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HomeMy WebLinkAbout0106 ROSA LANE - Health 106 Rosa Dane - Marstons Mills A = 061 - 011. YOU WISH TO OPEN! A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you, must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form'at 200 Main St:, Hyannis, Take the completed form to the Town Clerk's Office;.1'st FI., 367 Main St., Hyannis, MA 02601 (Town'Hall) and get'the Business Certificate that is required by law. Iy DATE: ! .2tr 1S ` Fill in'please . e a. r'H ' APPLICANT'S YOUR NAME%S: R To�TJ:�i a:: 1 �:iifii•iti i .i i s BUSINESS YOUR HOME ADDRES L 3 T:6�j 04als 6^5 144ilk. 9 50$7 7 "ff 5`� . TELEPHONE # Home Telephone Number F�rt•k7 BLi1'ap 3d; . Y' :O O .ORAT10 - N ME F C R{' A N NAME.OF NEW BUSINESS: :€} IJ r. r.14 .S• -.TY.PE,OE,BUSINESS:. �ri��. :.�.,: ;„�>::a=; , 15 T IS A.HOME:OCCUP.TIbN. , - ... .:..... YES., ,., ..... D. .... . . .. . ... .:., . ..:. .. :r,':`: _ S- n>_ :Y. 1�: ..�. {.• - i3(' sess`n' D .ES .O .:':Bl'�5lNESS ,��;•;:, ''. M When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town'of Barnstable. This form is intended to assist you in obtaining the information you.'may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. &Main Street) to -make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING 00 1M ON R'S OFFIG This individu�I hap b n in or d of y e mid r uireme is that pertain to this type of business: . MUST COMPLY WITH HOME OCCUPATION RULES AND REGULATIONS..' FAILL3RE.TO.. Auth ri d i m t r * -"'` COMPLY MAY RESULT IN.FINESMMENTCLAI� 1 . i 1 1� ' G'Ylwl e/l.0 �• 2. BOARDLF H LTH V • This individual has been informed o e rmit requirements that pertain to this type of business. ... �.I Authorized Signature** COMMENTS: 3, CONSUMER AFFAIRS LICENSING AUTHORITY This individual has been informed of the licensingrequirements that pertain to this e of business. q. type Authorized Signature** ' COMMENTS: o a( oFt�r Town of Barnstable P# Z �p� a Department of Regulatory Services BARNSTABLE, y Public Health Division Date MASS. � 059. ,0� 200 Main Street,Hyannis MA 02601 AtfD MA'1 A Date Scheduled /) i ` od 0()Time� Fee t1. Soil Suitability Assessment for Sewage Disposal Performed By: Witnessed By: - L _CATION &.GENERAL INFORMATION- . Location Address �!/v� Q Owner's Name Address l V Assessor's Map/Parcel: �! Engineer's Name &L V,- NEW CONSTRUCTION REPAIR Telephone# Land Use L Slopes(%) CJ— Surface Stones NG/'?e a —7 Distances from: Open Water Body > 'G ft Possible Wet Area 7(�G ft Drinking Water Well / r/� ft Drainage Way -> too ft Property Line ' ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands,in proximity to holes) N Z�G � 1 0 T K z � � a // 1-louse a ZGO Parent material(geologic)G�AC Ou "'��/7 Depth to Bedrock /� J /�� n/ Depth to Groundwater: Standing Water in Hole: /" 1 � Weeping from Pit Face /v i t`"-- O Esiimatcd Seasonal high Groundwater JV Y. i -- DETERMINATION FOR SEASONAL HIGH WATER TABLE can Method Used: _ ... Depth Observed standing in obs.hole: in. Depth to soil mottles: in."� CA7 Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft V1 Index Well# Reading Date: Index Well level Adj.factor LLA++dj.Groundwater Level P :T ERCOLATION EST, Date 7- 3 Time Observation Hole# Time at 9" Depth of Perc ��)� Time at 6" Start Pre-soak Time @ (/V- "CIO Time(9"-6") End Pre-soak It/p" / Rate 1,421/1r.cl:, Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) /V Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q AS EPTIC\PERC FORM.DOC .aDEEP OBSERVATION HOLE L'OG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) L 10\/ -2�i 13 l S o; L�p 2- (ION 6 DEtROBSERVATION HOLE LO;G Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) L S 100 s � DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Graven DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Graven Flood Insurance Rate Map: J Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes i Within 100 year flood boundary No Yes" Depth of Naturally Occurrine Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? '(-S If not,what is the depth of naturally occurring pervious material? Certification I certify that on /' 1 Z. (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.0017. Signature c� �!' ��^ � Date Q:\SEPTIC\PERCFORM.DOC '$ TOWN OF BARNSTABLE I*-, ION SEWAGE# X 0/3 —I rZ VILI AGE - ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) ,f 3, ?NO.OF BEDROOMS OWNER �-�4J LLI drrP, PERMIT DATE:Y�q�/3 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private.Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet e FURNISHED BY ATo �s B� g� -.e 8 Ot i• 4 , NO. v THE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH Ap O OF APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct (/Repair ( ) Upgrade ( ) Abandon ( ) - ❑Complete System -Individual Components /0 df 0 s cl a 6A� i L�� l��T J RFC�, 1 p di V&IR Location Owner's Name Map/Parcel# �� `1 �dres�,Jp Lot# Telep.1kone# a 1 ss/4 D Installer's ame Des' er's Name 44.4 �' v Address Address Telephone# Telephone# Type of Building: Ap s/ yc e_ Lot Size 3P.4-3,Q Sq.feet Dwelling—No.of Bedrooms Garbage Grinder (wa) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required) gpd Calculated design flow .33 0 gpd Design flow provided pd Plan: Date q —%3 Number of sheets Revision Date Title o_E SL @--P S Description of Soil(s) 1,r Soil Evaluator Form No. Name o 17Soll Evaluator Il�,d 6o,t�s COL�ffa e of Evaluation DESCRIPTION OF REPAIRS OR ALT,EyR�ATIONS rf Po �d��X . P- —tf5c— FXI tT iJ `Tjj o Sae61�L The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed A AAA Date — 2 a lInspections , FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 • � �../ `No. _ THEACOMMONWEALTH OF MASSACHUSETTS FEE BOARD ` OF, HEALTH =-'1P � �91 OF APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct (/Repair ( ) Upgrade ( ) Abandon (Y' ) - ❑Complete System PIndividual Components .a ..ate, i� r 1/ TD /� t Location' �"� Owner's Name 06 h),11 J LI4 Q .I �7 ,/Ir .,c-s:rfea- 0_(u6 v Map/Parcel# Addr,rti...vrY.r .or Ci resys !' Lot# Telephone# ✓3 Ll .3 C� t t 1 S S�. ,1 la,� P..Jcr i..i n' •1 i r Fyn r Installer's Name y Designer's Name r / rn 7t 'F/f, R'.. , ,F�.1-t'- k1J,4, 1,.,�V If 9�� Address Address .� . Telephone# r Telephone Type of Building: � _C. ,. ,, Lot Size 3 zl S3.2 Sq.feet Dwelling—No.of Bedrooms a Garbage Grinder (,jp) Other—Type of Building No.of persons Showers ( ), Cafeteria ,,.;�•'" Other fixtut;6., y „• Design Flow(min.required)�gpd Calculated design flow 3.3 0 gpd Design flow provided aippd Plan:',,Date�/ - v? -/R Number of sheets Revision Date Title Description of Soils -,-"u-/r- 57 Soil Evaluator Form No. Name ofySoiY Evaluator_f)q.r of Evaluation 61 DESCRIPTION OF REPAIRS OR ALTERATIONS f �¢ t 1 c— uj h.1-6 L! b�r= /a ✓��: .ri�� f �� t d R�lI S" The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of _ j TITLE 5 and further agrees not to place the system in operation'urifil"a Certificate of Compliance has been issued by the Board of Health. .m Signed I i ( Date ! - / Ins ections V V +, FORM 1 - APPLICATION FOR'DSCP DEP APPROVED FORM S/96 No. � -THE COMMONWEALTH OF MASSACHUSETTS ' ' FEE BOARD OF HEALTH CERTIFICATE OF COMPLIANCE ' Description of Work: [2-Individual Coi ponent(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System;Constructed(t/)Repaired( ),Upgraded( ),Abandoned( by.) at has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5),and the approved design plans/as-built. plans relating to application No. dated L Approved/Design Flow pd) Installer �AA �f 1• ( ' Y3, Designer .�I a,.•14r, ,` ,► Inspector t ate' I Il.