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Home My WebLink About0100 BRIARWOOD AVENUE - Health 100 BRIARWOOD AVENUE HYANNIS, MA. 02601 Y TOWN OF BARNSTABLE LOCATION Ibn aod Cde/ SEWAGE # y �n VILLAGE // ASSESSOR'S MAP & LOT /6 INSTALLER'S NAME & PHONE NO.c� 70/DW% (_Gn c SEPTIC TANK CAPACITY LEACHING FACILITY:(type) > "6L' (size) NO. OF BEDROOMS-PRIVATE WELL�PUBLIC WATiR'�y UILDER R OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes CN, '.r � i � � � I 1 °� i . � a n < V � u .. I � � R ASSESSORS MAP NO: 9ARCEL N0: No. - Fxs.... ../�._. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTHa 4W�? TOWN OF BARNSTABLE Appliratiun fur Bijpuiittl Works Tomitrnrtiun Permit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ff t/� Its1�1a��Q �D 11�(�r� �> ��i • --------•.......... .... .. P ........ Location-Address or Lot No. ob.e r r w...l...... r A. 'I -------------------•-•------ Owner Address --•---------`----- ---e... Installer Address dType of Building Size Lot...t. %=7gq........Sq. feet U Dwelling—No. of Bedrooms..__.T 0--------------------------Expansion Attic (jU e) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures -------------------------------- - - W .g gallons P P P day. Total daily flow--------------------------------------------gallons. Rr Septic Tank—Liquid Li uid capacity__-_.--_-__gallons eLen Length per P 9 P g g -.._._ Width................ Diameter---.------------ Depth................ Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. x 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 1.4 Test Pit No. 1----------------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......._................. p; -------------------------------------•-•----------•----•------•------------•--•-•-------•--......................................................... 0 Description of Soil........................................................................................................................................................................ x c, x --- ------------ -----------••---••--...-------- ------------•----•----•---•-----------•--••--...-------- ----------------------------------------------•----------•-------------•---------------_..... U Nature of Repairs or Alterations—Answer when applicable_--rtTLE_. ._ (��'� �- �.N51'�l.l.u-_.l,.s��. 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 issued th�sboard of health. Signed ............: .� ----.----- ...........c��----------------- . ...��c��t� . � ,• .. Dace Application Approved B .. :..........._:..... - �' �V, �'Y ------'—............. ...---*-------------------------- —. ..........ice.._... ....... Application Disapproved for the following rearon..:--:------_------------------------------------------------------------------------------------------------------------------------- ....... ............. ............... . .�i ....../..... ...... -----------------------------------...................----------/----------------------- --------------------------------------- Permit No. ..... �/./'"'S7.... = Issued f.. '' -ate Dace /Fv E:.. .....�� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ,��7' TOWN OF BARNSTABLE Appliration for Bi-ti•poottl Wor1w Tomitrnrtion Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Y7 y,,o ( ------Si'7oc- - n Location-Address or Lot No. iCUber d.�lC c,r►A td+.�R .S---------------- ......------ ......•..... ........ Owner Address Go...�ST. uC�t oN /N c. Installer ' Address UType of Building Size Lot... .........Sq. feet t-t Dwelling— No. of Bedrooms.... v____________________- ---Expansion Attic (Fi o) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOther 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------------------..................... W Test Pit No. I----------------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........................ 9 .-------------------------------------------------------------------............ ODescription of Soil........................................................................................................................................................................ W U ....................... -•••---••••--••-•-....---•-•••---••-----•-•-.....-----•--------------------------------------------------------------------------•---------------•---............•-••-•......---- W x ••-•••-----•--------------------------------•-••.....----•----------•----------.....-----•--------••---••-.....•---------------------••-•-----------••••--•---•--•••-•-••••......-•-•--.............-•-- U Nature 1of Repairs or /Alterations—Answer when applicable. UP.. is l� t- [•N�741.1.a-.�i-S?6Q.. `ems 2 FT..Sa►J 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/beeibn issued thepboard of health. Signed .................__.2-..�-'1............ fv .------------------ ----------/`/r-�3 9 � Dare Application Approved B i - _: ..........._....._.......... .... .................._.:r .....'. ''..... ". . ............................. Date Application Disapproved for the following reasons: ................................................................................................. .. . . ........._.... V ....------ .------ ......... ..................-------- ............. ................................................................................................................................... - .........._ ...�"."".r.. / Dare Permit No. ..... .....f" --------------- Issued ......./ Da`e...�' /..._...._. —_____._____________________a__------� —�/'L• ----G--- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (ILI-Prtifirate of U IImplianre THIS IS TO CER .IFY, That the Individual Sewage Disposal System constructed ( ) or Repaired at .......... '. �•� ...G 'lJe/a°. - '---------Tr;" --- "' `.--`-------------------------------------------------------- in tall d in a ordance with the provisions of TITI. of The State Environmental Code as described in has been installed cc the application for Disposal Works Construction Permit No. V1_. _ ------- dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. / DATE .. 1--.��"'.... ..... -��. - Inspector /.--1 .. .._... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � - TOWN OF BARNSTABLE No ....... •-- FEE--...................... Bioposal orko �onotr rtion rrntit Permission is hereby granted.... ®7 �.�� ' ` to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atNoJ .....GK''.tpAW]oo.f:�_-...R`_�..... ------------------------------------------------ ------------------------------------ Street as shown on the application for Disposal Works Construction Pe>�i�T10-- J----�------- Dated..-.,. .... -------------------- to''_-` Y.------ � ............. Board of Health / FORM 36508 HOBBS&WARREN.INC..PUBLISHERS TOWN OF BARNSTABLE LOCATION SEWAGE VILLAGE ASSESSOR'S MAP & LOTS -/�Y INSTALLER'S NAME & PHONE NO:�,- 7��01/ SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO. OF BEDROOMS _PRIVATE WELL PUBLIC WAT Z--� UILDER R OWNER DATE PERMIT ISSUED: ��. DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes CNo- X�-