HomeMy WebLinkAbout0504 PITCHER'S WAY - Health "504 Pitcher°s, Nay
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1 SENDER:
2 • Complete items 1 and/or 2 for additional services. I also Wish to receive the
m • Complete items 3,and 4a&b. following services (for an extra v
` • Print your name and address on the reverse of this form so that we can fee): >
> return this card to you.
• Attach this form to the front of the mailpiece,or on the back if space 1. El Addressee's Address
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does not permit. «
t • Write"Return Receipt Requested"on the mailpiece below the article number. 2. ❑ Restricted Delivery
" • The Return Receipt will show to whom the article was delivered and the date CD
c delivered. Consult postmaster for fee.
3. Article Addressed to: 4a. Article Number
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d ` MES CURRIE P 272 943 65
" ` 4b. Service Type
E'„ P.O. BOX 668 ElRegistered ❑ Insured
u HYANNIS, MA 02601 ® Certified ❑ COD I
W El Express Mail ❑ Return Receipt for I
Merchandise o
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5. Sig re ( dressee) 8. gddres se Address(Only if requested Y
and fee is paid)
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0 PS Form 3811, December 1991 *U.S.GPO:1993--352-714 DOMESTIC RETURN RECEIPT 1
UNITED STATES POSTAL SE RVIC " •
Official Business PENALT# OF3.,PRIVATE
/9 R USE TO PA1 ENT
-w- 'OF POSIla
Print your name, address and ZIP Code here I
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health Depattmen,
PTOwn Ofa nee
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HMnls, Massachusetts 172b�iI
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TOWN, OF BARNSTABLE BAR-W 1034
Ordinance or Regulation
WARNING NOTICE
Name of Offender/Manager U S Cykt-l-e-
Address of Offender 111k&.3 Eye-l*'g re.eh � My/M$ Reg.#
Village/State/Zips f Ln 'df�'�� . •
Business Name ..3 amp;/ on, 3 �/ 19 �
Business Address �,!(/ i...�►.�/'�
Signature of Enforcing Officer�'"--�
Village/State/Zip
Location of Offense
OF En orcing. Dept/Division
Offense Nv15cLoGC
Facts
This will serve only as a warning. At this time no legal action has been taken.
It is the goal of Town agencies to achieve voluntary compliance of Town
Ordinances, Rules and Regulations: Education efforts and warning notices are
attempts to gain .voluntary compliance. Subsequent violations will result ,in
appropriate legal action by the Town.
1-i _. ,.��' '^lr.. 9 p,r .�rY f:•_ T ^rv'i^Kn ?.jl',:;r „� 1 Sz�.y,e/_'•'_
TOWN OF .BARNSTABLE BAR-W1,034
Ordinance or Regulation
WARNING NOTICE
Name- of Offender/Manager uaou&
-. Address of Offender / ✓ -e.�-j ee e h �a► MV/MB Reg.#
Village/State/Zipa�"1t
Business Name ,„ 'am1 on 19
Business Address
Signature of Enforcing Officers
Village/State/Zip
Location of Offense Q )Uc ;!" IA7
Enforcing Dept/Division
Offense /Uyisa4ld4 . _Pu �47,4, t,6z
� J
FactsV`
. s
This will serve only as, a.. warning. .At `this time no legal action has been taken.
'Ii-is' the .,goal; o.f'...Town ..agencies to achieve- voluntary compliance of , Town
Ordinances,. Rules* . and Regulations Education efforts and warning notices are.
attempts. to gain voluntary compliance. : . Subsequent violations will result .in
appropriate legal action by .,the Town
TOWN OF BARNSTABLE BAR-W 1334
Ordinance or Regulation
j
WARNING NOTICE
Name of Offender/ManageTr4 U c
Address of Offender / *+ ? t et, knr.a MV/MB Reg.#
Village/State/Zip e 0 hi Z7 - . `
Business Name aml m; on x /y 19 94
Business Address ,, !" ,►► �:
r
Signature of Enforcing Of icer
Village/State/Zip Location of Offense 4niq Oio,.r 6? /A
Enforcing Dept/Division
Offense JA JV):% ?U /Qe-- f a-b
Facts �°' , ' ! ^ ' _ '. lam, /n vex— 4.'/
This will serve only as a warning. At this -time no legal action has been taken.
It is the goal of Town agencies to achieve voluntary compliance of Town
'Ordinances, Rules and Regulations. Education efforts and warning notices are
attempts to gain voluntary compliance. Subsequent violations will result in
appropriate legal action by the Town.
NAME OF OFFENDER B A R 0�3
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TOWN OF ADDRESS OF OFFENDER
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BARNSTABLE CITY,STATE,ZIP CODE ^ /
�OIf rqN, MV/MB REGISTRATION NUMBER
r��ti•
O„
OFFENSE
HAI M A'1'ABIA:. 1
MASS. t `` ii LJ
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Svt i E n l f,, #� f 1 .f _ s s >!.e j Z
TIME AND DATE OF'VIOLATIOA "' - LOCA IOWOF VIOLATION ' "�/'` '' w
NOTICE OF ,,� ' / P.M.)ON ;1s n 11�'.A any,_',_ M A
VIOLATION 11111AIRE O 1NF60°GIN.G.RE SON ENFORCINGDEPT. -+„r} 6AbGLINO. N
�#9 e_- AI ro /11V 1'S101tf o
OF TOWN I HEREBY ACKNOWLEDGE RECEIPT OF CITATION XUJI
ORDINANCE 0-1-Unable to obtain signature of offender. ~
THE NONCRIMINAL FINE FOR THIS OFFENSE IS I S q0.0
Date mailed ! �.�! w
OR' YOU HAVE THE FOLLOWING ALTERNATIVES WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTTON(1)OR OPTION(2)WILL OPERATE AS A FINAL
DISPOSITION WITH NO RESULTING CRIMINAL RECORD. w
REGULATION
11)You may elect to pay the above fine,either by appearing in person between 8:30 A.M.and 4:00 P.M.,Monday through Friday,legal holidays excepted, w
before:,The Barnstable Town Clerk,367 Main Street,Hyannis,MA 02601,or by mailing a check,money order or postal note to Barnstable Clerk, a
P.O.Box 2430,Hyannis,MA 02601,WITHIN TWENTY-ONE(2noncriminal p1)DAYS OF THEDATE OF THIS
do so yy NOTICE.
