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Home My WebLink About0014 PEPPER LANE - Health .14 Pepper Lane - Hyannis F A _°294 036 i P { I�� TOWN OF BARNSTABLE pole i SEWAGE EWAGE # f� "�,, L,LAGE /V1 ASSESSOR'S MAP& LOT INSTALLER'S NAME&PHONE NO. 1lXl/I �I►/ �, Ityi� SEPTIC TANK CAPACITY P LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER i 00s PERMITDATE: Q COMPLIANCE DATE:I4R 1 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility t 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 t within 300 feet of leaching facility) Feet Furnished by w � r i ,I H3 1 .P N, P QQ - I TOWN OF BARNSTABLE LOCATION ra SEWAGE# q II.LAGE n ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. r ` SEPTIC TANK CAPACITY .�'T u � 11� LEACHING FACILITY: (type) tom" ®+t j D-% size) q l K a x NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: v� �� COMPLIANCE DATE: Separation Distance Between the:., Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by ww � � r �� - � � t � x' a � �� 0 v �- c� 1- C • 1 , !� AIX ce Soso, G Q • + .f` - � - * - .. � � :� • (%ter t ry YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to ct erg e. cif'' a mList first obtain the necessary sign<ituri:ti can this form at 200 Main St:., Hyannis. Take the completed fOriTt tO the -[own Clerk's Office, 1 st. FI., 367/ Main St.., Hyannis, MA 02601 %Iown Hall) and get the Business Certificate that is required by law. f° a DATE: Fill in please: APPLICANT'S YOUR NAME/S: 5u1nri Loncz�Tc. r' BUSINESS YOUR HOME ADDRESS: 114 in (4!cje,►1n.'S M-, 779-991--0(t7y TELEPHONE # Home Telephone Number 7 74 ' a l ' O(a 7Li .. NAME OF CORPORATION: NAME OF NEW BUSINESS tj C, P r-A SS 10n S O 69 e C TYPE OF BUSINESS' Cr v F I&THIS A HOME OCCUPATION? _'Y NO _._ ADDRESS OF BUSINESS c MAP/PARCEL NUMBER (Assessing] When starting a new business there are several things you must do in order to be in compliance with the rules and regulation's of the Town_ of ., Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. (corner of Yarmouth Rd. & Main Street) to.make sure you have the appropriate permits and licenses required to legally operate your, usiness in this town. " 1. BUILDING COMMISSIONER'S OFFICE r This individual has been informed of any permit requirements that pertain to this type of business: c � Authorized Signature** COMMENTS: 2. BOARD OF HEALTH This individual ha en infor ed oft e p i>i r rements that pertain to this type of business. a Authorized i ature* COMMENTS: MI 14T,..nMaLy WITH l�66 14AZARD01IS UATERl�11_ 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type-of business. Authorized Signature* COMMENTS: r� o+ -et Date:( TOWN OF BARNSTABLE RIE- f TOXIC AND HAZARDOUS MATERIALS ON-SITE —NAME OF BUSINESS: of Cod BUSINESS LOCATION: J�_yG��1 s'� INVENTORY MAILING ADDRESS: i H Pei es- TOTAL AMOUNT- TELEPHONE NUMBER: 77L4- S a I - oco74 CONTACT PERSON: 3c31\,) Lopez- EMERGENCY CONTACT TELEPHONE NUMBER: 5015- 77( - 3( MSDS ON SITE? TYPE OF BUSINESS: INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: j Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) �'( 1 Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene,#2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives(creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison"labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous.Zlz-wm:R�r-. Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials -i va Town-,of Barnstable Barnstable Regulatory Services Department EMNSTABM 039. Public Health Division m 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL # 7012 1010 0006 2851 4068 June 30, 2014 Gregg Anderson 14 Pepper Lane Hyannis; MA 02601 The septic system located at 14 Pepper Lane,Hyannis MA was inspected on 4/17/2014, ' by Matthew Gilfoy, a certified septic inspector for th6 State of Massachusetts. The inspection of the septic system showed that the system "Conditionally Passed"under the guidelines of 1995 TITLE V'(310 CMR 15.00) due to the following: • Pump'must be repaired. You are ordered to repair or replace the septic system within Sixty (60) days from the date of 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 Ltr not sent-Permit not issued— Matthew Gilfoy did some repair at s time of inspection. ?of electrical permit See attached e-mail Thomas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\14 Uncle Willie's Way.doc Town of -Barnstable Barnstable Regulatory Services Department A P MAM ""L 0 D ��' Public Health Division MA'S A 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 28514068 June 30, 2014' Gregg Anderson 14 Pepper Lane Hyannis, MA 02601 ; The septic system located at 14 Pepper Lane,=Hyanliis MA was inspected on 4/17/2014, by Matthew Gilfoy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Conditionally Passed"under the guidelines of 1995 TITLE V (310 CMR 15:00) due to the following: • Pump must be repaired. You are ordered to repair or replace the septic system within Sixty (60) days from the date of 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 Ltr not sent-Permit not issued— Matthew Gilfoy did some repair at time of inspection. ?of electrical permit- See attached e-mail Thomas.McKean,.R.S., CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\14 Uncle Willies Way.doc IPage 1 of 1 .3 Miorandi, Donna From: Winston A. Steadman II [wsteadmanii@comcast.net] Sent: Thursday, May 01, 2014 1:01 PM To: Miorandi, Donna Cc: Parvin, Lindsay Subject: Pepper Lane Barnstable Expires: Tuesday, October 28, 2014 12:00 AM Hi Donna—B&B excavating did the title V on this system and did a conditional pass as the pump was not working. Matt called me to see if I could figure it out.The problem was with the electric line to the pump chamber was cut.The owner had an electrician come out and replace the line (he trenched in a new conduit as the old line was direct bury).The alarm would go off before the pump would turn on as the distance between the floats was less than an inch.The floats were attached to the pump and,while pulling the pump out the piping came apart as it was not glued properly(fitting came off). I re-glued the fittings adding a quick disconnect, adjusted the floats and reset the pump. I did this yesterday afternoon (7:00pm). I am not sure if you need me to pull a permit or not, if so I can come in after I get back, I am working out of country until the 10th (I am leaving later today) I will have email access but most likely no phone. Please let me know as they are trying to sell the home. Thanks—Winston I can be reached at(508)776-6219.until 7:00 tonight k 5/6/2014 - All Cape Environmental Inc. 0UV G 0�� P.O. Box 235 Yarmouth Port, MA 02675-0235 Invoice Number: 141136 USA Invoice Date: May 1, 2014 Page: 1 Voice: (508)776-6219 Duplicate Fax: (508)283-7951 BiI1�To � �. � Sh�p�o � n .•� , Greg Anderson Greg Anderson 147 Lakeside Drive Pepper Lane Marston Mills, MA 02648-1921 Barnstable, MA .. _. _ , 7CustomerPO,'3 xs'r n'w- '-m-��, g�', CustomerIDm r �= Payment Terms p.:.3 Cza�m i GREGANDERSON C.O.D. a __ Sales Rep 1D Shipping Method= 4 _ ,:Ship Date DueTDate WINSTONSTEADMANII Best Way 4/30/14 5/1/14 r „ � �Descn[�tion," " ' �� v� �i4" 'x4 • .d�M�9 5{MaR yA4 +�. { a L` 2.00 LABOR Troubleshoot Pump System 95.00 190.00 3.00 LABOR R/R Pump reset floats, re-pipe pump 95.00 285.00 1.00 QUOTEMATERIAL New pipe fittings and disconnect 38.00 38.00 Subtotal 513.00 Sales Tax Total Invoice Amount 513.00 Check/Credit Memo No: Payment/Credit Applied �513.00 CREDIT CARDS NOW EXCEPTED PLEASE CALL TO USE CREDIT-CARD FOR PAYMENT THANK YOU-Forthis opportunity to serve your waste-water needs i (� A t i i Commonwealth of Massachusetts . Tit e 5 Official Inspection Form ' Subsurface Sewage Disposal System Form'- Not for Voluntary Assessments °M 14 Pepper Lane Property Address.. Gregg Anderson Owner: . Owner's Name information is # required for every:. Hyannis Ma '02601 4-1.7-14 : page.. City/Town:: � State Zip Code Date oflnspection Inspection results must be`submitted on this form., ns,pection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information f "filling out forms on the computer, use only the tab ::.1. Inspector: (� Key to move your U`� cursor-do not Matthew Gilfoy.. Use the return: , key. Name of Inspector B&B.Excavation, fnc: "V�I Company Name p .14 Teaberry Lane ' t Company Address F a Forestdale MA 02644.: City/Town State • Zip Code (508)477-06b3 5113640 Telephone Number License Number I - B. Certification r I certify that I.have personally inspected,the sewage disposal system at this address and that the ` s 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 app.royed system Inspector pursuant to Section 15.340 of x. Title 5(310 CMR 15000).The system:' t • 77 F1 Passes. y ® Conditional) Passes: ElFails c • F] Needs Further Evaluation by the Local,Appmving:Authority, ' 4-18-14 .Inspector'sS' nature' - a ,.. 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'de'sign.flow of 10,000 gpd or greater,:the inspector and the.system owner shall submit the.`. report to the appropriate regional office of the DER The original should be sent to the system owner and copies sent to the buyer, If applicable, and the approving,p6thority . '"This report onlyAescribes conditions at the time.of inspection and under the conditions of use at that time.:This inspection does not address howahe'system.will perform in the future under _. the ame or different;:conditions of use - Lt 5l �I t5ins 3/13 Title 5,0ffiaal'Inspeytion Form: b ace Sewage Disposal System:•.Page 1 of 17 • Commonwealth of Massachusetts .' . W Title 5 Officiallnspection Form a _ - Subsurface Sewage Disposal.System.Form - Not,for Voluntary Assessments °wM 14 Pepper Lane t „•` Property Address Gregg Anderson Owner Owner's Name - information y ation is Hyannis 'Ma- 02601 4-17-14 required for every page. CityrFown ` State Zip Code Date of Inspection t B. Certification`,(cont.) ' r Inspection Summary: Check A,B,C,D or E/always complete all of Section'D A) System Passes: ti ! r ❑. I have not found any information which indicates,that any of the failure criteria described ., in 310 CMR 15.303 or in 310 CMR 15.304 exist.-'Any failure criteria not evaluated are indicated below' Comments: B) System Conditionally Passes: One or more system components as described in, "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;sN,'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 a inspection if the existing`tank is replaced.with &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 ` r Compliance indicating that the tank•is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain'below): y. g - r t5ins•3/13 4 Title 6 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts N w Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 14 Pepper Lane Property Address Gregg Anderson Owner Owner's Name , information is required for every Hyannis Ma 02601 4-17-14 page. City/Town 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): Pump and alarm must be fixed or replaced. Not working at time of inspection. ❑ '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 i ❑ 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 I _ 'h Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °wM 14 Pepper Lane Property Address Gregg Anderson Owner Owner's Name information is required for every Hyannis .Ma 02601 4-17-14 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (arid 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 El ® 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 Officialfris 'pe ction Form _ Subsurface Sewage Disposal System Form - Not for.Voluntary Assessments 14 Pepper Lane 7M � Property Address Gregg Anderson Owner Owner's Name information is required for every Hyannis Mai 02601 4-17-14 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. _- .