HomeMy WebLinkAbout0030 CRESTVIEW CIRCLE - Health 'l 30 Crestview Circle
� Hyannis
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TJWN OF BARNSTABLE
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LOCATION y3 e 2--"-V;Qvo SEWAGE #
V LLAGE� C �• ASSESSOR'S MAP& LOTS US1 azz
INSTALLER'S/NAiYIE&PHONE NO. 1_12— n
SEPTIC TANK CAPACITY 1 S•06
i
LEACIUNG FACILITY: (type toe►,,��h�ri�(zS (size) 13 7� Z
NO.OF BEDROOMS
BUILDER OR OWNER
PERMTTDATE:___ COMPLIANCE DATE:
Se-_sr_ oL Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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3 THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Apphratiou for Divi-Vo!ial lVarlai Towitrurtiou Urrutit
Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal
System at:/)
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....... ..... ... ...... •. ........... .....................I. ............ ........... ....... ............i4��......
, / or i_o,,.-A d
Lot No.
AV -------- ------- _---------
.............. .4
.. ..... ........ .
�:
w er 1—� - h Address L#............n
.......... ... .......................... .................................................... ........... . ................................................ ........
Installer Address
dType of Building
USize Lot...........................Sq. feet
Dwelling—No. of Bedrooll1i------------;_,--3------------------------.Ex pansion Attic Garbage Grinder
Other—Type of BuildillgWO--0'4-.rL444v-.e-No. of persons---------------------------- Showers Cafeteria
P4 Other fixtures ----------------------------------------
Design Flow.............................11P.......gallons per p@" n-,per--day.---Total--daily-flow---------�_., -----------------.'........g"a,1'1'o'-ns,
04 Septic Tank—Liquid capnityt0..0___0----gallons Length................ Width................ Diameter---------------- Depth.........._.....
Disposal Trench—No. .................... Width-.-._...-.._........ Total Length......-------------- Total leaching area....................sq. f t.
Seepage Pit No---------- -------- Diameter.................... Depth below inlet...-...____._.-_.__. Total leaching 'area..................sq. f t.
ZOther Distribution box ( ) Dosing tan�j( _X0_ -Percolation Test Results Performed by--------- ...................................... Date------- ..........
Test Pit No. I--- .....minutes per inch Depth of Test Pit-------------------- Depth to ground water_,V.R ----
44 Test Pit No. 2................minutes per inch Depth of Test Pit..--_--_----------- Depth to ground water............__-.-_......
0 Description of Soil...
x
------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
.................... ............................................ .......... --------------------------------------------------------------------------------------------------------------------------
U Nature 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 f rther agrees not to place the
undersigned
' rner a
by system in operation until a Certificate of Compliant e_.4�issuV the bo�atd health.
Signed - ---- -------- ----------------- ------------ ----- ----- ...............
Application Approved By ... ------- .....
�-------------- .......... ---------- --- -- ----- --------- -- -- --------------------------------------------- -----e----- -Dale
................................................................
Application Disapproved for the following onf-- ---------------------
---- ------------------------- ---*------- ------------------------------------------------------------------------------------------------- ......................
..............
- -
Permit No. --- Issued -----------------
ce
-------- -------- 170—,3—6-.)—----7-------------------------------------
THE COMMONWEALTH OF MASSACHUSE17S
BOARD OF HEALTH
TOWN OF BARNSTABLE
Gertifirate of Complianre
HIS�,I TO CER T That the Individual Sewage Disposal System constructed or Repaired
------------------------------------------------------------- ....................................................................................................
................................
by --- -------------------
Z
-------------- -- ----------------------------------------------------------------------------------------
/3------
at ........... -------------------T...............----------- ----------- ----------------------
has been installed in accordance with the provisions of TITLE of- he Stto En ironmental Code as described in
the application for Disposal Works Construction Permit No. ----------- -----_ .............. dated ----------------------......................
ST U
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT E of
AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY. c7 9 -�3
DATE......................----------------------------------------------------------------------------- Inspector -------------------------------------------__...............................................
9 O.S-I -C>1 R
No. �---•• Fiza......Y-.t/..
l /
THE COMMONWEALTH OF MASSACHUSETTS ✓'
BOARD OF HEALTH
TOWN OF BARNSTABLE
,�vpplirativtt for Bi-nputial Wnrkri C outitrnrtion 1hrutit
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System at /
-.....�..---......- - -------------• --------•-•--•••-••-•-•• _ -� ............................................. ...-----... ,_ e
L,oca ion-:\dd�s�� A � -_ or Lot No. � t� �F i�: \
____________________________________________ _________l _ ...
/9
n�� caner i �f/1 _ Address ` 1 L(
.V1
Installer Address ��
Q Type of Building Size Lot..... ________________Sq. feet
Dwelling No. of Bedrooms.__.__..._._ -� _Expansion Attic Garbage Grinder
Other—Type of Building ._.__._._.__.Ak—UA-0-No. of persons---------------------------- Showers ( ) — Cafeteria ( )
a' Other fixtures ------------------------------- - -
W Design Flow.............................J U......gallons per perm per day. Total daily flow......3 3-0_-_---_. -----___---•---__gallons.
WSeptic Tank—Liquid capacity f.--0 _.gallons Length---------------- Width---------------- Diameter----- .......... Depth................
x Disposal Trench—No- -------------------- Width.................... Total Length--------------_---- Total leaching area....................sq. ft.