FIRST If you desire
DIVISION,COURTCOMPntest this matter OUNO,MAINSTREET,BARNSTABLE,MA02630,AtC21DINa criminal written Hearingsan DISTRICT
dencl se a copy of this citation DEPARTMENT,
for a hearing.
131 If you fail to pay the above offense or to request a hearing within 21 days,or if you fail to appear for the hearing or to pay any fine determined at the
hearing to be due,criminal complaint may be issued against you.
❑ 1 HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$
Signature
TOWN OF BARNSTABLE BAR-W 1 050
Ordinance or Regulation
WARNING NOTICE
UwN Fit
Name of Offender/Manager ary�S c.,•v1-1-�
Address of Offender 1406.3 vex MV/MB Reg..#
Village/State/Zip b&4-6!4
d � � Jq
Business Name am pm, on �19 0/
Business Address
Signature of Enforcing Officer
Village/State/Zip
Location of Offense y0 t zrj� '.
Enforcing. Dept/Division
Offense JUu1Sa4y-t Ca
ll 1
Facts T"t-a�' (H e J k-9A,*' 6-1
l
This wE11 /serve only as a warning. At, this. time. no legal action has been taken.
It is the goal of . Town agencies to. achieve . voluntary compliance of Town
Ordinances, Rules and Regulations. . Education efforts and warning notices are
attempts to gain voluntary .compliance. Subsequent. ..violations will- result in
appropriate legal action by the Town.
J �.. .:. .� ,._e � -..*.... :ir .- ..;..,ter, .,..,�_rirsr . ��,. ••`T""^ N+,T' FJ•: r.r- -.. -....i•,4v�•. iy c"h{fnt. ,z
TOWN OF BARNSTABLE BAR-W
` Ordinance or Regulation
WARNING NOTICE
Uw�N Ffc x
";_t Name of Offender/Manager ra-e ,S dob
-Address Offender 141P,63 y'&,v4 y ezli " MV/MB Reg.#
Village/State/Zip �` D/ 6�2. VIP « SS#�
0
Name -am/pm, on 3
Business Address
4AA -
Signature of Enforcing Officer
Village/State/Zip
Location of Offensel3t ,.
Enforcing Dept/Division
Offense OV►ECG
Facts / YU " to, e '' kW`, ` '' _64,". q�''�..
This w 11/serve only .as a warning.. At this time no .legal action has been taken.
It is thee goal: of ':Town` agencies to achieve,. voluntary compliance of Town
Ordinances, 'Rules..and Regul:ations. . Education efforts :and warning notices are
attempts to gain voluntary compliance.. Subsequent violations-, will: result in
appropriate legal action by the Town.
Y
TOWN OF BARNSTABLE BAR-W
r Ordinance or Regulation
1
WARNING NOTICE
.,Name of Offender/Manager l
Address of Offender I 663 ue:*f- ,/e"-,,, My/MB Reg.#V
G`
Village/State/Zip " t91- `3 M." .
Business Name am/p on IJ 19
/
Business Address �t- ,�t
Signature of Enforcing Officer
Villag/State/Zip
Location of Offense Y
Enforcing Dept/Division
Offense OV15r-�O tj
�; c,+
Facts & e e.
�
> pr
This wPill /serve only as a warning. At this time no legal action has been taken.
It is the goal of Town agencies to achieve voluntary compliance of Town
Ordinances, Rules and Regulations. Education efforts and warning notices are
attempts to gain voluntary compliance. Subsequent violations will result in
appropriate legal action by the Town.
:,_t.J,,,._,10ME OF OFFENDER DAD ;!
c �" r BAR
TOWN OF ADDRESS OFFEN
BARNSTABLE CITY,STATE,ZIP CODE
IHE I MVIMB REGISTRATION NUMBER
f �OFFENSE '
IIAR\�'7'ARI.E. � �yj
�1a9. eS -�i t SP o Is•-. -. -n.� »✓'V _ a n _. O
Uj
TIME AND DATE OF-VIOL ION LOCATION OF VIOLATION }j j1j W
NOTICE OF r� l X( ' i P.M.)ON i' ,19 i� , � A .. Q
SIG A_E ANFORbIN&PEJisON J ENFORCING DEPT. BAftE NO. w
VIOLATION .. cJ_ = , } �! o
-,tJ,�_
'OF TOWN Ir-H,E R,EBY ACKNOWLEDGE RECEIPT OF CITATION X a
ORDINANCE D Dnable to obtain signature of offender.
THE NONCRIMINAL FINE FOR THIS OFFENSE IS I S 16.00
Date mailed-?I,/• �1 Ir+`7 y w
' LU
-DR YOU HAVE THE FOLLOWING ALTERNATIVES WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPITON(1)OR OPTION(2)WILL OPERATE AS A FINAL
DISPOSITION WITH NO RESULTING CRIMINAL RECORD. w
REGULATION 1 You may elect to a the above fine,either b a earin in person between 8:30 A.M.and 4:00 P.M.,Monda throw h Friday,legal holidays excepted,I I Y pay Y PP 9 P Y 9 Y. 9 Y P w
before: The Barnstable Town Clerk,367 Main Street,Hyannis,MA 02601,or by mailing a check,money';order or postal note to Barnstable Clerk, aJ.
P.O.Box 2430,Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OFyTHE DAou yTE OF THIS do so NOTICE.NOTICE.
(FIRST If you desire
DIVISION,COURT COMPOUND MAIN STcriminal REET,BAIRNS TABLE, A02630,Att 21 DmakI No criminalen gHearings anuest to lSTRICT COURT d enclose a copy of DEPARTMENT,
f
for a hearing.
13)If you fail to pay the above offense or to request a hearing within 21 days,or if you fail to appear for the hearing or to pay any fine determined at the
hearing to be due,criminal complaint may be issued against you.
