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1060 FALMOUTH ROAD/RTE 28 - Health
almouth"Rd /Rte 28 Hyannis ' T A= 250-027—H00 t f 1 i I I I I Town of Barnstable �FVE r, Regulatory Services Thomas F.,Geiler, Director '* Public Health Division BARNSTABLE, Thomas McKean,Director, 9 MASS. $, c� 1639, `� 200 Maim Street, Hyannis,MA 02601 Phone: 508-862-4644 Email: health(a,town.bamstable.ma.us Fax: 508-790-6304 Office Hours: M-F 8'00—4:30 i August 25,2009 Mr. Steve A..Mele RE: Underground Storage Tank Removal P.O. Box 956 Order, 1072 Falmouth Road/Route 28, Centerville,MA 02632 Hyannis,MA Tank# 1 Dear Sir/Madame: The Barnstable Public Health Division(BPHD) is in receipt of a copy of the"Application and Permit"for ",' . storage tank removal and transportation,issued by the Hyannis Fire Department,demonstrating that a two- hundred and seventy-five gallon aboveground storage tank was removed'from 1080 Falmouth Road/Route 28 on January 6,2004. (A one-thousand gallon underground storage tank was also removed at that time and location.)Based on the documentation-receive'd`and a discussion with the Hyannis Fire Department it appears.that the original underground storage tank location address of 1072 Falmouth Road/Route 28 was changed to 1080 Falmouth Road/Route 28 when the property was subdivided in 2003:Additionally,there' are no records available that indicate there was ever an underground storage tank at the address of 1060 Falmouth Road/Route 28 which was also referenced in an earlier letter.?. ' The Public Health Division appreciates your attention.to this matter and has updated its data base to reflect this fuel tank status change. Should you have any further questions please contact Cynthia Martin of this office at 508-862-4645: homas A. McKean,RS, CHO Director of Public Health Commonwealth of Massachusetts City/Town of Barnstable W Percolation Test Form 12 - �M Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. Important:When filling out A. Site Information forms on the computer,use Steven Mele only the tab key Owner Name to move your #1072 Falmouth Road Route 28 cursor-do not Street Address or Lot# use the return key. Hyannis . MA 02601 City/Town State Zip Code f� 508-771-9100 Contact Person(if different from Owner) Telephone Number B. Test Results 6/5/06 9:59 PM Date Time Date Time Observation Hole# #1 #2 Depth of Perc 42 inches Start Pre-Soak 9:59:30 End Pre-Soak 10:10:30 Time at 12" Time at 9" Time at 6° Time (9"-6") Rate (Min./Inch) Less than 2 mpi Test Passed: ® Test Passed: ❑ /lY'` Test Failed: ❑ Test Failed: ❑ Raul Lizardi-Rivera Test Performed By: Donald Desmarais Witnessed By: Comments: Percolation rate of less than 2 mpi assigned to the sand layers C1 and C2 approximately 40 inches from surface. 25 gallons of water held during percolation test for 11 minutes. Refer to percolation report dated February 14, 2004 (Perc. No. 10902)for additional testing on site. Perc. No. 11314 206077pf.doc Perc Test•Page 1 of 1 1 Massachusetts Department of Environmental Protection #1072 Falmouth Road (Route 28),Hyannis,MA Bureau of Resource Protection —Wastewater Permitting Program Site Address or Map/Lot Number Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal A. Facility Information 1. Facility Information Steven A. Mele FTYa �Z� Owner Name > #56 Lakeview Drive Map/Ldt 250-2 24 27 assessors 15l7, Street Address /f��.(,r�q�-- s " C , MA 02601 — 400 City State Zip Code B. Site Information 1. (Check one) New Construction ® Upgrade ❑ Repair ❑ 2. Published Soil Survey available? Yes ® No ❑ If yes: 1993 1:25,000 EaA Year Published Publication Scale Soil Map Unit Eastchop loamy fine sand Soil Name Soil limitations 3. Surficial Geological Report available? Yes ® No ❑ If yes: 1986 1:100,000 Qbn Year Published Publication Scale Map Unit Glacial Outwash Outwash Plain Geologic Material Landform 4. Flood Rate Insurance Map: Above the 500 year flood boundary? Yes ® No ❑ Within the 100 year flood boundary? Yes ❑ No Within the 500 year flood boundary? Yes ❑ No ® Within a Velocity Zone? Yes ❑ No 5. Wetland Area: National Wetland Inventory Map Map Unit Name Wetlands Conservancy Program Map Map Unit Name 6. Current Water Resource Conditions (USGS) 5/2006 Range: Above Normal ❑ Normal ® Below Normal ❑ Month/Year 7. Other references reviewed:Town Assessors Map Fema Maps Town Topography Maps, Cape Cod Groundwater Map file: ...