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HomeMy WebLinkAbout0141 LINCOLN ROAD - Health 141 Lincoln Road,Hyannis A= e o - o I C 1 I I I � I ` Town of Barnstable P#- I j 207 �t►+F Department of Re P gulatory Services aean L Public Health Division 'MASS Date 200 Main Street,Hyannis MA 02601 Date Scheduled_3i Tune / Fee Pd. Soil Suitability Assessment for Sewage is osal Performed By: c5T�V/ -C�1 /�y9�-s Pe P Witnessed By: rig t/ l v, Location Address LOCATION& GENERAL INFORMATION / / / [2 ' Owner's Name Gad!✓1 r J Address �� �. M Co�t-►� '� Assessor's Map/Parcel: _ l Engineer's Name Z A, 1� ,mac NEW CONSTRUCTION REPAIR ,R iVuss 1, Telephone# Si '- Land Use /Z C'�i i]CvJ n A'r Slopes(So) -L - Surface Stones /-w Distances from: Open Water Body_ _ft 'Possible Wet Area "— ft Drinking Water Well — ft Drainage Way 1 . Property Line rU+ ft Other ft I SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) QV too 2 v Parent material(geologic)bu'Tw i4:S H Depth to Bedrock 2vU Depth to Groundwater. Standing Water in Hole: i N A- Weeping from Pit,Face A)1-4 Estimated Seasonal High Groundwater---.) A Method Used: DETERiVIINATION FOR SEASONAL HIGH WATER TABLE Depth Observed standing in obs.hole: Depth t0 sgll mottles: Depth to weeping from side of obs.hole: ft. Index Well# in, Groundwater'AdJustment in Reading Date: index Well level „ Adj,factor, , ,t,dj,Groundwater Level,,, PERCOLATION TEST sttp':318 Observation Hole# Time at 9""., l it Depth of Pero `{ Time at 61' Start Pre-soak Time Q D_vL Time(9"-6" End Pre-soak L-I•S A I J Rate MinJlnch 4 Site Suitability Assessment: Site Passed_ Site Failed: Additional Testing Needed(Y/N) io Original: Public Health Division Observation Hole Data To Be Completed on Back---------; ***If percolation test is to be conducted within 100' of wetland ,you must first notify the Barnstable Conse>lvation Division at least one (1) week prior to beginning. Q:IS EPTICIPER CFORM.DOC DEEP-OBSERVATION HOLE LOG' ole# Depth from Soil Horizon Soil Texture Soil Color Soil Surface(in.) Other (USDA) (Munsell) Mottling; (Stnucture,Stones;Boulders. y ,� ostency 96 l3ravPn L i U etc- {}r i -------------- DEEP OBSERVATION HI(LMunsell) OG �Jialc a �_Depth from Soil Horizon Soil Texture. Color Soil Other Surface(in.) (USDA) Mottling (Structure,Stones,Boulders. on i en % ravel 3 ------------- DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.). (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Con it DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsistency, Flood Insurance Rate Map: / Above 500 year flood boundary No_ _ Yes V .Within 500 year boundary Noz, Yes,: . Within 100 year flood boundary No Yes • i Depth.of Naturally Occurring Pervious Material Does at least four feet of naturally occurring perviot}�s material exist in all areas gbserved throughout the area proposed for the soil absorption system? ' If not,what is the depth of naturally, occurring pervious material? . Certification 9 I certify that on (date)I have passed the soil evaluator examination approved by the Departmentlof E e 1 Protection and that the above analysis was performed by me consistent with . the required t aining;ex er sea d experience described in�10 CMR 15;017, Signature Date Q:%S HPTl0PERCFORM.DOC ,7 TOWN OF BARNSTABLE LOCATION wt L it.(CIxL iZ SEWAGE# VILLAGE sE-t, !( ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. . SEPTIC TANK CAPACITY (-:—Y— LEACHING FACILITY: (type) (size) ��� X I NO. OF BEDROOMS OWNER 9-7J,4 L�'� PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: s o 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 a�y e O r . a No. 02 0 I I -0 q c2 Fee V U THE COMMONWEALTH-OfMASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for Disposal *pstem Construction Permit Application for a Permit to Construct( ) Repair(.</Upgrade( ) Abandon( ) ❑Complete System 4ndividual Components Location Address or Lot No. /t/ [•jn�jh� ( , Owner's Name,Address,and Tel.No. Assessor's Map/Parcel o?7p /,1g 5 51 e&P4' L'•."§ Ad. oe-,01e«alp X 4- !J Instal er's Name,Address,and Tel.No.S -7�/-93?9 Designer's Name,Address,and Tel.No.-OV 369 ` '913X �tc�,' C'An sfirucj-i cn�,•i-.vac• �y fe�rt�ey�n�,:inc• ��,?3 ��fot4 Type of Building: n_ Dwelling No.of Bedrooms Lot Size u'4a'I4a�!5 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3 U gpd Design flow provided qV6 gpd Plan Date 1 p Number of sheets 1 Revision Date Title d1*ft ' �v?o Size of Septic Tank Type of S.A.S. r ' Description of Soil -150' Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and ance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environm tal Co and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Healt f Su'gKdA Date 41'. r Application Approved by Date Application Disapproved by Date for the following reasons Permit No. n °l Date Issued l r No. a D 11 , 0 01.2 ` E< Fee da THE COMMONWEAL;Ii ?MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS es \ y 2pplitatlon for bisposal *pstemAtonBtrUction Permit Application for a Permit to Construct( ) repair(Upgrade( ) ,Abandon( ) ❑Complete System TIndividual Components Location Address or Lot No` Owner's Name,Address,and Tel.No. ly/ Lincvinf 5'l�,nle� Assessor'sMap/Parcel n? y�aMrSSg �7� JIle Assessor's Installer's Name,Address,and Tel.No. 93g9 Designer's Name,Address,and Tel.No. S!s ,36 L9 g, l�r�r'�ti`fi C�Unsh�uc-; v,c • 8q1& SUr__ft rn , Inc 9,?-3 bs" low Type of Building: _ Dwelling No.of Bedrooms Lot Size 0 G a�ueS sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required)) gpd Design flow provided gpd Plan Date ��� ►_ nn11 1 Number of sheets ( � Revision Date Title��s „^A� b� l E34 , U I c `r� A Size of Septic Tank (__ ,, =r�—Type of S.A.S. � � j � ,r Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and mama ance of the afore described.ori"site sewage disposal system in accordance with the provisions of Title 5 of the Environme tat Co and not to place the system'in operation until a Certificate of Compliance has been issued by this 7Ze Si ed DateApplication Approved byDate / Application Disapproved by Date for the following reasons Permit No, n 1 �} °12 Date Issued v ---------------- -_ -.