HomeMy WebLinkAbout0073 NEW LONDON AVENUE - Health 73 New London Avenue
Marstons Mills
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TOWN OF BARNSTABLE �
LOCATION 1 ( o Akle SEWAGE # � to
VILLAGEZC44 � M�3-- ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. 4
SEPTIC TANK CAPACITY (�
LEACHING FACII.ITY: (type) t lr,o cc, �� ..�..� is:( Rr
NO.OF BEDROOMS
BUILDER OR OWNER
PERMTTDATE: 1 I I 10 2. COMPLIANCE DATE: P /I
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 ��pf Feet
within 300 feet of leaching facility)
Furnished by
A�t IOW
AAO
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Lead Paint Inspections by Fred Hemmila
16 Quaker Road, East Sandwich, MA 02537-1027
Tel. 508-888=8378 In Mass: 800-286-8378 FAX 508-888-8397
Email: fredlead@comeast.net Website: Nvww.fredhemmila.com
LETTER OF FULL DELEADING COMPLIANCE
DATE:_ �It}A111R k y
.�'A1'IES ;j'LMUEI..LEn
lO I A BLF_ WAJ
Dear MR. OUE-L k-l-
This letter is to certify that I re-inspected your property located at[;U AIW""'LON(bN74.V?-)V ,
apartment no /U and relevant common areas, in the City or Town of �iM_f1RS�TD A/SM_lL� ,
for full deleading compliance on J�A�"' .01 and on that date those surfaces cited in the
• initial inspection report of D'ELC-7"JQE72 f�, ;201 ( were found to be in full compliance with
Massachusetts General Laws, Chapter 111, Section 197, and 105 C.MR 460.000: Regulations for Lead
Poisoning Prevention and Control. Dust samples were taken and found to be within acceptable limits.
Massachusetts law does not require the abatement or containment of all residential lead paint. The
residential premises or dwelling unit and relevant common areas shall remain in compliance only as long as
there continues to be no peeling, chipping or flaking lead paint or other accessible leaded materials, as long
was covcrings and/or encapsulants forming an effective barrier over such paint or other leaded materials
gernamVin placd and as long as surfaces reversed to correct lead hazards remain reversed and securely in
place --The`lave grants you a 30-day maintenance period to repair deteriorated lead paint or detached
�'overings over uch paint, and to clean up, during which time this Letter remains valid.
The reverse si a of this letter indicates the authorized person(s) who performed deleading on the property
Cand general s ary of the methods used. A complete reinspection report is attached to this letter, which
speci`f'es how a d"on what date each surface was brought into compliance. Do not lose these documents.
�To tleybest of y knowledge, the cost of the legally required deleading is
Sincerely,
—Inspector I
-DPH License Number
•
Privatc LPDC Page 1 of 2
Rey A/n8
ADDRESS /.3 I4E44 La#!D0 nJ A M/te,50 Aks t;11 LG S, Hf► -0 261 y8_
Inspection and Deleading History
Initial inspection done on: _ !T �i I I I by Fdc;'rJ f>i gt41L,+ _License# 7.36
Reoccupancy reinspection, if needed, done on: — by License# --
Final Deleading reinspection done on: I 2 d I I X by F4 9 4MM 1-A License# Al 36
Deleading Contractor R6 6t-Rr A ifCNANDES License#: DC 5,34
Deleading methods: q=agugn
n !Replacement
m Power sanding Caustics
Covering
Liquid encapsulation er
Work was done in the following rooms: ► L, 3, 9 , $
Work was done on the following types of components: LotaPOUlS, pioJes, Jfw&s
Start Date: 1 / 11/ 2- Finish Date: 1 /-.0/12 Cost: S 5,600, ---
Lead-safe renovator: Liccrise#:
Moderate risk owner/agent: Autlaorization#:
• Deleading Methods: Replacement Making intact(interior,
Making intact (exterior) Cove ' Liquid encapsulation
Work was done in the following rooms:
Work was done on the fol ing types of components:
Start Date: / / Finish Date: / / Cost: $ _(Doesn't Include Owner's Labor)
Low-risk owner/agent: Authori.-;ation#:
Deleading methods: Covering Liquid encapsulation
Capping baseboards Replacement(ONLY doors,cabinet doors,shutters..s not affixed,drawers,windows on hinges)
Work was done in the following rooms:
Work was done on the following types Of components:
Start Dale / — Finish Date: / / Cost: $ (Doesn't Include Owners Labor)
Should you have any questions about this letter, call the Department of Public Health at 1-800-532-9571.
