Loading...
HomeMy WebLinkAbout0009 BETH LANE - Health 9 Beth Lane Hyannis A= 288 —273 - 199 _r r r Up THE Tp� DATE: + BARNSTABLE, * • y MASS. i639. ♦0 REC. BY Tf°MAMA Town of Barnstable SCHED. DATE: . Board of Health 200 Main Street, Hyannis MA.02601 Office: 508-862-4644 - Wayne A.Miller,M.D. FAX: 508-790-6304 C �&J/CO C'0(A_ Junichi Sawayanagi Paul J.Canniff,D.M.D. REQUEST FORM r7 O a d LOCATION ® � t Property Address: 1 Lnv M�,arn,S Assessor's Map and Parcel Number: �� t 2`�' Size of Lot: Wetlands Within 300 Ft. Yes Business Name: 'No _ Subdivision Name APPLICANT'S NAME: Phone Did the owner of the property authorize you�to represent him or her? ; Yes No PROPERTY OWNER'S NAME CONTACT PERSON - Name:�P-CIS-r!. �?i�M 2 n i o�S Name:.. ��" N Address: Address:_ 76 Va,,,keu)4 Lr. , Lls AA Pho ne: Ph ne: o -- 4 S « ••_ • Tr•(1TTT A TTlIAT(List Reg. REASON - 1 , � (May attach if more space needed) GCtctAan� slonrd� r�u��� ��.� `UnS�rcCtc� �j ._n✓�V! e COIJ '(aar c ar.u{ C M, 4 SYSgeeA NATURE OF WORK: House Addition 01 House Renovation �d Repair of Failed Septic System ❑ y` Checklist_(to be completed by office staff-person receiving variance request.application) Please submit copies in 4 separate completed sets.' Four(4)copies of the completed variance request form Four(4)copies of engineered plan submitted(e.g.septic system plans);'l. Completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registered sanitarian Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by.certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) y Full menu submitted(for grease trap variance requests only) 1 Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/lessee only], — 1 outside dining variance.renewals[same owner/leasee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) _ Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Wayne Miller, ,Chairman NOT APPROVED :Iunichi Sawayanagi REASON FOR DISAPPROVAL Paul J.Canniff,D.M.D. C:_\cache\Temporary Internet Fi1es\0LKAE\VARIR3Q.D0C. MAIL-IN REQUESTS Please mail.-the completed,variance application form to the address below. Also include four copies of-engineering plans, house pla-is, authorization letter, etc. (see check-list below). In addition, please include the required fee amount (see fees at bottom of this page). Make $95.00 check payable to: Town of Barnstable. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 Checklist _ Four(4)copies of the completed variance request form Four(4)copies of engineered plan submitted(e.g.septic system plans) Completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registered sani:arian Four(4)copies of labeled dimensional floor plans sibmitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorizes.you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only) _ Full menu submitted(for grease trap variance requests only) $95.00 variance request application fee (no fee for I feguard modification renewals, grease trap variance renewals [same owner/lessee only], outside dining variance renewals[same owner/lessee only ,and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, you must mail the required $95.00 fee. Please make the check payable to- Town of Barnstable. The check must be mailed to the address listed above. In addition, please mail four copies of engineered plans, house plans, authorization letter, etc. (see check-list below): Checklist Four(4)copies of engineered plan submitted(e:g.septic system plans) Completed seven(7)page checklist confirming review of engineered septic system plan by the submitting engineer or registered sanitarian Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variance requests only) $95.00 variance request application fee(no fee for lifeguard modification renewals, grease trap variance renewals-[same owner/lessee only], outside dining variance renewals[same owner/lessee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page i t, a z N a i` ---- 3 c J 3 3� 0 Z _Sp N, a Ir F 0 p - r- F 6 u Z l d < 1 S3 -w I uu i II. O I� ;I a § o I 0 4p u� I uQ I o { I { ASSESSORS MAP NO:Aid K 7 i N�o.__ z �s� PARCEL NO: THE COMMONWEALTH OF MASSACHUSETTS e ' BOARD OF HEALTH mP Axi iralion for Mfpml Marks Tomift �.ribn Vrrmif C tr �3 -� yl ;Application is hereby made for a Permit to Construct ( ) or Repair (j() an Individual Sewage Dtsp 4tSystem at: l.a Rr4_-__.3 C =g __.