\206077sf.doc DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal• Page 1 of 7 LlMassachusetts Department of Environmental Protection #1072 Falmouth Road (Route 28),Hyannis,MA Bureau of Resource Protection —Wastewater Permitting Program Site Address or Map/Lot Number _ Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (minimum of two holes required at every proposed disposal area) Deep Observation Hole: 6/5/2006 9:30 AM sunny 65OF Date Time Weather 1. Deep Observation Hole Logs Deep Hole Number #1 Ground Elevation at Surface of Hole 66 Location (Identify on Plan ) (refer to sketch) 2. Land Use: commercial (developed) No 0-2% (e.g.woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) cleared (gravel surface) outwash plain (refer to sketch) Vegetation Landform Position on landscape(attach sheet) 3. Distances from: Open Water Body > 600 ft. Drainage Way Possible Wet Area > 500 ft. feet feet feet Property Line 30 ft.+/- Drinking Water Well Other feet feet 4. Parent Material: Glacial Outwash Unsuitable Materials Present: Yes ❑ No If Yes: Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock❑ Bedrock❑ 5. Groundwater Observed: Yes ❑ No If Yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: >200 30+/- inches elevation file: ...\206077sf.doc DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal- Page 2 of 7 Massachusetts Department of Environmental Protection #1072 Falmouth Road (Route 28),Hyannis,MA Bureau of Resource Protection —Wastewater Permitting Program Site Address or Map/Lot Number Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Deep Observation Hole: Deep Hole Number: #1 Soil Soil Matrix: Redoximorphic Features Soil Coarse Fragments Soil Structure Soil Depth Horizon/ Color-Moist (mottles) Texture %by Volume Consistence Other De p Layer (Munsell) (USDA) (Moist) (in.) Depth Color Percent Gravel Cobbles &Stones 0 5 A 7.5 YR 3/2 Sandy Loam 40 B 7.5 YR 5/6 Sandy 5 0 Granular Friable Loam 84 C1 7.5 YR 6/6 Medium 30 0 Structureless Loose Sand Single grain 120 C2 7.5 YR 7/4 Medium 40 5 Structureless Loose g Sand Single le rain Additional Notes Distinct bands of soil color changes at the transition from Laver C1 to Laver C2. file: ...\206077sf.doc DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal• Page 3 of 7 Massachusetts Department of Environmental Protection #1072 Falmouth Road (Route 28),Hyannis,MA Bureau of Resource Protection —Wastewater Permitting Program Site Address or Map/Lot Number Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (minimum of two holes required at every proposed disposal area) Deep Observation Hole: 6/5/2006 9:45 AM sunny 65OF Date Time Weather 1. Deep Observation Hole Logs Deep Hole Number #2 Ground Elevation at Surface of Hole 66 Location (Identify on Plan ) (refer to sketch) 2. Land Use: commercial (developed) No 0-2% (e.g.woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) cleared (gravel surface) outwash plain (refer to sketch) Vegetation Landform Position on landscape(attach sheet) 3. Distances from: Open Water Body > 500 ft. Drainage Way Possible Wet Area > 500 ft. feet feet feet Property Line 30 ft.+/- Drinking Water Well Other feet feet 4. Parent Material: Glacial Outwash Unsuitable Materials Present: Yes ❑ No If Yes: Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock❑ Bedrock❑ 5. Groundwater Observed: Yes ❑ No If Yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: >200 30+/- inches elevation file: ...\206077sf.doc DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal • Page 4 of 7 Massachusetts Department of Environmental Protection #1072 Falmouth Road (Route 28),Hyannis,MA Bureau of Resource Protection —Wastewater Permitting Program Site Address or Map/Lot Number Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Deep Observation Hole: Deep Hole Number: #2 Soil Soil Matrix: Redoximorphic Features Soil Coarse Fragments Soil Structure Soil Depth Horizon/ Color-Moist (mottles) Texture %by Volume Consistence Other Layer (Munsell) (USDA) (Moist) (In.) Depth Color Percent Gravel Cobbles &Stones 0 5 A 7.5 YR 3/2 Sandy Loam 36 B 7.5 YR 5/6 Sandy 5 0 Granular Friable Loam 80 C1 7.5 YR 6/6 Medium 30 0 Structureless Loose Sand Single grain 150 C2 7.5 YR 7/4 Medium 40 5 Structureless Loose Sand Single grain Additional Notes Distinct bands of soil color changes at the transition from Layer C1 to Laver C2. file: ...