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Home My WebLink About0042 SEAGATE LANE - Health IF 42 Seagate Lane _. . � Hyannis s ;.._._ A= 249-037—OOB o . 1p z �1 c 7 � 5 ° . l o s i o M ° o No. C7"0/c_:)L 337 Fee Al THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 0[ppYicatiou for Mioozar *potem Cow5tructiou Permit Application for a Permit to Construct( ) Repair(pf"-Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. 41k C� 1-4 Owner's Name,Address,and Tel.No. �® V )"� � , Assessor's Map/Parcel f �/ 037 ©oC,- Installer's Name,Address,and Tel.No. - Designer's Name,Address and Tel.No. 4. Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil i. Nature of Repairs or Alterations(Answer when applicable) g-, load 444-4, \ D S Date last inspected: ...u�4'j "p Agreement: Z Q/ The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. + l 3 2 Date Issued .��,+® r � No. i.� FeeC./ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: TT PUBLIC HEALTH DIVISIONS - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZippYication for ig o aY. p tern Construction verinit Application for a Permit to Construct( ) Repair(rUpgrade( )-Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. � Ga y3 Owner's Name,Address,and Tel.No. O , Assessor's Map/Parcel J [ c ��4a � I 1'T� /, 037 L — �� t �".� Installer'srNaine,Address,and Tel.No. esigner's Name,Address and Tel.No. 3y Type of Building: Dwelling No. of Bedrooms Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date A. Title Size of Septic Tank Type of S.A.S. Description of Soil - fy ,� a Nature of Repairs or Alterations(Answer when applicable) t Or ,,d /9 .o•� ��l / � t S'� ®J r ..1 mac''., &d rc�x-a�g ,r ..era &-i � Date last inspected: - e-� � ! `- � J-P-8 6v Agreement: 17l5 /q/��-�/a. 76 :�` The undersigned agrees to ensure the construction and maintenance of the afore described"on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. , R Signed r F f L� ._�"/ t, Date . ,Application Approved by / Date ~ Application Disapproved by: ~aT Date for the following reasons_ ' e Permit No. 4 n/ 7; j Date Issued /Q /.),y/!A 1� THE COMMONWEALTH OF MASSACHUSETTS Q i BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( �)' Upgraded ( ) Abandoned( )by /1 �, , ,,,�►�� - ,r at_ _/ �`� „�,,, � � , �,,� � has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. / -337 dated Installer fl1 �,� ,, �,r�.� � 9�• Designer #bedrooms Approved design flow gpd The issuance of this permit shal not be construed as a guarantee that the system will-function-aa6 dsign Date � "7�/ Inspector No.rnf � �j Fee ^/Zo ✓ , `A THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION — BARNSTABLE, MASSACHUSETTS Migpo-5al 6pttem Construction Permit Permission is hereby granted to Construct ( ) Repair ( p ' Upgrade ( ) Abandon ( ) System located at !. C ,m —' • 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'bel completed within three years of the date of this'pe Date /` j 7 / Approved by �. A 4 i - Page 10 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 42 Seazate Lane Hyannis,MA Owner: Meredith YVaites Date of Inspection: October 1. 201 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. 3 On>i a I r\ I O 3 ;L . 3 3� y ao 40 1:1 E11E] na Ln p ('1GU1f11 . Er • � ... ._.:... m N� Pose $ � O certified Fee r 0 O Retum Receipt Fee S M (Endorsement Required) C0 O Restricted Delivery Fee �`;rq ,q (Endorsement RequireCO d) a _ _ E3 Total Postage&Fees 0 Sent To - ---!----1• ... or P0 Box No. �-- Certified Mail Provides: as�enay)zppZaunr ooaeu„o�sd a A mailing receipt - a A unique identifier for your mailpiece 0 A record of delivery kept by the Postal Service for two years Important Reminders: A Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®6 j a Certified Mail is not available for any class of international mail. a NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. 4 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. a For an additional fee, delivery may be restricted to the addressee or addressee's authorized a ent.Advise the clerk or mark the mailpiece with the endorsement"Restricted"Belivery". a It a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. -IMPORTANT:Save this receipt and present It when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. _ Town of Barnstable Barnstable /�pTHE Taw rly`vQ�/mo I0�, A55 A�-A111�IC�C�E1 ,/ , Regulatory Services Department I tBARNS'rABLE�; \9�" . Public.Health Division 00 .6gq. �m 2007 Al F°"5As a 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7006 0810 0000 3524 6895 October 22, 2012 Meredith Waites 42 Seagate Lane Hyannis, MA 02601 T ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 42 Seagate brive, Hyannis, MA was last inspected on 1.0/1/2012, by James M. Ford, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Conditionally Passes" under the guidelines of 1995 TITLE 5 (310'CMR 15.00),due,to the following: • Septic tank is not constructed of heavy duty loading (1120) and is not designed for vehicular traffic; however, it is located beneath the driveway. You are ordered to do one of the following; within two'(2) years) from the date you receive this notification: a.) replace the septic system component with a new component relocated into another area of •land.which is not beneath any parking area'or driveway, and properly abandoning the discovered H-10 component, or by b.) replace the septic system component with an H-20 component beneath the parking area or driveway, and properly abandoning the discovered H-1.0 component, or by c.) relocating the parking area or driveway in,such away that no vehicle will have access or the ability to drive over the existing H-10 septic system component. Failure to repair/replace the septic system within'the deadline period will result in future enforcement action. PER ORDER O THE BOARD OF HEALTH l _Thomas McKean, R.S., CHO = Agent of the Board of Health Q:\SEPTIC\conditionally passed\42 Seagate Dr Hy.doc. ' l e., t Y } l a �pTH Town of Barnstable Barnstable Regulatory Services Department po-AmeriCaCrtyP ,BARNS D MASS. Public Health Division o�AlFbb M A 200 Main Street, Hyannis MA 02601 2007 Office: 5.08-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7006 0810 0000 3524 6895 October 14, 2012 Meredith Waites 42 Seagate Lane Hyannis, MA 02601 ORDER TO COMPLY WITH STATE ENVIRON NTAL CODE, TITLE 5 