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HomeMy WebLinkAbout0080 GREENWOOD AVENUE - Health 80 Greenwood Avenue Hyannis = 139 - 001 o , 1' FORM3O C&W HOBBS&WARRENT" THE,COMMONWEALTHOFMASSACHUSETTS BOARD OF HEALTH CITY/TOWN W W DEPARTMENT a i ' ADDRESS Gv2 C,3 waa,0 !A TELEPHONE G� Address k-tAvA�c��� �'�'� — OccupantU o%A-.L So"ZA FloorC-#2.r4 Apartment No. i No.of Occupants No.of Habitable Rooms 2- No.Sleeping Rooms S't,s raK 0 No.dwelling or rooming units Z- No.Stories '7- Name and address of owner s 0---A a NI t-�.0 C.K Py - r2fXjy W pv Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: p a(L-t t-t k,., S Stairs: 4 ,444<- &L,-r -o JS f-c.vv 4alOC 41/& Wo 2 jj Li htin 1-4_OS 7o iw.i, STRUCTURE INT. Hall,Stairway: on- /1N .4 f.rr Cvn.�;tfa�-eE2 Obst'n.: �ui2i.„cr �-�/�vt �•• lia9�Q2 Hall, Floor,Wall,Ceiling: -C 0-Ae"" Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: iX Stacks, Flues,Vents: PLUMBING: Supply Line: Elms ❑ ST. ❑ P Waste Line: H.W.Tanks Safety and Vent(s) EL�.2TRICAL Panels, Meters,Cir.: 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen ('p z Bathroom Pantry Den Living Room Bedroom 1 . Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink Stove f2,4 Zy ly4.1 Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: l..i/A.4 6&.s Wash Basin,Shower or Tub: NG7 `-✓0X-M-1A, Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJ ' INSPECTOR * TITLE :ra A.M. DATE l /�L� 2��� TIME A.M. THE NEXT SCHEDULED REINSPECTION 72-34 P.M. i i 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises.This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation,any other violation has the-potential to fall within this category in Any.given specific situation but may not do so in every case and ttierefore 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. r-.1 . � ;1 (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,infestation's and other pests as required by 105 CMR 410.550. . f (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 Bbard of Health. t r Town of Barnstable Health Inspector F'THE T Regulatory Services Office Hours g yery 8:30—9:30 o� Thomas F.Geiler,Director 3:30—4:30 i STABLE, * Public Health Division 9 MAM 1639. A�O� Thomas McKean,Director �ArFO MA'I 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT — SEPTIC QUESTIONNAIRE Date:4/10/09 1. General Information: Size of Property: 0.57 acre Address: 80 GREENWOOD AVENUE HYANNIS MA 02601 Map 289 Parcel: 139-001 Name:MAUCH,ROBERTA E Phone#: 508-420-1 133 VDCASe yvv n* 2a. How many bedrooms exist at your property now? 2b. Are you planning to add any bedrooms? N(, If yes,how many? �. 2c. How many bedrooms total are proposed at this property(including the amnesty unit)? 2d.Please include a copy of the floor plans for the entire property. Neatly use a straight-edge. Show all existing rooms in the home and the proposed amnesty apartment. Provide width measurements of any open doorways. Please label'each room clearly. 3. Is the dwelling connected to public sewer? YES or NO If the dwelling is connected to public sewer, skip questions#4 through#9 below. 4. Location of dwelling is INSIDE or OUTSIDE a Saltwater Estuary Protection Zone? 5 . Location of dwelling is INSIDE or OUTSIDE a Zone of Contribution to public supply wells? 6. Is the dwelling connected to an ONSITE WELL or to PUBLIC WATER? 7. Is a disposal works construction permit on file? YES o,r NO '°' C3 8. If yes,how many bedrooms were approved according to this permit? Bedrpoms. c"} 9. Were any building permits obtained for construction of additional bedrooms? YES of NO o 10. Is there an engineered septic system plan on file at the Health Division? YES or NO ram,, . 11. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO ------------------------------------------------------------------------------------------------------------------- FOR OFFICE USE ONLY _. The Public Health Division has no objection to bedrooms at this property. Special Conditions: t Signed: Date: r MAY-04-2009 09.18 JANNEY MONTGOMERY SCOTT 15084204414 P.01 e I FACSIMILE TRANSMITTAL SHEET TO: FROM: . Cindy Dabkowski Roberta Mauch Town of Barnstable (508)420-1133 Growth Management Dept. (508)862-4743 PAX NUMBER: TOTAL NO,OF PAGES INC.UPTNG COVER: (508)862-4782 2 RE: DATE: 80A&B Greenwood Ave May 4,2009 Hyannis, MA Hi Cindy Here is the"rough"demensions that you requested for both my living space which is 80A Greenwood Ave and the studio which is 808'Greenwood Ave. Thank you for your help. I I I MAY-04-2009 09:18 JANNEY MONTGOMERY SCOTT 15084204414 P.02 T�D E�q 27A KA A U C 1--� g0 ft t-�B A yANA)IS U PSrA I RS S 7U 1 D T PATIO/ DSC-K 71 to Ki Ff�! KITCHOU T UlNINcr BATH 1 t 5 Y TOTAL P.02 n , Questionnaire - House Investigation (Continued) Please sketch location of house, street, septic tank and leach field,drywell, well or water service in the space provided. Show dimensions off side of house/building. dFz �o Please measure the depth of your sanitary sewer lateral and basement height in the sketch below. Finished Floor