HomeMy WebLinkAbout0044 MAPLE AVE - Health 44 Maple Ave ;
Hyannis
A= 308 — 169
Town of Barnstable Health Inspector
oFtW tp� Office Hours
do Regulatory Services 8:00-9:30
„ Thomas F.Geiler,Director 3:30-4:30
* snxxsrns�.E, Only
9� b 9. � Public Health Division
Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
AMNESTY PROGRAM APPLICANT QUESTIONNAIRE
1. General Information:
Address: 44 Maple Ave Map 308 Parcel 169
Name: Lawrence W. Bernard Phone: 508-775-4173
2. How many bedrooms exist on your property now? 6
2a. Please include a copy of your floor plans for the entire property.
3. Is the dwelling connected to public sewer? YES
If the dwelling is connected to public sewer, skip questions 4-9 below.
F
4. Location of dwelling is INSIDE or OUTSIDE a Zone of Contribution to public � -
supply wells?
5. Is the dwelling connected to an ONSITE WELL or to PUBLIC WATER? 40D 37
0.
6. Is a disposal works construction permit on file? YES or NO ;:
6a.If yes,how many bedrooms were approved according to this permit? m
Bedrooms. co
7. Were any building permits obtained for construction of additional bedrooms? YES or NO
8. Is there an engineered septic system plan on file at the Health Division? YES or NO
9. Has the septic system been inspected by a DEP certified inspector within the last two years?
YES or NO
FOR OFFICE USE ONLY
TO BE SIGNED BY A HEALTH INSPECTOR/AGENT ONLY
The Public Health Division has no objection to bedrooms at this property.
Signe A, Date: Q
Inspector rint): - IY1 L �,-
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BOARD OF HEALTH
ARTICLE 11:MINIMUM STANDARDS FOR HUMAN HABITATION
Date /
Owner "VL (!W Vd Tenant b
Address I• Address
WWI
Compliance Remarks or
Regulation# Yes No Recommendations
2. Kitchen Facilities ►",fA'�_�'°y't ✓ r - 7 f
3. Bathroom Facilities ~ ?'644^T f � �` _r r -ail 4
4. Water Supply --
5. Hot Water Facilities
6. Heating Facilities 7. Lighting and Electrical Facilities
B. Ventilation
9. Installation and Maintenance of Facilities "
10. Curtailment of Service
11. Space and Use
12. Exits h5 '�.`.
13. Installation and Maintenance of Structural
Elements
14. Insects and Rodents
15. Garbage and Rubbish Storage and Disposal r < 4
16. Sewage Disposal °
17. Temporary Housing
.)" ' , .a i f � ✓:: .S err�+�,.-.�
PART II ,.::C.�•'Y-+i. ef'y;' r"vi• ' /;. ;:'
37. Placarding of Condemned Dwelling;
Removal of Occupants; Demolition
Person(s) Interviewecr Inspectdr,_ %^r1�:✓��.; r� _ `.: '.-,>:._ ._. .
If Public Building such as Store or Hotel/Motel specify here
Hosas 4 WARREN.INC.