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HomeMy WebLinkAbout0004 MARK LANE - Health 4 MARK LANE, HYANNIS A = Z8�f. 030 v yy 1 G� TOWN OF BARNSTABLE LOCATION q MARA-e, LAME, SEWAGE# �L' �? 09' VILLAGE NYAwjtS ASSESSOR'S MAP&PARCEL 2 Rq 030 INSTALLER'S NAME&PHONE NO.CA�F-wtp Q',6 T�PASU cEi?�88-11 rAAW SEPTIC TANK CAPACITY bu pc cx it 0 6c/5c,© W (2.1 Ct;A<,0,4jZ7gtEL,7r LEACHING FACILITY:'(type)(8) Ge(d C,444JOE@S (size) 5(®� X t l e NO.OF BEDROOMS OWNER :TO ACC au3 (AA PERMIT DATE: 3-3 1 "oAO I-T COMPLIANCE DATE: Separation Distance Between the: M o,T I UC-C ` Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility C':LZ-V. (OP j 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) _ NIA Feet FURNISHED BY CAMOCD6 � a o a GJ G tlCJ by 0� pv � !c' � ,i y �➢ ,e y 00 CCr ® V+ 6` ®' N � g p 9 .,r f (t� O O 7 � � ® Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. X ❑Agent to Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. POeeived by(Printed Name) C. Date of Delivery la Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address different from item 1? ❑Ye 1. Article Addressed to: If YES,enter delivery address below: ❑ No 3. Servi a Type Certified Mail ❑ Expre Mail gistered et urn Receipt for Merchandise ❑ Insured Mail ❑C.O.D. ®� 0OOfL 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (transfer from service label) 4, PS Form 3811,August 2001 Domestic Return Receipt io25ss-oi-nn-25os I UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid LISPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box • Public H ion Town o Barnstable 200 Main St' 02601 Hyannis,Massachusetts j .t � �y :.. 8 �.,. � .. �- ��� n r _ . . _�.__ ,, ��._ _ :; _:__ __._ P .,A � Postage $ )� A, 02. l(7 �a I,-- Certified Fee postmark rt' JAL Ir,�R`2 7 2002 Return Receipt Fee L1 (Endorsement Required) C3 Restricted Delivery Fee 0 (Endorsement Required) a Total Postage&Fees U$PS M Er, Sent To a � -------------------------------- --tree_- ---- Street,A-pt.No.; r___ r9 or PO Box No. 1 \ V o Clty,State,ZIP :ee ee REM ■ Complete items 1,2,and 3.Also complete A. Signature ' ❑Agent item 4 If Restricted Delivery is desired. X Y �� ❑Addressee ® Print your name and address on the reverse so that we can return the card to you. B. eived by(Printed Name) C. Date of .livery im Attach this card to the back of the mailpiece, J q e I � S `4 (Z 6� or on the front if space permits. Ye D. Is delivery address different from item 1? 0 No 1, Article Addressed to: If YES,enter delivery address below: 3. Servi eType J Certified Mail ❑ Expre Mail gistered .turn Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. i i CD� Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number { t(Fomner from service label) - PS Form"3811,August 2001 Domestic Return Receipt 102595-01-M-2509r- io Cbmplete items 1,2,and 3.Also complete A. Sig e item 4 if Restricted Delivery is desired. ❑Agent 0Print your name and address on the reverse X � ❑Addressee so that we can return the Card to you. B. eceived b (Prin d Name) C. Date of Delivery 13 Attach this card to the back of the mailpiece, .f v b � /#--A or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No 3. Servi pe Certified Mail ❑ Express Mail ❑ Registered ZkAeturn Receipt for Merchandise ❑'Insured Mail ❑C.O.D. 4.oRestficted Delivery?(Extra Fee) ❑Yes 2. Article Number (Transfer from service label) ,.PS Form 3811,August 2001 Domestic Return Regerpt 102595-01-M-2509 i h _ CO - rn Postage $ 0 Er q N Certified Fee � M 3 Postma 1 Return Receipt Fee MAR 7 h MAR ul (Endorsement Required) v 2 / A,, C .Restricted Delivery Fee r-3 (Endorsement Required) O Total Postage&Fees O Sent To Er Street,Apt.No.; - I rq or PO Box Mo. o --�`.--Q---------- `! -._------- o ciiy,si�i®,aiP+'4 � e oFtMME rati _F Town of Barnstable Regulatory Services f • • BARNSfABLE, y MASS. g Thomas F.Geiler,Director 1639.`l p Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 / Office: 508-862-4644 Fax: 508-790-6304 Mr.Daniel Hostetter 770A Main St. Osterville,MA 02655 March 26,2002 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 4 Mark Lane Hyannis,MA.was inspected on March 22,2002, by Edward F.Barry 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: 410452 There is black mold on walls of the living room,the living room closet,the bathroom and the walls of the bedroom. Also,there is mold on the window casings of the living room,bathroom and bedroom. You are directed to correct the 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,this violation 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. You are also subject to non criminal citations of$40.00 for the first violation and$15.00 for each additional violation. Tickets will be issued daily until the violations are corrected. PER ORDER OF T BOARD OF HEALTH omas A.McKean Director of Public Health Mr.Jason Gibbs 4 Mark Lane Hyannis MA.02601 Q/Heal th/Wpti 1es!0rckT[euHostetWr/A E 1 � j FORM 30 C&w HOBBSS WARREN TM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HLOTH CITY/TOWN / W a to 0 DE PA THE T V ' G„M SVBy`0W ADDRESS ( �^ TELEPHONE Address — Occupant �''`� .Floor Apartment No. No.of Occupants— No. of Habitable Rooms No.Sleeping Rooms No.dwelling or rooming units Stories Name and address of owner 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: 64- Obst'n.: Hall, Floor,Wall,Ceiling: 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.Ten.,Gas,Oil, Elect.: , Flue ,Ven ties: Kitchen Facilities ink S. e , 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 S IGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERDU INSPECTOR TITLE DATE TIME A.M. THE NEXT SCHEDULED REINSPECTION ! " P.M. t: �y 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a oerson 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 it tl-is 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 requi-ements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of -05 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 Preve-itiDn 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, gasfitt nc, 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:he 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. i � �� ({ I I .A. ,r 1. .. �. aY FORM30 &W HOBBSBWARRENTM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF H TH CITY/TOWN .� 4 W DEPAR NT � ,p ADDRESS G1M Sye y`0W TELEPHONE Address Occupant Floor Apartment No. No.of Occupants \ No.of Habitable Rooms No.Sleeping Rooms No.dwelling or rooming units__ N_St es Name and address of owner _ _ ® 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: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N E ui . Repair TYPE: Stacks, Flues,Vents: PLUMBING: Su ply 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.Ten.,Gas, Oil, Elect.: F s V afeties: Kitchen Facilities tink ove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: 4 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 P RT IS SIGNED AND CERTIFIED UNDER TH PAINS AND PENALTIES U INSPECTOR TITLE DATE TIME 15 ' I A.M. THE NEXT SCHEDULED REINSPECTION P.M. f 410.750: Conditions Deemed to Endanger or Impair Health or Safety s The following conditions,when found to exist in residential premises, shali 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 incluced 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 oy 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'410.25L. (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. 