\206077sf.doc DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal•Page 5 of 7 LlMassachusetts Department of Environmental Protection #1072 Falmouth Road (Route 28),Hyannis,MA Bureau of Resource Protection —Wastewater Permitting Program Site Address or Map/Lot Number Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal D. Determination of High Groundwater Elevation 1. Method used: ❑ Depth observed standing water in observation hole A. B. inches inches ❑ Depth weeping from side of observation A. B. iinches inches ❑ Depth to soil redoximorphic features (mottles) A. B. inches inches ❑ Groundwater adjustment(USGS methodology) A. B. inches inches ® Other Projects and Cape Cod Groundwater Map A. Elev 30 2. Index Well Number Reading Date Index Well Level Adjustment Factor Adjusted Groundwater Level E. Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material a. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? Yes ® No ❑ b. If yes, at what depth was it observed? Upper boundary: 40 Lower boundary: 150 inches inches F. Certification I certify that I have passed the soil evaluator examination*approved by the Department of Environmental Protection and that the above analysis ��wasoperformed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature of Soil valuator a e Raul Lizardi-Rivera November 2002 Typed or Printed Name of Soil Evaluator `Date of Soil Evaluator Exam � Donald Desmarais Town of Barnstable Name of Board of Health Witness Board of Health Note: This form must be submitted to the approving authority with Percolation Test Form 12 file: ...\206077sf.doc DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal- Page 6 of 7 Lll� Massachusetts Department of Environmental Protection #1072 Falmouth Road (Route 28),Hyannis,MA Bureau of Resource Protection —Wastewater Permitting Program Site Address or Map/Lot Number Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal i Use this sheet for field diagrams• f4S ca� . SHE'D oFtP\)5 MouTH R©►ffn file: ...\206077sf.doc DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal • Page 7 of 7 FORM 11 - SOIL EVALUATOR FORM Page 1 of 4 No._P#10,902 Date: Feb. 14, 2005 Commonwealth of Massachusetts Barnstable, Massachusetts Soil Suitability Assessment for On-site Sewage Disposal , (n0 Performed By: Raul Lizardi-Rivera +�hU. u it 0 Date: Feb. 14, 2005 Witnessed By: Donald Desmarais Location AddressAk072 almouth Rd.(Rte.28) Owner's Name:Steve Mele nis,MA. Address, and 1600 Falmouth Rd. Ste. 29 Centerville,MA 02632 New Construction 21 Repair ❑ Telephone# 5 0 8-7 71-910 0 Office Review Published Soil Survey Available: No ❑ Yes Bf Year Published 1993 Publication Scale 1:25,000 Soil Map unit: EaA Drainage Class: Excessively drained Soil Limitations: Surficial Geologic Report Availabe: No ❑ -,Yes 0 Year Published 1986 Publication Scale 1:100,000, Geologic Material (Map Unit) : Qbn Landform : Barnstable Plain Deposits Flood Insurance Rate Map: 250001 0005 C,v . Above 500 year flood boundary No❑Yes 9 ' Within 500 year flood boundary No Z Yes ❑. Within 100 year flood boundary No 19 Yes-O Wetland Area: > 500 ft National Wetland Inventory Map (map unit) Wetland Conservancy Program Map (map unit) Current Water Resource Conditions (USGS): Month: January, 2005 Range: Above Normal ❑ Normal E9 Below Normal G Other References Reviewed: Town Assessors Map, Fema Maps z DEP APPROVED FORM-12/07/95 r FORM 11 - SOIL EVALUATOR FORM Page 2 of 4 Location Address or Lot No. #10 7 2 Falmouth Rd. (Rte. 28) , Hyannis, MA On-site Review Deep Hole Number 1 Date: 2/14/05 Time: 8:45AM Weather : sunny, 40° Location (identify on site plan) - Land Use: Commercial/Business Slope (%): 0-1% P Surface Stones: No Vegetation: Grass/developed Landform : Outwash Plain Position on landscape (sketch on the back) Distances from: Open Water Body >500 feet Drainage way feet Possible Wet Area >500 feet Property Line 10'+/-feet Drinking Water Well feet Other DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture . Soil Color Soil Other Surface(Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % Gravel) 0" - 25" FILL 25" - 50" B Sandy Loam 10 YR 5/8- roots 50" - 62" Cl Loamy Sand 10 YR 6/2 None roots 62" -120" C2 Med. Sand 7.5YR 6/6 None 25% gravel *MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material(geologic): Outwash Depth to Bedrock:>200 ft Depth to Groundwater: >30' Standing Water in the Hole: No Weeping from Pit Face:NO Estimated SeasonalHigh Ground Water: Elev.30+/- DEP APPROVED FORM-12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 4 Location Address or Lot No. #10 7 2 Falmouth Rd. (Rte. 28) , Hyannis, MA On-site Review Deep Hole Number 2 Date: 2114/05 Time: 9:15AM Weather : sunny, 40° Location (identify on site plan) Land Use: Commercial/Business Slope (%): 0-1% `. Surface Stones: No Vegetation: Grass/developed Landform : Outwash Plain Position on landscape (sketch on the back) Distances from: Open Water Body , >500 feet Drainage way feet Possible Wet Area >500 feet Property Line 10'+/-feet Drinking Water Well feet Other t _ DEEP OBSERVATION HOLE LOG* Depth from - Soil Horizon Soil Texture Soil Color Soil Other Surface(Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % Gravel) 0" - 23" FILL 23" - 36" B Sandy Loam 101YR 5/8 roots 36" - 45" C1 Loamy Sand' 10 YR 6/2 • None roots 45" -120" C2 Med. Sand • 7 .5YR 6/6 None 25% gravel * MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material (geologic): Outwash Depth to Bedrock:>200 ft Depth to Groundwater: >30 Standing Water in the Hole: No Weeping from Pit Face: NO Estimated Seasonal High Ground Water: Elev. 30+/- ,. DEP APPROVED FORM-12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 4 of 4 Location Address or Lot No. #1072 Falmouth Rd. (Rte. 28) , Hyannis, MA Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation,'hole inches ❑ Depth weeping from side of observation hole inches ❑ Depth to soil mottles inches ❑ Ground water adjustment ❑x Water-table Map of Cape.Cod, Other projects in the area Index Well Number Reading Date : Index well level: Adjustment factor: Adjusted ground water level: Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? Yes If not, what is the depth of naturally occurring pervious material? - Certification I certifythat on November 2002 I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.127. ' Signature Date:Date: February 14 , 2005 DEP APPROVED FORM-12/07/95 FORM 12 -PERCOLATION TEST Location Address or Lot No.: #1072 Falmouth Rd. (Rte. 28) , Hyannis, MA COMMONWEALTH OF MASSACHUSETTS <BARNSTABLE>, Massachusetts :Percolation Test* Date: 2/14/05 Time: 10:00 AM Observation Hole # 1 2 Depth of Perc 45" Start Pre-soak 9:59AM End Pre-soak 10:14 Time at 12" 10:14 Time at 9" 10:18 Time at 6" 10:22:30 Time (9"-6") .. 4.5 min. Rate Min./Inch < 2 mpi * MINIMUM of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed ❑x Site Failed ❑ -------------------=------------------------------------------------------ Performed'By: Raul Lizardi-Rivera, f Witnessed By: Donald Desmarais " Comments: Percolation rate of< 2 mpi in sand layer (C2) approximately 45" down within area. of Test Pit#2 and 62" down within area of Test Pit#1. DEP APPROVED FORM-12/07/95 . 0 3 co f MO N t�f O N LOT 2- 125,632f S.F. POLE ' "ELECTRIC 2.88f ACRES //333/56e TRANSFORMER .-. \......._...... __.. - ELECTRIC METER ^�o LOT 65 0) ON N/F i" FATHER MCSWINEY ASSOC. INC. It � JOHN KELLEHER, TRS i J 3 �k-107ot o POLE #333/AL 00 r 3 O41 STONE m 8� ii' 41 m 204.95' STONE WALLS #a 1 1 N 89'07'30" W o FALMOUTH ROAD.) .... ...... POLE POLE C2 Fps..3 :............._. HE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ♦ TOWN OF BARNSTABLE /lixti�� ivvftlr tinut fur�fksp=sal Workii ToMitrudio t Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (- an Individual Sewage Disposal System at: l 0 6 L ................ ems.......... ........ ........................ .....•---------------------- - - .... Location-Address Owner Address at..cc .....5n......�ki ems-------------- :Q.vT__.`3 .......zx;e....... ►,� = u��L--------- Installer Address Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( )U 'PL4_� Other—T e of Building No. of persons............................ Showers — Cafeteria P- Other fixtures -------------------------------- . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No..................... Diameter-__-___--___-___--__ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water--_-_---_____-_•-_- --. �T, Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ------------------------------------------••----••-•---•------------•-----------------------•-_.............................................................. 0 Description of Soil:!!K..------. ....................L-`.............. ........ ---•------C'!*,2...----•---------•---------............._.. W UNature of Repairs or Alterations—Answer when applicable-R94� Q..@!5!�......-AA .....(`-� ---------- ------- 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 Co 'ance has been issued by the board of health. SignedlL�✓a ? �.----'-"----- ------------- -------------- -- -----'---------- Dare Application Approved By --------------( ------Z- ------------------- ---- .................................................... Date Application Disapproved for the following reasons: -------------------------------- ---------------------------------------------------------------------- ----' ---- " — —- -- --'- ------------------ -------- Y&-3-'--------....