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HomeMy WebLinkAbout0868 MAIN STREET (COTUIT) - Health 868 MAIN STREET, COTUIT A= I "'_._.� � /�%� i /� L__._(�/ �� �� �`G �\` �� � i �.� //// �..J � ` \V" , ,' �� / 1 �i �. Commonwealth of Massachusetts Form 4--System Pumping Record ` Massachusetts System Pumping Record System Owner System Location Cotuit l+ederetted Church High Street Lc)cation 868 Main .Street 18 High Strzaot Cotuit, MA, 026:35 � � Cotuit, MA, 02635 (508)- 428_6163 x t (508)-428-6163 x Cotuit Federated Church Type: Emergenc Routine Cesspool: No Yes Septic Tank: No �Qllons es�q— Date of Pumping: Quantity Pumped: B System Pumped : Wind River Environmental,LLC Permit#: Y P Y Contents Transferred to: Contents Disposed at: �1 2: Date: 7 Pumper Signature: Condition of System/Other Comments f/ 562-450 Dep Approved Form-12/07/95 BarnstoEit't.ourity Health and ` Envircniiie :4,Dl vepGrtrr?�r,? Superioi ::ourt House LETTER OF LEAD ABATEMENT COMPLIANCE DATE: 3/6/95 Dear Ms. Parks ; This letter s�to=-.certify that I inspected your p;.karerty located at 1 868 Main S ,- , 'apartment no._ , and relevant common areas, in the City or -d Tow of 1COtuit for lead abatement compliance on _2/22/99 & 3/6/95 ` ,rand on that date those surfaces cited in the initial inspection report of 7/7/94 were found to be in compliance with Massachusetts General Laws, Chapter ill, Section 197, and 105 CMR 460.000 Regulations for Lead Poisoning Prevention and Control. Massachusetts law does not require the abatement of all residential lead paint. The residential premises or dwelling unit ' and relevant common areas shall remain in compliance only as long as there continues to be no peeling, chipping or flaking lead paint or other accessible leaded materials, as long as coverings and/or encapsulants forming an effective barrier over such paint or other leaded materials remain in place, and as long as surfaces reversed to correct lead hazards remain reversed and securely in place. See the reverse side of this letter for the location(s) of surfaces which were covered, encapsulated or reversed as an abatement method to achieve compliance, if applicable. To the best of my knowledge, the cost of the legally required deleading is $ 11 .662.00 • Sincerely, Insp or DPH Licen Number Jane Crowley C2829 . INSPECTION AND ABATEMENT HISTORY Doug Williams 1-1843 Name & License Number of Inspector Who Performed Initial Inspection Jane Crowley C 2829 1/4-/9y Date of Reoccupancy/Reinspection Name and License Number of (if. applicable) Inspector Who Performed Reoccupancy/Reinspection Name(s) and License Number(s) of Department of Labor and Industry Authorized Deleading Contractor(s) Who Performed Abatement: Ray Benson D 01025 LOLAC 10/24/94 " s 1 AREAS WHERE LEAD PAINT OR OTHER LEADED MATERIAL HAS BEEN COVERED, ENCAPSULATED OR REVERSED AS A LEAD ABATEMENT METHOD. INTERIOR Room # Side Surface/Fixture Type of COV/REV/ENC EXTERIOR Side Surface/Fixture Type of Covering/Reversal • Pg � Of a. } SEl�4 SOUTH EASTERN MASSACHUSETTS METHOD USED INSPECTION SERVICE C1 NA 2S Expire date C 1-617-230-5389 W) 428-3562 X-RAY P.O. Boat 1069, Centervil registration # le, MA 62652 D FLUORESCENCE . ' 11843 Model Serial I A.T i yl �.=3._K=.■ .�J_l. :1J-J__L_L_LLj CITY Ash WAR OF FWST MAMf I L6 A rr000 yy So. �wwr Vi.A'.Law Nwr Fron/Gurd.n'.FiM 14�r AI U Y pA N W UNITS orior- code enforcement determinaition LLa- 3.OTHM PORN 1.illO A NO.OF ROOMS 2.>'A A. - WCLUOE SAT" Children under 6 elevated blood level SORMORE OUT NOTNALLS OVA*WS NAME: >r OWNM ADDRESS: .11 ?� z I heve .recieved a co py of this report d not ' s rRTMARKS:La,s-c r'J�/�i c'v r�^e c.t�.o•�s � y � Paps l,.__ _ ���'�' ��- .?ac/I e 'C/`•oct�/P y � cam-�z.�'. � 0 Dow Secorded r 1.AFFAIR 1.OTWA M/i►.DATA to" m &VACAAICY VIOLATION see/vic. a OWMVT10N 0 17 Y ON N FLOOR I FLOOR `` `► 131 Clo D B S D A (STREET SIDE) A (STREET SIDE) Pb MORE THAN 1.2 mg/cm with x-ray fluorescence or positive with Ns=S is;ILLEQAt . :,� „ } uesricToe MML.OATt L III COM►1lAMCE. SI".DATE 1.IN COM►UMICS - F~.DATE 4.II=06A= i , •� t w0"M M.0011E1i /S .�161(S/ C/ ` Z.WORK IN P"Womfi 7.WOI I W FNOM . 