HomeMy WebLinkAbout0082 BUCKWOOD DRIVE - Health T
w 82 BUCKWOOD DRIVE
Hyannis
A'= 272 — 056
I
0 'TOWN OF BARNS'TABLE
LOCATION G j/@&W-Q2® 4e. SEWAGE #�"
VIL LAGS V,4dthi S ASSESSOR'S MAP & LO.T .79'
INSTALLER'S NAME & PHONE NO. &J'76(2 /7S= c� 00
SEPTIC TANK CAPACITY /, DDO Q,41/o;!
LEACHING FACILITY:(type)c;� 7 5 (size)
NO. OF BEDROOMS 7 PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER 14 V D/ e
=DATE PERMIT ISSUED:
DATE ,;COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
0
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,
Tar 0 S, ob I
NOY. Fics. .. .....
..
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
OM TOWN OF BARNSTABLE
Appliratinn for Di►i,puual Workii Tou trur#inn Prrniit
Application is hereby made for a Permit to Construct ( ) or Repair (Cor`an Individual Sewage Disposal
System at
.. ... ............._... ..f �l�l ........
rt o Location-Address or Lot No.
. . ............................................................ ...•--••--------------•--•-•---•---•-•--••-••••-----•-------•-----...••.................._........
Owner Address
.............
Installer Address
UType of Building Size Lot............................Sq. feet
►.� Dwelling— No. of Bedrooms.......... -____________________________Expansion Attic ( ) Garbage Grinder ( )
'04 4 Other—Type of Building No. of persons............................ Showers — 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........................................
aTest Pit No. I................ininutes per inch Depth of Test Pit.................... Depth to ground water........................
GZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
----------•------------------------•---------------------••-------•-----------••---.....--------............................................................
0 Description of Soil............................................................................................................---------------------------..._...--•-••-••-...........-----
x
V ---.....--••----••-•---•...--•---•------•-....------•-••------•-•--•-•-•---•--•---•---•..............•-•--------•---•--------•---•------••-•-----------••---•----------••---•--••......---•--........••.
W ••-------•-----'----------'-----------------•-••---------------•----•--------------------------••------•--- ...---- . ,
U Nature of Repairs or Alteratiorfs—Answer w en pplicable.- �� ---�---------->{__...___.! _�................... . .. ...........
........ C\r,--------- - -•-- ..........................
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 been is d by th�,board of health.
Signed .................. l..-D l-...: -.
Dare
Application Approved BY ' _ ..... ---- -7w"r
.....
......--...-.-.-'Dace...-.......----
Application Disapproved for the following rea on - ---------------------
................................. ..... " ' ' .. ............. . ....... ..-.
Dare
Permit No. -..�..... ......y- ( ... .... ......... Issued --
--------
../J.... .
s�'+r<_...^ �• �..•a.,.i`.r- ..wW,.w«-�. . .._ ....._� ,...-.--.-..._ .�....- - .....--...r.---•,w-`..t t++..-vw.�-....r...:,..tt..-:...-6.s..n,.-.-.�e..n..»-._.�.�L:�^--`�'.':.:sr....,..r..,...� .. '...t:-,.i. .._ -<_•��,
t Par DSCv. 661
No. Fim ........
THE COMMONWEALTH OF MASSACHUSETTS
_7 c./BOARD OF HEALTH
G / S 7
/ TOWN OF BARNSTABLE
Appliration for Diripwiul Works C owitrnrtiun ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( L�<an Individual Sewage Disposal
System at, / ll
--- .... .•-- -------•-••-•_------- or Lot No............................................
� ••Location•--\ddress---•• -•-----------••-...or Lot No.
..........I ......j..�. .............................. ....--................. •-••-------•........................................
a � � O�cncr Address---•-•......-- .......................................................... ••-•••--•--•---•---------------•••-•--•------...••-•---•----•--•-----••---•-......................
