID Their I u J _ 1 I E3 g State Local Option 4 ❑ Automatic aid given CONTROLLED optional,excepftor wildland fires 5 ❑ utner aia given ® Controlled Ll0 06 12007 N ® None LAST UNIT CLEARED, equired except wildland fire Special Special Their Incident umber ® Last Unit ] [ U Study ID# Study Value Cleared 10 06 2007 16:02 F Actions Taken C71 Resources G2 Estimated Dollar Losses&Values ❑ Check this box and skip this section if an 8 6 (investigate At Personnel form id. LOSSES: Required for all fires if known. Optional for non fires. � Apparatus or ersonne s use Primary Action Taken(1) Apparatus Personnel Non Pro pe El ,. 1 Suppression 0 0 I ❑ 70 Assistance,other 0 1 Contents Additional Action Taken(2) EMS 0 0 R E- PINCIDiENT;VALUE: optional Other I� Additional Action Taken(3) - Check box if resource counts include aid - ❑ received resources. Contents ❑ Completed Modules H1 t Casualties ® None �..�3 Hazardous Materials Release � I Mixed Use Property le Deaths Injuries ❑Fire-2 Fire N® None Service 1 Natural as: slow leak,no evacuation o HazMat actions N❑ Not mixed , ❑Structure-3 �� � 0� ❑ t l g ..., 1p ❑ Assembly Use ❑Civilian Fire �Cas.`4 2 Propane gas: <z1 1b.tank(as in home Bs4grili) ❑ Educaa ion use_- El n I 3 Gasoline:vehicle fuel tank or portable container 33 ❑ Medical Used ❑ Fire Serv. Casualty Civilian ❑ �0� ,` 40 ® Resintial use ❑EDAS-6 i l; 4 ❑ Kerosene:fuel burning equipment or portable storage - 51 ❑ Royvfqfstores' ❑HazMat-7 Detector 5 ❑ Diesel fuel/fuel oil: vehicle fuel ta,korportablestorag C53 ❑ Enl mall ❑Wildland Fire-8 H2 6 ❑ Household solvents: Home/office spill,cleanup only 8•❑ BuSitess&residential RBqugeclfof confirmed fires. 59 ❑ Office use 7 Motor OII:from engine or portable container ❑Apparatus-9 ,,, .. ❑ g p tr';• .:- 1 ❑'Detector alerted occupants 8 Paint:from paint cans totaling<55 gallons 60 ❑ Industrial u$e+ ❑Personnel-10 p ❑ 63 ❑ Milita uses; 2❑;Detector did not alert them 0 Other: Special HazMat actions required or spill>55 gal., wiry 3 ❑ 65 ❑ Farm use UN I Unknown Please complete the HazMal form t r,. � ❑ Other mixed ruse Property Use' Structures Ja fT J 341 ❑ Clinic,Clinic Type infirmary 539 ' Hous hold goods,salesfrepatrs 342 ❑ Doctor/dentist office 579 ❑ M.oto vehicle/boat sales/repairs 131 Church,place of worship � - 161 ❑ Restaurant or cafejeria 361 ❑ Prison or jail,not juvenile 57,1• ❑ Gas or service station ❑162 Bar/tavern or nightclub 419 [31-or 2-family dwelling 599 ❑ Business office 213 Elementary school or kindergart. 429 [3 Multi-familydwelling 615 [3 Electric generating plant 215 ❑ High school or junior high 449 ❑ Rooming/boarding house 629 ElLaboratory/science lab ❑ Commercial hotel or motel 700 ❑ Manufacturing plant 241 ❑ College,adult ed."." 459 ❑ Residential,board and care 819; ❑ Livestock/poultry storage(barn) 311 ❑ Care facility'for the aged 464 ❑ Dormitory/barracks 282 ❑ Nori-residential parking garage 331 Hospital ❑ 519 ❑ Food and beverage sales _891;; 0`,'Warehouse Outside 124 ❑ Playground or park ❑ Vacant lot �1 ❑ Construction site 655 Crops or'.orchard 938 [1Graded/cared for plot of land '<.❑ Industrial plant yard 669 Forest(timberland 946 [3 Lake,river,stream r 807 Outdoor storage area 951 [3 Railroad right of way 919 [3 Dump or sanity landfill ; %0 ❑ Other street Look a)and enter a Property Use ❑ P sanitary 961 Propr ty Ust code only h 419 931 ❑ Open land or field'. 962 ❑ Highway/divided highway ❑ Residential street/driveway you Use box: ecked a I1 or 2 family dwelling - NFIRSt Revision IXi/1199 A270983 - EXP 0, 101612007 PAGE 1 OF 2 HYANNIS FIRE DEPARTMENT - MFIRS REPORT.:;;";'r Person/Entity Involved K� Local Option Business name(if applicable) Phone Number ❑ Checktt`s box'rf same address as LJ u •-incident location Mr.,Ms.,Mrs. First Name MI Last Name Suffix Then skip the three duplicate address lines. LI I�I u u Number/Milepost Prefix Street or Highway Street Type Suffix Post Office Box " Apt./Suite/Room City Slate Zip Code ❑More people Involved? Check this box and attach Supplemental Forms(NFIRS-1S)as necessary. ,k f�ZK2 Owner � Same as person involved? Then check this box and ski Local Option ❑the rest of this section. p I —J Business name(if applicable) Phone Number ❑ Check this box if Ll I r same address as incident location. Mr.,Ms.,Mrs. First Name MI Last Name Suffix Then skip the three duplicate address lines. u u Number/Milepost Prefix Street or Highway Street Type Suffix L I _ Post Office Box Apt./Suite/Room I city State Zip Code L Remarks. Local Option fj r4 ik- : R • k ITEMS WITH A I MUST ALWAYS BE COMPLETED! ® More remarks?Check this boz and attach Supplemental Forms (NFIRS-1S)as necessary. M Authorization �+ 197201 J.Kraig E Farrenkopf C. I Captain /EMT Suppression 10 06 2007 Officer in charge ID Signature Position or rank "Assignment Month Day Year R Check box if same as Officer in charge. 111197201 ,. I I Craig E Farrenkopf C. I I Captain /EMT I Suppression 10 06 2007 Member making report ID Signature Position or rank Assignment Month Day Year If; t,,r s A270983 - Exp 0, 101612007 5 GENERAL PATTON DRIVE page 2 of 2 A'�'HYANNIS FIRE DEPARTMENT - MFIRS REPORT a L� Oly�2 MA 10/6/2007J 1 001 A270983 0` ❑ Delete NFIRS - 1S �j ❑ Change Supplemental State Incident Date Station Incident Number I Exposure I ""K2 Remarks 5 GENERAL PATTON DRIVE MR. MENDES WALKED INTO HEADQUARTERS COMPLAINING OF A GAS ODOR PRESENT [SIMILA TO SEWAGE GAS] IN A HOME AT 5 GENERAL PATTON DRIVE. MR. MENDES TOLD US THIS IS AN ISSUE BETWEEN THE LANDLORD AND TENANT. HE STATED THAT SOMETIME LAST WE A HEALTH INSPECTOR WENT TO THIS PROPERTY FOR THE SAME REASON AND APPARENTLY SQUARED THIS PROBLEM AWAY WITH THE LANDLORD MR. JAMES WALKER. ARRIVING ON SCENE, SIDE "A", ONE STORY, WOODEN FRAME, OCCUPIED, MR. MENDES