HomeMy WebLinkAbout0060 OAK NECK ROAD - Health 60 Oak N
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Town of Barnstable
.�`I„E, egatary Services
Thomas F. Geiler, Director # E f
Public Health Division
9BA MASS. Thomas McKean, Director f.,.
�ArF 039. a` 200 Main Street
Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
September 8, 2008
Janice Ford
10 Pem Lane
Mashpee, MA 02649
As of October 1, 2006 a new rental registration ordinance was put into affect requiring
all property owners of rental units to register their rental units with the Town of Barnstable
Health Division. According to our records, you own the rental property at 60 Oak Neck Road,
Hyannis.
Enclosed is an application. Please use a separate application for each rental unit you
own. Should you need more applications, they are available online at
www.tow7i..barnstabl.c..ma.us. Go to the Health Division page by looking in the Department
Menu. There is a link to the Rental Registration information on the Health Division page. You
may print out as many as you need, and return them to the Health Division with the appropriate
2008 fees included.
Failure to comply with this ordinance will result in the issuance.of a non-criminal ticket
citation in the amount of$100. Each day of non-compliance is considered a separate offense.
Should you have any questions, please feel free to call 508-862-4644. Thank you in
advance for your cooperation.
Timothy B. O'Connell
Health Inspector
Health Division
Direct#508-862-4646
MRVP # 03 w,X,0T
Assessor's office (1st Floor) ��
Assessors Map and Parcel #
Building Department (4th Floor)
zoning ��\\
INSPECTION FEE $ 0 66,06
RE-INSPECTION FEE $15.00
Request For A Sousing Inspection For Certification Under the
MA Rental Voucher Program
Your Name
Affiliation (Circle One) Real Estate Agent Tenant
Your Address /5e
Telephone Number (Day)
2 (Night)
Address of Property Where Inspection is Requested
Unit/Apt.# 4,1<"
Name of Owner C
Address / �/ ,�c9 .yP , z ems' � �o 2-
Mailing Address (if different)
Telephone Number (Dayj�1'Gd'1 �/ 2 4 kL-,�aNight) 4/5 L 4-
Will there be any children under the age of six (6) who will
be occupying the rental unit? (circle one) Yes C No
Was the dwelling constructed prior to 1979? Yes No-�
------------------------------------------------------------
FOR OFFICE USE ONLY:
Certification
The dwelling dwe l' g unit, or rooming unit located at
was inqpected on
by Health
Inspector for the Town of Barnstable and was found to be in
compliance with the provisions contained within 105 CMR
410.00, State Sanitary Code II: Minimum Standards of Fitness
for Human Habitation. However, this certification does not
include a determination as to whether this unit contains any
lead paint because under 760 CMR 49.02 Massachusetts Rental
Voucher Program, a separate lead paint inspection must be
conducted.
!Qn--C_�=�
Inspector's Signature
Date / ��c
�1
TOWN OF BARNSTABLE
BOARD OF HEALTH
ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION
Date
Owner \C� Tenant V
Address AddressCompllance Remarks or
Regulation# Yes No Recommendations
2. Kitchen Facilities
3. Bathroom Facilities
4. Water Supply
fY y1
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
PART II
37. Placarding of Condemned Dwelling;
Removal of Occupants; Demolition
���
Person(s) Interviewed Inspecto
If Public Building such as Store or Hotel/Motel specify here
No.----- . ---•• Fxa..o'L.l ...
THE COMMONWEALTH OF MASSACHUSETTS
------,BOARD OF HEALTH
q,61I <
......OF......... ..... ....... .. .... ------
Appliration -for Uiiplasal Works C onstrurtion Vanift
Application is hereby made for a Permit to Construct ( ) or Repair ( 'ran Individual Sewage Disposal
System at: .. ' .--- --
lam' u� 1----- --d- / ..-��---- •-•- ------•••-------------- -•------- - --- ------•••--
ocation•Add,`s or Lot No.
Owner Address
aW --� ------•------------------------
-------------------------•------
- Installer Address
Type of Buildi Size Lot____________________________Sq. feet
U Dwelling—No. of Bedrooms___________________________________________Expansion Attic ( ) Garbage Grinder ( )
pa-, Other—Type of Building ____________________________ No. of persons-_________-_________-___..._ Showers ( ) — Cafeteria ( )
Q' Other fixtures --------------------------------------- - - -
W Design Flow............................................gallons per person per day. Total daily flow----------------------------------------....gallons.
WSeptic Tank—Liquid capacity_______ __gallons Length________________ Width______--___ Diameter---------------- Depth----------------
x Disposal Trench—No_____________________ Width-------------------- Total Length-------------------- Total leaching area--------------------sq. ft.
Seepage Pit No..................... Diameter____________________ Depth below inlet.................... Total leaching area--__----__-_-_-___sq. ft.
z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by------------ ------------------•-•---•------------------------------------ Date__----------------------------------
a Test Pit No. 1----------------minutes per inch Depth of Test Pit_-_-_____________ - Depth to ground water-------_._____-_--__----
�14 Test Pit No. 2________________minutes per inch. Depth of Test Pit-------------------- Depth to ground water-_--_-_--__-___-____..-.