� 6_.�r�/? N_ N 1!�Lam______ ner Ad e - - Installer p Add... ss Type of Building Size Lot M�9C,�____Sq. feet U " .. Dwelling—No. of Bedrooms___,_ -----------_------------------_......Expansion Attic ( ) Garbage-Grinder ( ) a.a Other—Type ype of Building -------------------------- No. of persons-_t----------------------'Showers ( ) — Cafeteria ( ) dOther fixtures - --•----------------•---•--------------------------------------------•-••--••---------------------••--------- Design Flow----------------------------___---------gallons per person per day. Total daily W ily flow----------------------------------- gallons. WSeptic Tank—Liquid'capacity---_.--___-gallons Length................Width----------------Diameter----------------Depth---____-------.- x Disposal Trench—No.-----------------Width-------------------Total Length--------------_-_--Total leaching area--------_----------sq.ft. 3 Seepage Pit No----------_--------- Diameter-------------------- Depth below inlet_---------------Total leaching area-_-------------sq.,ft. z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by-----------------------------------------------------_ -------------- Date_----.-..___------------------------ a Test Pit No. I.---------------minutes per inch Depth of Test Pit------------------_ Depth to ground water..__":______-_-- -_. GT, Test Pit No. 2---------_---minutes per inch Depth of Test Pit___________________ Depth to ground water------------------------ ------------------------------------•--------------------••--- ...------------_-_----------------_------------- ODescription of Soil---------------- - ---------------------------•---•-•-•---------------••--_------------------------------------•-----•--------------- `.4 W -------------------------------•--------------------------------------------••--------------------------•--•-- ---------------- - U Nature of Repairs or Alterations—Answer when applicable----- .d i&v> � �-��-e,-____ _---_.______--- •---- -------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issue I by the gdo health. Signed_--•= 5' - — - '- Date Application Approved By-------------- tom.". --t� "'`= a - -- � .._____.___ Date Application Disapproved for the following reasons:------------------------------------------------------------------_----------------------------- --------------------------•-••----_•---------------------------------- -------------------------------------------------------------_-•----------------------------- �r Data Permit No...... Issued__.__..._..-_._._--•----____-- - Date. THE COMMONWEALTH OF MASSACHuSETTs BOARD OF HEALTH z OF.........izs.aar zwe l!Y L_-----_-- _----__ Tntifixtttr of (I mpliaur e { THIS IS TO CERTIFY,That the Individual Sewage Disposal System constructed ( ) or Repaired b -- y� Instpller at---------------L'-oT.....J�--°----1-ots �1_-_ !`-_•-----__l. •_ -------------- -------------•------------ ------------------- - " -- has been instailed in accordance with the provisions of Ti" 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No___ _____._ THE ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION ATISFACTORY. DATE - - 1------.-__ Inspector_ -- - - -- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HE P 8 go s - .......................O F. ............ ----------- ----•----•-- -..._..- �i��o��rk��ton��uz�ion �rrm�t mission is hereby grantgd ---- -- - •-•-•---•--••------------------------- ug�7c) o air - arOndixiflual Sewage Disposal System _.._.--•--- - - - - - - . -----....-- - - - - seeet the application for Disposal Works Construction Permit N' .__.. ___ _______ Dated----__---_:._.----•_-____-_--__----__ J------------------ — I —•-----Hoard of Health . A$Built Page 1 of 1 / N OF BARNSTABLE t4/ _ LOCATION fie'! .