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0010 HIRAMAR ROAD - Health
10 - 12 HIRANIAAR RD. ,HYANNIS A 292 029 1 1 o , _ r f? > TOWN OF,Bt ARNS��TABLE � x LOCATION >�/ / .�� - /� RD SEWAGE# ::1O/7—y 7,5 `VILLAGE ASSESSOR'S MAP&PARCEL: 7 INSTALLER'S NAME&PHONE NO. Gl/�i` �ih2 /G� SEPTIC TANK CAPACITY LEACHING FACILITY:(type) d0 a*z G• (size) NO.OF BEDROOMS OWNER "P G PERMIT DATE: o COMPLIANCE DATE: ®cA J Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY P IN �. G, No. ` Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS apphLation for 0sposal 6pstem Construction Vermit Application for a Permit to Construct( ) Repair(Upgrade` ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.w/P- Owner's Name,Address,and Tel.No. �F�d�l/�'S C-0 Y70,1 -70- Assessor's Map/Parcel Installer's Name Address,and Tel.No. LG/ 110W �(f H!yL ` Designer's Name,Address and Tel.No. �oyi7iac.97 Type of Building: !/ Dwelling No.of Bedrooms 7 Lot Size q0 sq.ft. Garbage Grinder( ) Other Type of Building /�P S No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank /:5 G0 Type of S.A.S.. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed t Date / / Application Approved by Date "/Application Disapproved Disapproved by Date for the following reasons Permit No. �� i Date Issued ��� C) — �} or> No. � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppfication.for Disposal *pstrm ConstCUction Vermit Application for a Permit to Construct(.j) Repair(A~)t pgr�aZlef Abandon( ) ❑Complete System ❑,Indiv`dual Components Location Address or Lot.No:/d%� // Ir-ai" ct r Gr Owner's Name,Address;ai d yin1 :fin�w L J - - N Assessor's Map/Parcel ✓ _ ' Installer's Name,Address,y,and Tel.,No.+ Ge/✓%//owl* Pity t Designer's Name,,Address,and Tel.No./ llc_ �/r �j/�� �!/G[ U EEO/ C��cy ./�/�c / �1 `� G•>>'ce�rlGrr/ /?<rG�C3�63�` h'o 1 3' - �i 5.8 - { s J-0:7- 36 Type of Building: Dwelling No.of Bedrooms G� Lot Size ✓ sq.ft. Garbage Grinder( ) Other Type of Building /`�- No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) G/ j/U gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title , Size of Septic Tank 7— / UU Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) • i Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed /��'y ✓ �<, �/' :-sr Date Application Approved by _ O, Date Application Disapproved by Date for the following reasons r Permit No. 0/ Date Issued air r -- --:------------------------------- �� THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-.site Sewage Disposal system Constructed( ) Repaired(4—)- Upgraded( ) Abandoned( )by �//i j�/cz ✓ ��� ' c r" /� at /D—% �f / i "%rl/lil" �i ii1� /-/r, Ahas been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.07�-qq_5dated 11�—�3 Installer � � r / Designer #bedrooms Approved design flow Wj gpd The issuance of this permlit�sha!l not be onst/rueed as a guarantee that the syss�-will' m ' n as�esld. � Date + / Inspector -------------------------------------------------------------------------------------------------------------------- No. 67-V( � `l Fee �'V THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *pstem Construction Jermit Permission is hereby granted to Construct( ) Repair(i:�' Upgrade( ) Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized 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 the date of this permit— `S Date � � f � ��---- Approved by 1 Town of Barnstable Regulatory Services Richard V.Scali,Interim Director • BARV3TAB4E, MAS& g Public Health Division . Thomas-:kMcKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 I Installer& Designer Certification Form Date: Q- 15 0017 Sewage Permit# �G� ' � 5-Assessor's Map\Parcel 7 q Designer: DRVt t - C—aUlGl1!a nC?Wr installer: Address: �S� GC-0 k y P er Address: C 6&6n , M� Ca2633 On was issued a perniit to install a ( ate (installer) septic system at 10 -11 14\1 rci lMM r �°� based on a design drawn by (address) -clPJdtlrr dated fZ ��( « I�✓i �Z��3117 (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. i certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State &Local Regulations. Plan revision or certified as-built by designer to follow. Strip out (if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed i �Mia ce with the terms of the AA approval letters (if applicable) ,".AO ca DAVID { COUGHANOWR �n (Installer's Signature) No. 1093 GIs,OIL s'1NtrRR���a . (Designer's Signature) (Affix Designers tamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THiS FORM AND AS- BUiLT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. QASeptidDesigner Certification Form Rev 8-14-13.doc Town of Barnstable Regulatory Services Ricntard.V.;Sea li, Interim Director t#AfL'iYTABL�.. S& Public Health Division Thomas.McKean,Director 200 Ntain Street, 11yannis,'MA 02601 . 01 ict.: 08 ct,2_.j644 Fax: 09-790-6304 Installer S Designer Certification Furm Date: 'Z i�, 2L 1 .se�s'tt a l'Crtttltr G, r�sscss r'1 1 pllyarcrl Z Designer: vtvre� ,j0vVr Installer: Address: k GeO k-de? Address: Of x�.r issued a crttt t toinst;afl'a (: ate � (ntstallcr� Septic systeitt at to 1 0" tc�ttn t !lased on a design drawn'by= (address) -qti�r dated - I certify that tits septic system referenced above was installed substantially according to tile- deSiga, Wilicli may include mincer approved dhinges stirh as lateral relocation of the. (listribuuon box andtor septic tank. Strip out (if required) was inspected 401 tlt� soil's were found satisfactory. I certify that tile- septic system referenced abovQ was installed with major Ilia nge:s{i;L; greater than If}' lateral r;.locaition of the SAS ur any vertical relocation of ally component of tile septic systern)but in accordance with State& Local Regulatioris. plan revision or certified as-built'hy designer to follow. Strip out (if rcquirc(i)was inspwed and the soibs were round sa listactory. i ct-rtiry than ttte system rcfcrcatccd above,was constrtictcd i tAPl cc withthe teats ofthe-RA,approval letterer(irapp}icable) Dfitfit5 ,}iij GHAN (htullt:r s Si�;nattirej� k `tto titi�::t � (Oitrter s Signaitt-ii {Afti Desit~ner s tamp Here) PLEASE RE-FURN TO BAWNSTABLE PUBLIC HEALTH DIVISION. CL'1z'.r CIC'xrE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS IBC RIM .AND AS- BUILT CARD,\ E, RECEIVED 3Y T14E BARNSTABLE PUBLIC N"EALTH 0111:1SIO . ITIANK VOU. (7 ticpiielr7csii;ner(?�rtific;n toll rornrJ(CVt-1•r-,:i.dnc THIS PLAN IS INTENDED SOLELY FOR INSTALLATION OF THE SEPTIC SYSTEM DEPICTED ON IT. FOR ANY OTHER CHANGES TO THE PROPERTY INCLUDING PLACEMENT OF ADDITIONS. SHEDS. FENCES OR SWIMMING POOLS, OWNER SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR. o SEPTIC INFO AT L�C�GI��]DD EC�OO - TECH LL SEPTIC COMPONENTS EXISTING 1500 GAL SEPTIC TANK n EXISTING R O O �! D O CESSPOOL/ EDGE OF PAVEMENT DISTRIBUTION BOX 92 — -- —y"�-+ PAVED SIDEWALK TEST PIT Q4 �— 50 55.91 ft PROPOSED SOIL'___ —r,37.50° r— ABSORPTION MINIMAL ro SYSTEM O \ PROPOSGRADINED cn UT#L#T§ES VENT PIPE -SEE DETAIL EXISTING --- ON BACK OC NTOUR (TYP) 50 WATER LINE 1 GAS LINE_ © UTILITY POLE 1 11 f t / G O p w a Oo T 72 AREA = 8190 sf+— N `ct,� 0 LAND COURT PLAN 17786—E f ��. � Q' \ASSA MAP 292 PCL 29 O�Qv rop G Q 51 OP Q � w N Q� �0 Pq \ c �� �\ 0 1 ELEVATION 99 LSO 3 qq Et 52.14op 51PLAN OP OF FOUND P�\� THIS IS A ®LOR 2g.26 ft SCALE: 1 in = 20 ft i PLAN 0 20 40 GARB USE COLOR PLAN ONLY \ G R FOR INSTALLATION 0 10 20 OT FULL DETAIL 15 BEST A OWED VIEWED IN PRINT ON 8—112 x 14 in FULL COLOR — PAPER FOR PROPER SCALE p G% L W O FC TOP OF FOUNDATION RAISE COVERS TO WITHIN I ALL PIPE TO 4 in SE CH. 40 PVC EL = 52.14 +- 6 in OF FINAL GRADE AND TO PITCH AT 1/8 in/ft MIN 50.10 D—BOX 3' _. ._ . MAX USE H-20 EMST IS 47.10 EXISTING 150000 GALLON .o" oo PRECAST SEPTIC TANK 47.70 �46.45 qo o�o� DRYWELL 0 0 ° EXISTING REFER TO DETAIL BOX in. NE �O�I� �o��OG�3p��01� 41 BASE 46:35 ��/f n� EXISTING 6 In STONE BASE IF NEW S u STE M -REFER TO 103 ff 5-12 ft DETAIL BOX � df NIP, 4435 NO GROUNDWATER LO BELOW HYANNIS° MA, _ MOTTLING OBSERVED _ 38.20 ' .MOUTH ROAD 28-FALM `�HOfM4ss �INOFM4, C�QTF� SEWAGE DISPOSAL ROUTE o,FA DAVID 9`yo ' s9�y 4 S SYSTEM PLAN Q0 D. O DAD. b� -TO SERVE EXISTING DWELLING pUCIA �+ COUGHANOWR w o COUGHANOWR ROADm H1PpMpH No: 1093 No. 461 DENNIS C O N N O R S AND DAVID HOLT ® N LOCUS QFGI E Q 9P O 0 •• `�� OWNERIS) OF RECORD S PROS / FRpNKLIN FRESNs RD N 1 oil �F� 0 RESP� 10-12 HIRAMAR ROAD AVE NAO NOT HYANNIS, MA { TO 155 Geo Ryder Rd S PROPERTY ADDRESS 5cacE Chatham, MA 02633 REVISED DECEMBER 73, 2077 Dovidcou@Hotmail.com DATE.- DECEMBER 6° 2017 L 0 U S M A P 508 364-0894 PG. # ETE-4242 ME S O L TEST LOG PE C# 11554MBER 5. 2017 D EGION (CALCULATION � 46.45 SOIL EVALUATOR: DAVID D. COUGHANOWR, ASE *461 DESIGN FLOW: 4 BEDROOMS X 110 GPD = 440 GPD WITNESSED BY: DONALD DESMARAIS, HEALTH DEPT. SEPTIC TANK: 440 GPD X �2 DAYS = 880 GALLONS I TEST PIT � NO GROUNDWATER ENCOUNTERED 'i PERC AT 62 In - 2 MIN/INCH IN C SOILS USE EXISTING-0000 GALLON SEPTIC TANK IF IN ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER SOUND STRUCTURAL CONDITION. IF NOT, INSTALL III INCHES HORIZON TEXTURE (MUNSELL) MOTTLES NEW 1500 GALLON SEPTIC TANK. 50.20 0-14 FILL DISTRIBUTION BOX: INSTALL UNIT DEPICTED 14-18 Ap SANDY LOAM 10 YR 3/2 NONE FRIABLE SOIL ABSORBTION SYSTEM: 18-45 Bw LOAMY SAND 10 YR 5/6 NONE FRIABLE f THE' LONG TERM ACCEPTANCE RATE FOR A CLASS ONE 38.2045-144 C MEDIUM SAND 10 YR 6/3 NONE LOOSE SOIL WITH A PERCOLATION RATE BELOW 5 MINUTES i PER E INCH -- 0.74 P GALLONS PER DAY PER SQUARE FOOT. NO GROUNDWATER ENCOUNTERED THE 33.5 ft x 12 .5 ft x 2 ft LEACHING GALLERY E E 4 TEST PIT 2 2 MIN/INCH IN C SOILS DEPICTED BELOW CAN LEACH: DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER = _ BOTTOM AREA (33.5 x 12.5) 418.75 s ft. ELEVATION INCHES HORIZON TEXTURE (MUNSELL) MOTTLES _ q 50.25 SIDEWALL AREA - [2x(33.5+12.5)] x2 = 184 so. ft. 0-12 FILL TOTAL AREA = 602.75 sq. ft. ! 