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Home My WebLink About0990 MAIN STREET (OST.) - Health 990 Main Street , Osterville o T A= J w f, � R 4 i i P' is 0 n 9 I n TOWN OF BARNSTABLE LOCATION T b 42hl/f S% SEWAGE # VILLAGE r ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. iUS Q X/ 7 71' SEPTIC TANK CAPACITY 4 LEACHING FACILITY: (type) (size) ®L �x NO.OF BEDROOMS _ yBVZNR OR OWNER PERMTTDATE: 7 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) # Feet Furnished by ` 1 Wl 9 7 e 1 � � 0 ' l es, l•- 7 �. No. �/ Fee 40 .00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0[pplication for IW5p dal *p5tem Conelruction Permit Application is hereby made for a Permit to Construct( )or Repair( x)an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 990 Main St Bill Warburton Osterville 428-7070 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. W.E. Robinson Septic Sery P.O. Box 1089 Type of Building: Dwelling No.of Bedrooms 4 Garbage Grinder( n)O Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Description of Soil sand Nature of Repairs or Alterations(Answer when applicable) install 4 stonepacked infiltrators 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 issued by this B d o ealth ,�� / Signed C�► �! Date /� [,, i Application Approved by Ljr Application Disapproved for the following reasons Permit No. li��5 Date Issued y,,... 4.. .. )1{ .✓• ,. A<"r.�',frL Y�°`•'•-...y-. .. .,.'.y^' 4 } ../ ^ .w-- --. -..-... �..' .r .. f..a .., r.,( _. 40.010 No. "' J Feeri�., THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS - 2pplicatiou for Digpool *p5tem, Co:ngtrurttou Permit Application is hereby made for a Permit to Construct or Repair an On site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 990 Main St Bill Warburton Ostervil&e 428-7070 Installer's Name,Address,and Tel..No. Designer's Name,Address and Tel.No. W.E. Robinson $NOptic -Sery P.O. Box 1089 z, :x . Type-of Building: t , Dwelling No.of Bedrooms 4 Garbage Grinder( n)O Other Type of Building No. of Persons Showers( ) Cafeteria( Other Fixtures d 1: -p Design Flow NN gallons per day. Calculated daily flow gallons. L Plan bate Number of sheets Revision Date Title Description of Soil sand f :».✓` Nature of Repairs or Alterations(Answer when applicable) install 4 stonepacked infiltrators' 3 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 issued by this B o ealtly Signed Date —/ j `' Application Approved by Application Disapproved for the.following reasons i r Permit No. L '.0 ... Date Issued ` 4x THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Certificate of eomplianrt�ll - THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced( X)on by W.E. Robinson Septic Sery for Bill Warburton as 990 Main St Osterviile has been constructed in ac ance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated 1 Use of this system is conditioned on compliance with the provisions set fo below: yNo. Fee 40.00 " - THE COMMONWEALTH OF MASSACHUSETTS WarburtonPUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS a . Digpool *pgtem Con!Aruction Permit Permission is hereby granted to. W.E. Robinson Septic Sery to construct( )repair( )an On-site Sewage System located at 0 Main St Oster,4, 1le 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. All construction must be completed within two years of the date below. Date: Approved byrJ ,. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) I, / 1. , hereby certify that the application for disposal works construction permit signed by me dated concerning the meets all of the property located at following criteria: 1 • There are no wetlands within 300 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system • The observed groundwater table is 14 feet or greater below the bottom of the leaching facility • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. r I � SIGNED: Gti _ DATE: .2 LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. ----- lC� �4 � ,, �_ ,; � , s �'� ,- �--- ,' i �� / �. _ . _ .- f VO Commonwealth of Massachusetts ® .. Executive Office-of Environmental Affairs Department of AUC 2 J Environmental Protection- WWM F.Weld t OMM /®, Tndy C•xe Algeo i9au1 CNhsod DOW B.Shuhs SUBSURFACE SEWAGE DISPOSAL SYSTEM.[INSPECTION FORM .S PART A //�� CERTIFICATION - l �T Property Address: Address of Owner. Cvm� ��J'/•�U/r�/� / Date of Inspection. 