HomeMy WebLinkAbout0062 TOWER HILL ROAD - Health 62. Tower Hill Road
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SENDER: COMPLETE THIS COMPLETE THIS DELIVERY
s Complete items 1,2,and 3.Also complete A. S' na
item 4 if Restrigted Delivery is desired. X �)c — ��"t
■ Print your name and address on the reverse ❑Addressee
so that we can return the card to you. B, eoeived by(Printed Name) C. Date of Delivery
,■ Attach this card to the back of the mailpiece, LG -a 7
or on the front if space permits. UQ ,t-e
D. Is deliveryaddress different from item 1? ❑Yes i
1. Article Addressed to: If YES,enter delivery address below: ❑No
3. Service Type I
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❑Registered ®Return Receipt for Merchandise
❑Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2.rArticle Number
(rransfe rrom service tebep i 37.0 0 6 0 81,O e 0 0 0z;3 5 2 4;,9 RO 4.1 s
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PS Form 3811,'February 2004 j.S I r ; bomestic Return Receipt 102595 oz-M-lSao
UNITED STATES POSTAL SERVICE. First-Class Mail
Postage&Fees Paid
LISPS
Permit No.Cr70
I
• Sender: Please print your name, address,and ZIP+4:in this box,•
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(CT II•I Town of Barnstable r3
�J Health Division o
200 Main Street
Hyannis,MA 02601
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Certified Mail#7006 0810 0000 3524 9704
Town of Barnstable
Regulatory Services
AARNSTABLE,
9 MASS` Thomas F. Geiler,Director
�t3 i639•
0MAt°r Public Health Division
Thomas McKean, Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
April 23, 2007
Priscilla Hostetter
770A Main Street
Osterville, MA 02655
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 62 Tower Hill Road Osterville, was inspected
on April 22, 2007 by Meredith Morgan, Health Inspector for the Town of Barnstable.
This inspection was conducted on the basis of the rental registration in accordance with
Chapter 170 of the Town of Barnstable Code.
The following violations of the Town of Barnstable Code were observed:
170-10—Smoke Detectors and Carbon Monoxide Alarms. No smoke detector in
basement.
You are directed to correct the violations listed above within twenty-four (24) hours
of your receipt of this notice by installing smoke detector in basement.
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.
QAOrder letters\Housing violations\Rental ordinance\62 Tower Hill Road.doc
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.
PE5as
DER OF TH BOARD OF HEALTH
L"
. Mc ean, R.S., C
Director of Public Health
Town of Barnstable
Cc: Brian Thompson, Tenant
Cc: Meredith Morgan, Health Inspector
QAOrder letterMousing violations\Rental ordinance\62 Tower Hill Road.doc
FORM30 &w HOBRSB WARREN TM THE COMMONWEALTH OF MASSACHUSETTS
B 0
jtRD OF HE LTH
CITY/TOWN
W
o DER TMENT
� ) "jawcr )is &6f
o ADDR S
GSM SVOy`eu SCi�1/N,�
TELEPHONE
Addres,= -�� O( �4�,__ Occupa - drTh
Floor Apartm o. No. of Occupants
No. of Habitable Rooms No.Sleeping Rooms_
No.dwelling or rooming units_ 1N�o.Stories ^�
Name and address of ownerl?-r — i , Pi1r�
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:
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,Vents: did
PLUMBING: Su ply Line:
❑ MS ❑ ST ❑ P Waste Line:
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
Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks
Kitchen
Bathroom
Pantry
Den
Living Room
Bedroom 1
Bedroom 2
Bedroom 3
Bedroom 4
Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.:
Stacks, Flues,_Vents,Safeties:
Kitchen Facilities Sink
Stove
Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.:
Wash Basin,Shower or Tub:
Infestation Rats, Mice, Roaches or Other:
Egress Dual and Obst'n:
General Building Posted
Locks on Doors:
ONE 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 IN TION ORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND
PENALTI S U "
INSPECTOR TITLE C.i7 U Y
�/� .M.
(J DATE TIME P.M.
A.M.
THE NEXT SCHEDULED REINSPECTION P.M.
s
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 11, 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 no 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 410.201 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 105 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 may expose the occupant or anyone else to fire, burns,shock, accident or
other dangers or impairment to health or safety.