The septic system located at 42 Seagate Drive, annis, MA was last inspected on 10/1/2012, by James M. Ford, a certified se c inspector for the State of Massachusetts. The inspection of the septic system sho ed that the system"Conditionally Passes" under the guidelines of 1995 TITLE (310 CMR,15.0R) due tto�the followir� You are ordered to heplac the above listed septic s within two (2) years)1from the date yo receive this notification. -s 0 r `Mf v(-z 'eke J)lz 1-0 Ce- Failure to repair/re ace the septic system within the deadline period will result in future enforcement act' n. PER ORDE OF THE BOARD OF HEALTH (fY Thomas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\conditionally passed\42 Seagate Dr Hy.doc / Q- 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: 42 Seagate Lart Ht%annis,A4 02601 r� Owner's Name: .: Meredith Waiter V Owner's.Address: Date of Inspection: October 1, 2012 Name of Inspector: (Please Print) James M. Ford: Company Name: Janes M. Foi•d Mailing Address: P.O: Box.49 Osterville,MA 02655-0049 Telephone Number: (508) 862-9400 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 m'y training and experience in the proper function and maintenance of on site sewage disposal systems'.J-am a DEP LE approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). .The system: Filsses Conditionally Passes M Needs Further-Evaluation by the Local Approving Authority -'» rx' Caiis 'ry ,� `! i Inspector's Signature: Date: October 11, 2012 The system inspector shall su it 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 r' DEP. The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Cornnients t - ****This report only describes conditions gt 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. _ t This is a three unit building Ws.38,42&46 SragAte.The original septic tank is H-10 and under the driveway.,Inspection and Septic design,plans.confirm this. It,needs to be,made unaccessible to'vehicle traffic or replaced with an H-20 tank. - Kl t{ r t /15/2 a .Title 5 Inspection Foinr 6 000 e, page 1 Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 42 SeaQate Lane Hvannis, MA Owner: Meredith Waiter Date of Inspection: October 1, 2012 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15:304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: ✓ One or`.more system componepts 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 de.-ternlined,(Y,N,ND) in the,:: for the following statements. If"not determined",please - explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal 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.yearsYold is available. ND explain: The septic tank is H-10 and under the driveway.. 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 fequired 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: 1 r Page 3 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property.Address: 42 Seagate Lane Hyannis,MA Owner: Meredith Waites Date of Inspection.: October 1, 2012 C. Further.Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303 (1)(b) that the system is not functioning in a manner,which will protect public health,safety and the environment: Cesspool or privy,is within 50 feet,of a.surface water Cesspool or privy is within,50 feet of a bordering vegetated wetland or a salt marsh ai 2: System will fail unless the Board of Health(and Public Water Supplier,if any) determines that the system is functioning in a mariner that protects the public health,safety and environment: The system has a septic tai*and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary,to a surface water supply. The system has a septic-tank and SAS and the SAS is within a Zone.1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. ,Method used to determine distance **This system passes if the well water,analysis,.perfoi-nied 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 inust be attached to this form. ,a a 3. Other - LfA, 3 '. Page 4 of I 1 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS v SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A ` CERTIFICATION (continued)' Property Address: 42 SeaQateLane Hyannis,MA Owner: - Meredith Waites Date of Inspection: October 1,2012 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes. No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters due.to ail overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool i ✓ Liquid'depth in cesspool is less than 6"below invert or available volume is less than.%day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. Any portion of the SAS,cesspool or privy is below-high ground water elevation. J.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 1 of a public well. i ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. i ✓ 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 list the well is free from pollution from that facility and the presence of ammonia nitrogen and nrti atgnitrogen 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.] No (Yes/No)The system fails. .I have determined that one or more of the above failure criteria'exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to detennine what will be necessary to correct the failure. E. Large.System: 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 arge sysie{ns 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 _ the system is located in a'nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone'II of a public water supply well If you-have answered"yes"to airy 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 Tailed 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: s 42 Sea Qate Lan e , Hvannis,MA ' Owner: Meredith Waites' Date of Inspection: October 1, 2012 Check if the following have been done: You must indicate"yes"or`:`no"as to.each of the following: Yes No ✓ Pumping information was'providedby the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in'the previous two weeks? ✓ Has the system received normal flows in the previous two week period? ✓ Have large volumes of water.been introduced to the system recently or as part of this inspection? ✓ — Were as built plans of the,system obtained and examined? (If they were not available note as N/A) ✓ Was the facility or�dwelling inspected for signs of sewage back up? ✓ Was the site inspected for signs of breakout T ✓ ,,:.Were all system components,excluding the SAS,located oil site i 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? ✓ Was the facilify'ownen(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 dewrinined based on`. Yes No ✓ _ Existing inforinatiori. For.example,aplan at the Board of Health.. ✓ _ Deferinined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)P 10 CMR 15.302(3)(b)]. k �': it'.4.'". 