Loading...
HomeMy WebLinkAbout0118 PINE STREET - Health 118 PINE.ST. HYANNIS A = 249 038 _ 1 r� k j m W Of &P,65TPE)LI—:::� OWN rn L 1_. C 0 rQ -M ncoo —04 \d 1�o r CA W,�U�X(I) �wv DTI ` - l � J ) r e r- 1(,P s W(3 r4a 0�+ inon :�-2av 6r- �1 am .-,"I oh�L ),5akW �Eco n�) an C/ "Iedlo g !� Moll IOU) CA r f i -1-i CA �A VW) a 01 0 j)" nil) n c4 e:;� d ive- 4 Q 1 I 6 Y1 1 V ct ) (A r�; no r- KY) 1,4 � , 141 IAI I , � � ` urJ 0 F B +�95T�q 13� i -6 u Cur Clr&,-A narkilm lvq+ , (vin nrimoi-�j w6ckiwa cj- A-E) n D u P4) Fi [A' Al)Q lam. �) :5e i5 affcq & e 4 �--j c44bbji�c- 10 lo d� fen cS 1,,.16 cA ce- n o ccc-4e —d yl verr icea4en-makl d&:51ve nece u ±fdffvk-lr) of Y)O �(,A I c rA y Weaavq (,�c 5110 ice,e5 IV) -go Onwp-1 Afi r o h vef 6p-eo an unNA41n sf a 1)d CA 1) ,-A kinanin 4 r af �a � 2AT ton 0 0 H , OZ . CAIJ A6e5 Oct ae A A r Pl�rm 14-1 fz E A) r)nc io< r h h r5 bA :5 6 10-5 ) Ae jj6(0)-�Zed G f) - Q P f �(A�14 Cje:�R 1 r C 1 &STAF-60M io�� mp i4 w6d� cd� G� of wh a mi (I�,j ef, n/1�4h� :L3 OW1012C! OM460010 ��ki5 I 1� � e + h i I i i i - I i �� i � - t I I i i I � I � .r w .6"vim �I Mps +� Gi EeTc- 0 0;4L:� o �& kind froo , / IJE T- oe, v I j Y)1) 6 5/04 � u a h 1O �ko'l Small tArA §- I, � r T G� G a v minher- f _ I ^ a r e�u 4a a c IV-tej a 0 3�-i unll&lpn oo � ha,� r),6 ea s .. . �, t I I I j -f. i I I I I ` � _ w �'� / ' Y _ I ���1 l 1 �� t` L i/4LLF- F7- lb IA ILE n :...i f,,, : .....:... 1. RIFE_' 0 :.z �d�P CC�✓� en-f-4 #f- H 10 A - 5 3 eJevl.4- r'- -R , I. s i . W CJ v ^ CID q(-Etin e r g�vs a�e - "a4, . r Co- ra, r � -- f 50 C4 St 60 i -6 e fij 5es r r v c r- —G ) nlrAle-s-- VJtl Ric- 6)yop.c-- I i eYt``via '!,7 <) Ll i. CA C-au.ses �X-,ivnm- ;.t S-4ha+ Ct e 1,4 Im no �1� d rCy� a yin c� V d A C()n6�C& llflloft!�% ' AUM (AAA (A )ym r\PAC\ �MCUW,-4 6 e0 OA4 cl k 0 1d 5-� 6 o A'i Pe 6 . 6-E ch e m or n f UV -9 �Act m e45 p� � c h�, I -)��- 5 v Apr U 1 oran oWINE o Town of Barnstable I li i DARNS-rAULE, ` 9) 1 b9: Board of Health AIF0 MA1 A, 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,DMD Junichi Sawayanagi January 28, 2011 Mr. Gary Gustafson 8 Short Way Sandwich, MA 02563 RE: Variance Decision - Low.Ceiling Heights in Two'Second. Floor Bedrooms at 118 Pine Street, Hyannis Dear Mr. Gustafson, You are granted a variance from Section 105 CMR 410.401, of the State Sanitary Code, Chapter 2, Minimum Standards of Fitness for Human Habitation. This variance is granted with the following conditions: 1) No more than one person shall occupy each of the two subject second floor bedrooms. 2) This variance decision shall be recorded on the deed. This variance will allow you to continue to utilize the second floor bedrooms for occupancy at 118 Pine Street Hyannis for human habitation with the existing low floor- to-ceiling heights. The State Sanitary Code requires a minimum floor-to-ceiling height of seven feet in every habitable room. However, at this dwelling, two of the existing second floor bedroom ceilings are slanted and only 50 square feet of floor space have a floor-to- ceiling height of seven feet. You stated that the dwelling was built in 1920 and there is no way to structurally modify the ceiling height within the second floor of the dwelling without expending a large sum of money. Although the lower ceilings could be a safety issue for taller individuals, the Board is of the opinion that the lower ceilings should not be a health issue for most individuals.and it would be manifestly unjust to order you to raise the ceiling height in this dwelling constructed more than 91 years ago, considering the projected cost to'.raise the ceilings. Sin rely your. Chairman Board of Health Town of Barnstable Q:\WPFILES\I 18PineStreet CeilingHeight Gustafson Jan201 Ldoc �fHEr DATE: FEE: v'C v * BARNSTABLE, * MASS. l/ 9Cb 039, ��� REC. BY �'rED39�A Town of Barnstable [ SCHED. DATE: II I Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Wayne A.Miller,M.D. FAX: 508-790-6304 s. Junichi Sawayanagi I Paul J.Canniff,D.M.D. VARIANCE REQUEST FORM LOCATION Property Address: 118 Pine Street, Hyannis- MA Assessor's Map and Parcel Number: unknown 9-O ize of Lot: unknown Wetlands Within 300 Ft. Yes Business Name: none No X Subdivision Name: none APPLICANT'S NAME: Gary/Stacey Gustafson Phone 508-648=9942 Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON Name: Gary and Stacey Gustafson Name: Gary Gustafson Address: 8 Short Way, Sandwich, MA 02563 Address: 8 Short Way, Sandwich, MA-02563 Phone: 508-539-6849 Phone: 508-648-9949 VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) 105 CMR 410.401(A) - ceiling height NATURE OF WORK: House Addition ElHouse Renovation ❑ Repair of Failed'Septic System'❑ . Checklist (to be completed by office staff-person receiving variance request application) Please submit copies in 4 separate completed sets. _ Four(4)copies of the completed variance request form _ Four(4)copies of engineered plan submitted(e.g.septic system plans) _ Completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or,registered sanitatian _ Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) _ Signed letter stating that the property owner authorized you to represent him/her for this request _ Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for`°F7Title V and/or local sewage regulation variances only) _ Full menu submitted(for grease trap variance requests only) _ Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/lessee only], outside dining variance renewals[same owner/leasee only],and variances to repair failed-sewage disposal systems lonly if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Wayne Miller,Chairman . NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Paul J.Canniff,D.M.D., C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\BAJ9P9B7\VARIREQ.DOC t ^w Certified Mail#7008 3230 0002 5177 9671 Town of Barnstable Regulatory Services BARNSTABLE, v� tbg. 1Qg Thomas F. Geiler, Director PrE° ' a Public Health Division Thomas McKean, Director 200 Main Street, `.yamUs,,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 November 4 2010 Gary Gustafson 8 Short Way Sandwich, MA 02563 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 17 . The property owned by you located at 118 Pine Street(Main House), Hyannis, was inspected on November 4, 2010 by Timothy O'Connell, R.S. Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of the Town of Barnstable Rental Ordinance. The following violations of the State Sanitary Code were observed 105 CMR 410.401(A) — Ceiling Height. No room shall be considered habitable.if more than 3/4 of its floor area has a floor-to-ceiling ,height of less than seven feet.-.Two bedrooms within this home that are located on second floor had 50 square feet of:floor area, which had a floor-to-ceiling height of(7).seven feet. This is not 3/4 of total floor area which is 90 square feet in first bedroom and 85 square feet in second bedroom. Although, you do have 60 square feet in first bedroom and 55 square feet in second of floor-to-ceiling height of 6'8" You are directed to correct the violations listed above within thirty (30) days of your receipt of this notice by increasing ceiling height throughout to a minimum of 7'0" as stated in the State Sanitary Code. 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. Note: If variance is granted by the Board of Health in this regard, then only ONE occupant may occupy this each bedroom due to total square footage. QAOrder letterMousing violations\Rental ordinance\]18 pine st.doc r PER ORDER OF THE PUBLIC HEALTH DIVISION Wc �n, .S., CHO Director of Public Health Town of Barnstable Q:\Order letters\Housing violations\Rental ordinanceCl 18 pine st.doc SECTIONSENDER: COMPLETE THIS SECTION COMPLETE THIS ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. 'gnat item 4 if Restricted Delivery is desired. X ❑Agent ■ Print your name and address on the reverse dressee so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, 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: ❑No uul I . 2009 3. Service Type ' .Certified Mail ❑Express Mail =t ❑Registered ❑Return Receipt for Merchandise � ����� ❑ Insured Mail [3C.O.D. Q 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number t i_ , , 7 0 0;7 3 0,2 0. 0001 3-4 2 9 8592 (transfer from service labe6 i' ,f f 3:! . i r: +; 1.,$ . A PS Form 3811,February 2004 Domestic Return Receipt 1o2ss5-o2-M-1540 UNITED STATES TAL 9W& . y. o ee 1-3 PM • Sender: Please print your name, address, and ZIP+4 in this box • I I I ["Hyannis, Barnstable vision Street MA 02601 I I I I i '• -JG ru �. • .- Er Ln CO Er I I A ;, ru Postage $ AQ� Certified Fee Postm (n O Return Receipt Fee Q. p (Endorsement Required) V C3 Restricted Delivery Fee O (Endorsement Required) 9 ru p Total Postage&Fees s m N Sent U579FS6� - Street,Apt.No.; n ��� ✓4 or PO Box No. jf -----L -- �,ty S te,ztP44 Certified Mail Provides: o A mailing receipt o A unique identifier for your mailpioce. o A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Malta or Priority Mail®. a Certified Mail is not available for any class of International mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o 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 Defivery°. o If a postmark on the Certified Mall 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. PS Forrn 3800,August 2006(Reverse)PSN 7530.02-000.9047 . Y� =' T oWfi of Barnstable pF YHe rp� Regulatory Services Department "�"'m'caC`� • BARNSTABLE, • " 1 MASS. . If �6g S Public Health Division 9�p ��� 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 CIOPY Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL 7007 3020 0001 3429 8592 October 6, 2009 Gary W. Gustafson 8 Short Way Hyannis, MA 02653 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 118 Pine St., Hyannis was inspected on September 22, 2009 by Jaime Cabot, R. S. Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of a complaint received by the Town of Barnstable. , The following violations of the State Sanitary Code were observed: 105 CMR 410.504—Non Absorbent Surfaces: Bathroom floor tiles.damaged. AarbagT�e 05 CR 410.351- caner, installation and Maintenance responsibilities: ll/ c►^�J disposal is of properly wired, heat from the gas stove h s damaged the cabinets and exposed wiring was observed in the dwelling. g-r u V r 105 CMR 410.482—Smoke Detectors and Carbon Monoxide Alarms: CO detectors not provided and smoke detectors not maintained. 105 CMR 410.350- Plumbing Connections: Bathroom sink drips. 105 CMR 410.500—Owner's responsibility to maintain structura eler.�. Peeling paint and water damage to the ceiling was observed. 