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HomeMy WebLinkAbout0042 BRIARWOOD AVENUE - Health 42 Briarwood Ave. A = 289- 131 Hyannis a ��T..OWN OF BARNSTABLE LOCATION t d`� �it t Aje—Wow vkVt—SEWAGE # I6 VILLAGE 6�--`C .t tS 'f7Z( ASSESSOR'S MAP&LOT.,)-S INSTALLER'S NAME&PHONE NO. ISCrl—C �o�•F�-cam 9��� SEPTIC TANK CAPACITY LEACHING FACIL=: (type) t`T— (size)NO.OF BEDROOMS BULL R OWNER l� i_�/L. o,✓ PERMIT DA O ' ' cI D COMPLIANCE'DATE: 0 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist �� Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by -� `c4 d fi 04 J ®-, /ery ASSESSORS MAP N0: No.� z THE COM�t51'�N�7�/E A H U SETTS BOARD OE . HEALTH TOWN OF BARNSTABLE Appliration for Uiripwial Works C omitrnrt"inn ranfit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Systesh at: • a....j(................. -----------•---------- ----------•--•----•--•--•---•-----••-•------•-- tion Address or t No. /�lJ W O%cncr ddress Installer ddress d Type of Building Size Lot.Afr_d,D. .......Sq. feet U Dwelling No. of Bedrooms..................�---------------------Ex tnsion Attic Garbage Grinder, 04 Other—Type of Building._.__________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures _______________________________ __ W Design Flow.................................$S.._._gallons per person per day. Total daily flow_:___3 ..........................gallons. WSeptic Tank—Liquid capacity/.gallons Length___,fl�-_�_ Width_ Diameter__---�" Depth_.Sf-s�_.. x Disposal Trench--No_ ____________________ Width.................... Total Length.................... Total leaching area.........._.........sq. ft. _.. Diameter.._..../ �_-..._. Depth below inlet.___._¢�_.____._ Total leaching area �.N__s ' ft. Seepage Pit No.___•---.----- I g q. Z Other Distribution box ( ) Dosing tank ( ) i Percolation Test Results Performed by._..t__L.L._--� !°�`` _ _!ll�_ ______________ Date.. .__ ... ............ Test.Pit No. 1 fS._ _minutes per inch Depth of Test Pit.../X.y...... Depth to ground water_.-------­.- fZ( Test Pit No. 2........_.......minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 --•-----••---•----- - - ---------------------------------------------------- O Description of Soil____ tEr ------ A__-r1IA4-jjZ4,t oj..----4�1fD �r .L_ 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system,in operation until a Certificate of Compliance has b n i sue �qof Signed ... ----- - -�s 71 Date Application Approved Bye. .. '.yA.,{,........'- ... .:`,,�. . .,_. / Date Application Disapproved for the following reasons- -------------_-------------- IIIIII...........-............................................................................ ...... ................ .... ..- ....................................................... -..........-............................ `'.. .. .. ..... ...... .. � --°ate Permit No. ........ Issued .............-- .. .... �` Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Cer#ifira e of Cgomplizxnce THIS IS TO CE TIF That the Individual Sewage Disposal System constructed (!i ) or Repaired ( ) R by .......... C9.r.. QfA. -� �� rl/G�`./©G7............ .. .._ .._._._...................... .. ..... ......... -- ............... Insaiucr has been installed tcordane with rowisions of T E 5 of The-Statelr-,7nvironmentalCode as described in the application for Disposal Works Construction Permit No. ''�lG�.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....... ........_7....-... ...�.C/ .....------ --- ---_.... .. Inspector ............... ---- �:......... .................... ......... ____-- -___,__ ---__.__,_d_,__---�__.__ --___,-- ___.-_,__ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE NO..._... ... FEE........................ Dispno t Workii �II4,i �l i�tri P lltt� //-- i h�.S fl.�G /dui Permission is hereby granted--•-----�/`'��P�.-----�-•-Q------�---------�--------•............-.............................................. to Construct (kl) or Repair ( ) an Individual Sewage Disposal System at No. •-----..Z&t i-'I LI�IC�C7D----- ......- V---5 ----------------------------------------------•--------- /�..^.�'. Street -// � as shown on the application for Disposal Works Construction Permit NO%.,_�__...f_...._ _ Dated.................................... --•-----:-.�_ --------------•-•------........ _ (Board'of Health DATE. ---------- - --•-------------------- `�J FORM 3830E HOBBS 6 WARREN.INC..PUBLISHERS r _ NO.I... .._..'.'1 THE COMMONWEALTH OP MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE t Appliratiun for Diripwinl Wnrk.5 Tonfitrnrtinn prntit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: I ....................1z_...... !sties.----------•---------� .- --........------------......----....---•-- r/ L�of ition- \ddress JIB'` a •yL y/ /�// /� --- Installer ddress Type of Building Size Lot. t..6047.......Sq. feet, Dwelling— No. of Bedrooms-------------------- ._._Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons.-.._____--____-_-___--.---- Showers ( ) — Cafeteria ( ) dOther fixtures --------------------------------------------------------------------------------------- ------------------------------------------------------------- W Design Flow.................................4�s___gallons per person per day. Total daily flow...... .T�..........................gallons. W Septic`Tank—Liquid capacity/-S27l'.galIons Length-_.�Q-_ _. Width_S n.�. Diameter_.-.- Depth...S.- ... x I Disposal Trench--No. .................... Width.................... 'Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.............../_... Diameter.......///_...... Depth below inlet..._..+�........ Total leaching area..-..;;� .2%,,..sq. ft. Z Other Distribution box ( ) Dosing tank aPercolation Test Results Performed by.... L lam..._ �� =_! ._................ Date. _-.--_ �l..... O...` a Test Pit No. lZ4A;�_.�.minutes per inch Depth of Test Pit...ly. _�_. Depth to ground water... ... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water............... ........ a ------------------A ----------•----------------------------•----- ---......--•--••-----......--•-•-•-----•-••---•--•-----........---•-•-•--•--------•-- 0 Description of Soil----77t1.�.------& Z 4"o'-.. s��i/.�,5.....fly/ .._ 2 �/s� . h� V _....--------------- -------------- ---......... -------------------------------------- ---------------------------------------------------- -------------- ---- ----- -•--••-•------•---- `•------ ••--- W .-- -•-------------------------------------------------------------------------------------------------------------------------------------------------------------------------•------•----------. .... x - U Nature of Repairs or Alterations—Answer when applicable............................._......._.__._.._........._._..._........_......_..............._.. ............................... ---••-----••---•-------••-•----------------------------•--..........---------- ............................................=.......................................... A Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the'i system in operation until a Certificate of Compliance has been i sued,@y th-/boa;d'of health. / Signed ............ .. .... ........................... _....._.........-.... .. '" / ( ............ Due Application Approved By .....'....Joe�Lt..��', ------ '��./�J'�J................................ . ..... _ `�{�C//;� V Date Application Disapproved for the following reasons: ....................... - _.............................................._ .................... ..................... . . ................. -- ................................................. .. ........................................ Dare Permit No. ..- Issued ;'.; � � - Dace tot 28 rut 4A j1p _�. ' --- :: ' 293 -, N -tam CjA2tot 29 . i 14 !00 a Xo t 3 S r I , r I oodl' V ism, Hueszue 0 t wlzRIC- 14. a r 1. ' -tot 30 l'-3o r Ji ipoa.a.L 'no i Cdt tixca teal,' ow Sate 8-20-94 Zeach a�tea 3-r ue " i At , itc/,Ce Capacity oe, Noc 49 /dao2 load ' I --..._._ fdyann , M4 0260! ko _ � ► , ice 1500 4,000 it w 2 �/,to se I I 1 Shetch nla� o ..('and.4.*& %dya ,&t4, i ! geijiq lot 2'9F a4,,h.own on a plan,,tec',oaded - 4i n book 38 p,c-e 91. Cteuat i,ona, Icy ce'on ad..iumed datum. Jcte: errt--,� n.�.table-I�oair,Z"0? ea1,mhit _ 9edt 1)'it #p-8263 Nd wa-e enco I �t R r ~� poicc.teeth. 2' min.p et 31.3 *�fPZN OF a,�: 2 �redi,urpt ° ` ARdand �0 '3r NAt 1 i I I lj _.. _. t1 -t- � -'-I'd- �-t .T �-7-r-f- --i--'•- - - - -1-�- -r I I a I j 4 4 I i s 1 1 �. �,.J -ice -01 f -1%.ti _-...___ — ..:.. - --_ T--•---F--,t- - --- - h1-M-r - -'r «,ti:3f'9'�.�J _ _ t- •i �. ., y 4. .I _. , .I. 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