5 Aj i� .` ;i Page 6.of I 1 'I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL`SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 42 Seaeate Lane Hyannis,MA Owner: Meredith Waites Date of Inspection: October 1, 2012, FLOW•CONDITIONS' RESIDENTIAL Number of bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):" 440 Number of current residents'. Nla Does residence have a garbage grinder(yes or no): Nla Is laundry on a separate sewage system(yes or no): Nla [if yes,separate inspection required] Laundry system inspected(yes or no): 110 Seasonal use(yes or no): no Water meter readings,if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No - Last date of occupancy: Current), COMMERCIAL/INDUSTRIAL _ -Type of establishment: „F Design flow(based on 310 CMRI5.203). gpd Basis of design flow(seats/persons/sq/ft etc.); . Grease trap present(yes or no): Industrial waste'holding tank present(yes.or no) Non-sanitary waste discharged to the Title,5 system(yes or no): Water meter readings,if.available Last date of occupancy/use: . . OTHER(describe): a. 3 GENERAL INFORMATION Pumping Records " . Source of information: Tank was pumped after the inspection Was system pumped as part of the iitspectioxy(yes or no): Yes If yes,volume pumped: all -=How was quantity pumped determined? 'Reason for pumping' Maintenance TYPE OF SYSTEM ! Septic tank,distribution bbx,soil absorption system Single;cesspool :,';.I Overflow cesspool Puuyi, Shared-system(yes or rio) .(if.yes,attach previous inspection records,if any) Innovative/Alter-native'tecluidlogy. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) .5 ` Tight Tank Attach a copy of the DEP'approval Other(describe); + Approximate age of all components,date installed(if known) and source of information: , Date ofinsiallatioh- original tank 1987. New system was added in 2008 ? Were sewage odors detected when arriving at the site(yes or no): No 6 r Page 7 of 11 OFFICIAL INSPECTION FORM-,NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property ert Address: 42 ea S ate Lane g Hvannis.MA ' Owner: Meredith lflaites Date of Inspection: October 1. 2012 BUILDING SEWER(locate on site plan) Depth below grade: t Materials of construction: _cast iron _40 PVC - other(explain): . Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence'of leakage,etc.): SEPTIC TANK: 1(2) (locate on site plan) Depth below gradei�"11"and 14." Material of construction. v/f concrete r. metal _fiberglass _polyethylene - other(explain) If tank is metal list age: : Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of- certificate) Dimensions: 1500 gal. and 1000 gal. Sludge depth t,,- 2 sT Distance from top of sludge,to bottom of outlet tee or baffle: _ 30" Scum thickness: 1„ ,. Distance from top,of scum to top:of outlet,,tee or baffle`. 6" Distance from bottom of scum to bottom of outlet tee or baffle 10" How were dimensions determined: Measuring stick Comments(on pumping recommendations, inlet and outlet tee or baffle,condition,structural integrity; liquid levels as related to outlet invert,evidence of leakage,etc.). The tees were vr'esent. The liquid level was even with the outlet invert There did not appear to be aiw signs of leakage The first taizlc 1500 Gal.Js H-10 and has a steel cover on the outlet The second tank is 1000 Qal. H-20 and has steel covers on both ends: t GREASE TRAP:- None (locate on site.pf'an) Depth below grade: Material ofconstiuction: concrete .,`_metal _fiberglass polyethylene _other (explain): Dimensions. Scum thickness.!.± Distance from top of scum to top„of outlet tee.or,baffle: Distance from bottom'of scum.to bottom of outlet tee or baffle: Date of,last pumping: Conunents(on puiii&g reconuliendations,inlet and outlet tee or baffle'condition,structural integrity,liquid levels as related.to outlet invert;evidence of leakage;etc.): ° ,f " Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS ..SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C. SYSTEM INFORMATION (continued) Property Address: 42 Sea-zate Lahe Hyannis,MA Owner: Meredith Wailes Date.of Inspection: October 1, 2012 TIGHT or HOLDING TANK: . None (tank must be pumped at time of inspection) (locate on site plan) Depth below grade: I Material of construction: concrete _metal —fiberglass._polyethylene _other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): -Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ if present must be opened)(locate on site plan) y . Depth of liquid level above•outlet invert <Even Comments.(note if box is level acid distribution to outlets equal,any evidence of solids carryover,,any evidence of leakage into or out of box; The D-Box was clean and the cover ivas to grade. PUMP CHAMBER:' None (locate.on site plan) Pumps in working order.(yes or.no): Alarms in working order(yes of,iio)_ ` Cornments(note.condition of pump chamber;condition of pumps and,appurtenances, etc.): j: ,.,y t t 1 _ r. 8 Page 9 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 42 Seaeate Lame Hvannis, MA Owner: Meredith Waites Date of Inspection: 'October 1,2012 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explainwhy: Type leaching pits,number: leaching chambers,number:: ✓ 'leaching galleries-, number: 3 -galleys 12'x 36'x 2'per design plan leaching trenches, number, length: leaching'fi'elds,number,iiirmensions: overflow cesspool, Innovative/alternative system Type/name of technology. Comments (note condition of soil', signs of'•hydratilic failure, level of ponding, damp soil, condition of vegetation, etc.): The Mlevs ivere drj+and clean. There did not bppea.r to be any signs of failure.A camera ivas used for the inspection CESSPOOLS: None cess pool`m st be pumped as art of inspection) s ion locate on site pla n) Number and corif guration Depth- top of liquid to inlet invert - Depth De th of solids layer:.' Depth of scum layer: - p Y r . Dimensions of cesspool: Materials of construction: ; Indication of.groundwater inflow(yes:or no): Continents:(note condition of soil,signs of Hydraulic failure;level of ponding,condition of vegetation,etc.): PRIVY: 'None (locate on srte'plan) Materials of:60:n: i-uciion: t ,Y lik i s? .. Dimensions. Depth of solids Conmlents(note condition of soil,signs oAydraulic failure,level of ponding,condition of vegetation,etc.): t a_• 1 i r Page 10 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 42 Seagate Lane Hvannis,MA Owner: •Meredith lVdites Date of Inspection: October 1, 201 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: t t - . o Z. ao yo t n. • Page I I of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE.DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 42 Seagate Lane p Hyannis,MA Owner: Meredith Waites Date of Inspection: October 1. 