The URL can be used to link to this page

Home My WebLink About0271 MONOMOY CIRCLE - Health (2) r 441 f I + r t c ` y g W g2jz) " ^ THE oowMx»mxwsucrw or mAssAC*ussrTs U�� U�� ^"" ~�~ K � ��y �� ............. -- ��,Wp� °j~ ��n~-- -'w�~��='°""-�==`°�=°"-�=�`---- ---- � ��m�' �� Disposal �� '�� rr�� ~ -n-n-------- ~ ~ ~-~-n- '- - Works ~~`- -~--~-` nr -~ Application is hereby made for u Permit to C uroc� ( \ or Repair ( ) an Individual Sewage Disposal ' S ' Led er ir <::�p--- ------ -- --------- -- .. ................ .................. .......................... ................. ............................... Installer Address Type of Building Size Lot./.S.. I.-".....Sq. feet Other--Type of Building ............................ No. of persons............................ Showers ( ) -- Cafeteria ( ) � Other 6zmrea ~� .----------.---_---'............................................................................................... Design Flow.---_-_' ........ ....gallons per person per duy. Total daily Ho~. . .goOun^ Seepage Pit No. ..... Diameter.................... Depth below inlet..t,,.....p.CT 0 1 achin ----- .......s'(1. Other Distribution box ( ) Dosing tank ( ) 6 Xe". Z "'T' ~~ Percolation Test Results Performed by.......................................................................... Dute--.--...-..-.*.. J�'--. Test Pit No. I................minutes per inch Depth of Test Pit. Depth ;3:q Test Pit No. 2................minutes per inch Depth of Test Pit. De�6 �� Description of ^�� ..*�c�.-' �'---.----_-_-. ................................. .............................................. ------_-----_ ...................................................................................... Z .....................................,---------_---'-------_----_----.--'_.-_--'------_----_-_. U Nature of Repairs or Alterations—Answerwhen -.------------'_---------------- ---'''--'-----------'-----'--'--'-------'------'----------'----------' Agreement: The oodcroigoc6 agrees to install the uforcdenccibed Individual System in accordance with the provisions of Article XI of the State Sanitary Code—The underd4ned further agrees not to lace the system in operation until a Certificate of 0�, Application Approved uy'.e�@�.��w�� ao�c�� '~� v" "��« - D*, r ^ Application Disapproved for the 6oDox�mo reasons:---------'&��--_------------�--_-_---.--------' ___________________________________________________ 71 PermitNo......................................................... _ _ Date - - ---------------- 1�1y'0.~ ................. Fss. THE COMMONWEALTH OF MASSACHUSETTS BOARD F HE _ T ..-..-.OF..... . ...:::::...... .......... Application -fur :41-4puiitt1 Workfi Tomitrurtion Vanfit Application is hereby made for a Permit to Co struct ( ) or Repair ( } an Individual Sewage Disposal Syst at: ,.�/ j ---••- . - .....................................I ------- --- r at .......... ...................... .....................•..... Owner Add W Installer Address dType of Building Size Lot----------------------------Sq. feet U Dwelling—No. of Bedrooms--------- --__-Expansion Attic ( ) Garbage Grinder ( ) ;1_4 Other—Type of Building ---------------------------- No. of persons----------------------------- Showers ( ) — Cafeteria ( ) Q' Other fixtures W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity/vvogallons Length................ Width................ Diameter------.--------- Depth--.--.---.------ xDisposal Trench—/No ___________________ Width.................... Total Length_-_-_____-_--______ Total leaching area-.--.._.--.-___-_._.sq. ft. __. Diameter..-_•_______________ Depth below inlet.................... Total leaclliltg<trea..____..__.._____.sq. ft. Seepage Pit No.6Aj.��.. Z Other Distribution box ( ) Dosing tank ( ) �•, Percolation Test Results Performed bY................................................... ...................... Date----- ------------------------------.... 1_4 Test Pit No. 1----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water.__.-_--_---...._.._.._- rX4 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water...--....___-__-____-. - P4 ------ -------------------•--••---••••-••••---•--•-----•----------•------------•---•--..----- DDescription of Soil w�, -+i �e -------------------------------------------------------------- ...................... 0 ----------- -------- - x ------ V ------------------------------------- ...........................................y....................................................:----------------------------------------------------- --------------------------------------------------------------------------- ra VNature 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 Article XI of the State Sanitary Code—The unZned further agrees not to lace the system in operation until a Certificate of Compliance has been s ed by of health P P Sig --•--•••••---• ---- ----- ---- ----- �/ �, '�A D---; Application Approved BY....../... ------. �K� ti--•---•-----.