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Home My WebLink About0282 BARNSTABLE ROAD - Health 282 Roftd,,t. Sewer Acct# 4293 Hyannis '.;:. ... - 1 I I i I I Nu.'C7,�r e '_ Fee `.. /� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ZIpplicatiop o Mgonl *pgtem Construction Permit Application for.a l/Permit to Construc )Repair( )Upgrade( )Abandon( �o Complete System El Individual Components Location Address or Lot No. Q a rn5 f.46'L 2k, Owner's Name,Address and Tel.No. CJ Assessor's Map/Parcel 0 / 3� - ( ��Y f . "L Installer's Name,A"01 emco Designer's Name,Address and Tel.No. 350 Main Street W. Yarmouth, MA 02673 Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( ) + 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 Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) cede r Co nnec on 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 Board of Health. Signed Date Application Approved by Date ! U Application Disapproved for the following rea ns Permit No. Date Issued 2{,', � gyp+No. - _ � Fee V 1� /'•�w ' THE i" COMMONWEALTH OF MAS SACHUSETTS Entered in computer: Yes w� �, !'` 1y f.f PUBLIC HEALTH DIVISION --TOWN OF BARNSTABLE., MASSACHUSETTS " Zfpplicatiou or Xigpogal *proem Congtruction Permit t r :Application for a Permit to Construe )Repair( )Upgrade( )Abandon(,, _�❑Complete System ❑Individual Components Location Address or Lot No. 9 a t n S�A� C ��d� • ' Owner's Name,Address and Tel.No. Assessor's Ma0arcel ,tq Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. k)/� TType'of;Building:: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder,( ) I OtheF Type of Building No.of Persons Showers( Cafeteria( ) ! r r Other Fixtures r• gn•.Flow gallons per day. Calculated daily flow gallons. Desi r ` Plan Date. Number of sheets Revision Date t Title Size of Septic Tank T e of S.A.S. f: r P yp., Description of Soil '4 Nature of Repairs or Alterations(Answer when applicable) v e we r l e)n n e c�;tin 1 � r. ti Date last inspected: t 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 Board of Health. Signed N i _ Date Application Approved by Date U Application Disapproved for the following rea ons f Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( ) Repaired ( )Upgraded( ) Abandoned(✓j by Cl--?A)C 0 at Q18 a r n sf 4 S(Z. Z D &•w has been constructe in ccordance with the provisions of Title 5 and the for Disposal System Construction Permit No.'Z*'?'I J_yK c dated G / 0 Installer Designer The issuance of this p t sa1J not be construed as a guarantee that the syst 11 fu tie design Date_ Inspector No.� . •.,_------•——--�.—___-=_._---___�-Fee—`-�—.�--��._,•_ . THE COMMONWEALTH OF MASSACHUSETTS Ga PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Misspogal *pgtem Congtruction Per it Permission is hereby anted to Construct( )Repair( )Upgr de( ) andon(� System located at o� r �f;A 1) 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. Provided: Construction inu be completed within three years of the date of this lit. Dater �// Approved by LOCATION SEW GE PERMIT NO. '/0 ' gOA/ZA-5 T3x/,3 Gj-- led 3/0 - 0 G -oC�! VILLAGE t, ac�� Y fl�w�y INSTALLER'S NAME- i ADDRES5% ` B U I L D E R OR OWN ER /40 DATE PERMIT ISSUED - �� DATE COMPLIANCE ISSUED � r �� A(` �� , �� o rr._ ��l �.! �I: i I l � I _ �� FEB THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEA,I_TH ...........................................OF.......................................................................................... Appliratiun for Disposal Works Tonutrarctiun Frrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Syste9j.#t: I ........ 4.9 ..y.•.'•..��................................. -•--•-•---......--------...........--•----- �.. ..�.�•.................... La 'on-Addres or Lot No. ...... -.. ........ ....... �,, `--•-•••. •-•-•...-•---•--•--•-------------••-••-•-.. ......................................._..... aa•-... .. - .- --.................................... Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of a Bedrooms...... ..................................Expansion Attic ( ) Garbage Grinder ( )Other—Type of Building x ✓ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Otherures .. ----•--•--••--------------------------------•----•.•••------------------------------------------------... ...................................... Design Flow_........._ .. ... ............gallons per person per day. Total daily flow.._..��.�r.....__................gallons. WSeptic Tank—Liq pacity/°?_gallons Length................ Width................ Diameter...........:.... Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No....../............. Diameter.._....V......... Depth below inlet_............... Total leaching area..................sq. ft. Z 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........................ 04 - •---...._..•----------------•---••..........--•--•---•------------....•-------------•....--••.•••............................................................ 