r,,,;plc.1TrX7 Page 2 of 2
�
�
TOWN OF BARNSTABLE
BOARD OF HEALTH
ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION
Date �I Time: In Out
Owner Tenant
Address ` Address �" """ e�
Complian a Remarks or
Regulation# Yes O Recommendations
2. Kitchen Facilities
3. Bathroom Facilities
4. Water Supply
5. Hot Water Facilities
6. Heating Facilities
7. Lighting and Electrical Facilities
8. Ventilation
9. Installation and Maintenance of Facilities
10. Curtailment of Service
11. Space and Use -
12. Exits
13. Installation and Maintenance of Structural
Elements
14. Insects and Rodents
15. Garbage and Rubbish Storage and Disposal
16. Sewage Disposal �- v "�—�
17. Temporary Housing
18. Driveway Width
19. Number of Tenants Observed
PART II
37. Placarding of Condemned Dwelling;
Removal of Occupants; Demolition
Number of Bedrooms Number of Vehicles Allowed (max)
Number of Persons Allowed (max)
Person(s) Interviewed Inspector
If Public Building such as Store or Hotel/Motel specify here
V
1
V �
FORM30 C&w HOBBSB WARREN TM THE COMMONWEALTH OF MASSACHUSETTS
BOARD F HE L
CIT OWN �el'
vl
4 w
E ARTMEN �
ADDRESS
M SV o o
T EPHONE
Wi-j
Address �3 —i4j)"�—Occupan U'Z&Floor Apartm t o. No.of Occupants
No. of Habitable Rooms 77 No.Sleeping Rooms
No.dwelling or rooming unit No.Stories
Name and address of owner - in Z&-,A--A rk
rks Reg. Vio.
YARD Out BId 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:
Li htin :
STRUCTURE INT. Hall,Stairway:
Obst'n.: `
Hall, Floor,Wall,Ceiling:
Hall Lighting:
Hall Windows:
HEATING Chimneys:
Central ❑ Y ❑ N Equip. Repair
TYPE: Stacks, Flues,Vents:
PLUMBING: Supply Line:
❑ MS ❑ ST ❑ P Waste Line:
H.W.Tanks Safety and Vent(s)
ELECTRICAL Panels, Meters,Cir.:
❑ 110 11220 Fusing,Grnd.:
AMP: Gen.Cond. Distrib. Box:
Gen. Basement Wiring:
DWELLING UNIT
Ventil. L to . Outlets Wails 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.:
s, FI .,V4jj Safeties:
Kitchen Facilities ink
e
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 ECKED 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 INS�"54
CTRT IS SIGNED AND CERTIFIED UNDER THE PAINS AND
PENALTIE
INSPECTOR TITLE
D -7
ATE - TIME` P.
.M.
THE NEXT SCHEDULED REINSPECTION P.M.
r
410.750: Conditions Deemed to Endanger or Impair Health or Safety
The following conditions,when found to'exist in residential premises, shall'be deemed conditions which may endanger or
impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those
items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the
occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for
human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so
in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that
other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local
health official to order repair or correction of such violation(s) pursuant to 105 CMR 416.830 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.
