HomeMy WebLinkAbout0243 FALMOUTH ROAD/RTE 28 - Health (2) 243 FALMOUTH RD. RTE 28
HYANNIS
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No. Fee /
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
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PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,, MASSACHUSETTS
2ppricatiou for Migonl *p6tem CowAruction Permit
Application for a Permit to Construct( , )Repair( )Upgrade( )Abandon/ LCComplete System O Individual Components
Location Address or Lot No. Owner's Name,Address and Tel No.
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. / Designer's Name,Address and Tel.No.
�t�l�Cf/f7�`
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder(• )
Other Type of Building ,f e G No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or lter Non (Answer when applicable) /��1T17 ®!7 Lam, /S�/�l9 ;f dg">L1G
✓.�.c. ' w✓, we
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been iss this oar of ealth
Signed Date `7
Application Approved by + Date 0
Application Disapproved for the following reasons
Permit No. 'ate Date Issued b
` ---------------------------------------
No. 9cb Fee
THE,COMMONWEALTH OF MASSACHUSETtS Entered in computer:
YY
PUB-LICHEALTH DIVISION -TOWN OF BARNSTABLE,, MASSACHUSETTS
01pplication for Miqo5al *p5tem Construction Permit
Application,for a Permit to Construct Repair Upgrade(t Abandon m-lomplete System 0 Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
-7 '71
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder
Other Type of Building e&ftffel�e No.of Persons Showers Cafeteria(
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank —Type of S.A.S.
Description of Soil
Nature of Repairs or Iteratio (Answer when applicable)
'T
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issue-d-b s oard of .ealth -
Signed —Date.
A A
Application Approved by —Date
Application Disapproved for the following reasons
Permit No. 14 '5 Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY, that the n-site Sewage Disposal,System Constructed Repaired(Upgraded
Abandoned( by C,1h"5;Z:L,
at 2— 3 Ae-1-47104-JS has been,constructe4,to accordance
with the provisions of Tide 5 and the for Disposal Sys in Construction Permit No. 06at-l-t.;_Z dated W,6/0 V
Installer Designer
The issuance of this ppimit shall not be construed as a guarantee that the system"All fun 0 as designed.
Date f)tl Inspector )PL- cj
--———————————————————————————————
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION . BARNSTABLE,, MASSACHUSETTS
Mfi6pog;al *potent Construction Permit
Permission is hereby granted to C Repai Upgrade( )Abandon
System located at 17 13
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided: Construgtion must be completed within three years of the date f this pe
Date: �1-1610 Approved by
)OND. I I MALL
/ I LIQUORS
HOUSE #2
INTERSTATE
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SEWERED
293/2 r-
85.5' 80.5' ` ..
DNCRETE HEADWALL �i/ / / ` 293/43
INV=30.61 / Q
293/33
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1=32.27 DIVERS t / I
HOUSE249 I hIOUSE239 ` 880
I IOUrSE—#143 i f
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Town of Barnstable
o Regulatory Services
vSrnB Thomas F. Geiler,Director
9. Public Health Division
rED MA'S A
Thomas McKean,Director
200 Main St,
Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
May 23, 2003
Wayne Sullivan
PO Box 1309
Sagamore Beach, MA 02562
IMPORTANT NOTICE
RE: Map & Parcel 292-164
Dear Addressee:
You are directed to connect your building located at 243 Falmouth Road, Hyannis,
Massachusetts, to public sewer on or before August 29, 2003.
The Department of Public Works, Engineering Division, has notified us that your
property abutts recently installed vacuum sewer lines. The lines were extended because of
the density, and the size of the lots in the area, and the potential for serious health problems.
Failure to comply with this order will result in a complaint against you, in a court of law,
due to your failure to comply with a Board of Health Order.
If you should have any questions, please telephone me at 862-4644.
PER ORDER OF THE BOARD OF HEALTH
Thomas A. McKean, R.S. CHO
Health Agent for:
TOWN OF BARNSTABLE BOARD OF ,HEALTH
Wayne Miller, M.D., Chairperson
Susan G. Rask, RS.
Sumner Kaufman, M.S.P.H.
Return receipt requested
Cc: Barbara Childs, Water Pollution Control
Mark Giordano, Engineering
Q:Sewerorder.doc
own of Barnstable � D Ba ns bye
ti
Regulatory Services Department ;a'caC j
ABARNSTABLE,
te.
i6gq. Public Health Division
tb �� m
ArfDMA+a 200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
August 27, 2008
Certified mail 7006 2150 0002 1042 1047 C(DFY
Wayne E. Sullivan
PO Box 1309
Sagamore Beach, MA 02562
NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY
CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION
AND THE TOWN OF BARNSTABLE CODE CHAPTER 170.
` The property owned by you located at 245 Falmouth Road,Hyannis. was inspected .
on July 3, 2008 by Jaime Cabot, Health Inspector for the Town of Barnstable, because of
a Rental Inspection.
The following violations of the State Sanitary Code were observed:
105 CMR 410.351 —Owner's Maintenance Responsibilities. Gas stove oven not
working properly.
105 CMR 410.552- Screens for Doors.
Screen on Entry Door Torn.
105 CMR 410.504(A)-Non-Absorbent Surfaces
Tears in kitchen flooring and edge of tub not properly caulked.
You are directed to correct the violations listed above within thirty (30) days of
your receipt of this notice by repairing the gas stove, repairing or replacing the torn
screens and repairing the Kitchen flooring and the edge of the bathtub.
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.
Should you have any questions regarding the above violations, please contact the Town
Health Division and ask to speak with the inspector who performed the inspection.
PER O=cean,
BOARD OF HEALTH
., CHO
Q:\Order letters\Housing Violations\Rental Ordinance\245 falmouth rd.doc
SHF Town of Barnstable Barn
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Regulatory Services Department A&AmedcaC"j
+ RA.RNMBLE.
MASS. 0 D
039. Public Health Division
�ArfD Mpg 200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
July 11, 2008
Wayne E. Sullivan
PO box 1309
Sagamore Beach, MA 02562
NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY
CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION
AND THE TOWN OF BARNSTABLE CODE CHAPTER 170.
fqK W/V
The property owned by you located at 245 Falmouth Road, Hyannis. was inspected
on July 3, 2008 by Jaime Cabot, Health Inspector for the Town of Barnstable, because of
a Rental Inspection.
The following violations of the State Sanitary Code'were observed:
105 CMR 410.351 —Owner's Maintenance Responsibilities. Gas stove oven not
working properly.
105 CMR 410.552- Screens for Doors.
Screen on Entry Door Torn.
105 CMR 410.504(A)- Non-Absorbent Surfaces
Tears in kitchen flooring and edge of tub not properly caulked.
You are directed to correct the violations listed above within thirty(30) days of
your receipt of this notice by repairing the gas stove, repairing or replacing the torn
screens and repairing the Kitchen flooring and the edge of the bathtub.
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.
Should you have any questions regarding the above violations, please contact the Town
Health Division and ask to speak with the inspector who performed the inspection.
PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO
Q:\Order letters\Housing Violations\245 falmouth rd.doc
FORM30 &W HOBBSRWARREN'" THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
CITYITOWN
W � �taL-tH
b DEPARTMENT
2d o Ma rk sT� �,
ADDRESS
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''V/ TELEPHONE
Address Zy SAL-r'+d 't &�NJS—Occupantp,,�[i�;Sf- ►SIOS fMfi_Xsoa a4EVAt 40
Floor Apartment No. No. of Occupants 'L
No. of Habitable Rooms 44 No.Sleeping Rooms Z
No.dwelling or rooming units -2. _No.Stor es %.
fame and address of owner 4 P � ',A A,VJ o v OX I Soot I S 1/71t:p Remarks Reg. Vio.
YARD Out Bld s.: Fences:
Garbage and Rubbish
Containers:
Drainage
Infestation Rats or other:
STRUCTURE EXT. Steps,Stairs, Porches:
Dual Egress:and Obst'n.:
❑ B ❑ F ❑ M Doors,Windows: !2 p-0 4t t0 S'52
Roof
Gutters, Drains:
Walls:
Foundation:
Chimney:
BASEMENT Gen.Sanitation:
Dampness:
Stairs:
Li htin :
STRUCTURE INT. Hall,Stairway:
Obst'n.:
Hall, Floor,Wall,Ceiling:
Hall Lighting:
Hall Windows:
HEATING Chimneys:
Central ❑ Y ❑ N -Equip. Repair
TYPE: Stacks, Flues,Ven s. WNWAR-S IAM N fNAN !
PLUMBING: Supply Line: s 20V IL b
❑ MS ❑ ST ❑ P Waste Line: -( w o Lh�,iC D S�NcL A( O''I
H.W.Tanks Safety and Vent(s)
ELECTRICAL Panels, Meters,Cir.:
❑ 110 ❑ 220 Fusing,Grnd.:
AMP: Gen.Cond. Distrib. Box:
Gen. Basement Wiring:
DWELLING UNIT
jVentil. L to Outlets Walls Ceils. Wind. Doors *FloorsL�cks
Kitchen t — S 4,CAt- 'C' �. 1 &N G�1/L
Bathroom Q O-C A
Pant N
Den
Living Room
Bedroom 1
Bedroom 2 p
Bedroom 3
Bedroom 4
Hot Water Facil. Sup.Ten. ect.:
acks, Flues,Ven Safe'es:
Kitchen Facilities Sink ip-
Stove
Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.:
Wash Basin,Shower or Tub:
Infestation Rats, Mice, Roaches or Othe—r—
Egress Dual and Obst'n:
General Building Posted d 8! ?O 'I
Locks on Doors:
LONE 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 INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND
PENALTIES O PERJURY."
INSPECTOR « TITLE --HFAL"Glj _
A.M.
DATE A TIME IS
THE NEXT SCHEDULED REINSPECTION SA P.M.
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 II, 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'rio 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 410.231 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 1J5 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 maj expose the occupant or anyone else to fire, burns, shock, accident or
other dangers or impairment to health orsafety.
L Failure to in electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating,
( ) P 9 9 9 9 p p 9 9
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 unco-rected 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.
r �
TOWN OF BARNSTABLE
LOCATION P�X* / SEWAGE # ®� ! 3_
w VILLAGE 6I'�� ASSESSOR'S MAP & LOTo29"171- 1G'1�L'
INSTALLER'S NAME & PHONE NO. V P 910 ZL- 779 22-9
SEPTIC TANK CAPACITY
-- E R� U
LEACHING FACILITYAtype) (size)
R"76iR
NO. OF BED ROOMS _PRIVATE WELL OR CUBLIC WATER
BUILDER OR OWNER 5 `j 1V6XA/ i
DATE PERMIT ISSUED: ?%o
DATE COMPLIANCE ISSUED: loll
VARIANCE GRANTED: Yes No
1
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Ate. � ^ ��►. 1^
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-� �41110
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o....... .0. // Fns.....��...._...............
L/7�7
�'' THE COMMONWEALTH OF MASSACHUSETTS
r BOAR® OF HEALTH '
TOWN OF BARNSTABLE
C-
Appliration for Disposal Works Tonstrnrtinn lirrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal
System at:
................
s.• .. or Lot No.
Owner Add r ss
Installer Address
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 ( )
Pa Other fixtures ......................................................
W Design Flow...........................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity./SW--gallons Length................ Width................ Diameter................ Depth................
Disposal Trench—No.c................:.. 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........................
f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
9 -------------------------------------------------------------------------------------------------------------------------------------------------------------
0 Description of Soil...........I-------•----•----------•----------------------•-------------------- -----------------•--------•------------••-------------------------.........--------
(xj �,.. .-------•-----
As.
