HomeMy WebLinkAbout0034 GROVE STREET - Health 34 Grove Street
Hyannis
A 309 082
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� SEPTIC TANK CAPACITY
`i:FACHING FACILITY:(type) (size) g�><(4-1 r
NO.OF BEDROOMS
i`ILDER OR OWNER
//�Vb'�IN C�I cSo�^✓u5o�'y /
PERMTTDATE: .I S 10 3 - COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted.Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and.Leaching Facility (If any wells exist
-on site or within 200 feet of leaching facility) Feet
Edge-of Wetland and Leaching Facility(If any wetlands exist,,
within 300 feet of leaching facility) Feet
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Town of Barnstable
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y Department of Health, Safety, and Environmental Services
' BAMSTABL&
9� ' � Public Health Division
A'ED1A°�A P.O. Box 534, Hyannis MA 02601
Office: 508-862-4644 Thomas A.McKean,RS,CHO
FAX: 508-790-6304 Director of Public Health
September 15, 1999
Nancy L. Johnson, Trustee
Jennie M. Wentzl, Trustee
P.O. Box 342
Hyannis, MA 02601
NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY
CODE U, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION
AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE, ARTICLE 51
The property owned by you located at 34 Grove Street, Hyannis, was inspected on
September 3, 1999 by Glen Harrington, R.S. Health Inspector for the Town of Barnstable,
because of a complaint. The following violations of 105 CMR 410.00, State Sanitary
Code H, Minimum Standards of Fitness for Human Habitation were observed:
410.253: Light fixture in basement was inoperable and loose.
410.280: Several windows are inoperable.
410.481: No posting of owner's name, address and telephone number.
410.482: Smoke detectors on second floor and in basement were inoperable.
410.500: Sills on second floor window were observed to be rotted.
410.500: The roof of the garage has missing shingles which has allowed plywood to
be exposed.
410.500: Facia board at front entry and a louver is missing on gable vent.
These conditions are potential for entrance of pests.
410.500: Chimney which extends above roof line is leaning due to decaying/missing
grout.
410.500: Basement window above washer/dryer was observed to be missing.
johnson/wp/q/ls
410.500: Dining room ceiling was observed not to be finished, sealed or painted.
410.501: Second floor gable and window observed to be missing a storm window.
410.501: All windows have chipping paint and cracked/loose glazing.
410.502: Lead determination indicated use of lead paint on dwelling.
410.503: No railings were observed on front or right side of stairs.
410.552: No storm door was provided for front door entrance.
You are directed to correct all violations within seven (7) days of receipt of this notice.
You may request a hearing if written petition requesting same is received by the Board of
Health within seven (7) days after the date order is received. However, these violations
must be corrected regardless of any request for a hearing.
Please be advised that failure to comply with an order could result in a fine of not more
than $500. Each separate day's failure to comply with an order shall constitute a separate
violation.
PER ORDER OF THE OARD OF HEALTH
omas A. McKean
Director of Public Health
encs.
johnson/wp/q/IS
TOWN OF BARNSTABLE
�Di TH E Taw
OFFICE OF
t He$a9TaHL i BOARD OF HEALTH
MA68. p�
i639' 367 MAIN STREET
CEO MP'�k'
HYANNIS, MASS.02601
LEAD DETERMINATION REPORT FORM
Date of Determination:
Inspector: G (.e.. E Ha v s,i" ILy-t—,
License#: D 3 .3 7 5- J
Method Used: ?C Sodium Sulfide Expiration date:
X-Ray Fluorescence Model:
Serial#:
Property Address: 314- &r d y e S'+►-e_e -1- Apt. #
U Ya,K vt %S ,� OVt.�9 Agt p log ect 08 7-
Description of Property:
Single family
Multi-family #units
J�Garage
Fence
Other structures
Age of Property: Pre-1978
Post-1978
Occupant: / 1 I r i a w, 13 a',--f8 L
Occupants under six years of age:
/V®,-faS DOB:
DOB:
DOB:
Occupant's Telephone: 77 S'-S-o r Z
Property Owner(s):
Owner's Address:
Owner's Telephone: `7'P_ l 11
Lead Hazards found? Yes� No
An X-ray fluorescence reading greater.than 1.2 mg/cm2 or a gray or black reaction to sodium sulfide
indicates a dangerous level of lead and constitutes a positive determination.
Deleading of lead painted surfaces as a result of this report or subsequent inspection must be performed
by a licensed deleading contractor and/or by an owner/agent who is trained to perform specific work as
required under the Lead Law. Contact the Childhood Poisoning Prevention Program for additional
information regarding deleading and training.
C:\WP50\LEAD1995\GENERALWOLTRHEAD\LEADREPT.DOC 12/96
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LOCATION SOURCE Pb
1. Child's bedroom Window Partin bead/exterior sill arep, ,x
r s ram, @ W.. 11-u [e4- 9/2 !. S
2. Child's bedroom Window sill
3. Living room Window parting bead/exterior sill area
4. Kitchen Window parting bead/exterior sill area
5. Interior Flaking paint
6. Exterior Flaking paint, A-; ('I v, Rw, PoS
7. Exterior Cellar window units
8. Exterior Window sills below 5' ss it& :-lck y�
9. Exterior Main entry door casing
10. Interior Outside corner of baseboard
11. Kitchen or Baduvmli Chair rail S
12. Bathroom Windowsill
13. Exterior Threshold
14. Interior hallway (common area) Stair tread or stringer
15. Interior hallway (common area) Balusters
16. Interior hallway (common area) Door casing
17. Porch Stair tread or riser
18. Porch Railing cap
19. Porch Balusters
20. Porch Support columns(<6" diameter or square)
21. Porch Staircase stringer
22. Exterior Bulkhead
23. Garage/ Door casing or jamb 1'1�5
24. Interior Closet door or baseboard (uncapped)
25. Interior Cabinet door, shelf, or wall
I.$'- pi
C:\WP50\LEAD1995\GENERALWOLTRHEAD\LEADREPT.DOC 12/96
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-
a y FSHET�� The Town of Barnstable
i BsTsM Department of Health, Safety and Environmental Services
o 9 k.�A Public Health Division
367 Main Street,Hyannis,MA 02601
Office 508-790-6265 Thomas A.McKean
FAX 508-775-3344 Director of Public Health
DATE: SEPTEMBER 14, 1999
ORDER TO CORRECT VIOLATION(S)
JFyNIE_M.WENTZEI;, TRUSTEE
P.O. BOX 342
HYANNIS, MA 02601
Owner or agent of the property located at 34 GROVE STREET, HYANNIS
Be advised that an agent of the Board of Health has determined certain portions of the aforementioned
residential property to be in violation of the State Sanitary Code Chapter II, "Minimum Standards of
Fitness for Human Habitation," 105 Code of Massachusetts Regulations (CMR) 410.750(J). This
violation also constitutes a violation of the Lead Law, Massachusetts General Laws (MGL), Chapter 111,
Section 197, and the Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000.