c UY\R wed
FORM30 C&w HOBBsBWARRENTM THE COMMONWEALTH OF MASSACHUSETTS
BOARAOF H AL H
QT /TOWN
a DEPAFIWENT
IV I ® �001
ADD Ss
gg � 1 ,,_ - a LEPHONE
Address /VPA�I� LcAndm Occupa /v
Floor Apartment No. No.of Occu ts__ __
No. of Habitable Rooms No.Sleeping Rooms
No. dwelling orrooming units No.Stogies
Name and address
ress of owner m)w-�-r �1�� �G"l`e'K
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:
Li htin :
STRUCTURE INT. Hall,Stairway:
Obst'n.:
Hall, Floor,Wall,Ceiling:
Hall Lighting:
Hall Windows:
HEATING Chimneys:
Central N E ui . Repair
TYPE: (�kStacks, Flues,Vents:
PLUMBING: Supply Line:
❑ MS ❑ ST ❑ P Waste Line:
H.W.Tanks Safety and Vent(s)
ELECTRICAL Panels, Meters,Cir.:
11110 ❑ 220 Fusing,Grnd.:
AMP: Gen. Cond. Distrib. Box:
Gen. Basement Wiring:
DWELLING UNIT
Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks
Kitchen
Bathroom
Pantry
Den
Living Room
Bedroom 1
Bedroom 2
Bedroom 3
Bedroom 4
Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.:
Stacks, Flues,Vents,Safeties:
Kitchen Facilities Sink IaME
Stove
Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.:
Wash Basin,Shower or Tub:
Infestation Rats, Mice, Roaches or Other:
Egress Dual and Obst'n:
General Building Posted
Locks on Doors:
ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH
MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE
OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE
AUTHORIZED INSPECTOR.(See Over)
"THIS IN P CTIO ORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND
PENALT mus�--
i
INSPECTOR TITLEi1A
`
® M.
DATE �v6 TIME
A.M.
THE NEXT SCHEDULED REINSPECTION P.M.
410.750: Conditions Deemed to Endanger or Impair Health or Safety
The following conditions,when found to exist in residential premises, shall be deemed conditions which may endanger or
impair the 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.
C �0', 60
Parcel Detail Page 1 of 3
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Logged In As: Parcel Detail Friday, Jur
Parcel Lookup
Parcellnfo
Parcel ID 103-007 Developer'LOT 47
Lot
Location 73 NEW LONDON AVENUE Pri Frontage 156
Sec Road U.CONN. ROAD I Sec Frontage 122
village MARSTONS MILLS { Fire District C-O-MM
Sewer Acct T Road Index 1077
Interactive
Map
Owner Info
owner MUELLER, JAMES B & RUTHANNE , Co-owner
Streets 61 ABLE WAY Street2
City MARSTONS MILLS State MA zip 02648 Country
Land Info
Acres 0.46 I use Single Fam MDL 01 zoning RF Nghbd 0105
Topography Road
Utilities J Location
Construction Info
Building 1 of 1
Year I Roof. Ext -
1920 1 Gable/Hip j Wood Shingle
Built - -. - Struct Wall
Effect AC
Area 1991 i Cover Roof`Asph/F GIs/Cmp Type None - -
Style Cottage l Int Drywall Bed 2 Bedrooms
-. Wall - RoomsI Bath
Model Residential I Floor Carpet )I Rooms 1 Full
Grade Average I Type Hot Water Total Rooms 15 Rooms
http:Hissql/intranet/propdata/ParcelDetail.aspx?ID=5941 6/29/2007
Parcel Detail Page 2 of 3
is
6;�
R BMT
Heat {{ Found- �-- — —
stories 1 Story I Fuel Gas- ------9 ation
Permit History
Issue Date Purpose Permit# Amount Insp Date Comme
10/3/2002 Remodel/Renov 64252 $35,000 1/14/2003 12:00:00 AM MOVE E
- Visit History
Date Who Purpose
7/19/2006 12:00:00 AM Paul Talbot Meas/Est
1/14/2003 12:00:00 AM Martin Flynn Meas/Listed
- Sales History
Line Sale Date Owner Book/Page Sale P
1 1/14/2002 MUELLER, JAMES B & RUTHANNE 14696/301