12-16 Ap SANDY LOAM 10 YR 3/2 NONE FRIABLE FLOW CAPACITY = 0.74 x 602.75 = 446.03 gal/dog 16-42 Bw LOAMY SAND 10 YR 5/6 NONE FRIABLE 46.75 42-144 C MEDIUM SAND 10 YR 6/3 NONE LOOSE INSTALL A 33.5 ft x 12.5 ft x 2 ft GALLERY AS CONFIGURED' 38.25 BELOW. FLOW CAPACITY = 446.03 gol/doy WHICH EXCEEDS it - -- --- - THE 440 gol/doy REQUIRED FOR A FOUR BEDROOM DESIGN. SOOo @ALL= SEPTIC TTANK amwamew a IBM% @ODIC AMOOMPTSON um smmlr >�W*Tffw Cm 'm om REPLACE WITH A NEW m Maw ffl@@w m I in 1500 GALLON TANK TAPER OR OTHERWISE DRYWELL 33.5 ft f IF CRACKED, ROTTED I COMPROMISED. UNIT �Y o 0 5 ft— U`� v� o-" N 8 In TF cl� LO - 00 - STONE I �� NOT 4 ft 8.5 ft 8.5 ft 8.5 ft 11 4 ft TO - -- — /0 ft-6 5 SCALE 500 GALLON DRYWELL DIMENSIONS & DETAIL INSTALL ONE INSPECTION - - - RISER TO WITHIN THREE INLET OUTLET USE INCHES OF FINAL GRADE & INDICATE LOCATION COVER COVER H-10 ON AS-BUILT -- - -- UNIT In 3 IN DROP FLOW LINE33 F Y FROM _ O.p,p� in 10 in TO - o _ 0 0 i4 BUILDING o 0 00:00 usE i D-BOX 48 in j LIOUID GAS 102 LEVEL BAFFLE CROSS SECTION VIEW INSTALL AN APPROVED GEOTEXTILE 6 in STONE BASE /F NEW FABRIC OVER STONE SEPARATION BETWEEN INLET & OUTLET TEES NO LESS THAN LIQUID DEPTH CROSS SECTION VIEW 28 314 In TO .i ® 24 In 3/4 In TO _- in 1-1/2 In GRAVEL ® 1) PTHTIVE® I-1/2 in GRAVEL In ni _ . l 46 in 58 in 46 in ��- D � R 1r3 CJ T 1 O 1\I : O�C ,: •`. - • ► :o o 150 in • •• • ALL STONE TO BE DOUBLE WASHED AND FREE OF IRONS, DUST AND FINES IN PLACE I i j' 12 in -INSTALLER TO OBTAIN DISPOSAL WORKS c MIN PERMIT BEFORE STARTING WORK. —> ALL COMPONENTS INSTALLED SHALL MEET LO S c THE MINIMUM REQUIREMENTS OF N TAONK TO O MASSACHUSETTS TITLE 5 SEPTIC a ,� SAS CODE (310 CMR 15). -INSTALLER TO VERIFY LOCATIONS OF ALL PDO°o`� c �00� UNDERGROUND UTILITIES BEFORE 6 in STONE BASE T EXCAVATING FOR SYSTEM. 21 /n 2� \ CROSS SECTION VIEW -ECO-TECH ENVIRONMENTAL RECOMMENDS i. THE INSTALLATION OF LOW FLOW E FIXTURES & APPLIANCES, AND PERIODIC PUMPING OF THE SEPTIC TANK. -SYSTEM IS NOT DESIGNED TO _WITHSTAND �J VEHICULAR LOADING. DO NOT, PARK OR DRIVE VEHICLES OVER SEPTIC,-SYSTEM. e i ji I SEWAGE DISPOSAL SYSTEM PLAN 10-12 HIRAMAR ROAD HYANNIS. MA DECEMBER 6, 2017 ETE-4242' PG 2/2i1 r%O=�ON17y'EALTH OF MASSACF-USETI'S XECL=m'E OFFICE OF ENS IRONIA4EIN7AL AFFAIRS ' DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM �9 a 0 PART A CERTIFICATION Property Address: {O -Q 14,ra h,f, 2A -r MA V Owner's Name: Owner's Address: tA` e Date of Inspection: 4'/3 0 j o s- Name of Inspector:( lease print) E-c4,te( � Company Name: rd(q;� _ VA k6 sPeeitC".3 Mailing Address: rOFok $ ASgfl va #1A 0,U-/,r Telephone Number: CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails - _ Inspector's Signature: _! JU- A Date: 6q 3 Q The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or x' DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of jfl;000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,raiid the approving authority. Notes and Comments no cn ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I i Page 2 of 11 OFFICIAL INSPECTION FORD—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 60 //Ara-0,4t r Owner: //,I j Date of Inspection• Q��.� Z Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have-not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved b e Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the follo - g statements.If`not determined"please explain. The septic tank is metal and over 20 years old*or septic tank(whether metal or not)is structurally unsound,exhibits substantial infiitration or exfiltration tank failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic as approved by the Board of Health. *A metal septic tank will pass inspection if it is Cturany sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years is available. ND explain: Observation of sewage b p or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a ken,settled or uneven distribution box.System will pass inspection if(with approval of Board of Heal broken pipe(s)area obstruction is removed distribution box is leveled or replaced ND explain: The m required pumping more than 4 times a year due to broken or obstructed pipe(s).The systm will pass insp _ on if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of I I OFFICIAL,INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: Owner: �f Date of Inspection: C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if a system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 R 15.303(l)(b)that the system is not functioning in a manner which will protect public health,sa j 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 we d or a salt marsh 2. System will fail unless the Board of Health(and P lic Water Supplier,if any)determines that the system is functioning in a manner that protects the blic health,safety and environment: _ The system has a septic tank and soil abs tion system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surfac water supply. _ The system has a septic tank and S and the SAS is within a Zone i of a public water supply. _ The system has a septic tank d SAS and the SAS is within 50 feet of a private water supply well. The system has a septic and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well'". ethod used to determine distance "This system passes if a well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile ganic compounds indicates that the well is free from pollution from that facility and the presence of onia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria ar triggered.A copy of the analysis must be attached to this form. 3. Other* 3 Page 4 of l l OFFICIAL INSPECTION FORA4—NOT FOR VOLUNTARY ASSESSMENTS =- SUBSURFACE SEWAGE DMOSAE SYSTEM INSPECTION FORM PART.A- CERTIFICATION(continued) Property Address: - Owner• It Date of Inspection: D. System Failure Criteria applicable to all systems: You must indicate"yes"or`ono"to each of the following for all inspections: Yes No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool < Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool Liquid depth in cesspool is less than 6"below invert or available volume is less than'/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 SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. o� 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.IThis system passes if the well water.analysis, performed at a DEP certified laboratory,for coffer=bacteria and volatile organic,comp�mds indicates that the well is free from-pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equat to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.) (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described is 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve.a facili a design flow of 10,000 gpd to 15,000 gpd- s You must indicate either"yes"or"no"to each of the owing: (The following criteria apply to large systems in rtion to the criteria above) yes no _ — the system is within 400 et of a surface drinking water supply _ the system is wi 200 feet of a tributary to a surface drinking water supply _ the system' located in a nitrogen sensitive area(interim Wellhead Protection Area—IWPA)or a mapped Zone H a public water supply well If you have eyed"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Sec on D above the large system has failed.The owner or operator of any large system considered a significan eat under Section E or failed under Section D shall upgrade the system in accordance with 310 CUR 15.304. a system owner should contact the appropriate regional office of the Department. 4 r Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CH/fECKLIST Property Address: to —/a r`!`& Owner: !t Date of Inspection• �l���/a s Check if the following have been done.You mast indicate"yes"or"no"as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health Were any of the system components pumped out in the previous two weeks? _ Has the system received normal flows in the previous two week period •! Have large volumes of water been introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined?(If they were not available note as NIA) _ Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? _ Were all system components,excluding the SAS,located on site? _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition ofthe baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? _ Was the facility owner(and occupants if different from owner)provided with information on the proper rn enance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no _ Existing information.For example,a plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)j 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM I.NFORMATION Property Address: a- /a i�.a•</ 7 �xGi.y+'t%S Owner: wly Date of Inspection: FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): // Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: l 10 gpd x#of bedrooms): f Number of current residents:1— Does residence have a garbage grinder(yes or no): A.