HomeMy WebLinkAbout0019 REDWOOD LANE EXT. - Health 19 Redwood Lane Ext.
Hyannis
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THE
Town.of Barnstable P#
Department of Regulatory Services
11MM"ABLK _ Public Health Division Date
1 3
MAa3 '
�� n6 ♦ 200 Main Street,Hyannis MAE
�__Date ScheduledTimeFee Pd.
Soil Suitability Assessmentfor Se e .L isp al
Performed By: Witnessed By: G,
LOCATION& GENERAL INF ORMATION
Location Address 000 Z Owner's Name i4H-4E9<5VZ-1 0,
Address ?ti//,se
Assessor's Map/Parcel: Engineer's Name
NEW CONSTRUCTION REPAIR _2
Telephone#
Land Use Slopes(%) Surface Stones
Distances from: Open Water Body ft Possible Wet.Area ft Drinking Water Well ft
Drainage Way ft Property Line ft Other It
SKETC11:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
Fr #Z,
4t
LD Cn
...,. i
Parent material(geologic) Depth to Bedrock
Depth to Groundwater. Standing Water in Hole: Weeping from Pit Fllce
Estimated Seasonal High Groundwater
DETERAHNATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: in. Depth to loll mottles: In,
Depth to weeping from side of obs.hole: _ In. Groundwater Adjustment ft.
Index Well# Reading Date: Index Well level Adj,ractor- ArAj,tlrnundwater Level
PERCOLATION TEST Date 'rime
Observation
Hole# Time at 4"
Depth of Pere Time at 6"
Start Pre-soak Time @ .4 / Time(V-6")
End Pre-soak
RateMin./Inch
Site Suitability Assessment Site Passed Site Failed: Additional Testing Needed(YIN)
Original: Public Health Division Observation Hole Data To Be Completed on Back-----------
***1f percolation test is to be conducted within 100' of wetland,you must first notify the
Barnstable Conservation Division at least one (1) week prior to beginning.
Q:\SEPTIC\PISRCFORM•DOC
DEEP.OPS+IZVATION IIOLI;LOQ mole
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders.
i onsi§tency,%Gravel)
�.
DEEP OBSERVATION DOLE LOG Dole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,% ravel
L
DEEP OBSERVATION DOLE LOG Mole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Con i to c Gravel)
S
�j
DEEP OBSERVATION IiOL1El LOG Dole
Depth from Soil Horizon Soil Texture Soil Color - Sol] Other
Surface(in.) (USDA) (Munsell) i Mottling (Structure,Stones,Boulders,
r
Consistency, a
Flood Insurance Rate Maw
Above 500 year flood boundary No_ Yes _._____
Within 500 year boundary No K es
Within 100 year flood boundary No— YeS
]Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system?
If not,what is the depth of ha urally occurring per ious maCarial?
Certification L Q
I certify that on (date)I have passed the soil evaluator examination approved by the
Department of Environ enta Prote ti and that the above analysis was performe by me consistent with .
the required training,ex se d x ri nce described in 10 CNM 15.017.
Signature Date
Q:WEPTICV RCPORM.DOC
TOWN OF BARNSTABLE
LOCATION J,', R Zr-0 1-1-,0`4 41' 'P�X?' SEWAGE#
VILLAGE ASSESSOR'S MAP.&PARCEL
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) (size)
NO.OF BEDROOMS
OWNER
PERMIT DATE: '�-2 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
X
Er
Y
17
3- 3 _ / 9. <
S"-
No. , Fee ��c✓
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
s
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
ftpliCati OC Vspo8al 6pstrut Construction 3pPrmit
Application for a Permit to Construct( Repair( ) Upgrade( ) Abandon( ) Complete System ❑Individual Components
Location Address or Lot No.19GC C-�J&,"",b o✓ GFXj Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel o;I cP rP - p I / 37
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
00AO%b ��3
7�S' 1'6/,7
Type of Building:
Dwelling No.of Bedrooms r Lot Size sq.ft. Garbage Grinder( )
Other Type of Building OC'4::9"J'- No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 1/yp gpd Design flow provided �S' gpd
Plan Date :�l Number of sheets / Revision Date
Title
Size of Septic Tankn,,1e,"w /S'yd 6�W1 Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) .1'4e'
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.