105CMR410.190-Hot Water: Temperature was above Odeg F. o to% 105 CMR 410.551 —Screens for Windows Screens not provided for all windows designed to be open J y The followingviolations of the To wn of Barnstable arnstable Code were observed: 170-4 — Certificate of Registration. Rental property is not registered with Town of Barnstable Health Department. You are directed to correct the violations listed above within twenty-four (24) hours of your receipt of this notice by installing smoke detectors in accordance with Mass Fire Codes and you are directed to register the property with the Town of Barnstable Health Division within ten (10) days of your receipt of this notice. You are directed to correct all other violations listed above within thirty(30) days of your receipt of this notice by 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-copliance 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.O F E BOARD OF HEALTH as A. McKean, R. ., CHO Director of Public Health Town of Barnstable cc: Richard Balser r Town of Barnstable �OFTHE Tp� Regulatory Services BARN.STABLE, Thomas F. Geiler,Director y MASS. 1639. Public Health Division AIEp�,�a Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 September 23, 2009 Attn: Hyannis Fire Health Inspector Jaime A. Cabot, R.S. conducted a housing inspection in response to a complaint. In accordance with the State Sanitary Code, 105 CMR 410.482, the Health Department is required to notify the Fire Department if there is a smoke detector violation, or possible smoke detector violation. The following property had possible smoke detector(and\or CO detector) violation(s): 118 Pine St., Hyannis, Assessors Map- Parcel: (249/038) - Smok detectors not in ' i and CO Detectors not provided. J me A. Cabot, R. S. Healtfi Inspector QAOrder letterAHousing violations\Rental ordinanceUire ViolationsTIRE TEMPLATE.doc ' I No. 5 �O 3 tea-- Fee v o THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01ppYication for 30igo0al *pgtem Com6truction 3permit Application for a Permit to Construct(Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Add re or Lot No. Owner's Name,Address and Tel.No. llB 7/7e_Sl- > nn►s (1.rr 6,V.5po ',son &4 We 9qq-9- Assessor's Map/Parcel zj 0 3 3- Installer's Name,Address,and Tel.No. �va,_ py� Designer's Name,Address and Tel.No. �e4 Roo Fer au # a r Jn40 s w%C 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 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) &Plal1 a n P c�✓�fari/14 SEUtr 40.,A 1�vr KY Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with.the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued 'Board of Health. Sigi d Date Ile" Application Approved by Date Application Disapproved for the following reasons Permit No. ' S �C9 3 Date Issued No. V�"� O 3 Fee v THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: IS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS v 01ppYication for 30io gal *pgtem Congtruction Permit Apphcation.for'a Permit to Construct(-./)Repair( )Upgrade( )Abandon( ) O Complete System `0 Individual Components Location Addr�e�s or hot No. Ow er's Name,Address and Tel.No. Assessor's MapJPaicel -39 t O f T / . Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.0� Sad-�d8 R� 0a j PooIer 17 Jan S�6aS �a(1�r0/1 , kk o) Type of Building: Dwelling No.of_Bedrooms Lot Size sq.ft. Garbage Grinder( ) e Other 'Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow f gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil a. Nature of Repairs or Alterations(Answer when applicable) KEPj4e(pT-a� n !- w, �oti�lq Swwer �i'o0'1 �h► kn SPA b� 4/1 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accord na ce with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued -y .'�Board of Health. Sig ed Date 6 .Application Approved by -" Date U Application Disapproved for the following reasons Permit No. �aa2 r5 r 0 3 Date Issued G - — ————— ----———————————— ------------ THE COMMONWEALTH OF MASSACHUSETTS N� BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CE TIFY, that the On-site Sewage Disposal System Constructed ( )Repaired Upgraded( ) Abandoned( )by at V, ra.Q_ has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. S 6 371—dated I 10 Installer �,.41� VJ2)eVCLAC Designer The issuance of this-permit shall not be construed as a guarantee that t e' —syste ,wi 1Ju'n•tion as designed. Date I 191 0t Inspector - No. CT`-�-i S^�-� s.®-------------—•————— Fee �G -i- -- •THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Zigpogaf *pgtem Con5truction permit Permission is hereby granted-t Construct( )Mr(�Upgrade( )AbandonSystem located at and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of of t�.it. Date: �� �G`� Approved }� �... No. �� �--� Fee THE COMMO WEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISIO -TOWN OF BARNSTABLE., MASSACHUSETTS 01 pplication f r 5po Y 6potern Construction Permit Application for a Permit to Construct( . epair( Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address o -ot No. Owner's Name,Address and Tel.Ny. Assessor's Map/Parcel �� 0 U� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Ka 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 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) a /y,c. 17 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of of the Environmental C de and not to ce the system in operation until a Certifi- cate of Compliance has been is o of He _ Si Date � Application Approv y Date Application Disapproved for the following reasons Permit No. n� "-�- �'—( Date Issued 5 No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISIO -TOWN OF BARNSTABLES MASSACHUSETTS Yication f r i'g�po Y 6potem Cott�truct>ion Permit Application for a Permit to Construct( Repair( Upgrade( )Abandon( ) ❑Complete System El Individual Components Location Address o Lot No, Owner's Name,Address and Tel.N Assessor's Map/Parcel I_I a Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) .Cafeteria Other Fixtures ! r Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil `r Nature of Repairs or Alterations(Answer when applicable) , Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of of the Environmental C de and not to ce the system in operation until a Certifi- cate of Compliance has been is o of He Si I Date Application Approveby Date Application Disapproved for the following reasons Permit No. UG Date Issued :5 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired(e- )Upgraded( ) Abandoned( by kc)2 e /--y' at //, y_Z r?' CIE has been construct.d i accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 0 - 1 7 dated 1 z u 7 Installer Designer The issuance of this permit shall not be construed as a guarantee that the sys m will unctio as designed.' Date Inspector ;, nN. <:or � - No. 3 — 1 �7 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS iqogaY � tem on Otruction Permit Permission is hereby granted to Construct Repair( Upgrade( )Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction musstt be completed within three years of the d e of this pe Date:_ /� / Approved by I y ! DATE: 4/30/03 PROPERTY ADDRESS: 118 Pine Street_______- A __ Centerville,Mass_ U' ------ v� 02632 ------------------------ On the above date, I Inspected the septic system at the above address. This system consists of the following: -- RECEIVED 1 -H2O 1000 gallon septic tank. 1 -Distribution box. 5-500 gallon leaching chambers in series. C�IAY 0 6 2003 Based on my inspection, I certify the following conditions: T�WHE�ALTHBLE F BARNST DEPTA This is a title five septic syste. ( 95 code) The septic system is in proper working order at the present time. The septic tank needs to be pumped. Heavy scum & solids layers are present. SIGNATURE: Name:_J_P_ Macomber Jr ._ ,6 Company: Jose_ph_P. Macomber_& Son , Inc . Address: Box 66 -------------------- Centerville , Ma . 02632-0066 Phone: 508-775-3338 THIS CERTIFICATION DOES NOT CONSTITUTES A GUARANTY OR WARRANTY JOSEPH P. MACOMBER & SON, INC. Tan ks-Cesspools-Leachfields Pumped & Installed Town Sewer Connections P.O. Box 66 Centerville, MA 02632-0066 775-3338 775-6412 d.� ,J 1 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 1 1 8 Pine Street Cpnt-pryi 1 1 p'Ma 1;G� Owner's Name: Gary Gustafson Owner's Address:Same Date of Inspection: 4 30 03 Name of Inspector: (please print) Joseph P. Macomber Jr. Company Name: Joseph P. Macomber & Son Inc Mailing Address: Box 66 Centerville Ma 02632 Telephone Number: 508-775-3338 CERTIFICATION STATEMENT 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 traitnng 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: 2// Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Q Inspector's Si �1 Date: �'d Insp nature:g The system inspector shal bmit 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 10,00d 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. Notes and Comments This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 04 Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1 1 8 Pine Street Centerville,Mass. Owner: Gary Gustafson Date of Inspection: 4/3 0/0 3 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. S stem Passes• ADO 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. Comments: Septic system is in proper working order at the presen ime 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. Alb The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) 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: '06 Observation of sewage backup or break out 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 distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 1 1 ` OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 1 1 8 Pine Street Centerville,Mass. Owner:Gary Gustafson Date of Inspection: 4/3 0/0 3 C. Further Evaluation is Required by the Board of Health: AA0 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 envirorunent. 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: Nb 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: /JL) The system has a septic 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. AM The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ,Ud The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 0 feet or more from a private water supply well". Method used to determine distance 4,��� "This system passes if the well water analysis,performed at a DEP certified laboratory, for caliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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: 3 ' 'Wage 4 of 1 1 L~ OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 1 1 8 Pine Street Centerville Mass. OwOer: Gary_t;ustafs n I Date of lospection: 4/-j o /r)-j _ D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No J _ �/ ackup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ,Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or - _zclogged SAS or cesspool Static liquid level imthe distribution box above outlet invert due to an overloaded or clogged SAS or cesspool .7�-y�,G dk4 0) �� _ squid depth in c4"Pool is less than 6"below invert or available volume is less than h day flow — �equired pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped Q Any portion of the SAS, cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ry portion of a cesspool or privy is within a Zone 1 of a public well. y portion of a cesspool or privy is within 50 feet of a private water supply well. y 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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.( A)jL(Yes/No)The system fails. l 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. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) 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 _ he system is located in a nitrogen sensitive area(Interim Wellhead Protection Area— IWPA Zone 11 of a public water supply well )or a mapped 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. 