❑ ® R 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'&cesspool or privy is within 50 feet of a private water supply well. 1-1 ® 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. w The system fails. I have determined;that one or more of the above failure Ell { ® 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. r _ r E) Large Systems:.To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15;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 feek.of a surface drinking water supply ❑ . ❑ the system is withinr200 feet of a tributary to a surface drinking water supplyA the system is located in a:nitrogen sensitive area (Interim Wellhead Protection El El Area- iWPA)or_a mapped Zone 11 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 CM 16.304. 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 r � .t Commonwealth of Massachusetts , Title 5 Official Inspection Form Subsurface Sewage Disposal System Form= Not for Voluntary Assessments . . 14 Pepper Lane Property Address:. Gregg Anderson , Owner.... _ Owner's Name .. information is ` required for every. Hyannis Ma 02601 4-1.7-14 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 El R-`: Pumping information was provided by the owner, occupant, or Board of Health4. ❑" Z Wereany of.the:system componyents: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)'.: ® 0 Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? Y 4 ® 0. . Were all system components, excluding the SAS, located on site? ® El 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 we (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 ` El 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 a roximation of distance is:unacce table 310 CM 15.302 5 . . (. )] cep table) D. System-information Residential.Flow Conditions: r Number of bedrooms (design): 4 Number:.of bedrooms (actual): 4 ..:::.. ...:::'. :..:::. .....:.• ;-.. C ....-. .... ...,.. ... .... a ... DESIGN flow based.on 310 CMR'15.203 440 " (for example: x#of bedrooms): . .... ...... .. c„,:, _ ...... .. ... 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 wM 14 Pepper Lane Property Address Gregg Anderson Owner Owner's Name information is required for every Hyannis Ma 02601 4-17-14 page. City/Town State Zip Code Date of Inspection D. System Information Description: Y Y A Number of current residents: 4 Does residence have a grinder? Yes No garbage 9 , 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: rt Sump pump? ❑ Yes ® No Last date of occupancy: current Date Commercial/Industrial 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 r Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System,Form Not for Voluntary Assessments G1A, 14 Pepper Lane Property Address Gregg Anderson " Owner Owner's Name . ., information is required for every Hyannis Ma' '02601 4-17-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): ; 4 s . 4 General Information Pumping Records: pi Source_of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: f ' 4, gallons' ; How was quantity..pu m ped determined? Reason for pumping:' Type of System: t ❑ ,-Septic tank,;distribution box,soil absorption system ❑ Single cesspool W , ❑ Overflow cesspool' ❑ Privy J ❑ _ Shared system (yes or no) (if yes, attach previous inspection records, if any) as . ; 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 r ❑ Tight tank. Attach a copy of the DEP approval: . ® Other(describe): Tank, Pump chamber, d-box and SAS 4 t5ins•3/13 , - Title 5 Official Inspection'Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 14 Pepper Lane Property Address ,- Gregg Anderson f ' Owner Owner's Name t information is H annis Ma- 02601 4-17-14 required for every _ y page. City/Town State Zip Code Date of Inspection D. System Information.(cont') Approximate age of all components, date installed (if known)and source of information: New Leaching 2005, Existing tank_ Were sewage odors detected when arriving at the site? - ❑ Yes ® No Building Sewer(locate on site plan): z. 8' Depth below grade: x feet ` Material of construction: '` + El 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.): t At time of inspection building sewer appears to be in working condition. No sign of leakage'. Septic Tank(locate on site plan):. I T Depth below grade: feet i Material of construction: ® concrete` ❑ metal .t , ❑fiberglass ' ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate ofCompliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gallon -Sludge depth: ,a E � l5ins•3/13 _ - - ,,Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 " Commonwealth of Massachusetts �13W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 4 M 14 Pepper Lane ' Property Address Gregg Anderson Owner Owner's Name. j. information is required for every Hyannis Ma' .: _02601 4-17-14 _ page. City/Town State Zip Code Date of Inspection D. System Information,(cont) 4 ; Septic Tank(cont.) 2811 Distance from top of sludge to boftom`ofAoutlet tee or baffle Scum thickness Distance.from top of scum to top of outleftee or baffle 3711 . Distance from bottom of scum torbottom of outlet tee,or baffle measured How were dimensions determined? Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, g liquid levels as related to outlet invert,evidence of leakage, etc.): At time of inspection septic tank appears to be structurally sound. No sign of leakage. Tank in need'of - pump for maintenance. - a .. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: El concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness g Distance.from top of scum to"top of outlet tee or baffle,, Y Distance from bottom of scum to bottom of outlet tee or baffle # , " Date of last pumping: Date l5ins•3/13 " Title 5 Official Inspection Form:Subsurface Sewage Disposal Systemi-Page 10 of 17 Commonwealth of Massachusetts. ',, W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 14 Pepper Lane t G„M • sr a Property Address Gregg Anderson Owner Owner's Name information is required for every Hyannis jMa . . 02601 4-17-14 page. City/Town ~.State Zip Code Date of Inspection D. System Information•(cont.). ` Comments (on pumping recommendations, inlet and 'outlet tee or baffle condition, structural integrity, y. 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): 'I Depth below grade: Material of construction: ❑ concrete - ❑ metal ❑fiberglass El polyethylene El other(explain): * s Dimensions: 4 Capacity: -gallons. Design Flow: gallons per day Alarm present: r tt,E] .Yes; ❑ No Alarm level:.' - Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float'switches, etc:): Y. : b .. xs a e. . •W . $•, , < *Attach copy of current pumping contract(required). Is copyattached? ❑ Yes ' ❑ No`.. t l5ins•3/13 # r Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 14 Pepper Lane Property Address Gregg Anderson Owner Owner's Name information is required for every Hyannis - Ma 02601 4-17-14 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 0 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.): At time of inspection d-box appears to be structurally sound. Some signs of carry over in d-box. - 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.): At time of inspection pump chamber was full, the pump and alar we of working. Signs of carry over into pump chamber. * 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: ` F, t5ins 3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 14 Pepper Lane Property Address Gregg Anderson Owner Owner's Name information is required for every Hyannis Ma 02601 4-17-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.), Type: ❑ leaching pits number: ® leaching chambers number: 3 ❑ 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.): At time of inspection leaching appears to be in working order. No signs of hydraulic failure. 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 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 14 Pepper Lane Property Address Gregg Anderson Owner Owner's Name information is required for every Hyannis Ma 02601 4-17-14 page. Cityrrown 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 F t Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 1 ' t5ins•3/13 1itle 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts .,. Ti#I:e 5 Official Inspection Form s Subsurface Sewage Disposal System.'Form-Not for Voluntary Assessments wM 14 Pepper Lane - Property-Address 'Gregg Anderson Owner Owner's Name information is required for every Hyannis Ma 0260.1 4-17-14 page. City/Town 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 it l6ast,two:perm anent:reference landmarks or benchmark& Locate all Wells within 100 feet. Locate where;public water supply enters the building. Check one of the boxes below: ® hand a ketch-in�the area below 0 'drawing attached separately 3 0 , C3 35° CpMilli 0 D"5 3f"'Y t5ins+3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° 14 Pepper Lane 7A, Property Address Gregg Anderson Owner Owner's Name information is required for every Hyannis Ma 02601 4-17-14 page. City/Town State Zip Code Date of Inspection D. System Information (cent.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells >12' Estimated depth to high ground water: 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: 10-05 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: Plan BOH. 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 t , . Commonwealth of Massachusetts W Title 5 Official Inspection .Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 14 Pepper Lane Property Address Gregg Anderson ti Owner Owner's Name information is Hyannis Ma 02601 4-17-14 required for every y page. City/Town t 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 y " l5ins•3/13 Title 5 Official Inspection.Form:Subsurface Sewage Disposal System•Page 17 of 17 , U.S. Postal ServiceTM CE TIFIED �7TeM--'PryqvvicdtdKd) over r �Fo�,delivery,information,visit our�web`site at,www.usps.com® OFFICIAL PS Form 3800,June 2002 See Reverse for.lnstnictinns Certified Mail Provides: esrenay)300Z eunf"oo9r waod1Sd n A mailing receipt t~ , +d c A unique identifier for your mailpiece a A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Maile or Priority Maile. o Certified Mail Is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. a For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. a For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. r 5 Town of Barnstable Regulatory Services . B"rnst�b'e e �FTHE Tp� g Y Thomas F. Geiler, Director AM-America City Public Health DivisionBA-RN SS. E'�* Thomas McKean, Director 2U07 ° 1639' 200 Main Street �ATfD MA'S Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Sent Via Certified Mail: 70051160 0000 0190 9847 - November 8, 2012 Gregg and Rebecca Anderson 174 Lakeside-Drive 1 Marstons Mills, MA 02648 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 14 Pepper' Lane, Hyannis, MA. 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.town.barnstable.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 2012 fees included. This must be completed within-(14) fourteen days of your receipt of this letter. Failure to comply with this ordinance will result in the issuance of a non-criminal ticket citation in the amount of$1.00. 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. i Karen Herrand hz Division Assistant - b�1 Y Public Health Division je0 5 Direct#508-862-4072 V,))Ii E • o • • • • • a Complete items 1,2,and 3.Also complete A. Egna item 4 if Restricted Delivery is desired. ❑Agent 13 Print your name and address on the reverse X ❑Addressee so that we can return the card to you. B. Reoeiv by(Printed Name) C. Date of Delivery I a Attach this card to the back of the mailpiece, I or on the front if space permits. 1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes If YES,enter delivery address below: ❑No be 2t/ 1 Cj m 1/'50 lm yt 3.FRegistered ce Type a� Crtified Mail ❑Express Mail tetum Receipt for Merchandise ❑Insured Mail 6CC.0.D. 4. Restricted Delivery?(Extra Fee,' ❑Yes 2. Article.Number-' E't fEi: '2i E 984.7(rr3nsfer from flabel 7?�®i5 ±] 16 0000� 0190i service PS Form 3811,February 2004 11 9 1 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE : ,fh'"slass Mail '�r�_♦."��.r .Gf"'C�":.'+"iir�?( �^..7: �"i.` `• .: PflS1,"B,�*FmS''Pald t er. • Sender: Please print your name, address, and•=ZLR**-iti this bb i I I j 0Sd a Town of Barnstable • n�• Health Division '° � 200 Main Street N I Hyannis,MA 02601 I I I I M - I I I ��_a". :;:: +�taaa::la�!