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0057 THIRD AVENUE (HYANNIS) - Health
57 Third Avenue Hyannis P " A = 246 103003 I �. I i k Certified Mail#7006 2150 0002 1041 9389 Town of Barnstable Regulatory Services > BARN%-TABLE, ` MASS. Thomas F. Geiler,Director MAMA Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 May 9, 2008 Bill Watson 5 Fawn Road Westford, MA 01886 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II — MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you located at 57 Third Avenue, West Hyannisport, was inspected on May 8, 2008 by Jaime Cabot, Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of a complaint. The following violations of the State Sanitary Code were observed: 105 CMR 410.482=Smoke Detectors No carbon monoxide detector in the downstairs bedroom. You are directed.to correct the violations listed above within twenty-four (24) hours of your receipt of this notice by adding a carbon monoxide detector in the downstairs bedroom. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of $100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the above violations, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. PER ORDER OF E BOARD OF HEALTH v s A. McKean, R.S., CHO QAOrder letters\Housing violations\Rental ordinance\57 Third Avenue.doc l FORM30 C&W HoeesaWARREN'" THE COMMONWEALTH OF MASSACHU'SETTS BOARD OF HEALTH ti 7 M 14,C_ CITY/TOW N o DEPARTMENT ' ADD ESS 4�M S By`eW TELEPHONE Address 7 TA/,ps0 -4 VG .; r ccupant_ Floor Apartmetlt No. No%f Occupants CG, No.of Habitable Rooms--(401—No.Sleeping Rooms No.dwelling or rooming units_ No.Stories Z- Name and address of owner '4„w r�^ �c;�_�,�.Q-r SON �19 WAJ IZO Q 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: tl Walls: Foundation: Chimney: R BASEMENT Gen.Sanitation: Dampness: d Stairs: Lighting: q16 q&2 STRUCTURE INT. Hall,Stair wa © ® A l Obst'n.: ,� Hall, Floor,Wall, Ceiling: 0C-, -9 12; 5090 Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. 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 Livinq Room Bedroom 1 �® Bedroom 2 f O Bedroom 3 Bedroom 4 6 Hot Water Facil. S Gas, Oil, Elect.: Stacks, F es,Ven afeties: Kitchen Facilities Sink 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 1 C3 vS Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES PERJURY , INSPECTOR TITLE rl ZA U_117^( 1kJS _rwt_ DATE TIME _2- : ®O P.M. A.M. THE NEXT SCHEDULED REINSPECTION- g - p M COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS b DEPARTMENT OF ENVIRONMENTAL PROTECTION RECEIVED MAY 0 S 2003 TITLE 5 TOWN OF BA RI ABLE OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY HEALTH KEPT. SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: , �r)J o /J7i¢ DoL6�� LlZ0 Owner's Name: o ✓'? y �, Owner's Address: r GI�i�O Date of Inspection: Name of Inspector: (please print) G� p MAP Company Name: PARCEL . (p3o 3 )vl:uling Address: D p( 6 � LOT 3 Art'! • let Telephone Number: — CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP' approved system inspector pursuant to�Sectioa 15.340 of Title 5 (310 CiINIR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: p The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) «ithin 30 days of completing this inspection. <f 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 authoritv. Notes and Comments ""*"This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Page 2 of I l OFFICIAL INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address. /— �//►r Q Ah•9is o.� Z O�d 7oC Owner: :P7 Date of Inspection: Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A- S cm Pauses: ,V I have not found any information which indicates that any of the failure criteria described in 310 CNM 15.303 or in 310 CNIR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. S/yytem Conditionally Passes: /VOne or more system components as described in the"Conditional Pass'section need to be relaced or repaired.The System, upon completion of the replacement or repair,as approved by the Board of Health, will pass. Answer yes, no or not determined(Y,N,ND) in the for the follo%'Ving statements. If not determined" please The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is inuninent. System%%ill 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 leak-ina and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution bo.x due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipc(s). The systcm «ill pass inspection if(«ith approval of the Board of Health): broken pipe(s)arc replaced obstruction is removed ND explain: Padc 3 of 1 I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A /CER/TIFICATIO�i (continued) Property Address: T {'lI rG9G �'4- 09-6 7d, Owner: el- Date of Inspection: a O C. Further Evaluation is Required by the Board of Health: ZConditions exist which require further evaluation by the Board of Health in order to determine if the s1-stem is failing to protect public health safety or the environment. I. System will pass unless Board of Health determines in accordance with 310 CivfR 15.303(1)(b) that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or pricy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. — The