HomeMy WebLinkAbout0161 RIDGEWOOD AVENUE - Health w, 161 Ridgewood Avenu ,
Hyannis, MA 02601
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SEWER
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Town of Barnstable Health Inspector
Office Hours
Regulatory Services 8:30-9:30
Thomas F.Geiler,Director 1:00—2:00
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9� � Public Health Division
A�F p MAC s Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
AMNESTY PROGRAM APPLICANT — SEPTIC QUESTIONNAIRE
1. General Information: Size of Property: %3 QS'- S`/-
Address: 16 / ;R1`D9 e LJW& p 4ye Map es Parcels
Name: 13A R&A/Z A k&MiQ ASke/l Phone #: SW-A04. 0!t7 1
t 2a. How many bedrooms exist at your property now? J
2b. Are you planning to add any bedrooms? y�S If yes, how many?
2c. How many bedrooms total are proposed at this property (including the amnesty unit)T
2d. Please include a copy of the floor plans for the entire property - showing--the existing
rooms in the home plus the proposed amnesty apartment and/or addition. Plcase Nail
each room clearly on the plans.
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3. Is the dwelling connected to public sewer? YES or NO
If the dwelling is connect sewer,skip questions#4 through#9 below.
4. Location of dwelling is �INSIDEor OUTSIDE a Zone of n to public supply wells?
5. Is the dwelling connected to an ONSITE WELL or to PUBLIC WATER.
6. Is a disposal works construction permit on file? YES or NO
6a. If yes,how many bedrooms were approved according to this permit? Bedrooms.
7. Were any building permits obtained for construction of additional bedrooms? YES or NO
8. Is there an engineered septic system plan on file at the Health Division? YES or NO
9. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO
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FOR OFFICE USE ONLY
The Public Health Division has no objection to bedrooms at this property.
Special Conditions:
Signed. Date:
Q,lhealth/wpfiles/amnestyapp
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HASKELL; HYANNIS MA DATE 3/II/O6 DESIGN BY: Q �DT deMARt
BIRCHACL CONSULTING il�/7 I\ I I I I \VI
SCALE 1/4"-1'-0" 37 TURTLE CODE ROAD
EAST SANOMCH.IAA
508-888-274/ y,...(� O C
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FOUNDATION; SECTIONS REV
a DESCRIPTION DATE P.O. BOX 622
REVISIONS APPD Ns EAST FALMOUTH, MA 02536
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DATE 3/II/06 OESOB BY:
HASKELL; HYANNIS MA 17—TLLLCDNSOLTI"� BERT del\IAR-EIN
1 1 - SCALE I/4eel:_�. EAST LE . ROAO
EAST SANOWCN,YA D B A A B O D E
SOB-BBB-vWl
ELEVATIONS DRAWN PCB
REV
«DESCRIPTION DATE P.O. BOX E-22
REVISIONS APPD N5 EAST FALMOUTH, MA 02536 -