A= Feet B= Feet A C= Feet Finished Grade B C To Septic Tank — Basement Floor 81/0B/2004 12: 40 50B7789628 AB CANCO PAGE 01/01 c SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 8c), owner: Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within -100(locate where public water supply comes into house) R kD (reirlsed ad/25/97) page 9 of 10 ' Ir+e tom, . "L = Town of Barnstable y MASS A Department of Pubjic Works �ATfU lAPy a 367 Main Street, Hyannis MA 02601 Office: 508-862-4090 Mark S.Ells Fax: 508-790-6400 Dir!ctor Dear Resident December 17, 2003 Enclosed is a questionnaire that will be used to assist the Town in planning a new sewer system to service your property. A sample questionnaire has been enclosed for your review to serve as a sample of how to .fill out your questionnaire. We ask for your cooperation in completing this questionnaire and returning it to us in the enclosed self-addressed, stamped envelope. The Town has been in the process of planning for the expansion of its sewer system since the early 1990's. The Town has studied the sewer issues, public health concerns,_ground water and surface water contamination throughout the entire town. With public input and support, two documents were published, "WASTEWATER FACILITIES PLAN, PHASE I and PHASE II", that developed the twenty- four Areas of Concern and the best method of treating the sewage from each one of those specific areas The.area that you live in was determined to be a top priority for sewer expansion. Our consultant, Stearns and Wheler, LI,C, is now in the early data collection stage of the design process. Therefore, it is difficult to accurately project a cost of the project or the impact on individual properties. We plan to have informational public meetings in March of 2004. At that time we would have a preliminary design, estimates of the preliminary cost and the estimated construction schedule. Please take the time to complete the enclosed questionnaire and return it by January 5, 2004. I .17 you have any questions concerning the questionnaire please call Jack Harris at the Barnstable Engineering Office at 508-862-4077 or Jeff Gregg at Stearns & Wheler at 508-790-1707. Thanking you in advance for your assistance. Sincerely yours, "Please note that the k Ell , Director Questionnaire return date Depart ent of Public Works has been extended to January 16, 2004. Appticant"- Jot auch locahom of-property: yanHzs �3rowq 107. 00 O 15torryy .o dwellfx / i6s.76 - tilv.8 deck O 3' 9.Z I l� N asp�tRl f 10 edt ot7 � .Lot 9 x I O I' ref 5769 /250 Mood pmu-i,- 250001 0006D flood zone: C, PAUL G J�{lcmf' ce�r�r6`f}1�a tw Y11mpaq.(,Je W' Pac�7tibn was. rtvai A- or T. DROVER 74 VYYAR � VVVhJ1, I.G er C1.1 iz"s Mortgage, Cor .� No 3 311 c he awcuing shown. [wre4LitLcloesitotfaUt'maspeaal, 4 o,s Eit a� ham ana with an eRcttive date o f�17-2 -9.2 and. qhe locahon� o� the dwelling does r-a th,e local mmru-q 6y-Laws ime* t� 11Pit the Mine oFconstruction with, respect to horisontul dw etu(onZ scale: 1^ - 60 setback requ ir'erttertts or i15 ¢x�rri t'from Vwiatyon, erf oreenum ' Date:. 5. 3. 99 Cz6)ti under Alas. General,Zaws Chapter4oA-_Secaoi m 7. File No. 9 . 2500 PLEASE NOTE- The structures as shown on this plot plan are approximate only. An actual survey is necessary for a precise determination of the building location and encroachments, if any exist, either way across property lines. This plan must not be used for recording purposes or for. use in preparing deed descriptions and must not be used for variance or building plan purposes. This plan must not be used to locate property lines. Verification of building locations, property line dimensions, fences or lot configuration can only be accomplished by an accurate instrument survey which may reflect different information than what is shown hereon. Please note that this is "NOT A BOUNDARY SURVEY" and is "FOR MORTGAGE PURPOSES ONLY". COLONIAL LAND SURVEYING COMPANY; INC. 269 Hanover Street - Hanover, Mass. 02339 - Phone: 781-826-7186 - Fax: 781-8264823 t iA Q Town of Barnstable Health Inspector 'THE r Regulatory Services Office Hours �o Wyr g y ces 8:30-9:30 o� Thomas F.Geiler,Director 3:30—4:30 BABIVSTABLE. * Public Health Division 1639 Thomas McKean,Director AjFD MA'S A 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT — SEPTIC QUESTIONNAIRE Date : 2009-04-03 1. General Information: Size of Property 0.28 acre Address: 19 CHECKERBERRY ROAD Map 269 Parcel 138 Name:PATRICIA R DEOLIVEIRA STAPLETON Phone#: 2a. How many bedrooms exist at your property now? 3 2b. Are you planning to add any bedrooms?NO If yes,how many? 3 2c. How many bedrooms total are proposed at this property(including the amnesty unit)? 3 2d.Please include a copy of the floor plans for the entire property. Neatly use a straight-edge. 'Show all existing rooms in the home and the proposed amnesty apartment. Provide width measurements of any open doorways. Please label each room clearly. 