(L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating,
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 uncorrected 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 b 105 CMR 410.503 A and 410.503(B).
q Y O
(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.
1nSpeco �
2�2 . 22
Parcel Detail Page 1 of 3
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Pa re Detail
Parcellnfo
Parcel ID Developer
141-117 002 Lot..LOT 2
Location'62 TOWER HILL ROAD Pri Frontage
Sec Road Sec i
Frontage
.. ....------
village'OSTERVILLE Fire District C O MM
..._.._----- ---___-
Sewer Acct£ Road Index 1729
Interactive
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Map ,
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Owner Info
_.._
Owner iHOSTETTER VINCENT M & Co-owner HOSTETTER PRISCILLA M
_. ...... ........................ ......-........ ........ . ._..__._...
Streetl 1 770A MAIN ST Street2
........ .. _..... ...._... ..... ....... .. ............. ..... ......... ....._. .._ .......... i..............
City OSTERVILLE State,MA Zip 02655 CountryluS
Land Info
-...
Acres'0 47 use'Single Fam MDL-01 zoning BA Nghbd 0108
_ _,__ _ _._..__ ,__.._............
Topography'Above Street Road Paved
utilities'Septic,Gas,Public Water Location
Construction Info
Building I of I
Yearf.. _. ,a Roof .._.._...__.__. .__.__.-_._.__;; Ext _ .. . _....._.
Built; Struct Gable/Hip Wall Vinyl Siding
Effect; Roof _.._._.______ __. AC
Area
1083 Cover:Asph/F Gls/Cmp Type None
.....
Style}:Ranch � Int Drywall Bed 2 Bedrooms
Wall ..�, .e. Rooms W m — n
Bat
_.... . ,,...._ ._.._._ ...,,...._ _� _.,_._.._ _.........._.__. ,. _
Model£Residential Floor Rooms E 1 Full
__... _ _ ....
Grade;Average Heat Hot Water Total 4 Rooms
Type ... ... . Rooms
http://issgl/intranet/propdata/ParcelDetail.aspx?ID=9089 2/22/2007
Parcel Detail Page 2 of 3
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- ... .......... . ._. �3
Stories!1 Stor Heat Gas Found- Poured Conc
Fuel ation
Permit History
............_...._.._ ...._._ _.._ .................. ....... ....._ . _.__..
Issue Date Purpos Permit Amount Insp Date; Corn
4/1/1990 B33665 $40,000 2/15/1991 12`00:00 AM OS 1
Visit History
Date Who Purpose
12/29/1998 12:00:00 AM Donna Dacey. Mea + Corrected Listing
1/15/1991 12:00:00 AM ML
Sales History
Line Sale Date Owner Bookl a e Saie
1 3/15/1990 HOSTETTER,VINCENT M & C120064
Assessment History
Save# Year Building Value XF Value OB Value Lard Value Ta al Pare(
1 2007 $120,000 $0 $0 $228,700
2 2006 $105,400 $0 $0 $215,300
3 2005 $102,000 $0 $0 $198,000
4 2004 $82,700 $0 $0 $198,000
5 2003 $74,800 $0 $0 $129,100
6 2002 $74,800 $0 $0 $129,100
7 2001 $74,800 $0 $0 $129,100
8 2000 $60,500 $0 $0 $55,300
9 1999 $60,500 $0 $0 $55,300
10 1998 $64,300 $0 $0 $55,300
11 1997 $62,800 $0 $0 $48,000
12 1996 $62,800 $0 $0 $48,000
13 1995 $62,800 $0 $0 $48,000
14 1994 $61,800 $0 $0 $43,200
15 1993 $61,800 $0 $0 $43,200
16 1992 $70,200 $0 $0 $48,000
http://issgl/intranet/propdata/ParcelDetail.aspx?ID=9089 2/22/2007
Parcel Detail Page 3 of 3
-Photos
htt ://iss l/lntranet/ ro dat _p q p p a/ParcelDetail.aspx.ID 9089 2/22/2007
i
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Town oi .Barnstable
Op SHE T0� -N�
Regulatory'Services
x BARNSrA6LE, Thomas F. Geiler, Director
9 MASS.
°o 3.639. Public Health Division
ArfD MAC a.
