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HomeMy WebLinkAbout0040 QUAKER ROAD - Health 40 -42 QUAKER RD. ,HYANNIS A = 310 293 `r 0 ` r TOWN OF BARNSTABLE ATION 14 I 4�, Ic or ad 141t,- SEWAGE# 00-3 2-? VILLAGE lJ*GhA4f ASSESSOR'S,MAP&PARCEL INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY ,eyLp®® - LEACHING FACILITY:(type) 3 5-®a 6,L ch�wr s (size) /3 X 3 NO.OF BEDROOMS 1� OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY e 1 TOWN OF BARNSTABLE L+z1('AT10N YO- qa SEWAGE # 00 - ?66' VILLAGE 1 /1011 ... ASSESSOR'S MAP & LO INSTALLER'S NAME& PHONE NO. A � C-/-?O- S SEPTIC TANK CAPACITY_ � Q F LEACHING FACILITY:(type) _ ,5EC C&2A& size) NO. OF BEDROOMS- PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: D -X9 DATE COMPLIANCE ISSUED: \J VARIANCE GRANTED: Yes No .i -, ,., � � . . ��, q. A� _ _/ M �� �. 4� �' � � . �� =--�? i s Town of Barnstable Regulatory Services Department +. anjuvsrABM MASS 1639. Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL70151730000149902847 June 14, 2017 Rosebud Trust PO Box 2248 Hyannis, MA 02601 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION The property owned by you located at 40 Quaker Road, Hyannis,MA was inspected on June 14, 2017 by.Timothy B. O'Connell, R. S., Health Inspector because of a complaint filed with Health Division. The following violations of the State Sanitary Code were observed: 105 CMR 410.351: Owner's Installation and Maintenance Responsibilities Loose tile observed within bathroom area near tub.. You are directed to correct the violations listed above within thirty (30) days of your receipt of this notice by repairing or replacing bathroom tile You may request a hearing before the Board of Health if written petition requesting same is received within ten(10) days after the date the order is served. Non-compliance will result in a fine of$100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the above violations, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. ORDER O THE BOARD OF HEALTH T omas A. McKean, R.S., CHO Director of Public Health Town of Barnstable ROSEBUD TRUST P. O. BOX 2248 HYANNIS,MA 02601 508-775-3336 July 23, 2017 Thomas McKean, Director of Public Health Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 RE: 40 Quaker Road Hyannis, MA 02601 Dear Mr. McKean: With reference to you r letter dated June 14, 2017,_which was received on via certified mail on June 29, 2017, copy enclosed,this is to notify you that extensive work has been completed to the bathroom floor in this apartment. As a result,the "loose tile observed within bathroom area near tub" has been repaired. Should you have any questions concerning this matter,kindly contact me at 508-775-3336. Your$truly, Nancy Krajewski, Trustee Encl: f _ •. 1 TOWN OF BARNSTABLE Approved: BOARD OF HEALTH MLA Cert:_ --- ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date ZI Z(s 0 Time: In 5•'0 U Out $%G Owner S 'emu �vS't Tenant Address 1 �U 2-Z `-� Address Z40 0L'4 IBC XX-- d0/2 Compliance Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply �(� v 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 2 f,VT- V Q N1 N-Z v S 8. Ventilation 9. Installation and Maintenance of Facilities S 1UvLAO 6'7 10. Curtailment of Service 11. Space and Use 12. Exits 4-4 v tom.t- 13. Installation and Maintenance of Structural Elements V #z-1-f$ 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal `v A,Z h 17.Temporary Housing 18. Driveway Width 19. Number of Tenants Observed Z PART II 37. Placarding of Condemned Dwelling; d ,� (�j�,,�,h N� Removal of Occupants; Demolition Number of Bedrooms Z, Number of Vehicles Allowed (max) 3 Number of Persons Allowed (max) � Person(s) Interviewed =� InspectorLAW S . &Z- If Public Building such as Store or Hotel/Motel specify here a 0 TOWN OF BARNSTABLE G BOARD