WAITING.AT THE FRONT DOOR. INVESTIGATING HE SHOWED ME AN OPENING IN THE FLOOR [REARQE- DROOM] WHERE AT ONE 1 TIME HAD A METAL GRATE OVER IT. IN THIS OPENING WAS A PIPE ABOUT SIX {61 INCHES ROUND WITH STANDING WATER IN IT SIMILAR TO SEWAGE GRAY WATER. THERE WAS A SEWAGE ODOR PRESENT. THEY DISCOVERED THIS GRATE AND OPEN`PIPE LAST WEEK WHEN CARPETING WAS REMOVED. I MONITORED THIS SPACE [HOUSE] FORNATURAL GAS AND C. O AND RECEIVED ZERO [0] READINGS ON A DEPARTMENT METER. A HEALTH INSPECTOR WAS E SUMMONS TO THIS PROPERTY, MR. DAVID STANTON BARNSTABLE BOARD OF HEALTH. INVESTIGATING FURTHER MR. STANTON WAS SHOWN THIS PROBLEM AND OTHERS AND TOLD MR. MENDES THAT HE WOULD CONTACT THE LANDLORD MR. WALKER. IN THE MEAN TIME HE RECOMMENDED THAT NO ONE REMAIN IN THIS DWELLING. MR. MENDES ALREADY HAD HIS GIRL FRIEND AND NEW BABY REMOVED FROM THIS HOUSE EARLIER THIS WEEKEND. MS. GRIFFEN BROTHER WAS PRESENT [IN HIS FIFTY'S] AND CHOOSE TO`REMAIN. THIS IS A BOARD OF HEALTH ISSUE NOT FIRE DEPARTMENT. CAUSE: HEALTH ISSUE. TENANT: MS. MONA GRIFFEN, BABY, AND BROTHER. 508-292-1 106 HEALTH INSPECTOR:MR. DAVID W. STANTON R. S. TOWN OF BA'gNSTABLE. WEATHER CONDITION: CLEAR, WA-R , WIND OUT OF THE SOUTH WE5T.ABOUT 6 MPH T 74• F. t FARIR KOPF-.C.:`CAPtT 10/06/07. r't 477noR'? _ FYD n in1r..1?f)n74 PYAWA/TC FTDF nPDADTMGAIT MFTDC DFDnDT s!t' DA(:F 1 Parcel Detail Page 2 of 2 Visit History FDa,le Who Purpose 1/2001 00:00:00 SM Meas/Listed-Interior Access 5/1987 00:00:00 ML - Sales History Line Sale Date Owner Book/Page Sale Price 1 04/15/1993 WALKER,JAMES A 8523/144 $1 2 WALKER,JAMES A 1826/146 $0 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2009 $75,900 $0 $0. $145,300 $221,200 2 2008 $88,400 $0 $0 $151,400 $239,800 4 2007 $88,400 $0 $0 $151,400 $239,800 5 2006 $80,900 $0 $0 $113,400 $194,300 6 2005 $74,500 $0 $0 $84,900 $159,400 7 2004 $60,300 $0 $0 $84,900 $145,200 8 2003 $44,400 $0 $0 $25,400 $69,800 9 2002 $44,400 $0 $0 $25,400 $69,800 10 2001 $40,400 $0 $0 $25,400 $65,800 11 2000 $29,500 $0 $0 $25,300 $54,800 12 1999 $28,400 $0 $0 $25,300 $53,700 13 1998 $28,400 $0 $0 $25,300 $53,700 14 1997 $18,000 $0 $0 $21,600 $39,600 15 1996 $18,000 $0 $0 $21,600 $39,600 16 1995 $18,000 $0 $0 $21,600 $39,600 17 1994 $19,600 $0 $0 $26,000 $45,600 18 1993 $19,600 $0 $0 $26,000 $45,600 19 1992 $22,400 $0 $0 $28,900 $51,300 20 1991 $30,400 $0 $0 $46,900 $77,300 21 1990 $30,400 $0 $0 $46,900 $77,300 22 1989 $30,400 $0 $0 $46,900 $77,300 23 1988 $27,200 $0 $0 $23,100 $50,300 24 1987 $27,200 $0 $0 $23,100 $50,300 25 1 1986 1 $27,200 $0 $0 $23,1001 $50,300 Photos http://issgl2/Intranet/Propdata/ParcelDetail.aspx?ID=22969 12/28/2009 Parcel Detail Page 1 of 2 • .ram tom` ys.� 3 /-i.•C_- Logged In As: Monday, December 28 2009 Parcel detail Parcel Lookup Parcel Info Parcel ID 292-098 1 Developer LOT-4 I Lot Location 5 GENERAL PATTON DRIVE Pri Frontage 56' , Sec Road I Sec I Frontage Village HYANNIS Fire District HYANNIS i Sewer_.Acct I Road Index 0595 Asbuilt Septic Scan: f t - �A Interactive 292098_'1 Map Owner Info - Owner WALKER,.JAMES A I Co-Owner streets 726 FALMOUTH RD i Street2 J City HYANNIS State'MA Zip 02601 Country USA Land Info Acres 0.44 I , use Single Far MDL-01 I Zoning RB , N hbd 0104 9 Topography Level I Road, Paved Utilities Septic,Gas,Public Water I Location i Construction Info Buildirm I of i Year Roof Built 1945 I Struct Gable/Hip I Wall Ext Vinyl.Siding Effect Roof Area 975 I Cover P ph/F GIs/Crisp I .7 Pe None _ a _ ` Bas- Style Ranch Int Bedwall!— wall Rooms3 BedroomsXMilli. I 3 �d Int Bath .Model Residential �d Floor I Rooms 1 Full I ktBAS t Heat � �` . Grade Average Minus I Hot Air :, Total Type Rooms 5 RoorS I � Stories 1 Story .- Heat Oil I Found- Fuel ation Conc. Slab �► Permit History !SSUe Date Purpose Permit Amount . Insp Date Con meats http:Hiss gl2/Intranet/Propdata/P arc elDetail.aspx?ID=22969 q/1nney ® Complete items 1,:2,and 3.Also complete • • •Item 4 if,Restricted Delivery is desired. ature e Print your name and address on the reverse X.so that we can return the card to you. ent ■ Attach this card to the back of the mailpiece, 6:Receiv Addressee I or on the front if space permits. Y(Punted Name) C Date of alive I. 1. Article Addressed to: D. Is.delivery address different m Rem 1? 13 Yes ' i H YES,enter delivery address below: 0 No -a1 FOH . Ct tU lv s. I"l7 1 3. S rvice Type. oaL9 I . crtified Mail ❑Express Mail , ' ❑RegisteredRetam Receipt for Merchandise ❑Insured Man Cl C.O.D. 4. Restricted Delivery?Oft Fee) ❑Yes 2. Article Number (Transfer from service label 7.1�0 6 I 0810. 0000 3525 0892 i PS Form 3811,February 2004. Domestic Return Receipt 102595=02-M-1540� rltIr CO n Up rrl Postage $ L4 ( is . P� Mq 0 Certified Fee. o A 0 Postmark O Return Receipt Fee H y� (Endorsement Required) OCT !e�or.n 0. Restricted Delivery Fee ' r (Endorsement Requved) w Total Postage&Fees OG , (�SPs 0 Sent Tq 0 liJlly/ l , LJ or PO Box No.. SA L� - (`- Street Apt.No.; 1 lX_ City,State,ZIP+4 �.. . Town of Barnstable �F'THE T Regulatory Services Barn Thomas F. Geiler,Director ;merica City Public Health Division+ � i * IiARNSTABI.E, 9 MASS. ,� Thomas McKean, Director 20c� �0r 1639. a`` 200 Main Street FD Mp•`l Hyannis; MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Mr. James Walker October 10, 2007 726 Falmouth Road Hyannis, MA 02601 PARTIAL CONDEMNATION 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 CODE CHAPTER 170. The property owned by you located at 5 General Patton Drive, Hyannis, MA was inspected by Health Inspectors Meredith Morgan on October 5, 2007 and David Stanton, R.S. on October 6, 2007. These inspections were conducted on the basis of complaints made by the Hyannis Fire Department. The following violations of the State Sanitary Code were observed: 105 CMR 410.500- Owner's Responsibility to Maintain Structural Elements: Observed rotten flooring in the bedroom area. 105 CMR 410.500- Owner's Responsibility to Maintain Structural Elements: Chronic dampness (mold-like growth) observed in bedroom area. 105 CMR 410.200 (A)- Heating Facilities Required: Observed floor heating pipe to have significant condensation and/or improperly maintained. 