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HomeMy WebLinkAbout0291 PITCHER'S WAY - Health 291 Pitcher's Way Hyannis F/R A = 290 005 U 9 O a� D A i TOWN OF BARNSTABLE LOCATION (t�G�C--/L'S ' ,4Y SEWAGE # 3 GO VILLAGE ffiJhVVNi5 ASSESSOR'S MAP & LOT2�U Ur NSTALLER'S NAME&PHONE NO. QQ I550 SEPTIC TANK CAPACITY 1,000 . LEACHING FACILITY: (type) i sNA f ft'(LPA'C%f -S s (size) 10 sC f O yA 40 NO.OF BEDROOMS_ BUILDER OR OWNfER Nvrtl��/ • PERMITDATE, '7L15 3 COMPLIANCE DATE: 7116 1103 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 �# o.V __ � R/ o -� i ---a-- q`JE�' �f'7a C �� Gam, j _ iy� � � c � —`_ F- a � � �' � a �-_ � n Fee 50.00 ` THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIppYication for �Disspaaf *pgtem Construction Permit Application for a Permit to Construct( . )Repair(x)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's p�ayetitcher' s Way Hyannis Jay Hurley 290-5 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. W.E. Robinson Septic Service Down. Cape Engineering P.O. Box 1089 Centerville 939 Main St Yarmouth Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(no) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Title 5 leach system with ipump station to plans of Down Capc-_ gnryinizo-rinq Kin it, � - IN Date last inspected: THE ^"',9 u.,5 INS D I i Agreement: to The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been is ed by s and of Health. Signed Date a( Application Approved by Date Application Disapproved for the following reasons -6�1 Permit No. Date Issued N.o: " � �.- Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: — Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 0[ppfication for �Digpogaf *pgtem Congtruction Permit Application for a Permit to Construct( )Repair(x)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. ?9ap�az%tcher' s Way Hyannis Jay Hurley Assessor's 290-5 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. W.E. Robinson Septic Service Down Cape Engineering P.O. Box 1089 Centerville 939 Main St. Yarmouth i Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(no) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil t. Nature of Repairs or Alterations(Answer when applicable) Title 5 leach system with Pump station to plans of Down Cane Engi_neerincl Date last inspected: V Agreement: t' The undersigned'agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- A. cate of Compliance has been iss ed by s 'Aard of Health. 2 Signed /�'2 1)® ,/)_ Date '"�Ir� ' g / / Application Approved by /�'% '414C �l1_ ��.��'/�i� 1 �_ Date Application Disapproved for the following reasons Permit No. Date Issued --------------------------y— THE COMMONWEALTH OF MASSACHUSETTS Hurley BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Consttucte( )Repaired ( x. Upgra ed( ) Abandoned( )by W E P i o at 291 Pitcher' s Way van�i.q s a ons[ructedai�accord jice�' with the provisions of Title 5 and the for Disposal System Construction Permit No. / dated Installer Designer The issuance of thi pe ;it shall not be construed as a guarantee that the system : a Vvgd. Date 7 rl o 3 Inspector No. Hurley ��� �. -------------------Fee 50.00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 'Wigpogal *pgtem Congtruction Permit Permission is herebyranted to Construct Repair Upgrade Ab NlN g ( �) P � ) Pg ( ) ENGIN MUST SUP IS System located at 291 Pitcher s Way Hyannis T'^ + TIiL" v�„ C 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 conditions. Provided:Constructod must/be completed within three years of the date of isr ermi'tl Date: �lI��/� � Approved b � { c _ / � �/ � PP Y U i ' TOWN OF BARNSTABLE / SEWAGE# `'� p' — ViL,LAGE :2�3 3 t CO LOCATION rw15 ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. rccti ►.ISu1� t SEPTIC TANK CAPACITY l 0� ',N�i f 2�`E' —S _ (size) �rwC LEACHING FACILITY: (type) ' NO.OF BEDROOMS IBUILDER OR OWNER t'L I pERMITDATE: `I 1 COMPLIANCE DATE: 7 l b f p " Separation Distance Between the: Feet Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Leaching