Sig Date
Application Approved by Date ! f 3
Application Disapproved by Date
for the following reasons
Permit No. -Q.o4 -3 Date Issued -
# CJ 0
.. Fee�—
THE COMMONWEALTH OF MASSACHUSETTS -Entered in computer:
YW
PUBLIC HEALTH DIVISION - TOWN F�:BARNSTABLE, MASSACHUSETTS
2pplicAtion for Mispoi sAt 0psifPYn Construction Wrifi t
Application for a Permit to Construct(Repair( ) Upgrade( ) Abandon( ) Complete System ❑Individual Components
Location Address or Lot No.,/
Reeee Owner's Name,Address,and Tel.No.
Assessor'sMap/Parcel o1 cPeP - o P.Ir- IA -Z `
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
o
Type of Building:
Dwelling No.of Bedrooms ��/ Lot Size sq.ft. Garbage Grinder( )
Other Type of Building ::;Fr C-. No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets / Revision Date
Title
E
Size of Septic Tankr,e-/,e,, / r-oa G Type of S.A.S.'
Description of Soil.
f
Nature of Repairs or Alterations(Answer when applicable) .Poee' w r
.. E
1
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.
Date /X "'--.Z
Sign d
Application Approved by - Date �c� J"5 /
Application Disapproved by Date
for the following reasons
Permit No. c)l Date Issued
TB E COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed Repaired Upgraded( )
Abandoned( )by V-i 11? G ,(' /`/i c
at/,��������2���, �-. has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit N dated
Installers:_zzz Ledgz�-� Designere94,0"e. /`o J
#bedrooms Approved design flow f A gpd
The issuance of this permits all not a construed as a guarantee that the system it ction as design?Date Inspector // 1�rg&
v f
---------------------------- ---------- -. -_ -. - - - . - - ------------------------------
No. °>�. ) ) 9 Fee Ir)
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Misposal 6pstent Construction 3dermit
Permission is hereby granted to Construct(�-'� Repair Upgrade( ) Abandon( )
System located at gj5- o® 1
I
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit.
Date �� r�� ) Approved by�,
DEC/12/2013/THU 03: 14 PM j FAX No. P, 001
Town of Barnstable
Regulatory Services
Richard V.Scali,Interim Director
a DAWGrAE= Public Health Division
� Thomas McKean,Director
200 Main Street,$yanYuls,MA 02601
Office: 508-862A644 Fax; 508-790-6304
Installer&Designer Certification Form
�33
Date: >� �3 /� Sewage Permit# 9 Assessor's MaplParcel 7
Designer: 9 1Y1,12 Y�6 ,:;Q - Installer: --4 l!U G
Address: Y�J i _ Address:
On 1Z, I 14 W)W 14wn C was issued a permit to install a
(d e) (installer)
septic system at 4 '
/ Y" W' E1 ' based on a design drawn by
,'I (, (address)
C4 NU L90. �fJ�"M, / dated t 2— )1 701
(designer)
I certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank Strip out (if required) was inspected and the soils
were found satisfactory.
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&Local Regulations., Plan revision or
certified as-built by designer to follow. Strip out(if required)was inspected and the soils
were found satisfactory.