-.c_-.-.-. -` _ .----- ----.------------------------------------• THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(( Upgraded( ) Abandoned( )by e, a at j/��j /�y,I J- Ali� �_4 f_r has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.�?0/J_ a A 2- dated Installer A I � Art Designer vst- - 9�r fir' E„�'C—I~-en`�r� #bedrooms _3 Approved design flow jgpd The issuance of this pe it shall not be construed as a guarantee that the system will i c i' a( designed. Date Ll Inspector V. C No. o I 1 - o a2 Fee- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal *pstem onstrnctlon Permit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at 7� ;n C0 1 0. a4l 4 J 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 perm' . _ Date Q IV 1 r^ Approved by 1 Town of Barnstable �p THE T Regulatory Services x Thomas F. Geiler,Director • BARNSTABLE, + 639MASS. � Public Health Division prFDMA+A Thomas McKean, Director 200,Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form A Date: 47461I Sewage Permit# al0//- ©%Z Assessor's Map\Parcel z10 Is e, Designer: Installer: ile�il,� ��✓f�<�✓ E*46F SOT-Ve�eo V4. i Imo. Address: qn, e CoA Address: �!`�`��, ��► On y— $ 4W//-4�fl" was issued a permit to install a (date) (installer) septic system at t q t L/A_�C _x_kD based on a design drawn by (address) ST2 A . .4-AA-S dated 4 t (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. 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. 9 qA.q CIVI e (Installer's Signature) No. 461 :�➢i �i qa Desi ners Signature)( ' g g ) (Affix Design 's Stamp 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. Q:\Septic\Designer Certification Fonn Revised.doc rr t Town of Barnstable Department of Health, Safety, and Environmental Services BAMSTABM ' ,.� Public Health Division '0rfn '�A 367 Main Street,Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean,RS,CHO FAX: 508-775-3344 Director of Public Health Mr.Trudy Sumner February 29, 2000 141 Lincoln Rd. Hyannis, MA 02601 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY CODE II, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE,ARTICLE 51 The property owned by you located at 141 Lincoln Rd., Hyannis was inspected on February 24, 2000 by Glenn 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 II, Minimum Standards of Fitness for Human Habitation were observed: 410.452 Basement stairs were observed to have a broken stringer and inadequate treads. 410.482 Inoperable smoke detectors observed in basement and first floor. The basement bedroom was more than 50%below grade and did not have two— means of egress. 410.500 Rear stairs are missing. Unsafe to exit due to distance from the rear first floor to ground is greater than eight inches. 410.501 Broken window observed at the rear door. 410.504 Rotted bathroom floor observed. 410.505/602B Unsanitary conditions. Dust and construction debris throughout. Occupant has been renovating the home without obtaining a building permit. 402.602 Ferret feces were observed on the floor. You are directed to correct the remaining above listed violations within seven (7) days of receipt of this notice. KS-q/wpfiles/order I - In addition,the basement bedroom must be vacated within fourteen(14) days. You shall obtain a building permit prior to any construction work, including the construction of a bedroom in the basement. 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. It should be noted that the house was under renovation particularly in the kitchen area. Several boards were observed on the kitchen floor with screws protruding out of them exposing sharp edges. You are ordered to remove the ferret feces and to replace or repair the smoking detectors within 24 hours of receipt of this order letter. Please be advised that failure to comply with an order could result in a fine of not more than$500. Each separate day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health KS-q/wpfiles/order aw HOBBSBWARREN'M THE COMMONWEALTH OF MASSACHUSETTS FORM 30 C BOARD OF HEALTH CITY/TOWN 4-1 o DEPARTMENT �- ADDRESS ' ? TELEPHONE Address / , L-I �r1_ � Occupants 1^VA"aGGv Floor Apartment No. _No.of Occupants No.of Habitable Rooms__No.Sleeping Rooms 3 No.dwelling or rooming units / No.Stories__ Name and address of owner Ste®S �a e_h Al 0 cf t tom, Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: to } 6L /Ot-&l Dual Egress: and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: v Roof & &.Fw t— Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: kaae le 4-CS3 �d1Y.v Dampness:, 4y Lak cam. (,. b Ide, Alri,-i f 1� ("v. 3o Stairs: r 41 Li htin : 30 CCU.Y S STRUCTURE INT. Hall,Stairway: fJ S d t ✓t ►� Obst'n.: C / Hall, Floor,Wall,Ceiling .4a 4.p-de n.y-�!ctvV.0-i d Hall Lighting ,Cr® w S�v� i Hall Windows: b S -v - 4-as 4tZ-v_,cf d'o C iu yW41/f HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: 71rc1 v, V--* ❑ MS ❑ ST ❑ P Waste Line: <D c H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: 10 AMP: Gen. Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT ®(GQ Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks , Kitchen Bathroom j2 Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: Stacks, Flues,Vents,Safeties: 011_ -✓i5 w- Kitchen Facilities Sink I(�-a✓ r ey Cam- / Stove Lj OL—GeA e eC f Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: tr►- r d� Wash Basin,Shower or Tub: 'T a.r 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 F PERJURY.' INSPECTOR a TITLE A.M. DATE TIME L l _ M A.M. THE NEXT SCHEDULED REINSPECTION P.M. � � ~ ' 4/0 /5u Conditions Deemed mEndanger � 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 ||. 