� The issuance of this certificate shall tibe construed as a g arantee that the system will•function as designed. FORM 3 CERTIFICATE OF'COMPLIANCE f DEP APPROVED FORM 5/96,. No. !� r"/5/THX_C_0.lY�MONWEAL H2OFMASS'%A,CHUSETTS FEE �A 1, 4 Erb v ,.01 t�" J, _ BOARD �OF HEALTH dui RV, DISPOSAL SYSTEM CONSTRUCTION PERMIT"' Permission is hereby grantr�d t }Co strut (� epair ) Upgrade ) Abandon ( ) an individual sewage disposal system at l !1. r fS /f1� °` as described in the application for Disposal System Construction Permit No. y rl dated Provided: Construc iop shall ,e completed within three years of the date of this r` it.A1iloda1 conditions must be met. hh Date Iilq Board of Health d - �i( 1 t ..,� y � .tl FORM 2 - DSCP DEP APPROVED FORM 5/96 ' � 1 _ FORM 1255 (REV 5/96) H&W HOBBSB WARREN rM PUBLISHERS - BOSTON $, J d FROM :down cape engineering inc FAX NO. :15083629980 Jul. 10 2013 02:00PN PI 13 — 0-2.1 .I bonlas `200 MWR1 StTeL't, Kk 02601 Fix: 508-190-.6-104 N er �Cft flw-aian F orn & yjal:e: .13'cw a ge.P en m f V 01 On. "wis tqsubda pe.r.r-lft Lo InSWA i t q ,IUqf. luased on ii.desi p-n datwu IYY (ad.diess) ET) I mitify that the qcptir, sYsIcm icIca:eac.-d above -,Wj3 -ill,LtIlM q12bsLmiiaHv accurdiLe, to changes such as I-1-teral x1c the dc�s* r � cti,-,-[Tib'otJ.nr. box md/or sc.Fti.c ta-.ik*. I Lit the sc-Pti'r ry,,tuan rd(ti-e-mced abo\?u waq inst'llied 771,11-1 maiai:, d-,migus ().e. oT e CA mn of a-Lq COT-IlPQa0.,f nd of fh-� SAN' amy vriti-c-al 1' 10 ''Ttfa,xf hall 10- late, of t]9(,- supfic 7su,"In) hilt In accarcallce Wlida Stale,Ac Plal) 1-t-visior. ar as--UIiilt by desi(mex lu bodow. Nth* OF 4f DANIELA. Sys civil.. No'48502' IS T 16 AL 7/40 L1.6. UXI I LIT,tY -K T' t'(0,R],Vj Afdj) AR--DTjjj,'t CARD AW"01 c0T�Vl"JATqCT? WTLL —1 ED 0141.u. 1079 TIU,,-, I �7 -L�ffk 0U. DIVISIC) T I . -Y LTH Town of Barnstable �oFn+ErOwti Regulatory Services °.� Thomas F. Geiler,Director BARMABLF, Public Health Division 9�pr `0� Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 a v/3 Date: 2— q - !3 Sewage Permit# /s`�_ Assessor's Map/Parcel Installer & Designer Certification Form -Designer: Installer: Address: d,` Address: 2 2 I;,-4i„4) �j11 On 91- /.3 ,Ak , c IV/S s bw6 was issued a permit to install a (date) {installer) based on a d septic system at--���,��a5-9�—�{� f.(�/�L/s- design drawn by (address) dated (designer) /I certify that the septic system,referenced above was installed substantially according to ep the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10'-lateral relocation of the SAS or'any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Stripout (if required) was inspected and the soils were found satisfactory. ( staller's Signature (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gAoffice forms\designercertification form.doc ` TOWN OF BARNSTABLE LOCATION /0 G z��s� Ll2� SEWAGE # f 9- 90 9 VTLLAGE.�?�.�rsTo�S olslls ASSESSOR'S MAP& LOT® %G INSTALLER'S NAME&PHONE NO. L/I'J-0,3 5'9 SEPTIC TANK CAPACITY /420 LEACHING FACILITY: (type) °.�"SdU-�,���,�ti �i:l� (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: M-2 G- 9 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facili Feet Furnished by ww, • o IN r D . .. { Fee No. THE COMMONWEALTH OF MASSACHUSE`ftS Entered in computer: � Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 2pplication for Oigonl *p.5tem Construction Vermit Application for a Permit to Construct(pair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. l o 6 R d5 l-1 Owner's Name,Address and Tel.No. t 0,'0U1'1j O�iEliT� Assessor's Map/Parcel �! Installer's Name,Address,and Tel.No. 4,'7 7— ®3 4137 Designer's Name,Address anA Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil .5 Nature of Ret1t s or Alterations(Answer when applicable) 3 eo Jul S14PI-I Tlr*k- 2�.t0d L� 0/10 z1,P7 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 thi Board of Health. Signed Date !D— 2� Application Approved by Date Application Disapproved for the following reasons Permit No. `? /� cf Date Issued � No. w;±se,`.e•�' .., ,. + �/ Fee �{/ 1 THE COMMONWEALTH OF MASSACHUSEIPT a Entered in computer: ­ I es/,I- -.PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETT_S 0[pprication for �Dizpozal bp!5tem Construction Permit 'Application for a Permit to Construct(4orrepair( )Upgrade( )Abandon( ) O Complete System El Individual Components Location Address or Lot No. /p( /�p g�q L�q.� Owner's Name,Address and Tel.No. / Assessor's Map/Parcel a6l51 Installer's Name,Address,and Tel.No. 4'71 0 E/9 Designer's Name,Address anA Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type"of S.A.S.. ` Description of Soil ,Nature of,Repairs or Alterations(Answer when applicable) 15ala_ .S /G Tf46j x i � 1 ram' Date last inspect: Agreement: j 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 thi Board of Health. Signed Date — G z Application Approved by Date Application Disapproved for the following reasons. Permit No. �=T Date Issued ---------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS ` - - BARNSTABLE, MASSACHUSETTS Certificate`of Compliance ` THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( e.4-Repaired( )Upgraded( ) Abandoned( )by oaeg,4 S at 1,06 90 l aavI-e— /�&de y reyA1`s s /;/x has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer Designer The issuanc of this e t shall t onstrued as a guarantee that the s��willfunction asdepg.ned ���"'� Ins ector�,- Date T r' _--—©-------------------—G/ ---- No. Fee !!�7z- q �--- THE COMMONWEALTH OF MASSACHUSETTS - PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Oizpogal 6pgtem Construction Permit Permission is hereby granted to Construct( pair( )Upgrade( )Abandon( ) System located at /DG /24'3 a _e, loo es;w r d?9& 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. La t_: )n % Approved by ­s� ob./ 0v'T 1 vll 1/6/" NOTICE: This Form Is To Be Used For the Repair Of Failed ` peptic Systems Only. - CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERNITT (WITHOUT DESIGNED PLANS) I, ,c Yg/rWS hereby certify that the application for disposal works f construction permit signed by me dated /I-.gl G- 9,9, , concerning the i f property located at /,oG A,,.sw meets all of the following criteria: t /The failed sy,;tern is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. it he soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. t,/�The re are no wetlands within 100 feet of the proposed septic system There are no private wells within 150 feet of the proposed septic system •Z There is no increase in flow and/or change in use proposed There are no i-ahances requested or needed • The bottom of'the proposed leaching facility will not located less than five feet above the maximum adjusted groundwater table elevation. (Adjust the groundwater table using the Frimptor method when applicable) • If the S.A.S. «zll be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facil;:ry will Mt be located less than fourteen(la)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface EIevation(using GIS information) E) G.W. Elevation High G.W. Adjustment. ----_ ustment. - �fD DfFFERF:NCE BETWEFN A and B - SIGNED ; (Sketch Proposes plan of DATE q:�u foie�r system on back]. c olq ` a � CV5 ,� sT , O 1560 a, 4 90,59 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA TOWN OF BARNSTABLE LOCATION SEWAGE #VILLAGE - I ASSESSOR'S MAP & LOTU - INSTALLER'S NAME&PHONE NO. f; SEPTIC TANK CAPACITY LEACHING FACILr Y: (type) - > - G. ,� (size) `-f NO. OF BEDROOMS T BUILDER OR OWNER PERMTTDATE: ? COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by COMMONWEALTH OF MASSACHUSETTS v EXECUTIVE.OFFICE OF ENVIRONMENTAL AFFAIRS r' DEPARTMENT OF.ENVIRONMENTAL PROTECTION. 