�� � `'�/� f�.fi/Jt SEWAGE #8 ' /�5 / , p773r �7 VILLAGE l71Vl+ lfl/� ASSESSOR'S MAP 6t LOT INSTALLER'S NAME & PHONE NOL_�. SEPTIC TANK CAPACITY J O 4 6 LEACHYNG FACILITY:(type) - (size) NO-OF BEDROOMS PRIVATE WELL O PUBLIC ATER a BUILDER OR OWNER. eAx d on ,,,r C DATE PERMIT ISSUED: DATE COEiPLIANCE ISSUED: —�S'• &' VARIANCE GRANTED: Yes No 1 02601 367 ? [tin �Lreel, Jd junnes� Barbara T. Ouber 9 Beth Lane Hyannis, Ma. 02601 Dear Ms., Ouber, Klimm, !";artin .J . .Flynn anO You are herby notified that' we, John C, b: Sar•nstabl e Ceun.t;Y Tarn' o .Barnita i e , Jeffrey D. Wilson , as celectr�.en or th:e. Easement aT a To�,n :lay, behalf Or said Town have taken ci i'JF`ilC, r `i�iaCj2 by tn2 S21E��- h'EZSSaChUSettS , OncGUare T22t Of yOUr land as SnO�':ri On c H•; c• in 6255 PRECINCT 3, men entitled TOWN OF BARNSTABLE, PLAN OF LAYOUT, BETH LANE VILLAGE: HYANNIS . t,d copy of our Order of T±kinp is, recONS Ec' with - i,ar i ; ( - i-bed rl C 5:,`1 ch sai d �� an b; i�n n -ble lOUn Ll� On�': that t we � _ =°j S Min o_- Jai d` Easement i n your sal d cainid rr +t, _ Ion c ons- for A ruction. ,� rnt inciudecl' in r,�; r-.oc - n �- ,;-;or; one LCnd i.b .t- _ . c�t ' es. r c- u _ u; S -.c Any trees Gj_ _ this C taking,� Q and you ' _ - n' 1 to _ _ L _i r1n ward is not accapta ur _ _ n years -Om i i he de- On the Court i U, �c N r -.)Eie e ,en tIIII' TOWN OF BARNSTABLE MASSACHUSETTS DATE —9. APPLICANT K 1t I c I , ( n t tit( r AI , Ij��nnrl� _ #OtmFr (NO ) r (STREET) m • (CDNTR 5 UCENSEI PERMIT -STORY - � Y, (TYPE OF IMPR pyE ME NT) NO (PROPOSED USE) ;. a, ATrFLOCAT10NIx � - k� i� i / i r I�r ,. { f zr r ZONING ¢ �' (NO ) R - (STREET} - DISTRICT +� i'� d- k�' tY x•4 f �� '� F .r EEN ��*� £� £ f b STREET) AND s -; SUBDIVISION 'r t r '* r � � -�� � � LOT LOT. ; x SIZE # 3 3 f� BUILDING IS TO BE � / y t t � x r � � K �- z � s y � .. rF�T WIDE ��;LONG�r�BY� 1�ta � �'k FT IN HEIGHT AND SHALL CONFORM IN-CONSTRUCTION*-_ ' - *TO TYPE z 'USE.GROUP � � k #� / � - .� BASEMENT WALLS ORFOUNDATION " ' -, : r (TYPE) ,r-- '' REMARKS s '1T r s t t J �rl[' "t u t rt_ � t a. ^r � ,. 7 S �`•.�" AREA'OR q bra, ., 1 is �, .< .�; ' } 'aa c t � s° a :" - � :� z :. � }. '+ESTIMATED�COST � FEEMIT � CJO 1CU01�/SOUA1iE FEETI.. uu �s � v t x ,c ;ADDRESS sy j{i,�.�y+1,.. I�s�''1n �f11I r7 t ii3r '' r �`�5,4`$- r i � �' "jx � t�-��BUILDING DEPTt t' xBY_.s '• �° I F t.:� r y�3'?5 �7 �.,t t f S �k �a -x't=r �� b - 1 ;. .�' :+:r 8-'� .v v,i—*vel-t4c—yrar t n� —fxC—M57tJ'i±7V'�.C T71"'x r hTl� t "OF ANY;gppLIC�ABLE $UBDIVIS.I�ON RESTRICTIONS � � <-. >�'R�I� Wt5'iN0-;Y'fYEC�As'ETREyA�L�CANT OM THE:CONDITIONS.,MI NIMUM xOF.r+ L:HREE C A'LL - ' �� x �� � � ,p�+'t s �, 1 NSPEC710N5 REQUIRE,D:FOR -�. �'�' AiPPROV;ED PLANS MUST BE RETAINED ON ,tl.OB AN.D THI �`�:W ' ALA CONS RUCTION�Wp:RKC.ARD�KEPT POSTED UNTIL�F{IzNaL-I.N�P -- - S HERE.;"APPLICABLE SE PYAR A.L_E� S ECTFON HAS�.;BEE1�.-;EER,1"11 T;5 AR,E�;REQ a FOUNDATIONS OR FOKOTINGS",E. T MADE a WHEF2E�A `CER`TIFICATE OF'�OC EC.;T:RICAL;rJPL'VM.B'LNG ....AND � s2 yPR10R TO C.OiV ERING'iSTR VC T,UR AL - r -+.. -;� ,,;�, CUP:A NCY CIS RE MECH ANICALeI:NSTAL�'L�ATION5 .' M1 M-B,£RS(RE'ADY 7ohLATH) Q: IRED'SUCH B:UILDIN.G SHaLL NOT BE OCCUPIED'UNTIL`;;; t ! 3 FINAL`INSPECTION BEFORE FINAL INSPECT°ION HASh1BEEN MADE 7 �' OCCU:PANCY xl �- - - - t � � ,n � : ELK � S '-.#. # :_F t s r n �'�• �,�;�"' �,, `ki ��!x �( P�OST�T1-II5�,C�R1� ��Ofi I,T�`�I /ISI�LE F`Rp� � �..��� ski � ���� �.:BUILDING INSPECTION APPROVALS` �• s y �T E E � - +? 's PLUMBING INSPECTION APPROVALS ' ELECTRICAL INSPECTION:APPROVALS • e t° a � r _.: i it ( - 'ic .' K*� : r � < -- � F: •F't .i SY p , 3�' e� �TY Y s( tl F s ��� $ x1 y� � � 7. 1 { �. +�`. �a ;Y - ry " r 1�fin.-.o �� "� -r,� atu4�.}�}�,� •� ":�,Yr`e� ( x c Fw- 5 t ''- r ,�� ? �-: yah.yv. t r p 1 ;}� `->1 .� .t� 1 i '• L F t Y . !a 4r x�Y � I 3.f P ) .i�` �"Y -:r c a x z •� V�''� '' i 6 Z -�� �''tr• _ � ,_,:3 4 '.. u ✓ APPROVALS � � ENGINEERING DEPARTMENT' 'f 4 F :.r s3- >; -c att �x�'.., P.Nya - I �� � • - a � OTHER a:' 1: r,.�"m.� �- - t r y '`-- -�>;�' +"�"` #*•�`' e .�` { � `` s BOARU OF'HEALTH { y s a. 5 11 i WORK SHALL NOT PROCEED UNTIL THE INSPEC ?' a E RMI T wl r,€ � w � LL BECOME yUL € TOR HAS APPgOVED THE VAgI0Ut1S STAGES OF `z ,wORK-IS=NOT SIARTED'wITL AND v01D'IF CONSTRUCTION ItVSPE�TIOtJS INDICATED ON'TFiIS CAFlD CAN BE t, CONSTRUCTION ? y. HIN�SI MONTHS OF,•,DATE T.HE ABOVE -� AttRANGED:.�FOR gY,-TELEPHONE UR:W9ITTEN } "` `�'� �' '� { fi s•�r� �, ; ,,, " 6' NOTIFICATION ,� r, BUILDINf e TOWN OF BARNSTABLE, MASSACHUSETTS' 19 y•T PERMIJi _ i GATE !