1O5CMR410.100 through 41O.02O 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 aoa determination that � other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty ofthe local health official to order repair ovcorrection of such violation(s) pursuant to 105 CIVIR 410.830Vhmugh 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. KV 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 CIVIR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 SMR 410.201 or improper venting or use o«aspace heater orwater heater as prohibited by 105CMR41020O(B)and 410.202. (C) Shutoff and/or failure Vo restore electricity orgas. (D) Failure ko provide the electrical faoUhi�u required by105CMR41U.25UB). 41U.251(A). 410.253 and the lighting incom- mon area required by 105 CMR 410.254. (B Failure Vo provide a safe supply ofwater. (F) Failure to provide a toilet and maintain u sewage disposal system in operable condition as required by 105CIVIR 41O.15O(A)(1)and 41O.300. ' y3> Failure to provide adequate exits, or the obstruction of any exit, passageway orcommon area caused by any object, including garbage or.trash, which prevents egress in case of an emergency 105CMR 410.450, 410.451 and41O.452. (M) Failure to comply with the security requirements of 105 CIVIR 410.480(D). ^ . (|) Failure Vz comply with any provisions of 105CMR 410.000. 410.601 m41O.0O2which results in any accumulation ofgar- 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 acciderits 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 CIVIR 460.000. (See M.G.Lo. 111 @@ 19O through 1QSj (K) Roof,foundution, or other structural defects that may expose the occupant or anyone else tofire, bumy, ahoch, accident or other dangers orimpairment to health orsafety. (L) Failure to install e|eotrioa|, p|umbing, heating and gas-burning facilities in accordance with accepted p|umbing, hoeking, gan4Uffing and electrical wiring standards ov failure 10 maintain such hmi|U0000 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 CIVIR410.353. (N) Failure to provide a smoke detector required by1O5CIVIR41U.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 orconditions: (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 CIVIR 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 105CMR 410.503(A)and 410.503(B). ' (5) Failure to eliminate mdams, 000knoaohoe, insect infestations and c4ho/pests as required by 105 CIVIR 410.550. (P) Any other violation of 105 CMR 410i000 not enumerated in 105 CIVIR 410.750KV through (0)shall be deemed to be a con- dition whichmayondango/ormaterial|yimpairthehoakhoroafetyandweU'h*ingofanoonuparkuponUhofai|umofdhemwnor � 10 remedy said condition within the time no ordered by the Board ofHealth. ` a � � FORM30 `"IIw HOBBS&WARREN THE COMMONWEALTH OF MASSACHUSETTS w- ,z BOARD OF HEALTH CITY/TOWN a - DEPARTMENT y 36__Z 4la S� AAA , h� I� � 4 , A �` 3 - , ay0 # ADDRESS L( TELEPHONE Address��._Lc2j(q_ d� lt,;w _ _ OccupantQt�' ►44 - UC Ckyq Li Q Floor Apartment No—_--___ No.of Occupants_ No.of Habitable Rooms._67— No.Sleeping Rooms3_- No. dwelling or rooming units / No.Stories Name and address of owner----. a__CA vrj t y� r' Y Vl�ko cf ��'`Kp-1� Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: ' STRUCTURE EXT. Steps,Stairs, Porches: ( G� I J ?nMO. c;/&I 19/0t4d Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: FAC4.1 11010 0--t 4,wdd1.1 /a10c 4- GJad C{ Ylv So( Roof 4"A OV 6Ww 1" Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Udvrov- C HI i✓} -�c► (na.�re �G 'tr� G/�v<d�w Dam ness: 4.j fort d vv%L b A r 4«jf 4 it^ TO c40.y S , Stairs: S ' v OIMs d C-/ (D/ Q I-W i f I Li htin : c To 01&y3 STRUCTURE INT. Hall,Stairway: UOL Win j t k UAW+(Q (4vi f ,Dt i4 i(4 S ✓vdy+o Obst'n.: C U cLtexg cri S ka '44 5 f- - - Hall, Floor,Wall,Ceiling: 13ot, a -f -4v "(_,(pwwccloV49j tr • ate. Hall Lighting: XtIO ILL al 0 bj-,e vvP Hall Windows: bo&JI UtiU h a Z okvr do Cili Id fow Ha i f Q HEATING Chimneys: Central ❑ Y ❑ N E ui . Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: m-N Wa-4A^ ❑ 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 a L/ to�-f Bathroom it tp a take Pantry Den Living Room Bedroom 1 - t Bedroom 2 T Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten:,Gas, Oil, Elect.: Stacks, Flues,Vents,Safeties: j�C GtM .11? 4� - 1hj►!1t(*'C4 Kitchen Facilities Sink i�C( M '( -q✓ t j fCj01C 9P"ROA t Irl (!(lf Stove ►t.Pi+ a ec-f . Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: 5eA 4,1 ," q& FA 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 F PERJURY." INSPECTOR fev TITLE a, t/ A.M. DATE 3 2 TIME 7• �v P.M A.M. THE NEXT SCHEDULED REINSPECTION •_ +' ' P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shali 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. No. ;f- �`Boacd-& Health Dept. of Public Works .� SEPTAGE PUMPING TICKET Street Address (number) (street) (village) Owner's Name �� (first) (last) Gallons Pumped Date Pumped Source: ❑ Cesspool ❑ Septic Tank ❑ Grease Trap Reason: ❑ Scheduled Maint. ❑ Unscheduled Maint. ❑ Overflowing ❑ Backing Up into Building I hereby certify that the information contained on this ticket is true and correct to the best of my knowledge and belief,and is made under the penalties of perjury. ]/ Signature of Pumper v Pumper Company � Form 33 i F e♦ � e yo \ e � e t . • �4 i 4 1 A ,�� I-'tvt' I . ` -TOWN OF BARNSTABLE r Lf-)CAT'ON 1Ay'd 04 X/ SEWAGE # LLp.GE ,QAIAI/s' ASSESSOR'S MAP & LOT _ 13 INSTALLER'S NAME �: PHONE NO. � �I SEPTIC TANK CAPACITY LEACHING FACILITY:(type) 7' (size)fo d a NO. OF BEDROOMS ,3 PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: " DATE COMPLIANCE ISSUED _ VARIANCE GRANTED: .Yes No �' E i ` — ' r p� i'� �d 1�.� s / � � � e�. i -� - � ��' 4 E _�, -- t' �- � � I " f `� �. �• jp,�11��j' y �I a go N0..... ...�.( Fss........ ....3 .....0 THE COMMONWEALTH OF MASSACHUSETTS APPROVED BOARD OF HEALTH ;rble Conaery 'an Depa e� TOWN OF BARNSTABLE gned ,3� lirtt t for Di�ipimal lVor1w Tonitrnrthin ramit Application is hereby made for a Permit to Construct ( ) or Repair kX) an Individual Sewage Disposal System at: .141 Lincoln...Road Hy a n n-is----------------------------- -------------------•--•-•-----...------------..._..-----....------•--•-•-----------------.......