I certify that the system referenced above was construct ce with the terms
of the RA approval letters(if applicable) 1� Rs
pAVID
s
MASON rn
taper's ignature) No.1066
�PC�87�p�
`�AN1TARlt`�
(De er's Signature) (.Affix Design s Stamp here)
PLYASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTNICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
QA8cpti6lDesigner Ccrtifioation Form Rev 8-14-13.doc
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�w HOBBS&WARREN'M THE COMMONWEALTH OF MASSACHUSETTS
FORM 30 �
BOARD OF HEALTH
_ o Lea 5aA, b&ef—
CITY/TOWN
DEPARTMENT
0
ADDRESS 4
G,M Svey`0r &—ot
TELEPHONE
Address` 61 CIEIp1,✓oop�N 1� _AN_L�b�cupav^4 1R-►'�41e�_4 -)U w ^I�
Floor Apartment No. •No.of Occupants Co,
No. of Habitable Rooms '7 No.Sleeping Rooms y_
No. dwelling or rooming units No.Stories
�rName and address of owner 1�►.a t.� __A y joy2—Si„j
C M u �T, �0. '+l 4%jA\C J Remarks Reg. Vio.
YARD Out Bld s.: Fences:
Garbage and Rubbish
Containers:
Drainage
Infestation Rats or other:
STRUCTURE EXT. Steps,Stairs, Porches:
Dual Egress: and Obst'n.:
❑ B ❑ F ❑ M Doors,Windows:
Roof
Gutters, Drains:
Walls:
Foundation:
Chimney:
BASEMENT Gen.Sanitation:
Dampness:
Stairs:
Lighting:
STRUCTURE INT Hall,Stairway:
;7 Obst'n.:
Hall, Floor,Wall,Ceiling:
Hall Lighting:
Hall Windows: `
HEATING Chimneys:
Central ❑ Y 1�1Equip. Repair
TYPE: Stacks, Flues,Vents:
PLUMBING: Su ply Line:
❑ MS ❑ ST CP Waste Line:
L H.W.Tanks Safety and Vent(s)
ELECTRICAL/ Panels, Meters,Cir.:
El110 0 Fusing,Grnd.:
AMP: (VVV/ 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 . G
Bedroom 2 S
Bedroom 3 C�
Bedroom 4 /ZO PJ
Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.:
Stacks, Flues,Vents,Safeties.-
Kitchen Facilities Sink tto
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 Buildin Posted c,f L /N
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 INSPEC ON REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND
PENALTIES PERJURY."
INSPECTOR TITLE /fiat?y 1^-S
A.M.
DATE Z TIME �• P.M.
,�/ A.M.
THE NEXT SCHEDULED REINSPECTION /✓ /� P.M.
410.750: Conditions Deemed to Endanger or.Impair:Health or Safety
The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or
impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of 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, 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.
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MONWEALTH OF MASSACHUSETTS
FORM 30 C,w HoBBS&WARREN n THE COM
BOARD OF HEALTH
CITY/TOWN
,. DEPARTMENT
Ni ►A Sri rA his MA GZC-O�
ADDRESS / UFO C,Z -44GcLy
�M ey`0
TELEPHONE
Address 6 e n t-,1,10 0 �,r�.1 ,fL z4'C, ��/�^•NOccup�� ��u N n't� ��7t n,,�
,i Floor Apartment No. No.of Occupants Cy
No. of Habitable Rooms 77 No.Sleeping Rooms
No.dwelling or rooming units No.Stories
i Name and address of owner A L0 r,j off A
k -7E:i iA w rt� Q A.,4 !A1�j �I/� Remarks Reg. Vio.