Conditions exist in this residence which may endanger and/or materially impair the health of the
occupants of these premises.
DECLARATION OF EMERGENCY
The Director of the Childhood Lead Poisoning Prevention Program and the Board of Health declare that
the presence of the aforementioned violation of the Lead Law and the Regulations for Lead Poisoning
Prevention and Control constitutes an emergency pursuant to the Lead Law, MGL Chapter I 11, Section
198 and within the meaning of the Sanitary Code, Chapter I, 105 CMR 400.200(B).
CORRECTION OF LEAD VIOLATION(S)
The Lead Law, MGL c. 111, ss. 189A-199B, and the Department of Public Health's Regulations for Lead
Poisoning Prevention and Control, 105 CMR 460.000, require that residential premises or dwelling units
built before 1978 have lead paint violations either abated and contained for full compliance or brought
under interim control when a child under the age of six lives in the residential premises or dwelling unit.
If you are interested in interim control, then you must hire a licensed private risk assessor to perform a
risk assessment and issue a "Lead Inspection/Risk Assessment Report" before you proceed. If you are
interested in deleading for full compliance, then you must hire a licensed private lead inspector to
perform a lead inspection and issue a "Lead Inspection/Surface Assessment Report" before you proceed.
C:\wP50\LEAD1995\GENERAL\GENER.IL.DOC\BIIOTC39A.DOC RED'. 10/97
I
The Lead Law, the Department of Labor and Workforce Development's Deleading Regulations, 454
,CMR 22.00, as well as the Regulations for Lead Poisoning Prevention and Control require that any high-
risk residential lead abatement and containment activities, including making loose paint, plaster or putty
intact, be performed by licensed deleading contractors—whether in the context of achieving interim
control or full compliance. An owner or owner's agent, after meeting the training requirements of 105
CMR 460.175, may perform certain low-risk abatement and containment activities in accordance with
these regulations without a deleader's license—again, whether in the context of achieving interim control
or full compliance. These specific low-risk abatement and containment activities are the following:
applying encapsulants; applying such coverings as carpet, vinyl, aluminum,plywood, plexiglass, and
acrylic, to surfaces, including siding of exterior surfaces; removing doors, cabinet doors and shutters; and
capping baseboards. In addition, an owner or owner's agent may perform structural repairs, as defined in
105 CMR 460.020, and cleaning of leaded dust, as may be required for interim control, except that the
final clean-up required after the completion of high-risk abatement and containment work by a licensed
deleader must be performed by a licensed deleader. Violations of these requirements shall be punished
by a fine of not less than $500 nor more than $1,500 for each offense.
ORDER
You are hereby ordered to remedy all violations of MGL c. I11, s. 197 and 105 CMR-k60.000; aa---�
identified by a licensed private lead inspector or, if you wish to pursue interim control, you must remedy
all urgent lead hazards identified by a licensed private risk assessor. Whether you pursue full compliance
or interim control, you must correct the relevant violations in accordance with the following schedule:
Within sixty (60) days of your receipt of this Order, you must provide to this agency a copy of a
signed contract with a licensed deleader, if any high-risk abatement and containment work,
including making leaded paint, putty or plaster intact, is required. If you or your agent is doing
owner/agent low-risk abatement and containment and/or interim control work, you must also
provide within sixty (60) days a signed and completed CLPPP form entitled "Documentation of
Training to Perform Owner/Agent Low-Risk Abatement and Containment and Deadlines by Which
Owner/Agent Low-Risk Work and/or Interim Control Work Will Be Completed." The contract must
specify, and if you or your agent will be performing low-risk abatement and containment work or
interim control work, then you or your agent will attest in the CLPPP form described above, that the
work will be completed according to the following schedule:
(a) Violations of the interior of the dwelling unit and interior common areas must be abated
or contained for full compliance, or as required for interim control, within ninety (90)
days of your receipt of this Order. However, you have a total of one hundred and twenty
(120) days from receiving the Order to complete the following activities:
(1) any low-risk abatement and containment work you or your agent perform, as
long as all dust-generating abatement or containment work, including surface
preparation, required to be done by a licensed deleader, has been completed, and
any doors removed have been replaced, within ninety (90) days of your receipt
of this Order;
(ii) application of encapsulants by licensed Level 11 deleaders, as long as all dust-
generating abatement or containment work, including surface preparation
required to be done by a licensed deleader, has been completed within ninety
(90)days of your receipt of this Order;
' (iii) installation of replacement windows, as long as you can demonstrate that new
windows have been ordered within ninety(90) days of your receipt this Order.
CAW P50\LEAD1995\GEN ERA L\GEN ERA LJDOC\BIIOTC39A.DOC REV 10/97
(b) Violations on the exterior of the residential premises and exterior common areas must be
abated and/or contained for full compliance or as required for interim control, within one
hundred and twenty(120) days of your receipt of this Order.
Any contract with a deleading contractor must also specify that the unit will meet acceptable
lead dust levels, as determined by the results of sampling done by the licensed private lead
inspector or risk assessor at the time of the reoccupancy reinspection, if one is necessary.
Should any of the dust samples fail to meet acceptable standards, the contractor will be
required to reclean the entire unit until all dust samples meet acceptable levels. In interim
control cases in which no reoccupancy reinspection is necessary and no deleading contractor
involved because no high-risk abatement and containment activities, including making leaded
paint, plaster or putty intact, were necessary, then you or your agent who performed required
work will bb responsible for cleaning the unit to meet acceptable dust levels. In these cases,
dust levels will be determined by the results of sampling done by the licensed private risk
assessor at the time of the risk assessment reinspection. Any room or interior area in which one
or more surfaces does not meet acceptable dust levels must be recleaned by you or your agent
in its entirety.
