Loading...
HomeMy WebLinkAbout0064 GREENWOOD AVENUE - Health 64 GREENWOOD AVE, HYa4NNIS f i A, ' TOWN OF BARNSTABLE �b fill -i SEWAGE # 701-1 VII,LAGE U)J AwW" . ASSESSOR'S MAP & LOT-Al" INSTALLER'S NAME&PHONE NO. _�` (� Oak- SEPTIC TANK CAPACITY /,�-00 C9Al�v►�s LEACHING FACILUY: (type 0P06 S W Y(" size) �,0 l.3- NO. OF BEDROOMS 3 BUII.DER O O 16 kii �(/1M i Wt L PERMIT DATE. COMPLIANCE DATE:1a��1—/`�7 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200.feet of leaching facility) Feet Edge of Wetland`'an Leachi acility(If any wetlands exist within 300 fe cility) Feet Furnished by 71� �'77 M;� oc QGil � I r � o TOWN OF BARNSTABLE LOCATION C IP ESA' eyo-o3 SEWAGE # VILLAGE /7`/� ASSESSOR'S MAP & LOT IN A & B CANCO 775-6264 LEACHING FACILITY:(type) /Of C If¢o L (size) NO. OF BEDROOMS 3 PRIVATE WELL O PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No e� o � M n z TOWN OF BARNSTABLE LOC-A l ON !o /'Cc/;W 000/ Ate-- SEWAGE # 'iiLLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE N0�0ucL�►� SEPTIC TANK CAPACrI'Y LEACHING FACILITY: (type) (size) NO. OF BEDROOMS_ OWNER (VaUdel4tc PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted.Groundwater Table to the Bottom of Leaching Facility Feet Private Water.Supply Well and Leaching Facility (If.any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wedand and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by ge 10 of l l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS y SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C. SYSTEM INFORMATION(continued) Property Address:64 G Mnwood Ave - - yarns Owner's Name: Gaudette w Date of"Impection:5a6M SKETCH OF SEWAGE DISPOSAL SYSTEM - Provide a sketch of the sewage disposal system including ties to at least two permanent referesce landmarks o, benchmarks.Locate all wells within 100 feet.Locate where public watts supply enters the building. ° C- A-U- i� A E as O O I13 3G- 2`l a - TOWN OF BARNSTABLE _LOCATI0 14 nwoo C) =' SEWAGE # VILLAGE ASSESSOR'S & LOT INSTALLER'S NAME&AONE NO. 4 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: .—COMPLIANCE DATE: Separation Distance Between the: : 1�eC k Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) ��r Feet Furnished by y�Qc"L ---Too lo I D N n � r ; t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �< 64 Greenwood Ave. Property Address Madalena Tatara Owner Owner's Name information is required for every Hyannis Ma. 02601 8/25/2011 page. Cityr 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 farms Q. General Information on the computer, use only the tab 1. Inspector key to move your cursor-do not Sean M. Jones use the return Name of Inspector key. Capewide Enterprises Company Name 153 Commercial St. Company Address Mashpee Ma. 02649 City/Town State Zip Code 508-477-8877 S14522 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 16.340 of Title 5(310 CMR 16.000).The system: ® Passes ❑ Conditionally Passes ❑ F,ails: y ❑ Needs Further Evaluation by the Local Approving Authority P» y.� 8/25/2011 Inspector's Signature Date yes: The system inspector shall submit a copy of this inspection report to the Approving Authc6y(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. � Z� ll t5ins•11110 Title 5 Official Inspection form:Subsurface Sewage System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 64 Greenwood Ave. Property Address Madalena Tatara Owner Owner's Name information is required for every Hyannis Ma. 02601 8/25/2011 page. Citylrown 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: The dwelling located at 64 Greenwood Ave Hyannis Ma. is served by a Title V septic system consisting of a 1500 gallon septic tank, distribution box, and 2 500 gallon pre-cast leach chambers. This system was found to be functioning but is inadequate in size for the number of bedrooms present. This dwelling passes but must be connected to town sewer when it becomes available. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 64 Greenwood Ave. Property Address Madalena Tatara Owner Owner's Name information is required for every Hyannis Ma. 02601 8/25/2011 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-11/10 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments "< 64 Greenwood Ave. Property Address Madalena Tatara Owner Owner's Name information is Hyannis Ma. 02601 8/25/2011 required for every 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 ❑ 0 Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool El ® 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-11110 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 "t 64 Greenwood Ave. Property Address Madalena Tatara Owner Owner's Name information is required for every Hyannis Ma. 02601 8/25/2011 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 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 16,000 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 ❑ El 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•11/10 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 64 Greenwood Ave. Property Address Madalena Tatara Owner owner's Name information is required for every Hyannis Ma. 02601 8/25/2011 page. City/Town 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): 5 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): tsins-11n o Tile 5 official Inspection Form:Subsurface sewage Disposal system-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments y� 64 Greenwood Ave. Property Address Madalena Tatara Owner Owners Name information is required for every Hyannis Ma. 02601 8/25/2011 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: f Number of current residents: 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 Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage d : 9 ( y 9 (9P )) Detail: Sump pump? ❑ Yes ® No Last date of occupancy: current Date Commerciallindustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-11H0 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 a 64 Greenwood Ave. Property Address Madalena Tatara Owner Owner's Name information is required for every Hyannis Ma. 02601 8/25/2011 page. Cityrrown 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): III t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form i; Subsurface Sewage Disposal System Form-Not for Voluntary Assessments "t 64 Greenwood Ave. Property Address Madalena Tatara Owner Owner's Name information is required for every Hyannis Ma. 02601 8/25/2011 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: unknown Were sewage odors detected when arriving at the site? ❑ Yes.® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line. 1 feeett Comments(on condition of joints, venting, evidence of leakage, etc.): Joints ok, no leakage, vented through roof 9 9 Septic Tank(locate on site plan): Depth below grade: 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: 1500 gallons Sludge depth: 5" 15ins•11/11, Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 it I� Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 64 Greenwood Ave. Property Address Madalena Tatara Owner Owner's Name information is required for every Hyannis Ma. 02601 8/25/2011 page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 3.5' 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 10" How were dimensions determined? opened covers and.took measurements ' Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank needs to be cleaned, water level was at bottom of outlet invert, inlet and outlet tees intact. 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•11110 rdle 5 Official hspeclion Form:Subsurface Sewage Disposal System•Page 10 of 17 I Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 64 Greenwood Ave. Property Address Madalena Tatara Owner Owner's Name information is required for every Hyannis Ma. 02601 8/25/2011 page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) 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•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 64 Greenwood Ave. Property Address Madalena Tatara Owner Owner's Name information is required for every Hyannis Ma. 02601 8/25/2011 page. Cityfrown 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 0" 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.): Box was video inspected and found to be functioning as intended. 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•11/10 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 12 of 17 � Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 64 Greenwood Ave. Property Address Madalena Tatara Owner Owners Name information is required for every Hyannis Ma. 02601 8/25/2011 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 2 ❑ 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.): S.a.s. was video inspected and found to have 8"of available leaching with no signs of past hydraulic overloading. s.a.s. is undersized for the number of bedrooms, dwelling must be connected to sewer when it becomes available per Board of Health. 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-11110 Tide 5 olfidal hmpeclion Forth: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 M y 64 Greenwood Ave. Property Address Madalena Tatara Owner Owner's Name required fo is Hyannis Ma. 02601 8/25/2011 required for every Y page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) 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•11110 Title 5 Official Inspection Form: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 M '< 64 Greenwood Ave. Property Address Madalena Tatara Owner Owner's Name information is required for every Hyannis Ma. 02601 8/25/2011 page. Cityfrown 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 A'( Z2 7L AQ a-I 33 S � '� fp9• A-3 9-3 qq ,q_y Zg 13-Y L(J6 A-9 zi t5ins-11/10 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 M 64 Greenwood Ave. Property Address Madalena Tatara Owner Owner's Name information is required for every Hyannis Ma. 02601 8/25/2011 page. Cityrrown 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 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: c ❑ Checked with local excavators, installers=(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Property is elevated compared to surrounding area Before filing this Inspection Report,please see Report Completeness Checklist on next page. t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts Tale 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 64 Greenwood Ave. Property Address Madalena Tatara Owner owner's Name information is required for every Hyannis Ma. 02601 8/25/2011 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 X09 MD313 '0 310d 1H9n sdow xc4 S)ossmy elcIamog fo umo1400ZA3 woq pez4161p waM Seull IwrDd ',001 t 10 aIWS D JD dow By UO BIIDx pB81Dlu9 *133109=WNI l sprDpuDJS 1101my dDW Iauo4oN Jeaw of paddow areM uo4ole6an puD'Aydw6odoJ'pWawluold •uo4wod;oJ spalgo IDalsdyd W sdlysuo4oler Imp luesarder Jou op s!yJ JD spropuoJS bmmey doW IDuo4oN 09 OE 0 ,� M 83M01 n 310d A111110 0039 Aq SgdDreoJoyd IDuaD 686 t woq paJerdia4ul eiaM uo4DJe6en pun AydW6odol•Aundwo)NoMeS M pun'suopmol eruJ Jou em Ae41•Se4Dpunoq Auedwd In Jeew 1ON Aow pun dow elms,00 t t ' SBWD(a41 Aq SydO160J0yd IOueD S66 t woq peJeldlaJUi B18M(Se1nJOBf BpOW-UOW)Sl D fo JeaDla uo sl dw. e slyl'310N* 1333 NI IMS 033NIId' N •� NIVN0 MO1S ® N91S 1 1 N n S W 3 J. S A S N O 1 1 V W it O i N I I H .1 V a O O 3 0 3 1 B V 1 S N a V e d O N M O 1 31019y11 O 1SOd C - 310HNtlW O 3h1tlA e \l ��;!\ O~7 `_ \ j OZ w 1NVSGAH X)30/H)NOd j1 1 l \ I......-..... \ i + ` ✓ 1008 9NIWWIMS A113f 3N015 •_•----•--� 1 I F p � 1 llVM 9NINIV13N ; ! lI \ dd i \-X- -- 3)N33 —X 1 ----- 1 .. : 1 11VM 3No1S NOIIVA313IOdS b'bi� t `•t I j - f •• P 9 4 DA0 6ZOh9N UO eso UO t 13 3NnNnoiNo)ioo3al. t 'vv 5 i - 3NI1 bnO1N0)1003 Z a38WON 3SnOH—3 L9E# s38WnN 13)VJ—I,Z0 i \ i F ►/� l **3 N 1113)NVJ %1 \ .... : t H)110 39VNIVNO i 101906vd avow Isla N3iVM 10 3903 533111SnONDIN01:103903, AnssnN NO ONVH)NO \�� .... _...... . ' y l S33b1 SnOn01)30 30 3903 '•..� ._.... ,l `_L`�,_�`\ J,`���,\ \ \ Avmsivi 3ssn0)d1o9 dow D uo;Daddo NlM SloywAs IID Jou:310N aN39?1 MONd1S � Ir I+E G .�--' 3J I r i I ) �, : i I r o � I ' i � } J S li v � CJ Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 64 Greenwood Ave. Property Address Madalena Isaura Tatara Owner Owner's Name information is required for Hyannis Ma. 02601 02/14/07 every 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. ,// Important: A. General Information �` When filling out forms on the computer,use 1, Inspector: only the tab key -�+ to move your Robert Paolini cursor-do not use the return Name of Inspectors key. Capewide Enterprises,LLC Company Name ='' �� C3., r� P.O.Box 763 fay Company Address i Y Lr% Centerville Ma. 02632 City/Town State p Code (508)428-4028 C-n M 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 02/14/07 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. 64 greenwood•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 c — Commonwealth of Massachusetts MEMO W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 64 Greenwood Ave. Property Address Madalena Isaura Tatara Owner Owner's Name information is required for Hyannis Ma. 02601 02/14/07 every 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: ® 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: The septic system is in proper working order at the present time. 