-)O Is laundry on a separate sewage system(yes or no):A)O[if yes separate inspection required) Laundry system inspected(yes or no)`V6 Seasonal use:(yes or no): NO Water meter readings,if available(last 2 years usage(gpd)): Sump pump(yes or no): p Last date of occupancy:Mot I(-C COMMERCIAL/INDUSTRIAL Type of establishment: _ Design flow(based on 310 CMR 15.203): �pd Basis of design flow(seats/persons/sgft,e Grease trap present(yes or no): Industrial waste holding tank pr t(yes or no): Non-sanitary waste discharge o the Title 5 system(yes or no):^ Water meter readings,if a able: Last date of occupancy se: OTHER(descri GENERAL INFORMATION Pumping Records -r Q , Source of information: Ado py Mplk C 5 k c< /.,4(( P Was system pumped as part of the r sn pection(yes or no): If yes,volume pumped: gallons—How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM Septic tank,distribution box,soil absorption system _Single cesspool Overflow cesspool Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be ob_tained from system owner) Tight tank _Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known)and source of information: la��er c 23 o tf Were sewage odors detected when arriving at the site(yes or no): /ud 6 Page 7 of I I OFFICIAL, INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUIBSUR.#ACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 10—(a f FEZ� ►Cl.o f�/ SGuR%s Owner:---f�=�-- Date of Inspection:—� BUILDING SEWER(locate on site plan) . Depth below grade: �� Materials of construction:_cast iron _40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: Y (locate on site plan) Depth below grade:62 If Material of construction:-concrete_metal_fiberglass_polyethylene _other(explain) If tank is metal list age._ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: Q Sludge depth: C2 a Distance from top of sludge to bottom of outlet tee or baffle: 30 Scum thickness: ,-9 of Distance from top of scum to top of outlet tee or baffle: Sr Distance from bottom of scum to bottom of outlet tee or baffle:_4 ' How were dimensions determined: /4?tiC<,t le--/ Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,Iiquid Ievels as related to tlet inv�eevidence of I o ue, n 4-e -fees, if l� � 1!< GREASE TRAP:_(locate on site plan) Depth below grade:_ Material of construction:_concrete_ I fiberglass_polyethylene_other (explain): _ Dimensions: Scum thickness: Distance from top of scum to of outlet tee or baffle: Distance from bottom of scu to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumpin ecommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet in v evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C !SYSTEM INFORMATION(continued) Property Address: !O—47 jY I hct r Q otl ona Owner:_ Date of Inspection• TIGHT or HOLDING TANK: (tank must be pumped at of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass__polyethylene other(expIain): Dimensions: Capacity: gallon Design Flow: 9 y Alarm present(yes or no): Alarm level: Alarm' working order(yes or no): Date of last pumping: Comments(condition o arm and float switches,etc.): DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal;any evidence of solids carryover,any evidence of leakage into or out of etc.)- PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no):. Alarms in working order(yes or no): Comments(note condition of p chamber,condition of pumps and appurtenances,etc.): 8 Page 9 oil il OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESS'WENN'S SUBSURFACE SE 'WAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 10— l7`rr.&tAr Owner: Date of Inspection: !_.1— SOIL ABSORPTION SYSTEM(SAS): Of (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number_ leaching chambers,number:' leaching galleries,number leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool,number innovative/altemative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): I - (& � 0 u rS Y'V'OZj 'E7 S! I CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer. Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater in rgrof ): Comments(note condition soilydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition oil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 71 OFFICIAL INSPECTION FIOR —NADT-FORK V91 AMa Y-AS:S SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: fb —��geaotd Owner: Date of Inspection• 6 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet Locate where public water supply eaters the building. C� a �n Pagel! of 11 OFFICIAL, INSPECTION.FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL., SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 0- m_L)Pf./ / Owner: ]' Date of Inspection: V SITE EXAM Slope N' Surface water / Check cellar Nv CAL(l4 r Shallow wells /✓9 Estimated depth to ground water 0 feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) _Accessed USGS database-explain: You must describe how you established the high ground water ele ation: t/� D L �.bUO CA t_•• ? ��VQ Tcy� p d U q . �d `yez • 11 r' TOWN OF BARNSTABLE ��Q ♦� OFFICE OF Bsaa9TSBr, i BOARD OF HEALTH MAMR p� 0o,e�039. `e0 367 MAIN STREET HYANNIS, MASS.02601 LEAD DETERMINATION REPORT FORM Date of Determination: J'a Inspector: G'�M �, -�i►ag'tbh , License#: D 3 3 9 5- Method Used: podium Sulfide Expiration date: �— X-Ray Fluorescence Model: I I Serial#: 2 t�Property Address: V valeta.- Poad Apt. # Description of Property: Single family �Z_ Multi-family #units Garage Fence Other structures Age of Property: %,--o- Pre-1978 Post-1978 Occupant: .PC I11Ck K t,,eL 'ak Occu ants under six years of age: kV&,1ife F0_,,gv}0&-% DOB: e- 2T- 9� DOB: DOB: Occupant's'Telephone: -7 7 73-0 Property Owner(s): .4A i j-jfy�-¢ T k eeeSA_ ;?-&cy k Owner's Address: f.3-Z® tea-, Owner's Telephone: r/ o - 'TZ% "s --00 —eeo_4 4/0 9F'? 3 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 r LOCATION SOURCE Pb 1. Child's bedroom Window parting bead/exteri r ill area s4 � 2. Child's bedroom Window sill /f 3. Living room Window parting bead/exterior sill area 4. 1 Kitchen Window parting LIPad/,e�xtterior sill area PO-5 5. Interior Flaking paint 6. Exterior Flaking paint' G SI de- 0 rea^ 441 7. Exterior Cellar window units 8. Exterior Window s below 5' KS.&- C^IdS fL(d"MC61AOS. 9. Exterior Main entry door casing 10. Interior Outside corner of baseboard - 11. Kitchen or Bathroom Chair rail - - 12. Bathroom Window sill 13. Exterior Threshold C t;&. r-ec, 8,,dt- 14. Interior hallway (common area) Stair tread or stringer 15. Interior hallway (common area) Balusters 16. Interior hallway (common area) Door casing tea-•may - 1J Sialg- 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/Outbuilding Door casing or jamb 24. Interior Closet door or baseboard (uncapped) 25. Interior Cabinet door, shelf, or wall f C:\WP50\LEAD1995\GENERALWOLTRHEAD\LEADREPT.DOC 12/96 ._2'T 1 Fee No. '� / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01ppricatton for 3Di!5po2;a1 *p5tem Conotruction Permit ` Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) Complete System ❑Individual Components Location Address or Lot No. /D'—/C If— kqV►o47__ Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. kip C-A-+���}C_ �o vi,S Sf- Type of Building: l / Dwelling No.of Bedrooms� Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow q LAO gallons per day. Calculated daily flow r c�� gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank I f;PA9�tfL. Type of S.A.S. G �, Description of Soil 0 Nature ofRepairs or Alterations(Answer when applicable) oN STe'A Nsm SfIN C.-Ta ij,A6 LEA Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has b Signed Date Application Approved by Date Application Disapproved for the following reasons Permit No. Z4-ay ` ZYtl Date Issued No. CCJC/CJ _ n ` Fee - Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS p Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS } ZppYication for Migboal *pftem construction permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) 'Complete System El Individual Components Location Address or Lot No. - `^%c 2 r& Owner's Name,Address and Tel.No. �-(t, Assessor's Map/Parcel �.? ? Q Lam" 7 aC`J Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: < Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures a 4 Design Flow �O gallons per day. Calculated daily flow J 7 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank! 4 V. OO f%P Type of S.A.S. (—q `f V (.. Description of Soil �V Lon f Nature of Repai. or Alterations(Answe wh n applicable) Y`►S �` � ' G-C V :A ST `� ►V \ taL`i tt/1 e�—T 0.`C r7 �. W Lk ca�U ET�j `:;�r'pe'S -� �S'� \.0_0P 9 y Date last inspected: Agreement: 6 The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance h u a� en _f 8-c�/Signed Date Application Approved by Date Application Disapproved for the fo ov&g a sons Permit No. Date Issued f,,w --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CER , that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( ) Abandoned( )by 1 10 -LAp� S at - Cap—fv\&,y— has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.ZOV' `� dated g- � Installer i Designer A p, The issuance of this permit 1�j of be c•nstru as a guarantee that the s Ast��wj i11,11 functio as�designed Date Pector j� L�u �i'Yi. Ins �i �/�/I /- .9 ! 