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0365 SCUDDER AVENUE - Health
;� 365 Scudder Ave 288-093 Hyannisport i OEM t 7 _ 0l C.cl y888p�p s I SAr 9 ' ,Y;j Mil,� }C3 f0 Lrl v Y !0 �• 1 2 1 f o 4ti Ln Z r ru Ln �L- 4 i U.S. Ni SOUTH 026 SEP�28 �' T 9 A UNITED STATES AMOU: rf POSTAL SERVICE y a l 9999 1, t Goo �N \ COMPLETE THIS SECTION ON DELIVERYSENDER: COMPLETE THIS SECTION �! �- - ■ Complete items 1,2,and 3.Also complete A. Signature - item 4 if Restricted.Delivery is desired. ❑Agent ■ Print your name and address on the reverse X ❑Addressee I so that we can return the card to you. B. Received by(Printed Name) G. Date of Delivery ■ Attach this card to the back of the mailpiece, i or on the front if space permits. D. Is delivery address different from item 1? '?es 1. Article Addressed to: If YES,enter delivery address below: ❑No y i Jordan L. Oswald I 31 Hollis Street . . , Marlborough, MA. 01752 3. Service Type IM Certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise € ° ❑Insured Mail. ... 0 C.O.D.- r I 4. Restricted Delivery?(Extra.Fee) ❑Yes - 12. Article Number 7004 0750 0002 2567 5154 f ' (transfer from service labe ` 8 ,t !€ti dl }i:r�i� ' ' t I PS Form 3811;-February 2004 Domestic Return Receipt tozsss oz-M t54o BARNSTABLE BOARD OF HEALTH ABUTTER NOTIFICATION LETTER DATE: September 28, 2004 RE: Upcoming Barnstable Board of Health Hearing To Whom It May Concern, As an abutter to the proposed project, please be advised that a DISPOSAL SYSTEM CONSTRUCTION PERMIT application has been filed with the Barnstable Board of Health. APPLICANT: Mrs. Catherine Doyle (former owner) OWNER: Jay&Donna Sweeney(#43) OWNER: Mrs. Berverly Lieberman(#38 formerly#141) PROJECT ADDRESS OR LOCATION: 43 &38 Stetson lane PROJECT DESCRIPTION: The proposed project involves the removal of the existing sewage disposal system components and construction of a proposed on-site sewage disposal system consisting of a 37'x 9'leaching area. The leaching area is for the use of#43 Stetson Lane and will be placed in an existing septic easement area on#38 Stetson Lane.Variances are being sought for the repair of the system from the Town of Barnstable Board of Health Local Onsite Sewage Disposal Construction and the" Commonwealth of Massachusetts Department of Environmental Protection State Environmental Code, Title 5. The local variance and Title 5 variance are as follows: • Town of Barnstable Board of Health Local Onsite Sewage Disposal Construction 1.) To allow the leaching system to be in a coastal bank in lieu of the 100'separation required. A 100' variance is requested 2.) To allow the leaching system to be 41' from edge of bordering vegetated wetlands in lieu of 100'. A 59'variance is requested. 3.) To allow the existing pump chamber and septic tank to remain in their present location 32' from bordering vegetative wetlands. A 68'variance is requested. C.... 1. f)' .. ... .S ' .. .. • State Of Massachusetts DEP health regulations 1.) 15.104: Due to the groundwater depth a percolation test was performed. A sample was taken and a sieve test was performed. Sieve analysis passed. (policy#: brp/dwm/dep-poo-4. 2.) 15.203: To allow a 15% reduction in the required flow of 440 gpd. 382 gpd provided. (This allows the leaching area to be within the septic easment.) 3.) 15.211:(1 To allow the pump chamber and septic tank to remain in their present location. 3' from the water line in lieu of 10'.A 7'variance is requested. 4.) 15.211: 1 To allow the leaching system to be in a coastal bank in lieu of 50' separation.A 50'variance is requested. 5.) 15.211: To allow the leaching area to be 4.4' above the groundwater in lieu of 5.0' A 0.6'variance is requested. APPLICANT'S AGENT: BSC Group, Inc. 657 Main Street, Unit 6 West Yarmouth, MA 02673 Attn: Kieran J. Healy PUBLIC HEARING: BARNSTABLE TOWN HALL, 367 Main Street, Hyannis. DATE: October 12`h, 2004 TIME: Meeting 7:00 PM NOTE: Plans and application describing the proposed activity are on file with the Barnstable Board of Health at 200 Main Street, Hyannis. Also, please be advised that there is a Town of Barnstable Conservation Hearing regarding this project on the same night beginning at 6:30 P.M. and that the Board of Health hearing will occur. after the Conservation hearing. Yours truly, Craig A. Field, PLS Project Manager TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date ' j -- Time: In Out Owner ( R Tenant (0, � c ` Address Address 6 Complian a Remarks or Regulation# Yes O Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities 1,9prove ." " (�- 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use - 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing ! �� 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) I►J Number of Persons Allowed (max) 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 Time: In Out Owner�Ll ► rTs t l Tenant JU6 Address Sw m Address 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 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use - 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal D 1 — ®1 17.Temporary Housing 18. Driveway Width 19. Number of Tenants Observed �A PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition ++ Number of Bedrooms i Number of Vehicles Allowed (max) 1 Number of Persons Allowed (max)_ _I Person(s) Interviewed .trVN , Inspector If Public Building such as Store or Hotel/Motel specify here f TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION Date Owner —L Tenant Address 3 l� 0,4 A Address Compliance Remarks or Regulation# Yes No Recommendations 2. Kitchen Facilities 3. Bathroom Facilities A. Water Supply t/ 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities B. Ventilation f 9. Installation and Maintenance of Facilities 10. Curtailment of Service All C .P 11. Space and Use J (n / . 12. Exits A 13. Installation and Maintenance of Structural / 0 Elements Lv �'UpW r h 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal ✓ Dye 17. Temporary Housing PART II A,t 37. Placarding of Condemned Dwelling; 'v Removal of Occupants; Demolition - L Person(s) Interviewed Inspector �' If Public Building such as Store or Hotel/Motel specify here — iAk -I i • b 2 L � � I _ I f) I I rl VnC OA!R A Q v I � co Q C) om 1 o\j N _ C 3E (Al © tt? tf1 i i A Certified Mail#7006 0810 0000 3524 9391 �oFT"E ro Town of Barnstable P ' 41+ IL1R`ISTABLE, Regulatory Services 9 MASS. a Thomas F. Geiler,Director a M �p i6gq. `gym � . plFAC a, Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 . . _.. April 10, 2007 Raineria Laftsidis 365 Scudder Avenue 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 362 Scudder Avenue Hyannis, was inspected on April 4, 2007 by Meredith Morgan, 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 Town of Barnstable Code were observed: 170-9—Parking Restrictions. Driveway observed to be greater then 25% of front yard. You are directed to correct the violations listed above within thirty (30) days of your receipt of this notice by reducing the drivewaysize to be no more then 20 feet wide or 25% of the front yard by using timbers, grasses, cinder blocks, etc. 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. QAOrder letters\Housing violations\Rental ordinance\365 Scudder Avenue.doc r S� I A i �— _— r .. .... •.. �f.�,a.^' ail l #S — I Date: ILI ,-7 odZ TOXIC AND HAZARDOUS MATERIALS REGISTRA ION FORM NAMEOFBUSINESS: �) d BUSINESS LOCATION: ti MAILINGADDRESS: 5 �(`(1-Q_ Mail To: TELEPHONE NUMBER: -1-1 Board of Health Town of Barnstable CONTACT PERSON: P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBE : ` S�CY�-p Hyannis, MA 02601 TYPE OF BUSINESS: \Ay)yLR Does your firm store any of the toxic or hazardous materials listed below, either for sale or for you own use? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: S V TELEPHONE: �`l����1\ - 2 I , LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) i lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) j Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint &varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor& furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers& cleaning fluids IL L' � .