❑ I HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$ J.
Signature ✓
.y- NAME OF OFFENDER' r n fT BAR p l
TOWN OF ADDRESOFOPFENDER
BARNSTABLE CITY,STATE,ZIP CODE l
�}IKEELTp� MV/MB REGISTRATION NUMBER
OFFENSE
LJ
MASS. .# { �..f =6 7?3'A R"' ._. on _+110 O
.63
ff W
4% t f� /i,A lf1 [�h�
TIME AND DATE OF VIOLATION LOCATION OF VIOLATION - UJI
z
NOTICE OF P.M.ION /r fsfter G+nn, S
SIGNATURE OF ENFORbING.P.ERSON F ENFO CING DEPT. BAQGE NO. LLI
VIOLATION r-,+ Zt^ ~f s477.1 ZD1V5rvN
0
OF TOWN I HEREBY ACKNOWLEDGE RECEIPT OF CITATION X a
ORDINANCE D-Unable-to obtain signature of offender.
THE NONCRIMINAL FINE FOR THIS OFFENSE IS S j , 0�
J
Date mailed ' 1.� ` y UJI
w
OR YOU HAVE THE FOLLOWING ALTERNATIVES WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPITON(1)OR OPTION(2)WILL OPERATE AS A FINAL a
DISPOSITION WITH NO RESULTING CRIMINAL RECORD. W
REGULATION (1)You may elect to pay the above fine,either by appearing in person between 8:30'A.M.and 4:00 P.M.,Monday through Friday,legal holidays excepted, w
before:The Barnstable Town Clerk,367 Main Street,Hyannis,MA 02601,or by mailing a check,money order or postal note to Barnstable Clerk, d
P.O.Box 2430,Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE DATE OF THIS NOTICE.
(2)If you desire to contest this matter in a noncriminal proceeding,yoU may do so by making written request to DISTRICT COURT DEPARTMENT,
FIRST BARNSTABLE DIVISION,COURT COMPOUND,MAIN STREET,BARNSTABLE,MA 02630,Att:21 D Noncriminal Hearings and enclose a copy of this citation
for a hearing.
(3)If you fail to pay the above offense or to request a hearing within 21 days,or if you fail to appear for the hearing or to pay any fine determined at the
hearing to be due,criminal complaint may be issued against you.
❑ 1 HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$
Signature
P' 272 943 965�
Receipt for
Certified Mail
No Insurance Coverage Provided
(k* ®
UrUTED STATES DO not use for International Mail
OOST,LL SERVCE
(See Reverse)
sent to _ __.. -I
JAMES CURRIE_
Street and No.
P.O. BOX 668
P.O.,State and ZIP Code
HYANNIS, MA 02601
Postage ,
$2.29=
Certified Fee
Special Delivery Fee
Restricted Delivery Fee
Return Receipt Showing
p� to Whom&Date Delivered
Return Receipt Showing to Whom,
c Date,and Addressee's Address
7
) TOTAL Postage
C &Fees $ 2.2 9
Postmark or Date 7-26-94
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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. rn
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. C
Q
00
4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, M
endorse RESTRICTED DELIVERY on the front of the article.
`oa
5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If LL
return receipt is requested,check the applicable blocks in item 1 of Form 3811. I a
6. Save this receipt and present it if you make inquiry. U.S.GPO:1991-302-916y y
A W- 1
The Town of Barnstable
`w Health Department
t "".: i 367 Main Street, Hyannis, MA 02601
Office 508-790-6265 Thomas A. McKean
FAX 508-775-3344 Director of Public Health
t •Ju 26`1,4994
Mr. James L. Currie
P.O. Box 668
Hyannis, MA 02601 ;: t E ;,- r.: •} ;
r'T4 Pt
NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY
CODE II MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION
The property owned by you located at 504 Pitchers Way,
Hyannis, was inspected on July 22, 1994 by Edward Barry,
Health Inspector for the Town of Barnstable, because of a
complaint. The following violations of 105 CMR 410.00,
State Sanitary Code II, Minimum Standards of Fitness for
Human Habitation were observed:
410.351: Hot air floor registers in living room and in
bathroom detached.
410.500: No window casings in bedrooms and bathroom.
Storm window detached in living room window.
Upper storm window in bedroom cracked. Screen
ripped on rear exterior door; bathroom window
screen partially missing.
Door knob of door entering bathroom is broken.
No windows in right rear bedroom.
410.280: No vent in bathroom.
410.351: No globe on light fixture in bathroom with wires
exposed.
410 A 82: Smoke detectors are inoperative.
410.481: House does not have 20 square inch sign listing
the owners address and telephone number.
�f r
-a
ti
You are directed to correct these violations within fourteen
(14) days of receipt of this notice.
You may request a hearing if written petition requesting
same is received by the Board of Health within seven (7)
days after the date order is received. However, these
violations must be corrected regardless of any request for
a hearing.
Please be advised that failure to comply with an order could
result in a fine of not more than $500. Each separate day' s
failure to .comply with an order shall constitute a separate
violation.
PER ORDER OF �THE BOARD OF HEALTH
Thomas A. McKean
Director of Public Health
cc: Howard Stein
I
a+
ti
IT .. L .•_q.•
= TOWN OF BARNSTABLE ,'-777
r;
Pie t o♦ ; r OFFICE OF
} „a„T st BOARD OF HEALTH
>o rNa �, 30 MAIN STREET _0 #4 14Iaf _ �✓��1J1
tb�9• �
oho Y Y k' HYANNIS,MASS.02601
W r. / Cur r(��i/e
�y
e
FTATE. "HILTARY-
&TIM'4Qx�KQR "(IAiiTTAT ' -
C'm ILA d1 H 1IiM' r e
The property owned by You located at 504 Pitchers Way,Hyannit,MA,.
Health
was inspected on July 22 iu by Edward auaeaofya complaint.
Inspector for the Town o'f 1�a`�'nstable ;
The following violatio darde Sanitary
osf ofCl Fitness CMR ifor0 Human t Habitation
Code II , Minimum Stan
were observed!