7— / 7 — (If different) Name of Inspector. W,E. Robinson SR Company Nam*,Address and Telephone Numbert 5 0 8) 7 7 5-8 7 7 6 W.E. Robinson Septic Service P.O. Box 1089 Centerville MA CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of inspection. The inspection was performed based on my training and experiF:hce in the proper function and maintenance of on-site sewage disposal systems. The system: r//Passes _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority _ Fails Inspector's Signature: �'' Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicat4 and the approving authority. i INSPECTION SUMMARY: Check A,B, C,or D: A) 7 m PA1MAEet I have not found any information which indicates that the system violates any of the failure criteria es defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. Bl SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or sepal jerl. The system,upon completion of the replacement or repair,passes Indicate yes,no,or not determined(Y,N,or ND). Describe basis of determination in all instances. If"not determined",explain why not) The septic tank is metal,cracked,structurally tumound, shows substantial infiltration or ezSltration,or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a ponforming septic tank as approved by the Board of Health: (revised 11/03/95) 1 One Winter Street a Boston,Massachusetts 02106 Is FAX(617)556-1049 a Telephone(617)2924= 0 Printed on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A a n y CERTIFICATION(contGinued) Property Addrreas: cl q6 //�7� 1 ` N ��J ��P f0'� owner. 0✓rA .. i�✓�,r/i�.� -i r� Date of Inspection: ` _Q B1 SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed C) ER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: ditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the pu lic health,safety and the environment. 1) SY TEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) BTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER,IF APPROPRIATE) D INES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND 8 AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a purface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is fee from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than ppm. 9) O (revised 11/03/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Addeeas: Owner. Date of Inspection: D] SYSTEM FAILS: determined that the system violates one or more of the following failure criteria as defined in 310 CMB 15.303. The basis for determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the fail _ Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6"below,invert or available volume is less than 1/2 day flow. Required pumping more than 4 tunes in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. _ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E]LARGE IYSTEM FAILS: following criteria apply to large systems in addition to the criteria above: tem serves a facility with a design flow of 10,000 gpd or greater'(Large System)and the system is a significant threat to public nd safety and the environment because one or more of the following conditions exist: the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area(IWPA)or a mapped Zone II of a public water supply well) Z=mjenof rator of any such system shall bring the system and facility into full compliance with the groundwater treatment program 14 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information.. (revised 11/03/95) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST r - ownsProperty Asa. owner. Date of Inspection v� Check if the following have been done: ping information was requested of the owner,occupant,and Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. /As built plans have been obtained and examined. Note if they are not available with N/A The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow The site was inspected for signs of breakout. 1/All system components,excluding the Soil Absorption System, have been located on the site. ✓The septic tank manholes were uncovered, opened,and the interior of the septic tank was inspected for condition of baffles or /tees,material of construction, dimensions,depth of liquid,depth of sludge,depth of scum. //The sire=Thefacility and location of the Soil Absorption System on the site has been determined based on existing information or ted by non-intrusive methods. _ owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub- Surface Disposal System. I (revised 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C , SYSTEM INFORM�A-TION d Property Address: cj q 1�� `�✓ a /J f /��r��`J Owner: Date of Inspection: FLOW CONDITIONS RESMENTL4JU Design flow: llons Number of bedrooms:411E Number of current residents: Garbage grinder(,yes or no):� _ Laundry connected to system(yes or no):Y Seasonal use(yes or no): A,o Water meter readings,if available: ICI 9'6/ '7`� i Sir//-S Last date of occupancy: 2 COMMERCIAL/INDUSTRIAU Type of establishment: Design slow: gallons/day Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Non-sanitary waste discharged to the Title 5 system: (yes or no)_ Water meter readings, if available: Last date of occupancy: OTHER:(Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: --?61 ,-lp e04 It 0, e - System pumped A part of inspection: (yes or no)_ If yes,volume pumped: gallons Reason for pumping: TYPE O YSTEM Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records,if any) \ Other(explain) APPROXIMATE AGE of all components,date installed(if known)and source of information: .{�VA.< -d!!�c/ 7 Sewage odors detected when arriving at the site: (yes or no) LO (revised 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C + SYSTEM INFORMATION(oo tiuued) Property Address /✓1 ;J>f'7 �'�" a<S / l/� Owner. Date of Inspection: ?