2012 SITE EXAM Slope Surface water Check cellar - 'Shallow wells. . Estimated depth to ground water 40+/= feet Please indicate.(check all methods used to,determine the high.ground water elevation: ,Obtained from system design`plans.on record'- If checked, date of design plan reviewed: Observed site"(abutting property/observation hole within 150 feet of SAS) ✓ Che&e6 with local:Boafd'of Health-explain: Topographic and water contours Wraps Checked with local excavators;installers-(attach documentation) Accessed USGS database-explain:' You must describe how you established the*high ground water elevation: ' Using Bar nsCable topo_araUlTic ai d tirdtei contours niays sh the snaps were owing aupr•oxirnatelr 40 +/-to Around water•at this site. r �t I This report has been prepared only for the septic system and components described herein. This septic system has been inspected;and condutona(;passed as of the date of inspection. This.report is not a warranty or guarantee that the system will Auction.properly in the fitkure. There have been..no warranties or guarantees, either expressed, written or•implied, J-elattng.to the septic system the inspection, this report crud/or ally components of the septic system which have not been located and inspected;r Ea .1 iJ.1 ib . .` fr r Town of Barnstable Barnstable �IHE Regulatory Services Department 1 i Public Health Division ED N1P�a�� 2007 200 Main Street, Hyannis.MA 02601 Office: 508-862-4644 r Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7008 3230 0002 5178 2879 December 31, 2012 �� o Mr. &Mrs. William Miner TRS 42 Seagate Lane, Unit B. 6 Hyannis, MA 02601 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,-TITLE 5 V The septic system located at 42 Seagate Lane, Hyannis,MA was last inspected on 10/01/2012 by James M.Ford,a certified septic inspector for the State of Massachusetts. r The inspection of the septic system showed that the system."Conditionally Passes" ! under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following e System is beneath driveway. Septic tank will either have to be relocated,'or replaced with an H-20 load bearing tank, or you have the option of relocating the drivewayto_prevent vehicles from driving over the septic tank. You are ordered to repair or-replace the Septic system within two (2)years from the date you receive this notification. ' PER ORDER OF THE BOARD OF HEALTH R orasc CHO Kean .S. Agent of the Board of Health ' Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\42 Seagate Ln.Hy.Dec 2012.doc' Is 00121Y/ Town of Barnstable _L U.S.POSTAGE>>PITNEY BOWES Public Health Division BARNSTABLE.g! 200 Main Street MASS. $ 005.750 �p f6)9 00 �'� ZIP 02601 lEo nw+ Hyannis,MA 02601 +i— 0001361475 OCT. 23. 2012. h 7006 0810 0000 3524 6895 .�Meredith Waites .� 42 Seagate Lane a Hyannis, MA v . R 1%1 TO SEND N AR bM L= ram... L. a a260 { {4.i31.0t9$ q o'�1i98v7+ ? ' STSta— g39S—Cd a � _� 99idllllftl3}ll}}191[�i93dili}}]iI:1H'}9�1�119}} �'19311338.i COMPLETE THIS SECTION ON DELIVERY SENDER' COMPLETE THIS SECTION ■ Complete items 1,2,and 3.Also complete A• Signature. item 4 if Restricted Delivery is desired. X ❑Agent . N Print your name and address on the reverse ❑Addressee { 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 0 o N C 1, 1. Article Addressed to: If YES,enter delivery address below: ❑ No T-4 ' � Q � �� 3. Service Type Q �(� s„ (L%�J7 J S Qo2 O ❑certifled Mail Express Mail � 0 Registered etum Receipt for Merchandise f ❑Insured Mail MC.O.D. Q m p 4. Restricted Delivery?(E7dra Fee) ❑Yes N CD <n 2. Article Number 4 6895 r -- _ _ -- - -- i '-^�• 1 (Transfer from service labeo 7006 0810 0000 352 Ps Form 3811,February 2004 Domestic Return Receipt 102595-02- 1540 / i I I -T ,S, �THE � Town of Barnstable Barnstable J `(` Regulatory Services Department ericaC"P *4 naa-is-rAB�E,) 8 D." 39. Public Health Division o°ArfD MA't A,� 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL # 7006 0810 0000 3524 6895 October 22, 2012 Meredith Waites 42 Seagate Lane Hyannis, MA 02601 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 42 Seagate Drive,Hyannis, MA was last inspected on 10/1/2012,by James M. Ford, a certified septic inspector for the State of Massachusetts. The>inspection;o,f'thet eptic;.,ystem showed that the system "Conditionally Passes" z under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: I ,*.r Sep�tc tank is.not.constructed of heavy duty loading (1120) and is not designed for vehicular traffic;-however, it is located beneath the driveway. IT You are ordered to'do one of the following, within two (2) years) from the date you receive this notification: a.) replace the septic system component with a new component relocated into another area of land which is not beneath any parking area or driveway, and properly abandoning the discovered H-10 component, or by b.) replace the septic system component with an H-20 component beneath the-parking area or driveway, and properly abandoning the discovered H-10 component, or by c.) relocating the parking area or driveway in such a way that no vehicle will have access or the ability to drive over the existing H-10 septic system component. Failure toirepair/replace the septic system within the deadline period will result in future enforcement action. q iqi i1t°h- .fie- /. i PER ORDER O 1THE•BOARD OF HEALTH �. r111, xgy�fi` I �t)) t5E1 i i rr: i I ' �,, r, s .-: 4� 1 t 3 rr�. r 1 ThomastMeKean,rR S ,}CHOL f• .? F, , , ,-.I rzr, ,, ,pzxj ;cF <ql�¢ $� , . >�t e, Agent of the Board of Health Q:\tSEPTIC\conditionally passed\42 Seagate Dr Hy.doc • _ 1Op THE TO\ Town of Barnstable Barnstable 4 'i'"�P�� ;'I, Regulatory. Services Department *Ame'caC itv .i BARNS'CABLE.)