------------- ................................................................................................................---
0 Description of Soil-..----"--—------------- .-- .J---•-- . ------ - ------- --- -
-
- - ---- ----------
----------- ------------ __. - -
w ---- ------ .�------- --- ------- = 4
- -- -------
U Nature of Repairs or Alteration —Answer when applicable-_ _____ ___ __ ____ __ _______- _._______---------------------------------
------------------------------------=--------------------------------------- --------------------------------------------------------------------------------------------------------- ---------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has ,- n sued by
t e board of healt .
Signe .....L -- ---------------
Dat
Application Approved By-- L --- ----- �il
ate
Application Disapproved for the following reasons--------------------------------- ---------------------•--•-------------._.._.___.--_----...-_-----._...----•--
-----------------------------------------------------------------------------------•.._..-----•-•--------------------.._.._..._..-•----------------------__.------------------...._..----------------
/' Date
Permit No......................................................... Issued.:r2- J -✓ :7.
_ ------.-._._--------- Date
•-
_-._-----/-------•------------------------------------------------------
No......�-.k..... ............. ...........
THE COMMONWEALTH OF MASSACHUSETTS
OARD OF HEALTH
-777��Ea
OF.
.........0 ........ ......
Appliration -fur 13hipuoal Worko Towi#rurtiuu Vrruli#
Application is hereby made for a Permit to Construct ( ) or Repair ( l an Individual Sewage Disposal
System at-
G1 " cl, -a- )1,
ocation-Add—
ss''�. ....- '� or Lot No.
!!!{{
f/Owner Address
a --•---------- �__-- _... 7•...... .�'�'� '------------ ---------------------------------------•-••------------------------------------------------------
Installer Address
d Type of Buildi Size Lot___________________________Sq. feet
U Dwelling—No. of Bedrooms_________________________________ ________Expansion Attic ( ) Garbage Grinder ( )
H
PL4 Other—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( )
Q' Other fixtures ------------------------------
W Design Flow--------------------------------------------gallons per person per day. Total daily flow-------_-_._----____-.________-_____-__.....gallons.
W Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth---.--------
_.-
x Disposal Trench—No..................... Width.................... Total Length-------------------- Total leaching area--------------------sq. ft.
Seepage Pit No..................... Diameter-------------------- Depth below inlet.................... Total leaching area.---_--.________.sq. it.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed bY---------- ----------------------------------------------------- ------ Date----•-----------------------------------
,� Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water-..__-___-__--_-__-__---
(14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_-_-_-______-_______-._.
.
D Description of Soil------_----- ---.._''�,�,�.,
---
x �
y
U Nature of Repairs or Alterations—Answer when applicable._-_.............. �--_--__..---.---._---___-----_..._-.__-_______-...-.
------------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has en i sued by the board of healt
Signe �-'....... ` ----- .................................................
Application Approved BY =- '------ - .=" ...• -•--•- ............
,�T y
Application Disapproved for the following reasons:................................
.---------------------••----•--•..............---.......------•-••-•---
..............•-.._........••---••--•------------------------•...._.......•••---•-•---•.-•-••••••-
Date
Permit No......................................................... Issued. � 3 to
i
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF/)HEALTH
....� ......OF............... . ..... ....0 :.. .
01rdifira#r of Tum tmnrr�
THIS S TO CERTIFY, That, the Individual ewage Disp sal- constructed ( ) or Repaired (�)
l
�. E
by------- -------- ,�, -
nstaller "'
f
-- .. ...
_ m,
has been installed in accordance with the provisions of ArttcleYI pf The State Sa rtary Cods deibed in the
I
application fort Disposal Works Construction Permit No..........es-_ _ _,,... _ ______ _______ _.-. .dated. ...1. ---___--7Y.........
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.......................................... .................................. Inspector....................................................................................
1 THE COMMONWEALTH OF MASSACHUSETTS
✓'�. BOARD /0.1 HEALT
....... < :...........OF...... / rs�' - '° ...... ..............•--.
No. *' ••... FEE.-- .............
R,ri uutt! fur. ,i Tuuitr - rtion rrnti
Permission is hereby grante , . _. `---'-----------------=-._
toRepair
_.�:.----------------. '.... rJ_.._s_------�-..-----='�� ----.....:...
Construct ( ) or Repairr (R"') an `ndividu l Tw,aie Dispo, I System..-..
at No.---X-•Y....-4.1•• A. •P-4.'_`t--•----`` .------• -- ---------•-
reet
as shown on the application for Disposal Works Construction PerNo.____._. Dated__-�'_ .._ �"'
,.. 't '' = '.........
-
^� /74�
�O'"board of Health
7Z,
DATE.••-=.'= -� ---------------------------------------
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FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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