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HomeMy WebLinkAbout0050 KEARSARGE AVENUE - Health 50 KEARSAGE AVE., CENTERVILLE A= 226147 l/ J � _ 7 I No. _ Fee 1� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer./ `L PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZippYication for jBisposai 6pstem Construction permit Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. S�- Ate_ Owner's Name, ddress,and Tel. [-1 y dd rroc-vc" o?g [�iv�Cd�. awe Assessor's Map/Parcel /Y 7 t, \,A- P ? Installer's Name,Address,an4 Tel No.Car-uh Q, Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size .0�5 sq-ft:-- Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) AAA- gpd Design flow provided /�� gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank / 5�d Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) L-ti v\9— C.I,�,,,�c �6fous�Q_' 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 Certificate of Compliance has been issued by this Board of Health. S' a Date a' ` Application Approved by Date lo OAD 1( Application DisapprovZbty� Date for the following reaso Permit No._ZC> Date Issued © TOWN OF BARNSTAB E Q LOCATION — ' SEWAGE # G f VILLAGE ASSESSOR'S MAP& LOT_` .? INSTALLER' ;AME& H.NE NO. A-- SEPTIC TANK CAPACITY LEACHING FACILITY: (type) is .t-S ' (size) NO.OF BEDROOMS "� BUILDER OR OWNER PERMUDATE: Z F'— '�—i COMPLIANCE DATE: 7 Z�Z--7 ; Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Fac' ty Feet Private Water Supply Well and Leaching Facility (If any wells e ' t on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands e ' t within 300 feet of leaching facility) Feet 'Furnished by .ra ✓ x No. �v�I — �b Fee 60 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: r `�- PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,,MASSACHUSETTS Yes 01pplicatloT[jor Disposal *pstem ConstrUctlon Permit „ Application for a Permit to Construct( )^ Repair(V)/Upgrade,(,,,) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. O QSS.0 S C0- �Ave— Owner's Name, ddre s,and Tel.No �� °� a-'q Assessor's Map/Parcel oZ o 4o >I ( 7 IPA o24,7-Q41(o- //9 Installer's Name,Address,an�Tg1 NTP-" Y1lgcN¢s Designer's Name,Address,and Tel.No. 1 S 3v `Cw.rh2 -0-1 o J o. �Ybs1• , 50&-t177-M7 Type of Building: Dwelling No.of Bedrooms Lot Size /y 9.5 A sq�- Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures J Design Flow(min.required) A 11" gpd Design flow provided' `/(�� gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank S� Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) L_fy�-`Q u " ot,5 @-+6 Sep+c 7►J__ 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 Certificate of Compliance has been issued by this Board of Health. 4 Sig ed Date Application Approved by Date/D Application Disapproved by Date for the following reasons Permit No. C-O( I J�Ib b Date Issued 1010 6 Zo 1 i s - ._ —- ---------------------- ---- - THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(V ) Upgraded( ) Abandoned( )by �-��tZl^-) o�L t�`�`�� pr�Se.S at 0 K�rS a� - �� has been constructed in accordance with the provisions of Title 5 and the for DisposalSystem Construction Permit NOV I"'36?6 dated A Installer CS,(1 AA tl)E ��►✓X3 �Q1 Sep Designer #bedrooms S Approved design flow and The issuance of this permit shall not be construed as a guarantee that the system will fimctio as d9sig en d. Date Z�c Inspector =�- /=-------------------------------------- No. 2o Fee �el AD THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS i Bisposal fppste�lt CoYC6trULt[on Permit Permission is hereby granted to Construct( ) Repair ) Upgrade( ) Abandon( j System located at Sd /���S0.