YARD Out Bld s.: Fences:
Garba e and Rubbish
i Containers:
Drainage
Infestation Rats or other:
STRUCTURE EXT. Steps,Stairs, Porches:
Dual Egress:and Obst'n.:
❑ B ' p F. ❑ M Doors,Windows:
Roof
Gutters, Drains:
Walls.-
Foundation: \
Chimney:
C BASEMENT Gen.Sanitation:
' Dampness: \j J'
Stairs: '
+r' Lighting:
STRUCTURE INT. Hall,Stairway: CJ \
Obst'n.: �+
_ Hall, Floor,Wall,Ceiling:
Hall Lighting:
Hall Windows: i
L-.--4..--- HEAT-IN.G -:._.__.j �.. 4:.-._Chimne .s:_ -
` Central ❑ Y` �'
/❑/N
V Equip. Repair �-- ' v`
f TYPE: Stacks, Flues,Vents:
PLUMBING: Supply Line:
❑ MS ❑ ST Q�P Waste Line:
l �f H.W.Tanks Safety and Vent(s)
ELECTRICAL Panels, Meters,Cir.:
f . ❑ 110 4 220 Fusing,Grnd.:
s AMP: I/ Gen.Cond. Distrib. Box:
i Gen. Basement Wiring:
yy. '
DWELLING UNIT
Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks
i Kitchen
Bathroom
I Pantry
i Den
Living Room
Bedroom 1 . 1 o
Bedroom 2 f
Bedroom 3
Bedroom 4
Hot Water Facil. Sup.Ten.,Gas,Oil;Elect.:
i Stacks, Flues,Vents,Safeties:
Kitchen Facilities Sink
Stove
Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.:
Wash Basin;.Showeror Tub ::
Infestation Rats, Mice, Roaches or Other:
Egress Dual and Obst'n: _
General Building Posted c, L i,
Locks on Doors:
ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH
MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE
OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE
AUTHORIZED INSPECTOR. (See Over)
"THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND
PENALTIES O,FPERJUFiY."
INSPECTOR l TITLE
A.M.
DATE Z / TIME �� �J P.M.
A.M. •
THE NEXT SCHEDULED REINSPECTION /�/ / _ P.M.
-.- y. ._.,..,....v^^,...--. ....... ....-._-�.-.... :..-....,� r,...._.. � .._. .,- .--.-...xsr.... ��.-..•...-+r.,,,....-.-.re5�.,--•:*".•++��.• ....�...r-rr++- r-�.a.•-- � ..
410.750: Conditions Deemed to Endanger or Impair Health or Safety
The following conditions,when found to,exist in residential premises, shall be deemed conditions which may endanger or
impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those
items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the
occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for
human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so
in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that
other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local
health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 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, 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.
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■ Complete items 1,'2,and 3.Also complete 7ASiTgnatureitem 4 if Restricted Delivery is desired. ❑Agent
• Print your name and address om the reverse dresseeso that we can return the card to you. eceived by(.Printed Name) C. Date f Delivery
0 Attach this card to the back of the mailpiece, 4 61
or on the front if space permits. t
D. Is delivery address different from item 1? ET Yes
1. Article Addressed to: If YES,enter delivery address below: ❑No
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4. Restricted Delivery?(Extra Fee) ❑Yes
2.. Article Number `ti 7003 19-80 0004 '1 45.8It `524
(Transfer from service labeq
PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540
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UNITED STATES POSTAL SERVICE First-Class Mail
Postage&Fees Paid
LISPS
Permit No.G-10
• Sender: Please print your name, address, and ZIP+4 in this%'ox•
' Town of Barnstable M
Health Division \�
200 Main Street
Hyannis,MA 02601
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Certified Mail#7003 1680 0004 5458 4524
P�oFZHE To�,ti Town of Barnstable
Regulatory Services
,
rt
+ IIARNS`CAtILE,
T MASS. ,erg Thomas F. Geiler,Director
ArEOMA Public Health Division
Thomas McKean,Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
June 8, 2007
onald Anderson k'
78 Channel Point Road
Hyannis, MA 02601
NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY
CODE II — MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION
AND THE TOWN OF BARNSTABLE CODE CHAPTER 170.
The property owned by you located at 19 Redwood Lane Ext. Hyannis, was inspected
on June 1, 2007 by Timothy O'Connell, Health Inspector for the Town of Barnstable.
This inspection was conducted on the basis of the rental registration in accordance with
Chapter 170 of the Town of Barnstable Code.