--'----- — _ -- .....-------...-'------ ---- ---'--------------------------------- ----------'-'-----"--'......'-"--''-- Permit No. .-.........-. ----�..7....:......... Issued --------------------.- ----.---.--_------------- .te....... Date -� - - � � ,- ' "' t �, _ ,,. ' �- +�' t � v> _ _ . . ` � _ t . r r � - r � � _ _� . �� ., .. No._._ ..- F�$....3 .... kL_ THE COMMONWEALTH OF MASSACHUSETTS 1�jJBOARD OF HEALTH TTOWN OF BARNSTABLE Applirttttun for Disposal Works Tonstrur#tun 11nmit Application is hereby made for a Permit to Construct ( ) or Repair ( .an Individual Sewage Disposal System at: f o (4 4, Location-Address ;l or Lot No. Owner Address 4 ------t-LCA._ ...... am.... 14 Installer Address d Type of Building `: Size Lot..................__________Sq. feet aDwelling—No. of Bedrooms________________________________ _Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons--------------- Showers ( ) Cafefe`ria ( ) _ Other fixtures ---- _ i WDesign 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.......... ft. ° Seepage Pit No--------------------- Diameter-------------------- Depth below inlet..-................. Total leaching area_____.__ -------sq.,f>. z Other Distribution box ( ) Dosing tank ( ) �. a Percolation Test Results Performed by.................... •---------------•-------------------:------- --- Date--------------- 7 c Test Pit No. 1_.__-__ ___4mmutes per inch Depth of Test Pit____________________ Depth to ground water___________.____._..._. LLt Test Pit No.,2_ _+=___ ___minutes per inch Depth of Test Pit------- ____ -�,,�Depth to:ground water- } ._.__________ __ _ �F Description of Soil Q ------ - ----------- �5 !J-------- ' -----------5 ,, ?- ----------------------- ~� t x .-----------------------------•--------------------------------------------- UW ----------------------------------------------------------------------------------------------------------------------------------------------------------------�---------------• -------•------- Nature of Repairs or Alterations—Answer when applicable__e�e__P'a�4------- -�1�____--(.............Icrsi:r.w-4------------- ----------1+_4.4.tvt' ----=---Q= '`.......... L4c.a 4► 2� t'Cv.�: ••-- Agreement: -t The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accorrdance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not t',o/place the system in operation until a Certificate of Com ance has been issued by the board of health. Signed ' - ',_' ,0.,...�- 'l � �g v ------... -------------- �� i ...' Dace Application Approved,BY C ..,'„"".... .------ -- ----------- ------ ----- ------� - Date�� Application Disapproved for the following reasons- ------------------------------------------------------------------------------------------------------------------------- - ------ -- ------------ -- ------------------------------------ -- ---------------- -------------------- ---------------------- ---- ------.--------.......------.---..... ---------------------------...`...... • Date '- PermitNo- ------------- -------------- Issued --------------....-------------------"----------------------------- Dme J THE COMMONWEALTH OF MASSACHUSETTS f- BOARD OF-HEALTH TOWN OF BARNSTABLE Ger#tfiratr of C ontyltnure THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by---------- V�V_ ----------- >a-S.......0 0' `�—------------------------------------ _ ------------.... ----"------------............................ Installer at ` 9aw.. `F` � Y- '1 ��. J` EY�V-1-_1 L --------_--------------"--------------------------------------- has been installed in accordance with the provisions of TITLE 5 oefyThe State Environmental Code as described in the application for Disposal Works Construction Permit No., --------/- - . -- - -- ---- dated .......�.................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE AS A GUARANTEE THAT THE SYSTEM WAL FUNCTION SATISFACTORY. DATE....... 1. v------------------ --------------------------------------- Inspector ------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH C� TOWN OF BARNSTABLE No...../.. --.� FBE.3a..........�•--- -- Disposal Vorkii Tuunutr ion rantit Permission is hereby granted_________ ` . .___- DNS4.______._ `tW � -• ------ to Construct ( ) or Repair (,%c,?an Individual Swage Disposal System at No.--------. R Q= --------T"dm......... --------- Gv -------z 8------- -- ° �S% fi-v► 4�4=................ Street as shown on the application for Disposal Works Construction Permit No,,_ /b 7 / - BS_ Dated.......................................... --------------------------------- - ------------------- >arDATE_ � S �ad o Health FORM 36508 HOBBS h WARREN.INC.,PUBLISHERS - t No......� ......... Fss.. ....... THE COMMONWEALTH OF MASSApCHUSETTS BOARD OFHFEAL,TH r �vH /� K/ ................. OF....:................................... WA-100 Appliratiou fear Ui4pnta1 arks Tomitrnrtion amit Application is hereby made for a Permit to Construct (G') or Repair ( ) an Individual Sewage Disposal system�VZ: ----...... •-• •- ---•---• - cation ddr s or Lot No- ---•-•-•-•---• ....... ............... ........_... Owner ,address �- /19PI ss ____________________________N __.... ._......_._._________.___.__._._.._ ...._ _._.____ __.__ ..___._..._..._.._.._e�¢.........._.._ Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms________________________________ _Expansion Attic ( ) Garbage Grinder ( ) L' _________________ No. of persons..... Showers — Cafeteria p`�•, Other—Type of Building �� p ( ) ( ) a' Other fixtures ----------------------------- - - _ W Design Flow............................................gallons per person per day. Total aail�y flow................... ......................... WSeptic Tank—Liquid capacityl_©d®_gallons Length-?``....... Width_`!.j__....._ Diameter................ Depth!8......... x Disposal Trench—No_ ____________________ Width.................... Total Length..................... Total leaching area....................sq. ft. Seepage Pit No...____1----------- Diameter........ Depth below inlet...__,_.......... Total leaching area..................sq. ft. Z Other Distribution box ( ✓j Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1.......Z.....minutes per inch Depth of Test Pit____________________ Depth to ground water........................ fi Test Pit No. 2............_...minutes per inch Depth of Test Pit------------------__ Depth to ground water........................ ........................................ ------------•--•-•-••-_............................................................. ODescription of Soil........................................._ 'uv------ r a ark e ----------••-------------••-----•-•----•---••-•-------•---••---•-•--••----------•- x V ................................................-.................................................................................................................................................... W ----------------------------------------------------------------------------------------- --------------------;----------------- ........... .............. s V Nature of Repairs or Alterations—Answer when applicable......z ll..__ ®---D- J� one -•-•-•----------------•---.......... ,��� S Y l©OO._c �i�_./�i- Ci� 2`�{fti, �. .!'1si.....s Agreement: / ®' The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TIL p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance.has be&suedhe board of healt - Sign -----------•------------•-----_._---•---- ' .. Date Application Approved By....... ti Date Application Disapproved for the following reasons_.......... _________________________ _..... -------••-.._..--•--------------------•--..-.---.-..--------•---•-------•-•--•---•------------•----------'-----•--•--•----•---------•---.•-------.__------------------------------••---------------- Date--•--- Permit No.....:... .............. Issued____''? Date ;, i ,. �, 'r= � _ , , i', , 4 �' f + i i J � ' J � l' t .t - ... / . _ �% � [,. ^• t -I� �� _ � , ' ,:� s, No:......100,A........ Fx$...4"Ct..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ' �ry � ApplirFatilan for Di-gVoa al Workfi Tom6trnrtion rrmit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: ,• // `/ fl y /vs tr �d. � S ...............-. .... ----- -----------•------..._.......-----•---------•---------------•-------...---••----•--------......--- ocation.Addr s or Lot No. .:�---------------------------------------------------------__- dd,esr V O -..... _ {�• �/ G+ i// �a✓!/S f 6d/. Ai'�jisrC/ 0 ./L9Cf )q Installer - Address Type of Building Size Lot...........................Sq. feet .-� Dwelling—No. of Bedrooms......................... _.___.__..Expansion`Attic ( ) Garbage Grinder ( ) pa-, Other—Type of Building _t .'............. No. of persons.....:2.................... Showers ( ) — Cafeteria ( ) Q' Other fixtures _ W Design Flow......................:.................... per person per day. Total daily flow-__..............