0i —-- -Z------------------------------5 No. Fee Z THE COMMONWEALTH OF MASSACHUSETTS 2 PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS Mi6pogai *pgtem Construction Permit Permission is hereby granted to Construct( )%Repair( )Upgra )Abandon( ) System located at 1 d — � 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 mustbe completed within three years of the date of this t. f Date: / — � Approved by r i 1/6i99 . ..E NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (W=OUT DESIGNED PLANS) I, ✓ S hereby certifythat the application for disposal works construction permit signed by me dated �'�`VI-0'D concerning the property located at �,�—`�- `� r c,r 1�QF �� meets all of the following criteria: u The failed system is tonne✓ed to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil is classified as CLASS I and thepercolation rate is Iess than or equal to 5 minutes per inch. �/T-here are no wetlands within 100 feet of the proposed septic system There are no private wets within 150 Feet of the proposed septic system "ere is no incense in flow and/or change in use proposed There are no variances requested or needed. The bottom of the proposed leaching faclity•will not be located less than five feet above the ma durum adjusted groundwater table elevation. (Adjust the groundwater table using the Frimptor method when applicable] �If the S.A.S. will be located with'_50 feet of anv vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14) feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS inf6rmation) B) G.W. Elevation ��=the'v1A.:(. High G.W. Adjustment340 DFEIRENCE BETWEEN A and B �T SIGNED : DAT=: "'6'7 (Sketch proposed plan of s<rsem on back]. q:4cakh folder.ce:t TOWN OF BARNSTABLE Ap LOCATION /0 /1 eta (� SEWAGE # r VILLAGE j->✓Li- ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE N0. h� SEPTIC TANK CAPACITY /J70 y LEACHING FACILITY: (type) 1VT�i17'"FOAS (size) NO.OF BEDROOMS _C BUILDER OR OWNER, v PERMITDATE: COMPLIANCE DATE: CIDb� Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Hurciished by ._ .........--................... -- - -- — - Z� 7T7C9 I /,%-I V- 1 1 i t P 339 579 064 t uS Postal Service Receipt for Certified Mail No Insurance Coverage Provided. Do not use for International Mail See reverse Sent to r1/1„ eV Pest Office, t ,&ZIP Cocje/ 02-Jli� Postage y� $ Certified Fee Special Delivery Fee Restricted Delivery Fee u� rn Return Receipt Showing to Whom&Date Delivered Q Retum Receipt Showing to Whom, Q Date,&Addressee's Address W TOTAL Postage&Fees $ Z. V) Postmark or Date E LL o 01Z/0 a. G h. Stick postage stamps to article to cover First-Class postage,certif led mall fee,and charges for any selected optional services(See front). 1.If you want this receipt postmarked,stick the gummed stub to the right of the return h address leaving the receipt attached, and present the article at a post office service y ff window or hand it to your rural carrier(no extra charge). m I 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the Q) return address of the article,date,detach,and retain the receipt,and mail the article. in 3. If you want a return receipt,write the certified mail number and your name and address rn on a return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space permits. Otherwise,affix to back of article. Endorse front of article C RETURN RECEIPT REQUESTED adjacent to the number. Q ` 4. If you want delivery restriced to the addressee, or to an authorized.agent of the G addressee,endorse RESTRICTED DELIVERY on the front of the article. GGo M 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt. If return receipt is requested,check the applicable blocks in item 1 of Form 3811. 6. Save this receipt and present it if you make an inquiry. a I I oFTKMErH Town of Barnstable Department of Health, Safety, and Environmental Services • BMWSrABL& "�: per Public Health Division � P.O. Box 534, Hyannis MA 02601 Office: 508-862-4644 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health Mr. Millton L. Szarek March 2, 2000 1320 Main Street Coventry, RI 02816 ORDER TO COMPLY WITH 310 CMR 15.00, THE STATE ENVIRONMENTAL CODE, TITLE 5. The septic system owned by you located at 10 Hiramar Road, Hyannis was inspected on February 29, 2000 by Donna Miorandi,RS, health inspector for the Town of Barnstable. The inspection of your septic system showed that your system has failed under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Raw sewage observed overflowing onto the ground from cesspool. • Septic'system backing up into tub and toilet. You are directed to hire a licensed Town of Barnstable septic system installer to submit a sketch diagram of a proposed system to the Town of Barnstable Health Division Office (Town Hall, 367 Main Street, Hyannis)that will bring the septic system into compliance with 310 CMR 15.00, The State Environmental Code, Title 5 within(14) fourteen days of receipt of this notice. You are also directed to bring the septic system into compliance within thirty (30) days of receipt of this order letter. You are further directed to maintain the system by hiring a licensed septage hauler to pump the septic system to prevent discharge of sewage or effluent into the buildings, onto the surface of the ground, or in to surface waters. KS q/wpfiles/donna Any person aggrieved by any order issued by the local approval authority may appeal to any court of competent jurisdiction as provided for by the laws of the Commonwealth. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., C.H.O. Agent of the Board of Health cc: Alison Reid,Housing Assistance KS q/wpfiles/donna Health Complaints 17-Jul-00 Time: 12:42:15 PM Date: 7/17/00 Complaint Number: 2451 Referred To: GLEN HARRINGTON Taken By: LS Complaint Type: CHAPTER II HOUSING Article X Detail: Business Name: Number: 12 Street: HIRAMAR ROAD Village: HYANNIS Assessors Map_Parcel: Complainant's Name; j Address - - Telephone Number:' - - Complaint Description: IT HAS FAILED THE BARNSTABLE HOUSING INSPECTION 3 TIMES AND THEY TOLD HER TO CALL THE HEALTH DEPT. THE WALLS ARE FALLING OUT IN THE BATHROOM AND FLYING ANTS ARE COMING OUT OF A HOLE IN THE WALL. THE PAINT IS PEELING IN DIFFERENT PLACES AND SHE HAS A CHILD UNDER SIX THAT PICKS AT IT. NO ONE KNOWS IF THERE IS LEAD IN IT. OWNER IS DOING NOTHING TO REPAIR ANYTHING. Actions Taken/Results: Investigation Date: Investigation Time: 1 Handed to: `' Received by: IHET Town of Barnstable Department of Health, Safety, and Environmental Services BARNSrABLE "�: ,.� Public Health Division P.O. Box 534, Hyannis MA 02601 Office: 508-862-4644 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health Mr. Milton L:Szarek March 15, 2000 1320 Main Street Coventry, RI 02816 ORDER TO COMPLY WITH 105 CMR 410.000, STATE SANITARY CODE II, Minimum Standards of Fitness for Human Habitation and 310 CMR 15.00, THE STATE ENVIRONMENTAL CODE, TITLE 5. The septic system owned by you located at 10 and 12 Hiramar Road, Hyannis was inspected on February 29, 2000 by Donna Miorandi, RS, health inspector for the Town of Barnstable due to a complaint. The following violations were observed: 105 CMR 410.300 Failure to maintain onsite sewage disposal system in an , operational condition - Raw sewage observed overflowing onto the top of the ground above the cesspool cover. 105 CMR 410.300 Failure to maintain onsite sewage disposal system in an operational condition - Raw sewage observed backing up into tub and toilet inside 10 Hiramar Road. On March 2, 2000, I mailed a letter to you regarding the problem of raw sewage overflowing onto the ground and backing-up into the bathtub:and toilet at the property owned by you located at 10 Hiramar Road, Hyannis. The certified order letter was returned to me with the word"refused" written on it. You're action of not accepting a letter by certified mail does not obviate your responsibility to comply with the State Sanitary Code II and/or Title V. I also mailed you a copy of that letter on the same date, delivered to you by regular mail. That letter was not returned to me so I assume you received it. In addition, on March 9, 2000, the order letter was posted on the front door of the affected dwelling unit in conformance with provision 105 CMR 410.833 (B) (4), of the State Sanitary Code II. This is an acceptable and legal method of serving the order letter to you. You are again ordered to hire a licensed Town of Barnstable septic system installer to submit a sketch diagram of a proposed system to the Town of Barnstable Health Division Office (Town Hall, 367 Main Street, Hyannis) that will bring the septic system into compliance with 310 CMR 15.00,The State Environmental Code, Title 5 within seven (7) days of receipt of this notice. You are also ordered to bring the septic system into compliance within fourteen (14) days of receipt of this order letter by installing a replacement septic system which meets the State Environmental Code, Title V. Immediately upon your receipt of this notice, you are further ordered to maintain the system by hiring a licensed septage hauler to pump the septic system to prevent discharge of sewage or effluent into the buildings, onto the surface of the ground, or in to surface waters. Any person aggrieved by any order issued by the local approval authority may appeal to any court of competent jurisdiction as provided for by the laws of the Commonwealth. You are also subject to automatic non-criminal ticket citations of$40.00. Tickets may be issued daily until the violations are corrected. PER ORDER OF BOARD OF HEALTH o as A. McKean, R.S., C.H.O. Agent of the Board of Health cc: Alison Reid,Housing Assistance KS q/wpfiles/donna OFIKE' Town of Barnstable * wuvsrnst.e. Department of Health, Safety, and Environmental Services MASS. Public Health Division ArEDjA°�A P.O. Box 534, Hyannis MA 02601 Office: 508-862-4644 Thomas A.McKean,R9,CHO FAX: 508-790-6304 Director of Public Health Mr. Millton L. Szarek March 2, 2000 1320 Main Street Coventry, RI 02816 ORDER TO COMPLY WITH 310 CMR 15.00, THE STATE ENVIRONMENTAL CODE, TITLE 5. The septic system owned by you located at 10 Hiramar Road,Hyannis was.inspected on, February 29,2000 by Donna Nliorandi, RS; health inspector'for the Town of Barnstable. The inspection of your`septic_system showed that your system has failed under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Raw sewage observed overflowing onto the ground from cesspool. • Septic system backing up into tub and toilet. You are directed to hire a licensed