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32, 34 WOODBURY AVENUE - Health
32/34 W(U(717BUTZY AVr -�� k n o 0 q "r a s 9 7 eF� No. 7 Fee 7 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes RppliLation for Bisposaf .pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon()� ❑Complete System ❑Individual Components Location Address or Lot No. (,(j(J(,� �( iQ-1Jty Owner's Name,Address,and Tel.No. i�� $l-1•lf2C.E t{ F{'�3(,lK� T�°�T' Assessors Map/Parcel Installer's Name,Address,and Tel.No. $p$"tT7-$$7'j. Designer's Name,Address,and Tel.No. 0,A0C_ .We'0 6 60- - 7 OW5,S c4C, DtY Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board o ealth. C Sig Date � '� ��✓ Application Approved by Date— Application Disapproved b Date for the following reasons Permit No. 2 /S G Date Issued C`j� �!?/5 ,w r 1 7,5 No. 7 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftplitation for lDisposal 4, pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon(k ❑Complete System ❑Individual Components Location Address or Lot No. 3%(,Oomopw A, V e Owner's Name,Address,and Tel.No. r Assessor's Map/Parcel rl�l 15151 1 W oD O(.�K�S 6 1 Installer's Name,Address,and Te.No. Sp$ �`1"�—$$7`� Y ^D.esigner's Name,Address,and Tel.No. CaP 60 `u Type of Building: `f} 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 ,v _ K n' 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��dij &i3c �yC� S iG �� 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 Certificate of Compliance has been issued by this Board o ealth. Sig Date Application Approved by �— Date Application Disapproved b Date for the following reasons Permit No. 20/S 25 Date Issued U�y f?yi 5 --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS ' BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS //IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) r Abandoned(/�)by / - at 3 a L 'O C)Z�U P L/ AV6 C/'1' has been constructed in accordance / with the provisions of Title 5 and the,for Disposal System Construction Permit No2jWW 7qs dated 9 4f!�i> Installer 0AP67UJ16 E Q &X9,WC3 64.C. Designer IVIA #bedrooms Approved design flow god The issuance of this permit shall,nott be construed as a guarantee that the system w�l`function as`ddesig�n,ed\\ Date i ! 1 Inspector --------------------------------------------------------------------------------------------------------------------------------------- r No. OF5 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( System located at 3 vZ Vl/06,0800—Y AU6: t4 VA�JA)/.s and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:C/onstruction must be completed within three years of the date of this permit. Date I / `� Approved by , - � I TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date "m Time: In Out Owner �I 9v-nAS HoL-im.e.5 Tenant Address 51 IA1D6D�,(A W �U(; Address Wn meo R Q 10001 Awls- MA Compliance Remarks or Regulation# Yes j NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities --.l.r..:` 4. Water Supply o 5. Hot Water Facilities i or 5 PbC%O 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17.Temporary Housing 18. Driveway Width T2 C". ,2,0 Z 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition ` Number of Bedrooms Number of Vehicles A d (max) 2- I Number of Persons Allowed (max) (f rPerson,$) Interviewed 1(�� I Inspector Building such as Store or Hotel/Motel specify here j, Date_, _°21 -o? 01. To Whom It May Concern: I, �A G%7y , voluntarily grant permission to the Town (Occupants name) of Barnstable Board of Health (Agent or Health Inspector) to inspect my dwelling unit located at Wck��bl�d in accordance (House#, [A \Unit#if applic ble], street,village) with the Town of Barnstable Code (Chapters 59 and 170) and the State Sanitary Code (105 CMR 410.000 on -/ a`�� 1, 7 's ul,�.. I hereby authorize and name �! (Date of inspection) , to be my tenant representative,for..the (Occupant representative) purpose of this inspection. y� ��-„ — is an adult person (Occupa t representative) designated and duly authorized to act on my behalf and will be accompanying the Town of Barnstable Board of Health for the inspection, granting access to any and all locations (including bedrooms, bathrooms, closets, etc.,) allowing the use of photographs and answering questions. This authorization is only valid for the inspection date specified above, and must be renewed for any future inspection(s.) '_ -/"'q' ? —a� L—t,9 c2� Occupants-Signature \ Date Occupants Representative.Signature \ Date Q:\Rental Ordinance\inspcclion permission 2.doc TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date 2 Time: In Out Owner �Ddd14; I UL!M 6 S Tenant i 1 Address L�IN 1�1�17 A P-I /� C Address 3 q �JQaD 13(1 F-q A& Compliance Remarks or Regulation# Yes NO Recom en !ions 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply A)o Q L V1 110 5. Hot Water FacilitiesOt 6. Heating Facilities 7. Lighting and Electrical Facilities 9 9 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use - 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing l Pj�- 18. Driveway Width 19. Number of Tenants Observed /I PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms L �J Number of Vehicles All x Number of Persons Allowed (max) 0— Person(s) Interviewed W '5LI 1° Inspector If Public Building such as Store or Hotel/Motel specify here I e r t (e r---� L:' TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION o Date a 2^ Time: In ( 5 Out r ( - [ " Owner Tenant 020-62 ` fir Address Address Compliance Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation andiMaintenance of Facilities >(v 10. Curtailment of Service Approved: MITI n f,.e*- C/ 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing 18. Driveway Width 19. Number of Tenants Observed PART II �31 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms ,A 0 Number of Vehicles Allowed (max) Number of Persons Allowed (max) Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION MAY Z92001 TITLE 5 TUwry -:- OFFICIAL INSPECTION FORM—NOT FOR VOL A Y—HEALTH DEPT. S SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 32 / 34 Woodbury Ave. Hyannis, MA Owner's Name: Wernick Properties .Owner's Address: c/o 1413 Falmouth Rd. —renterville, MA— Date of Inspection: `- - Name of Inspector: (please print) W i 1 1 i am E_ • Robi_nson Sr. Company Name: William E. Robinson Septic Service Mailing Address: P O Box 1089 Centerville, MA Telephone Number: (5 0 8) 7 7 5-8 7 7 6 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: —zPasses Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Z-0 . �� - Date: ��— l—d The system inspector shall submit 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 approymg 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 _ P Y conditions of use. Title 5 Inspection Form 6/15/2000 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: 32 / 34 Woodbury Ave, Hyannis Owner: Wernick Properties Date of Inspection: Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. :Sy ste 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. S stem Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaire .The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer es,no or not determined(Y,N,ND)in the for the following statements.If"nor determined"please explain. e septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsoun exhibits substantial infiltration or exfiltration or tank failure is imminent.System will pass inspection if the existin tank is replaced with a complying septic tank as approved by the Board of Health. *A me 1 septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indica g that the tank is less than 20 years old is available. ND plain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or ob cted pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection if(with appro al of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND ex ain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass ' pection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 32 / 34 Woodbury Ave Hyannis Owner: Wernick Properties Date of Inspection: / ', C. urther 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 fail' g to protect public health,safety or the environment. 1. yytem will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the ystem 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. 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the sy tem 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 su_rface 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 front 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: k 3 Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 32 / 34 Woodbury. Ave. Hyannis Owner: Wernick Properties Date of Inspection: 1/" 1-0 l D. System Failure Criteria applicable to all systems:. You must indicate"yes'.'or"no"to each of the following for all inspections: Yes No _ Backupof sewage into facility or stem component due to overloaded or clogged SAS or cesspool g tY Y P gg P _ 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''/2 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 1 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. [Tbis.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.] (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 determine what will be necessary to correct the failure. E. Large Systems: To a considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You ust indicate either"yes"or"no"to each of the following: (The ollowing criteria apply to large systems in addition to the criteria above) yes o the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary.to a sm face 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 in Sectiaia 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 airy 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: 32 / 34 Woodh»rz Ave. Hyannis Owner: Wernick Properties Date of Inspection: Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes o / Pumping information was provided by the owner,occupant,or Board of Health t//— 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? _ _ZHave 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) 2/_ Was the facility or dwelling inspected for signs of sewage back up Was the site inspected for signs of break out? ,t,/_ Were all system components,excluding the SAS,located on site? s/ _ 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 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 t/ Existing information.For example,a plan at the Board of Health. L//_ 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 I Page 6 of 11 . OFFICIAL INSPECTION FORM.