You must comply with all of the deadlines stipulated above, and with all applicable sectians of-105 CMRA—
460.000. Compliance with this Order will be determined by this agency's receipt of the appropriate
documentation within the specified deadlines. The documentation consists of the following:
a) if any high-risk abatement and containment work is necessary, including making lead-painted
surfaces intact, a copy of a signed and dated deleading contract with a licensed deleader;
b) if you or your agent will be doing low-risk deleading work or such other work as may be
required for interim control, such as structural repairs and lead-dust cleaning for interim
control, a completed and signed copy of the CLPPP form, "Documentation of Training to
Perform Owner/Agent Low-Risk Abatement and Containment and Deadlines by Which
Owner/Agent Low-Risk Work and/or Interim Control Work Will be Completed,"
c) a Letter of Lead Paint (Re)occupancy (Re)inspection Certification issued by a licensed private
lead inspector or risk assessor, in cases in which interior high-risk abatement and containment
work, such as making loose lead paint, plaster or putty intact, is necessary, thus requiring
occupants to be relocated from the unit for the duration of the work;
d) copies of results of all dust samples taken by the licensed private lead inspector or risk
assessor;
e) a Letter of Full Deleading Compliance issued by a licensed private lead inspector or a Letter of
Interim Control issued by a licensed private risk assessor.
In addition, a copy of the deleading notification must be received by this agency at least ten (10) days
prior to any commencement of deleading, whether performed by a deleader or you or your agent, and
whether in the context of full compliance or interim control.
PENALTIES
Failure to comply with this order will result in criminal prosecution. The law provides penalties of up to
$500 for each day of non-compliance. In addition, you may become liable for civil punitive damages
equal to three times any actual damages for failure to comply with this order if a child becomes
poisoned.
c:\wPS01LF.;\D174S\GE�ER:\1.\GE�EK:\L.DO(1R11O"rC39:\.DOC REV 10/97
i
CORRECTION OF VIOLATION BY CODE ENFORCEMENT AGENCY
If within the time periods stipulated above the aforementioned residential property is not brought into
full compliance or interim control, this agency may contract with a licensed deleader to correct the
violation(s) and obtain a Letter of Full Deleading Compliance or a Letter of Interim Control, and bill the
owner, or initiate court action to reimburse itself.
RIGHT TO A HEARING
You may request a hearing pursuant to 105 CMR 460.900 of the Regulations for a Lead Poisoning
Prevention and Control, in conjunction with the procedures of 105 CMR 400.200(B), the Sanitary Code
provision for hearings in emergency public health matters. As already noted, the aforementioned
violation constitutes an emergency. (See "Declaration of Emergency" section.) As such, you may
request a hearing only if you have complied with this Order. The hearing will be provided within ten
days of your request. This agency shall issue a written decision within seven days after the hearing.
Inspector hector
Certified Mail No.
C:\WP50\LEAD1995\GENERAL\GENERAL.DOC\BHOTC39A.DOC REV 10/97
r
- °�T"ET°� The Town of Barnstable
? 31AH39TAM 'r Department of Health, Safety and Environmental Services
o 9 M���� Public Health Division
367 Main Street,Hyannis,MA 02601
Office 508-790-6265 Thomas A.McKean
FAX 508-775-3344 Director of Public Health
DATE: SEPTEMBER 14, 1999
ORDER TO CORRECT VIOLATIONS)
NANCY L. JOHNSON, TRUSTEE
P.O. BOX 342
HYANNIS, MA 02601
Owner or agent of the property located at 34 GROVE STREET, HYANNIS
Be advised that an agent of the Board of Health has determined certain portions of the aforementioned
residential property to be in violation of the State Sanitary Code Chapter II, "Minimum Standards of
Fitness for Human Habitation," 105 Code of Massachusetts Regulations (CMR) 410.750(J). This
violation also constitutes a violation of the Lead Law, Massachusetts General Laws (MGL), Chapter 1 11,
Section 197, and the Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000.
Conditions exist in this residence which may endanger and/or materially impair the health of the
occupants of these premises._
DECLARATION OF EMERGENCY
The Director of the Childhood Lead Poisoning Prevention Program and the Board of Health declare that
the presence of the aforementioned violation of the Lead Law and the Regulations for Lead Poisoning
Prevention and Control constitutes an emergency pursuant to the Lead Law, MGL Chapter I 11, Section
198 and within the meaning of the Sanitary Code, Chapter I, 105 CMR 400.200(B).
CORRECTION OF LEAD VIOLATION(S)
The Lead Law, MGL c. 1 11, ss. 189A-199B, and the Department of Public Health's Regulations for Lead
Poisoning Prevention and Control, 105 CMR 460.000, require that residential premises or dwelling units
built before 1978 have lead paint violations either abated and contained for full compliance or brought
under interim control when a child under the age of six lives in the residential premises or dwelling unit.
If you are interested in interim control, then you must hire a licensed private risk assessor to perform a
risk assessment and issue a "Lead Inspection/Risk Assessment Report" before you proceed. If you are
interested in deleading for full compliance, then you must hire a licensed private lead inspector to
perform a lead inspection and issue a "Lead Inspection/Surface Assessment Report" before you proceed.
C:\wP50\LEAD1995\GENERAL\GENERAL.DOC\BIIOTC39A.DOC RED'. 10/97
i
The Lead Law, the Department of Labor and Workforce Development's Deleading Regulations, 454
CMR 22.00, as well as the Regulations for Lead Poisoning Prevention and Control require that any high-
risk residential lead abatement and containment activities, including making loose paint, plaster or putty
intact, be performed by licensed. deleading contractors—whether in the context of achieving interim
control or full compliance. An owner or owner's agent, after meeting the training requirements of 105
CMR 460.175, may perform certain low-risk abatement and containment activities in accordance with
these regulations without a deleader's license—again, whether in the context of achieving interim control
or full compliance. These specific low-risk abatement and containment activities are the following:
applying encapsulants; applying such coverings as carpet, vinyl, aluminum,plywood, plexiglass, and
acrylic, to surfaces, including siding of exterior surfaces; removing doors, cabinet doors and shutters; and
capping baseboards. In addition, an owner or owner's agent may perform structural repairs, as defined in
105 CMR 460.020, and cleaning of leaded dust, as may be required for interim control, except that the
final clean-up required after the completion of high-risk abatement and containment work by a licensed
deleader must be performed by a licensed deleader. Violations of these requirements shall be punished
by a fine of not less than $500 nor more than $1,500 for each offense.