_Hot air floor registers in living room and
--- - �, in bathroom detached.
___` --- --- ' No window casings in bedrooms and bathroom
/_12 ` � 4 No vent in bathroom
No..'globe on light fixture in bathroom with
wires exposed
-------------- t to ve s n
You are directed to correct these violations within twenty .
four (24) hours of receipt of this notice-
You
are also directed to within days of
receipt .of this notice.
You may request a he if written Petition tin sevens (7) days
is received by the Board of Health these violations
after the date order is received . However,
must be corrected regardless of any request for a hearing.
". -Pleasewith all order coud
be advised that failure to comply Each separate dayls
result in a f ine of not more than $50
failure to comply with an order shall constitute a separate
violation.
PER ORDER OF THE BOARD OF HEALTH
Thomas A. McKean
Director of Public Health
r '
Storm window detached in living room window.Upper storm -
window in bedroom window cracked;Screen ripped on rear
" exterior door;bathroom window screen partially missing
ti
L ,
Door knob of door entering bathroom is broken
!� 4 No windows in right rear bedroom
Smoke detectors are inoperative
House does not have 20 square inch sign listing
the owners address and telephone number
The Town of Barnstable
C' �w
Health Department
} 'A""an& 367 Main Street, Hyannis, MA 02601
r ,
Office 508-790-6265 Thomas A. McKean
FAX 508-775-3344 Director of Public Health
July 25, 1994
Mr. James L. Currie
P.O. Box 668
Hyannis, MA 02601 ,_
NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY
CODE II, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION
The property owned by you located at 504 Pitchers Way,
Hyannis, was inspected on July 19, 1994 by Edward Barry,
Health Inspector for the Town of Barnstable, because of a
complaint. The following violations of 105 CMR 410.00,
State Sanitary Code II, Minimum Standards of Fitness for
Human Habitation were observed:
410.500: Window on west side of building broken.
410.602A: Multiple old, used rusted, broken articles
scattered throughout the entire property included',
but not limited to: auto parts, boat parts, auto
tires, batteries, paper, garbage, trash, etc.
You are directed to correct these violations within fourteen
(14) days of receipt of this notice.
You may request a hearing if written petition 'requesting
same is received by the Board of Health within seven (7)
days after the date order is received. However, these
violations must be corrected regardless of any request for
a hearing.
Please be advised that failure to comply with an order could
result in a fine of not more than $500. Each separate day' s
failure to comply with an order shall constitute a separate
violation.
;PER ORDER OF THE BOARD OF HEALTH
R.-D, . .
Thomas A. McKean
Director of Public Health
cc: Howard Stein, tenant
TENANT: Howard Stein "PTA- COD
504 Pitchers Way,
Hyannis,MA.02601
TOWN OF BAnNSTABLE
OFFICE OF
st BOARD OF HEALTH
""SI 387 MAIN STREET
s� t679 `
'0>ip N Y HYANNIS.MASS.02801
11kr.James L.Currie
P.O.Box 668
Hyannis,MA. 021j0b L,,M gjQ.OQ; S�TB �
�MTNT U Y1 8 FTTNF FQR HUd9,H- NABTTATI�K
The property owned by you locate at504 Pitchers Way,H�ea��'MA
was inspected on July 1991994 y Edward F B rW complaint.
Inspector for the Town of Barnstable , beeausd State
The following violations of 105 CMR 410or0, mar Habitation
Code II , Minimum Standards of
were observed:
,t�Qd �" _-Window on west side of building broken
tCO : Multiple old,used rusted,broken articles scattered
throughout the entire property included but not
limited to : auto parts ,boat parts,auto tires,
batteries ,paper,garbage trash and etc
---------------
You are directed to correct theseotice tions within twenty
four (24) hours of receipt of tillsn
You - are also directed to Within days of
receipt of -this notice.
ting
You may request a hearing if written petition
within sevens (7) .days
is received by the Board of Health
after the date order is received.of
any request, fo}reaehearingiona
must be corrected regardless
Please be advised that failure to comply with an order could
result in a fine of not more than shall constitute 500 . Each aate day's
separate
failure ;to comply with an order a
`violation.
PER ORDER OF THE BOARD OF HEALTH
Thomas A. McKean
Director of Public Health
P 272 943 963
Receipt for
Certified Mail
of o No Insurance Coverage Provided
I PUNITEDSTATEs Do not use for International Mail
ALIWC (See Reverse)
HOWARD STEIN
Streepand No. j
504 PITCHERS WAY
P.O.,State and ZIP Code
HYANNIS, MA 02601
Postage
Certified Fee
Special Delivery Fee
Restricted Delivery Fee
Return Receipt Showing
p� to Whom&Date Delivered
Return Receipt Showing to Whom,
c Date,and Addressee's Address
7
--3 TOTAL Postage 1
C &Fees
C Postmark or Date
00
M
E
0
LL
rn
a
STICK POSTAGE STAMPS TC ARTICLE TO COVER FIRST CLASS POSTAGE,
CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front).
ar
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 light of the return �
address of the article,date,detach and retain the receipt, and mail the article. rn
3. If you want a return receipt,write the certified mail number and your name and address on a 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.
00
4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, M
endorse RESTRICTED DELIVERY"on the front of the article. E
5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If
LL
return receipt is requested,check the applicable blocks in item 1 of Form 3811. rn
a
6. Save this receipt and present it it you make inquiry. t U.S.GPO:1991'362-916
ro, The Town of Barnstable
.�0 Health Department
{ NAUSTAX =
NMa ,
367 Main Street, Hyannis MA 02601
263
r
Office 508-790-6265 Thomas A. McKean
FAX 508-775-3344 Director of Public Health
July 25, 1994
Mr. Howard Stein
504 Pitchers Way
Hyannis, MA 02601
NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY
CODE II, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION
The property leased by you located at 504 Pitchers Way,
Hyannis was inspected on July 19, 1994 by Edward Barry,
Health Inspector for the Town of Barnstable, because of a
complaint. The following violations of 105 CMR 410.00,
State Sanitary Code II, Minimum Standards of Fitness for
Human Habitation were observed:
410.602B: Plastic bags of trash on ground.