---- � at!'� �r�� Application Disapproved for the following reasons:---•---•--- - -- .. .... ---••---•--•...........................•-----...---..............._......--•---•---- .......................•--•-•----•--•------------------------•••-•-••--•-------•--........-•••----••••.....--•-................---•-...------------. ---•------------ -----------•--------------- D e PermitNo......................................................... Issued--. ----G L ----------- ------------ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF EALTH Trdifiratror T 1 IS ERTIF hat the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by ....--- --- " -------------- ----------------•------ ---- ----------•---•--- ...................................... nst/' }�. ••- I alter .............•.............................. has been installed in accordance with the proviso of Article XI of The State Sanitary CAP as described in the }application for Disposal Works Construction Permit No----------- __ _ —---------- dated.._._ THE ISSUANCE OF THIS CERTIFICATE SHALL. NOT BE CONSTRUED AS AOGUARANTEE TGT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ' ----------------------- Inspector THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH � r ... .OF_ .... +........................................ N .. --•• FE E.._-.f�.............. ChUpgtrurtion Errant Permission is reby granted----- ------ ---- ............................................................ to Constr ( or Rep r ( ) an ndivldual Sew Disposal Sys at No --a��` ,$.4--•-. . •----. ---- ------ow --- ---- . -----••••-- Street as shown on the application for Disposal W Construction P t Dated_ ,! f -- - - _. Board of Health DATE-------------------------------------------------------------------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS `,f: C� Mr. Theodore J. Gumienny USMC(Ret) 271 Monomoy Circle Centerville , Mass. 02632 October 12 , 1981 Mr. John M. Kelly Director of Public Health Town of Barnstable P.O . Box 534 Hyannis , Mass. 02601 Dear Mr. Kelly: It is requested that the following data be provided relative to the septic system on my property, Lot 51 , Center- ville Highlands , for presentation to the Barnstable First District Court in an action brought_ by me against Mr. Alan E. Small, the• builder. (1) Town Regulations in effect on August 31, 1974 relative to construction and size of septic tank and cesspool to be emplaced in new home construction? (2) Type and size of septic tank and cesspool emplaced, and as approved by the Health Department? (3) Name of Inspecting Officer and date emplaced? (4.) Any other pertinent information for the Court? The above is needed by October 16 , 1981; please call me at 771-7316 for hand pick-up. Sincerely, 4keokrje . Aumienny7 1 Assessor's map and lot number/..�� ./...-:.%3.........,��- O /Te �PTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE " ,S— MATH AI;TI;:LE 11 STATE Sewage Pefmit number ... `..................�......:.................... "' SANITARY CODE ANQ j T"ET TOWN OF BARNS' ` 9AE3STADL i M BUILDING ' INSPECTOR' r ri • .APPLICATION FOR •PERMIT TO; .. ...... ................... .............................................. ..... .. ` TYPE OF CONSTRUCTION .........! �`�i • . ............................................ ..................................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby pp lies for a permit according to the following infor ti zGe Location ........... .... .. .... ................................. ................................... yl ProposedUse ..... 1°x...... . .....................................:.............................:...................................................... Zoning District ..................................:. ....................Fire District .......:. ................ ..................................................................... �r4l�........................... Name of owner ............ ...... ..... Address ............ Nameof Builder .............:......................................................Address .......:............................................................................ Nameof Architect ..................................................................Address .................................................................................... Numberof Room ...............................................................Foundation .... ......................................... Exierior 4" :`� ...Roofin .. ........................................................ : ......................... g ................................Interior .. ..... :. Floors ' '" ! ::9, ................................................. Heating ..... - `......................................Plumbing .. Fireplace ... � '.........:...............................Approximate Cost ............ 11'L� Definitive Plan Approved by PI Wing Board -----------_—-----------19______., Area Diagram of Lot and Building with Dimensions Fee //�� .....�........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH / 1 G � �4u - I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name " ........................ No .....1 05. Permit for ....94.0..V.0.T'y............. ................91A.&JO...fifflily...4W.CLUIP&.............. Location ...I Q.ifto J4y...c1=14.............................. ..................... euzA;".111e..... .. . .. Owner .......Alau...E....Slull.............................. _a ce Type ofjConstruction ..........frame..................... ...........�i......................................................... ........................................ ......... ..... 1 .. Plot .......`.................... Lot .........#53 ................ ' - ~ Permit Granted ................June........18..........:.....1974 Date of Inspection �� Date Completed ........ .....19 i PERMIT REFUSED ........................................ ................. 19 ................................................................. ......... 1 .............. ........... ,. ................................. ....................`.......................................................... I, .• . V . ............ ................................................... ......... _ ..d,.. Approved ............................................. 19 r ............. . .............................. ; x.............. . . ....................................................... No. U L Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS es 01ppliLAtion for Disposal 6pstrm Construction 3pPrmit Application for a Permit to Construct( ) Repair*11"Upgrade( ) Abandon( ) ❑Complete System &Individual Components Location Addr or Lot No. r Owner's Name,Address,and Tel.No. 27 oK*wt Assessor's Map/Parcel q t/ N Installer's N e, dd ss and Tel. `tl V V QS''4f 7 Desi er's Name,Address,and Tel.N . M �o ��o►►'sue T)rpe of Building: Dwelling 'No.of Bedrooms N Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided �1/1✓ gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank B D a Type of S.A.S. 4 Description of Soil Nature of Repairs or Alterations(Answer when applicable) /,914 C Y 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 n ce the syster operation until a Certificate of Compliance has been issued by this Board of Heal Sign Date ,,//—/7—Z/ Application Approved by Date Application Disapproved by Date for the following reasons Permit No. '� n l 1 �.� 2 Date Issued 7 No. � 0z(= �� '� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS es 2pplication for Misposal 6pstem Construction Permit Application fora Permit to Construct( ). Repair(&'/Upgrade( ) Abandon( ) ❑Complete System individual Components R~' Location Addres or Lot No. Owner's Name Address and Tel.No. ; ll. Assessor's Map/Parcel I 6 tl M 1 ng AI? Installer's Nan e�ddfess,and Tel.to.n t e I/ F 5,'t Desigiler's Name,Address,and"Tel.N . Type of Building: Dwelling No.of Bedrooms �` lV/ Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) p✓ gpd Design flow provided 04 gpd Plan Date Number of sheets Revision Date -Y •' Title Size of Septic Tank Type of S.A.S. t t� f cal S �' Description of Soil Nature of Repairs or Alterations(Answer when applicable) / /y/4 �'o� �( Date last inspected: Agreement: The undersigned agrees to ensureoe 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 notto_place the system in,operation until a Certificate of Compliance has been issued by this Board of Healt . / / Signerd Date < 00 Application Approved by f,/ oVo A 12 S Date /t Application Disapproved by Date for the following reasons Permit No. ) n a f t.1, Date Issued �� 2 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY hat the On-site Sewage Disposal system Cons cted( ) Repaired( •�� Upgraded( ) Abandoned( )by D 4` t.�V r w o ,,G' 6v Af f�.h ( yo r at �! 0 H a/•'►Dy e r I G I e has been constructed in accordance with the provisions of Title 5 anghe for Disposal System Construction Permit No.D d,�- �'z�' dated 1 f��7/ Installer D, 4---1,0, JU °L--; ®rA. ) ^Designer #bedrooms Approved design flow 1\/�/1' gpd- J , The issuance of this permit shall not be construed as a guarantee that the system wi,IT furibti4)n }designed. Date //" . -I*I Inspector f � No. o 2 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal Opstem Construction Permit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at , /F 4 e i►r o 5' �� / C and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. ;7 Provided:Construct ust be completed within three years of the date of this perm . Date Approved by - �,