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HomeMy WebLinkAbout0030 SCORTON HILL ROAD - Health 30 Scorton Hill RoO,d< A = 111 021 GI No. 4210 1/3 .BLU F)snd celvDs ESSELTE 100,100 0 0 0 0 FORM30 &w HCBBSS WARREN TM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CITY/TOWN a DEPARTMENT I/ A ADDRE S _ y G G,M SvOyeW a '1 1 TELEPHONE Address +U_ Occuupano. ir Floor Apartment No. No.of Occupants\f ACA_"_j No. of Habitable Rooms__C2 No.Sleeping Rooms No. dwelling or rooming units ---� No.Stories Z- Name and address of owner _' " Kelp 0621- L SA Lry Z�,, R 1141V S 71% 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: i® Dampness: 42 Lvv,0 co Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: go (L 60 Hall Lighting: Hall Windows: vtEv L, C, Zito •b'd(Cq> HEATING Chimneys: Central 2 Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.: Stacks, Flues,Vents,Safet s: Kitchen Facilities Sink 4 Z M7 s� Stove V <JY -f 4- Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: r 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 PERJURY." INSPECTOR -4 TITLE Lam_ c�02 A DATE TIME �-P U P•M• A.M. THE NEXT SCHEDULED REINSPECTION P.M. . , - -1. .�, „ 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so r 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 conditiohs 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, ressure and temperature, both hot and cold, to meet the ordinary O P PP Y q Y P P Y 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. HoeesaWnaReN FORM30 C&wTM THE COMMONWEALTH OF MASSACHUSETTS 1 BOARD OF HEALTH . CITY/TOWN a DEPARTMENT zoo V\A ADDRE S U GSM SVey`oz •— _ W y TELEPHONE c _ �� ��A,QNS'tAPJV� Address - �i2"Cb 1J ';��- Q b_ Occupant fyT1 4 Floor - Apartment No. No.of Occupants Arvf 1-(AS t,v 6.p �J1 No. of Habitable Rooms__No.Sleeping Rooms 3 No. dwelling or rooming units---" No.Stories Z- Name and address of owner S S L r SA LN w. /s 44A?S_f Pj Lt Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish ,f Containers: V 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: rLS'( �•A"( lit o t ?C !�b / Dampness: 4.V NS<V-�k.-w . Stairs: Lighting: STRUCTURE INT. Hall,Stairway: I' Obst'n.: Hall, Floor,Wall,Ceiling: C- (gip N I L Hall Lighting: Hall Windows: VZUvCCNJ I1® •Splck 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 Fusiri Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks oc s Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: Stacks, Flues,Vents,Safeties: > Kitchen Facilities Sink J Al C✓— Stove V r- r -� Bathing,Toilet Facil. Vent., Plumb.,Sanit,,n.: —roc Wash Basin, Shower or Tub: Infestation Rats, Mice, Roaches or Other: r Q 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 O PERJURY." INSPECTOR i 9 TITLE ,a. Z-. E c.?C+Z a f i A.M. DATE // c Li �i TIME ; f• U / P•M• (/ A.M. THE NEXT SCHEDULED REINSPECTION '4 P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions,when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold,to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 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. LVMMAL4D ..o Icc E3 s Postage $ Q�Ni a ru Certified Fee -w p Return Receipt Fee JUN 1 �o O (Endorsement Required) C3 Restricted Delivery Fee (Endorsement Required) r�-1 Total Postage&Fees $ PS ru Sent T —a �or PO ity, IP+4 1 U Certified Mail Provides: ® A mailing receipt a A unique identifier for your mailpiece ® A record of delivery kept by the Postal Service for two years Important Reminders: ® Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. o Certified Mail is not available for any class of international mail. n NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. n For an additional fee,a Return Recelot may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery'. a If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. if a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT.Save this receipt and present it when making an inquiry. PS Form 3800,August 2006,(Reverse)PSN 7530-02-000-9047 A I ❑ Complete items 1,2,and 3::AIso complete A.,Si item item 4 if Restricted Delivery^is desired. ❑Agent ❑ Print your name and address on-the reverse X ❑Addressee so that we can return the card to you. ceiv Pri ted Name C.pa f Delivery ❑ Attach this card to the back of the mailpiece, (� or on the front if space permits. C- D. Is delivery address different from item 1? Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No SS L,'s 4 �/�• �/,1/1N S�/��� /Vy 3. Service Type ❑Certified Mail ❑Express Mail G 7-466 ❑Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7006 2150 0002 1041 9860 (transfer from service label) PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE w l 0. %Send Pleas print your name, address, and ZIPP+41Pt>�i i" is box 0 a I � N I ri of Barnstable �"`:=�' I ��lth Division i ��Fa, 260 Main Street " Ht annis,MA 0260� I I I j t j( /j jj j )jj )jj jj j j j 1'11I1:?lildhdhiiiidi/?3/1't1i i�tjin� Ilbliflu ?/ h i �, �, � Barnstable Epp SHF Tp� P � ' Regulatory Services Department AS-AmedcaCfly IIARNnABLE, ` . ,�� Public Health Division 4i'°TFo MAC" 200 Main Street, Hyannis MA 02601 2007 m Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO June 17, 2008 Theodore Hitchcock 55 Lisa Lane C(DPY West Barnstable , MA 02668 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 30 Scorton Hill Rd. was inspected on June 16, 2008 by Jaime Cabot, Health Inspector for the Town of Barnstable, because of a complaint. The following violations of the State Sanitary Code were observed: 105 CMR 410.500— Owner's Responsibility to Maintain Structural Elements (free from chronic dampness) Flooding and signs of mold and water damage were observed in basement. 105 CMR 410.501 —Weathertight Elements Basement windows broken. 105 CMR 410.482—Smoke Detectors and Carbon Monoxide Alarms CO detectors missing from bedrooms. The following violations of the Town of Barnstable Code were observed: W04— Certificate of Registration. Rental property is not registered with Town of Barnstable Health Department. You are directed to correct the violations listed above within twenty-four(24) hours of your receipt of this notice by installing smoke detectors in accordance with Mass Fire Codes and stopping the source of chronic dampness and repairing the windows within thirty(30) days of your receipt of this notice. 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 an a to speak with the inspector who performed the inspection. BOA OF HEALTH Thomas A. McKean, R.S., CHO PA30 scortonhill rd.doc Town of Barnstable OF THE Tp� Regulatory Services Barnstable o Thomas F. Geiler, Director ;mericaCity Public Health Division ' I BAMSTABrE, 9 MASS. g Thomas McKean,Director zooz �Ar 059. e►`` 200 Main Street FD PAp`l Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 June 16, 2008 Theodore L. Hitchcock 55 Lisa Lane West Barnstable, MA 02668 As of October 1, 2006 a new rental registration ordinance was put into affect requiring all property owners of rental units to register their rental units with the Town of Barnstable Health Division. According to our records, you own the rental property at 30 Scorton Hill Road, West Barnstable. Enclosed is an application. Please use a separate application for each rental unit you own. Should you need more applications, they are available online at www.town.barnstable.ma.us. Go to the Health Division page by looking in the Department Menu. There is a link to the Rental Registration information on the Health Division page. You may print out as many as you need, and return them to the Health Division with the appropriate 2008 fees included. Failure to comply with this ordinance will result in the issuance of a non-criminal ticket citation in the amount of$100. Each day of non-compliance is considered a separate offense. Should you have any questions, please feel free to call 508-862-4644. Thank you in advance for your cooperation. Jaime