—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 32 / 34 Woodbury Ave. Hyannis Owner: Wernick PrnpPrtips Date of Inspection: %z O- FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):. Number of bedrooms(actual): :7— DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): �'6 Number of current residents:1_ Does residence have a garbage grinder(yes or no):4-0 Is laundry on a separate sewage system(yes or no):!/�O [if yes separate inspection required] Laundry system inspected(yes or no):X-1 Seasonal use: (yes or no):li.- U Water meter readings, if available(last 2 years usage(gpd)): 7o, 500 gal. Sump pump(yes or no)�d 1 9 9 9—0 0 69, 000 gal. Last date of occupancy: CO M ERCIAL/INDUSTRIAL Type o stablishment: Design w(based on 310 CMR 15.203): gpd Basis of sign flow(seats/persons/sgft,etc.): Grease tra present(yes or no):_ Industrial aste holding tank present(yes or no): Non-sani waste discharged to the Title 5 system(yes or no):_ Water m er readings,if available: Last date of occupancy/use: OTHE (describe): GENERAL INFORMATION Pumping Records Source of information: Qi 2 o .v o 1 Was system pumped as part of the inspection(yes or no): o If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: TYPE PF SYSTEM eptic 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) _Tight tank _Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known) d source of information: A.,LE t� X S i�O dV _CU l— %X-K Were sewage odors detected when arriving at the site(yes or no): 6 Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 32 / 34 Woodbury Ave. Hyannis Owner: Wernick Properties Date of Inspection: BUI ING SEWER(locate on site plan) Depth b low grade: Materia s of construction:_cast iron _40 PVC_other(explain): Distanc from private water supply well or suction line: Co nts(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: (locate on site plan) t Depth below grade: Material of construction:�oncrete_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) vl Dimensions: (� 6, 16 Ze Sludge depth: P) 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 of outlet tee or baffle: How were dimensions determined: Lr''-�/ /�6 a n s A Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): GREAS TRAP:_(locate on site plan) Depth b ow glade: Materia of construction: concrete . r metal_fiberglass_polyethylene_other (expla' Dime ions: Scu thickness: Distan a from top of scum to top of outlet tee or baffle. Distan a from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comm nts(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): jr— Page 8 of 1 l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 32 / 34 Woodbury Ave. Hyannis Owner: Wernick Properties Date of Inspection: TI T or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Materi 1 of construction: concrete metal fiberglass polyethylene other(explain): Dimensi ns: Capacity gallons Design ow: gallons/day Alarm p esent(yes or no): Alarm 1 vel: Alarm in working order(yes or no): Date o last pumping: Co ents(condition of alarm and float switches,etc.): DISTRIBUTION BOX: (if 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.): PUMP CHA BER: (locate on site plan) Pumps in wor ing order(yes or no): Alarms in wor ing order(yes or no): Comments(n to condition of pump chamber,condition of pumps and appurtenances,etc.): i 8 R I Page 9of11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 32 -1 34 Wnnrib ry Ave. �i�za�n i s Owner: P operties Date of Inspection: D SOIL ABSORPTION SYSTEM(SAS):7(10cate on site plan,excavation not required) If SAS not located explain why: Type aching pits,number:_ leaching chambers,number: leaching galleries,number: 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.): CESSPOOLS: (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: /V i 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.): PR (locate on site plan) Materia s of construction: Dime tons: Depth f solids: Co ents(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 Page 10 of 1 l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 32 / 34 Woodbury Ave. Hyannis Owner: WPrnick Properties Date of Inspection: LI^</—G 1 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. i J s y d 71 10 i Page l l of l