Paper, magazines, old plastic, empty plastic oil containers
and other debris scattered throughout the ground area.
Molded food found on ground. Multiple old scraps of wood
with nails scattered throughout property.
Twenty plus old automobile tires scattered throughout the
property. Multiple old rusted pieces of metal of various
descriptions scattered throughout the property. Old rusted
multiple used auto parts scattered throughout the property.
Over twenty-five old used batteries of various shapes
scattered throughout the property.
You are directed to correct these violations of within
fourteen (14) days of receipt of this notice.
You may request a hearing if written petition requesting
same is received by the Board of Health within seven (7)
days after the date order is received. However, these
violations must be corrected regardless of any request for
a hearing.
Please be advised that failure to comply with an order could
result in a fine of not more than $500. Each separate day' s
failure to comply with an order shall constitute a separate
violation.
PER ORDER OF THE BOARD OF HEALTH
Thomas A. McKean
Director of Public Health
cc: Howard Stein, tenant y
s
r
TENANT: Howard Stein
'504'Pitchers- Way . - . .
Hyannis,MA.02601
t ,TOWN OF_BARNSTABLE
OFFICE OF
w
0
„T St. ,_., BOARD OP HEALTH
387 MAIN STREET
HYANNIS,MASS.OMI ;
Mr. Howard Stein
504 Pitchers Way
NOynnsi,Ma. 02�6�0��� iQ� CMB� M..HS'tA'T T of
TSB Ai;AT� V I O 4� F 7 T N E
CODI� LI..-. tli�M BTA
Leased 04 Pitchers Way',Hyann so
The property owned u ly 9 1994 ate byaEdward Flep ,Bar Heath
was inspected on
Inspector for the Town of Barnl�15 bCMR 410 00, State a Sanitary
The following violations of
Code II , Minimum Standards of Fitness for Human Habitation
were observed:
Plastic bags of trash on ground
_ � _ -- Paper,magazines,old plastic,empty plastic
oil containers and other debri scattered throughout
_ ------ the ground area
Moulded for fo04 found on ground
.Multiple eld scraps of wood with nails scattered
You are dire twent
c eoc Q8u-6o� tthesenotice tiong 9ithin y .
four (24) hours of receipt of this
You are also directed to within 4111,
days of
receipt of this notice.
ting same
You may request a he if written petition
within sevens (1) days
is received by the Board of a these violation's
after the date order is received . However,
must be corrected regardless of any reo compquest for a hearing.
A '- with all order coud
Please be advised that failure than $50(lly Each separate dayls
result in a fine of not more
failure to comply with an order Shall constitute a separate
violation.
PER ORDER OF THE BOARD OF HEALTH
�.
Thomas A. McKean
Director of Public Health
< 6�� twenty plus old automobile tirestscattered throughout
the property _
Multiple old rusted pieces of metal of various
descriptions scattered throughout the property
Old rusted multiple used auto parts scattered throughout
-�=- the property
Over twenty five old used batteries of various shapes
scattered throughout the property
t
COMMONWEALTH OF MASSACHUSETTS omma
4 EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
a
d DEPARTMENT OF ENVIRONMENTAL PROTECTION
ti
OW
O,� Syev
PARCE4 ; 2
TITLE 5 v®T t 2A
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address: 504 Pitchers Way RECEIVE®
Hyannis MA 02601
Owner's Name: M K Nickerson AUG 1 7 2004
Owner's Address: 13 This Way
Osterville MA 02665
BARNSTABLE
Date of Inspection: July 22,2004 TOWN
HEALTH DEPT.
Name of Inspector: PATRICK M.O'CONNELL
Company Name: SEPTIC INSPECTION SERVICES CO.
Mailing Address: 189 CAMMETT ROAD
MARSTONS MILLS MA 02648
Telephone Number: 508-428-1779
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported
below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my
training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP
approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: OF
i
__X_ Passes
Conditionally Passes A t K m:
Needs Further Evaluation by the Local Approving Authority
Fails NNELL 'to
Inspector's Signature:s— L Date: _7/22/04_ � 'Q'*�
FS;NS,
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or
DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000
gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the
DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving
authority.
Notes and Comments: Cesspool with overflow, both empty.
****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 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 504 Pitchers Way,Hyannis
Owner: M K Nickerson
Date of Inspection:July 22,2004
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes:
_XX_ 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 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,settled 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(s)are replaced
obstruction is removed
ND explain:
T41a C Tne ,tinn 17nr 411 VIAM) 2
` Page 3 of I 1
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 504 Pitchers Way,Hyannis
Owner: M K Nickerson
Date of Inspection: July 22,2004
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.A copy of the analysis must be attached to this form.
3. Other:
Titles G Tncnontinn Fnrm!Jl r'ilnnn 3
Page 4 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 504 Pitchers Way,Hyannis
Owner: M K Nickerson
Date of Inspection:July 22,2004
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all inspections:
Yes No
_X_ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
—X— Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or
clogged SAS or cesspool
—X— Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or
cesspool
_X_ Liquid depth in cesspool is less than 6"below invert or available volume is less than '/2 day flow
—X— Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped
_X_ Any portion of the SAS,cesspool or privy is below high ground water elevation.
X— Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface
water supply.
X Any portion of a cesspool or privy is within a Zone I of a public well.
_X_ Any portion of a cesspool or privy is within 50 feet of a private water supply well.
—X_ 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.]
_No_(Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as
described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of
Health to determine what will be necessary to correct the failure.
E. Large Systems:
To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000
gpd.
You must indicate either"yes"or"no"to 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.
T41a G Tnennrtinn Vnr 411;nnnn 4
Page 5 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 504 Pitchers Way,Hyannis
Owner: M K Nickerson
Date of Inspection: July 22,2004
Check if the following have been done.You must indicate"yes"or"no"as to each of the following:
Yes No
_X_ Pumping information was provided by the owner,occupant,or Board of Health
X_ Were any of the system components pumped out in the previous two weeks?
_X_ Has the system received normal flows in the previous two week period?