The following violations of the State Sanitary Code were observed:
11/105 CMR 410.351 —Owner's Installation and Maintenance Responsibilities. Open
wiring in basement.
� Q5 CMR 410.500—Owner's Responsibility to Maintain Structural Elements. Four
(4)broken window panes observed throughout home.
The following violations of the Town of Barnstable Code were observed:
70-10—Smoke Detectors and Carbon Monoxide Alarms. No operable smoke
etectors or carbon monoxide alarms in basement.
QAOrder letterMousing violations\Rental ordinance\19 Redwood Lane Ext..doc
You are directed to correct the violations listed above within twenty-four (24) hours
of your receipt of this notice by providing operable smoke detectors and carbon
monoxide alarms in basement. You are directed to correct the violations listed
above within thirty (30) days of your receipt of this notice by properly covering
open wires and by replacing broken window panes.
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 OF HE BOARD OF HEALTH
T omas A. McKean, R.S., CHO
Director of Public Health
Town of Barnstable
Cc: Timothy O'Connell, Health Inspector
Donata&Rich Guerney, Tenants
QAOrder letters\Housing violations\Rental ordinance\19 Redwood Lane Ext-doc
FORM30 C&N HOBBS&WARRENTM THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
CITY/TOWN
W
L DEPARTMENly
I�
1
ADDRESS
4„M yv9 y`0W (' J
TELEPHIPNE
Address 1 /v` Occupant
Floor Apartment No. No. of Occupants C� 2�-
No.of Habitable Rooms No.Sleeping Rooms
No. dwelling or rooming units No.S rie
Name and address of owner-
7 _
b Remarks Reg. Vio.
YARD Out Bld s.: Fences:
Garbage and Rubbish
Containers:
Drainage
Infestation Rats or other:
STRUCTURE EXT. Steps,Stairs, Porches.-
Dual Egress:and b 'n.:
❑ B ❑ F ❑ M Doors,Windows:
Roof
Gutters, Drains:
Walls:
Foundation:
Chimney:
BASEMENT Gen.Sanitation: ^^�
Dampness: s
Stairs:
Li htin :
STRUCTURE INT. Hall,Stairway:
0 bst'n.:
Hall, Floor,Wall,Ceiling:
Hall Lighting:
Hall Windows:
HEATING Chimneys:
Central ❑ Y ❑ 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.: (t) S
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 2-
Bedroom 3
Bedroom 4
Hot Water Facil. Su .Ten.,Gas,Oil, Elect.:
s, F u , ent e�es:
Kitchen Facilities i k
16+Ke
Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.:
Wash Basin,Shower or Tub:
Infestation Rats, Mice, Roaches or Other.-
Egress Dual and Obst'n:
General Building Posted
Locks on Doors:
ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH
MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE
OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE
AUTHORIZED INSPECTOR.(See Over)
"THIS INSPECTION REPORT IS SMED AND CERTIFIED UNDER tTHE PAINS AND
PENALTIES PERJU Y.
INSPECTOR '" TITLE
r r 2 l A.M.
DATE 1 ® TIME J V P.M.
A.M.
THE NEXT SCHEDULED REINSPECTION T P.M.
f
410.750: Conditions Deemed to Endanger or Impair-Health or Safety
The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or
impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those
items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the
occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for
human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so
in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that
other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local
health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 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
( ) P PP Y
needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer.
f
(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 provider adequate exits, or the obstruction of any exit, passageway or common area caused by any object,
including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452.
(H) Failure to comply with the security requirements of 105 CMR 410.480(D).
(1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar-
bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests
or otherwise contribute to accidents or to the creation or spread of disease.
(J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public
Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.)
(K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or
other dangers or impairment to health or safety.
(L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating,
gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352,
so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety.
(M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release
of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105
CMR 410.353.
(N) Failure to provide a smoke detector required by 105 CMR 410.482.