3. Is the dwelling connected to public sewer? NO If the dwelling is connected to public sewer,skip questions#4 through#9 below. 4. Location of dwelling is INSIDE or OUTSIDE a Saltwater Estuary Protection Zone? 5 . Location of dwelling is INSIDE or OUTSIDE a Zone of Contribution to public supply wells? 6. Is the dwelling connected to an ONSITE WELL or to PUBLIC WATER? 7. Is a disposal works construction permit on file? YES or NO 8. If yes,how many bedrooms were approved according to this permit? Bedrooms., 9. Were any building permits obtained for construction of additional bedrooms? YES or NO 10. Is there an engineered septic system plan on file at the Health Division? YES or NO IT. Has-tho:septic system beeninspected by a DEP certified inspector within the last two years? YES or NO ------------------------------------------------------------------------------------------------------------------- FOR OFFICE USE ONLY The Public Health Division has no objection to bedrooms at this property. Special Conditions: Signed: Date: Q:\GMD-Housing\Accessory Affordable Apartment Program\ADMIN\FORMS&LETTERS\Blank Forms amnestyapp 1.DOC I I .� q 6 � - I J` ima t 1 a LJ f ti Barnstable o� Town of Barnstable BARNSTABL.E, + ,` g Board ()(Health Arfi� �A 200 Main Street,Hyannis MA 02601 2007 Office: 508-8624644 Wayne Miller,M.D. FAX: 508-79076304 Paul Canniff,D.M.D. Junichi Sawayanagi March 9, 2009 Ms. Roberta Mauch 80 Greenwood Avenue Hyannis, MA 02601 Dear Ms. Mauch, You are granted a two-year extension to replace the failed septic system onto connect to public sewer, if it becafhes available, at 80,Greenwood Avenue Hyannis. ; You stated that only one person resides in the studio apartment and you live alone upstairs. You also stated that the.existing septic system has been operational, without failure, since 1965. Also, Robert A Burgmann, P.E.,.the Town Engineer advised the Board that this property is located in Area of Concern H-1 as one of the highest priority areas for the installation of public sewer. The preliminary design has already been developed for this area and installation is anticipated within the next several years. This dwelling shall be connected to public sewer or the septic system shall be replaced/upgraded within two years, on or before February 10, 2011. This extension is granted with the following conditions: 1) No person shall install or utilize a washing machine at this property.. 2) No person shall install or utilize an electronic dishwasher at this property. 3) The septic tanks.shall be pumped once every two years,.if needed as determined by a licensed septage hauler. 4) No more than two occupants (plus occasional visitors) are authorized to reside at this property. Sinc ely, e iller, M.D. Q:\Order letters\Housing Violations\MauchExtension80Grecnwood2009.doc ` Roberta Mauch ''" 80 Greenwood Avenue ..Hyannis,MA 02601 Wayne Miller, M.D. ~ 1 Town of Barnstable Board of Health 200 Main Street Hyannis, MA 02601 Ale Re: 80 Greenwood Avenue, Hyannis ParceIA39-8fff Dear Dr. Miller I hereby request to come before the Board of Health on February 10th to ask the town to grant a time variance on the upgrade of my working sewerage system at 80 Greenwood Ave, Hyannis. My home was built in the mid 1960's It is set back from the road, built on a cliff right on the creek with a studio downstairs and a single bedroom upstairs. The reason I bought the home was because it had a studio. I have lived in my house for ten years and`have made no structural changes. That is, I have not installed an illegal kitchen. My downstairs studio is now in the amnesty program and the town has requested my septic system be upgraded. Only one person lives in the studio and I live alone upstairs. The existing septic system is adequate and has been working as it has since 1965 with adequate capacity. The problem is that the system is in close proximity to the marsh. I wish to make improvements to my property by upgrading to town sewerage which would require a pump station and sewer line be installed to meet town sewerage. I have signed papers with the town for a low interest loan to install a pump station and sewer lines to hook up to town sewerage. The Stewart's Creek town sewerage project is half completed. It was broken down into two sections. The first section on the other side of the marsh has been completed. I have been told that my section is the town's next sewerage project to be completed. Robert Burgmann,the town engineer on the project explained to me that a preliminary plan has already been designed for my side of the marsh. They are however currently re- working the design. Elevation challenges require the town to install a pump station. My request is for a two-year variance until town sewerage is completed for my end of Greenwood Avenue. This will relieve me of the stress and fear of losing my home. I cannot afford to pay for both a Title V and also pay for town sewerage. It would be costly and imprudent to install both. I am willing to submit to mandatory septic monitoring until such time I may upgrade to town sewerage. My septic inspector is Tim Ferreira of T&D Septic(508)775-4962. He has many years of experience working for Canco and knows my system well. I wish to be proactive in protecting this creek. I have begun searching for bids for proper work to be done. It is a beautiful little haven for wildlife. My hope is that the town will complete Stewart's creek project sooner than the two years. Thank you. Sincerely, " e � Roberta E. Mauch Date: January 12, 2009 Work: (508)420-1133 L�u Roberta Mauch 80 Greenwood Avenue Hyannis, MA 02601 January 13, 2009 Mr. Thomas McKean Director of Public Health 200 Main Street Hyannis, MA 02601 Re: . 