_X_ Have large volumes of water been introduced to the system recently or as part of this inspection?
_X_ Were as built plans of the system obtained and examined?(If they were not available note as N/A)
_X_ _ Was the facility or dwelling inspected for signs of sewage back up? .
_X_ _ Was the site inspected for signs of break out?
_X_ _ Were all system components,excluding the SAS, located on site?
_X _ 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?
_X _ Was the facility owner(and occupants if different from owner)provided with information on the proper
maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System(SAS)on the site has been determined based on:
Yes no
_X_ Existing information. For example,a plan at the Board of Health.
_X_ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of
distance is unacceptable) [310 CMR 15.302(3)(b)]
T41. C Tncn.Pf;^n P-All 01000 5
'Page 6 of 11
OFFICIAL INSPECTION FORM-NOT.FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 504 Pitchers Way,Hyannis
Owner: M K Nickerson
Date of Inspection: July 22,2004
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): 3 Number of bedrooms(actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):330
Number of current residents: 0
Does residence have a garbage grinder(yes or no): No
Is laundry on a separate sewage system(yes or no): No ' [if yes separate inspection required]
Laundry system inspected(yes or no):
Seasonal use:(yes or no): No
Water meter readings, if available(last 2 years usage(gpd)): n/a
Sump pump(yes or no): No
Last date of occupancy: 18-24 Months ago
COMMERCIALANDUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): gpd
Basis of design flow(seats/persons/sgft,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: None
Source of information: -
Was system pumped as part of the inspection(yes or no): No
If yes,volume pumped:_gallons--How was quantity pumped determined?
Reason for pumping:
TYPE OF SYSTEM
Septic tank,distribution box, soil absorption system
_Single cesspool
X_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
_Other(describe):
Approximate age of all components,date installed(if known)and source of information:
unknown
Were sewage odors detected when arriving at the site(yes or no): No
Titles S T"o—finn Rnr 4/1 vonnn 6
Page 7 of I I
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 504 Pitchers Way,Hyannis
Owner: M K Nickerson
Date of Inspection: July 22,2004
BUILDING SEWER: X (locate on site plan)
Depth below grade: 3'
Materials of construction:_X_cast iron _40 PVC_other(explain):
Distance from private water supply well or suction line: 30'
Comments(on condition of joints,venting,evidence of leakage,etc.):
SEPTIC TANK: No (locate on site plan)
Depth below grade: -
Material of construction: concrete_metal_fiberglass__polyethylene
_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:-
Sludge depth: -
Distance from top of sludge to bottom of outlet tee or baffle: -
Scum thickness: -
Distance from top of scum to top of outlet tee or baffle: -
Distance from bottom of scum to bottom of outlet tee or baffle:-
How were dimensions determined: STICK WITH HINGE FLAP.
Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels
as related to outlet invert,evidence of leakage,etc.):
GREASE TRAP: No (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.):
T;tla G Tn artinn Rnr 411 cnnnn 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: 504 Pitchers Way,Hyannis
Owner: M K Nickerson
Date of Inspection: July 22,2004
TIGHT or HOLDING TANK: No (tank must be pumped at time of inspection) (locate on site plan)
Depth below grade:
Material of construction: concrete metal fiberglass_polyethylene other(explain):
Dimensions:
Capacity: gallons
Design Flow: gallons/day
Alarm present(yes or no):
Alarm level: Alarm in working order(yes or no):
Date of last pumping:
Comments(condition of alarm and float switches,etc.):
DISTRIBUTION BOX: No (if present must be opened) (locate on site plan)
Depth of liquid level above outlet invert: -
Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of
leakage into or out of box,etc.):
PUMP CHAMBER: No (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 pumps and appurtenances,etc.):
t
Titlo G Tncnnrtinn 17^ m 411 VIMA 8
'Page 9 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 504 Pitchers Way,Hyannis
Owner: M K Nickerson
Date of Inspection: July 22,2004
SOIL ABSORPTION SYSTEM(SAS): XX (locate on site plan,excavation not required)
If SAS not located explain why:
Type
leaching pits,number:
leaching chambers,number:
leaching galleries,number:
leaching trenches,number,length:
leaching fields,number,dimensions:
_X_overflow cesspool,number: One 6x6 Precast pit
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.): pit empty at time of inspection with no definite high stains.
CESSPOOLS: XX (cesspool must be pumped as part of inspection) (locate on site plan)
Number and configuration: One with overflow
Depth—top of liquid to inlet invert: 6'
Depth of solids layer: 0"
Depth of scum layer: 0"
Dimensions of cesspool: 6x6
Materials of construction: Precast concrete
Indication of groundwater inflow(yes or no): No
Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.):
Cesspool empty,liquid level had been at bottom of outlet pipe.
PRIVY: No (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.):
Titla C 1--t;— P—4/1 r,110nn 9
. • . Page 10 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 504 Pitchers Way,Hyannis
Owner: M K Nickerson
Date of Inspection: July 22,2004
SKETCH OF SEWAGE DISPOSAL SYSTEM x
Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or
benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building.
Pitchers Way
7q 3S
1`1 ZZ
�Sc�{
Cesspool with overflow
Titles G ul ci,)nnn 10
Page 11 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 504 Pitchers Way
Owner: M K Nickerson
Date of Inspection: July 22,2004
SITE EXAM
Slope None
Surface water None
Check cellar Dry
Shallow wells None
Estimated depth to ground water: More than 20 feet
Please indicate(check)all methods used to determine the high ground water elevation:
Obtained from system design plans on record-If checked,date of design plan reviewed:
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)
X_Accessed USGS database-explain: USGS topo map and town GIS
You must describe how you established the high ground water elevation:
Town groundwater contour map shows water below el.30 and topo map shows property at or above
el. 50.
1
Titles Pn Oil;i')nnn 11
f
C)
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
d
DEPARTMENT OF ENVIRONMENTAL PROTECTION
viAP
,�. PARCEL,
�OT -y--
TITLE 5
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address: 504 Pitchers Way
Hyannis MA 02601 RECEIVE®
Owner's Name: M K Nickerson
Owner's Address: 13 This Way
Osterville MA 02665 AUG 2 7 2004
Date of Inspection: July 22,2004
TOWN OF BARNSTABLE
Name of Inspector: PATRICK M.O'CONNELL HEALTH DEPT.