1 (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 uses 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 4 10.503 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. I � � s �5om� i i Health Complaints 28-Sep-05 Time: 3:30:00 AM Date: 9/23/2005 Complaint Number: 18485 Referred To: DONALD DESMARAIS Taken By: Complaint Type: RUBBISH Article X Detail: Business Name: Number: Street: MARK LANE Village: HYANNIS Assessors Map_Parcel: Complaint Description: DUMPSTER OVERFLOWING AND BLOWING AROUND. FEAR OF DRAWING ANIMALS Actions Taken/Results: DD called Allied Waste. They will pick up immediately. Hostetters office told me that they had called and that noone had picked it up. There was trash on the ground around it. Allied Waste said no calls came in except for mine. Investigation Date: 9/28/2005 Investigation Time: 11:15:00 AM AI _ 4 1 i o Complete items 1,2,and 3.Also complete A. Signatu ' item 4 if Restricted Delivery is desired. X 13-A ent ® Print your name and address on the reverse ❑Addressee so that we can return the card to you. ® Attach this Card to the back of the mailpiece, B -Received b (Printed Name) C. Date of DeliveLy F- or on the front if space permits. JUQ ( er� �43—e 1. Article Addressed to: D. Is delivery ad ress different from item 1? ❑Yes If YES,enter delivery address below: ❑No s+Q e 3. Service Type `i_11�1f Q' o JCCCertified Mail ❑ Express Mail ❑ Registered M-Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number( 7002 1000 0004 66B3 1860 transfer from service label) g PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540 i a ' a oFt tw,, Town of Barnstable Regulatory Services BARNSrABM v MASS. Thomas F. Geiler,Director �p 1639. ♦0 Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Daniel Hostetter May 19, 2005 770A Main St. Osterville, MA. 02655 NOTICE OF VIOLATIONS OF BARNSTABLE CODE CHAPTER 360 ARTICLE VII 4360-16, ARTICLE I 4353.1. VIOLATION OF 105 CMR 410.354 STATE SANITARY CODE The property owned by you located at 4 Mark Lane, Hyannis, was inspected on May 17, 2005 by Donald Desmarais, RS Health Inspector for the Town of Barnstable, because of a complaint. The following violations were observed. 4360-16; Town of Barnstable Code: The septic system is in hydraulic failure. Raw sewage was observed at ground level and some liquid wastes were observed seeping down the side yard. Sewage odors were detected. Puddles from sewage overflow, were observed on top of the ground. 1) You are directed to hire a licensed septage hauler to pump the overflowing septic system within twenty-four(24) hours of receipt of this letter. 2) You are also directed to keep the on-site sewage disposal system pumped as many times as necessary(daily if need be)to keep it from overflowing onto the ground. 3) You are further directed to contact and hire a professional engineer to design a septic system which meets local and state regulation requirements within twenty one (21) days of receipt of this letter in order to repair this system or connect to town sewer. 4) The newly installed septic system shall be completed on or before June 30, 2005. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance may result in the issuance of a $100.00 non-criminal ticket citation. Each day's failure to comply with an order of the Board of Health shall constitute as a separate violation. PER ORDER O THE BOARD OF HEALTH /vim omas A. McKean , �prov� 6 e;xyn Director of Public Health m - MR y. i� c • Health Complaints 16-May-05 Time: 1:22`00 AM Date: ',,'5%16%2005 Complaint Number: 18108 Referred To: DONNA MIORANDI Taken By: JOAN AGOSTINELLI Complaint Type: TITLE V SEWAGE Article X Detail: UNSANITARY CONDITIONS Business Name: Number: 4 Street: MAR LANE Village: HYANNIS Assessors Map_Parcel: Complaint Description: Septic System is overflowing onto the lot. The ✓ smell is terrible; It has been going on for a few months. ;. .. / Actions Taken/Results: Investigation Date: Investigation Time: �. ,� . Y 3 � � � ,+'�,. � � �,. .. w ,, � $ ��'. �. ,�_ t. • , �. �,, . „ e � � � .�„ � � �, � fir.: �„ "* .., - . � � ,. t, .� _ .� ti �._ � � � x� �. ., .. W �.. � � �,� �. '� ,;. � �/1„ tii �� 9 ,' ,rig Y.� � � � "� ti�',� 1���u �,�. �i s, v� s �. � i -. 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Thomas F.Geiler,Director 1639. �0 °' Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Mr.Daniel Hostetter 770A Main St. Osterville,MA 02655 March 26,2002 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 4 Mark Lane Hyannis,MA.was inspected on March 22,2002, by Edward F.Barry Health Inspector for the Town of Barnstable because of a complaint. The following violations of 105 CMR 410.00,State Sanitary Code 11,Minimum Standards of Fitness for Human Habitation were observed: 410-452 There is black mold on walls of the living room,the living room closet,the bathroom and the walls of the bedroom. Also,there is mold on the window casings of the living room,bathroom and bedroom. You are directed to correct the 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,this violation 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. You are also subject to non criminal citations of$40.00 for the first violation and$15.00:for each additional violation. Tickets will be issued daily until the violations are corrected. PER ORDER OF T OARD OF HEALTH omas A.McKean Director of Public Health Mr.Jason Gibbs 4 Mark Lane Hyannis MA. 02601 Q/keal th(ih,'pti les/OrderletiHostetttT.fs _. - ..v_,.. .,r -r+. � �3.+«.r.-�-r'.a w!`^'«.fry r "i W. • . .�, t .::�.q.Y.�.-wfi..' 'yam� .... ... ,y,.. v .. -,Y+` _ !�•�/ �� .1� \ .ter.Y. ` ' ,1 FORM 30I�w HOBBSB WARRENTM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CITY/TOWN J/ DEPARTMEN r` �- - ADDRESS A 4. ��^JJ 570 f+ol.-+- _� TELEPHONE Address _ � '1 '�`'' `-Occupant_ . -'-4 f_0 Floor_ Z Apartment No._._ __ _ _ No. of Occupants No. of Habitable Rooms-~_ _,,__ _No.Sleeping Rooms. No.dwelling or rooming units _ No.Stories Name and address of owner � yam'" " - Q✓ /fig,, 0(—, 0.1W 40 ,°` ry 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: r; .5C4 ,&4Y Mo '' Obst'n.:,s;r�Ws�.s,?r � _ r� a ,.a '�^ 1r'''.r��'4,►•/� ��'� Hall, Floor,Wall,Ceili'n , h,,; "'p, ' " Rw ' Hall Li htin :l Iwo= Hall Windows: HEATING Chimneys: -,e. '!%!+� Central ❑ Y ❑ N E ui . 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: f DWELLING UNIT Ve41.' 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.Ten.,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 TITLE A.M. DATE TIME _ 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 n -esidential 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, 103 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%vhom 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 CK1R 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 o'os`ruction 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 w-iich 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 nsulation 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 snorver 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, gasfittinc, 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. Town of]Barnstable P# 530 Departitnent of Regulatory Services ZNTM Public Health Division DateNAM 3 h1'6� 200 Main Street,Hyannis MA 02601 co r Date Scheduled /� Time t'^ Fee Pd. a� Soil Suitability .Assessment for Sew e ,disposal Performed-By:A/609/ Yl►'+ MAGI F T 7 Witnessed By: v1 / 14V LOCATION& GENERAL INFORMATION Location Address 1 l� nP,rL �[ �,�/// Owner's Name (DkO&C, £ r«J�E1;L (.ta TCZr-� • � L /t G��V� Gr��s11�5 ��E�rCC 7�ZUS7' Qq Address 770,E MAjvST OS'i Assessor's Map/Parcel: �v G 1��0 Engineer's Name NEW CONSTRUCTION REPAIR _ Telephone# Land Use: Slo cs 96 S 10 _ P ( ) Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well — ft Drainage Way V ft Property Line ft Other ft SIKETCH:(Street name,dimensions of lot,exact locations of test holes&pere tests,locate wetlands in proximity to holes) Parent material(geologic).014+WaT Depth to Bedrock, :z Depth to Groundwater. Standing Water in Hole: IoZO b:�.e _ Weeping from Pit Fpee Estimated Seasonal High Groundwater /Q a r` DETERAHNATION FOR SEASONAL HIGH WATER TABLE Method Used: lNnec4 ObSg!r�-44;0v(, Depth Observed standing in obs.hole: k A0 In, Deptlr to soil mottle!: . Depth to weeping from side of obs.hole: _ —in, Groundwater Adjustment Index Well# Reading Date: Index Well level, - Adj.factor Adj.