OF HEALTH s ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date �Z(1 D Time: In IS-'GU Out $,(J \� �j Owner s ��O c.S�( Tenant `?2 i mac. A/ i Address Z Z- `( CG Address l—1 U G1 tip u/t/L— J)Z/9 Compliance Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 14— V a tit vt s 8. Ventilation 9. Installation and Maintenance of Facilities �rL 10. Curtailment of Service 11. Space and Use 12..Exits 13. Installation and Maintenance of Structural Elements " � t--,. rz C h 1� aN V fi,q- 1 e/L 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal C. v (� 16. Sewage Disposal ✓ f 17. Temporary Housing '+ } 18. Driveway Width h 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms Number of Vehicles Allowed (max) 3 Number of Persons Allowed (max) x) , L- Person(s) Interviewed Inspector S , O . If Public Building such as Store or Hotel/Motel specify here TOWN OF BARNSTABLE APProved:_ BOARD OF HEALTH MLD Cert: — ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date Z- Z-G- 200 t, Time: In ; C U Out I Owner Tenant fz Address ZZ Lf 2-2 Address 'eAz ay�, V-C I2- Compliance Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities ✓ / y a 6. Heating Facilities 7. Lighting and Electrical Facilities r✓ ��� IVA* 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use f 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal n/L v,4 7 17. Temporary Housing IVA- 18. Driveway Width 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms Number of Vehicles Allowed (max) Number of Persons Allowed Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here } TOWN OF BARNSTABLE (� BOARD OF HEALTH ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION Date 2 " Z—G- ZGO t Time: In & Gy Out 3 S W v"ve3 4jt-L(r.N � �� ad?--,�1 Owner �� r �2>t_,,o �✓L� S—{ Tenant I��Z-ti A A%4 s<� Address PU Address yr, i,(c a— 120 klA Q'ZQ,o 1 Compliance Remarks or Regulation# Yes NO Recommendations J 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply r e 5. Hot Water Facilities / N �(J 6. Heating Facilities 3. lam. 7. Lighting and Electrical Facilities �/ L. a �►'�1 /�h. 6Se7 rC./L A-` 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use. 12. Exits (/� I�rJ"T \'w a.rt—• ��2�. �.� 13. Installation and Maintenance of Structural P C VA %r V Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal ✓ 70L u— 16. Sewage Disposal VA -r 17. Temporary Housing "A- �� 18. Driveway Width ; 19. Number of Tenants Observed 3 PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms �^` Number of Vehicles Allowed (max) Number of Persons Allowed x �. Person(s) Interviewed Inspector . L 9 % If Public Building such as Store or Hotel/Motel specify here No. '' Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: .PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for � gpo5al *pgtem Con.5truction Permit Application for a Permit to Construct( ) Repair( 'Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 3 l b) a 9 Owner's Name,Address,and Tel.No. 40/L&r Qtt96ler �`w1 }�� rZS Ro`chwro! ''�r,Pn$'h `� P-08,tki Assessor's Map/Parcel �},rr�.Sv 9 Gl— `� 9 � �,• n (� d/ Installer's Name Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date IS d�007 Number of sheets ( Revision Date Title Size of Septic Tank `��� Type of S.A.S. 13 , A 3 3 r &al 1`r,�KCh tl�ci^LwOL-� Description of Soil 5-C � ���� � o) 2--,To& G r Nature of Repairs or Alterations(Answer when applicable) S"'a'Y ,�,P_n,)-i Date last inspected: Agreement: l The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. n �` Sig d �' `' _ ♦ Date U �� Application Approved by Date Application Disapproved by: Date for the following reasons. t Permit No. � � ' 7 Date Issued l v J No.. Obi 1, 7 Fee 0 tf Entered in computer: -THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-; TOWN OF BARNSTABLE; MASSACHUSETTS Yes F 01ppYication for Bigoal *Vmen��owaruction 'Permit Application for a Permit to Construct( ) Repair( " Upgrade( ) Abandon( ) ❑Complete System .