4 ' 'Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 1 1 8 Pine Street Centerville,Mass, Owner:Gary gustafson Date of Inspection: _4/i n/o 3 Check if the following have been done.You must indicate`yes"or"no"as to each of the following: Yes NN 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 �as the system received normal flows in the previous two week period? Have large volumes of water been introduced ced 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,�e�ding the SAS, located on site? Y _ 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 dimensio ns,ons, depth of liquid,depth of sludge and depth f P 9 scum P g P o s m o/ 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: Yes no Existing information.For example, a plan at the Board of Health. — Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)) 5 < t page 6 of 1 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 1 1 8 Pine Street Centerville,Mass . Owner: Gary Gustafson Date of Inspection: 4/3 0/0 3 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 5.203 (for example: 110 gpd x#of bedrooms):c4 q))&4 7�Od Number of current residents:Zta i Does residence have a garbage grinder(yes or no); Is laundry on a separate sewage system ( e§or no):�/ [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use: (yes or no):UD Water meter readings, if available(last 2 years usage(gpd)):2 0 01 =1 6 8, 7 5 0 ga 11 o n s=4 6 2. 3 3 GP D Sump pump(yes or no):--PV1D 2002= 9 /, 5UU gallons=267 . 13 GPD Last date of occupancy: COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): eDd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):V_A Industrial waste holding tank present(yes or no)X,4 Non-sanitary waste discharged to the Title 5 system(yes or no):,,/—A Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: None available Was system pumped as part of the inspection(yes or no): If yes, volume pumped: gallons--How was quantity pumped determined? /44"4 Reason for pumping: 10 TYPE?OF SYSTEM Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool 2Privy 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) Tight tank -,�Attach a copy of the DEP approval °L'U Other(describe): nnrnxi ate ae of all co po ents,date installed(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no):I 6 i Page 7 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1 1 8 Pine Street Centerville,Mass, Owner: Gary Gustafson Date of Inspection: _ 4/-3 o -1 BUILDING SEWER(locate on site plan) �/iI Depth below grade: Materials of construction: cast iron A PVCAL)other(explain): to Distance from private water supply well or suction line:iD,� Comments(on condition of joints, venting, evidence of leakage,etc.): Joints appear ti aht No a �i t�anr�c f p� � ,�r�, ® --tem is vented through the roof vents. SEPTIC TANK:Zlocate on site plan) Jd� � Depth below grade: ��_ � Material of construction: �✓concrete,U,J metal/d fiberglassV polyethylene A%ther(explain) /IM- If tank is metal list age: LZ) Is age confirmed by a Certificate of Compliance(yes or no):,60(attach a copy of certificate) 1J ,� Dimensions: �lj�i(p�Y� 10d"14i1j 6'fI7 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 f outlet tee oy baffle:�� How were dimensions determined: Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of.leakage,etc.): in_ n� la�F The tank is stuc ura ly -soL and sh nn Px7 -Of leakage. he tank should be pumped. Heavy scum & solids layers are present. GREASE TRA _(locate on site plan) Depth below grade:,J Material of construction*/,d concrete*/metaW,#fiberglass,�0 olyethylen&OW other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of sculn Jo bottom of outlet tee or baffle: Date of last pumping:_ Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): C;rc�a�P trap i c not present- 7 f • Page 8 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1 1 8 Pine Street —rent erx7i 1 1 P,Ma s S. Owner: Gary Gustafson Date of Inspection: 4/3 0/0 3 TIGHT or HOLDING TANKxd,(tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Z)1 Material of construction: W,4 concrete.10 metal 41X fiberglass,4ZO polyethylene4,0 other(explain): Dimensions: Capacity: gallons Design Flow: allons/day Alarm present(yes or no): /d Alarm level: A4 Alarm in working order(yes or no): W14 Date of last pumping: 1W Comments(condition of alarm and float switches, etc.): Tight or holding tanks are not presen . DISTRIBUTION BOX: —Z—of present must be opened)(locate on site plan) Depth of liquid level above outlet invert: -6<9 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,etc.): Nn Av; APnrP of solids carry over No evidence of leakage into or. oLt of the box PUMP CHAMBER(locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): piirnp rhamher is not present 8 Pagt 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1 1 8 Pine Street Centerville,Mass. Owner: Gary Gustafson Date of Inspection: 3 SOIL ABSORPTION SYSTEM(SAS):Zlocate on site plan,excavation not required) 5-500 gallon leaching chambers in series. TDry) If SAS not located explain why: __Located- See }ache 10 jpleaching pits,number: 0 leaching chambers,number:$-�'leaching galleries,number: 0 _ 106 leaching trenches,number, length: 0 ATU leaching fields,number,dimensions: 0 overflow cesspool,number:0 ,VLinnovative/alternative system Type/name of technology:j, e 1 ova Comments(note condition of soil, signs of hydraulic failure,level of ponding, damp soil, condition of vegetation, etc.): Loamy sand to. medium fine sand.No signs of hydraulic failure or ponding. Soils are dry. 500 ' s are dry.Vegetatoin is normal. CESSPOOLS,f4jA,' (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 or no): Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): Cesspools are not present. 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.): Privy is not present - 9 `. •:" WURK TO BL PE1tN ANTED AT: NAME: ADDRESS: d, .` T..,.^,n•��r 1 is PINE STREET ' 1 \� 1z � h (� Q J TOWN OF BARNSTABLE LOCATION �i �/E �T SEWAGE o ,2 .-Z D 5 VILLAGE yA s✓�`--S ASSESSOR'S MAP&LOT INSTALLER'S NAME dt PHONE NO. SEPTIC TANK CAPACITY Fk s 7- a> LEACHING FACnZrY: (type)S�s'oo C�.� �t Gx,¢ (size) Sy,�—k / X p NO.OF BEDROOMS BUILDER OR OWNER z z. / PERMITDATE: 6 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Fect FAge of Wedand and Leaching Facility (If any wcdands exist within 300 feet of leaching facility) Feet Furnished by 2d WdEV:20 200E 62 .idd 0et7t7+017S+622+I Xed 122I dU3 WOd= Page 11 of]1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1 1 8 Pine Street Centerville,Mass. Owner: Gary Gustafson Date of Inspection: 4/3 0/0 3 SITE EXAM Slope Surface water Check cellar Shallow wells r Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: Ob ' stem_de si_gnpl s on record-if checked,date of design plan reviewed: 'fly ' '$ erved site(abuttingproper56observation hole within 150 feet of SAS) Checked with local Boar o ealth-explain: AU/ lome�zChecked with local excavators,installers-(attac do(umentation) t✓, Accessed USGS database-explain: TT ' You must describe how you established the higgh ground water elevation: Jsed: Gahrety & Miller Model. 12/16/94 Ground water elevations above sea level. Jsed: USGS: Observation Well Data. June 1992 Jsed: USGS: Technical Bulletin 92-000-1 Plate #2 Annual ranges of ground water elevat4on�,, January 1992 up Of Ground 5-500 gallon leaching chambers. in series. 50. 5 ' X1 3 'X2 ' eet Groundwater: Feet Below Bottom of Pit High Groundwater Adjustment 1.8 ft per Frimpter Method Therefore,the vertical separation distance between the bottom t of the leaching pit and the adjusted groundwater table is feet. 11 r+*trr.-n•r•�rr-arnrmt•ntrn�.t renrrf.+rr.�T'r�rrr�mmrn'V tta'�a►t.rt Tt� - .. � � .t-rr•r'rt. t—r-. -.,r-. . TOWN OF Barnstable BOARD OF IIEALTII SUI)SURFACF SEWAGE DISPOSAL ,SYSTEM INSPECTION FORM - PART D •- CENTIFICATIUN l •••T•' -T••.••.: -T.11���TT{.TIT.TI'.f.'T/'.T`IT1fT.I T.1.T.T-1't T'IIRR1�1'IIAI-•P�.Rl.IAr/!n•111.1.A'.T� A...A -TYPI OR PRINT CLEARLY- PROPERTY INSPECTED STREET ADDRESS 118 Pine Street Centerville,Mass. 02632 ASSESSORS MAP, BLOCK AND PARCEL # 79"O✓0 OWNER' s NAME Gary Gustafson PART D - CERTIFICATION I NAME OF INSPECTOR Joseph P. Macomber Jr. COMPANY NAME Joseph P. Macomber & Safi ' Inc COMPANY ADDRESS Box 66 Centerville Mass 02632 Stre9t Town or Clty Sta.9 t,P COMPANY TELEPHONE (508 ) 775 - 3338 FAX ( 508 ) 790 _ 1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system nt this address and that the information reported is true , accurate , and omplete as of the time of .inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one : /System: PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public healLh or the environment as defined in 310 CMR 15 . 303 , Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form , System FAILED* \ The inspection which I have co Meted has found that the system fails to Protect the pub nlic health and the environment in accordance with Title 52 3.10 CMIi 15 , 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signature Date '-d Xe copy of this c tification must be provided to the OWNER, the BUYER here applicable ) and the 130ARD OF HEAL71I. * If the inspection FAILED, th'e owner or""operator shall upgrade ' aYste within one year of the date of the inspection , unless allowed orthe requiredm otherwise as provided in 3.10 CHR 15 . 305 . partd . doc r ST119 © DATE:AjaQLo3-_—__ PROPERTY ADDRESS:, 118A Pine Street Centerville J)q- o,I�� '7 Mass 02632 ------------------------- On the above date, I inspected the septic system at the above address. This system consists of the following: 1 . 1 -1 500 gallon septic tank. RECrIVED 2 . 1 -Distribution box 3 . 2-1000 gallon precast leaching pits. NIAY 0 6 2003 Based on my inspection, I certify the following conditions: 4 . This is a title five septic system. (78 Code) TOWN OF BARNSTABLE HEALTH DEPT. 5 . One cottage line is under water. (Needs to be raised.) 6 . Distribution box cover broken. (Needs to be replaced) 7 . One line from the distribution box needs to be replaced to pit.Pipe is gonig up hill.Does not work.The other pit is full and should be pumped. . 8 . The septic tank needs to be pumped.Heavy scum & solids layers are present._ 9 . The system presently conditionally passes.Ond&allkf the repairs made. The system will pass inspection SIGNATURE:s" Name:—J . P. Macomber Jr . --------------------- Company: Jose_ph_P. Macomber_& Son , Inc . Address: Box 66 -------------------- Centerville , Ma._02632-0066 C Phone:- 508-775-3338 -------------------- THIS CERTIFICATION DOES NOT CONSTITUTEtA GUARANTY OR WARRANTY JOSEPH P. MACOMBER & SON, INC. Tan ks-Cesspools-Leachflelds Pumped & Installed Town Sewer Connectlons P.O. Box 66 Centerville, MA 02632-0066 775-3338 775-6412 • I i c y COMMONWEALTH OF MASSACHUSETTS = EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION i TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:1 1 8A Pine Street Centerville Mass Owner's Name: _Gary Gustafson Owner's Address: Same Date of Inspection: 4/30/03 Name of Inspector: (please print) Joseph P. Macomber Jr. Company Name: Joseph P. Macomber & Son Inc Mailing Address: Box 66 Centerville Ma 02632 Telephone Number: 508-775-3338 CERTIFICATION STATEMENT 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: Eesses /Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: /—� The system inspector sha ubmit 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. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:1 1 8A Pine Street Centerville Mass OwnerGary Gustafson Date of Inspection:4/-i p l o-1 Inspection Summary: Check A,B,C,D or E//ALWAYS complete all of Section D A. System Passes: .�L I have not LULId any jafLrMajion 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. Comments: OnrP rpDairc ara Marla i-n t-ha ca t1Cc:ySt-- The snpi:in system wi 1 1 naS¢ i nsnpni-i nn Qaa r+nvar cl�cPt B. System Conditionally Passes: I One or more system components as described in the"Conditional Pass"section need to be replaced or repau ed. 