�aA� �nJ� � �^^`S e x V and as described in the above Application for Disposal System Construction Pennit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit / Date /�/ZG 20,1 Approved by -�' TOWN OF BARNSTAB E Q LOCATION` SEWAGE # �. VILLAGEASSESSOR'S M�APP & LOT- Al 7 INSTALLER'S NAME&PH NE NO. ���i ld6 ti SEPTIC TANK CAPACITY LEACHING FACILITY: (type) �'`'S ' (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: S- �,�COMPLIANCE DATE ,L��"9 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Fac' ty Feet Private Water Supply Well and Leaching Facility (If any wells e ' t on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands a tt Feet �• within 30Q feet of leaching facility) Furnished by 1� 7[� r b ry . 0 (� ASSESSORS MAP NO: No. l 7" Fee $5 0 . 0 0 PARCEL NO: / THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 4ppr cation for Mfgpogar 6pgtem Cottgtruction Vermit Application is hereby made for a Permit to Construct( )or Repair(xx)an On-site Sewage Disposal System at: Location Address or Lot No. 50 Kearsarge Ave Owner's Name,Address and Tel.No. Lucinda Sanders W Hyannisport, MA- 28 N Lincoln Ave, Newtown, PA 18 40 Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. Wm E Robinson Sr, Septic Sry P 0 Box. 1089 , Centerville, MA 026 2 Type of Building: Dwelling No.of Bedrooms 5 Garbage Grinder(no) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Description of Soil sand Nature of Repairs or Alterations(Answer when applicable) i t 1 e 5 Septic repair consisting of 1500g tank, D—box, and six Cultex infiltrators { stonepackedj . Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental ode and not to place the system in operation until a Certifi- cate of Compliance has been issu by th' a of blealL/i' Signed Date f�77 Application Approved b "l Application Disapproved for the following reasons Permit No. Date Issued Cf 9 ; t j HEGOMMONWEALTH OF SSACHUSErtTS PUBLIC HEALTH DIVISION - BARNSTAB$CE, MASSACHUSETTS Samders Certif irate of Compliance - THIS IS TO CERTIFY that the On-site Sewage Disposal System installed( )or repaired/replaced(x )on by Wm E Robinson Sr Septic Sry for at: 50 Kearsar a Ave, W H anniS ort has been constructed in accordance i with the provisions of Title hrid the for Disposal System Construction Permit No. - dated Use of this system is conditioned on compliance with the provisions set forth below: 9 $50.00 No. O Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE. MASSACHUSETTS Sanders i� oaY- pten� Construction Permit Permission is hereby granted to to construct( )repair( x)an On-site Sewage System located at 50 Kearsarge Ave W Hyannisport, MA Installer: Wm E Robinson Sr Septic Srv - and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with-Title'5 an&the'folldWifig local provisions or special conditions. 4 All construction must be corn lletteed within two years of the date below. Date: ,/ �' 27 % / Approved by i i ...r. ' may . . .No. ^-� stiee $50.00 +u. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 4 Yicatiott for o5afipgtemogtructon erntt i Application i ereby made for a Permit to Construct( )or Repair(xx)an On-site Sewage Disposal System'at: Location Address or Lot No. Owner's Name'Address and Tel.No. 50 Kearsarge Pe_,.' ' w . � w Lucinda Sanders W Hyannisport MA28 N M ic�ln Ave, Newtown, PA 18940 215-860-0743 75- 86 Installei`s Name'Address,and Tel.No. 7 7 5-8 7 7 6 1 Designer's Name,Address and Tel.No. Wm E Robinson Sr, Septic Sry P O Box 1089, Centerville, MA 026 2 = I Type of Building: Dweilmg No.of Bedrooms 