(Groundwater Level, PERCOLATION TEST Dale3/27 1 111ine lo'00 AM Observation Hole# 1 Time at 9" Depth of Pere Time at 6" Start Pre-soak Time @ 16,00 AM Time(9"-6") End Pre-soak 10;11 AA4 Rate Min./Inch L Site Suitability Assessment: Site Passed�_ Site Failed: Additional Testing Needed(YIN) 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 Conservation Division at least one(1) week prior to beginning. ,` Q:ISEPTICIPE S RCFORM.DOC Q�V DEEP-OBSERVATION HOLE LOG Hole#A + Depth from Soil Horizon Soil Texture .Sdil Color Soil• Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. r oTisistengy,%'Gravel) 1a-36 Q Loamy Sar,4 i'd•Yr 616 36- )3 i G M. sand , 2.5 Y Z// ]DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. o si cncy.%Gra e DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(iu.) (USDA) (Munsell) Mottling (Structure,Ston s,Boulders. ConsistenM.yg a c DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders, Consistency, i Flood Insurance Rate Map: Above 500 year flood boundary No— Yes Within 500 year boundary No/ Yes ' Within 100 year flood boundary No.-, Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? yGS If not,what is the depth of naturally occurring pervious matarlal? Certification I certify that on 10 a� q (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertn4e an a perience described in 10 CMR 15.017. Signature Date 3-3 a-I'7 Q:\S.EPT1MERCFORM.D0C Health Complaints 21-Oct-99 Time: 9:00:00 AM Date: 10/20/99 Complaint Number: 2113 Referred To: GLEN HARRINGTON Taken By: BARBARA SULLIVAN Complaint Type: CHAPTER II HOUSING Article X Detail: Business Name: Number: 4 Street: Mark Lane (Apt. #4) Village: HYANNIS Assessors Map_Parcel: 289/030 Complaint Description: Floor in bedroom is splitting and has a hole in corner of the room. Actions Taken/Results: Ralph Jones and I met at site. Sharon Schrand did not let us in until her sister, Denise Pauline, arrived. The maintenance man showed up too. We all went upstairs to the studio apt. The maintenance man had put foam adhesive on the floor boards to address a previous complaint regarding squeaky floor boards by the occupant. The foam had expanded and bubbled up approx. one inch. The hole in floor was cut to install insulation between the floor and ceiling. The maintenance man scraped up the access foam so there was not any trip hazard. The building appears to be an old barn or carriage house due to open rafters on second floor. Ms. Schrand was also worried about the strength of the floor. The floor was sloping slightly but appeared sound. Ralph and I went downstairs to the first flor apt. The occupant of the first floor allowed us in. We checked the ceiling of the bedroom which did not have any cracks or signs of sloping/slanting. 1 Health Complaints 21-Oct-99 Investigation Date: 10/20/99 Investigation Time: 10:00:00 AM 2 i/, V Health Complaints 18-Oct-99 Time: 11:30:00 AM Date: 10/18/99 Complaint Number: 2113 Referred To: GLEN HARRINGTON Taken By: BARBARA SULLIVAN Complaint Type: CHAPTER II HOUSING Article X Detail: Business Name: // � corner of the room. Actions Taken/Results: Investigation Date: Investigation Time: —P pv+ C 4e �( 6 C,"q OA A 1� f e.ce car, Al A.;,x �CV4,,, Sc � ��°4- 1,,L,, o c uy' j-(,� o� at"_c/ /5* 1 b�a2r w, i S ��,. d� SQ cc►,.P° /op,- �-a►e.al-�w� Al o C V-a.LCC) ♦ r r l 1 1 d- Fr( L e,• wj 1 kFor / Jr . UM OAf Inspectoei I Action/Comments D . .I.i I I i 1 Follow-up Action Addhional1 • IH MI • (I?ca=to IJ SENDER: ■�romplete items 1 and/or 2 for additional services. I also wish to receive the W ■Complete items 3,4a,and 4b. following services(for an to ■Print your name and address on the reverse of this form so that we can return this extra fee): ID card to you. 2 U ■Attach this form to the front of the mailpiece,or on the back if space does not 1. El Addressee's Address permit. d d ■Write'Retum Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery to r ■The Return Receipt will show to whom the article was delivered and the date +• ° delivered. p Consult postmaster for fee. L f °d 3. cle Addressed o f 4a.Article Numbe �/ , r E E 4b.Service Type d ° ❑ Registered JO Certified N � r G ❑ Express Mail ❑ Insured W WY ❑ Return Receipt for Merchandise ❑ COD 7.Date of Deliv ry �Z 4 5.Received By:(Print Name) U.Addressee's Address(Only if requested s W and fee is paid) 6.Signat e:(Ads �rAgen�V ,° XI PS Form 3 , December 1994 Domestic Return Receipt 'FETE FOLLOWING IS/ARETHE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) m A F / �(C�"-J L DATA z� 348 659 944 Receipt for a Town of Barnstable (Certified Mail !-In Insurance Coverage Provided A Health, Safety and Environmental Services Apr F_o not use for International Mail (See Rev rse Public Health Division M 367 Main Street,Hyannis,MA 02601 ,et and ra Thomas A.McKean U lean ZIP , Director of Public Health r') Postage E Certified Fee IL � Special Delivery Fee a Restricted Delivery Fee Return Receipt Showing' IO Whom&Date Delivered Return Receipt Showing to Whom, Date,and Addressee's Addrp. s TOTAL Postage 1 P Fees Postmark or Date 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 165 West Main Street, Apt. #2, Hyannis was inspected on November 4, 1996 by Christina Kuchinski, Health Inspector for the Town of Barnstable because of a complaint. The following violations of the Town of Barnstable Rental Ordinance Article 51 and the State Sanitary Code were observed- I � 410.SU0:, There were no storm gutters over the front and rear entrances causing —�' water to puddle on the stairs. �61NVR .501(B): There was a space between the prime door frame and the bottom right corner of the door thus not making the door weathertight. 410.500: There were round indentations in the floor of the hallway, kitchen, and s4-t t l bedroom due to insulation that had been blown into the floors. Q cam` You are directed to correct the above listed violations within seven (7) days of receipt of this notice. i 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, this violation must be corrected regardless of any request for a hearing. i s t f 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. You are also subject to non criminal citations of$40.00 for the first violation and $l 5.00 for each additional violation. Tickets will be issued daily until the violations are corrected. PER ORDER OF T 17 BOARD OF HEALTH Thom s . McKean Director of Public Health cc: James Kelley a o�pyofTMfTp`�.► The Town of Barnstable ,�� Department of Health, Y Safet and Environmental Services T i P o 9. Public Health Division 367 Main Street,Hyannis,MA 02601 Office 508-790-6265 Thomas A.McKean j FAX 508-775-3344 Director of Public Health November 27, 1996 Daniel Hostetter TR Eagle Trust ���� 770A Main Street �� Osterville, MA 02655 36 NOTICE TO ABATE VIOLATIONS OF 105 R 410.00 STATE SANITARY CODE II MINIMUM STANDARDS OF FIT ASS FORJLUM.A►N HABITATION AND THE TOWN OF BARNSTABLE REN AL ORDIN.A-NEE _ARTI iLu The property owned by you located a L165West]Main Street, Apt. #2, Hyannis wasinspected on November 4, 1996 by C hinski, Health Inspector for t own of Barnstable because of a complaint. Th ing viulationrufthu-Town of Barnstable Rental Ordinance Article 51 and the State Sanitary Code were observed: 410.500: There were no storm gutters over the front and rear entrances causing water to puddle on the stairs. 