80 Greenwood Avenue, Hyannis, MA. Parcel 139-001 Dear Mr. McKean: Per your request, please find enclosed a letter of request to come before the Board of Health on February 101h at 3:00 pm to request a two-year variance on the upgrade of my - septic system so that I ,may choose to hook up to town sewerage instead of the installation of a Title V system. It would require that I install a pump station and sewer line. `I'ha`ve already obtained one bid for the work that needs to be done. I have also "signed papers with the town for a low interest loan that could be used. My working system that meets the capacity of dwellers in my home, two people, is currently being monitored by Tim Ferreira of T&D Septic. The two-year variance would relieve me of the stress of potentially losing my home in this poor economic environment we are currently experiencing while. I work to hook up to town sewerage in the Stewart's Creek project that is currently underway. Per your request, I have enclosed four copies of the letter. Thank you for your assistance. Sincerely, Roberta E. Mauch Work: (508) 420-1133 Enclosure(s) original letter to Wayne Miller, MD dated 1/12/09 and three copies L t� , ��"►"' "� :- �� Ernst ble + lARMAPABLE. ' Town of Barnstable ` kyAml 16 °'� Department of Public Works M-fted aCfty 230 South Street, Hyannis MA 02601 http://www.town.bamstable.ma.us 2007 Mark S.Ells,Director Office: 508-862-4090 R. W. "Bud"Breault,Jr.,Assistant Director Fax: 508-862-4711 TO: Thomas McKean, Director, Health Division FROM: Robert A. Burgmann, P.E., Town Engineero � CC: Dale Saad, Ph.D., Special Projects Manager DATE: January 8, 2009 r-41 SUBJECT: Sewer Service for 80 Greenwood Avenue, Hyannis i r.Z., �1 Please be advised that the property at 80 Greenwood Avenue, Hyannis (Map 289, PhI el 139.001) is located in Area of Concern H-1, as identified in the Town of Bamstabl Wastewater Facilities Plan. Area H-1 is one of the highest priority areas for the instal ation off- sewer because of its proximity to and ability to connect to the Town's existing waste ter collection system. tO A preliminary sewer design plan has already been developed for the area. It is anticipated that the installation of a sewer collection system for the area will be accomplished within the next several years. Map Page 1 of 1 Town of Barnstable Geographic Information System New Search Home I Help Parcel Viewer Custom Map I Abutters Map Size E9 Zoom Out In � R• PC,y h; ® & 7PG Map: 289 Parcel: 139 001 Full T '�— Property Location: 8 GREENWOOD AVENUE Info 289d43 ;,, 289046 t'o 0 G EEN OOD q 1D �' 289d45' q 1do ,VMS � ' A.z�`• � � Owner: MAUCH, ROBERTA E N78 `L 289093003 ?89 ., M a .. Location Information ' 111 �� Map & Parcel 289139001 Q. Location 80 GREENWOOD AVENUE 289074 135 ' s 289112 Acreage 0.57 acres �g73` 28 ' 289093 004 N 25 �+ 289093001Current Owner 7r 162 fy�: 289113 Y 289110 dI�` • �� k38 -� iY35 �* Mailing Address MAUCH, ROBERTA E 289076 28909 P O BOX 995 a� g1t3539 a BARNSTABLE, MA02630 289167 289091 a .4$ id^a . '�' Appraised Value (FY 2008) q 175 87 � Y x� p r . • 289 29 289094` Extra Features $5,000 289D77- 289d90 �>u53 `,I M ' ' Out Buildings $400 .41, Land $176,400 rrc �` 289095 Itl65 '} i q84 wt+ 9 g Buildings $76,100 89078 Total Appraised $257,900 ?s908a •2s91?e p75 Assessed Value (FY 2008) q35 ♦f q30• " 7 'r a 289139002 ` 289t40' .k82 �: Extra Features $5,000 os7 , 289110 Out Buildings $400 i' 961i1582116 .# q28 Land $176,400 - — Buildings $76,100 Total Assessed $257,900 .� Set Scale 1" =f 220 I April 2001 Hi Res MAP DISCLAIMER 'S Copyright 2005-2008 Town of Barnstable,MA All rights reserved.Send questions or comments to GIS BarnstableMA v1.2.3083 [Production] http://www.town.barnstable.ma.us/arcims/appgeoapp/map.aspx?propertyID=28913900l&mapparback= 10/17/2008 T T � ; �� I ; i � � � �� � � OF��lQ1y Town of Barnstable Barnstable A&AnmdcaCft MRNSTAZLF� ` Board of Health ' 9e z639. 