------------------------------------------- -----------------------------------------------------------------------------------------------------------
V Nature o Repair or Alterations—Answer when applicable-------f.N_�__- _&4=-_-_- _____ ................................
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 issuej by the board of health.
a
Signed .-�.... ...
...... ................
Application Approved By ----- ---------------------- - ff-�19
Application Disapproved for the following reasons- ---- ---- -----------------------------------------------------------------------------------------`...------ ............---
---------------------------------------- ----------------------------------------------- --------------------------------------------.............................................................. ------- ------------------------------
Permit No. -�'�-U.--�---� -------_-------------- Issued ------. ��te 1�a
Date
No...... ...._..y' Fimig ... ...........
„K THE COMMONWEALTH OF MASSACHUSETTS
+:ems•- .
BOARD OF HEALTH
(V_ TOWN OF BARNSTABLE
Applutt#ion for Disposal Works Tonstrnrtiun jrrmi#
Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal
System at:3
--.....: .y__.-__.� =m o_� ----------------- _ ............
!v'5....._.� 1 - .................................
o ation-A dre s or Lot No.
.... SrA-�L�(....._._. . _-? .............................
Owner Addr s
Installer Address
UType of Building �( Size Lot_____________•_.__--_..____Sq. feet
Dwelling—No. of Bedrooms.__--__._•__-_f____........._____\_---
Expansion Attic ( ) Garbage Grinder ( )
WOther—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__5W__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........................................
- W
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
f1 Test Pit No. 2................minutes per inch Depth of Test Pit____________________ Depth to ground water........................
aq .••--•-••-•---•---------•-•--•-•-••-•-__..._•••-•••-•-----•.............•-._...---•••-••-••------•--........................................................
ODescription of Soil..........................................................................................................................................-------••--••-•••------•-•-•-
W
U Nature of Repairs orAlterations—Answer when applicable-_______.(rv_�__7i L-�-_____. __._-/._ _C�________________
i
1`- 'J��•Q. : ---•--•----.-•-----------------------•••-...------•---•--..._......----•-------. ------.._..-----------------------------------------------....••••---•-•--
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
systeAin operation until a Certificate of Compliance has been issue by the board of health.
p
Signed ............... --------------------------........------ -- ...�... ....�Q.
re
Appli -.cation Approved By ... ----- ----- .................................................... ...1 --e0?a
. Application Disapproved for the following.reasons• -------------------------------------------------------------------------------------------------- ..............................
i Permit No. ......... /_U, --_---_---------------- Issued /l054----------------- -----
!!I J
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH /40 /C�
TOWN OF BARNSTABLE
(f.ez#ifiett#e of (gantylianre q
THIS IS TO CERTIFY', That the Individual Sewage Disposal System constructed ( ) or Repaired ( k)
by............ -�-------W..--e--1 -.Cn----..................................--------- .. --------.........--.....
---------------------------...-------- . ..... --...---------
,�� Ins[aller ,, " /nA
at --.�{ -.... ....L l.l'!'�.. ..... l.�-u.. `'l f'TCv.t)..`5 1...r 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. 9/)..^..4.�'f dated .� /y.��-j�................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE .THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE......1.G ''i 4-1 t ll�. �... ......................------------------------------- Inspector /.......................... ........................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
No.-. n TOWN OF BARNSTABLE FED I�-- -•1..�. ......
Disposal Works Tonstrnr#ilan 0ern i#
Permissionis hereby granted ....................I.......................................................................................................
to Construct ( ) or Repair �an Individuuallam Sewage Disposal System
atNo..2V.,?-... ,�� lvG�k`7�.:� F�f, ....... ...................................................................
Street as shown on the application for Disposal Works Construction Permit No.C7dLn 7S Dated./0/05 �_
E�.................
DATEl.�_ 1 �¢ -----------------------------------------------
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iFORM 36508 H088S R WARREN,INC..PUBLISHERS