��!atal:aa!aa�ila�:aji�aai�l!a!!a�s��a!a�iaaar�!1ai M � I i 1 No. CV , Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH-DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYicartion for �Oiopozal *p.5tem Con.gtruction Permit Application for a Permit to Construct( Repair( )Upgrade( )Abandon( ) El Complete System N&dividual Components Location Address or Lot No. I LA Pe-pp-r, Lecp- Owner's Name,Address and Tel.No. t �N�S:; Assessor's Map/Parcel (:9,9'1 --Installer's Name,Address,and Tel.No. i� Designer's Name,Address and Tel.No. a(3oc, 5 Type of Building: �11 Dwelling No.of Bedrooms Lot Size ®,�_sq.ft. Garbage Grm er(NI Other Type of Building oCYL No.of Persons to Showers(Cafeteria(✓) Other Fixtures LAUD roV, ki-rCtt'grJ Sirdk4. (.PuTJfl Lf Design Flow /' 40 gallons per day. Calculated daily flow gallons. Plan Date —4- a!'1O Number of sheets Revision Date Title Size of Septic Tank `C)Ci s-1 'y� e1��Cal , /,Jj" i.ocoTv of S.A.S. Description of Soil: Q--�i t--VA) Nature of Repairs or Alterations(Answer when applicable) Q Date.last inspected: Agreement: The undersigned agrees to ensure the construction and maintena afore described on-site sewage disposal system in accordance with the provisions�ofei5 of the ronme Code and to place the system in operation until a Certificate of Compliance has bees B f e _ Sign d Date /,Os Application Approved by Date Application Disapproved for the following reasons t Permit No. Date Issued 9 Now ,±y .�� -�� ,��"' Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH PIVISION,-TOWN OF BARNSTABLE, MASSACHUSETTS .Yes ZIPplication for Migogal *pgtem Con.5truction Permit Application for a Permit to Construct IX)Repair( )Upgrade( )Abandon( ) ❑Complete System�Individual Components Location Address or Lot No. Nt✓� Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. a L4LD Type of Building: Dwelling No. of Bedrooms 4— Lot Size 6..000 sq.ft. Garbage Grinder(AA) Other Type of Building 0(1* No. of Persons Tzp Showers(✓) Cafeteria(�) -- Other Fixtures (...AuA"ro2Y kn-rc tFj,) Sink U0DE.-e Design Flow 4 4D gallons per day. Calculatehaily flow 141 104 gallons. Plan Date '1- l ae/QT S Number of sheets -k't Revision Date Title Size of Septic Tank C XtST y�0ob cir, 1000Type of S.A.S. 3 AMg 25 Lai/L/I Description of Soil `a�o Q' r Nature of Repairs or Alterations(Answer when applicable) -�-o P\� r,' Date last inspected: "` „ , 1 1j,16 1."2 Agreement: �. The undersigned agrees to ensure the construction and mamIte�" ce o€t�It'o fore descr-bed on-site sewage disposal system in accordance with[he provisions of Title 5 of the.E vironm ta'1 Code and plac the`system in operation unti•1 a Certifi- cate of Compliance has bee 's�ued,>z this B A;oHe 1 ' i Sign d Date lJ �S Application Approved by Date Application Disapproved for the following reasons Permit No. 1qqDate Issued , THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIF th jt the On- 'e Sewage Disposal System Constructed( Repaired ( )Upgraded( ) Abandoned( )by at h s been constru to n l or ance with the prov' ' n of Title and the for Disposal System Construction Permit - Q dated �" �^ Installer '� , /rl_. Designer The issuance of this ermit sha99llrnlo b c , strued as a guarantee that t�e sys unction as designed. Date i )�i Inspector\ � --------------s---------'—— V . . .. No.�5 T1 Fee /y THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mig aal 6 4tem �tCot�gtruction Permit Permission is hereby granted to Co struct( Repair( )Upgrade( )Abandon( ) System located at �`7 /'�-ePDe2 qa' 1 and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditionQthiispermM*t. ,_�= Provided: C ns uctton must be completed within three years of the date of Date:_.• 0� Or Approved by ,l AsBuilt. Page 1 of 1 TOWN OF 13ARNSTABLE LOCATION 2 SEWAGE# S VILLAGE ASSESSOR'S MAP&LOT ^�S� INSTALLER'S N &PHONE NO. SEPTIC TANK CAPACrry Pt LEACHING FACILM:(type) kv d (size) NO.OF BEDROOMS �' BUILDER OR OWNER PERMIT DATE: COMPLIANCE DATE: IL Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet , Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by G;t= Xy G 3s L C.if A), D a n2: �S A Ds= 3Y 7 v A 1= 311 4� 1= 4 � � POMP http://issgl2/intranet/propdata/prebuilt.aspx?mappar=294036&seq=l 5/1/2014 Town of Barnstable °FTHe r Regulatory Services Thomas F. Geiler,Director r BAMMBLE, r � ' �0� Public Health Division Thomas McKean,Director 200 Main�tre'et,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: O . Designer: Shay Environmental Services Inc Installer: Address: P.O. Box 627 Address: EEG East Falmouth, MA 02536 VVNCWsCv� On was issued a permit to install a (date) (in"a er) septic system at a��E �C QZ'a-; MzcA Ck�,r,6 based on a design drawn by (address) Shay Environmental Services, Inc. dated (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' latera' re cation of the SAS or any vertical relocation of any component of ptic system) but ' accordance with State & Local Regulations. Plan revision or certifi as-builf by des' ner to follow. �y'(N of MgS S ��o�� CARMEN N " nstalle s Signature) o E. SHAY N No. 1181 G/STE��o �T SgN1,7AR\PN µ (Designer's Signature) (Affix De i tamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE ~. OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form ' C) 5 . COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL.AFFAIRIS DEPARTMENT.OF ENVIRONMENTAL=PRO,TECTIQEIVED n •� rr. J� �" t 1,0 yy 4pry 20 5 4 TOWN OF BARNSTABLE TITLE 5 HEALTH DEPT. OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION FRIED INSPECTION Property Address: i . ,f_y. �' ,fit Owner's Name: Owner's Address: Date of Inspection: . - 0 C e4ZK AZ zD-_-�S&�. Name of Inspe please print r 4 ">r Company Nam • t Mailing Address: Telephone Number: CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at t-iis 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 sits 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 ti Conditionally Passes Needs Further Evaluati_on;by"the Local Approving Authority • � ails Inspector's Signature. �--- � Date: -/ �i�`l 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 tc the buyer,if applicable, and the approving authority. Notes and Comments ****This report only describes conditions at the:time of inspection and under the conditions of use at that • time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of l I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: A Owner: j Date of, nspection: 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 in6,10 CMR.15r304 exist. Any.failure criteria not evaluated are indicated below. Comments: & 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. Answer yes,no or not determined(Y,N,ND) in the 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. ND explain: 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,.set-led or uneven distribution box. System will pass inspection if(with. approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: 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(sj are replaced obstruction is removed ND explain: 2 Page 3 of 11 4 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 146i�?1,1012PA Owner: / Date of Inspection fG 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 .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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence'of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria,'are triggered. A76opy of the analysis must be attached to this form. 3. Other: 3 t Page 4 of 11 OFFICIAL INSPECTION.FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE.DISPOSAL SYSTEM INSPECTION:FORM PART A CERTIFICATION(continued) Property Address: _ f Owner: Date of nspectio j O D. System Failure Criteria applicablie to all.systems: You must indicate"yes"or"no"to each of the following for all inspections: Y� No Backup of sewage into facility or system component due to overloaded or.clogged.SAS or.cesspool Discharge or ponding of effwent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution.box above outlet invert due to an overloaded or clogged SAS.or cesspool Liquid depth in cesspool is less than 6"below invert or available volume is.less than '/z day flow _ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped _ Any portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or Frivy 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 coliform bacteria and volatile organic-compounds indicates that the well is.free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen.is equal to or less than 5 ppm, provided that no other failure criteria. are triggered.A copy of the analysis must be attached.to this form.] �i (Yes/No)The system.fails: I have determined that.one or more of the above failure criteria exist as described in 310 CMR 15.30'),therefore-the system fails. The system owner should contact the Board of Health to determine what w-11 be necessary to correct the failure. E. Large Systems: 4. To be considered a.large system the.system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes or"no'V)each of the following: (The following criteria apply to large systems in addition to the criteria above) 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. 4 Page 5 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B': CHECKLIST ProperAnspection: ,� Owner ' Date o G,h/ /", Check if the following have been done. You must indicate"yes"or"'no"as to each of the following:: Yes o Pumping.information was provided by the owner, occupant,o_Board of Health Were.any of the system components pumped out in the previous two weeks? C/ Has the system received normal flows in the previous two week period? t/ 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? L/__ 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 fSASI on the site has been determined based on: Yes o Existing information. For example, a plan.at the Board of Health. _✓ _ Determined in the field(if any'of the failure criteria related tc Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] 5 Page 6 of I l OFFICIAL INSPECTION-FORM—NOT FOR VOLUNTARY°ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner. / Date Inspection00(� FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): . Number of bedrooms(actual): DESIGN flow based on 310,CIviR 15.203 (for example: 1]:0 gpd x#of bedrooms): Number of current residents: Does residence have.a garbage grinder yes or no): ' Is laundry on a separate sewage system (yes or nok'& .fif yes separate inspection required) Laundry system inspected(yes or no Seasonal use:(yes or no)�:4w... Water meter readings, if available(last2 years usage(gpd)): Sump pump(yes or no) v &Z�� Last date of occupancy: COMMERCIAL/INDUSTRIAL/ Type of establishment: Design flow(based on 310 CMR.15.203): gpd Basis of design-flow(•seats/persons/sqf�,etc* Grease trap present(yes or no): Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(yes or no):-_ Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records -- Source of information: In 0U Was system pumped as Part of the i sp-ction(yes or no): If yes, volume pumped: gallons--How was quanti 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) —Tight tank _Attach a copy of the DEP,approval �ther(describe): Moximate age of al components,dar l �ifknown ,e instaland so rce�of iormation: Were sewage odorsdetected when arriving at the site(yes or no . 6 Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: C J Date of Inspectiont17 BUILDING SEWER(locate on site plan Depth below grade: Materials of construction:_cast iron 40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of j,oints;.venting;evidence of leakaae,.etc.):..' SEPTIC TAN V(locate on site plan) ' Depth below grade Material of construction: t�oncrete metal fiberglass=polyeth✓lene other(explain) If tank'is metal list age:_. Is age confirmed by a Certificate of Compliance(yes or no):_.