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Home My WebLink About0035 POINT LANE - Health 35 POINT LANE Hyannis A = 288 — 172 F'7 Malkus, Karen To: Matt Conley Subject: RE: Extension request Hi Matt, Thanks for the update. Please get back to me in 6 months, March 2018, with another update. At that point you may need to go before the Board of Health for another longer extension, if needed. Best Wishes, Karen Karen Malkus Town of Barnstable Health Division Coastal Health Resource Coordinator karen.malkus(a town.barnstable.ma.us phone: (508) 862-4641 cell: (508) 857-6558 From: Matt Conley [mailto:mattconleyl5 gmail.com] Sent: Saturday, September 09, 2017 1:10 PM To: Malkus, Karen Subject: Extension request Hi Karen, We are asking for an further extension for the sewer connection. We continue to be in a financial situation that does not allow us to incur the installation costs at this time. If you need additional information please let us know. Thank you, Matt and Cathy Conley PO Box 625 W. Hyannisport, MA 02672 774.836.5060 Property: 35 Point Lane Hyannis, MA 02601 i i I a Mont ® Complete Items 1,.2,and 3. A. (gnat ® Print your name and address on the reverse so that we can return the card to you.. . ® Attach this card to the back of the maiiplece, B• R ved by( noted Name) CpDa,,of Dovery or on the front if space permits. O ems-/i 1.Article Addressed to: c1� D. Is delivery address different from Item 1? ❑Yes AL If YES,enter delivery address below: p No P.v UJR Is UZ II �IIISI I II III I II II I II I III I I I DIIIIII I II III ❑Aduity Mail[Npmsso lt Service ureeRestricted Delivery ❑Reo stared Mall Restricted �Cedifled Ma I® ❑Delivery estered Mall 9590 9402 1934 6123 0977 53 ❑certified Mall Restricted Delivery ❑Return Recelpt.for ❑Collect on Delivery Merchandise 0 Collect on Delivery Restricted Delivery' ❑Signature Conflrnatlon, 2:_•Arttcle Number ffiroee'r from*rservlce fabeD insured Mail ❑Signature Confirmation 7 015 1730 0001 4990 4964V#Vinsured Mail Restrlcted•Delivety }4Restricted Delivery # over too) `> t paV rm 3811,duly 2015 PSN 7530-02_900-9053 poPf6a ti R®tOrri Receipt 1 t 1 F Y• tit e�. Er 1 Q' Certified Mail Fee Er l t v Extra Services&Fees(check box,add fee as appropriate)),; f\ ..•t ❑Return Receip t(he copy) $ I�ost'mark. 0 ❑Return Receipt(electronic) $--- — n ere 0 Certified Mail Restricted Delivery $-- Y j � k CJ lj Adult Signature Required $ i •e ` Adult Signature Restricted Delivery Postage m $ a Total Postage and Fees u1 rq Sent T OA �� •_$ Cc �� _ . Street and Pt.No.,o r PO Box No. Clfy State,ZIP+4® Town of Barnstable Barnstable Regulatory Services Department AMUNiNCRY , 1639. ,p. Public Health )Division �1d� m 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard Scali Director FAX: 508-790-6304 Thomas A.McKean,CHO August 4, 2017 CERTIFIED MAIL#70151730 0001 4990 4964 Matthew& Catherine Conely P O Box 625 West Hyannis, MA 02672 Dear property owner, You were asked to connect your dwelling at 35 Point Lane,Hyannis MA to public sewer, on or before July 30,2016. As of this date, August 4, 2017,there is no record of you having complied with the Boards' request. Applications for abandonment permits are available at: Barnstable Health Division, 200 Main St. Hyannis. You may request an extension from the Board at a public hearing, if needed. If no action is taken, or an.extension is not pursued, you will not be in compliance and a legal compliant may result. If you have any question please call the Health Division at 508-862-4644. Your prompt attention to this matter is greatly appreciated. Karen Malkus Coastal Health Resource Coordinator Public Health Division 200 Main St.,Hyannis MA Email: karen.malkus@town.barnstable.ma.us Town of Barnstable Barn �gSNF T Board of Health j eficaC j 9 w MASS. o` 200 Main Street, Hyannis MA 02601 0 i ATf D M `� 2007 P'�a, Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Cariniff,D.M.D. Junichi Sawayanagi March 21, 2016 Matthew and Catherine Conley P.O. Box 625 West Hyannis, MA 02672 RE: Extension Granted / Sewer Connection 35 Point