Loading...
HomeMy WebLinkAbout13, 15 HIRAMAR ROAD - Health 13 Hiramar Rd 3 jf 292-1�40 - Hyannis 1 i I 6 j I i FORM30,?s.H BBS&&&WARREN,INC. THE COMMONWEALTH OF MASSACHUSETTS OACD A T H,) I CITYJOWN W Q a F TMENT � VA ADDRE S - ® TELEPHdNE p Q Addres MAE M, ) If OcEupantnl ' c l V e floor Apartment No. Noof Occupa No.of Habitable Rooms No.Sleeping Rooms No.dwelling or rooming units .St s fJ �� Name,and address of owner 11 jj Re arks Reg. Vlo.�q YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Ob t'n.: , ❑ B ❑ F ❑ M Doors,Windows: N^ Roof r, ) r` 1 Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Lighting: STRUCTURE INT. 1 15 R : rtM Ti id ) NI -m Obst'n.: _ iL LU _ ( )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)o ELECTRICAL Panels, Meters,Cir.: / ► jttv LW )ld2 )ry , ❑ 110 ❑ 220 Fusing,Grnd.: � / AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.: Stacks,Flues,Vents,Safeties: Kitchen Facilities Sink Stove 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 :::T- 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." �( I 116 INSPECTOR TITLE - r3 p ally+. DATE TIME F4 A.M. THE NEXT SCHEDULED REINSPECTION P.M. 7: 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 these items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the opcupants or the public. Because Chapter II, 105 CMR 410.000 through 410.499 state minimum requirements of fitness for human habitation, any violation has the potential to fall within this category in any given situation but may not do so in every case and therefore cannot be included in this listing. Failure to include shall in no way be construed as.a determination that other violations 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 the violation(s) pursuant to 410 CMR 410.830 through 410.833 nor shall it 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 GMR 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) Shut-off and/or failure to restore electricity or gas. (D) Failure to supply the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253(A), 410.253(B) and the lighting in common area required by 105 CMR 410.254. (B) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage 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 an object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450 and 410.451. (9) Failure to comply with the security requirements of 105 CMR 4110.480(D). (I) Failure to comply with any provisions of 105 CMR 410.600 through 410.602 which.results in any accumulation of garbage, 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 lead-based paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regualtions for Lead Poisoning Prevention and Control 105 CMR 460.000. :(B) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or ii*AtrMent to health or dafety. (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 facilities 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 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 operable. (2) failure to provide a washbasin and a shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3) and 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,, gas-fitting, 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. (N) Amy other violation of Chapter II not enumerated in 105 CMR 410.750(A) through (M) shall be deemed to be a condition which may endanger or materially lm"$r 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. s s v z - o � � r 30 4A v *. C � C ' © as � v Ivp� � ' O y :> i . � / / �; ,. � `�� - ! �'`3 � �. i � b, i � � ,� �fi � �. �^� .. � , �� �,J r. e 4 Fim THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...................... ....................OF.......................................................................................... Applira#ilan for Dhipvii al Works Tnnitxnrtion Vamit. Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at .............11--j •-•- --f:! X.1q.M. 12 ....................... ......-- ------------------------......_...------. -A cress / r or Lot No___________ ............ a,,.",,L,-ocation ... ►.1_!_a st---------------------• ............_....`��n r�--5• Owner Ad ress Installer Address dType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.................................. Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. ersons............................ 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--___---___-_-__---_--_. f3. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 04 •-------•---------------------------------------•------•----------------.........._••--••-•-•-------......................................................... ODescription of Soil........................................................................................................................................................................ x U ---------------•--••-•-----------------------------------------•------------------------------------...-----------------------------------------....-------------------------------••.....-------------- W --------------------------------------•-•---------------------------------------------...-------------------- -- --- ------•-------- UNature of Repair or Alterations—Answer when applicable_____________1 s�.®._:____ > __._._. <___._._.._..___.__...__.___. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TL ILTL11. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issue y he board health. Signed.................. ...................... ....................................... ..... ® ._ ..... ( Date Application Approved By........--- '- -•./. . • -= .................... Application Disapproved for the following reasons----------------•-----...--------------------------------------•-----------•---------------..Da.----------_... ..............