3 Seepage Pit No--------__----_-_..'Diameter.................... Depth below inlet.................... Total leaching area......._..........sq. ft.
Z Other Distribution box ( ) Dosing tank (� )��_
a Percolation Test Results Performed by �--x-�'`.' ---- . Date ------
Test Pit No. l.... ._--minutes per inch Depth of Test Pit.................... Depth to ground water--Ai.q-----`-- -...
Gi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a
DDescription of Soil. ---------4 A- ---------------------------------------------------------------------------------------------•----------•---••-----------
v ....--•-•-•-•-•-•-••---•--•--- -----------------------------------------------------------------------------•-------------------------------------------••------------------
-=---- -----
--- --------- ---------- ---------fie-------- --- -------------------------------------------------------------------------------------------------------------------------------------------------
U Nature of Repairs or Alterations—Answer when applicable-
i
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-1,iasbe I n-issue.4 by the board health.
Signed ---/_� r'A //
f
- Q- ------- 1...G f .
Application.Approved By .r............. .._ f 4 r ///
.�� �... - !,c_. -u .... j----------
Application.
Application Disapproved for the following rea onf: --_------...._-----------------------------_-------------------------------1.....------------......---------..----------------
.... ..... ---- ............._ ....-------.....----_...._............----.....--------------------------------------------- - ( .......................
Permit No. .....>>......... ..... . Issued I
� i DSce r
�
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate of Complian-ce
THIS I TO CERTIF , That the Individual Sewage Disposal System constructed ( �) or Repaired ( )
by .� �............ _. ----�----------------- ------------------------------------------------------------------_....----------------------------------------------------- -- ----------
c
h,. c _ n f•r n t d described in
at - ----------- G. -�^.. -
has been installed in accordance with the provisions of TITLE 5 of�h�e_lqte E�v o men al Coe as e
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. 7 a -3--:));�_
DATE------ -----------------------. ----------------- --- ------- ---------- ------........ Inspector ---------------- -------------------------------- ----
--------------------------•---•--------------------- ------
--
THE COMMONWEALTH OF MASSACHUSETTS — --
/ BOARD OF HEALTH /^
o f TOWN OF BARNSTABLE
100No _........ !_/-I. FEE.....
....,.............
�i�jimal nrkii Tunitnutinn "antit 1
Permissionis hereby granted------�TJ ....... �-----------•--------------------------•---------------------......•--.............._.....--
to Construct ( �) or Repair)( ) an Individual7Sewage Disposal/Slystem
at No......-1�f)''fi. 1-1 3-•-- «_ �►'2r'v` � `�1�= _k---------------------------------------------
Street` ����
as shown on the application for Disposal Works Construction Permit No�`s�______ _`-Dated...........................................
..--------•-•----•-•-----------------------------------------------------------------------------
q Board of Health•
DATE f 5'" 3,3 ")--
FORM 36508 HOBBS R WARREN.INC.,PUBLISHERS
�St�►-i DATA
'51 1,16LE FAM IL{ ® r2r--a PL.A OW BAUL ua�tz.Fo�"
qo GA=3A`Q Gw+lvse-
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SQ-nc TAW L -33 0 J(700 y=ta(00&D
u�F IC200 GAL. a'vve ?ws-
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,IppUGAT�ON AM D�Sletit
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VoTTOAA APIRA = 12' 1 2s' = 300 -=
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ACC. M I
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Of
STEPHIN
ALLYN
WIL"
TOWN OF BARNSTABLE I
CERTIFICATE OF OCCUPANCY •; � �
i
I
PARCEL ID 252 051 0221 . CEOBASE III 43467
ADDRESS 30-, CRE STVIEW CIRCLE PROLE
ZIP
LOT . 43 & 43 BLOCK
DBA LOT SIZE
DEVELOPMENT DISTRICT HY
,I
PERMIT 31849 DESCRIPTION
I
PERMIT TYPE . ECOO TITLE CERTIFICATE OF OCCUPANCY' i
1
CONTRACTORS-.
Department.of Health, Safety !.
ARCHITECTS: and Environmental Services I
TOTAL FEES: i.
BOLD $,OC TILE �.
CONSTRUCTION COSTS . $.00 i
i�
'7a8 CERTIFICATE OF OCCUPANCY 1 PRIVATE P
* 1ARN3TABLE; • �,
MASS. �► �.
1639: ♦0 h
ED M1r►I� : �.
- 1
BUILD vI ON
B
DATE ISSUED 06/29/1998. EXPIRATION BATE is
------------- -------------------- ------=-- ---- --------------- ------------ ---- -J.
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- .
CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR
ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORK$.THE.ISSUANCE OF THIS
PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF FOUR CALL INSPECTIONS REQUIRED
FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND
THIS CARD KEPT POSTED UNTIL FINAL INSPECTION WHERE APPLICABLE; SEPARATE
1.FOUNDATIONS OR FOOTINGS PERMITS ARE REQUIRED FOR
2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF.00CU-
I (READYTO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT.BE ELECTRICAL,PLUMBING AND MECH-
3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS.
4.FINAL INSPECTION BEFORE OCCUPANCY.
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
OK
ff
3 t 1 HEAT NG INS CTION APPROVALS ENGINEERING DEPARTMENT
2 7 C) BA D OF HEALTH
OTHER: SITE PLAN VIEW APPROVAL
:-WORK SHALL NOT PROC D UNTIL 11 PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS
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