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HomeMy WebLinkAbout0079 CAPTAIN ELLIS LANE - Health (2) 91 Captain Ellis Lane Hyannis A = 250-101 I� . TOWN OF BARNSTABLE i► LOCATION C6 l s SEWAGE # � '3� VILLAGE ASSESSOR'S MAP & LOT '9J'D I60 INSTALLER'S NAME PHONE NO. 2 SEPTIC TANK CAPACITY/b 6 LEACHING FACILITY:(type) "� (size) Id b G b c.�-� NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER Fa U �� c DATE PERMIT ISSUE �--, , DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No- C,-' 3 � T i ti 5 ® fob No-73.:3-73 /Fms THE COMMONWEALTH OF MASSACHUSETTS y BOAR® OF HEALTH TOWN OF BARNSTABLE / � Appliration for Bispwial oaks T omoux to Writ 0= Application is hereby made for a Permit to Construct ( ) or Repair (' } an Individual, Sewage Disposal System at: ................__... ... .� �1-r.-... ..... ...................... -..---------------------------....-----..------•-----------------•-------------------------------- �,/ Location-Address or Lot No. i! �?. /.. 1�-'.n lo / `.•-...........................`-•=a -----•-••--•--------•----s--•.........1.......i�..... Owner Addre 13 ---------------------------------------------- --------------------- ....... .......... Installer Address Type of Building .� Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) P4 e of Building a Other-T yp g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures -------•------------------------------------ ----------------------------------------------------------•--------------••--•--------------.-•--- W Design Flow............................................gallons per person per day. Total daily flow..........................................;-gallons. WSeptic Tank—Liquid capacity2o.O. 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ 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........................ ...... --------------•-•---•-•-•--...---•-•--...----•---------.....----------••............--......................................................... 0 Description of Soil_- - -44................................................................-........................................................................................ U •--••----•-----•-----------------------------------------------------------••---------------•-•-------•-•------------------•--------------------------------------.....-------------•••-------•-•--•---- ------------- --------- ---- --- ------- -------- - ---- ----------- - ------ --------- -------------------- U Nature9f Repairs or Alterations—Answer when applicable_-.--I - .-...�..A_ _.....- c.G'6 81 __ lJ L - J. 1------•-------------------•------------------•--•-----•---•-•--•-•------------•----------------------------------•-------------------------------------...............---- 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 Signed Compliancehas bee issued b t board o health. g 7�� _� Date Application Approved BY � �1.Z�. .::,.....-,.-------------------------------------- -------------- ..y-'� .._-.. Da[e Application Disapproved for the following reasons- --------------- - -- --------------------------------------------- ---------------------- ----------- --- ------------ .................................................. --------------------------------------- Date PermitNo. J..-.... 7 ------------------ Issued ---....--...----- ---------------------- ------......--- -- Date � 0 0 THE COMMONWEALTH OF MASSACHUSETTS, BOARD OF HEALTH TOWN OF BARNSTABLE ApplirFafilan for Disposal Works Tnnstrurtion R rani# Application is hereby made for a Permit to Construct ( ) or Repair-(jf) an Individual Sewage Disposal System at: ...... _..-C ' ''_L.' • r ................................ ..•---------------------------.......------ ---------•-------•--.................---- Location-Address or Lot No. W ......v � .fir.. .� ..................................................... � .� ...s:........................................................---- Owner Address Pa Installer Address Type of Building Size Lot............................Sq. feet U Dwelling No. of Bedrooms___.........................................Ex ansion Attic U g— p ( ) Garbage Grinder ( ) a Other—T e of Building __..... No. of persons............................ Showers a YP g -------------•-•----- ------------ ( )--- Cafeteria ( ) dOther fixtures --------------------------------•-•- --•.••••••••••---------•••------•--•-"••......•--•-•-----••---••. ........... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity/0./_S?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------------------.............-----••- a - Test Pit No. I----------------minutes per inch Depth of Test Pit______-_-_--_-•--• Depth to ground water....................... (r4 Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................ -----"--------------------------------------------------------------------------------------------------------------------------==----------- O Description of Soil..Slo .....------------------------------------------------------- �. x (� = ---------------------------------- ............ ...............•-••••.....-------••••-•--•••••-------•••••---•----------•----•-•-•--••----••-------•-•-•---....---••-•--•••---••-......•.... ------ --------------- U Nature of Repairs or Alterations—Answer when applicable....../U_0._ ___._ _�d.�____.._rC��. _d 5/.....C U L ................................................ ------------------------------------------------------------- -. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of he-State Environmental Code—The undersigned further agrees not to place the system in operation.until a-Ce'rtificate of Compliance hX,ee issued b�tboard of health. +r 1 n — 3 A Signed :GC/ -- -------- - -� ... Dare Application Approved BY ----------------------------------------------------------- « e Application Disapproved for the following reasons- ............................---------------------------------------------........................................................... ------------------------------------------ -------------------------------------------------------------------------------------------------------------------------------------------------------------- ...................................... Dace PermitNo. ..... ................. Issued ---------------------------­-'-.................................. �Daw THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Cler#ifira e of (garayltttxuP ' THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by .......... =....4, ----��-Z- Ss A l-G �<- .:£-�..., ... ° has been installed I accordance with the provisions of TITLE 5 f The State Environmental Code as described in the application for Disposal Works Construction Permit No. -.-. ..--. ..-.... ..73.._.. dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE--- ...:. -2-------------- J� /Inspector ------------------ . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Disposal Vorkg Tnnstr ion inmi# Permission is hereby granted__ ..... _.___ ......... ..'•.. ................................................... to Construct ( ) or Repair 4-" ) an Individual Sewage Disposal System Street �� as shown on the application for Disposal Works Construction Permit No.73 3 Dated.......................................... ------------------------- �j •J ,-----------------------------------------------------•- DATE.�1... ........................................................... Board of Health FORM 36508 HOBBS&WARREN.INC.,PUBLISHERS L 0 A T�V � % �.,, 1 � SEWAGE P EMIT O d1 (tAGE i1 INSTA LLER'S NAIRE & ADDRESS _ B URDE R OR OWNER S Y ,P a h a v I DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 2_ � ,/ b� ,�' ,�� a __,�-- Q ,���" a l No.------ �. F�s...f®..".©..®....... THE COMMONWEALTH OF MASSACHUSETTS �O BOARD OF HEALTH Appliration -fur Uiipuial Works Tongtrurtion Prruid Application is hereby made for a Permit to Construct (`j-� or Repair ( ) an Individual Sewage Disposal System at Lo n•Address or Lot Nu.� - —Owne ess �g/� ,�.. v .___-._.. .. Y. __. Installer o Address Type of Buildin 1 W Size Lot---43 .ej_m:1___-____Sq. feet U Dwelling—No. of Bedrooms-------------�.................._-.--_..Expansion Attic ( ) Gar'6age Grinder ( ) is aOther—Type of Building __________________________- No. of persons --------------------------- Showers ( ) — Cafeteria ( ) Q' Other fixtures ------------------------------ -- W Design Flow.:_.50..................................gallons per person per day. Total daily flow____ ------------------------------gallons. WSeptic Tank—Liquid capacity_1-06D..gallons Length---------------- Width................ Diameter_-_.-_----..-_-_ Depth---------------- x Disposal Trench—No- ___________________• Width-------------------- Total Length-------------------- Total leaching area....----------------sq. ft. Seepage Pit No..........1--------- Diameter...L_Q.Q.&---.. Depth beloyinlet____________________ Total leachiu area-._--..__._--__--sq. ft. z Other Distribution box ( ) Dosing tank ( ) � aPercolation Test Results Performed by-------------------------------------------------------------------------- Date----.-.------------------------•------- a Test Pit No. 1...____•-___-_-_minutes per inch Depth of Test Pit.................... Depth to ground water----------.__..-_.-__.- L.T//, Test Pit No. 2______________minutes per inch Depth of Test Pit.................... Depth to ground water-..---__.-----_----_-__- f+.� .--__--__/_______________ __ ____________......... ______G......_.._�. �..__c._ 0 Description of Soil-.-.----- -_41f_1�.._.( 3 .s _.. - -` �., t _ --I/ ----------------------------------------- W ------------------ ------ ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ VNature of Repairs or Alterations—Answer when applicable...