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 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 iss d by the board o iealth. fir./ ., gned �r1!1`i�•• =s -�..':... _ . D Application Approv --------- -•-----•--•---------•---•------------------------- 2 Date Application Disapproved f o the ollowing reasons---------------------------------------------------------------------------------------------------------------- --------------------••••--••----------------•----...------------••---•-••---------...........-----••.....---................----•--------------------------••----•---------------•----------•----------- Date PermitNo...................................................--.... Issued....................................................... Date NJ.L1.......a��' .......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................O F........................................----•---..........------.................---.----- Appliratiou for Ropoiitti Works Tonstrurtion thratit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Systat LJo�Lion-Add res�� /��'_� or Lot No. . �..- ... .. .......... 7----------- .............................................. rie ..... ."r............................... ...................}/�-.� .Ss. ..................................... Installer Address dType of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms.... . ..................................Expansion Attic ( ) Garbage Grinder ( ) a -- Other—Type of Building . ......... No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ------------------------------------------------------------------------------------------------------- Design Flow - • �i _ V17P 2 g P P P Y Y � L 4. W1.......___. allons er erson er da Total dail flow.._....::............ .....................gallons. WSeptic Tank—Liq acity ,.gallons Length................ Width................ Diameter..........._.._. Depth................ x Disposal Trench—No.................... Widt .................. Total Length.................... Total leaching area....................sq. ft. Seepage Pit NO-----J:._...______- Diameter..... ........... Depth below inlet.........4......... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) `-� Percolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ GG ..------•--•------------------------•---------•-----------.........-----................----•---••--......................................................... D Description o#°iSoil .. U --'••-'•-•--•••--••-_=--•---•---------------•'-•-'_..•---•-----'•................•-------....••••-•----•••---•-••-•-------•'-•--•----•-•----------••---•---••--•-••--••-•--------...........--•-------- w x -•--••••................••-•------------•-'-'•-•---••-••-•••......•-• ••-'•-••-•-••-----•-••--•••-------•-----•------•---•-••-••••••----••--•--•••-•---•----••--•--•...-•-••-•-••--•--•-.............•-- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... t 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.beeW- a d by the board o ealth. Signed7 ......•-----•-- ...............,.- Application ApprovBy= �--�`»-- ------------------------ ref"'✓ . . Dafe f Application Disapproved far'the following reasons:............................................................................................Date----•--------- --•--•----------••----'------••-•----:-----------------••'-'-....---•••--------........--------••••-•----.._..._.....--•--•-----•--•--••••-•-•••••----------•-••--•-•---'••¢-----...ti----...•------•-••- Date Permit No............... Issued.......................e.....-----•------------------• Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH-- , Trrtif iratr of Tomplianrr _ T S. TO'CERTIFY, That the Individual Sewage Disposal System constructed ( or{Repaired ( ) ( ... ...................................................................................................................................�1 �14 -----••------------------------------Installer has 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.... ... . f`�"..._....... dated................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. r DATE........................................... B-"---t------ Inspector............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - ""2-/ .. No......................... FEE........................ Disposal IVr n�#rttr#ilan rrntii Permission is hereby granted............ ...................... ...• ------......•-•--...................._.... to Construct ( ) or Repair ( ) an Individual Se �ageii S25 step jt�:.. l Street as shown on the licatio for Disposal Works Construction Permit No._,__ __ Dated.......................................... ti Board of Health DATE.. -- ..... ......... -------------•--------••--•-.....-•-----------•--•---- FORM 1255 A. M. SULKIN. INC.. BOSTON •a s fi i' 7 '4. I � , I ,�9 r 07,�, Ao R�� ;. /dam/�y'.� ,� .j�G...•1L_.,r:..Y�yj y�� I �''�' ��3 / � "( � -r" `fit`. � �.� j / /oA,/ ,9yxy � 99•.g � �r�'w' I 1� ,� C> �y,` `! .K. /mod./ � ,` ♦�J /�� 5� �,.. r+. /"'Jd� \ �'� ..... i -- I .4z,37 - f AZ -.4 �` ..V: ';.,�';•/ /'� fir--_"' •-----^—.._'—'.:._—=--� .��:..t+ ., .4 .