Town of Barnstable septic system installer to submit a sketch diagram of a proposed system to the Town of Barnstable Health Division Office (Town Hall, 367 Main Street, Hyannis)that will bring the septic system into compliance with 310 CMR 15.00, The State Environmental Code, Title 5 within(14) fourteen days of receipt of this notice. You are also,directed to bring:the septic system�into compliance within thirty (30) days of receipt of-this`Order letter. You"are'further'drected to�maintdin the system by Hiring a licensed.septage hauler to" pump the septic system to'prevent discharge of sewage or effluent'into the buildings, onto the surface of the ground, or in to surface waters. KS q/wpfiles/donna ti Any person aggrieved by any order issued by the local approval authority may appeal to any court of competent jurisdiction as provided for by the laws of the Commonwealth. PER ORDER OF THE BOARD OF HEALTH V;�li Thomas A. McKean, R.S., C.H.O. Agent of the Board of Health cc:Alison Reid,Housing Assistance KS q/wpfiles/donna r JANE F. DAVIS Attorney at Law March 23, 2000 Thomas A. McKean, R.S. , C.H.O. Agent of the Board of Health Town of Barnstable Department of Health, Safety and Environmental Services Public Health Division P.O. Box 534 Hyannis MA 02601 RE: 10-12 HIRAMAR ROAD, HYANNIS, SEPTIC SYSTEM OWNER: MILTON SZAREK Dear Mr. McKean: As you know, I represent Milton L. Szarek. He is diligently pursuing the repair or replacement of the septic system at 10-12 Hiramar Road, Hyannis. I would like to ask you for a three week extension on Mr. Szarek' s behalf. This request is due to delays caused by getting estimates and obtaining a contractor to do the work. Please advise. Sinc.e'rely, Jane�F. D&' is - FD: rlp cc: Milton L. Szarek P.O. Box 1887 • 712 Main Street • Hyannis,Massachusetts 02601 • (508) 771-4551 • Fax: (508) 790-4050 JANE F. DAVIS Attorney at Law March 17, 2000 Thomas A. McKean, R.S. , C.H.O. Agent of the Board of Health Town of Barnstable Department of Health, Safety and Environmental Services Public Health Division P.O. Box 534 Hyannis MA 02601 RE: 10-12 HIRAMAR ROAD, HYANNIS, SEPTIC SYSTEM OWNER: MILTON SZAREK Dear Mr. McKean: This is to inform you that I represent Milton Szarek, owner of 10-12 Hiramar Road, Hyannis. Mr. Szarek is actively pursuing installation of a new septic system. He has been in contact with sex installers and has decided to have Robert Roberts do the work. I will be done in all due haste, as soon as possible. The system was pumped by Winslow Plumbing and my client will pump it again if necessary. I will continue to advise you of the timetable for installation of the new system. This letter is intended to comply with your letter of March 15, 2000. Sin ely, Ja F. vis JFD: r p cc: Milton L. Szarek P.O. Box 1887 • 712 Main Street • Hyannis,Massachusetts 02601 • (508) 771-4551 • Fax: (508) 790-4050 FORM 30 Caw HOBBSB WARRENTM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �ja�v vrl fa,to/-e- CITY/TOWN ��-- W P. /r✓✓6 o D PARTMENT 3 Ll I , 6 441' 44 4- - o^ ADDRESS TELEPHONE Address 2 ��ra G+� (2!,_I 441r" Occupant kezatvouo 1, _ Floor Apartment No.— No.of Occupants if No.of Habitable Rooms_No.Sleeping Rooms Z_ No.dwelling or rooming units Z No.Stories_ Name and address of owner J'Z �`� ,COv-e_ . Z Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: G 1+y Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup. en.,Gas, Oil, Elect..- Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH ` MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY."INSPECTOR `J TITLE `7`"�///� A.M. DATE 7���/ TIME 3` 07?) �M �g,�, _ A.M. THE NEXT SCHEDULED REINSPECTION 0 60-?0 ��J l "— � L Pa�°J� P.M. ..�,Ton'�{,gY»"•p'7i'Y"l.,+n,;1e'i"?elm°"",at{iJ�4�{.�/"�iYFt'F+q.'�gfsp�7i`�'+f$!'h 'q+r"""`„+'■a'^�lpf'�p�}+� �1�s `Ps�+�.'"�',�.l�t�;��r +ki�#.� ���'�`7SPr-"^.,.,ec� -..., .. .:- + 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. _ (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests - or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. FORM30 Caw HOBBS&WARREN tm THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH , 3a.✓' o k- CITY/TOWN W q o DEPARTMENT 3 G M a,_�,�''f". STY a14 C44-0 ADDRESS Ll i%1L/j GSM sv0y`0 �`' V 1 / TELEPHONE Address 11 �� +^ + 1 a44 Occupant kh0A--'0^^t Floor Apartment No. No. of Occupants No. of Habitable Rooms No.Sleeping Rooms I Z � _- No.dwelling or rooming units _—No.Stories Name and address of owner 5'Z o"k-k- _ Remarks Reg. Vio. YARD Out Bld s.: Fences: a v oef,S P_"Sa,Kd-.i/0 L110 60AIP Garbage and Rubbish o o_LA _ v v k Containers: L r OLZ, Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: &, $rd 66Qti, - 1444 W Roof F,,,cAt iAA dv ro L, L.� to ;r-on d ' Gd%SI,-Z Gutters, Drains: i 0. Je 0 P-AM /O Salo Walls: k A,-v v h R- e s� Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: r 4AedeLh L4r►.1 Vf Q Hall Li htin Una Hall Windows: 1r,O-P% a v v%G& a,11 vl� +` V&;3`d0 HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: T#'4-(#_ H.W.Tanks Safety and Vent(s)e ELECTRICAL Panels, Meters,Cir.: sAgAl Ak& voIgy ❑ 110 ❑ 220 Fusing,Grnd.: (V&-k.,a4rpwfR a AMP: Gen.Cond. Distrib. Box.- Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom(1). Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup. en.,Gas,Oil, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: /I,- Sb5/ Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: d°G16 el.-L re&U yr ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION REPORTIIS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTI PERJUR INSPECTO TITLE 4 / A.M DATE TIME 4®& � M. 3 A.M. THE NEXT SCHEDULED REINSPECTION //� � V P.M. -.«ar.*�Wi;�,sH}e+.',iis�rq:+1M'Div"'�`..'��'^�^: `zle?9"a'a".7y�5��anp'P�Tn:`a+°;e§g;•�..,m��w.'Mw�j�° c��,i'Sr,�y�;C"'^.�+'i�i$�I' ' '%�4r`+rt� +'�j'�a�'�"+Ff�'�°� �'�r'F�.;.. -v: .,. _ ,..•, . • s 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- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute'to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling-or dwelling unit in violation-of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to•expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. t.� ��pUtHE to��� Town of Barnstable X Regulatory Services RAMMASS.SrABLE Thomas F.Geiler,Director 9 4 6'ArE1639n. A Public Health Division Thomas McKean,Director 367 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 July 19, 2000 Milton Szarek 1320 Main Street Coventry, RI 02816 Dear Mr. Szarek: Glen E. Harrington, R.S. of the Town of Barnstable Health Department did a lead paint determination of the home or apartment you own at 12 Hiramar Road on July 18, 2000. This determination found lead paint in violation of the Lead Law, Massachusetts General Laws, chapter 111, section 197, and the Massachusetts Department of Public Health's (DPH's) Lead Poisoning Prevention and Control Regulations, 105 Code of Massachusetts Regulations (CMR) 460.000. These laws require owners of homes or apartments built before 1978 to have lead paint violations deleaded for full compliance or brought under interim control when a child under six years old lives there. A private risk assessor has to do a risk assessment and give you a lead inspection/risk assessment report before you can go ahead with interim control. A private lead inspector has to do a lead inspection and give you a lead inspection report before you can go ahead with deleading for full compliance. If you already have a Letter of Compliance, contact this agency and the state Childhood Lead Poisoning Prevention Program, at 1 (800) 532-9571, immediately. The Order that comes with this letter has important information telling you: • what you have to do • what deadlines to meet • what documents you have to send to this agency • who can do the necessary work • what the penalties are for not meeting the Order's requirements. Please call me at this office at 508-862-4644 as soon as possible to discuss this Order and how to meet it. To help you take the first step—getting a full inspection or risk assessment—a list of lead inspectors is enclosed. We recommend that you check references and check if the inspector is still licensed. You can check on the license by calling the state Department of Public Health's Childhood Lead Poisoning Prevention Program (CLPPP) before hiring an inspector. To get a list of risk assessors for interim control, call CLPPP's central office at 1-800-532-9571. You can also get two other helpful materials from CLPPP. One is a guide explaining all the choices for full compliance deleading and interim control. The other has places to call to get money to help with deleading. Again, you can get these by calling CLPPP at the number above. Requirements for Doing Deleading Work High-risk deleading: If you need to or choose to have high-risk deleading work done, such as having lead paint stripped or scraped, you have to hire a deleading contractor. A list of deleading contractors is also enclosed. Just as in the case of inspectors, we recommend you check references and check if the deleader is still licensed. You can check on the license by calling the state Department of Labor and Workforce Development(DLWD) at 1-800-425-0004. Moderate-risk deleading: Before you or your agent can do moderate-risk deleading work, such as removing windows and woodwork, you have to take a course, pass it and get a certificate from CLPPP. These courses are given by a number of groups and organizations at various places, times and prices. To find out about when and where the courses are, call CLPPP at 1-800-532-9571. Remember that you still have to meet the deadlines in the Order. If a course for owners