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0149 SEABROOK ROAD - Health
149 Seabrook Road Hyannis _ A = 307 038 i i B F �I ill Date:QP//a TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: r ��G�12/n /'� 4?00 i° BUSINESS LOCATION: A'11Y, Feo- h00k qd 4Sdrt Wlr �• INVENTORY MAILING ADDRESS: 1J3 XQ- 7110VA-- P01 llpr4121( * 02SOI TOTAL AMOUNT: TELEPHONE NUMBER: YWI/ 32 791 003, CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: 7-',�' 3 2- ©d.9 , MSDS ON SITE? .TYPE OF BUSINESS: Awnr" INFORMATION / RECOMMENDA IONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) r Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED - Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes. Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture.strippers may be toxic or hazardous(please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Sig at re Staff's Initials I! Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149-153 Seabrook Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 12-17-14 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. General Information 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 , Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification , I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 12-17-14 Inspector's Signature ;Date The system inspector shall submit,a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design.flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ""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. System is in good working order and is under order from the town to be connected to town sewer. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149-153 Seabrook Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 12-17-14 page. City/Town State Zip Code Date of Inspection B. Certification (cost.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: System is in good working order with no sign of failure. B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally F unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Pace 2 of 17 Commonwealth of Massachusetts = W Title 5. Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 149-153 Seabrook Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is r required for every Hyannis MA 02601 12-17-14 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipes) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N' ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ 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 ❑ Y- ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ' ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments GM , 149-153 Seabrook Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 12-17-14 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts T F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments I ' �M 149-153 Seabrook Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is requ e for every H annis MA 02601 12-17-14 ird y page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No , ± 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. El ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. i ❑ ® 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. } ❑ E Any portion of a'cesspool or privy is less than 100 feet but greater than 50 feet 4 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 fecal coliform bacteria indicates absent 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 and chain.of custody must be attached to this form.] The system is a cesspool serving a facility with a design flow of 2000gpd- ❑ ® , 10,000gpd. 'The system fails. I have determined that one or more of the above failure 1 E:], ® criteria exist as described in 310 CMR 15.303,therefore the system fails. The j r system owner should contact the Board of Health to determine what will be ! necessary to correct the failure. i 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. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. I Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply t ❑ ❑ 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. El El Area IWPA) or a mapped Zone II of a public water supply well i If,you have answered "yes"to any question,in Section;E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed.The owner or operator of any large ' system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 MR 15.304. The system owner should contact the appropriate Ire gional office of the Department. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 4 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 149-153 Seabrook Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 12-17-14 page. City/Town State Zip Code Date of Inspection C. Checklist 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? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as Cuilt plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ 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 the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ 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: ® ❑ 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(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins•3t13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form A Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �qM 149-153 Seabrook Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1.800-966-2448) Owner Owner's Name information is annis MA 02601 12-17-14 required for every H Y - page. City/Town State Zip Code Date of Inspection D. System Information Description: i ikk • I j Number of current residents: Does residence have a arba•a grinder? Yes No 9 9 9 ❑ Is`laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No S Ieasonal use? ❑ Yes ® No ' Water meter readings, if available (last2 years usage (gpd)): ` r Detail tr S'mp Pump? , . ❑ Yes ® No 20 Last date•of occupancy: t Date { Ca mmercialAndustrial Flow Conditions: Type of Establishment:' Y# Design flow(based on 310 CMR 16.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): G ease trap present?; ❑ Yes T-1 No Industrial waste holdingtank resent?