HomeMy WebLinkAbout0074 COOLIDGE STREET - Health 74 Co®1idge Street
--- -- Cotuit
A= 036 - 003
�l
i
No. go �1 s
Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2pplitation for Vsposal *pstem Construction Permit
Application for a Permit to Construct O. Repair( ) Upgrade( ) Abandon( ) ❑Complete System G]Individual Components
Location Address or Lot No. t>o ;cQ S�'retiT Owner Name,Address,and Tel.No.
Assessor's Map/Parcel O
Installer's Name,Address,and Tel. o. 'I'l^� & "1�"� Designer's Name,Address,and Tel.No.
JS 3 G-oevi vil-cra.i✓Y S = nA on-Sti�4.�e f ✓�
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) u gpd Design flow provided Al J4 gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil - t L" t X,'
Sl. S k� I�r o n.. r1 f L`1 Co i1 '�, +-e- a-%- n14 -t-C>
/oo o �4 h!:$ v t7 Z- 74VIA_
o
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected: ��OD
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Boar of H
Sig
ne k:) C C _rr
Date to-3C �
Application Approved by Date /
Application Disapproved by U Date
for the following reasons
Permit No. aG 3 Date Issued 8" 50-
h..`�.,�,..i..^'f '^"'�''Ie'i-9,T"'r . .::.a''Y#,."+."'}y,,%7v-+""'rF�Cr''�o^' ..v ..a ..-ny.�,r,:q* a.•.r..xf'�"".y.,;!.-+.e;..-^'�-�'^�l,,r�.��.c.�..., .s�'.."1,,.�c^.:}.., ,yy.'y.,.Fr..:r}.�"'^r,Kv�+.'"*��YaFf2
1t'• .' ho-,,).}.
�No. J( f Fee
THFf COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
0[pplitation for 33isposal *pstem COnstruttion permit
Application for a Permit to.Construct( Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑,t' Individual Components
Location Address or Lot No. rl H G o a ;r_t Ti t.,.£z Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel
1
Insttaalller's Name,Address,and Tel.No. Lk 1' G c n "� Designer's Name,Address,and Tel.No.
S Be C u rr,vin r . r. V)
Type of Building:
Dwelling No.of Bedrooms �`'� Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
t Other Fixtures ,,
Design Flow(min.requi'red) _ � A- gpd Design flow provided W 4 gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil Q r� ) t� `j c,L, t.� Q� 1 r l +�-t �j )C S 1
r� l i7 r J o
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected: ;7
Agreement:
The undersigned agrees to ensu�the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Boarl of Health-7-•�
Signe��. Dates (f�' 3 ` rY
ApplicatiorrA'-rouedb' -M s
_ Pp Y -
:.
Application Disapproved by Date
for the following reasons
Permit No. aG I > Date Issued (6 -- 50— t
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate Of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( )
Abandoned( ))by iA(Qa,J�, cU' Pt f D d C P 5
at 7 (-( ( o o ;c�Cle �N.e �T' has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 00 rt`33/ dated 10- 3ll _f
Installer i du 901 t a -e.) Designer
#bedrooms ov Approved design flow gpd
The issuance of this permit all not be construed as a guarantee that the system wil "acWasesilgpn�Date �
No. ��,�� 3� Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
r Disposal *pstem Construction permit
Permission is hereby granted to Construct( ) p Repair( ) Upgrade(` ) Abandon( )
System located at �'f �Sa 1 rJIC n �j I ° 0
s
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit.�~
Date {U -3 O (Z Approved by
i
ASSESSORS REF.:
g Map 036, Parcel 003
,7- ZONE: RF
° Area (min.) 57,120 SF (RPOD)
h p iD
CB/DH cot"'t 1J� 'm 5 Frontage (min) 150'
..48 Fnd Fire D/strict at Setbacks:
I s? Front 30'
I 1 \ S77 15 E Side 15'
I esss• Rear 15'
I
CB/DH
— Fnd
FLOOD ZONE:
Proposed 39.5• Zone C
Community Panel No.
Garage
I
J250001 0018 D
July Z 1992
I � 34.9'
I
OVERLAY DISTRICT:
AP — Aquifer Protection District
-
I o �
Conc Slab O T z
IZ w w/Block Walls (C:}.i W 2.
Io o (Former Garage) M,
N� r
Vlwo Approx Se o
1� S,ystem
y BOH car i"i:'y 1
I N
O
U
45.6' m
15.2,
I
Stone Wood
�n Rewall Deck
O v
v I •� 15.1 r
3 �
O<o j ° #74 I on
1. ��� i m 2 Sty v ewaf
W rn N D
°j Dwelling
� I o
\ I 1
vered -_ - - ---_. _. . _ Z• _-- _ .__.-- ----- Co
I Parch
Lot Area
16,933±SF
I
I �
I 3° 36.0•
C rb S m
Fnd (W�
�14.19•
OO/, 156.06' CB H
C /'� say 78 py E �. Fnd
Oh, 9a o
C (Voriable a1emen
Width — Public Way)
et
I certify that the structures
�M •4 �4 shown hereon conform to the
setback requirements of the
Aap Ft. Zoning Bylaws of the town PLAN OF PROPOSED GARAGE
R�p�pVkEux of Barnstable. At 74 Coolidge Street
BARNSTABLE
Al A (Cotuit)
No MASS.
1.) The structuress shown were located on the ground DATE: 121NOV115 SCALE: 1"=30'
by conventional survey methods on or between 0 15 30 45 60 FEET
281JUL110 and 11/NOV/15.
2.) The property information shown hereon was PREPARED FOR:
compiled from available record information and The James D Bristow
does not represent an actual on the ground survey. Revocable ''rUSt
3.) This plan is not for recording and is not
to be used for construction layout or deed PREPARED BY: CapeSury
description purposes.
23 West Bay Rd, Suite G
Osterville MA 02655
DWG .#: C427_5g1 cpp3 FIELD BY: WHK/KAR (508) 420-3994 / 420-3995fox
DEED RESTRICTION
Whereas,James D.Bristow,Trustee of the James D.Bristow Revocable Trust,under
declaration of trust dated September 19,2007,a Certificate of Trust for which is filed with the
Barnstable County Registry of Deeds in Book 23194,Page 123,of 2280910711,Ave. SW,
Vashon,Washington 98070("Owner"),is the owner of the land shown as Lot 2A on plan of land
recorded with the Barnstable County Registry of Deeds in Plan Book 501,Page 78,located at 74
Coolidge Street,Barnstable(Cotuit),Barnstable County,Massachusetts,record title to which is
evidenced by deed recorded with said Registry of Deeds in Book 23120,Page 51. (hereinafter,
the"Lot");and
Whereas,Owner has agreed with the Town of Barnstable Board of Health to a restriction
as to the number of bedrooms which can be included in any home on the Lot as a pre-condition
to obtaining a disposal works construction permit in compliance with 310 CMR 15,000,State
Environmental Code,Title V,Minimum Requirements for the Subsurface Disposal of Sanitary
Sewage;and
Whereas,the Town of Barnstable Board of Health, as a pre-condition to granting a
disposal works construction permit for a septic system in compliance with 310 CMR 15.200,
State Environmental Code,Title.V,Minimum Requirements for the Subsurface Disposal of
Sanitary Sewage,is requiring that the agreement for the restriction on the number of bedrooms in
any house constructed or maintained on the Lot be put on record with the Barnstable County
Registry of Deeds and/or the Barnstable Registry District of the Land Court,as applicable,by
recording this document.
Now,therefore,Owner does hereby place and impose the following restriction upon the
Lot in accordance with their agreement with the Town of Barnstable Board of Health,which said
restriction shall run with the land and be binding upon all successors in title:
The dwelling constructed or maintained upon the Lot shall contain no more than three(3)
bedrooms unless and until it is connected to the municipal sewer or the Board of Health of the
Town of Barnstable permits otherwise.
Property Address: 74 Coolidge Street,Cotuit,Massachusetts
For title,see deed recorded with said Registry of Deeds in Book 23120,Page 51.
r
Executed as a sealed instrument this ,2018.
James D.Bristow Revocable Trust
By: 3z)jV-I-I �("kxl�—�
James D.Bristow,Trustee
STATE OF WASHINGTON
County of e�c
On this �_�day of 0(� ,2018,before me,the undersigned notary
public,personally appeared James D.Bristow, 9 who proved to me through satisfactory
evidence of identification,which was ,JJ ij Lftft DfjVer Li(,eYfSf ,or 0 who is known by
me and to me known,to be the person who es name is signed on the preceding or attached
document, and acknowledged to me that he signed it voluntarily for its stated purpose and as his
flee act and deed,as Trustee of the James D.Bristow Revocable Trust.
t
Notary Public
My Commission Expires:
Notary Pubfio
State of Washington
Sara M Ruby
Commisslon Expires 0sa-2020
2
r
TRUSTEE'S CERTIFICATE
I,James D. Bristow, of 22809 107`h Ave. SW,Vashon,Washington 98070,under oath,
do depose and say as follows:
1. That I am the sole trustee of the James D. Bristow Revocable.Trust,under declaration
of trust dated September 19,2007,a Certificate of Trust for which is filed with the Barnstable
County Registry of Deeds in Book 23194,Page 123.
2. That the Trust has not been revoked or amended and is still in full force and effect.
3. That I am duly authorized by the terms of the Trust and have been duly authorized and
directed by all of the beneficiaries of the Trust,to sign,seal,acknowledge and deliver the
attached or foregoing Deed Restriction concerning the land shown as Lot 2A on plan of land
recorded with said Registry of Deeds in Plan Book 501,Page 78,located at 74 Coolidge Street,
Barnstable(Cotuit),Barnstable County,Massachusetts.
4. That I am not the sole beneficiary of the Trust; and that no beneficiary of the Trust is a
minor,a corporation or a limited liability company selling all or substantially all its
Massachusetts assets,or a personal representative of an estate subject to estate tax liens,or is
now deceased or under any legal disability or operating under any constraint or undue influence.