1 II TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 106 Rosa Lane I Marstons Mills.MA 02648 . Owner's Name: Tom&Kathleen Faline Owner's Address: Date of Inspection: February 6, 2013 Name of Jnspector: (Please Print) James M.Ford Company Name: JamesM. Ford Mailing Address: P.O.Box 49 Osterville,MA 02655-0049 Telephone Number: . (508) 8624400 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 functiop qnd 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: ry. ✓ Passes w 8 Conditionally Passes x Mx- w N ds Further Evaluation by the Local Approving Authority C N W Inspector's Signature: Date: February 7..f013 The system inspector shall sub a copy of this inspection report to the Approving Authority(Board f Health c-63 DEP)within 30 days of completing this inspection. If the system is a shared system or has a design dw of 10,00.0 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 i ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address hq)y the system will perform in the future under the same or different conditions of use. Title 5 Inspection Fonn 05/2000 page 1 1 Page 2 of 11 Mj OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 106 Rosa Lane Marstons Mills:MA Owner: Tom&Kathleen Faline Date of Inspection: February 6. 2013 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. 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 itis structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: ' 2 Page 3 of 11 .J OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 106 Rosa Lane Marstons Mills.MA Owner: Tom &Kathleen Faline Date of Inspection: February 6. 2013 C. Further Evaluation is Required by thi�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 mariner 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 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-4 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,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: I 3 i Page 4 of 11 :.a OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) M ' Property Address: 106 Rosa Lane' Marstons Mills.MA Owner: Tom&Kathleen Faline Date of Inspection: February 6. 2013 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%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. [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.] 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 determine 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 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 in:Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 ;f Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 106 Rosa Lane Marstons Mills;MA Owner: Tom &Kathleen Faline Date of Inspection: February 6. 2013 Check if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No ✓ Pumping information was�rovided 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 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(anti 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: P Yes No ✓ Existing information. For example,a plan at the Board of Health. ✓ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)]. ;i 5 Page 6 of I 1 OFFICIAL INSPECTION.FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 106 Rosa Lane Marstons Mills,MA Owner: Tom&Kathleen Faline Date of Inspection: February 6, 2013 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 0 Does residence have a garbage grinder(yes or no): No 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: Unknown COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sqft,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): GENERAL INFORMATION Pumping Records Source of information: unavailable Was system pumped as part of the inspection(yes or no): No If yes,volume pumped: _gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM ✓ Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records,if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Installed on 2111109-per as built card Were sewage odors detected when arriving p•t the site(yes or no): No 6 Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SE)kAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 106 Rosa Lane Marstons Mills. MA Owner: Tom&Kathleen Faline Date of Inspection: February 6, 2013 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: ✓ (locate on site plate) Depth below grade: 9" 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. Sludge depth: 2" 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: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Tees were present. There were no signs of leakage 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: Date of last pumping: Comments(on pumping recommendations,inlei and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): 7 4% i Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C STEM INFORMATION (continued) i Property Address: 106 Rosa Lane Marston Mills.MA Owner: Tom &Kathleen Faline Date of Inspection: February 6. 2013 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: 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: Yes (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.): D-box was normal. PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): f I 8 i Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 106 Rosa Lane.`. Marstons Mills:MA Owner: Tom &Kathleen Faline Date of Inspection: February 6, 2613 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: leaching chambers,number: ✓ leaching galleries,number: 2-500 gal. chambers 13'x25'-per as built 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 chambers were dry and clean. There was no scum line.Bottom to evade was 5. 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,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: None (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 I 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: 106 Rosa Lane Marstons Mills,MA Owner: Tom &Kathleen Faline Date of Inspection: February 6, 2613 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benclunarks. Locate all wells within 100 feet. Locate where public water supply enters the building. i EJI0 0 0 � i ao a 8 3 a i(o yq 3 33 s� A 10 Page 11 of 11 OFFICIAL INSPECTION FORM-.NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 106 Rosa Lane Marston Mills.MA Owner: Tom&Kathleen Faline Date of Inspection: February 6, 2013 SITE EXAM Slope Surface water Check cellar Shallow wells Y Estimated depth to ground water 20' 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) ✓ Checked with local Board of Health;-explain: topographic and water-contours maps Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established thehigh ground water elevation: Using Barnstable topographic and water contours maps, the maps were showing approximately 20' to ground water at this site. This report has been prepared only for the septic system and components described herein. This septic system has been inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the fixture. There have been no warranties or guarantees,either expressed, written or implied, relating to the septic system, the inspection, this report and/or any components of the septic system which have not been.located and inspected. 11 TOWN OF BARNSTABLE !/ LOCATION SEWAGE # VILLAGE�// r5?J ?