105 CMR 410.831(E)- Dwellings Unfit for Human Habitation: Hearing: Condemnation: Order to Vacate: Demolition: Until all violations have been corrected, the bedroom has been deemed unfit for human habitation and has been issued a condemnation. The condemnation only applies to the bedroom and not the rest of the house. You are directed to correct the violations listed above within fourteen (14) days of your receipt of this notice by pulling any required building permits (if applicable); by repairing the damaged flooring and by repairing or replacing the heating system so that it functions properly and maintains in good repair. All mold-like growth must be removed and the source of the chronic dampness must be identified and repaired. You are ordered to provide to the Barnstable Health Division a report from a licensed plumber and or HVAC contractor which identifies the problem. This report must be submitted within five (5) days of your receipt of this notice. r You may request a hearing before the Board of Health if written petition requesting same is �iecdived 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. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable CC: Meredith Morgan, Health Inspector Mona Griffin, Tenant Town of Barnstable 0FIKE r, Regulatory Services Barnstable ti�P� ti� Thomas F. Geiler,Director ,"mericaCity Public Health Division * BARNSTABLE, 9 MASS. Thomas McKean,Director zoos 1639. s`0 200 Main Street AlFD�� Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Mr. James Walker October 16, 2007 726 Falmouth Road Hyannis, MA 02601 PARTIAL CONDEMNATION 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 CODE CHAPTER 170. The property owned by you located at 5 General Patton Drive, Hyannis, MA was inspected by Health Inspectors Meredith Morgan on October 5, 2007 and David Stanton, R.S. on October 6, 2007. These inspections were conducted on the basis of complaints made by the Hyannis Fire Department. The following violations of the State Sanitary Code were observed: 105 CMR 410.500- Owner's Responsibility to Maintain Structural Elements: Observed rotten flooring in the bedroom area. 105 CMR 410.500- Owner's Responsibility to Maintain Structural Elements: Chronic dampness (mold-like growth) observed in bedroom area. 105 CMR 410.200 (A)- Heating Facilities Required: Observed floor heating pipe to have significant condensation and/or improperly maintained. 105 CMR 410.353-Asbestos Material: Every owner shall maintain all asbestos material in good repair, and free from any defects including, but not limited to, holes, cracks, tears or any looseness which may allow the release of asbestos dust, or any powdered, crumbled or pulverized asbestos material. Every owner shall correct any violation of 105 CMR 410.353 in accordance with the regulations of the Department of Environmental Protection appearing at 310 CMR 7.00 and in accordance with the regulations of the Department of Labor and Workforce Development appearing at 453 CMR 6.00 and with any other applicable statutes and regulations. Rotten, deteriorated floor tiles were observed in bedroom area. Owner stated that the tiles were made of asbestos. 105 CMR 410.502-Use of Lead Paint Prohibited A child under the age of six (6) resides at the property. Will provide future lead determination to ensure the property is lead free. A.J 105 CMR 410.831(E)- Dwellings Unfit for Human Habitation: Hearing: Condemnation: Order to Vacate: Demolition: Until all violations have been corrected, the bedroom has been deemed unfit for human habitation and has been issued a condemnation. The condemnation only applies to the bedroom and not the rest of the house. You are directed to correct the violations listed above within fourteen (14) days of your receipt of this notice by pulling any required building permits (if applicable); by repairing the damaged flooring and by repairing or replacing the heating system so that it functions properly and maintains in good repair. All mold-like growth must be removed and the source of the chronic dampness must be identified and repaired. You are ordered to provide to the Barnstable Health Division a report from a licensed plumber and or HVAC contractor which identifies the problem. This report must be submitted within five (5) days of your receipt of this notice. 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. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable CC: Meredith Morgan, Health Inspector Mona Griffin, Tenant Town of Barnstable oFt r Regulatory Services Barnstable Thomas F. Geiler,Director _ Public Health Division I BAMSTABLE, • . 9 MASS. g Thomas McKean,Director 200 `bAr 1639. a`� 200 Main Street FD MA'S Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Mr. James Walker October 16, 2007 726 Falmouth Road Hyannis, MA 02601 PARTIAL CONDEMNATION 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 CODE CHAPTER 170. The property owned by you located at 5 General Patton Drive, Hyannis, MA was inspected by Health Inspectors Meredith Morgan on October 5, 2007 and David Stanton, R.S. on October 6, 2007. These inspections were conducted on the basis of complaints made by the Hyannis Fire Department. _T_ , /,_XR1c)-7 The following violations of the State Sanitary Code were observed: 105 CMR 410.500- Owner's Responsibility to Maintain Structural Elements: Observed rotten flooring in the bedroom area. 1�1 CC o r 105 CMR 410.500- Owner's Responsibility to Maintain Structural Elements: Chronic dampness (mold-like growth) observed in bedroom area. 105 CMR 410.200 (A)- Heating Facilities Required: Observed floor heating pipe to have significant condensation and/or improperly maintained. 