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. Answer yes, no or not determined (Y, N, ND) in the ❑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. ND Explain: ❑ 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 ❑ obstruction is removed 64 greenwood•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 64 Greenwood Ave. Property Address Madalena Isaura Tatara Owner Owner's Name information is Hyannis Ma. 02601 02/14/07 required for y every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ 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 ❑ obstruction is removed ND Explain: 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 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. 64 greenwood•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 64 Greenwood Ave. Property Address Madalena Isaura Tatara Owner Owner's Name information is required for Hyannis Ma. 02601 02/14/07 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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 El ® 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 ❑ ® 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. 64 greenwood-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 64 Greenwood Ave. Property Address Madalena Isaura Tatara Owner Owner's Name information is required for. Hyannis Ma. 02601 02/14/07 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® 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 El ® 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 1-1 the system is located in a nitrogen sensitive area (Interim Wellhead Protection El 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. 64 greenwood•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 64 Greenwood Ave. Property Address Madalena Isaura Tatara Owner Owner's Name information is required for Hyannis Ma. 02601 02/14/07 every page. City/Town 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? El ® 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)] 64 greenwood•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 64 Greenwood Ave. Property Address Madalena Isaura Tatara Owner Owner's Name information is Hyannis Ma. 02601 02/14/07 required for y every page. City/Town State Zip Code Date of Inspection 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 Number of current residents: 05 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 ears usage d 2004- g ( y g (gpd)): 2006:268,000 Sump pump? ❑ Yes ® No Last date of occupancy: 02/14/07 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: Last date of occupancy/use: Date Other(describe): 64 greenwood•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �^M 64 Greenwood Ave. Property Address Madalena Isaura Tatara Owner Owner's Name information is required for Hyannis Ma. 02601 02/14/07 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: Capewide Enterprises,LLC Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: pumped tank 10/06/06 maintenance Type of System: ® Septic tank, distribution box, soil absorption system J ❑ 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) ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: 1999 Were sewage odors detected when arriving at the site? ❑ Yes ®. No 64 greenwood•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 64 Greenwood Ave. Property Address Madalena Isaura Tatara Owner Owner's Name information is required for Hyannis Ma. 02601 02/14/07 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 14"feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: 10'+ feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of Ieakage.System vented through the house vents. Septic Tank (locate on site plan): Depth below grade: 1611 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: 10'6"X5'10"X57" Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle 38 Scum thickness 3„ Distance from top of scum to top of outlet tee or baffle 7" Distance from bottom of scum to bottom of outlet tee or baffle 12" How were dimensions determined? Measured 64 greenwood•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 64 Greenwood Ave. Property Address Madalena Isaura Tatara Owner Owner's Name information is required for Hyannis Ma. 02601 02/14/07 every 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.): Pump tank every 2 years.lnlet and outlet tees are in place.Tank appears structurally sound.No evidence of leakage. 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 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): 64 greenwood•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 64 Greenwood Ave. Property Address Madalena Isaura Tatara Owner Owner's Name information is required for Hyannis Ma. 02601 02/14/07. every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) 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 Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert No 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.): Box is level and has two laterals.Distribution is equal.No evidence of solids carryover.No evidence of leakage into or out of box. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 64 greenwood-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 64 Greenwood Ave. Property Address Madalena Isaura Tatara Owner Owner's Name information is required for Hyannis Ma. 02601 02/14/07 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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: Type: ® leaching pits number: 02 ❑ 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.): Sandy soil.No evidence of hydraulic failure.Water was 14"to invert pipe at time of inspection.Vegetation appears normal. - 64 greenwood-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 64 Greenwood Ave. Property Address Madalena Isaura Tatara Owner Owner's Name information is required for Hyannis Ma. 02601 02/14/07 every page. City/Town State Zip Code Date of Inspection I D. System Information (cont.) �. 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 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, levef of ponding, condition of vegetation, etc.): 64 greenwood•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System,Form - Not for Voluntary Assessments 64 Greenwood Ave. Property Address Madalena Isaura Tatara Owner Owner's Name information is required for y H annis Ma. 02601 02/14/07 ` every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch 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. / Soack ','OR I nvS . 