The URL can be used to link to this page

Home My WebLink About0014 PAINE AVENUE - Health (2) -14 PAINE AVE Flyann-is 288 - 144 1 i i i E y SHE Tti Barnstable a� Town of Barnstable AEAmeBcaCdy .. MAS& Board of Health 039. '°rfa►�� 200 Main Street, Hyannis MA 02601 91 . 2007 Office: 508-8624644 x Wayne Miller,M.D. FAX: 508-790-6304' Paul Canniff,D.M.D. Junichi Sawayanagi November 24, 2014 Ms. Ruth Duchesney 14 Paine Avenue , Hyannis, MA,02601 ` Dear Ms. Duchesney, You are granted an extension to connect your dwelling located at'14_Paine Avenue to public sewer: This extension is ranted until such time our is sold. g Y property, . After the date of transfer, the new owner will have up to two years to connect the dwelling to public sewer. However if at-the time of transfer, it is determined that the septic system is in hydraulic failure, then the sewer connection must occur within sixty days after the date of real estate transfer. This extension is granted because, as you explained in your recent letter, you cannot afford to perform the required work and this would cause great financial hardship. You are a 94 year old widow living only on.social security. Sin.erely yours r Wa e er airman Board of 1 ealth Q;\WPFILES\DuchesneyExtensionSewer Connection2014Aoc i 10/27/14 Town of Barnstable Attn: Board of Health 200 Main St. Hyannis, MA 02601 To Whom It May Concern, . jj .i My name is Ruth Duchesney and I reside at 14 Paine Ave. in Hyannis. I am writing to you regarding the Stewart's Creek sewer connection project that is supposed to be done at my property by 3/31/15. 1 am a 94 year old widow living only on social security and cannot afford to do this.This would cause me a terrible hardship. I respectfully request that you put this on the agenda for the next meeting and allow this to be deferred to a later date. If you have any questions or need to contact anyone regarding this matter, please contact my granddaughter Lesley Souza-Oakley @ 508-364-6980 or Lesleyo@comcast.net. She will be handling this for me. Thank you for your time. Sincerely, /fou &Lae Ruth Duchesney "� Town of Barnstable Barnstable IME Board of Health O "'e`c'Cfty '"aA'zNSTA°`E' 1� 200 Main Street, Hyannis MA 02601 OprF A�ale 2007 OFFICE: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi Lesley Souza-Oakley (for Ruth Duchesnev) 508-364 Y6980 Email: Lesleyo@comcast.net REMINDER OF BOARD HEARING: November 13, 2014 You are on the agenda for our Board of Yfeafth meeting <1`'e: 14 Paine Avenue, Yfyannis �Stewark_free , requesting to defer sewer connection.. Thankyou. Your item will be heard at the Board of Health Meeting on the: Date of Tuesday,Novemeber 18, 2014 You, or a representative for you, is expected to be present to answer questions the Board may have. t Meeting Location:' Town Hall,'367 Main St, Hyannis Hearing Room, Second Floor . Time: 3:00— 6:00 P.M. Approximately three days prior to meeting, an agenda will be sent out to you— once it is available. It will also be available on line at the town website: www.town.barnstable.ma.us Go to "Boards & Committees >'Board of Health - or Go to Official Agendas Q:\AGENDAS BOH\let Receipt of BOH Submission 14 Paine Ave Nov 2014.doc E I to Complete items 1,2,and 3.Also completeY A.,Signature N v-,- �eS h e-y item 4 if Restricted Delivery is desired. X ®'Agent: G Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery I I o Attach.this card to the back of the mailpiece, IJ I or on the front if space permits. D. I ddress different from item 1? ❑Yes I I 1. Article Addressed to: If YE , me delivery address below: ❑No I I I n RUTH-L. DUCHESNEY N Ul ddb 14-EA1NE AVE o HYANNIS, MA 02601-4449 08 Pe j ertified Mail ❑ ress Mall ❑Registered Ofieturn pf for Me andise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (rransfer from service labeq 7 012 1010 0000 2848 0905 PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-15Q I UNITED STATES POSTAL SERVICE First-Class Mail I Postage&Fees Paid I LISPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box • I Sewer Connect Public Health Division I � 4 Town of Barnstable 200 Main Street I Hyannis,MA 02601 I � I I I .l Ina � • o . .. Ir O OFFICIAL USE co rru Posta rO13 O Certified Fe OZ M O Retum Receipt F �� i?ostm�rk O (Endorsement Require Here+ (n (L ; Restricted Delivery Fee N O (Endorsement Required) rl _ O Total Postage&Fees 6 ff ' a RUTH L. DUCHESNEY 14 PAINE AVE _ 1 HYANNIS, MA 02601-4449 1 t Certified Mail Provides: n Amailing receipt o A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years Important Reminders: t o 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. a NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3B11)to the article and add applicable postage to cover the fee.Endorse mallpiece"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 mallpiece with the endorsement"Restricted Delivery". e 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 r r r Town of Barnstable Barn ic Regulatory Services Department ;NIaC"j snuvsreei.