�—•_, / J`"i/ � (1 YI('. ADDRESS - (STREET) y I (NO ) APPLICANT I� I (� I - _ - NUMBER OF WEU-ING UNITS ..:Y• .E�•�-) STORY I PR OPOSED l5E) PERMIT TO ` No. ZONING (TYPE OF IMPROVEMENT) DISTRICT--�� AT (LOCATION) (No.) (STREET) AND (CROSS ST REE71 BETWEEN (CRoss STREET) LOT LOT BLOCK_— SIZE SUBDIVISION - FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION FT.. WIDE BY FT. LONG BY - �= BUILDING IS TO BE - BASEMENT WALLS OR FOUNDATION (TYPE1 USE GROUP TO TYPE REMARKS: PERMIT ' rJ 0 0'0 - Q@ i ter cl _FEE i ESTIMATED COST $ • i AREA OR VOLUME (CUBIC/SQUARE r BUILDING DEPT. n OWNER ;ic. i) 1. , .;1i1 _ By t?T ,l ADDRESS - y r,.,,�n,r.:irte--i-Sw-A'ryu''e`U'r..r:n"I'ST''EFtMI'I--UU>=5'NUT'�RELE ASE THE T'P ANT FROM T DITIONS HE CON t ...__. =+- •- ""`��" WHERE APPLICABLE SEPARATE OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. RETAINED ON JOB AND THIS FOR �` I PERMITS ARE REQUIRED MINIMUM OF THREE CALL APPROVED PLANS MUST BE c. —,CrkICAC PLUMBING AND INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL IN HAS BEEN MECHANICAL INSTALLATIONS. ALL COIJSTRUCTION WORK: •MADE. WHERE ?. CERTIFICATE OF OCCUPANCY IS RE- I. FOUNDATIONS OR FOOTINGS. 2. PRIOR TO COVERING STRULTURALIQi IREC, S CH BUILDING I DIING SHALL BEEN MADE. BE OCCUPIED UNTIL MINAL INSPECTION N PE TI TO BEFORE BLE FROM ����5�, 3. FINAL INSPE f_710N BEFORE BW� OCCUPANCY. 5 p®� ■ THIS CAR PLUMBING INSPECTION APPROVALS BUILDING ELECTRICAL INSPECTION APPROVALS BUILDING INSPECTION APPROVALS ---_- - z j z 2 / •� ENGINEERING DEPARTMENT HEATING INSPECTION APPROVALS ' It I I BOARD OF HEALTH OTHER CONED ON THIS ARD CAN BE PERNIIT W!LL BECOME NULL NSDI•VOIDITHS OFS DATE TTHE ARION RANGEDSFOR IBYTTEELEEPHU E(i%R 'd/RITTEN VVOR:SHALL NOT PROCEED UNTIL THE INSPEL: WORK I S N 0' STARTED NOTIFICATION. TOR HAS APPROVED THE VARIODUS STAGES OF I PERMIT iS ISSUED AS NOTED ABOVE. CONSTRU(:TIU)` _ - EfIYt: / Receivedby Date @yo*'THE,To�o TOWN OF BARNSTABLE w OFFICE OF i sAsasTssLa l NAdR BOARD OF HEALTH i639. 367 MAY MAIN STREET k� HYANNIS, MASS. 02601 October 26, 1989 Barbara Ouber •. 9 Beth Lane Hyannis MA '02601 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410. 000, . SANITARY ' CODE II, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION The property owned by you located at the apartment at 9 Beth Lane, Hyannis, MA was inspected by Jerome Dunning, Health Inspector for the Town of Barnstable, on October 25, 1989 'because of a complaint. The .following violations of 105 CMR . 410. 000 State Sanitary Code II, Minimum Standards of Fitness for Human . Habitation were observed: Regulation 10.5 CMR` 410:190: Insufficient hot water provided, temperature of water only 57 degrees farenheit Regulation ' 105 CMR 410.200: - Insufficient heat provided, temperature of habitable room °only 58 degrees farenheit. Regulation 105 CMR 410.482: Smoke detector inoperative at time of inspection (10:00 A.M. ) i Regulation 105 CMR 410.450: No second means of egress observed. The above listed violations are also listed as violations of 105 CMR 410.750 as conditions deemed to endanger or impair health or safety of the occupants and must be corrected within twenty-four (24) of receipt ,of this 'notice.. You may request a . hearing if .written pet ition. regiiesting is received by . the Board of• Health within seven. M— days after the . date order is received. However, these violations must be corrected regardless of any request for a hearing: ..- Non-compliance may result in a • fine' of up to $500.00. Each days, failure to comply with an order shall constitute a separate violation. PER _.ORDER OF THF� BOARD OF HEALTH Thomas A. McKean Director of Public.-Health cc: Hyannis Fire Department Building Department `- TM:cst 367 Fain �freel, �d'tunni�, it/asp. 02601 Barbara T. Ouber 9 Beth Lane Hyannis, Ma. 02601 Dear Ms. Ouber, ._.j L r J . •Flynn anO You are hereby no'L I Pd that we, ,;onn C, Kl l>1m, ` ! 51e Co!lnty 1 nstab_l erns-a JeT ii"ey D. Wilson ,l Son , as Sel eC try 2n of the. Town o Bbr, _.�c e �sE:Went of o T01,tn 11ay �1aSSaChuSettS , on behal� of sal To�:n nave t,ak n n 'rJhi1.0 , in 6255 square feet of your land as- Sho'vlri on. a Plc ma�'2 by Ln2 s^clECi-. men entitled T014N OF BARNSTABLE, PLAN OF LAYOUT, BETN LANE, RECINCT 3, VILLAGE: HYANNIS �` o , ; n - : e^ c o our Order O , = r r , n ,. o - ` i ,:b i� l•_,-inL�� C1inC Laid . c -���� ?"\, `,j :: � - C � J �.. - V \,�-i c ; � :_ , Its In your a d c, 0 b � J t, !� - : I eL i cr! c i con - o,:r: G I _ Str~� lC l" cri 1',ll i Ve a` - uc ion. _��( - - j1 C1 L i nC t it 1,.Ci i n tr- ..aSLrie Ir.rlo r.�:�:VC _ .. .. .. 't\' . -es or c..'i, �' _ - r uT es, Cc i .cbl2 to y�L', ``C:i ea. 