61 greenwood•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 64 Greenwood Ave. Property Address Madalena Isaura Tatara Owner Owner's Name information is required for Hyannis Ma. 02601 02/14/07 every page. City/Town State Zip Code- Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water l II ® Check cellar ❑ Shallow wells `Estimated depth to ground water: 30feet 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: As-Built Card ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Used:Gaherty& Miller Model 12/16/94 Ground Water Elevations.Used:USGS observation well data June 1992.Used:Technical bulletin 92-000-01 plate#2 annual ranges of ground water elevations. 64 greenwood•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 15 Town of Barnstable d Regulatory Services Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-86274038 Fax: 508-790-6230 Notice of Building code Violation and Order to Cease, Desist and Abate: Ms.Sandra C.Tatara and all persons having notice of this order. As owner/occupant of the premises/structure lcicated at 64 Greenwood Ave Hyannis,MA 02601 Assessor's Map 289 Parcel 114 you are hereby notified that you are in violation of4he Massachusetts State building code 780 CMR Section 121.0 and are ORDERED this date October 19,2005 to: 1. CEASE AND DESIST all functions connected with this violation on or at the above mentioned premises within(14)days,November 1,2005 Deadline. SU IMARY OF VIOLATION: 780 CMR Section 119.0 Stop Work Order.Any one who shall continue work after being served shall be liable to fines up to$1000.00.Each day constitutes a separate offense. 240-12 RB Residential District,Single-Family Dwellings only Compliance:All and any new work in the garage area to be abated and returned to its original use, and remove an illegal lower level apartment to a (1)single-family dwelling. 2. COMMENCE : within the dated timeline to abate this violation or legal action is to be taken SUMMARY OF ACTION TO ABATE: Dismantle all un-permitted work and return the garage back to its natural use and not to be used as habitable space,and to remove the bedroom and kitchen within the lower level.You are required by law to obtain the necessary permits to proceed. And,if aggrieved by this notice and order,to show cause as to why you should not be required to do so,by filing an appeal with the State Building Code Appeals Board(as specified in Article 1, Section 122 of 780 CMR State Building Code)within forty-five(45)days after the service of this notice.. order, Russell Wheeler. Local Inspector Q/FORMS/violatel r Linda Whitcomb - 88 Greenwood Ave/mail: 707 Main St. Hyannis MA 02601 8/22/05 Town of Barnstable Building Inspector's Office/Health Dept. ` 200 Main St Hyannis MA 02601 Dear Sir/Madam: I am a 20-year resident at 88 Greenwood Ave, Hyannis. There has been 2 properties transfer ownership this past July, #'s 64 and 65 Greenwood in which I am writing in complaint of extensive remodeling currently taking place. #65 Greenwood- Has paved the front lawn completely, making a large parking lot for several vehicles, and apparently have added apartments in this single- family house. #64 Greenwood- has added a kitchen in the basement and also has added partitioned walls and bathrooms for apartments as well, with many people working late into the evening on the renovation, sometimes until midnight. We currently have a rooming house in our neighborhood owned and operated by Nancy Johnson, which in itself seems on the fringe of building codes, (but has been there for many years). I cannot see without applying for variances to building and health codes a way in which either of these other 2 properties could possibly be in compliance with current codes for residential neighborhoods. And do they not have to notify abutters of such application? Many of the neighbors on the street are in an uproar and we do not want approval of either of these apartment houses. Please let me know what we can do to be proactive in protecting our neighborhood from such development. Regards 4_ Linda Whitcomb 88 Greenwood Ave Hyannis MA 02601 508-771-5446 (bus.tel.) 508-775-3481 (home tel.) .i COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION �y A y S+ev i TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION. Property Address: 64 Greenwood Ave SS 3aa �o Hyannis F -+ Owners Name: Gaudette ' Owner's Address: �~ y CD Date of Inspection:5/26/0511 Name of Inspector: (please print) Douglas A.Brown r ^. Company Name: Douglas A.Brown Septic Inspections _ Mailing Address:P.O Box 145 � m Centerville,MA 02632 Telephone Number: 508-4204534 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of 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: X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: =;tom-d 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. Notes and Comments at this time,system appears to be in good working condition ****This report only describes conditions at the time of inspection and under the conditions of use at that 'ime.'fins inspection does not address how the system will perform in the future under the same or different Conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Revised on 10/31/2000 L 1 Page 2 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SERSURFACE SF,`WXGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Vyopevty Xj"Tess: 64 Gcep-nvwd Ave Hyannis Owner's Name: Gaudette Owner's Address: Date of Inspection: 5/26/05 inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information winch indicates that any of the failure criteria described in 3 10 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 Pase'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. Answer yes,no or not determined(Y,N,ND)in 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. ND explain: 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 obstruction is removed distribution box is leveled or replaced The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will Voss insnertiau_if(with aj?nroval of the Board of Health) broken pipe(s)are replaced obstruction is removed Page 3 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SLB.SLRFACE SEWAGE DISPOSAL SYSTENE INSPECTION FORM PART A CERTIFICATION(continued) Property Address: !y Gies w,7&) AJ p a:�as�a Owner's Name: �c7 Owner's Address: C Date of Inspection: 3"- ..6 .O 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 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 I 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_.�'•cc'-.'.