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Home My WebLink About0045 FALMOUTH ROAD/RTE 28 - Health 45 Falmouth Road Cape Tire 311 -053 Hyannis �o 1 t } No. 60® . -1 v Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes �pphcation for Mi.5po!5a1 ,p!9tem Com6tructiou Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandonk ❑ Complete System ❑Individual Components Location Address or Lot No. �S N?Oz✓-t' , Owner's Name,Address,and Tel.No � Assessor's Map/Parcel _7?l �� Installer's Name,AAA Ad . 0 Designer's Name,Address and Tel.No. c r`=• 350 Main.Street o a �W. Yarmdut�i: MA 02673 -a S4 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garba Linder (�) Other Type of Building No.of Persons Showe ) Cafeteria( '?) Other Fixtures Design Flow(min.required) gpd Design flow providedd 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) /1 ecL t) ow-kl 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 E vironmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boaid.of Hea Signed t t 4 A-/ Date Application Approved by c Date it, - ;- -0 r0 Application Disapproved by: Date for the following reasons Permit No. 2-00 `4 S Date Issued f 0 77 a 6 No. 2 - -t 5,b 1 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered incomputer: , PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE,-MASSACHUSETTS -.Yes Y Application for Migpogar Opgtem' Congtruction Permit '-Application for a Permit to Construct O Repair O Upgrade O Abandonx ❑ Complete System ❑Individual Components Location Address or Lot No.1/S �f� I d y t� I I Owner's Name,Address,and Tel No 1.Assessor's Map/Parcel ( D 7?r/ Installera Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No'of,Bedrooms Lot Size sq.ft. Garbage`-Grinder (, 1 Other Type of Building No.of Persons Showeis( ) Cafeferia( ) Other Fixtures r^ Pesgn Flow(min.required) gpd Design flow provided gPa r = Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil y r Nature of Repairs or Alterations(Answer when applicable) G I7/} 2 c r - , Date last,inspected: t 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 Hea h. ;; / L Signed 1 Date I Application Approved by ` Date Application Disapproved by: Date for the following reasons Permit No. &0 fo Lf S Date Issued to - db ------------- -————————————————————————————————— "— ———— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS 1 Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( ) Abandoned( )by efzq�(U at L/ �A/.,1 1 U✓-�A "' � // , has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 9-0 o6- L1 S16 dated Installer /-r Designer #bedrooms Approved design flow gpd The issuance of this permit hall of be construed as a guarantee that the system wall fu t o _as esigned. Date ��lp � Inspector --------------------------------------------- No. �L,5,0 6- 1�f 56 Fee C) J ^ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS 1=i5pogaf *pgtem Congtruction Permit Permission is hereby granted to Construct ( ) Repair ( r pgrade ( Abandon System located at �/-�� t 1 leeJ VV. 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 be completed within three years of the date of this errrit. Date 10 �� `�� Approved by v r , LOCATION SEWAG PERMIT NO. 7� VILLAGE I N S T A LLER'S NAME i ADDRESS B U it D E R OR OWNER GATE PERMIT ISSUED DAT E COMPLIANCE ISSUED /1c - 71 -- eck Y=.. Ar, TOWN OF BARNSTABLE a -LOCATION �,-�e o�� t a-7 ,SEWAGE # VILLAGE nh ASSESSOR'S MAP .& LOT�� INSTALLER'S NAME & PHONE NO. �t� �i¢hGy %��f_-- O23'oo SEPTIC TANK CAPACITY - g `LEACHING FACILITY:(type) 000 A • 02 � (Size) j�,eW NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER' DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: .Yes No �/ a CJ 'V v� O r� N � T/...... Fmc.......... ........... ` THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -------.-._--r !-....-.--...OF...-..-AA4-1l!!.'-•---......---------....................................... Appliration, for Uiipoiial Workii Tomitrortion ramit , Application is hereby made for a Permit to Construct ( ) or,Repair ( ) an Individual Sewage Disposal System at: .. - ` -------- ... ----.... _: ..!1. - 1 ..............._.. }�;ocatiogt-Address or Lot No. s Own Address G•�•F--•- E? :er.........--------- --------.......-- ------------------------------------------ Installer Address Q Type'gf-Building Size Lot............................Sq. feet D welling—No. of Bedroom Expansion Attic ( ) Garbage Grinder ( ) Qther Type of Building COA-A--5 . No. of persons............................ Showers ( ,) — Cafeteria ( ) Other fixtures ------------•-• •-•--•••-----•- - --• W Design Flow.............3 S__.___.__._____._._._____gallons per person per day. Total daily flow.......1.v_u...........................gallons. 1 9 Septic Tank 4 Liquid'capacity/lll3-V-•gallons Length................ Width................ Diameter______________--:Depth................ W x Disposal Trench—No_____________________ Width.................... Total Length................_... Total leaching area....................sq. ft. Seepage Pit NO-------I............. Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Other Distribution box (✓- Dosing tank ( ) a; Percolation Test Results Performed by--------------------------------------------------------------•-•---•-•-- Date........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water........:__.,__________- Ci, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...............:........ ..................... -- - - - t O Description of Soil___________________ ..._. `. x U -••-•-••-•-----••--••--••-•••••••-•••••-•••-----••--•-•----••--•••••••---•---•-••-._.._..-•••••••••••-•-•••••---•-------•-••--•-•---•----------•-••-•---•--•---- W VNature 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 TIT1. 5 of the State Sanitary Code—*The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss�/L�byAlf and health. Signed.