Facility (If any wells exist Feet 1 Wel l g u . private Water Supply Y 'n facility) eet of leaching . wit hin 200 f on site or wetlands east Feet i� Edge of Wetland and Leaching Facility (If any within 300 feet of leaching facility) Furnished by i t � ' y�i t W I a 711 ri Ir JF, i { 4, el �)� i r4 - i ® SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM / PART A CERTIFICATION Property Address: 291 Pitcher's Way, Barnstable Address of Owner: Federal Home Loan Mortgage Co. Date of Inspection: April 11, 1996 (if different) 12222 Merit Drive, Dallas, TX Name of Inspector: Daniel A. Moniz Company Name, Address and Telephone Number: Able Building Services, Inc. P.O. Box 51081, New Bedford, MA 02745 (568) 990-2218 CERTIFICATION STATEMENT �� \ I certify that I have personally inspected the sewage disposal system at this address an hat the information reported below is true, accurate and complete as of the time of inspection. The inspection was per orr5, d based��n my training artd experience in the proper function and maintenance of on-site sewage disposal system $The�y$tefi:' '� . C 't'Oy X Passes Conditionally Passes t0D _ Needs Further Evaluation By the Local Approving Authority ' r996• Fails , - •� w T° Inspector"s Signature: Date: April 16, 1996 i The System Inspector shall submit a copy of this i spectio report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a s red sy em or has a design flow of 10,000 god or greater, the inspector and the system owner shall submit-the report to th appr riate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SIAMARY: Check A,B,C, or D A SYSTEM PASSES: X I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303_ Any failure criteria not evaluated are indicated below. B) SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair, passes inspection. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If "not determined", explain why not. The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or exfiltration,.or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 8/15/95) 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 291 Pitcher's Way, Barnstable, MA Owner: Federal Home Loan Mortgage Co. Date of Inspection: April 11, 1996 B) SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if (with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four 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 obstruction is removed 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD of HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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 APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coLiform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. D) SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure.. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. _ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS. or cesspool. . (revised 8/15/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 291 Pitcher's Way, Barnstable, MA Owner: Federal Home Loan Mortgage Co. Date of Inspection: April 11, 1996 D) SYSTEM FAILS (continued) 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 112 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 Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than.100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E) LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The design flow of system.is 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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 (WPA) or a mapped Zone II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 8/15/95) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 291 Pitcher's Way, Barnstable, MA Owner: Federal Home Loan Mortgage Co. Date of Inspection: April 11, 1996 Check if the following have been done: X Pumping information was requested.of the owner, occupant, and Board of Health. X None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part 'of this inspection. As built plans