=�: "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: Page 4 of l i OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 64 Greenwood Ave Hyannis 113rW-nC-e'S'h-a-ME. �Ydt1 1� Owner's Address: Date of Inspection:5/26/05 D. System Failure Criteria applicable to all systems: You must indicate "yes or no to each of the following for all inspections: -Yes No X 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 k Liquid depth in cesspool is less than 6"below invert or available volume is Iess than 1/2 day flow X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number — of times pumped X 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. X Any portion of a cesspool or privy is within a Zone I of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well. k 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] No (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 3 10 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• V_'Qu nv .v imb rate either_"ye-s"or no to each of the following. (The following criteria apply to large systems in addition to the criteria above) 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 Ifyou have answered"yes"to any question in Section E the system is considered a significant threat,or answered yeg'm 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 Page 5 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: CH A ae Owner: 6.&,de ' Date of Inspection: Check if the following have been done.You must indicate"yes"or."no"as to each of the following: Yes No x Pumping information was provided by the owner,occupant,or Board of Health x Were any of the system components pumped out in the previous two weeks ? x Has the system received normal flaws in the previous two week period? x Have large volumes of water been introduced to the system recently or as part of this inspection? x _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) x Was the facility or dwelling inspected for signs of sewage back up? x _ Was,the site inspected fnr signs of break out? x Were all system components, excluding,the SAS,located on site? x _ Were the septic tank manhotes 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? x, 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: Yes no x _ _Existing information For example,a.plan at the Board of Health. x _ 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(3 ))(b)], 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:64 Greenwood Ave H3, s Owner's Name: Gaudette Owner's Address: Date of Inspection. 5/26/05 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN How based on 3 10 CMR 15.203 (for example: 110 gpd x# of bedrooms): 330 Number of current residents: I Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NA _ Seasonal use: (yes or no): NO $�'2-1-0 Water meter readings,if available(last 2 years usage(gpd)): VO,SaU Sump pump(yes or no): NO. Last date of occupancy: current COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(yes or no): _ Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or no): NO If yes, volume pumped: gallons--How was quantity pumped determined? Reason forpumping: TYPE OF SYSTEM X 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) Tight tank _Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: 1999 R.B. OUR Were sewage odors detected when arriving at the site (yes or no)? NO Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SLTBSITRFACI;SEWXGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 64 Greenwood Ave Hyannis Owner's Name: Gaudette Owner's Address: Date of Inspection: 5126105 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: cast iron _40 PVC other(,explain):. Distance from private water supply well or suction line: Comments f on condition of joints,venting,evidence of leakage,etc.): SEPTICTANK: (locate on site plan) _ � I Depth below grade: 911 Material of construction: X concrete metal fiberglass _polyethylene _athar(axplainl . —If tank is metal list age:— Is age confirmed by a Certificate of Compliance(yes or no): _(attach a copy of certificate), Dimensions: 1500 gal Sludge dapfb TRACE Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness:. TRACE ' Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: as built Comments(,gn_pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.)- GREASE TRAP;_(locate on site plan) Deptb.belnw grade; Material of construction:—concrete metal fiberglass—polyethylene—other f explaigl: Dimensions: Scum thickness:. Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scorn to bottom of outlet tee or baffle: Date of last pumping: Comments(aapumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 64 Greenwood Ave Hyannis Owner's Name: Gaudette Owner's Address: Date of Inspection: 5/26/05 TIGHT orBOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) TJWxhbPJnwc grade. Material of construction: concrete metal fiberglass polyethylene other(explain): Dimensions: Caaci<<j gallons Design Flow: gallons/day Alarm present&s or zoo): Alarm level: Alarm in working order(yes or no): T.la4e al 1.?91,*vaw.pirg. Comments(condition of alarm and float switches,etc.): DISTRIBbTTION BOY: (if present must be opened)(locate on site plan) T,lZpthof 1;.-gzAlevel ,nvert. 0 Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage&r o or out of box,etc.): PUMP CH-kNLUV1R-. (locate on site plan) Pumps in working order(y,es or no): Alarms in working order(yes or no): . CommeThs lknule condition of pump chamber,condition of pumps'and appurtenances,etc.): Page 9 of I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL,SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 64 Greenwood Ave Hyannis Owner's Name: Gaudette Owner'%Address: Date of Inspection: 5126IU SOIL ABSORPTION SYSTEM(SAS): _(locate on site plan,excavation not required) If SAS not located explain why: Type leac."u'ag pits,number: leaching chambers,number: 2 Irrar„N01%Wallw sIYmaber. leaching trenches,number,length: ka. -h vg Fields,number,dimensions: overflow cesspool,number: iw.,i2tawela44ess?tuNe system T' peImm of technology. Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): chambers were opened approx 4"of liquid at this time CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-mp of liquid to inlet invert: Depth of solids layer: Depthof.-rjwxtayes� Dimensions of cesspool: ,10aterials €construction: Indication of groundwater inflow(yes or no): Comdmytr.I'Ci ft condi&m of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) ' Materials of construction: '�tmens�rnr�. Depth of solids: C'ommerrts�,wte condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Page 10 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SERSERFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property AcHress: 6-4 Greenwood Ave Hyannis Owner's Name: Gaudette Owner's Adalress: Date of"Inspection: 5nV05 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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. O ® Page I of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM ] INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 64 Greenwood Ave Hyannis Owner's Name: Gaudette Owner'%4mress: Date of Inspection: 5/26/05 SITE EXAM Slope: Surface water: Check cellar: Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: 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: r 'k fc TOWN OF BARNSTABLE q LOCATION (tt WWW0� SEWAGE # VILLAGE l-1�/IAW tN� `S ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. r. SEPTIC TANK CAPACITY 1 S-00 CAA I/WS LEACHING FACILITY: (type G°U L 11e S Lu (size) 13- NO. OF BEDROOMS BUILDER OK ft- �Jf 0 �/yKt WPERMITDATE COMPLIANCE DATE: Ia�`I_y5 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200.feet of leaching facility) Feet Edge of Wetland'an Leachi acility(If any wetlands exist within 300 fe cility) } Feet Furnished by £! 