Company Name: SEPTIC INSPECTION SERVICES CO.
Mailing Address: 189 CAMMETT ROAD
MARSTONS MILLS MA 02648
Telephone Number: 508-428-1779
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported
below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my
training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP
```�Uttitt��H��ii
approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: `����ZH OF
Passes
Conditionally Passes = AT I K �=
Needs Further Evaluation by the Local Approving Authority NNELL '
Fails
Date: 7/22/04 i��' 1�q:
Inspector's Signature:- — — ''�4i,�FSINSPE
6mnuna�
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or
DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000
gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the
DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving
authority.
Notes and Comments: Cesspool with overflow,both empty.
****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
Paae 2 of I 1
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 504 Pitchers Way,Hyannis
Owner: M K Nickerson
Date of Inspection:July 22,2004
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes:
XX 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 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, settled 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(s)are replaced
obstruction is removed
ND explain:
Titlo C incnPrtinn Fnrm ail v�nnn 2
Page 3 of 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 504 Pitchers Way,Hyannis
Owner: M K Nickerson
Date of Inspection:July 22,2004
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.A copy of the analysis must be attached to this form.
3. Other:
Titlo All';i)nnn 3
i
Page 4 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 504 Pitchers Way,Hyannis
Owner: M K Nickerson
Date of Inspection:July 22,2004
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all inspections:
Yes No
_ _X_ 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
_ _X_ Liquid depth in cesspool is less than 6"below invert or available volume is less than day flow
_ _X_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped
_ _X_ Any portion of the SAS,cesspool or privy is below high ground water elevation.
—X— Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface
water supply.
_ X Any portion of a cesspool or privy is within a Zone 1 of a public well.
_
_ X_ Any portion of a cesspool or privy is within 50 feet of a private water supply well.
_
_ _X__ 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.]
No_(Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as
described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of
Health to determine what will be necessary to correct the failure.
E. Large Systems:
To be considered a large system the system must serve a facility with a design now of 10,000 gpd to 15,000
gpd•
You must indicate either"yes"or"no"to 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.
Titla G Tncnartinn Rnrm 4/1 snnnn 4
P4ge 5 of 1 I
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 504 Pitchers Way,Hyannis
Owner: M K Nickerson
Date of Inspection:July 22,2004
Check if the following have been done You must indicate"yes"or"no"as to each of the following:
Yes No
_X_ Pumping information was provided by the owner,occupant,or Board of Health
X Were any of the system components pumped out in the previous two weeks
X Has the system received normal flows in the previous two week period?
X Have large volumes of water been introduced to the system recently or as part of this inspection?
X Were as built plans of the system obtained and examined?(If they were not available note as N/A)
X Was the facility or dwelling inspected for signs of sewage back up?
X Was the site inspected for signs of break out?
}( Were all system components,excluding the SAS, located on site?
X _ 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?
JC _ Was the facility owner(and occupants if different from owner)provided with information on the proper
maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS)on the site has been determined based on:
Yes no
X Existing information. For example,a plan at the Board of Health.
Determined in the field(if any of the failure criteria related to Part C is at issue approximation of
distance is unacceptable)[310 CMR I5.302(3)(b)J
Titles G Inenartinn Fnrm ui�i�nnn 5
Page 6 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 504 Pitchers Way,Hyannis
Owner: M K Nickerson
Date of Inspection: July 22,2004
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): 3 Number of bedrooms(actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330
Number of current residents:0
Does residence have a garbage grinder(yes or no): No
Is laundry on a separate sewage system(yes or no): No [if yes separate inspection required]
Laundry system inspected(yes or no):
Seasonal use:(yes or no): No
Water meter readings,if available(last 2 years usage(gpd)): n/a
Sump pump(yes or no): No
Last date of occupancy: 18-24 Months ago
COMMERCIALANDUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): gpd
Basis of design flow(seats/persons/sgft,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/user
OTHER(describe):
GENERAL INFORMATION
Pumping Records: None
Source of information: -
Was system pumped as part of the inspection(yes or no): No
If yes,volume pumped: gallons--How was quantity pumped determined?
Reason for pumping:
TYPE OF SYSTEM
—Septic tank,distribution box, soil absorption system
_Single cesspool
X 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
Other(describe):
Approximate age of all components,date installed(if known)and source of information:
unknown
Were sewage odors detected when arriving at the site(yes or no): No
'ritla r%inenartinn Rnr 4/1;nnnn 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: 504 Pitchers Way,Hyannis
Owner: M K Nickerson
Date of Inspection: July 22,2004
BUILDING SEWER: X (locate on site plan)
Depth below grade: 3'
Materials of construction:_X_cast iron _40 PVC_other(explain):
Distance from private water supply well or suction line: 30'
Comments(on condition of joints,venting,evidence of leakage,etc.):
SEPTIC TANK: No (locate on site plan)
Depth below grade: -
Material of construction: concrete_metal_fiberglass_polyethylene
_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:-
Sludge depth: -
Distance from top of sludge to bottom of outlet tee or baffle: -
Scum thickness: -
Distance from top of scum to top of outlet tee or baffle: -
Distance from bottom of scum to bottom of outlet tee or baffle:-
How were dimensions determined: STICK WITH HINGE FLAP.Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid uid levels
as related to outlet invert,evidence of leakage,etc.):
GREASE TRAP: No (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: g
Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid uid levels
as related to outlet invert,evidence of leakage,etc.):
Tit1a 4 incnartinn Rnrm 4/1�i�nnn 7
Page 8 of I 1
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 504 Pitchers Way,Hyannis
Owner: M K Nickerson
Date of Inspection: July 22,2004
TIGHT or HOLDING TANK: No (tank must be pumped at time of inspection) (locate on site plan)
Depth below grade:
Material of construction: concrete metal fiberglass_polyethylene other(explain):
Dimensions:
Capacity: gallons
Design Flow: gallons/day
Alarm present(yes or no):
Alarm level: Alarm in working order(yes or no):
Date of last pumping:
Comments(condition of alarm and float switches,etc.):
DISTRIBUTION BOX: No (if present must be opened) (locate on site plan)
Depth of liquid level above outlet invert: -
Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of
leakage into or out of box,etc.):
PUMP CHAMBER: No (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 pumps and appurtenances,etc.):
TitlA G inennrtinn Fnrm/.i��i�nnn 8
Page 9 of I 1
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 504 Pitchers Way,Hyannis
Owner: M K Nickerson
Date of Inspection: July 22,2004
SOIL ABSORPTION SYSTEM(SAS): XX (locate on site plan,excavation not required)
If SAS not located explain why:
Type
leaching pits,number:
leaching chambers,number:
leaching galleries,number:
leaching trenches,number, length:
leaching fields,number,dimensions:
X overflow cesspool,number: One 6x6 Precast pit
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.): pit empty at time of inspection with no definite high stains.