105 CMR 410.353- Asbestos Material: Every owner shall maintain all asbestos material in good repair, and free from any defects including, but not limited to, holes, cracks, tears or any looseness which may allow the release of asbestos dust, or any powdered, crumbled or pulverized asbestos material. Every owner shall correct any violation of 105 CMR 410.353 in accordance with the regulations of the Department of Environmental Protection appearing at 310 CMR 7.00 and in accordance with the regulations of the Department of Labor and Workforce Development appearing at 453 CMR 6.00 and with any other applicable statutes and regulations. Rotten, deteriorated floor tiles were observed in bedroom area. Owner stated that the tiles were made of asbestos. 105 CMR 410.502-Use of Lead Paint Prohibited e A child under the age of six (6) resides at the property. Will provide future lead determination to ensure the property is lead free. C1611"\1, C.,+_ v-^ r/\ J-.2 C 1-a L p� G.r� 105 CMR 410.831(E)- Dwellings Unfit for Human Habitation: Hearing: Condemnation: Order to Vacate: Demolition: Until all violations have been corrected, the bedroom has been deemed unfit for human habitation and has been issued a condemnation. The condemnation only applies to the bedroom and not the rest of the house. You are directed to correct the violations listed above within fourteen (14) days of your receipt of this notice by pulling any required building permits (if applicable); by repairing the damaged flooring and by repairing or replacing the heating system so that it functions properly and maintains in good repair. All mold-like growth must be removed and the source of the chronic dampness must be identified and repaired. The source of the water/moisture in the cold air returns is unknown, as is the physical condition of the returns. It is the opinion of the Building Department that the most economical solution would be to fill the cold air returns with cement and install new returns through the attic. This is only a recommendation. If you choose to use the existing returns, you must demonstrate their effectiveness via an independent heating specialist's report. You are ordered to provide to the Barnstable Health Division a report from a licensed plumber and or HVAC contractor which identifies the problem. This report must be submitted within five (5) days of your receipt of this notice. 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. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable CC: Meredith Morgan, Health Inspector Mona Griffin, Tenant Town of Barnstable OF THE 1p� Regulatory Services Barnstable do Thomas F. Geiler, Director M-AmericaCity Public Health Division BARNSTABLE, v MASS. Thomas McKean,Director 1639• ♦0 200 Main Street O Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Mr. James Walker October 10, 2007 726 Falmouth Road Hyannis, MA 02601 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 CODE CHAPTER 170. The property owned by you located at 5 General Patton Drive, Hyannis, MA was inspected by Health Inspectors Meredith Morgan on October 5, 2007 and David Stanton, R.S. on October 6, 2007. These inspections were conducted on the basis of complaints made by the Hyannis Fire Department. The following violations of the State Sanitary Code were observed: 105 CMR 410.500- Owner's Responsibility to Maintain Structural Elements: Observed rotten flooring in the bedroom area. 105 CMR 410.200 (A)-Heating Facilities Required: Observed floor heating pipe to have significant condensation and/or improperly maintained. You are directed to correct the violations listed above within fourteen (14) days of your receipt of this notice by pulling any required building permits (if applicable); by repairing the damaged flooring and by repairing or replacing the heating system so that it functions properly and maintains in good repair. 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 nstitute a separate violation. R F TH BOARD OF HEALTH om "s A. McKean, R.S., CHO Director of Public Health Town of Barnstable CC: Meredith Morgan, Health Inspector Mona Griffin, Tenant Barnstable °F t►+e rOwtiXXXI Town of Barnstable Regulatory Services Department ;McaC 1 DARMS't'ABLE, MASS.9. Public Health Division �AtFD MA't a`� - 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO October 29, 2007 Mr. James-Walker 726 Falmouth Road Hyannis, MA 02601 COPY Dear Mr. Walker, The property owned by you located at 5 General Patton Drive, Hyannis was re- inspected on October 29, 2007 by Health Inspector Timothy O'Connell. The inspection was conducted on the basis of a follow-up inspection to ensure compliance of order letter dated October 16, 2007. All violations were corrected including the inspection of the HVAC system by a certified technician and the encapsulation of the asbestos flooring (encapsulated as per instruction by Andrew Cooney, Department of Environmental Protection). Therefore the emergency condemnation order has been lifted. Please either contact Health Inspector Meredith Morgan to conduct a lead determination, or hire a licensed lead inspector. No persons under the age of six (6)years shall re-occupy the d elling until after a lead determination is conducted. <)omas cKean, S, CHO Director of Public Health Town of Barnstable Cc: Meredith Morgan; Health Inspector Andrew Cooney, DEP Q:\Order letters\Housing Violations\5 general patton2.doc q r^ i Barnstable °FsKKE TOwti Town of Barnstable Regulatory Services Department AD-Amadca0v BAFLVSTABLE, MASS. i639gq. Public Health Division O° �0 ArFO MAC A' 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO October 29, 2007 Mr. James Walker 726 Falmouth Road Hyannis, MA 02601 / t r jtjccl��tr � rn NQXJCA TO Aj3AT9VIO TION S 10 CMFA 10. STATE SANITARY C6qW&61gUhj 0AjD4PqOfjF1jNVWWR#U ION AN T E N A ABL COD HA ER ft.