��,.i�� ASSESSOR'S MAP & LOT2 � - Cy INSTALLER'S ER'S NAME&PHONE NO. 4/7'%- SEPTIC TANK CAPACITY %;--'>o LEACHING FACILrrY: (type) -S✓- r;%��, -,�, �� (size) NO.OF BEDROOMS = / BUILDER OR OWNER PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by r' ------------ i " o a� e b'n I ' I I I ' F Otte r° �1 Town of Barnstable y� d� j a 1A ASS.3LE. HASS. Q= - Board of Health 9 0 :6gq. awe '°�Fp N1Ay 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayangi April 30, 2007 Thomas & Kathleen Faline 40 Cranberry Ridge Road Marstons Mills, MA 02648 Dear Mr. and Mrs.Faline, The Board voted to uphold the orders from the Director of Public Health Division dated March 22, 2007, to correct violations at 106 Rosa Lane, Marstons Mills. However, you are granted additional time to make the corrections. The following violations shall be corrected within seven (7) days 105 CMR 410.190 — Hot Water. No hot or running water provided. 105 CMR 410.200 — Heating Facilities Required. Temperature of home held at 50°F. Heating system inoperable. 105 CMR 410.482 — Smoke Detectors. No smoke detectors within home. The following violation shall be corrected within six (6) months, on or before October 18, 2007: 105 CMR 410.500 — Owner's Responsibility to Maintain Structural Elements. Holes in walls and ceiling throughout rental. These extensions are granted because you testified the tenant is not currently at the location and his whereabouts are unknown. The tenant is not available to make arrangements for the necessary corrections. Sincere yours, ayne Miller, M.D. hairman Q:\WPFILES\Faline106 Rosa Lane2007.doc 4� SENDER: COMPLETE THIS SECTIOW. COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,.and 3.Also complete A. Si item 4 if Restricted Delivery is desired. X ❑Agent ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. -. Received by(Printe ve)�SD v ■ Attach this card to the back of the mailpiece, o ��tiu'Z _ or on the front if space permits. /�' D. Is delivery addre"ss-different from item 1? El Yes 1. Article Addressed to: If YES,enter deliveri'�Address"tiiYM elo r� ❑No y z } f u 3. Service Type ®.Certified Mail ❑Express Mail ❑Registered 5k Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7006 0810 0002 352.4 8974 (Transfer from service label) PS Form 3811,February 2004 Domestic Return Receipt 1 o2sss-o2-M-154o: i UNITED STATESPPLtE1d�.?&,r •;,� `•;a '"'+.' .i +• Sender. Please print your name, address,-and ZIP+4 in this box • �n: L3 —�.� Barnstable is Health llivision i � 200 Mairi Street Hyannis,MA 02601 i N ho YnC'i--ecLr� S CKo — (`l ��1t12 �� V ca-( oyes Koscx Fct-t ,4 -e— U.j co y `ct q Cr O C Certified Mail#7006 0810 0000 3524 8974 P�0*WE r0ty� Town of Barnstable Regulatory Services k IIARNS'rAULE, r MbASS. �� Thomas F. Geiler, Director �Arf0MA�A` Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 March 22, 2007 Thomas & Kathleen Falline 40 Cranberry Ridge Road Marstons Mills, MA 02648 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II — MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you located at 106 Rosa Lane, was inspected on March 1, 2007 by Timothy O'Connell &Meredith Morgan, Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of a complaint received by the Town of Barnstable Health Department. The following violations of the State Sanitary Code were observed: 105 CMR 410.190—Hot Water. No hot or running water provided. 105 CMR 410.200—Heating Facilities Required. Temperature of home held at 50°F. Heating system inoperable. 105 CMR 410.482 —Smoke Detectors. No smoke detectors within home. 105 CMR 410.500—Owner's Responsibility to Maintain Structural Elements. Holes in walls and ceiling throughout rental. Q:\Order letters\Housing violations\106 Rosa Lane.doc I You are directed to correct the violations listed above within twenty-four (24) hours of your receipt of this notice by providing smoke detectors on every habitable floor in accordance with Mass State Fire Codes. You are directed to correct the violations listed above within thirty (30) days if your receipt of this notice by repairing all walls and ceilings; by ensuring that heat is operable and maintains a minimum temperature of 68°F between the hours of 7AM and 11PM and WIT between 11:01PM and 6:59AM. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of $100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the above violations, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable Cc: Timothy O'Connell, Health Inspector QAOrder letters\Housing violations\106 Rosa Lane.doc FORM 30_ \'{�� Hows&WARREN'"" THE COMMONWEALTH OF MASSACHUSETTS BOARD OF IWALTH CITY/TOW ^ _ PARTMENj t,,,, 'p ADDRESS TELEPHONE Address _ Occupant__. Floor _Apartment No.---,-. No.of Occupants---- No.of Habitable Rooms No.Sleeping Rooms___ No. dwelling or rooming units_—__ No. Stories Name and address of owne+r �Ww�.t--- (] - --- Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Lighting: i STRUCTURE INT. Hall,Stairway. S P y b, Obst'n.: .%.. y/0 • SoJ Hall, Floor,Wall,Ceilin 0. Hall Lighting: �p Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair ° q(0_ TYPE: Stacks, Flues,Vents: = a 0 PLUMBING: Supply Line: 10. 3 s ❑ MS ❑ ST ❑ P Waste Line: 0 S 1 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 VValls Ceils. Wind. Doors Floo s Locks Kitchen M&A.) - C.4 ID• l�J Bathroom !0• S —Pantry Den Living Room Bedroom 1 ,, y10 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities rin t0• [ d S ove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub.- Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY." INSPECTOR TITLE A.M. DATE TIME _ P.M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. �'�ic�. 2+,•-t}�s;�:3;v.f."z�rA++.} wlb'�t�.'�].;�..�, y'�+t.}� .�+�'r`.�^G�>30�y�''�'*'rjd' .'M�!�' '�::�,'�s4_4 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the heaith, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 t',)rough 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 (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 fcr 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. t FORM 3b C ItiW� HOBBS 8 WARREN' 'M THE COMMONWEALTH OF MASSACHUSETTS �. BOARD OF HEALTH e j �EPARTMENT, 1� ADDRESS TELEPHONE ti Address b Occupant- Floor— Apartment No No.of Occupants : No. of Habitable Rooms _ No..Sleeping Rooms No. dwelling or rooming units-- No.Stories j Name and address of owner_ I�su�_t rtiu fv l C _ Remarks Reg. Vio. YARD Out Bld s.: Fences: J Eti�w✓ t ' 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:s Foundation: Chimney: BASEMENT Gen,Sanitation: Dampness: Stairs: Li htin , STRUCTURE INT. Hall,'Stairwa : ,*J 5 . � �, .fit s f t o" ) � Lf,. . ) Obst'n.: 4c -j E 1' Hall, Floor,Wall,Ceiling: �lA . iq (o►LA) Hall Lighting: lam', a �, v'✓ Hall Windows:. f %. t-'C r�✓� tr-•-t G t�,� ..4^ HEATING Chimneys: y Central ❑ Y ❑ N E ui . Repair �+u -„ r. ;ry _,cam,c,.t Tf., 14 ,o. TYPE: Stacks, Flues,Vents: PLUMBING: Su liLine: ❑ MS ❑ ST ❑ P Waste Line:. I`�� vw A. t r 1 4L� 1-tI0- 5 t 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. Lqtng. Outlets Walls Ceils. Wind. Doors Floors Locks r Kitchen M� . .� ., �v .;1° 4 �,� �� T ,U. (50 Bathroom p� v� ` ►, ,,r G� ; -0--E �v.>.. "C. y v �i,o• 2 Ij 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 Sin,, L4 00. f� 0 �­ . Stove Bathing,Toilet Facil. .Vent:, Plumb:;Sanit'n:: Wash Basin;Shower or Tub: Infestation Rats,Mice,.Roaches or Other: Egress q Dual and Obst'n: s: General Building Posted A. ''�sIX Locks on Doors: ONE OR MORE OF`THE VIOLATIONS'CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTWOR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE' OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY." INSPECTOR TITLE i A.M. DATE TIME P.M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. 410.750: Concns Deemed to Endanger or Impair Health or Safety The follgving conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the heaith, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 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 tk3refore 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. Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection Southeast Regional Office Wiliam F.Weld Governor Trudy Coxe Secretary,EOEA Thomas B. Powers Acting Commissioner URGENT LEGAL MATTER: PROMPT ACTION NECESSARY C (0 CERTIFIED MAIL: RETURN RECEIPT REQUESTED April 4, 1995 Mr. Erving Weymouth RE: BARNSTABLE--BWSC 106 Rosa Lane 106 Rosa lane mAoTff� Marstons Mills, Massachusetts RTN: 4-11220 G 02648 NOTICE OF RESPONSIBILITY M.G.L. c. 21E. 310 CMR 40. 0000 On March 23 , 1995, . at 2 :50 p.m. , the Department of Environmental Protection (the "Department") received oral notification of a release and/or threat of release of oil and/or hazardous material at the above referenced property which requires one or more response actions. In addition to oral notification, 310 CMR 40.0333 requires that a completed Release Notification Form (BWSC-003, attached) be submitted= ,to the Department within sixty (60) calendar days of the date of the oral notification. The Massachusetts Oil and Hazardous Material Release Prevention and Response Act, M.G.L. c.21E, and the Massachusetts Contingency Plan. .(the "MCP") , 310 CMR 40.0000, require the performance of response actions to prevent harm to health, safety, public welfare and the environment which may result from this release and/or threat of release and govern. the conduct of such actions. The purpose of this notice is to inform you of your legal responsibilities under State law for assessing and/or remediating the release at this property.. For purposes of this Notice of Responsibility, the terms and phrases used herein shall have the meaning ascribed to such terms and phrases by the MCP unless the context clearly indicates otherwise. The Department has reason to believe that the release and/or threat of release which has been reported is or may be a disposal site as defined by the M.C.P. The Department also has reason to believe that you (as used in this letter, "you" refers to Mr. Erving Weymouth) are a Potentially Responsible Party (a "PRP") with liability under M.G.L. c.21E §5, for response action costs. This liability is "strict", meaning that it is not based on fault, but 20 Riverside Drive • Lakeville,Massachusetts 02347 • FAX(508)947-6557 • Telephone (508) 946-2700 -2- solely on your status as owner, operator, generator, transporter, disposer or other person specified in M.G.L. c.21E §5. This liability is also "joint and several", meaning that you may be liable for all response action costs incurred at a disposal site regardless of the existence of any other liable parties. The Department encourages. parties with liabilities under M.G.L. c.21E to take prompt and appropriate actions in response to releases and threats of release of oil and/or hazardous materials. By taking prompt action, you may significantly lower your assessment and cleanup costs and/or avoid liability for costs incurred by the Department in taking such actions. You may also avoid the imposition of, the amount of or reduce certain permit and/or annual compliance assurance fees payable under 310 CMR 4.00. Please refer to M.G.L. c.21E for a complete description of potential liability. For your convenience, a summary of liability under M.G.L. c.21E is attached to this notice. You should be aware that you may have claims against third parties for damages, including claims for contribution or reimbursement for the costs of cleanup. Such claims do not exist indefinitely but are governed by laws which establish the time allowed for bringing litigation. The Department encourages you to take any action necessary to protect any such claims you may have against third parties. Specific approval is required from the Department for the implementation of all IRAs, with the exception of assessment activities, the construction of a fence and/or the posting of signs. This site shall not be deemed to have had all the necessary and required response actions taken for it unless and until all substantial hazards presented by the ..release and/or threat of release have been eliminated and a level of No Significant Risk exists or has been achieved in compliance with M.G.L. c.21E and the MCP. In addition, the Department requires that. you submit a written IRA Plan to this office which addresses remedial actions to be taken at this location within 30 days from receipt of this Notice. This deadline constitutes an enforceable interim deadline established pursuant to 310 CMR 40.0167. Additional submittals are necessary with regard to this notification including, but not limited to, the filing of an IRA Completion Statement and/or a Response Action Outcome (RAO) statement. The MCP requires that a fee of $750. 00 be submitted to the Department when an RAO statement is filed greater than 120 days from the date of initial notification. JI -3- You must employ or engage a Licensed Site Professional (LSP) to manage, supervise or actually perform the necessary response actions at this site. You may obtain a list of the names and addresses of these licensed professionals from the Board of Registration_ of Hazardous Waste Site Cleanup Professionals at (617) 556-1145. If you have any questions relative to this notice, please contact Robert Kearns at the letterhead address or at (508) 946- 2865. All future communications regarding this release must reference the following Release Tracking Number: 4-11220. Very truly yours, Richard F. Packard, Chief Emergency Response / Release Notification Section P/RK/7t CERTIFIED MAIL #Z 001 192 553 RETURN RECEIPT REQUESTED Attachments: Release Notification Form; BWSC-003 and Instructions Summary of Liability under M.G.L. c.21E cc: Town of Barnstable 367 Main Street Hyannis, MA 02601 ATTN: Warren J. Rutherford, Town Manager Board of Health 367 Main Street Hyannis, MA 02601 ATTN: Brian R. Grady, R.S. , Chairman Board of Fire Commissioners Hyannis, MA 02601 DEP - SERO ATTN: Andrea Papadopoulos, Deputy Regional Director Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection Southeast Regional Office William F.Weld Governor Trudy Coxe Secretary,EOEA Thomas B. Powers Acting Commissioner URGENT LEGAL MATTER PROMPT ACTION NECESSARY �, RTIFIED MAIL: RETURN RECEIPT RE UESTED 0 April 4, 1995 Fred O. Earle, Jr. , Oil Co. RE: BARNSTABLE--BWSC Route 6A 106 Rosa lane Sandwich, Massachusetts 02563 RTN: 4-11220 NOTICE OF RESPONSIBILITY M.G.L. c. 21E. 310 CMR 40. 0000 ATTENTION: William Earle On March 23 , 1995, at 2:50 p.m. , the Department of Environmental Protection (the "Department") received oral notification of a release and/or threat of release of oil and/or hazardous material at the above referenced property which requires one or more response actions. In addition to oral notification, 310 CMR 40. 0333 requires that a completed Release Notification Form. (BWSC-003 , attached) be submitted to the Department within sixty (60) calendar days of the date of the oral notification. The Massachusetts Oil and Hazardous Material Release Prevention .and Response Act, M.G.L. c.21E, and the Massachusetts Contingency Plan (the "MCP") , 310 CMR 40. 