------• -•---...... �� 7-�� -----=---------•- •-------------•------•-----•-- Date Application Approved By............................................................ -•....... Date Application Disapproved for the following reasons:-. lQ � _ y.___.. _.%_________________________ .._._._.....••_••-•-••--•--•-----------------------------------------------------•-----•••-••-•--•--•-•-----•-••-•-__7•-.--.---------------------------------------------------- ---------•--- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD ff HEALTH y • %TF. ertifirate of Tootlrliattre I I CIFY at the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by...... .. ----------------••-----------•-- - e Installer "_....._...__ atr' G?2 - - ' r ------------- -- •-------•------------------------- has been installed in accordance h the provisions of T 5 of The State Sanitary Code as describ d in the application for Disposal Works Construction Permit No ____��___7l______________ dated__..-�._:�= Z�________.__ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DA ...`..J�.. 7�........ Inspector.............. No 3 71 -- Fizz �.6 �� ..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................._..................._OF......-.........-.....-......_-......... - ..._.-.-...---------..._-...----------- Apphration for Uhip saf Works Tnnitrnriion Vantit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: (f.. ......../•. ---- ....................................0....................... r -� c ion-Addre7§ l. G or Lot No. ......................----••---•----...........7............................._.... ---...----•--•--........._..................----•- Owner Address T� 'installer Address dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms________________________________ _Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Buildin _ No. of persons____________________________ Showers — Cafeteria dOther fixtures -------•••-• -----•-••••------•----•---•---••-----•••••---•-•-•••-----••-----------"-------•--�/ W Design Flow........... __5________________________..gallons per person per day. Total daily flow____.?_2_J__._........................gallons. WSeptic Tank-� Liquid capacityolt�....gallons Length................ Width---------------- Diameter................ Depth................ x Disposal Trefich—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.....f.-------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box O Dosing tank ( ) - '-� Percolation Test Results Performed by....................................................-...................... Date........................................ Test Pit" No. 1____.______'___minutes per inch Depth of Test Pit____________________ Depth to ground water-----------------_-____- (i Test Pit No. 2........._......minutes per inch Depth of Test Pit.................... Depth to ground water........................ Descriptionof Soil .................: ---• •-•---.................._..................................................... x W ------------------------------------------------•-------------------------------------------------------------------------------...----•--------------------------•----------•-••-•-••••-•---------•-•-- 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 Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been�;isssud by thf& (6a/'health. Signed.......` ............................................... - Date ApplicationApproved By--••-----------------------------•-••.................................................. ........._..............__ -. ........................................ �� v�.. �•1�--- '1 i.............................................Date Application Disapproved for the following reasons:-----_....;�__________________/._ - ._.__ . . •-•------------------•---------------...-----•----------•----...-•---•-----------------•-•-•••-----•••-•---•-••---•-•/--•---•---•------•-••---•-••••-------------------••--••---------•-•-•-••----•-•--- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH j \ (9rdif iratr of Tuntlifiaurr �- fI .,ISITO CE T FY That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) �� by.... • ...........�•------- ............--•-•-•••_:� ....••----•-•--..._--•••--• -- - .............. .... ---------------•••-•-•-••---••- 'u Ut„ � �Installer�r ��'.�'�� at.................Y----...----- ---' !_......__...---- v has been installed in accordance with the provisions of TTry of. The State Sanitary Ceo e gsco�e`d_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.......9-.��-.. ................................................. Inspector........................•---•---•••------------•••-•--- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF'IMALTH G-r--a.-. No.......................... FEE........................ gisjlnsat ,, ork -_TvOtr , Uan lermii h Permission is hereb ranted_ __ ' Y � .. - =..................................................................................... }� f r- to Construct (_ ) o'r;Re ir� �`-)/an.Indivitele Se ge Disposal System atNo.-------ff....-{-------�---.•=.=..-:....------•��•--•-•--•••----. r-'!� -------•------- -- --------------------------•-------•- y -•- Street -_ _-._7_________as shown on the application for Disposal Works Construction Permit AI `�G�� ._.._. rye ............... -----•--•••-----•------ ----•-•------------------• '--•---••----•------ f Board of Health DATE................................................................................. FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS �A = 3 � i - os3 No....�.._.__._._......1 Fas.......:10.... ::... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratinn fur Di ipwial World, TouBtrnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair (-ran Individual Sewage Disposal Sy `....S ....