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. --0) The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)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: AObservation of sewage backup or break out 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 distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:1 1 8A Pine Street Centerville Mass Owner:Gary Gustafson Date of Inspection: 4/3 0/0 3 C. Further Evaluation is Required by the Board of Health: A)d 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: 10 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: /V/ The system has a septic 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. /Vz 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. The system has a septic tank and SAS and the SAS is less than1VO feet or more frorrl 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 and volatile organic compounds indicates that the well is free from pollution from that facility 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: 3 I Page 4 of 1 I OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:1 1 8A Pine Street Centerville Mass Owner:Gary Gustafson Date of Inspection: D. System Failure Criteria applicable to all systems: You must indicate "yes"or"no"to each of the following for all inspections: Yes No ,/ Ba�ckup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _ i-- scharge 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 distn, ution box above outlet invert due to an overloaded or clogged SAS or cesspool W-- — :,,.,Liquid depth in.s�l 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 Hof times pumped O . �/_ 'a y portion of the SAS, cesspool or privy is below high ground water elevation. _f�Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface /water supply. _✓ Any portion of a cesspool or privy is within a Zone I of a public well. f�Any portion of a cesspool or privy is within 50 feet of a private water supply well. Y 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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 t e analysis must be attached to this form.) ro.�fyst�� e) (Yes/No)The sy - stem 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 now of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes n/ _ ;i 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 Zone 11 of a public water supply well (- Wellhead Protection Area— IWPA)or a mapped 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. 4 Page 5 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 11 8A Pine Street Centerville Mass OwnerGary Gustafson Date of Inspection:4/3 0/0 3 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 ere any of the system components pumped out in the previous two weeks v _ Has the system received normal flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of this inspection ? l// 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 1� Was the site inspected for signs of break out? Were all system components,eftluding the SAS, located on site? y _ 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? Y — 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: Yes no Existing information.For example,a plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)) 5 Page 6 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 11 8A Pine Street Centerville Mass OwnerGary Gustafson Date of Inspection: _ 413 o J n-1 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): Q DESIGN flow based on 310 =AIA 203(for example: 110 gpd x#of bedrooms): Number of current residents: Does residence have a garbage grinder(yes or no):�v Is laundry on a separate sewage systerrl(ye or no):Zb [if yes separate inspection required] Laundry system inspected(yes or no):yFr Seasonal use: (yes or no): 4-0 Water meter readings, if available(last 2 years usage(gpd)):Imr, Sump pump(yes or no): Last date of occupancy: COMM ERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): d Basis of design flow(seats/persons/s ft,etc.): /10 Grease trap present(yes or no):&&l Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): /lam Water meter readings, if available: Last date of occupancy/use: 4J OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or no):_ If yes, volume pumped: 0 gallons--How was quantity pumped determined? Reason for pumping: TY OF SYSTEM Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool Privy 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) tih Tight tank /VA Attach a copy of the DEP approval �h Other(describe): ,ilJ/f Approximate age of all onents,date installed(if known)and source of information: id•Isx , 7 Were sewage odors detected when arriving at the site(yes or no): 6 Page 7 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Addressa 1 8A Pine S reet Centerville Mafia Owner:Gary Gustafson Date of Inspection: 4/3 0/0 3 BUILDING SEWER(locate on site plan) N Depth below grade: :9-P— Materials of construction: _cast iron •/ e�40 PVCAN other(explain):� Distance from private water supply well or suction linerlX Comments(on condition of joints,venting,evidence of leakage,etc.): joints appear tight No evidence of leakage.System is vented through the roof vents. SEPTIC TANK: z0ocate on site plan) �l Depth below grade: Material of construction:l/ concrete&meta LthO fiberglasWd olyethylene /VPother(explain) ,& !f tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):,�(attach a copy of certificate) Dimensions: .N6 Sludge depth: ZP1 Distance from top of sledge to bottom of outlet tee or baffle: Scum thickness: A/ Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or b¢affle: . How were dimensions determined: 1,&.'4 Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of.leakage,etc.): Pump the septic tank annually ( . Shared system 3-Cottages) Inlet h outlet tees are in place The tank is structurally sound and shows no evidence of leakage. GREASE TRAPteAlocate on site plan) Depth below grade:4,X' Material of construction*W,4 concreteoO meta W)/�fiberglassl_polyethylene,6 other (explain): Dimensions: 1-fl Scum thickness: .(/ Distance from top of scum to top of outlet tee or baffle: AJy Distance from bottom of scum�,tp bottom of outlet tee or baffle: i�ii Date of last pumping:�'L 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,reaSe trap is not present. 7 I Page 8 of 1 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1 1 8A Pine Street en ervi a Mass Owner: Gary Gustafson Date of Inspection: 4 3 0/0 3 TIGHT or HOLDING TANK4"(tank must be pumped at time of inspection)(locate on site plan) Depth below grade: V01 Material of construction:V.4 concrete,40 metal4),e�_fiberglass d_A polyethylene e)A other(explain): Dimensions: Capacity: XJ,4 gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: �IX Alarm in working order(yes or no): V4 Date of last pumping: ,6 Comments(condition of alarm and float switches, etc.): Tight or holding Tanks are not pre4Pnt DISTRIBUTION BOX:Zif present must be opened)(locate on site plan) 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, etc.): Di St-ri but-ion hnx has twn 1 afera 1 G Thare is evi r9e�e of col iric marry n Ar Nn .avi rlanr•a of 1 eakage ].ni-n nr niii- (-,f +-he 0.y�box' Cr i broken and needs to be replaced.Line leaving box to the south pit does not fun ��ppn.Needs to be replaced. ( going. uphill) PUMP CHAMBE��'E'(locate on site plan) Pumps in working order(yes or no): 4,0 Alarms in working order(yes or no): 4,0 Comments(note condition of pump chamber, condition of pumps and appurtenances,etc.): Pump chamber is not present 8 Page 9 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL S OSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 11 8A Pine Street Centerville Mass Owner:Gary Gustafson Date of Inspection: 4/3 0/0 3 SOIL ABSORPTION SYSTEM (SAS): locate on site plan,excavation not required) 2-1 000 Ba 1 1 nn p repast 1 ear.hi ng pit--;- If SAS not located explain why: T.nrated- See, ],age 1 n T2leaching pits, number: leaching chambers,number: J 2)leaching galleries,number: 0 _ leaching trenches,number, length:�7 leaching fields,number,dimensions:_ overflow cesspool,number: 0 innovative/alternative system Type/name of technology:,7, ,, % Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil,condition of vegetation, etc.): T,pamY Gancl t-n medi rim fi rie Gandl —pit is in hydraulic failure 1 pit doq not iu-n.cti on because 1-be pi pe I gaing »phi 1 1 frnm the di St-ri hllti on box.Vegeation is normal.New line needs to be installed to the dry pit. CESSPOOLSI)WLI (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: NX Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.): rPGsi nnl c art- not present PRIVY/�6(locate on site plan) Materials of construction: Dimensions: 0 Depth of solids: Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): Privy is not present. I 9 Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1 1 8 Pine Street Centeryille,Mass. ' Owner: Gary Gustafson Date of laspection: 4/10/0,3 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. ry o � T� • i .9 i l� 10 Page 11 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 11 8A Pine Street Centerville Mass Owner: Gary Gustafson Date of Inspection: 4 30 03 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: Obt ' om system des* Tans on record-if checked,date of design plan reviewed: Observed site(abu property bservation hole within 150 feet of SAS) .UT� Checked with local Boar o ealth-explain: ,L(r¢ Checked with local excavators, installers-(�ttach documentation) Accessed USG database-explain: /�I7"�l/%rlU�y .W�j��i /6" You must describe how you established the high ground water elevation: Used: Gahrety & Mi 1 1 Pr Made 1 2/1 A/ga Qrniind water eIevatabove sew-level. Used: USES- nhsPr ;;t-i r•n.wpPi 1 .data June 1992 Used: USCS- TPrhniral hill1etin 97_060 1 Pzate—#2 Annual l ranges of taatAriQp1 g ins.—January 1992 �GYY Leaching Pit :eet TMe0z Groundwater: Feet Below Bottom of Pit High Groundwater Adjustment 1.8 ft per Frimpter Method Therefore,the vertical separation distance between the bottom Of the leaching pit and the adjusted groundwater table is '4 % feet. 11 + AnT.—RIr�*•-.r—\11�l.R'w1rT/lTrt+snrs*trR•f+•+:w�ItRRnI'nfRrRfslA7rmf1T .. �• TOWN OFBARNSTART.F 130ARD OF HEALTH 0. SUJISURFACE SEWAUE DISPOSAL SYSTEM INSPECTION FORM - PART D - CEIZ'fJFICATION I•t"'1•T•••::�—T.It•.�.�TT,.�irR1'.,.1ri TIr JltllirT{rr %n r'1tRT�iIR1.rT7.,AA'r , n -TYPO OR PRINT CIXARLY- PROPERTY INSPECTED STREET ADDRESS 118A Pine Street Centerville ASSESSORS MAP , BLOCK AND PARCEL # 249-038 OWNER' s NAME Gary Gustafson PART D - CERTIFICATION r NAME OF INSPECTOR Joseph P. Macomber Jr. COMPANY NAME Joseph P. Macomber & St5t ' Inc COMPANY ADDRESS Box 66 Centerville Mass 02632 Street Town or CSty COMPANY TELEPHONE (508 ) 775 - 3338 State rtP FAX ( 508 ) 790 _ 1 578 CERTIFICATION STATEMENT I I certify that I have personally inspected the sewage disposaj system nt this address and that the information reported is true , accurate , and omplete as of the time of .inspection . The inspection was performed recommendations regarding upgrade , maintenance , and repair are consistentny with my training and experience in the proper function and maintenance site sewage disposal systems , of on- Check one: .�� . Sy.s tevi PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 16 . 