(0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or
knowledge of the owner of said condition or conditions:
(1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven
or any defect that renders either inoperable.
(2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any
defect which renders them inoperable.
(3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of
generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard.
(4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as
required by 105 CMR 410.503(A)and 410.503(B).
(5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550.
(P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con-
dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner
to remedy said condition within the time so ordered by the Board of Health.
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Town of Barnstable
Regulatory Services
* BARNSTABLE.
Thomas F. Geiler�Director
*
p$ A Public Health Division
Thomas McKean,Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
January 11, 2007
Attn: Hyannis Fire
Health Inspector Timothy B. O'Connell conducted a rental inspection in accordance with
Chapter 170 of the Town of Barnstable Code. In accordance with the State Sanitary
Code, 105 CMR 410.482, the Health Department is required to notify the Fire
Department if there is a smoke detector violation, or possible smoke detector violation.
The following property had possible smoke detector(and\or CO detector)violation(s):
83 Breakwater Shores Dr Hyannis,Assessors Map-Parcel: (306-227):
No CO Detector in home. No Smoke Detector in basement.
19 Redwood Ln ext. Hyannis,Assessors Map-Parcel: (288-084):
No smoke Detector in basement. No CO within basement
5 Holiday Ln Hyannis,Assessors Map-Parcel: (267-084):
Smoke Detector not working near bedroom on right. No CO's within home.
Timothy B. 'Connell-Health Inspector
Q:\Order letters\Housing violations\Rental ordinanceUire ViolationsTIRE TEMPLATE.doc
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PARCEL : 1) The installation shall conii `, with Title V and Town of? �i, Hoard of
FLOOD ZONE: h/C.' ^' SO I L EVALUATOR: I NYC 0 C Health Regulations.
I � � 2) The installer shall verify the location of utilities, sewer inverts and septic
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REFERENCE: WITNESS :� ���-� ����..�`' � � � DATE: R 1 a components prior to installation and setting base elevations.
PERCOLATION RATE: G ► � F R 3) All gravity septic piping to be 4 inch Sch 40 PVC at 1/8" per foot. The first
two feet out of the d-box to the leaching shall be level.
�0 rL r77- (�l R 5,ke? V Zb►b 4) This plan is not to be utilized for property line determination nor any other
TH- I TH-2 purpose other than the proposed system installation.
5) All septic components must meet Title V specifications.
Nov.
I 6) Parking shall not be constructed over HI septic components.
7 7 The property is bounded b property corners and property lines.
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8) The property owner shall review design considerations to approve of total
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LOCATION MAP design flow and number of bedrooms to be considered for design. Receipt
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of payment for the plan and installation based on the plan shall be deemed
approval of the design flow by the owner.
i 9 The existing g
leachin or cesspools shall be pumped and filled with material
per Title V abandonment procedures. Those within the proposed SAS shall
be removed along with contaminated soil and replaced with clean sand per
Title V specs.
�� �` 10 System components to be 10 feet from water line. Sewer lines crossing the
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water line shall be sleeved with 4 inch SCH 40 PVC with ends grouted if
applicable. The proposed SAS is being installed below the water service
i line. The line is to be sleeved as aforementioned and maintained in place.
SEPTIC SYSTEM D E S ! G N 11) If a garbage grinder exists it is to be removed and is the responsibility of the
owner to ensure such.
FL W ESTIMATE I 12)The installer is to take caution in excavation around the gas line if such
exists.
' BEDROOMS AT � GAL/DAY/BEDROOM GAL/DAY 13)The installer shall verify the location, quantity and elevation of the sewer
- lines exiting the dwelling'prior to the installation.
14)This plan is representative only that a system can fit on a property meeting
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25 _SEPTIC TANK Title V requirements.
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DBC ENVIRONMENTAL DESIGNS
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DATE HEALTH AGENT EAST SANDWICH . MA
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( 508 ) 833- 2177