Lane, Hyannis A= 288 - 172 Dear Mr. and Ms. Conley, You are granted an extension,until July 31, 2016, to connect your dwelling, located at 35 Point Lane, to public sewer. This extension is granted because you stated you needed additional time for the contractor to plan and to complete the required sewer connection work. If you have any questions please call the Barnstable Health Division at: 508-862-4644. Sinc rely, Wayne iller,M.D. Chai an TOWN OF BARNSTABLE BOARD OF HEALTH Q:\WPFILES\35 Point Lane Hy Conley Sewer Ext Mar 8 2016.doc r s Crocker, Sharon From: Crocker, Sharon Sent:To: Tuesday, January 26, 2016 1:23 PM McKean, Thomas; Malkus, Karen Subject: 35 Point Lane, Hyannis 3 FYI, RE: 35 Point Lane, Hy-Matthew& Catherine Conley The BOH wanted us to contact Doug Brown to verify how much progress they are making w' ANSWER: g y g with him. Doug said that the have already given him a deposit and he just needs to ft the schedule after the snow melts -expects within 2-3 wks. ...___ in his 1 i Town of Barnstable Barnstable 114E jy° f Health Board o ►• J I 9`"KA�`Eg 200 Main Street,Hyannis MA 02601 - 039. 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi January 22, 2016 Matthew and Catherine Conley P.O.Box 625 West Hyannis,MA 02672 RE Board of Health Sh`ow�Cause Hearing , ORDERTTO 9PPEAR ',. 35 Po><ntI�ane,�Hyann><s y t; � y rf, }• , ri , A 288 „172 ? Dear Mr. and.Ms. Conley, You failed to appear at your scheduled Board of Health meeting in January. Therefore,the Board hereby orders you.to attend the March 8, 2016 meeting at 3:00 p.m. at the Town of Barnstable Town Hall,Hearing Room, second floor, 367 Main Street, Hyannis, for a continued show-cause hearing. This hearing will be held to show-cause why your property at 35 Point Lane has not been connected to Town sewer by the March 30, 2015 deadline. During this hearing,you will have an opportunity ity to be heard,present witnesses, and provide documentary evidence pertinent to this case. If you have any questions please call the Barnstable Health Division at: 508-862-4644. PER ORDER OF THE BOARD OF HEALTH. McKean, C.H.O. Agent of the Board of Health Q:SEWER/ConleySewerHearing2016.docx • t r o Town of Barnstable Barnstable . _RE�"� Board of Health . XAS& Street 02601 �,,as. � 200 Main Str t,Hyannis MA . 'b 165 ,4 zoos Office: 508-862-4644 Wayne Miller,MD. FAX: 508-790-6304 Paul Cannif,D.UD. Rmichi Sawayanagi CERTIFIED MAIL# 7015-0640-0005-8489-8256 ugust,2015 •� , Matthew and Catherine Conley P.O.Box 625 West Hyannis, MA 02672 IMPORTANT NOTICE: 288 - 172 --- - RE: Show-Cause Hearing R Dear Matthew and Catherine, You are scheduled to appear before the Board of Health on.Tuesday,November 10, 2015 at 3:00 p.m. at the Town of Barnstable Town Hall,Hearing Room, second floor, 367 Main Street,Hyannis, for a show-cause hearing. . This hearing will be held to show-cause why your property at 35 Point Lane, Hyannis MA has not been connected to Town sewer by the-March 30,2015 r deadline. During this hearing,you will have an opportunity to be heard,present witnesses, and provide documentary evidence pertinent to this case. If you have any questions please call the Barnstable Health Division at 508-862-4644. PER ORDER OF THE BOARD OF HEALTH • a Thomas A. McKean, CHO Agent of the Board of Health Town of Barnstable Barn ~* Board of Health RAMSTABM I a'"j 9 KAM g 200 Main Street, Hyannis MA 02601 2007 iOiEc�.r A Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi , January 22, 2016 Matthew and Catherine Conley P.O.Box 625 West Hyannis, MA 02672 RE Board of Health Show Cause Hear><ng ORDERkTO APPEAR 35 Po><nt Lane Hyann><sF Dear Mr. and Ms. Conley, You failed to appear at your scheduled Board of Health meeting in January. Therefore,the Board hereby orders you to attend the March 8, 2016 meeting at 3:00 p.m. at the Town of Barnstable Town Hall, Hearing Room, second floor, 367 Main Street, Hyannis, for a continued show-cause hearing. This hearing will be held to show-cause why your property at 35 Point Lane has not been connected to Town sewer by the