1 0 000 t J9 lee -� .� No. Fee 4 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Mt!7Upgrade r *potent Con6truction Permit. Application for a Permit to Construct( )Repair( ( )Abandon( ) El Complete System O Individual Components Location Address or Lot No. Y A"l Owner's Name,Address and Tel.No. ` �ry �p wt l w C Assessor's Map/Parcel �v Z.YIPI W � /p 15-15 Wo0 ,p Installer's Name,Address,and Tee l.No. Designer's Name,Address and Tel.No. wfd Type of Building: V Dwelling No.of Bedrooms_ Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alter tions Answer when applicable) S� /�✓� Z�o/310- Abe Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the ironmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss d by this Bo�of Heal c Signed Date rl:l Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued Fee Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS~ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprtcation for 30ig o aY *p5tem ConztructionAPermit Application for a Permit to Construct( )Repair( Upgrade( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No.6 Y G REEAlvooD Ave Owner's Name,Address and Tel.No. ,+ Assessor's Map/Parcel Y AR q--- 10 _37 F wooer Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. V ouk Type of Building: ff Dwelling No.of Bedrooms Lot Size .1 . ., sq.ft., .�C Garbage Grinder( ) Other Type of Building No.of Persons" `' a Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calct7l ed daily flow gallons. Plan Date Number of sheets 1 Revision Date Title Size of Septic Tank Type of S.A.S. 'Rn Description of Soil i Nature of Repairs or Alterations(Answer when applicable) Z:) � * Date last inspected: ` Agreement: f The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the ironmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss ed by this Bo 6f Heal Signed Date ZlIr Application Approved by — i Date Application Disapproved or the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS ` Certificate of (Compliance THIS IS TO CERTIFY,that the On it/e Sewage Disposal System Constructed( )Repaired )Upgraded( ) Abandoned( )by rev '�/ at �' bee constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer Designer f /(�n t",The issuance of this vern it sh 1 n a construed as a guarantee that the sy t6 ill function a si A/`�lu Date Inspector i0 .n , / v s v �� No. `.'! ..— --%-------------------------Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE.,MASSACHUSETTS loigoai *pztem Construction Permit Permission is hereby granted to Construct( )Repair( .Upgrade( ) ba d System located at eV and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/h , duty to comply with Title 5 and the following local provisions or special conditions. Provided:Constructio mu t be completed within three years of the date of thi - Date: Approved by • "1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - CERTIFICATION OF SKETCH AYD APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I, hereby certify that the application for disposal works construction permit signed by me dated concerning the property located at meets all of the following criteria: • The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. • There are no wetlands within 100 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • The bottom of the proposed leaching facility will not be located less than five feet above the madmum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] • If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14) feet above the maximum adjusted groundwater table elevation, Please complete the following: l A) To of Ground Surface Elevation(using GIS information v P 5 ) B) G.W. Elevation p�the ivl. lX. High G.W. Adjustment . _ DIFFERENCE BETWEEN A and B SIGNED : DATE: [Sketch proposed plan of system on back]. q:heslth folder.cert HYANNIS FIRE DEPARTMENT bIlol 95 HIGH SCHOOL ROAD EXTENSION HYANNIS, MASS. 02601 RICHARD R. FARRENKOPF BUSINESS: 775-1300 CHIEF Swephe Oeteeftj Jane odived EMERGENCY: 775-2323 June 8, 1990 ��� _ C � TO UNDERGROUND STORAGE TANK OWNERSr� ir �.. .� This Department is aw,ae that "you _have an underground tank at ,your' property which is over twenty V `years old is �yt According to Fedefal, State anal; Town reguldtions,'-arrangements must be'made for the removal f' these t ks`' We suggest that prior t.o emptyingf your , present . ,i.undergNo nd a k yob).<look into having a. replacement tank in the basement}Or outsi eE,the..premises, after which time you wi i have a '1 period of two {years to r move the''underground ':tank.' ., We have been n f ormedi by Some residents that the underground'tangy - {their �'� jam.,,,., f.., ( �I �•` - ---I`' t ' property has b n:.abandor� d .and. is not iri user These tanks steal ,: a removed y ,, t, . as soon as pos: ble:- - Please do not hg�itate ot..,ofaact ,this Department if we. can be+6 _ rtherl a'ssistance. orsi o`er i1�i Uk+ �a�listing,:of some of the, underg round- .ta removal companies 'ems; t f ~ ' ::�1 , !,.` n•.., �� ��"' Sincerely, V RICHARD R. FARRENKOPF, Chief (C) 00 l Hyannis Fire Department f. ;� ✓ RRF/dl 44 Of �. FIRE DEPL STATE USE ONLY rtRE DEPT. DEPART1 EN O.P PUBLIC SA'FE�Y U S;,T. 1:� Number 6 RT1rICATIOM r P'. 0 BOX 490 MAIL TO d/!Z TEWKSBURY: MA 01867` Date Re sill } Notir[eation is required by Federal law for all underground tanks that have;been 4 pipeline facilities`(including'gathering line.) regulated under the Natural Gas used to store regulated substances since January 1;1974,that are in the ground as of Pipeline Safety.Act of.1968.or the Hazardous Liquid Pipeline Safety Act of 1979.or May 8,1996.or that are brought into use after May 8,1986.,The information requested which is an intrastate pipclinc facility it gulatcd under State laws: is required by Section9002 of the Resource fotiservation and Recovery Act,(RCRA), 5.surface impoundments.pit-,_p ds,enlagowtsc as amended. 