❑Individual Components Location Address or Lot No. /O/ a 9 Owner's Name,Address,and Tel.No. �►,fa1 L4clIt-or /2-a-v,4 +� \ S A,,c h,rri! Assessor's Map/parcel ��,�Sj-7(,'j. l� 9� r, 1 � �4- n n /-1 Installer's Name Address,and Tel.No. Designer's Name,Address and Tel.No. M v Type of Building: S Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures -Design Flow(min.required) gpd Design flow provided gpd Plan Date ,i d�G0-7 Number of sheets / Revision Date Title `Size of Septic Tank 0cj�) Type of S.A.S. 13 � h 3 3 Description of Soil ,S-e ?° so e $00 Gr «'h G 9 1i.,O r V Nature of Repairs or Alterations(Answer when applicable) Er-e 7 "�' Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Sign ) Date ' Application Approved by Date Application Disapproved by: Date / for the following reasons is Permit No. 00 7 3 Date Issued -------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded Abandoned( )by I Z 1 1+S /3 f-J h,o`S Ccvt } 4 at `t has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ; 7— 3 7� dated Installer is6-G�I S (_G h S Designer S (,v 4-1 JJ-Ao--- ff!!1 ',)-e .+--rq #bedrooms Approved design flow ,,✓ _ gpd The issuance of this permit shall Act be construed as a guarantee that the system 'l fu ction as desi ned. f i �^1 r Date /Ir/I Inspector , _1 �i���l i � .�✓ �- No. �00' —5 7 / Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS ' 1wi,5pon i§p.5tem CCOtt!9tructiott Permit Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) System located at t-I o U Ci c'..v' r n Ski i /� ��,i _- "1-1 / and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the dat of this p `it: Date 1 Approved FROM :Sweetser Engineering 'FAX NG. :SW 398 3063 Sep. 20.07 02:02PM Pi Town of Barnstable Regulatory Services ` Thomas F.Geller,Director 1e MAW t Public Health Division ieg�'a Thomas McKean'Director 200 Main Street,llyannis,MA 02601 office:.508-862-4M4 Fax: 548-790-6304 taller A D—esigner Certification Form I pie• Gf L7 47 Sewage Permit#���' 3�7 Assessor's Map11!'arcet 3 © - cf,3 i Designer: �r,�� d'L- '�•+♦„�,•z Installer: 1=.I I IS /re 77W P ConV, � Address: l • Address: 9,3 S / hrpt�d,� '11// 1 On p" / -D-7 �i s 6 v v`f'I�S was issued a permit to install a (date) septic system at t10 - LJOX Ov vk er g /�It4qf L based on a design drawn by (address) tMG1t l v,r1l� dated 3/4- (designer I certify that the septic system referenced above was installed substantially according to the design, which may include minor appfoved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if r¢guired) * 'e tedz an( the soil were found satisfactpry f'�°' -�;''"' `;''"�y"° i certify that the septic system referenced above was installed with;major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State di Local Regulations. Plan revision or certified as-built by designer to follow. Stripout(if required) ted and the soils were found satisfactory. T A. y r � staller ed OU s ignature) .6193 f s�NItA�M� Ir� (Affix Designer's Stamp Here (Designer's Signature) B T B 5 LE.PUBLIC DEAL B TH T OATE !FORM AND AS- L B F RECE BY THE TAB PUBLIC HEALTH UMNAM, THANK X -� Q-%S*Oc%De6Sndr Cftlificatiom Fenn-Rev 0349-MAx � i FORM30 C&W HOBBS&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS BO OF EAL H Fr 41)w b AR /NT I s^ Q,M SVey`eW ADDRESS 'FE LEPHONE Address Occupa ) 1 �s Floor Apart t No. No. of Occu is No.of Habitable Rooms No.Sleeping Rooms No.dwelling or rooming units o.Atories Name and address of ownertJ 11V,6�;,_t�vo Remarks Reg. Vio. YARD Out BI s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: i 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 IJ Y N E ui . Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: 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 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 IN PECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALT UHY." INSPECTOR TITLE V A.M. DATE TIME 'JU P.M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety 1 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 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. } (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security 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,_por_ch 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. l/" Y i. - -- �. f H&W HOBBS&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS FORM 30 C BOARD OF HEALTH C T /TOWN W 7 . a DEPARTMENT � 9 ADDRES IrttEPH15Rk Address g1,01L _uaLw Occupa Y , P es Floor Apartm yt No. No. of Occup s_ No. of Habitable Rooms No.Sleeping Rooms r`2 i�✓t�i�� No.dwelling or rooming units,,..-- nits,. �No.Stories n �. �t� PO/ lC Name and address of owner OSP_1111d nro �o�c� - d 4 ( emarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Q Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Su ply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen. Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten. lect.: Stac Flue ,Vent , afeties: Kitchen Facilities Sin Q Stov Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) "THIS INSPECT REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTI ER J Y " INSPECTOR J/ TITLE DATE IL3 / y d TIME A.M.. �f-� M A.M. THE NEXT SCHEDULED REINSPECTION P.M. 1 410.750: Conditions Deemed to Endanger or.lmpair 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. (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. I �, ,A (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. t No. wo�66ZY" �G 6 Fee J� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipplication for ]h5poeal *r6tem Construction Permit Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components y Location Address or Lot No. f � . k Lin flo, Owner's Name,Address and Tel.No. �j��� Assessor's Map/Parcel q o ,` Installer's Name,Address,and Tel.No. � � yQ'j f� Designer's Name,Address and Tel.No. ae 7& aP CA M Type of Building:-.; Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building f)&RL6)( 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) ZMJX—L 1150-0 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title f the ron Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by Bo Signed Date Application Approved by 44 ZdAl Date j!5---JL fftJ Application Disapproved for th follo ing reasons Permit No. Ida,- 2S 0 4 Date Issued TOWN OF BARNSTABLE LOCATIONCO-�L �>� �� SEWAGE # - -_ ;(5 VILLAGE •: ASSESSOR'S MAP & LOT� INSTALLER'S NAME PHONE NO. SEPTIC TANK CAPACITYQQ LEACHING FACILITY:(type)� r NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER 4ISSUED: r�-FIT 1DATE PERMIT ISSUELDATE COMPLIANCE Q VARIANCE GRANTED: Yes No Eff% 9�9 l i t i No. O�LGCJ © � Fee t THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Zippfication for Mtzpogar bpztem Congtruction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. L�_�Z �(/�h R�, Owner's Name,Address and Tel.No. G/r j" ( STFQ1/ Assessor's Map/Parcel O - nE•� ���� Installer's Name,Address,and Tel.No. Ol't���/ f�y07�E Designer's Name,Address and Tel.No. �o -Ik(TuP uR ,fy)- a Type of Building: Dwelling No.of Bedrooms_ Lot Size sq.ft. Garbage Grinder( ) 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 k_ Title -"Size of Septic Tank Type of S.A.S. Description of Soil t z Nature of Repairs or Alterations(Answer when applicable) 5lqzzayy 3 6'0- 0 6;19//01 ZAsCl cooaS. IL Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title f the ron nda@ Code and not to place the system in operation until a Certifi- cate of Compliance has been issued byBo d I4 Signed Date s j � Application Approved by Date Application Disapproved for the following reasons