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0613 SKUNKNET ROAD - Health
613 Skunknet Road Centerville A= 011-009 5 M EAD® No.2.153LOR UPC 12534 smeadcom • Made In USA �i Certified Mail#7006 2150 0002 1041 9150 r Town of Barnstable y Regulatory Services HARNSTARM r Thomas F. Geiler, Director Public Health Division Thomas McKean,Director / k.� 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 June 23, 2008 Malek Esrawi 197 Barstable Road Ale bq Hyannis, MA 02601 1 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION, THE STATE ENVIRONMENTAL CODE, TITLE 5. The property owned by you located at 613 Skunknet Road Hyannis, MA was inspected on June 23, 2008 by Timothy O'Connell, Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of the rental registration of the Town of Barnstable. The following violations of the State Sanitary Code were observed: 105 CMR 410.300 and 310 CMR 15.00: There were a total of four (4) bedrooms observed in this dwelling; three (3) were observed on the first and second floors, (1) one was observed within the basement. However, the existing septic system (permit # 94- 156) was not designed for(4) four.bedrooms. It was designed for three (3)bedrooms. 105 CMR 410.500—Owner's Responsibility to Maintain Structural Elements. Observed cracked and damaged casing on entrance door to bedroom on.first floor. 105 CMR 410.551- Screen's for Windows. Observed screens missing in windows within kitchen, mud room and in second floor bedroom. 105 CMR 410.552- Screen's for Doors. Observed missing screen door for sliding glass door within three season room. 105 CMR 410.450- Means of Egress Observed bed within room in basement without proper second means of egress. QAOrder letters\Housing violations\Rental ordinance\613 skunknet cent You are ordered to correct the violations listed above within sixty (60) days of your receipt of this notice by pulling any required building permits (if applicable); You are ordered to remove the bedroom from the basement by removing entrance door and by opening door-way entrance to room in the basement to a minimum of five feet wide opening. This will bring the total bedroom count down from (4) four to the appropriate (3) three as designated by your septic permit; you are ordered to remove bed from room within basement and not use room as bedroom; by installing screens in all windows in doors mentioned above; by repairing or replacing door casing to bedroom on first floor. 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. PER ORDER OF E BOARD OF HEALTH Thomas A. McKean, R.S., O Director of Public Health Town of Barnstable Cc: Timothy O'Connell, Health Inspector Q:\Order letters\Housing violations\Rental ordinance\613 skunknet cent k. n5q-eufic/�� 0 ,-Q0 c�� C � v FORM30 C&w HOBBS&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HE H CITY/TOWN 4 W r a DEPARTME p� 'c, 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 owner I, Remarks Reg. Vio. YARD Out Bld s.: Fences: 1 Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: UIAT Roof Gutters, Drains: Walls: LLIA Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Lighting: STRUCTURE INT. Hall,Stairway: Obst'n.: r 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.: 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):=4 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect..- Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink 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 13uildin 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 INSPECTIO PORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF P INSPECTOR TITLE —41AL � ` n DATE TIME t P.M. ...�� A.M. THE NEXT SCHEDULED EINSPECTION P.M. ;t i 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 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. i TOWN OF BARN:STABLE ` LOCATION /� SlSlf��jae-� Oon� SEWAGE # VILLAGE c� l'Ui��� ASSESSOR'S MAP & LOT 169-6!1 d0P INSTALLER'S NAME & PHONE NO.�FWr9Q1 1*rl--; C t-)tj SEPTIC TANK CAPACITY 00/1OX LEACHING FACILITY:(type) �' (cam (size) NO. OF BEDROOMS PRIVATE WELL O UBLIC WATER` BUILDER OWNER) .(210i/' DATE PERMIT ISSUED: �41 DATE COMPLIANCE ISSUED: VA-RIANCE GRANTED: Yes No x:: 37° r� LOCAT1 SEWAGE PERMIT NO. VILLAGE 1 I N S T A LLER'S NAME lk ADDRESS BUILDER OR OWNER DATE PERMIT ISSUED / /l i DATE . C,OM.PLIANCE ISSUED I�Klt- l - _: � , � ��. 1� ... � �� �� y 1 � � jfi �l � f - .................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ApplirFation for Ditipaii al Workii Cho itrurtiom Vamit v o Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 3 5 f�v kweT C' w'( S �.l...._.__.... ....................vP ( ` - ••••. .......................................... cl -•----•--•••-•••--•--...