2 DONOFRIO, MATTHEW J & FLORENCE 1482/775
- Assessment History
Save# Year Building Value XF Value OB Value Land Value Total Parc(
1 2007 $102,200 $0 $0 $152,100
2 2006 $86,000 $0 $0 $157,200
3 2005 $80,300 $0 $0 $142,800
4 2004 $64,700 $0 $0 $107,100
5 2003 $0 $0 $0 $47,700
6 2002 $0 $0 $0 $47,700
7 2001 $0 $0 $0 $47,700
8 2000 $0 $0 $0 $29,100
9 1999 $0 $0 $0 $29,100
10 1998 $0 $0 $0 $29,100
11 1997 $0 $0 $0 $29,100
12 1996 $0 $0 $0 $29,100
13 1995 $0 $0 $0 $29,100
14 1994 $0 $0 $0 $26,200
15 1993 $0 $0 $0 $26,200
http://issql/intranet/propdata/ParcelDetail.aspx?ID=5941 6/29/2007
Parcel Detail Page 3 of 3
16 1992 $0 $0 $0 $29,100
17' 1991 $0 $0 $0 $50,900
18 1990 $0 $0 $0 $50,900
19 1989 $0 $0 $0 $50,900
20 1988 $0 $0 $0 $17,100
21 1987 $0 $0 $0 $17,100
11 22 1986 1 $0 $0 $0 $17,100
Photos
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■ '14
http://issql/intranet/propdata/ParcelDetail.aspx?ID=5941 6/29/2007
No. 200 a L1 0d FEE
f Wm�O'NWEA LTH OF MASSACHUSETTS' ��✓
Board of Health, 1`��'` STD
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to Construct(-rlRepair( ) Upgrade( ) Abandon( ) - Q<omplete System ❑Individual Components
Location PC Uj L-O"-WM /g'V 2. Owner's Name -JA M P S y-K u N l9-NNC M u e l elC
Map/Parcel# 103 Address
Lot# Telephone#
Installer's Name �GC� C'� Designer's Name ,qwePe S UR U,! C ov%SvL)`p A)f Sl
Address S J Address Lip. ,A b,'I Od4 fZS�t1/l1S �vl 1 t/
Telephone# Telephone# SUg- ya -QQ U
Type of Building **----�� Lot Size ®1 / sq.ft.
Dwelling-No.of Bedrooms of —Lt+E�11'`t"� G'l� i ST�/t cT Garbage grinder o
Other-Type of Building No.of persons Showers ( ),Cafeteria ( )
Other Fixtures
uSe -Vac vow�� 1 4
Design Flow (min.required) gpd Calculated design flow oZ aO Design flow provided 7 gpd
Plan: Date Number of sheets ct Revision Date
Title e-+4 N
rY-
Description of Soil(s) tt G 09�' u
Soil Evaluator Form No. /0 ] ] -7 Name of Soil EvaluatcgY�Ce&, MUz�D%of Evaluation
DESCRIPTION OF REPAIRS OR ALTERATIONS
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further agrees to not to plac peration until a Certificate of Co pliance has been issued by the Board of Health.
Signed Date d
6
Inspections
-,2vv�- `p?o
r c ; FEE —
r
I yq /-
Board of edlth _ AR'(`�T �.
APPLICATION rog',DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to Construct� Repair( ) Upgrade( ) Abandon( ) - Complete System ❑Individual Components
Location ��(.V �IU N' J e' Owner's Name-JA Meg +R tjTtl 6PIU` M V e e/e—
Map/Parcel# /0 3 7 Address
4
Lot# Telephone#
Installer's Name ' C'� Designer's Name ;q,4,ePe, SU�VP� �CUvI$UC7p
Address ( ' ( ,
`� Address 4/0($ T', ! l S)r � 0A�MA _SA)tiS /K 11
Telephone.# (�L"1 Telephone# Sd£}'� L/ "OC75 u
Type of Building Lot Size 1?10J / U sq.ft.
Dwelling-No.of Bedrooms OC "W'`tom"`t"� 7 7 ST t7 Garbage grinder (10
Other-,-,Type of Building No.of persons Showers ( ),Cafeteria ( )
Other Fixtures \
Y u f e
' Design Flow(min.required) °gpd Calculated design flow o1 0 Design flow provided gpd
Plan: Date f - 1-7-C( Number of sheets of Revision Date
% Title 5
Description of Soil(s) S ft L o9 A-
Soil Evaluator Form No. toy 0 Name of Soil Evaluatcr? t.;. y�n Date of Evaluation
DESCRIPTION OF REPAIRS OR ALTERATIONS
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further agr es to not to place- operation until a Certificate fmophiane has been issued by the Board of Health.