-- The property owned by you located at 5 General Patton Drive, Hyannis wa44inspected on October 29, 2007 by Health Inspector Timothy O'Connell. The inspection was V conducted on the basis of a follow-up inspection to ensure compliance of order let � dated October 16, 2007. h�^ �" r All violations were corrected ' c ura eme - lha s Flooring was ceffQ4ed as per Andrew Cooney, Department of Environmental - PAL ✓� - 105 R 410,502— se ead int Prohi d—Awa' ' g ocum ion that Vn per is-e fx6,�s oc en mu e sub itt o Mere orspec r, pr' r to re-occu ncy of one younger than six (6) years of age. -��je 4-1 e-vzyex C-D,�c�.Q.�--a� O rC /V (A,,) ER 6RDER OF THVBOARD OF HEALTH alb _:I. dnor z� �o �oAbljk A jv Abso+s „S V°*Q Thomas McKean, R.S., CHO Director of Public Health c:.Vn Town of Barnstable �,c 44r,� C-©0--tr Q:\Order letters\Housing Violations\5 general patton2.doc i !` Barnstable Epp the rok� Town of Barnstable n , IIy�P.Z °. Regulatory Services Department AMme`CeC j 1+9�RAA rRFNSTABLE, M . 639. Public Health Division 0 M _ D 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO October 29, 2007 Mr. James Walker 726 Falmouth Road Hyannis, MA 02601 Dear Mr. Walker, The property owned by you located at 5 General Patton Drive, Hyannis was re- inspected on October 29, 2007 by Health Inspector Timothy O'Connell. The inspection was conducted on the basis of a follow-up inspection to ensure compliance of order letter dated October 16, 2007. All violations were corrected including the inspection of the HVAC system by a certified technician and the encapsulation of the asbestos flooring (encapsulated as per instruction by Andrew Cooney, Department of Environmental Protection); therefore the emergency condemnation order has been lifted.` Please either contact Health Inspector Meredith Morgan to conduct a lead determination, or hire a licensed lead inspector. No persons under the age of six (6) years shall re-occupy the dwelling until after a lead determination is conducted. Thomas McKean, R.S., CHO Director of Public Health Town of Barnstable Cc: Meredith Morgan, Health Inspector Andrew Cooney, DEP Q:\Order letters\Housing Violations\5 general patton2.doc t x .k u 2 6!Q '. 7} t H j �RLF t {'. r�r �. er, } s'rat.• 5 IL 4 r, e R ? J i. r Vt :i ,IZSI', w u Coot i Is'00 t'• 9 4i"S� � 6A� top 'IM F��'.'� '`y[y�y► eyy��3� m' ,. ", �?, .a. _ a^ 3 ° AC�p*iu {, r St' 1 = 12 As °9 r a ;r � t f w F r i1 �. 'fie K'oi,k"i ` j", f�, rrysisjfft j*.3 f1 —, y� �.d .�# 'p' o -•�A s,Rom. 3 .\ r {iy'f f r � . ,- �1J r ¢q 3A k) " , \ ; 1 Zf�o }- - r +» �' � � w'Y+�N � ♦ � �+�'�'� is t.,.a� j! � ... *.. a •T�`Mf 'e'..'rw'T r��." i � �*(C, �'- 'k 'y'f'`�� - y'sr • .,.,�a. .F •..,fir '}.. �^� ._ �" 3 '.1:°� ram`�:""*-�,.� -� ..�......_.,•.Ny�.,,,.�,,,.;.�,,ww :�5' a �i G f y4y %x A W 4 .. 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' '�.+.,,�.° .. r• it a QZ-R, _75.4! t - - IZ6 /O FORM30 CEw HOBBS&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CITY/TOWN W VA L."T N a DEPARTMENT H I A 0 Z(,,oI �G ADDRESS ISo G 1,N Syey`e TJ CD'7 S r Qez4 L PoqT7eN Vrt� TELEPHONE Address / V411/4.,JS A-14 02(go Occupant_ L Floor / Apartment No. — No.of Occupants__ No.of-Habitable Rooms No.Sleeping Rooms_ No.dwelling or rooming units P , No.Stories / Name and address of owner L,'!^o V—T H 12yo . . k ` ° 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: A0 U-'-V Roof e-7 /O Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: ex_rvz-1 cyR- r Ct"-I !v°' Stairs: L .S' �it1 �/J K cs Boo /►sue i✓ Li htin : at'l- rr07 cQ-7 ro1v L>'I AIV- 1?aam w© s B®!�� STRUCTURE INT. Hall,Stairway' 2.11/ lz-oAl Obst'n.: 1:24, C !� Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: -I/N -e_ iv- rZoAj-4 HEATING Chimneys: �!L Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: /'� Z®11-Z I ❑ MS ❑ ST ❑ P Waste Line: i H.W.Tanks Safety and Vents 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 le, 12P Zv Pant 10 6p0 Den Living Room 11 COa 7T_1 f-& q 410 iij: Bedroom 1 , /1�1 /.1 -ta Bedroom 2 /'7G Cry .,G.L f Z I Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted -1/a.L 1/1 "?o Locks on Doors: Ft 7 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 P T IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES O PERJ r INSPECTOR �' J TITLE �� S��r✓TU 2 DA TIME /J— P.M. 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 potential 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 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 (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. R , Kevin I Medeiros Plumbing&Heating,Inc. Estimate 63 Kerry Drive Marston Mills,MA 02648 Date Estimate# 1252010 20 Name/Address James Walker 726 Falmouth Road Hyannis,MA 02601 Job Location 5 General Patton Drive Description Qty Rate Total Mr Walker Upon visiting your property at 5 General Patton Drive on,after receiving your call about the problems on 1-14-2010 ....customer was not home on that day—went back on 1-25-2010 after I was able In make sit with the tegmt I ford leakage of water which is getting into the vent The 800rwiff need to be opened up to do necessary plumbing work,concrete removal and patching.Due to the nature of the work,it would be best if the b0dixgwas UMCCUPiOd daeto dust,and delmis