� (dry cleaners) Other cleaning solvents 1400SIQ 0�1 `d d '�c CL���_ Bug and tar removers W.K.XaA__. ba WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION t RECEIVED JJ 'N 1 7 Z001 TITLE 5 TOWHEALT OF H DEST BLE OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSE S� SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 365 Scudder Ave_ Hyannisport� MA Owner's Name: Jeff T.)znn g j Tnrlign—Mgt. Owner's Address: pC_gnX 61 1 Date of Inspection:L , — '� Name of Inspector: (please print) Wi 1 1 i am E_ • Robinson Sr. Company Name: William E. Robinson Septic Service Mailing Address: P O Box 10 8 9 Centerville, MA Telephone Number: (5 0 8) 7 7 5—8 7 7 6 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.1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: 42 ,a��✓/ ✓z— Date: //Zz—® 1 The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Heatth'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 ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of l 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS N SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 365 Scudder Ave_ - Hyannisnort Owner: Lyon G Date of Inspection:.,Z/;L—O Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. Sy fem Passes: V I have not found an information which indicates that an of the failure criteria described in 310 CMR y y 15.303 or in 310 ChM 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: A-eki So �,s B. S stem Conditionally Passes: One or more system components as described in the`.`Conditional Pass"section need to be replaced or repaire 1.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 expla' e septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unso d,exhibits substantial infiltration or exfiltration or tank failure is imminent System will pass inspection if the exist' g tank is replaced with a complying septic tank as approved by the Board of Health. •A etal 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 obs cted pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection if(with appr val of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND a plain: 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 xplain: II J Page 3 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 365 Scudder Ave. Hvannisport Owner: Lyons Date of Inspection: / — /2--a l C. urther Evaluation is Required by the Board of Health: onditions exist which require further evaluation by the Board of Health in order to determine if the system is failin to protect public health,safety or the environment. 1. S stem will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the sy tem 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. S, stem will fail unless the Board of Health(and Public Water Supplier,if any)determines that the syste 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 J urface 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 priv to water supply well**.Method used to determine distance **T,is system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bact ria and volatile organic compounds indicates that the well is free from pollution from that facility and the resence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other fail a criteria are triggered.A copy of the analysis must be attached to this form. 3. O her: 3 Page 4 of 11 ' OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 365 Scudder Ave. Hyannisport Owner: Lyons Date of Inspection:`—/ b D System Failure Criteria applicable to all systems:. Yo must indicate"yes"or"no"to each of the following for all inspections: Yes No _ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _ Liquid depth in cesspool is less than 6"below invert or available volume is less than''/:day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped Any portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone 1 of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is'less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] (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 in st indicate either"yes"or"no"to each of the following: (The f llowing criteria apply to large systems in addition to the criteria above) yes o 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 ave answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes" n Section D above the large system has failed.The owner or operator of any large system considered a signifi ant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 4 i Page 5 of l l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 365 Scudder Ave. Hyannisport Owner: Lyons Date of Inspection: Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes /No Pumping information was provided by the owner,occupant,or Board of Health ✓Were any of the system components pumped out in the previous two weeks? V Has the system received normal flows in the previous two week period? jz Have large volumes of water been introduced to the system recently or as part of this inspection? _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) 1 Was the facility or dwelling inspected for signs of sewage back up L/ — Was the site inspected for signs of break out? — Were all system components,excluding the SAS,located on site? (/ _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of th/e baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? L/ — Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no 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 15.302(3)(b)] 5 Page 6 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 365 Scudder Ave. ; Hyannisport Owner: Tryon G Date of Inspection: /—/,;--6 1 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 - Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: l 10 gpd x#of bedrooms): LSO Number of current residents: 3 Does residence have a garbage grinder(yes or no):/ Is laundry on a separate sewage system(yes or no):_ [if yes separate inspection required] Laundry system inspected(yes or no):�e Seasonal use:.(yes or no): /1., v Water meter readings,if available(last 2 years usage(gpd)): 1 9 9 9—0 0 102,750 gal. Sump pump(yes or no): A•O 1 9 9 8—9 9 90,000 g a-1. Last date of occupancy: 1 c, / COI MERCIALMiDUSTRIAL Type f establishment: Desig flow o (based on 310 CMR 15.203): gpd Basis design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industr al waste holding tank present(yes or no): Non-s itary waste discharged to the Title 5 system(yes or no):_ Water meter readings,if available: Last d to of occupancy/use: OTH R(describe): GENERAL INFORMATION Pumping Records Source of information: Jcp cj b Was system pumped as part of the inspection(yes or no):li_.O If yes, volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: TYP"F SYSTEM Septic tank,distribution box,soil absorption system _Single cesspool Overflow cesspool —ivy _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 V Were sewage odors detected when arriving at the site(yes or no):IL, D 6 i Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) . Property Address: 265 Scud.d.