have been obtained and examined. Note if they are not available with N/A. X The facility or dwelling was inspected for signs of sewage back-up. X The system does not receive non-sanitary or industrial waste flow. X The site was,inspeeted for signs of breakout. X ALL system components, excluding the Soil Absorption System, have been located on the site. X The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. X The size and Location of the Soil Absorption System on the site has been determined based on.existing information or approximated by non-intrusive methods. X The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. (revised 8/15/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 291 Pitcher's Way, Barnstable, MA Owner: Federal Home Loan Mortgage Co. Date of Inspection: April 11, 1996 FLOW CONDITIONS RESIDENTIAL: Design flow: 330 gallons Number of bedrooms: 3 Number of current residents: 0 Garbage grinder (yes or no): b Laundry connected to system (yes or no): Y Seasonal use (yes or no): N Water meter readings, if available: Last date of occupancy: March 1996 COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow: gallons/day 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: OTHER: (Describe) Last date of occupancy: " GENERAL INFORMATION PUMPING RECORDS and source of information: _ Not pumped in last 5 years System pumped as part of inspection: (yes or no) N If yes, volume pumped: gallons Reason for pumping: TYPE OF SYSTEM X 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)' Other (explain) - APPROXIMATE AGE of all components, date installed (if known) and source of information: 1962, Building Department `.Sewage odors detected when arriving at the site: (yes or no) N (revised 8/15/95) 5 • e SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 291 Pitcher's Way, Barnstable, MA Owner: Federal Home Loan Mortgage Co. Date of Inspection: April 11, 1996 SEPTIC TANK: X (locate on site plan) Depth below grade: 21" Material of construction: X concrete _metal _FRP _other (explain) 5" x 10" x 5.]F deep Dimensions: Sludge depth: 5" Distance from top of sludge to bottom of outlet tee or baffle: 2911 Scum thickness: VI Distance from top of scum to top of outlet tee or baffle: 141, Distance from bottom of scum to bottom of outlet tee or baffle: 1711 Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) Recommend pumping of Septic Tank, otherwise system in good shape. Recommend removal of wash water effluent pipe to another teach pit if possible_ GREASE TRAP:_ (locate on site plan) Depth below grade: Material of construction: _concrete _metal _FRP _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: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level injelation to outlet invert, structural integrity, evidence of leakage, etc.) (revised 8/15/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (Continued) Property Address: 291 Pitcher's Way, Barnstable Owner: Federal Home Loan Mortgage Co. Date of Inspection: April 11, 1996 TIGHT OR HOLDING TANK:_ (Locate on site plan) Depth below grade: Material of construction: _concrete metal _FRP _other (explain) Dimensions• Capacity: gallons Design flow: gallons/day Alarm level: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX•_ (Locate on site plan) Depth of Liquid level above outlet invert: Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of Leakage into or out of box, etc.) PUMP CHAMBER:— (Locate on site plan) Pumps in working order: (yes or no) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 8/15/95) 7 x SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 291 Pitcher's Way, Barnstable, MA Owner: Federal Home Loan Mortgage Co. Date of Inspection: April 11, 1996 SOIL ABSORPTION SYSTEM (SAS):_ (locate on site plan, if possible, excavation not required, but may be approximated by non-intrusive methods.) If not determined to be present, explain: Type: Leaching pits, number: 1 Leaching chambers, number: Leaching galleries, number: leaching trenches, number, length: Leaching fields, number, dimensions: overflow cesspool, number: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Coarse sand and gravel are adjacent to leach pit. Piping is clean with no sludge evident. Top of teach pit is 171' below grade. CESSPOOLS-- (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: i Indication of groundwater: inflow (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY: - (Locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, Level of ponding, condition of vegetation, etc.) (revised 8/15/95). 