410.501(B): There was a space between the prime door frame and the bottom right corner of the door thus not making the door weathertight. 410.500: There were round indentations in the floor of the hallway, kitchen, and bedroom due to insulation that had been blown into the floors. You are directed to correct the 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, this violation must be corrected regardless of any request for a hearing. G, 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. You are also subject to non criminal citations of$40.00 for the first violation and $15.00 for each additional violation. Tickets will be issued daily until the violations are corrected. PER ORDER OF THE BOARD OF HEALTH Thom s . McKean Director of Public Health cc: James Kelley � -- 630 i y Mr./Mrs. a-U.��f - S'�P-f - NOTICE TO ABATE VIOLATIONS OF 105 CMR 410,00, STATE SANITARY CODE 11, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE,ARTICLE 51 The property owned by you located at 1 �� % ' was inspected on W- V- G I by C4-vw"" f lealth Agent for the Town of Barnstable because of a complaint. The following violations of the Town of Barnstable Rental Ordinance Article 51 and (lie Sanitary Code II were observed: Soo +,-0-4�� YV �U� �� III--a=� Uy � G�'' so You are directed to correct the violation of within 24 hours of receipt of this notice by 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 I lealth 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. You are also subject to non criminal citations of$40.00 for the first violation and $15.00 for each additional violation. Tickets will be issued daily until the violations are corrected. Enclosed are citation numbers due to violations observed on PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health Town of Barnstable FORM3o HOBBSB WARREN,INC. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH cITY/TOWN DEPART ENT TELEPHONE / Address w• 0C(M Occupan �! floor Apartment No. No.of Occupants No.of Habitable Rooms No.Sleeping Rooms5-� No.dwelling or rooming unit No. ories � Name and address of owner ! O S' 6 t? J-4Ao 0 T-► L S r-=-G V/( �/ (� s`' emarks Reg. Vlo. 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: vvV. ) 4-elt Roof U L,_� Q v Gutters, Drains: 1' Walls: Foundation: 1� Chimney:BASEMENT Gen.Gen.Sanitation: Dampness: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: P !- 1yl Hall Lighting: 114 / toh Hall Windows: -j 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.Ten.,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: I Egress Dual and Obst'n: ► General Building Posted , ,H- Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A C NDITION 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." ­INSPECTO yI 4T It lam-(TLE DATE�C'" `� '- �� TIME d� / P•MA.M.•� A.M. THE NEXT SCHEDULED REINSPECTION P.M. a 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, 1 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 these items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the opcupants or the public. Because Chapter II, 105 CMR 410.000 through 410.499 state minimum requirements of fitness for human habitation, any violation has the potential to fall within this category in any given situation but may not do so in every case and therefore cannot be included in this listing. Failure to include shall in no way be construed as.a determination that other violations 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 the violation(s) pursuant to 410 CMR 410.830 through 410.833 nor shall it 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) Shut-off and/or failure to restore electricity or gas. (D). Failure to supply the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253(A), 410.253(B) and the lighting in common area required by 105 CMR 410.254. '(8) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage 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 an object, including garbage or trash, Which prevents egress in case of an emergency 105 CMR 410.450 and 410.451. (H) Failure to comply with the security requirements of 105 CMR 4110.480(D). (I) Failure to comply with any provisions of 105 CMR 410.600 through 410.602 ._'which results in any accumulation of garbage, 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 lead-based paint on a dwelling or dwelling unit in :_violation of the Massachusetts Department of Public Health Regualtions for Lead Poisoning Prevention and Control 105 CMR 460.000. =([) `Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or ispAriftnt to health or dafety. (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 facilities 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 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: (t) 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 operable. (2) failure to provide a washbasin and a shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3) and 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,. gas-fitting, or electrical wiring standards that do not create an immediate hazard. (r) 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. (N) Amy other violation of Chapter II not enumerated in 105 CMR 410.750(A) -through (M) shall be deemed to be a condition 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. RESIDENTIAL PROPERTY LOT N.O. FIRE DISTRICT SUMMARY tpv, :3 STREET j+Test Main St. Hyannis LAND / Jr H /3 2 3 SAS o _ 7 0! BLDGS. OWNER17 sf1.,.6:;t+';•, ., TOTAL aa, x LAND PONc,ti5 RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: BLDGS. rn tst Fiances L & Ma C ' N 23 6 9 2 8 TOTAL LAND Blocs. p$p{ x TOTAL yi a � LAND Blocs. Z 3� (� TOTAL LAND rn BLDGS. TOTAL LAND BLDGS. (3€ TOTAL BLDGS. ,i 5 fan G y TOTAL 'LAND ���'� iY J lIRIOR�INSPECT D:V ►►� BLDGS. TOTAL �AT LAND -717,44 ACREAGE COMPUTATIONS / r f BLDGS. S /�< s 'safh'w.".';LAND-,TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL HOUSE LOT 'r°` s CEO O �O U 50 ._�J LAND QLEARED FRONT BLDGS. t;= , .— TOTAL 'WOODS&SPROUT FRONT. LAND fiaa,s{xjrx!ram i t.,:•.•::�::-,> . : �., . REAR � BLDGS. _;WASTE.'.FRONT::. TOTAL LAND w` REAR ^tea bt:� r yi, BLDGS. fi 4111xa ,.. ` TOTAL r•;�{•.,a ,,E .a�_; _ Je .LAND BLDGS. LOT COMPUTATIONS TOTAL LAND FACTORS y2,F14QgT.7; , %•::z�DEPTR ••: STREET PRICE DEPTH FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND f ve, ROUGH TOWN WATER BLDGS. HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND SWAMPY NO RD. BLDGS. }yrn ^� � _ TOTAL Cone. Blk.Walls Bsmt.Rec.Room ' at. u.i — , Bsmt. 1 FURCH. UAl E Cone. Slab Bsmt.Garage St. Shower Ext. Wells PURCH. PRICE. Brick Walls Attic FI.&Stairs Toilet Room Roof RENT Stan Wells Fin.Attic Two Fixt. Beth Floors �y /%�!� f�t'I •� Piers INTERIOR FINISH lavatory Extra Bsmt. F 1 2 3 Sink z- Attie , 2 r/r tb Plaster Water Clo.Extra EXTERIOR WALLS Knotty Pine Water Only Bsmt.Fin. Double Siding Plywood No Plumbing �34 Int.Fin. , Single Siding Plasterboard O` J 2 Z (�7?;")Shingles TILING 7�tr,.�Z1J f / Conc.Blk. G F P Bath Fl. Heat v ' Face Brk.On Int.Layout Bath FI.