Permit No. 611 - 3 0 A, Date Issued --------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERT that the On-site Sewage Disposal System Constructed( )Repaired( L-f Upgraded( ) Abandoned( )by /9y4TTl at O-!lJ © 411c"R /4W1 has been constructed in accordance with the provisions f Title 5 and the for Disposal System Construction Permit No. ;.DW 06 dated S-2-2 -GG a Installer O Designer The issuance of this g t shdll�of construed as a guarantee that thry'";�m will,Ifunction asesigned� / f - Date C � f / Inspecto t r ? ' � 1 No. fib" 3 D-!a FeeTHE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS ioogal Opgtem Con0tructton hermit `e Permission is hereby ranted to Construct( )Repair(v)Upgrade( )Abandon( ) System located at D-401 Q(JrQkL�2 f2C7 and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to f comply with Title 5 and the following local provisions or special conditions. " Provided:Construction must be completed within three years of the date of this permit. i Date: .]a?o7-��-� Approved by n, , a 1 '• 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I, .BpCfi/ hereby certify that the application for disposal works construction permit signed by me dated S-a�`� , concerning the property located at �-O-w Q—Um ha- A& meets all of the following criteria: J This failed system is connected to a residential dwelling only. are no commercial r y g y o business uses associated with the dwelling. %/• The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. '/• There are no wetlands within 100 feet of the proposed septic system J• There are no private wells within 150 feet of the proposed septic system v• There is no increase in flow and/or change in use proposed do There are no variances requested or needed. Vo The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] V• If the S.A.S.will be located with 250 feet of any vegetated wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14) feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) B) G.W.Elevation +the MAX. High G.W.Adjustment. _ DIFFERENCE BETWEEN A and B a SIGNED : 1Z) '-Je DATE: ,gip [Please Sketch proposed plan o ys m on back]. NOTICE Based upon the above information,a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:cert �. v �1 � � �.1 o n e f o � � �� �� I1 mtCHtM � - - -- --------------------- SOLE TEST P # 11867 I TOP OF FOUNDATION I 20 FT. MINIMUM FROM CELLAR OR CRAWL SPACE _ DATE OF SOIL TEST A�i.�ST_17__ 100.00_ 10 FT. MINIMUM 10 FT. MINIMUM FROM SLAB SOIL TEST DONE BY 5y�[S� EhjQJ(j EKING ELEV'. - _I WITNESSED BY _Q,_M ANPI_-------- (ASSUMED) I CONCRETE CLEAN SAND COVERS CONCRETE 06SERVATION HOLE 1 ELEV.=_-97.8- _ COVERS - LOAM AND SEED 4" SCHEDULE 40 PVC PIPE PERCOLATION RATE ___<__z MIN./INCH AT _54 INCHES MIN, PITCH 1/8" PER FT. 2" LAYER OF DEPTH HORIZ TEXTURE COLOR MOTT. OTHER 6 MA 1/8" TO 1/2" 0-21" FILL NO &00 4" CAST IRON PIPE " 68.30 MAX. WASHED STONE VENT , (OR EQUAL) MINIMUM " MA 96.05 INL NOT REQUIRED �1-25 A LOAMY SAND 10YR4/1 ROOTS __- ' PITCH 1/4" PER FT. � ---- Z 25-44* B LOAMY SAND 10YR7/4 ROOTS FLOW LINE TEE ` 31 TI - 44-126" Cl COARSE SAND - 2.5Y7/4 110% COBBLES 10" -� FLOW LINE 93 rn - - 1 ELEV. s f�7.00- MIN. --- .�--- _ hur•[.• e { �y J � ELEV. MIN. ,O -.- --95_00-_ 2 ° -- - - - ELEV. _ __9•QO_ ELEV. LEVEL o ° D 0 0 0 ❑ ❑ ❑ O ❑ 0 O o ° NO WATER ENCOUNTERED AT 126 ELEV. = B7_3_ ADD GAS ELEV. _ _�' _ GAS ELEV. _ -94.90_ 6" SUMP ELEV. _ _94.j. ° o ° �° 0 D L7 cl 0 00 0 D O O o 2 ° OBSERVATION HOLE 2 ELEV.