l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 32 / 34 Woodbury Ave. Hyannis Owner. Wernick Properties Date of Inspection: l_7_01 SITE EXAM Slope Surface water Check cellar Shallow wells i Estimated depth to ground water PT 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) hecked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: M 11 I TOWN OF BARNSTABLE BOARD OF HEALTH Approved:�30 6 , MLD Celt ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION -- Date - y—aek Time: In 11:o o Out t V. OS Owner -NatnAS j Sl(%9-Ly--, oL-M.f_c.. Tenant -3 E Vr F Address Address .32- Wooto fb &Vt Compliance Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities t/ r 3. Bathroom Facilities 1 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities AS 7. Lighting and Electrical Facilities i 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use it 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal It N a 01 16. Sewage Disposal Y2 \4 17.Temporary Housing 18. Driveway Width 19. Number of Tenants Observed 1 PART II 37. Placarding of Condemned Dwelling; v 0!*fto Removal of Occupants; Demolition Number of Bedrooms � 1�0� S� Number of Vehicles Allowed (max) Z Number of Persons Allowed (max) 2— Person(s) Interviewed Inspector12. If Public Building such as Store or Hotel/Motel specify here Chri�pher�►�� �►�'� �Q rQ Jb C�j d�1 a� S� fed 4-15D IV, ��}► - E vne -( ryl 0,110LA)ftl I�eiah�r 3� Wo dl�ur � (who 1'5 �► so ScV1�d U led a� inSee c-hbr) C) F 7 Date 4 To Whom It May Concern: I, G 1�G(lST �_�f}LT(1� , voluntarily grant permission to the.Town (Occupants name) of Barnstable Board of Health (Agent or Health Inspector) to inspect my dwelling unit located at in accordance (House#, [Ap Unit#if applicable],street,village) with the Town of Barnstable Code (Chapters 59 and 170) and the State Sanitary Code (105 CMR 410.000) on 170 go % I hereby authorize and name (Date of inspection) JaFr- KiTT1f to be my tenant representative for the (Occupant representative) purpose of this inspection. ,75FIf /'t/dT - is an adult person (Occupant representative) designated and duly authorized to act on my behalf and will be a ccompanying_the Town of Barnstable Board of Health for the inspection, granting access to any and all locations (including bedrooms,bathrooms, closets, etc.,) allowing the use of photographs and answering questions. This authorization is only valid for the inspection date specified above, and must be renewed for any future inspection(s.) ; � a t Occupants Signature \ Date \ Occupants Representative Signature \ Date Q:\Rental Ordinance inspection permission 2.doc � c% � f I TOWN OF BARNSTABLE Approved: (BOARD OF HEALTH MLD Cert: ARTICLE It: MINIMUM STANDARDS FOR HUMAN HABITATION Date 130 01 Time: In It: 10 Out 1 k: 2.0 Owner THO Mi4S 4 H% VS Tenant C �k Y.t S QA- I_Z b71 Address yee.,60 Sy2•,r Address 3 H w a, S"Yly,: A�/'�. �.*A `,�—� D2 fool aA S r 4-;,Z4=0 I Compliance Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply / 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural / Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal ` 16. Sewage Disposal lzs, 17.Temporary Housing 18. Driveway Width 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms ,- I lito S r-- Number of Vehicles Allowed (max) Z Number of Persons Allo__w//ed (max) Z Person(s) Interviewed T Inspector If Public Building such as Store or Hotel/Motel specify here TOWN OF BARNSTABLE BOARD OF HEALTH Approved: ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION MLD Cert: Date �� O— G�1 Time: in. Out Owner— IR(jt ,ti3 Si V-L-fi:tPUL" Tenant Uo,Ca 1.1� Address 57 w Do iD 6c„e±i ASP- Address `t(p V\J000 Compliance Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities c,,,A��tL -T c,4-,-,ca 6. Heating Facilities v 1-1 V A caN'( 7. Lighting and Electrical Facilities ►LI ist,k Q'-�►�""'' t 8. Ventilation 9. Installation and Maintenance of Facilities ✓ 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal ,/a-(C 17.Temporary Housing /✓* 18. Driveway Width 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; '76 4,* 00 5ZE0 Removal of Occupants; Demolition Number of Bedrooms 2-- /10 S Number of Vehicles Allowed (max) -3 L SIG Number of Persons Allowed m Person(s) Interviewed Inspector ' If Public Building such as Store or Hotel/Motel specify here FORM 30 C&W HOBBS&WARREN'M THE COMMONWEALTH.OFMASSACHUSETTS BOARD OF HEALTH J�P2N S'rAf31.� CITY/TOWN DEPARTMENT god MP1N SZ, A%4-4iS 'MA ADDRESS 8 -�t a S) �o Z yG 4/4f TELEPHONE Address 34 L-^-**13G0 Q 1T� Arj"4cupant_C H (45 DA L-TO Tl Floor I Apartment No. e!!� —Nd.of Occupants No.of Habitable Rooms Z No.Sleeping Rooms No.dwelling or rooming units Z- No.Stories Name and address of owner 7r H o MA.S }i o(,MIL 5,�^ . �� f�0 0 n V Avt. y� .9N/Vl r ' �7 Remarks Reg. Vio. YARD Out BI s.: Fences: / Garbage and Rubbish V/ Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation.- Chimney: BASEMENT Gen.Sanitation: / Dampness: V 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) 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. s,Oi, Stacks, Flues,V nts,Safe! s: Kitchen Facilities Sink Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted "T U 59 9 O 'I Locks on Doors: w^, ,` A. &. ity 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 PERJURY INSPECTOR TITLE //4444 Tit =N S a -Ta2 DATE TIME_ !CJ C7 D P.M. ^ A.M. THE NEXT SCHEDULED REINSPECTION /T P.M. r w J1 s 7 410.750: Conditions Deemed to Endanger or,Impair Health or Safety The following conditions;when found to exist in.residential premises,shall be'deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of 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.faJl 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 410830 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. r (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. _ .____._.�-- � , coo ����d �b � �� jo� TOWN OF BARNSTABLE _ BOARD OF HEALTH c t 4t- ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION Date 1 © i Z 0e,.e3t; ) A4Ae Owner Ort S Ho lvtnd S Tenant Address Z WDIJ 6,)4 Address 1n1.7iTcQ ID Complionce Remarks or Regulation# Yes No Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities -- C/ 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use ) A 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing �1 n PART II .�lL N 9 Vo s�-eP� r(j�QQX U 37. Placarding of Condemned Dwelling; �R- Removal of Occupants; Demolition r t f '*+ Cr- (0 4 &W--- Persons) Interviewed Inspector �� If Public Building such as Store or Hotel/Motel specify here I . - c3,o Ate- 3 `f t 3.-- As i- - a or--- r ° F j� � 0 Bwztable Assessing Searfh Results Page 1 of 2 Home: Departments:Assessors Division: Property Assessment Search Results New Search E - New Interactive Maps >> w am Owner: 2006 Assessed Values: HOLMES,THOMAS F&SHIRLEY A 32 WOODBURY AVENUE Appraised Value Assessed Value Map/Parcel/Parcel Extension Building Value: $ 129,100 $129,100 307 /059/ Extra Features: $5,200 $5,200 Outbuildings: $0 $0 Mailing Address Land Value: $148,400 $148,400 HOLMES,THOMAS F&SHIRLEY j A Totals $282,700 $282,700 51 WOODBURY AVE HYANNIS, MA.02601 '2006 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation) Community Preservation Act Tax $53.52 Fire District Rates I Town Barnstable-Residential. $1.90 $6.31 Barnstable-Commercial $2.51 Commei Hyannis FD Tax(Residential) $455.15 C.O.M.M. -All Classes $1.06 $6.54 Cotuit FD-All Classes $1.33 Persona Town Tax(Residential) $ 1,783.84 Hyannis-Residential $1.61 $6.49 Hyannis-Commercial $2.50 Other R, W Barnstable- Residential $1.60 Commur W Barnstable-Commercial $2.46 Total: $2,292.51 Construction Details Property Sketch Legend Building Building value $ 129,100 Interior Floors Vinyl/Asphalt Style Family Duplex Interior Walls Drywall Model Residential Heat Fuel Gas Grade Average Heat Type Hot Air Stories 1 Story AC Type None Exterior Walls Wood Shingle Bedrooms 2 Bedrooms http://www.town.bamstable.ma.us/assessing/assess06/di splayparcelO6map.asp?mapparbac... 10/3/2006 Barnstable Assessing Seara,h Results Page 2 of 2 Roof Structure Gable/Hip Bathrooms 2 Full Roof Cover Asph/F GIs/Cmp living area 1180 Replacement Cost $148434 Year Built 1975 � Depreciation 13 Total Rooms 4 Rooms � ' Land . . CODE 1040 Lot Size(Acres) 0.33 Appraised Value $ 148,400 Assessed Value $ 148,400 � Uiew Interactive Maps Sales History: Owner: Sale Date Book/Page: Sale Price: HOLMES,THOMAS F&SHIRLEY A Jun 12001 12:OOAM 13897/034 $ 135,900 WERNICK, PHILIP Oct 15 1987 12:OOAM 6000/319 $ 1 WERNICK,PHILIP TRS Jun 15 1985 12:OOAM 4582/160 $ 112,500 COUNTRY FARM ESTATES, INC Feb 15 1985 12:OOAM 4432/096 $75,000 GALLAGHER, FREDERICK P JR Apr 15 1984 12:OOAM 4062/321 $ 12,000 STEVENS,WELDON M 3191/164 $0 Extra Building Features Code Description Units/SO ft Appraised Value Assessed Value FPL1 Fireplace 2 $5,200 $5,200 Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area UST Utility Area(Unfinished) (Finished) FAT Attic Area(Finished) GAR Garage UTO Three Quarters Story (Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story (Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TOS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/assessing/assess06/displayparcelO6map.asp?mapparbac... 10/3/2006 R TOO h nrvr� i'F`b ,. c� .0 "'" y k 'Y .. -T ,h _" s t -as TOWN OF-,PB,A, ASTABLE r� F ITT �€ r 'T x;�r...�R•t,^.rii�"�. .�xse«"�.' .�� 3�Ordinant Ap e - gulation> Y a x �� �• fi - ,..-4',. fi WARNINGxNOTICE : 4 ,fir r i . use °� }� :i"d-'�'h � � .� � 2� - y�� `a, �e :. ,a t'"rz'IN x f.��' s`�•s�c.sa,p�,y�a.�'", :• ag 4' Hof O ferder/Mafia er ry-. {^' }Xd,-*!�a!� "i`'". fi3y C, ''J res:'s off Offenders 'x r � hTyf$ *rt c .€ � � � '�� ...•�*3�3t+,�'xxYr"#-::� ca4vasm�c �'al lit//M�,�iReg S �7.*%�k'���ka �.5 5.*.ysa r ;�`s`,�*'.{..<t. t&, � ,?Any � : zx � ...,*` s -`c"€, .t ,� rg a;+t.� 't,✓a fi 1a v o-'� � {r r � s ,� 'k, a " a'k � r a"' > ft:.� � y ��l�"� "_- .� t'sl. ,t'" '+tr.