303 , Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. System FAILED$ \\ The inspection wtlicll I have con acted has found that the system fails to Protect the public health and the environment in accordance with Title 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signatur , Date Xncopy of this ert.ification must be provided to the OWNER, the BUYER re applicable ) and the BOARD OF HBALI')I. * If the inspection FAILED, thle owner or"*operator shall u within one year of the date of the inspection, unless allogeddorthe requiredm otherwise as provided in 3.10 C�JR 16 . 305 . Partd . doc r:s. Er Postage $ . 37 f` Certified Fee - Sd`s"tn fr'I P Return Receipt Fee ` He ul (Endorsement Required) \t n 0 Restricted Delivery Fee O� ®c (Endorsement Required) Total Postage d Fees 01. Sent To Street,Apt No rl or PO Box No. O -- o aty.ware,ZIP+a tti -GL�t Pr IS ILI b,2400 Certified Mail Provides: ®A mailing receipt A A unique identifier for your mailpiece a A signature upon delivery a A record of delivery kept by the Postal Service for two years lmportant Reminders: la 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. 'o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. I '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 E..required. ®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". +a 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. PORTANT:Save this receipt and present it when making an inquiry. orm 3800,January 2001 (Reverse) 102595-M-01-2425 j Town of Barnstable ` Regulatory Services Thomas F. Geiler,Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Thomas Capizzi (Owner) January 29, 2003 Marsha Moore (Property Manager) 85 Woodland Ave. Hyannis, MA 02601 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000 STATE SANITARY CODE II -MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION The property owned by you located at 118 Pine Street (Main House), Hyannis, was inspected on January 28, 2003 by Sam White, Health Inspector for the Town of Barnstable, because of a complaint. The following violations of the State Sanitary Code were observed: 105 CMR 410.150(D): Shower walls in both bathrooms need re-grouting; not currently an impervious surface that can be properly cleaned. 105 CMR 410.351(A): Numerous faceplates missing for outlets and switches throughout dwelling. 105 CMR 410.482: Missing and inoperable smoke detectors (possibly the result of missing batteries) throughout entire dwelling. Hyannis Fire Department notified. 105 CMR 410.500: Door to upstairs left apartment (facing Pine St.) in disrepair. Cracks and depression in door. 105 CMR 410.500: Wallpaper in kitchen peeling up, keeping walls difficult to keep clean. 105 CMR 410.500: Hole in linoleum flooring in kitchen. 105 CMR 410.500: Missing handle in downstairs bathroom to open window for proper ventilation. 105 CMR 410.500: Broken windowpane in apartment#1. 105 CMR 410.500: Hole in wall near floor in living room. Q:Health/WP/Capizzi 105 CMR 410.500: Hole in wall by television in living room. No cable faceplate installed where cable runs into wall. 105 CMR 410.500: Stairs leading to second level in disrepair. Some stairs soft when stepped upon. Chipped paint. 105 CMR 410.501: Back lass doors are not weatherti ht. Daylight was observed g g between the cracks of the closed doors. You are directed to correct the violations within thirty (30) days of your receipt of this notice, by re-grouting the shower walls in both bathrooms, by installing faceplates for all electrical and switch outlets, by providing operable smoke detectors throughout the dwelling conforming with the State Fire Code, by replacing or repairing the door in the upstairs left apar-tment,-by_r_e__app_lyingAhe__ wallpaper in the kitchen, by repairing or replacing the linoleum flooring in the kitchen, by installing.a handle to open the window in the downstairs bathroom, by replacing the broken window in apartment #1, by repairing the holes in the wall in the living room, by repairing the stairs leading to the second level, and by weather- stripping the glass doors in the rear of the dwelling. 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 could result in a fine of up to $500.00. Each day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S. Director of Public Health Town of Barnstable cc: Tom Perry, Town of Barnstable Building Commissioner David Littleton, Tenant Merrilyn Robert, Tenant Dustin Pina, Tenant Dennis Edwards, Tenant Dawn McEachern,Tenant and Manager Q:Health/WP/Capizzi TOWN OF BARNSTABLE � 'LOCATION//�``�� 1 ST SEWAGE b VILLAGE H% A ti i S ASSESSOR'.&MAP & LOT 2y -0 3 INSTALLER'S NAME&PHONE NO./%Vle ���T ?��1-3 2 SEPTIC TANK CAPACITY /7�a LEACHING FACEL=: (typeJz�, SOO C/l� E `-r (size) 13 X Q NO.OF BEDROOMS BUILDER.;OR OWNER 7p^v z Z PERMITDATE: y a COMPLIANCE DATE: 7 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 yo�sr - G E=T as 110 9 No. / �ZG Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓ PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Yes ZIpprication for Migoga[ *p5tem Construction Permit Application for a Permit to Construct( )Repair(grade( )Abandon( ) ❑Complete System ❑Individual Components Location Addrefis or Lot No. Y'A V A/o S Owner's Name,Address and Tel.Ng. Assessor's Map/Parcel —/ 7 D Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 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 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) .SOU�A Ilt� A� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Bbqaxd of He Signed Date Application Approved by Date 0O Application Disapproved for the following reasons Permit No. Z4V Date Issued T� — C) No': `C.1/U —Z�1 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes 'PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for'Miquar *pgtem Congtruction Permit Application for a Permit to Construct( )Repair( grade( )Abandon( ) El Complete'�System ❑Individual Components Location Address or Lot No. 1 S Owner's Name,Address and Tel.No Assessor's Map/Parcel D a Installer's Name,Address,and Tel.No. -Designer's Name,Address and Tel.No. 6o4-r7 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 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. x , Description of Soil aP, 1 Nature of Repairs or Alterations(Answer when applicable) �S SO�rA Ta (� A/'� c4 r Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of Hea / Signed Date Application Approved by Date o Application Disapproved for the following reasons Permit No. 7i(RJ /—Zu 9 Date Issued —4 — ff, — U ----------------------------------------- - THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( �raded( ) Abandoned( )by at i✓ v1 has been constructed o rdance with the provisions of Title 5 and the for Disposal System Construction Permit No.'?ia'v dated Installer Designer The issuance of this permit shall not be construed as a guarantee that the syst 11 func on a d signed. Date 1 Inspector _ --------------------------------------- No. ric/l/ Z 0� _ Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migpooar *pgtem Con!truction Permit Permission is hereby granted to Constructej )i Repair( grade( )Abandon( ) System located at S and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Constructiorym4st be completed within three years of the date of this It. Date: Approved by -'' ' I' 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONS TRUCTION PERMIT (WITHOUT DESIGNED PLANS) I 104k�Z'1Csgs9-0-SO Lff hereby certify that the application for disposal works construction permit signed by me dated a �l , concerning the property located at IS meets all of the following criteria: • This failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • . The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. • There are no wetlands within 100 feet of the proposed septic system • There are.no private wells within 150 feet of the proposed septic system • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] • If the S.A.S.will be located with 250 feet of any vegetated wetlands,the bottom of the proposed leaching facility.will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) S B) G.W.Elevation 2 3 +the MAX.High G.W. Adjustment. = a DIFFERENCE BETWEEN A and B 3 SIGNE DATE: [Please etch prop ed plan of system on bac ]. NOTICE Based upon the above information,a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:cert ->'$..iXf,. ;,°z.F k k"3'�ka�W�k ��`N^"3.,�(�.•�!e-�..-�. 'fik rS S �,�ttf l rt i � F 9t ?rk,7'R,'tt �.r Ysu -r s� v P r°�"+^ ,. K��. _1 � TOWN OF SARNSTABLE �C/ LOCATION _ T SEWAGE:# 00�-� S VILLAGE H% A ti , S ASSESSOR'S MAP & LOT'Zy 'o.77 3 r INSTALLER'S NAME&PHONE NO. G 6�:!57T �J�1-3 Z SEPTIC TANK CAPACITY /� LEACHING FACILITY: (type �� SOD cl1 A 1 d t 2S (size) S6,.� NO:OF BEDROOM'S` �..r,::�, BUiI:DER'O�t'OWNER �� . .��9�P'i��'// `} , u • t r;,1iw rtr t t,:.,- ,, t PERMIT DATE: y: o COMPLIANCE DATE: Separation_Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water::Supply_Well:and Leaching Facility .(If any wells exist;_': on site or within 200 feet of leaching facili:ty). Feet i. Edge of Wetland:and Leaching._ ,acil.ty,(If any,wetlands east within 300 feet of.leachh faciLty) Feet Furnished by t . `�1 r �j ---------------- qN J y� i w ,.. � �•!' I F:vJ_.Ae.n ,s,l..+..:. ' y-f �,�•��� , vr.:n4:L., - .^ •:n •Y v: sr.v... I F E�.,snrw ., vast• ray��'•r -- ' - - v _ __.....____..:. Nye � ..F4>'/• _. � 0.rti7HF Gran G• a. .) rr 1_£�-.�`4 tS,•VA IR'•Ji 4 �"I'`.tv'e" r - / n . FF_ryniw �t,rn�L •- 9 r/t•.j:.♦ vi_ 3t�+-"„ter � � G. I �r � '. Ul o�KAn,.,•.4� a�0"v aa...,r+;r> 1•�i�'---1 �C H'—_ry71= .__.-- �Sr r '- �;it � I:� L!I SP,•oY I� b •� • i � SYG rc...r tQ• •... ! .v♦nrN I Pre ' _ ��G:v,•u...y��. SiC� 10h.� J�+9vrvr♦..r_ i� uUw �V pfG�L—gL.L.r�� S ,. erye,.- '� CIi jl;,l.(Wpw Prw,s G�ROPM 'IP •�r.: IJI PI(O LI VIM ri t1coH �' - ,e>r a'i w•vJ r•••n.e0....u.. I.: � �--�" 1'f,..� Y.Y•sPrr..-� _ A91El TI:LIJ.e.4 1 iP. ,r Ir 0 E�.rST h4 I L:I It[.GQY.1(L SH,rwLF4 - LL N E L� I I�JC=N7�O N'ii ' / 1Jri•41 I 1',•fir-I,• L•urn}'t". i%e:M1 nt1 9 IL°.!! ,. ................... F.•o•. .j 1/t JI_!9��N6` ..r•1M� - _..-__...-_.......__._.....__-.._ ----�c:�.��—rc--=Y'y � .... _ pl- �,y.l](tlt4 6nAPF�_- __. ..-��,�_`� __ ...:....... ... ...... ��._c�-1 +-r � �l�1xrG _�_.. ._ _ .. ..�.._--•-- t•f t Yf"Q1W _.. _..__ 1� ;2.O F1T � ,-�I I 4 ov:t Vr•.,t. C��n g •er 9'rjr .. f' l�"(�"1'd C�1� _Fr t !18 Pn•IE STP-frcT Audi,,B d'•s" "h (� r• r - z ,W LgLQU - la`/. W)415, Lw- tz, T-I 51 F::1 F-I F-I 4- ,Ftu J F7 �OL I'd LIFu ICi P-!t-N I i E:1 I T 12 Lu lcr, (D -------77 t, 3 k3 ul -Nr- L TOWN OF BARNSTABLE LOCATION -ST SEWAGE VILLAGE H% A ti r S ASSESSOR'S MAP& LOT ZY _0 3 INSTALLER'S NAME&PHONE NO.,70QGA/ ��sT ?� �-3 2 SEPTIC TANK CAPACITY LEACHING FACILI.I : (type s, s�� ��I3 �,d 6 2S (size) Q NO.OF BEDROOMS i A BUILDER OR OWNER 7,P--7 PERMTTDATE: y o COMPLIANCE DATE: 7'f 7—Zvi l Separation.-Distance Betwee.—n the: Maximum Adjusted Groundwater Table to-the Bottom of Leaching Facility Feet Private Water Supply Well andLeiching 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 7L I a � � 4 hi ? ® �ft \ y � I I Nll ) �TTI D �r f.s 1 T-e-11 ST WHo l� 5�1o5 CoMl 5R41 wA e, r CA �e lfn�e IA-toral,605 n4 �ed'dera e U ra - 1 v v r ` 0 C00i GIGJ �A h �n r ot TiqC Ho097- ITV - ),/,0wJ�C4 - A s w fC r oo 1 • � ` • �'i x ' �� i, I . R . I 1 � I . • I � � • F i .�j!) j l • — v. � . � • �� � � �. a . / �. — � � � �Mllw _ ■ i • ■. / 1t1 I 1 1. ' • r' / bi 1 � I _ u as W, - r • pis MAXIMIAMA7. iA its" . 