-__97.6_ BAFFLE BAFFLE DISTRIBUTION ° LI ID OUTLET ° FLU = j ° o ° ❑ C7 0 (� ❑ D C7 © D CJ [7 ° ° DEPTH riORIZ TEXTURE _ COLOR MOTT. OTHER 1 (E 7;NG) L-_ BOX 84.5 ° °__ _ ° ° ° ° ELEV. ___ __ �-- 1 4 FEET 1 !NCHES TO BE PLACED ON FIRM BASE p. 0-8' A LOAMY SAND 10YR4/i NO ROOTS I 5 FEET 19 INCHES ( ) TO BE WATER TESTED 3 - 500 GALLON GALLEYS WITH i -- 6 FEET 24 INCHES 1000 GALLON 18-37" B LOAMY SAND 10YR7/4 ROOTS 7 FEET 29 INCHES 1000 GALLON IF MORE THAN ONE OUTLET STONE IN AN Lss ZONE . ` 18 FEET 34 INCHESJ SEPTIC TANK (TO BE PLACED ON FIRM BASE) 1.y X � X Y TRENCH FORMATION WELL MIA _ �37-120" C1 COARSE SAND 2.SY7/4 t0% LOOBLES DOUBLE WASHEO STONE l SOIL. ABSORPTION INDEX ��:r ' . _ . . _. • _....__ _ _ �,�_.. ADJUST_____.- FREE OF FINES do SILT SYSTEM {SAS) NO WATER ENCOUNTERED AT ??e" ELEV, • -$7.4 _ SEWAGE DISPOSAL SYSTEM PROFILE - - . _ - II USGS PROBABLE WATER TABLE ELEV. - ____.__ I ` OBSERVED WATER TABLE ( / / ) ELEV. - 1 BOTTOM OF TEST HOLE ELEV. - _IZJL- (ff NOTES: 1. ALL. WORKMANSHIP AND MATERIALS SHALL. CONFORM TO D.E.P. TITLE 5 AND THE TOWN'S RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 2. ALL COVERS TO SANITARY UNITS SHALL 8f BROUGHT TO i' DESIGN CALCULATIONS WITHIN 6" OF FINISHED GRADE. NUMBER 4 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF GARBAGE DISPOSAL UNIT HQ_ WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN / TOTAL ESTIMATED FLOW 10 FT. OF DRIVES OR PARKING AREAS H-20 LOADING SHALL BE ( 110 GAL•/Ot./DAY X 4 BR.) _. 44Q__ GAL./DAY USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. REQUIRED SEPTIC TANK CAPACITY 000 Qt MO GAL. 4. ANY MASONARY JNITS USED TO BRING COVERS TO GRADE SHALL ACTUAL SIZE OF SEPTIC TANK 1000 + 1000 GAL. BE MORTARED IN PLACE. 97.1 97.5 SOIL CLASSIFICATON L_ 5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH w. DESIGN PERCOLATION RATE S MIN./IN. DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT IS TO EFFLUENT LOADING RATE Q�� GAL./DAY/S.F. OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY, LEACHING AREA 61 SQ. FT 6, UTILITIES 94OWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR _ (13X33)+(46X2X2) !S TO CALL *DIG-SAFE" AT 888-344-7233 AT LEAST 72 HOURS / LEACHING CAPACITY (.AREA X RATE) 45, -02 GAL/DAY PRIOR TO COMMENCING WORK ON SITE. ( 98.2 613,00 X 0.74 7 CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS \ RESERVE LEACHING CAPACITY NONE- GAL./DAY SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION rq�.7 IS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER IMMEDIATELY. 97.9 F. PARCEL IS IN FLOOD ZONE ( 98.5 9. LOT IS SHOWN ON ASSESSORS MAP 310 _ AS PARCEL _ Aloul, , • 98 10. EXISTING LEACHING FACILITIES ARE TO BE PUMPED AND BACKFILLED 97•9 UNLESS THEY ARE WITHIN 5' OF SOIL ABSORPTION SYSTEM, THEN THEY D"T'r✓Fy�q y 9 •0 SHALL BE REMOVED ALONG WITH ANY POLLUTED SOILS. 11, THE INSTALLER IS TO GIVE THE ENGINEER A MINIMUM OF 48 HOURS 7 5 gg 7 (2 WORKING DAYS) NOTICE FOR THE FINAL INSPECTION (NUMBER BELOW). 12. ALL UNSUITABLE MATERIAL SHALL BE REMOVED FROM UNDER AND Q 8 /98.6 By 98.9 FOR A MINIMUM OF 5' AROUND SOIL ABSORPTION SYSTEM AND BE 98 9 / REPLACED WITH SAND AS SPECIFIED IN 310 CMR 15.255:(3). Q- �v - 1 99.1 � �16. EXrsn gz�)) 0 GALLON (EP(TIC GALLON 98.5 D�rp NG Q SEPTIC TANK TANK Q 100.000, V' Qi- c' T - 9 .8 4 6E SIDE ( r �r 3 ,I: � v 9 .4 I T OBOO 97. 95.8 I, 97 t 4 �� D. o t• 41 o ' APPROVED: BOARD OF HEALTH ISTE 97.9 Brr 198.3 `� - OO� 4 V --.� 99.2 98.9 I� SOIL to DATE AGENT 9 .6 i' 7. 97.8 PROPOSED SEPTIC DESIGN .:. _ • 98.1 RICHARD ARENSTRUP 6.2 1 97.3 98.1 �� solL LOc 40 42 tIAKER R'D.96.7 1 95.4 T TEST 2 L 0/ BARN 7 AB� MASS. 47 AND 49 <�` - 23,269.9 SF • 98,1 SWIC97SM? ANGLMONG I � � 235 GREAT 0. BOX 71 ROAD 508_ 398-3922 SOUTH DENNIS, MASS. 02660 LEGEND: EXISTING SPOT ELEVATION �20_� DATE SCALE CALE EXISTING CONTOUR ----00 JULY 15, 20�7 1 " = 20' FINAL SPOT ELEVATION FINAL CONTOUR -- SOIL TEST LOCATION REVISED -� J08 NG. 6G71�M UTILITY POLE 0- TOWN WATER -W�W CATCH BASIN ®� �-� GAS LINE C V� -�_ L LOCATION MAP J REVISED --� SHEET I ^ i CLEAN OUT V F CESSPOOL C.P T F` C: �S8'�f'R0J�6571-OO�dwyi,657 54S.OWG ©2007 SWEE SER ENGINEER' �Y .{ .1:i.i } , Y.. � , �, �- • �„ X