®rz Ave. Owner: T 17QZ Date of Inspection: B DING SEWER(locate on site plan) Dep below grade: Mate ials of construction:_cast iron _40 PVC_other(explain): Dis ce from private water supply well or suction line: Com6ents(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: (locate on site plan) o� 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) I ' e I , Dimensions: 7 Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: 0 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: (3 ►PC i-- T.6 '. < Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of.leak age,etc.): 1 .8 --dG GR SE TRAP:_(locate on site plan) Depth elow grade:_ Materia of construction:_concrete_metal_fiberglass_polyethylene_other (explain Dimensi ns: Scum th ckness: Distanc from top of scum to top of outlet tee or baffle: Distanc from bottom of scum to bottom of outlet tee or baffle: Date of ast pumping: Comme is(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as relat d to outlet invert,evidence of leakage,etc.): 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: 365 Scudder Ave. Hyannisport Owner: Lyons Date of Inspection:�-0�--� TI T or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Materi 1 of construction: concrete metal fiberglass_polyethylene other(explain): Dimen 'ons: Capaci gallons Design low: gallons/day Alarm I resent(yes or no): Alarm 1 vel: Alarm in working order(yes or no): Date o last pumping: Comm nts(condition of alarm and float switches,etc.): DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: n 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.): y� ;,ti I�IiCJ d off"U I9 6 V PU CHAMBER: (locate on site plan) Pumps in working order(yes or no): Al s in working order(yes or no): Co ents(note condition of pump chamber,condition of pumps and appurtenances,etc.): 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: 365 Scudder Ave. Hyannisport Owner: Lyons Date of Inspection: —O 1 SOIL ABSORPTION SYSTEM(SAS): G/{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: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding, damp soil,condition of vegetation, etc.): G�[>4,v CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet inve . _ Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PR (locate on site plan) Materi Is of construction: Dime sions: Dept of solids: Co ents(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Al 1 Page 10 of 1 I. OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 365 Scudder Ave. Hyannisport Owner: Lyons Date of Inspection./- 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. I '� n� L � - c 3g 3 9 a 30ry 0/ p Y A r 10 f Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 365 Scudder Ava, Hvannisport Owner: Lyons Date of Inspection: SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water i 3 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: .J Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: 11 TOWN OF BARNSTABLE LOCATION .3 G�� 41�0�;Vt A SEWAGE #01 VILLAGE /4 P l ASSESSOR'S MAP & LOT I 1 0 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACTTY,�� LEACHING FACILITY: (type) 2- 01 L (size) des —X ► NO.OF BEDROOMS .3 BUILDER OR OWNER PERMTTDATE: 1=11-6 / COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to e Bottom of Leaching Facility Feet Private Water Supply Welland Leac ' g Facility (If any wells exist on site or within 200 feet of leac ng facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by .�. 4 4 Q �� ` .. •. ((� W ��, 0 _`� �; ^4 ,.II'� �� r `1 � i\ c' � T `. r -�i �. x _ , 9 r^1` ` � A �� ��- t No. Fee i ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: N Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0(ppftcation for Mig;pog;ar *potent Construction Fermat Application for a Permit to Construct( )Repair( X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 365 Scudder Ave. , Hyannisport Jeff Lyons Assessor's Map/Parcel .� �3 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Servic P O Box 1089, Centerville Type of Building: Dwelling No.of Bedrooms 3 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 Title Size of Septic Tank Type of S.A.S. Description of Soil Sand Nature of Repairs or Alterations(Answer when applicable) Title-5 leach system on G i G t i n q of a heavy duty ( H 20 ) D-box and 2 H 20 chambers with stone all around 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 Certifi- cate of Compliance has been issu d bys B ard of He". Signed z /( � Date Application Approved by Date Application Disapproved for the following reasons Permit No Date Issued —————————————————-- -----— —-------- f TOWN OF BARNSTABLE LOCATION G�� L ��c L/ SEWAGE #01 — (� fGn 1 VILLAGE /� �/a...•.�s / ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. l?G�, 2 7, — 2-2, SEPTIC TANK CAPACITY LEACHING FACILITY: (type) a- (size) /2---X S- 2, Nn. nF RFr)RCW)M4 . 3 BUILDER OR OWNER PERMITDATE: /i/—a i COMPLIANCE DATE:/ —11—� Separation Distance Between the: Maximum Adjusted Groundwater Table toIRe Bottom of Leaching Facility Feet Pnvate Water Supply Well and L,eachang Facility (If any wells exist on 'site or within 200 feet of lea ng facility) Feet i Edge of Wetland and Leaching Facility (If any wetlands,exist Within 300 feet of leaching facility) Feet Furnis .: hed b ;. . Y : i I 1 - ' _S �7 ........... r No. _ Fe THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS Apphratton for �Dtgpogaf *pgtem Com5tructton Vermtt Application for a Permit to Construct( )Repair(X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's 34)5�a%rudder Ave. , Hyannisport Jeff Lyons Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Servic P 0 Box 1089F CAntmrVille Type of Building: Dwelling No.of Bedrooms 3 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 Title Size of Septic Tank Type of S.A.S. Description of Soil Sand i Nature of Repairs or Alterations(Answer when applicable) of a hAavv r3,itV u 20 D-box and 2 u 30—sh—mhlar= witla _tone all arrninrl 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 Certifi- cate,of Compliance has been issued by this Board of Healt Signed, Date !-11-6 / Application Approved by Date Application Disapproved for the following reasons _7 Permit No. 1: Date Issued --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS f , ; BARNSTABLE, MASSACHUSETTS Lyons Certiftcate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired (X )Upgraded( ) Abandoned( )by wm. E. Rab4413anL I ) at 36 5 S r•,1 3�a,- At o o /rya.,n; s p t ' has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ^ /I / dated Installer 1 Designer V 1 !� r The issuance oTthis pelt tqh g&'t co§isttted as a guarantee that the system,will function as-designedd; I 1 Date a / Inspector } fi,,l .� sh V I,� -V//" Al r --------------------------------------- No. — Fe THECOMMONWEALTH OF MASSACHUSETTS 28� �d°l3 PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Lyons lwtgpogal *pgtem Congtructton Vermtt Permission is hereby granted to Construct( )Repair(X )Upgrade( )Abandon( ) System located at , ti t 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 date of this ermit. Date: /�>�z�rn / Approved by 1161" NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CER'rMCATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WTTHOUT DESIGNED PLANS) -i, William E. Robinson,S�eby cenify that the application for disposal works construction permit signed by me dated ll 6 , , concerning the property located at 365 Scudder Ave. , Hyannisport meets ail.ofthe Mowing criteria: • The failed syste is connected to a residential dwelling only. There are no commercial or business uses associated th the dwelling. The soil is ed as CLASS I and the percolation rate is lass than or equal to 5 minutes per inch. There are no etlands within 100 feet of the proposed septic ktistem • There arc:no rivatc wells within 150 feet of the proposed septic system There is no increase in flow and/or change in use proposed • There no variances requested or needed. • The bo m of the proposed leaching facility will tgt be located less than five feet above the ma.,d tun adjusted groundwater table elevation: [Adjust the groundwater table using the Frimptor when applicable) • if e 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 informtion) B) G.W.Elevation +the MAX. Ifi G.W. . ' - _ gh adjustment DIFFERENCE BETWEEN A and B J, I SIGNED :-- ! ! ( d— DATE: C1 [Sketch proposed plan of system on back). +hearth folds.urn ' 4 7- � 4 b k 5:7 � o 5 5-7 ..�/�,,..o-.','-'y�c-' SE•Tv:�s-�yl� t>>,�,.,-�`..i�,�tt����iv�l�" ni C �w f � 1 I "O r- r 'I •r H 1 I d b -' 1 ,ur. w , � � ` , . � � . � � � � � . , � � � . � � I / � � / . . g � $ . � \ .:\ - a v August 24, 1999 Health Department U Hyannis, M Dear Sir/Madam, It is with regret that I again write this letter but it seems nothing is being done. When will the Health Department open their eyes and ride by the properties at 365 Scudder and 393 Scudder. What will it take for you to notice the unregistered vehicle at 365 Scudder located in the front yard;what will it take for you to notice the occupants of this house? That this house is zoned as a single family dwelling and yet individual rooms are being rented out to shady characters. In July occupants were tossing fire crackers in the street. Some passersby were complaining because the firecrackers were in front of their cars. What about 393 Scudder? Trash barrels are left out in the front of the property with the lid open and on hot,steamy days,trash odors can be smelled for at least'/z mile. What will it take for you to look into these properties before we're infested with rats? This is not a Section 8 community and we don't appreciate these slovenly people living like this. As tax payers we would like these areas looked into. Thank you. Concerned neighbors a DATE: _2/28/97 PROPERTY ADDRESS: 365 Scudder • Ave Hyannis ,Mass . 