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 291 Pitcher's Way, Barnstable, MA Owner: Federal Home Loan Mortgage Co. Date of Inspection: April 11, 1996 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' 159, ---------------- L—h Pit ."'27.0' O a" A297 5�t ;3ecbc f�k5.2. JBR Owel%n9 MAP 290 Lot Step row Corp9e W _ � V 01 �^ 0. BARNSTABLE 77 APR 96 DEPTH TO GROUNDWATER Depth to groundwater, >6.OY feet method of determinat�ion qf�,approximation: Basement floor measurement only. No evidence of any moisture in cellar. (revise&8/15/95) 9 HOBBSBWARRENTM THE COMMONWEALTH OF MASSACHUSETTS FORM 30 C&w BOARD OF HEALTH CITY/TOWN W A 14 D PARTMENT 0 2-c.,0 Mom. —'��C S //^ADDRESS c q 1bat- TELEPHONE c�,M SV0 0 l` '0 Address �1'�CNit Occupant� Y U A M J►'�1Z 1E¢-® Floor Apartment No. No. of Occupants No. of Habitable Rooms 'I No.Sleeping Rooms A No.dwelling or rooming units No.Storie k Name and address of owner _e_Z%N , N A fJG�C \-7 \� S Mpi C) I b(a Remarks Reg. Vio. YARD Out Bld s.: Fence . Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: LD 0 S o6s Irv" Chimney: '[ G S' 't CrA G BASEMENT Gen.Sanitation: 13E 0% Dampness: lU Stairs: Li htin : C. STRUCTURE INT. Hall,Stairway: (j v1 Obst'n.: CovtA Vet t%,CI la l Hall, Floor,Wall,Ceilin : Hall Lighting: U Hall Windows: '4't ILG-to 1 � 'C. HEATING Chimneys: l� �Z'T z4 Central ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 S Bedroom 2 / )r- r, v% Sr- Bedroom 3 GiG sic fv h 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 o GS Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES F PERJUR ." INSPECTOR S TITLEti S �-®�— DATE J TIME A.M. THE NEXT SCHEDULED REINSPECTION -7 & A 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 those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect'the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. t (G) ,Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with;the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J)' The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public "Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. .. 1 ��'` .''�..'�'r•..-fi`N+�::*7v-.+.+:y,M,ry,,,f,...ii.n"�4N''RY'7w•if'n.'r-.+...,t'T'^�"N"'y;�+"".'r+'4xyr*"'+t�-��«.rX,;c�'�'•17`•w,..+a.rw�..-. ^-R+.r;"�'-'"r-e„�r.., FORM30 C&W HOBBSBWARRENTM THE COMMONWEALTH OF MASSACHUSETTS ' BOARD OF HEALTH A f— is S"t A 13c la. CITY/TOWN DEPARTMENT ADDRESS TELEPHONE Address 2"A ` s'TC0f 4S VJ1 V A S Occupants Floor_ ' -- Apartment No. 1 No.of Occupants S No.of Habitable Rooms__—No.Sleeping Rooms .. No.dwelling or rooming units No. Stories 1 Name and address of owner_ c�t_ G Y�J AL Remarks Reg. Vio. YARD Out Bld s.: Fences": Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: r Walls: Foundation:. �n CC;- S r'.3 2 Chimney: 3 "C iC t� 't r c-� C�Ns---t BASEMENT .Gen:Sanitation: s kI G VFo I p,,)4.. `� �F YZoa'A C, DaIm ness: �4 10 cap Stairs: Lighting:,, -k4�6 _ STRUCTURE INT. I Mall Stairwa : Ob�st v (A Ha II-,Flo Wall,Ceiling: + Hall LI htin }. Hall*W,Indows:__ = ° HEATING " Chimne`'s:. t ��C� ' �1C.te ca�<a 1a •T'f FA,4, Central EI*Y ❑ N E'uip.,Repair ` TYPE: Stacks;Flues,Vents: V0 PLUMBING:. Su`. I Line: ❑ MS ❑ ST ❑ P Waste Line: H.W..Tank s Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: 110 El Fusin ,iGrnd.: AMP: . Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 I h S 5 �,�� 1(1 f __1 LV,,,+ / 7 S� Bedroom 3 /UU 5 Not s. c a " N.J-r✓ -4- %2 prat Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink / J! Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: t Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other.- Egress Dual and Obst'n: General Building Posted U 1`�r� z;tg E0 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) , I; "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY " INSPECTOR n S i`TITLEti .� A.M. DATE 2. © TIME Z M. A.M. �'THE NEXT SCHEDULED REINSPECTION -A P.M. -- #..^ v. �...,._n .....-,.-^rum ,�•.,,.,r-..--�.-.,�-•--•r...r-+.--. ._-._..-�-.4 ,- .-. ...- -�..��-.�.-••_-_ �r--••-v=--tl---•n-.-.-+.w.-ti. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions,when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises.This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but'may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.880 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash,which prevents egress in case of an emergency 105 CMR 410,450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the-creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting,or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. 1 ROM Postal Service TN, 1 CERTIFIED MAIL RECEIPT 1 (Domestic,'Mai11OnIy;No Insurance■Coverage,Provided) 1 tFo�,delivery,informationvvisit our�website aatyww.uspsxomo ¢�1 � OFFICIAL USE =w1� 0 0 1 w - 1 Q 101 - w 0. 1� a•¢ 0 1Sent Yw1� or PO Box No. U go��• a 1 1 1 1 1 1 S Form 3800,August 2006 See Reverse fo�lnstructions Certified Mail Provides: o A mailing receipt o A unique identifier for your mailpiece '. o A record of delivery kept by the Postal Service for two years Important Reminders: ; e Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. o Certified Mail is not available for any class of international mall. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. e 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 s fee.Endorse mailpiece Return Receipt Requested'.To receive a fee waiver for a duplicate return receipt,a LISPS®postmark on your Certified Mail receipt is required. o 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". e if a postmark on the Certified Mail receipt is desired,please present the arti- cis 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. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 �i I UNITED STATES POSTAL SERVICE First-Class Mail 1' Postage&Fees Paid USPS I Permit No.G-10 I{ I, • Sender: Please print your name, address, and ZIP+4 in this box• I{ �I I; ll 4 ;I I; I I I I I I I I I II I �I I' I II I. 41 I I I' � I i E COMPLETE • COMPLETE • ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature I item 4 if Restricted Delivery is desired. ❑Agent ■ Print Y I our name and address on the reverse X ❑Addressee I I so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, I or on the front if space permits. D. Is delivery address different from item 1? ❑Yes I 1. Article Addressed to: If YES,enter delivery address below: ❑ No I I I I I I I I I 3. Service Type ❑Certified Mail ❑Express Mail I ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (transfer from service label) I I PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date 2, Time: In Out Owner , A Tenant j Address P Yam)( T /� Address 21 I P I TC I Ic/Q�a OAAW I r � Compliance Remarks or Regulation# Yes I NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply V/ p 10LAI V 5. Hot Water Facilities t 6 , 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural / Elements ✓ 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 3 � 17. Temporary Housing 18. Driveway Width 19. Number of Tenants Observed RADIM AJ SAPMOr 1.90e T-Codq PART IIEjS �� 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms Number of Vehicles Allowed (max) Number of Persons Allowed (max) Person(s) Interviewed -IL- )A-0J \ Inspecto a,,-70/ If Public Building such as Store or Hotel/Motel specify here I = �� .� ` SYSTEM PROFILE TEST HOLE LOGS •TOP FNDN. ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NOT TO SCALE) ACCESS COVER (WATERTIGHT) TO ENGINEER: D.A. OJALA, SE FERNOALE MINIMUM .75' OF COVER OVER PRECAST WITHIN 6" OF FIN. GRADE 2% SLOPE REQUIRED OVER SYSTEM SAM WHITE 29.0 -- 29.5 WITNESS: ocus El. 25.9'% �L �� 2/11/03 FOREST RUN PIPE LEVEL 2" DOUBLE WASHED PEASTONE DATE: EXIST. _ 1000 = vv//0 fr vx� LITEE FOR FIRST 2' 28.2' PERC. RATE =. < 2 MIN/INCH FnwceTT GALLON SEPTIC 24.5' * J` CLASS ! SOILS P# 10430 WEST mvN TANK (H- 1aGAS BAFFLE © 4' AT SIDESRE-USE 4 27.80 27.78 27.97 I go 0.58' 3' AT ENDS j MIN �g �N©«, 27.2' I ono ( 2 q . SLOPE) 6" CRUSHED STONE 0 MECHANICAL I ELEV COMPACTION. (15.221 [2)) 0" I 2 ( % SLOPE) ELEV. DEPTH OF FLOW = 4' MIN ( MIN% SLOPE) " I TEE slzEs: 3/4 TO 1 1/2 DOUBLE 'WASHED STONE INLET DEPTH = 10" UNSUIT. OUTLET DEPTH = 14" 6" i 5, LOCATION MAP NO SCALE FOUNDATION---EXIST. ST 11 10 D BOX 4'PUMPLEACHING CHAMBER FACILITY I ASSESSORS MAP 290 PARCEL 5 UNSUIT. *APPROX. INVERT OUT. GROUNDWATER ADJUSTMENT CALC: CONFIRM PRIOR TO 30" j 24.9' WELL: MIW 29 INSTALLATION OF ANY PORTION OF SEPTIC SYSTEM USE ADJ. WATER AT EL. 22.2' ZONE: C z8.a' ADJ: 3.3' ALARM AND CONTROL PANEL UNSU17. TO BE INSTALLED INSIDE BUILDING. ALARM TO BE ON 'INV' IN 24.2' SEPARATE CIRCUIT FROM PUMP 2" PRESSURE PIPE TO O'80X i 1000 GAL. H�10 S/ I 700 GAL.+ SLOPE TO DRAIN BACK TO PC 44„ 23.7' ALARM ON RESERVE WEEP HOLE FLOAT SWITCH CHECK VALVE PERC C2 SETTINGS, PUMP ON 8' 4' WORKING RANGE ZOELLER 'WASTEMATE' I MED/COS 4' SUBMERSIBLE MODEL M282 1/2 HP PUMP 102" f 18.9, PUMP OFF 8' SYSTEM (OR EQUAL) OBS. WATER moo oacro oaoo TR SILT 6" CRUSHED STONE OR-. .--. 2.5Y 6/6 COMPACTION ---- "� ,. PUMP CHAMBER 12a 17.4' NOTES: (NOT TO SCALE) WATERPROOF i 1. DATUM IS ASSUMED SEPTIC DESIGN: (GARBAGE DISPOSER IS _ __NOT_ALLOWED 171-99' n. -- fXIST:.!N.G , .. .. _ , . :.__ _2; tvilrU�t.�PAL VAT ER IS DESIGN FLOW: 3_. BEDROOMS _(?1 G GPD)' = 3,,0 - GPD r 330.. . 3. MINIMUM_ PIPE PITCH TO..BE 1/8" PER FOOT. 4 USE A _ GPD DESIGN, FLOW 12 P.P E x I!a II 1 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H- 10 ' o I SEPTIC TANK: 330 GPD (_?_) = 660 GALLONS 5. PIPE JOINTS TO BE MADE WATERTIGHT. x L o 10a0 GALLON SEPTIC TANK EXIST.) A Ow TH � _ ` y USE A ____ G LLO SE (RE--USE E S I ) 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MSS. LOT 40 I LEACHING: I ENVIRONMENTAL CODE TITLE V. / 17,138f SQ. FT. ''CS 2 37.25 + 10.83 .58 (.74) 41 7. THIS PLAN IS FOR PROPOSED SEPTIC SYSTEM ONLY AND NOT TO BE [-P EXIST. ST 0.39E ACRES is SIDES. � , ) �..) USED FOR ANY OTHER PURPOSE. 10" 0 K C O -- s EXIST. I BOTTOM: 37.25 x 10.83(.74) = 298 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. DWELL. + 4 TOTAL: 4 _8_ S.F. 3_39, GPD 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT 12" oAK TF = 29.7' I _ ( INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED 0 26 I USE (5) STANDARD INFILTRATORS WITH 4' STONE AT SIDES AND 3 FROM BOARD OF HEALTH. o x 31' I ' AT ENDS t 0I I 10. LEACH PIT TO BE PUMPED AND FILLED WITH CLEAN SAND OR 0) 10" OAK I _._ I REMOVED AS NECESSARY. " I I N I 28 w �� w DECK -7-- w w w w j ,'� LEGEND I I I I �9 ----0_ G --_0 1 Oa.O PROPOSED SPOT ELEVATION x + 30.5 G / TITLE 5 S rTGC pL.A Y A� 2 _ T/E Fq� I 100x0 EXISTING. SPOT ELEVATION OF x I I S �; 10o PROPosED CONTOUR 291 PITCHERS WAY IN THE TOWN OF: 100 EXISTING CONTOUR � ( HYANNIS) BAR N STAB LE x- __` - - _ _ I PREPARED FOR: AY HURLEY 131,69' GRAVEL DRIVE / PARKING BOARD OF HEALTH BENCH MARK - NAIL SET IN 30--- ��- �8 MA 20 0 20 40 60 Feet 14" OAK. ELEVATION = 30.5 I APPROVER DATE PROP. VENT __ 30 29 I SCALE: 1" = 20' PATE: FEBRUARY 19, 2003 3p I off 508-362-4541 TI®N F ► fox 5os 362-98eo C®N '1'RUC 5 REMOVAL 0 UNSUITABLE SOIL 1 ( � FOR !� REQUIRED AROUND PERIMETER OF < CITATION LEACHING FACILITY, DOWN TO C2 I down cape engineering, Inc. � of �rqs, rARNE of CTATION LAYER. REPLACE WITH CLEAN i o�,� ARNE ��� �+ty I .CIVIL ENGINEERS ' �. �'MED. SAND. ENGINEER TO INSPECT z o,,AAC �_ AND CERTIFY REMOVAL. LAND SURVEYORS y No 26 8 `g IL H ' 939 vain st. yarmouth, rho 02675 �,�s�9Fc1 do Q,��o N 30792 E 03--033 A N. OJAL A .L.S. DATE