---•--•••.......•- Location-Address or Lot N ............... 2!iK !.".V..�............................................. ©d ®ft -5Z �tle..l! `3v' .✓............ ......•---... W Owner Address ............ z.-------.C-1-1....................................... .._. .......-------........_.__ Installer Address � Uy .�, UType of Building Size Lot___1___,F____0________.......Sq. feet Dwelling—No. of Bedrooms_______.______________________________Expansion Attic (✓) Garbage Grinder ( ) aOther—Type of Building -• X !`?_<_ No. of persons_-_______Y_.............. Showers ( ) — Cafeteria ( ) Otherfixtures ------------------=----------------------------•------•••-•-----•-••--•-----•-----•••••- W Design Flow....................57.67_..............gallons per person per day. Total daily flow............ -----------------gallons. WSeptic Tank—Liquid'capacity__0W___gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No_________________ ... Width.................... Total Length.................... Total leaching area------_.............sq. ft. �- Seepage Pit No--------------------- Diameter..............•..... Depth below inlet.................... Total leaching area..................sq. ft. Z ' Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 4� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -•-•---•-•••--------------•••••••••--••-....--•------•••-------.._..--•-....----._._...... 0 Description of Soil..................................................=..................................................................................................................... x U -----•----•---•---••------••-•-----------•----------------•-•--•---------•---------•----.._..--•-••------•----•••-----•-•---•-•-----•-••----•-•-•-----•-•----•••-•-•••------•---••---••............. W U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ---•-------------------------------••---------------------------------------•-----------•---••----------••-----------------------------.;•••-----•••-----••-••.......................................... Agreement: The undersigned agrees to install the aforedescribed Indivi al wage Disposal System in accordance with the provisions of TITLL 5 of the State Sanitary Code— e gned further agrees not to place the system in operation until a Certificate of Compliance has been issu e and of health. S. Application Approved Boe v ---•---------•-------•.....................................•--••-••••-•---_----- -_--f��• ................... Date Application Disa ov llowing reasons:.............................---------------------------------=•e-----------------------•------•-------•---•- ::. Date PermitNo-----------------------•-----------••---------------.._.:' Issued.--------.....•-------------------••-•••••-•--•-....__. Date ` Is ° ° = ' � ............... .......... THE coMmomvvsxLrx OF MASSACHUSETTS � BOARD Y�K� ���� HEALTH ���T U� / -- _ '-- _ =--' '-- | ' | �A ...........................................0F........................................... ��°�x�� ° � ' ���u�����«����«» Disposal� 4�»��o�� *�^wow����o��mwu4 �u������ Application is hereby made for u Permit to Construct ( \ or Repair ( ) an Individual Sewage Disposal System at: '--��'=-_=�_, -'-__----'-�=-_-'�'_-'''�-'-'�-^-'-�_- '----'--------------_�^-^-----'-_____-_---__-_' Location Address or Lot -------+"�^='''---'��=`�==`�----------------------- -'^^'===--'=='^'`~-'='----' ------------- | Owner Address ______ ---------------_'_ .... ................................................................... ' ^u�"� Type of �� Sq. feet Dwelling ..........................Expansion Attic (V) Garbage Grinder ( ) aq Other—Type c6 Building - No. of persons_-'_��_---- Showers ( ) -- Cafeteria ( ) ^� Other fixtures- - ------------------------------------------------------------------------------------------------------------------------------------------ ----------- Design Flow...................... .............. per person per day. Total daily flow............ .7...................... . Septic Tank—Liquid _Y20L.guDouu Length................ Width................ Diameter---------------- Depth................ Disposal Treuch--No..................... Width.................... Total Length.-.'------' Total area....................sq. ft. Seepage Pit No..................... Diaoetcz'--_.-- Depth below Total leaching area..................sg f t. Z Other Distribution box ( ) Dosing tank ( ) ~^ Percolation Test 8eso8o Performed 6y.......................................................................... Date............... c.------.`,� Test Pit No. 2-----.--.minutes per inch Depth of Test Pit.