Installer Address
Type of Building Size Lot...........:................Sq. feet
Dwelling— No. of Bedrooms..........2--------------•-------------Expansion Attic ( ) 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 ( )
aPercolation Test Results Performed bY.........................................................-................ Date........................................
Test Pit No. I ...........minutes per inch Depth of Test Pit-------------------- Depth to ground water........................
0-4
44 Test Pit No. 2.................minutes per inch Depth of Test Pit-----------------•-. Depth to ground water........................
R:
0 Description of Soil............... .................................................................... .....................-...........................................................
x
U --------------------
•--------------------••...--• -------------------------•-•-------•--------------------- --------------------------------.....-----•------------------ -----
w
U Nature of Repairs or Alterations—Answer when applicable.- Y1 a. R. .....--._I--'.-..-/.!a.�00_�_-••---t J.�c _••••.•___.
.. .......� ........:�.ICL .i _✓i G.._.... �;� k.....: �-.--._.-...5-- _'-_<_C--- •-.------ ------------ -
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 been issued by th board of health. p� `
Signed .....-..�.1/11............ .......��.l ,n..,._.�=,...... 7.'--�.c.1....:....'
v p Dare
Application Approved BY -�....7�rs?� .- .��.. 2.. ...... ...-.,..............l//: /L- `t .e .............. ........................................ i
Application Disapproved for the following rea>�f� ...................... .................................... ,..............
............
..--.
..................-..`- ----------..--.._--- --.....,....n..................-------------..---.....--..--......................................... - -------
-----
.:........--Dace.....------.......
Permit No. ..............
�....... ....................... Issued . --- -- /te D �.
� a �
---------------------------------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
vErtifirate of V��T omplianre
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( �)
by --------------------------- v4-,✓1>-.C....-........ ............_................. ................ .. ........ .. ..... -- . .............. ...........................................
t ` Installer t
at ......... ! .��C.--. .�.. .(' 1,�.>r--...-..._.... ------------------ ..............................................................
has been installed in accordance with the provisions of TITLE of he State Environmental Code as described in
the application for Disposal Works Construction Permit No. -_.. '--..._..-.. _t' dated .................
...... ...._-.....-.......
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT E ONS� ED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE _ . .....-... ... /. - - ... _ . ------ ` .: ..'ector _. - --- -. %t�' ------------------------
.....--.-.._....
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
s �� TOWN OF BARNSTABLE
o —
No.....i...........----`,. FEE........................
MoVooal qkg Tunotrurtion "rrmit
Permission is hereby granted...................6�%?.C.6.__...---.._.__:.
-----------------------------------------------------------------------------------
to Construct ( ) or Repair (✓) an Individual—Sewage Disposal System
at No. ` vdd__1.a 3r)n t/ - r. ..............................................
Street
as shown on the application for Disposal Works Constructio 'Permit No. ' -
- .. -
19_ U 13oa d of Health�v.V v V
DATE.------..... ...�..�/ r/ V
FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS f J Le
L,O -AT40N SEWAGE PE MIT NO.
/'�i
VILLAGE
INSTALLER"S NAME i ADDRESS
a' d U I L 0 E R OR OWNER
(;DATE PERMIT I t S V E 0
fl
DAT E COMPLIANCE ISSUED �`� �
f/
� r, „
�C • _
V
P
C Ci
• � _
a _�
� D
_ • f
i `` y
•f
No.-•-•-•--••--•-_....... Fx$..............................
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
oF........ �......................
Appliratiou for Uiupu.ial Workri Tomitrurtion Frrutit
Application is hereby made for a Permit to Construct ( 4) 65 Repair ( ) an Individual Sewage Disposal
System at:
e
............................. ........................... l
? Lo t!N-o-.-------------------•-=-------.......------
Location-Address or
..._.--....5 ----------------------------- ---./�_. -�C -
O ner Address_ _.. _T---•moo......----------------•-•-a .