March 30, 2015 deadline. During this hearing, you will have an opportunity to be heard, present witnesses, and provide documentary evidence pertinent to this case. If you have any questions please call the Barnstable Health Division at: 508-862-4644. PER ORDER OF THE BOARD OF HEALTH l McKean, C.H.O. Agent of the Board of Health Q:SEWER/ConleySewerHearing2016.docx / r RN 13 Complete items 1,2,and 3.Also complete A. S7elvedPr/n stricted Delivery Is desired. X ❑Agent A Print your name and address on the reverse ❑Addressee so that,we can return the card to you. B. Rd Na e) C. D e of livery o Attach this card to the back of the mailpiece, or on the front If space permits_. D. Is delivery address different from item ❑fees MATTHEW& CATHERINE CONLEY If YES,enter delivery address below: ❑No PO BUXA625 - WEST.HNy,%4NNISPORT, MA 02672'-1;. 3. Type r �I 13 Ex P ail Registered � umR t 16r-—MerMc dies(1I ❑Insured Mall ❑C.O.D Li 4. Restricted Delivery?(Extra Fee es f 2.Articie Number i i i i i i 7 i ; e i (Danster firim service tabeq I 7 012 1010 0 0 0 0 2848 0929 I PS Form 3811;February 2004 Domestic Return Receipt 102595-02-M-1540 • ® i(14y,�rl rru .. • u�sn�uu IT 0 4 'Posta $ rij S C3 Certified Feb-, ,.'.`U —ai Postmark Retu01 rn Receipt F e € O (Endorsement Requir [— Here,, �`� ' Restricted Delivery Fee r3 (Endorsement Requiredt C3 Total Postage&Fees $ c r� r-1 'MATTHEW& CATHERINE CONLEY C3PO BOX 625 WEST HYANNISPORT, MA 02672 ! w Y 3f Town of Barnstable Barnstable of z�row A& Board of Health 11111.1 e'�U Y BA MASS LE, M 200 Main Street, Hyannis MA 02601 - ASS. a �iDlfb 39. 1% 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi March 21, 2016 Matthew and Catherine Conley P.O. Box 625 West Hyannis, MA 02672 RE: Extension Granted / Sewer:Connect><on .' _ 35 Point Larie,Hyannis A= 288 172 Dear Mr. and Ms. Conley, You are granted an extension,until July 31, 2016, to connect your dwelling, located at 35 Point Lane,to public sewer. This extension is granted because you stated yo needed additional time,for the contractor to plan and to complete the required sewer connecti work. If you have any questions please call the Barnstabl Health Division at: 508-862-4644. Sincerely, Wayne Miller, M.D. Chairman `t- TOWN OF BARNSTABLE BOARD OF HEALTH BLS Q:\WPFILES\35 Point Lane Hy Conley Sewer Ext Mar 8 2016.doc 0Q _' !i 7/J✓L r °Fj„Eto Town of Barnstable Barnstable Regulatory Services Department BARNSTABLY- 9 MASS. � i639. Public Health Division ATED MA'S 200 Main Street,Hyannis MA 02601 2007 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO August 1, 2016 Barnstable Deputy Sheriff's Department PO Box 729 Barnstable,MA 02630 RE: Matthew and Catherine Conley, 35 Point Lane,Hyannis Dear Deputy Sheriff: Please deliver the enclosed letter dated August 1, 2016, for Board of Health Hearing Notice, as an"In Hand" delivery to: Matthew and Christine Conley,35 Point Lane, Hyannis, MA 02601 regarding a show-cause hearing for not complying in connecting the property up to the town sewer. The billing address for the service is: Public Health Division—S. Crocker Town of Barnstable 200 Main Street Hyannis, MA 02601 If you have any questions,please feel free to call me at 508-862-4644. Thank you for your assistance in this matter: Sending my regards to you all, Sharon Crocker Administrative Assistant 4 Q:\Legal\CONSTABLE\legal Stewart Creek Connect-35 Point LnHy Aug2016.doc Civil Processing Division 508-362-9578 HE Town of Barnstable Barnstable y�P Board of Health j e"a�j aA MASSB1�m 200 Main Street, Hyannis MA 02601?MASS. a I o°prED 39. p` 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi August 1,2016 Matthew and Catherine Conley 35 Point Lane Hyannis, MA 02601 IMPORTANT NOTICE : 307 - 050 RE: Show-Cause Hearing Dear Matthew and Catherine Conley: You are scheduled to appear before the Board of Health on Tuesday,August 23,2016 at 3:00 p.m. at the Town of Barnstable Town Hall, Hearing Room, second floor, 367 Main Street, Hyannis, for a show-cause hearing. Your presence at this meeting is mandatory. This hearing will be