02601 On the above date, I Inspected the septic system at the above address. . This system consists of the following: 1 . 1 -1000 gallon septic tank. 2. 1 -Distribution box. 3 . 1 -4' precast leaching pit. 4. 3.- infiltrators.Packed in stone . Based on my Ins.-section, I certify the following conditions: 1 . This is-,a title five septic system. ( 78 Code ) 24_Th�e septic;'system` is `in-pr6per working ,order at the present time . 3 .-No repairs needed at the preserit' time . SIGNATURE: Name:-J . P. Macomber -Jr.. Company:_J. P_MacoMber & Son- 'Inc .. , Address:_-$eac-bb-----=1-- -- __Cente�rvil le . Mass__0.2.632 Phone:___548.175�3338_______ . t THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY 1 2 3 cV JOSEPH P. MACOMBER & SON, INC. Tanks-C*upools-Leachflelds Pumped & Installed )b,� 3 P.O. Box 66 Town Cewer nter illle nectonsMA102632-0066 ®, ti Ty �99J 775-3338 775-6412 F �I T i Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection WUUam F.Weld Trudy Cosa oa..rnor 8.�er.ry Argeo Paul Celluool David B.Struhs lL 1pf CaNTAslorw SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 3 6 5 Scudder Ave Hyannis ,Mass . Address of Owner.J a c k Williamson Date,of Inspection: (It different) 566 COMM A V E # 606 Name of Inspector. Boston,Mass . Company Name,Address and Tele hone Number. 02215 J.P.Macomber & Son Ipnc . Box 66 Centerville ,Mass . 02632 508-775-3338 CERTIFICATION STATEMENT I cartily that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate sad oomplate as of the time of inspection. The inspection was performed based on my training and exp"nos in the proper function and maintenance of on-site sewage disposal systems. The system: _ Coadiiioaally Passes _ Needs Further Evaluation By the Local Approving Authority —na Fails c �Inspector's Sigture / Date: The System Inspector&hall submit a copy of this inspection report to the Approving Authority within thirty(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 Department of Environmental Protection. The original should be sent to the system owner Ind copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: Check A, B, C,or D: A)—SYS PASS `— I have not found any information which indicates that the system violates any of the failure criteria su defined in 310 CUR 15.303, Any failure criteria not evaluated are indicated below. B) SYSTEM CONDITIONALLY PASSES: One or more system components used to be replaced or repaired. The system,upon completion of the replacement or repair, passes tasPedion. Indicate no, or not determined(Y,N,or ND). Describe basis of determination in all instances. If'not determined',explain why not) d� The septic tank is metal, cm ked, structurally unsound, shows substantial infiltration or ediltration,.or tank failure is imm)nsnt. The system will pass inspection if the existing septic tank is replaced with a ponforming septic tank as approved by the Board of Health. (revised 11/03/95) 1 One Winter Street a Boston,Massachusetts 02108 a FAX(617)sm-1W9 a Telephone(617)292•S500 Primed on Racycled Papa SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ' PART A CERTIFICATION(continued) Properq Adar.ee, 365 Scudder Ave Hyannis ,Mass . Owner. Jack Williamson Date of Iaspeotlon: 2/2 7/9 7 B)SYSTEM CONDITIONALLY PASSES(continued) ' Sewage backup or breakout or ho static water level observed in tba distribution box is dua to broken or obstructed pipes) or duo to a broken,settled or uneven distribution boa. The system will pass inspection if(with approval of the Board of Health): broken pipe(&)am replaced obstruction Is removed distribution boys is levelled or replaced The system required pumping more than four time&a year due to broken or obstructed pipe(s). The system will peas inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is romaved Cl FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTIL Conditions eiist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public bealih,safety and the eaviroament. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT. 4/0 Cesspool or privy is within 60 feet of a surface water Z)O Cesspool or privy is within 60 feet of a bordering vegetated wetland or a salt marsh 3) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALT'S AND SAFETY AND THE ENVIRONMENT. �Q The system has a septic tank and veil absorption system and is within 100 feet to a surface water supply or ui-butary to a surface water supply. The system has a septic tank and&oil absorption system and is within a Zone I of a public water supply well. NO The system has a septic tank and veil absorption system and is within 60 feet of a private water supply well The systam has a septic tank and*oil absorption system and is Ws than 100 feet but 60 feet or more from a private water supply wall,unless a well water analysis for coliform bacteria and volatile o Vu*compounds iadicatea that the wall is tree from pollution from that facility and the presence of ammonia,nitrogen and nitrate nitrogen is equal to or feu than 6 ppm 3) OTHER J � (revised 11103/95) Z C SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 365 Scudder Ave Hyannis ,Mass . Owner. Jack Williamson Date of Inspection: 2, 2 7/9 7 D) SYSTEM FAILS: • ,06 I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. ALV 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 "/�ati At t rNFi1,TrR7or4- 'D Liquid depth in eesspeel is Is"than 6"below invert or available volume is less than U2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped AW Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. j Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. A Any portion of a cesspool or privy is Is"than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analysed to be acceptable, attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. El LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: A-J''6 the system is within 400 feet of a surface drinking water supply —A W 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for Auther information.. (revised.11/03/95) 3 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Addrws: Jack Williamson Owner. 365 Scudder Ave Hyannis Mass . Date of Impeotlon: 2/2 7/9 7 s Check if the fallowing have been done: Pumping information was nquwW of the owner,oocupaat,and Board of Health. None of the system compona4ts have been pumped for at least two weeks and the system has been receiving normal now rate during that period. Large volumes of water have not been introduced into the system rsoantly or as past of this inspection. ZA,built places have been obtained and examined. Not@ if they are not available with N/A Y-41 fadlity or dwelling was inspected for suss of sewage back-up. ZThe system does not receive non-sanitary or industrial waste now kh@ site was inspected for signs of breakout. ZAAII system components �uu"the Soil Absorption System,have been located on the site. ZThs septic tank maaholss were uncovered,opened,sad the interior of the septic tank was Inspected for condition of baffles or tree,material of construction, dimensions, depth of liquid,depth of sludge,depth of scum ZTh@ size and location of the Soil Absorption System on the site has been determined based on a dstiag information or cep tad by aoa•intrualw methods. The fscs7ity owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub. Surface Disposal System. (revised 11/03/95) . 