(attach a copy of certificate) _Dimensions: P'l (P° kS ° + f Sludge depthQ Distance from top of sludge to bottom of outlet tee or baffle: '',3V - , Scum thickness: Distance from top of scum to top of.outlet tee or baffle: Distance from bottom of scum to bolt outlet tee or baffle: , How were dimensions determined: j Comments(on pumping recommen ations, i let and outlet tee or baffle condition, structural integrity, liquid levels (nyelated to outlet invert,evidence of leakage etc.): jr GREAS'r TRA (locate on site plan) Depth below grade:_ 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: : Comments(on pumping recommendations, inlet and outlet tee or baffle,condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM.-.NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: r Owner: Date of Inspection: Iro 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: gallonE Design Flow: gallons/day Alarm.present(yes or no)`. - y Alarm level: Alarm in working order(yes or no): Date of Iastpumping: Comments(condition of alarm and float switches.,.etc.): DISTRIBUTION BOXk(if preser_t must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution tc.outlets,equal,any evidence of,solids carryover,any evidence of leakage into or out of box,etc.): PUMP CHAMB/V: , h(locate on site plan) Pumps in working,order(yes or no): Alarms in working order(yes or no): Comments(note.condition of pump chamber, condition of pump`s and appurtenances,etc.): 8 Page 9 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner:&J4l (� Date o Inspection: " SOIL ABSORPTION SYSTEM (SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number:_ eaching chambers, number: aching galleries, number: leaching trenches, number, length: leaching fields, number, dimensions: overflow cesspool, number: innovative/alternative system Type/name of technology: Comments(note condition /Jof�soil, signs ofby"draulic failure, level of ponding, damp soil; condition of vegetation; d/ 41Z6, 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 laver: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): ^.. 1 l' le Ja' ti 1' ornments(note condition-of soil;signs of hydraulic failure,•.,level of por,u:ng,condition o, vegetation,etc.): .- PRIVYV (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.): 9 Page.10 of I 1 OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:,A/J //_-9e Owner: Date of nspectionF. SKETCH OF SEWAGE DISPOSAL.SYSTEM Provide a sketch of the sewage disposal systerr_ including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 fee:.Locate where public water supply enters the.building. �o �3111t,- / . 1� a l0 Page l l of l I OFFICIAL-INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(ccntinued) .Property Address: / — Owner. � � Date of Inspection: l a.( Q SITE EXAM .Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from plans system design lans on record-If checked date of design plan reviewed: Y � _ 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) :VAccessed USGS database-explain: You,must describe how you established the.high ground water elevation d0 .� 11 Permit Number: Date: Completed by: � HIGH GROUND-WATER LEVEL COMPUTATION Site Location: �/S Lot No. Owner: el��r� I./&, &, fAddress: Contractor: �drllp C�J�lS Address: � � �/ Notes: STEP 1 Measure depth to water table tonearest 1/10 ft. .............................................................................. .Date 7� month/day/Year i STEP 2 Using Water-Level Range Zone and Index Well Map locate site and.determine: OA Appropriate index well.......................-" OWater-level range zone ................................................. STEP 3 . Using monthly report "Current4 Water Resources Conditions" determine current depth to ©D 2� water level for index well ........................... month/year STEP 4 Using Table of Water-level Adjustments for index well (STEP 2A), current depth to water level for index well (STEP 3), and water-level zone (STEP 2B) determine water-level adjustment ............................._...... ................................................ 7 STEP. 5 Estimate depth to high water by.subtracting the water- level adjustment (STEP 4) from measured depth to water 7 levelat site (STEP 1) ........................................................... ................................................. Figure 13.--Reproducible computation form. 15 'V � )�� y��'. �\.t~ :,3•.y .,.,,,.c �.,, ^ 1 4,�' ' ��' A�� _ �; � � � -_ .rev - ��r�__:�O i. ;ii + Z ' l' 9 + L iI�1 I i / , L �� 3 Z . # 0 t ± � � _� } �.. i -�, . � . . r . �� ., '� I;:q E j _I i . ' __F.� T ¢,� � � � t • ;� i , : ; 1 s- � i = 4 .. 6� I ��Q f • � \ . . � i � � t t • 3 i � 1 ��. �, t :� �� `-�z �� '= . . �,, � - -•.� . t "`----�---= f j i �.� \ \ ?.� .. � �^\�� j Y � l< 7 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40:00 or-4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to'operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st Fl., 367 Main St., Hyannis, MA 02601 Town Hall") and get the Business Certificat that is required by law. y DATE: Z l - Fill in please: �- APPLICANT'S YOUR NAME/S: S O _ BUSINESS YOUR HOME ADDRESS:_ r <� fI�R-2g2-99 5 TELEPHONE # Home Telephone Number pia$ Zc12-99f S NAME;OF CORPORATION- VNQ IN NAME OF NEW BUSINESS a SA JD A foijklic TYPE OF BUSINESS iN1 �, IS THIS A.HOMEOCCUPATIO ? YES NO R ADDRESS.OF BUSINESS IIN ffy A iq fv C AG t MAP%PARCEL NUMBER 2- ! ! 4OL [Assessing] � When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable.:This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. (corner of Yarmouth Rd. & Main Street) to make.sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. - Authorized Signature COMMENTS: 2. BOARD OF HEALTH - This individual ha a gfo ' ed of the permit requirements that pertain to this type of business. MUST�.OMPLYWITH ALL . !/�� 1-!A7A RM-jU Pf?ATERIA S RRGULATIr)PIq Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS LICENSING AUTHORITY This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: TOWN OF BARNSTABLE Date:Z /�/ �f3 smemen F,rzil TOXIC AND HAZARDOUS MATERIALS ON-SITE NAME OF BUSINESS: SC 60 I1I BUSINESS LOCATION: N PE ER IN Ntv! 0:2 C/ INVENTORY MAILING ADDRESS: Iq PC TOTAL AMOUNT: TELEPHONE NUMBER: 5q2.5Z 9q 4S CONTACT PERSON: D dear 5CyImj t- EMERGENCY CONTACT TELEPHONE NUMBER: 509 524 (Q CC MSDS ON SITE? TYPE OF BUSINESS: rh(1 /, i N INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants = ' Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes ��r/ UO Laundry soil &stain removers l� (including bleach) C w -O& Spot removers&cleaning fluids (dry cleaners) S4 M 10f�- Other cleaning solvents 0�I � �' c Bug and tar removers 0 1. Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Appli nt's Si gna re Staff's Initial Sep- 20-01 13 : 62 BARNSTABLE HEALTH DEPT 5087906304 sns;o� :\�)T7CE, This Form Is To,Be Used t e Repair Of Failed Septic Systems Only, PEUCOL,aTIO.N TEST AtVll SO.IL`EVALUATYON EXEMPTION FORM w, k C7N ;,��Q�tl•.i i✓�� hereby certify (ha( the engineered plan sio ed by me �eteC �ot t concerning the property located at all of the .Mtena This failed'sysrem is conraecied to a res.iden(ial dwelling only. There are no :omrier ia!'or business uses associated with;the dwelling, T? e soil is ciass:f:ed as C.'LASS I and the percolation rate is less than or equai to 5 -71:-1u1!s per inch. The applicant may use historical data to conclude this f3c; or may. ;orduCt �re!tmt:;ary tests at the si;e.withow a health agent°present • herc,:s no ncrease in flow gndlor,changejr_use`proposea 4 Then are ,to vanances requested oc needed. , The boucm of the proposed leaching facility wtll.not be located less than fourteen feet aonve the maximum adjusted,groundwater table elevation. (Adjust the -nundwater table using the Frimptor method when ap'licablel Please complete the following: , Top oi' Ground Surface E!zvanon (using GIS information) {j tJ W .El,CV3 :0n :.djus(merlt for r F1"FREt�c F.EETWEEN A 66d B �a, IU �4 S 6 aIE D DATE, U -NOT IC.E abo�;e irformawon,'a reoair'permit wif! be issued for 'Dedmoms ' T� ;n,uT `:� cd.ct:nal bedrooms are authorized to ;future wi.hout en,tncerec k :eptv'te^� plans. I A .'• 'f ice,' 6`T �3 ` 1 _ . u t TOWN OF BARNSTABLgiq CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops -�f 4.Manufacturers COMPANY �' 5.Retail Stores 6.Fuel Suppliers ADDRESS Class: 7.Miscellaneous "UANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MAZ' ][DIALS � � :° , ._ - _ IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,J�t Fuel(A) t j \ Diesel, Kerol,,ene, #2 (B) Heavy Oils: waste motor o.1 (C) r new motor oil ( ) transmission/hyd a is Synthetic Organ s:, degreasers Miscell eous: � I i DISPOSAURECLAMATION REMAR.ItS: 1. Sanitary Sewage 2.Water Supply r O Town Sewer (Z'Public c A On-site OPrivate _ — 3. Indoor Floor Drains YES NO O Holding tank:MDC_ O Catch basin/Dry well ` o O On-site system _ 4. Outdoor Surface drains:YES NO ORDE O Holding tank:MDC O Catch basin/Dry,well -�- O On-site system 5.Waste Transporter �n 2. Person (s) IiA6rviewed Inspector Date Date: // 2zft TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: �D /S ,9u7r2 SV Z6�d BUSINESS LOCATION: f EP?w ,0v MAILING ADDRESS: Re Qox ?66 3 _ W,1At . A0,V oe a.2G b J Mail To: TELEPHONE NUMBER: 7 2f Board of Health CONTACT PERSON: AallW & Town of Barnstable P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: Hyannis, MA 02601 TYPEOFBUSINESS: afo Gow .: iWze_ Does your firm store any of the toxic or hazardous materials listed below, either for sale or for you own use? YES NO /L-' This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor & furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS ai Cohi SENQER: O ■ ete items�l and/or 2 for additional services. I also wish to receive the y ■Complete items 3,4a,and 4b. following services(for an rn ■Print card toourr name and address on the reverse of this form so that we can return this extra fee): Y ■Attt ch this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address 2 .. permit. ai d ■Write°Return Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery to ■The Return Receipt will show to whom the article was delivered and the date .. delivered. Consult postmaster for fee. ° o � v 3.Article Addressed to: 4a.Article Number d /��/ C U 0;; 4b.Service Type «' r° toe El Registered Certified W ❑ Expre ss Mail,& ❑ Insured 777 �i� [IRe1.tbrnsi ei 5 or Mefctiandise ❑ COD a a ��Oyo 2 6 ©/ 7.Date'of Delive`.ry',1� w 0 p 5.Weceived By: (Print Name) 8.Addre's dress(Only if requested LU and,fe'e-is: id) ��e�` t g 6.Signatpr dresseVp� gent) a° ig : :{t ii # ` '• i it it it i i ,,PS .PS Form 3811, December 1994 Domestic Return Receipt a� UNITED STATES POSTAL SERVICE Firslass Nail Postage&Fees Paid USPS Permit No.G-10 • Print your name, address, and ZIP Code in this box • Public Health Division Town of Barnstable PO Box 534. Hyannis, Massachusetts 02601 Fax(508)775-3344 Phone(508)790-6265 u I 11111It 11111111113111 toil 11111,11 Z .31-18 659 806. : Receipt for Certified Mail �. No Insurance Coverage Prglided UNIT IE1DSEfiATYE ;=o not use for International Mail (See Reverse) Sent to e-,'p6i t Stre t n N A P.O, tate andoElP ode C �. co Posta E Certified Fee O Ml Special Delivery Fee 0) a "{�.Ent icVgd�ClefivejYFr�e -- f-,e urnr ecetpt7S owing to Who78ibate Delivered o Return Receipt Showing to Whom, Date,and Addressee's Address TOTAL Postage - 7� &Fees / Postmark or Date I STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see 401110. 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier(no extra charge). S 2. If you do not want?his receipt postmarked,stick the gummed stub to the right of the return rn address of the article,date,detach and retain the receipt,and mail the article. t 3. If you want a return receipt,write the certified mail number and your name and address on a return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT REQUESTED adjacent to the number. G O 00 4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, co endorse RESTRICTED DELIVERY on the front of the article. 0 M 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If tL return receipt is requested,check the applicable blocks in item 1 of Form 3811. d 6. Save this receipt and present it if you make inquiry. 