Installer Address ����
Type of Building Size Lot.?_ tN� .... feet
at Dwelling—No. of Bedrooms..._....._2o..........................Expansion Attic ( ) Garbage Grinder ( )
,a Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
dOther fixtures -----•--------------------------------------------------------------------------------------------------------------------•••------------....-•-•-••-
W Design Flow........,7 .........................gallons-per person per day. Total daily flow------.2.z.�....._ gall
ons.
WSeptic Tank—Liquid capacity, gallons I- '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...40/9-ZK onj... Date...... (_7 _.l-_._ -------
�l a r
Test Pit No. 1...... z-minutes per inch Depth of Test Pit-_�.�` __ Depth to ground water....ti._.
�X4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
O .....................................................'-f---rr-- ------ ........................e-•--------•--••--�•--•-
Descr tion of Soil `= *�` �.....
V1� .......... .................. ...... ....................................................
UW ---------------- ----------------------------------I...................................................................................................................................................
Nature ofl Repairs or Alterations—Answer when applicable..................................................::...........................................
----------------------------------------•-••-------•••••-••••••••-••----------------...........----------------•------------------------------••-••----------------•----••-----------••-••--------•----
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 not to place the system in
operation until a Certificate of Compliance h een issu by the boa ealth.
igned.�_ ----- •--� ..........
D
Application Approve n
i Date
Application Disapprov for e following reasons-----------------------------------------------------------------------..------•-------------------•--.......•--- ?
. Y✓ • C( Date
PermitNo......................................................... Issued--- ....................................................
I ► Date
No...................... FRic.............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...........OF........�`5 -Z .. .......................
Appliration for Dhipaoal Works Tvmitrurttq4j-Vrrmit.
Application is hereby made for a Permit to Construct ( /-y-0-`r.,;,,Repair an Individual Sewage,Disposal
System at:
................................................................................................. ......... ........ ............................................
Location-Address or Lot N):2
,oI44 4--1<- 7
- -------------------
4 ...........
..........................................................---------
0 ner :Address
7 L�,7
........................ ..........................................I C)
.........................................................
Installer Address
Type of Building Size Lot...21�............3
.............Sq. feet,,
Dwelling—No. of Bedrooms._.____._. Z.:..........................Expansion�At�id7( ') -",,
................Expansio Garbage Grinder ( )
Other—Type of Building ............................ No. of persons......_..;;_. ..... Showers Cafeteria ( )
P4 Other fixtures .............................................................................................................................
..........................
Design Flow.......... ........................gallons per person per day. Total daily flow---'... ......gallons.
......... ....................
1:4 Septic Tank—Liquid capacity/��gallons Length___- Width__.... Diameter,_:_._ ....... Depth...K...
Disposal Trench—No..................... Width_................... Total Length.......7�......... Total leaching area.. sq.ft.�-
Z .01, - 7 "1',----------
Seepage Pit No_______----------- Diameter..- -Dkpthibel -C-i-hlet..... Total leaching�rea.... .�=,,..sq. ft.
;P146,
Z Other Distribution box Dosing ank'('
Percolation Test Results Performed by.... Date._
...................4........:..J�...... .
Test Pit No. I.......—*'-..�-.minutes per inch Depth of Test 'Depth to ground water..::............~__Test Pit No. 2................minutes per inch Depth of Test Pit..,_.,:....._.._._.. Depth to ground water........................
.............................................................................................................................................................
41P
0 Description of Soil......Z:2-.'=..... 2 .......... .......w.................................................................
..----- ..
------- --
-- -- . ..1------------------------------- -------------- - - ------------- ------------------- ---- ----Z-------- ------------
------ -----------------------------
.......................... -----------------------------------------------------------------------------.............................................................................................
U Nature of Repairs or Alterations—Answer when applicable.______........................................................................................
.................................. ..................................................................................................................................................................
Agreement:
The undersign4d agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TLITIZ 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has-b-eeni`ssued by the board-of1Fealth..-.,,
.e ...... ..
gned.)......d 5 .
.......................................... ...................