ORDER
You are hereby ordered to remedy all violations of MGL c. 111, s. 197 and 105 C*IR-460.000� as--
identified by a licensed private lead inspector or, if you wish to pursue interim control, you must remedy
all urgent lead hazards identified by a licensed private risk assessor. Whether you pursue full compliance
or interim control, you must correct the relevant violations in accordance with the following schedule:
Within sixty (60) days of your receipt of this Order, you must provide to this agency a copy of a
signed contract with a licensed deleader, if any high-risk abatement and containment work,
including making leaded paint, putty or plaster intact, is required. If you or your agent is doing
owner/agent low-risk abatement and containment and/or interim control work, you must also
provide within sixty (60) days a signed and completed CLPPP form entitled "Documentation of
Training to Perform Owner/Agent Low-Risk Abatement and Containment and Deadlines by Which
Owner/Agent Low-Risk Work and/or Interim Control Work Will Be Completed." The contract must
specify, and if you or your agent will be performing low-risk abatement and containment work or
interim control work, then you or your agent will attest in the CLPPP form described above, that the
work will be completed according to the following schedule:
(a) Violations of the interior of the dwelling unit and interior common areas must be abated
or contained for full compliance, or as required for interim control, within ninety (90)
days of your receipt of this Order. However, you have a total of one hundred and twenty
(120) days from receiving the Order to complete the following activities:
(1) any low-risk abatement and containment work you or your agent perform, as
long as all dust-generating abatement or containment work, including surface
preparation, required to be done by a licensed deleader, has been completed, and
any doors removed have been replaced, within ninety (90) days of your receipt
of this Order;
(ii) application of encapsulants by licensed Level II deleaders, as long as all dust-
generating abatement or containment work, including surface preparation
required to be done by a licensed deleader, has been completed within ninety
(90) days of your receipt of this Order;
(ill) installation of replacement windows, as long as you can demonstrate that new
windows have been ordered within ninety(90) days of your receipt this Order.
C:\wPSO\LEAD1995\GENERAL\GENERA UD0C\BH0TC39A.D0C REV 10197
(b) Violations on the exterior of the residential premises and exterior common areas must be
abated and/or contained for full compliance or as required for interim control, within one
hundred and twenty (120) days of your receipt of this Order.
Any contract with a deleading contractor must also specify that the unit will meet acceptable
lead dust levels, as determined by the results of sampling done by the licensed private lead
inspector or risk assessor at the time of the reoccupancy reinspection, if one is necessary.
Should any of the dust samples fail to meet acceptable standards, the contractor will be
required to reclean the entire unit until all dust samples meet acceptable levels. In interim
control cases in which no reoccupancy reinspection is necessary and no deleading contractor
involved because no high-risk abatement and containment activities, including making leaded
paint, plaster or putty intact, were necessary, then you or your agent who performed required
work will be responsible for cleaning the unit to meet acceptable dust levels. In these cases,
dust levels will be determined by the results of sampling done by the licensed private risk
assessor at the time of the risk assessment reinspection. Any room or interior area in which one
or more surfaces does not meet acceptable dust levels must be recleaned by you or your agent
in its entirety.
You must comply with all of the deadlines stipulated above, and with all applicable sectisbns-of-I05 CN,R -�
460.000. Compliance with this Order will be determined by this agency's receipt of the appropriate
documentation within the specified deadlines. The documentation consists of the following:
a) if any high-risk abatement and containment work is necessary, including making lead-painted
surfaces intact, a copy of a signed and dated deleading contract with a licensed deleader;
b) if you or your agent will be doing low-risk deleading work or such other work as may be
required for interim control, such as structural repairs and lead-dust cleaning for interim
control, a completed and signed copy of the CLPPP form, "Documentation of Training to
Perform Owner/Agent Low-Risk Abatement and Containment and Deadlines by Which
Owner/Agent Low-Risk Work and/or Interim Control Work Will be Completed,"
c) a Letter of Lead Paint (Re)occupancy (Re)inspection Certification issued by a licensed private
lead inspector or risk assessor, in cases in which interior high-risk abatement and containment
work, such as making loose lead paint, plaster or putty intact, is necessary, thus requiring
occupants to be relocated from the unit for the duration of the work;
d) copies of results of all dust samples taken by the licensed private lead inspector or risk
assessor;
e) a Letter of Full Deleading Compliance issued by a licensed private lead inspector or a Letter of
Interim Control issued by a licensed private risk assessor.
In addition, a copy of the deleading notification must be received by this agency at least ten (10) days
prior to any commencement of deleading, whether performed by a deleader or you or your agent, and
whether in the context of full compliance or interim control.
PENALTIES
Failure to comply with this order will result in criminal prosecution. The law provides penalties of up to
$500 for each day of non-compliance. In addition, you may become liable for civil punitive damages
equal to three times any actual damages for failure to comply with this order if a child becomes
poisoned.
C:\WP50\I.E:kD1995\GENEIIAl,\GEN*ERAL.[)O('\BIIOTC39:k.DOC REV 10/97
CORRECTION OF VIOLATION BY CODE ENFORCEMENT AGENCY
If within the time periods stipulated above the aforementioned residential property is not brought into
full compliance or interim control, this agency may contract with a licensed deleader to correct the
violation(s) and obtain a Letter of Full Deleading Compliance or a Letter of Interim Control, and bill the
owner, or initiate court action to reimburse itself.
RIGHT TO A HEARING
You may request a hearing pursuant to 105 CMR 460.900 of the Regulations for a Lead Poisoning
Prevention and Control, in conjunction with the procedures of 105 CMR 400.200(B), the Sanitary Code
provision for hearings in emerZD
gency public health matters. As already noted, the aforementioned
violation constitutes an emergency. (See "Declaration of Emergency" section.) As such, you may
request a hearing only if you have complied with this Order. The hearing will be provided within ten
days of your request. This agency shall issue a written decision within seven days after the hearing.