�sr�i"t .'. .+'�v " E aat,rrrx "Nw, . , ...�.ayez"7r"' 4 :::�r+t a °.• ,xs , ra .r P�a e/�at e/Z 1 a 3sr `x^Y gidy Y^�. 3..i6 +{,�.�,-3 V k# .r A P e`? 4 L 7..: p +i4z.'t�9^rxwp�:;o. n- 43,.M,tr"'-.�1i'•Sw xa^ `,T3x k1 �T s takr�3�= as ! - 's - - s_ t � : u � axe ss�� g. t iOnOf Of l � f.e=nsea sub x al t'?"`.�•, i -�cv; :,t r•' � r "mot, _€�r # a .L a .wi..-,t € ..:+ r - s " Yt` _ — . ,c F' 1`. r"w ,- ..y. �a;,r +xs €" pj�as3r.rk fa $a 2,:r� g �tChr �' .,r=-'�7 ^�; ��°�i �� {{ '�}"1dr�r'z�h k� ��' �w c.,�-��nm � �� '�"r�E�Se i/�.wj. ,n,<� x� ,-' .;„a`r��1 �� �,.z•.. ,z aka -3 �„ � � r"�. _ ac .>t e.'x,,;r fi' t'Vft�'�' aye sv5 � '�` :..r�tIrlN.�,r. &t•Tfx �.y� f`� �^ �y /� 77 swill serve only ;as a' warns°ng: r At th s t e H-8 e-g ,ac ion;h" ,b_een taken `.;y f xz 4.4',�." >f s the,*goal ,of_ �ToGm .a$gYencies i�o��ac;hieve voluntasry compliance of"= tT WKE n' +' f w'4+'.x�I' .'• §nanees, RuiesandRegulations Educationefforts and warnings notices are mpt's tom gasxn�'�volunta �°com l� anceY�`�,;..��Subseque`nt �rviol�ations=awill� res"u t� �n`� � yF- a+fi'.+` ?.: � ss+uaz� a�- ... y.�,,; a�v. R� �r Marx,. ,:+:,, ✓�.4 .xi 7 -.:e :a ��',,. �x' t� s t r.� c.. �. � .v.r ,� r. opr�at-elegalaction;,by the Town � _ � «� r� ��� n � � +�'�"��-� 1 WHITE- OFFENDER �€CANARY CORD/REG-PROG PINK ENFORCING OFFICER f'"�'GJLD°ENFORCING DEPT�f�tr< CAI A�"h�`'fir'��`t' _\ .� :: .cy.+v-_. Sx..+'...:K�.x(ww.Mit�w-?h,fwi%i.. ,..=..r..'lts,: d:..,<��: � .e3� -F . b -, - 1� �•oS� e�� Actions Taken/Results: DS WENT TO COMPLAINTANTS HOUSE TO SEE WHERE THIS ODOR WAS COMING FROM, AS NO ODOR WAS OBSERVED AT 149 SEA STREET. NO ONE WAS HOME AT 32 WOODBURY AVE. DS OBSERVED AND PHOTOGRAPHED WHAT MAY BE THE FOOD AND SHELTER SOURCE FOR THESE ANIMALS AT THIS LOCATION. THERE IS A LARGE WOOD PILE, MULCH PILE, CAN OF RUBBISH WITH INSULATION IN IT, AND PILE OF CONSTRUCTION DEBRIS PRESENT AT 32 WOODBURY AVE. THERE ARE ALSO FOOD SOURCES LEFT OUTSIDE, WHICH WOULD ALSO ATTRACT ANIMALS TO THIS LOCATION INCLUDING A RAGU JAR WITH SAUCE STILL IN IT, MILK AND ORANGE JUICE JUGS AND A COFFEE MUG. THERE WAS ALSO AN ASHTRAY AND SEVERAL CIGARETTE BUTTS ON THE GROUND AT THIS LOCATION, AND TRASH CANS WITH STAGNANT WATER AND LEAVES WHICH 1 - it i c 8 �- �.�- 13 z �'-� � Q� P �- � r . . FORM30 fiW HOBBS&WARREN'" THE COMMONWEALTH OF MASSACHUSETTS r BOARD OF E TH r CITY TOW a o �J� DEPART EN� ADDRESS GSM 5 By`0W _I OA l�w / TELEPHONE Address �� _ � _ Occupant__ Floor Apartment No. �1/�_^No.of Occupants No. of Habitable Rooms � No.Sleeping Rooms /____— No. dwelling or rooming units /'VAr No.Stories�� - Name and address of owner _ J1 A Remarks Reg. Vio. YARD Out Bld s.: Fences: Q Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Li htin : 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). 3 ) ' Bedroom 2 Bedroom 3 Bedroom 4 - Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: Stacks, Flues,Vents,Safetie : Kitchen Facilities i ove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) "THIS INSPECTION REPORTA SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES-OF PERJURY." jam? � INSPECTOR �` TITLE DATE 1 0 TIME If 5 _ P.M. A.M. ` THE NEXT SCHEDULED REINSPECTION P P.M. Fr «ni '' ,-+... ,.<.— ji :.,. ,.. .. .. s w. c •.t``+l ...«=Mk ''N ... .Y.`fi r+- '�':f'�..., +d`...,��d�M V ;i'k: M..'��4F.� vFy,i','w+>•j...�. : ',�;M'�"',a`i+�r, - F 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found`to exist in residential premises, shali 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. S? 3 k e 4-CC� I f TOWN OF BARNSTABLE LOCATION 3 3 SEWAGE # GT ! VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. GC 6 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) o�I- (size) Gobi I NO.OF BEDROOMS BUILDER OR OWNER Z�' i PERMITDATE: G-C's COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted GroundwateVing Bottom of Leaching Facility Feet Private Water Supply Well and cility (If any wells exist on site or within 200 feet of lity) Feet Edge of Wetland and Leaching y wetlands exist within 300 feet of leaching facility) Feet Furnished by TOWN OF BARNSTABLE LOCATION -3 d- 3,Q Itio odiD&s�V SEWAGE # i VILLAGE J`1V 44WA--A1S ASSESSOR'S MAP &LOT' 7-0S_ INSTALLER'S NAME&PHONE NO._K®�i a-Jrd 7 -2 S�—,T;7 7 4 SEPTIC TANK.CAPACITY Y LEACHING FACILITY: (type) #2-''45� `t, (size) ' NO.OF BEDROOMS BUILDER OR OWNER�C PERMIT DATE: COMPLIANCE DATE: -y-s-CS Separation Distance Between the: Maximum Adjusted Groun/Table Bottom of Leaching Facility Feet Private Water Supply Wecility (If any wells exist on site or within 200 felity) Feet Edge of Wetland and Leacny wetlands exist within 300 feet of leaching facility) Feet Furnished by I • j I I Rj c /Z L • Parcel Detail Page 1 of 3 h'L V 55 °" ,.