-- Location-Address or Lot No. ....................................................................... ...........................................•----.............----.........................._...... Ow er Address P:MaeorerbAr c� =------------------ Installer Address UType of Building Size Lot............................Sq. feet DwellingX—No. of Bedrooms-------------3.............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ---------------------------------- W Design Flow............................................gallons per person per day. Total daily flow..._........................................gallons. WSeptic Tank—1 Liquid capacity.l.0.0-0galIons Length................ Width--------------.- Diameter_-............. Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..........1......... Diameter...6'............ Depth below inlet___.6-('........... Total leaching area..................sq. ft. Z Other Distribution box (X) Dosing tank ( ) 0.4 Percolation Test Results Performed by-------------------------------------------------------------------------- Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Lr Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Ri -----------------------------------•----••---------------------.....------------•---.......----•-..........-----•----.........-------•---..................-- 0 Description of Soil........................................................................................-----------------------------------------------------------------............--- x Sand & Gravel U -----------------------••-•----------.......---•----•------------------------------------.....------------•-------------•---------•---------------------------•--•--------...---....-----•----......---- W --------------------------------------------------- -----------------------------------------------------------------------------------------------•-------•-----•-----------------------------....... U Nature of Repairs or Alterations—Answer when applicable-------Om i_t---- e s s-p_o o i,____1.-_10 0 0_.- a l l o n tank 1.-distributi-on...b0«_-_1•-1000....g�j11on... each-._pit ack2c in stone . Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code —The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee i ued by the boa of ealth. Signed A(4*411/8/93 b - - ----P--.�'„l .. ... .. ........ .. DareApplication Approved By --- .�"" ............................................................ . . .�/,------L........ Dace Application Disapproved for the ollowin easons: .......................... ................................................................... ..... .. ............... 6.......................... ...................... . ........................ -----............................ ........................................ Dare PermitNo. ............. - Issued ..................................................................-- Date ,.�wW ti... y.,.• �. ,,. .`.u..,��.-_f•'�"-"�I i,:.,,,;-u�:.,..�;�-'�1i.....:.yr�-"`v`r'ary.�-.mow�._e � ..-vy_.--�--�-'- . - ,-r"-� - .--_. .�-� .-�"','.r .,-�. ._-_...a No..... 1 - S 30.00 THE COMMONWEALTH OF MASSACHUSETTS // 1 BOARD OF HEALTH TOWN OF BARNSTABLE I/ 9 �- Appliration for Diriplimal lVarkri C omitrnrtinn ramit Application is hereby made for a Permit to Construct ( ) or I.kepair (KX) an Individual Sewage Disposal System at: 141 Lincoln Road Hvannis ...-•....................................................--•----------•--•---................... .-•-•-•-------•---------•-----...•---••-•-------------••••----••--._.............-----------..---- Location-Address or Lot No. Centrella •----------•-----------------------•------ ----•------•--•------•--•-------------•--•------................................................. owner Address a n_.Ik rann.. a-:'----j-r--•-------•-••--•---•-•------•--•--••---•-------•------ • ..Ya__ _a �J i ________•_____________________________________________________'______...__________................ y Installer Address Type of Building Size Lot............................Sq. feet ..� DwellingX— No. of Bedrooms............3_____________________--------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOther fixtures ....................................................................................................................................................... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank i Liquid capacity.1-0.O.OgalIons Length---------------- Width................ Diameter................ Depth................ x Disposal Trench—No. ......:............. Width-------------------- Total Length................_--- Total leaching area....................sq. ft. Seepage Pit No-----_..._ .......... Diameter---6'............ Depth below inlet-__.5............. Total leaching area..................sq. ft. Z Other Distribution box (X) Dosing tank ( ) 0.4 Percolation Test Results Performed by-------------------------------------------------------------------------- Date...._...-----_------ .._.__._............ 1..4 Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.___.._......._......_... .fZ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ----•.............................•-----------------------------•--------------.............._...........................................-.................... ODescription of Soil....................................................................................................................................................................... Sand & Gravel U .--------------- . . . ----•------•--------------••--•-----------••-•---------•---•---•--•-----------•---......._...---•--------•-----.....--•-•----------=......••-- W VNature of Repairs or Alterations—Answer when applicable.__...Omit---cesspool ._...1-10 0 0._gallon tank 1—distribution bOx 1-1000 gallon leach pit packed in stone. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system 1 operation until a Certificate of Compliance has bee, is-ued by the board of ealth. Signed ------ .... /•� --.......................... .........1.1/8./9 3...... Dare Application Approved By ............. ._A........... .. ....b.:..