Inspector irector
Certified Mail No.
C:\WP50\LEAD1995\GENERAL\GENERAL.DOC\BHOTC39A.DOC REV 10/97
FORM30 Caw HOBBSBWARRENTM THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
CITY/TOWN
DEPARTMENT (�
ADDRESS � /V Q
c -76 2 4 y y— 6 �A
G,1M Syey`0. F
TELEPHONE 3Fw\
/ Address-
Floor-grove -t , i/A c�{.w iS _ Occupant-M i riA tn.� OCro i-a ✓U
Apartment No. No.of Occupants s
. No. of Habitable Rooms--7 No.Sleeping Rooms
No.dwelling or rooming units / No.Stories 'Z
Name and address of owner
Remarks Reg. Vio.
S/ YARD Out Bld s.: Fences:
Garbage and Rubbish
`-' Containers.-
Drainage
Infestation Rats or other:
STRUCTURE EXT. Steps,Stairs, Porches: v(k- Cw,.CVer4C ei- r'e3c,r .d
.dual Eg ress:and Obst'n.: ,ft r,&;I:yq dja Sde.; @Q,; �.,nyrcw►c� ,S?�
❑ B ❑ F ❑ M Doors,Windows:S,'l(S rojW ever.Z �, g c,,.7,°^ /, koo D�
Roof t,&,)
Gutters, Drains: ia, �
Walls: Zorovea V% sS fK4 it, c-161-C vek+-
Foundation:•:4i® shrY &" l Nev-,--
Chimney: C -cr✓+ &) c -C(,�it,, 11 ��c.'a�
BASEMENT Gen.Sanitation:
Dampness:
Stairs K L r'S IDS e U�, z s3
Lighting: S
STRUCTURE INT. Hall,Stairway: ok iV-d S &" Alividol,,0%, `Z`` F/ /e ,Tv
Obst'n.: L Qacl p&4,vvt oL• Dc,,e,!(,H iw Yr old eG.il z
Hall, Floor,Wall,Ceilin g. I Ko�
Hall Lighting: 4A Z
Hall Windows: ,. e, T kaA e C&,6,e, ;,, CLz a z;&A 5-0(
HEATING ®1*L Chimneys:
Central ❑ Y ❑ N E ui . Repair
TYPE: .. u Stacks, Flues,Vents:
PLUMBING: Supply Line: , vr,,
❑ MS ❑ ST ❑ P Waste Line: S- - Ft,06,74eJ4Al
H.W.Tanks Safety and Vent(s)
ELECTRICAL Panels, Meters,Cir.:
❑ 110 ❑ 220 Fusing,Grnd.:
AMP: Gen.Cond. Distrib. Box:
Gen. Basement Wiring:
DWELLING UNIT ov
Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks +-
Kitchen es
Bathroom
Pantry vio,
Den
Living Room
Bedroom(1),
Bedroom 2
Bedroom 3
Bedroom 4
Hot Water Facil. Sup.Ten.,Gas,Oil, fec lr�t (Zd jth
Stacks, Flues,Vents,Safeties:
Kitchen Facilities Sink
Stove
Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.:
Wash Basin, Shower or Tub:
Infestation Rats, Mice, Roaches or Other:
Egress Dual and Obst'n:
General Building Posted ✓ICU jga5�jy�-
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
PENALTI F PERJUHY ".^ �.
ti INSPECTO `✓" 4 TITLE
t• DATE 3 TIME G P.M.
(,/_A.M.
.THE NEXT SCHEDULED REINSPECTION 0 O(a w /" " lO� P.M.
l01
,__ ,w,,,,, ,�, ;;,�,.1��1:,.r-.�ti ....,.;�,}�,...r,H, , ..;.�..*n .�,M1+1L'i£�'t+j^ til�r�W'tlij�fT�.. .„h,. v.. er ... ... ow,r-y..`.r•(lWry;a•t,•aw,.�wiir..rr. .,Y.,. ...
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 heaith, 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-
monarea 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,
r
(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.
ryIlk r
i
No. c9w.,3 'V 3 �o Fee$S 7 ,0 0
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
2pptication for Miopogar *pgtem Construction Permit
Application for a Permit to Construct( )Repair(K )Upgrade( )Abandon( ) 0 Complete System El Individual Components
Location Address or Lot No. 34 Grove Street Owner's Name,Address and Tel.No. 7 71 —1 1 9 0
Assessor'sMap/Parcel Hyannis, MA Nancy Johnson/John Grant
309-82 PO Box 342 Hyannis
Installer's Name,Address,and Tel.No. 7 7 5—8 7 7( Designer's Name,Address and Tel.No. 3 9 8—8 31 1
W.E. Robinson Septic Service CR Short
PO Box 1089 Centerville PO Box 1044 S Dennis
Type of Building:
Dwelling No.of Bedrooms 4 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 sand
Nature of Repairs or Alterations(Answer when applicable)topl anG of CR Shnrt-
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 Vvironmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by this0olar0of Health.