105603-e3-B-0218 Sy �I,Er .o� Town of Barnstable y Department of Health, Safety, and Environmental Services BAMSTABIX. a Public Health Division �FD'A0�A P.O. Box 534, Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health November 20, 1998 Defreitas Geraldo&Vilma 14 Pepper Lane, Hyannis,MA 02601 RE: Aboveground Fuel Storage System located at 14-B Pepper Lane,Hyannis and listed as Assessor's Map 294 ,Parcel 036. Dear Sir: Our records indicate that you have a fuel oil aboveground storage tank that is presently unregistered with the Health Department. You are now required by the"Health Regulation Regarding Fuel and Chemical Storage Systems" published in the December 17, 1987 issue of the Barnstable Patriot,to register your aboveground tank(s) with the Board of Health. Please complete the enclosed Registration card(s). Include any evidence of the date of purchase and installation,a copy of the permit from the Fire Chief,and a sketch map showing the location of such tank(s)on the property. Upon entire completetion of the Registration card(s),you will be issued a brass valve tag(s)by the Board of Health. These valve tags shall be picked up by you or your representative at the Health Department located in the Barnstable Town Hall. The tag(s)shall then be attached to the filler pipe/cap of the aboveground tank(s). Please return completed Registration card(s)to: Town of Barnstable.Health Department,P.O. Box 534, Hyannis,MA 02601, as soon as possible. If you have any questions,please telephone(508)862-4644 for Glen Harrington or myself during office hours. Office hours are Monday through Friday from 8:15 -9:30 a.m. and 1:00-2:00 p.m. PER ORDER OF THE BOARD OF HEALTH omas A. McKean Director of Public Health t t No. [ Q (iG Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: `— Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS RpPlication for Mioo.5ar *ps�tem Construction Vermit Application for a Permit to Construct( )Repair("—*epgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 1'-,( Owner's Name,Address and Tel.No. Assessor's Map/Parcel �V�"1— 0316 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. —cwol-_ ve,c Type of Building: Dwelling No.of Bedrooms `f Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures ,t Design Flow y�� gallons per day. Calculated daily flow 't q7 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank SN kab-0 Type of S.A.S. Description of Soil Ari ,-_� S f Nature of Repai or Alterations(Answer when applicable) =%r 5 Y 04 N::4y IE� 0 oy—, lie 1�-rUSSbQS 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 Environme tal Code and not to place the system in operation until a Certifi- cate of Compliance has be this B It . Signed Date Application Approved by Date C---7 r q� Application Disapproved for the following reasons Permit No. Date Issued Y a Y- No. Fee I / THE COMMONWEALTH OF MASSACHUSETTS ., tered in computer: 1�1 Yes PUBLIC HEALTH DIVISION- TOWN OF BARNSTABLE., MASSACHUSETTS 0[pplicatton for Mig;paal *pgtem Con6truction Permit ` Application for a Permit to Construct( )Repair(�pgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/Parcel O3� Installer's Name,Address;and Tel.No. Designer's Name,Address and Tel.No. � _ x c e)P11.__ V_ to, Type-,of Building , r ` Dwelling t No.of Bedrooms `f Lot Size sq.ft`,` )'` Garbage'Grinder F f Other Type of,Building No.of Persons Showers( ) Cafeterias( ) Other Fixtures 1r � Design Flow y y gallons per day.- Calculated daily flow 't 7 a`�j p y y ,gallons. Plan Date / Number of sheets Revision Date t'. Title _ ti t Size of Septic Tank �r�r s!�y CcltN' 'a :. Type of S.A.S. �`c�w ��ITS o►?S . , Description of Soil ' ✓1re,9 S'A Nature of Repairs or Alterations(Answer when applicable) " Date last inspected: 1 Agreement: , f '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 Environm tal Code and not to place the system in operation until a Certifi- Cate of Compliance has b this B. al .,. Signed p Date Application Approved by Date- Application Disapproved for the following reasons 4 w t* PP g Permit No. Date Issued 5--7 THE COMMONWEALTH OF MASSACRUSEfTTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( ) Repaired ( ) Upgraded(K) Abandoned( )by (V\i 0-C%A 0'_ 57�F C- at f ..-•Q_ has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. / jr-77 %' dated - 7'g Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date f-_ Gf _ t C� Inspector x No. 7 ZO � -----------------------Fee , v I'�� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Miqu al *p!gtem Construction Permit Permission is hereby granted to Construct( )Repair(�4 )Upgrade( )Abandon( ) System located at ✓ �-Q_ - ajt`d as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this permit. Date: Approved by f i For the Repair.of Failed NOTICE: This Form Is To Be Used $eptic Systems Only. ETCH AND;APPLICATION FOR A CERTIFICATION OF SK ON PERMIT (WITHOUT DISPOSAL WORKS CONSTRUCTION ENGINEERED PLANS) � the a licat,.for disposal works certify thatpp I+ concerning the — ? � ` • gstcuction permit sighed by me dated meets all of the property located at following criteria: �There we no wetlands located within 100 fed of the proper leeching f acilhy i • septic system vote wells within 1 SO fed of the proposed There are no Private �/ ed • Than is Beno Increase M flow andlor change in use • I L� Thero no veriencd or need ►1 the poptned leeching Nscility will be h>cated with' 250 fed of any wetlands,the bottom of the /� �feted less then fourteen(14)feet above the maximum adjusted i Y �r ill will d� i proposed leaching fee tX i VMMdwatar table elerat 0- im"se eompleh the f0nowleg: sneering Division A)tap'etOronnd Elevatlon(wing to the Eng , Elevetlon(accord Ing to Health Division well map) + 8)Obi ci�dweter Table �� f LicENSED SEPTic SYSTEM INSTALLER IN THE 'TOWN OF BARN STABLE NUMBER — tM stdM pfep�a��.AMs Itd+e Ile«+Md M�tall�r peMs+�a owl" plea plans this plan should be subn+ktedl. 4!too mbr ot IA �, 1 TOWN OF BARNSTABLE - �. � 91 LOCATION � �" � SEWAGE # VILLAGEt��I n�w w L ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. - SEPTIC TANK CAPACITY _ elli LEACHING FACILITY: (type) 1" ��J �Y Ssize) NO OF:B.EDROOMS BUELDER OR OWNER PERMTT.DATE: v! ?J COMPLIANCE DATE: L - 71? Separation Distance Between the: i Maximum.Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on'site or within 200 feet of leaching facility) Feet Edge:dMetland and Leaching Facility(If any wetlands exist Feet :within 300 feet of leaching facility) Furnished by j . J II Pe � The Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph M. Crossen Fax: 508-790-6230 Building Commissioner June 9, 1997 Ronaldo Eloy 168 Barnstable Road Apt. 6K Hyannis, MA 02601 Re: SPR-38-97, Eloy's Auto,Sales, 14B Pepper Lane, Hyannis Proposal: To sell used cars,having no more than 4 cars at a time Dear Mr. Eloy: The above referenced site plan was reviewed at the June 5, 1997 meeting of Site Plan Review,and deemed approvable under Section 4-7.4 (2) of the Barnstable Zoning Ordinance with the following conditions: Maximum of 4 cars on site No sign No washing or repair of vehicles on site A site plan delineating parking submitted to the Building Commissioner within 7-10 days Septic system inspection submitted to Health Division In addition,please contact Carol Ann Ritchie in the Licensing Authority(790-6252) to obtain a license. Please be informed that a building permit is necessary prior to any construction. Upon completion of all work,the letter of certification required by Section 4-7.8 (7) of the Town of Barnstable Zoning Ordinances must be submitted. Also, all signage must be discussed with Gloria Urenas of this Division. Should you have any questions, please feel free to call. Respectfully, Ralph Crossen Building Commissioner eloy P 733' 291 125 RECE°PT FOR CERTIFIED MAIL NO INSURANCE CdVERAGE PROVIDED NOT FOR INTERNATIONAL MAIL r (See Reverse) Sent to Mr. Dale Crowder ' Street and No. 27 Cesar's Way P.O.,St to and ZIP Cod Marstons Uills, Ma 02648 Postage S 2-00 Certified Fee Special Delivery Fee Restricted Delivery Fee Return Receipt showing to whom and Date Delivered Return%beceipt showing to whom, Date,and Address of Delivery m TOTAL Postage and Fees S 2.00 , Postmark or Date co C+, E`o July 13, 1988 t1 fA a STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES.(see front) 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier. (no extra charge) 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return address of the article,date,detach and retain the receipt,and mail the article. 3. If you want a return receipt,write the certified mail number and your name and address on a return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space per- mits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT REQUESTED adjacent to the number. 4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee,endorse RESTRICTED DELIVERY on the front of the article. - t. 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt. If return receipt is requested,check the applicable blocks in item 1 of Form 3811. 6. Save this receipt and present it if you make inquiry. U.S.G.P.O.1987476-131 •SENDER: Complete +;ar and 4. 2 when additional services are desired, and complete items 3 Put your address in the C� Space on the reverse side. Failure to do this will prevent this card from being retuf• 0C. return receipt fee will arovide you the name of the Derson delivered to and the date off ::, ._-Y. For additional fees the following services are available. Consult postm ter for fees and check box(es)for additional service(s) requested. 1. 9KShow to whom delivered,date,and addressee's address. 2. ❑ Restricted Delivery T(Extra charge)T V t(Extra charge)T 3. Article Addressed to: 4. Article Number Mr. Dale Crowder P733291128 P.O.BOX 762 Type of Service: ❑�3 ❑ d Centerville, Ma 02632 ❑'C egistered Insured certified ❑ COD ❑ Express Mail Always obtain signature of addressee or agent and DATE DELIVERED. 5. Signa re Ad ss 8. Addressee's Address(ONLY if X requested and fee paid) dd� 6. Signature—Agent d X 7. Date of Delivery 17 ,)L-v - PS Form 3811, Mar.1987 ,t U.S.G.P.O.1987-178-268 DOMESTIC RETURN RECEIPT ` UNITED STATES POSTAL SERVICE OFFICIAL BUSINESS SENDER INSTRUCTIONS � Print your name, address, and ZIP Code in the space below. • Complete items 1,2,3,and 4 on U the reverse. Vim® • Attach to front of article if space permits, otherwise affix to back of article. PENALTY FOR PRIVATE • Endorse article "Return Receipt USE,$300 i Requested"adjacent to number. " RETURN Print Sender's name,address,and ZIP Code in the space below. TO i i Rna rd of HPa 1 th `y 367 Main Street ' Hyannis, Ma 02601 Crv,✓dv— >� / Zs-- ISZv yOfTMe"T� TOWN OF BARNSTABLE 7l Z5 G '""'4iL 5''0 16.,-d tvIST1M�e/' OFFICE OF HsaM.� BOARD OF HEALTH ras i63a.9. 367 MAIN STREET HYANNIS, MASS. 02601 July 13, 1988 July 13, 1988 �� ,,,✓drr .-H 5 rum, Dot. 6u Mr. Dale Crowder 27 Cesar's Way 53veV'-/L.s Ste^'-VA11 �"_ Marstons Mills, Ma 02648 r age�G CA ,- CoMle 7 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY, . CODE, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND TOWN OF BARNSTABLE BOARD OF HEALTH REGULATION lid G q 2.703 CU The property owned by you located at 14 Pepper Lane, Hyannis was inspected �� on July 12, 1988 by Donna Miorandi, Health Inspector for the Town of Barnstable,`f because of a complaint. The following violations of 105 CMR 410.000, State Sanitary Code, Minimum Standards of Fitness for Human Habitation were observed: REGULATION 410.602 (A): Old damp mattresses, shopping carts, cardboard boxes containing refuse, stored in shed on property. This shed is a potential harborage area for rodents. REGULATION 410.100 (A) (2): Rear burners of stove inoperable. REGULATION 410.482 and 410.750 (N): Smoke detectors inoperable. REGULATION 410.551: No screens provided at several windows. REGULATION 410.354: Only one meter provided for two rental units. The owner shall provide and pay for the electricity and gas used in each dwelling unit unless such gas or electricity is metered through a meter which serves only the dwelling unit. TOWN OF BARNSTABLE HEALTH REGULATION REGARDING FUEL TANKS: A fuel oil tank is located on pervious soil in the basement. The oil tank must be securely anchored. Every tank shall be placed onto a foundation capable of supporting the tank. The foundation must be larger than the size of the tank in length and width to prevent spillage and leakage onto pervious surfaces. You are directed to correct these violations within five (5) days of receipt of this notice. You may request a hearing before the Board of Health if written petition requesting same is received within seven (7) days after the date the order is served. However, these violations must be corrected within five (5) days, regardless of any request for a hearing. Non-compliance could result in a fine of $500. Each day's failure to comply with an order shall constitute a separate violation. PER O R THEjBOARD OF HEALTH cc: Howard Wensley ,�ex " Raymond Kramer Thomas A. McKean Robert Parello Director of Public Health THE COMMONWEALTH OF MASSACHUSETTS BORF A"n2 yo'r1)!mn!! s c.7" s 9,9nc+ '. si �/V'y1/..1�..