•J, 90 "As9: i6T9 Ck Public Health Division O , \�TFD 200 Main Street Hyannis MA 02601 _ 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7006 0810 0000 3524 6895 - October 22, 2012 Meredith Waites 42 Seagate Lane Hyannis, MA 02601 . ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 The septic system located at 42 Seagate Drive, Hyannis, MA was last inspected on 10/1/2012,by James M. Ford, a certified septic inspector for the State of Massachusetts. } The inspection of the septic system showed that the system "Conditionally Passes" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Septic tank is not constructed of heavy duty loading (1120) and is not designed for vehicular traffic; however, it is located beneath the driveway. You are ordered to do one of the following, within two (2) years) from the date you receive this notification: a.) replace the septic system component with a new component relocated into another area of land which is not beneath any parking area or driveway, and properly abandoning the discovered H-10 component,or by b.) replace the septic system component with an H-20 component beneath the parking area or driveway, and properly abandoning the discovered 14-10 component, or by d c.) relocating the parking area or driveway in such away that no vehicle will have.access or the ability to drive over the existing H-10 septic system component. , C3 Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER'O THE BOARD OF HEALTH Thomas McKean, R.S., CHO Y Agent of the Board of Health Q:\SEPTIC\conditionally passed\42 Seagate Dr Hy.doc I UNITED STATES POSTAL SERVICE I First-Class Mail ' Postage&Fees Paid LISPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box • Town of Barnstable Public Health Division 200 Main Streety - Hyannis, MA 02601 t 0 Ii I 1 SENDER: COMPLETE THIS SECTION COMPLETE THIS'SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Si yture /1 item 4 if Restricted Delivery is desired. / jAgent X I ■ Print your name and address on the reverse L. (/�- O Addressee so that we can return the card to you. B. R ived by rin dme) C. D to of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. U I D. Is delivery address different from Rem 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No I I Mr. & Mrs. William Miner TRS I j 42 Seagate Lane, Unit B 3. Service Type i Hyannis, MA 02601 ❑Certified Mail ❑Express mail ' I - ❑Registered ❑Return Receipt for Merchandise �— - - -- -- - - - ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7008 3230 0002 5178 2879 (Transfer from service label) PS Form 3811,February 2004 f Domestic Return Receipt 102595-02-M-1540 Q" •. • CIO C� ru co f` Postage $ � NIS� Certified Fee '9 ru stmark O Return Receipt Fee 0 (Endorsement Required) �r� O Restricted Delivery Fee v `° C3 (Endorsement Required) `u' 7.5 GSp fU Total Postage&Fees m co E3 Mr. & Mrs. William Miner TRS 42 Seagate Lane, Unit B Hyannis, MA 02601 Certified Mail Provides: a A mailing receipt o A unique identifier for your mailpiece ` 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 Mail®or Priority Mail®. o Certified Mail is not available for any class of international mail. • NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables;please consider Insured or Registered Mail. o For an additional fee,a Retum 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. a For an additional fee, delivery may be restricted to the addressee or addressee's authorized agant.Advise the clerk or mark the mailpiece with the endorsement"Restricted%elivety. o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02.000.9047 IHf Town of6arnstable Barnstable Regulatory Services Department MMSTABLE r Public Health Division A16 9. im w 2007 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 ` s Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO. f CERTIFIED MAIL# 7008 3230 0002 5178 2879 December 31, 2012 r: Mr. &Mrs.William Miner TRS 42 Seagate Lane, Unit B - Hyannis, MA, 02601 F ORDER TO COMPLY,WITH STATE,ENVIRONMENTAL CODE,TITLE 5. The septic system Located at 42 Seagate'Lane, Hyannis,MA was last inspected on 10/01/2012 by James"M.Tord,a certified-septic inspector-for'the State of g Massachusetts. The inspection of the septic system showed that ihel system "Conditionally Passes" under the guidelines of 1995 TITLE 5 (31 O.CMR 15.00),.due to the following C System is.beneath driveway. :, _ ,•� r Septic'tank will either have to be relocated, or replaced,with an H=20 load bearing tank, or you have the option of relocating the driveway to prevent=vehicles from driving over the septic tank You are ordered to repair or replace the Septic system within two(2)years from the date you receive this'notification. PER ORDEROF THE BOARD OF HEALTH , Dims McKean, R.S. CHO Agent of.the Board of Health F R` Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\42 Seagate Ln.Hy._Dec 2012.doc' _ i COMMONWEALTH OF MASSACHUSETTS ! r EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS 0 I DEPARTMENT OF ENVIRONMENTAL PROTECTION i 'I --TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE.SEWAGE DISPOSAL SYSTEM FORM i° PART A CERTIFICATION Property Address: 42 Seagate Lane Hyannis,MA 02601 Owner's Name: Meredith Waites Owner's.Address: Date of.Inspection: October 1.'201 ` Name of Inspector: (Please Print) Janes M.Ford Company Name: Janes M.Fond . b . Mailing Address: P.O:Box 49. Osterville,MA 02655-0049 Telephone Number: (508) 862-9400 - 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. Lama DEP approved system inspector pursuant to Section 15.340 of Title 5.