and possible hazardous conditions during the construction repairs_ This:1ob w e permit and hmpection but will have jo be dome on a timeand bad dae to jibe gefuvescm g3k=offwjQb_ j Tbank you for yaw business. SUbtata F�, l $000• All material is guaranteed to be as specified. All work to be completed in a professional Any A&nam fim above qmcffolfigm iwh—m. SBWS Ta[ cam oaw� araaa and above the estimate.Person signing the estimate is owner of property. A servrce chargO Total Up to 2%per month or.240/a amauafly will be 10a 30 days or move Pam - 0-00 Phone# Fax# 3 signature II r I �ENDER:'COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete itefins 1,2,and 3.Also complete A. i ature item 4 if Restricted Delivery is desired. X ❑Agent � 1IN� ( ■ Print your name and address on the reverse rV Addressee s0 that We can return the card to you. ec ived by(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, �D or on the front if space permits. [D. s deliveryna;d . 1? ❑Yes 1. Article Addressed to: f YES,en �No �7 Z-6 f-4L"DuTN go/, 3. ice Type UNCertified Mail ❑Express Mail 6 26,0 1 ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (transfer from service label) t 7 o a.92.� 3 316 81-�2 8 2 i f I PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE First-Class Mail . Postag&Feeq Paid `= Perm_itt lo.G-10 • Sender: Please print your name, address.�anfd ZIP+4 IN-this x • ca I I Town of Barnstable { O� Health Division W 200 Main Street i Hyannis,MA 02601 . ii?il�l4?1411:1itiiIilt?.2:I <. ,.� : e rru �. I • • �. �.� oco =ru M . , co OFFICIAL USE r—i .Postage $ m Certified Fee M O Return Receipt Fee p� ark saw O (Endorsement Required) C3 Restricted Delivery Fee O (Endorsement Required) c" rco Total Postage&Fees $ u y� ,_ E3 enTo JA GS {✓✓1 L k fit :._.».--.-�--1--�--•----- Sfreet,llpt'iVo...... E3 or PO Box No. .- flDuo 7,j Certified Mail Provides: o A mailing receipt , a A unique identifier for your inailpiece o A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. o Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For. valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a LISPS®postmark on your Certified Mail receipt is required. a For -an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". a if a postmark on the Certified Mail receipt is desiredglease present the arti- cle at the post office_for postmarking.' If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. ' PS Form 3800,August 2006•(Reverss)PSN 7530-02.000-9047.` f Town of Barnstable ' Regulatory Services Barnstable �O FTHETp� eti w� o Thomas F.Geiler,Director AD-Amencacily Public : , * Health DYis lOn BARN �. 9 MASS. 0 Thomas McKean, Director 1eM a�� 200 Main Street. 20 )7 MA FD 'S Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 CERTIFIED MAIL 7009 2820 0003 3168 1282 Mr. James Walker January 8, 2010. 726 Falmouth Road Hyannis, MA 02601 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 CODE CHAPTER 170. The property owned by you located at S General Patton Drive, Hyannis, MA was inspected on December 28, 2009 by Jairne Cabot, R.S. Town of Barnstable Health Inspector because of a complaint. r The following violations of the State Sanitary Code were observed: 105 CMR 410.500- Owner's Responsibility to Maintain Structural Elements: Observed damaged floor tiles in the dwelling. 105CMR 410.350- Plumbing. Connections: Water from plumbing system maybe source of water entering heating ducts. 105 CMR 410.551- Weathertight Elements: Bathroom window is cracked. 105 CMR 410.500- Owner's Responsibility to Maintain.Structural Elements: Chronic dampness, heating ducts are filled with water. 105 CMR 410.351: Owner's Installation and Maintenance Responsibilities: Electrical wiring does not operate properly; outlets and light switches do not work. Float valve in toilet does not operate properly. 105 CMR 4.10.353- Asbestos Material; Every owner shall maintain all asbestos material in good repair, and free from any defects includ4ng, but not limited to, holes; cracks, tears or any looseness which may allow the release of asbestos dust, or any powdered, crumbled or pulverized asbestos material. Every owner shall correct any violation of 105 CMR 410.353 in accordance with the regulations of the Department of Environmental Protection appearing at 310 CMR 7.00 and in accordance with the regulations. of the Department of Labor and .Workforce Development appearing at 453 CMR 6.00 and with any other applicable statutes and regulations. You may contact Mr. Andrew Cooney at the Massachusetts Department of Environmental Protection DEP (508) 946-2844 for assistance with -asbestos related matters. Page two: Health Division You are directed to correct the violations listed above within fourteen (14) days of your receipt of this notice by pulling. any required building permits (if applicable); by repairing the damaged flooring and by repairing or replacing the heating system so that it functions properlyand maintains in good repair and,the source of the chronic dampness must be identified and repaired. The source of the water/moisture in the cold air returns is unknown, as is the physical condition of the.returns. It is theopinion of the Building Department that the most economicalr solution would be to fill the cold air returns with cement and install new returns through the attic. This is only a recommendation. If you choose to use the .existing returns, you must demonstrate their effectiveness via an independent heating specialist's report. You are ordered to provide to the Barnstable Health Division a report from a licensed plumber and or HVAC contractor which identifies the problem. This report must be submitted within five (5) days of your receipt of this notice. You may.request