0 1 l i i • I _ a . • r , iJai a 114 phssII A ..9 No-"d, All �,O, uh Lo M4 MM POMMI rME 11— ONOWN - �• - M r, Illl �• ji � 7 wk ot NO$ A— ME I tI _�I ■ - M � � it �,. � '. ', � i � � i I i III TOWN OF BARNSTABLE L(vCATION j'/d im" 5i F c f— SEWAGE # VILLAGE �P ASSESSOR'S MAP & LOT O �' INSTALLER'S NAME&PHONE NO. AA e-M SEPTIC TANK CAPACITY /.r 0 LEACHING FACIL=: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER 7 % PERMITDATE: 3 -2 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 r !� Sf fgel c - �� I TOWN OF BARNSTABLE LrC-ATION l ' ""� s T SEWAGE # VILLAGE 6 - ASSESSOR'S MAP & LOT • d v INSTALLER'S NAME&PHONE NO.6 y-3 e a SEPTIC TANK CAPACITY /0 0 LEACHING FACILITY: (type) SST T (size) S p6tiF NO.OF BEDROOMS 3 l BUILDER OR OWNER 10A11V r rZ' /' ;2 e'/1� PERMITDATE: COMPLIANCE DATE: - 7 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist - on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by i 7 toy . t3pLET i I �P/ AlsT TOWN OF BARNSTABLE C15 J.00ATION 1 �S ��-e S SEWAGE# J�I�u VILLAGE A%A ASSESSOR'S,MAP & LOT 2 q� —O 3 9 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS Akik 3 BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 ��V\. �I - + k T S - r r. �� 1 . I . �.,, � �� � A I " :J: i .-4-- �j i ... _ � -�, �, ,,0,s (( v /V ., r �,.. f .. _�\ .. . . � � � _ - � k .,. a ,^ r. � !� .i,` � t cc� No.... 5._.V. y FI�s.....30.................. THE COMMONWEALTH OF MASSACHUSETTS / BOAR® OF HEAL TH TOWN OF BARNSTABLE Appliration for Dhi-p 3al Wor1w Tomitrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ) an Individual Sewage Disposal System at: 118 PINE STREET fLE •--••---•--.......•.............................................................................: �----•-------•---•----.-------•------•--- Location-Address or Lot No. ANNETTE MEROLLA 49 COLLEGE AVE. WEST SOMERVILLE NIA 02144 Owner Address W ARCH CONST._ CO HYANNIS ,.� ----•-•-•••••--- -••- --------•------•----------•---••--•-•-••--•---•-•--•-----•••••----•-•--•-••••-••-•..........-•-•-- Installer Address Type of Building �� Size Lot............................Sq. feet �., Dwelling—No. of Bedrooms................. ..� 1.._..----_-------- �xp nsion Attic ( ) Garbage Grinder ( ) aOther—Type of Building -------------------------!_ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) QOther 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 Test Pit.................... Depth to ground water......................... tz, Test Pit No. 2................minutes per inch Depth of Test Pit.-----..-.-..._--_ Depth to ground water........................ Ri ................. •---•--------•-----•-•-------•------••-•-----•--....................................................................... ••---- •--- •..... ODescription of Soil........................................................................................................................................................................ W UNature of Repairs or Alterations—Answer when applicable._INSTALL..TWQ---TLT.L.E---V.......... .......................... ...S.E.PTICS..MA.IN...HOUS.E...1f1D D.S.T.,..-Dbax,.__..1QIlD l.p./.3---cat-t.agss---1.5.D.O.s.t....._Dhox................ Agreement: 10001p 2ft stone 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 as been issued by the board f health. Sig�I ' -- - /`..........:..:... - .........:31. 5/.9 5----- Dve Application.Approved By .... .....: -' _..-..... -..I_r.-. '.:. Application Disapproved for the following reasons: ------------------------------------------------------------ ..----.-------------------------- ......._...................---....................._.............................................._...............------....-----....—`...........................................—......--------- .........------Dace ................ Permit No. ....:..- L.. ................. Issued............ . Dare No....L.�>~.'���� ! ` " _j FEs.....40.................. THE)COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �- TOWN OF BARNSTABLE Appliratiou for Diij-po ial Work, Tomitrnr#ign ramit . f Application is hereby made for a Permit to Construct ( ) or Repair ( ) ;an Individual Sewage Disposal System at: ' 118 PINE STREET C414T- W.E E -� h... f Location-Address 'or ` =ANNETTE MEROLLA 49 COLLEGE AVE. WEST SOMERVILLE MA 02144 ......................-............................................................•------•------ ---------------------------•--•--••-•••.....--•-----.....-----••-•---......._..........---.....--- Owner Address W ARQH CONST. CO HYANNIS ,-I ---------••-•-•----------------•------•................................................ -------••-----------------------------------------•-------••------------•---••......----•--------• Q •<_ Installer Address Tyge;of Building j` f = �, Size Lot............................Sq. feet V Dwelling—`No. of Bedrooms__________________L!'----(--�--_...Expansion Attic ( ) Garbage Grinder ( ) `. a Other—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOther fixtures ------------------------------ W` , Design Flow--------------------------------------------gallons per person per day. Total daily flow............................................gallons. 04 Septic Tank—Liquid capacity------------gallons Length________________ Width.-.--_...___---. Diameter................ Depth................ \ Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. .. > Seepage-Pit No---------------------- Diameter-___.__--_---_---_ Depth below inlet........... Total leaching area.................. ft. z Other Distribution box ( ) Dosing tank ( ), - •" Percolation Test Results Performed by.......................................................................... Date........................................ 1 Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water..................... 44 Test Pit No. 2................minutes per inch Depth of Test Pit--------_----------- Depth to ground water........................ a --------------------------------------------------------••-•---------------...---•--...---- 0 Description of Soil......................................................................................................................................................................... U . ---------------------------------------•----------------------------------------------------------------------------------------------- ............................................................. --------------------"---.------:--------------------- -----------------------------------------------------------------------------------------`------------------------•--------------------••-- x �V Nature of Repairs or Alterations-Answer when applicable-__.TATST ALL---TKO...TTTLZ_.V..................................... E.--1On STD---tJ x =-=1000.p/3---cottaues-- 1500s-t- Dbpx•• --••------- '` m - Agreement: 10001p 2ft stone u, 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 issued by the board o_f health.�j , /.Signeed�'��� K- �'>'i G ----- ----------3/16,.-9 5.-- Dace Application,Approved BY \ ..R .... -�� •-.., --_....------------------------------------------/------------------- ...... ---_.-a- ----�'..`?... a Application Disapproved for the following reasons- --------------------------------------------------------------------------------------- ......---------------------------- .......... . ............................... .... .... .............. . ............................. .. . ..... ---------------------------------------- Date PermitNo. --- 5`!... •^................. Issued -----...----....----...............-------------------------------- Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (11Prttfirate d C11oraptianre THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed ( ) or Repaired ( x ) AkCH CONST. CO by ............._......._................ .... ...... .. .. ..... .._.... .. :..._..... .... -._..----------------------------------------------------------------------------------- ilu at --------- 118 PINE STREET CENTERVJ LIE ............................................... ........ ...._. 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. ._0`1� _-...1 �.J�'........_. dated .._,_ _�-._t!.�." .1�`�'..... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...._--------------------q.------ ��../----------------------------- -- ---- Inspector ----------------- . . ------ -------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No..... .:i... . �� FEE ^} ...... Disposal Workii Tomitrur#ion "antic ARCH CONST, CO Permissionis hereby granted-----.....' ............................................................. . -------•---------------------....------•-------.....--...... to Construct ( )I1or Repair ((EX) anCInd���avl Sewage Disposal System at No.................................••-----------------•----••-------- ----- -ANNET I'E MAROLA Street ` as shown on the application for Disposal Works Construction Permit No...__1:._ - _ Dated----- _...... _ ._ ---------------------------------------------------•--- 1 `�r Boid of Health DATE. :1...----•---•----------------------------------- FORM 36508 HOBBS Q WARREN,INC.,PUBLISHERS TOWN OF BARNSTABLE '^ LOCATION I �S �/ -� �) SEWAGE # TIC%u1_ VILLAGE � �°� ASSESSOR'S MAP &LOT Z "®3 INSTALLER'S NAME&PHONE NO. l � SEPTIC TANK CAPACITY )VILA LEACHING FACILITY: (type) (size) NO.OF BEDR60MS ask r4 BUILDER OR OWNER - PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility .(If any wells exist Feet on site or within 200.feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching.facility) Feet - Furnished by i v. isT�° ILL I � v TOWN OF BARNSTABLE LOCATION 7 SEWAGE # VII:LAC3E �E ? Q v �(C ASSESSOR'S MAP& LOT , d INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /Oo o G.9 LEACHING FACILITY: (type) (size) 6 a S 1a,vE' NOOFBEDROOMS 3 BUILDER OR OWNER PEPMTTDATE: —3 / S COMPLIANCE DATE: Seligation Distance Between the: Maximum Adjusted Groundwater Table and 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 9f Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by `Z. 1 4N. M 0 ._ o TOWN OF BARNSTABLE LOCATION//? �i�✓ 5 !Z H t f SEWAGE # VELLAGE ��'��F_2 `� t? ASSESSOR'S MAP.& LOT a YJI 0,38 INSTALLER'S NAME&PHONE NO._Ae G/- Co.vs� SEPTIC TANK.CAPACITY GIf LEACHING FACILITY: (type) L A 5-9 (size) 6x 6 �SZs Nf NO.6 BEDROOMS BUE DER:OR OWNER 7% PERM"TTDATE: / / S COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 fi Jsoot/�,7 NLU ti � rw I. TOWN OF BARNSTABLE BAR-W 2078 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager rdc ge-c - Address of Offender 3 9 Ck VTV% d z4r,,,-. i MV/MB Reg.# Village/State/Zip &,,z, A/tl+ 0-?4 o I Business Name (��✓ J �l l TV-V ZA1"/a1CW t:6V(9/pm- on Business Address �` �K �S� ( Iau��c�✓ Signature of Enforcing Officer Village/State/Zip Location of Offense Enforcing Dept/Division Offense /uV►SC� �� � 91<<� ov� � Facts �YG� �^�o -3 4��c .� rravl�c Ca,3 A,&fz w, - ✓� 6-d wz,,,di war - /rz3 S°o2-, Aril This will serve only as a warning. At this time no legal action has been take A. It is the goal of Town agencies to achieve voluntary compliance of Town i Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. : 7 � • :M . .S. :.. .,. 3.. .'«A ,f."«,...�.. .......—.........r...A,'y".... w ..r.w,r •'t. •�' � '.1-rap ,4 r f tr-.+ y rn Y j �• *. „ � "" TOWN OF BARNSTABLE ` ;,. W` 20 7 Ordinance or Regulation ' WARNING NOTICE Name of OffendetlManager .;, il��+ f@,� [TO-Ct� �ry � � Address of Offender. L4 (1vcv,' � `�' MV/MB Reg.# Village/State/Zi AA4 OZlvb, ` Business Name b1xAA4 � 6a dvszi- AiG pm, on ZJ i=gZrrO Business Address cU,v hco�fi✓ , ?s r Signature .of Eii forcing Officer Village/State/Zip Location of Offense 14�, T*ee V TOY ..,Enforcing Dept/Division Offense �tI►SG�f� (�e�d� �J.v�c,:�o�.�.