HomeMy WebLinkAbout0055 BASSETT LANE - Health to i
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�J e oe o 0 o v o
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tea: THE COMMONWEALTH OF MASSACHUSETTS
OOARD OF HEALTH
J(�6 .. ..T.wn.... Barns table
r
.......... e..................................................
or t� al Works Tonstrnrtion Vamit
Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal
System at:
Nart .....Yannis. ..�--•--02501.......-----•---•-- -----••-•-----.....--••-•---.....---
Location-Address or Lot No.
Shawmut Bank of Cape„Cod._N,A.,,,,__„,,,,,,,,,,,,,,„ Narth Street,__ Hyannis ,MA 0260i
................ -- ._.. ..... ... .....................••
Owner Address
A & B Cesspool Service „ „ 128 Bishops„Terrace, Hyannis, MA 02601
Installer Address
d Type of Building Size Lot------- ------------------Sq. feet
U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
Other—Type T e of Building No. of persons............................ Showers
Ga YP g ---•--.....-•--•---••---••-• P ( ) — Cafeteria
Q' Other fixtures ..-_......-•••••......-••---•--- . -------------------------------------•--•--------... ...........
..........
.
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 ( )
►-' Percolation Test Results Performed by--•-••-••-•••••-••••-----•--••-------...•-•••---•-•----•••....---•-•---- Date........................................
►l
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.....................--.
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
�+ ----•-•--•-•••-•••••••----•--•---•••..................••-------........--•---------..._----•-................................................................
ODescription of Soil......Sand.......................................................................................................................................................
W
UNature of Repairs or Alterations—Answer when applicable-----installation.--of..a...1,.Q0O.-gallon,...nre-Cast
..atone...packed..leach-•Pit,.(.oiorfl aw)........--•------------------••--•------------------------•-----•--------------•--•-----•--------------•-----•--------
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 V th boar f health..
Stgned� % -�L ( .... .�`- ?�_ s�. J/9V$11
•84
----........
Da e
r Application A r
;l PP PP • . •-------•------••--•-••••••-•................•---•-----•-----------------------........-- ............5/Q4
'Y. Date
Application Disapproved f t following reasons:..............................................................................................................
........................................ ..... ...-•-•-•------•--........----------•-•-••-------........----•--------------------••-•-...............................................................
Date
Permit N��L...........--•-----------------------•--•----------_. Issued....................510y1 ...................
Date
. ...............................................................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...............T.own................OF........Bamstable...................................................
Trdifirair of TompliFanrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ) or Repaired (X )
by,,,_,,,„A & B_ Cesspool-Service. 128 Bishops Terrace, Hyannis,,,MA_---_02�01
...................................•.
- Installer
at. North St.......Hyannis.:..M......02601 - Shawmut Bank of .Cod,---N•A.
has been installed in accordance with the provisions of TITLE G oLj The State Sanitary Code/was/ described in the
application for Disposal Works Construction Permit No.8�4-_3 7................ dat ........�1�i
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRU A GUARANTEE-THAT THE
SYSTEM WILL FUNCTION SATI•SF �
.
DATE.......... s..... ..... ........ Inspector...... ..-••----•---------•••....--•-•-------------.........-----..----
THE COMMONWEALTH OF MASSACHUSETTS
i
-• THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.........................Town.......OF..........Bam table
.....................................................................
Appliratinn for DhipaaFal Works Tnntrnrtiun Upermit
Application is hereby made for a Permit to Construct ( ) or Repair ) an Individual Sewage Disposal
System at:
Nrka..rea.. Y. 13} 021601 -.......-
•ty
Location-Address or Lot No
Shawmut Bank..of_Cape Cod, N.A. Ncth Strets yannis, r?A 02601-
_ ........................... ..... ..........................
Owner Address
a A-& B Cesspool Service 128 Bishops Terraces Hyannis, MA 02. 601
Installer Address
Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
� Other—T e of Building g ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Otherfixtures -------------------------------•---------------.........................................:............................................................
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........................
rzq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
04 •-•••--•---•--------------••-•-•-••-•-------•-••--•.......-------•-.........----.......-----•.....--.........................................................
0 Description of Soil....Sand...........................................................................................................................................................
x
w
UNature of Repairs or Alterations—Answer when applicable_A5S.t&1 a.+,tom..of--a-.1,-000--�allonl.•pre-Cast
atone---packed__leach.-Pi-t+-(.o.wxflox) ........
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of T I T LE 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 t boar f health.