Cabot Health Inspector Health Division (508) 862-4644 FSHE T Town of Barnstable Barnstable P. Regulatory Services Department 1 e`Ce j RARNSfABLE, 9MASS. Public Health Division m �639.gq �0 200 Main Street, Hyannis MA 02601 2007 Office: 508-852-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO June 17, 2008 Theodore Hitchcock 55 Lisa Lane West Barnstable , MA 02668 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 30 Scorton Hill Rd.was inspected on June 16, 2008 by Jaime Cabot, Health Inspector for the Town of Barnstable, because of a complaint. The following violations of the State Sanitary Code were observed: 105 CMR 410.500—Owner's Responsibility to Maintain Structural Elements(free from chronic dampness) Flooding and signs of mold and water damage were observed in basement. 105 CMR 410.501 —Weathertight Elements Basement windows broken. 105 CMR 410.482—Smoke Detectors and Carbon Monoxide Alarms CO detectors missing from bedrooms. The following violations of the Town of Barnstable Code were observed: 1� 70-4—Certificate of Registration. Rental property is not registered with Town of Barnstable Health Department. You are directed to correct the violations listed above within twenty-four (24) hours of your receipt of this notice by installing smoke detectors in accordance with Mass Fire Codes and stopping the source of chronic dampness and repairing the windows within thirty (30) days of your receipt of this notice. 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 C:\Documents and Settings\cabotj\Desktop\Housing\30 scortonhill rd.doc r Citizen Web Request Page 1 of 2 11, Till .v�eY Citizen Request Management Request ID: 21898 Created: 6/13/2008 10:27:20 A Status: Closed Assigned To: Cabot, Jaime Health Office Anonymous: No Category: Chapter II : Housing Substandard E.C. Date: 7/31/2008 Created By: Couto, Melissa Citations: Health Office Time Worked: 4.50 Response Time: 5.00 Request Location: Parcel Number: Map: 111 Block: 021 Lot: 000 Request: CALLER IN TENANT OF RENTAL AND RECENTLY THE WATER PUMP HAD BEEN LEAKING AND FINALLY GAVE OUT AND FLOODED ENTIRE BASEMENT WITH 1 INCH OF WATER.THEY HAVE TRIED TO GET IN TOUCH WITH THE OWNER BUT HE HAS FAILED TO GET BACK TO THEM. THE BASEMENT WAS ALSO FLOODED BACK IN DECEMBER WHEN A PIPE BURST, TENANTS HAD TO CLEAN AND REPLACE CARPET. ALL OF THEIR BELONGINGS IN BASEMENT GOT WET. Request Work History: Entered on 6/13/2008 3:51:05 PM JAC has sceduled an aptontment for Monday 1:15 (6-16-08) at the property. Entered on 6/17/2008 11:59:51 AM JAC inspected property on 6-16-2008. Tenant no longer living in house. Drafted order letter tc property owner. Entered on 7/3/2008 8:31:51 AM Last modified on 7/3/2008 8:40:44 AM Order Letter Sent dated 6-17-08. E-mailed copy to tennant. http://issgl2/IntemalWRS/WRequestPn'ntPub.aspx?ID=21898 1/16/2009 TOWN OF BARNSTABLE r LOCATION 3 0 SC ogAl'fo.A/ A°/L1 Rd SEWAGE # — VILLAGE RAF RAX A1.5'1',4 Bl f ASSESSOR'S MAP & LOT 01 Oal INSTALLER'S NAME&PHONE NO. M 4 C d,M�ee I � SEPTIC TANK CAPACITY /a S-0 0 LEACHING FACILITY: (type) e BRA %:ke S(size) NO.OF BEDROOMS 3 1 BUILDER OR OWNER PERMIIDATE: i -JQ COMPLIANCE DATE: i — 7 -- Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Fw"ished by �t w� ® gl \ S \ No. l I ( � Fee $ 50.00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppficatton for 33tgpoear *pftem Com5truction Vermtt Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) XX Complete System ❑Individual Components Location Addressor LotNo.30 Scorton Hill Road Owner's Name,Address and Tel.No. Ed Beilman West Ba�nstable,Mass. 02668 362-2333 Assessor's Map arcel 30 Scorton dill Road W. Barnstable Mass/ Installer's Name,Address,and Tel.No. — —3j36 Desi ner's Name,Address and Tel.No. — 1'1 — J.P.Macomber & Son Inc. J.P.Macomber & Sin Inc. Box 66 CEnterville,Mass . 