5 Garbage Grinder(no) j Other Type of Building No.of Persons Showers( ) Cafeteria( ) rrli.c ,fir lllair 1 .. Other Fixtures i Design Flow gallons per d y. Calculated daily flow gallons. Plait— n Date Number of sheets Revision Date ' Title Description of Soil sand Qi[ii.a ear iYlrn vi >irii -- - - Nature of Repairs or Alterations(Answer when applicable) Title 5 Septic repair consisting t`15009"' tank;"b'-box, and -six Cultex infiltrators ('stonepacked) , ._ Date last inspected: I Yel l i W P, L\,i Agreement, te�aaxat:eii: ' The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system, l iL mSi7r 1 ... in accordance with the provisions of Title 5 of the Environmental ode and not to place the system in operation until a Certifi- ,. lli 4�l'.rlil.3lll4 \niiil rit i i r 1,� -c s - Cate of Compliance has' been issu by ic thi of liiealth. �0,7 man rr I u.a�ilhYi�a i,a� r. 1 a.. Signed I Date Application Approved Application Disapproved for the following reasons { r4 Permit No._��� Date Issued 7—4? 92 Y o,® NOTICE: This-form-is to,be-used for the-repair of failed sgptW systems-only 1 \ f'Tt I & 1 1..OF SKETO NA A»JLCA PIGN IM A. AL WO S-C—ONSTR CTMN--gEIMI-T(WI-THOUT-DESIGNED FLANS) , iilia Robinso�r, Sr:,hemWvertifytha�the appheation fordisposal works constrmfienpermAsigned by me dated 2, XV 9 / .concerjg the pmpeAyAocated at. St Keam=AM W I� MA jn is all of the:&flovAng criteria: �* There are_no wetiands.withia3H.fi�et.of,Me.propos-ed septic 7stem. /* There are no,private wells.withim 150 feet of the proposed septic system: J * The ebseved groundwater-table is-14feet-or greater below-the-bottom of the leaching€pility. There-is no,increase in-How andforehangein use Proposed. " * There-areim variances requested-qr n"eded. SIGN DATE- I.CENSED.:SEMCSYSTEM i1V T"AT.LFR IN THETQWT-OF B"AMST;d BBLE.NLMME� 60 (Attach-a-sketch plan-of the proposed PjAem.. Also-if the licensed-installer-proposes a certi"ion plot plan;this.lhmv should be subTitted). ck 1�b—GJ-1yytj Wt$;4UHf7 C N I U5 I r i Ktl)tr i 5087902385 P.03 ,.:.� •......., vMr.w....-... w .vvae a nc uc}im uucaee.. Fire Department retains original application and issues duplicate as Permit 0/ a APPLICATION and PERMIT Fee: :I0.00 for storage tank renncv—d and transportation to approved tank disposal yard in accordance with':*the' provisions of M.G.L Chapter 148-Section 38A, 527 CMR 9.00, application is hereby made by: ' --q N i-- Ic- Tank Owner Name(pi print) Saunders x • �ynaturo 90 apemn/ Address 50 Kearsarge Avenue, Centerville Strse! MY Stsie Lp Advanced Environmental Company Name AAvanrPA Vnyi rnnmanfA1 Co.or Individual P.O. Box 472, Sv��ennis, MA °r"` Address Address Prier �„� Signatur if applyi r=e i Signature(if applying`.cr permit) C IFCI Certifier Other _� ^ lFCl Certified M ?# Other 115MIMT7711 Tank Location 50 Kearsarge Avenue. Centerville SteelAddtmi C r Tank Capacity(gallcrs. 10000 Substance Last Store-- #2 Fuel Oi 1 i . e. Tank Dimensions(diarr*mf x length) _ r r Remarks: � Ftranspor�fingw=a kV. Fi Advanced Environmental State tic. # MV5083856100 Hazardous waste mare, E.P.A. # Approved tank d"rsposas ysrd J.G. Grant Tank yard# 03501 Type of inert gas Tank yard address Readville Centerville 01920 City or Town FOID# Permit# June 2.4, 1998 July 8, 1998 Date of issue Date of expiration Dig safe approval nurnber_ 982008048 Dig Safe Toll=;�Tel. Number-80b-322-4844 Signature/Title of Ofq ranting permit t/�/ After removal(s)send Fr..7-?-29OR signed by Local Fire Dept. to UST Regulatory Complisrx`Unit,One Ashburton Place, Room 1310, Boston. W. 1:;,8-1618. TOTAL P.03 04-133-20 J e9:34AN CEIJT OST F 1 REDEPT 5087902385 P.O2 .