--.-... _- ----^- ........._....-.--.....-......-............................. ....._l�..g_-5�---- --3 J Application Disapproved for the folloeasons: . ................. . . ...................`..................... .......................-- -------------- .......................................... ................................. . ... ........... ........ . . ......................................... .................................------- Date PermitNo. ------ ---`--- �d...25................ Issued ............................................................-...-.-. Date — _.— —moo------o .®__, --"I--------------------------------- win) . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (11-er#ifi a e of C11oznyliance t it THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (X XX) by J .P.Macomber Jr. .... -........................... ..._.......... - ........... -......................... ._.............................. t�,tanet 141 Lincoln Road Hyannis. at ....................................... ....... ......... ...... . ... ..... --------- .................. ...... ... ................. .... ............................. .. has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ...51.- .....ln...5............ dated ........................._--.-.-------...:... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTIONSATISFACTORY. DATE..........................��-- .� :.--.-.._../..__1.. _..._ Inspector .. ..y... .-_ ------..-----.-------------------------------- 71 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE 30.00 FEE........................ orkii Tunitrurtion Permit J P.Macomber Jr. Permissionis hereby granted..... ........•---------...---•---•--------------------------••--------•-----•----------- ................................................. to Construct ) or Repair (X ) an Individual Seivage Dispos System at No..141 Lincoln._ Road Hyannis.................................... Street ` as shown on the application for Disposal Works Construction Permit No,&42` & Dated............................... .......................................... //' _ �} Board of Health DATE. / ----- --•.�.......................... FORM 36508 HOBBS&WARREN.INC..PUBLISHERS s Dec 1997 �' °wrooF D AT E : 1 197N' �NDFPjj���' PROPERTY ADDRESS: Anne--Centrella y � 141 Lincoln Road Hyannis,Mass. 02601 1 On the above date, I Inspected the septic system at the above address. This system consists of the following: 1 . 1 -1000 gallon septic tank. 2 . 1 -Distribution box. 3 . 1 -1000 gallon precast leaching pit. ease,d on my InPc-action, I certify the following condltlons: 4 . This is a title five septic system': (= 78 Code ) 5 . The septic system is in proper working order at the present time. l' SIGNATURr Name : J . P . Macomber Jr•, i -------,--------------- Company:_�• P_Macomber &- Son-_*Inc A g _66 �___ ,-_ __Centeryi1Le LMass__02632 Phona : 5G8—Z7-5. J38------- I THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY )OS EPH P, MAGOMBER & SON, INC. TankrC#upoolrL��chfl:ds Pump+d L Instill►d Town Sower Connections P.O. Box 66 ' Centerville, MA 02632.0066 775-3338 775- 412 COMMONWEALTH OF MASSACHUSETTS ,1 EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS _ �C DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 617.292.5500 WILLIAM F WELD TRLDY CO? SC:TCt3 Governor ARGEO PAUL CELLUCCI DAVID B STRU) Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commission PART A CERTIFICATION Property Address: 141 Lincoln Road Hyannis,Mass . Address of Owners30 Fairmount Street Date of Inspectionl2/3/97 (If different) Arlington,Mass . Name of Inspector: Joseph P.Macomber Jr. 02174 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: J.P.Macomber & Son Inc. Mailing Address: BOX 66 Centerville,Mass . 02632 Telephone Number: 508-775-1338 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience.in the proper function and maintenance of on-site sewage disposal systems. The system: V Passes ' Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ Fail Inspector's Signature: v Date: 10 The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the repon to the appropriate regional office of the Department of Environmental Protection. The original should be sent to ttse system owne and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: A) SYSTEM PASSES: I have'not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 1 5.303 Any failure criteria not evaluated are indicated below. COMMENTS: BI SYSTEM CONDITIONALLY PASSES: ,PZ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upof completion of the replacement or repair, as approved by the Board of Health, will pass. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection, o the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tan► failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (ravioed 04/25/97) Pago 1 of 10 DEP on the World Wide Web: http:1twww.mag net.state.ma us/dep Printed on Recycied Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Anne Centrella Owner: 141 Lincoln Road Hyannis,Mass. Date of Inspection: 1 2/3/9 7 Bj SYSTEM CONDITIONALLY PASSES (continued) �/t Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, sealed or uneven distribution box. The system will pass inspection if (with approval of the Board of Health). Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced /Up The system required pumping more than four times a year due to broken or obstructed pipelsl. The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: ,L'6 Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL P TECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: D •C-tt9peof-Ur privy is within 50 feet of a surface water dCl) o*VNI or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. Gl0 The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well z' The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more irom a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance ,}//3 (approximation not valid). 