�. % O 9� 6 ,.� Public Health Division � ,�•_ 2ffl-Rain trS eet, Ilyanni—sV1A 62601 260 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7012-1010-0000-2848 -0905 March 28, 2013 RUTH L. DUCHESNEY 14 PAINE AVE IMPORTANT NOTICE HYANNIS, MA 02601-4449 Map & Parcel: 288- 144 The Department of Public Works informed us that public sewer lines are now available in your neighborhood. According to our records, your property has a septic system. This letter directs you to connect your dwelling, at 14 Paine Ave, Hyannis,MA, to public sewer on or before 3/30/2015. The old septic system must be either removed or filled in due to future safety concerns. This may be done by the same contractor who connects you to the sewer. Septic Abandonment Permits ($ 25) are issued at the Public Health Division, 200 Main Street, Hyannis. Failure to comply with this Board of Health Order may result in a complaint against you, in a court of law. For additional information pertaining to the sewer connection, please see the reverse side of this page. PER ORDER OF THE OARD OF HEALTH f -- Thomas A. McKean, R.S., C.H.O. Agent of'the Board of Health Cc: Barbara Childs, WPC/Roger Parsons,Town Engineering, DPW Enc. / Q:\SEWER connect\L.etters Stewart Creek Sewer Connects\MAn,ING L.etA Sewer 2Pgs Merged 3-28-13 Yr2015.d6c Public Health Division March 28, 2013 ADDITIONAL INFORMATION AND REMINDERS FROM OTHER DIVISIONS: SAVINGS AVAILABLE/GRINDER PUMP: A reminder to those of you who need a grinder pump for your connection: Department of Public Works (DPW) sent you a letter in December 2012 stating the town, for a limited time of two_years. only from the receipt of the DPW letter, would provide you with the pump at no charge. (This can save you thousands of dollars.) Please note: You must pay the installation cz)st through y2ur own contractor. Please make your contractor aware of this, if interested. Also be aware: this is a shorter deadline than the Public Health Division's deadline on the reverse side of this page. SAVINGS AVAILABLE/PERMIT FEE: The Town offers a waiver of th-_ residential sewer connection fee of $420.00 for those properties that connect within two years of the receipt of the DPW December 2012 letter. LOANS: For loan(s) available, please see-he enclosed brochure, or see the town website: http://www.town.bat-nstable.ina.us/cdbg (under the "CDBG Programs", see "Sewer Connection Loan Program). Fo-loan specific questions, you may contact Kathleen Girouard, Growth Management, at 508-862-4702. CONTRACTORS: Information on Licensed Sewer Installers is available on our web site at www.town.bartistable.ma.us/PublicWoi-ksTech/sewerinstalIels. Contractors, approved to perform sewer connection work in the Town of Barnstable must obtain and file a Sewer Connection Permit with DPW-Water Pollution Control Division, 617 Bearse's Way, Hyannis—contractors, please call Dave Anderson at(508) 790-6244. FOR ANY QUESTIONS /ASSISTANCE: Len Gobeil at the Town Manager's Office is available to provide you with direction you may need in reference to the Stewart Creek Sewer Connections. You may contact him at 508-862-4701. QASEWER connecALetters Stewart Creek Sewer COnnectA MAII NG LetA Sewer 2Pgs Merged 3-28-13 W2015.doc No........................ Fis...,v�................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF LHEALTH ...... tqn. OF....1�4r!m�!�a[?I4,...... App iratinn for Ili_qpAiia1 Works Tomiunrtinn rumit Application is hereby made for a Permit to Construct ( ) or Repair (-) an Individual Sewage Disposal System at: j.q.....P4inj�...Akswa.. -Y=Mddr�ssApt..--•----•----....---•--........ .-•--------------------=--------------------•------ - .... Ldat A Lot No. J�„ac�naetxt....... ----•------•-----•-•. t y Pa- ....................................... Owner ►. _. L 4qs�................................................... Sa /�4i� c5 a -� ..__� S 4 ' Installer Address UType of Building Size Lot----------------------------Sq. feet Dwelling—No. of Bedrooms................................ .......Expansion Attic ( ) Garbage Grinder ( } aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures ............................................................... --------------------------------------••••.----•••...- Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............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 ( ) Percolation Test Results Performed by..................................... --••-••-------•-•......•-•-•-•-••-•. Date....................................... Test Pit No. 1----------------minutes per inch Depth of Test Pit...........:........ Depth to ground water--___________--_-.-----. GXq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water____-_---_.--•_.-.______ Pa' ---------------------------------------- ................................................................................................................... 0 Description of Soil................. U -••-•••-•••--••---•••--••••-•-----•-••---...--•••---•-•-•••-------•••--•-•-------•--•--------•-•-••---....-•-•---•-•--••••--•-•-----•------•--••-••--•-•--•-••••••••-•----••......-•--••---•••-••--•••. W --------------------------------------------------------------------------------------------------------------------�-.---�-p----------------------- U Naturg of Repairs or Alteratio s—Answer when applicable_r)-o e+�X__.l9PA_q o7t__�$ig!�... 04. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of L :L p S of the State Sanitary 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 .... :___FS? �!t -----••. ---•l 6-e� ------- - . D t Application Approved --------------------••-•� - =-------........... -------- Date Application Disapproved for the following reasons:-------•-------•------------------------------------------------------------------------------------------------ ---••••---••••--•-•••---------•-•----•-•--••-•-•••-•--•-•-••-------•-•--•----••-------•--•--•-•••---•---••---•-•--•--•.._............................................................--•••--••••-•--- Date. -•-'• - PermitNo............. .�.._�....-----•-•--• Issued.-•-------•--•------------•-------------------•-------- Date :.:_. ..... ................... THE COMMONWEALTH OF MASSACHUSETTS BOARD-,OF HEALTH -................_.... - ................................ ........................................... ApplirFation for M-4poii al Workii Tontrurtion "anti# Application is hereby made for a Permit to Construct ( ) or Repair (t!) an Individual Sewage Disposal System at: ,� .�. ........................_. . ..............._..............._..._...._ ............._....................._................_...._....._.._............................... Location-,Address , Lot No. --I1 .w1,.n <,— ... , l� . � I J./ �f rt'n ;.. , .......•..--.....» _ .._............................................. ...................................... .. . .. ------------------- ------- .------------- Owner Address _...:rrr....... .+.. � Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.................................._......Expansion Attic ( ) Garbage Grinder ( } aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures -------------------------------------------------------•••••---------------••••-••••••------••--•-•-•••-------•-------•-•--•••---•-------•---•----•--- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............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 ( ) Percolation Test Results Performed by--•-•---•--•----••-•----•---•-•----•--------•---•••..................•... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water----_-_______-___-_____. r, Test Pit No. 2................minutes per inch Depth of Test Pit............._...... Depth to ground water........................ a --••---•--•.....................•---...-•--••---•-•--•--•••..............-•-•--..........-•-----•---......................................................... 0 Description of Soil-----------------------------------------------------------•----•------------------------------------------------------------------------------------------------.--••- x U ----------------------------------------------------------------------------------------------------------•-•-------------------...... ------.......------------------------------------......•---•.-•-- UW -----------------------------------------------------------------------------------------------------------------•--------------------------------------------- Nature of Repairs or Alterations—Answer when applicable._�._, -c��_--.l r:.,., - (��-- �------`,. -----,.--r -_�n�r--- / ff ``''�� ! -- ----- L,Z J r 4_!u1•1�:,C' ,v `�'_...�'.lr. e Fe r' t-,,r 7e,h,4 t 1 1 -•----- ...........;- _......... ................................................. ......... ...................»...--------------...._..__..._................