(310 CMR 15.000). The system: }sses Conditionally Passes. deeds Further Evaluation by the Local Approving Authority Fails Inspector's Signature:' Date: October 11, 2012 The system inspector shall su it 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 gt thimime of inspection and undefthe 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. This is a three unit building#.'s 3 81 42&'46 S�ag¢ite.'The original septic tank is H-10 and under the driveway.Inspection and.Septic design plans confirm.this.It needs to be made,unaccessible to vehicle traffic or.replaced with an H-20 tank. Title.5.Inspection Foiin 6/15/2000 ' , page] v �� E I_ Page 2 of 11 OFFICIAL INSPECTIONv FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 42 Seakate Lane Hyannis, MA Owner: Meredith Waiter Date of Inspection: October 1: 2012 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D ------------------ A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 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. r 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 iris structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: The septic tank is H-10 and under the driveway: 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 ban 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board o`Health): ,. broken pipe(s)are replaced obstruction is removed ND explain: , ,R 2 Page 3 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEW AGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 42 Seazate Lane Hyannis,MA Owner: Meredith Waites Date of Inspection: October 1, 2012 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine.if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15:303 (1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within'SO.feet of a surface water Cesspool or privy is within.50,feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any) determines that the system is functioning in a manner that protects the public health,safety and environment: The system has 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. . J„ The system has a septic`tauk 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 than,100 feet but 50 feet or more from a private water supply well**. .Method used to determine distance' **This system passes if the well waier.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 +:ci 3 r Page 4 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEM'AGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 42 Sea ate Lane Hyannis,MA Owner: Meredith Waites Date of Inspection: October 1.2012'4", D.. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _ ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool - ✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than%z day flow. ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped._. .. ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation. ✓ Any 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 l of a public well. ✓ Any portion of,a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion.of a cesspool or.privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP.certified laboratory,for 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 nitrigen 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.] No (Yes/No)The system fails. I have de*M.nined 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 System: : . To be considered a large system the systeni'must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"toeach :f 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 ' the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a'public water supply well If you have answered."yes"to any question it Section E the system is considered a significant threat,or answered "yes'.'in Section D above the large system hA.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. J . 4 Page 5 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 42 Seazate Lane Hyannis,MA' Owner: Meredith Waites Date of Inspection: October 1. 2012 Check if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No ✓ Pumping information was provided by the owner,occupant,or Board of Health' Were,any.of the system components.pumped out in the previous two weeks? ✓ _ Has the system received normal flows in the previous two week period? ✓.' Have large volumes.of water been introduced to the system recently or as part of this inspection? ✓ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up? ✓ Was the site inspected for signs of break out? ✓ _ Were all system components,excluding the SAS,located on site ✓ Were the septic tank manholesuncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,maierial of construction,dimensions,depth of liquid,depth of sludge and depth of scum? ✓ Was the'facility owner(and occupantsif different from owner)provided with information on the proper maintenance of subsurface,sewage disposal systems? -The size and locatiowof 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) [310ICMR 15.302(3)(b)]: l t • l :t' 5 a Page 6 of 11 OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C 'SYSTEM INFORMATION Property Address: 42 Seagate Lane Hyannis,MA Owner: Meredith Waiter Date of Inspection: October 1, 2012 FLOW .CONDITIONS RESIDENTIAL Number of bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 Number of current residents: N/a Does residence have a garbage grinder(yes or no): N/a Is laundry on a separate sewage system(yes or no): N/a [if yes separate"inspection required] Laundry system inspected(yes or no): no Seasonal use(yes or no): no Water meter readings,if available(last 2 years usage(gpd)): Unavailable Sump Pump (Yes or no): No Last date of occupancy: Currently COMMERCIAL/INDUSTRIAL t '1 i .. Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sq/ft etc.), Grease trap present(yes or no): . Industrial waste holding tank present(yes or no? Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: t OTHER(describe): GENERAL INFORMATION Pumping Records 1V. ,,h Source of information: Tank was pumped after the inspection Was system pumped as part of the inspection=(yes or no): Yes If yes,volume pumped: gallons was quantity pumped determined? Reason for pumping: Maintenance ._ I TYPE OF SYSTEM ✓ Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool. Pricy. , SMred'system(yes or no) (if yes,attach previous inspection records if P � 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 Other.