5 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Addre" 365 Scudder Ave Hyannis ,Mass . Owner. Jack Williamson Date of Inspeotiow 2/27/97 FLOW CONDITIONS RESIDENTIAL• Design flow- inns ,ems d4 y Number of bedrooms: Number of current reaidants: Garbage Vindar(yes or no):�` Laundry connected to system(yes or no):YL)� Seasonal use(yes or no): A)D Water meter readings,if available: 19 7 OK. Last data of occupancy:1 COMMERCIAL NDUSTRIA.0 Type of establishment: Design flow: n1& gallons/day Grease trap present: (yes or no) QLI Industrial Waste Holding Tank present: (yes or no). Non-sanitary waste discharged to the Title 5 system: (yes or no), ! h Water meter readings, if available:AA A Last date of occupancy: OTHER: (Describe) AM Last data of occupancy: A GENERAL INFORMATION PUMPING RECORDS and source of information: I/--15--9/ bLy e;r�/5,&t4 l System pumped as part of Inspection: (yes or no)A?2 If yes,volume pumped: 4W ons Reason for pumping. TYPE OF SYSTEM LiZeptic tank/distribution box/soil absorption system A/6 Singis owpool - Overilow oesspool Privy Shared system(yes or no) (if yes, attach previous inspection records, if any) Other(explain) APPRO)aMATE GE of all components, date installed(if known)and source of information /II�Il�/i''/Q�/II�S �iL' %�� t� Sewage odors detected when arriving at the site: (yea or no) (revised 11/03/95) 6 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C• • SYSTEM INFORMATION (continued) Property Address: 365 Scudder Ave Hyannis ,Mass . Owner: Jack Williamson Date of Inspection:2/27/97 SEPTIC TANK:,VVghg kA) '�'v'� (locate on site plan) /1 Depth below grade;_ material of construaion: Z/Concrete _metal _FRP _other(explain) Dimensions:_ 0'' Sludge depth: Al" If r r 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 bonom of scum to bottom of outlet tee or baffle._V6 Comments: (recommendation for pumping, condition of inlet and outlet tees or baffle. depth of liquid IPvel in relation to outlet invert, structural rity, evidence of leakage, etc.) Ptimp tank e r i uici[ ievei to outiet inver n is ruc ura sous a bows no signs of leakage : CREASE TRAP. /P/OA-L (locate on site plan) Depth below grade:.V4- material of const,rror%ion-A'--Ancrete _metal _FRP _other(explain) Dimensions. Scum thickness.XW Distance from top car scum to top of outlet tee or baHle:A112 Distance from bosom nt it„m In bonom of outlet tee or balue Comments. (recommendation for pumping, cond+r-^n of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage. etct.i Grease trap is not present I t:�v:sta siis�sst 6 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (000tinued) PropertyAddr•asu 365 Scudder Ave Hyannis ,Mass . Owner. Jack Williamson Dais of Inspootioas 2/27/97 TIGHT OR HOLDING TAN&&Z'P- (locale on g tw pL a) Depth below grade:t M+iarial of coastr%LcU :ANw=vta_,metal_FRP_otha(upILW - Dimansions: Capacity: 'VA nllous Dasip aow n4day ALrm ls"L- Commaata: (ooaditioa of inlet t",condition of aLrm and aaat switches, etc.) Tignt or noling tanks are- not present DISTRIBUTION Box, (locuu on site PILO Depth of liquid Iml above outlet invert: xll� Commaats: (nou if level and distributipa is eq*L evj 4=0 solids sae ys evidaaca of late or out of bar etc.) Distribution Dbox is leve o eVVi ence o s i s carry o o evidence of 17akage in or out of the box. No repairs nee7-7 a the jresent time . PUMP CHAMBER. (locate on siu pLa) Pumps in working ordar:(yes or ao) NA Commaau: (eau ooadition of pump chamber,ooad1t4oa of pump+ Lad appwunanow,etc.) Piim= chamhar is not present (revised 11/03/95) T f Cq SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Add:ees: 365 Scudder Ave Hyannis ,Mass . o.aer. Jack Williamson Date of Inspection:2/2 7/9 7 SOIL.ABSORPTION OYST8M (BA9k poosts cm sit*Plan,if Possible;ascavation act required,but may be approximated by acn•intrust"methods) If act determined to be present,explain: T)'PK Ohl pis,number.f 14+rh1ai chambers,number. �ti' 1�T/y4l�t^5 pndrw number: 1wn trenches,number,bagth: Is"Mr, Ulds,number,dimensions: overflow aeepool, number Comments: (not.condition of e4.t;as of hydraulic failure,level of pondunL,condition of veoft.tioa,ete.) failure : No level ol ponaing: Veg?.a ,ion is norms eac pl anr inrlitators are ury. TSn raria; rc nPPr3Pr3 at the present time CESSPOOL: (locate as site plan) Nambsr Lad conAguration:_ AA Depth-top of liquid to inlet invert: 44 Depth of solids later_ A Depth of scum Layer. Id A Dimeasioas of ouspoal M.ferials of constsucdon: InAkstion of pvuadw&tar. inflow(oeespool must be pumped u part of inspection) A - /U - Comments:(note condition of eoil, sagas of hydraulic failure,level of pondia& condition of vegetation, stc.) essU00 s are no PRIVY: (locate on site plea) Idatarials ad ooastruction. �/19 Dim.adons• /L°� Depth of solids:_ AM ' Comments:(not.eonditioa of soil,signs of hydraulic Ullure,level of pondin4,oonditioa of vegetation,-stc) Pr; Iry ; G not, present (revised 11/03/95). g �.�. eo,e/ ° 0 7LJ1!• C, p ° 50 P, t1J 00' JJ oo •] V t1 .1 ,.jo/ 4e ••+• ,0 I<O Jti 77 JO!-.t i CJ 00' ,00 00 l4 .7-400 or ♦' !!JS )Los' Io, 'Coco t 47 t � �Q , •L ♦� C�oo � ♦ �� J� \ J11 K 10!• ` Coco' 8 7500 / • r. /. i \ �18 Io oo' )LL/' edJ/• . 1L1o!•S N 4�i ^ 4 O g 57 e $ �L oo t Je�o/.8 . l7so/ . 1�1J o . • C roec"' :w+ . J'cf ' e u 8 o . 'S4 64 +� JaJ.Od.p!- ��� PI •t �/ Co ��1fn lj4i, , i �i2 f v ei3J/A'; 0000' /oa oo' 4 4 do o•r. JoJJ.'l5t JU od io"<• , O 8 J,o V li ON `�:�'� �lJb �� "08 71�'1. t's�f 43 ` 1 - �� T�•�i`r' crrr' �ja jo. � , v • %Pc. /o0 .,? poi,/4 1 f•a ter. 4 13 Asa,. ,. � �8 moo• ,e �,,�,� . CIO 14 Cb I/Y `•'J• 'L p�` / 1 .�j� C6 J•, po' i 11O cv i z i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION .FORM PART B • SYSTEM INFORMATION continued SKETCH OF SEWAGE L=SPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 1001 Hyannis Water Company 775--oo63 A �9 t y` DEPTH TO GROUNDWATER + depth to groundwater r+pth,od of determination or approximation: 1 yard. I >•n..nT�>-n rTt/�-1'T- .nraw•n.rw�-nR��itn>rr-.�+wtn�rTR*e.w.n nRwy.,nrwTun�T+ �1 TOWN OF Barnstable BOARD OF HEALTH j ,. SUIISH FACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D •- CERTIFICATION `� ��•T}7R"".'>-T.tiT.�.T.7T\,T,t:'nl',f.Tri nIRJR.IR'.ITT.T-!'IrItT11i11I�-7�./IRArIA'I�A.�IA'Af7 A� ..T'T'>-�. -..� -TYPE OR PRINT CI.EARLY- PROPERTY INSPECTED STREET ADDRESS 365 Scudder Ave Hyannis ,Mass . ASSESSORS MAP, BLOCK AND PARCEL _ R288-093 OWNER' s NAME Jack Williamson PART D - CERTIFICATION NAME OF INSPECTOR Joseph P.Macomber Jr. COMPANY NAME J.P.Macomber & S6fi 'Inc . COMPANY ADDRESS Box 66 Centerville ,Mass . 02632 Street Town or City State Lip COMPANY TELEPHONE (508 ) 775 - 3338 FAX ( 508 ) 790 - 1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true , accurate , and complete as of the time of .-inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one : QXXXXXXXXX.Systeui :PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public healLh or Lhe environment as defined in 310 CMR 15 - 303 , Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. System FAILED* The inspection which I have con lcted has found that the system fails to protect the public health and the environment in, accordance with Title 5 , 310 CMR 15 . 303, and as specifically noted on PART C - FAILURE CRITERIA of this inspection form , le Inspector Signature "�ilzDate 2/28/97 One copy of this certification must be provided to the OWNER, the BUYER ( where applicable ) and the BOARD OF IMAL'I'!1, * If the inspection FAILED, the owner or"'o` erator shall u P pgrade ' the system within one year of the date of the inspection , unless allowed or required otherwise as provided in 3.10 CHR 16 . 305 . partd .doc W V sb'hr 3r�1 THE COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION BE IT KNOWN THAT Joseph P. Macomber, Jr. Has satisfied the Department's qualifications as required and is hereby authorized to use the title CERTIFIED TITLE 5 SYSTEM INSPECTOR as provided in 310 CMR 15.340 and Section 13 of Chapter 21A of the General Laws. Issued by The Department of Environmental Protection. June 8. 