_. Agreement: 6 The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with }of t the provisions of TTT:E '. .ze State Sanitary 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-- � 240,1(....................................................t.nr. r----r......................., Application Approved B ......... ....... / ......... PP PP y-•-••• �� f Date Application Disapproved for the following reasons---------------------------------------------------------------------------------------------------------------- ..-•--•-------------•--------•---•-----------•------••-•-•-••----•••---•---••-....------...•-•-----••-----•••--••--•--••-•--••••-••----•----•------•-•••-•-----•---------••-•••------•--••--•--•-------- Date Permit No.-----------�--------------------------•. ........... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................................ .................................... Trr#ifiratr of TompliFanre THIS IS O ER�I Y That the Individual Sewage Disposal System constructed ( ) or Repaired (1)) - �� VG' �� .. br%...................••-•------•--- •---•--•-•---•---------•••------------•-•-...------...............-•-----••-•--•---......--•--•-•-••----•----•--------•--- ,- Installer ---------------------------.................................................................-------------- ------...... has been installed in accordance with the provisions of TiTIE 5 of The State Sanitary Coe as described in the �c _ application for Disposal Works Construction Permit No..... �............... _._.__».._...... dated___l: _ -__ _..ts__-�.................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A G ARANTEE THAT THE SYSTEM WILL FUNCTION SAT 3FACTORY. -_ DATE.. -� - Inspector_.. ......_ ............................................................. THE COMMONWEALTH OF MASSACHUSETTS V BOAR(/D� OF ^plHEALTH 7,1 _.C3 1 "I'll O F....!::.r.l nc.cl 9A-ll e.; ...... h No.... ........... FEE...»1:�1...... orko �on�� ion rraati� Permission is hereby granted .I:.....................................................----•---------•----•-----••••-••••------••......••••--....................---• ^to,.Conitr t ( or Rep it ) an Individual Sewage Disposal System Street as shown,on the application for Disposal Works Construction Permit No..................... DatedLl?_/5:._? / Board of Health BATE.-- ....._.. ............................... _ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS TOWN OF BARNSTABLE LOCATION /y SEWAGE # VILLAGE /�/,i _ ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. A & B CANCO 775-6264 SEPTIC TANK CAPACITY /6 6 LEACHING FACILITY:(type) 1 Q q�J (size) c('" F NO. OF BEDROOMS__2 _PRIVATE WELL OR PUBLIC WATER %4 U., �-- BUILDER OR OWNER 1. , Q,;,c 14 Cc/t- DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: -- a VARIANCE GRANTED: Yes No 4C ' � I T 1 �\ 31 1 c � ASSESSORS MAP NO: �•` SS PARCEL NO-- W �............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratioit for Uhi-poottl Works Tomitrnrtion Vamit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: 3 Paine .Ave Hyannis ..... .... _ ..... .......................... ----------------------------------------•-------------------------•------------------------------- Location-Address or Lot No. Mr. Doherty Owner Address a W.E. Robinson Septic Service P.O. Box 1089 Centerville .................................................. •••••---•-••-•---•-•-------------------------•-•-----------•-----•----•--•--••---••-••------...... Installer Address UType of Building 3 Size Lot............................Sq. feet �. Dwelling— No. of Bedrooms-----------------------------------------_-Expansion Attic ( ) Garbage Grinder ( ) aOther —Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOther fixtures --------------------------------------------------------------------------------------- ------------------------------------------------------------- W Design Flow--------------------------------------------gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity-------.--_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........................................ a Test Pit No. I----------------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 --•-------••------------------------------•---•--......------•--•---•-•-----•---•---••-•----•--..........-•---------------•-•--•-.........-•-•---------•---- Descriptionof Soil sand--------------------------•---------......._....-----------...------------------------------------------------...--------------------------------••••. U W . . ------------------------- -------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------- V Nature of Repairs or Alterations—Answer when applicable---Pump---&---fill....old Cesspool, install . 