Thomas McKean, Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
April 23, 2007
Attn: COMM Fire
Health Inspector Meredith E. Morgan conducted a rental inspection in accordance with
Chapter 170 of the Town of Barnstable Code. In accordance with the State Sanitary
Code, 105 CMR 410.482, the Health Department is required to notify the Fire
Department if there is a smoke detector violation, or possible smoke detector violation.
The following property had possible smoke detector(and\or CO detector) violation(s):
62 Tower Hill Rd. Osterville Assessors Map-Parcel: (141:117):
Smoke detector lacking in basement.
re rth E. Morgan--Health Inspector
Q:\Order letters\Flousing violations\Rental ordinance\\Fire ViolationsTIRE TEMPLATE.doc
Ce TOWN OF BARNSTABLE
LOCATION 1 ocseR I�.�i 11 4 c , L-0+� SEWAGE # CIS•
VILLAGE ()Sj-eg ji ASSESSOR'S MAP 6z LOT W14 to 466 J
®INSTALLER'S NAME & PHONE NO. 6oad, ,. -f,3umjesc
SEPTIC TANK CAPACITYb �4 {
LEACHING FACILITY:(type) (size) /oD,(:64
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: -:p /z �
VARIANCE GRANTED: Yes No
Irpl -
ASSESSORS MAP NO:
No ....... PARCEL PARCEL NO.: 111
- _-- SEPTIC SYSTENf DSf•8C-.....-
THE COMMONWEALTH OF MASSACHulKWALLED IN COMPLIANCE
BOARD OF HEALTH WITH TITLE 5
ENVIRONMENTAL CODE ANr-
T0"'REOULA '"4 ?;
Applira#ioo for IlioVviial Workp Tonstrur#ion Urrutit
Application is hereby made for a Permit to Construct (L,�`or Repair ( ) an Individual Sewage Disposal
System at: �� \
... ------------ ...... ........ ..-•-------------- -•---......-----..........._...........__.
Location_Address or Lot No.
-• N�. ...._.Lksa i_L-� h � a !JS 5 `
. ...... ... ... ... . ------- LL�.....................
..........
owner ....
Address
a
Installer i*`' Address
Type of Building/ Size Lot----igj.�C)...�q. feet
U Dwelling—No. of Bedrooms............... .....Expansion Attic oj) Garbage Grinder (NI)
Other—T e of Building No. of persons............................ Showers — Cafeteria
. Other fixtures .-------•---=------------------•---•------------------.--------•--•--•-----•-------------------•----------•--------•---.......--••----•..........._...
W Design Flow............................................gallons per person per day. Total daily flow
_._.............._......_...................gallons.
WSeptic Tank—Liquid capacity_1 .gallons Length................ Width................ Diameter---------------- Depth................
x Disposal Trench—No. .................... Width.................... Total Length................... Total leaching area....................sq. ft.
Seepage Pit No------------I-------- Diameter..........1 .... Depth below inlet.......'51 S_.... Total leaching area._.'552 ---sq. ft.
Z Other Distribution box ( ( ) Dosing tank ( )
'-' Percolation Test Results Performed by___...._ 1� ....... �---.--- _ ... Date.....L-A\ .- 9(0..........
Test Pit No. I........Z?...minutes per inch Depth of Test Pit.......I':. ...... Depth to ground water...O
µ, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-__-•_--------.-
w' —,I...............................................•---•----------.............._....-) .
O Description of Soil....0 S----.... ....................................................................'
x ................................t ................•---
.. .-•-••-•------•••------•-
W
UNature of Repairs or Alterations—Answer when applicable.........................................................:..:..................................
.. .---•--------•-----------------•-----..........------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System,in accordance with
DE,`f1�� ai� l. US�{ he State Sanitary Code— The undersigned further agrees not to p ace the system in
;�Sc� cfti��j�e� t �ST IOIJ gas bee issue by the board of health.
r=Y
THE SYSTEM WAS INSTALLED IN R ING d.._..
ACCORDANCE TO PLAN. I • •---•..............•-- ..... •.
Date
ApplicationApproved By............ .....................-----................:....................................... _
Date
Application Disapproved for th following reasons:-----•..........................••-•----------------•-•-------•-----•----------- ---------
------------------
-
--------------------•-•-•----•----•-•.....---•-...-----•.._...---•---••------••-•---••---•-•-•••------..:........--••--....-----•-•---•----•-----...-----•-•-----------•-• --•--------•-•-••------------
Permit No.--••------d � -- ----------------
--- Issued-...........................................