Application App -----r ------------•-- ---. 5104 '
'Sign
Date
Application Disapproved f` following reasons_______________________________________________________________
..................••----------------••........._--•-•.•-•---.------..---•••....••••--......................••.•• .............................
Date
Permit 10.7...............
Issued ----5.04:��!:............•-•-••--
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
............T.W.A..................OF.....Aarn stable.....................................................
T rrtif iratr of T ampliFanrr
THIS IS TO CERTIFY, That the I dividual Sewage Disposal System constructed ( ) or Repaired )
by------- A & B Cesspool Service, 12� Bishops Terrace, Hyannis, MA 02601
' ns a ll
at.....Noxth.St., Hyannis , MA 02601 - ShawmIu� dank of Cape Cod, N.A.
has been installed in accordance with the provisions of � TLE . 5 o�The State Sanitary C��described in the
application for Disposal Works Construction Permit No.........., ,1..................... dated................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE 84
5�04� --------------------••••-............... Inspector.....................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
T ocrn.........I.........0 F......'.sarnstable ...............
. ............................. . . ...... 15.00
No... ... .... FEE........................
Dispaii al Workii. Onntrurtinn Permit
A & B Cess Service
Permission is hereby granted -- --- ------------- ?...00l ----•-------------------------------•--•-----------....------....-••-••............... ....
to Construct ( ) or�Repair (X ) an Individu Sewa a Disposal System
at No..........North St., Hyannis, MA 02 01 - Shawmut Bank of Cape .
Cod N.A.
.----••...............•---------------------------•••• ----•-..... •••-•---•-••-------••--•--•-••--............
Street
as shown on the ap icat• n for Disposal Works Construction Permit No.. .. .......... Dated................�°.��............
Board of Health
DATE --- ---
. •-•• -•
FORM 1255 A. . Sr LKIN, INC., BOSTON 1'
LuL;ATI ON PE ! d
SEWAGE PERMIT•NO..
VILLAGE
Hyannis, MA 02601 �0
A & B CESSPOOL SERVICE
128 BISHOPS TERRACE, HYANNIS, MA 02601
BUILDER OR OWNER
Shawmut Bank of Caps' Cod, N.A.
North St.; Hyannis, MA 0260i
DATE PERMIT ISSUED
k 8 '
DATE COMPLIPkCE ISSUED i
;
rot
74
ol
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�.�
ro�gAr
l.tTA4Lk 1�'h
-----------
MUST CONNECT 40 TOWN SEWER
THE
�dgaw AVAILABLE No.---�------
TO
�. wo OFFICE OF THE BOARD OF HEALTH
•0 '� OF THE
BAB89TABLE, o TOWN OF BARNSTABLE,. MASS.
y MASS.
O
i6 3 9.
� �
°MA,( A, SEWAGE DISPOSAL_ RMITQ�
Permission is granted to to to construct
Upon the Premises of ` �`ta'�`�` L - 3� C' ��� rstch-eD �, 9�
---------------------- -- - -- -------- ------------------------------------ �✓
In the village of
i � p
--- ---- -- -— - -- - --------------------------------------------------
75 or"r�nore feet f m any source of water supply
20 feet`from building
10 feet from property line 1 0 '
Health Officer. —1
No.
FTHF T
'OFFICE OF THE BOARD OF HEALTH
OF THE
® B9HHSTALLE, a
TOWN OF BARNSTABLE, MASS. .
y MASS.
ADD MAY �\ R� } �--
SEWAGE DISPOSAL _PERMIT
Permission is granted to '_______�____________-? ____s __ __` to construct `___ _�- M_—___—______ -- -------_-------
Upon ,the Premises of �, ' �R <: ! Skrtch
In the, village of
.75 or more feet friprp any source of water supply
20 feeNfrom building _ -.���� •�
10 feet from property line
Health Officer • --�------ - r
razardous.Materials Inventory Sheet Checklist
Date
Physical Street Address-Check database to ensure it exists
Working Phone Number NQ � 0, Nn
� orti2;
�� Actual Amounts -( ie. gas being used to fuel machines, thinner to q.r�-
' clean brushes all count as hazardous materials)
Storage Information -location of storage, how long is storage for?
f none, note that.,
Dis
posal Information -where and who? If none, note that.
(Z pplicant Signature - understand what is listed and noted
Staff Initial -any questions, know who to ask
Vehicle Washing/Rinsing? - provide a vehicle washing policy and
explain it - note that it was given
Attach the Business Certificate with your sign off and comments
"The inventory form should explain what the business consists of and the procedures
they are doing. Notes need to be left to explain what you discussed with them.