<_ ❑ Yes ❑•a No P Non-sanitary waste discharged to the Title 5 system? l Yes No I ry • g Y • y ❑ � Water meter readings, if available: t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 7 of 17. � I Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149-153 Seabrook Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 12-17-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: N/A Was system pumped as pa-t of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system i ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/alternative technology.Attach a copy of the current operation and maintenance contract to be obtained from system owner and a co of latest ( Y ) copy e t inspection of the I/A system by system operator under contract ❑ Tight tank..Attach a copy of the DEP approval. ❑ Other(describe): t5ins-3f13 Title 5 Official Inspection Form:Subsurface Sewage Cisposal System-Page 8 of 17 it 4J Commonwealth of Massachusetts 1 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149-153 Seabrook Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is Hyannis MA 02601 12-17-14 required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2005 I i Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 1 36" Depth below grade: feet Material of construction: i ® cast iron ® 40 PVC ❑ other,(explain): Distance from.private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.):. Good condition. i I Septic Tank(locate on site plan): 30" Depth below grade: feet I Material of construction: i ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) I If tank is metal, list age: years Is!age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gal 12„ Sludge depth: t5ins-3113 Tdle 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 I A Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 149-153 Seabrook Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 12-17-14 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 20" Scum thickness 2" Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign of leakage. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Dale t5ins•W3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 I Commonwealth of Massachusetts = W Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 149-153 Seabrook Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is for every Hy annis required MA ` M 02601, - 12-17-14 r page. City/Town State Zip,Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and,outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding"Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: concrete. ❑ metal ❑ fiberglass. ❑ polyethylene ❑ other(explain): t t Dimensions: Capacity: gallons r Design Flow: f gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No ' Date of last pumping: M Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No t5ins-3t13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 99 Commonwealth of Massachusetts Title 5 official Inspection Fora _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 149-153 Seabrook Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 12-17-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert .0 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.): Good condition with water at working level and no sign of back-up from field. Pump Chamber(locate on site plan): Pumps in working order: Yes No* P 9 ❑ ❑ Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are no=_in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts - T W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 149-153 Seabrook Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 12-17-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: , {❑ leaching pits number: ® leaching chambers number: 5-Infiltrators ❑ leaching galleries number: ❑ leaching trenches number, length: I , ❑ leaching fields number, dimensions: 10 overflow cesspool number: �❑ innovative/alternative system . Type/name of technology: E Comments (note condition of soil, signs of hydraulic failure, level-of ponding, damp soil, condition of vegetation, etc.): Infiltrator leach field was emtpy at inspection with no sign of back-up into d-box or surrounding stone. I ' i I i 1 I .. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration t - Depth—top of liquid to inlet invert Do pth.of solids layer Depth of scum layer i Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-3113 Title 5 Official Inspecfion Form:Subsurface Sewage Disposal System-Page 13 of 17 t I Commonwealth of Massachusetts w Title 5 Official Inspection Fort Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 149-153 Seabrook Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 12-17-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note-condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 149-153 Seabrook Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 12-17-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view 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. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately 4 �- /V �. �� ca l - F t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 149-153 Seabrook Rd Property Address Bank Owned (Contact David Halt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 12-17-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12 feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, dale of design plan reviewed: Date ® 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: Original design plans show no groundwater at 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts r Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 149-153 Seabrook Rd Property Address Bank Owned (Contact David Holt @ Today.Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 12-17-14 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file J t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 t UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 ' Sender. Please print your name, address, and ZIP+4 in this box• I I Town of Barnstable Health Division f 200 Main Street Hyannis,MA 02601 ii (t 1 tt ttt J j1 11 yy [[ yy f�ta1!la�a�l+�aa��!!!er!1�!�!rl�i!!!�ia!all�e�l'�i!7f�!Ir!IIJ!i W Irn mplete items 1,2,and 3.Also complete 7.e 4 if Restricted Delivery is desired. ❑Agent nt your name and address on the reverse ❑Addressee that we can return the card to you. Name) C. Date of Delivery ach this card to the back of the mailpiece,on the front if space permits. r D. Is delivery address different from item 17 ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No r 11 Cd"W'rk Dr.. h' �`' jj��� g �- "=ServicdypeE, 1'A IMG�TYIr6��1 �v�� 3� ed Mail ❑Express Mail ❑Redistered Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7 0 0 6 8�1 Q, 7 00 3525 0120 (F sfer ' <�. I6 Retum Receipt 102595-02-M-1540 Ip I ru r=l I . _ • Ln . �,. � ,'� ` I m Postage o Q Certified Fee A�iis p Retum Recelpt.Fee Here ' (Endorsement Required) ao O Restricted Delivery Fee r9 (Endorsement Required) ASPS to � M Total Postage&Fees $ J° f p Sent To (.