to do moderate-risk deleading is not available at a convenient time or place for you to meet the deadlines of this Order, you won't be able to do moderate-risk deleading work yourself. You then have to use other methods to delead, or hire a licensed lead-safe renovation contractor. To get a list of these contractors, or to check their licenses, call DLWD at 1-800-425-0004. Low-risk deleading: Before you or your agent can do only low-risk deleading work, such as covering surfaces, you have to read the CLPPP low-risk booklet, take a self-corrected exam that you send in to CLPPP, and get a certificate from CLPPP. If you want to encapsulate, you have to first call CLPPP's encapsulant coordinator, who will go over your inspection report with you and discuss surfaces that may be good for encapsulation. You have to read CLPPP's encapsulation booklet, take a self-corrected exam that you send in to CLPPP and get a certificate from CLPPP. To get a free copy of the low-risk booklet, or to speak to the CLPPP encapsulant coordinator, call CLPPP at 1-800-532- 9571. f Interim control work: If you or your agent will be doing other work for interim control, such as structural repairs and cleaning of leaded dust, you have to take safety steps and clean up in the way described in the CLPPP booklet for interim control. To get a copy of this interim control booklet, call CLPPP at the above number. Deleading work has to be carefully done to be safe. To protect the people who live in the home or apartment, you have to keep them out of the home or apartment, or area being worked on, in these ways: • All people and pets have to be temporarily moved from the home or apartment for the whole time that high- or moderate-risk deleading work is taking place inside the home or apartment. You have to provide the residents with a reasonable alternative place to live for this period. People and pets who have been temporarily moved from their home or apartment can only come back after a licensed private lead inspector or licensed private risk assessor says it is safe for them to return. The inspector or risk assessor does this after reinspecting the home, including taking dust samples to assure that lead dust levels meet approved standards. This reinspection will be done at least three hours after deleading work is all done. • People and pets have to stay out of the work area while you or your agent does most low-risk deleading work or structural repairs or cleaning of lead dust. They also have to stay out of the work area while there's any deleading work in common areas outside the home or apartment, as long as they have another regular way (not a fire escape) to go in and out of the building. In these cases, people and pets can use the area after cleanup following the end of the work in that area. • People and pets have to stay out of the home or apartment for the workday while you or your agent put coverings over a surface with peeling, chipping or cracking lead paint or plaster, or during applying of encapsulants with an airless sprayer. They also. have to stay out for the day during deleading in common areas when they do not have another regular way (not a fire escape) to go in and out of the building. When people and pets are out of their home or apartment for the day, it means they can come back to the home or apartment after cleanup at the end of the workday, and don't have to be out overnight. All work for deleading and interim control has to be neatly and properly done, in a professional way, and the home or apartment has to be returned to a condition that meets the requirements of the State Sanitary Code. Deleaded surfaces can't be repainted until after they have passed reinspection by a licensed private lead inspector or risk assessor. You have to give written notice about common area lead paint violations to all other residents of the building. "Notice to Tenants of Lead Paint Hazards" is enclosed for that purpose. You also have to send a copy of the lead inspection report or lead inspection/risk assessment report, and any reinspection reports, to all mortgagees and lienholders of record. If you have questions about the Department of Public Health's Lead Poisoning Prevention and Control Regulations, you can ask me, or call the CLPPP central office (1-800-532- 9571 or 617-753-8400). If you have questions about the Department of Labor and Workforce Development's (DLWD) Deleading Regulations, you can ask me, or call the DLWD central office (1-800-425-0004 or 617-727-1933). Remember to refer to the attached Order for more informatio about what you have to do. Inspector Director l Telephone:602) �J BHCOV.DOC 1/2000 PAGE 1 r ;6 POE THE rti o� Town of Barnstable ' BARNSfABLE. « Regulatory Services MASS. 039. Thomas F. Geiler,Director Public Health Division Thomas McKean,Director 367 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 ORDER TO CORRECT VIOLATION(S) July 19, 2000 Milton Szarek 1320 Main Street Coventry, RI 02816 Owner or agent of the property located at 12 Hiramar Road, Hyannis: Be advised that an agent of the Board of Health has determined certain portions of this residential property to be in violation of the State Sanitary Code, 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. If you already have a Letter of Compliance, contact this agency and the state Department of Public Health Childhood Lead Poisoning Prevention Program (DPH/CLPPP), at 1 (800) 532-9571, immediately. Be prepared to forward your paperwork, including Letter of Compliance, and all lead inspection and reinspection reports to this agency and DPH/CLPPP. In most cases, the law gives you a 30-day maintenance period to repair violations after a Letter of Compliance exists, but if so, that time begins to run with your receipt of this Order. 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 Massachusetts Department of Public Health Childhood Lead Poisoning Prevention Program and the Board of Health declare that the presence of this violation of the Lead Law and the Regulations for Lead Poisoning Prevention and Control constitutes an emergency pursuant to the Lead Law, MGL chapter. 111, section 198 and within the meaning of the Sanitary Code, 105 CMR 400.200(B). CORRECTION OF LEAD VIOLATION(S) The Lead Law, MGL c. 111, §§189A-199B, and the Department of Public Health's Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000, require the owner of a residential premises or dwelling unit built before 1978 in which a child under the age of six lives have lead paint violations either abated and contained (referred to as "deleading") for full compliance or brought under interim control. 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 Report before you proceed. 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 residential deleading work be done by appropriately trained and authorized people. Any high-risk deleading activities — primarily stripping and scraping lead paint to bare substrate —must be performed by licensed deleading contractors. Moderate-risk deleading work — removing windows and all residential surfaces with the exception of walls and ceilings, as well as making intact small areas of deteriorated lead paint — may be performed by an owner or owner's agent after taking the course of instruction and meeting the requirements of 105 CMR 460.175, or licensed lead-safe renovation contractors. Low-risk deleading — mainly applying coverings, such as carpet, vinyl, Sheetrock, aluminum, plywood, Plexiglas and acrylic, to surfaces, applying encapsulants and removing doors—may be performed by owners and owners' agents who meet the requirements of 105 CMR 460.175. These rules on who is authorized to perform what kind of deleading work apply whether the work is being done for full compliance or for interim control. An owner or owner's agent may also make structural repairs, as defined in 105 CMR 460.020, and clean leaded dust, as may be required for interim control. ORDER You are hereby ordered to remedy all violations of MGL c. 111, §197 and 105 CMR 460.000, as identified by a licensed private lead inspector. 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 or copies of 1) the Lead Inspection/Risk Assessment report of the licensed private lead inspector or risk assessor, and 2) a signed contract or contracts with people authorized to perform the risk level or levels of deleading work involved (referred to as "authorized persons"). If you or your agent will be doing moderate-risk or low-risk deleading work, you must also provide within sixty (60) days a copy of your or your agent's certificate of instruction. Any contract or contracts must specify, and if you or your agent will be performing work, then you or your agent must attest in writing, that the work will be completed according to the following schedule: (a) Within ninety (90) days of your receipt of this Order: Abatement of interior dwelling unit violations must be completed. In addition, any interior doors that were abated must be in place, any surface preparation necessary for encapsulation must be completed and any interior dwelling unit surfaces that contained loose lead-based paint at the initial inspection and were covered as a low-risk activity while still loose must be completely covered. Finally, any such work must be documented by a private lead inspector, or for interim control a private risk assessor, to have been satisfactorily completed within this timeline. (b) Within 120 days of your receipt of this Order: Any interior common area and exterior deleading work, and any remaining interior dwelling unit low- risk deleading work or interim