system has a septic tank and SAS and the SAS is %vithin a Zone 1 of a public water supple. _ The system has a septic tank and SAS and the SAS is «ithin 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 pprn- provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3• Other: Page 4 of I l OFFICLkL INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: Owner• I"Givr Date of Inspection: aZa D. System Failure Criteria applicable to all systems: You must indicate"yes" or"no" to each of the following for all inactions: Yes No acicup 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 t/ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or _ �,,,,-cesspool tquid depth in cesspool is less than 6"below invert or available volume is less than V..day flow Required pumping more than 4 dmes in the last year NOT due to clogged or obstructed pipe(s).Number — /of times pumped �y portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface st'hter supply or tributary to a surface ,/1'%vater supply. : v portion of a cesspool or privy is within a Zone 1 of a public well. y portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, p,.rformc DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates t::,., :ne well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria arc triggered. A copy of the analysis must be attached to this form.] (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 3 10 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. La be Systems: To be considered a large systerr the system must sene a facility with a design flow of 10,000 gpd to 15,00l) gpd• c You must indicate either"yes" or'-no** to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no _ the S,stem is within 400 fe---t of a surface dririldng water supply _ — the system is within 200 feet of a tributary to a surface drinking water supply _ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes" to any question in Section E the system is considered a significant threat- or answered "yes" in Section D above the IL,_-e system has failed The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. Page S of 11 OFFICLkL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEIt INSPECTION FORM PART B �7�j CHECKLIST J / Property Address: TAI✓`J Owner: �N Date of Inspection: (, 7 Check if the following have been done. You must indicate`ves" or"no" as to each of the following: Ye No _ Pumping information was provided by the owner, occupant, or Board of Health _ Were any of the system components pumped out in the precious two weeks v Has the system received normal flows in the previous two week period v Have large volumes of water been introduced to the system recently or as part of this inspection v — Were as built plans of the system obtained and examined? (If th ,were not available r / e5' note as N/A) V 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 maintenance of subsurface sewage disposal systems on the proper The size and location of the Soil Absorption System (SAS) on the site has been determined based on: Yes no Existing information. For example,a plan at the Board of Health- Determined in the field(if any of the failure criteria related to Part C is at issue approximauon of distance is unacceptable) (310 CMR 15.302(3)(b)I Page 6 of 11 OFFICIAL INSPECTION FORNI- NOT FOR VOLUNTARY ASSESSMENTS : SUBSURFACE SEWAGE DISPOSAL SYSTENI INSPECTION FORM PART C SYSTEM INFORNIATION Property Address: r�i�� fire, ggOwner- eta Date of Inspection: O RES>DENTIAL W CONDITIONS Number of bedrooms(design): Number of bedrooms(actual): Lf DESIGN flow based on 310 Ch 15.203 (for example: 110 gpd x K of bedrooms): Z Number of current residents: / _ Does residence have a garbage grinder(yes or no): /P-O Is laundry on a separate sewage system 4ve-s or no):,�fX(if yes separate inspection required] Laundry system inspected(yes or no): Nam/ Seasonal use: (yes or no):/YO Water meter readings, if available(last 2 years usage(gpd)): SumP Pump(yes or no): /li4 Last date of occupancy: ctlr COMBIERCIAL/IND USTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgftetc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):— Non-sanitary waste discharged to the Title 5 system(yes or no): — Water meter readings,if available: Last date of occupancy/use: OTIIIER cx): GENERAL INFOPUNIATION Pumping Records Source of information: /10 J C1 111,S J- -� C%x-!S_-EJ (,✓k1p Was system pumped as part of the inspection(yes or If yes, volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: TYPSYSTEMoptic tank,distribution box, soil absorption system Single cesspool Overflow cesspool -ivy Shared system (yes or no) (if yes, attach previous inspection records, if anv) _Innovative/Alternative technology. Attach a copy of the current operation and maintenance contra(to be obtained from system owner)' _Tight tank _Attach a copy of the DEP approval Other(describe): Approximate age of all components, date insta e(' mown)and source of i ormation: 0 Were sewage odors detected when arriving at*he site(yes or no):,11�6 Page 7 of I I OFFICIAL INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: !r e n�+Is elV/ „� ,s W / 6 � Owner: ��,; Date of Inspection: BUILDING SEWER(locate on site plan) Depth below grade: c Materials of construction: cast iron _ 0 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage, etc.): SEPTIC TANK: (locate on site plan) Depth below grade: // /l Material of construction; concrete_metal fiberglass_polyethylene _other(explain) — If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: Sludge depth: Distance from top of qj dge to bottom of outlet tee or baffle: �O Scum thickness: Distance from top of scum to top of outlet tee or baffle: _ Distance from bottom of scum to botto�j 99f outlet tee�f r baffle: /o �J How were dimensions determined: MCI K�Al �ve, 7e ' Comments (on pumping recommendations, inlet and odUct tee or baffle condition, structural integrity, liquid levels as aced to outlet invert,evideace of leakage,et .): _ / y''y �n �o h �� �'� •- its �i•^-�e. l G�-.� �h of �,,� GREASE TRAP• (locate on site plan) Depth below grade:— Material of construction:_concrete_metal fiberglass_polyethylene other (explain): — — Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments (on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): Page 8 of l 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEINI INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: �/ /'J Owner: /'gam. e / ,� e%L �01 Date of Inspection: 04� TIGHT or HOLD LNG TANK:,jZ(t,ank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass_polyethylene other(explain): Dimensions: Capacity: goon Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in worldng order(yes or no): Date of last pumping: Comments (condition of alarm and float switches,etc.): DISTRLBG tiuY LO`;: (if present must be o n pe ed)(locate on site plan) Depth of liquid level abo%_ .. invert: ��d�Ot / Comments(note if box is Ic%cl a;;d distribution to outlets 'equal,anv e�zdence of solids carryover,any evidence of _ le �e into or out of�ox,et .): Gt/ PUMP CHA,IBER:' eoocate on site plan) Pumps in working order(ycs or no): Alarms in working order(yes or no): Comments (note condition of pump chamber,condition of pumps and appurtenances.etc.): Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTENI INSPECTION FORM PART C SYSTEM LNFORtvIATION(continued) Property Address: /tee' G1/e Owner: ��, Date of Inspection: p SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located e..Vlain why: TOP, yp leaching pits,number.�. leaching chambers, number: leaching galleries,number: leaching trenches, number,length: leaching fields,number,dimensions: overflow cesspool, number: innovative/altetnztive system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding,damp soil,condition of vegetation etc.): �c3 N i C CESSPOOLS: cesspool must be pumped as rti P Pe part of inspec:t09 Ocate on site plan) Numbcr and configuration: }- Depth—top of liquid to inlet invert: uepcn of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: i Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure, level of ponding condition of vegetation, etc.): te on site PRIVY:"(, an)Pl Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation,etc.): OFFICIAL LNSPECTION FORM — NOT FOR VOLUNTARY ASSESSlfENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORtN1 PART C SYSTEM LYFORINIATION (continued) Property Address: Owner: Date of Inspection: ofa► SKETCH OF SEWAGE DISPOSAL.SYSTEiv1 Provide a sketch of the sewage disposal system including ties to at least two permanent referent; landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. L4 Soo T�in� C,O(6 JL 0, /�� �. Its ��- 3r,) = W Page I l of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS •, SUBSURFACE SEWAGE DISPOSAL SYSTEIN1 INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: a Owner. c1a Date of Inspection: 3 SITE EXA,NI scope Surface water Check cellar Shallow wells Estimated depth to ground water/3tiSfeet Please indicate(check) all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked date of design plan re-vlewcd: 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 databasc-explain: You st describe how ou established the high ground wateer elevatii(J Ya o ��, Mo: lONNcJii�'fCr ICCo cam , ' of O eC� i Oct'-, -0F s above h, ti mtin '„r .Q To of .�Cle � p O O °'� ��� �^ t BOOo 09 \ r P F o oOff`r D O 0 0 � G�/QZ D 00 0 �x �©oe - - 03 f /745� �/0vtn�Vai�- Ali l�7 I 4/0 AsBuilt Page 1 of 1 TOWN OF BARNSTABLE LOCATION Lyt ,3 %/�,,�� ay SEWAGE # VILLAGE /f vJ L ASSESSOR'S MAP & LOT INSTALLER'S NAME 6r PHONE NO. V o/ln SEPTIC TANK CAPACITY — o LEACHING FACILITY:(type) 09 - /J, f5 (size) 6 X S NO.OF BEDROOMS `7� PRIVATE WELL OR UBLIC WATE BUILDER OR OWNER ��y,�., Sh�'Gr►'Py^ DATE PERMIT ISSUED:_ DATE COMPLIANCE ISSUED- VARIANCE GRANTED: Yes No 19 �5 r r� http://issgl2/intranet/propdata/prebuilt.aspx?mappar=246103003&seq=1 3/14/2016 �i�,457 ' TOWN OF BARNSTABLE LOCATION et 3 / ,i d___ �/_ SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. tTonn y, �'O clo� S�yd/ce SEPTIC TANK CAPACITY LEACHING FACILITY:(type) o? - S (size) X NO. OF BEDROOMS PRIVATE WELL OR UBLIC WATE BUILDER OR OWNER �ey�v� S-/��Gdreil, DATE PERMIT ISSUED; DATE `COLIPLIANCE ISSUED: VARIANCE GRANTED: Yes No 40 `\ /fv C r b � r- _ . � 1 3 3��s r