Sign Date �7 V
Application Approved by Date
Application Disapproved for the following reasons
Permit No. 0--ka0 3 --4 3 4- Date Issued 0-
- ---------------------------------------
THE COMMONWEALTH"OF MASSACHUSETTS
Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS
ZfooYicatiowfor �Di paaf *pgtem Construction Permit
Application for a Permit to Construct( )Repair Q( )Upgrade( )Abandon( ) ❑Complete System ❑Individual;Components
Location Address or Lot No. 34 Grove Street Owner's Name,Address and Tel.No. 7 71 —1 1 9 0
Assessor'sMap/Parcel Hyannis, MA Nancy JojFheen/John Grant
309-82 PO Box 342 Hyannis
Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. 3 9 8—8 31 1 a
W.E. Robinson SepticiServicer CR Short
PO Box 1089 Centerville 1PO Box 1044 S Dentis
Type of Building:
Dwelling No.of Bedrooms 4 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 sand
Nature of Repairs or Alterations(Answer when applicable) to glans of CR Short
R
2`"Date last inspected:
'I 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§nvironmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by this oar, of Health. ✓/'�.�
_ Signed Date Q J
Application Approved by `�. Date 1 o 1>
Application Disapproved for the following reasons
Permit No. a() Date Issued C, -1,
THE COMMONWEALTH OF MASSACHUSETTS,
Johnson/ BARNSTABLE, MASSACHUSETTS
lgrant
Certificate of Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired(X )Upgraded( )
Abandoned( )by W.E. Robinson Septic Ser$ytee
at 34 Grove Street ""' Hyannis has been construyteq in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.=3- y3 to dated '7/5 v3
Installer Designer 4
The issuancepf this ermit shall not be construed as a guarantee that the system ' as es
Date 9 1 Z 316 3 Inspector
t
---------------------------------------
No. D_C.)G _ �° _- . - Fee$50.00
THE COMMONWEALTH OF MASSACHUSETTS
JohnsPOBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
Johnson/ Xigoogar *pgtem Construction Permit
Grant
Permission is hereby granted to Construct( )Repair(X )Upgrade( )Abandon( )
System located at 34 Grove Street Hyannis
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided: Construction must be completed within three years of t e dates a off thi peF
Date:_ /U� Approve
I
J
TOWN OF BARNSTABLE.
LOCATION 3J4 GRauc $�ak<� SEWAGE# ;ao3
VILLAGE I
n yet W ASSESSOR'S MAP&LOT v Z
INSTALLER'S NAME&PHONE NO. "A 5F�+i C. Sep-77S-�77b
SEPTIC TANK CAPACITY 15 cxv
LEACHING FACILITY: (type) .5 t I S (size) 7�1<41 .X 2+
o
NO.OF BEDROOMS
BUILDER OR OWNER NA W �o�n�SovV
PERMPTDATE: 9 Is [0 3 COMPLIANCE DATE: 9 9,3 I'a-3
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist Feet
within 300 feet of leaching facility)
Furnished by
I '
�Atk. 0� t4o�SF
® ® o
A
CRAIG R. SHORT, P. E.
235 Great Western Road P.O. Box 1044 0-a
v G 97/ Telephone(508)398-8311
South Dennis, MA 02660 Fax (508)398-3063
PROFESSIONAL CIVIL ENGINEER, SOIL EVALUATOR, SEPTIC INSPECTOR
SEPTIC SYSTEM DESIGNS, COASTAL&BUILDING DESIGNS
SEPTIC DESIGN PROPOSAL PAGE 2
PROPERTY SURVEY AND FLOOR PLAN SKETCH
Please fill out this form,including the floor plan sketch, and return to us with the signed proposal and retainer.
This information is necessary to properly prepare your Septic System Design.
IF YOU ARE PLANNING AN ADDITION PLEASE INCLUDE THAT INFORMATION ALONG WITH THE
FOUNDATION DIMENSIONS AND LOCATION FOR THE NEW ADDITION.
Total#of Rooms Year Round Home Seasonal Home 4) Owner Occupied Rental
it Bedrooms Family Room/Den Living Room Dining Room #Bathrooms
/y Washer/Dryer /Dishwasher f Garbage Disposal Jjf Gas Service Town Water
In-ground Electric Wires* ZIn-Ground Oil Tank* /In-ground Sprinkler* IV In-ground Gas Pipes*
* Please note on sketch where located. Craig R Short, P.E. assumes no responsibility if in-ground components are
damaged during Soil Testings, Inspections, Locations of and/or Installation of New Septic System.
Cellar: Y Full X Partial(Crawl) A.) Slab
Wells: 4 Main Use Irrigation Only (please provide location of all wells)
PLEASE USE THE SPACE BELOW AND THE BACK OF THIS SHEET TO PROVIDE US WITH A ROUGH SKETCH OF
THE EXISTING FLOOR PLAN(ALL FLOORS). Also include any items that should be avoided,IF FEASIBLE,i.e.shrubs,
trees,patios,electric lines,tanks,etc.
IF YOU ARE PLANNING AN ADDITION,PLEASE PROVIDE THE LOCATION AND FOUNDATION DIMENSIONSRYVA
Farn 3u''
LOC �"�IQ��ue �.1 SEWAGE 'PERMIT N0.
VILLAGE 9
l
,INSTA LE�S N�ME D DORESS
iUIlDER OR _OWNER
�vhti svr�
DATE PERMIT ISSUED _ , _ 79
DATE COMPLIANCE ISSUED y13- 7
0
Cd
�tD 0
�9
A V
ICJ
No........... f/�.'.. Fles..15....0.r0...........
`THE COMMONWEALTH OF MASSACHUSETTS
r BOARD OF 'HEALTH
'down...........OF.,w...Barns tab le....................................................
Applira#ion for Bispviial Works Tonstrnrtinn rrmit
.Application is hereby made for a Permit to Construct',( ) or Repair (K ) an Individual Sewage Disposal
System at:
-34 Grove Street
.. ..........._............................................................................... ......•-••-•-•---------....-------•--....._..-----•---------.......----------------...............
Location-Address or Lot No.
...1VancY.:_Johns... ............................ Hyannis - .....__......._.... ................
Owner Address
....Jos elah P. M...gn, l�ar---&..�QxL--Inc-.............. ------------------------•---•-----...---•-•----•--••-•---...----...................--•---------...
P. -•--
Installer Address
Type of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building No. of persons............................ Showers — Cafeteria
Q' Other fixtures ..................................
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter___.------------ Depth................
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No..................... Diameter......._............ Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date......-:.:........-......................
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water_:___-_____---____--.__.
Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water........................
•---•----••--------------------------------------------------------------------------------------•--.....................-........................-..........
0 Description of Soil..-- a 8� Grarv� ----------------- ---------- - - • -
Ux ---•••-•----•--••-.._......--•----•----•----•••--_.----
-- -----------4,6 -,,or - - (,�- ...
W •----------------------------------•---•---•--••••-------•---•••••••-••--•-••--•••••-•-----•-•--••--••-•-----•----....._....--------------------------------....----------------------------------------
UNature of Repairs or Alterations—Answer when applicable_-_1-1000•--gallon-_plt.•:--....................................