1 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi March 9, 2009 Ms. Roberta Mauch 80 Greenwood Avenue Hyannis, MA 02601 Dear Ms. Mauch, You are granted a two-year extension to replace the failed septic system or to connect to public sewer, if it becomes available, at 80 Greenwood Avenue, Hyannis. You stated that only one person resides in the studio apartment and you live alone upstairs. You also stated that the existing septic system has been operational, without failure, since 1965. Also, Robert A Burgmann, P.E., the Town Engineer advised the Board that this property is located in Area of Concern H-1 as'one of the highest priority areas for the installation of public sewer. The preliminary design has already been developed for this area and installation is anticipated within the next several years. This dwelling shall be connected to public sewer or the septic system shall be replaced/upgraded within two years, on or before February 10, 2011. This extension is granted with the following conditions: 1) No person shall install or utilize a washing machine at this property. 2) No person shall install or utilize an electronic dishwasher at this property. 3) The septic tanks shall be pumped once every two years, if needed as determined by a licensed septage hauler. 4) No more than two occupants (plus occasional visitors) are authorized to reside at this property. Sincerely, Wayne Miller, M.D. Q:\Order letters\Housing Violations\MauchExtension80Greenwood2009.doc Citizen Web Request Page I of 3 r er F5 4f' � "ate. �3', ?' 4 ,4 ,.r ,a` .'"a�a, �c�y.; 4tst mt _ ` a �i SFr '.,' f. .a*' ✓ �"3' dip �'" �} N�ya"29 'S [[..Yixr.......pA spa. [M',M....,...:«. ._ny VN\ ke?n, i GinzaRequest & �� �.��.�Gf��r fi C; ��vf� r�J'6•"`Y�; L£t[It iE.':L Citizen a �°a...`�Q �c A' Request Information ...................._......_.................---._..__.......... _..__.__.._ Request ID: 20925 Created: 5/8/2007 10:50:58 AM ___.___..___.___...._.._..._.... Status: Closed Assigned To: O'Connell, Timothy Health Office Anonymous: Yes Request Category: Chapter II : Housing Substandard Routine work: No Estimate: No Date scheduled: ___........._..__..._._...._.._.._._._....__........_.._._.__....__.._.._ Estimated 6/8/2007 Change Estimated M y 3une 2007 Sul Completion Completion Date: Date:.r .sue Wed Thu Fri Sat 1.?` 28 29 30 ..F 3_ .I. 2 6 <3 9 8 19 20 21 12 23 24 25 26 27 291 ;"9 3 4 1 6 7 Created By: Shea, Sally Priority: Medium Building Dept Citation Numbers: Reque for Information - Requestor Request DETAILS: LOCATION: 80 GREENWOOD AVENUE Hyannis, Ma 02601 Request Parcel Number CALLER REPORTS AN ILLEGAL Map289 Block: 39 ,Lot: APARTMENT. THERE ARE NO PERMITS ON RECORD REFLECTING A -� Parcel_Loo..k..... LEGAL APARTMENT. THIS PROPERTY IS ON ROBIN GIANGREGORIO'S WATCH LIST. http://issgl2/intemalwrs/WRequest.aspx?ID=20925 2/10/2009 Citizen Web Request Page 2 of 3 t Email: Track Request Progress Request Work History: Internal Note History: Entered on 5/17/2007 8:34:38 AM System entry on 5/8/2007 10:50:24 AM: by O'Connell, Timothy Related Request 20924 Went by property on 5-15-07 knocked on door - -- - --- had no answer. Will continue to monitor. System entry on 5/8/2007 11:07:05 AM: Entered on 5/25/2007 4:09:07 PM -Please Review- email sent to O'Connell, by O'Connell,Timothy Timothy Last modified on 5/25/2007 4:14:05 PM . - - On 5-24-07 went to said property with night System entry on 5/8/2007 11:10:38 AM: team. There is an illegal apartment but they may go Assigned to O'Connell,Timothy i into amnesty. No septic info on file. So if they may need a title 5 inspection done. Will follow up after System entry on 5/25/2007 4:14:15 PM: owner talks with Robin. Estimated completion changed from 5/10/2007 to 6/8,/2007 System entry on 9/5/2007 8:06:00 AM: Request Closed by oconnelt Enter work progress: Enter internal note: (Viewed by everybody) Viewed internally only) i I i ' .;Spell.Check f„` � �`Spell Check I Add document or image link: Y I a.a,i : i5v(; £ {cs? r €? i",€ L 5° �' tp .€.iYq die ,`o http://issq l2/intemalwrs/WRequest.aspx?ID=20925 2/10/2009 Citizen Web Request Page 3 of 3 t F1 .. ..-.............. _...................... Time worked on request Fi07 Response time 540 00l Time entries are in 1 �urs. Examples of time entries: 1,25, 0,5, 0,75, 1, 15, 0,25, 0.10 Response time: 1e:,Surcd from the creation cute to your first actions on the request, o not incl,Je nights, :lr;'.ekertds, and holidays in r"er,po '2 sEe t[nv� for rnost: depat menus. Reopen , Reopen and notify citizen Reopen . . .... ... . Public_Use-_Pr_ nter._Frien_d_ly_Vers_.ion. Internal,._Use: Printer Friendly Version http://issgl2/intemalwrs/WRequest.aspx?ID=20925 2/10/2009 i /0?Inc 10� � y i f n� 0 P � MASS. a Barnstable Town of Barnstable 9LATF D639• � �Al QftmicaCft M Regulatory Services Department D � Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTTIFIED MAIL 7009 2820 0003 3168 1268 January 5, 2009 Roberta Mauch 80 Greenwood Ave. Hyannis, MA 02601 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you was inspected on December 28, 2009 by Jaime Cabot, R.S. Health Inspector for the Town of Barnstable equest from the Building Department. v The following violations of the State Sanitary o e were observed: 105 CMR 410-402—Grade Level. Walk out basement apartment has more than of its floor to ceiling jAelow the average grade of the adjoining ground and is subject to chronic dampness. [4 dlccK'( 105 CMR 410.351- Owner's