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HomeMy WebLinkAbout0040 WAYLAND ROAD - Health 40 WAYLAND RD. ,HYANNIS A = 271 193 TOWN OF BARNSTABLE V LOCATION k0 WA /A�c� n�° SEWAGE # 11 � sZ VhMLAGE h" /S ASSESSOR'S MAP & LOT�Zq I INSTALLER'S NAME&PHONE NO. �/1/1 / -C V e f IffA. 2 SEPTIC TANK CAPACITY / G o -- 4©0® )0/r LEACHING FACILITY: (type ;1—J0e10 EeJ Cyi1ZA1f&f`S (size) % 0® NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by � � � .` �� i i� ' r �� �� !;' �� a � � D ,, , . . 8z- LOCATION SEWAGE PERMIT NO. VILLAGE 41y7�cS IbSTA LLER;t `NAB i � D RESS I U I L D E N OR OWN ER f !O RP`4/ C� ✓I`�2'o V'y�, �b4 � ; US DATE PERMIT 4SSUED 23� �-✓ t DATE COMPLIANCE ISSUED 1;2,,�� ,jY i ; . 6S Q£ S� z SZ ti£ Y1�bq � J No. G Fee $ 5 0.0 0/ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS `RPAiration for Mtoponl bpztem Construction permit Application for a Permit to Construct( )Repairx(X )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 4 0 W a y 1 a n d R o a d Owner's Name,Address and Tel.No — Hyannis ,Mass . Baview Real Estate Assessor'sMap/Parcel 193 3180 Main Street Barnstable ,Mass. Installer's Name,Address,and Tel.No. 5 0 8-7 7 5-3 3 3 8 Designer's Name,Address and Tel.No. 82630 J.P.Macomber & Son Inc . J.P.Macomber & Son Inc . Box 66 Centerville ,Mass . 02632 Box 66 Centerville ,Mass . 02632 Type of Building: DwellingXXXNo.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 55 gallons per day. Calculated daily flow 3 x 110=3 3 0 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Adding two 500 gallon leaching chambers to an existing tank & pit . There will be 4 ' of stone all around the two leaching chambers . Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issu d by this and f Hea Signed Date 10/5/9 9 Application Approved by . Date 1 y` 2 v 9 / Application Disapproved for the following reasons Permit No. Date Issued G ` TO No. l"�jr fr( 2 Ay, Fee $ 50.00 `' Entered in computer: THE COMMONWEALTH"0 SACHUSETTS 1 Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS " rtcation for ig oga,r patent on!5truction Permit Application for a Permit to-Construct( )RepaiFX(X )Upgrade( )Abandon(-,) ❑Complete System . ❑Individual Components Location Address or Lot No. 4 0 W a y 1 a n d R o a d Owner's Name,Address and Tel.NoW 2—8 3 Hyannis,Mass. Bayview Real Estate Assessor'sMap/Parcel /373 3.180 Main Street Barnstable ,Mass. (32630 s Installer's Name,.Address,and Tel.No.5 0 8—7 7 5—3 3 3 8 Designer's Name,Address and Tel.No. J.P-.Macomber & -Son Inc. J.P.Macomber & Son Inc. Box 66 Centerv. 11e ,Mass. 02632 Box 66 Centerville ,Mass . 02632 Type of Building _ _..__ DwellingXCXNo.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 330 gallons per day. Calculated daily flow 3 x 110=3 3 0 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank � Type of S.A.S.. Description of Soil Nature of Repairs or Alterations(Answer when applicable) A d d i n g t w o 5 0 0 g a 11 o n 1 e a c h i n g chambers to an existing tank & pit . There will be 4 ' of st,one ali around the two leaching chambers . 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 is d by this oar f Hea h. Signed Date 10/5/9 9 Application Approved by oe Date Application Disapproved for the following reasons Permit No. L32 409 Z Date Issued G --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed`( )Repaired(XX)Upgraded( ) Abandoned( )by J.P.Macomber & Son Inc. at 40, W a y 1 a n d Road Hyannis,Mass . has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer J.P.Macomber & Son iInc. Designer J.P.Macomber Song' Inc. l The issuance of this permit s11haiil n t be/construed as a guarantee that the sys eemm will function as designedTV Date �I 1 t �'I p �y ./&;�,r/nW Y� V t�l��A /`l, Inspector � .� U L/ Y I✓ j\ No. ��`���. --------------------------Fee 50.00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS li5paal *pMem (Construction Permit Permission is hereby granted to Construct( )Repair�X�Upgrade( )Abandon( ) Systemlocatedat 40 Wayland Road Hyannis,Mass. 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 thi ermit. Q Date: /10 Z c ��/ Approved by TOWN OF B�/ARNSTABLE Gc LOCATION IYQ 1 A XIAAIW 9 ' SEWAGE # iZ VILLAGE A V AA1,VI S ASSESSOR'S MAP & LOT`� INSTALLER'S NAME&PHONE NO. C 6221 l f0f, S a./� SEPTIC TANK CAPACITY /',/r d ; LEACHING FACILITY: (type A—FL a W C#"eX—5 (size) CO NO.OF BEDROOMS o BUILDER OR OWNER bA `C�v PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by i I \ `lp � � I l/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I, Joseph P.Macomber J r . hereby certify that the application for disposal works construction permit signed by me dated 10/5/9 9 concerning the property located at 40 Wayland Road Hyannis ,Mass . meets all of the 1 following criteria: 4,1✓The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. •v The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. •v There are no wetlands within 100 feet of the proposed septic system •t�/ There are no private wells within 150 feet of the proposed septic system 1� There is no increase in flow and/or change in use proposed There are no variances requested or needed. The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. (Adjust the groundwater table using the Frimptor method when applicable] •'f If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) B) G.W. Elevation ':2.!r +the MAX, high G.W. Adjustment. �• _ �.�. DIFFERENCE BETWEEN A and B SIGNED : ! ® DATE: 10/5/99 (Sketch posed plan of system on back]. q:health folder.cert �R� y �' �. f ' Y 1 L' � L ir/ Town of Barnstable Health Inspector - Op THE 1p� Office Hours Regulatory Services 8:30-9:30 „ Thomas F.Geiler,Director 3:30—4:30 * snaxsTnsLE, 9� MASS. ,0r Public Health Division erF p `�p Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT - SEPTIC QUESTIONNAIRE Date: 11/10/08 1. General Information: Size of Property:Lot Size (Acres) 0.26 2.Address: 40 Wayland Road Hyannis,MA 02601 Map 271 Parcel 193 Name: Gina M. Stewart Phone#: 508-778-9090 2a. How many bedrooms exist at your property now?4 2b. Are you planning to add any bedrooms?NO If yes,how many? 0 2c. How many bedrooms total are proposed at this property(including the amnesty unit) 2d.Please include a copy of the floor plans for the entire property. Neatly use a straight-edge. Show all existing rooms in the home and the proposed amnesty apartment. Provide width measurements of any open doorways. Please label each room clearly. 3. Is the dwelling connected to public sewer? YES (r nNO , If the dwelling is connected to public sewer,skip questions#4 through#9 below. 4. Location of dwelling is INSIDE or OUTSIDE a Saltwater Estuary Protection Zone? it 5 . Location of dwelling is INSID or OUTSIDE a Zone of Contribution to public supply wells? 6. Is the dwelling connected to an ONSITE WELL or to PUBLIC W ? 7. Is a disposal works construction permit on file? YE or NO 8. If yes,how many bedrooms were approved according to this permit? Bedrooms. 9. Were any building permits obtained for construction of additional bedrooms? YES or 10. Is there an engineered septic system plan on file at the Health Division? YES or NO 11. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO ---------------------------------------------------------------------------------------------------------------- L FOR OFFICE USE ONLY IC+ �}yiC�cCQ The Public Health Divi on ha,s no je tion to bedrooms at this property. Special C nditions: �VC .h L C-0n S)NC, 0 ti dve rot?eve$ %Vbr►,t ,0 I Gn o Signed: Date: Q;/health/wpfiles/amnestyapp 7 b) T O p �. a On UN fi -� -i _ O 9, 3 = I � a � r �A V , �b peh�v�� t 0 o i e m �Q 'U co X4 S 1 9} CP m ' a � f co r4v�2 �U O�P h yr S Ao bXCLod } i m — V � o a � fi E I� I I I i 8 �� I � cPP O ; m � 31 � l Town of Barnstable Health Inspector f tHE Tp� Office Hours o Regulatory Services 8:30—9:30 Thomas F.Geiler,Director 3:30—4:30 • BARNSTABLE, 9� � Public Health Division Argo►�,tA Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT — SEPTIC.QUESTIONNAIRE Date: 11/10/08 1. General Information: Size of Property: Lot Size (Acres) 0.26 _4 2.Address:40 Wayland Road Hyannis,MA 02601 Map 271 Parcel 193 Name: Gina M. Stewart Phone#: 508-778-9090 a 2a. How many bedrooms exist at your property now?4 f' s 2b. Are you planning to add any bedrooms?NO If yes,how many? 0 2c. How many bedrooms total are proposed at this property(including the amnesty unit)?4 �n 2d.Please include a copy of the floor plans for the entire property. Neatly use a straight-edge. Show 11 existing rooms in the home and the proposed amnesty apartment. Provide width measurements of any open doorways. Please label each room clearly. 3. Is the dwelling connected to public sewer? YES or NO If the dwelling is connected to public sewer,skip questions#4 through#9 below. 4. Location of dwelling is INSIDE or OUTSIDE a Saltwater Estuary Protection Zone? 5 . Location of dwelling is INSIDE or OUTSIDE a Zone of Contribution to public supply wells? 6. Is.the dwelling connected to an ONSITE WELL or to PUBLIC WATER? 7. Is a disposal works construction permit on file? YES or NO 8. If yes,how many bedrooms were approved according to this permit? Bedrooms. 9. Were any building permits obtained for construction of additional bedrooms? YES or NO 10. Is there an engineered septic system plan on file at the Health Division? YES or NO 11. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO ------------------------- --------------------------------------------------------------------------------- - FOR OFFICE USE ONLY The Public Health Division has no objection to bedrooms at this property. Special Conditions: Signed: Date: Q;/health/wpfiles/amnestyapp McKean, Thomas From: McKean, Thomas Sent: Tuesday, November 25, 2008 8:14 AM To: Dabkowski, Cindy Subject: Two Applications Good Morning, I received two amnesty septic questionnaires yesterday. - 193 Fawcett Lane, Application for three [3] bedrooms - Outside of the bedroom, the garage apartment appears to have two additional enclosed rooms, one is unlabeled (is it a closet?) and one is a TV room. Is the TV room enclosed? Is there an opening between the TV room and the corridor? How wide is it? -40 Wayland, Application for Four[4] Bedrooms -This application is disapproved because only three bedrooms are allowed at this small 0.26 acre lot located in a zone of contribution to public water supply wells. Permit#99-692 was issued on 10/20/99 for three bedrooms, not four. 1 m - 0 3 d y � J �T 75 _ C Cfj G m p I � � 3 rn Mrh HOMEOWNERS HO 04 46 04 91 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INFLATION GUARD For an additional premium, the limits of liability for Coverages A, B, C and D will be increased annually by *, applied pro rata during the policy period. *Entries may be left blank if shown elsewhere in this policy for this coverage. HO 04 46 04 91 Copyright, Insurance Services Office, Inc., 1990 Page 1 of 1 A OJ � - p �- cl c 3 s �_ - �' .��•�e_.,- —u,ago I� o L -Tc s o `9 � w x e o CA D �L/ X \i Q (T Y � p Homeowners policy, we provide no coverage for loss (a) Conviction of an act which in- under Sectional. Property Coverages if, creases the chances of loss under whether before or after a loss, one or more this policy; "insureds" have: (b) Discovery of fraud or material mis- (1) Intentionally concealed or misrepre- representation by the "insured" in sented any material fact or circum- obtaining this policy; stance; (c) Discovery of willful or reckless acts (2) Engaged in fraudulent conduct; or or omissions by the "insured" in- (3) Made false statements; creasing the hazard insured against; relating to this insurance. (d) Physical changes in the property in- b. Under Section II — Liability Coverages, we sured, which result in the property do not provide coverage to one or more In- becoming uninsurable; or sureds" who, whether before .or after a (e) A determination by the commis- loss, have: sioner that continuation of the poli- (1) Intentionally concealed or misrepre- cy will violate or place the insurer in sented any material fact or circum- violation of the law. stance; d. If the return premium is not refunded with (2) Engaged in fraudulent conduct; or the notice of cancellation or when this poli- cy is returned to us, we will refund it when (3) Made false statements; ascertained. relating to this insurance. Where the stated reason is nonpayment of pre- y. Cancellation mium, you may continue the coverage and avoid the effect.of the.cancellation by payment Paragraphs b. and d. are deleted and replaced at any time prior to the effective date of cancel- by the following: lation. b. We may cancel this policy only for the rea- 6. Nonrenewal is deleted and replaced by the fol- sons stated in this condition by notifying lowing: you in writing of the date the cancellation takes effect. The cancellation notice shall 6. Nonrenewal state the specific reason(s) for cancellation. We may elect not to renew this policy. We may This cancellation notice may be delivered to do so by delivering to you or mailing to you at you or mailed, by first-class mail, to the your last mailing address shown in the Declara- mailing address shown in the Declarations tions, written notice at least 45 days before the or to your last address known .to us. A expiration date of the policy. Proof.of. mailing United States Postal Service certificate of shall be sufficient proof of notice. The No nre- mailing showing your name and that ad- newal Notice shall state the specific reason(s) dress will be sufficient proof of notice. for Nonrenewal. If you do not want to renew (1) When you have not paid the premium, this policy, you should notify your agent or us. whether payable to us or to our agent If Scheduled Personal Property Endorsement HO 04 or under any finance or credit plan, we 61 is made part of this policy, the following ap- may cancel at any time by letting you plies: know at least 10 days before the date Condition 3. Pair, Set Or Parts Other Than Fine cancellation takes effect. Arts of Endorsement HO 04 61 is deleted and re- (2) When this policy has been in effect for placed by the following: less than 60 days we may cancel for 3. Pair, Set Or Parts Of Property Other Than Fine any reason, other than nonpayment of Arts premium, by letting you know at least 5 days before the date cancellation takes In case of a loss we may elect to: effect. a. Repair or replace any part to restore the (3) When this policy has been in effect 60 pair or set to its value before the loss; or days or more, or after 60 days from b. Pay the difference between actual cash val- any anniversary date, we may cancel ue of the property before and after the loss. for one or more of the following by let- ting you know 5 days before the date cancellation takes effect: All other provisions of this policy apply. SP 01 20 01 08 Includes copyrighted material of Insurance Service Office, Inc. with its permission Page 7 of 7 i Town of Barnstable Health Inspector �oF1HE� Office Hours do Regulatory Services 8:30—9:30 Thomas F.Geiler,Director 3:30—4:30 r 1639. Public Health Division �0 'O�Fn tea+" Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT — SEPTIC QUESTIONNAIRE Date: l l/10/08 1. General Information: Size of Property:Lot Size (Acres) 0.26 2.Address:40 Wayland Road Hyannis,MA 02601 Map 271 Parcel 193 Name: Gina M. Stewart Phone#: 508-778-9090 2a. How many bedrooms exist at your property now?4 2b. Are you planning to add any bedrooms?NO If yes,how many? 0 2c. How many bedrooms total are proposed at this property(including the amnesty unit)?4 2d.Please include a copy of the floor plans for the entire property. Neatly use a straight-edge. Show all existing rooms in the home and the proposed amnesty apartment. Provide width measurements of any open doorways. Please label each room cle:l-ly. 3. Is the dwelling connected to public sewer? YES or NO If the dwelling is connected to public sewer,skip questions#4 through#9 below. 4. Location of dwelling is INSIDE or OUTSIDE a Saltwater Estuary Protection Zone? 5 . Location of dwelling is INSIDE or OUTSIDE a Zone of Contribution to public supply wells? 6. Is the dwelling connected to an ONSITE WELL or to PUBLIC WATER? 7. Is a disposal works construction permit on file? YES or NO 8. If yes,how many bedrooms were approved according to this permit? Bedrooms. 9. Were any building permits obtained for construction of additional bedrooms? YES or NO 10. Is there an engineered septic system plan on file at the Health Division? YES or NO 11. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO ------------------------------------------------------------------------------------------------------------------- FOR OFFICE USE ONLY The Public Health Division has no objection to bedrooms at this property. Special Conditions: Signed: Date: Q;/health/wpfiles/amnestyapp r e DEC.. 3.2008 8:13AN BARNSTABLE BOARD OF HEALTH NO.689 P.3/3 M o© C J X A S ------------- C,� x Lq 3 � - �11 � ��) U o � � — € _ room dC)coo C -f CD CD CD co co i c) CV 10 0 ` 3 D m z co rh m m a r �u1 naC� Q ;a d IE x ' u T 13, o a,, A .co 619 h Lo w140Lz) (/ „ N C e CAD UCv I.AWlGEMENfi - 135.00' MASSACHUSE ' SO UTHERN O \ EASEMENT TELEPTIONE COMPANY 60 WIDE — 4l: CD LOT 13 28f Q. .J w I LOT 14 42' 1.y �0.33'- L,�5.77 12�•�0 O AD YLA SD RES ZONE.- "RU This MORTGAGE INSPECTION PIa" is For FLOOD ZONC- "C" Bank Use Only TOWN: _W AAY IS __ _ _ _ _ _ _ _ _ REGISTRY O WNER: FIRST FRf1NK_LLN FI-ALA KCl-1L-CO-RD __ DEED REF: _0TF- 15-L 5,f _ _ _ _ _BUYER: _G_1NA1 L1_S-TVV.4RT - _ _ _ DATE: 10_23_99_ _ _ _ _ _ _ _ _ PLAN REF: L_C_ 36508=C_ _ _ _ _ SCALE: I"= 20`___FT. I HEREBY CERTIFY TO _C.'0�1fP.�SS_B IIVIC_f OR_.S:�I`VIIVCS _ YANI�EE SURVE-Y _ _ _ __________ THAT THE BUILDING 1N OF SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS + PAtj1 CONSULTANTS SHOWN AND THAT 'ITS POSITION DOES __—_ CONFORM A. lOB (SUITE 1) TO THE ZONING LAW SETBACK REWREMENTS OF THE NIEAITHLW �+. I.NDUSTRI' 1) TOWN OF B._IR/US'T IBIC --------__AND THAT ft32M MARSTONS NULLS, MA. 026.18 l`f DOES,vOT _ LIE WITHIN THE SPECIAL FLOOD HAZARD AREA AS SHOWN Off( THE II.U. D. MAP DATED H_1.9_f�5 _ '�s TEL: I'2fl -0055 C'c, �rtnity— Panel 7 `15000I-0005—( ilA1� FAX -120-.:):)3 Tlll� PLAN NOT MADE FROM J; w\II'•N'I' � ;'8i i I'�I I `Il ltll'IIV:u LL I'f hj: (lt ((1''fll' I 'I.I'i 'vm? I`f'�r'f' I"fr" r f Baking Sketch(Page- 1) BorrowedClient Stewart Gina M Prover Address 40 Wayland Rd Ci H annis Coun Barnstable State MA Zip Code 02601-2455 Lender Cape Cod Co-operative Bank 46.0' Bedroom Dining Bath athedral Ceiling [Kitchen Area W&D o lasolC `1' Living Room v Cathedral Ceiling N Bedroom Bedroom (7 in 46.0' 4 Sketch by Apex IV Wind—rs Comments: AREA CALCULATIONS SUMMARY LIVING AREA BREAKDOWN Code Description Size Net Totals Breakdown Subtotals GLAl First Floor 1104.00 1104.00 First Floor 24.0 x 46.0 1104.00 TOTAL LIVABLE (rounded) 1104 1 Calculation Total(rounded) 1104 Form SKT.BldSkl—'TOTAL for Windows'appraisal software by a la mode,inc.—1-800-ALAMODE TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: � � ap n,-)po- ® Mail To: BUSINESS LOCATION• &vd Rd YIA Board of Health MAILING ADDRESS: �O�if' /�9 f,(/�,y�'�mOt��"II Z6 �3 h4,q Town of Barnstable P.O. Box 534 TELEPHONE NUMBER: 725-�i z® , Hyannis, MA 02601 CONTACT PERSON: . �/,a,�C�O G,01)�7A2-� EMERGENCY CONTACT TELEPHONE NUMBER: ,.3e ? �/ 9,6 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities tot alli�q, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners /o- rA+vs Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) GA Floor & furniture strippers.eAe l;A,Y Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business T Z"r"203 49--8 940 US Postal Service Receipt for Certified Mail No Insurance Coverage Provided. Do not use for Ihtern tional it See rev ise et&Nu r r ce, e,&ZIP 1;..tag;' $ Certified Fee Special Delivery Fee Restricted Delivery Fee Ln rn Return Receipt Showing to Whom&Date Delivered Return Receipt Showing to When, Date,&Addressee's Address TOTAL Postage&FeesGo Is Co) Postmark or Date COLL �� �� 9 a t Stick postage stamps to article to cover First-Class postage,certified mail fee,and charges for any selected optional services(See front). j1. If you want this receipt postmarked,stick the gummed stub to the right of the return i address leaving the receipt attached, and present the article at a post office service window or hand it to your rural carrier(no extra charge). 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the Q) i return address of the article,date,detach,and retain the receipt,and mail the article. fLO i 3. If you want a return receipt,write the certified mail number and your name and address � t on a return receipt card,Form 3811,and attach it to the front of the article by means of the [ gummed ends it space permits. Otherwise,affix to back of article. Endorse front of article 0. RETURN RECEIPT REQUESTED adjacent to the number. Q 4. It you want delivery restricted to the addressee, or to an authorized agent of the addressee,endorse RESTRICTED DELIVERY on the front of the article. 0000 M 'r 5. Enter fees for the services requested in the appropriate spaces on the front of this rE receipt. If return receipt is requested,check the applicable blocks in item 1 of Form 3811. 16 LL 6. Save this receipt and present it if you make an inquiry. t o2595-s7-e-ot 45 a 4J i Town of Barnstable o� sSTAB Department of Health, Safety, and Environmental Services RAM ,' : ,�� Public Health Division P.O. Box 534, Hyannis MA 02601 Office: 508-862-4644 Thomas ' A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health September 8, 1999 Marilia Jordao 41 Wayland Road Hyannis, MA 02601 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY CODE II, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE BOARD OF HEALTH NUISANCE CONTROL REGULATION NUMBER ONE The property owned by you located at 40 Wayland Road, Hyannis was inspected on September 7, 1999, by Jerry Dunning, Health Inspector for the Town of Barnstable, because of a complaint. The following violations of the Nuisance Control Regulation Number One Regulation and the Sanitary Code II were observed: 410.602: Old chair, mattresses, furniture and trash in front and back yard. You are directed to correct violations within five (5) days of receipt of this notice. You may request a hearing if written petition requesting same is received by the Board of Health within seven(7) days after the date order is received. However, this violation must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order could result in a fine of not more than $500. Each separate day's failure to comply with an order shall constitute a separate violation. You are also subject to non criminal citations of$40.00 for the first violation and $15.00 for each additional violation. Tickets will be issued daily until the violations are corrected. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health M (L� aa6o1 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY CODE II, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE BOARD OF HEALTH NUISANCE CONTROL REGULATION NUMBER ONE The property owned by you located at Li O ��,,� l .,�.�; Ma- Cao t was inspected on cl --7 _ q� 1997, by Health Inspector for the Town of Barnsta le, ecause of a tomplaint. The following violations of the Nuisance Control Rezulation Number One Regulation and the Sanitary Code II were observed: You are directed to correct violations within �8 of receipt of this notice. You may request a hearing if written petition requesting same is received by the Board of Health within seven(7) days after the date order is received. However, this violation must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order could result in a fine of not more than $500. Each separate day's failure to comply with an order shall constitute a separate violation. You are also subject to non criminal citations of$40.00 for the first violation and $15.00 for each additional violation. Tickets will be issued daily until the violations are corrected. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health t 000000b elan r DUAL; 6 )8-C 0,MARILIA 41 LAND RD , ear `doted 00 HYANNIs MA 02 0000-000 cl JORDAO.MARILIA 66600 40 1797 WAYLAND ROAD fire s#,< HY Unassigned Road Namen 8 nnnn Health Complaints 07-Sep-99 Time: 12:00:00 PM Date: 9/7/99 Complaint Number: 2067 Referred To: JEROME DUNNING Taken By: K.S. Complaint Type: NUISANCE CONTROL REG. 1 RUBBISH Article X Detail: UNSANITARY CONDITIONS Business Name: Number: 40 Street: Wayland Rd. Village: HYANNIS Assessors Map-Parcel: Complaint Description: There is a rental property has been vacant since May. Trash, mattressess, furnature are all around the property. Actions Taken/Results: Investigation Date: Investigation Time: 1 y Fxs..�J� THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...........T_own.....---....6F......... ................................................. Appliratinn for Bi-spnal ilirkg Tomitrurtinn ramit Application is hereby made for a Permit to Construct (g ) or Repair ( ) an Individual Sewage Disposal System at: ........Zo t-•#....13.... &J_GJ_.•-- -- ............Hyannis....M&...-.... . .....................•--- Locati n-Address or Lot No. .....Caprico.........................n Ry...Thus ............................ 7.:6.5...F.almouth..iioad.,...Hyamx.Lis................... Owner Address W $t v.e--•Lehel----------------•-- Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............. .............................Expansion Attic ( ) Garbage Grinder ( ) a Other—T e yp of Buildingranch................ No. of persons............................ Showers (2 ) — Cafeteria ( ) a Other fixtures ------------------------------------•------------- W Design Flow...............5-5........................gallons per person per day. Total daily flow...........330........................gallons. WSeptic Tank—Liquid capacity1000gallons Length__B'.6.':... Width..4_'1.0_"Diameter................ Depth.....5.'.8.! x Disposal Trench—No..................... Width.........._......... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter-__-- .......... Depth below inlet........ .......... Total leaching area.....266....sq. ft. Z Other Distribution box ( ) Dosin tank ( ) '-' Percolation Test Results Performed b .Eldredge_•Engineering.._,.__._... Date......1-1_-2.5.7-51........... a Test Pit No. l�•2/ _..minutes per inch Depth of Test Pit------1.2._._.__.. Depth to ground water.==---an.0 o unte d 44 Test Pit No. 2-_N/.A-•_._minutes per inch Depth of Test Pit...N/A........ Depth to ground water.......N/A........ P4 ••-•••--••--•-••--------•---•-•--•••......-•--------•-•.....................................••--------•---...-•---•-••--------------....••---------•--------- ODescription of Soil-------0•'---_---�....------.1.0. .l_:8k...tL1psaL ---------------------------•----------------•----------------------•--------•-.......------. x • 2 ' - 10 ' medium yellowsan.d••_.•••----•-••._--._ .....................................� white Sand/t aee_ __.o ' gxavo�./�10 a_t r t 12 U Nature of Repairs or Alterations—Answer when applicable.__._........................................................................................... ................................=....................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TT Es=. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been,i ued y the 4boaof health. ..................... ��� --------• {-.c-��......---•-- /D Application Approved BY-eligne( N ........................ ........ .. .......... .......... ... ........ -�Y-- Date Application Disapproved f ing reasons:---• -•-•-•--•-----•----•---- ••---••--••.............................................................. ...............................................•-...----------------•------------•--•-••--••••......----... Date PermitNo......................................................... Issued_....................................................... Date FEs:........................... r f I THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ..................Tolan-...........O F.-.....-.Bar-ns.table-...--..---...:._.........---..............._.__ ApplirFation for Disposal Works Tnnstrnrtiun Vrrmit � F Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal System at: ............... ............. ...................................................... Locatidn-Address or Lot No. ......CaP.r!.Q_grn...Rea1ty_...zrtis t---------------------------- .....7-65---Fal Mora tb...R2, d.t---Hy��.................. Owner Address ......Steve...Lebe1............................................................. -------••-••-••••-••-••-----..__._...---•-------•--._.._.......-•----•••.............._...._..... Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms._.......__.3.............................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Buildiil rAXl_Ck1_____________ No. of persons...................._------- Showers 2 Cafeteria al Other fixtures ______________________________ __ W Design Flow...............5,5.......................gallons per person per day. Total daily flow...........339...............:........gallons. WSeptic Tank—Liquid capacity-IQDDgallons° Length__B.'6"__ Width._.4.'--II"Diameter................ Depth_____5_!_$!! x Disposal Trench—No.......::............ Width............._...... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......1............ Diameter:_...b_--_____-___ Depth below inlet........6......... Total leaching area.....2.66....sq. ft. Z Other Distribution box ( ) Dosing tank aPercolation Test Results Performed by....__jtft!9 b-f-'-__E?1g1neeri Date......U7n2.,5.-a1.......... a Test Pit No. 1 _2_e_Q..minutes per inch Depth of Test Pit.......1.2__....... Depth to ground water_riorie...EnCounte�- (i Test Pit No. 2__N/A___._minutes per inch Depth of Test Pit___II�.