� � . ;: Facts (� (vc� / rfoalcr a This will serve only a Jrn4 ng. At this time no legal actiro-Mt- beenFta�. It is the goal of ''Town. ' agencies to. achieve voluntary eQmp Tand ft4pf Town Ordinances, Rules and Regulations. Education efforts and ..warnigg;; n�t'aces : are attempts .to gain voluntary compliance." Subsequent violationsL wills=result in appropriate legal. action by the Town. ' �t�. /`' ' r .... .;.e,-._e+ser=.,„ ,.. „*. ,_.......YY•a :,r- •rr .. .• ,. .p;t:.. F4cy ,y,'-K.- y, te .:7k_'¢" �,i TOWN OF BARNSTABLE BAR—W M2 3755 OOrdinance or Regulation WARNING NOTICE 1--,/17A Nape of off e er/Manager / C(1 r-1 � ,.. dob o 0 fen'dae"r _ r f �' y/l e i MV/MB Reg.# , Village/State/Zip t' ,YAA/N 1Y)' 0 / SS# Name . ;on , 20,Q/ Business Address Signature of orc`ing Officer Village/State/Zip / ] (� yap (�+' .�' Location of Offense i l ) rfl (",. `a! a� , ! � /;P V , I /'� (1� �I� l(" t. i Enforcing Dept/,%Division Offense -)A Facts Facts Y This will serve only as a warning. At this ^time no legal action has been taken. It is the ,goal of Town agencies to achieve voluntary compliance of Town ' Ordinand,,e's•, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. - _-.-•-`4--.+.-r^v..^-,7�.4^'^+'�v.•o.?I_ .�','.`+lr'. '^"'.,,e'.+,'-r;.^',-..!_•...-"�^�+....+�^tM+.a.+...;.aM,-+•-..3..a,,..--.w'-•x' .-.�'-q.,:.r"Fe;s�.....-,- s ;..:' -l- e. " TOWN OF BARNSTABLE BAR-W NO. 3756 Regulation Ordinance or Re g (, WARNING NOTICE Nab f �Of f ende /M nager tf� , ;o Address.'f f 0 fe d`err .� . .- r, f l '*t 1. 1y 3 MV/MB Reg.# . Village/State/Zip Y4 Y Business Name arn7pm� on r1 2001 Business Address Signature of Enforc-ing Officer Village/State/Zip " Location of Offense `l� pi)(v 1 �t �i:' � P 7 Enforcing Dept./D `vision - Offense m / ' A Pk:-j i 1� "• Facts This will serve only as a warning. At this time no legal action has been taken. 01V , It is the goal of Town agencies to achieve voluntary compliance of Town;& ' OrdinancYes., Rules and Regulations. Education efforts and warning notices are 1114 mptsF�,,to gain voluntary° compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. FORM 30 CH&w FI068$8 WARREN TM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CITY/TOWN a DEPARTMENT s-2N, J G 7_ ,0 , Jr+-, 0a,4, W,0 � ADDRESS A/ 7 ,�/ TELEPHONE Address / (� Sfy Occupant L Vd- (VuSr^ Floor Apartment No. No.of Occupants �� �"d- No. of Habitable Rooms /d No.Sleeping Rooms— 7 <3RA5,��, No. dwelling or rooming units No.Stories Z V/ ° 07 ICf Name and address of owner ?Vk Remarks Reg. Vio. YARD Out Bld s.: Fences: 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: 06 +,n Fi gyres dv &a go�kdt1 . TwJc laM� Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Lighting: STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: j rM ( ,� vkoccv Ind rd�3i`^ v' , y/a SZj�O Hall Lighting: Hall Windows: HEATING Chimneys: v Central ❑ Y ❑ N E ui . Repair G• a is Cu Gj TYPE: Stacks, Flues,Vents: vS PLUMBING: Su I Line: '7&vv. I✓- ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: Wv v a rry fi 1-/ U :E ❑ 110 ❑ 220 Fusing,Grnd.: Lv i W -w VA AMP: Gen.Cond. Distrib. Box:N d1ay 1,jov-i irv1,at.v.v-0 loor 6i v Gen. Basement Wiring: alvv-.. DWELLING UNIT st"t0 Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks PeP Kitchen O Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas,Oil, le .: / 0 G Stacks, Flues,Vents,Safeties.- Kitchen Facilities Sink 111V 3 Stove &AJ inn (C-^a t eV4 L Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.:(f L.,w•erg I 1 /a t-Wa u ti old 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 (JUr AUTHORIZED INSPECTOR. (See Over) y "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTI ERJURY.' �fv INSPECTOFU TITLE14-1 S DATE TIME � '+/ _ ) L A.M. THE NEXT SCHEDULED REINSPECTION P.M. a _ :.;.r.�r--r •- ^M :`•tM! ..,RSf«;... :, t.a: +N;II�y,,,CN-w,.X•,�.y,yq;;} ��w s�•�,N+� ��7.+i�r•�e ' JJam,`j�� ,nt� �a��q �Sw *w■*' 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 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 ever stairway, porch balcony, roof or similar lace as ( ) P 9 Y Y p Y P 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. W HOBBS&WARREN'"" THE COMMONWEALTH OF MASSACHUSETTS FORM30 �I BOARD OF HEALTH - '� CITY/TOWN W CA o DEPARTMENT d x S 1�l, 3 67 .its_1_gAi, J i , X 4 a.+, w -7 441'� ADDRESS G9M pG 2 - g6gV 1 TELEPHONE Address / S��--y— _ ___—___Occupant - �� v► ySC _ Floor Apartment No.__ _ - No.of Occupants may' No. of Habitable Rooms_ L0 No.Sleeping Rooms—_7_ j7tAS"CV7"_ � Y No. dwelling or rooming units No.Stories 4- (� ✓�'�v F/ Name and address of owner _1Jeka I _ Remarks Reg. Vio. YARD �. . Out Bld s.: Fences: 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: }6tt �v, W I 4 1 Io 1 ocL.-c6o( v . Zt,Jv/c.aFfv�,. Foundation:cfv I" c r , O K' Fv,r O t✓gct -t t �• Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: O I M i'.., i, or v i Od rod+•^ �kc�t,+ 411e Sao Hall Lighting: c Hall Windows: HEATING Chimneys: 64S ( 6ot,t„1C. Central ❑ Y ❑ N E ui . Repair &.L,,,,. lk&4z, %S Gc z,curt•Java d TYPE: Stacks, Flues,Vents: 60A x4AS PLUMBING: Supply Line: '��v% I✓w4 ❑,MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) II ELECTRICAL Panels, Meters,Cir.: Wive Cvvwc. d -oid ❑ 110 ❑ 220 Fusin ,Grnd.: j AMP: Gen.Cond. Distrib. Box:G`(LPj)c✓y h„;ri rv�nac�otJ 1pdv iv, ��1.+..w v Gen. Basement Wiring: w i N aG,rti.. DWELLING UNIT S-k,01 ' Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen 0 K Bathroom Pantry Den Living Room Bedroom(1) Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas,Oil, 'led.: / 0 U Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink -tL v 13 Stove 6 A 5 inn tZ ✓v a vg C CA, Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.:6n t,w-,M C t I to RY,,S v o y d.zr1., — ok 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 SI&J OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) Y "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES`O ERJURY.,, V` L INSPECTOR. - r TITLE / A.M. DATE ( � TIME A.M. THE NEXT SCHEDULED REINSPECTION P.M. 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 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 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. -Z 548' 659 778 Receipt for Certified Mail © No Insurance Coverage Provided osirES Do not use for International Mail vosru sewv�u (See Reverse) O) 2 t et an P. . Stale and ZIP C Cr Go Postage $ 3 M r E Certified Fee 12 Special,Delivery Fee CO) _ a Ft�st�icte D�1iV�ry �e� to-VJtio'm&Date Delivered. V Return Receipt Showing to Whom, Date,and Addressee's Address TOTAL Postage &Fees Postmark or Date STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front). 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address ` leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier Ino extra charge). 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return rn address of the article,date,detach and retain the receipt,and mail the article. t 3. If you want a return receipt,write the certified mail number and your name and address on a return receipt card,Form 3811,and attach it to the front of the article by means of the gummed Co ends if space permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT REQUESTED adjacent to the number. O O n0 4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, M endorse RESTRICTED DELIVERY on the front of the article. 0 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If tL return receipt is requested,check the applicable blocks in item i of Form 3811. a 6. Save this receipt and present it if you make inquiry. 105603-93-B-0216 The Town of Barnstable i 3,Aw TAn I Department of Health, Safety and Environmental Services 1639. Public Health Division 367 Main Street,Hyannis,MA 02601 Office 508-790-6265 Thomas A.McKean FAX 508-775-3344 Director of Public Health December 31, 1996 Antonietto Merolla 49 College Ave. Somerville, MA 02144 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY CODE H MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE,ARTICLE 51 The property owned by you located at 118 Pine Street, Apartment 1, Hyannis, known as Map 249 Parcel 039 was inspected on December 27, 1996 by Jerry Dunning, Health Inspector for the Town of Barnstable because of a complaint. The following violations of the Town of Barnstable Rental Ordinance Article 51 and the State Sanitary Code were observed: 410.200: The use of any portable space heater observed is prohibited. 410.150: Seal on toilet leaking. 410.501: No storm door provided on front entrance. 410.501: No storm window provided on kitchen window. 410.505: Holes in walls located in kitchen and bedroom. 410.505: Kitchen and bedroom floors need covering. 410.482: No smoke detector provided. You are directed to correct the remaining above listed violations within seven (7) days of receipt of this notice. i 0 c.d./jerry/q } You may request a hearing if written petition requesting same is received by the Board of Health within seven (7) days after the date order is received. However, this violation must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order could result in a fine of not more than $500. Each separate day's failure to comply with an order shall constitute a separate violation. You are also subject to non criminal citations of$40.00 for the first violation and $15.00 for each additional violation. Tickets will be issued daily until the violations are corrected. PER ORDER OF THE OARD OF HEALTH Tho a;. cKean Director of Public Health cc: Building Dept. - C.C. David c.a.rerryiy Mr./Mrs. fh -�-�-- O :1 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410,00, STATE SANITARY CODE 11, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE,ARTICLE 51 M-P j_qQ' 039 Atr The property owned by you located at 118 p tee.51, °"'`"" was inspected on 7-9L 19946 by health Agent for the Town of Barnstable because of a complaint. 'I'he following violations of the Town of Barnstable Rental Ordinance Article 51 and the Sanitary Code II were observed: GG r ' Y You are directed to correct the violation of within 24 hours of receipt of this notice by You Are also directed to correct the remaining above listed violations within seven (7)days of receipt of this notice. You may request a hearing if written petition requesting same is received by the Board of I lealth within seven (7) days after the date order is received. However, these violations must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order could result in it fine of not more titan $500. Each separate (lay's failure to comply with an order shall constitute a separate violation. You are also subject to non criminal citations of$40.00 for the first violation and V 5.00 for each additional violation. Tickets will be issued daily until the violations are corrected. Enclosed are citation numbers due to violations observed on PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health Town of Barnstable ] PAR ] Real Estate System - General Property Inquiry] Help [ ] Parcel Id: 249 038- - Account No: 157779 Parent : Location: PINE ST HY Neighborhood: 55DC Fire Dist : HY Devel Lot : PAR1&2 Lot Size : .46 Acres Current Own: MEROLLA, ANTONIETTA State Class : 101 MANGANO, EMMA A No. Bldgs : 4 Area: 1540 49 COLLEGE AVE Year Added: SOMERVILLE MA 2144 Deed Date : Reference : 2313/1 January 1st : MEROLLA, ANTONIETTA Deed MMDD: 0000 Deed Ref : 2313/1 Comments : Values : Land: 29100 Buildings : 107200 Extra Features : Road System: 118 Index: 1258 (PINE STREET ) Frntg: 70 Index: 1455 (SEAGATE LANE ) Frntg: 310 Control Info: Last Auto Upd: 050695 Status : C Last TACS Update : 021987 Land Reviewed By: Date: 0000 Bldgs Reviewed By: Date : 0000 Tax Title : Account : Taken: Account Status : Hold Status : Cancel [ ] Press XMT for more data Next screen [PAR ] Action [ ] Owners Name [ ] Road Index [ ] Road Name [ ] Parcel Number [249] [040] [ ] [ ] [ ] 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 occupants 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 regLired-by 105 PHR 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. (E) 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. S (H) Failure to comply with the security requirements of•105.CMR 41,0.480(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. (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 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). r (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 s 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. • f n / 1 FORA3U Hosm&WARREN,INC.NOV.1979-1983 THE COMMONWEALTH OF MASSACHUSETTS t BOARD OF HEALTH I`! CITY/TOWN b DEPARTMENT — ADDRESS TELEPHONE "17 .