0000, require the performance of response actions to prevent harm to health, safety, public welfare and the environment which may result from this .release and/or threat of release and govern the conduct of such actions. The purpose of this notice is to inform you of your legal responsibilities under State law for assessing and/or remediating the release at this property. For purposes of this Notice of Responsibility, the terms and phrases used herein shall have the meaning ascribed to such. terms and phrases by the MCP unless the context clearly indicates otherwise. The Department has reason to believe that the release and/or threat of release which has been reported is or may be a disposal site as defined by the M.C.P. The Department also has reason to believe that you (as used in this letter, "you" refers to Mr. Erving Weymouth) are a Potentially Responsible Party (a "PRP") with liability under M.G.L. c.21E S5, for response action costs. This liability is "strict" , meaning that it is not based on fault., but 20 Riverside Drive.0 Lakeville,Massachusetts 02347 9 FAX(508)947-6557 • Telephone (508) 946-2700 i -2- 1 solel on our status as owner, operator, enerator, transporter, Y Y � P g � disposer or other person specified in M.G.L. c.21E §5. This liability is also "joint and several", meaning that you may be liable for all response action costs incurred at a disposal site regardless of the existence of. any other liable parties. The Department encourages parties with liabilities under M.G.L. c.21E to take prompt and appropriate actions in response to releases and threats of release of oil and/or hazardous materials. By taking prompt action, you may significantly lower your I ssessment and cleanup costs and/or avoid liability for costs incurred by the Department in taking such actions. You may also avoid the imposition. of, the amount of or reduce certain permit and/or annual compliance assurance fees payable under 310 CMR 4 .00. Please refer to M.G.L. c.21E for a complete description of potential liability. For your convenience, a summary of liability under M.G.L. c.21E is attached to this notice. You should be aware that you may have claims against third parties for damages, including claims for contribution or reimbursement for the costs of cleanup. Such claims do not exist indefinitely but are governed by laws which establish, the time allowed for bringing litigation. The Department encourages you to take any action necessary to protect any such claims you may have against third parties. Specific approval is required from the Department for the implementation of all IRAs, with the exception of assessment activities, the construction of a fence and/or the posting of signs. This site shall not be deemed to have had all the necessary and required response actions taken for it unless and until all substantial hazards presented by the release and/or threat of, release have been eliminated and a level of No Significant Risk exists or has been achieved in compliance with M.G.L. .c.21E and the MCP. In addition, the Department requires that you submit a written IRA Plan to this office which addresses remedial actions to be taken at this location within 30 days from receipt of this Notice. This deadline constitutes an enforceable interim deadline established pursuant to .310 CMR 40.0167. Additional submittals are necessary with regard to this notification including, but not limited to, the filing of an IRA Completion Statement and/or a Response Action Outcome (RAO) statement. The MCP requires that a fee of $750.00 be submitted to the Department when an RAO statement is filed greater than 120 days from the date of initial notification. r .r -3- You must employ or engage a Licensed Site Professional (LSP) to manage, supervise or actually perform the necessary response actions at this site. You may obtain a list of the names and addresses of these licensed professionals from the Board of Registration of Hazardous Waste Site Cleanup Professionals at (617) 556-1145. If you have any questions relative to this notice, please contact Robert Kearns at the letterhead address or at (508) 946- 2865. All future communications regarding this release must reference the following Release Tracking Number:. 4-11220. Very truly yours, J Richard F. Packard, Chief Emergency Response / Release Notification Section P/RK/jt CERTIFIED MAIL #Z 001 192 554 . RETURN RECEIPT REQUESTED Attachments: Release Notification Form; BWSC-003 and Instructions Summary of Liability under M.G.L. c.21E cc: Town of Barnstable 367 Main Street Hyannis, MA 02601 ATTN: Warren J. Rutherford, Town Manager Board of Health 367 Main Street Hyannis, MA 02601 ATTN: Brian R. Grady, R.S. ,. Chairman Board of Fire Commissioners Hyannis, MA 02601 DEP - SERO ATTN: Andrea Papadopoulos, Deputy Regional Director f Certified Mail#7006 0810 0000 3524 8974 ��s ray Town of Barnstable NAP' OT Regulatory Services � BARNS -, r� MASS. $ Thomas F. Geiler,Director 1659- �� DM co Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 March 22, 2007 Thomas & Kathleen Falline 40 Cranberry Ridge Road Marstons Mills, MA 02648 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II — MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you located at 106 Rosa Lane,was inspected on March 1, 2007 by Timothy O'Connell &Meredith Morgan, Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of a complaint received by the Town of Barnstable Health Department. The following violations of the State Sanitary Code were observed: 105 CMR 410.190—Hot Water. No hot or running water provided. 105 CMR 410.200—Heating Facilities Required. Temperature of home held at 50°F. Heating system inoperable. 105 CMR 410.482—Smoke Detectors. No smoke detectors within home. 105 CMR 410.500— Owner's Responsibility to Maintain Structural Elements. Holes in walls and ceiling throughout rental. QAOrder letters\Housing violations\106 Rosa Lane.doc You are directed to correct the violations listed above within twenty-four (24) hours of your receipt of this notice by providing smoke detectors on every habitable floor in accordance with Mass State Fire Codes. You are directed to correct the violations listed above within thirty (30) days if your receipt of this notice by repairing all walls and ceilings; by ensuring that heat is operable and maintains a minimum temperature of 68°F between the hours of 7AM and 11PM and 64°F between 11:01PM and 6:59AM. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of $100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the above violations, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. ORDER O THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable Cc: Timothy O'Connell, Health Inspector QAOrder letters\Housing violations\106 Rosa Lane.doc o )N 4 Certified Mail#0000 0000 0000 0000 0000 Town of Barnstable Regulatory Services Thomas F. Geiler, Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 eIJ �I�IOe, date j j/� me , .J city,state,zip NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000 STATE SANITARY CODE II — MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you located at ao was inspected y �H (Address) on3 /�/_� by f I' , Health Inspector for the Town (date) pector's name) of Barnstable, (Reason for inspection) The following violation(s) of the State Sanitary Code were observed: State code violatio umber-violation description) 105 CMR,410. 105 CMR 410LM - �►� ` 105 CMR 410a - i Alc 105 CMR 410. - Q:\Order letters\Housing violations\Rental ordinance\template.doc 105 CMR 410. The following violation(s) of the Town of Barnstable Code were observed: (Town code violation number-violation description) §170-�- §170-_- You are directed to correct the violations listed above within ( ) days. (written#) (#) of your receipt of this notice by�k fl-e ►'�U Ct 1 °ir/ N Ce QS /1 I dA �j i M tI c/y hife "n� rep 1 ; a, &e e v���I11�rs �- 7�� be, the Board of Health if written petition requesting same You may request a hearing be is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of $100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the above violations, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean,R.S., CHO Director of Public Health Town of Barnstable Cc: (Name,tenant,owner,Fire Dept.,Building Dept....) Cc:,/ (Health inspector's name) (Generic codes located at QAOrder letters\Housing violations\Rental Ordinance\GENERIC CODES.DOC) QAOrder letters\Housing violations\Rental ordinance\template.doc Certified Mail#0000 00oo 0000 0000 0000 �t r Town ®f Barnstable x �. Regulatory Services I3R R SLF +� :. Thomas F. Geiler, Director Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-464a Fax: 508-790-6304 date name address ------------- city,state,zip NOTICE TO ABATE VIOLATIONS O.. Inc CMR 410.000 STATE SANITARY CODE II — NIINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you located at was inspected on y/L/ C/ by-r� "dam (Address) (date) , Health Inspector for the Town s ector's name) of Barnstable, (Reason for inspection) The following violation(s) of the State Sanitary Code were observed: State code violation number-violation descri t'on 105 CMR 410. ` j j/0 1 d— r� 105 CMR 410. � 105 CMR 410.�_ 105 CMR 410.5W_ Q:\Order letters\Housing violations\Rental ordinance\template.doe f05 CMR 410. - . j I - /' ie- The following violation(s) of the Town of Barnstable Code were observed: (Town code violation number-violation description) §170-_ - §170-_- You are directed to correct the violations listed above within ( ) days (written 4) ) of your receipt of this notice by IJ AJ IA) !-7 6( JI;tJ A �' �f� f e A JY I You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of $100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the above violations, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean,R.S., CHO Director of Public Health Town of Barnstable Cc: (Name,tenant,owner,Fire Dept.,Building Dept....) Cc: (Health inspector's name) (Generic codes located at Q:\Order letters\Housing violations\Rental Ordinance\GENERIC CODES.DOC) Q:\Order letters\Housing violations\Rental ordinance\template.doc Certified Mail#0000 0000 0000 0000 0000 wm � To Town of Barnstable 4 Regulatory Services pia ,fig � ` Thomas F. Geiler, Director t l a Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 date name address city,state,zip NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000 STATE SANITARY CODE II — 1VIINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you located at� , �� was inspected on V 1_L1_,�_qb VLO 4, "� (Address) y , Health Inspector for the Town (date) (In pector's name) of Barnstable, /I'Yrl t� d l� (Reason for inspection) The following violation(s) of the State Sanitary Code were observed: State code violation number-violation descri tion 105 CMR 410. 105 CMR 410�Z oU kt,00+ y 105 CMR 410. 105 CMR 410. Q:\Order letters\Housing violations\Rental ordinance\template.doc L_ 105 CMR 410. The following violation(s) of the Town of Barnstable Code were observed: (Town code violation number-violation description) §170-_ - §170-_- You are directed to correct the violations listed above within ( ) days (written of your receipt of this notice by (II✓ I I� 1/ " r 9 A 0 U L I� You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of $100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the above violations, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable Cc: (Name,tenant,owner,Fire Dept.,Building Dept....) Cc: (Health inspector's name) (Generic codes located at QAOrder letters\Housing violations\Rental Ordinance\GENERIC CODES.DOC) QAOrder letters\Housing violations\Rental ordinance\template.doc a, EXCERPT FROM THE BOARD OF HEALTH MEETING MINUTES 4/.17/07: II. Hearing — Housing (New): A. Kathleen Faline, owner, - 106 Rosa Lane, Marstons Mills, requesting extension to correct violations. The Health division said it is uninhabitable and no one is currently in the house. The tenant hasn't removed all his items and police advised the owner that she couldn't enter until the tenant moves out. However, the BOH believes she can fix emergency repairs with proper notice and advised her to seek legal advice. Upon a motion duly made by Dr. Canniff, seconded by Mr. Sawayanagi, the Board voted to require the first three violations: 1) fill the oil tank for heat — completed, 2) turn the water back on, and 3) install smoke detectors completed within 7 days, and the final violation of hole(s) in wall to be completed within six months (due to the difficulty of locating the tenant). Unanimously voted in favor. (and, if legal counsel says she can not enter unit to install smoke detectors, she will contact Mr. McKean.) ALL SYSTE SHALL SYSTEM PROFILE MARKED WITHCMAGNETICTTAPE ORBE COMPARABLE MEANS FOR FUTURE LOCATION. PROVIDE WATERTIGHT MIN. 20" DIAM (NOT TO SCALE) ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2" PEASTONE OR GEOTEXTILE CONCRETE COVERS TO WITHIN 3" GRADE \ TOP FOUND. EL. 65.2' FILTER FABRIC OVER STONE iddle Pon i I MINIMUM .75 OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM PRECAST H-10 BLOCKS OR RISERS (iYP.) PRECAST RISERS 2'0 4"OSCH40 PVC MORTAR ALL 2,- a qTEE PIPES LEVEL 1ST 2' COMPONENTS H-10 ocus °C4 (TYP.) 4' Q�ENDs SIDES 59.33' �, S*61.0 10" RE-USE EXIS °° / b\ ;000 °o° °60.5t* TEE SEPTIC TAN * ® _®®®® °° 3 0� Qj 60.25 f ®®® ®®®® ®®®® ° o ® ® Q° Co o� ° ° °° ®®®®®® ®® ®®® ®®�®®®® °00000 ooa000000000 6" MIN. SUMP o ®®®®®®®®®®® ®®®®®®®®®®®GAS BAFFLE: 0�0„?,o o- 12" MIN. INT. DIM. °°°°°° ° go ®®®®®®®®®®® ®®®®®®®®®®® °°°°°o°o 59.17' S9.0' ° °° 56.5' 4' LIQ. LEVEL (ACME OR EQUAL)' °°° °°° sue• ( 3 % SLOPE) } . H-10 500 GAL. LEACHING CHAMBER BY ACME PRECAST OR°EQUAL. 3/4"-1-1/2" DOUBLE WASHED STONE 4' MIN. d ( REQUIRED ALL AROUND PRECAST STRUCTURES (REUSE EXISTING, REPLACE STONE ptershe *THE INSTALLER SHALL VERIFY THE 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 25.00' X 12.83' AS NEEDED LOCATIONS OF ALL UTILITIES AND ALL COMPACTION. (15.221 [21) ) ;0 BUILDING SEWER OUTLETS AND ELEVATIONS LO Elec• PRIOR TO INSTALLING ANY PORTION OF MIN. `r CIO 2.3 o SEPTIC SYSTEM ( % SLOPE) 1 a '- o `•. ( % SLOPE) 51.0' BOTTOM TH-1 & 2 NO GROUNDWATER FOUND �+ FOUNDATION- 16' SEPTIC TANK 47' D' BOX 13' LEACHING LOCUS MAP **INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT FACILITYSCALE 1"=2000'f 1000 GALLONS AND ITS SUITABILITY FOR RE-USE. REPLACE 200.00' WITH 1500 GALLON SEPTIC TANK APPROPRIATE TO SITE ASSESSORS MAP 61 PARCEL 11 CONDITIONS IF NOT SUITABLE x 60.86 NOTE: IF VEHICLE TRAFFIC EXPECTED, THEN H-20 LOCUS IS WITHIN FEMA FLOOD ZONE C AS TANK REQUIRED. 59.41 SHOWN ON COMMUNITY PANEL #250001 x 57.14 5 .43 0015C /oe LOT AREA 63 x 59.5/ �"� / 0 37,532 SF ZONING SUMMARY PROP. RE- OCATED LEAC NG FACILITY x 64.83 °j ZONING DISTRICT: RF DISTRICT ix 0.90 MIN. LOT SIZE 43,560 S.F. / 1.45 MIN. LOT FRONTAGE 150' ' f59 � 1.7 .80 x 65.81 x 58.48 / // TH1 / 2 63.6 MIN. FRONT SETBACK 30,' 1.25 62. 4 EXISTING 3 BEDROOM SAS MIN. SIDE SETBACK 15 0 2.4' H2 \ �6 62 / (TO BE RE-LOCATED) SYSTEM DESIGN: MIN. REAR SETBACK 15' PROVIDE GRAVITY FLOW HOOK-UP TO 6 6y055 _- / EXISTING SEPTIC TANK AT MIN. 2% PITCH ST. J�1W171 / GARBAGE DISPOSER IS NOT ALLOWED EXISTING INVERT INTO SEPTIC TANK = GARIAGE / �Ox160 0 x 61.68 �C 63. DESIGN FLOW: 3 BEDROOMS ® 110 GPD = 330 GPD ELEV. 60.5't PUCE _ F145 x �6t.,46 x USE A 330 GPD DESIGN-FLOW PROPOSED LOT COVERAGE, INCL. DECKS = 8.25% 60.17 /� ' 2 C 7 x61.8 ,h 63.42 SEPTIC TANK: 330 GPD (2) = 660 / ` \ **SEPTIC TANK MUST BE /� / / j \ 62.09 x x 63.80 **RE-USE EXISTING 1500 GAL. SEPTIC TANK SITE IS LOCATED WITHIN WELL PROTECTION CONFIRMED AS H-20 TO BE / 1160. 1 �� DISTRICT AND ESTUARINE PROTECTION 1 LEACHING: DISTRICT, RESOURCE PROTECTION OVERLAY SUITABLE FOR VEHICLE TRAFFIC EXIS . 500 x`6�22 OLD <^\ SIDES: 2 (25 + 12.83) 2 (.74) = 112 GPD GA_ ST* x 61.91 O6 9/96 TANK x61.