CESSPOOLS: XX (cesspool must be pumped as part of inspection) (locate on site plan)
Number and configuration: One with overflow
Depth—top of liquid to inlet invert: 6'
Depth of solids layer: 0"
Depth of scum layer: 0"
Dimensions of cesspool: 6x6
Materials of construction: Precast concrete
Indication of groundwater inflow(yes or no): No
Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.):
Cesspool empty,liquid level had been at bottom of outlet pipe.
PRIVY: No (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.):
I
Titlo G 1ncnPrt;^-Rnrm 4/1 v'nnn 9
Page 10 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSUR
FACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 504 Pitchers Way,Hyannis
Owner: M K Nickerson
Date of Inspection: July 22,2004
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or
benchmarks.Locate all wells within 100 feet. Locate where public water supply enters the building.
Pitchers Way
zy 3s
�5c�{
U`
Cesspool with overflow
T41a G 10
Page 11 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 504 Pitchers Way
Owner: M K Nickerson
Date of Inspection: July 22,2004
SITE EXAM
Slope None
Surface water None
Check cellar Dry
Shallow wells None
Estimated depth to ground water: More than 20 feet
Please indicate(check)all methods used to determine the high ground water elevation:
Obtained from system design plans on record-If checked,date of design plan reviewed:
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)
X Accessed USGS database-explain: USGS topo map and town GIS
You must describe how you established the high ground water elevation:
Town groundwater contour map shows water below el.30 and topo map shows property at or above
el.50.
Titlo G Tncnortinn Fnrm �iT ci�nnn 1 I
i __ _ _ _• . .•J � .... .. :1.tr „ _ µ.;, _ .3 y\ti -� _ti.ra'"; 'ram
FORM30 HOBBsa WARREN,INC.NOV.1979-1983 THE COMMONWEALTH OF MASSACHUSETTS /"O2—)
BOARD OF HEALTH
rn5*?,6&
CITY)T�O.�(WN
a DEPARTMENT
�(n7 Merin S .{ �n�il
ADDRESS
_ 7 90 ' 60 2&vS
TELEPHONE
Address 9 PACE e�5 wb 2^n5 Occupant J Sfle-
Floor Apartment No: No.of Occupants
No.of Habitable Rooms No.Sleeping Rooms
No.dwelling or rooming units _ No.Stories S Name and address of owner t 5 rx n,Q s L. Cuit , P0 . gzw
/N C�2tG�^ /
Remarks Reg. Vlo.
YARD Out Bld s.: Fences: _ISVQ, ,P s -h re!,- 7A-c t
Garbage and Rubbish dgtoe s 400 U`v
Containers: on y, ;,,&
Draina a
Infestation Rats or other:
STRUCTURE EXT. Steps,Stairs,Porches:
Dual Egress:and Obst'n.:
❑ B ❑ F ❑ M Doors,Windows:
Roof
Gutters,Drains:
Walls:
Foundation:
Chimney:
BASEMENT Gen.Sanitation:
Dampness:
Stairs:
Lighting:.
STRUCTURE INT. Hall,Stairway:
Obst'n.:
Hall,Floor,Wall,Ceiling:
Hall Lighting:
Hall Windows:
HEATING Chimneys:
Central ❑Y ❑ N Equip.Repair
TYPE: StacksQjues,Vents:
PLUMBING: /9u-pplyLine: Water w.s4e4qa'�*- o+� ,,,� w,n 4/10 -5;1
❑ MS ❑ST ❑ P Waste Line:' bf'-�v --r ko I- oor o
s Safe and Vents ,)es+e ;^e -Yhe b 4,do
ELECTRICAL Panels,Meters,Cir.: V yca4- •s rm ck
❑ 110 ❑ 220 Fusin a,Grnd.: I U-
AMP: Gen.Cond. Distrib. Box:
Gen.Basement Wiring:
DWELLING UNIT
Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors- Locks
Kitchen
Bathroom
Pantry
Den
Living Room
Bedroom 1
Bedroom 2
Bedroom 3
Bedroom 4
Hot Water Facil. Sup.Ten. Gas,Oil, Elect.:
Stacks Flues,Vents,Safeties:
Kitchen Facilities Sink
Stove
Bathing,Toilet Facil. Vent. Plumb.,Sanit'n.:
Wash Basin Shower or Tub:
Infestation Rats;Mice Roaches or Other:
Egress Dual and Obst'n:
General Building Posted na M� A Av 1wr i tf�l
Locks on Doors: s n 1- o&4e Q y-Y
ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH
MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE
OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE
AUTHORIZED INSPECTOR.(See Over)
"THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND
PENALTIES OF PERJURY."
INSPECTORma S / 1 't TITLE D j re G-6
DATE ��'a � ��/ �Q19 y TIME
THE NEXT SCHEDULED REINSPECTION ����c� y� 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.
(GI 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 41b.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.
(i) 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.
5a9
LO=CATION SEWAGE PERMIT NO.
cam`
VILLAGE
INSTA LLER'S NAME & ADDRESS
B U I'L D E R OR OWNER
orto eF-Rs ti
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
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