6.storm Cato or waste water collection sv%temi; The primary purpose offhis notification.program is to locaic and cialuaie under- 7..nmt:�through process tanks: 8.1i uidtra sorassociatcd therm Iinesdircctlt�elaiedlo<ii1'cit' r: ground tanks that,store or hate stored petroleum or hazardous substanctts.It.is 4,.- r. !d B. strip oduetionand expected that the information you provide will be based on reasonable available gathering ope' -ores; records,or in the absence of such records touj knowledge,belief.orrecoilection. 9:.`storage tanks situated 'in an underground area (such as a baurtknc altar, Who Must katify? Section 9002 of RCRA.a amended;requires that, unless . mineworking,drill,shaft,or tunncU itthe suiragLtank;isvituated:upon.or_;abotc the exempted..ow•riers:of underground tanks that stom.regulated substances must notify suiface of thrtloor. designated State or local agencies of the existence of their tanks.Owncr means- What Substances Are Covered? The notificautrit requirements applt to under- (a) in the raSY of air underground storage tank tit use on November 8, 1984,or ground sioragc tanks that contain regulated%ubuances.This includes am substance brought:into use after ihat.date,am'persoa.who owns an underground storage tank defined:as harardods in sccuon-t01 (f4) of the +Gomprchensisr E.n�ironmcntal ' used Sor the storage,usi ordispensing of regulated substances.and Response Compensation and Liabilitt Act of 1980(CEXCLA),with the-execpuan of (bl in the case of am underground storage tank in usefbclore Notember 8,1984: those substances regulated as hazardous waste under Subtitle C of RCRA. It also but no longerin use on that date,any person who owned such tank immediately be Ore includes'tutrolepm a g:,crude oil or any fraction tfkreof ti:hich is liquid at standard the discontinuation of its usi: condition, f tcin" raturc'and pressure(60'degreco t ahrenhdt.and 14.7 pounds per _... Q pe What Tanks Are Included? Underground storage tank is defined as ant one or xpiare inut>abiti lute): combination of tanks thar(1)_s t,ed to contain an accumulation(if-regulated sub- . Where To Notify? Completed,notification forms should bc:-sent urthe'address stances."and.(2)whose olumr_(uicluding connec'M underground piping)is*.j or given at thejao of this page` more beneath the ground.Some examples�are 66ti rground tank steering i,gasokne. , used oil:or.diesel fuel,arid.2:industrial solttrntc;;pesticidcs,herbicides or fumigants, When TooNbtiry? I:Owners of.underground storage tank,in use or that hate been WpatTanks Are Excluded?Tanks remo%ed from the ground.arc,no[subject to taken out oT operation after January 1, 1974,but still in tlie.groitnd,must notilj by notification.Othertanks exetuded from notifieati mare: Mat 8,1986 2.Owners who bring underground storage tanks into use after May g. 1Sfirmor residential tanksol 1100gallon%orlcsscapacitj used Ibrstoring'motorfuel 199&must notifyatithin,.10 days of bringing the tanks into use.` for noncommercial purposes; Penalties: Any owner who knowingly fails to notify ar submits false information 2.tanksused forstoring heating oil forconsumptite,use un[bepremiseswherestored. shall be ud)* t;to a`avil'.peh Ity.noUto exceed SI0,000 for each tank for which a:aeptic;fanks Y tiatificationis not given ar for which false information is submitted. INSTRUCTIONS '..Pleas�tlrpeorpnm m ink, all items except"stgnatuW-in Section V.This forth tatetst by completed for indicate number of esie6 Eetotr eontatnin�underground storage tanks [f more than S tanks arc owmed at thts�orauon <. confinuagon'sheets phottxopy the reverse side:and staple continuation sheets to this form attached " • • • •. OWner Name(Corporation,Individual,Public _ cy;or Other Entity) rtn k (If same.as.Section 1,mark box.here ): t} E - Facility Name or Company Site Identifier,as applicable Stt�eet Address' ., ��,P _ountY Sheet Address.-or State Road as:applicable C fy . . Sta ZIP"C6de Xdunty I S Hof/ 02�o Area Code RFione Number77 City(nearest] State ZIP Code. f 7- '7 7.I' 3 � Wcurren of Owner (Markaff that apply®)t State orLocal Gov't' Pnvate orIndicate .Mark box here if tank s® Corporate number of are located on land within aFortner. Federal Gov't Ownership tanks at this' an Indian reservation or (GSA facility I.D.no. �'.uncertain' bycation, on;other Indian trust lands • • • Name.-(Ifsame as Section 1,mark box here Q) Job Title Area Code Phone Number • • Mark`boti,here onlytf this amendedorsubse uent nofiftcatton for this location . 4 I;certify under penalty of law:that I have personally examined and am familiar with the inforrnation subrnitted in•this an'd all attaehetf documents,and that based on my inquiry of those individuals immediately responsible for.obtaining the informations hbelieYe that-the submitted information is true,accurate,and completer Nn d ffiei I till of o r w oner's authorized representative ' re ©ate Sign d am a CONTfNUE ON REVERSE SIDE Form F.P. 290 Part 1 Page t Q 6) 1. �► i • _J l I I I I ss%e�.O j AI-tw I� i 10T2 � O' V C' h • PLOT PLAN OF LAND ' "ro rHE BEST OF NY KNOWLEDGE THE BUILDitG LOCH rED IN SHOWN ON THIS PLAN IS AS I r ACTUALLY EXISTS AND , ,►,y BARNS TA BL E -- MA SS rHA T I T CONFORMS TO THE TOWN OF BARNSTABLE ION ��11 OF ` Js. REGUA TIONSr REGARDING YARD SETBACKS' �`,a �!��, PREPARED FOR R'CRAR %-11471w4ls , we. 'OOC AV b)A TE.-,4vtlM:" ,,I Swe a / tt0. 31, " DAM' 410, oO-.v JSW SCALE- t CAPE 6 ISLANDS SURVEYING FLOOD ZONE C °��� S U IZ•` TEA rICKE r - mASS. a of 'allarllaetts DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION � APPLICATION FOR PERMIT TO MAINTAIN AN EXISTING/NEW UNDERGROUND STORAGE FACILITY To: Head .of Fire Department aNAl j'S 190 T Hy City or Town ate ormF.P. 29D Application is hereby made for a permit to maintain an existing/new arts underground storage facility as .required. by/527CMR9.00: Permits. Location of property: p oC! Street a dress Owner of property: ' , " l Full name of person, firm or co r Signature of owne,ror authorized representative: u t` Fee:$ �y (M.G.L.A. Chapt. 148 Sec. 10A) (Eire Department's Copy to be Filed with F.P.290 part 2) P _TV 101- �p of �tto�ttr P$�i :DEPARTIMENT. OF PUBLIC-SAFETY—DIVISION OF FIRE PREVENTION ILA ED ".jW Date '-orm:F.P. 290 TO MAINTAIN.AN EXISTING/NEW UNDERGROUND STORAGE FACILITY 'art 4 In accordance with the provisions. of 527CMR9.24 this permit to maintain. an existing/new underground storage facility is granted to: Location of property: Street addr s Owner of property: o — Full name of person, f rm or corporation Restrictions• 4Z9,0 �, AV 44 Fee Paid:$ (M.G.L.A. Chapt. 