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Home My WebLink About0086 DUMONT DRIVE - Health 86 Dumont Drive Hyannis j A= 307-090 = ,` �r 1 i No. V��'G q Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftplitatiOU for Misposal *pstem Cott 'ULtion 'Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon(A ❑Complete System ❑Individual Components Location Address or Lot No. �� OU#A o ff-( t,J`v Owner's Name,Address,and Tel.No. Assessor's Map/Parcel ,3oaf Q �Y��N1'� g�2v �IAJO� v6 W YAJ ALS Installer's Name,Address,and Tel.No.S09,CP77—'98 7 7 Designer's Name,Address,and Tel.No.. lS C 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(min.required) gpd Design flow provided gpd 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(Answer when applicable) A]9k)bJ®au F_xt ( 1)C, S E?Ttc, 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 Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Healt Signed C V Y tn2,A- Date Application Approved by 0 ► Date ra— Application Disapproved by Date for the following reasons Permit No. ' Date Issued No. Y� V N l - ! Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes r e cs ' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ZippYication for -Misposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ❑Complete System ❑Individual Components Location Address or Lot No. FS(o ()UMO%jT DR..I✓C Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 30 16 NyANNI� I�� yo s x r p sAV-tr( xJx�/S Installer's Name,Address,and Tel.No.Sog,:477- '98 77 Designer's Name,Address,and Tel.No. CAPEWtDe V"qT klsEs "C' N (A { 1. 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(min.required) gpd Design flow provided °A• gpd Plan Date Number of sheets Revision Date `•, Title �x1 Size of Septic Tank' Type of S.A.S. I; Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: `k tY ' The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Healt Signed Date Application Approved by `��rYU V Date — � Application Disapproved by Date -for the following reasons "Permit No. !v� \ Date Issued Th E COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS . Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded Abandoned(�by CAP6(g){t) L, S � �- ry at _ O 1 j 'DjZ I VC— 14YA)VA)IS has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated InstallerejOtCuxb6 FOT�P ka 4_Z C Designer N 1A #bedrooms Approved design-flow .. gpol The issuance of this p'ennit'shall not e codstrued as a guarantee that the system wi func5' tio'� d/esigned., (AP_ J#1vU_ Ins ector // / `,!� i Date ^l. IJ— p /��j v r e. f r - Y c --- - ------- ----- ------ No, c _ j,- Fee . THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Mis.posal &pstem ConBtruttion Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon(�) System located at 2(P Domnwr bout and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be c/om leted within three years of the date of this permit.n ,n- Date �'/ Approved by V 1 BUILDER O R Hi\, ", k} t� 8 DATE PERMIT ISSUED: tS �~ 1 DATE COMPLIANCE ISSUED:� J�-G'/3 ,yr � VARIANCE GRANTED: Yes NO ?4k :icy ail # u ' Y� Ali 8 3 L ji #,4 Gp*p ft 5 A J� t4> 6 u \ \ \ _ b http://issgl2/intranet/propdata/prebuilt.aspx?mappar=3 07090&seq=1 9/11/2013 s TOWN OF. BARNSTABLE LOCATION D(,t•1(M,0 4:bc`10 E� SEWAGE # 9-3" 93E VILLAGE t�y,hni_S ASSESSOR'S MAP & LOT3O'7- (390 INSTALLER'S NAME & PHONE No.&4 SEPTIC TANK CAPACITY /, 600 QQIS LEACHING FACILITY:(type) �i' �/ (size) 4 )U6 NO. OF BEDROOMS PRIVATE WELL OR UBLI�WATE BUILDER OWNERS DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: ��-�`/� VARIANCE GRANTED: Yes CNo.:� �l .#b Q ti 9. t Y wit No.. .. Fas.. `:�a. . THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE A plication is hereby made for a Permit to Construct ( ) or Repair Y� an Individual Sewage Disposal System at: Vr'►'�ldp.�j a.1 .�ivl. Location : i 9rrss or Lot No. .... .1- �" � v✓1� �/�l✓�.� '_. o, ner Address Installer Address Type of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms.-................____._._.._...Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) d Other fixtures -------------- ---- ----- --- - w Design Flow................. gallons per person per day. Total daily flow...__.______.��C_............._.gallons. WSeptic Tank—Liquid capacity�ZM/._)-gallons Length................ Width-----.---------- Diameter................ Depth................ x Disposal Trench--N....................... Width------e............ .Total Length.._........../--- Total leaching area....................sq. ft. Seepage Pit No.......... .... .... Diameter-_-_-- le....... 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........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.................-...... 9 ------------------------------------------------------------------•------------•----......------.....-----•------......---.....------•---•.............•-•--- ODescription of Soil............................................................................................................. ----------------------------------.............----------- x U w U Nature of Repairs or Alterations—Answer when app cable._____% / /�-_..._.1,p00 .... �f' f� J/L f Q.l x d / �Q GC1 �T .W l c - T r ?J✓�J.Z... 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 Complia h s be n ' sued y he oard of health. Signed ... ................ .... ............................................. :...................... ....., Dace ApplicationApproved By ........... .. ..... ... .................................................... Application Disapproved for the following reasons: .... ............................................................................. . . ........................................ .................................................................................. ..... ................................. ........................................ ........................................ Date Permit No. ........�-3...-.....V.,3...1B�.................... Issued ..--------- Date •,.:tcly�+r:..•-.�,,,vs'�_�,�'•-r.�...,�„ "..r's+�-5.+..�,.•--..-.�,.•,..r'- s .�.. ... r.�..�......,.�.r•-wc...t^�.a5y.��.... ..w•�.�.. .._...�'+: :wfs.� w..,...r--a�_-�.--.-....v�.�,,.i.•-`-•- ..."`•'1r-+...--� 1 No..;C ` - Fla$....- ....r.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH "-- TOWN OF BARNSTABLE i �e ;Allplutttil Yi taf 3li�ipwial Works C onfitrurttnn "Prato Application is hereby made for a Permit to Construct ( ) or Repair ('X) an Individual Sewage Disposal System at: --....._.... ... s ------------------------------------------------------------------------------------------ Location-Address or Lot No. --------••----•-•-•---------- ................................ Owner 76,r� ,u Address ......................... --•• ................................. 7 t............ Installer Address Q Type of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms-----I....._..._ --------------.......Expansion Attic ( ) Garbage Grinder ( ) p� Other—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOther fixture -- =--=------------------------------------------ --------------------------------------------------------.............................................................. W Design Flow...................�_ ...._....._........gallons per person per day. Total daily flow.._.____-___.-- ..................gallons. 0: Septic'Tank—Liquid capacity, /L/U..gallons Length................ Width---------------- Diameter.....----------- Depth................ MW Disposal Trench-- No. .................... Width.................... Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No----------/......... Diameter-----.,�!1........ 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........................ W - -----------------------------------•----•--•--------------------••--------••---•------.......--•--•......................................................... 0 Description of Soil........................................................................................................................................................................ W V ....-•••----------•--....-•-----••-•----------•••--••------••-•••--......---•------•••...............•-------•--•-------•-••---------'--•-•-....--•-•-••••'•-•----•--------------.:...-----•-•••--•---•- W x ----•-•....••.. ...........•-----------•---------------•----------------._...---...------•----••--•-----•-------•-------•-•-----....--•--..........--- •-•-•-••-- . --..---- U Nature of Repairs or Alterations—Answer when appi cable------ '.^��-'�.a�_.__.�-__..__ DOQ .�r -(�----. �?!�l/ `. •/)_l 5.�:_.��..0 �.--•-•-•-- GS.. +��?...... i.._..__Ly_�.......................5�?"Q-A'........--•- 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 h s be n i.sued by the board of health. ��_ Q Signed .../..._-...... - ....... .......................... ............................................. - / ..... ....... I Dace......... Application Approved By ...... ..... a._ /.. ..................... .......... Date Application Disapproved for th following reasons: ..................... ........ .-- -- ........ ....--............................ .............. ... .. ................................................................. ............ C� Date Permit No. I '3..-----va-s ................ Issued .-- . . ......--._.......................... ...... Date --------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE 1IErtifirate of Q-1110 plianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ^�) by .... _.-.... _..--.....- " at .................................. ......._.............. ......._.... Installer -: 1// .al ld� / --.-... ---------------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ..--..��.---.-_.y dated ..-_......._...__...-.....--_--.-_.-... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. - DATE............__1"�.. L...g3............. _......._............ .....-...... Inspector .... ............ . --------- ................ ..._............ �J THE COMMONWEALTH OF MASSACHUSETTS 20-7 - G ' G BOARD OF HEALTH TOWN OF BARNSTABLE No... .-...7. FEs..�O.-•------- �is�n�tt1 >ar��un�tr�tirin �Prnttt - Permission is hereby granted. . C .�.5 ............................................... to Construct ( ) or Repair an Individual Sewage Disposal System atNo.... � o ='�U!!F�1.P_ .............................................. Street as shown on the application for Disposal Works Construction Permit No.73-.y,�-13' Dated.......................................... ----------- -•------J �------------------------------------------------ DATE.............(_/••. ............ Board of Health FORM 36508 HOBBS&WARREN.INC..PUBLISHERS AsBuilt Page 1 of 1 TOWN OF BARNSTABLE �1 LOCATION SCo-DUYYX�rl � �. SEWAGE # VILLAGE /7-� ASSESSOR'S MAP G LOT,�b~I-O INSTALLER'S NAME 6i PHONE NO.&(, [p44:t os` SEPTIC TANK CAPACITY QQ LEACHING FACILITY:(type) (size) 4 )!/Q NO. OF BEDROOMS. PRIVATE WELL OR U�BLICWA�T BUILDER OWNER am °�-� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes =NoL http://issgl2/intranet/propdata/prebuilt.aspx?mappar=307090&seq=1 9/11/2013