��_. CI /TOWN „i•. msYq lslinsblsai nl ia#Ra o3 bhy jo+ / ry: ,,nns }fin, s.nl1,t7 ,t io ,d.licad sill 'rlagml Yt) iaigSrr+tins �l_ iui!+ rv3 !, nr t d 1 b sld sldT r IEN m ENT. •N: J - , -iY9M tl r ,Y9 arts 3o anlfifl 88 YO 1(,�l A DR S T SQnY,ptl Xi 3 rJ1a'riaun7rtY 000 otA SIM3 eo1,.XZ Ya]gsrl�j tiYtuKas9 alc<tuq 7 J.'_�_�p5_�Jj l -� ' M1 eA All}.y t v s 1 s A r a,$ nes(Sat2 to sl *e,rzttc,TELEPH.ONE p't Ao y rs VAaI 9. nr 7 n t CCU 8f,1t ; '�.[-+/-1 c _ Floor _ •,Apartmg, aMona , No Occupant + t a No of,ifabitabie,Rooms;t Act.,Sleeping Rooms No.dwelling or rooming unit r o,Storie's Name ani!•addre§s of dwna' t If Al lob-to _•+di r!rnriw r,+S r5n11vq s 5 '#n rrn1,1a5!•! .. ta, I �t 7 Rem9rKs Reg; Vlo. 3\ YARD „ Out Bld s.: Fences i, ,. Garbage and Rubbish" Containers: a 3l s Drainage. .... ,r Infestation Rats or other: a l_ -5/SI_I " STRUCTURE EXT. Steps,Stairs,Porches. rr±Dual Egress:tend Obst n t +,a ' I t ❑B ❑F III MMo ?t!( Doors Windows:sn 751G9/' ,nF,, v, t , , o Roof a Gutters,Drains: :. Walls: .,..., ,_.. . ' r' r(a)425.01 Foundation: y ) BASEMENT Gen.Sanitation: r>' c ' - Dampness: r " Stairs: 9c vlrt un, ?n+ F nl,ty:r Lighting: .•, STRUCTURE INTij rl 7'uVH811,Stairway eyFw•ia A « w?J„z>m tan; s t n r n, $ r Hall,Floor,Wall,Ceiling: a , rN18t4 all Lighting o all Windows; f .z HEATING I, I Chimneys: ..( ,i Central ❑Y CD(1908 .rt7:Equip. epalr, i.,�sa,h ti,.,'•Y rlt•, „t+ r� nr•:• _ TYPE: Stack ,Flues,' ents: - a PLUMBING: n.! s pqr"SUppl seta t. CU fs, e:rtd ntv:',2c7 y,;r rr,r." 5 y' ❑MS ❑ST d!P3 zD i•>n Waste Line: a — t•` slos inI H.W.Tanks)Safety and Vent s o ELECTRICAL ` Panels,Meters,Cir.i' ❑110, ❑220 Fusin ,Grnd.: g : AMP n .77.,Gen.,Cond.Distrib.,Boxr wh s «r a«lnr h .r.=!--fi n( o S3 .ne},, en..BasementWiring: 'f 9ra ar nm,rr.q•rt 4 3.. n(111.i)64 qK') Oil DWELLING UNIT ! Ventil. L to Outlets I Walls Cells. Wind Doors-Floors Locks Kitchen - r •oz.: Yrt;r .7 :,.79• r.n ,. „r:r:; -.� Bathroom 12.z_, Pantry Den Living Room , Bedroom(1) , — r, Bedroom(2) 7 h>:ytl of Qlrt J c t _ Bedroom(3)•ai,Yi ,Rm.t •w i+nFt, x sio 7« t, P;t.tr .4, ric w: ,k! Bedroom(4) r t' Hot Water Facll.b"l' 'g '"Su .'Ten'Gas`OII"Elect'''1l ri,ff"W Arlo if) urrr 7t:•: _ Stacks Flues Vents Safeties: } r{ Kitchen Facilities $ink t Stove .. f # Bathing,Toilet Facll. Vent,Plumb.,Sanit'n;;:-. 4 3 5 b.-m1m, l mWash;Basin,Shower,orTub:,, r10 7r,?e.0 r :tr ', • , !r? Infestation in I i,, als/ ice;Roache o Other.t t ) 6 c1, Egress Dual an Obst'n: ' NC '.General sarlsm Abi tw nBuilding Posted" ir, +nn.trtrtert fl7'7� (4 - 'bs3g9^311 +;Locks on'doorsl'ra,rlrc.tahv nt 'soast,na itgi rnt,i,< r:.:,re, ,,•'.:• ff r ' ONE OR MORE OF THE VIOLATIONS,CHECKED ABOVE IS A CONDITION WHICH MAY,MATERIALLY.fMPAIR.THEM EALTH OR SAFETY AND,WELL-BEING OF THE, 5 OCCUPANT!,AS,DETERMINED,BYt 105CMRr_41)1,750,tOF,THE"CODE,OR,THE AUTHORIZED INSPECTOR. (See Over)(E)f0?sn 16 hnn f A l r ttt:(f 0 V!W) 01 It b"THIS INSPECTION'REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND `E PEN ALT FPERJURa( �Sj•Dld Sit:.' tDi tId [;t; pyr. a,z a•+,i _� �/ x,INSPB�T.OR r 1A dry n r �TL n / " a� 36 avu l m u000 nih-3o gss} tTeri bns y:191za 30 ,T»•i ��;,� ^DATE ea .' elu�•1--a4?'3 er}a�i'�E • r.r a A.THE NEXT SCHEDULED REINSPECTION P.M. £�S�t�,� X^s��.l,�"xy yY'A'�,5 ��`,�%{x r"3�5t. �'6�t � '6a'n;��v r -'t,. ,� 4,1' rf •i;!.^ � ' ' ' ''�HS•COMMONWEALTH bF:MAssACHUSETTB f BO �/ARD OF HEALTH �\ X.191n2 To tlaIA9'.�'G: �'>g n! I 16&(z CITY/To N �+ i m9Yg 161:1nobtea-3 fits ft yelxs a nuo9 rra i/ t> t I-•' Ia ,rb'Joad 90 >Ingmt 720 tsgner � N. vzhd ll el4 .seat . , 8r Palinspo sd gvyy,�,,�1(�Jc�• ll ^'I,,,rfY 3o bntsd fisv bnn �'�tp3msio. dSIADDR '1 rfsuoirts 000.01A f1HD 201p:uraaR ,tJAuy �otlrl ,tv p o 1 7tcirr RPM— or If � r �; 4o r.-1 v`,°rTEL HO E /� r'• +;n ram 9v t Add4e�¢' A ccuPantFlo art en o No., ccupant ,*7 No.of>Habitable,Roomsr ,NO:,Sleeping Rooms. /7 r."( No.dwelling or rooming units�1 " r N cries , 7 `: Mix: )1/f/t.' Name And address'ot,owner/./ 1. J 1�I L tx.' et 7ol,�n a,f1 mnri+ rtCsti•�q ir, •r ! Re k Reg: Vio. ' YARD Out Bld s.: Fences: r Garba a and Rubbish. 9Yuae Containers, . . . 3naqu;»o .. o o Drainage ,.. Infestation Rats or other: STRUCTURE EXT. Steps,Stairs,Porches: �� •,�,'Dual Egress: and Obst'n1 isswz ❑B ❑F LJ M 111P3 prlr Doors Windows: l)Ir' Roof Gutters,Drains: 'r Walls: (e')025.01 Foundation: _ Chimney: BASEMENT Gen.Sanitation. 1 Dampness: 7+: Stairs: Lighting: t STRUCTURE INTP 4 r09-Hall,Sta!rWa :"gnwny a ntn:ln)r.m bnn, J�,i tot A � 1 i Obst'n: .v,r Hall,Floor,Wall,Ceiling: , ,dan .Hall Lighting-.,i 7777, ._ _ . , Hall Windows: i HEATING Chimneys: - i Central ❑Y !{1ely10& 1 Equip.Repair , )— 1/1� W r•' TYPE: Stacks,Flues, L,: ' I a us 'la"S W1.) <o toPLUMBING uppy�Llnen eren)�tvar,r yr r n t' _[[¢¢ 3 ❑MS ❑ST ❑:Pd1t z' ""Waste Line: } a�a9i!nt H.W.Tank(s)Safety and Vents ELECTRICAL Panels,Meters;Cir.:' ❑110 ❑220 Fusing,Grnd AMP: n ,t,Gen.Cond..Distrib..Box r, . r I „ t o roi no]den.-Base enttWiring:1,q 30 rsr, :•r• nke,a: ? 4 u l."tosP AM") 2r`1 DWELLING UNIT a,r, Ventil. L to Outlets Walls Ceils. Wind. Doors Floors Locks L,,, Kitchen n T.:,. .tom e_r� „c !, ,+,n, a Bathroom 'u, :n,�ors .. ,vain ;`•. <:.: ._ Pantry J Den y Living Room ,; ; _ Bedroom 1 . ,, — r— Bedroom(2) an 7 I•u ad! a?n<! 7 nr rcF )JI Ir Bedroom(3),no,s .rmt 90 s°I rnab t tin 7o I nstrt-, a to ,l`., .r •f s, UG,. Bedroom(4) t 'f b"" t r. t riniria-rco.la.t n. nfit w f f 1 = -- Hot Water Facil. f Su`.Tort',Gas Oi Etact Stacks Flues Vents a etiest S Kitchen Facilities Sink $k)VIf , { Bathing,Toilet Facll. Vent Plu b.,Sanit' ballup t ,Wash Basin„Shower,o(T,ub.,; r n1 t + Infestation na'i W J also! IcvT1 e,Roacq or ther.i+ r Egress Dual and Obst'n:. i ; fal[u "'.Building osted: »s.Pouncvt r7inre vI r.19,-iTWu:aItt. J1)7n,qS 9 Xns r, cnbsJgsa a vLockdond r.f i l .A.. ONE OR MORE OF THE VIOLATIONS.CHECKEO ABOVE IS A CONDITION WHICH >fioMAY-MATERIALLY,IMPAIR:THE,HEALTH OR SAFETY AND WELL-BEING OF THE. OCCUPANT,:AS,DETERMINED!BYtr.1Q}SCMR•t,41Q.7501 if'J..HlEi CODE,OR.THE AUTHORIZED INSPECTOR. (See Over)(•s)Fot.oiA (+nr. rm , f' br"THIS INSP TION REPORT S SIGNED AND CERTIFIED UNDER THE PAINS AND! iJ; 4' PENALTI O PERJURY"'-£•01A till: ZOf va,•b:rrt . ar en anr•�q ,•: n ti 0-1 s'$pe!:rht'I ItNS�PEQTO,R ,;i+A'7SP1! s ' ! I nagLo o nn 30rr.to' 'law, nn Z193rly -.in �'•n!7 ' r I u DATEg A ris n,koiimI., k -+,:v; A.M. THE NEXT SCHEDULED REINSPECTION P.M. 4. r}�yFa'i1•;••)ap'�+''�:..".yr�:`!*�r•.Jt�;m••trl�sc•+ww�{;-+.,,,,r�-•t.cyy,A�'..-.�e•r�-o--..p"t�t..�:,s�..-.•.a.v,.-,�•,.,-vw:.r.w�-°etv'-..+n.s•,i^wur...�-,..: THE•COMMONWEALTH OF`MASSACHUSETTS BOARD OF HEALTH s, -rA Y�6� clnriTowN �Z W jT DtlEPARTME T r.-t ADDRESS 'c�M Sveye +� TELEtPHJ06ZEE � . y - _ Address fir_ . Occupant FloorApartment No. t No.Occupant No. of Habitable Rooms No. Sleeping Rooms q r O No. dwelling or rooming units No Stories > / Name and address of owner Xr fk ' Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish-" I,) j C M Containers: - Drainage IN ,�t +�,, Infestation Rats or other: .nl.J�xk 3'_ �,� �.`"� <x1jA STRUCTURE EXT. Steps, Stairs, Porches: / ! Dual Egress: and Obst'n.: fl I/ AAF --• 11113 ❑ F ❑ M Doors, Windows: "" y �`"'`/ `` `� ' Roof Gutters, Drains: Walls: Foundation. Chimne : BASEMENT Gen. Sanitation: Dampness: _ Stairs: _ Lighting: STRUCTURE INT. Hall, Stairway: Obst'n.: Hall, Floor,Wall, Ceiling: Hall Lighting: Hall Windows: V, _�. z HEATING Chimneys: _z Central ❑ Y ❑ N �. Equip. Repair / l lv .- (f'� t'>� ) ✓1%% z TYPE: ` Stacks, Flues,Vents: W a PLUMBING: Supply Line: ❑ MS ❑ ST ❑'P Waste Line: _ m H.W.Tank(s) Safef and Vent(s) ELECTRICAL Panels, Meters, Cir.: 0 ❑ 110 ❑ 220 Fusing, Grnd.: ' AMP: Gen. Cond. Disfrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. Lgtng. Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen ) � _ Bathroom y Pantry Den I Living Room ' Bedroom (1) ' ,,� - ' Bedroom (2) , W IC iit Bedroom (3) Bedroom (4) Hot Water Facil. Sup.Ten.,Gas, Oi , Elect.: - _ Stacks, Flues Vents S fa eties: Kitchen Facilities Sink , Stove UT WULE MI� 1 'I Bathing, Toilet Facil. Vent., Plumb., Sanit'&: . /�p Wash Basin, Shower.or Tub: Infestation . Rats, Mice, Roaches or Other: (� i . Egress Dual and Obst'n: / a��.-r General - Building Posted: � i 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 INS�ECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY." 17 INSPECTOR TITLE L. A. DATE a� 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 in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of these 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 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. (E) 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 410.480(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. (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 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 410.1352 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: (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 operable. (2) failure to provide a washbasin and a shower or bathtub as required in 105 CMR 410.150(A)(2) and 4,10.150(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. (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. (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. A THE COMMONWEALTH OF MASSACHUSETTS ! OARD OF ' EA TH f CITY/TOWN W ' i = 14 Z6- ARTMENT — ADDRESS ,,.�f ! j( TELEPHONE Address l + kkl l �f t- - 1/ r� � �'a . Occupant. Floor 1 -I4 p ! Apartment No..._ No.Occu ants No. of Habitable Rooms_ _ No. Sleeping Rooms �y�' r No. dwelling or rooming units o. Stories_ . SIN<V �� ( v M Name and address of owne 3(A f F.; � g � (,0 Y Ar 016 14 Remarks Reg. vio. YARD Out Bld s.: Fences:- ) NEN Garbage and Rubbish: Containers: � .__ _ J Drainage _ Infestation Rats or other: Y'0 j 0� M UP , 1k)A( (1 ) Py U f36l sf4 STRUCTURE EXT. Steps, Stairs, Porches: ! Dual.Egress: and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: t Foundation: 'L— _1� 0 (Jl I1\f �l' /�1kWAII ON Chimney: JA�'�f� BASEMENT Gen. Sanitation: Dampness: Stairs: _ Lighting: STRUCTURE INT. Hall, Stairway: 0 Obst'n.: ° Hall, Floor, Wall, Ceiling: Hall Lighting: Hall Windows: , z HEATING Chimneys: z Central ❑ Y ❑ N Equip. Repair LU TYPE: Stacks!Flues,'Vents: Q PLUMBING: Supply LLine: ❑ MS ❑ ST ❑ P Waste Line: m H.W.Tank(s) Safety and Vent(s) ca ELECTRICAL Panels, Meters, Cir.: 0 ❑ 110 ❑ 220 Fusing, Grnd.: AMP: Gen. Cond.Distrib. Box: cr u Gen. Basement Wiring: DWELLING UNIT Ventil. Lgtng. Outlets Walls Ceils. Wind., Doors Floors ILocks Kitchen — BathroomL li41 Pantry Den Living Room Bedroom (1) .,( �J1 hit M 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 1S SIGNED AND CERTIFIED UNDER THE PAINS AND PENALT:E FPERJUR� INSPECTOR TITLE 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 in residential premises, shall be deemed conditions which may endanger or impair the health, or safety ? and well-being of a person or persons occupying the premises. This listing is composed of these 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 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 01R 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. (E) 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 410.480(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. (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 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: (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 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. (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. 