3) OTHER �� (revised 04/25/97) Page 2 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 141 Lincoln Road Hyannis,Mass . Owner: Anne Centrella Date of Inspection:12/3/97 D) SYSTEM FAILS: You must indicate ej: er "Yes" or 'No" as to each of the following 0 i have determined that the system violates one or more of the following failure criteria as defined in 310 C•�sR 15 303 Tne oar s for this determination is identified below. The Board of Health should be contacted to determine what will be necessa•.Y to cones the failure. Yes NO Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or cicgge' SA'S o• cesspool. Static liquid level in the distribution box above outlet inven due to an overloaded or cloggeo SAS or cesspoo 4 - J,*- )s. d,�e. Liquid depth in co44-pgol is less than 6" below invert or available volume is less than 112 day flo,, Required pumping more than a times in the last year NOT due to clogged or obstructed pipes) Number of times pumped 0 -I Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributan to a surface -ater s.;p0;, 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 eil w:•n nc acceptable water quality analysis. If the well has been analyzed to be acceptable, anach copy of we'i wale, anai.s-s :Or coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E) LARGE SYSTEM FAILS: tou must indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above. The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system s a s 3:n,l:can: ;•nrea; tc public health and safety and the environment because one or more of the following conditions exist Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area • IWPA) or a mapped Zone 1 o: a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater trea:^-e--, or^e aT requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Depanment for further nforma!,or. ir•vy.•C 0�/75/97) Yap• 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 141 Lincoln Road Hyannis,Mass . Owner: Anne Centrella Date of Inspection: 1 2/3/9 7 Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes , No .Y/ Pumping information was provided by the owner, occupant, or Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. _ As built plans have been obtained and examined. Note if they are not available with N/A. _ The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. _ The site was inspected for signs of breakout. _ All system components,.( cluding the Soil Absorption System, have been located on the site. — The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: The facility owner (and occupants, if djfferent from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. Existing information. Ex. Plan at B.O.H. Determined in the field (if any of the failure criteria related to Pan C is at issue, approximation of distance is unacceptable) (15.302(3)(b)) (revised 04/25/97) Pegs 4 of 10 �1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 141 Lincoln Road Hyannis,Mass . Owner: Anne Centrella Date of Inspection: 1 2/3/9 7 FLOW CONDITIONS RESIDENTIAL:: Design flow: W g.p.d./bedroom for S.A.S. Number of bedrooms: Number of current residents:Q Garbage grinder (yes or no):_AL Laundry connected to sys (yes or no):_2 Seasonal use (yes or no): jf; Water meter readings, if available (last two (2) year usage (gpd): _ '�7,6!T�0l4aW 4 '? �tl/� 6a•�t� Sump Pump (yes or no): A✓0 = l W`J� /t s 5 '?y'ld Last date of occupancy: COMMERCIAUINDUSTRIAL: Type of establishment: /iQ Design flow: A4 gallons/day Grease (rap present: (yes or no)&d Industrial Waste Holding Tank present: (yes or no)-,tm Non sanitary waste discharged to the Title S system: (yes or no)2/1 Water meter readings, if available: 41A N� Last date of occupancy: OTHER: (Describe) 11 Last date of occupancy: / GENERAL INFORMATION PUMPING RECORDS'and source of information: System pumped as pan of inspection: (yes or no)_ If yes, volume pumped: A/l¢ gallons Reason for pumping: .zip TYPE O�SYSTEM Septic tank/distribution box/soil absorption system 424 Single cesspool 4)0 Overflow cesspool �)0 Privy 4 e) Shared system (yes or no) (if yes, attach previous inspection records, if any) t2d I/A Technology etc. Copy of up to date contract? Cnher .04 APPROXIMATE AGE ofalj components, date installed (if known) and source of information: Sewage odors detected when arriving at the site: (yes or no) Al (revised 04/25/97) Pago 5 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 141 Lincoln Road Hyannis,Mass. Owner: Anne Centrella Date of Inspection: 1 2/3/9 7 BUILDING SEWER: iLocate on site plan) It Depth below grade: Material of construction: /ast iron 4/40 PVC — other (explain) Distance from.p�vate water supply well or suaion line Vly� I ameter �/ Comments: (condition of joints, v ntin''g/,, evidence of leaks e, e(c.) _ l �i�'7'K✓ vQ,DL�l^ � /I'd C"-�l�.�'-t�f`'�G► �s��P t��S�I�I h� Ylr'�Uifi�✓ �`�i��rt.GbZ �G� SEPTIC TANK:LU�If?/ �G'S (locate on site plan) Depth below grader Material of construction: Zncrete —metal —Fiberglass —Polyethylene —other(explain) If tank is metal, list age � Iss age confirmed by Cenificate of Compliance ojj(Yes/No) �h ��[/Gt9 1 /�I�LUI� -, � . - Dimensions: ' B VC__��./Z' Sludge depth: yw Distance from top o sludge to bonom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffl( Distance from bonom of scum to bonom of outlet to or baffle How dimensions were determined: Comments. trecommendation for pumping, condt(i of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, a idence of leakage, etc.) / d i r r s �- S GREASE T"P:,J,��V (locate on site plan) Depth below grade.d2iQ Material of con struction:,VAconcrete,</Anetal,(/ ibergl ass-4/ Polyethylene-CAther(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bonom of outlet tee or baffle:Z2Z,7 Date of last pumping: 16// Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural ntegriry, evidence of leakage, etc.) (revisod 04/25/97) Page 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 141 Lincoln Road Hyannis,Mass . Owner: Anne Centrella Date of Inspection:) 2/3/97 TIGHT OR HOLDING TANK:.