'v f i \ i 1 it Lnl S Ce 1"l::frlC ! ell of y��tur _ C,,.;'Jcy^ l VTR CC>J7 L for `-,'C - _ tr:= _ i.e iiCl-Col er T!pvin k) - G, t f AsBuilt Page 1 of 1 pp N OF BARNSTABLE L LOCATION y, (3 �� .�� ' ,� SEWAGE �{.�� ""8 � _ d /9 VILLAGE J��'_ ASSESSOR'S MAP 6 LOT a73 INSTALLER'S NAME PHONE NOr,X1l4i;,j.' C) SEPTIC TANK CAPACITY j 0 C3 6 LEACHING FACILITY:(type)_ (,I j (size) f 60 0 f NO.:OF BEDROOMS PRIVATE WELL O PUBLIC ATER BUILDER OR OWNER. &Qf SAP4 Ccr C DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: � — � S'• �B' VARIANCE GRANTED:- Yes No / .. y http://issgl2/intranet/propdata/prebuilt.aspx?mappar=273199&seq=1 8/6/2012 z � - _----- - -------------------- s ° ------------ a �cJ o x , F o a a u- i i I i !i � 0 i i o Q TOWN OF BARNSTABLE LOCATION SEWAGE #C) a�3d i9 VILLAGE �(0 C� ASSESSOR'S MAP & LOT INSTALLER'S.NAME & PHONE N0.C /�f11�1,�;' 9v SEPTIC TANK CAPACITY , 0 0 6 f LEACHING FACILITY:(type);a - o n- (/ (size) f(3a NO,,OF BEDROOMS PRIVATE WELL O `PUBLIC�VATER BUILDER OR OWNER AAe 94'e4. oo as'c DATE PERMIT ISSUED: DATE COLIPLIANCE ISSUED: ':VARIANCE GRANTED: Yes No 4 " � f t f; L t t� i ,l k ASSESSORS MAP NO: PARCEL NO: 1�PAX-r FEB.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ------...... -_.._.......--------...OF......................................... ApplirFatinn for Uh4pos al Works Cfnnstrnrtiun Errant a 7 3 ✓I9 q ,Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disp System at: T =Oqjvws-----.-------------- --------------------------------------- ..-------------,--------- Locati Lot No o. r_a�tP .----...... ................-.............. .....:9--. . _... O ner Add e s JAj ' Installer Address /� Type of Building Size Lot__�61----_____Sq. feet ., Dwelling—No. of Bedrooms_ ____________________________________Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building ____________________________ No. of persons _____._________.___.___ Showers ) — Cafeteria ) a YP g P ( ( 04 Other fixtures •-.................................................................................................................................................... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. f 1:4 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter________________ Depth................ 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 ( ) a Percolation Test Results Performed by--------------------------- --••--•------------------•--•-----............ Date........................................ Test Pit No. 1....._..........minutes per inch Depth of Test Pit.................... Depth toground water.....................__. Gz, Test Pit No. 2..._............minutes per inch Depth of Test Pit____________________ Depth to ground water........................ Q+' -----------•---•..................•---•-----•--•----•------•---......_._..--•---•-------------...__.._..--•---•--...-----------._....---...--••-...._...._._. 0 Description of Soil........................................................................................................................................................................ V W ----=----•-----------------------------------••---------------------------•--------._..._•---------•------- UNature 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"T';i s>. �of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has 1)e,'h issue ` y t e oa•d o health. w Signed. ........ Application Approved By..........._. �. ......................... ate Date Application Disapproved for the following reasons:---....-•--•---•-•----•----•---•----------•--------•----------•---------------------------•--------------....._. ...............•----..._.._•-----------•--•----------•----•--......__...__....•---------...._._._..----...-•--••-----------------------•---------------•-•----•-------•--•-----•••------•----•----------- Date PermitNo...... -._ ---------•---------- Issued....................................................... Date, T:7 Fim..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appfiration for Disposal Works Tonstrnrtion Prrmit ;p Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual-,Sewage Disposal _ System at: <� ..................T J� . .�r�..._.. ', .n� �. ------------------- ---------------------.......'---.....--.-....._..x1� -....... •- d_7._S/ .........Locati. .. A--•----------------------------- - --. +.J-S..l... ....