__ ^ ._.__._______.___.gallons. WSeptic Tank—Liquid capacity.A44� gallons Length.? -L�_.._ Width:`_j�......_ Diameter................ Depth_.`+_____... x Disposal Trench—No..................... Width............. Total Length..................... Total leaching area.._.................sq. ft. 4eepage Pit No........!----------- Diameter........ ......... Depth below inlet................ Total leaching area..................sq. ft. Z Other Distribution.box ( 6-1 Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1.......2--____minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water----------- -------------------------- O Description of Soil.--------------•-•-•-••- -•••--•--•-••-• h '.....................................................l x UW Nature of Repairs or Alterations ......................................................... x-------------------................-- --•--•..-_- : ---------- P `Answer when applicable.__-__- d "�-.___ /t----- �� e " -•----•-•----•----••---------•----••-- h .�- ....•. ---.....�=_l G? _. / �a r 6`ic f'-"---- -- Agreement: he undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with !-1� . the pr visions of f•'IT ice: 5 of theState SanitaryCode—The undersigned further agrees not to place the system in opera ion until a Certificate of CpAplian�e has be#iued, y the board of heaSigne ....... •------•--•... ................. te i� Application Approved BY-•-__--- � �-1:----• -----f� ate A lication.;Disapproved for the f ellowing reason ---°-------------•----------------------------------------------------------------............... PP , -- -------------------•---- •----•--•--••--............................................................................................... x ! � Date Permit No------------------- ----- ................ Issued....................................................... - Date _•.:THE. COMMONWEALTH OF MASSACHUSETTS ., BOARD OF HEALTH f .....O F.:.......... ................ Trr_ tifiratr of TompliFana �- T' ISITO CER FY, t ithe hndividual Sewage Disposal System constructed 1( eor Repaired ( ) /� by... _a_f/ ••---' -= -----------------•-- i nstal ler ,lies been installed in accordance with�the provisions of TI�'I;� j The State Sanitary Code as described in,the ,� application for.Disposal Works Construction Permit No.160C✓�'_-_/. .....?,,----------- dated . _.t�/ ......... THE ISSUANCE OF THIS.- CERTIFICATE SMALL NOT BE CONSTRUED S A GUARANTEE THAT THE SYSTEM VlFILL. FUNCTION SATI FACTORY = ` DATE....... _ .'°......... ....................... ..............................� Inspector { ` THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � /d7........0F................ � .------................................... No:.........� FEE......6............... i �au�atl k.9 ai nrtinaa rranit Permission is hereby granted..�,-" d - - >----•----------------------------------------•-----•-----------__-_--_-------_--_ to Construct ( ) or Repair ndivid 1 Se rage Disposal System at Street as shown on the application for Disposal.Works�,Construction _ Umit ' •. -•----- -•-•••••• Dated .... --• ----_•_--- '� .. - 1 - µ.me.. ,...�J'• a Y_ oard of Health eZ �= !�` FORM 455 HOBBS & WARREN, INC., PUBLISHERS - w c 4j O C) ct o � I cn o cv a • . • • a Complete items 1,2,.and 3.Also complete A. Signature azs MA 0_-,, item 4 if Restricted Delivery is desired. enta� ® Print your,name and address on the reverse X Add�ssee so that we can return the card to you. g,`Received by(Printed Name) C. Date of De�very ® Attach this card to the back of the mailpiece, � °,�� �vu or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below�� USPS I or ivN�n C) 3. Service Type �.� Q1.n�•�S� 08 b?.(ae\ 19-Certified Mail ❑Express Mail ❑Registered a IR Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7006 0 810 0000 3524 8 912 (Transfer from service labeq ` %� PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 i UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 Sender. Please print your name, address,-and ZIP+4 in this box ° N Town of Barnstable c Health Division • 200 Main Street V Hyannis,MA 02601 1 F Certified Mail#7006 0810 0000 3524 8912 Town of Barnstable Regulatory Services + BARNWABLE, + _ MASS. Thomas F. Geiler,Director i63q. �� ArE MAta Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 / March 22, 2007 � v Norman Botsford 1069 Falmouth Road Hyannis, MA 02601 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 atL1069 Falmouth Road Hyannis, was