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Ili :. 1 :!:i r"i :'I i::i { ... _ 1 _._ _. i v.!........•....: + ......•_:::...I•;..!.... :: ;..!:::! ?.I 1 ;..! i ±1 ::l i.::' t.:. .. 1'::'1,.. .Y'i .. ! ...i'i t::i. i C:::::::.%= E::` L:.E i 1:::i =...%.?�t t::i 4�i�:.. .y.,j l.a_j i.:I 1.:1 F.:�'::: ...... ... i:::!i i!_!-!._ •_? i l'i:::?f i D_ ?`� ..: f such dwelling who resides therein , shall post and maintain on such dwelling a notice constructed of durable material , not less than twenty square inches in size, bearing his name, address and tel ephone number,, ......... I............ structural elements. The gutter is clogged and disjointe-,J not allowing for proper drainage of water from roof . The exterior light at entrance to front upstairs door is not installed which renders the area an accident hazard . REGULATION WMARp1hp ............................................. % A fuel oil tank is located on pervious soil in the basement.. The oil tank must be jecurely anchored . Every tank shall be placed onto a foundation capable of supporting the tank . Tht......-- foundation must be larger than the size of the tank in length and width to prevent spillage and leakage onto pervious surfaces:! You must also inform any future tenants as to the status of the inoperable chimney due to the broken flue and that you have boarded it up and is not intended for use. You should also include in your lease a mutual agreement as to who is responsible for the maintenance of the yard with regard to lawn mowing , raking of leaves, disposal of trash and(J rubbish, aid removal of snow and icen These violations must be remedied as previously indicated an.-.::! should not be rented out until all violations are rectified . Official notice shall also be posted on the premises and not removed until violations are yompletely rectifieK 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, the violations must be corrected before any tenant occupancy occurs. PER ORDER OF THE BOARD OF' 1EALAM 71--i.omas A. ............. Director Of Public Health cc : Group Rental Task Force Barnstable Housing Authority Howard Wensley, State Department of Public Healt! Town of Barnstable Building DepartM2nt -0-521 459 180 RE�s`i WT FOR CERTIFIED MAIL NO INSURANCE COVERAGE PROVIDED NOT FOR INTERNATIONAL MAIL (See Reverse) QSent to $ Dale Crowder Str a�and No. Caesars Way 0 0; P.O.,State and ZIP Code c? arstons Mills, Ma 02648 Postage 5 Certified Fee Special Delivery Fee (O Restricted Delivery Fee Return Receipt showing to whom and Date Delivered U) Return Receipt showing to whom,: r' Date,and Address of Delivery m -7 -/7 TOTAL Postage and Fees . 5 ' Postmark or Date LL " STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, " CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES. (see front) i. 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier. (no extra charge) 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return address of the article,date.detach and retain the receipt,and mail the article. 3. It you want a return receipt,write the certified mail number and your name and address on a return receipt card,Form 3811.and attach it to the front of the article by means of the gummed ends if space per mits.Otherwise,affix to back of article. Endorse front of article RETURN RECEIPT REQUESTED adjacent to the number. M 4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee,end) " RESTRICTED DELIVERY on the front of the article. 5. Enter fees for the services requested in the appropriate spaces on the front of this receip J If return receipt is requested,check the applicable blocks in item t.of Form 3811. C6. Save this receipt and present it if you make inquiry. 1 J ------------------ f� oftNtTo TOWN OF BARNSTABLE P OFFICE OF ssassT.aL �rNa BOARD OF HEALTH '� 0 39 367 MAIN STREET HIYANNIS, MASS.o28o1 t ` January 26, 1988 Mr. Dale Crowder 27 Caesers Way Barstons Mills,MA 02648 NOTICE ZQ ABATE VIOLATIONS Q$ RM OR 410 , 00 , STATE SANITARY CODE. .MINIMUM STANDARDS QE FITNESS FQR BAN HABITATION The property owned by you located at 14 Pepper Lane, Hyannis Massachusetts was inspected on January 21 , 1988 and January 26, 1988 by Donna Mioriandi, Health Inspector for the Town of Barnstable, because of a complaint from the tenants,John and Patty Eastman. The following violations of 105 CMR 410. 00, State Sanitary Code, Minimum Standards of Fitness for Human Habitation were observed: Regulation 410. 354(A) (2j-.LNo written rental agreement provided for payment of electricity by the occupant. Regulation 410. 190:Capacity 'of hot water tank only ten ( 10) gallons , insufficient quantity of hot water provided to satisfy ordinary use of all plumbing fixtures. You are directed to correct these violations within five (5) days of receipt of this notice. You may request a hearing before the Board of Health if .written petition requesting same is received within seven (7) days after the date the order is served. Non-compliance could result in a fine of $500. Each separate day's failure to comply with an order shall constitute a separate violation. PEj� ORDER 05 THE BARNSTABLE BOARD OF HEALTH Thomas. A. 11cKean Acting Director of Public Health cc:John and Patricia Eastman Howard Wensley, State Department of Public Health Edward Jenkins,Town of Barnstable Plumbing Inspector OftMETp TOWN OF BARNSTABLE OFFICE OF MAG&s�►a ; BOARD OF HEALTH .� MACS. 00 039. ` 367 MAIN STREET HYANNIS, MASS. 02601 CERTIFIED P042998257 I - . February .1`�, 1987 Mr. Dale Crowder P.0; From 767 Centerville, MA. 02632 Dear Mr. Crowder, nIJ"I":fCF' 1"U FIh:Al'F VI:UI_..A.f :ft::)Q UE 105 C:h'(F: 412„20, EIhIg SAP.I'1' T'aRY f�C1L}l= MINIMUM S Tfah•IDARDS OF FITNESS FOR h-II_ll` ON HAB I TAT I CO)N The property owner..) by you located at 14 PQpnIn L.�- n� e, hlr�annis9 �. Massachusetts, was r-c. inspected on February 21t� 8E3, by Anna Moir-a.ndi , Health Inspector for the Town of Barnstable. The following violation of 105 CMR 410„00, State Sanitary Code, Minimum Standards of Fitness for Human Habitation st.i.11. exists FiF_Gi1t�ATI(71�1 4.1�=?.:; 2-..1_: No written rental agreement provided for payment of electricity, including heat, by the occupant. You stated , per phone call on February 8, 1988, that you do have a .wr-itten rental agreement for the payment of electricity by the occupants, and that you would send a copy of the agreement to the Health Department. A ropy of the written rental agreement still has not been received . I unjer-stand that you have recently converted to electric: heat, and are currently entering into a new lease with your tenants. Thier-efore, you are directed to send a written copy of the revised rental agreement for payment of the electricity including who pays for the heat, plus a copy of the new lease, to the Health Department within three (:') days of receipt of this order-. PyOFiMETO� TOWN OF BARNSTABLE OFFICE OF Bout BOARD. OF HEALTH 039. U ` 367 MAIN STREET �0 �Y k' HYANNIS, MASS. 02601 February 8 , 1988 Howard S. Wensley Division of Community Sanitation Department of Public Health 150 Tremont Street Boston, MA 02111 Dear Mr. Wensley, The dwelling owned by Dale Crowder located at 14 Pepper Lane, Hyannis was reinspected on February 2, 1988 . The following conditions have been rectified: 1 . The hot water heater has been replaced with a unit of larger capacity; 2 . The replacement hot water heater was installed in accordance with accepted standards with a permit, and was inspected by the Plumbing Inspector; 3 . Mr. Crowder stated, per phone call on 2/8/88, that he does have a written rental agreement for the payment of electricity by the occupant. A copy of the written rental agreement will be sent to the Health Department. The following documents are being or have been revised: 1 . Brief summary of. legal remedies - name and address of Legal Services has been inserted (#1 enclosed) ; 2 . New updated inspection forms have been ordered. The outdated inspection forms will be discarded as soon as updated inspection forms are received. Thank you for your assistance. Very truly yours , Thomas A. McKean Acting Director, of Public Health encl . TAM/dm THE FOLLOWING IS A BRIEF SUMMARY'OF SOME OF THE LEGAL REMEDIES TENANTS MAY USE IN ORDER TO GET HOUSING CODE VIOLATIONS CORRECTED. 1. Rent Withholding (General Laws Chapter 239 Section 8A) ; if Code Violations Are Not Being Corrected you may be entitled to hold back your rent payments.You can do this without being evicted if: A. You can prove that your dwelling unit or common areas contain Code violations which are serious enough to endanger or materially impair your health or safety and that your landlord knew about the violations before you were behind in your rent 8. You did not cause the violations and they can be repaired while you continue to live in the building. C. You are p• Pa re red to pay any portion of the rent Into court if a judge orders you to pay it (For this it is e rent mono ' best to put the Y aside in a safe place.) 2. Repair and Deduct (General Laws Chapter 111 Section 127L). The law sometimes allows you to use your rent money to make the repairs yourself. If your local code enforcement agency certifies 'that there are code violations which endanger or materially impaieyour health,safety or well-being and your landlord has received writtisa notice of the violations,you may be able to use this remedy. If the owner fails to begin necessary repairs (or to enter into a written contract to have them made)within five days after notice or to completerepairs within 14 days after notice you can use up to four months'rent in any year to make the repairs: 3. Retaliatory Rent Increases or Evictions Prohibited (General Laws Chapter 186.Section 18 and Chapter 239 Section 2A). The owner may not increase your rent or evict you in retaliation for making a complaint to your local code j enforcement agency about.code violations. If the owner raises your rent or tries to evict within six months after you have made the complaint he or she will have to show a good reason for the increase or eviction which is unrelated to your complaint.You may be able to sue the landlord for damages if he or she tries this. 4. Rent Receivership(General Laws Chapter 1111 Sections 1270H): The occupants and/or the board of health may petition the District or Superior Court to allow rent to be paid into court rather than to the owner. The court may then appoint a"receiver"who may spend as much of the rent money as is needed to correct the violation. The receiver is not subject to a spending limitation of four months' rent EL Sreach of Warranty of Habitability. You may be entitled to sue your landlord to have all or some of your rent returned if your dwelling unit does ,S not meet minimum standards.of habitability. 6. Unfair and Deceptive Practices (General Laws Chapter 93A). Renting an apartment with code violations is a violation of the consumer protection act and regulations for which you may sue an owner. ' THE INFORMATION PRESENTED ABOVE IS ONLY A SUMMARY OF THE LAW. BEFORE YOU DECIDE TO WITHHOLD YOUR RENT OR TAKE ANY OTHER LEGAL ACTION, IT 1S ADVISABLE THAT YOU t CONSULT AN ATTORNEY. IF YOU CANNOT AFFORD TO CONSULT AN ATTORNEY, YOU SHOULD CONTACT THE NEAREST LEGAL SERVICES OFFICE WHICH IS: LEGAL SERVICES FOR' CAPE COD & ISLANDS, Inca 775-7020 (NAME) (TELEPHONE NUMBER) i 460 West Ma'_n Street, Hyannis, MA. 02601 R (ADDRESS) _f Saweche CAw o f Awwn �ewv c Commissioner's Office /50 �remmowt Aw't F i oaCox o�� January 29; 1988 Thomas A McKean Acting Director of Public Health Board of Health 367 Main Street Hyannis, MA 02601 Dear Mr. McKean: Thank you for following up on the complaint regarding 14 Pepper Lane Hyannis. Your prompt response is appreciated. A review of the documents we received indicated a few problems that should be addressed. They are: 1. The order did not note that the electrical and plumbing facilities were not installed in accordance with accepted standards ( 410. 