(describe): _ Approximate.age.of all components,.date installed(if known)and source of information: Date of installation-orieinal tank 1987.New system was added in 2008 ? Were sewage odors detected when arriving at the site(yes or no): No Page 7 of 11 OFFICIAL.INSPECTION FORM ' NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SY')TEM INFORMATION (continued). Property Address: 42 Seagate Lane Hyannis,MA , Owner: Meredith Waiter Date of Inspection: October 1 2012 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: cast iron 40 PVC other(explain)::: Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.):' SEPTIC TANK: 1(2) (locate on site plan). y Depth below grade: 11"and 14 ( '',I ! :' Material of construction: ✓. concrete,., metal fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1500 Qal, and 1000 gal. Sludge depth` 2" Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: 1,, i Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: 10" How were dimensions determined: Measuring stick Comments`(oii pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,.liquid levels as related to outlet invert,evidence of leakage,etc.). The tees were Present. The liquid level was even with the outlet invert There did not appear to be any signs of leakage The first tank 1500 Gal. Is H-10 and has asteel cover on the outlet The second tank is 1000 Qal. H-20 and has steel covers on both ends. J, GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: concrete = metal _fiberglass _polyethylene _other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle:` c' 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.): t 7 Page 8 of 11 P OFFICIAL INSPECTION FORM -.NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEV6'AGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 42 Seagate Lai,- Hyannis,MA Owner: Meredith Waiter Date of Inspection: October 1. 2012 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: _concrete _;neFal _fiberglass _polyethylene _other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alann in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): 1 DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert:: Even 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.): The D-Box was clean and the cover Was to tirade. PUMP CHAMBER: None (locate on sits.;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.): ,1 S :1 Page 9 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 42 Seazate Lan^ Hyannis,MA Owner: Meredith Waitcs Date of Inspection: October 1, 201 _ SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: : Teaching chambers,number: ✓ leaching galleries, number: 3 - galleys 12'x 36'x 2'per design plan leaching trenches, number, length: leaching fields, number, dimensions: overflow cesspool,number, Innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The galleys were dr);and clean. There did not appear to be any signs of failure.A camera was used for the inspection: CESSPOOLS: None . (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,sighs of hydraulic failure,level of:ponding,condition of vegetation,etc.): PRIVY:, None (locate on site plan) Materials of construction: Dimensions', f , , t:: -MAC, Depth of solids - Comments(note,condition' of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): r'..a . ,.l 9 r r Page 10 of 11 . OFFICIAL INSPECTION'FORM`- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INS PECTION PART C SYSTEM INFORMATION (continued) Property.Address: 42 Seagate Lane Hyanhis,MA , Owner: Meredith Waites Date of Inspection: October 1. 2012 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. b Ig 3 {� dj ...a I QL y ao yo 11 a S �Io ,El ETEI Page II of 11 OFFICIAL INSPECTION FORM.- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEV4,"A_GE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 42 Seagate Lane' Hyannis,MA. Owner: Meredith Waiter Date of Inspection: October 1, 2012 SITE EXAM Slope Surface water . Check cellar Shallow wells Estimated depth to ground water 40+1- feet Please indicate (check) all methods used to determine-the high ground water elevation: s✓ Obtained from system design plans of record - If checked, date of design plan reviewed: ' Observed site(abutting property/observation hole within 150 feet of SAS) ` ✓ Checked with local Board of'Health-explain: Topographic and water contours maps �'j Checked with local excavators;installers-(attach documentation) Accessed USGS database-explain: _ You must describe how you established the high ground water elevation: } Using Bail table topographic and water eotitours mans the inaps were showing approximately 40 +/ to ground water at this site. This report has been prepared only for'the septic system and components described herein. This septic systein has been inspected.and conditional passed,'as of•the date of inspection. This report is not a warranty or guarantee that the system will fit fiction p-operly in the firtiite i,there have been no warranties oi-guaraintees,either expressed, written or implied, relating to the septic system,;the this report andlor any components of the septic system which have not beers located and inspected':. t' Xj �i. . i 337 - Fee. (J v THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes Tipplication for �Diopo$al 6potem Con6truction Permit Application for a Permit to Construct O Repair(Vr Upgrade/O Abandon O ❑Complete System❑Individual Components Location Address or Lot No. �(jJ V tf�C Owner's Name,Address,and Tel.No. Or�yf_,fit Assessor's Map/Parcel li o,37 0o��--yyyy Installer's Name,Address,and Tel.No. / Zml Designer's Name,Address and Tel.No. " d 772ct�i1�� Type of Building: I Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder I Other Type of Building No.of Persons Showers( ) Cafeteria{ ) Other Fixtures Design Flow(min.required) gpd Design flow.provided gpd Plan Date Number of sheets Revision Date Title Size of-Septic Tank Type of S.A.S. Description of Soil l Nature of Repairs or Alterations(Answer when applicable) I Sr- 6dOB Date last inspected: tl Agreement: 17�5 iq -/f3f -lf a 4'7>6 The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in. accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by Date a 1� Application Disapproved by: Date for the following reasons Permit No. �W z 3 Is Date Issued Q Ali THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS -- R Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( ) Repaired Upgraded ( ) Abandoned( )by at !d1< —/7 �� /1LJ_ Y„„�f�J has been constructed in accordance with the provisions of Title 5 and the.for Disposal System Construction Permit No.-i 3 3 dated Installer 'A i- /a rs%��}�if/. Designer #bedrooms l Approved design flow gpd The issuance of this permit/shall,not be construed as a guarantee that the system(wi 1-function afesvned\\- Date �! / % «� Inspector ----—————.——————————————————————� No _ ;'✓��'— .�.� Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Migofsai 6pstem Construction Permit Permission is hereby granted to Construct.