+ l 4 `✓ +F" w w Logged in As: Parcel Detail Wednesday,)anus Parcel Lookup Parcellnfo Parcel ID 307-059 Developer LOT C Lot Location 132 WOODBURY AVENUE I Pri Frontage j 110 Sec Sec Road# I Frontage village HYANNIS I Fire District.HY N Sewer Acct I Road Index 11869 g ` f�r •n, `mow.. z ari Interactive Map7 , Owner Info owner HOLMES, THOMAS F &SHIRLEY A I Co-owner Streets 151 WOODBURY AVE I Street2 __ ,, m_ M City HYANNIS I State�M Zip 02601 Country Land Info Acres 0.33 use jTwo Family uI zoning RB J Ngnbd_0105 Topography!Levei Road Paved Utilities Public Water,Gas,Septic Location Construction Info Building 1 of 1 Year G Roof Ext _ ... _ -...._ Built 1975 I Struct labie/Hlp I Wall Wood..—Sh..i ngle.— ... Effect Roof AC 1403 `As h/F GIs/Cm None Area I I cover p p I Type Style I Family Duplex I IntD wall Bed 2 Bedrooms Wall 1 Drywall I Rooms .�..�__.�_�..�I Int Bath Model Residential I Floor= I Rooms 2 Full . ----_..._...._. Heat' ....._ Total .. Grade 1Average Type[Hot Air I Rooms 14 Rooms I http://issgl/intraneUpropdata/ParcelDetail.aspx?ID=24602 1/24/2007 • Parcel Detail Page 2 of 3 6-4 Heat .._.._ Found- stories 1 Story Fuel IGas Poured Conc. ation ..-_.... ---_- __. Permit History Issue Date iPurpose Permit# Amount IInsp Date I Comments Visit History Date Who Purpose 3/11/2002 12:00:00 AM Paul Talbot Meas/Listed 4/15/1988 12:00:00 AM ML ........... Sales History Line Sale Date Owner Book/Page Sale P 1 6/1/2001 HOLMES,THOMAS F &SHIRLEY A 13897/034 ; 2 10/15/1987 WERNICK, PHILIP 6000/319 3 6/15/1985 WERNICK, PHILIP TRS 4582/160 4 2/15/1985 COUNTRY FARM ESTATES, INC 4432/096 5 4/15/1984 GALLAGHER, FREDERICK P JR 4062/321 6 STEVENS, WELDON M 3191/164 --- ----------.._.-- Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parc( 1 2006 $129,100 $5,200 $0 $148,400 2 2005 $128,300 $5,200 $0 $114,300 3 2004 $105,800 $5,200 $0 $80,700 4 2003 $56,700 $5,200 $0 $30,700 5 2002 $57,300 $5,200 $0 $30,700 6 2001 $57,300 $5,200 $0 $30,700 7 2000 $51,600 $4,700 $0 $26,800 8 1999 $50,000 $4,700 $0 $26,800 9 1998 $50,000 $4,700 $0 $26,800 10 1997 $62,500 $0 $0 $23,400 11 1996 $62,500 $0 $0 $23,400 12 1995 $62,500 $0 $0 $23,400 http://issgl/Intranet/propdata/Parce]Detail.aspx?ID=24602 1/24/2007 TOWN OF BAR)NST/ABLE LOCATION -3 y� �(Jd o 014-V SEWAGE # �� I 'VILLAGE ASSESSOR'S MAP& LOT�X7-0T INSTALLER'S NAME&PHONE NO. �j wSQ 7 777 4 SEPTIC TANK.CAPACITY —1 LEACHING FACILITY: (type) o�" (size) NO. OF BEDROOMS . BUILDER OR OWNER / �ZtiyG PERMITDATE: 3 `4�—e--;` , COMPLIANCE DATE: L` —SGCS Separation Distance Betw/able h Maximum Adjusted Groune Bottom of Leaching Facility Feet Private Water Supply Welcility (If any wells.exist on site or within 200 feility) Feet Edge of Wetland and Leacany wetlands exist within 300 feet of leaclvng facility) Feet Furnished by I �� W 1 a � E �� � . � wG. .. s: <r TOWN OF BARNSTABLE LOCATION 3 'L`d -3 SEWAGE VILLAGE ASSESSOR'S MAP&LOT AV INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY fS�� LEACHING FACEL=: (type) ate- NO.OF BEDROOMS BUILDER OR OWNER '�Z�dGle PERMTTDATE: COMPLIANCE DATE: 46 —s d l Separation Distance Between the: Maximum Adjusted Groundwater Table tot a Bottom of Leaching Facility Feet Private Water Supply Well and Leachi g Facility (If any wells exist on site or within 200 feet of leac 'ng facility) Feet Edge of Wetland and Leaching F cility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by \�. 4 �_ v` c,,, � � a rt G ti � � _ ,.. t � � i Y ' , TOWN OF BARNSTABLE BAR-W 4880 Ordinance or Regulation WARNING NOTICE T Name of -Offender/Manager 3eVreL4 , kej 4 Address of Offender '�2 woodki l ri-4 ,4ne MV/MB Reg.# Village/State/Zip A4A-'n4"( r ()1) 40/ Business Name J: 0ram/""P,�m' I on Business Address SUgnature of Enforcing Officer Village/State/Zip Location of Offense wo"I'j"6V /I P Q V/V-JU'r44 M4A fnfor6ing Dept/Division Offense 8-Ar,-A4Ak1,r roile 13s--3- ) Facts Yd'; A*,;e Crra4jei 50offe r ()d a r ""tj 04el 4, 4 461". 61 �Ar Arr, 7 fit /,Jr f 0,-r� Mv.'i'm.)i This will serve only as/a warning. At this time no legal action has been taken. tr It is the goal of Town agencies to achieve voluntary compliance of Town ,f Ordinances, Rules and Regulations. Education efforts and warning notices are 5Ar attempts to gain voluntary compliance. Subsequent violations will result in A, appropriate legal action by the Town. 0A(t (IrO0411,J#11 fr4V wim". AOkvr, A �V r Am AoA WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-YNFORCING OFFICER GOLD-ENFORCING DEPlo(/"/ TOWN OF BARNSTABLE BAR -W 4880 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager T Address- of Offender MV/MB Reg.# " 7 Village/State/zip M-A _ Vv G. Business Name amtj�m- on, /20,,,< Business Address Signature ,,gnat re .of E-riflorcinj' Officer Villa4e/StateZZip Location of Offense Enfbrdihg Dl*p,t/nivision Offense -F-, Facts al , 0", -T 4-9111 1 for A^. C.