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Home My WebLink About0068 BRISTOL AVENUE - Health 68 BRISTOL AVE. , HYANNIS -A= 291-145 t e e 0 ._TOWN OF BARNSTABLE• � .... . _. LOCATION . 1 �s/� ,�. SEWAGE # y.-ELI GEC GE!WY( ASSESSOR'S MAR&LOT-2_..4/� s °INSTALLER`S N /r, 'SE . C-TANK CAPACTTY` - ``LEACHI G FACU rrY: (type)'!'"�/t� t y�� (size) NO:yaEDR:OOMS - � v.. �• i 81 DER OR°OWNER _ �S�FEI MI'TOt J' =�/ '` _ -COMPLIANCE DATE: 97 -'Se paratio'r)Distance Between ttw� s Maiiimuui Adjusted Groundwater Table and Bottoiri of Leaturig Facility Feef Private Water Supply.Well'M4 Leaching:Facility_ (If any wells exist ; on site'or within 200 feet-of leaching facilityr Feet,. Edge of Wetland and Leaching Facility(If any`wetlands exist > ' within 300 feet of ach'n aci /V Feet Furnished by"" � � 'G""�- •� V A jp6o . a a7 q 3C � _ — C, - a\9 _ c _ s tq 13 - 3 No. Fee 4 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01ppYication for Mizpozar bpztem Congtrurtion .permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Locatio dd or Lob Ow s Name,Add ess Tel. b j' Assessor.'s Map/Parcel �^ �--- J.t1 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.N . JP me,-t � 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(Answew en plicabl ;72 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 o 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issue"by this oard�, al!j Signed ' '_`` Date , �� Application Approved by w Date 7 Application Disapproved for the following reasons Permit No. 9 7 46 7 Date Issued P'-9 7 No. .F y Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS 91,01ication for 30i5pozai *p.5tem Construction permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System ❑Individual Components Locayoddfor Ow 's ,Add ss Tel.Iyo., Assessor's Map/Parcel Gi^ir�� ct,•�i� 5 vtief Installer's Name,Addres jand Tel.No. Designer's Name,Address and Tel. 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 l Nature of Repairs or Alterations(Answer w en a plicabl �. 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-Titl 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issue by this oard of Ix alth ,, Signed mrn= Date ,�/r�� 7 7 Application Approved by Date 7 ,Application Disapproved for the fo owing reasons Permit No. 2 7`GG 7 Date Issued IJ 7 --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CEI TPY, that the On-site Sewage Disposal System Constructed( )Repaired 4QQ Upgraded( ) Abandoned( )by (d"7 at _ has been constructed in accordance with the provisions ofTitle 5 and the for Disposal System Cons ruction Permit No. 7-6.4 7 ' dated Installer �!/ / Cly! Designer_�� The issuance of this permit shall not be construed as a guarantee that the syste functgnr signed. Date �� 7�' 9 7 Inspector 17.�c ; _ 24111, � --------------------------- No. 7-6(O / Feet/./ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Migpogar *pgtem Congtruction Permit •' Permission is hereby granted to Construct epair,. Upgrade )Abandoq,( ), System located at 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 must tbbe—completed within three years of the date of thisAermit. p Date: ll—�� / / Approved by 10/9197 NOTICE:. This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) hereby certify that the application for disposal works construction permit signed by me dated �/—l - �7 7 ,concerning the property located at �' meets all of the following criteria: `�/• There are no wetlands located within 1 o0 feet of the proposed leaching facility There are no private wells within 150 feet of the proposed septic system c/" There is no increase in flow and/or change in use proposed v' There are no variances requested or needed. �If the proposed leaching facility will be located within 250 feet of any wetlands,the bottom of the proposed leaching facility will W be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation. Please complete the following: o A)Top of Ground Elevation(according to the Engineering Division G.I.S.map) 2_'C� B)Observed Groundwater Table Elevation(according to Health Division well map) 26 DATE: —�7 SIGNED: �— LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system.Also If the licensed Installer posesses a certified plot plan, this plan should be submitted). q:health folder:cert I I L TOWN OF BARNSTABLE - LOATTON SEWAGE# 9 7 G�0 7 4I ;OE^ _ASSESSOR'S MAE-Bt LOT "IN5'T :LER'S NAME dz PHOI!1E NO.:, SEP' C;TANK CAPACITY' ;'O :%�s, �� (size) . . LEACI��4G FACILITY: (type) �r � . NO.: BEDROOMS _BUI btR OROWNER 4 issPEItMITDA ;QI 7 ...COMPLIANCE DATE: .Sep,"dh Distance Between c 7v Ma�timuui AdjusteQ t3roundwiiter Table and BOttOHi of Lea�lting Facility l 2- 1 o F Fe v*iite Water Supply Well'ailYd Leaching Facility_ (If any wells exist on:site"or within 200 feet of_leaching facilityT VQ�Q Feet Edge,nf,Wetland and Leaching Facility(If any wetlands exist . /l ::within 300 feet of 14achin aci ' �Vd'7 Feet co . t I1 �3 - c - s LOCATION SEWAGE PERMIT NO. 2 R � �s�01-- I-v F , VILLAGE //yaw^,4 S, �'l/YS<, IA L L E R'(S _N E� iADDRESS R U I L D E R OR OWNER 70�Yw5-VA-�otp, ��ou c% DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED i OOo l.• PIT -531 ' � oNi � � �'�. ,. ,. raj' ' .. .. '_ - "_�► . No.... -�.�.L � '<• Fizz............._....._..... _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF -HEALTH =i �.:W..,1,% ..-.......OF..........k�G�.r.-.. �'�..1o.•r' ...................... , ppliration for Difqpviial Works Tonotrur#iun Permit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ....:.......... .5 ........... �o.l............. ...... .................. �... T...... .� ................. ( Loc lion-Address �\ l or Lot No. ........... ........S__!_.l_............................................ ner Address ., ..._... t� '--------•. . .......o� .. .�- ��- °� •� •••••••---•--......... a 14 Installer Address ' d . Type of Building Size Lot.................... Sq. feet U Dwelling—No. of Bedrooms... Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Othefixtures -----------------•--------...__________.--------._._..._-___..._..._....---...•------------....---._.....••--._..._...-•••-•-•--..................._.. WDesign Flow........... _ ._.....................gallons per person per day. Total daily flow......... .................gallons. a Septic Tank I Liquid capacityl_00.0._gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No_..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.........t............ Diameter_._.._ ...... Depth below inlet.....(w.. ........ 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......................... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ sC�. R: !t. ODescription of Soil..............................:........................................................................................................................................... U `..............=°-•-•---•.....--•---•---•-----••--•-----------------------------•-`-_........--•--..._.__ M -----•-•------------------------ -----•-----_____-----••---•-._._..___.__.......___.-----------•__- ______-•-•---------._..----...---•____________----••-•-•--•--___---••-...V t_D_0............ U Nature of Repairs or Alterations—Answer when applicable.____`.Q_0-0_.....M t7t-," _._....._�-,.. ..- Ir�clU........-�'-1-ate•-(-•--•..2T S7 -----•-_...f� -------- IP' 'e s _ La....................... Agreement: The undersigned agrees to install{ the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLr. 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Complian ed'by the Signed �_o •- -----••- - __._ Date ..... ApplicationApproved By........................................................................... ..................... ........................................ Date Application Disapproved for.the following reasons______________________________________________________ { ----------------------------••-•-.....__..._.._......---••--•---••-•-••--•-•-••----•--_____._....__-•-......__-------•--••---•-•---------•---•-•---••-------•---•--•----•------_...•-•---•------..:.•=--- Date PermitNo......................................................... Issued_....................................................... Date _ - -------------_---------------------'- No.... '.. l.r�� Flms..................._..... _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Q...6✓I/.i` ........-.OF......... ...� '.../ti �"7. .a .`.n.. ....................... Apphrat lan.for liuvuuttl Workii Tonutrartion Verntit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: �s�D � fi/ e , ....:.......... ...... �2.. - --......------------........ -- _..tom` ....... s ............. L c tion-Address or,L No. --........ y . . ........... �-� .:..!..t............. ........................ ner Address 0.4 Installer -�J CQ Address Type of Building Size Lot.................... .....Sq. feet �-, Dwelling—No. of Bedrooms.---..---.............................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of a YP g -------------•--•----------- persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures ... W Design Flow......��.......................gallons per person per day. Total daily flow........_ _��. ................gallons. WSeptic Tank Liquid capacity:1.0.0.gallons Length................ Width................ Diameter...----......... Depth................ Disposal Trench—No..................... Width- ....... Total Length............._._... Total leaching area....................sq. ft. 3 Seepage Pit No.........I........... Diameter.....Lb........ Depth below inlet.....Jt........... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-----•--------------•-------......--_.... Date......................................... Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.....................--. f�. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.--..................... a --••-•-••••-----•--••---•------------------------------------------••-------......................--......................................................... 0 Description of Soil........................................................................................................................................................................ W U •-------•-------------•----•--------•-•-•••--------..........•-----------.........------........-•---•----••••---------......------•--•••-----......----......------------....••---..................... W ••--••-----••---------------•-•-----••--•-----------•----------------------•---------------•--------•---•--•---------•----•----------••-----------•---- 1' b._... . � P� V Nature of Repairs or Alterations—Answer when applicable-.....1-�7 d ......,5 .��... .........:.... .-..'.........._.___......... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System.in accordance with the provisions of TITLZ 5 of the State Sanitary Code—.The undersigned further agrees of to place the system in operation until a Certificate of Compliance-l�been-issugd by the f"hEa-tth:.� Si ned .r Date ApplicationApproved By.................................................................................................. Date Application Disapproved for the following reasons--------------------------•-•----•------------...-•--•--------••-•-----------•---•---..........•---......._..... ....................•---•---------•------•--.....-•------.....----------•--••---......--••-•....__--•-•-.---._.......---•-------....•-•-----------------------••-•---------•---•--------•-••----......-- Date PermitNo...................................................---_ Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS i �'.. BOARD OF HEALTH ....�.�D...../................OF.......... Trrtif uttte of Toutphaurr THIS ISM- RTI Y, That tlxEli 'dua Sewage Disposal System constructed ( ) or Repaired ( ) by - __:. .�, a.c............. ............................:............•-•-•-------•---....................•........_ Installer ^ ui 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......................................... dated..............,................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.... ................:g.S-•-•---••-----.........------...... Inspector.................... ... --- ---- .. ........... ................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH l T'a..w. .......OF.........15. _v w'S►a,��--� .............. } No.....•---------_......... FEE....................... Rapa,a#jWorks Ton n rrmit Permission Is hereby granted - �j..Z-" _ ` '5..-••--•..........................••-•---•-•-••---..._... to Construct ( or Repair *)'an Individual Sewage Disposal System at No................... •-K...•-----.( r=x.�`1. C^.. Street as shown on the application for Disposal Works Construction Permit. No.'.?.. JIa ......1�'.`.6 ......•.. x t ......-•----•----•......---•---•-----•---- . .. ................... •i rdv6f Healt DATE------- '--------------•----..................... FORM 1255 A. M. SULKIN. INC., BOSTON F Tao loco L eAck4 p r SToN�'- o+ OwT 30� 1000 5 E p'tc- Art 4C 3Q Q1-t- 1 Sci, 40 oo Pv POOL— Cal --�-4 I-If, DRIV 4C �- 5 Tb .3 0 E O 200w\