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NE NOM®® wo • ®®®®REMARKS NEENNION i • Ham ��mooEmFA mm�� Film ir jo ■co LYA N=Mmm� rlo ,. iCz®� =Mmmm irpIQ Eam� WIN •�J�rnpwmm®MGM OC'��®file �W ��o�� ismJ M ismO ®®® (rr, !ia M M 0 im 0.0191 Lam-® W/WA mimm" � ®��■� ® mom_ mm�® � am MINION ♦ b .S , TOWN OF BARNSTABLE LOCATION IW A I AI S l SEWAGE # VILLAGE [O;r u IT ASSESSOR'S MAP & 1.0103S`10'7 INSTALLER'S,NAME & PHONE NO. J /� A4 A C QM /3eR t- S'OA/ SEPTIC TANK CAPACITY LEACHING FACILITY:(type) /�/6T� (size) /. p 0 0 NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUMbVIrOR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: . - - M VARIANCE GRANTED: Yes No `�-' ' I a No..17 '��✓.. F�s. ....3.0.00 THE COMMONWEALTH OF MASSACHUSETTS 1 BOARD OF HEALTH TOWN OF BARNSTABLE ,��.�rlirtt i t�nr �i���n��l �nrlt� Cnngt��rnr#inn Pruti� 1 App)cation is hereby made for a Permit to Construct ( ) or Repair �CX) an Individual Sewage Disposal System at: 868 Mai ..................................... --•---------------------------•----••---....--------------------------••---•----------...-----.._. .................. Location-Address or Lot No. Phi 11 i-p IDS -............................................................................ -•------------------------------•---------..........-..----......... W J .P.Macomber Jr. owner Address Installer Address d Type of Building Size Lot............................Sq. feet DwellingX- No. of Bedrooms.___________3 -----------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures _______________________________ _ _ W Design Flow............................................gallons per person per day. Total daily flow........................._..................gallons. WSeptic Tank—Liquid capacity............gallons Length________________ Width---------------- Diameter...,............ Depth................ x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..................... Diameter____.__..__.-___..._ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 1­4 Percolation Test Results Performed by.......................................................................... Date........................................ 0.4 ,.� Test Pit No. I________________minutes per inch Depth of Test Pit.................... Depth to ground water-...................... LZq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •------•---------------------------•----••-•---..__.._.._._....--------...._......._•----•-----..._.....................:.................................... Descriptionof Soil-------------------------------------------------------------------- --•--••------ ---•------•--------••--------------..._._...---...._..---.........._•---------_------ x ---•-----Sand................................ -----------••-•------ V W UNature of Repairs or Alterations—Answer when applicable.Om i------nn ......s o o l-s . I n....a 11 i n 1-1000 gallon-- tank---1--distr-i ution••.box 1--1000 gallon leaching fit 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 Complia e has be ditied y the bo •d health. Signed .. ............ ...............:...... ............................... ..5./...�.Q.�9. ......:...... Dace Application Approved By ---- --- .... .... ..... Ga An a..-. J.........................:...... ....6..-.3...-. `� ............................... Dace -...-...... Application Disapproved for the ollowing reasons: ........................ .............................................................--..--...........--...................... . ......................... ......... ................ ........ . ............ . .. ..........---.................................................. ............ . ....................... qUU Date PermitNo. .........,(.-l-----.. . /./........................... Issued ..................--............................................... Dare �^-ra.+'�t..'L-.+Nr.ti=./'r.7-�✓/"+,.:ytYLr�.JM�.-�'4» Lrr4t�sfi; ..S a 6, a..e".`-...,..4�.5�.y ..-v r,+.�.r.-�.•+.r.�ty K ��'``'S�'''+...�n..V:1.d'�kl«!kr"`��ri�i.�;9,�.�,+d.��...#+Y�?•.,t��,,y,.;..�+a&.+�"���Ji�i�+-II.YwTy!v....�&' Tx+'-x+'�./W'�./a' /(/�//j 1 THE COMMONWEALTH'OF MASSACHUSETTS BOARD OF HEALTH ' TOWN OF BARNSTABLE c�� ���r,�, Z���lirttti�t fur �i���n�u1 �nzlt� Cnngt��rn�t#inn �rruti� Application is hereby made for a Permit to Coilstruct ( ) or Repair '(X) an Individual Sewage Disposal System at: _..Street,. C o t to .