control work must be completed. Any such work must be documented by a private lead inspector, or for interim control a private risk assessor, to have been satisfactorily completed within this timeline. Dust sample results and reinspection report(s) issued by the licensed private lead inspector or risk assessor must be submitted to this agency, along with the compliance document. Any contract with an authorized person must specify, and if you or your agent will be performing deleading work without a contract, you are responsible for making sure, that the unit meets acceptable lead dust levels under 105 CMR 460.170, as determined by the results of sampling done by the licensed private lead inspector or risk assessor. Should any of the dust samples fail to meet acceptable standards, the last authorized person who performed high- or moderate-risk work will be required to reclean the entire unit until all dust samples meet acceptable levels, unless dust samples fail three times, in which case a licensed deleader will be required to reclean the entire unit until all dust samples meet acceptable levels. In the event that no high- or moderate-risk deleading work occurred, the authorized person who performed low-risk deleading work will be required to reclean the entire unit until all dust samples meet acceptable levels, again, subject to the same condition stated above in the event dust samples fail three times. PROSECUTION AND CIVIL PUNITIVE DAMAGES Failure to comply with any of the deadlines set out above will require this agency to initiate criminal or civil proceedings against you within seven (7) business days. Compliance with this Order will be determined by this agency's receipt of the appropriate documents within the specified deadlines. The documents consist of the following: a) the initial Lead Inspection/Risk Assessment report of the licensed private lead inspector or risk assessor, and, if any deleading work is necessary, a copy or copies of a signed and dated contract or contracts with authorized persons; b) if you or your agent will be doing moderate- or low-risk deleading work, a copy of your or your agent's certificate of instruction, and if you or your agent will be doing such work or structural repairs and lead-dust cleaning for interim control, a signed written statement attesting that the work will be completed in accordance with the required timelines; c) a Letter of Lead Paint (Re)occupancy (Re)inspection Certification issued by a licensed private lead inspector or risk assessor, in cases in high- or moderate-risk deleading work occurred, 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, and copies of all reinspection report(s) issued by a licensed private lead inspector or licensed private 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, you must make sure this agency receives a copy of the deleading notification(s) at least ten (10) days before the start of any deleading, no matter who is performing the work, whether it is for full compliance or interim control. The law provides penalties of up to $500 for each day of noncompliance. 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. CORRECTION OF VIOLATION BY CODE ENFORCEMENT AGENCY If within the time periods stipulated above this residential property is not brought into full compliance or interim control, this agency may contract with an authorized person or authorized persons 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 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. . `terzLX;i Inspector Director Q Telephonbg- Certified Mail No. BHOTCDET.DOC 1/2000 oFtHE lo,,, Town of Barnstable Regulatory Services • saxrrsTastE. Mass. Thomas F.Geiler,Director 1639. MA'�A Public Health Division Thomas McKean,Director 367 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 DISCLAIMER CONCERNING LEAD DETERMINATION REPORT The information contained in this report concerning the presence of lead paint does not constitute a comprehensive lead inspection. The surfaces tested represent only a portion of those surfaces that would be tested to determine whether the premises are in compliance with the Massachusetts Lead Poisoning Prevention Law(Massachusetts General Laws,chapter 111,sections 189A through 199B). Serious lead poisoning hazards are created when materials containing lead paint are disturbed, unless proper safety guidelines are followed.Therefore,Massachusetts's law requires that: A licensed deleader must do all high risk deleading, such as scraping or the use of caustics. Property owners, their unlicensed agents, and licensed lead-safe renovators may do some deleading activities without a deleader's license. Before they do so, though, owners, their agents, and lead-safe renovators must become trained and receive authorization to perform these activities. Owners and their agents should contact the Childhood Lead Poisoning Prevention Program for more information on the specific activities they may perform and on how to become trained and authorized to perform these deleading activities. Lead-safe renovators are licensed by the Department of Labor and Workforce Development and should contact them for training and authorization requirements. Letters of Full Compliance will be withheld if unauthorized deleading has occurred. Any renovating or rehabilitation of premises containing dangerous levels of lead paint must be done in compliance with the procedures set forth in the Deleading Regulations issued by the Department of Labor and Workforce Development (454 Code of Massachusetts Regulations 22.11), including sealing off the work area from adjacent areas, and performing a thorough clean- up. Any deleading work done on the basis of this report will not qualify the property owner for a state income tax credit, nor will the cost of such deleading be reimbursable under any state loan or grant program. In order to qualify for such programs, the premises must first be subject to a comprehensive lead paint inspection. If a child under six resides in this dwelling, the property owner may face criminal or civil liabilities unless all lead paint violations have been corrected.This lead report cannot assure that the property owner has met his or her obligations under the law. It is unlawful for rental property owners to use the presence of lead as the basis for discrimination against tenants or potential tenants with young children. it J's P��FTHET��` TOWN OF BARNSTABLE OFFICE OF = e AB& MA68. BOARD OF HEALTH 7 039. 367 MAIN STREET RFD MPY k\ HYANNIS, MASS. 02601 LEAD DETERMINATION REPORT FORM Date of Determination: -- i- I Inspector: C- C, ivtg't,b1, License#: ID 4 J Method Used: l,'-Sodium Sulfide Expiration date: 2COV -- X-Ray Fluorescence Model: f Serial 9: Property Address: t Z tr i"G`6,,a✓ 90ad Apt. # A-� Description of Property: Single family .Z �-Multi-family # units Garage Fence Other structures Age of Property: xe--_Pre-1978 Post-1978 Occupant: F@,I Ke, Occupants under six years of age: 5yati fe �ef5�)o� DOB: 8 - 25- 9 4/ DOB: DOB: Occupant's Telephone: -7 7 f- 7 KS-0 Property Owner(s): slit i/-jfy-�:f: T(Ae.-r1'0. 22 w,%-- k Owner's Address: /3Z0 4?A.,:--, Ste' b y-eC, y 2 0 2 0, Owner's Telephone: 9 U/Z / s s"-00 -F'a K 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 ownedagent 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. CANV P50\LEA D 1995\G EN EPA UNO LTR 11 EA D\LEA D REPT.DOC 12196 f r rr� LOCATION SOURCE Pb 1. Child's bedroom Window parting bead/exte> r� area 2. Child's bedroom Window sill 3. Living room Window parting bead/exterior sill area 4. Kitchen Window parting�Pad/.e:oerior sill area5 (Cie P05 5. Interior Flaking paint 6. Exterior Flaking paint' G si d� deav rpa, /(A 7. Exterior Cellar window units 8. Exterior Window . ' s below 5' 9 Sod- c(,,►d% 1 e W, fas. 9. Exterior Main entry door casing 10. Interior Outside corner of baseboard 11. Kitchen or Bathroom Chair rail - - 12. Bathroom Window sill 13. Exterior Threshold C t;& rew Q•i.,t�►- 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/Outbuilding Door casing or jamb 24. Interior Closet door or baseboard (uncapped) 25. Interior Cabinet door, shelf, or wall Ck/ 1 u /f J4/ CC/ Cep &of 4A� �2 A S< cl� zcl C:\WP50\LEAD1995\CENERALINOLTRHEAD\LEADREPT.DOC 12/96 sy�^t:�:..4'r+"ar�!++,...is•?br,._....,'2 ,�rw:o -. "..w.. �-.^e _. T3'r!-i�,rFTswsy'i�4+4.+n�'ra"i1'M"�'+f'xb..+.•, ��.:>x�•i�fwll4Ck's......-Y+`^*t�Y'?�"A.r.;_t.i.4-.;,.{� ?«„1•: { TOWN OF BARNSTABLE BAR-W ��} � -• i V. Ordinance or Regulation g ' WARNING NOTICE { _ C. Name of Offender/Manager`4! I / MA /L �&Abl , MA,jarAddress of Offeder• ( �aP PD-AP, �� . MV/MB Reg.# Village/State/Zips. / � �� , -A r Business Name { r r �-� / i � am P-m�, on 2 0 Business Address Signature of fEtlnfa=c ng Office4r Village/State/Zip v Location of Offensef Enforcing°Dept/`DiOirsion Offense " V Facts /1 7/I, - or This will serve only as a warning. At this time no leg ,l ..actfion has been aken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are` " attempts to gain voluntary compliance: Subsequent violations will result %in appropriate legal action by the Town. : =K,.N � W CANARY ORD./REG.-PROG PINK-ENFORCING OFFICER GOLD-ENFORCINGDEPT. RITE-OFFENDER .. ..-: . ..+.y{T.,,Lr..s_^ti..s•.,r .:.�.!.._;-.�.-..-.-,.-.n+�-.-,...--.sr+._.�wi..,-..�;--'a•..mrv-,:;�.rye'iv.��r•,r�.�.?�i�lyys,..✓..,,.w..-�t^'in.,..'.tw.!1..'�..f+^»r .•+'7.,...c+wqb-.Ftir,...'�1...«•....v,�.•.•..-^.dr. s�.,�..-.y3..,y:: . TOWN OF BARNSTABLE BAR-W }Fs=: - Ordinance or Regulation v , WARNING NOTICE '.