-I GARDEN 1 88 �\ O BOTTOM 25 x 12.83 (.74) = 237 GPD DISTRICT ---21 i 0 x 61.94 N TOTAL: 472 S.F. 349 GPD x 60.52 I S / .91 C. .\ x 62.62 _ 64.03 cV 1 62.83 I RE-LOCATE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) A ER �z-_-'/ ' x 62.15 I 64.03 WITH 4' STONE ALL AROUND I \ /64.34 REFERENCES ETER 1� / _ } ,o \ x 5.06 DEED BOOK 13367 PAGE 117 "e1 ` PROP. ;P0'0 \ // x 61.55 PLAN BOOK 108 PAGE 47 GAR. \ x 65.34 w TEST HOLE LOGS SEPTIC AS-BUILT CARD ON FILE WITH TOWN, ` v PROP. 3 BR DWELLING o�C' \x 3.88 ' INSTALLED 1999. CONSISTS OF 1500 GAL ST AND / o TOP FNDN. = 65.2't / \ - x 66.Ci1 rn WITNESS: D. DESMARAIS, RS /51.43 i- \ W < /6 DATE: 4/12/13 BK 11859 PG. 219 (WATER ESMT.) x 6 x 65.94 PERC. RATE = < 2 MIN/INCH 61.34 \ W ��\ \\ x6 / CLASS I SOILS P/ 13918 Q' \ EXISTING 9.2' 3 BR DWELLING x 6 1 ELEV. 2 ELEV. Z0.80 (TO BE REMOVED) 0" 61.5' 0" 61.5' A A W 62.99 BENCHMARK: /�� �' `r 63 x `� 1 10YRL3/'3 10YRL3/3 SITE PLAN co HYDRANT / 60. , co oz / _ - x 64.84 6" 8" OF TAG BOLT i w 8 B B ELEV. = 62.5' / � - ^' x LS LS 106 ROSA LANE / � x x-�3-� 59.3'0- --x p-�- - 18 24" 10YR 5/� 59.5' 26" 10YR 5/6 60.52 / 06��� MARSTONS MILLS WIRE , .60 200.00' C C PERC PREPARED FOR 2 X 60.09 off 508-362-4541b . 7 OF�� Y� CS CS ROY TOLLIVER 49.9� fox 508-362-9880 gad 9Cy k•�3�� oq\ DA^J uLA. DANIEL €. downcope.com © /� I s • o OJA� `�, j A. Cn 10YR 6/4 10YR 6/4 JANUARY 29 2013 down cope e4gNlee/Y ,g, h7C" C VIL N <, OJALA `^ �Fi502 � q No. REV 4/16/13 (DESIGN CALCS) civil engineers 5 - land surveyors 0, /STEM ��� t OFE SRO , 939 Main Street ( Rte 6A) -1. ONAL ECG A u, SCQIe: 1 = 20 YARMOUTHPORT AfA 02675 lib"( J t 0 126" 51.0 126" 51.0' NO GROUNDWATER ENCOUNTERED 0 10 20 30 40 50 FEET 13-021 DATE DANIEL A. OJALA, P.L.S. _ _ I it i I SYSTEM SHALL SYSTEM PROFILE ARK D WITHCMAGNETICTTAPE OR BE PROVIDE WATERTIGHT MIN. 20" DIAM (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. !Q �P ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2" PEASTONE OR GEOTEXTILE CONCRETE COVERS TO WITHIN 3" GRADE \ TOP FOUND. EL. 65.2' FILTER FABRIC OVER STONE iddle Pon MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM PRECAST H-10 BLOCKS OR o RISERS (TYP.) /Q PRECAST RISER 2'0 ✓✓ 4"0SCH40 PVC MORTAR ALL H-10 pCa PIPES LEVEL 1 T 2' 4 COMPONENTS 4, ocus Q <- f ENDS SIDES 59.33' 10" RE-USE EXIST. 14" y0000aooD; o0000000° 0 60.5f* TEE SEPTIC TANK** TEE 60.25 f* ®®®®®;. ®�®® ®®®®- ®®® 'o°o°o°o° �o� m °o °° ®®®®®®®®I�®® ®®®®®® ®®® I°o°°° °°° ° oog,000,�o5, 6" MIN. SUMP b °°° ° °°°°° GAS BAFFLE::: °Oo !.O..6,°,°o? 12" MIN. IN T DIM. o°a°o°°O ®®®®®®®®®®® ®®®®®®�®®®® '�°�°°°O° 59.0' 0.10 °°°° °°°° 56.5' sue. 4' UQ. LEVEL (ACME OR EQUAL) . ° ° ° ° ( 3 % SLOPE) } H-10 500 GAL. LEACHING CHAMBER BY ACME PRECAST OR EQUAL. /4"-1-1/2- DOUBLE WASHED STONE 4' MIN. (2) UNITS REQUIRED *THE INSTALLER SHALL VERIFY THE 6" CRUSHED STONE OR MECHANICAL ALL AROUND PRECAST STRUCTURES (RE-USE EXISTING, REPLACE STONE ALL DIMENSIONS TO OUTSIDE OF STONE: 25.00' X 12.83' AS NEEDED) Watershe ���`' LOCATIONS OF ALL UTILITIES AND ALL COMPACTION. (15.221 [2]) � .:-` �• �`•,• BUILDING SEWER OUTLETS AND ELEVATIONS PRIOR TO INSTALLING ANY PORTION OF MIN. SEPTIC SYSTEM (2.3% SLOPE) 1 SLOPE) ( 51.0' BOTTOM TH-1 & 2 Cr NO GROUNDWATER FOUND FOUNDATION- 16' SEPTIC TANK 47' D' BOX 13' LEACHING LOCUS MAP FACILITY **INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT SCALE 1"=2000'f 1000 GALLONS AND ITS SUITABILITY FOR RE-USE. REPLACE 200.00' WITH 1500 GALLON SEPTIC TANK APPROPRIATE TO SITE x 60.86 ASSESSORS MAP 61 PARCEL 11 CONDITIONS IF NOT SUITABLE NOTE: IF VEHICLE TRAFFIC EXPECTED, THEN H-20 / LOCUS IS WITHIN FEMA FLOOD ZONE C AS TANK REQUIRED. J`�9.41 SHOWN ON COMMUNITY PANEL #250001 \ x 57.14 �C 5 .43 0015C / LOT AREA I 37,532 SF x 59.5��� / ZONING SUMMARY PROP. RE- OCATED LEAC NG FACILITY x 64.83 ZONING DISTRICT: RF DISTRICT __x 0.90 MIN. LOT SIZE 43,560 S.F. 1.45 1 7 x 65.81 MIN. LOT FRONTAGE 150' �59 � �` 2.80 MINI. FRONT SETBACK 30' x 58.48 / TH1 62 4 �63.6 EXISTING 3 BEDROOM SAS MIN. SIDE SETBACK 15' H2 �1�25 � SYSTEM DESIGN: 6 2.4 J6 .62 (TO BE RE-LOCATED) MIN. REAR SETBACK 15' 6 6Lo5 PROVIDE GRAVITY FLOW HOOK-UP TO 1 x-61.11 EXISTING SEPTIC TANK AT MIN. 2% PITCH EXIST 0.12 x 61.68 /63. GARBAGE DISPOSER IS NOT ALLOWED . A EXISTING INVERT INTO SEPTIC TANK = x 60 0 ELEV. 60.5'f GARAGE �N DESIGN FLOW: 3 BEDROOMS 0110 GPD = 330 GPD / 61.45 x P UCE x - - PROPOSED LOT COVERAGE, INCL. DECKS = 8.25% x 6 4 USE A 330 GPD DESIGN FLOW 60.17 -� , 2 - 63.42 SEPTIC TANK: 330 GPD (2) = 660 70.11 /I . x 61.8 ` �" x 63.80 ** SITE IS LOCATED WITHIN WELL PROTECTION x RE-USE EXISTING 1500 GAL. SEPTIC TANK **SEPTIC TANK MUST BE / // "` J \ 62.09 DISTRICT RESOURCE PROTECTION OVERLAY CONFIRMED AS H-20 TO BE / / �So. I \` 1- �3 - LEACHING: DISTRICT AND ESTUARINE PROTECTION SUITABLE FOR VEHICLE TRAFFIC / I EXIS . 500 x 6222 OLD c^ SIDES: 2 (25 + 12.83) 2 (.74) = 112 GPD 9/96 OIL GA_ ST* GARDEN x 61.91 �� o DISTRICT x 61 BOTTOM 25 x 12.83 (.74) = 237 GPD 1.88 1 TANK . O / N N TOTAL: 472 S.F. 349 GPD --�� O' x 61.94 N6283 x 60.52 i ,5 , / g1 ' '� x 62.62 64.03 RE-LOCATE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) A ER � x 62.15 I 64.03 WITH 4' STONE ALL AROUND E IER /64-34 REFERENCES Y \ / ' x DEED BOOK 13367 PAGE 117 / / `/ � \\ / 5.06 x 61.55 PLAN BOOK 108 PAGE 47 61. ` 1 PROP. D,o / am)GAR. \ 65.34 w TEST HOLE LOGS SEPTIC AS-BUILT CARD ON FILE WITH TOWN, INSTALLED 1999. CONSISTS OF 1500 GAL ST AND PROP. 3 BR DWELLING ��� \\ 388 , ENGINEER: DANIEL GONSALVES, SE (2) 500 GAL. CHAMBERS WITH 4' STONE AROUND o TOP FNDN. = 65.2't / / \ WITNESS: D. DESMARAIS. RS /6 DATE: 4/t2/13 BK 11859 PG. 219 (WATER ESMT.) 61.4 W \ x 6 / x 65.94 P'ERC. RATE = < 2 MIN/INCH x 61.34 6\ \ CLASS I SOILS P# 13918 W \ EXISTING 9.2' 3 BR DWELLING x 6 ELEV. ELEV. (TO BE REMOVED) 0 0" 61.5' 0" 61.5' x 60.80 W A A T.1 " GS 62.99 / �- 63 S` SL SITE PLAN BENCHMARK: 1- HYDRANT O / i x . 1 1 OYR 3/3 1 OYR 3/3 _. 60. 4 / O i '` x 64.84 6" 8" OF TAG BOLT / i c,+ 8 B B s ELEV. = 62.5' / - LS LSx � z 106 ROSA LANE x � "� 18 10YR 5/6 tOYR 5/6 59.5 59.3'60.52 24" Q6 MARSTONS MILLS WIRE ~� C:D 6�1 .60 200.00' G PERC C PREPARED FOR Yo2�rq 9 /60.09 foff ax 508-362-9880 4541 � F NoF1,fj god �r OFff ss9\ CS CS ROY TOLLIVER downcope.com © DANI DA141 GN<7 1OYR 6/4 1OYR 6/4 JANUARY 29, 2013 mt R':L� A. ��> down cope engineerinf, h7C. o CIVIL 0j'A.LA ; civil engineers x 46502 �� � Z`\ � No.4098 q l REV 4/16/13 (DESIGN CALCS) land surveyors r8T �� �� 1 FE s�� ` 939 Main Street ( Rte 6A) t ( �w oNA1';- o 1� SCOIB:1"= 20' YARMOUTHPORT MA 02675 �1 01 � 5 ' � ' 126" 51.0' 126 51.0 13-021 DATE DANIEL A. OJALA, P.L.S. NO GROUNDWATER ENCOUNTERED 0 10 20 30 40 50 FEET II ° 0 i4 3,Y, l - �-s _ /3- -- ---- yi r� v rl v 10 . y; s f ' xr, SCALE: APPROVED BY: DRAWN BY rE _ x44� ATE: REVISED r^b DRAWING NUMBER At i ; a 6' 20 00 .2 3° 3� 3° 3° � 1 - - _-15cl T"rl I �6 `` � w ------ ol , 6 4 � a fi `t s APPROVED BY {¢ SCALE: � �, � DRAWN BY DATE: // REVISED DRAWING NUMBER i 13-0 I � 15-fl4 3`z r 4 �I I i I zz SCALE: APPROVED BY: ' DRAWN BY DATE: REVISED y� R DRAWING NUMBER !,I j ?r- it I I j S _i I l - - i ► -- I ttLIJ Rea ce 5A A f -�-D-6 ---kos9--_-_.�_�' e _.._.__....�__._...._.__..__..__... Sql .. ...�. . __.._..__..__.._ ........ I I A�. I I r i ; I , i i r icFt cH 1_71 1 / APPROVED BY: SCALE: „ DRAWN BY DATE: REVISED DRAWING NUMBER n I � �edromwl ' R o c C o X I f 9 I�Y t 5br`s All Ott C4rfP_ UAJ Het de, &C5 -.. 2 FOR" e� d �f'tgc l'W M rn� f — . .�__ _.w_.. _ _ _ I , P.- CIO h -roc q'ly I t '- o f el ��ec 5.. _Per s .�s:� ��c �t I i . . y 1�`'Ater - -- 4 ?"10 APPROVED BY: SCALE: _ DRAWN BY IE DATE: REVISED DRAWING NUMBER