_;r/JSigned ( Date
v.:� -'cie^-
Inspections
1
No. a 00>�y.�0 FEE fia^
COMMONWEALTH OF MASSAC14USETTS
Board of Health, " 'MA.
CERTIFICATE Of COMPLIANCE
Descri tion of Work: ❑Individual Component(s)onent(s) I]- om lete S te
P P P Yms ,
The undersigned hereby certify that the Sewage Disposal System; ConsA uctedt-T,Repaired ( ),Upgraded ( ),Abandoned ( )
by. _ p
at -73 Ne�c,r C-vt�1JoN UC
has been installed in accordance with the provisions of 310 CMR 45.00 (Title 5) and the approved design plans/as-built plans relating to-
application No. aUU?' y20 , dated 1 q 0' Approved Design Flow 3 417 (gpd)
Installer t,,,,
Designer:)�Akj-C Sy✓ije`) euh5ue7-r4n nspector: �' Date:
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
No. P FEE
COMMONWEALTH OF MASSAC14USETTS
Board of Health, , MA.
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereby granted to; Construct(}" Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system .
at J NCIAJ ti 60/V leu as described in the application for
Disposal System Construction Permit No.�V� " ?l datedL"L
i a
Provided: Construction shall e completed within three years of the date of th' �ni ./All localAioneitions must be met.
Board of Health Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date y X 'l/"-
TOWN OF BARNSTABLE
LOCATION SEWAGE #
VII,LAGE Mtn:< ;� ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: ( pe) Ga
NO.OF BEDROOMS
BUILDER OR OWNER, 9'� `(A )
PERMITDATE' I I 1 � IU 2 COMPLIANCE DATE: P / I
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 �p
on site or within 200 feet of leaching facility) C`� Feet
Edge of Wetland and Leaching Facility(If any wetlands exist Feet
within 300 feet of leaching facility)
Furnished by F
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AA0 �� �f
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Town of Barnstable P#_ . �� 7
SEP S 0 gal
Department of Health,Safety,and Environmental Services
Public Health Division Date �V °/
367,Moln Street,Hyannis MA 02601
H /()v
rb�Q. � t 1:o0/ - Fee Pd.
rEu I. Date Scheduled Time
Soil Suitabili Assessment for Sewage Disposal
Performed By:
c-e l!"• ut R- J Witnessed By:
...............................
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Locafion Address >E i;... 's Owner Name
Nt' .:
Address
61 M` I rs Su✓Ve✓`
Engineer's Name yW
Assessor's Map/Parcel: 161 I7
'keG J
NEW CONSTRUCTION REPAIR TelephoneH
`� Surface Stones
Land Use �/1�--� w� Slopes(%) i
fi
Distances from: Open Water Body "� ft Possible Wet Arco —ft ' Drinking Water Well ft ;
r' It Property Line ft Other ft
Drainage Way p Y .---�----
SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes)
�eu-) to av /�°��
V
£0 ex— p. S
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2 �
l - 090a
Parent material(geologic) R U 2 Depth to bedrock
3 -
1..1CJ AJC, Weeping from Pit Face
No,N c,=
Depth to Groundwater: Standing Water in Hole:
Estimated Seasonal High Groundwater N
....::.:..
N.
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vlhad usoa: in. Depth to soil mottles: in.
Depth Observed standing Inobs.hole: in. Groundwater Adjustment ft•
Depth to weeping from side of obs.hole: j•factor Ad}.Groundwater Level
.•Index Well,# -._ -Reading Dale: In ex Well leval Ad
Observation Time at 9"
Hole N
Time at 6" — ._--,..•�—
Depth of Perc TUB --
/0.1 Time(9"-6") —
Start Pre-soak Time® l I
aw gallows Cl] /o.a7 law. �tj oJull aI
End Pre-soak gJ'h•Z v,y. /v,i V"
Rate Min./Inch /
l/ Site,Failed: Additione Testing Needed(YIN)
Site Suitability Assessment:.Site Passed �--
Observation Hole Data To Be Completed on Back -j
S
.......................
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Depth from ATIO
Soil Horizon Soil Texture Soi(Color , Soli. Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
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Depth from Soii Horiion Soil Texture Soil Color
soil , otire�
Surface(in.) (USDA) (Munsell) Mottling (Structure.Stones,Boulderes.
a�t 0R-i;4AA C-
rxrCr a/-.01
Pv0 ✓v�n'el LP/2
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Depth from Soil Horizon Soil Texture Soil Color
Molding (Structure,Stones,Boulderes.
Surface(in.) (USDA) (Munsell)
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5oif Other
Depth from Soil Horizon $oil Texture Soil or clure,Stones Boulderes.
Surface(in.) (USDA) (Munsell) Mottling (Stu e ,
Flood_ fusurance Rafe 1lZn:
Above 500 year flood boundary No _ Yes t
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w I A.M 103/2 BARNSTABLE 4' LOCUS
A.M. 103/94
WELL �yti
s
LAX�SIDE
- i � DRIVE
-2O 00, o SHUBAEL
1"0 —3LO r� POND
��• �� BENCHMAR : 9� \ L-IgAABLIN
A.M. 103/3 O ELEV.=100. (ASSUA/ ) �, FLINT ST.
(VACANT) 0� �,G
DRIVEWAY /
A.M 103/15
LOCUS MAP
ASSESSORS MAP
103
100 A M 103/ �O �9Gc�� d PLAN REF 157197
AREA= 20,340 S.F. 24 0' ~ ✓�o�`"c ZONING. RF
OP
IRON—o FLOOD ZONE- "C"
TOWN WATER AVAILABLE9f-
PI
` ✓"' / PROPOSED '�
2 BEDRAf. 0 VERLA Y DISTRICT "GP"
C T OUOEo, ,a �� TWO BEDROOM MAXIMUM
SITE AND SEWAGE PLAN
OF LAND
150 ,cc
LOCATED AT
73 NEW LONDON A VENUE
TP, MARSTONS MILLS, MASS.
99 1`� PREPARED FOR
A.M. 103/6 ✓a,0 12.01 JAMES B & RUTHANNE MUELLER
98 o �N�� DECEMBER 17 2001
9
9q ✓� 5a9 a / A.M 103/14
�0
(VACANT)
YANKEE SURVEY CONSULTANTS
i SRuCE I € UNIT 1, 40B INDUSTRY ROAD
G. PAa���� P. 0. BOX 265
Q. �p HV ✓��_ 0. MARSTONS MILLS, MASS. 02648
PROPOSED a . TEL: 428—0055 FAX 420—5553 SEPTIC IN REAR o �,
A.M. 103/8 1 inch = 30 ft.
PROP. WELL IN FRONT
PACE 1 OF 2 J# 52969
1
TOP OF FVUNDATION "
20' MIN.
10' MIN. CONCRETE COVERS 4" SCHEDULE 40 P. VC
MIN. PITCH 1/8 PER FT. 2"LAYER OF
112'
c / MAX , CONCRETE COVER
B 98. 75' WASHED S 98 0
' ' ' ' i i ,
4' CAST IRON PIPE
6;4fAX 6 MAX
(OR EQUAL) MINIMUM
PITCH 114 PER FT. i RISER CLEAN �4
FLOW LINE SAND EL=95.0
INVERT , 15 1 10 I 14" °°
MlN. °
- 98. 0 -zo' °° o 0 0 0 0 0 o tV
EL. --- IN C,qs INVERT LEVEL ° ° ,
INVERT BAFFLE EL.= 97 25' INVERT 6" SUMP INVERT o °° °o 0 0 0 o m � O ° ° °°° L = 92.25
EL.=�97.5 EL.= 95_25 EL.=95_0_ 4' 4'
IN
1500 --GALLONS DISTRIBUTION EL.=94_25'
BOX
PROPOSED SEPTIC TANK ! TO BE W 4TER TESTED -25' X 12.B' TRENCH FORMATION
IF MORE THAN ONE OUTLET N
PLACE ON 6" STONE SOIL ABSORPTION
PROFILE OF DOUBLE WASHED/STONE SYSTEM (SAS)
SEWAGE DISPOSAL SYSTEM BOTTOM OF TEST HOLE OR USGS PROBABLE WATER TABLE ELEV.=_84.5_
NOT TO SCALE NO OBSERVED WATER TABLE (12114101) ELEV.=_84.b
OBSERVATION HOLE 2 ELEV.=_975'
€G OBSER VA TION HOLE I ELEV.=_9_8.0_ PERCOLATION RATE < 2 MINI INCH AT 42 INCHES
j^ DEPTH HORIZ TEXTURE i COLOR MOTT. OTHER DEPTH HORIZ TEXTURE COLOR MOTT OTHER
0'-2" 0 ORGANIC 0'-2" 0 ORGANIC
2"-10" A LOAMY SAND lOYR 4-4 2"-10" A LOAMY SAND IOYR 4-4
10"-3' B LOAMY SAND IOYR 5-6 10"-3' B LOAMY SAND 10 YR 5-6
3'-12' C MEDIUM SAND IOYR 6-6 3'-4' Cl POCKETS OF IOYR 6-6
TIGHT SAND
EAST SIDE OF HOLE
4'-13' C2 MEDIUM SAND IOYR 6-6 PERC
NO WATER NO WATER
GENERAL NOTES
1) ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. P # = 10,117 SOIL TEST
TITLE 5 AND THE TOWN OF -BARNSTABLE---_ RULES AND
REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. i
2) ONE COVER ON SEPTIC TANK SHALL BE BROUGHT TO DATE OF SOIL TEST 12114101 SOIL TEST DONE BY BRUCE G. MURPHY , R.S.
WITHIN 6- OF FINISHED GRADE, OTHERS WITHIN 12' �S S E D B Y: DA VID STANTON
3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITNE
WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN ii DESIGN CALCULA TIONS.'
10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE OVERLAY DISTRICT 1''GP"
USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. TWO BEDROOM MAXIMUM NUMBER OF BEDROOMS . ?.PROP . (3 DESIGN)
4) ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL ,� GARBAGE DISPOSAL . . . . . . . . . NO
BE MORTERED IN PLACE. TOTAL ESTIMATED FLOW
5) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH INSTALL TWO (2) ACME ( I1!2--GAL/BR./DAY x _3__ BR.) 330 GAL/DAY
, DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO 500 GALLON LEACHINC,i!CHAMBERS
OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. WITH FOUR FEET OF olUBLE PROPOSED SEPTIC TANK CAPACITY 1500 GAL
6) UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR WASHED STONE SIDES AND ENDS SOIL CLASSIFICATION . . . . . . . . 1
IS TO CALL 'DIC- SAFE" AT 1-800-322-4844 AT LEAST 72 HOURS 25' X 12.8'
PRIOR TO COMMENCING WORK ON SITE. 1!1 DESIGN PERCOLATION RATE . . . < 2 MIN./IN.
7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS EFFLUENT LOADING RATE . . . . . . • 74 GAL/DAY/S.F.
NOTE BOARD OF HEALTII TO INSPECT
SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. LEACHING CAPACITY (AREA X RATE) 347 GALIDAY
8) PARCEL IS IN FLOOD ZONE_-_ C"__ . SAS EXCA VATION PRIOR Tn, INSTALLATION.
RESERVE LEACHING CAPACITY . . . 347 GAL/DAY
9) LOT IS SHOWN ON. ASSESSORS MAP _103 AS PARCEL _7___ TO INSURE NO POCKETS ON TIGHT SAND (25 X 12.8 X . 74)+(25 + 25 +12 8+12.8 X . 74 X 2) 52969
SHEET 2 OF 2 JO,q NUMBER ______
� '6