----------------------------------------------------------------------------------------_ - ----------------------------- -•------------- ------------------------------------------------------------------------------------------------------------------------------------------------ ---------Agreement: e undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with visions of Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in on until a Certificate of Compliance has en issued by t e board of health. Signed __ -���'' Date Approved By---- V-•--- -- ---�---- -- -----•---- � .l,Y� _S_ation Disapproved for the fo/lowing reasons:................... ..............--=----•...............................................Date--•--•----•--- ----•------•--------•-----------------------------.-•----•--•---•---•-----------------------------•--•-----•-_-----•---••------------------------------------ --•-----------------------•-- Date PermitNo.---....•-------•-------•--------------•----•-•-•••...... Issued--------------.....--- -------------------------•----. Date 6s ENO......................... ........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _................OF........................................................................ Appliration -for M.41 ial Workfi C ongtrurtion Vrrmft Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: / //0 � _ _ ______ _. 7 .__.----_i_>__�_..,.__.._______._r.__ .._._ _ _.._....___..__.__...___.__.________._.__.___.._____-- Gr LLbcpti n-A�ess✓f'J f--�!��'�" ci"�N/['�T or Lot No. ..... ..I/ - �'�' •- `. ��•'� Address /j//-/ ______________________ ________i_......._.___.._.._..._...._..._......_.__. ..____ _ _"_� ..__ ,— � I i 1 S InStai7er' KJ•, JLC �� a 4 1 ddress < v Q Type of Building-,) Size Lot_. ._ Sq. feet Dwellin &1of-Bedrooms------------:-'-----------------------------Expansion Attic ( ) Garbage Grinder ( ) aq Other—Type of Building --_-________ __________ No. of persons............................ Showers ( ) — Cafeteria ( ) QI Other fixtures ............................... .. W Design Flow_-- ___________________________gallons per person per day. Total daily flow..,'l )�-------------------------------gallons. 9 Septic Tank'—vQiquid capacitivGGv_-_-gallons Length-------------_ Width................ Diameter---------------- Depth................ xDisposal Trench—No_____________________ Width-------------------- Total Length-._-__--_.._____--.. Total leaching area--------------------sq. ft. Seepage Pit No.-___--_�____-______ Diameter.i...._G.v....._ Depth below inlet.................... Total leachnig�i a��r,ea._...___......_.sq. ft. Z Other Distribution box ( ) �osing tank ( ) ��- t�- /,T- 7J'� `1�c Percolation Test Results Performed by--------- ------------------------------------------••----•-----•--•------ Date-----•--•------------------------------- ,� Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water__-.-__-----_.-.__.-_--- Gi Test Pit No. 2-___•_-_----._._minutes per inch Depth of Test Pit.......•............ Depth to ground water_--------------------- --- -------•----a t---------- /'- -------•-•'--'-••-......--- Y� - i � f Descr tion of Soil_--------- __. � Q� iJ�-�----------�--'-- �----�`r ----/ �-7�-------------- .. .s�_. /- U ------------------------------------S7 /3 - fz1 ........................------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 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 Article \I 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. Signed n %_...- ..... .............. �S �. �,` _vV�� W't•_.(T:'tJ�' Date Application Approved By----- Date Application Disapproved for the following reasons:---•--- ' ---- ------•---------•---....._...•---------••-•...............••---• ---..............•- --•-----------------------------------•- ................................................. ---------------------------------------------•--•------------------------------•---•-------------------------- Date PermitNo........................................................ Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH ..`.....OF...... ... ....G /.''.1�... -............................:................. 101rrtifiratr of f ompliarcrr T I IS TO CER" , Tl �t'he Individual Sewage Disposal System constructed (' ) or Repaired ( ) by------ ---------'•-••----••••• --•••--'•-••••••-••---•----•----------•--•-•-•-'--••••••--- - - -- --- ------- -- --------- - ---- ----------- at. -- -- 1-••... �� In r/- ha een installed in accordan e with the provisions tRle 2;i4 The St e Sanitary ode 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 TILL FUNCT�N SATISFACTORY. DATE.....................----. -- -- Inspector---- ---------------- --•-•••--------•-----•-••--•-•----•-•••- THE COMMONWEALTH OF MASSACHUSETTS I _ BOARD .,,H TH �-�"- ...........................OF................................................ `---------------------------•-- No. ......... / FEE---..................... i rmit Permissi i reby gr. ed. !............ .. ....' G ' r�4 '....__.... to Cons u ) o_Rep it ) nd a e s tem _ — Str et as shown on the application for Disposal Works Construct' n o ____ --__ __`...................... .................................. DATE......... 7---1--- .• Board of Health FORM 1255 HOBBS & WARREN, INC.. 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