HomeMy WebLinkAbout0026 HUCKINS NECK ROAD - Health 26 Huckins Neck Road
Centerville
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No.H163OR
UPC 10259
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TOWN/OF BA STABLE
LOCATION o�6 /�/yC�irs s /l1CClT�Q/ SEWAGE
VILLAGE �r'���iPfii�/ ASSESSOR'S MAP
INSTALLER'S NAME&PHONE NO._(30 B -1-6 410
SEPTIC TANK CAPACITY h-9 0 0
LEACHING FACILITY: (type) f4C4-J/e�)c L/(size) '& X JCc
NO.Of BEDROOMS
BUILDER OR OWNER '�:713 K/,49)e® 0/11rl
PERMITDATE: 'ten t 11�7b 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 7J�,99 iv t-,x'S
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No.
Fee
THE COMMONWEALTH OF MASSACHUSETTS
- PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
ZippYication for Mtgponl *pgtem Congtruction 3permit
Application is hereby made for a Permit to Construct( )or Repair(k,, an On-site Sewage Disposal System at:
Location Address or LotNo. , I Owner's Name,Address and Tel.No.
EOw wkss
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
LlO2Ao��uw�, u,
Type of Building:
Dwelling No.of Bedrooms 3 Garbage Grinder( )
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow :33� C&���� gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Description of Soil
r
Nature of Repairs or Alterations(Answer when applicable) I nc?a c$pr\.OTt
�S ec- Ps�Orod.c� p i� �f?(E.0 �'1��3"8® "—�✓�x/ef2�J��.0
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 lfas been issuSo by this Bo f Healt ,(,y j'
Signe - Date!!. 14 Yv
es
Application Approved by
Application Disapproved 1or the following reaso
Permit No. Date Issued
,ice. _- ; ^ •".� «.,:_.JD "- k,_ r Llq.n.
Ile
No. Fee ,vV/
'. THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
0[ppYication for Mt!6paar 6petem Congtructton Vermtt
Application is hereby made for a Permit to Construct( )or Repair( an On-site Sewage Disposal System at:
e
Location Address or Lot No. Owner's Name,Address and Tel.No.
i
Installer's Name;Address,and Tel.No. Designer's Name,Address and Tel.No.
G0 R_e20
i, Type of Building:
Dwelling No.of Bedrooms -3 Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow .3 30 � gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Description of.Soil
Nature of Repairs or Alterations(Answer when applicable) t o s ���' A w A \. +
J
�= Date last inspected:
Agreement: r
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 pla , the system in operation until a Certifi-
cate of Compliance has been issuo by this Bo dpf HealaD
Signe 7 Date
Application Approved by 9
Application Disapproved for the following reaso
Permit No. 41 .-- Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Certfftcate of Comphance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System inst lied( )�`epaired/replaced(�on
by -rr�� _1
as G 6' J.�" has construct d in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. dated " G5
Use of this system is conditioned on compliance with the provisions sgL forth bel IV
000
-4 /
_-----Fee
No. A
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
=t2;poa1 *pgtem Con5tructton Vermtt
Permission is hereby granted to G 2no� �rhPu) r
to construct( )repair(�n On-site Sewage System 1 cated at c2 uC)lf,, Alf-CA
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.
O
All construction must b mplete 't m two years of the date below. &(7
Date: Approved by
TOWN OF BARNSTABLE
LOCATION AIVC� C'!T� • SEWAGE
VILLAGE OTC�_2Plii 1/� ASSESSOR'S MAP&�p r
INSTALLER'S NAME.&PHONE NO. l�0(�Dc�n�yv►tipv� �a-a -cs6 L/Q
SEPTIC TANK CAPACITY /
LEACHING FACILITY: A�f-t !�/�o./ Pic D��'
(type) � '/(size)
NO.OF BEDROOMS
BUILDER OR OWNER if JO AV)9)1?0 O k/",
PERMITDATE•�,, /TF16 COMPLIANCE DATE: ��'" 2-.7 ^ 9e
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 7,;j�,Py e y�'S
9,2
0
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal
System at:
Locati'n-Address or Lot No.
Owner Ad esr
Installer Address
Type of Building Size Lot----A::�.46Z' M_ .....Sq. feet
Dwelling—No. of Bedro m
Seepage Pit No,—_. Diameter........ ..... Depth below inlet_.. Total leaching area.2..4?/....sq. f t.
Z Other Distribution box (x-11 Dosing
tank
Percolation Test Resu ts Performed by---4< )t............ ....vd.77!q............... Date...
----```` '--------'---`--------`---------------'—
'~s^`~~"t'
The undersigned agrees to install the aforedescribed,'individual Sewage Disposal System in accordance with
the provisions of TL I TAU 5 of the State Sanitary Code—`The unqersigned further agrees not to place the system in
operation until a Certificate of Compliance has hpm by th aO df health.
Date
Application Approved By....... .42�/0..... e—------------------ -__
Date
-----------'-----'—'-----'-----'--------------------'---'-'--'-'—'------'---''-'------
---
Parmod
Date
No................yJ` ... x$...........................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF.......
..................................... :....