Subscribed and sworn to under the pains and penalties of perjury this '2-5- day of
2018.
tt
J�
James D.Bristow
STATE OF WASE INGTON
County of kroe
On this` �?it-\ day of DQ 2018,before me,the undersigned notary
public,personally appeared James D.Bristow,19 who proved to me through satisfactory
evidence of identification,which was��� %� WjVeFLj renSf ,or 0 who is known by
me and to me known,to be the person whosd name is signed on the preceding or attached
3
document,and who swore or affirmed to me that the contents of the document are truthful and
accurate to the best of his knowledge and belie£
i otary Public
My commission expires:
Notary PON
State of Wasbington
Sara M MY 0
202
Co
mmisstaa EON OS-0S-
4
SARNSTABLE REGISTRY OF DEEDS
John F. Meade, Register
1
Yown of Barnstable
F
tHE .Regulatory Services I Barnstable
C 1p�
Thomas F. Geiler, Director ;mericaCity
Public Health Division III
BARNSTABLE,
Thomas McKean,Director 2ce7
200 Main Street
ED MA'S
Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
August 6, 2010
James Bristow
167 Carl Street 4
San Francisco, CA. 94117 _
RE: Assessors (map-parcel) 036-003
As of October 1, 2006 a new rental registration ordinance was put into affect requiring all
property owners of rental units to register their rental units with the Town of Barnstable Health
Division. According to our records, you own the rental property at 74 Coolidge Street, Cotuit
02635. Enclosed;is an application. Please use a separate application for each rental unit you
own. Should you need more applications, they are available online at
www.town.barnstable.ma.us. Go to the Health Division page by looking in the Department
Menu. There is a link to the Rental Registration information on the Health Division page. You
may print out as many as you need, and return them to the Health Division with the appropriate
2010 fees included.
Please contact me to schedule inspection of the property as soon as possible. If there are tenants
presently occupying the property please provide the contact information being sure to include a
daytime phone number for all tenants. For your use an occupant's permission form has been
included to allow for inspections to be performed in the tenant's absence.
Failure to comply with this ordinance will result in the issuance of a non-criminal
ticket citation in the amount of $100. Each day of non-compliance is considered a
separate offense.
Should you have any questions, please feel free to call 508-862-4072. Thank'you in
advance for your cooperation.
r �v
—r-
•
Teresa Wright � ----M
Division Assistant 0 -
Health Division
Direct#508-862-4072
� r
Health Master Detail _ Page 1 of 1
A - Health faster a
Logged In As: TOWN\wrightt Health Master Detail Friday, Aug
Application Center Parcel Lookup
Parcel Septic Perc Well Fuel Tank
Parcel: 036-003 Location: 74 COOLIDGE STREET, COTUIT Owner: BRISTOW, JAMES, TR'
Business name: Business phone:liF-
Rental property: F-i Deed restricted: C-4 Number of bedrooms :r . 0
Contaminant released: F--, Fuel storage tank permit: f..,l
Save Parcel Changes I Return to Lookup
Parcel Info Parcel ID: 036-003 Developer lot: LOT 2A
Location:74 COOLIDGE STREET Primary frontage: 140
Secondary road: Secondary frontage:
Village:COTUIT Fire district:COTUIT
Sewer acct: Road index:0352
Asbuilt Septic Scan: 036003 1 Interactive map w9
" ""
Town zone of contribution:WP (Wellhead Protection Overlay District) State zone of contribution:IN
.
Owner Info Owner:, BRISTOW, JAMES, TR Co-Owner:JAMES BRISTOW REVO
TRUST
Streetl': 167 CARL STREET Street2:
City:SAN FRANCISCO State:CA Zip: 94117 Countr
Deed date:8/25/2008 Deed reference: 23120/51
Land Info Acres: 0.39 Use: Single Fam MDL-01 Zoning: RF Neighborhood: 0108
Topography: Level Road:•Paved
Utilities: Public Water,Septic Location:
Construction Info Building No Year Built Gross Area Living Area Bedrooms Bathrooms
1 1924 2088 1170 3 Bedroomsl Full + 1H
Buildings value:$142,700.00 Extra features: $0.00 Land value: $202,700.00
e
http://issgl2/intranet/healthMaster/HealthMasterDetail.aspx?ID=036003 8/6/2010
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Postage $
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p Certified Fee
C3 &ark (n
p Return Recelpt Fee Mete
(Endorsement Required)
M Restricted Delivery Fee
r0 (Endorsement Required) �f 5k
Total Postage&Fees $5- VA
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Certified Mail Provides:
e A mailing receipt (esianey)zooz eunv000e wjod sd
e A unique identifier for your mailpiece
n A record of delivery kept by the Postal Service for two years
Important Reminders:
o Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®.
o Certified Mail is not available for any class of international mail.
c NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables,please consider Insured or Registered Mail.
a For an additional fee,a Return Receipt may be requested to provide proof of
delivery.To obtain Return Receipt service,please complete and attach a Return
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 USPS®postmark on your Certified Mail receipt is
required.
o For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent.Advise the clerk or mark the mailpiece with the
endorsement"Restricted Delivery".
o 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.
SEN DEk: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3.Also complete A. Si7rAa a'
item 4 if Restricted Delivery is desired. Agent
e Print your name and address on the reverse X 13 Addressee
so that we can return the card to you. B. Received b Printed Name) I C.Date of Delivery
■ Attach this card to the back of the mailplece, I I �-1, � �,�Z���
or on the front if space permits.
D. Is deliveryaddress different from`d4r 1? ❑Yes
1. Article Addressed to: if YES,enter delivery address below?,, Q No
{ u012l7W
'161�clines Bristow
Az : 167 Carl Street 3. service Type
"z-San Francisco, CA. 94117 i'CertifiedMail ❑Express Mail
Q Registered ❑Return Receipt for Merohandlse
❑Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number I
(Transfer from service iabeo I 7005 1160 0000 0190 9687
PS;Form 3811.,February M04 Domestic-Return Receipt 102595-02-M-1.540
UNITED STATC—A{�P-�`A-6'SFMQ7,.,,j T-,�t .Xt
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s�St Fe
• Sender: Please print your name, address, and ZIP+4 iris box•
VIP
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Town of Barnstable rn
Public Health Department
200 Main Street
Hyannis, MA. 02601
i
Massachusetts Depar ent of.Environ ental Protection
100263955
BWP A 0 ANF-0(
Q ) CC �� Asbestos Project#
Asbestos Notifi ation Form )
/ r Project Revision
Project Cancellation
s .
A. Asbestos Abatement Description
-0
1.Facility Location:
JIM BRISTOW 74 COOLIDGE ST. ri
Instructions 1.All a.Name of Facility b.Street Address q t�
sections of this form BARNSTABLE MA 02635 4153788643
must be completed in
order to comply with C.Citylrown d.State e.Zip Code f.Telephone
MassDEP notification SAME AS ABOVE OWNER
requirements of 310
CMR 7.15 and 9•.Facility Contact Person Name h.Facility Contact Person Title
Department of Labor Worksite Location: RESIDENCE
Standards(DLS)
notification i.Building Name,Wing,Floor,Room,'etc.
requirements of 453 2. Is the facility occupied? a.Yes r b.No
CMR 6.12
3`..Is this s fee exempt notification:,(pity town, district, municipal housing authority, state facility, or
owner-occupied residential.property of four units or less)? a.Yes, f"`, b.No
MassDEP Use Only
4.-Blanket Petmit.Project Approval,if applicable:
Date Received Approval ID#
S NontTr d�tipttaC:7�sb oS,:A telt_Rt W actice Approval;
2.,Submit Original tf.applicable: Approval ID#
Form To:
commonwealth of
Massachusetts 6i Asbestos Contractor;
P.O.Box 4062
Boston,MA 02211 ASBESTOS MAN REMOVAL 929 STATE ROAD
a.Name b.Address
PLYMOUTH MA 02360 5082245500
c.City/rows, :c "d.State a Zip Code f,Telephone
Contract Type: 1.Written r 2.Verbal
g.DLS License#.
7• ELMER E,PINEDA AS001291
a.Name of.Contractor's On-Site Supervisor/Foreman b.DLS Certification#'
8; JOHNNIE UTUMA AM000146
a.Name of Project Monitor b.DLS Certification#
9 GUERTIN&EL KERTON AA000173
a:Name yf Asbestos An ytica[Latr r ;: ,> `-b.'DLS Certification
10.
5/13/2017 5/14/2017
a..Project Start Date(MM/DD/YYYY) b.End Date(MM/DD/YYYY)
7AM-3PM 7AM-3PM
C.Work Hours-Monday Through Friday d.Work Hours-Saturday&Sunday
11.What type of project is this?
f"';r a.-D molifttR b- r'Reftgvataart c.Rdpair d.Other-Please Specify:
Revised: 11/13/2013 Page 1 of 4
i
Massachusetts Department of Environmental Protection 1---02 1063955
BWP AQ 04 (ANF-001) �--- -------------
rF .Vt� Asbestos Project#
Asbestos Notification Form r7. Project Revision
Project Cancellation
A.Asbestos Abatement Description: (coat.)
12.Abatement procedures(check all that apply):
I— a.Glove Bag I— b.Encapsulation r c.Enclosure r d.Disposal Only r e.Cleanup
(✓ f.Full Containment g.Other-Please Specify:
13.Job is being conducted: rie a.Indoors r b.Outdoors
14 a.Total amount of each type of asbestos Containing materials(ACM)to be removed,enclosed,or
encapsulated:
600
1.Linear Feet(Lin.Ft.) 2.Square Feet(Sq.Ft.)
b.Boiler,Breaching,Duct, c..Transite Pipe
Tanl<.4u facCwoAting to}f LlnFj �4 S4yF�t `1.Lin Ft 2.Sq.Ft.
d.Pipe lnsu�ation e.Transite Shingles
1.Lin.Ft '2.Sq:Ft. 1.1Lin.Ft. 2.Sq.Ft.
f. Spray70n Fireproofing g.Transite Panels
1.Lin.Ft. 2.Sq.-Ft. 1:-Lin.Ft. 2.Sq.Ft.
hr Cloths;WpvenFalirics is Other-Please Specify.'
1.Lin.Ft. 2.Sq.Ft.
j.Insulating Cement VERMICULITE 600
1.Lin `42 Sq..Ft _ 1..Lin.Ft. 2.Sq.Ft.
r. a g
15.Describe the decontamination system(s)to be used:
REMOVE VERMICULITE IN FULL CONTAINMENT UNDER NEGATIVE AIR PRESSURE
16.Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2)
(g) .
- WET1:30ff1ItJ. ., RMICULI',I�AND.33QlJBT-�`SAG.USINt�6 MIL MARKED AND LABELED BAGS
17.For Emergency.Asbestos Operations,the MassDEP and DLS officials who evaluated the emergency:
a.Name of MassDEP Official b.Tile of MassDEP Official
c.QaYe'olAutFio Iz9tiRnIVl/D�T/YYYI ';_ a.Waiver#;
e.Name of.DLS Official" . ' . f.Title of DLS Official
g.Date of Authorization(MM/DD/YYYY) h.Waiver#
'18.Do prevailing wage rates as per M.G.L.c. 149, §26,27 or 27A—F apply to this r a.Yes T b.No
project?
Revised:.1-1/13/2013_ . ; Nti. Page 2 of 4
i
Massachusetts Department of'Environmental Protection-
• �_ 100263955
BWP AQ 04 (ANF-001) � 9 . l
Asbestos Project#
Asbestos Notification Form ' Project Revision
I— Project.Cancellation.
B. Facility Description
RESIDENCE
1.Current or prior use of facility:
2.Is the facility owner-occupied residential with 4 units or less? 0 a.Yes l b.No
3 SAME AS ABOVE SAME
a.Facility Owner Name b.Address
SAME MA 02635 4157388643
c.City/Town d.State e.Zip Code f.Telephone
N/A N/A
4 a.Name of Facility Owner's On-Site Manager b.Address
N/A MA 02635 4157388643
c.City/Town d.State e.Zip Code f.Telephone
N/A N/A
5.
a.Name of General Contractor b.Address
N/A MA 02635 4157388643
c City/Town d•State e.Zip Code f.Telephone ,
g.Contractor's Worker's.Compensation Insurer,
99999999999999999999996999999999 9/9/9999
h.Policy# : is Expiration Date(MM/DD/YYYY)
.S 2
6.What is the size of this.facility? aq
a.Square Feet. b.#of Floors
• �'. Asb�stQs �'ra�psportat�Qn� I�ispos;�l -, ._ -.
1.Transporter of asbestos-containing waste material from site of generation:
a.Directly to Landfill orb.To Temporary Storage Location/Transfer Station
ASBESTOS MAN REMOVAL CO. 929 STATE RD.
c.Name of Transporter d.Address
Note:Temporary
storage of Asbestos PLYMOUTH MA 02360 5082245500
containing waste e.City/Town f.State g.Zip Code h.Telephone
material is only
allowed at the place g >:.
of business ofa DLS 2.'If a temporary.storage"locationitransfer station is used,list name of transporter of asbestos containing
licensed Asbestos waste materialfrom temporary storage location/transfer station to final disposal site:
contractor or a transfer
station that is
permitted by JOB ROLLOFF. POB 609
MassDEP and a.Name of:Transporter b.Address
operated in
compliance with Solid' HAMPSTEAD NH 03841 6173871495
Waste Regulations c.City/Town d:State e.Zip Code f.Telephone
310 CMR 19.000
Revised: 11/13/2013 Page 3 of 4
Massachusetts Department of Environmental Protection
100263955
BWP AQ 04 (ANF-001)
Asbestos Project#
Asbestos Notification Form (" Project Revision
r: Project Cancellation
C.Asbestos Transportation&Disposal: (cont.)
3.Name and address of temporary storage location/transfer station for the asbestos containing waste
material:
ASBESTOS MAN REMOVAL CO. 1428 BEDFORD ST.
a.Temporary Storage Location Name b.Address
ABINGTON MA 02351 5082245500
a City/Town d.State e.Zip Code f:Telephone
4.Name and location of final disposal site(asbestos landfill):
TURNKEY LANDFILL WASTE MANAGEMENT
a.Final Disposal Site Name b.Final Disposal Site Owner Name
90 ROCHESTER NECK RD.
c.Address
ROCHESTER Ni 03839 6033390039
e.Stat
e f:Zip Code Telephone
wn 9
d.Citylro Pi
D. Certification
>... .
g '1 PAULIUCOUA PAUL ILACQUA
('certify that.l leave personally;„�` 1.Name• 2.Authorized Signature
examined the foregoing arid ampkEsIDENT 5/1/2017
familiar with.the information 3.Positionfritle 4.Date(MM/DD/YYYY)
Note:Contractor must contained in this document and
sign form for DLS
all attachments and that,based 5082245500 AMR CO
this
notification purposes on my inquiry of those 5.Telephone 6.Representing
individuals immediately 929 STATE RD. PLYMOUTH
responsible for obtaining the 7:Address 8:City/Town
information, I believe that the MA 02360
information ig tfue,,,accurate,and -
r.>, 9 Late s> 10.Zip Code
compiete. am aware,.. thjtq ,
are significant penalties for
submitting false information;.;
including possible fines and
imprisonment.The undersigned
hereby states that I,have read the
Commonwealth of
Massachusetts,regulations
governing asbestos abatement
(453 CMR 6.00 promulgated-by
the.DepartmentofJ,abor r r.
promulgated by the Department.
of Environmental Protectioh),<
and that I am aware that this
permit application or'notification
shall not be-deemed valid
Unless payment of the
applicable fee is made."
Revised: 11/13/2p13 Page 4 of 4
d
M L) - -°
2909 MAR 12 SLAM 7: 35
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Commonwealth of Massachusetts
_ - Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
74 Coolidge Street, Cotuit MA 02635 �3
Property Address
Pamela O'Neil
Owner Owner's Name
information is g2 Tecumseh Trail Medford Lakes NJ 08055 July 3, 2008
required for
every 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.
Important: A. General Information
When filling out
forms on the
computer,use 1. Inspector:
only the tab key
to move your Patrick M. O'Connell µ
cursor-do not Name of Inspector
use the return
key. Septic Inspection Services Co:
Company Name
189 Cammett Road
Company Address
Marstons Mills MA 02648
City/Town State Zip Code•
508-428-1779 SI 12855
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
July 3, 2008
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
g at that time. This inspection does not address how the system will perform in the future under
the same or different conditions of use.
08-148 o Neil.doc 08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15.
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
74 Coolidge Street, Cotuit MA 02635 -
Property Address
Pamela O'Neil -
Owner Owner's Name
information is y 3; 2008ecumseh Trail, Medford Lakes NJ 08055 Jul required for 82 T '
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
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. f
Comments:
Tank was`not in need of pumping, distribution box was replaced for inspection. Leaching pit was
found empty with a high stain line 1'from bottom of structure.
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.
Answer yes, no or not determined (Y, N, ND) in the ❑ 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 ornot) is
structurally 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.-
ND Explain:
❑ Observation of sewage backup or breakout 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 pipe(s) are replaced,
❑ obstruction is removed
08-148 O'Neil.doc-08106 r Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
M 74 Coolidge Street, Cotuit MA 02635
Property Address
Pamela O'Neil
Owner Owner's Name
information is Y ,82 Tecumseh Trail, Medford Lakes NJ 08055 `Jul 3 2008
required for' •
every page. Citylrown State Zip Code . Date of Inspection
B. Certification cont.
B) System Conditionally Passes (cont.):
❑ distribution box is leveled or replaced
ND Explain:
Yi •
❑ The system-required um•in more than 4 times a year due to broken or obstructed i e s : The
Y q pumping 9 Y PPO
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s) are replaced
❑ obstruction is removed
ND Explain:
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
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 aseptic 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.
08-148 aNeil.doc•08f06 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 3 of 15
' Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
74 Coolidge Street, Cotuit MA 02635
Property Address
Pamela O'Neil
Owner Owner's Name
information is required for 82 Tecumseh Trail Medford Lakes NJ 08055 July 3, 2008
every page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
C) Further Evaluation is Required by the Board of Health'(cont.):
❑ 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 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:F n
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
❑ 01,
clogged SAS or cesspool
E]- ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than_day flow
❑ _ ® Required pumping more than 4 times in the last year NOT due to clogged or .
obstructed pipe(s): Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
Any portiomof cesspool or privy is within 100 feet of a surface water supply or
El ® tributary to a surface water supply.
08-148 O'Neil.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15
Commonwealth of Massachusetts
4 Title 5 Official Inspection Form
a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
74 Coolidge Street, Cotuit MA 02635
Property Address
Pamela O'Neil
Owner Owner's Name
information is required for 82 Tecumseh Trail, Medford Lakes NJ 08055 July 3, 2008
every page. Cityrrown State Zip Code Date of Inspection .
B. Certification (cont.)
D) System Failure Criteria Applicable to All Systems (cont.):
{
Yes No
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
El ® Any portion of a cesspool or privy is within 50 feet of a private water supply
well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for 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
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of.Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000,gpd to 15,000 gpd.
For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the
questions in Section D.
Yes No '
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
the system is located in a nitrogen sensitive area (Interim Wellhead Protection '
❑ 11' 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 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 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
08-148 O'Neil.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15
Commonwealth of Massachusetts
. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
'74 Coolidge Street, Cotuit MA 02635 k
Property Address
Pamela O'Neil
Owner Owner's Name
information is 82 Tecumseh Trail, Medford Lakes NJ' •08055 Jul 3 2008.,-
required for y ,
every page. Cityfrown 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?,
El ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
❑ ® Were as built plans of the system obtained and examined?(If they were not
available note as N/A)
® ❑ 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? "
® E3 . 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 the7field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
08-148 O'Neil.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 15
I
i
Commonwealth of Massachusetts
w - Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
74 Coolidge Street, Cotuit MA 02635
Property Address
Pamela O'Neil
Owner Owner's Name
information is 82 Tecumseh Trail, Medford Lakes NJ' 08055 Jul 3, 2008
required for Y
every page. Cityfrown State Zip Code Date of Inspection
D. System Information
. P
Residential Flow Conditions:
Number of bedrooms (design): 3 Number of bedrooms (actual)' 4 3
DESIGN flow based on 310 CMR 15.203*(for example: 110 gpd x#of bedrooms): 330
Number of current residents: 0
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a`separate sewage system?[if yes separate inspection required] ' ❑ ,Yes ® No
Laundry system inspected?, ❑ Yes ❑ No
Seasonal use? ❑ Yes ® No '
141,000 gal. _
Water meter readings, if available (last 2 years usage (gpd)): 193 gpd.
Sump pump?' ❑ Yes ® No
Last date of occupancy: Unknown
Date
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based.on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No:
Water meter readings, if-available:
Last date of occupancy/use: Date
Other(describe):
08-148 O'Neil.doc-NOS Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 15
Commonwealth of Massachusetts_ ,
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
, 4
'~ 74 Coolidge Street, Cotuit MA 02635 '
Property Address
Pamela O'Neil
Owner Owner's Name
information is 82 Tecumseh Trail Medford Lakes NJ 08055 Jul 3 2008 required for � y ,
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.) .
4
General Information
Pumping Records: ,
None
Source of information
Was system:pumped�as part of the inspection? *. ❑_ Yes ® No
f 2 ;.. �. .:
.If yes, volume pumped:'
gallons
How was quantity pumped determined?':
Reason for pumping: s•}
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool '
❑ Overflow cesspool
Privy
❑N 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)
❑, w Tight tank. Attach a copy of the DEP approval.
° Other(describe): -
.Approximate age of all components, date installed'(if known) and-source of information: r
1994
Were sewage odors detected when arriving at the site?, ❑ Yes.® No
d •
08-148 O'Neil.doc•08/06 „ i Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15
Commonwealth of Massachusetts
97) Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
74 Coolidge Street, Cotuit MA 02635
Property Address
Pamela O'Neil
Owner Owner's Name
information is required for 82 Tecumseh Trail, Medford Lakes NJ 08055 July 3 2008-
every page. Cityrrown State Zip Code Date of Inspection
D. System Information cons
Building Sewer(locate on site plan):
Depth below grader 1
_ � feet
Material of construction: ~
® 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.):
' y t
Septic Tank(locate on sit
e plan):
Depth below grade: feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑ polyethylene - ❑ other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach.a copy of certificate) ❑ Yes ❑ No
-----------------------------------------------------------------------------------------------------.--------------------
Dimensions: 8.5' long x 5.2'wide- 1000 gal.
0,,
Sludge depth:
Distance from top of sludge to bottom of outlet tee or baffle
Scum thickness `
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
How were dimensions determined? 4 Measured
08-148 dNeil.doc•08106 s Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
74 Coolidge Street, Cotuit MA 02635
Property Address
Pamela O'Neil
Owner Owner's Name
information is 82 Tecumseh Trail, Medford Lakes NJ 08055 Jul 3, 2008
required for Y
every page. Cityfrown 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.):
Tank is structurally sound, baffles intact and clear.
Grease Trap (locate on site plan):
Depth below grade: .feet
Material of construction:
❑ concrete ❑ metal 'w ❑ 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: Date
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert,evidence of leakage, etc.): ,
r
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):
4
08-148 UNeil.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15
Commonwealth of Massachusetts`
w : Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
r 74 Coolidge Street, Cotuit MA 02635
Property Address
Pamela O'Neil R
Owner Owner's Name
information is required for 82 Tecumseh Trail, Medford Lakes y , y
NJ 08055 Jul 3, 2008
every page. Citylrown State Zip Code Date of Inspection
D. System Information (cont.) .r
Tight or Holding Tank (cont.)
-
Dimensions: T .
r Capacity:
gallons
- Design Flow:
gallons per day
Y Alarm present, ❑: Yes ❑ No
` Alarm level' Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches,etc.):
*Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
i Distribution Box (if present must be opened) (locate on site plan):
0.
Depth of liquid level above outlet invert
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,
Distribution box was replaced for inspection. .
Pump Chamber(locate on site plan):
Pumps in working order: _ ❑ Yes []'No
Alarms in working order: ❑ Yes ❑ No
t ,
08-148 O'Neit.doe-08106 n Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 11 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
74 Coolidge Street, Cotuit MA 02635
Property Address
Pamela O'Neil
Owner Owner's Name
information is required for 82 Tecumseh Trail Medford Lakes NJ 08055. July 3, 2008 '
every page. Citylrown State Zip Code Date of Inspection
D. System Information (cont.) '
Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.):
d .
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
Type
-® - leaching pits ` number: One 6x6 pit.
❑ leaching chambers number:' .
❑ leaching galleries number: y
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool r number;
❑ innovative/alternative system
Type/name of technology:
Comments (note condition of soil, signs,of hydraulic failure, level of ponding, damp soil, condition of
vegetation,'etc.):
Leaching pit was empty at time of inspection with a high stain line one foot from bottom of structure
leaving five feet of effective leaching.
08-148 O'Neil.doc-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 15
Commonwealth of Massachusetts
4 - Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for.Voluntary Assessments
74 Coolidge Street, Cotuit MA 02635
v Property Address -
Pamela O'Neil
Owner Owner's Name
information is
required for Y 82 Tecumseh Trail, Medford Lakes NJ 08055 Jul 3 2008
every page. Cityrrown State Zip Code Date of Inspection
D. System Information,(cont).
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool
Materials of construction
Indication of groundwater inflow ❑ Yes. ❑ No
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.):
08-148 ONeil.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 13 of 15
r
Commonwealth of Massachusetts =
Title 5 Official Inspection Form
s Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
y 74 Coolidge Street, Cotuit MA 02635
Property Address
Pamela O'Neil
Owner Owner's Name
information is 82 Tecumseh Trail, Medford Lakes NJ 08055' July 3, 2008
required for
every page. Citylrown State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties
to at least two permanent reference landmarks or benchmarks. Locate all wells within.100 feet.
Locate where public water supply enters the building..
Cooli-a a Street
Water
Service
2 •
3 27
1 ,
46
Commonwealth of Massachusetts
. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
' 74 Coolidge Street, Cotuit MA 02635r
Property Address
Pamela.O'Neil _
Owner Owner's Name "
information is required for 82 Tecumseh Trail Medford Lakes M•tr , NJ 08055- July 3,2008
every page. Cityrrown State ` Zip Code Date of Inspection.
D. System Information (cont.)
Site Exam:
® Check Slope
® Surface water. ,
-
Check cellar ;. ,. �. . �, . .. � •
m ® Shallow wells y x
Estimated depth to ground water. feet`
r Please indicate all methods used to-determine the high ground water elevation: -
, ❑ Obtained from system design plans on record 2
If checked,date of.design,plan reviewed: pate
}
❑ Observed site(abutting property/observation hole within 150, feet of SAS) r
❑ - Checked with Iocal,'Board of Health -,explain.
❑ Checked with local"excavators, installers- (attach documentation)
` Accessed USGS database-explain: w ,
USGS topo map and town GIs.
You must describe how,you established the high ground water elevation: '
Town groundwater,contour map shows water abelow el. 10 and topo map shows'property at el. 30.
r
•
08.148 O'Neil.doc•08106 �' : Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15
y
Town of Barnstable
j INE 1p�
Regulatory Services
BARNSTABM Thomas F. Geiler,Director
y MASS.
E16 9. 0 Public Health Division
Thomas McKean,Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 - Fax: 508-790-6304
REGARDING SEPTIC INSPECTIONS BY PRIVATE CONTRACTORS
DISCLAIMER
This septic system inspection report was completed by a private inspector who is certified by
the State of Massachusetts, Department of Environmental Protection.
Although the Town of Barnstable Health Division received the original or copy of the report;
this Division does not warranty the functionality of the septic system in the future nor does
this Division agree with any technical observations and interpretations contained within this
report.
In addition, by receiving this report the Town of Barnstable Health Division does not
automatically approve the number of bedrooms listed within this report. The actual number
of bedrooms approved at a particular property would be listed on the "Disposal Works
Construction Permit".
If you should have any questions regarding this report, please contact the' certified Septic
System Inspector who conducted the inspection.
OASEPTIC\Disclaimei Private Septic Inspections.1)OC
Town of Barnstable
oFIME t Regulatory Services
P� 0 Thomas F. Geiler,Director
Public health Division
* sARNSTAaLE, Thomas McKean,Director
1639, `�� 200 Main Street, Hyannis,MA 02601
ArFD MA'S A,
Phone: 508-862-4644
Email: healthgtown.barnstable.ma.us
Fax: 508-790-6304
Office Hours: M-F 8:00—4:30 0
4
March 23, 2007 �U
Ms. Pamela J Bigelow-ONeill
82 Tecumseh Trail
Medford Lakes,NJ 08055
RE 74 Coolidge Street, Cotuit,MA 02635
Dear Ms. Bigelow-ONeill:
On March 16,2007,Health Agent Timothy O'Connell completed a home inspection at 74
Coolidge Street in Cotuit,MA. During the inspection, the Health Agent found a 275 gallon home
heating fuel Aboveground Storage Tank(AST) in the basement of the residence. Th&pipes were
leaking small amounts of fuel. Those pipes were replaced that day. The tank is in good working
condition and has been properly permitted with the Cotuit Fire Department.
The Health Agent also found a fill pipe and vent pipe in the westerly side yard of the home. The
pipes lead into the basement of the residence to a spigot near the rear door. Cotuit Chief Paul
Frazier believes these pipes lead back to a kerosene tank located underground that was used years
ago. In addition to the previous pipe, another fill pipe was found in the rear yard of the residence
that leads to an Underground Storage Tank(UST).
The Health Division and Cotuit Fire Department have no records of these tanks. The installation
dates are unknown, the sizes of the tanks are unknown,and the contents of the tanks are
unknown. According to 326-3 A(1) -Regulations more stringent than or in addition to state
regulations states that "on or before May 31, 1988, every owner of an underground fuel or
chemical storage system shall file with the Board of Health and the Fire Chief a notice
disclosing the size, type, age, and location of each tank and the type of material stored." The
code also states in 326-3 A(2)that"In zones of contribution, tanks without complete
documentation shall be removed forthwith." (Code enclosed). The location of 74 Coolidge
Street,Cotuit,MA on the assessor's record as parcel 3 on map 36 is within the zone of
contribution to public supply wells.
At this time,both of the tanks shall be removed. The contents of the tanks shall be removed by a
licensed hazardous waste transporter. Permits will need to be pulled from the Cotuit Fire
Department to remove the tanks. Upon removal of the tanks a receipt shall be presented to the
Fire Department with a location of disposal. (Copy enclosed)
Thank you for your cooperation in this matter and if you have any questions or need further
information, guidance, or assistance,please do not hesitate to contact the Public Health Division.
Sincerely,
sk L
Ali ha L.Parker
Hazardous Materials Specialist
Thomas A. McKean, RS, CHO
Director of Public Health
You are directed to remove this tank within sixty (60) days from the date of this notice.
After your tank is removed,please furnish this office evidence in the form of a permit from
your local Fire Department within ninety(90) days of receipt of this notice. You may
request a hearing provided a written petition requesting same is received by the Board of
Health within ten (10) days after this order is served.
CC: Chief Paul Frazier,.Cotuit Fire Department •
Timothy O'Connell,Town of Barnstable Health Agent
Enc. Chapter 326: Fuel and Chemical Storage Tanks
List of Licensed Haulers(copy)
Page 1 of 1
Parker, Alisha
From: Paul A. Frazier [pafrazier@cape.com]
Sent: Friday, May 18, 2007 12:01 PM
To: O'Connell, Timothy
Cc: Parker, Alisha �. -.
Tim, here are the pictures of 74 Coolidge St. The tank was removed without incident, the excavation hole was
free of visible contaminants and no odor was present once the site was opened. Tanks were cleaned and
removed to a tank yard. Soil vapor tests came back negative from Frank Corp. who did the removal. FYI
Paul A. Frazier, Chief
Cotuit Fire - Rescue Dept.
64 High St. - P.O. Box 1632
Cotuit, MA 02635
508-428-2210
508-428-0202 Fax
pafrazier(o)cape.com
DISCLAIMER:This email and any files transmitted with it are confidential and are intended solely for the use of the individual or entity to whom they are
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received this email in error,and that any use,dissemination,forwarding,printing or copying of this email is strictly prohibited. If you received this email
in error,please immediately notify pafrazier cape.com.
5/21/2007
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J SENDER: • • COMPLETE THIS SECTION ON,,DELIVER,r
■ Complete items 1,2,.and 3.Also complete Sig ture
item 4 if Restricted belivery is desired. ❑Agent
■ Print your name and address on the reverse ❑Addressee
so that we can return the card to you. B. eived by n e) C.Date of Delivery
■ Attach this card to the back of the mailpiece, s!,; ��
or on the front if space permits. 'T
D. Is delivery address different from item 1? ❑Yes I
1. Article Addressed to: ❑ 1
If YES,enter delivery address below: No
N T p K OS S 3. Service Type I
�±' ) hiyertified Mail ❑Express Mail
❑Registered ®.Return Receipt for Merchandise
❑Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number 7 0 0.6 ..0 810 0000 3524 9117
(Ransfer from service ,
PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540
I
UNITED STATES POSTAL SERVICE First-Class Mail
Postage&Fees Paid
LISPS
Permit No.G-10
I
Sender. Please print your name, address,-and ZIP+4 in this box •
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Town of BarnstableHealth Division
200 Main Street
Hyannis,MA 02601
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FORM 30xW Ho�esaWnaaEN` THE COMMONWEALTH OF MASSACHUSETTS
BOARD O EALTH
CITYCITY/T� —
4 W
o DEPARTMENT
6DRESS
GSM 58 y`0� (Sog) 96 L/Lf
C( TELEPHONE r.
Floor _Apartment No._ _ No.of Occupants )_ a
No.of Habitable Rooms S No.Sleeping Rooms3__ /
No.dwelling or rooming units____ _No. ones
Name and address of owner (_—_ _ _ A_ ram.
-�J Remarks Reg. Vio.
YARD. Out Bld s.: Fences: 691055
Garbage and Rubbish
Containers:
Drainage
Infestation Rats or other:
STRUCTURE EXT. Steps,Stairs, Porches:
Dual Egress: and Obst'n.: t �lJd❑ El
B F M Doors,Windows:
Roof *-z
Gutters, Drains:
Walls:
Foundation:
Chimney:
BASEMENT Gen.Sanitation:
Dampness:
Stairs:
Li htin : J 3
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: 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 tog. Outlets Walls Ceils. ind. QQors. Floors Locks
Kitchen
Bathroom
Pantry
Den
Living Room
Bedroom 1 . a
Bedroom 2
Bedroom 3
Bedroom 4
Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.:
S cks, Flues,Ve s,Safeties: f_ _
Kitchen Facilities iri
- - - _-
ove
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 REPO IS SIGNED AND CERTIFIED UNDER THE PAINS AND
PENALTIES OF PERJURY.'
INSPECTOR TITLE_
12 M.
_
DATE > 1 b� TIMEl v
'�L, A.M.
THE NEXT SCHEDULED REINSPECTION � P.M.
;. ' _ w "c"a��r'�.��,ka �1i fk.��r'�+'j a:�.l� gip; -/M4:�,� ;.r »�,+ «,;��fr•*.. _•.. ry.Y C .. e,+F•!' .?"c.• `� ., +
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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 heaith, 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 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 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.
Certified Mail#7006 0810 0000 3524 9117
�oFtwe r � Town of Barnstable
Regulatory Services
BARNSYABLE,
p MASS. Thomas F. Geiler,Director
Public Health Division
Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
March 28, 2007
Pamela Bigelow
82 Tecumsah Trail
Medford Lakes, NJ 08055
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 74 Coolidge Street Cotuit, was inspected
on March 16, 2007 by Timothy O'Connell, Health Inspector for the Town of Barnstable.
This inspection was conducted on the basis of the rental registration in accordance with
Chapter 170 of the Town of Barnstable Code.
The following violations of the State Sanitary Code were observed:
105 CMR 410.201 —Temperature Requirements. At 10:20AM, observed temperature
in kitchen and pantry area to be at 62°F. Required to be at least 68°F between 7AM—
11:59PM.
105 CMR 410.351 —Owner's Installation and Maintenance Responsibilities. Faulty
light fixtures, wiring, and light switches.
105 CMR 410.480—Locks. Observed double keyed lock on main entrance; observed
inadequate door locks on cellar and side doors which may not prevent unlawful entry.
105 CMR 410.503 -Protective Railings and Walls. Side deck more then 30" above
ground without proper balusters.
QAOrder letters\Housing violations\Rental ordinance\74 Coolidge Street.doc
t
You are directed to correct the violations listed above within thirty (30) days
of your receipt of this notice by pulling appropriate permits and installing balusters
on side deck; by removing double keyed lock on main door; by installing locks on
cellar door and side door to prevent unlawful entry; by providing proper heat to
each habitable room as stated in code 410 CMR 201; by repairing wiring issues as
discussed.
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 $100.00 per violation. Each day's failure to
comply with an order shall constitute a separate violation.
Should you have any questions regarding the above violations, please contact the Town
Health Division and ask to speak with the inspector who performed the inspection.
bPERRD TH BOARD OF HEALTH
Thomas A. McKean, R.S., CHO
Director of Public Health
Town of Barnstable
Cc: Louis Butler, Tenant
Cc: Timothy O'Connell, Health Inspector
QAOrder letters\Housing violations\Rental ordinance\74 Coolidge Street.doc
Town of Barnstable
�oFTHE t Regulatory Services G
Thomas F. Geiler,Director J �
Public Health Division
* BARNSTABLE, * Thomas McKean,Director
�$ 1MASS
3 S; 200 Main Street, Hyannis, MA 02601
ArFO MA'S A
Phone: 508-862-4644
Email: health@town.barnstable.ma.us
Fax: 508-790-6304
Office Hours: M-F 8:00—4:30
March 23, 2007
Ms.Pamela J Bigelow-ONeill
82 Tecumseh Trail
Medford Lakes,NJ 08055
,RE: 74 Coolidge Street, Cotuit,MA 02635
Dear Ms. Bigelow-ONeill:
On March 16,2007,Health Agent Timothy O'Connell completed a home inspection at 74
Coolidge Street in Cotuit,MA. During the inspection, the Health Agent found a 275 gallon home
heating fuel Aboveground Storage Tank(AST) in the basement of the residence. The pipes were
leaking small amounts of fuel. Those pipes were replaced that day. The tank is in good working
condition and has been properly permitted with the Cotuit Fire Department.
The Health Agent also found a fill pipe and vent pipe in the westerly side yard of the home. The
pipes lead into the basement of the residence to a spigot near the rear door. Cotuit Chief Paul
Frazier believes these pipes lead back to a kerosene tank located underground that was used years
ago. In addition to the previous pipe, another fill pipe was found in the rear yard of the residence
that leads to an Underground Storage Tank(UST).
The Health Division and Cotuit Fire Department have no records of these tanks. The installation
dates are unknown,the sizes of the tanks are unknown, and the contents of the tanks are
unknown. According to 326-3 A(1) =Regulations more stringent than or,in addition to state
regulations states that "on or before May 31, 1988, every owner of an underground fuel or
chemical storage system shall file with the Board of Health and the Fire Chief a notice
disclosing the size, type, age, and location of each tank and the type of material stored." The
code also states in 326-3 A(2)that"In zones of contribution, tanks without complete
documentation shall be removed forthwith." (Code enclosed). The location of 74 Coolidge
Street, Cotuit,MA on the assessor's record as parcel 3 on map 36 is within the zone of
contribution to public supply wells.
At this time,both of the tanks shall be removed. The contents of the tanks shall be removed by a
licensed hazardous waste transporter. Permits will need to be pulled from the Cotuit Fire
r
Department to remove the tanks. Upon removal of the tanks a receipt shall be presented to the
Fire Department with a location of disposal. (Copy enclosed)
Thank you for your cooperation in this matter and if you have any questions or need further
information, guidance, or assistance,please do not hesitate to contact the Public Health Division.
4Sincerely,,,, n
5 L
ha L. Parker
Hazardous Materials Specialist
Thomas A.McKean, RS, CHO
Director of Public Health
You are directed to remove this tank within sixty (60) days from the date of this notice.
After your tank is removed,please furnish this office evidence in the form of a permit from
your local Fire Department within ninety(90) days of receipt of this notice. You may
request a hearing provided a written petition requesting same is received by the Board of
Health within ten (10) days after this order is served.
CC: Chief Paul Frazier, Cotuit Fire Department
Timothy O'Connell, Town of Barnstable Health Agent
Enc. Chapter 326: Fuel and Chemical Storage Tanks
List of Licensed Haulers (copy)
� P�
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"Citizen Web Request \ Page 1 of 3
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OWN\ Ionn Citizen Request Management Thursday, Mar(
TOWN\oconnelt Request Management
0 Route to Users Search Requests Create Requests
Request Information
Request ID: 20779 Created: 3/15/2007 9:27:12 AM
Status: Assigned To Staff Assigned To: O'Connell, Timothy
Health Office
Anonymous: No Request Category: Chapter II : Housing
Substandard edit
Estimated 3/20/2007 Change Estimated Feb March 2007 Air
Completion Completion Date:
Date: Sun Mon Tue Wed Thu Fri I Sat
25 26 27 28 1 2 3
4 5 6 7 8 9 10
11 12 13 14 15 16 17
� c c
18 19 20 21 22 23124
25 26 27 28 29 30 31
1 2 3 4 5 6 7
Created B : Fontaine,Tina. Priority: High edit
Health Office
Citation Numbers: edit
Requestor Informat" n
Requestor
Request ParcelNum r ,
diesel fuel leaking in basement. Map: 036 -1 Block: 003 Lot: 000
When they turn the lights on in the
basement sparks fly. Nervous with 2 Parcel Lookup
kids in the house. Very old wiring
through the house. Also the water is
black when it comes out.
http://issql/lntemalwrs/WRequest.aspx?ID=20779 3/15/2007
Citizen Web Request Page 2 of 3
I Email:
Edit Re uestor Information
Track Request Progress
Request Work History: Internal Note History:
Entered on 3/15/2007.9:26:39 AM
by Fontaine,Tina
rental property not registered. CB sending
application.
System entry on 3/15/2007.9:26:39 AM:
Assigned to O'Connell, Timothy
Enter work progress: Enter internal note:
(Viewed by everybody) (Viewed internally only)
��71�1
S neJlCheck
�SpeIkCheck�`"
Add document or image link:
* You can also type in a folder name to see everything in the folder
Current Links:
Time worked on request: Response time: 0 �
*Time entries are in hours. Examples of time entries: 1.25, 0.5, 0.75, 1, 3.5, 0.25, 0.10
* Response time: Measured from the creation date to your first actions on the request.
* Do not include nights, weekends, and holidays in response time for most departments.
(F' Save changes F-j- Check to notify town employee below
to review this request.
http://issql/intemalwrs/V,Request.aspx?ID=20779 3/15/2007
U Citizen Web Request Page 3 of 3
C Save changes and notify Health office__
citizen* Agostinelli, Joan
Close request and notify citizen* Brief message to reviewer:
*notify works if email address was given ll
Update''
- SpeIG'Check,::
Public Use: Printer Friendly Version
Internal Use: Printer Friendly Version
http://issql/intemalwrs/WRequest.aspx?ID=20779 3/15/2007
Parcel Detail Pagel of 3
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Logged In As: Pa rce I Detail Thursday, Mar(
Parcel Lookup
Parcellnfo
Parcel ID j036-003 - Developer LOT 2A
I Lot __ W. w _�..._.--..._
Location 174 COOLIDGE STREET I Pri Frontage 140
-- Sec
Sec Road i I Frontage
Village ICOTUIT Fire District COTUIT
Sewer Acct 1 _ Road Index 0352
Interactive n � i
Map ,i
� w
- Owner Info
owner!BIGELOW-ONEILL, PAMELA J & I Co-owner IONE�ILL DENNIS P JR
streets 74 COOLIDGEST, � � I Street2 i
City I COTUIT I state EA Zip,,02635 Country.j US
- Land Info
Acres'0.39 use�Single Fam MDL-01 I zoning RF _ - Nghbd 1,2108
Topography Level Road Paved
... ._................ .................._ -- ...--
Utilities Public Water,Septic I Location
Construction Info
Building 1 of 1
Year#1924 le
g_ oo Ext
,_I Roof Gable/Hip �' Wood Shin
Built Struct Wall I
Effect _ _.____ Roof _-_---_____ _ AC
Area 1282 I Cover Asph/F GIs/Cmp I Type None
Int _____. Bed
Style jConventional Wall:Plastered I Rooms 13 Bedrooms I
Int Bath
Model Residential I Floor Hardwood I Rooms 1 Full + 1 H I
Grade;Average Plus Type Hot Water Total Rooms[6 Rooms
http://issql/intranet/propdata/ParcelDetail.aspx?ID=2307 3/15/2007
Parcel Detail Page 2 of 3
{{ Heat i Found-
Stories i2 Sty w/UAT i Fuel i0il ation Typical
9 x �
'roP`
Permit History _
Issue Date iPurpose Permit# Amount Insp Date Comments
Visit History
Date Who Purpose
6/14/2005 12:00:00 AM Paul Talbot Meas/Est
8/23/2002 12:00:00 AM Paul Talbot Meas/Est
7/17/1999 12:00:00 AM Frederick Stepanis Meas/Listed
Sales History.
...... --.. ---._..........................._....._ ........-
Line Sale Date Owner Book/Page Sale P
1 2/20/2003 BIGELOW-ONEILL, PAMELA J & 16421/072
2 5/15/1994 BIGELOW, PAMELA J 9191/286 ;
3 3/15/1994 GIFFORD,W HAZEL 9121/079
4 3/15/1978 GIFFORD,W HAZEL P56170
5 GIFFORD,W HAZEL P1254EP1
6 GIFFORD, W HAZEL M-792 9121/079
Assessment History
Save# Year Building Value XF Value OB Value Land Value Total Parc(
1 2007 $135,700 $0 $0 $224,300
2 2006 $116,000 $0 $0 $207,900
3 2005 $103,700 $0 $0 $138,300
4 2004 $86,800 $0 $0 $117,600
5 2003 $75,400 $0 $0 $69,900 ;
6 2002 $75,400 $0 $0 $69,900
7 2001 $75,400 $0 $0 $69,900 ;
8 2000 $53,900 $0 $0 $46,100
9 1999 $55,000 $0 $0 $46,100 ;
10 1998 $55,000 $0 $0 $46,100 ;
11 1997 $55,000 $0 $0 $46,100
http://issql/Intranet/propdata/ParcelDetail.aspx?ID=2307 3/15/2007
Parcel Detail Page 3 of 3
c`
12 1996 $55,000 $0 $0 $46,100
13 1995 $55,000 $0 $0 $54,900 ;
14 1994 $61,500 $0 $0 $61,800
15 1993 $61,500 $0 $0 $61,800
16 1992 $70,100 $0 $0 $68,600
17 1991 $78,300 $0 $0 $73,200
18 1990 $78,300 $0 $0 $73,200
19 1989 $78,300 $0 $0 $73,200
20 1988 $56,300 $0 $0 $48,800 ;
21 1987 $56,300 $0 $0 $48,800
22 1986 $56,300 $0 $0 $48,800
� Photos _
http://issgl/intranet/propdata/Parce,lDetail.aspx?ID=2307 3/15/2007
r
Page 1 of 2
O'Connell, Timothy
From: Paul A. Frazier[pafrazier@cape.com]
Sent: Wednesday, March 21, 2007 5:00 PM
To: O'Connell, Timothy
Subject: Re: 74 Coolidge St. UST
Tim,
Below is text of the letter I sent to the owner of 74 Coolidge St. today, I can forward a copy of the letter by mail if
you wish.
Paul
March 21, 2007
Pam Bigelow-O'Neill Re: 74 Coolidge St., Cotuit
82 Tecumseh Trail
Medford Lakes,NJ 08055
Dear.Ms. Bigelow-O'Neill,
I am writing as a follow up to our conversation yesterday and again today regarding the underground
tank(s)that appear to be located on your property. To provide some background, your tenant, Lewis
Butler, called the Board of Health last Thursday reporting a fuel oil leak in the basement. Health
Inspector Tim O'Connell contacted me and we met at the property. As you recall, I spoke with you by
phone from your cousin's home that same afternoon..
Upon inspection, I found an oily residue on the fill pipe; couplings appeared to leak whenever the tank
received a delivery of oil. An inspection of your new oil furnace was already scheduled for the following
Monday however I called the installer to advise them of what I found. Your installer replaced the tank
fill piping; the installation passed inspection and a permit was left at the property. Your tenant was
verbal about a number of other concerns that Mr. O'Connell was going to include in a follow up housing
inspection. I am aware that you have already hired an electrician to make repairs.
Of immediate concern is the likely the presence of two underground tanks. The tenant stated that during
periods of rain, a watery substance with an oily odor has leaked from the spigot near the basement door.
I surmised this was most likely an underground kerosene tank and you were able to confirm this during
our conversation yesterday. In addition, what appears to be a tank fill connection for an underground
tank was found protruding from the ground to the left of the door leading into the basement.
I have not been able to locate any records or permits for these tanks. Given their age and the probability
that the kerosene tank's walls have been breached, it is imperative to confirm the presence of any
underground tanks and, if present, take action to remove them immediately. Concurrent with this, the
Board of Health will be issuing an order to remove the tanks in accordance with their regulations for
underground tanks. I have chosen not to issue an order for removal because I have every confidence that
you will act appropriately and in a timely manner.
3/22/2007
I
Page 2 of 2
If you have any questions or need additional information please contact me at 508-428-8010.
Sincerely,
Paul Frazier, Chief
Cc: Board of Health C/O Tim O'Connell
Paul A. Frazier, Chief
Cotuit Fire- Rescue Dept.
64 High St. - P.O. Box 1632
Cotuit, MA 02635
508-428-2210
508-428-0202 Fax
afp razier ca e.com
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received this email in error,and that any use,dissemination,forwarding,printing or copying of this email is strictly prohibited. If you received this email
in error,please immediately notify pafrazier(o cape.com.
3/22/2007
I .APR-06-2007 02 : 14 PM P. 01
' tI IIff �{ 111Mi B'o Ilo��n ':•gill:: I III I111:1 .'I"I Li.�11��dnl.+t.Yru..�....�.-..�...�.:—..
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Denfli6 ONCil1
82 Tccumsch Tteil 4
Mellow AM,NJ 0805$
(C)609-314-0887
(W)215-282-8237
�n..l°I :.c. •.Ir"r.p'.p41,. ,L,pip�a ii(8ky.., vF"ly.�. :�',,��„I. �f��V� � �• �r ,
:..:. � ,.. x •,,.V :.'I':ial'.pll.,i�II ::,1#�1•,. , �, .�. ::d °[�:I' ,
,,,.:..I'..I•:�•. J,':I;f�+).�;l .ell,•, ;�',
III ,I:
O'Conne�� Fax: 508-790-63014
To: Timothy
DOW: 4/6/2007
From; Dennis O'Neill
Re: Invoice for electrical work r`a"'= a
CC,
❑ L"P t x For RewWIw t7 Please CommetR 0 PWMq p4m y ❑ Please
Tom° that P>arn and I used to oorte�t
Here is a copy of the invoice from the electrical conb'od"
the bm which were bmWht to our attention via yme conversation with Pam regarding
Our Pro oo property at 74 c: k*e Sucmt,oc*jit FM. Plow call mA if ymi have anv Ouesdons•
Thank you
Dennis
I
APR-06-2007 02 : 17 PM P. 01
Denis O'Neill
82 TeOumseh 71*j
���Lakes,NJ 0905s
)609-314,0897
( 5-282.8237
To. Tim ft
y O'Connell Fax.
608-790-6304
From: Dennis O'Neill -``_`-----�
-..� Date: 4/6/2007
Ra: Invoice fnr electrical work ----_,
2
CC:
D U"t x For Roeyiow
D Please Carte p pp,m pA* D Plaiaso pA� i
Tlmoth � I�
Hehe iSyBinvoice � •
w6c of the roL t tom the�ectrlcal c actor that Pam and I used to corms
mere bf0�ht to our aftention (e:p
our property at 74 Coor Ana your�rsation with Pam regarding
Steet,Cotuit MA. Please call me if you have any questions.
Tharoc you
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APR-06-2007 02 : 18 PM P. 02
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PROM .:W-W I N.SLOl9 , FAX NO. :150®39441 S6
AFr. 06 2007 09:26AM P2
E. F. Winslow Plumbing & Heating Co g . Inc,
8 ardon circle
South Yarmouth, Massachusaft 0Y884
Phone-808.394.7778 Fax-308.394.VZ5
e-mall-qusationsaefwinelow.com
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1M THE HOUSE,•EY-MYTHIN0 IS UP TO CODE.
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Certified Mail#0000 0000 0000 0000 0000
� T Town Of Barnstable
Regulatory Services
X�T3�4R`+tS'Ti$lE �
Thomas F. Geiler, Director
Public Health Division
Thomas McKean, Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
date
name
ad ss
city,state,zip
NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000 STATE SANITARY
CODE II —MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION
AND THE TOWN OF BARiNSTABLE CODE CHAPTER 170.
The property owned by you located at `� . was inspected
on / / by �'� (Address)
(date) (Inspector's n Health Inspector for the Town
am�of Barnstable, _
(Reason for inspection)
The following violation(s) of the State Sanitary Code were observed:
State code violation number-violation descr* do
105 CMR 410. 5a3 - 1k�"� t -e- 76 - 3 0 ''
105 CMR 410. 490 - �� d'�-��` c�►^—
105 CMR 4 3 6 j ' �t'n - ,/zS .
a.-.Q _
Q:\Order letters\Housing violations\Rental ordinance\template.doc
I
a
105 CMRLA
_
The following violation(s) of the Town of Barnstable Code were observed:
(Town code violation number-violation description) .
§170-_ -
§170-_-
You are directed to correct the violations listed above within w
? n p ( ) days..
of your receipt of this notice by (` *en#)
I
�'" �✓v��.Q-� - �-t�t'�S CSC- G���-C�- I�troc,
q10 a O m
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 THE BOARD OF HEALTH
Thomas A. McKean, R.S., CHO r
Director of Public Health
Town of Barnstable ^ O -7
Cc:
(Name,tenant,owner,Fire Dept.,Building Dept....)
Cc: ( 0
(Health inspector's name)
(Generic codes located at QAOrder letters\Housing violations\Rental Ordinance\GENERIC CODES.DOC)
QAOrder letters\Housing violations\Rental ordinance\template.doc
MAR-15-2007 10 :24 PM P. 01
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FAX TRANSMISSION FORM
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Fax #: SO — ? 1?6 .
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Date: 3 .../S-- O
Pages:
Comments:
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MAR-15-2007 10 :25 PM P. 03
` Page 1 of 2
Barnstable Assessing,Search Results
9
Home: Departments:Assessors Division, Property Assessment Search Results
New Search
74 COOLIDGE STREET
Owner. 2006 Assessed
Values.
BIGELOW ONEILL,PAMELA J a Appraised Value Assessed Value
Map/Parcel/Parcel Extension Building Value: $118,000 $ 118,000
036 /003J Extra Features: $0 $c
Outbuildings: $0 $0
Mailing Address Land Value: $207,900 .$207,900
BIGELOW-ONEILL,PAMELA J&
ONEILL, DENNIS P JR Totals $323,900 $323,900
74 COOLIDGE ST
COTUIT,MA.02635
2006 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation)
Community Preservation Act Tax $81.31 Fire District Rates Town
Barnstable-Residential $1.90 $6.31
Barnstable-Commercial $2.51 Commei
Cotult FD Tax(Residential) $430.79 C.O.M.M.-All Classes $1.06 $6.54
Cotuit FD-All Classes $1.33. Persona
Town Tax(Residential) $2,043.81 Hyannis-Residential $1.61 $6.49
Hyannis-Commercial $2.50 Other R
W Barnstable-Residential $1.60 Commur
W Barnstable-Commercal $2.46
Total: $2,535.91
Construction Details
Building Property Sketch Legend
I
Building value $116,000 Interior Floors Carpet
I
Style Conventional Interior Walls Plastered
Model Residential Heat Fuel Oil
Grade Average Plus Heat Type Hot Water
Stories 2 Sty w/UAT AC Type None
I .
iExterior Walls Wood Shingle Bedrooms 3 Bedrooms
i Roof Structure Gable/Hip Bathrooms 1 Full+1 H
btt„,//tnwn ha,rnctahle_ma.uc/assessing/assess06/displayparce106.asp?mapparbacl-address&... 6/9/2006
MAR-15-2007 10 :26 PM P. 04
Barnstable Assessing Search Results Page 2 of 2
Roof Cover AsphlF Gls/Cmp living area 1152
Replacement Cost $146056 Year Built 1924
Depreciation 20 Total Rooms 6 Rooms
Land
Lot Size(Acres) 0.39
Appraised Value $207,900
Assessed Value $207,900
Interactive Prop" Map: men reauires Rua In:
I have visited the ma s before �
Show M11111e-MAR
And)2001 photos avallable
Sales History:
Owner: Sate Date Book/Page: Sale Price:
BIGELOW ONEILL, PAMELA J& Feb 20 2003 12:OOAM 16421/072 $1
BIGELOW, PAMELA J May 15 199412:OOAM 9191/286 $112,000
GIFFORD,W HAZEL Mar 15 1094 12:OOAM 9121/079 $1
GIFFORD,W HAZEL Mar 15 1978 12:OOAM P56170 so
GIFFORD,W HAZEL M-792 9121/079 so
GIFFORD,W HAZEL P1254EP1 $1
Extra Bullding Features
Code Description Units/SO ft Appraised Value Assessed Value
Property Sketch
Legend
OAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished)
BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished)
CAN Canopy FUS Second Story Living Area UST Utility Area(Unfinished)
(Finished)
FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story
(Unfinished)
FCP Carport GRN Greenhouse UUA Unfinished Utility Attie
FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story
(Unfinished)
FHS Half Story(Finished) SF13 Semi Finished Living Area WDK Wood Deck
FOP Open or Screened in Porch TQS Three Quarters Story(Finished)
httD-//www.town.barn.stabl.e.ma.us/Assessing/Assess06/displayParce106.asp?mappar=-036003 6/8/2006
MAR-15-2007 10 :27 PM P. 05
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TOWN OF BARNSTABLE
LOCATION 74 C c o l- i d G C Sr SEWAGE # 9/,/,. --,-7 "
VILLAGE C o"ril ! r ASSESSOR'S MAP & LOT 0 6',
INSTALLER'S NAME & PHONE NO. ,T• �. /V1 G O/Vf,dC� f S o
SEPTIC TANK CAPACITY � O O O
LEACHING FACILITY:(type) A,7l,r (size) A o o e
NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER
BIER OR OWNER �1
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: ���'�
VARIANCE GRANTED: Yes No /f�
`1
i_
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.a �
,.
� � �� :/,�
� �"� i' ' /
� v� �', .•
� � � 33 , /
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� �
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o
` TOWN OF BARNSTABLE
LOCATION Ii CQ - —°���� SEWAGE# '►^5P
VILLAGE Ccu ASSESSOR'S MAP&PARCEL c
IN E S NAME&PHONE NO wcS Y'3C- Ayq 0 e-198- I- 7
SEPTIC TANK CAPACITY /OCO_QJ
LEACHING FACILITY:(type) (size) 1000
NO.OF BEDROOMS
OWNER ,vV�`�.
PERMIT DATE: C01"Ph+AAiGl DATE:`y► ->p
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
Coolidge Street
Water
Service i
2 2
3 27
46
No.... .....- Q Fz�s..... ....3... OQ
APPROVED THE COMMONWEALTH OF MASSACHUSETTS
B ns le Conservati DeRart ent, BOARD OF HEALTH
�-f�.
D� Co �vV
OWN OF BARNSTABLE
igned Date
Appliratiun for Divi-puuttl Ourku Tomitrnrtiun ramit
Application is hereby made for a Permit to Construct ( ) or Repair kX) an Individual Sewage Disposal
System at:
7.4 Cooli-d_ge S-tretft.�Co�uit�
.. _ - -------- ------------------- ----------------------------------------•-----•----.----...-.......----------•--..................
• .•-• � Location•Address or Lot No.
W.,l�. Gifford
W J.1.D.Macomba-r Jr . Owner Address-
Installer Address
UType of Building Size Lot............................Sq. feet
,., DwellingX— No. of Bedrooms...............----------------------------Expansion Attic ( ) Garbage Grinder ( )
aOther—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 ( )
Percolation Test Results Performed by-------- ------- ------•-•-----------•-----------•-•-----•----•---•------- Date........................................
Test Pit No. I................minutes per inch Depth of t Test Pit.................... Depth to ground water........................
44 Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................
P4 •------------•..................................•----............----••------------•---•--••••----..........---------•-•-•--•-------...---.....--•...........
Descriptionof Soil............................................Sa-n-=l.................................................................................................................
x
c,
w
-- -•--------------------------------------•---•-------------------------------------------•--•--------.....------......-----------•-••-----------------•----------•---------------------------•-----
U Nature of Repairs or Alterations—Answer when applicable......Om_i t--•c e s s o o l-s . --Install• - i-1-0 0 0--_-.
gallon tank 1—distribution 'pox 1-1000 -allon leaching ..............................................it
..--•------------------------------------------------------•----------------------------------------------• .....................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compliance has bee ;isosedWbbyhe boar of alth.
Signed ... .. ....... .. ...................... ....4./...2.6./_.9.4- ------
Application Approved By ---------- Dace
Application Disapproved for the following reasons: .................................................... ... .............. ........ . ........................................
---------------------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------------- ............................
Date
Permit No. ------- .. ...................... Issued
Date
No... _.�W FEB...........30:00
s'
THE COMMONWEALTH OF MASSACHUSETTS
` BOARD OF HEALTH D� �, 6D3
TOWN OF BARNSTABLE
Appliration for Diijiponttl Worko Tonntrnrtion ramit
Application is hereby made for a Permit to Construct ( ) or Repair (KX) an Individual Sewage Disposal
System at:
7 9Cp@... . i. tteeteCCl a��rvi ll............. ............•------•------••-----•--------....--•-----•----••-----•-------...--------•------......
-••._....-•••------.........
W.H. Gifford Location-Address or Lot No.
W J.p.Macomber Jr. Owner Address----------------------`-----•-------------
9Q Installer Address
UType of Building Size Lot............................Sq. feet
�..� DwellingX— No. of Bedrooms...............3--------------------------Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( )
dOther fixtures -------------------------------------------------- ----------------------------------- -------------------------------------------------------------
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity__.__-.___gallons Length________________ Width_____...._____.. Diameter................ Depth................
x Disposal Trench— No. .................... Width-------------------- Total Length.................... Total leaching area.........._---------sq. ft.
Seepage Pit No--------------------- Diameter--------------------. Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( .) , Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date...................................
Test Pit No. 1...... .........minutes per inch Depth of Test Pit-____:_______-- _-- Depth to ground water__.-_._____-____-__-._..
Gzt Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................
Pill a
ODescription of Soil......................---------•----..._....sa.n.d............................. .................................................................................
U ---------•-- --------------•--------------••--------------------------------------•-----------------------------------------------------------------------------------•-•-••------...._......----•-....
W
----------------------------------------------- ---------------------------------------------••-------------------------•------------------••----------------•---•----------------•--•--•------------•.
U Nature of Repairs or Alterations—Answer when applicable.....-Om t...cesspool-s-, Insta-ll-- 1-1000_._..
gallon tank 1—distribution box 1-1000 gallon leaching pit.
..------•---------------------------------------------------------------------------•-......-•------------------------------------------------------------------_.._._..--•---•----•---•------..........
Agreement: 3; ,
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 Complian has been issued by the board of ealth.
Signed -... r � ----4-/2.6./94-----------
/ .............. Date
Application Approved By ----µ--- - � [t%...- - --- �t.
.�^�.=ql � Date
J._............._--.-....---`---------------------------
Application Disapproved for the following reasonr: .................. ..... ... ..........--............ . . ...._.... . --...................
-------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------ ----------------------------------------
Date
Permit No. ......... Ln/-----.-- ...................... Issued .............................
Date
t
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
(lertifi ate of (11omplinure T
THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed ( ) or Repaired ( XX )
by J.P.Macomber Jr .
............................................................................... ....... . . ........--........------------------------------------------------------.....................................................
Installer
74 Coolidge Street Cotuit
at -------- -- ----- - ----------------- --------------------- ------------------------------------------------- --------------------------------------------------------------------------------------------------------------------
has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in
the application for Disposal Works Construction Permit No. ........................................... dated --------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISEk%CTORY.
DATE .........'?`......... ._ '"-/'.%-�'------------------------- Inspector "� : `d.... .../.r. ""J� ''
� f
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
q TOWN OF BARNSTABLE
No...
.l FEE..$....3 0:0 0 -
Displip t1 Workii Tonotrudion "unfit
J P.Macomber Jr.
Permission is hereby granted--- --------------------------------------------------------------------------------•-__-•---•-•---
to Construct ) or Repair (KX) an Individual Sewage Disposal System
at No....--•. ••...... p
74 L..00lidge Street Cotuit
..---•-•• ---•-----•---
Street
as shown on the application for Disposal Works Construction Permit No.��n�-_ Dated__-__t/_-,.��_-%M..........___...
-----------------•------•-----••--- :.\...-------------------------------------------------
(� Boar
DATE I;�---�=_- `�-u d of Health
•••------------- •------------------• �✓
FORM 36508 HOBBS&WARREN.INC..PUBLISHERS
1-
NOTES:
14•.(r 1.) CONTRACTOR IS TO VERIFY ALL EXISTING CONDITIONS
(EXISTING) (EXISTING,) &DIMENSIONS IN THE FIELD
2.) CONTRACTOR TO VERIFY ALL INTERIOR&EXTERIOR MATERIALS,
DETAILS,&FINISHES IN THE FIELD WITH OWNER
3_) ALL SIMPSON COMPONENTS&HARDWARE EXPOSED TO THE WEATHER
o (° TO BE MADE OF STAINLESS STEEL
b o r 4) ALL CONSTRUCTION TO CONFORM TO 780 CMR MASSACHUSETTS
` STATE BUILDING CODE.SEVENTH EDITION
NEW 5.) FOLLOW ALL MANUFACTURER'S SPECIFICATIONS FOR INSTALLATION OF ALL
EXIST- DECK
Z SIMPSON COMPONENTS
ro 6•) ALL CONCRETE USED FOR FOUNDATION WALLS,FOOTINGS&SLABS
EXIST z o - TO BE 3000 PSI
b a 7.) TIMBER FRAMING TO BE SPRUCE/PINE/FIR NO.2 GRADE
w ADomom) WI CASINGUSTS $_) VERIFY ALL PLUMBING&ELECTRICAL DETAILS W/OWNERS ON THE SITE
EXIST. W-0• DURING FRAMING CONSTRUCTION -
u
11
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(EXISTING). - ;ADDITION/ - •. NEW 4x 4 POSTS '
W(CASING
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FIRST FLOOR PLAN s�. . ® —
f - NEW MATCH
EXI To
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NEW CORNER BOARDS
LEGEND: TO MATCH OUST,
o EXISTING CONSTRUCTION TION TO BE REMOVED ( FRONT ELEVATION PRELIMINARY DRAWING
�--� CON �
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NEW CONSTRUCTION i
FOR DESIGN REVIEW -
COTUIT BAY DESIGN, LLC NEW ADDITION FOR: TT���NE� L`IIET.LT "N SCALE : DRAWINGNO.:
Egp OR 04i55Wrv5-Z FOLMED"O,..1
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TTE�OTTpv�Mll;S PR TJ ST/31T -V
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MASHPEE MA. 02649 BRISTOW RESIDENCE OtIESEO ENT. OUT SOLELY
FO THE
PH. (508 274-1.166 � OF T.E OR -.ry ETai°p<O TON G4EO
llE�IAiAMINGS ARE SOLELY FOR le�T6E DATE Al
OF i OwNER S REO LM OTNEH It.E OF
T1-ESE W OF D 1E OES1Ghf WID"RTK 1 1/2/201 0
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