---------------------------------------•---•--•-••-•----•--•------------------------...............----•----...----•------------------•--••-••-•••---•---•---•---••-••-•-••-•-----••-•-•----•--•..-•--•.
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has bee sued by t�bboao V health.
Signe .. j�1 `�r ..•••---------------------
Application Approved By........... � �/ .. �1 :` � �-`- .
Date
Application Disapproved for the following reasons-------------•-•------••-• - -•-- --------------•----...................................................
..............•----•-•--------•--...--•••-•---•----............--•-•••••..._..•---------•----•--._...-•----•----•-••--•-••-••-------•-•---.............................................................
/ Date
Permit No................................................
......... Issued_.-1.1- '�
Date
No.. Fims...$5_00•........
THE COMMONWEALTH OF MASSACHUSETTS
' BOARD OF HEALTH
A Town O F.......Barnstable
. ...................................•----... ..................................------------•-----...............................
Appliration for Big vo at Works Tonstrnriion Prrmit
Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal
System at:
'34 Grove Street
.... ....-----....... r
ss............................... . .._. ---------------•-----•--or-Lot_No.-----••-••------•-------•-•--•--.----•-
Location-Addre
....�Ta y...J.01 am.--"----...r....""""-...--"------"-----".............. ........W.anniz.................-- _-"- ..._....._................_.
Owner Address
w J. epk�_.P._._.Macomleer___-c..BQn..Inc------•---•• ....-""""-"""""----------------
Installer Address
d Type of $wilding Size Lot............................Sq. feet
Dwelling—to.`of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
pa Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
a Other fixtures -----••----"-----------------------------------
W Design Flow............................................gallons per person per day. Total daily flow..........._................................gallons.
WSeptic Tank—Liquid*capacity..........__gallons Length................ Width................. Diameter................ Depth................
x Disposal Trench .NA P.................. Width.................... Total Length.................... Total leaching area....................sq. ft.
3 Seepage Pit No`.........:.......... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
0.4 Percolation Test Results Performed bY---•-------•.............................................................. Date---"""""-".____........-----------------
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.........................
Test Pit i'o. 2...... ...._,=_minutes per inch Depth of Test Pit.................... Depth to ground water........................
', Y --=-"--------"-----------------""""""---""""""--""""---......---""""-.............._.....__..___...____._...___.....__......._.._•...___.... ......._._--
Description of Soil......Sated..&--GM-Ve-1-----------------------•-_------•-----------------
V ------------------------}..............................................................................................................................................................................
W
UNature of Repairs or Alterations—Answer when applicable_...1_�100�-_-$8110t1_.jJ t.......................................... '
Agreement
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
T/'1�^
'-,the provisions of T LILT E 5 of the State Sanitary Code— The undersigned fur.,iher agrees not to place the system in
operation until a Certificate of Compliance has been/i sued by the boarA o health.
/1
> 1
igne ............. �_.
A lication A roved B ... .. - '�", -`- :7
PP PP Y ..:...-• �r
,� , <. Date
Applieatio`iDisapproved for the following reasons '-------------- ----------------------------------••-------------------------- -------------------
.......................I..............................;..i�..................................................................:........................
nh w......... Date
Permiti No....••-•-•-•-.•---.................................................... _ Issued_.......................................................
Date
THE COMMONWEALTH OF MASSA-GMUSETTS
BOARD OF HEALTH
........................TO M. ......OF.....Barns-tlable.--............................................
(90fifirate of Tomptian"ir
THJS?,IS TO CERTIFY, That the Individual Sewage Di s osal System constructed ( ) or Repaired ( X)
by--;-_--:JgseI..h...P Macomber--&--Son._Inc "--------"
Installer
at.. G.rove--Streets .. yan i....................................---""""""---"-""""-"--"-"""------------"--"--"-------"""--J9 13.0n.."-""-
has been installed in accordance with the provisions of T 5 f e State Sanitary Code as �Lescr}�e in the
application for Disposal Works Construction Permit NO...............I.T. �•�~`/dated 7 .......__.._
THE ISSUANCE OF THq CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
._. � ; �•.DATE... G ..- Inspector-
THE
rn
COMMONWEALTH OF`MASSACHUSETTS
�r BOARD OF. HEALTH
�7 Town......... Barnstable i . .. .4.
// ........... OF......_
.... tY......_....� FEE ....$.5.OO--
Dis c at 19orks 10romitrnr.ion frrmit
Permission is hereby granted..."-=` osep� P. Macomber...&.. 0A. � .....--""...................... ......."-••-- ........-••••-•--.. 5 ... � �
to Construct ( ) or Repair (X),an Individual Sewage Disposal System
at No.. _:: ! Oyt' " ............s y_4ggis.._._.....- J�J S?n....
Street /
as shown on the application for Disposal Works Construction Permit /f. . d...._7`...1...2
..��'�' � T 9 Board of Health /
DATE......7.- -•"-•---•"-"-..•••--(--"........................................
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS , ,
BENCHMARK SOIL TEST
TOP OF FOUNDATION 20 FT. MINIMUM FROM CELLAR
100 00 10 FT. MINIMUM 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE DATE OF SOIL TEST
ELEV. = CAN SAND SOIL TEST DONE B`� CRAIG R. SHORT_P,�
----- WITNESSED BY
(ASSUMED) CONCRETE
covERs "AND OBSERVATION HOLE 1 ELEV.
4" SCHEDULE 40 PVC PIPE
MIN. PITCH 1/8" PER FT. PERCOLATION RATE <�_ MIN./INCH AT �� INCHES
YER OF
D STONE LEGEND:
nT ELEVATION OOxO DEPTH HORIZ TEXTURE COLOR M07T. OTHER
2'
4" CAST IRON PIPE 1004MAX.L*L
3 MIN. EXISTING CONTOUR ----00----
(OR EQUAL) MINIMUM x _ FINAL SPOT ELEVATION 0-80 A
PITCH 1/4" PER FT. FINAL CONTOUR LOAMY SAND 10YR4 2
zNo
ZABEL FILTER SOIL TEST LOCATION
FLOW LINE M 97.05 UTILITY POLE -�
10 TOWN WATER -W�.�W=- 8-120 B LOAMY SANG 10YR5 4 NO
ELEV. 98.00_ MIN. ❑ ❑ ❑ ❑ ❑ O ❑ ❑ ❑ ❑ D CATCH BASIN ®� - -
EXIST. ELEV. 97.00 2'0" ° ° ° ° GAS LINE i
LEVEL ° ° ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ CLEAN OUT C � �
ELEV. _ _�]_. _ GAS ELEV. _ _96.75 6" SUMP ci,_E✓ - _96.58_ ° ° ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ° 2.° ° OARSE SAND
BAFFLE I TRIBUTION ° ° cEssPooL C.P.cP � 12_60-' Cl cRA 1 N coBeLFs .