----� ---.------1!_ey---- --•--- ------ Stn et,Apt.No or PO Box No. •Z �% city,war"+4 G�S3 Certified Mail Provides: asiana z Zo uii oJSa a A mailing receipt f � 4, o' +o A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years Important Reminders: 4 Certified Mail may,ONLY be combined with First-Class Maile or Priority Maile. o Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. Il Foran additio�ia��fee;;e Retum Receipt may be requested to provide proof of delivery.To nil Retiim Receipt seance,please complete and attach a Retum Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt s required..- t i For an additional fee delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailplece with the endorsement"Restricted`Delivery". a If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry.. Internet access to delivery Information is not available on mail addressed to APOs and FPOs. • i Certified Mail#7006 0810 0000.3525 0120 `oar Town of Barnstable Regulatory Services t RARNSTAUM Thomas F. Geiler, Director �; Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 1 Mr. Lawrence Kelley August 16, 2007 21 F Chilmark Dr. Falmouth, XilA 02536 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II J TOWN MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE OWN OFIBARNSTABLE CODE CHAPTER 170. The property owned by you located at 149 Seabrook Road,Hyannis,was inspected on June 27, 2007, by David W. Stanton R.S., Health Inspector for the Town of Barnstable because of a complaint. The following violations of the State Sanitary Code were observed: 105 CMR 4i10.300: Sanitary Drainage System Required: A four bedroom septic system is present at said locatiioon er septic permit 2005-047. 6 bedrooms total were observed in the dwelling units. L 105 CMR 410.482: Smoke detectors: Operational Carbon Monoxide detectors were not present on every habitable floor of the dwelling units. 105 CMR 410.450: Means of Egress: Adequate egress was not provided in the basement bedroom of the Eastern unit per the Massachusetts State Building Code. The code re�ds specifically: 11105 CMR 410.450: Means of Egress: Every dwelling unit, and rooming unit shall have as many meansf of exit as will allow for the safe passage of all people in accordance with 780 CMR 104.0, 105.1 and 805.0 of the.Massachusetts State Building Code." i �vb However, it is noted that the correct reference to the Massachusetts State Building Code for egress is 780 CMR 102, 103, and 1010. Ste\ It is noted that the Building Inspector issued an exit order for the basement bedroom without adequate egress on the Eastern unit at the conclusion of the complaint.investigation on 6/27/07. i� The following violation of the Town,of Barnstable Code was observed: j 170-4 of the Town of Barnstable Code: Owner's Responsibility to Register Rental Units. These units are not currentl registered with the Town of Barnstable Health Division. Q:\Order letters\H i using violations\149 Seabrook Road.doc You are ordered to correct the violations listed above within Thirty(30) days of your receipt of this notice by restoring the property back to four (4) bedrooms total or by upgrading the septic system to the appropriate number of bedrooms present with any and all necessary building and\or septic permits, by ensuring that each habitable floor has working smoke and carbon monoxide detectors and by registering the rental units with the Town of Barnstable Health Division. Enclosed is a rental registration application for your convenience. You may request a hearing before the Board of Health if written petition requesting same is received. Non-compliance will result in a fine of$100.00 per violation and\or a criminal complaints being filed against you. Each days failure to comply with an order shall constitute a separate violation. PER ORDER OF THE BOA . OF HEALTH Thomas A. McKean, R.S. Director of Public Health Town of Barnstable QA Order letters\Housing violations\149 Seabrook Road.doc i ~� FORM 30 �—W HOBBS&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS �H& OARD OF HEALTH CITY/TOWN a DEPARTMENT ADD SS �{� 06Z— g64fq M sv¢so (D "I ` TELEPHONE Address `� S` 2oau- ��0%&_Occupant 1n0 Floor �/' Apartment No. No.of Occupants No.of Habitable Rooms No.Sleeping Rooms No,dwelling or rooming units No.Stories i Nam�Ae and address of owner w Remarks Reg. Vio. YARD Out Bld s.: Fences;: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimne BASEMENT Gen.Sanitation: Dampness: Stairs: Lighting: STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Su ply Line: ❑ MS ❑ ST P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAV Panels, Meters,Cir.: El110 ❑ 2Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 G Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Stacks, Flues,Ven ,SalefieN. Kitchen Facilities Sink Stove Bathing,Toilet Facil. Vent.,7 um anit n.: Wash Basin,Shower or Tub.- Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Cs S Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH UI 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 &PERJUR ' INSPECTOR 4 TITLE r'`S (Z. > Q� A.M. DATE G© 07 r/ TIME �'� J� P.M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions,when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to e-idanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. =ailure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold,to meet the ordinary needs of the occupant in accordance with 105 CMR 41C.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash,which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, turns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, i-)sect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the 'iealth 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. �,o. -,,.... r-- _...- -•..,.gym..- .,,....,x,.,� �,,,.r.'.,�}.�•,,T„r�»�,�..n,,,,Ae�,:�,�..^,.N,.,•.....,,,;„,�,,,"mt,s , FORM 30 &W HOBBS&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r ca/Ln.. SZP►��. CITY/TOWN DEPARTMENT ADDRESS (.77j45) TELEPHONE Address _,%"Occupan I'A$;N d I.W Floor' !s^" Apartment No. -�- No.of Occupants No.of Habitable Rooms_r No.Sleeping Rooms_ No.dwelling or rooming units No.Stories Name and address of owner Aw t2 R►�G tl? . �`'(kA N t.1 15,.