•------•-------•---•----------•-----------------....--------....----•----------------...-----------------•------------------------------•--------------------•--------------•------------ Date PermitNo.....•••-••••-•-•••-•••••••••••-•-•-•••••••••••-----•--_. Issued....................................................... Date r No-d 15_22 ..................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............OF.......................................................................................... Appliratiou for Disposal Works Tonotrurtion mit Application is hereby made for a Permit to Construct or Repair an Indivi&Q Sewage Disposal System at: ­3_6. ................................................ ............. e.41M..AZI....L Lot No. .......................................... Locationdin _ or........................................................... IF .....4e. ............. Jr............ ............. ......................... ........... ... Own ( S........... ......... ..........................bg T.- ........... .........t�f..(.kA ress.......................................... 14tavIller Address Type of Bbildiiij' Size Lot----------------------------Sq. feet U Expansion Attic No. of Bedrooms.................................. ....... Garbage Grinder ( ) Othdf.vw -T.y,.ye..,Qf ............... No. ersons ............. Showers Cafeteria ( ) .Other fixtures ..... .................................................... ............. "I........................................................ p; V, Design Flow____. _:__________________ ._.._.__gallons per person per day. TotiiFdaily fl*6mf_'...........................................gallons. W Septic Tank—Liquid capacity............gallons Length__.__-_____._____ Width_ _.__ . Diameter________________ Depth___.___.__.___.. Disposal Trench—No--------------------- Width____________________ T&ial 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__._....____...._...._______.._......... 0.4 04 Test Pit No. I................minutes per inch Depth of Test Pit_.____.______.__.___ Depth to ground water_______________________. 1-4 �14 Test Pit No. 2...............minutes per inch Depth of Test Pit.__._._.__________.. Depth to ground water....__._.__________._... P4 ............................................................................................................................................................ 0 Description of Soil........................................................................................................................................................................ U ................................................................................................................_....................................................................................... .......................... ...................................... ...................................................... .1 .....................(................................................... U Natur of epiur� gr Alterations—Answer when applicable------------ .... .0 ...... .M_n-.4.........1......lk............................. ............................................................................................................................ .................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TT 5 of the State Sanitary Code— he undersigned further,agrees n?j,toplace the system in Operation until a Certificate of Compliance has been issue the board", 'health�i"d Signed................. ..................... ....................................... ....... ..... Datef Application Approved By.._.._..__ - ------------------- ------- ........... Date Application Disapproved for the following reasons:...............I ...?......................................................................... 4 .................................................................................................... .............. .........................................74 .... ---------- Date PermitNo......................................................... Issued...................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................ ......................................... ... Trrtifiratr of Tompliaurr THIS ISXQ CEAXIFY, That the Individual Sewage Disposal System constructed or Repaired ....................................................................................................................... by.......... ......... Installe at........ r ...........3.....�­ ...... ..... . . ................................................................................... has been installed in accordance with il}e provisions of T I T LE4 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No._20�� ............. dated_--.______-_-_-__.____-____._._._.__-___________ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE........................................... ................. . Inspector...................... j�t...................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...... ...................... ............OF...................................................................................... FF.E...--3.................. Disposal Works 0_1411W it permit Permission is hereby granted----- ....... _-&,........... ..:A.................................................................. to Construct or Repair an individual Sewage isposal,System ........................................................ at No........../2..!A/`­­­_7........ ------- . ....... ................ trl treet as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... ....................It,.................. rd�. DATE--------... ...................................... 4 FORM 1255 HOBISS & WARREN. INC., PUBLISHERS