held to show-cause why your property at: 35 Point Lane,Hyannis MA has.not been connected to Town sewer by the July 31, 2016 deadline. During this hearing,you will have an opportunity to be heard,present witnesses, and provide documentary evidence pertinent to this case. Failure to comply with an order of the Board of Health may result in further legal action. If you have'any questions please call the Barnstable Health Division at 508-862-4644. PER ORDER OF THE BOARD OF HEALTH as A. cKean, CHO Agent of the Board of Health Q:\Legal\CONSTABLE\legal Stewart Creek Connect-35 Point LnHy Aug2016.doc Civil Processing Division 508-362-9578 r . BOH AUGUST 23, 2016 Hearing—Sewer Connection A. Matthew & Catherine Conley, owners— 35 Point Lane, Hyannis, contractor Doug Brown (Jan2016) No one was present. Mr. McKean said the file reflects that the owners had contracted with Doug Brown. He did not receive the deposit to start the work; and no longer plans to do the job. The owners had connected the health department in December 2015 when the mother was in the hospital. Then, they did not appear at the Board meeting in January 2016. In March, they were granted an extension (until the end of July 2016) as they had contracted with Doug Brown. Upon a motion duly made and seconded, the Board voted to have a constable serve the owners a notice to appear at the August 23, 2016 meeting to explain their situation. (Unanimously, voted in favor.) r nstable Town of Barnstable Bar .�. Regulatory Services Department i WcaQ j BARNSTAUM 9 ,0� Public Health Division nil A ZOONTain Street, yannis—WA 0260f-- ----- -- —2�07 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7012-1010-0000-2848 -0929 March 28, 2013 MATTHEW& CATHERINE CONLEY PO BOX 625 IMPORTANT NOTICE WEST HYANNISPORT,MA 02672 Map & Parcel: 288- 172 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 35 Point Lane,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 BO RD OF HEALTH Thomas A. McKean, R.S., C.H.O. Agent of the Board of Health Cc: Barbara Childs,WPC/Roger Parsons,Town Engineering, DPW Enc. QASEWER connect\Letters Stewart Creek Sewer Connects\MAILING LetA Sewer 2Pgs Merged 3-28-13 Yr2015.doc 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 cost through.,your 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 the 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 the enclosed brochure, or see the town website: http://www.town.barnstable.ma.us/cdba (under the "CDBG Programs", see "Sewer Connection Loan Program). For 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.barnstable.Ina.us/PublicWorksTech/sewerinstallers. 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 connectEetters Stewart Creek Sewer Connects\MAILING L.etA Sewer 2Pgs Merged 3-28-13 Yr2015.doc ® Complete items 1,2,and 3.Also complete A. nature ❑Agent item 4 if Restricted Delivery is desired. A dressee a Print your name and address on the reverse so that we can return the card to you. 13. Received (Printed me) ate el�yery 0 Attach this card to the back of the mailpiece, y or on the front if space permits. D. Is de' ery address di rent from item I? ❑ es ArticleAddressed to:C If YES,enter delivery address below: ❑No 1. CjV S fM y�S �` y�t P I r4. Resteicted Type t fied Mails ❑Priority Mail Express"° t U Z stered ❑Return Receipt for Merchandise red Mail ❑Collect on Delivery Delivery?(Extra Fee) I❑Yes 2.;ArticleNumber 7014 1200 0001 0358 2202 (Transfer from service labeQ -- P8 Form 3811,July 2013 Domestic Return Receipt a w ' ru M • ru ru LJ Ln rrl Postage $ 1� � p r i " Certified Fee I/.ice �yy Postmark C3 Return Receipt Fee Here (Endorsement Required) Restricted Delivery Fee (Endorsement Required) x jfF - � 0 .