# _(��'p�#•?R '= Remarks Reg. Vio. YARD i , Out Bld-s:: Fences: Garbage and,,Rubbish Containers:- Drainage - ` Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F . ❑ M Door`s,Windows: Roof. Gutters, Drains: Walls: t Foundation: i /T ' Chimney: : CT I I �-1 BASEMENT Gen.Sanitation: � S it ;Hess: r t w tai i STRUCTURE INT./// Hall,Stairway:' 0bst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: 1 - Hall Windows: HEATING Chimneys: Central-�❑_Y .N,- E ui :-Re air TYP E: � Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST/ P f Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir:: ❑ 110 ❑ 220 Fusin ,Grnd.: AMP: Gen.Cond. Distrib. Box;•, - /t Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors' -Floors Locks Kitchen r Bathroom (' , Pantrys 1 Den Living Room 1 Bedroom 1 L-10 cl, Bedroom 2 Q / Bedroom 3 r` Bedroom 4 "v r Hot Water Facil. Su .-Ten-;Gas,Oi1-E4ect.: Stacks, Flues,Ven s,Sa etie Kitchen Facilities `Sink ` Stove Bathing,Toilet Facil. Vent., Plumb S`a`n t"n._ Wash Basin,Shower or Tub.- Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH 1{ 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 PERJUFtY�' ". INSPECTOR TITLE f"AIC401Z w� n A.M. DATE h fD r TIME G. I 1101' P.M. a TA ' A.M. THE NEXT.SCHEDULED REINSPECTION A l• P.M. vj ' 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 cr persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash,which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower-or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. .THE T[y v , # 'J «rmn'J3 uatnh Town of Barnstable _ • Public Health-Division f 200 Main Street CUR £' �Fo +° Hyannis,MA 02601600OC 9-2 4 `,` 01- NOV MAILED FROM zip dG 0260 7006 0810 0000_3524 _6789 Lawrence Kelley4 / '9 "ram Seabrook Road Hyannis, MA. 02601 m _ N xxC-: RETURN TO SENbER UNCLAIMED UNABLE TO FORWARD - :'. 0280104eef lil,j„:I:III„II�����JI�I��III,,,IIt>>:�I�III���II����l►GI �- i SENbER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature ,11 < item 4 if Restricted Delivery is desired. ❑Agent X ❑Addressee c Print your name and address on the reverse so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery ® Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No 3. Service Type /ftCertified Mail ❑ Express Mail ❑ Registered XReturn Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number i I (Transfer from service label) 7006 0 810 0000 3524 6789 _ 1 PS Form 3811,August 2001 Domestic Return Receipt 102595-01-M-0381 QOA II o- . ru F d rJ 1 J m Postage $ c . ( 6p1` 0 Certified Fee � ► 65 (� erk p Retum Receipt.Fee ' C) Here In (Endorsement Required) p ;" q p Restricted Delivery Fee rl (Endorsement Required) �y co ) p Total Postage&Fees $ ► 1 p Sent To tti Sfreet,:ApCNo ' or PO Box No. . City, e,ZIP+ YY1 G 1 -•-•----•..:--•. •-.•-------• d3� . A $ ,r rr Certified Mail Provides: --au)z0oz eunr'ooes two-4 sd a Amailing receipt a A unique identifier for your mailpiece a A record of delivery kept by the Postal Service for two years Important Reminders: a Certified Mail may ONLY be combined with First-Class Maile or Priority Mai:®. a Certified Mail is not available for any class of international mail. a NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. et For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt seance,pease complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailplece'Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a LISPS®postmark on your Certified Mail receipt is required, a For an.additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpieoe with the endorsement"RestdctedDeiivery". • If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information Is not available on mail addressed to APOs and Ms. oFIME t Barnstable Town of Barnstable MlAmWcaCft �wA9B Board of Health Q `"200•Main'Street,Hyannis MA 02601, 2007 fjf`'U. ';ti�.'`q v�1:�s Ya�'c;td.:: ;•73,4T'% .`aA..�. t.J.i•'q> �a..'i_'u - - - ' Office=a5,0 8- 4644 oc r, prf ? z v a.,r , .4 L�tr�r, Wayne Miller,M.D. FAX, 508 790 6304 -- ' w r. .._ Paul Canniff,D.M.D. '4'C s y�. °� '# ,. .,`YZ,? � •� F�' +t,s.. Junichi Sawayanagi ` , - Lawrence Kelley j, ' t November 1, 2007 149 Seabrook Road Hyannis; MA. 02601 NOTICE TO ABATE VIOLATION OF THE TOWN OF BARNSTABLE 0 060-20'(I) - The property owned by you located at 149-153 Seabrook Road, Hyannis, MA_ was in'specfed on'0etober 27, 2007. by Donald Desmarais RS, Health Inspector for the Town of Barnstable"because of a complaint regarding overcrowding. The following violation of the Town of Barnstable On-Site Sewage Disposal Systems Ordinance, §360, was observed: I 20.'(I): Criteria for Determining System Repair or Replacement There were a ;ttotal?.offive bedrooms observed in the dwelling (four bedrooms upstairs (total) and one i bedroom downstairs (left side). However, the existing septic system was designed for four(4) bedrooms total only- are,ordered to remove one'(1)'bedr6om from dwelling by removing the bed 'immat ediely upon your receipt of this-letter. 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 the issuance of non-criminal ticket citations of$100.00 each. PER ORDER OF THE BOARD OF HEALTH Thomas A.McKean Director of Public Health Q/health/order letters/149 Seabrook l Donald na 'Id R. esmarais, R.S.Health inspector Town of Barnstable Department of Regulatory Services I. �f0 AApV a PUBLIC HEALTH DIVISION Office Hours: 200 Main Street, Hyannis, MA 02601 Tel:(508)862-4644 8:00-9:30 Daily Fax: (508) 790-6304 3'30-4:30 Daily Email:donald.desmarais@town.barnstable.ma.usk.• _ 'd FORM30 C.gw HOBBS&WARREN TM THE COMMONWEALTH,OFMASSACHUSETTS BOARD OF H. ALTH CITY/TOWN a L.DEPARTMENT ADDRESS 1M Sye"e [,� TE PHONE Address_ i t — Occupant fjllis� Floor Apartment No. No. of Occupants No.of Habitable Rooms_ 5 No.Sleeping Rooms / No.dwelling or rooming units_ No.Sto ies Name and address of owner `1 0� —1 1 Remarks Reg. Vio, YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress: and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: _ Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N E ui . Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room 61) Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: s, Flues,Vents afeties: Kitchen Facilities jikve Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION R O IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJ R " INSPECTOR TITLE DATEI TIME oP. A.M. THE NEXT SCHEDULED REINSPECTION P.M. i 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises,shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises.This listing is composed of those items which are deemed to always have the potential_o endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such vio ation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress it case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure-o maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain incorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or Condit ons: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. FORM 30 C&W HOBBS 8 WARREN TM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CITY/TOWN ' e, o DEPARTMENT ADDRESS '1M SyOyO TELEPHONE Address. Y""`� — Occupant— :; _... Floor—Apartment N�o. No. of Occupants_ No.of Habitable Rooms No.Sleeping Rooms r --- No.dwelling or rooming units_ No.Stories i Name and address of owner � . ,._f .7 `�t yb J Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: µ Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ii ❑ B ❑ F ❑ M Doors,Windows: , Roof 's i Gutters, Drains: t k :► Walls: Yk `V Foundation: _ Chimney: BASEMENT Gen.Sanitation: �•..., Dampness: Stairs: - � Li htin : T) STRUCTURE INT. Hall,Stairway: , fw C ' Obst'n.: I If P Hall, Floor,Wall,Ceiling: Hall Lighting: t Hall Windows: HEATING Chimneys: - Central ❑Y ❑ N E ui . Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: f H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: !� DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom I Pantry Den Living Room i tso f jL Bedroom(1), 40 f(- Bedroom 2 i Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.: Sucks, Flues,Vents,,Safeties: Kitchen Facilities ,Sink, i it Sto e Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: , General Building Posted ., ;( Locks on Doors: is 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 f �' .'` ! TITLE "' `% k, "" 4 A.M. DATE th� v, TIME f ��. s A.M. THE NEXT SCHEDULED REINSPECTION P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety 9 P Y The following conditions,when found to exist in residential premises,shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises.This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. . tovm oF, BARNSTABL. B U1LCAt�E ., Y`✓t n, S t��Sfv550Tt'S tVI/� '& Ih�S'1'fh�L.Et�'.z i�1Atltlf 23t p bitE N®. UACIIlNG:)E+,kirry' : OYtaa) RO St'�r�rat�attP+�agt#tgsrc;'�cttvteettSTAa ,; e, ,, Nlnxtnum Asljusf�d Gtaumclwat�t'!'nbia to tlac�rnf.'at�a!X.raulttn,�I�aciUty .�-.� ��� I'tiva2�q�Jtzt r�;ul�`iEy-VI �l.v��c ca�;h�reg C 1crUty . guy eve l4s ux(st pt�9 c�t�BntG �;wltJhsn 20A f T},) 1?d :cj�VV�it9anrl cutl I,eac6tit► �aflity(Y acty tvct�and5 exis¢. r+i1Sf��cd. 10(1 fret t teaL&') ng tmrlltry) 776' ". R � .�, �; � � v't � U� _ � v °Q � � � G � � n n � �� � LJ � v � n-� TOWN OF BARNSTABLE Y LOCATION ! ��� e-cc 1011d0k 'kJd SEWAGE # Zoo. - oy -7 VILLAGE I 1� f2 t4 kk ( ,5 ASSESSOR'S MAP & LOT ®3 7-03k INSTALLER'S NAME&PHONE NO. /�C`� �4'2St ? I SEPTIC TANK CAPACITY l?f LEACHING FACILITY: (type) I`'� t z✓/5v7 E' (size) .� NO..OFBEDROOMS F3UILDER OR OWNER PERMITDATE: 2- COMPLIANCE DATE: '-�'3-0S' Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by i - CV� � Q Z�s C- No. d�� V ! / Fee roy • THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 4e�s PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Zipplication for �Digaal *pztem Cow6truction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot Noe--(,b ra D ,,�vC Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tell.No. Designer's Name,Address and Tel.No. /3 J.Gia .0vi,A PVt&S®,;-\ Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building e.g' No.of Persons Showers( ) Cafeteria( ) Other Fixturees� Design Flow `''q® gallons per day. Calculated daily flow �a gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. i ' !J ^� a�er r . Description of Soil -e. Cj,kx 3Gl- 2 S7 Nature of Repairs or Alterations(Answer when applicable) 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 at not to place the system in operation until a Certifi- cate of Compliance has been issued boy this.Board of Health. _ Signed Date - .ApplicationApprovedby ti`� Date Application Disapproved for the f lowing reasons Permit No. 9 UO S = (��� Date Issued a--,;> No. r Fee /00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for �Digpogal 6pgtem CCongtructton Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. ` u( ra 0 Owner's Name,Address and Tel.No. Assessor's Map/Parcel Q`� SA e Q kAl) Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 0�1 Lot Size sq.ft. Garbage Grinder Other Type of Building 9 r'S No. of Persons Showers( ) Cafeteria( ) Other Fixtures / Design Flow '7 0 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets 2 Revision Date Title I� ' Size of Septic Tank J Type of S.A.S. `5 i / rU U w� I T�l� 014 f Description of Soil 1/ a to 3� Nature of Repairs or Alterations(Answer when applicable) 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 iss�ue�d-b-� this Board of Health.. Signed// a J Date ` - -Application Approved by. i Date _ Application Disapproved for the folllowing reasons Permit No. ?oo,5 ' OLI-7 Date Issued 2 `oS THE COMMONWEALTH OF MASSACHUSETTS • - BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( ) Repaired (X) Upgraded ( ) Abando Geed( )by at V! '��'b moo . ai`+A'1 i,C has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. GU S'"U`�7 dated a- a -o-S r Installer 19 2 G X r -- 5 4> Designer n The issuance of this permit shall not be construed as a guarantee that the system w ll fundio"n as des Date + S-D�- Inspector ' / ��✓N� �r. Q -- -------------------------- i No. o q? Fee l oo THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS lwigpogal 6pgtem CCongtruction Vermit Permission is hereby granted to Construct( )�epair�S,X)Upgrade( )Abandon( ) System located at ' 44 Qro U/< J? 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 thh: perniit.J1J Date:_ a 0 S_ Approved by Town of•Barnstable RegahteYY so-vices, --- Thomas F der'Dun"r Public Bealth DiviSWR ' _ t 'Fhomas,McKea ,Ui eetor tix- 2A0Main street,-yam MA 02601 Fax: 508-790-6304_ Office: 508-862-4644 _ V installer& Designer Certification idY`• fzC Date: _ �. � Installer: ,�c�h Designer: •� ���` �l�'! LL � .il Address: Address: was issued a permit to install a Qnn�- 3-o2bQ_� (installer) (date). - b wn y septic system at bad ion a d��' ce ''v'g AWW j dated - (designear) referenced above` installed substantially according to I certify that the septic systegnthe design-wbich May include mmor approved such as lateral relocation of the didn'buion box andlor septic tML installed with Major changes (i.e. I comfy tha the � m ief above was on of airy component than IG, lateral relocation of the SAS or any vertical relocaRi smater accordance wilh State&Lnca1 Reg om- Plan revision or ocf�fied a.5-bac�by designerto llow- f+t s Sigma) gner:s:Stamg Hjue) DiR'1'IFI4:ATE pI„EASt RE1'tJRN B,ARNSIV PUI><I�C.'TODIV[ � tenuwr eNn AS- o� �oMela�►rlc� B u un c� S-Al.zsD>�nrssoN. BUILT �� " • - TZIAI�YOU. Q:HealttJSeptidUesiper Certification Pom► a TABLE //TOWN OF,BAR�JNS LOCATION c��) Q rord0k �CQ� SEWAGE I, :Zoo.