1995 Acung Director of the ion of Water Pollution Control I Lipman, Drummond & Freeman Attorneys at Law 3180 Main Street { Barnstable, Massachusetts. Stephen I. Lipman* Tel: (508) 362.4700 Mailing Address: Tucker Drummond Fax: (508) 362.8281 P.O. Box 578 Peter L. Freeman Barnstable, MA 02630-0578 August .23,.,,C,1,996 Mr. Thomas A. McKean , Board of Health �. TOWN OF BARNSTABLE 41jo ® `, 367 Main Street 2 6 Hyannis, MA 02601 ate: 13,96 Re: 365 Scudder Avenue, Hyannis `k� Qompkv- John P. and Eunice R. Williamson Tenant: Marsha and Paul. Fisher Dear Mr. McKean: As a follow up to my letter to the Board of Health and request for hearing dated August 13, 1996, my client has visited the premises with an electrician and has remedied all matters that needed remedy. The specifics, with reference to the four alleged violations listed in your letter of July 23, 1996, are as follows: 105 CMR 410.351 (A) Toilet Flush/Bath Tub Drain The toilet-mechanism was viewed and operated several times and no malfunction was observed: The bath tub drains adequately. . A rubber plug has been supplied to retain water when desired. 105 CMR 410.500 Windows in Bathroom and Living Room Inoperative The windows were found to be sticky because the tenants had painted the sashes without- authority. Each window was freed up and' operated. Rear Door - Distance to .Frame Greater than 1/16 Inch The gap appeared ,to be` just about 1/16 inch. IF the concern is about heat loss, it should be noted that the landlord pays for heat. Storm Door Handle Missing/Door Close Mechanism Missing The door handle was replaced. The closer was never' missing. Also Admitted in Rhode Island and New York Boston Office: 21 Custom House Street, Boston, MA 02110-3500 Telephone: (617) 261-7800- Fax (617) 261-7878 Lipman, Drummond &. Freeman Mr. Thomas A. McKean - Board of Health TOWN, OF BARNSTABLE Page 2 August 23, 1996 105 CMR 410.351 - Smoke from Electric Stove The stove apparently needs a new thermostat and a repair was scheduled for August 16, 1996. However, the tenant refused to let Mr. Williamson in the apartment with the repairman. . Refrigerator Water Collects in Trays This is normal operation for this older model refrigerator. 105 CMR 410.481 - Owner' s Name Address and Telephone Number Not Posted This has been done. I am enclosing herewith a copy of a letter from' Nate' s Electric, Inc. , dated August . 14, 1996. , If you have any. further questions•, please give me a call. Very truly yours, PETER L. FREEMAN PLF:njm cc: Jack Williamson Thomas A. Lynch, ,Barnstable Housing Authority C:Williams.JB _ j 1 NATE'S ELECTRIC, INC. P.O. BOX 518 West Barnstable,MA 02668 Master Lic. #A7828 West Yarmouth 775-9309 West Barnstable 362-9345 Date `/ ,19 9 < 1 e 1 6?d �9-�/� '��-t c7 0 v �/13 A o r L-iE rl O,P51z 4>> VAl . USA Lipman, Drummond & Freeman - P.O. Box 578 -•� Barnstable, MA 02630-0578 �' P ' Mr. Thomas A. McKean Board of Health TOWN OF BARNSTABLE 367 Main Street Hyannis, MA 02601 t Town of Barnstable ` Health Department 367 Main Street, Hyannis, MA 02601 Office 508-790-6265 Thomas A. McKean FAX 508-775-3344 Sept m�ier of �ic Health John&Eunice Williamson 365 Scudder Avenue Hyannis, MA 02601 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY CODE II MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE,ARTICLE 51 The property owned by you located at 365 Scudder Ave., Hyannis was reinspected on September 3, 1996 by Edward Barry, Health Inspector for the Town of Barnstable because of a complaint. The following violations of the Town of Barnstable Rental Ordinance Article 51 and the Sanitary Code II were corrected: 410.351 A: The toilet now flushes when using handle. A bath tub stopper is now provided for the drain. 410.500: The windows in the bathroom and two in living room are no longer difficult to close. Rear door hole in bathroom panel was repaired. The storm door handle and the closing mechanism were replaced. 410.481: Sign displaying name, address, and telephone number of the owner is now posted on the front door. However, the following violations remain: 410.351: Stove oven thermostat not replaced. 410.351: Water still accumulates on bottom of refrigerator shelf. You are directed to correct these violations within seven (7) days of receipt of this notice as originally ordered in the certified letter to you dated July 23, 1996. PER ORDER OF THE BOARD OF HEALTH T mas A. McKean Director of Public Health cc: Marsha Fisher The Town of Barnstable °it 0`` Health Department ' out 367 Main Street, Hyannis, MA 02601 wa .e30. \A tY� Office 508-790-6265 Thomas A. McKean FAX 50b-j7PP344 Director of Public Health _NO_TICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY CODE I11 MINIMUM STANDARDS OF FITNESS FOR'HUMAN HABITATION The property owned by ou located at 3 4:!5 � 1 was A4 inspected on 4- j , ' 1994< by,* '�'J Health Inspector for the Town of Barnstable, because of/" a complaint. The following , violations of 105 CHR 410.00, State Sanitary Code II, Minimum` Standards of Fitness for Human Habitation were . ������ �C You are directed to correct these violations within twenty- four (24) hours of receipt of this notice. You are also directed to correct within days/hours 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 $500. Each separate day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health �' O w � � �� � � � s � �� � �� � <: ..17 348 659 884 Receipt for Certified Mail No Insurance Coverage Provided UNiTE�DSIMrS o not use for International Mail POSTAL WE ICE (See Reverse) a to 0) O) 7'u treat and No. tate an IP Co 00 Postage J M E Certified Fee O U U Special Delivery Fee u- 'I_ s�ricGeSICY�Sy Ede ! CJ urn-Flece pl-$howlr�9 fkf_s6;e� I S." to Whom&Date l elivered Return Receipt Showing to Whom, Dat�egy 6-Fadel see's Address OtostysO Fee j stll or Date I 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 E2 leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier(no extra charge). Q 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return rn address of the article,date,detach and retain the receipt,and mail the article. r 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 of ends if space permits:Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT i REQUESTED-adjacent to the number. 000 4. If you,want delivery restricted to the addressee,or to an authorized agent of the addressee, M 1 endorse RESTRICTED DELIVERY on the front of the article. o, 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If 0 return receipt is requested,check the applicable blocks in item 1 of Form 3811. a 6. Save this receipt and present it if you make inquiry. 105603-93-eo21e 1 TOWN OF BARNSTABLE LOCATIONS 4t'r SEWAGE # VILLAGE ASSESSOR'S MAP & LOTQ 0-O INSTALLER'S NAME& PHONE NO. j4G_, SEPTIC TANK CAPACITY -T LEACHING FACILITY:(type) (size) Kf) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No c.. - � i� `J� , � s-��� !z: r-• N.. �� ,�: � p �•S �,. L. � � - ` � �' s a �^ � Ste �� � / �� i/ � ip i� � S � � s ��. a •, 1 _.... r �OftHET��� The Town of Barnstable DsaaJTeDL I Department of Health, Safety and Environmental Services o 9�,�� Public Health Division 367 Main Street,Hyannis,MA 02601 Office 508-790-6265 Thomas A.McKean FAX 508-775-3344 Director of Public Health July 23, 1996 John and Unis Williamson 566 Commonwealth Ave. Room 606 Boston, MA 02215 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY CODE II MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE,ARTICLE 51 The property owned by you located at 365 Scudder Avenue, Hyannis was inspected on July 15, 1996 by Edward Barry, Health Inspector for the Town of Barnstable, because of a complaint. The following violations of the Town of Barnstable Rental Ordinance Article 51 and the Sanitary Code H were observed: 410.351 A : Toilet does not flush when using handle. Bathtub drain shut-off valve inoperative. 410.500: Windows in bathroom and living room inoperative to open or close; Rear door: distance between door frame and door greater than 1/16 inch; Storm door: handle missing, door close mechanism missing. 410.351: Excessive amounts of smoke observed when electric stove is turned on. Refrigerator water continually collects in bottom trays of unit. 410.481: No sign provided on building displaying name, address, and telephone number of the owner. You are directed to correct the violation of within twenty-four (24) hours of receipt of this notice. You are also directed to correct the remaining above listed violations within seven (7) days of receipt of this notice. r 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, this violation 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. You are also subject to.non criminal citations of$40.00 for the first violation and $15.00 for each additional violation. Tickets will be issued daily until the violations are corrected. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health cc: Marsha Fisher, tenant ��iM[l0 The Town of Barnstable .5 Health Department •uurran •�• 367 Main Street, Hyannis, MA 02601 Office 508-790-6265 _ 'Thomas A. McKean `= FAX 50b-j3344 Director of Public Health ,NOTICE-TO-ABATE VIOLATIONS .OF '1105 CMR 410.00, STATE SANITARY CODE II MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION �yy� ' The property owned by you located at ` ��d�-' was inspected on 'c. i /, -� �� , 1990 by, c�'1�1Zo ' Health Inspector „for the Town` of Barnstable,. because of a complaint. ' The following vioiat'ions, of" '105 CMR 410.00, State Sanitary Code II, Minimum Standards of Fitness for Human Habitation were observed: /4511',:rt1e* /'g �-'s l,`e�'"""vat r r�aor ; �rA45"4'�P , You are directed to correct these violations within twenty- four (24) hours of receipt of this notice. You are also directed to correct within days/hours 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 r_•- i 1 4 FORM30 HOBBSB WARREN,INC.NOV.1979-1983 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CITYrrOWN m , b DEPARTMENT w ADDRIfS6 ,�7 Q TELEPHONE r ` Addres �� d .p ✓ �� Occupant J&��V/1 ; 41 <" Floor Apartment No:Vf 4 No.of Occupants No.of Habitable Rooms 114, No.Sleeping Rooms No.dwelling or rooming units—_No.Stories Name and add �ryyess of owner � e� �2�r� .71..3- �4 6+ 44^ W Z—,4 ,y j�j Remarks Reg. Vlo. YARD Out Bld s.: Fences: f 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:VIA1.44 4A1.1 1AJ Obst' ,� : l Hall,Floor,WaM,Ceilin . r,rT�ti.e.i Hall Li htin �,W i Hall Windows HEATING Chimneys: f < � Central ❑Y ❑N Equip. Repair -Zgkf TYPE: Stacks, Flues,Vents: PLUMBING: Sty Eire: ,a j14 ❑ MS ❑ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s)'•c1f ELECTRICAL Panels, Meters,Cir.: C ' / f ❑ 110 ❑ 220 Fusing,Grnd.: 0.x .! AMP: Gen.Cond. Distrib. Box: ,, l'.�' Gen. Basement Wirin :/.` �Gf',� DWELLING UNIT A "�54y Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Lhrina 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 Facll. Vent.,Plumb.,Sanit'n.: Wash Basin Shower or Tub: Infestation Rats, Mice Roaches or Other: Egress Dual and Obst'n- General Building Posted T ge � 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 PENALTIE8�PERJURY." c INSPECT,R � �/-'' TITLE_� ���� `�/ Lei %�'y✓ ��t A.M. DATE / '.• /-�5�!'1s' TIME - 5 � P.M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may.endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of these items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.000 through 410.499 state minimum requirements of fitness for human habitation, any violation has the potential to fall within this category in any given situation but may not do so in every case and therefore cannot be included in this listing. Failure to include shall in no way be construed as.a determination that other violations may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of the violation(s) pursuant to 410 CMR 410.830 through 410.833 nor shall it affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 GMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shut-off and/or failure to restore electricity or gas. (D) Failure to supply the electrical facilities required by 105 CMR 410.250(B); 410.251(A), 410.253(A), 410.253(B) and the lighting in common area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage system in operable condition as required by 105 CMR 410.150(A)(1) and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by.an object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450 and 410.451. (H) Failure to comply with the security requirements of 105 CMR 4110.480(D). (I) Failure to comply with any provisions of 105 CMR 410.600 through 410.6.02 '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. (&) 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. W_ 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. I�..............w+....,r�..-..,—,�._-.....-..�...�..•••_ ,.J�..s';•'�-•-�"'ve.--��.-'..^t3--�'.w'.ra"".r."1:f�/`._✓+'-y.,t.r+-.�"h'^=�'�./""tS�"'"s"h-"'.el:rst.!'.....,.✓�T'�•.ra-^"- ,as r.r.. .., FORM3o Hoass&WARREN,INC.NOV.1979.1983 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 4-_j � CITY/TOWN W a DEPARTMENT ` ADDRESS TELEPHONE Address 3 kr [/ W.,,, 00 ., /l /V o'Occupant RAO�1- AF Floor Apartment No:2V 4 hl No.of Occupants J No.of Habitable Rooms .Lr No.Sleeping Rooms No.dwelling or rooming units No.Stories 0 ,� Name^and /address of ownerair � f/ /,4 ,z ;l f . WO 4�e—l_ � / Remarks Reg. Vic YARD Out Bld s.: Fences: r 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:U11 t q> �?�ir ,c1 ,�r rj` _ ,� , ,• Hall, Floor,Wat,Ceilin . , .� , � e� "-,o Hall Lighting .,►�rl -!Jlia' . T'T:.�- „A : , r r' Hall Windows. t*:Z A, HEATING Chimne s:7'�rr ' Al _ jo, J*14 4 Central ❑ Y ❑ N Equip. Repair TYPE: Stacks,Flues,Vents: PLUMBING: 5u . l=Line:e`,Q ❑ MS ❑ ST ❑ P Waste Line:r.3s3?' "?�Lr0 IA-1 �,.f h r/` rD Z p4, .,r=',_ ti_rj H.W.Tanks Safety and Vent(S) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑220 Fusing,Grnd.: A �' etc,ri' .� AMP: Gen.Cond. Distrib. Box:V,,4 r • ► —•.-'�►rt �A�irl -a . a �_ Gen. Basement Wiring:4,4. 4--p r l �y ", _ A r 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 Facll. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats,Mice Roaches or Other:: -Egress Dual and Obst'n: General Building Posted ,s f/�' ✓. ,, 10,6��mj 11 ez,i— / l 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 OF PERJURY." INSPECTOR- r✓";=a rff TITLE s / f` A.M. DATE / �-15 '' TIME / - /!� �`G�� P.M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of these items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.000 through 410.499 state minimum requirements of fitness for human habitation, any violation has the potential to fall within this category in any given situation but may not do so in every case and therefore cannot be included in this listing. Failure to include shall in no way be construed as.a determination that other violations may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of the violation(s) pursuant to 410 CMR 410.830 through 410.833 _ nor shall it affect the legal obligation of the person to whom the order isS 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 OIR 410.201 or, improper venting or use of a space-heater or water heater- as prohibited by 105 CMR 410.200(B) and 410.202. _ (C) Shut-off and/or failure to restore electricity or gas. (D) Failure to supply the electrical facilities required by 105 CMR 410.250(B); 410.251(A), 410.253(A), 410.253(B) and the lighting in common area required by 105 CMR 410.254. (E) Failure to provide-a safe supply of- water. (F) Failure to provide a toilet and-maintain a sewage system in operable condition as required by 105 CMR 410.150(A)(1) and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by an object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450 and-410.451. (R) Failure- to comply with the security requirements of 105 CMR 41'0.480(D). _ (I) Failure to comply with any provisions of 105 CMR 410.600 through 410.6.02 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, for 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. _ W 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 v - 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., (0 -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 410.5030). (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. ai SENDER: I also wish to receive the M ■Complete items 1 and/or 2 for additional services. y ■Complete items 3,4a,and 4b. following services(for an y ■Print your name and address on the reverse of this form so that we can return this extra fee): card to you. ai a Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address permit. d ■Write'Return Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery N r ■The Return Receipt will show to whom the article was delivered and the date a C delivered. Consult postmaster for fee. .E 0 v Arti le Addres ed to: 4a.Article NNumber d o 6Z � '� Cr V 7 u�� C� 4b.Service Type L ❑ Registered ® Certified fr rn N ❑ Express"Mail O�Insured 9 allN o ��� ❑ Returr'(Wceipt for Merchandise 1]_,COD a 7.Date off-Delivu 1 9 1g96 n;� Z OZ Z/ ria 5. celved By: riot Name) 8.Addressee;s Address(Only if quested c W and fee tq pa'd) r of . C t— g 6,Signature:(Addressee or Agent) a' ' X N Pq Form 3811, December 1994 Domestic Return Receipt UNITED STATES POSTAL SERVICE First-Class MailPostage&Fees Paid USPS Permit No.G-10 • Print your name, address, and ZIP Code in this box • I . I I I HOCNt'h Prupartment I TOWn of Barnstable I P 0. Box 534 j Hyannis,Massachusetts 0260, Fax(508)775-3344 1 Phone(508)790-6265 y Samatero ev=ntga UWnment 0 Not - �: -:= ` �t �... �k F�s....