&Wains. Auto Ht.Unit 38 , Veneer Int.Cond. Bath FI. R Walls Fireplace Com.Brk.On H EATING Toilet Rm.Fl. Plumbing 0 ' Solid Com.Brk. Hot Air Toilet Rm.FI. R Weins. Tiling , Steam Toilet Rm.FI.6 Wells Blanketlns. Hot Water St. Shower Roof Ins. Air Cond. Tub Area Total Floor Furn,-� ROOFING COMPUTATIONS Asph.Shingle Pipeless Furn. Wood Shingle No Heat S.F. Asbs.Shingle Oil Burner S.F. / L Slate Coal Stoker S.F. • OUTBUILDINGS Tile Gas S.F. ROOF-.,TYPE Electric S F 1 2 3 4 5 1617 18 9 101 1 213 4 5 6 '7 1 Ill 9 10 MEASURE[ GeDle Flat Pier Found. Floor Mansard FIREPLACES S.F. Hip Wall Found. 0.H.Door LISTED Gambrel Fireplace Stack Sgle.Sdg. Roll Roofing [v FLOORS Fireplace Cone. LIGHTING Dble.Sdg. Shingle Roof ;;,DATE Earth No Elect. Shingle Walls Plumbing Electric f !, Pine Soo Cement Blk. PRICED Hardwood ROOMS / Int.Finish ` Brick Asph.Tile Bsmt. 115t G !2 TOTAL C Single 2nd 3rd FACTOR i REPLACEMENT OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. . PHYS. VALUE Funet.Dep. ACTUAL VAL. I: DWLG. 1 i 2 3 4 5 6 7 i i 6 j 9 10 - TOTAL No ,7 V Fee v v THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes appfitation for Misposar 6pstem cons"ttion j3erMit Application for a Permit to Construct( ) Repair()o Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. C.AUG Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 3 Q '14����� p 4nPr as y GT+c�t a r�Ac3 c/�I Cive 1 RA 7 A HA10 '5 T-,a.sr It WA4 L<IAQ Installer's Name,Address,and Tel.No. 500-41 'W91 7 Designer's Name,Address,and Tel.No. j©2',1"73-e 3 7'7 CA pew+bc_ ac c,xG cot1ei r.Dcx_I.xic- 653 1 5`* . 4PELr_ lg C9AAJr30LP4 b4 Type of Building: -3 at oV Q Dwelling No.of Bedrooms `J of 4 d OLMY-Lot Size D21, 9%—sq.ft. Garbage Grinder( ) Other Type of Building R(9�'J btW n A-t_ No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 550 gpd Design flow provided 5755 gpd Plan Date 0 /.7 Number of sheets 1 Revision Date Title (G tA1UL �(Y& t_5' Size of Septic Tank Nr,W- t,30Q/j c9O A - Type of S.A.S. r 9 L L° {-,- j,�� .t7 Description of Soil 04 SA07) 52 36 Nature of Repairs or Alterations(Answer when applicable) US C7Lt�SZ t i�C-s l�f C�uLOO cSC!:VT t C`TAkA 01*20 7 Js 000 .14•-1 r oaol oa�� cc�a►cd'.4arrac> 'r s��itl L F,�(C 'To PCELV )— DK Tb LC �p L c a&tkX,< 4eP+Tf1 -T ®� et •4TW �� ot��� 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 a ompliance has been issued by this B d of a S' ed Date - Application Approved by Date c>� ;;''Application Disapproved by Date forxhe following reasons Permit No. Date Issued ----------------------------------------------------- ---------------- --- -- No /`�/ ! {. Fee E�6 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for Disposal 6pstent Construction Permit Upgral Abandon Complete System Application for a Permit to Construct( ) Repair(X) ( ) ( ) ❑ ElIndividual Components Location Address or Lot No. (_Ak4sOwner's Name,Address,and Tel.No. --V*wl fzc N OS?6-rTFtt r TbAv 7 VN&,_to I RA Assessor's Map/Parcel oZg 4 3© '� c�A 1p11Q IlU S Y^B.St (l �b3xk3l ca.r¢E �c1A Installer's Name,Address,and Tel.No. 509-41-1 '?9'77 Designer's Name,Address,and Tel.No. $02's173-03 71 G-PEW'I)CPRlS�S S<- Cr-Cr r0CW 1Q<=- _T JC, 15 3 5'r K14P&-;C 2 Type of Building: _ ,3 Ad At Dwelling No.of Bedrooms `J eL D-J(PLZV_ Lot Size �1, 9'j;--- sq.ft. Garbage Grinder( ) Other Type of Building RE�t b M 4 L. No.of Persons Showers( ) Cafeteria( ) I Other Fixtures Design Flow(min.required) 550 gpd Design flow provided gpd Plan Date 3 -30- 1-7 Number of sheets Revision Date r Title ��Q4�,(G 6 A JAL �(YA OW.S Size of Septic Tank sL�t 00 t.e���D ?i) ti- scsup.}irSc Type of S.A.S. (�� L C Description of Soil Nil ZD "0Ddbtj�,6 50 s iD CQ,-34 s Nature of Repairs or Alterations(Answer when applicable) OS E (0 6T t h)G. l.,000 Q4-L of.J 6ePTi G TAkA J5�4cL Neu -� 0 1 000/soa( �owcoA�rr�cc�xTz s�'Tsri L reF�(c To NEw b OoK. Tb lS LC Lakkl*. Y 4eo1Tt-1 !0� or- A4&k46C-A_6, Sv vrJo� - Date last inspected: ri Agreement: j 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 th/is�Bo_erd of Signs ed Date Application Approved by Date 3/,3. Application Disapproved by Date for the following reasons Permit No. 1 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(x) Upgraded( ) Abandoned( )by CAPEW!Ac �r,1Tu2DR�StS i at mAet, e_Am 6 HYApAJi S has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit Noc901;7 -6-7/dated Installer CdpE w t-b is Designer ?C- J&G #bedrooms 5 Approved design flow 50 gpd The issuance of this permit s'hal +, -ed as a guarantee that the system will n do designed. Date `� , Inspect8r� ------ COMMO T Fee THL WEALTH OF MASSACHUSETTS PUBLIC HEALT SION-BARNSTABLE,MASSACHUSETTS BisposaY *pstrm Cone-trurtion Permit Permission is hereby granted to Construct( ) Repair( Upgrade(I ) Abandon( ) System located at 4 MAR.V LA J6 HYA VV 1S 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. r °• i Provided:Construction must mple ed,wi 'n three years of the date of thi ermit. Date ✓ , // Approved 04/10/2017 10: 14 5082730367 #5422 P. 001/001 Town of Barnstable Regulatory Services Richard V. Scali, Interim Director tiwtuaar�et.Q � ►+ Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: y 6" 7 Sewage Permit# 26 1 1' oJ-L Assessor's Map\Parcel Designer: TOC, Installer: r dee_WiAe- nt�r�ctse� Address: 2b5'! Address: 15-5 cOw►me.rccO SFreJ ecut w rekyrn OA 07a5�, Mos�,,�ee., 4tA 02�y9 On Zu 17 was issued a permit to install a (date) (installer) septic system at ark L arse- based on a design drawn by (address) -S C t:n ivlee io 'TO'-, dated 361 z017 ` / (designer) �v I certify that he septic system referenced above was installed substantially according to the design, w ich may include minor approved changes such as lateral relocation of the distribution b x and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that he septic system referenced above was installed with major changes (i.e. greater than I ' lateral relocation of the SAS or any vertical relocation of any component of the septic s ystem) but in accordance with State & Local Regulations. Plan revision or certified as-bi ilt by designer to follow. Strip out(if required) was inspected and the soils were founds isfactory. I certify that the system referenced above was constructed ' e with.the terms of the AA ap oval letters(if applicable) oaa,P��M aSSAyG JOHN L CHURCHILLJR cl Installer' Sig at re No lacy is i 7SE 'RETKM,TO gner's Sig azure) (Affix Des' a amp Here) PL ARNSTABLE PUBLIC HEALT DI SION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BO TEAS FORM AND AS- BUILT CARD ARIE RECEIVED BY THE 13ARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q;\Sepiic\l)esigner Cereffica tion Form Rev 8-14-13.doc f Iq-Complete items 1,2,and 3. A. Signature /l �(lgent s`Print your name and address on the reverse X �/ �j y� 0 Addressee so that we can return the card to you. B. Received by(Printed Name) C. ate f Deli ry ,8 Attach this card to the back of the mailpiece, or on the front if space permits. x 1.`Article Addressed to: D. Is delivery address different from item 1,7 ❑Y if YES.enter delivery address below: ❑No p -I�✓i I le, -M A M aT 1:1III flllllllllllllillllllll IIIIIII IIII I II I I III Priority Mail Expre ss®3. Service Type Registered MaIITM ❑Adult Signature ❑ ec ed ❑Adult Signature Restricted Delivery ❑Registered Mail Rstrit Certifed Mail® Delivery ry SSS 9590 9402 2480 6306 7768 10 ❑Certified Mail Restricted Delivery eturn Receipt for ❑Collect on Delivery Merchandise # O Collect on Delivery Restricted.Delivery ❑Signature Confirmiation14 j :`articrA N❑mhcir%Transfer from-senrire labeh —- O Signature Confirmation i 7 Q 1r 2 1,Q 1 Q 0 0 0 Q 2 8 4 7 8568 it Restricted Delivery Restricted Delivery PS Foim.3811,July 2015 PSN 7530-02-000-9053 ' � _ Domestic Return Receipt r Afn .., Ln s .O s �� -..gip .x• \ ,.rat: CO Postage $ ru Certified Fee O . C] Return.Receipt Fee Postmark C3 (Endorsement Required) H1-3 ere Restricted Delivery Fee « 0 (Endorsement Required) r=1 O Total Postage&Fees rq Sent To /p Sru ri treet,Apt No.: % - or PO Box No. A/non �i�L.Yl1/ Ciry,Stale,Z/P+4 o lle MA aa�� Town of Barnstable Barnstable .