-- off( -7 ` VILLAGE IL_Tl a e'- � l S ASSESSOR'S MAP & LOT 3®1n0 INSTALLER'§NAME&PHONE NO. /eC ? 7, SEPTIC TANK CAPACITY S'd LEACHING FACILITY: (type) S r''� Z+//5 7�ts7 a (size) l f '( 14 NO.OF BEDROOMS BUILDER OR OWNER Sh�e{•N•► PERMTIDATE: ��`�' COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge,of Wetland and Leaching Facility(If any wetlands exist f within 300 feet of leaching facility) Feet Furnished by < I 4 " i I I f I i } 1 I 4 i i .�, TOWN OF BARNSTABLE /Ul LOCATION � '/�3 �� tad C /4. SEWAGE# /3 VILLAGE ASSESSOR'S ASSESSOR'S MAP & LOT 36`7_ 0,32 INSTALLER'S NAME & PHONE NO. A. & B CANCO 775-6264 T SEPTIC TANK CAPACITY MG / LEACHING FACILITY:(type) (size) b)e 4 NO. OF BEDROOMS__y PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER ___9 DATE PERMIT ISSUED: �� l �� DATE COMPLIANCE ISSUED: " VARIANCE GRANTED: Yes No �"� Z � O i A� O_ n Y No... Fss..... �......... THE COMMONWEALTH OF MASSACHUSETTS } BOARD OF HEALTH Barnsr�. U C)ouH Uepd isle'tOWN OF BARNSTABLE n® e' r i��pag al Wi ur1w Towitrnr#inn Permit Application is hereby made for a Permit to Construct ( ) .or Repair (LjXan Individual Sewage Disposal System at: S l �� 4O I' ---------- ruation-:address o Lot No. ..i,n•�A-IV �4 h1 !2 C1� o rncr E A ress Installer Address UType of Building ��.// r t Size Lot............................Sq. feet Dwelling— No. of Bedrooms------------- ...Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building _-------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) 04 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........................................ aTest Pit No. I................minutes per inch Depth of Test Pit...........-........ Depth to ground water........................ GZ4 Test Pit No. 2................minutes per inch Depth of Test-Pit.................... Depth to ground water........................ ------------------------------------------------------•-----------•-••--............---•-----•--•---......................................................... ODescription of Soil......................................................................................................................................................................... W U Nature of Repairs or Alterations—Answer when applicable.-__ ./4..__._.._.�........... �_..............__....-.t._a......... .......... •------------------•------------------------•---•---------------------......------------------......---------------------------•--------------•-•------...-•---- 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 h een issued bylpe board of health. Signed ........... .. - ------ ...... ... . ............. ......(S...`�..)...:7... .3. Date ApplicationApproved By ....... ... ......... ........ ... .. ... ..... .............. .......... ...............................:..... ................ ................. Date Application Disapproved for the following reasons: . ........................................................................................................................... ......... ... ... ... .. ----------------------------------------------------------- *.......... ..... . .......... Date Permit No. - ----------- Issued .................: Dare No.. 05 ........... ......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE ppliratiodfor Diriputial Works Towitrurtiou Prrutit Application is hereby made for a Permit to Cotisti-LiCt ) .or Repair (VKan Individual Sewage Disposal System at: r ...- 57 ........N3 ....... . .................. ......217, .................... 0 Ljt (Xk�cation-:ddress L., No PCA.....................................,............................................................ T Z .t....... U Owner Adll,ess ...........74-.&......zhn.C6................................................... ....3a1 ...... ..... ...... ................ Zt .. ......... Installer Address Type of Building Size Lot............................Sq. feet U Garbage Grinder Dwelling— No. of Bedrooms----_------y-----/)_V;D(9_X.,.__Expansion Attic a -Other—Type of Building ............................ No. of persons__............_............. Showers Cafeteria Otherfixtures ------------------------- ---------------------------------------------------------- ................................................................. Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 04 Septic Tank—Liquid capacity............gallons Length---------------- Width--_.__...--.---_ Diameter._.-.--_.--_.._ Depth_............... Disposal Trench—No. .................... Width_.__......_......... Total Length._....__._.......... Total leaching area....................sq. f t. Seepage Pit No--------------------- Diameter----.---.-..._.__--. Depth below inlet_..._._............. Total leaching area..................sq. f t. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-------- ................................................................. Date........................................ Test Pit No. I.... -----------minutesperinch Depth of Test Pit._._..___..._....... Depth to ground water..__........_........... (Zq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......_......._......... 9 ............................................................................................................................................................. 0 Description of Soil................. ..................................................................................................................................................... W *,*--*-----------------*-------------------------------------------------------------------------------------------------------------------------*-------------------------------*--------------- ................................................................................................... ..................................................L--5-------------------------i--------f...... U Nature of Repairs or Alterations—Answer when applicable- ----- ......A............. ...........7........................................................................ ........................................................................................ 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 Compliant has been *issued b,"the board of health. Signed ...........e;K .1-------------- I....... ............ ......(a......I......1..3... Due Application Approved By ....... ..---.........-Date..........:....... te Application Disapproved for the following reasons: ........................................................................................................................................ .................................... ---------- ....................................................................................................... ........................................ Dam Issued ................................................................... Permit No. ................. Due ——————---———— THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Tomplianre THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed or Repaired ( by.................... ................A-/1 ......... ....... I----------------........................ ................................................................................... ................... ..... - Inst.d1c, at --- --------------_5 44-1-6.01A---------- A--------------- . - .. .. ....................................... .................. ...... ----- -------.... *-----------.- .. has been installed in accordance with the provisions of TITI �] Thh, .5.r,;t �Ep,.�irental Code as described in iron the application for Disposal Works Construction Permit I . ... dated ........ ............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CON TRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................._Ll.-.1�... ..................... ................... ---------- Inspector ................. ...... ------------------------------------- --- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No.�� �J�-- ..... .... FEE._...................... Workii TUonotrudion V"ermit Permission is hereby granted ................................................................................ ......... ...... to Construct or Repair ----a-n-----Individual Sewage Disposal System - -----------1 -!/-........... ------------------------------------------------ Street at No.....NA------ ............... ......QA..:....... .......... as shown on the applicati n for Disposal Works Construction it ,-, WXD-',,—tel(,__ .,... T) t-1d, re ................ --- ..... Board_of alt_h ------------- ........ ---- DATE............6.2177 'P / I /.....?...*------------------------------------------ FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS 1 No......--..81�. 2-� FE$....$... ........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...Town.............oF........Barnstable irtttgnn for Uti niial Workii Tnnitrnr#inn ramit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: . � 15-9t156 Seabrook Rd. , _Hyannis, MA 02601 ...----.... ------------------- --••...._...._......-•-.........--•------------...................-•-------..................•. Location.Address or Lot No. Kenneth Quinlan 70 Grasmere St. , Newton, MA 02158 -------------••-----------.........--------------...--•---------------.........-------------•--.. ..••----••-•-----._................------............. W A & B Cesspool Service, 128 Bishops Terrace, yannis, MA 02601 � Installer Address Q Type of Building Size Lot-•-__---------------------Sq. feet a. Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type of Building ............................ No. of persons........... .............. Showers ( ) — Cafeteria ( ) a' 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 ( ) I Dosing tank ( ) Percolation Test Results Performed by.----------------------.................................................. Date........................................ ,.a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.........._............. rZ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 •------------------------------ •--- •--------------- •------- •---------------------------------------- -...--.-.-------------•-------•.... -•-------------------- 0 Description of Soil--•-••••Sand....................................................................................................... x UW ..............._----------------------------------------------------------------------------_-------------------------------............................................................................ Nature of Repairs or Alterations—Answer when applicable.____installati -- a , -_. - , ... ._-rato - stone..I?acked._leach__pit.--aver..low.,- ----------------------------•-- - --- -------•--------•---------- - Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'THE, y g g p y 5 of the State Sanitary Code— The undersigned further rees not to lace the system in operation until a Certificate of Compliance has be i tied by the bo• o alth. / /Y Signed--? IN = t'c t.a c. e ........6/151 ------------ ate/ Application Approved By--•-•.....l i - (--- ...---•--.........-••-•---- 6 15J81 .... Date ......... Application Disapproved for the following reasons_____________________________________________________________ ... .....................................................................................--............................ ---------••-------•-----------•--------••-----------•-............---•- Date Permit No..81-...................................................... Issued------•---•-6�15181--•---•------------------- Date No.......... 1=-S 2.8 Fmc $....5.,00......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................T-own..............O F........Barnstable.... Appliration for Di-qV.anal Workfi Tomitrnstiun rrntit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: i 3+156 Seabrook Rd., Hyannis, MA 02601 ..........-•-•_•---•••••-•.....----•----••-•................. ...........•------•----•-------••-----•--•----•I-,-�-.....--•-••-•----...._.......---•---•---------•. Kenneth Quinlan Location Address 1�f lwon' MA 02158 Qu 70 Grasmere St., , W A & B Cesspool Service;r 128 Bishops Terrace, 'ff+annis, MA 02601 Installer Address Q Type of Building Size Lot----------------------------Sq. feet aDwelling—No. of Bedrooms............................... .