�:'fli-Y..S.__t.�T o yJ_7_ Owner Add e s W C�> '''�-I----------------------------------------------- ---------- `�t /.....::.` -. r'�AA. Instalier Address U Type of Building n Size Lot. .��. ......Sq. feet Dwelling—No. of Bedrooms-__j........................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________-:__- No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures .................................. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. I:4 Septic Tank—Liquid capacity............gallons Length.............•.. Width................ Diameter................ Depth................ 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........................................ a P P P - Test Pit No. 1________________rimutes per Inch Depth of Test Pit.__..__.__._.__._.__ Depth to ground water____.____._._._...._.. . 44 Test Pit No.12................minutes per inch Depth-of Test Pit.................... Depth to ground water........................ ----------•--•--•------------•----•-•-----•----•---.......-•--------------------------------------•......................................................... 0 Description of Soil...................................................... -----.....-•-•--------....-----•-----------------------------------------•------------. U -----------------------------•....------------------------------------------........-----•----....-----------------•------...--------------•----•-------------....-----•--------•---......•••... � ••----••----•-------•---------------•--••--•••----.........---•-----•-•••--.......-----••-•-•-------••------- --••••--••-------------.......................................... U Nature of Repairs or Alterations—Answer when applicable_.._.f C�! �r ____-- 'rrA F_•_______ ---------------------------------------------- ------------•--------------------------------..............--•---•--------••---------••••----------•-.................................................. Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T1'LE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has issu y e oard o ihealth. n Signed . --- Date w,Application Approved By...............*% `1-- - "'r`-- ---------------- •----------- ........................................ Date ft Application Disapproved for the following reasons------------------••-•-•••......•---•••••......••---•-••--•--------•---•------•-----•---•----•••--•._...---•---- ------------------ Date PermitNo.----- --------------------- Issued_....................................................... Date id THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH h � � �. Gt.c +-1.r........OF......... ................... 1 %Trrtifirtttr of Tomplianrr r .THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (� by.............. -...a....o �.-------•------•-----•---------------------------------------------------•---•-•---••----••--------_..._--------------•----•------ at---...............• ••---•r----- ..........I nst••iller• ---------•---- has been installed in accordance with the provisions of T_L 7 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No---- dated------------------------------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FU CTION,�ATI•SFACTORY. DATE........................... ...t.- ................................. Inspector........................J ----- 2�..2.....E ------------------••-- �y THE COMMONWEALTH OF MASSACHUSETTS c �-- - BOARD OF HE NO......................... _; FEE........................ Dispo,s rk �on�a�rion rruti Permission is hereby grant d� ------------------------------------P -----•-------•--------------------•--.....---------.._....---------------.------------ to Construe�� o'�Rgair �Z di�t�lu� Sewage Dis oral.S stem atNo................................................... ...........................................__.._..._.. ...... Street1 J ....................................................... as shown on the application for Disposal Works Construction Permit N .. _ -__ Dated.......................................... ......................... ---- ----- ------ Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS Ld"CiAT IOW - SEWAGE PERMIT q0: 4 dI-LLAGE IHSLA LLER'S tgAME to ADDRESS D�U I L DYE R OR`; OVU ER svly �(t.s DATE P Eft I1IT IS.S9ED DATE C0raPLIAN'CE ISSUED -, . . '� c -{-.