DISTRIBUTION °
ELEV, _ ° ° ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ °
LIQUID OUTLET BOX � 4- ° °° ° ELEV. _ _94.30
DEPTH TEE
F (TO BE PLACED ON FIRM BASE) TO BE WATER TESTED 5-500 GALLON DRYWELLS WITH G0-144�_ C2 MEDIUM SAND; 10YR7/6 NO _
5 FEET 19 INCHES IF MORE THAN ONE OUTLET STONE IN AN
6 FE T 24 INCHES 1500 GALLON WELL N A -
8 FEET 34 INCHES SEPTIC TANK (TO BE PLACED ON FIRM BASE) 8' X 47' X 2' TRENCH FORMATION Z NO �,Q-`G ti •J'.+^+ EREf _12_ _ E� . :
INCHES7.0 ZONE N/A__
H1 DOUBLE 1 1/2- CLEAN WASHEDSTONE SOIL ABSORPTION AD UST
( ) `� NDEX � DESIGN CALCULATIONS
FREE OF FINES & SILT SYSTEM SAS NUMBER OF BEDROOMS 4
USGS PROBABLE WATER TABLE ELEV. _ _�(A_ GARBAGE DISPOSAL UNIT NOT ALLOWED
SEWAGE DISPOSAL SYSTEM PROFILE OBSERVED WATER TABLE ( / / ) ELEV. _ _ TOTAL ESTIMATED FLOW
NOT TO SCALE BOTTOM OF TEST HOLE ELEV. _ = _ ( 110 GAL,/BR./DAY X 4 _ BR.) _-4:IQ- GAL./DAY
REQUIRED SEPTIC TANK CAPACITY _L'_ GAL
ACTUAL SIZE OF SEPTIC TANK _1500 GAL.
SOIL CLASSIFICATION _ I
DESIGN PERCOLATION RATE < g_- WN.,AN.
EFFLUENT LOADING RATE _Q,.7-4- GAL./DAY/S.F.
LEACHING AREA _596 SO. FT.
TITLE 5 & BARN. B.O.H. VARIANCES REQUIRED: (8'X47")+(11o'X2')
SECTION 15.211 MIMINUM DISTANCES: LEACHING CAPACITY (AREA X RATE) _441_ GAL./DAY
596 X D
1. BETWEEN S.A.S & CELLAR WALL
A 2.7' VARIANCE REQUESTED. RESERVE LEACHING NG CAPACITY _ _ GAL./DAY
2. BETWEEN S.A.S & SLAB FOUND71ON (GARAGE)
A 8.6' VARIANCE REQUESTED.
3. BETWEEN SEPTIC TANK AND CELLAR WALL. NOTES:
A 2' VARIANCE REQUESTED. 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P.
TITLE 5 AND THE TOWN RULES AND REGULATIONS FOR THE SUBSURFACE
DISPOSAL OF SEWAGE.
2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO
WITHIN 6" OF FINISHED GRADE.
3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF
WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN
10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE
USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS.
4. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL
BE MORTARED IN PLACE-
5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH `
I DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT IS TO
OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY.
6. UTILITIES SHOWN ARE APPROXIMATE ONL.'. EXCAVATION CONTRACTOR
gg 1 IS TO CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS
PRIOR TO COMMENCING WORK ON SITE.
7- CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS
SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION
IS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER
99 IMMEDIATELY.
8. PARCEL IS IN FLOOD ZONE __CAZECA
5,999 S.F.f 9. LOT IS SHOWN ON ASSESSORS MAP _; _ AS PARCEL 82 _.
((� 98.9 10. ALL UNSUITABLE MATERIAL SHALL BE Rt:MOVED FROM UNDER, AND
El 98.8 > FOR A MINIMUM OF 5 FEET FROM AROUND THE SOIL ABSORPTION SYSTEM,
`fl9B, AND BE REPLACED WITH SAND AS SPECIFIED IN 310 CMR 15.255: (3)
(I.E. TITLE 5) IF ENCOUNTERED BELOW S.A.S. PIPE INVERT.
98.9
11. EXISTING SEPTIC SYSTEM TO BE PUMPED AND FILLED WITH SAND
OR REMOVED
O o0 99.2 T. 'e 0r '.�t " 'r <OB �\? 12. PROPOSED CONSTRUCTION IS TO PROVIDE AN EMERGANCY REPAIR TO A
FAILED SEPTIC SYSTEM.
98.9 CRAIG
rlO - APPROVED : BOARD OF HEALTH
CIVIL __4
No. Z74C3
98.9
� EX/STING Iv�" -------- --- - _ _ _ ----- -------
Q 4 .�
�,�• " OkWLLING t;,�JG, / I DATE h N
• 98 8.8 40 MIL. 100.4
VINYL _ _-. _ ---- -- ----------- --------�
LINER PROPOSED SEPTIC DESIGN
99
98.9 98.7 �' 0
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Ov
Q P,NE COURT NANC Y JOHNS 0 N
8 ti 8. _ - - -
moo-
98'9 GARAGE , g9 k CHARLES ST LOB. :34 GROVE STREET
99.4 N loci o HYANNIS,
'B 100.4 w BIRCH ST Z --
\�y `� I- o
3>1
C Arn
IGR R SHORT,WESTERN RoP E.
AD
508- P. 0. BOX 1044
LOUIS ST 398-8311 SOUTH DENNIS, MASS. 02660
i
100.3 � l
DATE AUG. 15, 2003 j 1 scALE , = 20'
JOB NO. 1 '_981 i
LOCATION MAP REV SHEET 1 OF 1
- - -- -- --
01-0981 Johnson-01.dwg 02003 CRAIG R. SHORT, P.E.