___.Expansion SAttic ( ) Garbage Grinder ( ) p, Other—Type of Building ____________________________ No. of persons................_----------- Showers ( ) — Cafeteria ( ) a' 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 ( ) aPercolation Test Results Performed by.................................................................•----•-• Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water_-__-._-_____-__-___---- Gi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------___-_-_______-_--- P4 ..................................................................................................................•........................................ 0 Description of Soil--- Sand-•----....= x W ............................................-........................................................................................................................................................... U Nature of Repairs or Alteration —Answer when applicable.__.-installation.-of__a. 1�000 11en1 pz!8-oast stone packed leach pit l overfloFr)...................•-___._._____ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T I T L. y g g p y 5 of the State Sanitary Code—The undersigned further agrees not to lace the system in operation until a Certificate of Compliance hasAbn ' sued by the bo' ealth. / Sined ----- � ------------ .................`.s......... Application Approved By_._._._.;,�,.� %./�!..._. _ 6/ �a?/�1 ------------------------------------- ---------------------- ---------•-•--- Date Application Disapproved for the following reasons---------------------------------------------------------------------------------•---------......_.._......------ ......---•--•-•-----•--------•--•----•--•••--•-•••---••••---....••--•-•--•-•-••---•----------•---•-•-••-------•--------•---•-•-----•- •----•--••-•--------------------••••---•--.........•----••-•••--- Date PermitNo.81---•--------------------•.--•- ------------_.... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........................................OF.......Barnstable......................................................I...................... %T rtifi at of (��rnt�r�tnnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (X ) by A & B Cesspool Service, 128 Bishops Terrace,_ Hyannis, M.A 02601 53 + 156 Seabrook Rd., Hyannis, 1`A,A � � Kenneth Quinlan at -••-••. -••--••• •-•----- -••••--- -•--•--- ---•---- -------• --••---• ---- . ••--••-• --•-- has been installed in accordance with the provisions of TU`"LE j of The State Sanitary Code as clescribed in the application for Disposal Works Construction Permit No.--"1'. - '_________________ dated_......_6t. 50----------_............. THE ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE:.---6/15/81.......................................................................... Inspector------ •.j ' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 81- ..�e' G ........................'...oW21.......OF. Barnstable................-----.............................. $ 5 00 No..---•---••••........._.. FEE....................•-.. Binpnial Morks T-Fnnntr ion rantit Permission is hereby granted.._..__.A_4_.B Cesspool Service a 128 Bishops Ter., Hyannis 02601 to Constr (+ r Repair ( Xl an Individual Sewage Disposal System lj �5g Seabrook Rd., Hyannis 026gb1 — Kenneth Quinlan at No ----------- -•--•••.................. Street / as shown on the application for Disposal Works Construction Permit No.81-............. D�ted.6!-ZS181 DATE6/15/81 of Health ---------- FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS O C A T ION I�� SEWAGE PERMIT -,N0• /S 3 t )5-� �- VILLAGE -�v7/03 g INSTA LLER':S NAME D ADDRESS ; BUILDER OR OVA DATE PERMIT ISSUED DAT E` COMPLIANCE ISSUED � ��� � 0 0 z. 7- `a ro � � G`— w00,)> lbo" Qa� sr. ASSESSORS MAP: c3_o _ _ TEST HOLE LOGS 1 �p NOTES: PARCEL : � moo._. ._-- ,- - � / ;__ _ _-__- ___ _ _ SO I L EVALUATOR:�)q V/z> VS. IY'��� OG �l FLOOD ZONE: T � UC'g�L�- - I WITNESS : �b`T� -DPP �C�I ®C, U REFERENCE: CD.� 6—mie- 9�8�, 1� ' �� DATE:��A-4 04VI / ZO 1) The installation shall comply with Title V and Town of Barnstable Board of � Health Regulations. PERCOLATION \RAT 2) The installer shall verify the location of utilities, sewer inverts and septic 00 V� � components prior to installation. i TH- 1 TH-2 3) All gravity septic piping to be 4 inch Sch 40 PVC at 1/8"per foot. - --- ----- - -- Lo 4) This plan is not to be utilized for property line determination nor any other I 7 >3 � purpose other than the proposed system installation. meet Z '� 6r IA�1 MfW� 5) All septic components must meet Title V specifications. 6) Parking shall not be constructed over H10 septic components. j r l �� , (�Q p�(� 7) The property is bounded by property corners and property lines as depicted. LOCATION MAP 8) The property owner shall review design considerations to approve of total design flow to be considered for design. Receipt of payment for the plan and G • /j ! installation based on the plan shall be deemed approval of the design flow. 1 ! 9) The existing leaching system shall be pumped and backfilled per Title V '4,1 1 1,71 b Abandonment Procedures. 10)System components to be 10 feet from water line. The property owner is responsible for relocating all water services that are discovered or damaged I I during construction. k � q 11)Units with garbage grinders are to have the garbage grinders removed. i 2 12)Unsuitable material encountered during the installation are to be removed for I S E P T I (: SYSTEM DES I G N 5 feet around and down to elevation 14.75 and replaced with clean washed sand per Title V specs. 1 � FLOW ESTIMATE ' BEDROOMS AT OO GAL/DAY/BEDROOM - b GAL/DAY jSEPTIC TANK Q ( dt—, GAL/DAY x 2 DAYS - GAL ID,� - _..- USE /tOOGALLON SEPTIC TANK �r,�(I M► w .. SOIL kB ORPT I ON SYSTEM UH I 5 NZ !�► �a 1Va l.�'�4 iZs 1-77 SIDE AREA: Z'X- vet. 25 +- 10 183 XZX 7 - - 'DV S C7 BOTTOM AREA: 6 . Z, v E>--;:, X, EPT I C SYSTEM SECT 1 ON > 5 \\` �Z wlyl ' 4-...•: w ;' .,�F..,,A. .ya -, i+0 ...... .R XGY..n 't:.'•,'- ..`'. h'fa hi �rI�� /� ,.VV �TS ,M �C �p [� - 3Zo a 1 -66iA t�ddGAL SEPTIC TANKS_- +7 .�WE., 07 I Axe / 31t 2-15x191 83 '----;t=i 3 , t *tjsl!� YFr(1, SITE AND SEWAGE PLAN LOCATION : a PREPARED FOR 0 7 SCALE:ce Ce DAV I D B . MASON R5 DATE: 5 DBC ENVIRONMEOAL DESIGNS DATE SANDWICH . MA ATE HEALTH AGENT ( 508 ) 833- 2177