-t......................... --------- ...--------------------------------------•-----....--•--••---......._..---•------•---.....----.... Phillips Location-Address or Lot No. Opener Address W J.P.Macomber Jr. ---------•------------------------------------------------•---- Installer _ Address d Type of Building Size Lot............................Sq. feet Dwellings— No. of Bedrooms-------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures --------------------------------------------------------------------------------------- ----------------------------------•-----•--•-----....._------ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length----------- ---- Width---------------- Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..................... Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-------- ----------------------------•-•-----------------•--------•------- Date........................................ W Test Pit No. I................nunutes per inch Depth of Test Pit.................... Depth to ground water......................... GZq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •------------------------------------------------------------------------------------------------------•--.....---.............---•----.......•----......---- 0 Description of Soil..............•-------------•----•------•--...-----•----•-•------------•----•-----------...-------------•-----------•-----------------------------------•••---••-_-•---- V ---.---•--Sand-------------------------------------- W -------------------------------------------------------------------------------------------------•----------------------...--------------------------------------------....--••------ ._..... U Nature of Repairs or Alterations—Answer when applicable.Omi----ing cesspools . Installing .1_-1000__.gall-on tank 1-distribution box 1-1000 cfal-lon leaching pit 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 been sued y the bo "d f health. ..r:Signed ........ 5/20/94 Application Approved By .- Q , _.....1.../: :�d ^..� .. ........................... - .e �1.. !.....f...'.............. I C J Dace / Application Disapproved for the f llowing reasons: .............. .................................................................................................................. .......... ...................................................................................................................................... .... ....... . . .. .. .. ........................................ Dare PermitNo. ........ .... . �........................... Issued ............................................... .....Da Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of C�omplianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (XXX) P Macomber Jr. b '.....'..............._------------_---- _......_............... ---------.......................... _------------.----..._............-----------------------------------..--------------- Installer 868 Main 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. .... -7----.-o -9/._.............. dated -------......_.......................... ._.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE S ......... 1 -......_.......... .. --------- _------ Inspector ......... .__.. 1 .._.:. '' "f s 4 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE $ No....�...y=--�=-�/ FEE.............30.....00...... e �in�n�ttt n��� C�nat,�#jinn �rrutit Permission is hereby granted.....P.Macomber Jr. ...............................................................to Construct ( ) or Repair T,.X ) an Individual Sewage Disposal System 868 Main Street Cotuit atNo.................................................................. ............................................................................................................................ Street q as shown on the application for Disposal Works Construction Permit Noo.J.`.�✓�..1e)�_91---- Dated------- ........ .......................... •---.....----•---•••-----. ... - ---------------------------------------------•-----•---------- DATE.......... 3 c1 .............................................. Board of Health FORM 36508 HOBBS 6 WARREN,INC..PUBLISHERS