� cs y� � �I� � F .�. � G. � G, (� G d � Q � � � i �,o �, _ � ��� � �cY :_ F t `t a ' � _� � 1'�' __' No.................. Fss................._............ THE COMMONWEALTH OF MASSACHUSETTS BOARD., OF HEALTH --------------OF..... ....................... Y �Sf ........ l��--------.--_.............•----------- Appliratioo for Diipoia1 Works Tomitrurtioo Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Sy at: j. ko+ `� --------- --•----•-•-----•--. ....._/... -.•-•....-•..G.t............................re, ........ i tAs- of C©s � =s "v,5oLer'Aes . yL oj-s a )q .........�.. ------------------------- `-------.. .-. ------. ..... e ---- --.--- ------- -------- --------------------------------------------- ------- ------- ------- ...0 1` Installer Address ,,,,..... U Type of Building Size Lot..1/ rr!0S_..�_.._..._..Sq. feet Dwelling—No. of Bedrooms......................................Expansion Attic ( ) Garbage Grinder ( ) aOther=Type of Building .... 0_0;d.___..... No. of persons............................ Showers (2-) — Cafeteria ( ) a' Other fixtures -------------------------------- W Design Flow_______________________________ _________gallons per person day. Total daily flow....... �...._...... . .. _gallons. y f W Septic Tank—'Liquid capacity. ®-gallons Length................ Width__- ..........:_ Diameter................ Depth.. .__--____--- x Disposal Trench—/ ._.. No -------------------- Widthh�...`�............ Total Length...... _.J-------_- Total leaching area----------_.........sq. ft. Seepage. Pit No...../--------------- Diameter../ _�i.___---_ Depth below inlet.. ............. Total leaching area..c;18�...sq. ft. Z Other Distribution box (L-� Dosing 2 nk ( ) Percolation Test Results Performed b .-______&W2 n....& . .................................... Date........................................ as Test Pit No. 1.._2.......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.--___-_-_--_--_--___-_. P4 ---•----...---••-.............................................................................................. O Description of Soil -�-.�j-----•...... "5.6,�2%4)C, x `� --------------------------------------------- s 7 dD 1C,5�------�.--�-n------------- W ------------------------------ I.�"-L.Z. -...... __ $And # _t'?�E4: -`---------!ao.. /S/ .---��4° �...........................aS d UNature 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'TILE p 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. / Si ed � /v/�� ................ �0 ✓ / Date Application Approved By.... Date Application Disapproved for the following reasons-------------------------------------------------------------------------------------------- -•----...._....---- --•-----------•-----••------•••--••-•--------•--------------•--••-•---••---------•---------•-••-----.....•-------•------•---•---------•••--•---=-------------------------•------•-----------••---------- �a" Date PermitNo......................................................... Issued.-=�---..----.---------..`..F...----.._ --•--- Date a................. THE COMMONWEALTH OF MASSACHUSETTS BOAR OE HEALTH Now�, .. � s�� -�-°e._------------------------------- _. . OF.................. Appliration for Uii#oiia1 ork�i Tonfitrur#'ton thrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Sy at Z LfJaL f J* .14nq dres Coss +, 'T�o 4..cq4 8e r (� 1 J � ........................ ••....... ..�.......---- ... ..... -•--_---- f... - r a .... . --.•---- •---•--- ----•-•--...._.. -•.............• ............................_.....C..... - --P`"! ... Installer AddressPQ �, UType of Building Size Lot_ _ ____ _________________Sq. feet Dwelling—No. of Bedrooms___.:__. .___._____ __Expansion Attic ( ) Garbage Grinder ( ) No. of persons............................ Showers Z — Cafeteria Other—Type of Building ............. p � ( ) ( ) al Other fixtures ----------------------------------••--• - W Design Flow............................................gallons per person day. Total ily flow--- Ions. G; Septic Tank—Liquid capacit Q_zallons Length.._....... Width__._._..... Diameter................ Depth..-_----- Disposal Trench—,No..................... Width.................... Total Length---- Total Total leaching area....................sq. ft. Seepage Pit No.