1_, 000- c tank, d-box & 3 stonepacked_ precast sallies 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 .... ..... .............. . ................................. .. .......... ................... Dace Application Approved By I� --- �- - - - ..' -- ---------- Dace Application Disapproved for the following rearons: ------........................................:..........•.....-----...............---------------------------------------------- ................------.......'.'.-----------------------------------------------------.-.....--------------------s..........---....----.......:........[.......................................... ---------------------------------------- Dace - Permit No. ... - Issued Date s_ 30 00 t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratilatt for Cn ittitrurtilatt firrutit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage-Disposal System at: ..........................................P Ae Hyannis. -•----------------------------•---------------•-------.........--.....--•------•----•---....---•-- ---------• ---•---- Location-t\ddress or Lot No. Mr' Doherty---- ... Own R Address a W.E. Robinson Sepiic Service P.O. Box 1089 Centerville Installer Address UType of Building t•� ,3 Size Lot............................Sq. feet t-, Dwelling—No. of Bedrooms___________________________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building __________________________ No—of persons---------------------------- Showers ( ) — Cafeteria ( ) Q Other fixtures --------------------------------- --------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity_____.--___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 ( ) '-, Percolation Test Results Performed by-------- -------------••-...--•-----•-•------------••----•------•-•-•----- Date........................................ a Test Pit No. I................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........................ R: ODescription of Soil......San d--------••-•--••-•....•-•-••------•--•---•---•---•---------••---••------------•------•---------•-----------•••••••-•--••------------•................. x W -------------- --------------------------••----------------------------•.....--------••-••-------------•--------------------------------------------••------•---•-•-•-••••••---•-----•-•-•.••-•-....... U Nature of Repairs or Alterations—Answer when applicable._Pump & fill _old cesspool, install 1 , 000 gal tank, d-box & 3 stonepacked precast gallies ------------------------------------------•--- 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 -------------------------------------------------------------------------------------------------------- ...... ..--............:...... Date Application Approved By ........`��<>.s�� -� -. .�._---------------------------- ----------------------------------- aw Application Disapproved for the fol owing reasons- ------------------------------------------------------------------------------------------------------------------------------------ ......................................... ....................................... . . .......................--............. . ....--------- ....................................... Date PermitNo- --------------------------- ---------------------------------- Issued ................ . . ............ .. .......... Dare THE COMMONWEALTH OF MASSACHUSETTS 'BOARD OF HEALTH TOWN OF BARNSTABLE V.1 arti f irutr, of Tantlatinure THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( x ) by -----W.E. Robinson Septic .Service .--.._....._..-... ------- .......................................... 3 Paine Ave Hyannis Installer ---- 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. ---- -.�....... dated ...---._--_------------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. s . DATE............-7. . '. f.. -.-...- Inspe� t _.. � Doherty THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No. - ¢. FEE TOWN OF BARNSTABLE 30.00.................. Rupnsal Worho TomitrttrtUan "erntit W E Robinson Se fltc Service___----•------------------ Permtsston is hereby granted ------ ---------------- -- p ---- -------•---------.....-•--•-..... to Constru t ( ) or Repair l�y X ) an Individual Sewage Disposal System PaineAve annis -----•-----------•---------------------------------------•••--.....-•_..... Street as shown on the application for Disposal Works Construction ,Permit No._��:3—?�Dated___.�_A.--,� _'._........ ------------ ...•-• - ---- -- --- B a d of Health DATE............................ --------------- FORM 36508 HOBBS h WARREN.INC..PUBLISHERS