354) . The installation of the electric heat and hot water tank was not done in accordance with accepted standards in that no electric or plumbing permits were pulled. 2. The inspection form utilizes regulations numbers that have been out dated for at least 10 years. 3 . Where the name of legal services office should be inserted the name of the tenants was inserted. If you have any questions *or need any assistance please feel free to contact the department. Sincerely, Howard S. Wensley, Director Division of Community Sanitation HSW/ch c ��te Tod TOWN OF BARNSTABLE 7 I A3a J P �I OFFICE OF ' DA"STADB i sS& BOARD OF HEALTH 367 MAIN STREET HYANNIS, MASS. 02601 1 .January 26, 1988 �1 scc�N�✓E(� Mr. Dale Crowder 7 - 27— aeser y a }` Mai Btona M i 1 a_M`p2648 43 z NOTICE TQ ABATE VIOLATIONS a M OR 410. 00. STATE SANITARY QQDY,, MINIMUM STANDARDS QR FITNESS F_QR HUMAN HABITATION The property owned by you located at 14 Pepper Lane, Hyannis Massachusetts was inspected on January 21 , 1988 and January 26 , 1988 by Donna Mioriandi, Health Inspector for the Town of Barnstable, because of a complaint from the tenants,John and Patty Eastman. The following violations of 105 CMR 410. 00, State Sanitary Code, Minimum_ Standards of Fitness for Human Habitation were observed: Regulation 410. 354(A) (2) :No written rental agreement provided for payment of electricity by the occupant. Regulation 410. 190:Capacity 'of hot water tank only ten ( 10) " gallons , insufficient quantity of hot water provided to satisfy ordinary use of all plumbing fixtures. You are directed to correct these violations within five (5) days of receipt of this notice. You may request a hearing before the Board of Health if .written petition requesting same is received within seven (7) days after the date the order is served. Non-compliance could result in a fine of $500. Each separate day's failure to comply with an order shall constitute a separate violation. PE ORDER 0 THE BARNSTABLE BOARD OF HEALTH Thomas A. cKean Acting Director of Public Health cc:•Tohn and Patricia Eastman Howard Wensley,State Department of Public Health "' Edward Jenkins,Town of Barnstable Plumbing Inspector VARIANCE REQUESTED 1 REQUEST A VARIANCE TO REDUCE DISTANCE FROM SAS TO A FOUNDATION PERCOLATION TEST FROM 20' To 13'. A 40 MIL RUBBER LINER HAS BEEN PROVIDED. I Date of Percolation Test: JULY 25, 2005 3-24' REMOVABLE COVERS Test Performed By. CARMEN E. SHAY, R.S., C.S.E. -24' DAM. AccEss MANHOtFs ` Results Witnessed By. WAIVER ( per BARNSTABLE B.O.H.) e' -o' --r--• r-- Excavator Shay Environmental Services, Inc. Percolation Rate: Less Than 2 MPI ® 36" ;�" J''`"" - `" 1 ,N� I e�mh 1m�� clearance I '-T. • 'r I ---_ J�"_min. inlet to Outlet a min. +]• M.E 5' -0. -�- LTiw t__ OUTLETLl '•5' -O. NEE- 1 ! 1 "� '' • 4'-0' min. Test Hole Test Hole INLET `/ \ / ou g •�• Liquid depth No. 1 2 1►' DEPTH SOILS ELEV DEPTH SOILS ELEV Loamuv y Loamy STEEL REINFORCED PRECAS' CONCRETE S -� i � Sand sand ' PLAN VIE4 CROSS SECTION END-SECTION j 10 YR 3/2 1 1 0 YR 3/2 0"-6• A, 197.75 0•-6' I R 195.50 LSa tlY Loamy T1'PICAL EXIST.) 1000 000 GALLON SEPTIC TANK THE ACCESS COVERS FOR THE SEPTIC TANK, Sand DISTRIBUTION BOX AND LEACHING COMPONENT NOT TO SCALE I 10 YR 5,/e to vR 5/e SHALL BE RAISED TO WITHIN 6" OF LOT #29 LOT #30 I I B ! FINISHED GRADE. 6"-36• ' 95.00 6"-30' 9e 193.50 I Medium Medium (H 1 0 LOAD►NG) INSTALL TUF-71TE GAS BAFFLES OR EQUALS ! Sand iSand ON ALL OUTLET T EE ENDS l 7.$ vR e/1 7.5 YR 36"- 132 C 07.00 30'- 132 C 85.00 1 ---- ALL OUTLET PIPES FROM THE DISTRIBUTION BOX SHALL BE EXISTING i I Sri LEVEL FOR AT LEAST 2 FT - ,T -i CONCRETE COVER SHED �. 3 - 5' OUTLETa.....- -► c9p TO BE REMOVED FOR INSTALL OF SAS ---- :{ KNOCKOUTS r . 15.5 OUTLET �,. I i T' INLET ` l.. t 1�, t Perc #1 --15.5• 4 . 4' - SCH0 T 7 ,1\ V�\TEST HOLE Depth to Perc: 36" 1, 5' + s�'- Perc Rate= Less Than 2 MP! assumed T EXISTING ELEV.= 98.00 FT�- -�-�- - I I -AN -SECTION ION CROSS SECTION SHED t\ II OBSERVED H2O Elev. None Observed HOLE H- 1 0 DISTRIBUTION BOX NOT TO SCALE LOT #32 1 2-21•aAM. AOlaee MANHOUIS \ 10,000 Square Feet +/- 2-20' REMCVEABLE _ I } 1 TEST HOLE #2 I MANHOLE COVERS WITHIN ELEV.- 96.00 LOT #33 8 OF FlNiSHED GRADE I ram• t O �.� o (--------•------ '1 � I RESTORE •-'tiS � I • �.:.k.✓:az.".�•,�:,y• 1 O EXISTING / / u/' 1/ Y { //��1� / / / �L/,..t,� T (//�\\// A I ` I I B�,./ ID 'I I V C ! �./ / I (' C l./ L_ / I / / O! V SI LIFT OUT CrWN K ! T THE ACCESS COVERS FOR THE SEPTIC TANK, 4 BEDROOM 1 I INLET INVERT i r< DISTRIBUTION BOX AND LEACHING COMPONENT t 1 ASPHALT 1 " t HOUSE � v SET DEEPER THAN e' BELOW FINISHED 1 1 DRIVEWAY I I O E�r�Q � '� � -�--- ouTLeT INVERT ELEV.- Bo.00 i ,.•_,-,��-f�EEp �pL� �pyE GRADE SHALL BE RAvSED TO MATHiN s' OF 1 0 40 POLYETHYLENE LINER FROM ELEV. { 3;EEZE pR*CE aN) CHECK VALVE ,.r - . -� • '' FINISHED GRADE. 1 j 14 I I 2• SWING CHECK YAL'/E-P v C STEEL REINFORCED PRECAST CONCRETE 0 96.00 to 92.25 AND TO EXTEND ! 1 i O j I e0• PLAN VIEW PROJECT BENCH MARK r TWO SIDES AS SHOWN I st•! L>M . 11 I (J I I `1 i �j 2_ TOP OF FOUNDATION IL---- , I I r ELEV. = 100.00 (Assumed) ', Z loon GALL N e � I '� � NONE REQUIRED - NO GROUNDWATER ENCOUNTERED 1 I .6. , ; ! ,�, _ „� =Y� e.,e.t ., r (�-'�• , t I _PUMP 1HA BER PUMP CHAMBER ELEV- eeo0 auTLLT tl I e i C O �OO C' 20 40 50 f >o I EXIST. I _0 1000 GALLON `� 2 at 3/4• SEPTIC TANK / ____ I ' ---------r'--T------ ------ -� - PUMP DEFT t 1 / I Not to Sco'e e 0 s' to FAILED SAS (APPROX) r , 3 SCALE: 1 "=20' CROSS-SECTION END-SECTION i ; ---- ----r ------- ------ ' `� L` I PUMP NOTES & SPt c:%FICA TONS 1000 GALLON H-20 SEPTIC TANK USED AS PUMP CHAMBER GRAVEL ` O i NOT TO SCALE l /100.00' I DRIVEWAY •t = _ I t PUMP SHAD BE INSTALLED /N $TRIC' COMPt[ANCE NOTE: PUMP CHAMBER TO BE FACTORY WATERPROFFED PRIOR TO SHIPPING. Ill MANUFACTURER'S SPEC'FICA'IONS 1 Ai�IRM SHALL CONSIST OF AuDIBL£ 5,'G!vAL & i lI oJ� I RED WARNING LIGHT rC BE INS1�t L£D IN BUILDING �t 1 F- I ANO POWERED By s£PARATE r-"C`UfT FROM PUMP SPECIFICATION C✓'tLCULAT/0NS ; ----- ' ----- ----- -- - -------------------------- --- - Des�Cn Calculations CIRCUITS To p;,!Mc Number of Bedrooms 4 Equivalent to 440 Gal./Day (440 gal./day per Title � 440 cALLONs/4 DOSES-',C ;ALL5vSlDoSE 1 51A77C HEAD CALCULAn )N I Garbage Grinder No 95.37' - Do. o/ O-Box In (40 FOOT RIGHT OF WAY; ! Leaching Capacity Required: 440 Gal./Day (MIN. PER TITLE V) • \� j Septic Tank - 2 x 440 Gal./Day = 880 USE NEW 1,500 GAL. Septic Tank. FLOA T LOCA T/ON CALCuLA RQNa I e6.00' - Devotion of Barrom of Pump Chamber O ( 95.37 - 86.00' - 9 J7" Stob'c Head SOIL ABSORPTION AREA. Using percolation rate of <2 min./inch I 110 Gallons / 7.48 .r,AL./Cu Ft - 14.7 Cu Ft p 1 Bottom Area: 0.74 gal/sq. ft. x 416 sq. ft. 307.84 gallons I Area or Bottom or Cnomber - 8' x 5' - 4e Sq. R QMAMIC HEAD Sidewall Area: 0.74 gol./sq. ft. x 180 sq, ft. 133.2 gallons �, j Height of Water for One Doss (r+, - 14.7 L t 4C SQ Friction Head For 3- SCH 40 Pt•C Pipe Providing: 441.04 gallons H = 0.37 Ft. 4.40` • j Use: (3) PRECAST 500-C UNITS, HAVING A 2' EFFECTIVE DEPTH, Ot0 CPU - 0.005 Ft./f00 Ft Pump On - 10 5, 050 GPM - 0.01 Ft./100 Ft. Use Gould Modelf 3887(WS03118F) Pump TO BE USED WITH 4' OF WASHED STONE ON THE SIDES AND 230 vox Phose Pump Off - 6• 0100 GPM - 0.40 R./100 Ft \ 3.25' OF WASHED STONE ON THE ENDS. 1/2 HP 2' Solids Handling \ A/orm 20.0' '- Total Dynamic Hood - 9.77' O ?Do GPM OR EQUIVALENT EXISTING SAS TO BE PUMPED DRY & i PUMP PERK pRMgNCE�.4 ;A FILLED IN PLACE THE PROPERTY LINES ARE APPROXIMATE AND _ LOT #35 LOT #36' COMPILED FROM THE SURVEY PLAN ENTITLED i GENERAL RAL NOTES PLAN OF LAND IN HYANNIS, MA of JAMES SPOJR NOTE: THE STRIPPED OUT SOIL CONTAINING LEACHATE DATED OCT. 13, 1953 BY CHASE, KELLEY & SWEETSER, j FROM THE EXISTING SEPTIC SYSTEM TO BE DISPOSED AND IS NOT INTENDED TO BE A4 SURVEY PLOT PLAN 40 1. Contractor is responsible for Digsafe notification IT SHOULD BE USED FOR NO PURPOSE OTHER THAN I and protection of all underground utilities and pipes. OF AS PER BOARD OF HEALTH SPECIFICATIONS. THE SEPTIC SYSTEM INSTALLATION. i I I 2. The septic tank on j distribution box shall be set level on 6" of 3 2' stone. 3. Backfill should be clean sand or gravel with no AA [1 "I�11 I I I I stones over 3" in size. (� r- f� L E L7 E N D m 40 4. This system is subject to inspection during installation PROFILE OF S r I C S Y S T I by CARMEN E SHAY - Environmental 5. The contractor shall install this system in accordance 88X0 DENOTES PROPOSED o I I I with Title V of the Massachusetts state code, the approved plan SPOT GRADE _ I and Local Regulations. u 6. If, during installation the contractor encounters any DENOTES EXISTING I E 20 soil conditions or site conditions that are different 104X46 SPOT GRADE 0 I " from those shown on the soil log or in our design VENT PIPE (• Least 24 Inches toll) � .0 �% ! I installation must halt & immediate notification be Schedule 40 PVC w/Charcoat Odor Filter mode to CARMEN E. SHAY - Environmental J414hWwIm " i PL PROPERTY LINE o 1 *NOTE.- INSTALL TUF-T1TE GAS BAFFLES OR EQUALS ON ALL OUTLET TEE ENDS. Fin'ahed grade over system=2X ebp• awayo 1 _ '_ 7. No vehicle or heavy machinery shall drive over the ----- i Provide Risen if necessary ! ' ~ 10 septic system unless noted as H-20 septic components. to bring D-Box coverr1F'11J F nished grade over system= 98.00 y. PROPOSED CONTOUR within 6" of finished grade ! 8. Install Tuf-Tile gas baffles or equals on all outlet tee ends. 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes. DBOX ' 97- - - - - -97 EXISTING CONTOUR 10' min. from Provide Risers I! + EXIST. HOuBe hOUse to septic tank Provide Risen if necessary to bring INLET Pump Chamber cover / " I I 10. All solid piping, tees & fittings shall be 4" diameter to brin Septic tank coven to grade and outlet cover to within • gg I I _ Schedule 40 NSF PVC pipes with water tight joints. DEEP within 6' of finished grade g^ of finished rotle 0 20 40 60 V SO 100 120 140 gviviumv m PERGOLAS ON OTES&LOCATION I 1 1. Municipal Water is Available And All Houses Within 150 Feet j --� S- '/e per foot 3 MmJmym Cove, Top of SAS--E�ev=95'S Level for 2' i i1!Ce are Connected. s ` 1/4'PM MAIN ^- p pa --2' Effective Dept P R�,, r,� .---• STOCKADE FENCE J root 5a T/9 Pert FORCE t �' $ o m W."WRmi�,aiyd.tr"dMNIll o Capacity - US G.P.M. u'i EXIST. PIPE + (j uj Fill EXIST $ 0' � cJG o+ IF r ' l 11 4''I 5' '' to , xlsr. 1000 GALLo `5'� 11� �) I; I ( i0 lr- y t' Sol► 40 O fV 1000 GALLON R' Soh 40 P ; u ; S, SEPTIC TANK n 77�� o PUMP CRAM a m� 13'- EVI CONCRETE FOUNDATION - II H T D Of H-1 D l O Erfectwe Vldth ; SI O N iULL iOUNpATtaN > o i i, \ P R � P A R E J �--= C R . ♦ O iI , d L) c u II PRO DOS It Cr)v1 c c 3i > a- OF 3/4"-11/2" STONE 'ia aa, g» OF 3/4`-11/Y STONE > 6. OF 3/4•-11/2" STONE p SUBSURFACE SEWAGE DISPOSAL SYSTEM > v cl Bottom of Test Hole , Elsv.-86DO CHAMBER ---------------------------- PUMPN 0. DATE: DEFINITION i OF SYSTEM PROF/LE SECTION A -A � I GERA�DO DeFREITA.S # 1 4 PEPPER LANE PROFILE VIEW OF LEACHING SYSTEM i HYANNIS, MA 4 PEPPER LANE ASSESSORS MAP - 294 PARCEL - 036 �4/4• « A In • eeeAe!c.,..Aw Se.ne �7--e'v ve•- Iris ee++••r••••�• •' PREPARED BY: NOTE: PUMP CHAMBER TO BE FACTORY WATERPROFFED PRIOR TO SHIPPING. HYANNIS , M A 4k, S R �/ �/ 000 oao �� CR N ��1 � 1/ E. SHAY 3 Units , I= ", /-\ Q 0_ 2s s' L'NVIR0JVAfENTAL SERVICES, INC. `3.25 -25.5' i 3.25 U r�l1 81 P.O. BOX 627 EsFective Length STEO EAST FALMOUTH, MA 02536 SOIL ABSORPTION SYSTEM (SAS) gN17AR�P� 500 - C H-20 LEACHING UNITS / WIGGINS PRECAST TEL/FAX : 508-548-0796 Not to scale SCALE: 1 "=20' DRAWN BY: CES DATE: JULY 29, 2005 PROJECT#SD-781 FILENAME: SD781 PP.DWG SHEET 1 OF 1