0032 Box 66 Centerville,Mass, 02632 Type of Building: Dwelling XX No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder P) Other Type of Building RES No. of Persons 3 Showers( ) Cafeteria( ) Other Fixtures Design Flow 33 0 gallons per day. Calculated daily flow 3x1 1 0 gallons. Plan Date 12/3 0/9 6 Number of sheets Revision Date Title Size of Septic Tank 1 500 gallons Type of S.A.S. 330 Rechargers ( 3 Description of Soil Sand 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 Certifi- cate of Compliance has been issued by this B arplf He th. Signed a Date 12/ 0/ 6 Application Approved by Date Application Disapproved for the following reasons Permit.No. 77 Date Issued -- — ------- —�.�Q-_— ------ - — — ------ - (� Fee $ 5 0.0 0 No. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: V Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS 2pplicati-on for Migpogal *pgtem Congtruction Permit y Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) XX Complete System ❑Individual Components Location Address or LotNo.30 Scorton Hill Road Owner's Name,Address and Tel.No. Ed Beilman West Barnstable,Mass. 02668 362-2333 Assessor's Map/Parcel ; ,. ` 30 Scorton Hill 'Rbad W. BarnstableiMass/ Installer's Name,Address,and Tel.No. '-� Desi ner's Name,Address and Tel.No. - J.P.Macomber & Son Inc. J5.Macomber & S&n Inc. Box 66 CEnterville,Mass. 03632 Box 66 Centerville,Mass, 02632 Type of Building: Dwelling XX No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder '10) Other Type of Building RES No. of Persons 3 Showers( ) Cafeteria( ) Other Fixtures { Design Flow 330 gallons per day. Calculated daily flow 3x1 10 gallons. Plan Date 12/3 0/96 Number of sheets Revision Date Title c Size of Septic Tank 1 500 gallons Type of S.A.S. 330 Rechargers 3) Description of Soil Sand Nature of Repairs or Alterations(Answer when applicable) '7 tf f t' .. 1 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system Y 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 iss d by this B ar,'of He th. t Signed/ :/4 Date 12 0/9 ' { Application Approved by/ Date 1 Application Disapproved for the following reasons' F Permit No. 17 v r4 Date Issued - ———— ——————— ———— —————— ——————————— THE COMMONWEALTH OF MASSACHUSETTS I' BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded(7 Abandoned ( -. )by J•P.Macomber & Son Inc at 30 Scorton HI11 Road West Barnstablemass . 02668 has been construct d ' ccoo dance with the provisions of Title 5 and the for Disposal System Construction Permit No. Q dated S / j Installer '� Designer � The,issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date f � / ? Inspector I --�—�--------_—�—ti------------ No. Fee 50.00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS i % Migpogal 6pgtem Congtructton Permit Permission is hereby granted to Construct( )Repair( )Upgrade(XX)Abandon( ) System located at 30 Scorton Hill Road West Barnstable,Mass.. 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:Constructi n must be completed within three years of the date of this permit. 4 �� Date. / Approved by _— � l CERTIFICA'I'ION Or SI<ETCFI AND APPLICATION FOIZ A DISPL.. WORKS CONSTRUCTION PLlz�,ll'I' (1VlTfl0UT DESIGNED PLANS) 1 J.P.Macomber Jr. c�rtily that tllc application for disposal works construction pernut signed by nle 12/30/96 , concerning the priperty located at 30 Seorton Hill Road W. Barnstable meets all of the following criteria: • There are no\vctlands within 300 feet of the proposed septic Ustelli • There are no private wells within 15U 1,cct of the proposed septic system • The observed groundwater table 1 feet Ur greater below the bottom of the leaching facility • There is no increase in floNN,and/or change Ill use proposed • There are no variances requested or necdcd. SIGd: — DATE: 12/30/96 LIETIC SYS'fEi�1 ijN1 ' t,tLLCR 1N'I'i TOWN OF BARNSTABLE NUMBER (Attach a sketch plan of the proposed s)stem. Also if the licensed installer posesses.a certified plot plan, this plan should be sub:niacd]. i 3-330 Rechargers 1-Distribution box 0 1-1500 gallon Septic Tank