Da
ApplicationApprove ... .... ................................................................................... ................. .. . ............
ate
Application Disapprove or e following reasons:................................................................................................................
.................................. ......... ........................................................................................................................................................
Date
PermitNo......................................................... IssuedL.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH T
..........................................OF...................................................................................
(9rdifiratr of Tantliftaurr
/ I V,.
T, I TO CERtTJFY, Thielt'he Individu I Sewage Disposal System*:constructed or Repaired
by. .. .. ....... . . ........... ........... ......................................................................................................
/11, staller
at........... ...
. ................... ........................................................
E
. . .. •.. ..... ..... ..... ...........
State Sanitary Code le"scZ
has been installed in accordancZ with th,e provisions of TI 71K des the
application for Disposal Works Construction Permit No-... ... .... da ed......I -------- -----------
S
THE ISSU NC F THIS CERTIFICATE SHALL NbT BE C�ONSTR S A GUARANTEE THAT THE
'I U
SYSTEM I F ION SATISFACTORY.
torDATE... . ............. ........................................................ Inspector'.... .............................................................................
r
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
No. ..........................................0 F.....................................................................................
...................... FF. ........................
rmit
Xy
Permissioni er by granted_..-'--' G ........ ...........................................................................................................
to Construct or Repai ndivi al Sewage—Disposal. System
. . ..............................................................................................................................
at No.... . 7' ' Street
as shown on the ap/plica n for Disposal Works Construction Permit No.......... . ........ ..........................................
........................... .........................................................................
Board of Health
.DATE... 1!�7 . ...............................................
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
fop 074 found
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A � covers
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►y .¢"easy` iron or aye r o�
N`v��yy cone wQ,she Cl
Zv- sch. 4�� PVC- pipe /2'inaaG• '' G,7 C
�7 \ rn%ep.ltt �� 4 Sch. 20 -vc. p%pe peastone
Min. p%f'cf7 ��a" Per fy'-.
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Septic fa.nK in C/. gyDO •" i�/z
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pre cat.s
S� WAG � SYST� /M P�2OF/LE- born "
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grouncl water fah/e
b07't0177 Pest i70/e e% _ �G.O
OAS /GIV L�ATf� 7T4E ST HOG. L O G
NUMBC= P— OF 0E4;)AE!00MS TEST AD,-qTE 2,,
DISPOSAL lJAJ17-: Z/ - 4o4,//7-N& SSGP
(� �E ,e G O L f9 T/ Oil/ ,FATE <Z /17/A/. /AJ 4
c�i may} �, /��95 9�. TOTfi L EST/MATED FLOW
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4 �ZL2 / HOLE HoL z
GAL. DAY
y71 l �2EQ. SEPT�/G� TA/Vl� CAPAG/TY: 33�✓ GAL.
Dw'¢' 2� 33S S AGTUAL SEPTIC- TAIVIe! 5124�- : 1 O GAL. M
LEACH/Nc . A�2EA �EQU/2EMENT y
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TOTigC.. LEACHIII/G CAPACITY
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c �9ti U gAN�
AJOT& S
ALL �fo�kMRNSN/P flNlJ MATE,e/f�LS
SHALL COA/FOjeM TO y�� .,E. Q. E TITG.E $
i ANL:) THE 7-OL.v/v OF
�� �2ULES ANt� IeEGU4- R7-1oAjS FOAp 4,10 Gf/��-
�C SUBSU�E'Fe9CE 01SPOSA,- OF
S A A./ / T A S E LA/A G E-.
2� COMPLIANCE WITH ZON/NC- ,2EGUL197-10AJ5
SHALL BE DE7-E2M/IVEL7 BY BU14_ ,D/NG
95` /A/SPEG7-0Ee / GOM/--?/SS/ONEi2.
3) EXISTING .9No F/n/,19L. GF'_ROES SHALL
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OATS APPl2oVEl� :
9i�'if�STA f3C`c 8 ZD• O F H E A L T H
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fyp. Pr—Op— f'i)7. SpotCD
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