- f'....J.6................................................. .....------. ---- -----------------------...._--- Location-Address or Lot No. .............. ...............................•--- __......................__..... w C' J C® Owner Address IustalIer Address Type of Building Size Lot............................Sq. feet ., Dwelling—No. of Bedrooms...........!r!n---------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ------------------_----_-- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) at Other fixtures ------------------------------- - - W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity............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 ( ) Percolation Test Results Performed by.......................••--•••-•••••••---------......---•••......--••--•-• Date........................................ Test Pit No. 1................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........................ P4 ...---•----------------------------•----•-----------------------•--•------------•------...........--......................................................... ODescription of Soil........................................................................................................................................................................ V W ----------------- --- ------------------- VNature of Repairs or Alterations—Answer when applicable.--.- 3 f_........_/'.....1 j_ .®....... .. � ... (S�iw _ . ....... ........d . ........�� ................. �f �_.t ...._... _ e 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 bee issued by he bo rd of health. Signed ----A.............. . . . ............ ..... ......... I..... .:...1. Application Approved By .. ... .......... ...... .. .... . _.... .. ... .. .Zj Application Disapproved for the following re r n.r: ................................................................ ............................................... ... ..... ---............................................................ -------_-- ................ PermitNo. ............ ...................... . .. .............. Issued ....... ..- 6. . . ....................ate...... No.. ... Fint r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Diripwial Wi ork,i Tonitrnrtion firrutit Application is hereby made for a Permit to Construct ( ) or Repair ("l-an Individual Sewage Disposal System aJa* • 1 1 ....-----�..--.....-/�...... CA 1) 't P _ Location-Address or Lot No. w A C O Owner Address .... Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms---_-__--_-_—______________________----Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) 0.1 Other fixtures ---------------------------------------------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 0y Septic Tank—Liquid capacity............gallons Length................ Width---------------- Diameter--- ............ Depth................ 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 ( ) 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........................ a ----------------------------------•••••-••••--•••••••••••••..__...--•••-•-••.........--'----•-.....•......................................................... 0 Description of Soil........................................................................................................................................................................ V W .....----••-----------------------------••••--••••••-••--••---------•----------•---•-••••••-------•----•----------...---------•-----•••••.....-•--•...----•----......_..---•--••-------•---•----.....•. U Nature of Repairs or Alterations—Answer when applicable..... 1?3 1�!41...__.___.._. .'...._��:. .v_...... ..P16".o... Agreement. �� v 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 the board of health. Signed c ,y, .. ............. ..... ......C' .._.... ......... �. �..�...... �. � . Application Approved By ............�.............. %. ... -------- /L1J' 4:.,......................... ........... .... f' �..I .. /Dare / / �.. Application Disapproved for the following rea�6nr: - ...................................................... ----------- -----------------------*...............C......3 .......................... ,� Dare Permit No. ...a............ ............ ��................. Issued .......0�r- �D re...�-......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE k"LlPrttf ra e of (111nmyliattre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by .................. hc a I / at ....... ............. ............. rdcr 1� .....'11 . .� .......................................f 5 .... � � . - -V. -----_ --- --------..I<. has been installed in accordance with the provisions of TITLEi of The a e E vironmental Code as described in the application for Disposal Works Construction Permit No. . . ...'.... ................... dated ....._......................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT CONS TAR AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. 1_ DATE....................... .. .../.� ........... .. .._.... ----. Inspector ...........V. ...... ..._....._..................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No.y TOWN OF BARNSTABLE FEE.....;..?C�...�... Riipoottl norko Ton,atrudion rrntit Permissionis hereby granted..................!/-/�ca-----------------•------------------------------------.---------------------•-----------.------------ to Construe ) or Repair (✓'S an Individual Sewage Disposal System 1 atNo............. / a S ------ - ------------- Street ( �...1....... P_a',Ijed-•----..... . .1. ...,.1_.C�as shown on the ap lication for Disposal b�'orls Constructioner t No._ _.�.. �' V ��.!......... .._. 2 lq4 .................... Board of Icalih�p DATE............ 1?f FORM 36508 HOBBS R WARREN.INC.,PUBLISHERS