inspected on March 14, 2001 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 410.500—Owner's Responsibility to Maintain Structural Elements. All walls within home in need of repair; doors in home need to be trimmed out; cabinets in need of repair; hole in wall in bathroom; back bedroom filled with debris; observed room within home not to be used as bedroom(i.e. less then 70 square feet). The following violations of the Town of Barnstable Code were observed: 3� 60-9—Onsite Sewage Disposal Systems. Single cesspool servicing house. This is a failed system under this code. QAOrder letters\Housing violations\Rental ordinance\l069 Falmouth Road.doc You are directed to correct the violations listed above within thirty (30) days of your receipt of this notice by pulling appropriate building permits and repairing all walls; by trimming out all doors; by removing debris from bedroom; by repairing cabinets; by discontinuing use of room as bedroom (room with bed in it). You are directed to correct the violations listed above within two (2) years of your receipt of this notice by pulling appropriate permits and upgrading system to satisfy the requirements of 310 CMR 15.00. 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 $100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the above violations, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. PER ORDER OF THE BOARD OF HEALTH pom A. McKean, R.S., CHO Director of Public Health Town of Barnstable Cc: Timothy O'Connell, Health Inspectors Q:\Order letters\Housing violations\Rental ordinance\1069 Falmouth Road.doc ,• Certified Mail#0000 0000 0000 0000 0000 IFf$T- Town Of Barnstable Regulatory Services « Er4R'V4TAF3L .:.. �s� a 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 address M 1 ` 0360 1 city,sta e.,zip NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000 STATE SANITARY CODE H —MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE UHAPTER 170. The property owned by you located at I 6 69 was inspected i L( 0 � (Address) on_/_/ by TO (date) , Health Inspector for the Town (Inspector's name of Barnstable, (Reason for inspection) The following violation(s) of the State Sanitary Code were observed: State code violation number-violation desq ption) .���� � 105 CMR 410. 1300 - Y-X- �� J In) j-- 1 _ M ra _ 105 CMR 410. Q:\Order letters\Housing violations\Rental ordinance\template.doc 105 CMR 410. The following violation(s).of the Town of Barnstable Code were observed: ,(Town code violation nu ber-violati descri tion You are directed to correct the violations listed above within ) days. of your receipt of this notice by t:$� t rum. R4 fie_ pb_1'111� V Y(P Y 310 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 Director of Public Health Town of Barnstable Cc: (Name,tenant,owner,Fire Dept.,Building Dept....) Cc: ( 6 (Health inspector's name) (Generic codes located at QAOrder letters\Housing violations\Rental Ordinance\GENERIC CODES.DOQ QAOrder letters\Housing violations\Rental ordinance\template.doc FORM30 HAW HOBBSBWARREN M THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HJa�E,,A L T H CITY/TOW N b DEPARTMENT z___= A-- Sye e ADDRESS ELEPHONE XI 'v Address © � __ _ �__.Occupant_-.-- Floor _Apartment No. __No. of Occupants No.of Habitable Rooms No.Sleeping Rooms_ No. dwelling or rooming units No. Stories__ Name and address of owner _ ''v^^�^^- 1661 t Remarks Reg. Vio. YARD Out Bld s.: Fences: �y Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. . Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Lighting: STRUCTURE INT. Hall,Stairway: Obst'n.: — % Hall, Floor,Wall,Ceiling— yt_f14__ Hall Lighting: Hall Windows: 3e, HEATING Chimneys: Central ❑ Y ❑ N E ui . Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: " H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring:. DWELLING UNIT Ventil. L to Outlets Walls Ceils. Wind. Doprp Floors Locks Kitchen X Bathroom. Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: ak Flu s,Ven s, feties: Kitchen Facilities irik 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 REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY." - . INSPECTOR �` TITLES_ .M. DATE J ® TIME A.M. THE NEXT SCHEDULED REINSPECTION '� � P.M. � r 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violationis) 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 rray provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or scread 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 o-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. I