Appliratinn for Disposal Works Tonstratrtinn Frrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
1` s t,
................__. .......-•- -- ...._.. ........ ............_-••-•---•---•---..................---•--.....•-•••--------•--•--•---•---...........--
Location-Address or Lot No.
i_ �i
Owner dd A ress
.I " f /e
�+y7 -
'", i s/.//r
.............................................•------......-----•----------............._ ........................................ -----•--......•..........................•..........
Installer Address
PQ
UType of Building Size Lot........= .....Sq. feet
Dwelling—No. of Bedrooms........_ :_- ..:......................Expansion Attic ( ) Garbage Grinder ( )
a'4 Other—T e of Building .. No. of persons............................ Showers
YP g --•----------------------- P ( ) — Cafeteria ( )
d Other fixtures
W Design Flow....................•....•.......-`_.. ..gallons per person per day. Total daily flow............................ ..............gallons.
WW Septic Tank—Liquid capacity......:.....gallons Length................ Width................ Diameter................ Depth................
Disposal Trench—No.p............ Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit Noi ___. Diameter.__.....d'- ------ Depth below inlet..... --------- Total leaching area.`./)/.....sq. ft.
Z Other Distribution box (✓) Dosing tank ( )
,-7
Percolation Test Res is Performed by.._ _Y..V............ .............. Date----f .'.. _ _.' .
Test Pit No. 1 '-------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........................
.../.....................I..............................
t �
f ......
0 Description of Soil.
U -•..................•••-•------.._.._..--•---•---..................•••--•--•-----...---------------•--•---------•-•••-------•-.......-------•-------••-•--............................................
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 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.
Signd ......................................................... ............"--- G
/ Date
Application Approved B .
I Date
Application Disapproved for the following reasons.............................---------------••--•••---•-•----•---••-------------••----••-----...------......-•-••-
.......................................................................................................................................................................................................
Date
PermitNo............................................................ Issued_......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD- OF HEAL
f ;
............ .:fir. . ........OF...... .... ..... ....
tl
�rrtifira of fl ompli�inrr
THIS IS `CE IFY at t ndivid' ual Sewage Disposal System constructed ( �or Repaired ( )
by---- --- ......................... . ................................................... --- `• Installer
v � �C � ' v
has been installed in accorda ce with the provisions of T 5 of The State Sanitary Code as described in he
application for Disposal Works Construction Permit No I......*.p.......... dated-....------9,. �.�--__:�
•.....
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT.THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE..... .................................................. Inspector...._ -------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD -OF ALTH
.................... -'y..c.f.....OF................. .... ` .•t.................................--...
N FEE...............J�/.0!-1�
o. ... l y'�
Disposal 's ft it prrutit
Permission reby granted----.•. .I f`' .
to Construct or/Repair, ( ) ate Indi dual. Sewage Dispop,Tal S t 71
at No..---- . . ........
f ....-.-• = "'fl .... � � 1; i... �..+ � � 1 a�fl �
St eef t
as shown on the application for Disposal Works Construction Permi- o.....-._ f...__.--Dated.____9!`_ " d....•..•
..............
Board o Health
DATE------f- -------•-•---•-----------•--••........................•----......---•
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS ^�'
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YOU WISH TO OPEN A BUSINESS?
For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you
must do by M.G.L. -it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis.
Take the completed form to the Town Clerk's Office, 1st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is
required by law.
DATE: a -1. 17 Fill in please:
0' APPLICANT'S YOUR NAME/S: as ayi 46d&5
BUSINESS YOUR HOME ADDRESS:_ 2(19 F4vc�4Lk-.� Ntclt ad
Confer✓r'l,� MA 6 -32_,
TELEPHONE # Home Telephone Number 8 7±7& 5-�-9
NAME OF CORPORATION: J a 91,1 toAe_* ,,cse, Rik ( l✓ro wo)-Lr'
NAME OF NEW BUSINESS 93v4s F,� Voo4 w6rJ4' TYPE OF- SINESS
IS THIS A HOME OCCUPATION? YES NO
ADDRESS OF BUSINESS _/I,. 0yc/ " Al"Y P. C�,r.,.,�;l�o 1AA a�32- MAP/PARCEL NUMBER �` "� (Assessing)
When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of
Barnstable. This form is intended to assist you in obtaining the information you may need.' You MUST GO TO 200 Main St. - (corner:of Yarmouth
Rd. &Main Street) to make sure you have the appropriate permits and licenses required_ to legally operate your business in this town.
1. BUILDING COMMISSIO R'S FFICE MUST COMPLY WITH HOME OCCUPATION
RULES AND REGULATIONS. FAILURE TO
This individual haVbe T f med of a mit requirements that pCain this type usinesECOMPL.Y MAY RESULT" INFINES.
horned ig aqurVw
C MENT z(A/,
2. BOARD OF HEALTH
This individual has been informed of the permi r ents that ertain to this type of business. MUST COMPLY WITH ALL
HAZARDOUS MATERIALS REGULATIONS
Authorized Signature*
COMMENTS:
3. CONSUMER AFFAIRS(LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature*
COMMENTS: