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HomeMy WebLinkAbout0022 CRANBERRY LANE - Health Cranberry Lane , V Barnstable A=234-047 Al o Q I o , c t MRVP # Assessors office (1st Floor) p `' Assessors Map and Parcel # - r- Building Department (4th Floor) Zoning INSPECTION FEE $60.00 RE-INSPECTION FEE $15.00 Request For A Housing Inspection For Certification Under the MA Rental Voucher Program Name r- Affiliation (Circle ne) Real Estate Agent O Tenant Your Address )elagvspors PaAk a KO 0- TIA xn. Telephone Number (Day) 3o8 ,3q�- Lf1S5 (Night) AMA, Address of Property Where Inspection is Requested Unit/Apt.# Name of Owner �(S GF4��2YL GCC c,��l►� Address Mailing Address (if different) � e , Telephone Number (Day)56?-3(-,0-?1.03 (Night.) 5ftwl Will there be any children under the age of six (6) w79; . 11 be occupying the rental unit? (circle one) Yes Was the dwelling constructed prior to 1979? Ye No ------------------------------------------------------------ FOR OFFICE USE ONLY: Certification The dwelling, dwelling unit, or rooming unit located at 4-4�) ( Pe* - was inspected on by Health Inspector for the Town of Barnstable and was found to be in compliance with the provisions contained within 105 CMR 410.00, State Sanitary Code II: Minimum Standards of Fitness for Human Habitation. However, this certification does not include a determination as to whether this unit contains any lead paint because under 760 CMR 49.02 Massachusetts Rental Voucher Program, a separate lead paint inspection must be conducted. Inspector's Signature , Date Li - ��� TOWN OF BARNSTABLE LOCATION 22- CV# �fX l/V, SEWAGE VILLAGE ASSESSOR'S MAP & LOT7,.3#`Oq7 INSTALLER'S NAME & PHONE NO. 6&J41-.4/2FS OP2Z SEPTIC TANK CAPACITY fdQQ LEACHING FACILITY:(type) 4 (size) NO. OF BEDROOMS PRIVATE WELL R PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: ,�/Zl ✓� DATE COMPLIANCE ISSUED ''° _ s� !9 VARIANCE GRANTED: Yes No �otL� r q5 A-3 _ � ® . . /F ric x.............................. .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE App iration for Di-ripwiai Work.6 Tomitrnr#inn Vamit ,-Application is hereby made for a Permit to Construct ( ) or Repair 1Q an Individual Sewage Disposal System at: ...--`-..... =---.....2h..'-.... l�r...►....---------1--------- .................................................. G ,.,c 61 vim U 7 Locati n-:\ddress or Lot' No. _ �r,Z .�...GS.`% /I ........................ ....... •-----• ------------------------•---•----- ----•-•---------•--•---------- •-----••------•--........------•-- Ow r ddress W L�!LrrP_O�l�cf» ---�11�.4_------ Installer� - Address UType of Building Size Lot............................Sq. feet ,., Dwelling— No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder (--j 04 Other—Type of Building ----------------------------- No. of persons---------------------------- Showers ( >) — Cafeteria ( ) Q' Other fixtur ---------------- ---- - - - W Design Flow____________________________________________S15gallons per person per day. Total daily flow....___..__ ............................gallons. WSeptic Tank—Liquid capacity% q---gallons Length................ Width---------------- Diameter.___.._._.--____ Depth____--_--__----- x Disposal Trench—No- ____________________ Width-------------------- Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No......... Diameter......lU....----- Depth below inlet........._.._..... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by------- ---------------------------------•------------------------------.. Date........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit_.................. Depth to ground water........................ G� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -------------------•-•---•---------•-•--•---•------•------•-----------•---•---.-------------.....---...... •------ .......... ..----------------------------- * .. 0 Description of Soil........................................................................................................................................................................ x W , U Nature of Repairs or Alterations—Answer when applicable. ___ .. A -.. A __._./d -_-_ ------_ "-7 . ,c, A1 �' � ,0�. /GD o /-/�iQ L :fin Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance s be n issued y board of health. Signed --- �/ /--g Date Application.Approved By ...............��-- =^"--------I �--.-------------------------------------------------------------------------- Application Disapproved for the following reasons: ...._..................................------------------------------------------------------......---------------------------- ---------......_......._---- --- -------------------- - -- - - - - __ — -- -------------- -- ..............--- -- ---- ---- ------.......... . ........----------- ---- - ------------ .........