•' Fug Department retains original application and issues dupb=e as Permit. ��efia�irn�ntc�'C,/'iixeC�e�z�cce� - �rxr�a�C=��re ��,�en�.oan APPLICATION and PERMIT 10-Qo Fee: for storage tank rerncval and transportation to approved tank disposal yard in accordance with the provisions of M.C.L. Chapter 148>Sectior. 38A, 527 CMR 9.00, application is hereby rnade by: Tank Owner Name print) Saunders X Address 50 Kearsarge Avenue, Centerville S1reM City ----- J— state -rip . • �-. i Adv&iced lEn.vi.rontuental "Companyme n,(vAne-ed FnyjrnnMPnrat Co.or Individual. P.Q. Box 472, S�'�bennia, MA Address Address ..•t Pdnt Frrn: Signaharfx appfyi r_e .i I Signature(if applying fcr-ermit) 7 IFCt Cattifri- otter t/ =: IFCI Certified - 'w=# Other Tank Location 50 Kearsarge Avenue,- Centerville Seer pooress Tank Capacity(gallcrs. ] Mill Substance Last Store-- Tank Dimensions(Cia�_Ir x length) r Remarks: I Firm transporting,,,:;_, Advanced Environmetnal _State Uc.0 MV5083856100 Hazardous waste n arm E.P.A. It Approved tankdisposJysrd J.G. Grant Tank yard 4 03501 i Type of iner,,gas Tank yard address Readvilie Centerville 01920 ! City or Town r-- - FDID#_---------. -. -_ - _Permit# June 2.4, 1998 July 8, 1998 Date of issue Date of expiration Dig safe approval nurme- 982008048 D"Safe Toll Fr-_Tel. Number-KG-322-4844 fSignature!'Fibe of Of i t_rantir;g permit w After removal(s)send F--r. -290A signed by Local Fire Cept. to UST Regulatory Compli r=Jnit,One Ashburton Place, Roorn 1310, Boston.W. FP-282(revised.9U) 04-03-2000 09:34AM CE14T CST FiREDEPT 5087-302385 P.02 Fme Department retains original application and issues dupfate as Permit. o��kae& Q� s�- �g APPLICATION and PERMIT Fee: 10X0 !or storage tank remcval and transportation to approved tank disposal yard in accordance with the provisions of M.G.L. Chapter 148, Section, 38A, 527 CMR 9.00, application is hereby made by: TankFer Name(pig print) Saunders X .apnarwal eGWt.�.�l�ormrt) ^" Address 50 Kearsarge Avenue, Centerville SfreCt � Removal Contfactcw!- Sl81• i Advanced Environmental Company Name a.ivanrpri F, rnnmon t, I Co.or Individual Address P.O. Box 472, Sy*bennis, MA r Address �� inn: 'Signatur fit appto ,r_e 7i Signature(it applying'cr nearmit) u lFCI CtrtifieC Other ., t/ I i=. iFCi Certified — ',w=4 Other l Tank Location 50 Kearsarge Avenue, Centerville ue•raoo�•,ss .;� Tank Capacity(gallcra. t_nOn Substance trast Store-- #2 Pue1 Oil Tank Dimensions fcic�. :gf x length) 1 Remarks: .. Ertl . .:. . Firm transportingwasa Advanced Environmennal M�'5U83856100 i State Ur.,0_, : ! Hazardous waste rranr'� i E.P.A. It 1 ' Approved tank dispos t J.G. Grant Tank yard 4 ___ 03501 Type of inert gas Tank yard address Readville Centerville 01920 Gtyor?own FDldri _Permitff Date of issue June 2., 1998 July 8, 1998 Date of expiration Dig safe approval nunme- 982008048 i Dig Safe Tcii:^�?ei. Number-$00-322-4844 I , , Signatur®!Title of OfS :ranting p$mtisl After removals)send Frrr.?-290A signed by Local Fire Cept.to UST Regulatory Cornpliart Jnit,One Ashburton Place, Room'310,Boston.W 1:"18.1618. FP-282(revised9fit) :I it 4' - =....c....rn Inr_a! Fire Deoart-rent. 1 01'Ysbate ._ ... �:_. is ::e:�Via.._• ,r d rn P.O. 9LX 475 m J South Cer�F:'!s, MA G2$50 Q (508)385-6 s✓� 0 IP) FAX(508)31135-CA22 za cQ i NAME --- �I r N AbDRESS �- �jAe PH,NO. DATE 6 s 06 ;i OTY. DESCRIPTION PRICE AMOUNT r 15T- W --- - - — - W U1 I] Z �t W� LLl -- U 6 WA Zr e t b�• !�1 T --.._. . m fV I l9 TAX REC' FIVER g iOTAI_ IL a ALL CLAIMS AND RETURNED GOODS