^1.7_q t. SEPTIC TANK_v (locate on site plan) Depth below grade: T Material of construction:_concrete metal_FRP_other(e:plain) CZ Dimensions: fV `-1 Sludge depth:_ o Distance from top of sludge to bottom of outlet tee or baffler Scum thickness:_ . Distance from top of scum to top of outlet tee or baffle:_ Distance from bottom of scum to bottom of outlet tee or baffle: Comments: (recommendation for pumping,condition of inlet d outlet tees or balffles,depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage,etc.) C; -- .0� e G E AP: (locate o sTRite plan) Depth bel w grade: Material o construction:_concrete_metal FRP_other(ezplain) Dimensio Scum ess: m top of scum to top of outlet tee or baffle: Distance m bottom of scum to bottom of outlet tee or baffle: Comments: (reoommen tion for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity, evidence of ,etc.) (revised 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C 1 SYSTEM INFORMATION NN-(continued) Property Address: ' /Vl . �r ��'/ / ��'�✓ Owner. Dade of Inspection: TIGW OR HOLDING TANK:_ (locate site plan) Depth grade: Material constmction:_concrete_metal FRP—other(explain) Dimeasi0 Capacity: or" Design w: Gallons/day Alarm 1 1: Comments: (condition f inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX:_ (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of boa,etc.)-6- 4 PUMP BER:_ (locate on plan) Pumps in wor ' order:(yes or no) Comments: (note condition f pump chamber,condition of pumps and appurtenances,etc.) (revised 11/03/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C Gj �/�,� SYSTEM INFORMATION(continued) Property Address: / Q � /i �/ �/CX'- f/�/j Owner. fi(/ /1't I Date of Inspeotion: _ .L / SOIL ABSORPTION SYSTEM(SAS):_✓ (locate an site plea,if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present,explain: Type leaching pits,number: leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: Comments:(note condition of soil,signs of hydraulic failure, level f ponding, tion 9f vegetation,etc.) ® ® -I— d a. ✓✓.a C.lC ' Glk b — 4 CESSPOOLS:_ (4oflayer: site plan) Nd configuration: Dliquid to inlet invert: Do layer- Depth layer: Ds o cesspool: Mf astru Lion: Iof water: w(cesspool must be pumped as part of inspection) Comments condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) PRIVY:_ (locate on site p ) Materials of oo n: Dimensions: Depth of solids• Continents:( n of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) (revised 11/03/95) 8 s SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address cl (J / G n 6V f7 J 7 / Fes///e, Owner. '-(JM - 1,(-)h i-/a r f40 Date of Inspection: 7 SKETCH OF SEWAGE DISPOSAL SYSTEM: include tier to at least two permanent references landmarks or benchmarks locate all wells within 100' Sly✓ 45 w . , DEPTH TO GROUNDWATER Depth to groundwater. 11r)— feet method of determination or approximation: (revised 11/03/95) g . 1 LOCATION SEWAGE PERMIT NO. ' 19,d VItL E A & B CESSPOOL SERVICE ` 128 BISHOPS TERRACE, HYANNIS, MA 02601 BUILDER OR OWNER DATE PERMIT ISSUED S DATE COMPLIANCE ISSUED r sf• f I S r �� K �- (� ,. --- � a� � M in "O � �. ,•, ' .� ^�,�` 1 e � �' _ No.. a 5..0......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............................ own. .OF..........Barnstable.... Appliration for llhipvii al Works Tonitrurtion rantit Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal System at: .......290..Ma in_Street,...Os t e ry i l l e.,...MA.....0 26 53 ......--•---•------------------------------------------------ • ...---- ocation-Address or Lot No. William Warb on, III 0 Main Street 0 to v' e 6 .......--•.....................•. ----•-....................................... 94__..... - �..... ...__ .. 1 -----R2,..5L......... Owner Address A & B_ Cesspool Service e Inc. 128 Bishops Terrace,..Hyannis,,. MA 02601 ............................. Installer Address Type of Building Size Lot............................Sq. feet a Dwelling—No. of Bedrooms....................... ......._...._..._..Expansion Attic ( ) Garbage Grinder ( ) p., Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' 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. 2 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...................... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ----•-••-----------------------•......_..................................................................................................................... O Description of Soil.....Sa?�............... x U ......-•-----•-------------•------------...---•-------------------------------------•••-••-----•-------•-•--•---•••---------------------•----------------•--•-••----•-•--...---•----------•--.-----•----- w ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable...Abandorl___greserlt--.system--to-- � t ]. a.�...... _1,000 .ga1...._septic_tank,_..d-box_and._a..1,000 --- 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 Compliance has been issued by the board of health. Signed912 ....