(/O. ,(Tank must be pumped prior to, or at time, of inspection) (locate on site plan) Depth below grade: X4� Material of construction 414concrete, 4 metal A)4Fiberglass,&PoI yet hylene4,14other(explain) :;M Dimensions: ;4 Capaciry: 14 gallons Design flow: ,('1 gallons/day Alarm level: Alarm in working order VV0 Yes;14 No Date of previous pumping: Comments. (condition of inlet tee, condition of alarm and float switches, etc.) Are DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: ,t)6 Comments: in if I el and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) PUMP CHAMBER:QdQ4& (locate on site plan) Pumps in working order: (Yes or No) 1,60 Alarms in working order (Yes or No) 2201 Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revia-d 04/25/97) Pnge 7 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 141 Lincoln Road Hyannis,Mass. Owner: Anne Centrella Date of Inspection:1 2/3/9 7 SOIL ABSORPTION SYSTEM (SAS):L06��yr (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Tye. / leaching pits, number: leaching chambers, number: leaching galleries, number:= leaching trenches, number,length:�_ leaching fields, number, dimensions:-4 overflow cesspool, numbe : d Alternative system: Name of Technology: 7 Comments: (not condition o soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) CESSPOOLS: �t; (locate on site plan) Number and configuration: Depth-top of liquid to inlet inven: Depth of solids layer: IVA Depth of scum layer: A;4 Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow (cesspool must be pumped as part of inspection) AX Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (revised 04/25/97) page B of 10 II SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Propert, Aodre9S. 141 Lincoln Road Hyannis,Mass . O.ner Anne Centrella Date or Inspection.( 2/3/9 7. SKETCH OF SEWAGE DISPOSAL SYSTEM: -crude ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (locate where public water supply comes into house) 01/ r 4C: J--j i It.vi..e G�/15/1)1 D.y. 9 of 10 I SUBSURFACE SEWAGE DISP;: t SYSTEM INSPECTION FORM I C SYSTEM INFOI:., !ION (continued) Property Address: 141 Lincoln Road Hyannis,Mass. Owner: Anne Centrella Date of Inspectional 2/3/9 7 1 Depth to Groundwater/5 Feet Please indicate all the methods used to determine High Groundwater Oce-'a;ion: Obtained from Design Plans on record Observation of Site (Abutting property, observation hole, basemtnf•simp etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records heck local excavators, installers Use USGS Data Describe in your own words how you established the High Grounclvvxer Elevation. Must be completed) Used Ground water contours map. Gahrety & Miller. 12/16/94 (rovis•d 04/25/97) Pac. of 10 ran rr^nrr•n- rnr m.•nrrrs^++r..rerr.rr.r.:•.�+•+:ra*r:m-sr:r.•�rss*zv ns-rnar.r+s+ .rn-rrr-r—r-. - _..,' 4 BOARD OF HEALTH TOWN OF Barnstable SUI)SURFACF SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D •- CERTIFICATION `_ �•••�•�•T••••.:i--..-^.:-nr.T..n•rt:TT r�rr ssTr rr••.rr-�—.9 "IR+rlas+rmr'T1T+c1ARRRTrTTTR7 nm nTmr+rrtso-7rrrrrr.::rrrr-�• -..� -TYPO OR PRINT CI,EARI.I'- PROPERTY INSPECTED STREET ADDRESS 141 Lincoln Road Hyannis,Mass . ASSESSORS MAP , BLOCK AND PARCEL # OWNER' s NAME Anne Centrella PART D - CERTIFICATION NAME OF INSPECTOR Joseph P.Macomber Jr. COMPANY NAME J.P.Macomber & S(m Inc. COMPANY ADDRESS Box 66 Centerville,Mass. 02632 Street Town or City State LIp COMPANY TELEPHONE ( 508 ) 775n - 3338 FAX ( 508 ) 790 - 1 578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system nt this address and that the information reported is true , accurate , and complete as of the time of .inspection , The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one : _zsystem. PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the. environment as defined in 310 CMR 15 . 303 , Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form . System FAILED* _ The inspection which I have con acted has found that the system fails to Protect the 'public !health and the environment in accordance with Title 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . •y - i Inspector Signature Date 12 7 ^-cam:�'�T—�-T--. One copy of this certification must be provided to the OWNER, the BUYER ( where applicable ) and the BOARD OF 11HAL7I1. * If the inspection FAILED, the owner or"'oparator shall upgrade ' the ayetem within one year of the date of the inspection , unless allowed or required otherwise as provided in 310 CMR 15 . 305 . partd . doc G W �7 7 � ti - S THE COII�LMOI��`�YEALTI� Off' I��A.SSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION BE IT KNOWN THAT Joseph P. Macomber, Jr. Has satisfied the Department's qualifications as required and is hereby authorized to use the title CER 1 { D TITLE S SYSTEM INSPECTOR as provided in 310 CMR 15 .340 and Section 13 of Chapter 21A of the General Laws . Issued by The Department of Environmental Protection. Junc H 1"5 ---- — Acting Oircctor 7(-) I toll (if Witct Pollution Control FORM30 C_w HOBBS&WARREN'M THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 01t�$ a--ksIlLi__bIle Z� CITY/TOWN o DEPARTMENT ADDRESS �yj/,ry 62 4,M Svey`0 O rQI7Li4 TELEPHONE Address y L i t, Lv P t� 12�2_/,�y am v� Occupant_.��"""�`P" - O. e c- Floor / Apartment No.— No.of Occupants No. of Habitable Rooms____S� _ No.Sleeping Rooms .3___ No.dwelling or rooming units_/ No.Stories__? Name and address of owner_ a�(� �e V- ►^® Ca r I i`^y _Ey to-(+C.-) Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers.- Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: > 40 e%y y/0 S)DO Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: . r✓�tc.kl,,L; ,Jot--, , v.e.ek_d /o w Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: j3 @dam 0 V". t a0 p p(,✓ -,Vo .