�. Regulatory Services Department AlAmedcaC"j BAM ABM 039. ,� Public Health Division m �FDN4P�p 200 Main Street, Hyannis MA 0260.1 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2847 8568 March 27, 2017 HOSTETTER, DANIEL & FINNELL TRS 770A MAIN STREET OSTERVILLE, MA 02655 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 4 Mark Lane,Hyannis,MA was inspected on 03/16/2017 by Sean M. Jones, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Leaching pit or cesspool with high liquid level,<12" below inlet(per Town Code 360-9.1). Septic tank is old and brittle and needs to be replaced at time of repair. You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH cKean, ., CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\4 Mark Lane Hyannis.doc Town of Barnstable MAS& Regulatory Services Department 'OrFa ram'' Public Health Division 200 Main Street,Hyannis MA"02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 - Thomas A.McKean,CHO Feb 6, 2007 Rev. 5/11/16 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) _ An"x"marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA r ❑ Discharge or ponding of effluent to the surface of the ground w -. ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1)YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2)YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any"conditionally passed systems" (broken cover,relocation of a pipe, relocation of a driveway due to H-10 components, etc) yLeaching pit or cesspool with high liquid level, <12"below inlet (per Town Code §360-9.1) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER • .. %IV + �P �� tU�k. i S o'�� ��� �✓�'r T��� lN-��l � �.e 1`� (u c..ed �•��j'�e �t ��� �-;i- P P Repair deadline: (A—ho �_ a rs Q:ISEPTICIDEADLINES TO REPAIR FAILED YSTEMS.doc Commonwealth of Massachusetts 0(0 u W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M '( 4 Mark Lane Property Address r4� Hostetter Owner Owner's Name a� information is —4 required for every Hyannis Ma 02601 3/16/2017 page. City/Town State Zip Code Date of Inspection :A► Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms L5,4 /0?/9�, on the computer, use only the tab 1. Inspector: key to move your cursor-do not Sean M. Jones use the return Name of Inspector key. S.M.Jones Title V Septic Inspection Company Name 74 Beldan Ln. Centerville Ma 02632 Cityrown State Zip Code 774-248-4850 smjonestitle5@gmail.com S14522 Telephone Number License Number B. Certification 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 ® Fails ❑ Needs Further Evaluation b the Lo73/16/2017 Authority Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form e Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 4 Mark Lane Property Address Hostetter Owner Owner's Name information is required for every Hyannis Ma 02601 3/16/2017 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 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: This report represents only the front house, the septic system that serves the duplex was determined to be failed in 2005. 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 by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 4 Mark Lane Property Address Hostetter Owner Owner's Name information is required for every Hyannis Ma 02601 3/16/2017 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) .❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):- ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4 Mark Lane Property Address Hostetter Owner Owner's Name information is required for every Hyannis Ma 02601 3/16/2017 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal 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. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"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 '/2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments G 4 Mark Lane Property Address Hostetter Owner Owner's Name information is required for every Hyannis Ma 02601 3/16/2017 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® 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. ❑ ® Any portion of a cesspool or privy is within a Zone 1 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. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 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 facility with a design flow of 10,000 gpd to 16,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. 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 II of a public water supply well If you have answered"yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under,Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts 4 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4 Mark Lane Property Address Hostetter Owner Owner's Name information is required for every Hyannis Ma 02601 3/16/2017 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ❑ ® 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 N/A) ® ❑ 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 of the 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 maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS) on the site has been determined based on: ® ❑ 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(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 gpd t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 5 4 Mark Lane Property Address Hostetter Owner Owner's Name information is required for every Hyannis Ma 02601 3/16/2017 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: vacant Date Commerciallindustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts ugTitle 5 Official Inspection Form o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4 Mark Lane Property Address Hostetter Owner Owner's Name information is required for every Hyannis Ma 02601 3/16/2017 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® 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 obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts v d Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4 Mark Lane Property Address Hostetter Owner Owner's Name information is required for every Hyannis Ma 02601 3/16/2017 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: system installed per town records Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3 feet Material of construction: ® cast iron ❑40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joint were ok, no leaks, vented through the roof Septic Tank(locate on site plan): Depth below grade: inlet end 2', outlet end exposed feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gallons Sludge depth: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts _ 4 - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4 Mark Lane Property Address Hostetter Owner Owner's Name information is required for every Hyannis Ma 02601 3/16/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? measurements not taken Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Septic tank is old and brittle, tank need to be replaced at time of system repair. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date 15ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts u W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4 Mark Lane Property Address Hostetter Owner Owner's Name information is required for every Hyannis Ma 02601 3/16/2017 page. Cityrrown . State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4 Mark Lane Property Address Hostetter Owner Owner's Name information is required for every Hyannis Ma 02601 3/16/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert N/A Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts h W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4 Mark Lane 4 M Property Address Hostetter Owner Owner's Name information is required for every Hyannis Ma 02601 3/16/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach pit was found to have standing water 3" below inlet invert resulting in a failing inspection. 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 inflow ❑ Yes ❑ No t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts u W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 4 Mark Lane Property Address Hostetter Owner m Owner's Na e information is required for every Hyannis Ma 02601 3/16/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont) 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.): 15ins•3113 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 ` agmmonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a 4 Mark Lane Property Address Hostetter Owner Owner's Name information is required for every Hyannis Ma 02601 3/16/2017 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view 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 enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately P � � ►S 13-Z �11• a 3 33 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4 Mark Lane Property Address Hostetter Owner Owner's Name information is required for every Hyannis Ma 02601 3/16/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water: ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12'+ feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ 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 elevation: Groundwater elevation was determined by accessing Town of Barnstable groundwater contour map. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 4 Mark Lane Property Address Hostetter Owner Owner's Name information is Hyannis Ma 02601 3/16/2017 required for every y page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 WY ' Y36 J /3Y l v (Al a—v,ZIL-% �►�� VvC W E g 4 V C= ��N �/ i�tz w►c=l� %ft�T L�F �/CC=Z) N spp TI s,� s � / C L L (4AV J N G 1 srA< < c-D> E 5'ySTt r► l nJ Ur HAV 16 5- Ty �v P/N 6 r ���5 NuI2�E(- Div �N �5 Cry i/L -TI-' i v �fEG F� SdbG- % B2UL 67 CIA ►5Tz�- i�� 7-LID i� M,tr-� l { i ti 1 n G NQ 4 s (' M M C1 r - s 1 VI. /� N W } � � � 4 � � i � � i �' ! � _. ._ .- Iv !� �. �� �� CT �� i �t � � m �, � . � s . �' . a TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date f — _I U Time: In Out Owner h—Llt � Tenant Address _--SX Address rl r ' i Complia a Remarks or Regulation# Yes Y NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply Approved: �- +.m I%HnrMt 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17.Temporary Housing 18. Driveway Width 19. Number of Tenants Observed a PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms 1 Number of Vehicles Allowed (max) Number of Persons Allowed (max) a2� Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here � | ' � ' s TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date I ° Time: In Out c Owner Tenant Address 770 Address t i ComplipKce Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities .� 3. Bathroom Facilities �pcoved' � -:� �. a 4. Water Supply w 5. Hot Water Facilities 6. Heating Facilities " 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use ` 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing 18. Driveway Width 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms f Number of Vehicles Allowed (max) Number of Persons Allowed (max) Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here + _ GENERAL NOTES HOUSE T.O.F. EL.= 27.0± : FINISH GRADE OVER D-BOX- 1 G.$_ - _ FINISH GRADE OVER CHAMBERS= 16.0' - 16.8+ N „ PROVIDE EXTENSION RISER 3/4 TO 1-1/2 DOUBLE WASHED �! WITH COVER OVER INLET& REMOVABLE WATER-TIGHT COVER OVER OF PIPE 1• UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION RISER TO WITHIN 6"OF FINISHED GRADE STONE TO CROWN OUTLET TO WITHIN 6 OF F.G. 2" OF 1/8"TO 1/2".DOUBLE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISH GRADE + _ + 5"DIA. OUTLET 4"SCHEDULE 40 PVC MIN SLOPE 1°� PVC VENT PIPE WITH CODE AND ANY APPLICABLE LOCAL RULES. FND. EL: 25.6± F.G. OVER TANK EL.= 21 .0-23. (S) WASHED STONE CHARCOAL FILTER SLOPE @ 2%MIN.OVER SYSTEM 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE f DESIGN ENGINEER. i 4"PVC TEE " I PROPOSED 4" FROM EX.SEPTIC 9 MIN. TOP OF SAS 13.$3' 3. ., EXISTING 4 TANK ONLY 3WMIS(- + 9 MIN. 4 SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL SEWER PIKE SCH.40 PVC 13.00 36"MAX. PLACE RISERS ON ALL SYSTEM UNLESS OTHERWISE NOTED. L �C _ M V' 11 � f SEWER PIPE CHAMBERS WITH INLETS BREAKOUT EL 13.50 fiO 6"OF FINISHED GRADE 4. TO PREVENT BREAKOUT THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN ,• » 3 DROP MAX ,, 6 3 ,2 DROP.MIN PROVIDE WATERTIGHT ELEVATION - 13.50 FOR A DISTANCE OF 15 AROUND THE PERIMETER OF THE SAS. UNLESS A MIN.SLOPE�1% JOINTS YP. o n 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF 10L= 48't 4"Pvc " �_ �4 PVC OUT TO THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. � � 0 � � 0 0 0� � O 0LEACHING FACILITY oCONTRACTOR TO PROVIDE �� + p � 5. SLOPEALLSOLID PIPE AT 1.0%MINIMUM. 20.E -€ ' 12 6 0 SPECIFfED DROP BETWEEN 13.50 » » 0INLET AND OUTLET CONTRACTOR CONTRACTOR (EX.TANK) MIN + 06. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. UTLET TEE 13.33SHALL VERIFY SIZE 48 VERIFY CONDI 4 4 4' 4' 7• LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK AND CONDITION OF EXISTING TEES \-GAS BAFFLE 13.50' 6"CRUSHED STONE 6'0' V 3' FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION.SYSTEM IS EXISTING SEPTIC AND REPLACE AS (PR.TANK) OVER MECHANICALLY 56` (TYP.) NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH TANK NECESSARY COMPACTED BASE 7.00' 11.0' AND DESIGN ENGINEER. 3 12.00' GROUND WATER ELEV INLET DISTRIBUTION BOX 8. ELEVATIONS BASED ON APPROXIMATE M.S.L DATUM. BENCHMARK ELEVATION OF 17.00' TO BE INSTALLED ON A LEVEL STABLE - _ - 5'MIN. REQUIRED $ LC 6 CHAMBERS ESTABLISHED ON A NAIL SET IN UTILITY POLE#456/2,AS SHOWN ON PLAN.. BASE. FIRST TWO FEET OF OUTLET CHAMBER END VIEW EXISTING 1,000 GALLON CONCRETE SEPTIC TANK -PIPES TO BE LAID LEVEL. TYPICAL,,, CHAMBER PROFILE 9. CONTRACTOR SHALL ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT 1-888- I -SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES CROSS SECTION VIEW D G CONTRACTOR TO VERIFY EXISTING g � /� CHAMBER DETAILS TO THE DESIGN ENGINEER. _, � EXISTING TIC TA DETAIL ODISTRIBUTIONDETAIL ELEVATION PRIOR «O ANY WORD& NOT TO SCALE NOT TO SCALE NOT TO SCALE 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC.STRUCTURES SHALL BE MADE WATERTIGHT. NOTIFY ENGINEER IF DIFFERENT. 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING DUPLEX T.O.F. EL.= 17.0± L !", ; r� A REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM .�.�: TEST T PIT T P"'1+TA PROVIDE EXTENSION RISER WITH AUTHORITY. APPROPRIATE COVER OVER INLET&OUTLET TO �.. + . �� � PERC NO. 1530�1 FINISHED GRADE F.G.OVER :; 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED WITHIN 6 OF F.G. (TYP OF 3) ' TANK EL.= 16.3'} INSPECTOR: David W.,Stanton,R.S. AT FOUNDATION= 16.2± INSPEC O UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT,.DRIVES,OR EVALUATOR: Michael Pimentel C.S.E. TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. 