-. ?___ °.. ... ,�? J.�-........ -2125�85.....-_. D to Application Approved By--------- -------- -- ------ . ................................ ..........212578 ............ Date Application Disapproved for th Blowing reasons:................................................................................................................ ................•---.......----•--•-------•--------••--•------------•--••--------..._........--------.••. / Date Permit No........85........................................... Issued-----------2` 85 251 ....... Date k, No.8..5-........--....... F4...y5...OA........... THEnGO:MMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................_. Town.....OF.........Parnstable........................................................ ApplirFation for Disposal Works Tonstrut.rtion Prrutif Application is hereby made for a Permit to Construct ( ) or Repair (x) an Individual Sewage Disposal System at: et<....asterlcille_,...r A.....OZ .5. .................................................................................................. Location-Address or Lot No. William Warburtonr...III......... 99Q.I'la�ntsrKst, Qa�ter ].]s*..MA .O?6-55.......... Owner Address a .. . BCessool. e -•••• ...- . p . .•---------•--•---------•. i _: i hip ..Te x �e.� .3 ,vann ,..SS .....0261---..... Installer Address U Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a`4 Other—Type of Building No. of ersons...._..2.................. Showers YP g --•-•--••••...-••----•-..-- P ( ) — Cafeteria ( ) Otherfixtures -----------•------------------------------------------..-----------•------•------------- ............................................................. WDesign 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. I Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. , Zj Other Distribution box ( ) Dosing tank Percolation Test Results Performed by.......................................................................... Date........................................ 1 Test Pit No. I................minutes per:inch Depth of Test Pit.................... Depth to ground water........................ �14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ---•--••---••----------•------•---••......•---••................••--.........__.....------........--.....................................................' DDescription of Soil....5aAf ....................•.............------------------••---------------------------------•----------•-------------... --------------------------- '- x .. V W VNature of Rgeapairs or Alterations—Answer when applicable...Abe-adQ?I__U _isyreaeat- tem_.�-Q-_installa ,......... 1 000 1. •septic_tank,-.d-box-•and_- __1 j 000-•ga�llon1••_pe-cast,••stone--� cked.leach-•pit. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of1compliance has been issued by the board of health. Signed='............. Application Approved By.... / ....... �--••...--•-..--••- ..........-•--•-•--2� 5� 5 Date 1.•ti Application Disapproved for the 11 wing reasons:.......................... ................ . ?rr ------------------------------- ---•-•-------- .. :. Date 85 ; ...,. z 5 85 PermitNo......................................................... Issued -------.•-•--- -•••-----•----------------------- x,: Date r" THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................T own .....-..OF... aznstable........................................................ Trrifirate of Toap T�II 'IS. TO CERTIFY That the NMI' I Sewa e Disposal System constructed ( a or Repaired (x) b A & B Cesspool Service, Inc., bishop- Te�ace, Hyannis, MA 02doI 990 Hain S,.raet, Osterville, MA 0263�" r- William Warburton, III -�-- at......?,...........--------•--------- •-------------------------------------------•---------------------------------------------------------------------•-•-----------------•-----•---------------- has beeri\.installed in accordance with the provisions of TIT 5 of The State Sanitary Code ��l�s ed 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 SAT,ISF44CTORY. DATE..... f r z?....................................................... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �t Town Barnstable g5_ GI� ..........................................OF..........................._............ $ 15.00 1 No...........-•-..........# FEE........................ t: Disposal Works (VIT111notrttrtion rrutit A & B Cesspool Service.,...Inc. Permission is hereby granted -- --- -- ---------------• ----------------. ------ to Co s ruct or,Re air (x an I diuidual Se T e Dis osal System nq 0 Main)Streept, Qst�rvile=;N'A O�L�jS -_-William Warburton ---III at No...••••••......-••-•--------------••--------•-------...---------••------- ---..............L as shown on the application for Disposal Works Construction Permit No................. d.._.__._ �25/85_._._ ------- --- ••... --c--------••-----------..............._ Boa of Health V DATE--------------�--- -��-�,}._..--------..._....---•-----r- �._._..�. FORM 1255• A. M. SU KIN, IN ., BOSTON J