� ru Total Postage&Fees " Sent Ir M----- O Street,Apt.No.; r%. or PO Box No. P.U i ------------------------- --------------- . C/ty,St tel �/� t_ ��J�� 0.t In i Jr V ° l/ �Z� Z Town of Barnstable Barnstable Regulatory Services Department M-AoC j HAiiNSfABLL 6 ,��` Public Health Division & 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 ,, Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7014 1200 0001 0358 2202 February 9, 2015 MATTHEW& CATHERINE CONLEY PO BOX 625 IMPORTANT NOTICE WEST HYANNISPORT,MA 02672 Map & Parcel: 288-172 DEADLINE APPROACHING According to our records your dwelling at 35 Point Lane, Hyannis, MA, should be connected to public sewer on or before 3/30/2015. This is a reminder that all permits need to be in place before this date to.be in compliance: 1) Septic Abandonment Permits ($ 25) are issued at the Public Health Division, 200 Main .Street, Hyannis. 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. 2) 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: w 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. Thomas A. McKean, R.S., C.H.O. y " Agent of the Board of Health i L-OCAT 0 S E W A C PERIV T N0.- VILLAGE INS TA LLER'S NAIVE & ADDRES,SCRA14G MERE OS wool �I s^zrcki >, & T lldazir..� 142 Corporaflon Street OR OWNED q es 94 . DATE PERMIT ISSUED f ' S 4DATE COMPLIANCE ISSUED a —� Gov'y� ��.� �� ,... " �a � .��: �o (i^b Q S s P� - T �` �� — -- �. ` r N ` � z. .a @ ® �\ o -°� 1 �/ �,. l 0 ��` t � , Yam. � ` � ,ay' ,: ... No...$ _ .5° `� FHB........ `...............THE COMMONWEALTH OF MASSACHUSETTS ' BOAR® OF HEALTH e` "'"�................0 F...-,l !..` .......................................................... Appliration for Disposal Works ClAotrnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Syst ......6 ......... .. .,.. .............. 1 - .C.1.:. : 'A 4,................ --------.... r. j Locat'o� o.� •- ...{,:: � \15p� � _.__-- ---------- ------ ......... f... .._..._�h. :.... d? k � �/{/ y -- /~ Installer Address Type f Buildin Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—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. 3 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........................ 1� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_--____________----__-_. �+ 0 Description of Soil---------- . ..- - -- - - - U --- U Nature o epairs or Alteratio —Ans when a ble_.__ Q____ , Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITL% 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of C mpliance has been issued by the board of health._ Signe .. ............................................. ... at Application Approved By........... ...... ---••---- .............. -- .................•-••-- -•--•- S(i/71p ate Application ..... Disapproved for the o lowing reasons---------------•-----•-•---•-•--•------------------------------•-------------•--•----------•---••-------......._ ..----------•-•-----------•-••-•------------•------•----------------••-------------------............-•---•---•------•----------•-----•••=---•------•--••-----•------------------------------------•--- Date PermitNo......................................................... Issued....................................................... Date No...Z -.qt:Z- ............................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .�7 .................OF ..... ......................................................... Appliration for 11isposal Works Tonstrurtion Frrmit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal Systems .............................. ............................................................ ----------I.,. ............................ ..................................... L oca io"Ao_ or . ............. ..... ...................... je----------- caner Ad , 1.4 Installer Address r ............... 6...... .. ........ ......... .. ... ....................... .................... P Type 13 uildin Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder Other—Type of Building ............................ No. of persons........_._................. Showers Cafeteria Otherfixtures ...................................................................................................................................................... Design Flow.............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid*capacity............gallons Length................ Width__............__ Diameter-_._-__-____-___ Depth....__..._._._.. Disposal Trench—No. .................... Width....._.__....__..... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.._........._._..... Depth below inlet.................... Total leaching area..................sq. f t. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Per-formed by........................................................................... Date........................................ Test Pit No. I........... ....minutes per inch Depth of Test Pit..........._........ Depth to ground water____-__................. f14 Test Pit No. 2................minutes per inch Depth of Test Pit__.............._._.. Depth to ground water........................ P4 ...r�_------------I..................................................................................................................................... 0 Description of Soil.......... ...............................................................................I.............................................. ..................................................................................................................................... ---------------------------*--------------------------------- .................................................... ----------------------------------------------------------------------------------*----------------------------------I-------------------------------- - U Naturegf-4epairs or AlteratioXLk—Ans)y4r when ayp4able........... 49 0 O-Z ........... - ------- )-- r ............. . ..................................I...................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of ompliance has been issued by the board of health. 00e Signe .• ..... ... .... .............................................. .... ...... ................. atg Application Approved By.......... .......... . ...... . .................................... ........�/ Date Application Disapproved for th f 11owing reasons:................................................................................................................. ......................................................................................................................................................................................................... Date ...................................... ........... Permit No......................................................... issue& .. .. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH f 5, 0 F.. ......... .............................................................. ......... Cluntifiratr of Tompliaurr 1 TH4 R ons 0 CERTIFY, That the Individual/8ewage Disposal SptAn c t or by........TU 4 ........... ..... ...7R. r Installer at........................... ........... ------------- ........... ------------ ----------------------------- ha's been installed in accordance with the provisions of TIT LE' f) of The. �takra_.Aiil z ode as described in the application for Disposal Works Construction Permit No..AC.-- . ........... dated----- ...................... THE ISSUANCE OF!'THIS CERTIFICATE SHALL NOT BE C STRUED AS A G �R NEE THAT THE SYSTEM WILL PUN TION SATISFACTORY. - STRUED t Z DATE............ .......................................... Inspector.......' .... ...b-------- - - ....... us TT THE COMMONWEALTH OF�,MASS HUSETTS��,,�,,i;.,,. BOARD,QF HEAj_TH ...... OF. ................................................. FEE.... Bill 11 at paks Tons!r it rMit 0 a' ..............4-e.......... Permission is hereby granted__ ................ ............ .............................................. s sal-S to Construct ( jr.Repair diw4&d age stem_-,I' ............. ....... ........... ....... i_` .. .... ........................ Street . ... ... .......................... as shown on the application for Disposal 'NAT s Construction Permit N085tt.!.S*L... Dated..... --------------- Board o ea .......................................... ......... DATE.. 1:C5----------------- ------------- FORM 1255/A. SULKIN, INC.. BOSTON