• {�l� �` Address � ! Occupants Floor Apartment No: G No.of Occupants No.of Habitable Rooms No.Sleeping Rooms I No.dwelling or rooming units No.Stories `p Name and address of owner ►� �..� n1, �� (� � i/ a/��t / / .� t RRemarks" Reg. Vlo. M YARD Out'Bld s,a r Fences Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: AA + ✓vi ,,,.,,�" . {r-�-$ (drr c. [,C/ Roof ` Gutters, Drains: Walls: .Pf ill " Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Lighting: 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)" rr, k,r 1✓r ." -�.,�., ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑220 Fusing,Grnd.: AMP:. Gen.Cond. Distrib. Box: ' Gen. Basement Wiring: i DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen f Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 l Bedroom 3 1 Bedroom 4 ' Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.: Stacks Flues,Vents,Safeties: Kitchen Facilities Sink �t Stove Bathing,Toilet Facil. Vent.,Plumb.,Sanit'n.: Wash Basin Shower or Tub: t' Infestation Rats, Mice Roaches or Other: �, t E ress Dual and Obst'n: 1 General Building Posted a Locks on Doors: 1` 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." Y INSPECTOR ; TITLE A.M. DATE TIME P.M. THE NEXT S-C-,, EDU12D REINSPECTION + y -�f- - P.M. TOWN OF BARNSTABLE BAR-W 1426 Ordinance or Regulation . WARNING NOTICE Name of Offender/Manager (�kew/'LtS J ' r Address of Offender r,� Pi nQ MV/MB Reg.# Village/State/Zip_-"Atsj Business Name a /pm on 19 � Business Address Signature of Enforcing Officer Village/State/Zip --t Location of Offense21 rt,[ Enforcing Dept/Division Offense �tJ�fCt�i4GP CZdln Facts LCIklbetl d )4m7-r trt, ,�L4P - bo�9 ZE--f Lear ank -Zge�10- y tv Opt This will serve only as a rning.,/At this time no legal i )nl bAs beeh aken. h It is the goal of Town agencies to achieve voluntary compliance of TownPlt. Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. TOWN OF BAR BAR-W 42S _ t r Ordinance or Regulation , -, WARNING NOTICwol lL` �A ll Name bf Offender/Manager yR . -L,ts Wd0U Address of Offender MB Reg:1#. v Village/State/Zip "'A # Business Name /pm on 919C Business Address ` '-'Signature of Enforcing Officer- Village/.State/Zip. r: Location of Offense • Enforcing- Dept/Division J y_ Offense �y�SrM;4 GQ � ldl� ". r Facts L vki-tiet- d eli[( Dt, u hP c�fP; ,� bot eat "LQI a r.a le This will serve only as a w rning�At this ,t-ime no�lefgall:action"hes beeh aken. It is the goal of Town agencies to achieve; W-olffitary comp .iance of Town0i Ordinances, Rules and Regulations. i; Education,;ef�o'rstss.'and . warning notices are attempts to gain voluntaryse compliance. Subs" violations! will result in appropriate legal action by the�rTown. -` 5 TO ,i ARKSTABLE, Wei OF .B TPBLE BAR W ' - Ordinance or' Regulation ,.; WARNING NOTICE ,. 6 f wr —4Y� M �` i- •, } yet y'. .UA zot Name o°f Offender/Manager � 5Ldob Address o,f Offender Ilk ��'nk+. �r�Y � x s NI�7/MB Reg,�# ` Village/State/zip,_ ram. . $ '°� Business Name `' /pm on �j3 19 ' �-- Business Address Signature of Enforcing Officer Village/State/Zip a�.; , 0 Location of Offense P I ra - fet_( Enforcing Dept/Division ! - Offense Oo Lf4A.I rf Facts LUlM d )4 r't IJ�, rdv tNomv" 41 boyd.6'i"Id- I _.Wa r4,-1 14 ' This will serve only as a warning.,/At this .time nor` 1egafl. action 'has been taken- it is the goal of Town agencies to achieve voluintary compliance of 'Town))) Ordinances, Rules and Regulations. -Education "effort',, nd warning notices are attempts to gain .;voluntary compliance. Subsequent violations. will result in � ` ` appropriate legal action by the,Town. 1 TOWN OF BAR_ NSTABLE BAR-W U` Ordinance or Regulation g..-. WARNING NOTICE j Name ofOffender/Managert .L ; . ,�€ x Address of Offender I ,y s€ -�.�-� s MV/MB Reg:# Village/State/Zip t" J 't-11A 4S # , Business Name '"' ", am/pm; on 19_ G Business Address } Signature of Enforcing Officer Village/State/Zip Location of Offense + ' Enforcing Dept/Division Offense cat ir� ,�,;�; _, r Facts 4 #.,.3'1 Jt A- t , 4J `T .L'+ (,• This will serve only as a warning.y'At this .t`ime4no legal action` has been taken. tad It is the goal of Town agencies to achieve ,voluntary compliance of Town )#, Ordinances, Rules and Regulations. Education efforts. and warning notices area attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. r CENTERVILLE. MA l 4//V � m STRF--_ Z FT N m i \ I D W D m m m A Locus m m *-D m Z C 18-0 PINE A x STREET 4� q LOCUS MAP \ LOT 2-5I. NOT TO SCALE AREA = 14986 sr � \ ( . 33.5ftx12.5ftx2ft \ \ Q LEACHING GALLERY R, . . \ . I . I I I -A z X cF D-BOX :; \ ` �r0 14 m 4 P-2 � � � W W p -ti m � z N m \ R / � \ 54 O\ �E c\ P BENCH MARK W / Wiq PK NAIL IN DRIVEWAY \ T / ER / r �\G,9 ELEVATION,-.55.44 \ E C BARNSTABLE GIS DATUM � 56 / \ SEPTIC TANK AND LEACHING GALLERY ARE SUFFICIENT TO \ --- — s4 ACCOMODATE A FLOW OF -- — — 55 # _ 440 GALLONS. PER DAY 145.75 ft f - t LEGEND �'. SEWAGE DISPOSAL AS-BUILT PLAN PLAN -TO SERVE EXISTING DWELLING IOOIOTING G AL o o SCALE: l in = 20 Ft � HOWARD & NANCY THOMAS SEPTIC ' TA ��tH°FMassq 128 PINE STREET CENTERVILLE. MA DAVID cy� KO-TECH ENVIRONMENTAL' . NUMBER REFERS TO DIAMETER 18 P * COUGHANOWR m IN INCHES. LETTER DENOTES TYPE No. 1093 43 TRIANGLE CIRCLE SANDWICH MA 0256 O-OAK M-MAPLE P-PINE �FO/STSR�o 508 .364-0894 l S4NIT ETE-2238 JAN I. 2006 I/I THIS PLAN IS TO BE CONSIDERED A DRAFT PLAN UNLESS IT BEARS THE STAMP AND SIGNATURE OF THE DESIGN ENGINEER ORIGINAL PLANS INTENDED FOR SUBMITTAL TO THE BOARD OF HEALTH WILL BE SIGNED IN BLUE AND STAMPED IN RED. FLOW PROFILE ALL PIPE ELEVATIONS SPECIFIED ARE INVERT ELEVATIONS VENT RAISE COVERS TO WITHIN PIPE TOP OF FOUNDATION j EL 5727 6 in OF FINAL GRADE- +- ONE INSPECTION RISER FOR LEACHING GALLERY /��Q�� 2" LAYER OF I/8" f Q-BOX 1/2" STONE �3" DROP H-20 FLOW LINE rL 10- = 14. 13 48- GAS�� PRECAST 3/4-4 1/4- BAFFLE NNOLl s DRYWELL W STONE 53.13 +- 6 in BOTTOM�'OF EXISTING STONE 51.53 LEACHING SYYSTEMSOIL SORPTION ExtsrNo BASE EXISTING 510 51.40 GALLERY EltlST1Np 1000 GALLON (END VIEW) 49.40 5.00 Ft ExgTNo SEPTIC TANK 29 ft v) 5 ft 12.5 ft ) 14 ft ADJUSTED � 26.2 SEASONAL HIGH GROUNDWATER � N m�ox yA m �y o boy (� arm =Z 0 not mmy vmo ~ k �O m Q �941 VI'�Z Uo Z d >} m mm yNSOS r n • ® � o mm ►} � m 1 b 4 Obi N O � y -A N ... 10 r 1� ��a day N o in m �aN� MO oN o Z 111� - �N ��� W m 11 00 ��s oDo m W cJN �-0 ti m i O p �� � -v m mm� W 00> Z �mM- ffl 1 m C� v, `>> n � u, N m \ rOZ mZ o / nOMMD')'�y v v'm ,ZDj _ r ca ,,� o A o _ o cvi N o X vJ w Oz v a3 3 m co Sll�`'� r Z 0 G7 z Di 0 b G) C i m w Ill W i rT1 / / Ln p 1 N � O � � � � '' �cn w z t m G> 4 00 m=>m z O m n T, < =_ I N e w l} oT�� w (Ar m Z m,< o -I x z c) 2$ 4� N 0 m Z _ > _ r � !J cn C Z Z N z 0 133?It5 SUIIHD ti m MQ a tOlt O Z m n G) <J7 O ^ Z Y Rl -1 l J m 3A V MVS3NN3X �r-A� n Z m x o C QVO?I Nl 338 ? n o r -p = � � _ � 3 N.) � � IIIH ,�aa3aM v�/l s �y AQQ� 3 r r "� � '� > � 3 v Z� A D Z r 0 Z r- y g z O z m p —11 "' 3 G) r- -� m m rr- Kn 'D°2"' fV >- 3 > -� ar �— m vvM N r- D U) DATE OF 7EST4 NOVEMBER 23, 2005 SOIL TEST L O r y WIT EV L UI EMENT VID D. CONOHVARIANCES SOU�iHT PESIGN CAL­'(l`_,-U L AT IONS NNO`GROUNDWATER ENCOUNTERED TEST PIT I PARENT MATERIAL: PROGLACIAL OUTWASH DESIGN FLOW: 3 BEDROOMS X 110 GPD - 330 GPD ELEVATION - 55.15 •- PERC AT 70 in 2 MIN/INCH IN C SOILS SEPTIC TANK: 330 GPD X 2 DAYS - 660 GALLONS DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER USE EXISTING 1000 GALLON SEPTIC TANK IF IN SOUND STRUCTURAL 55.15 (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING CONDITION. IF NOT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) 0-8 Ap SANDY LOAM 10 YR 3/2 NONE FRIABLE DISTRIBUTION BOX: USE H-20 3 OUTLET D-BOX. 8-45 B LOAMY SAND 10 YR 4/4 NONE FRIABLE 51.40 SOIL ABSORBTION SYSTEM: A 24 ft x 12.5 ft x 2 ft LEACHING GALLERY CAN LEACH 45-72 Cl COARSE SAND 10 YR 5/4 NONE LOOSE Abot - ( 24 x 12.5 ) - 300 sf 72-144 C2 MEDIUM SAND 10 YR 5/3 NONE LOOSE Asdw - ( 24 + 24 12.5 - 12.5 ) x 2 - 146 sf Atot - 446 sf 43.15 NO GROUNDWATER ENCOUNTERED Vt 0.74 x 446 - 330.04 GPD TEST PIT 2 PARPERENATTM�A6TEIRIA 2 MIN/PROINCH IAL N C SOILS H USE A 24 f t x 12.5 f t x 2 ft GALLERY. Vt - 330.04 GPD > 330 GPD REQUIRED ELEVATION - 81.12 •- DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING 55.10 0-8 Ap SANDY LOAM 10 YR 2/2 NONE FRIABLE 8-44 B LOAMY SAND 10 YR 4/4 NONE FRIABLE LEACHING GALLERY 500 GALLON DRYWELL 51.43 44-80 Cl COARSE SAND 10 YR 5/4 NONE LOOSE DMENSIONS AND DETAL 80-132 C2 MEDIUM SAND 10 YR 6/3 NONE LOOSE CONSTRUCTION DETAIL USE hHo LNT 44.10 DRYWELL UNIT INSTALL ONE INSPECTION STONE RISER TO WITHIN SIX 2 11 EFF. DEPTH INCHES OF FINAL GRADE AND INDICATE LOCATION 24.0 t ON AS-BUILT PLAN 0 T NOTES - 0 33 In Op�� Opp in 1) GARBAGE GRINDER NOT ALLOWED WITH THIS DESIGN N c �4pp�Q:3 _.jp 2) ALL LINES TO BE SCH 40 PVC AND PITCH AT 1/8 INCH PER FOOT MINIMUM. M p��p�aQo� QOO 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REQUIREMENTS 3.5' 8.5' 8.5' OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15) NOT TO ��2 in 4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES 24.0 ft SCALE BEFORE EXCAVATING FOR SYSTEM. 5) EXISTING LEACH PIT TO BE PUMPED. COLLAPSED. AND FILLED. OR REMOVED 6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST IN PLACE 7)' LINES EXITING D-BOX TO RUN LEVEL FOR 2'-0- •BEFORE PITCHING DOWN GROUNDWATER ADJUSTMENT 8) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF LOW FLOW FIXTURES EXISTING GROUNDWATER LEVEL SEWAGE DISPOSAL SYSTEM PLAN AND APPLIANCES. AND BIANNUAL PUMPING OF THE SEPTIC TANK BASED ON TOWN OF BARNSTABLE -TO SERVE EXISTING DWELLING 9) SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT GIS DEPARTMENT RECORDS. PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. �:;* ;,-" INDICATED GW 22.00 HOWARD & NANCY THOMAS 10) INSTALLER TO OBTAIN DISPOSAL WORKS., PERMIT 'BEFORE;,STARTING WORK. INDEX WELL MIW-29 11) SEPTIC TANKS SHALL BE INSTALLED LEVEL,'ANDI`TRUE' TO GRADE ON A LEVEL ZONE D 128 PINE STREET CENTERVILLE. MA READING DATE STABLE BASE THAT HAS BEEN MECHAt4lCfALLY;.COMPACTED AND ON TO WHICH 8.2 2005 SIX_ INCHES OF CRUSHED STONE HAS BEEN. PLACED -TO.-MINIMIZE UNEVEN SETTLING ADJUSTMENT 4.2 ECO-TECH ENVIRONMENTAL 12) SEPTIC TANK TO BE PUMPED DRY AT TIME. OF=.B'YSTEM--REPAIR AND CHECKED ADJUSTED GW 26.2 FOR STRUCTURAL INTEGRITY. INSTALL PVC`OUTLET..TEE FITTED WITH 'GAS BAFFLE. 43 TRIANGLE CIRCLE SANDWICH MA 02563 ETE-2238 NOV 23. 2005 2/2