-I 11 1 Thi's will 'serve 'only' as/a'warning. At this time no legal action his been taken. It is the goal of Town agencies to achieve voluntary compliance of Townf Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in5A'- ""r appropriate legal action by the Town. G 0 WHITE-OFFENDER CANARY-ORD./RE _-PROG: PINK-,ENFORCING OFFU R GOLD-ENFORCING DEPT. t. Fe � No. w _ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZippYication for ]igpont *potem Construction Verrnit Application for a Permit to Construct( )Repair( X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components L i Address or Lot No. Owner's Name,Address and Tel.No. s e2 r tap�gWbury Ave. , Hyanni Wernick Properties - Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Sercie P O Box 1089, Centerville Type of Building: Dwelling No.of Bedrooms 3 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 Sand Nature of Repairs or Alterations(Answer when applicable) Title-5 s e i r- G y G t pm consisting of a 1 ,500 ,gaA. tank D-box and 2 precast leach Chambers with stone all around. 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- cateCompliance h een issue b this and Health.cate o as b y _ ) Signed Date Application Approved by s Date �-- G Application Disapproved for the following reas ns Permit No. �'� �� Z Date Issued Fe L,) THE COMMONWEALTH OF MASSAC, Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01pprtcation for 3Di5pooal *V!5tem Congtructiort Permit Application for a Permit to Construct( )Repair( X)Upgrade(,, )Abandon( ) El complete System ElIndividual Components Loc ion Address or Lot No. Owner's Name,Address and Tel.No. As3e pfflgUdbury Ave. , Hyannis Wernick Properties Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Sercie P O Box 1089 , Centerville Type of Building: Dwelling No.of Bedrooms 3 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 S b,a X_ Nature of Repairs or Alterations(Answer when applicable) Title— septic ('hambers wi tb stone a 1 n�Fnu 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 Board o ealth. / Signed _ Date Application Approved by - Date Application Disapproved for a following reaso s Permit No.::74Aj �� Date Issued --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Wernick Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( X)Upgraded( ) Abandoned( )by Witt. E. Robtnson pep is Service has been constructed in accordance at 32 34 .., _ with the provisions of Title 5 anU e for Disposal System Construction Permit No._�.., I 4 dated Installer Win E. gr. Designer . The issuance of this permit shall not be construed as a guarantee that the syst will ffupcti' as designed. Date f1 �/1><n t Inspector n l r � r --------------------------------------- No. Fee$_5 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Wernick Zt!6po.5ar *pgtem Construction Permit Permission is hereby granted to Construct( )Repair( X)Upgrade( )Abandon( ) System located at 32 l 3 Q Woodbury Av!g. , d, p-n i 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:Construction must be completed within three years of the date of this permit. �n Date: Z S / Approved by ljjV U6l99 NOTICE: This Form Is To Be Used For the Repair Of Failed septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMPf(WITHOUT DESIGNED PLANS) L William E. Robinson.S%creby centify that the application for disposal works consavtction permit signed by me dated l—C - G , concerning the properly located 3 / oodbury Ave. , Hyannis meets all of the following criteria: • The failed qis connected to a residential dwelling only. There are no commercial"business uses associated the dwelling • The soil is as CLASS I and the percolation rate is less than or equal to 3 minutes per inch. There are wetlands within 100 feet of the proposed sepuc*,sleet — There arc private wells within 150 fert of the proposed septic System There is immense in flour andlor change in use proposed There no variances n quested or needed • The to of the proposed hality will tube located less than five feet above the ttta ' »m adjusted groundwater table elevation.(Adjust the groundwater table using the Frimptor when applicable) If S_ALS.will be leaned with 250 feet of any vegtiated wetlands,the bottom of the proposed 1 g facility will m be togted less than fourteen(141 fee above the maximum adjttsed groundwater table elevation, Please complete the Mowing. A).Top of Ground Surface Elevation(using G1S ink matkm) 3 Z-- Bl G.W.Elevation `i +the MAX. ifigh G.W.Adjusment Ai DIFFERENCE BETWEEN A and B !/LO SIGNED:� G /, DATE: '3'C> G (Sketch proposed plait of System on back). hwth fame:cent �/ � • � � L-�/ � �� +. x TOWN OF BAR)NST/ABLE LOCATION 3, - a'oc r uAV SEWAGE # — I VILLAGE )I �'��S // ASSESSOR'S MAP & LOT" 7-0-5 INSTALLER'S NAME&PHONE NO. h i a-Scs /L.— 7 SEPTIC TAN_ K.CAPAC= ,IS 0a 0 LEACHING FACILITY: (type) (size) ' NO. OF BEDROOMS _ B.Un DER nu 1 . PERMITDATE: _ j COMPLIANCE DATE: Separation Distance Between the: � Maximum Adjusted Groundwater Table/10the Bottom of Leaching Facility Feet Private Water Supply Weiland Le eking Facility (If any wells exist on site or within 200 feet cf caching facility) Feet Edge of Wetland and LeacFacility (If any wetlands exist within 300 feet of leaclung facility), Feet Fumished by:. s V .......... k