�________ Depth to ground water_,____.T$�A.____... e ----•------- -----------•----------------.....__-_-•-•-•--•-•-••------------•-•••-----•------•---......_--•-----......._•---•-------•--•-_.-------------- p Description of Soil..------Q..----.-...2---•-------a.Qs'4.m---&---�.Q_ggeaa•1-------------------••---•------------------------•----------------------------.._.__...----- x 2' - 10 ' medium yAjj jvsand v •-•------....-•--•---------••-....••-• --:;•-•••-•...•-•--1.............. ....... 10 1 med.._-whi-tee sand`trace_ .__0 ._grayel/no..Xter..At..1 �.; ­ U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ......................................----•-----------•---•---•--------•-------------..._._....-•••-•-•----••--------.-__.---------•--------------------------...--•-................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT,,µ. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been,is ued y the boa;A of health. _ J ?' -j' /-� _-- igne ......................:.................�a..!. ----•---- D Application Approved BY R= ------- ----- - - ...... ......... _: - - Date Application Disapproved f t e following reasons: ..- ---•-••---•---- ...---------•----------------- -----•----------- --------•--------------------------------•--•----------------•---•-------••------•----......_..._....----------•-....-•---•--•--------------- Date F PermitNo......................................................... Issued._...----•-----•...................................•-•- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................... own.-...-..-.OF........Barnstable........................_...:......-:...._... %Trr#ifiratr of TnmpliFanrr TH CIVe Q CJR�TIFY, by -..... That the Individual Sewage Disposal System constructed (X' ) or Repaired ( ) !., -----•--•-_....•----------•--•--•---••------••----••---•---•-----•-•------•----------------•-----•-•---•-•-----------•-••_....._........--•._....----•----•--••------ 1 Installer Hyannis, IMA at.......................... OF has been installed in accordance with the provisions of TITLE 5 of/T�e State Sanitary C sc ibed in the application for Disposal Works Construction Permit No.... ._.44.,?.............. dated_- ..... ___.__._.__.____ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE A GUARANTEE THAT THE SYSTEM WIL U TION SATISFACTORY. f DATE.../� 1.�.? Inspector ............. ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town................OF....-......Barnstable ............ No ... FE; ........ Disposal Works %'Dnns#rnriilan remit Permissions hereby granted ------------ ----------teve ---Lebel-- to Construe or) or Repair ( ) n Individual,Sewage Disposal System at No.--•----•---o...__ .... _�l�(�. sa ^�" �L HyaYlnis, _........... MA Street e� � �' /� as shown on the application for Disposal Works Construction Permit Noh_�"____:-M_____ Dated_._:_.� )':S .. " f - .......... ............. '...."---•---------------•-------------...-•---•-----...---._...._._ Board of Health DATE �L_y .- FORM 1255 HOBBS & WARREN, INC., PUBLISHERS i 1 00 W 1 C'r--4 20` F. S (�• l..l, 5-2_l S,r ? , 0 N 4 v v. °0 .CxnA T4. 0 _ — 12 ul 1 _ /000 21 ' oo s�14T�c,-r^ ' Tcs r N MOLE' pu d V-1 OF Mgss 6.29874 4o �1 a' \,J i C R SUR�� _._..._._.. LEGEND EXISTING SPOT ELEVATION OsO ��"��="��. CERTIFIED PLOT PLAN EXISTING CONTOUR --- O —--— nl,,,a.s�r FINISHED ' SPOT ELEVATION \ !."7 lr 'q IPINISHED CONTOUR 0--- �° �aE N � __ /— /--.r` =/h'i ,A OVEDs BOARD OR HEALTH A pNo.10951 IN�p�4 FG/STs� O�F'rS/ONAtL _ O AGENT SCALES / 3v DATE , -7//,TLON EDQE E'NOINEERINQ Ca IN11 CLIENT R _ 1 CERTIFY THAT THE PROPOSED EGI81' E RE819TE�ED JO® NO. BUILDING SHOWN ON THIS PL AN CIVIL LAND CONFORMS TO THE ZONING LAWS RV OR.BY n� OF DARNSTA E , AS$. : 712 M-Al N STREET. CH. By `/,'R'E, �, h HYANNIS,, MA83. µ � SHEET_.L or DATE 0 LAND SURVEYOR F' 1 3 � oN� ►� c�D �' aq 0.. y tA N 6! bo C m-2M O.t� • ��ti FO` ,�a`' -�. � It :>:� \ � y � � � `^ y y , Ao x,IKy Z fA oy 0. �,n oo �Jv yo tb o �•� y ,A . • a s. d e _ Vo to tj 44 tj th _. 2 � ` O y _N � T � Z ,A � � A (A �;, O O "tb °t • • , v .° I n T � � `� yyb `I C r ou o • o• rb •'e ° . ,' ' Ih� oyy3 y N �' ti � . .� � � m � y `� z � � � �► ° °.�N��: fin, � 0 � ° � 1.4 tA tA 3 rN