Date -----
Date
No......................... Fss................
....__
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...----...........:.......................O F.......................................-----............................................--
Appliration for Bispoiittl cWorks Tonstrudion "amit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
................_........_............................................•••................._..... .......-••--•.._.......-•••......-•--••••••••.................-•••................................
Location-Address or Lot No.
......................_--....................-•---.....------............•......_...._........... -•-•........._...-------•..................•-••--.....».........................................
Owner Address
W
Installer Address
Type of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms.......................:. .....Expansion Attic ( ) Garbage Grinder ( r)
,.
14 Other—Type T e of Building No. of persons............................ Showers
w yP g --------•----•.............. P ( ) — Cafeteria ( )
G4Other fixtures --------------•-•-•------------•----•--..........-----.-----......--------------------•-----•.....---.................................---•--•---------
d
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........................................
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........................
P4 --------------------------
-------------------------------------
-......
----------
•----------•-.••--•-•••..........
....
_.....
•.......
-.....
.--------------
•••-
0 Description of Soil.........................................................•-----------.......-----------•----........--------............-•-•--------...------•..._......................
V .....................
W
----•-------------------------------------•--------------------------------------------•--•--•---------•-----••----------------------•-----------------.....-----•----•-------.............._...__.....
U Nature of Repairs or Alterations—Answer when applicable................................................:..............................................
...----•--------------------------•-••-----.•.........---...........-•-•------•---•--------.......-•-•------•-•-------------•--.....---•-•------•--•--------•-•--•-•--•-....--•...•-•--........._......
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of T I TLE 5 of the State Sanitary Code The undersigned further agrees not to p ce the system in
operation until a Certificate of Complia ce has been issued by the board of health.
-------------------------------•---•--... ��.. ._....
Date
ApplicationApproved By----------------•-•----.._..............--•--•-•---------.....--•--•-•--•---....------•--......_ .......................................
Date
Application Disapproved for the following reasons:................................................................................. N
..............................•----.•......----..........._--•--•-•---•--.•---- ..
•......-•-•-----.. ...-----•---•...............------..._._.......------------•---- ...........................
Date
PermitNo...................................................--- Issued......................................................_
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.............. .......................OF.....................................................................................
Trrtif ratr of Tomphatta
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by ..............•....._........... ---••-......•-•-•.. _.....-••--•-••---•--•....................-••-•--•-......................_........ .__..._
/ l aaller _
at.. ...�..... rr��- u `.1- ���.. ........�J.�/�_H_� �c........... ff .�...= 5 ....
Ras been installed/'in accordance with the provisions of TITLE 5 of The State Sanitary 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
SYSTEMI-egl
FUN ION SATISFACTORY.
DATE.. Inspector. . ® •. •-........ • --•----•-
1/
4 1 THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
No....- ...........................................OF.. ......................................... .................................. F> ........................
f a
�i� o�ttl for � �on�tr�rtion rrmit
Permission is hereby granted.....•-_.. ,t G -- •---- �---•--....---••••••-•--••...................................._......
to Construct ( ) or Re air ( )�an Individual Sewage Dispo System
at No..��T..� ..... f/ l/............ S��sv/�(c. -/�-/y _ d e G.`?..5.^................... .......--•-
77 ...... .._. ............�
Street $} c f!
as shown on the application for Disposal Works Construction Permit No. . . —7... Dated..................(_.....:_..............
-•............................•--- .1�-- - t - -........_
Board of Health �..
DATE.....................................................................--•--•••_.. (�
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TOWN OF BARNSTABLE
LOCATION -Tawee 14; 11 (� _ I of- -7- SEWAGE # F�- .595r
VILLAGE n 4ot_'J;l l e ASSESSOR'S MAP 6z LOT_V4j
NSTALLER'S NAME & PHONE NO. 1 +epnp+sS �I2�r—SG4D
\SEPTIC TANK CAPACITY =3 o� v
LEACHING FACILITY:(type) (size) 40 r
NO. OF BEDROOMS ®Z PRIVATE WELL OR PUBLIC WATER h;1
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
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