•ps} Dampness: Stairs: 13 ralUz. S d►-i vV,3A yla qS'Z Li htin : STRUCTURE INT. Hall,Stairway: qJ @ ;5-160Z15 Obst'n.: W'.0) urn car Hall, Floor,Wall,Ceiling: /=zvvL ) c '1/o 6oZ Fj Hall Lighting: Hall Windows: HEATING *t' Chimneys: Central N�f ❑ N Equip. Repair TYPE: I✓ Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks S fety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT ►�ta?i�� - Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks ) Kitchen 0 8 Z Bathroom Pantry Den Living Room Bedroom(1). Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, i Elect.: �iOl ,f (.�� f�i, Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink °' Stove v- Bathing,ToiletFacil. Vent., Plumb.,Sanit'n.: of-✓' vim Ik roceFJ rL giriti �o 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 I TITLE /AAAPA DATE � yy TIME * P.M " .,� A.M. THE NEXT SCHEDULED REINSPECTION P.M. .. .•s ... . .(Y.. .,,;�•_, r , .. •. !. .Sri: ... .. . .. r ' 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 1051CMR 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 c'il`w� HOBBS&WARREN'M THE COMMONWEALTH OF MASSACHUSETTS Y e BOARD OF HEALTH 0-4,- 14 S 41- b lie 2 CITY/TOWN a DEPARTMENT v. tjoxs3 LL 30 Afa4.l r-f a,'r kco ADDRESS TELEPHONE 1 Address y ( t ti f u_I(n-� �_ _ two Occupant_ ©`"^�`r - tI- e Floor / A artment No.__- _ No. of Occupants_,__ P fH No. o Habitable Rooms——57-__No.SleepingRooms- No. _ dwelling or rooming units-1 _ No.Stories _ Name and address of owner �6 C_(�, �x_r �^O _f 7�vd ��a'' ""y �9y U'`t4 t r, Remarks Reg. Vio. YARD Out Bld s:: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: m— S'40-�-, > 1 40 C7 AWV.d ` O TOO Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: ,ulex.v l,,iv.olow to V Rom,,, dov— 1�/0 5-0 Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: [j a c(✓u V 1M J 0075 70v" .5 e,6 -,Vo ,e.Q Dampness: .1 Stairs: 4SZ Li htin : STRUCTURE INT. Hall,Stairway: U y (Al,&4,o.A I dj 40 ( ,,> y Cchov q10 c/Zj07 . 0bst'n.: (vw- Hall, Floor,Wall,Ceiling: F'tv,vc. ,) o.,, rjvv" 100 60z Z; Hall Lighting: Hall Windows: HEATING_ 01- 1 Chimneys: .. ,� >•,. Central O4 ❑ N E ui . Repair TYPE: ✓ Stacks, Flues,Vents: PLUMBING: Supply Line: g,.a W C- - ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Saf ty 5nd Vent(s) ELECTRICAL Panels, Meters,Cir.: 0110 ❑ 220 Fusing,Grnd.: AMP: Gen. Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Kk, t-R Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen $ZL Bathroom Pantry ` Den R Living Room Bedroom(1) Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Su p.Ten.,Gas, i Elect:: / Z"!` k-e'{C(Q,,,,, Si 4 1,. Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink Stove k� Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: ROG,, 1-e ,,o'er rroq r j W Shy 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 " TITLE ly', /V,'A f A. DATE / TIME ' e A.M. THE NEXT SCHEDULED REINSPECTION �"� ` ' P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shali 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 providea smoke detector required by 105 CMR 410.482. l (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. l uaewnNlNimvaa gpl a3sin3a �,� :31va 1 A9NMVaa At3 a3/�Oaddv V - � i�-1 ( ttJ' r Ln - - — -- - - Jim lov S • <J� Its �� t l 7 NO, TES A A/S�,:,' - ', DES -k$ A6$T' BE W1 TIN: �INSPECTION 9' MINIMUM.,'' T"- ELE-V TIO 6N CR, TERJ A' .� L RA ACCESS,COVE NVER ' GEE FINISH 6' 6 0 RAD P ORT 3 AX I#UM COVER '-INVERT OUT,SEPTIC ANK: -OW:, DESIGN FL, TO CONSTRUCTIO FI�RSr`2' -!:INVERT Iff'-DISTI�:BOX: - 6,57' 3 BEDROOMS',A T, 110 '0,P.D. PER I TkI S.,'PL AN IS FOR THE"PES G,N ;AND -BE L EVEL 6FTHE -SEWA0E. DISPOSAL S YS rtM ONLY. ,4 :BEDROOM EOUALS 330 G.P.D. , INVERT IN,LEACH' CHAMBER AND_�'2' OVER CHAMBERS 'BOTTOM �OF AROUND TE P�AN. L_EACH,,,CHAM8ER;i 9�5.2 SET SEE ' 95.2,1 WA R'�, "NIA UND TE CLEAN SAND'BACKFILL 2.- VERT ICAL DATUM I$ A S S UMED FOR BENCH. MARKS NO. GARBAGE GRINDER .' 7 ADJUSTED� GRO SEP TI C:rAkk REOUIRED.-t. BAFFLE NIA -HIGH -G'P' X 00% 660 GAL. ILTRA TOR- �DBSERVED,'OROUNO WA TER: 10 - CAPACITY IINF ALL, CONSTRUCTION METHODS�AND MATERIALS AND OUTLET 3jo, 3, MA,I TtNANCE OF::THE,:'SEPil,C� TEO SH�LL_ 7 N SYS EXISTING CHAMBERS, IN TRENCH FORMATION �80 M�W OF, rES T OL Stpric. 1000 �GAL. EXISTINGi� Io6o GAL CONFORM TO MASS. Ta 5 AWLOCAL 6,* CRUSHED STONE:OR WEALTH-R GULATION EPTIC� TANK,':': , 'IRED- BOARD OF , Ek REQU E OILABSORPI68�SY�r DESIGN _Ptge COMPACTED :BASE., SYS TE4`600PONWS 1 OC*TED �UN ER 'S 0 TEX TURA L: 4 AL4,1_1SEP T1 C 'A T : NOT �TO 'SCALE PROF E,, ' 'RA TE 0. 74�-OPDISF -A EAS' 'SUBJECT. TO,-*EWCUL R'�,-TRAFFJC. OR ORE EFFLVEN T�LOAD I Nd R' IRED�, THAN 3 ',IW ,W -74 'dPbISF S.F,� EOU 'OF H­��- E I:E 46 EPYWIHALL B TAND NG kt-20 OH&L PROVIDED, 10 IGH.CAPACI TY NF L TRA TOR, SE '5 �ALL,� '79�5 T,-'- 4671S.F. , VC-OR 62 x 7.-- WER P1PE`�,$HAl_%L BE SCHEbUCE;46�lp CHAMBER$, 0, GPD,�, APPROVED�6. SEPTICIJANK,,�AND,-D-BOX. SHALL ,'BE REINFORCED 'DA TA -POL PRECAST tONCRETE.OR'APPROVED -YETH LE El 50 L ES T P :BOTH $HALL BE,WA TERTI GHT. �D�BOX:SNA4 THERE ND/CA TFS` IND CA fES E MORE'­THAN ONt�' TES ED PERCOLATION OBSER VED' 7 �i'�POR L V-EL 'WHEN 'TES T 'OR 0 UND WA StPOREiCONSTRUCTION TP,#2 P*Ij 0 tp 1, 2 7 7.' WWT R RIZON ':','TEXTURE COLOR ORIZON , EXTURE - COLOR FOR LOCATIO ER OR 0 UND T.I IES­ 0' 100.7 �,O' 100.7 ' �:' OF Y YR, YOYR LOAMY SOfIF ALLFR;,.SH4L SAMVI 314 EM' L IV y INE too 0-� ' _. , _ . �r . i �-,, -,4,:,, .11,�., I " � --, -,-'SAN ' 8 &TIC-SW 314 TO"CONSTR UC T(M R9' L Y JOYR MY L OAM OA Or�JHEII�STE 'TO"A L L OWAcOR S64DUCINGt OVJHE­:�", 0�R 516 AND AND i5' 24 _gi 7 �.CONSMUCTION JNSP CTIONS. ':� ........... IOYR 0 YR MEDI AND C-/ ACH Y AND TOL%8E:PVMPED" 16,� SAND :6/6;' S 6 B CKrILLD. A 9 J7'fu_.ffiGWsCAP C 'JAF1 OA f0ff CHA48 FER 4 TT NO: WA ER NU wA TER 4� -90 7 ex I DA TE., SEP 1C.T. NK STEj W I TNES SED' BY, �,DAVID'.STA N,ON tRC' RA TE,,:,'- �2_1 k 181,INCH" Ag, WAS R 0 A,�A P 0 poll" vlv- N7 A'R�E0 --/=-a 001 L EGEND:� 7 L 6 du ,,,,CA ,r T /V_7 S CB � #rA A >R. `0 V S_ U GAS� LINE -L INE ER N V �E `6'A ia2 3 R a�L 't"' 0 W. Y� MA�­H E— -,'�-----'VNDERGROUNO,.-FL�ECTRICl�t.- �IUNDE 0 GR 0 UND NE _33 A:EVA TI ON 40�4