( ) Repair ( ✓T 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 S and the following local provisions or specialconditions. Provided:Construction must be completed within three years of the date of this permtr Date. V C(! (C7 Approved by ✓� � i DF'"E' Town of Barnstable U.S.POSTAGE>>PITNEY BOWES Public Health Division BARNSfABLE.� 200 Main Street MASS. O 6)q.p0 Y ZIP 02601 $ 005.75 ED Mi.� H annis,MA 02601 - L 0001361475 JAN, 0.3. 2013 7008 �3230�0002 5178 4287r a Mr.„& Mrs. William Miner TRS 42 Seagate Lane, Unit B Hyannis, MA 69,6,9 w LI:Z 6 Of)':L`. � 4 �t 0. 9 @➢ 1�gg H @ 9H 1 Town of Barnstable Barnstable Regulatory Services Department 8�� 1 '�^ r Public Health Division Fo� Publ ic 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7008 3230 0002 5178 2879 December 31, 2012 Mr. & Mrs. William Miner TRS 42 Seagate Lane, Unit B Hyannis, MA 02601 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 42 Seagate Lane, Hyannis, MA was last inspected on 10/01/2012 by-James M. Ford, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Conditionally Passes" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following • System is beneath driveway. Septic tank will either have to be relocated, or replaced with an H-20 load bearing tank, or you have the option of relocating the driveway to prevent vehicles from driving over the septic tank. You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification. PER ORDER OF THE BOARD OF HEALTH �dmasMcKean, RS. CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\42 Seagate Ln.Hy.Dec 2012.doc t, FORM30 C&w HOBBS&WARREN'" THE COMMONWEALTH OF MASSACHUSETTS BOARD OF H TH CITY OWN 4 W D PARTMENT c ADDRESS / fV1 TELEPHONE Address 1�" _ Occupant_" Floor Apartment No. No.of Occupants__ _ 2 No.of Habitable Rooms No.Sleeping Rooms No. dwelling or rooming units N . Stq_ Dries Name and address of owner �„"„ Remarks Reg. Vio. YARD Out Bld s.' Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: er STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ,❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Lighting: LA Flu STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: Stacks, Flue ents,Safeties: Kitchen Facilities in It OUT ve Bathing,.Toilet Facil. _Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATION HECKED 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 ORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES O U " INSPECTOR TITLE I ,� � ��p A. DATE � —6 TIME U 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 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 II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s)pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CIv1R 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 requirec 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 a,)d 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, gasfittirg, 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. r 3CAb FORM30 H&W HOBBSSWARREN'M THE COMMONWEALTH OF MASSACHUSETTS BO RD OF HEALTH 1r � ITY/TOWN W v, b DEPARTMENT HA Qwo 0 DRESS ^M SveJ�t E ONE Address - �-�1 _ N VS Occupant.C1MJ iia.�oy I1' ) �" Floor Ap tment No. No. of Occupants-3 nts..3x vll�( �1�Oco� No. of Habitable Rooms_ 1�"' No.Sleeping Rooms__ No.dwelling or rooming units_ No.Stories , '-.- �►,Q �,/� Name and address of owner(I ( YI�_I �U '(�dM� y o I`J W otoo l Rema s Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish 44 Containers: Drainage 6tF \4 Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Lighting: STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Sup ly Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen. Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink v Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) "THIS INSRECTIQN REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTI E U l INSPECTOR TITLE �I�� DATE TIME A.M. THE NEXT SCHEDULED REINSPECTION P.M. .<-M,. - .:..... it.r. ,;. :'}..'• z."rS"'r...w., ..._. -,-ti- t ,...r .. .r sf..'C.• - An; n v i ,. ... e. .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 pote,)tial 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 o 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 requiremerts 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. W IA-Od\ bed roc rn� S il� Parcel Detail Page 1 of 2 0,7 li I E i2�f l 1 Logged In As: Parcel Ce) Detail Wednesday, Ap Parcel Lookup Parcel Info Parcel ID 249-037-OOB II Condo Unit JUNIT B42 Condo ` SEAGATE LANE �� Building Complex -- ----- - -- ----------- - Location 42 SEAGATE LANE �� Pri Frontage j - _._ Sec Road SecFrontage.- - ------- __—_-- ---_-- - Village HYANNIS r T Fire District>H ANNIS Sewer Acct Road Index 1455 Interactive Ma p l� ' - i" - Owner Info owner MINER, WILLIAM F & MARIE C TR Co-owner MINER FAMILY TRUST Streets C/O WAITES, MEREDITH M Street2158 SPEEN ST City NATICK State lMA j zip,01760 Country - Land Info Acres 10 Use!Condominiu MDL-05 JI Zoning i j Nghbd '0001 Topography ,_...._II Road ' Utilities 7111 Location - Construction Info Building 1 of 1 Year - Roof Ext 1989 'Gable/Hip Wood Shingle !�Built Struct Wall Effect NOne 899 Roo -p p f lAS h/F GIs/Cm I AC� --J) Area - - - - - il Cover - -- Type Style Condominium Int Drywall Bed rY- 12 Bedrooms - Wall - --_I Rooms -- - -ll Model,Res-Condo Floor _l� Rooms http://issql/intranet/propdata/PareelDetail.aspx?ID=17986 4/11/2007 Parcel Detail Page 2 of 2 Heat Total - US[4.40[ Grade Average _ Elec Baseboard 5 Rooms - — Type Rooms I AS[4401- B M T[d40j I—.- ;WDK[7001. stories 2 Stories Heat Found Fuel ation Permit History Issue Date Purpose Permit# Amount Insp Date Comments Visit History Date Who Purpose Sales History Line Sale Date Owner Book/Page Sale P 1 11/5/1996 MINER, WILLIAM F & MARIE C TR 10469/305 2 9/15/1992 MINER, WILLIAM F & MARIE C 8191/062 3 9/15/1992 WALTERS, FRED W & 8191/048 4 3/15/1991 MCCLELLAN REALTY, INC 7470/174 - Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcc 1 2007 $164,300 $0 $0 $0 2 2006 $157,800 $0 $0 $0 3 2005 $149,800 $0 $0 $0 4 2004 $121,300 $0 $0 $0 5 2003 $73,600 $0 $0 $0 6 2002 $73,600 $0 $0 $0 7 2001 $73,600 $0 $0 $0 8 2000 $65,300 $0 $0 $0 9 1999 $65,300 $0 $0 $0 10 1998 $65,300 $0 $0 $0 11 1997 $53,700 $0 $0 $0 12 1996 $53,700 $0 $0 $0 13 1995 $53,700 $0 $0 $0 14 1 1994 1 $72,400 $0 $0 $0 Photos http://issql/intranet/propdata/ParcelDetail.aspx?ID=17986 4/11/2007