installation and Maintenance responsibilities. a-ci.c Bathroom floor has cracks in the flooring. The following violations of the Town of Barnstable code were observed: 1§ 70-4—Certificate of Registration. Rental property is not registered with Town of Barnstable Health Department. You are directed to repair the following violations within thirty (30) days of your receipt of this notice by eliminating the source of chronic dampness in the dwelling by providing for a dehumidifier and or an air conditioner to be operated during the period from June 151h to September 15th inclusive. In addition you are directed to repair or replace the damaged bathroom flooring: AN0 A01H 2UVM r r Page two: Health Division e You are directed to file to be accepted into the Amnesty Program offered by the Town of Barnstable if you wish to keep this second apartment, as per Board of Health Order Letter dated May 21, 2007. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of$100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the above violations, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable Cc: Building Commissioner, Amnesty Program Coordinator P�0pIKE rp Town of Barnstable Regulatory Services AARNSTABLE, Thomas F. Geiler, Director MASS. O i639- Public Health Division AlFO MA't a, Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 May 21, 2007 Roberta E. Mauch 80 Greenwood Avenue Hyannis, MA. 02610 The property owned by you located at 80 Greenwood Ave., Hyannis was visited by Timothy B O'Connell, Health Inspector on May 24, 2007 in response to a complaint of overcrowding. Two apartments were observed. If you wish to keep this second apartment you must file to be accepted into the Amnesty program offered by the Town of Barnstable. The following is a violation of the State Environmental Code: 2� 32-5: Maximum allowable wastewater discharge: A. Within zones of contribution to existing and proposed public supply wells, the maximum allowable wastewater discharge from new individual on-site sewage disposal systems shall not exceed 330 gallons per acre per day. On December 16, .1980 Septic permit 1980-163 was issued for 3 bedrooms. You may have no more than three bedrooms total at said location. You are directed to correct the violation listed above within thirty (30) days of your receipt of this notice. You are ordered to correct the violation by eliminating the extra bedrooms so that a total of three bedrooms are present at said location. The Town of Barnstable Health Department has a policy to eliminate the privacy of being considered a bedroom by installing a minimum five (5) foot cased opening with no doors, and no beds or people sleeping are allowed in the room. You are required to obtain a building permit to accommodate this order. Please call Health Inspector Donald Desmarais, RS to schedule an inspection of the property when the extra,bedrooms have been eliminated at (508) 862- 4740. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of$100.00 per violation PER ORDER OF THE BOARD OF HEALTH Q:\Order.letters\Sewage.violations\I Beth Lane.doc r Thomas A. McKean, R.S.CHO Director of Public Health Town of Barnstable Cc: Building Dept. i QAOrder.letters\Sewage.violations\1 Beth Lane.doc Town of Barnstable Health Inspector Regulatory Services office Hours t��,l, g y 8:30-9:30 Q, Thomas F.Geiler,Director 3:30—4:30 SUB 1 Public Health Division MASS. v 1639. �e� Thomas McKean Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT — SEPTIC QUESTIONNAIRE Date:4/10/09 1. General Information: Size of Property: 0.57 acre Address: 80 GREENWOOD AVENUE HYANNIS MA 02601 Map 289 Parcel: 139-001 Name:ROBERTA E.MAUCH Phone#: 508-420-1133 2a. How many bedrooms exist at your property now?2 (one in main house and 1 in accessory apartment) 2b. Are you planning to add any bedrooms?NO If yes,how many? 2c. How many bedrooms total are proposed at this property(including the amnesty unit)?2 2d.Please include a copy of the floor plans for the entire property. Neatly use a straight-edge. Show all existing rooms in the home and the proposed amnesty apartment. Provide width measurements of any open doorways. Please label each room clearly. 3. Is the dwelling connected to public sewer? NO . .; If the°dwe11ing is connected to public sewer,skip questions#4 through#9 below. 4. Location of dwelling is INSIDE or OUTSIDE a Saltwater Estuary Protection Zone? 5 . Location of dwelling is=' INSIDE or OUTSIDE a Zone of Contribution to public supply wells? 6. Is the—dwelling connected:to an PUBLIC WATER? tC> 7. Is a disposal works construction permit on file? NO 8. If yes,how many bedrooms were approved according to this permit? Bedrooms. 9. Were any building permits obtained for construction of additional bedrooms? YES or NO 10. Is there an engineered septic system plan on file at the Health Division? YES or NO 11. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO FOR OFFICE USE ONLY The Public Health Division has no objection to bedrooms at.this property. Special Conditions: Signed: Date: Q:\GMD-Housing\Accessory Affordable Apartment Program\ADMIN\FORMS&LETTERS\Blank Forms amnestyapp 1.DOC r,- 15084204414 P.02 �24-2009 09�42 JANNEY MONTGOMERY SCOTT 00 A Cvrs-w woob A v L UN-TA I f�S ►�, 5 SFr ---�- -�--- FT I �r � f 13 8a Ro I3 o� 0�6 n4q C o� JUI;24-2009 09:42 JANNEY MONTGOMERY SCOTT 15084204414 P.03 G�r . Sao AVE- 5TUDcD P_S Lbw N A-P4 r f.------,--1,-- �-t J� 1r .a��►�p .� �R��:4�iN�w�r o�iu �—;--y Z.-cK `� r • � COMMONWEALTH OF MASSACHUSETTS y EXECUTIVE OFFICE OF ENVIRONMENTAL AFF 12 j DEPARTMENT OF ENVIRONMENTAL PRO E°T N ONE WINTER STREET. BOSTON. NIA 02108 61 7-29?=5j'0 JLry P WILLIAM E-WELD �� Sectetar\ TR 0D,Y�COXE Govcmof 350 MAIN STREET �'+ ARGEO PAUL CELLUCCI WEST YARMOUTH, MA T A111)'B.STRUHS Lt.Govcmor 508-775-2800 1- Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM I (� PART A 90 ( CERTIFICATION PROPERTY ADDRESS: 64A Greenwood Ave, Hyannisport ADDRESS OF OWNER: DATE OF INSPECTION: March 18, 1998 Markarian, Charles NAME OF INSPECTOR : Richard K.Cannon I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 9310 CMR 15.000) COMPANY NAME: A&B Canco MAILING ADDRESS: 350 Main Street, West Yarmouth, MA 02673 TELEPHONE NUMBER: (508)775-2800 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: X PASSES CONDITIONALLY PASSES NEEDS FURTHER EVALUATION B THE LOCAL APPROVING AUTHORITY FAILS INSPECTORS SIGNATURE: j1AA DATE: March 18, 1998 The system Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer,if applicable and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D; A] SYSTEM PASSES: X I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: B SYSTEM CONDITIONALLY PASSES: N/A 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 b the Board of Health, will pass. Indicate yes, no, or not determined (Y, N, or NO). Describe basis of determination in all instances. If"not determined", explain why not) The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached) indicating that the tank was installed within twenty(20) years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank is failure is imminent. The " system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 09/25/97) Page 1 of 10 - DEP on the World Wide Web:http://www.magnet.state.ma.un/d 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (CONTINUED) Property Address: 64A Greenwood Ave, Hyannisport Owner: Markarian, Charles Date of Inspection: March 18, 1998 B]SYSTEM CONDITIONALLY PASSES(continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box.'The system will pass inspection if(with approval of the Board of Health). Describe observations: broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed C] FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: N/A Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health,safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone 1 of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine " distance (approximation not valid). 3) OTHER (revised 04/25/97) Page 2 of 10 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 64A Greenwood Ave, Hyannisport Owner: Markarian, Charles Date of Inspection: March 18, 1998 D]SYSTEM FAILS: You must indicate either"Yes" or"No" as to each of the following: N/A I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303.The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an over- loaded or clogged SAS or cesspool. 9 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 '/Z day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s) Number of times pumped Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E) LARGE SYSTEM FAILS: You must indicate either"Yes" or"No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: N/A The system serves a facility with a design flow of 10,000 gpd or greater(Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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 mapped Zone II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04/25/97) Page 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 64A Greenwood Ave, Hyannisport Owner: Markarian, Charles Date of Inspection: March 18, 1998 Check if the following have been done: You must indicate either"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 None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. X As built plans have been obtained and examined. Note if they are not available with N/A. N/A The facility or dwelling was inspected for signs of sewage back-up. X The system does not receive non-sanitary or industrial waste flow. X The site was inspected for signs of breakout. X All system components, including the Soil Absorption System, have been located on the site. X The manholes were uncovered, opened, and the interior was inspected for condition of tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: X The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub-Surface Disposal System. X Existing information. Ex. Plan at B.O.H. X Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable)[15.302(3)(b)] (revised 04/25/97) Page 4 