9 MIN. 10/27/1999 SHALL BE FREE OF ALL DUST AND FINES. C.S.E.APPROVAL DATE. 13. DOUBLE WASHED CRUSHED STONE L , PROP. 4"SCH.40 36 MAX. -�--- : .�, � _ � � � � DATE: March27,2017 PVC SEWER ..- ----, 14. WHERE REQUIRED,CONTRACTOR SHALL REMOVE LOAM SUBSOIL AND UNSUITABLE 4 SGH.40 PVC TO � �: '� .� , , _ E Q , F .,F: 1 MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALLSIDES OF LEACHING FACILITY. " OP MIN. ST ,:� >. �, N ., ,. ,. . TEST PIT#. 2 DR DISTRIBUTION BOX �» :> 1 » " .. : REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, MIN.SLOPE C 1% 6 3 3 DROP MAX. 3 9 3 9 'g/ V TOP 16.00' -- MIN.SLOPE 1% R/ N A, ELE O _ _- -- q@� ST I ' ' �� FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). s F R M rti, FF Zt�NE 2 L 41 t `'. O �' ' - ELEV WATER= 7.00' '� Th 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN 1 1-11 ? _ SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. .�� 1 + PERC RATE- <2 min./inch ,* 5 ,A� �. r LOCUS 14.60 14.20 " » 16. PROPOSED PROJECT IS LOCATED WITHIN: DEPTH OF PERG= 36 -54 �, l • ! ASSESSOR'S MAP 289 LOT 30 48 p' 1 NOTE. O P 1 ., . ��, ., ;:;� ;,• W TEXTURAL CLASS: 1 + J II STETTER&FINNELL TRS 14.45 OWNER OF RECORD. DANIEL C. HO ALL INLET AND � �\ BAFFLE GAS BAFFLE �• w ., GAS B OUTLET TEES SHALL 0 r a . 100 GAL. 500 GAL. BE PLACED DIRECTLY , „ : y ) 0 / . qa o- ,:- 1t ADDRESS. 770A MAIN STREET _ a _ ► is cr 0 16.00 4 HRS DETENTION (24 HRS DETENTION) UNDER A COVER. I 10.4 TO FND ( 8 ) -2�' ...__ / N x 3 Fill OSTERVILLE,MA 02655 a 6"CRUSHED STONE �/ " / m U.P. 448 .__ 2& \ / * '�---�, 12" 15.00' FEMA FLOOD ZONE X OVER MECHANICALLY -2$- �..-- � � a +� * �. „ti, :, C3ttt" COMMUNITY PANEL# 25001 C0568J COMPACTED BASE �rr � - ter / / . • * ,70 ��° C1rt�/ --- U.P. #I52515 W C31 {r1v [/H/ ?� * ' :n ' * 17. DEED REFERENCE. BOOK 4346, PAGE 10 GALLON TWO COMPARTMENT SEPTIC TANK H-10 '�-`�� • PROPOSED 1000/500 G t ) / .� � , •. ;., ". � Loamy Sand 18. PLAN REFERENCE: PLAN BOOK 257, PAGE 11 LENGTH 10-2 /2 WIDTH 6 1 /2 DEPTH 5 3 /2 DIMENSION AS PER �g S86 34 50 E •: x 27-- �o Q- 3 CONTRACTOR TO REPLUMB EXISTING . 127. �,. , ;. ,� 19. A 4"PERFORATED SCH.40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A WIGGIN PRECAST CORP. 24 ,y " :.,. 00, SEWER PIPING AND EXIT.HOUSE AT -g� Q / ,y; �' ... DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3 OF FINISH GRADE. A PROPOSED SEPTIC TA DETAIL POCASSET,MA t.0 > G .. r Pere �.r. ION AND LOCATION AS - - 2 � __ REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. THIS ELEVATION (800 564 6774 ,i NOT TO SCALE t� « 2 6 r - ,_, _ D .� , _ _ _ 11:50 T PLAN BELOW. __ a ,. , ,,. :., SHOWN ON HE LA ,,.E. 20. OWN /APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE T OBTAIN A N L ERL O B AIN NY AND z ti _,, I PROJECT. 6 REQUIRED PERMITS AND APPROVALS FOR THIS P JE 2'. � ,•. Med Coarse Sand / II 2.5Y 6/6 LEGEND �- EXtS / ! » x TONG LOCUS PLAN Matt.@108 108" - - -� 7.00' 50xO EXISTING SPOT GRADE 4 \ a EXISTING SWING-TIESw � \. SELLING ! / f' SCALE. 1 l000 DWELLING Z 0 w 7'OF-27.0`+ 120' Stand: 120iV 6.00 23� � - - 50 - - EXISTING CONTOUR DESCRIPTION HCA HC-2 � >- -�-23 t � � r z /� / ca �tr \ EXISTING 1,000 GAL. SEPTIC TANK DATA 50 PROPOSED SPOT GRADE TANK INLET COVER(1) 35.3' 12.8' c Y ,ii \ z _._TO BE UTILIZED IN THIS DESIGN 132 5.00' Q 5- -22 `-` / Z `� / MAIN HOUSE 50 PROPOSED CONTOUR TANK OUTLET COVER 2 38.3' 19.6' _ '� o O � o z 25 .. P NUMBER OF BEDROOMS (DESIGN) 3 ❑/H/W EXISTING OVERHEAD UTILITIES / �.. CORNER OF STONE 3 30.7 25.0 z ` 24 J 110 O "- • CONC. EXISTING LEACHING PIT TO BE DESIGN FLOW GAUDAY/BEDROOM 21 / ,� - « -STEPS i PUMPED, FILLED OATH CLEAN TOTAL DESIGN FLOW 330 GAL/DAY GAS EXISTING GAS LINE O CORNER OF STONE(4) 39.6 33.8 ��`22 \ � .�' � P c7. ___ -'' COARSE SAND,AND ABANDONED DESIGN FLOW x 200 °k _ 660 GAL/DAY TEST PIT DATA 1 CORNER OF STONE(5) 49.0 78.9 -20 �. 20..., LP ,gyp ` / ..._._ USE EXISTING 1,000 GALLON SEPTIC TANK �W__W EXISTING WATER LINE w PROPOSED PERC NO. 153Q1 CORNER OF STONE 6 42.2' 75.5r� - .PROP.4 PVC VENT PIPE 0 O `� ---"" \.., -----. 3-INLET D-BOX � INSPECTOR: . David W. Stanton,R.S. TEST PIT LOCATION a �A1 � ,. -- DUPLEX 19 � EVALUATOR: Michael Pimentel,C.S.E. to ,..- (DESIGN)� GRAVEL- DRIVE�- '�•� / NUMBER OF BEDROOMS (DE I ) 2 i*I_ GR, �_ PROPOSED EIGHT(8)LC-6 110 C.S.E.APPROVAL DATE: CP EXISTING CESSPOOL m (5) DESIGN FLOW GAUDAY/BEDROOM 10/27/1999 o: �, -18 F xa -.. ' CHAMBERS W/4'OF DATE: March 27,2017 !T .,,.,.. � � 18_ TOTAL DESIGN FLOW 220 GAUDAY _.SURROUNDING STONE o .., .,.,.,.. .....-.. x TEST PIT#. 2 O O EXISTING 1,000 GALLON SEPTIC TANK (4) /' \. DESIGN FLOW x 200 /o GAL/DAY ;.... , z .. : .:- .: .. .. .... _ _ . ELEV TOP- 16.60 » PROPOSED 1000/500 GALLON COMPARTMENT EXISTING 4 SOLID SCHEDULE 40 PVC PIPE :.• USE PROPOSED N INSPECTION PORT SEPTIC TANK = 8.93 O ,0. ::. ELEV WATER fD > _ .. .: ,.; C? COMPARTMENT 1. LZ JU. . �. - ::_.:_: ;-::•<;.. 3 t -17 ¢ • :.,._� :::.. ,::�::...:_.., C) .�.r-.,. -.. � � ° _ _ PROPOSED 1,0001500 GALLON 6.0 O Q ::. :r. -2 DESIGN FLOW x 200/o-220 x 2- 440 ,GAL/DAY(REQUIRED) PERC RATE= O O O (2) L� / �,,,eTP -:;_: �, DESIGN CAPACITY 1,000 GAUDAY (PROVIDED) TWO-COMPARTMENT H-10 SEPTIC TANK O --16 ` U.P. w \ 16k6 •L, _ » 0 � MAP 2$9 CoMPARTMENT2. DEPTH OF PERC PROPOSED 4 SOLID SCHEDULE 40 PVC PIPE o (1) 456/2 f1r O BtT 0 DESIGN FLOW x 100%=220 x 1 220 GAL/DAY (REQUIRED) o Nr '-- . DRIVE O LOT 30 _ - TEXTURAL CLASS: 1 N �- } DESIGN CAPACITY - 500 GAUDAY (PROVIDED) HC-1 " 1 n-yamflll� " '..-_-- 0 27,992±S.F. ® PROPOSED 3-INLET DISTRIBUTION BOX o J TOTAL 15 L PROPOSED LC-6 CHAMBER --.. r DEC " c, Benchmark o f4 r TOTAL NUMBER OF BEDROOMS (HOUSE+ DUPLEX) 5 0 16.60' HC-2 Nail Set in U.P. -� �'yi `'� o TOTAL NUMBER OF BEDROOMS(DESIGN) 5 _ � .�• E PROPOSED 1,000/500 GAL. Fill EXISTING Elev. 17.00 1 o o EXISTING o .�� , TOTAL DESIGN FLOW 550 GAUDAY A rox.M.S.L. - DUPLEX TWO COMPARTMENT 12 15.60 / DUPLEX PP o - (2-BEDROOMS T SEPTIC TANK(H-10) , TOTAL) REV. DATE BY APP D. DESCRIPTION ,Ay - w w TOF=17.0'± INSTALL 8 - LC-6 CHAMBERS W/AGGREGATE -- ____ GIs 3AS -14G` V CRAWL=13.0'± Loam Sand PROPOSED SEPTIC SYSTEM UPGRADE �- GAS-- B GAS As SIDEWALL CAPACITY y 10Yr 5/6 ����.�Q44,��4 THE (LENGTH +WIDTH) (2) (1 HIGH) (0.74 GPD/S.F.) _ GAUDAY �NUF a`,,A5-a PREPARED FOR: _ E'LIV�tE CP (56'+ 11) (2)°(1') (0.74 GPD/S.F.)= 99.2 GAUDAY 36 13.60 `�° I -APPROX. DUPLEX PIPE E REDIRECTED _ soHN4. CAPEWIDE ENTERPRISES DU. LEX SEPTIC P PE SHALL E� E E E � URC iLL.1R. N WATER LINE INTO NEW 10001500 GAL S.T.AS SHOWN CN -� BOTTOM CAPACITY ,L EXISTING CESSPOOL TO BE PUMPED FILLED � 41ao _ LOCATED AT SEPTIC DIMENSIONS VC SETBACKS (LENGTH x WIDTH) (0.74 GPD/S.F.) - GAUDAY q WITH CLEAN COARSE SAND, AND ABANDONED - Med-Coarse Sand o crs �. . SCALE: 1"=20' �.. (56 x 11) (0.74 GPD/S.F.) 455.8 GAUDAY 4 MARK LANE 136.78 2.5Y 6/6 C HYANNIS, MA 02601 _ N$s° os'3o"w TOTALS I TOTAL NUMBER OF CHAMBERS: 8 SCALE. 1 INCH 20 FT. DATE. MARCH 30,2017 EXISTING 20' 9 Mott. 116" Q o TOTAL LEACHING AREA: 750.0 SQ.FT. DRAINAGE EASEMENT N MAP 2$9 116 - --- --.� 6.93' o 10 20 40 so Feel NOTES: TOTAL LEACHING CAPACITY: 555.0 GAL./DAY LOT 151 Stand. 127" _ 1. CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE PROPOSED LEACHING - RESERVED FOR BOARD OF HEALTH USE 127 - -0 6.00 PREPARED BY. SYSTEM TO ENSURE CONSISTENCY WITH TEST PIT DATA SHOWN ON THIS PLAN. REPORT TO JC ENGINEERING, INC. . _ 132" 5.60' ENGINEER AND LOCAL BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. 2854 CRANBERRY HIGHWAY 2). ENTIRE PROPERTY IS LOCATED WITHIN A DEP APPROVED ZONE 2 AND THE WELLHEAD SITE PLAN- EAST WAREHAM, MA 0253$ PROTECTION OVERLAY DISTRICT. SCALE: 1"=20' 508.273.0377 Drawn By: BJW Designed By:BJW Checked By: MCP JOB No. 3762