a Bearing -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. PER.ORDER OF THE BOARD OF HEALTH G T omas A. Mc ean, R.S.;CHO - Director of Public Health Town of Barnstable CC: Linda Savoie 0f LAW OFFICES OF RON S. JANSSON lY P. O. BOX 147 �' - - BARNSTABLE; MASSACHUSETTS 02630 j l �UJ v1�5eNR / ryr. STR T ADDRESS: 86 Willow Street, Suite 4. TELEPHONE: (508) 362 - 3377 Y_ armouth. Port, MA 02675-1758 FACSIMILE: (508) 362 - 3433 VTS/11.0 efo January 201 2010 Barnstable Board of Health Barnstable Town Hall 200 Main Street Hyannis, MA 02601 LA 1 NZ f)A'tA J�.AS Re: 5 General Patton Drive, Hyannis Dear Mr. McKean: The undersigned has been retained by James Walker regarding a notice to abate j violation to the state sanitary code, as well as minimum standards of fitness to human habitation and Barnstable Municipal Ordinance #170 regarding 5 General Patton Drive, Hyannis,-MA. The above notice was received on January 14, 2010, and accordingly, I would request a Hearing before.the Board of Health regarding the notices. Please contact the undersigned forthwith, upon receipt of this notice in order that we -can discuss a mutually convenient hearing date. Very truly yours, Ron ansson Cc James Walker Message Page 1 of 2 Cabot, Jaime From: Cabot, Jaime Sent: Thursday, January 14, 2010 3:26 PM To: 'Jim Walker' Subject: RE: 5 General Patton Dr. Hello Mr.. Walker, I thank you for your prompt reply. I would like to note that, the order letter does not ask for repairs to be completed in 5 days, but for you to provide a report from a licensed plumber or HVAC contractor identifying the problem. An estimate for repairs would be sufficient at this stage and a contracted agreement to perform the needed repairs within two weeks (14)days is needed as well. I have provided you with the contact telephone number for Andrew Cooney of the Massachusetts DEP (508) 946- 2844, 1 advise you to contact him before any work is done on the VAT (vinyl asbestos tile) flooring. Mr.. Cooney can best provide you with information on safety precautions to protect the health of the occupants of the dwelling. Please contact me with any questions you have regarding this matter. Sincerely, Jaime Cabot Jaime Cabot,R.S. Health Inspector Health Division Town of Barnstable (508) 862-4651 -----Original Message----- From: Jim Walker [mailto:jimwalker0100@comcast.net] Sent: Thursday, January 14, 2010 2:19 PM To: Cabot, Jaime Cc: Ron Jansson Subject: 5 General Patton Dr. Jaime, I received your letter today regarding an inspection at my rental 5 General Patton Dr. Hyannis last Dec. 28. 09 . As per our telecom today I am following up with a written explanation of the situation . The Savoie family moved into the unit 4 Oct. 2008 one year later Oct. 09 they notified me of a problem with water in a cold air return duct in the bedroom floor I made numerous attempts to remedy the situation but failed. as a result I asked them to find another place to live late Nov. and was told they were looking . No rent has been paid scene late Sept. other than credit of$ 675.00 for repairs to my truck and $ 300.00 in cash which paid up Sept's rent . I allowed them the 1.200.00 Oct. rent free for renburtsment for any moisture damage to there furniture.. I believe the drain pipe and trap under the bath tube has failed and the repairs are extensive and time consuming the house should not be occupied during the time of repair's. As they were asked to move out almost two months age and I am sure the problem is no better. 1/22/2010 r Message Page 2 of 2 Your letter only gives me 5 days to make repairs that cannot be accomplished with the house occupied. if you can help the Savoie's find another rental I am sure we would all appreciate it. Thanks, Jim James A. Walker 726 Falmouth Rd. Hyannis Ma.02601 508-775-0100 1/22/2010 f r x> T, 17, VQ iv 71 rr �:Tfrs+tj..w•R-ram� �J :�1, t i n r� :e� � ,: F- 33, it4t.4 , r i . f _ f ._ § '� F � �'� 7i.• J r r4. f it - � • i may. aY' 414 F J. T It 47, 'Y • d • . k<, fin. .. z, � � i�, .. � •I � r�,,� �.+`. TOWN OF FARNSTABL R LOCATION_ �L�°'G�inG��- ll J����SEWAGE # VILLAGE ,�,(' ��Y vs ASSESSOR'S MAP & LOT _1/ ff __.1 G y — -- T J. CRAIG MEDEIROS , INSTALLER'S NAME & PHONE NO.78I�NDE� YA NNIS, MA 02601 o Svc SEPTIC TANK CAPACITY / " ° 5a 1 ; _ LEACHING FACILITY:(type)e� � I�(size)�kC-'� NO. OF BEDROOMS _PRIVATE WELL OR PUIlLIC iWATF . L- -offlc O W N E R; J DATE PERMIT I.A- DATE COMPLIANCE ISSUED- VARIANCE GRANTED: Yes No i, ____ Ile yr a v No.--- :.. F�s....... ...� THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH -/.-C9..! L* ........OF...'............D.`'.. `._5..... Appilratilliftrior Dispas al Works Tilmi rnrttnn 1hrutit &Z;;=== Application is hereby made for a Permit to Construct ( ) or Repair (41�an Individual Sewage Disposal System at ------------ ------------------••---.....----•-_----.........-----•----•---•---•-•------------ --....---••--•----........-----------...-------------•-------•------------•------...............-- Locati Addre7 *-C or Lot No. w. _............................. ...a------• s`---------•-----•-•-•••- ------ �l Owner /� A dress a ..........................+ a�:: h�!/� +`-...............•-•--.....------ •�..� ......(.....---- 1_ `(..... ------------------.................. Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms------------- - ---- -----Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building .... No. of persons............................ Showers — Cafeteria p' Other fixtures ....--•---••-•-------------•---- . W Design Flow............................................gallons per person per day. Total daily flow---------_..................................gallons. 1:4 Septic Tank—Liquid'capacity...._._.....gallons Length................ Width................ Diameter---------------- Depth................ xDisposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. �: - Seepage Pit No---------------_---- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. ]................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (T Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...............:........ • ---------•--•--•--------------•--......-------•---------------•--......................................................... ODescription of Soil..................................................................................................................v�-------------•-•------------------.....--•---------------------------•--- ------.............................................. W ............................................................................................................................... Y U Nature of Repairs or Alterations—Answer when applicable._.._.e%q.°__ .__..._ l fl . .............................................................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i T T L�� p S of the State Sanitary Code The undersigned further agrees not to place the system in operation until a Certificate of Compliance has'been ' sued the board of health. Signed........ ...- -� 9 ate q Application Approved By..... ---�J' V — �•--'L_ .�. Date Application Disapproved for the following reasons:-------•----------------------------------------------•-------------------------------------------._.....--•--- ....................•----.......---•-----...---...-•----------------------------------......_•----------_._......_....-•••-••-••-•---•••--•--••---------------•---••••-••------•----•-••---•--•---•----- Date Permit No.._._..� -'"19 •--. Issued....................................................... Date r t No................-....... Fizs........................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH l� w �..............OF....!-3..1 L-t,► 5—L',v4le ----------------- ---------.....----------------•----.............._......--------- Appliration for Bi;polial Works Tomtrnrtion rani# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ..............A •-----.....-•----_.............................. ----...----•-----------------•------r----...........------...----•-............-_................ e-S Location•alss-- 4" �" � or Lot No.---...------ -------------------------1�_ ..--•--••-----•-------.--•---.--._..... ._..._.. C ............................................../ Add ess Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) P4 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures -------------------------------• ... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 04, Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ 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 ( ) F-1 Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.................... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_._.-_-____-___---___--. Ix ODescription of Soil------..... . aY ....--------•--•-------•--.....---•--•.-•--------•----•------------------ --•---.... ------.------... x W N of Repairs or Alterati ns—Answe when a 1• ble_1`! fib___ � 1 .. _..•__- /�Z l.�.t2s.? %� �S�ta�y'�r•`• ---------------------------------•------------•--•----------------•------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance.with the provisions of T i 1 1E 1 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issue by the board of health. Signe ... ..... .............. -------•-.-•-- Oa C.. —- Application Approved By................ a/ U •-----------•------------------ ------------ Date Application Disapproved for the following reasons:--------•-------•-------•--•----••--•-----•--------•---•-----••-•-----------------------•-•-•--••--••----------- ..-•-----•-----------•---------••--•----...-----•-•••---••••-•-•----••-•---------------------•------..._.. 11 Date PermitNo.........&n.k.tI......................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS / BOARD OF HEALTH ..........................................O F....!..cT ................................................................... Trtifiratr of Tontpliattrr THIS IS CERTIFY, hat th Individual Sewage • po 1 $ stem tr -te' ) or Repaired by .._ .. Installer . ----_... ----------••-- at --••••• - --- -------------- •......................... -- ------------------------- ...................... ...--••-•--•.... t �------•---- has installed in accordance with the rovisions of mTi'�' " of The State Sanitar Codescrbed in the P -� � Y application for Disposal Works Construction Permit No.._..... -.-�-._`�,�.__...... dated-----------------------_-.._._.__-------____--. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO RUED AS A GAXRANTEE THAT HE SYSTEM WILL FUNCT S ISFACTORY. ((// �; nn DATE V..•-rj-�-------------•-....._. Inspector....... .... . ..._. . ...._.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH f " .�'.................0 F.... ....................... ................................ N o.. . `� r r EE........................ �t��o �tl rk� ,�,gon���tion rrnti� Permission is hereby granted•... • '- ........ •_V_:.--Q'----.....�.'"��----------------------------- -...... -•-.-----.................. to Constrl1qq��ct ( ) or Repa ir Ja IInndividual S - Tag Disposal Syst J�.!_. �1. ......_. /A �tr IJ.�- `�k.t'.... '�.-�,�{�� .(_..!. -----------•--- ��JJ V Street as shown on the application for Disposal Works Construction Permit No.__�:_?.-__ Dated.......................................... ................................. ` ..................................................... T` "` Board of Health FORM 1255 HOBBS & WARREN, INC., PUBLISHERS