�....3....:0 /1t r TU.F' Cnn&MONWEALTH OF MASSACHUS TTS Signed UUA R® OF HEALTH TOWN OF BARNSTABLE ppliratiun for Diupuiial Morks Tomlrur tun ramit Application is hereby made for a Permit to Construct ( ) or Repair 4x ) an Individual Sewage Disposal System at: 365 Scudder Ave. Hyannis . ...............- --•-•• .................................................. _..•--------•--------------•..........-------•----------------•---•---•---------............--_... Location-Address or Lot No. Williamson ......................_.......................................................................... --•--------------._..........------...............---......_..--•---------•-----•--.......---•---- W J.P.Macomber Jr. Owner Address Installer Address d Type of Building Size Lot............................Sq. feet Dwelling X No. of Bedrooms........... ...............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ---------------------------------------------------------•---------•-•-------•-------•--•----••----------.....------•----------......---•--•--------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ G14 Test Pit No. 2................minutes per inch Depth of.Test Pit---:................ Depth to ground water........................ 04 ....___•..............................•____._._.____._.__________.___......------------......_............................................................... 0 Descri tion of Soil............ xand & Grave-l-----------------------------------------•--•---------------------------------------------------•---------------•--------------------•------------------- v --------------------•-----------•---------------.....---•--•-------•----------------•----•-•----------------------•--------------------•-----•--•----•------...............•------•----....------------ W ---•-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of 1-p1�Jr Alt tions—A sw �aq�on tank w -- --------------- - .... _ --------.n....a.._ ...... A-g-r- ............................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b26� issued by the board of health. Signed .. .... 11I27/91 !!// Date Application Approved By -------------------- ------ ------ - ----- 1.E- —� -.. •.�.-. 1-------- DaM Application Disapproved for the following reasons- ---------- -------------------------------- .............................---- --------------------------- ................... ---------------------------------------------------------........--- --------------------------------------- --------------------- ----------------------------------- ---- ------- ----------- ---------- ------------------. . �-• Dare PermitNo. ........................... Issued ........................................................ ... Date No,......... .. . ... i 3J.J� °� Fps............................_ THE COMMONWEALTH OF MASSACHU 5 TTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Disposal Works Tonstrurtiun ramit Application is hereby made for a Permit to Construct (100), or Repair 4X) an Individual Sewage Disposal System at: 3...1..3imiddPar....AtrP.ti...H1alMi-a-}.....--.............. .... - ..._........:............. e Location-Address or Lot No. idi1 1 i a ma-01?..... — ................. ................................................................................................ ... Owner Address W ' ..er........................ --------------- --•------------------------•-----------------.._`ddrere'fi - Inss ta s :-.-------•-------------------------------------------------- ll Ass Type of Building Size Lot............................Sq. feet aDwelling-X No. of Bedrooms...........� ___________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers. ( ) — Cafeteria ( ) Other fixtures ---------------------------------------------------•-- ----------------------------- W Design Flow............................................gallons per person per day. Total daily flow..................:.........................gallons. WSeptic Tank—Liquid-capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.� Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date------------------....--------- Test Pit No. 1-----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 "Test Pit No. 2................minutes per inch Depth of Test Pit.................•.. Depth to ground water.................... ' P -------------------------------------------------------•--------•--•-------------•-----•-------••--•......................................................... O Description of Soil = ------------------ ------------------------------------------- ----- v _>�4� & Gra:ve7 W x ••--••-----•-----------•---------•-----------•--------------------------------------•-••-•.--•---•-----••-•-------....--•-------------•....•--------••••••••---•------•----•-••......•--•---•-•-••.•••. U Nature of Repairs or Alterations—Answer when applicable___________________ o 1-1 J•.. allon tank - •-f1_ojzd Ue-5-©rsrl,(Ilr_f,J ,............................ -- Agreement: 4 The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. 5 4 t" P _ �w Signed--= `W �ee" :� ------_-------- --------1127 91._-._ r �1 Date Application Approved By ............... ------ - I!I-.a>..�P.� / ---.. �� ---- ------------------------------ I i Date Application Disapproved for the following reasons- ..............---------------------------- - ---- -- ------ -------------- - --- -------------------------------- --- .. ...... ................ ............... ....---------...----. ---...---- -------...---....------....----------- --- --.............---------. -- ........................................ Dare -- Permit No. ......... f-.'_. �r..Y�s Issued ------------------- ---- ------------------------------ Date t THE COMMONWEALTH OF MASSACHUSETTS , BOARD OF HEALTH TOWN OF BARNSTABLE C ertifirate of C�ontlalianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( -"}or Repaired (XX ) by......T.._P_4_ac_0mb.er Jr..................-------------------=-----...................................................----------------------------------------------------- ---------------------------------- ^^_ Installer at ----- F`....S.ud.de.r.---Aye.: Hya.-r nJ_.s........................................................--------------------` , has been installed in accordance with the provisions of TITLE_5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. .. ��/. � ..r�.... ........... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE UNCTION SATISFACTORY.SYSTEM WILL F �Y4. --...:DATE.. 1 ;----- -... Inspector ............ ............ II --- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 9� /l1 TOWN OF BARNSTABLE 3 No...:...............__ FEE...............'.... Disposal Works Cnunstr ion rrmit Permission is hereby granted........ _e-P.MaCOmber Jr........• ...•-----------------•••--••-••-•••---•---•.......-----...............---...... to Construct ( °)' or Repair (X� an Individual Sewage Disposal System at No. h .•Sr�zrrlear_.AvP...HV zln s' Street ?_ �'!� as shown on the application for Disposal Works Construction Permit No.77_ ._:...__.__Y.___.. Dated.......................................... ............................. r� pBoard of Health DATE..... - / J ......................................... FORM 36508 HOBBS&WARREN.INC..PUBLISHERS