- Name of Offender/Manager / 1r- M (. A b y .Address of Offender ,� P A l)o P .HN/MB Re # •Yt �. �l J' t - - � i g' � Village/State/Zip ('T 1I k a A � f �//7* )/ Business Name ,-. I(A4z)pm, of 20 .e� 11� Business Address Signature of/EnfoArcing Officer Village/State/Zip Location of Offense ' e En*orcing' Dept�Di'sion Offense �j Facts 1 J ./ i plx*),_� MfM eg-20A W) �lzlje, CZAAW� 8fiP,69--6 02jMAI 14) IC Y SvA TWAY' or, This will serve only as a warning. At this time no lega1l 'act!ion has been�'taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result % in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER' GOLD-ENFORCING DEPT. ! ' ` TOWN OF BARNSTABLE BAR-W r 06 2 Ordinance or Regulation ` WARNING NOTICE f) Address of Offender ,' i 1 '"� `!_ t , MV/MB Reg.# -t Village/State/Zip Business Name I E am% op, J 4 20L/ Business Address f t Signature of/Ehforcing Office,-r 1 Village/State/Zip Location of Offense Enforcing Dept�Division # r a } -T, Offense [k1P/ 4 % 1 } Facts in -y.�z , Y ,-�4PA This will serve only as a warning. At this time no legal action has been/taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result , in appropriate legal action by the Town. {� WHITE-OFFENDER CANARY-ORD./REG.-PROG. '.';NK--ENFORCING OFFICER GOLD ENFORCING DEPT. Z 273 502 631 US Postal Service /0--10 �+ Receipt for Certified Mail e'- No Insurance Coverage Provided. i Do not use for International Mail a reve,ue Se Str a Numb P s Office,State, ode Postage $ Certified Fee Special Delivery Fee Restricted Delivery Fee Return Receipt Showing to Whom&Date Delivered n Return Receipt Showing to Whom, Q Date,&Addressee's Address 0 TOTAL Postage&Fees $ CO Postmark or Date - �® E ' 0 LL W a Stick postage stamps to article to cover First-Class postage,certified mail fee,-and f charges for any selected optional services(See front). 1. If you want this receipt postmarked,stick the gummed stub to the right of the return; i address leaving the receipt attached, and present the article at a post office service y window or hand it to your rural carrier(no extra charge). 2. If.you do not want this receipt postmarked,stick the gummed stub to the right of the Q) return address of the article,date,detach,and retain the receipt,and mail the article. It U) 3. If you want a return receipt,write the certified mail number and your name and address °) M on a return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space permits. Otherwise,affix to back of article. Endorse front of article a RETURN RECEIPT REQUESTED adjacent to the number. Q 4. If you want delivery restricted to the addressee, or to an authorized agent of the addressee,endorse RESTRICTED DELIVERY on the front of the article. co M 5. Enter fees for the services requested in the appropriate spaces on the front of this E receipt. If return receipt is requested,check the applicable blocks in item 1 of Form 3811. o I tL 6. Save this receipt and present it if you make an inquiry. 102595-99-M-0079 a i i i UNITED STATES POSTAL SERVICE First-Class Mail . Postage&Fees Paid USPS Permit No.G-10 0 Print your name, address, and ZIP Code in this box C Tom of F.O.8otrc53� ^. ...011 11�3.?'filli3flfFillfi}FIfI�`£�iiF£If1F!!}1311Filfil�iilFflil�F{I ai SENDER: I also wish to receive the D ■Complete items 1 and/or 2 for additional services. rn ■Complete items 3,4a,and 4b. following services(for an ■Print your name and address on the reverse of this form so that we can return this extra fee); ,•card to you. ■Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address permit. d ■Wdte'Retum Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery rn r ■The Retum.Receipt will show to whom the article was delivered and the date C delivered. Consult postmaster for fee. 0 3.Article Addressed to: 4a.Article Number s�9 C E 4b.Service Type d ❑ Registered iq Certified a N (l ❑ Express Mail ❑ Insured lZ ❑ Return Receipt for Merchandise ❑ COD 0 J Q� 7.Date of Delivery O 5.Received By:(Print Name) 8.Addressee's Address(Only if requested W and fee is paid) t t— � 6.Sig�- ddre,,,ssee or ent) PS Form 381'1, Decernbe�1994 '' ' 1o2e96-97-B-01'7'9 Domestic Return Receipt _ TOWN OF BARNSTABLE m m ,1 LOCATION �l r/�i` ��2 /•I obi SEWAGE # VILLAGE Z4/, yri/!C ASSESSOR'S MAP 8c LOT INSTALLER'S NAME&PHONE NO. h� SEPTIC TANK'CAPACTTY /J o y LEACHING FACILITY: (type) /-l/7"/ FOR S (size) .� NO.OF BEDROOMS BUILDER OR OWNE "R'j - PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted"Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) -Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) _ Feet Furnished by ' 4 7 1 I Q o I� i Town of Barnstable Regulatory Services- Thomas F. Geiler, Director y, Public Health Division • BARNSTnaL& 9cb "�; ��� Thomas McKean, Director A'fD"i10�a 367 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 July 21, 2000 Milton Szarek 1320 Main Street Coventry, RI 02816 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY CODE H, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE, ARTICLE 51 The property owned by you located at 12 Hiramar Road, was inspected on July 18, 2000 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: 410.351: Electrical outlets were observed to be broken, without cover plates and inoperable in the living room and child's front bedroom. 410.480: The locks on the rear entrance door were observed to be inoperable. 410.500/452: The front entry was observed to be rotted where the support posts meet the roof. The entry is considered unsafe. 410.500: Facia boards at the rear side of the house were observed to be rotted. There was evidence of entrance of pests. 410.500: A hole from the rear bedroom door knob was observed in the wall. 410.500: - Chipped paint and plaster was observed in living room and bathroom. 410.500: The carpet in the living room was observed to be stained and worn where it is considered uncleanable and unsanitary. 410.501: The rear door was observed to be broken and not weathertight. 410.502: Lead paint was observed via lead paint determination using sodium sulfide. Order letter enclosed. 410.504: A hole was observed in the wall by the bathtub. The sheetrock appeared moldy and soft caused by water damage and lack of seal around tub/shower enclosure. f 410.602A/D: The yard was left without loam and seed after septic repair. There is potential for transmission of disease by leachate inpacted soil. Loam and seed must be provided. You are directed to correct the violations of 410.351 and 410.452 within twenty-four (24) hours of receipt of this notice. You are also directed to correct the remaining above listed violations within seven (7) days of receipt of this notice. You may request a hearing if written petition requesting same is received by 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. I PER ORDER OF THE BOARD OF HEALTH ac_V� C:IZ_,) A"r"`"'r . Thomas A. McKean Director of Public Health Enc. gold copy of inspection report Town of Barnstable OF THE t0� Regulatory Services Thomas F. Geiler,Director BARNSrABLE, 1639.MASS. ,� Public Health Division Thomas McKean,Director 367 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 DISCLAIMER CONCERNING LEAD DETERMINATION REPORT The information contained in this report concerning the presence of lead paint does not constitute a comprehensive lead inspection. The surfaces tested represent only a portion of those surfaces that would be tested to determine whether the premises are in compliance with the Massachusetts Lead Poisoning Prevention Law(Massachusetts General Laws, chapter 111, sections 189A through 199B). Serious lead poisoning hazards are created when materials containing lead paint are disturbed, unless proper safety guidelines are followed. Therefore,Massachusetts's law requires that: A licensed deleader must do all high risk deleading, such as scraping or the use of caustics. Property owners, their unlicensed agents, and licensed lead-safe renovators may do some deleading activities without a deleader's license. Before they do so, though, owners, their agents, and lead-safe renovators must become trained and receive authorization to perform these activities. Owners and their agents should contact the Childhood Lead Poisoning Prevention Program for more information on the specific activities they may perform and on how to become trained and authorized to perform these deleading activities. Lead-safe renovators are licensed by the Department of Labor and Workforce Development and should contact them for training and authorization requirements. Letters of Full Compliance will be withheld if unauthorized deleading has occurred. Any renovating or rehabilitation of premises containing dangerous levels of lead paint must be done in compliance with the procedures set forth in the Deleading Regulations issued by the Department of Labor and Workforce Development (454 Code of Massachusetts Regulations 22.11), including sealing off the work area from adjacent areas, and performing a thorough clean- up. Any deleading work done on the basis of this report will not qualify the property owner for a state income tax credit, nor will the cost of such deleading be reimbursable under any state loan or grant program. In order to qualify for such programs, the premises must first be subject to a comprehensive lead paint inspection. If a child under six resides in this dwelling,the property owner may face criminal or civil liabilities unless all lead paint violations have been corrected. This lead report cannot assure that the property owner has met his or her obligations under the law. It is unlawful for rental property owners to use the presence of lead as the basis for discrimination against tenants or potential tenants with young children. q/wpAeadsisc