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 64A Greenwood Ave, Hyannisport Owner: Markarian,Charles Date of Inspection: March 18, 1998 FLOW CONDITIONS RESIDENTIAL: Design flow: 110 g.p.d./bedroom for S.A.S. Number of bedrooms: 1 Number of current residents: 2 Garbage grinder(yes or no): NO Laundry connected to system (yes or no): NO Seasonal use(yes or no) NO Water meter readings, if available(last two(2)year usage(gpd): NEW METER PUT IN AUGUST 1997 Sump Pump (yes or no): NO COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow: gallons/day Grease trap present: (yes or no): Industrial Waste Holding Tank present: (yes or no) Non-sanitary waste discharged to the Title 5 system: (yes or no) Water meter readings, if available: Last date of occupancy: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: N/A System pumped as part of inspection:(yes or no) YES If yes, volume pumped: 500 gallons Reason for pumping TYPE OF SYSTEM Septic tank/distribution box/soil absorption system X Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) I/A Technology etc. Copy of up to date contract? Other LEACHING TRENCH APPROXIMATE AGE of all components, date installed (if known)and source of information: UNKNOWN Sewage odors detected when arriving at the.site: (yes or no) NO (revised 04/25/97) I.: Page 5 of 10 f . SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 64A Greenwood Ave, Hyannisport Owner: Markarian, Charles Date of Inspection: March 18, 1998 BUILDING SEWER: N/A (Locate on site plan) Depth below grade: Material of construction cast iron 40 PVC other(explain) Distance from private water supply well or suction line Diameter Comments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK: N/A (Locate on site plan) Depth below grade: Material of construction concrete _ metal _ Fiberglass _ Polyethylene _ other(explain) If tank is metal, list age Is age confirmed by Certificate of Compliance (Yes/No) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How dimensions were determined Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) GREASE TRAP: N/A (locate on site plan) Depth below grade: 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: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) (revised 04/25/97) Page 6 of 10 ti f • SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 84A Greenwood Ave, Hyannisport Owner: Markarian, Charles Date of Inspection: March 18, 1998 TIGHT OR HOLDING TANK: N/A (Tank must be pumped prior to, or at time, of inspection) (Locate on site plan) Depth below grade: Material of construction _ concrete _ metal _ Fiberglass _ Polyethylene _ other(explain) Dimensions: Capacity: Design flow: gallons/day Alarm level: Alarm in working order _ Yes; _ No Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: N/A (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc,) PUMP CHAMBER: N/A (locate on site plan) Pumps in working order: (Yes or No) Alarms in working order(Yes or No) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.). (revised 04/25/97) Page 7 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 64A Greenwood Ave, Hyannisport Owner: Markarian, Charles Date of Inspection: March 18, 1998 SOIL ABSORPTION SYSTEM (SAS): X (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number: leaching chambers, number: leaching galleries, number: leaching trenches, number, length: 1 12' leaching fields, number, dimensions: overflow cesspool, number, alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) 12'TRENCH WITH STONE TRENCH DRY CESSPOOLS: X (locate on site plan) Number and configuration: 1 Depth-top of liquid to inlet invert: 12" Depth of solids layer: 6"' Depth of scum layer: 0" Dimensions of cesspool.- Materials of construction: BLOCK Indication of groundwater: NO inflow(cesspool must be pumped as part of inspection) Comments:.- (note condition of soil, signs of hydraulic failure, , level of ponding, condition of vegetation, etc.) MAIN POOL AT WORKING LEVEL, NO INLET TEE, OUTLET TEE IN PLACE, CONCRETE COVER AT GRADE. PRIVY: N/A (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.) (revised 04/25/97) Page 8 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 64A Greenwood Ave, Hyannisport Owner: Markarian, Charles Date of Inspection: March 18, 1998 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100(locate where public water supply comes into house) SITO u GPaA� (revised 04/25/97) Page ,9 of 10 � r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C 1' SYSTEM INFORMATION(continued) Property Address: 64A Greenwood Ave, Hyannisport Owner: Markarian, Charles Date of Inspection: March 18, 1998 Depth to groundwater feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained fro Design Plans on record Observation of Site(Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators, installers Use USGS Data Describe in your own words how you established the High Groundwater Elevation. (Must be completed) NOTE: LOT WELL HIGH, NO GROUND WATER PROBLEM. ty I (revised 04/25/97) Page 10 of 10