--- -- ---------- --- Dare Permit No. .................1��:. . { ............. Issued .._... .. . ------ Dare © ? y THE COMMONWEALTH OF, MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE ApplirFatiou for Bi-tipmi al ork,i C omitrnrtion termit Application is hereby made for a Permit to Construct ( ) of R-epair an Individual Sewage Disposal System at: La :.;2...r ...E--�..: Location-Address "�- _}„ or'I,o[,No.—_ _.._... ..._.. ---•-----------------------------•-•--------•------ --•-•-•-------------•--------•- . _. .. ----•....__....---- Owner Address t� C-G N-Si,z uc�c�J —7G`1.� tfU �I y +�° �/L' J•tCtiZ,.cs .0 t t1 s a _____________________ _ _____________________ __ __ r __________________________ _________ ___________________ � Installer Address UType of Building Size Lot........_...................Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ^k1 aOther—Type of Building ____________________________ No. of persons._._______-___________-_---_ Showers ( ) — Cafeteria ( ) Otherfixtures ......................................................-----------•---•--------------•--..._..__.......--------...-----••.._.------•--•--•---••------. W Design Flow..............15 ..................gallons per person per day. Total daily flow_-_...._...�-7a......................gallons. WSeptic Tank—Liquid capa6tv,40__gallons Length---------------- Width---------------- Diameter----_-___-__-__ Depth................ x Disposal Trench—No_ ____________________ Width.................... Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No____________ _____ Diameter------X0_f_____ Depth below inlet_.___._�a_ _____ Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 1­4 Percolation Test Results Performed by---------------------------------------- ---••-•--•---••------------------ Date........................................ W Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water------------------------ 9 --•---------------------------------•------•----•---...------......------------•------------••-•----................................... 0 Description of Soil......................................................................................................................................................... x U ----------------------------------------------- -----------------------------------------------------------------------------------•---------------------------------•-•••------------------•------ W V Nature of Repairs or Alterations—Answer when applicable_ _ _ 3E/77 L A y! ___ .-_-_ __ ---•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions•orTITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance han issued bY� board of health. Signed .............. Application,Approved BY Date -ti r... ci S _\ re J Application Disapproved for the following reasons: ................................................ .......... ........................ .... - - . ....... ------ -------------------------------------------------------------------------------- ----------------------------- ---------------------------- ----------------------------------------- - ...... . ............ p Date ------------------ Permit No. - 1 Issued ............... . ---. ..-?-,.. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (11ertiftra e of (fomptia re THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by ...................................'.I �%L-VC.v�'7 ...-...G.t1i�J-s' �uc�, c,r. --- ------------------------------------------ ----------- Iner.Jlrr at ............. .. ........... �---..--G-�r�1- - /L@�------------------',�1�----- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ._.y- ------- dated .--..- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL/FUNCTIO SATISFACTORY. DATE.............`..:..-------- � '.,r ----------------- Inspecto ----- �(r ;V P THE COMMONWEALTH OF MASSACHUSETTS 12y 0q7 BOARD OF HEALTH TOWN OF BARNSTABLE Bispoii al Works Tnnitrudinn "f rranit Permission is hereby granted...................__��___.61_a Lv- ___.__ ' L'_ ----•----•--------------------------•--...._-•••-- to Construct ( ) or Repair ( .)'.an Individual Sewage Disposal System ---------------•---------•---••-•-••---....._ PP P street q� SrtJ _ as shown on the application for Disposal Works Construction Permit No.l._,_:"(_\_.`{.��____(.\�D\ated______.�-�.-�--::•�•�.----. . ..........................................s._a-:3_,/_-._._.___._____._.__._________.._______.._.._ -' UBoard of Health DATE ........................................ FORM 36508 HOBBS B WARREN.INC..PUBLISHERS F r TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE 11:MINIMUM STANDARDS FOR HUMAN HABITATION Date V —10 - e®iJ Owner A ..IA,;t Tenant - Address .. 1 Address Complionce 'Remarks or Regulation# Yes. No ti' Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply - V 5. Hot Water Facilities b. Heating Facilities 7. Lighting and Electrical Facilities r 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use v 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing PART 11 37. Placarding of Condemned Dwelling; C% Removal of Occupants; Demolition Persons Interviewed �th6' C[tl -'` ' 4 Inspector If Public Building such as Store or Hotel Motel specify here HOBB.S&WARREN,INC. I f