148 Sec. 1 r This permit will expire 19 Date S ature of Head of Fire Dept. or appoin ed ignee (Owner's Copy to be posted at the storage facility with F.P.290 Part 3) i 4* Make application to local Fire Department. Fire department retains original application and issues duplicate as Permit. /GCGGZGIZG(/SP q _2 gq - �e�ia��G��rcC a��axe�Prwvccea— �aa��t�isr�re ���vu�ratro�rc vim APPLICATION and PERMIT Fee: ,n for storage tank removal and transportation to approved tank disposal yard in accordance with the provisions of M.G.L. Chapter 148, Section 38A, 527 CMR 9.00, application is hereby made by: • Tank Owner Name(please print) �'�"`-' � '�� X Signature(it apllying�►`or permit .Address . 6"Z6d Street ity stare zip _ CtrMpany Name Advanced Environmental Co. or Individual Print Print Ad0ressP'.0'-R0x 472 r197,�,Great Warztern R Pddress Print ;Signature p yi per i Signature (if applying for permit) IFCI Certified Other: p IFCI Certified t. O LSP # Other Tank Location j c y ..Tank Capacity(gallons) _. L �Substance Last Stored i Tank-Dimensions (& metes x length) Remarks: - 10. . Firm transporting wasteAdvanced Environmental State Lic. # MV5083856 0.0 Hazardous waste manifest# E.P.A.# _� i Approved tank disposal yard fames G.Grant Co. . Inc Tank yard# 008 I 1 -• i Type of inert gas ��'1 Tank yard address 1oT�.1 —St R®advi 1le-„ MA City or Town �1,4 ti/"IS FDID# ya Permit# V9 8 2® I I Date of issue � 9�'� Date of expiration Dig safe approval number: Dig Safe Toll,J ree Tel. Number 800-322-4844 r Signature/Title of Officer granting permit �� E P JS r nin, <aR t,•L�B IF After removal(s)send Form FP-29OR signed by Local Fire Dept. to UST Regulator yCompliance Unit, 0fg , � b II, ids doom 1310, Boston, MA 02108-1618. At`3°fJ$ Fj y w .. A'\ , NA G260'1 92(revised 9/96) "--...._"_ ....._.._._._..---- or Town of Barnstable V. T . A' E OFTt1 sAMSTABM Department of Health, Safety, and Environmental Services 9� '1 �0r Public Health Division Q<<0"dUJ J- A'E0"A°�A P.O. Box 534, Hyannis MA 02601 a,)-i ��uesec vle>WJ 1 Office: 508-8624644 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health November 3, 1998 Ms. Linda Markarian 64A Greenwood Ave. 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 RENTAL ORDINANCE,ARTICLE 51 The property owned by you located at 64 Greenwood Avenue, Hyannis, was inspected on November 3, 1998 by Donna Miorandi, Health Inspector for the Town of Barnstable, because of a complaint. The following violations of 105 CMR 410.00, State Sanitary Code II,Minimum Standards of Fitness for Human Habitation were observed: 410.200: The gas wall furnace was inoperable. 410.402: The rental unit has more than one-half of its floor-to-ceiling height below the average grade of the adjoining ground and is subject to chronic dampness. 410.450: No second means of egress provided. Only one doorway provided for entrance and exit. 410.500: No door provided at the entrance and exit-way. The violations listed above as 105 CMR 410.200 and 410.450 are also listed as conditions deemed to endanger or impair the health, safety, and well-being of a person occupying the premises and shall be corrected within (24) twenty-four hours of your receipt of this notice by supplying heat and by providing a second egress. l l markarian/wp/q/Is The remaining violations listed above shall be corrected within five (5) days by providing a door at the entrance and exit-way and by correcting the violation of 105 CMR 410.402. If you are unable to rectify the violation of 105 CMR 410.402, this unit cannot be occupied by any person in the future. You may request a hearing if written petition requesting same is received by the Board of Health within seven (7) days after the date order is received. However, these violations must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order could result in a fine of not more than $500. Each separate day's failure to comply with an order shall constitute a separate violation. PER 0"ER O THE-BOARD OF HEALTH 007U)� Thomas A. McKean Director of Public Health . cc: Ralph Crossen Legal Services markarian/wp/q/ls f } PAR `] Real Estate System - General Property Inquiry] Help [ ] Parcel Id: 289 114- - Account No: 19463 Parent : Location: 64 GREENWOOD AVE HY Neighborhood: 55EC Fire Dist : HY Devel Lot : Lot Size : 1 . 13 Acres Current Own: FOKAS, KATHY, WILLIAM & CHR State Class : 101 MILLER, JEAN E No. Bldgs : 1 Area: 1834 50 RAYMOND ST Year Added: NASHUA NH 3060 Deed Date : 060192 Reference : 8067/314 January 1st : FOKAS, KATHY, WILLIAM & CHR Deed MMDD: 0692 Deed Ref : 8067/314 Comments : Values : Land: 55700 Buildings : 150600 Extra Features : 11300 Road System: 64 Index: 633 (GREENWOOD AVENUE ) Frntg: 213 Index: ( ) Frntg: Control Info: Last Auto Upd: 050695 Status : C Last TACS Update : 041294 Land Reviewed By: Date: 0000 Bldgs Reviewed By: ML Date : 0688 Tax Title : Account : Taken: Account Status : Hold Status : Cancel [ ] Press XMT for more data Next screen [PAR ] Action [ ] Owners Name [ ] Road Index [ ] Road Name [ ] Parcel Number [289] [115] [ ] [ ] [ ] A9 Go v \ Wit' �� '4•+'`e-�}�'u '^11•�^w.+ ,w,�,1���( 'f ^+a��.`�.�'�'`'Rv-.a.w.^�rf� !✓"x� { � `' r � �1• � �-!'+ry�,�, rf-.�._•"•.-s,...,. ' FORM30 HOBBSB WARREN'iM THE COMMONWEALTH OF MASSACHUSETTS V#RD OF HE L.T x a r < F CITY/TOWN _ #r, A W DEPARTMENT f l l 1 M\ f rYv' ADDRESS ... l /V^ l0IELEPHONE Address ✓ �' y �LOccupan /se Floor Apartment No. )�64 No. of Occup�aots No.of Habitable Rooms_ No.Sleeping Rooms No.dwelling or rooming units No.Stories Name and address of owner r Remarks Reg. Vio. ' YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage K.. Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obs'n_: ca ea ❑ B ❑ F ❑ M Doors,Windows: `_ 0 / e, i Roof ' Gutters, Drains: J t ' Walls: Foundation: Chimney: BASEMENT Gen.Sanitatiort: Dampness: (j Stairs: ' Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: hi Hall Lighting: Hall Windows: ' HEATING Chimneys: 40 a Central El 1(;' ElN ` E ui . Re airy K&I& L T s 4 • 7 TYPE:,.. Stacks, Flues, ents: PLUMBING: Supply Line: ❑ MS ,❑ ST L Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 11220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen ---,'-Bathroom Pantr ., 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: E/ 0 General - Buildin Posted ` Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS Aj CONDITION�W IH CH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750.OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION REPORT IS/SIGNED AND CERTIFIED UNDER THE PAINS AND PENALT ELF ERJURY." ® �✓ INSPECTOR DIM, 1 ITLE A.M. DATE TIME P.M.'� '_ A.M.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) 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. - I r � I r � I , f \` Oar , i t- i 11[G t� i 4 ppp wk 14�� Rr f 1 I ✓ i ' I Tb� 3� fL i i i t r Y w�+ 1. t i t E . t 4