----------------- Diameter.I:Q'.6.._..... Depth below inlet. =____..._____._ Total leaching area$ ....sq. ft. Z Other Distribution box (L-.1 Dosin tank ( ) Percolation Test Resul s Performed by.__ ;0.f�....do ................................... Date............................ aTest 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...... ................ ----•-•------------•--•-•-••--••----•--........................................................ O Description of Soil.©_` i� "004P.-'.'_'.__ _ ? 4.?. x '�y'�� . ........... > n .l ....................................... --------------------------------- _Y_r z _.... u +n � '�0-_ley.............................................., .............. , an� UNature 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 T`L p 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. S)*Cne ... ............ ..P .............. A�....... Date Application Approved By... >'" = •---j•. _J ----� / Date Application Disapproved for the following reasons--------------------------------------------------------------.................................................. .................•-----------•---....------------------------------------------------------------------------------------------------------------------------------------------------------------------ Date PermitNo......................................................... Issued-..:_ _..••-----------•---••--•--.....-•-•----------•- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF" HEA H ........ -ts*1.........0 F............. .............. .... .:.. :........ .........� Tatifiratr of Tompliitnrr HIS IS/ 0 R That thq4ndividual Sewage Disposal System constructed ( ) or Repaired ( ) by ... ....:. .: �',I t ._.. ----- ---------------------------------- I j /r at- ......) has been installed in accordance with the provisions of l T 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit Nq_ __�d 4............... da.ted_...._J.---/�_'`___�`_1f._._...... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ir iInspector —� .. .......................DATE._.:........ ----•-••--........ .._----....... ...-----••-•�THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH !" s�t.........OF.......... . ..... �'° .4.----------------...-----------.........._ . .Eo.!...__.. FEE ......................... $�A �G ��Iltt� Permission i herebyranted + 1-� ---------------------------------- g to Construe ) or Rep anAn -idual wa e Disposal Sys J�j at Non ....0•01.-• �/�� Street as shown on the application for Disposal Works Construction P t N j___ ____ ______ Dated 'l1'_- -�".------. .. ------------------------•_.... d � DATE-�----�-`Z'- ------ ---• ---'-•--•------------------------....... $oar of Health FORM 1255 HOBBS & WARREN, INC., PUBLISHERS f LOCATION SEWAGE PERMIT q0. • VILLAGE INST,A LLER'S NAME & ADDRESS B U I L D E R OR` OWNER i �( yl0i8tiS DATE PERMIT ISSUED ��Z�� / DATE C0MPLIA'NCE ISSUED tt r — --- -- -. 50 Uc,::ti i /�6 I loco G.4 l r . ' NOTE a/l , /oca.tiorns Showr7 are /�l P�'aPotsd on/ , x a ca�a��-urr, s S. t 85.Ts w T N ."" `moo e Air a at 32. v • \j � ol o r , C1 Z- O 7- '5o z9 , 9 , SE k/A u T !OA 7 t9 T S T N O E-S v 4L 7 S FGO`t/ Ge'mS /6it./ 1A.1 ' T EL�1/.-9T/o�/S dcafe .�5 /� 7Z Supervised bra: t�,eoon�S /000 qa / s4Pt.'c f,a.-7k 7©rvw OF' Bg �rST�eL - ...- AC>0--S/Gill i O lam/ 33 0 � f��t�f'OSE-O L Ef�GI-1 i9�?E� ca�iStributior7 bcac' o z4' `' 5'•� �a��dCLt�/ ..�a. �`..' f01:7-r7-7 £ SUbSoi ' - r•�ot �c/uodir'�9 eX�czr,Siori - oft/ret',e/tv ,�. �8 Of H . /each- i t ` •;.,, . • • - ,. Goa,rSc; . .5tt.-sc✓ , washed stone. - 48 i"/e f- a!e V. y Win. r botito� Ofi t toP Of F.0 Ur - cle cz 17 GOCZr a/ /4 4„ SB ' cxit '- miry Plf-o/i y,er focf- /aeaSforre x . . , . i distri,buti ors -boar • .' . - 1 Sd of I'VC 7' ,-7& u , Q,♦ /o re c L257i ' scQ.le- 1 a 1 ft e e • ' /each , • ,$�`O rf G ' • o w /O.S z ' The 45, Cr�glir�e±er whose S/`ar» a earS ors these c4-,cx wlr7. s M .. / 7►- �'L..i4/l/ o,- Z..v.vv `MY P f'f 9 ' sha/l be r'esPorrsible. for 74hC- ` sci/vervisior�` a»o/ cer�>,¢icafior� o,� - kF�0S7- o9F-'e:-: Z4J1e- Z�) Gorstrvcfiorr A-7 s7rict aGC-ordaoic Sc a/G • „ = ex with �•hese pars when a,Pf'rovea/ by /777 - fht govc,-r7irn,y board of hea/th. 7` .v�C 7/ aP�rovec�!' BfI.E.'il/5T9�LE- BOAP_O OF .4A4C o G 7-H OF k 7 f v r • - pia�'G r7 r r7 y ,E'OvT,rr 6 -- )'Olq 'Mau7-H M104sS.41 b 77-00