----.---- Depth to ground water........................ _._--__---.-'-_'__.---_'----____---___'__'___--____--_-__'-___'-' � 0 - o6 � Description Soil........................................................................................................................................................................ � ------------_---_-'--_--..---_.-.-_--..----._------_-'-'-'_--_-'_.--'-_--_-'____-.. U. Nature of Repairs orAlterud000--Aoswerwbeo applicable. ---_------_._'---.---_--._'-__---.. ` . ''--'----_-'-_-__-__.-'_'-_'--._-_--____-_'_---_----_---'---.----__--- - � Agreement: The undersigned agrees to install the uforcdesccibc6 Indivi pal wage Disposal System in accordance with the provisions of T IT LE 5 of the State Sanitary Code—;P57 �d�-;�gned further-agrees not to place the system in operation until a Certificate of Compliance has been issued b�d r/e�l-gard of health. Application Approved ----'r--���------- � Application Dis,apgr<ov�ed�,�Or xfollowing reasons:................................................................................................................. � -----------' ----------------'---'-'-------'-----------'-'-'--------------''--'--'---- Date Permit- No- -- o^te THE oowwomvvsALrH OF MAssAoHussrrs 71-1 _ ---`---'��p� ---_---------' ' ~°�� w���tufir�utr �« To4uuphaurr � TH13 ISZIO'CERTIFY, That the Individual Sewage Disposal System constructed Repaired .has_ been installed- _ in accordance ..'-' the provisions of - '_ State_ -_-_-' -'- in the u�pl�ut�oo �� D�o�os� �Vor�sC000t Construction pc��� DTo-�C����.+���'��'.--'--- d�t«6.,��2���«���-��--.----- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO�N�� � THAT THE SYSTEM WI�L F6NCTION SATISFACTORY. -----'�r--�-~-------'------'-----'-'--'-'-'-- Inspector- --'- ----------'---------'--'-------' �~ �, ' THE comwomvvEALr* or mAsSACxussrrs BOARD OF HEALTH ��D/� -------------'~ ----------------------------. 4��� 2�o�-��_��(-�� Fu��-'..-'----'-- it rrmit Permission is hereby granted..... Street r as shown on the application" " for ^' sv""a ``"^^" Construction" " ^=^~~` ^`° ' . ated/4- /1) , r �"=aof Health DATE ___' popM /oss xnaam w WARREN, INC., ruouaxsnS � ^ . - - a «w A. No.... .. .._ Fps .............. APPROVED 8 THE COMMONWEALTH OF MASSACHUSETTS to rva M Date O A R D OF HEALTH ji9ned OWN OF BARNSTABLE App iratiun for Uijpnuttl Works Tunutrur#inn rautit Application is hereby made for a Permit to Construct ( ) or. Repair (040 an Individual Sewage Disposal System at: . - .. 3........1-..Zv .. .....C—.—'mot— •--•---- �L/J Q��j Location:,ddress (�� or Lot o .......... ' er t Address sn— W --• ------. �� ---- -------_ Installer Address d Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons________-___---.-__..______- Showers ( ) — Cafeteria ( ) QOther fixtures --------------- ---------------------------------------------------------------------- ------------------- W Design Flow..............-_-_---_______gallons per person per day. Total daily flow_.____.. 10.-_-_-.-.__--_-___--gallons. WSeptic Tank—Liquid capacity./100_gallons Length---------------- Width___.__....-..___ Diameter-----.---------- Depth................ x Disposal Trench—No. .................... Width-------------------- Total Length.................... Total leaching area--------------------sq. ft. 3 Seepage Pit No......... Diameter____._l._�_ -__. Depth below inlet------4..(....... 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........................ (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -----------------------------•-------------------•---••--•-•---------•--------......----•---•-------......................................................... 0 Description of Soil............................................................................... ---------------------------------------------------------------------•--•--••-----_----- x x ----------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable______.....�:Q.______�-__.___.l4 . _ 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 hA beenW issuued b the d of health.Signed . ....... .... �Application Approved By ....e .... ...... ...�� ...................................... ................Date.................. Application Disapproved for the following reasonr- ----------------------------------------------------- ---------------------------------------------------------------------------- Date ----------------------------------------------------------- --- te ...................................... Permit No. .............................. ........ :............... Issued ............... f h No.... ...... —70 " -• Fps. ........................... THE COMMONWEALTH OF MASSACHUSETTS �� BOARD OF HEALTH TOWN OF BARNSTABLE r � Appliration for Uiopoottl Workii Tomitrur#ion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair O an Individual Sewage Disposal System at: .��Util/�hl irdJ C'Z� �Ji �fc cJri1 � t�........................................Location-.r.,.•......•---....------........_..__ a-..............._._.... Address Gam... 4.............�2..--••------•..........................•--!or Lo .... •--=------h•`•---t--�-'(.1/l:��s.D-----•--�--.- - �-''•�'--`�--r•�-- -•--� � �'�c..�n.11..✓V�"_'.. ff�..._._.._C _"!i Owner Address dress ..... 0 InJ.S i J ••- ---------------- G�J/1?L Z4 L> i� ,�'LI /v!_-�( C S ,-1 •. ..--•.......... • ..... Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms---------------- -!i�-------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures ............................ W Design Flow.............. ...............gallons per person per day. Total daily flow--------Z- 70................... Cl' Septic Tank—Liquid capacity_//AqQ.-gallons Length________________ Width......---------- Diameter................ Depth................ W Disposal Trench—No. .................... Width_._.__....____.._... Total Length....___......_...._. Total leaching area....................sq. ft. x , Seepage Pit No...........-:'----- Diameter.._._.�_q......_. 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_.__-..____-_-______._.. fs. Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ -_--.-•------------------------------------•-----•---_--------------•---•-•-•-•-•-••---------------- •• •------------------------------------ ••-------- --.-•--- 0 Description of Soil........................................................................................................................................................................ x U •--... W x •-••-•-••--------------------------•-••-•--•---••••----•...•-•-••--•------------...----••••...----------•---------------------------------•-----------------•••-••......•-•--=........................ U Nature of Repairs or Alterations—Answer when applicable_.__._.._..__A_Q__0------- :4.......... .._t..�_e--,":`1_.. 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 has been issued by,/the board of health. Signed -------- �1Ff ------------------------ --G--G ��O t ( Dare ' �- ,. /.� -............... - Application Approved By ----� .....ra./{_. I ,,.. - I/� '� Dace Application Disapproved for the following reasons- -- ------------------ -------- ---------------------------------------- ----.--------------------- .. .............._.. ................... ^----- r......................_.- s...---------------------------------.----------------------------------------------- 1.... . Permit No. ...... I I IT ���� Da e --------��u .. Issued ................. ' r.... � r 1 J Date ----- -------------------------------------------------------------------- -- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH i TOWN OF BARNSTABLE C�erttfirate of Compliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by ------------------------------------------------------------ - ---------------c.'r�ry S I A- ;y /v,- 1..... .........................._.......... Installer at ---------------------------------------------------- ------------------------- —--------- .---------------- ----- has been installed in accordance with the provisions of TITLE 5'-f The Stat(�,Environmental Code as described in the application for Disposal Works Construction Permit No. ---- .....__. - -_ dated ..........._.------.._.._..._............. � THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRU A AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. - G� DATE...... .=-----------I— ... ....r..I---------- ----------- Inspector ..._... -° - �'-------- ! '-- THE COMMONWEALTH OF MASSACHUSETTS I �_ oz)l BOARD OF HEALTH TOWN OF BARNSTABLE �® No.........f... .... FEE........................ �i��rnottl v��� �on��r�r#uan �rrmi� Permission is hereby granted........................ ._...._-_`:-...'..JS�G�. to Construct ( ) or Repair (,) an Indivi ual Sew>,age Disposal System atNo..................................................................':!. '..-------••--------------•••---- --------------------- =j Street as shown on the application for Disposal Works Construction Permit No. _"r..._.._ !95ated.......... I - Board of Health DATE :.....!------------------•--••.---•-•---•••-•-...._.......... 1 - FORM 36508 HOBBS&WARREN.INC.,PUBLISHERS gr T _ _ _ - _ _ _. _. _ _ n ,w _ _.� �, 1 L� -(, . ____� . . . � � ...-. .. �1I.�--I:'-.-,'.J��. -..!,.. .--...-, Y. 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