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Home My WebLink About0223 FAWCETT LANE - Health 223 FAWCETT LANE,HYANNIS A= 270 109 i TOWN OF BARNSTABLE 04 K ATION plyC� SEWAGE # VIZLAGE I�ND t-�—� ASSESSOR'S MAP & LOT %4 0 INSTALLER'S NAME&PHONE NO.Gt�1 �• '1�A L SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS .� Biff6BgR OR OWNER 00/'� PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the 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 Page I0 of l I OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 223 Fawcett Lane - .. Hyannis Owner. Odvan Hernandez Dateorinsp.a.... SKETCH OF SEWAGE DISPOSAL SYSTEM - PmAde a sketch of the sewage disposal system including ties to at least two pesmanenl reference landmarks or benchdtarks.Locale all wells within 100 feel Locate where public water supply enters the building. A 13 �.14 A-3-30 -;3`3°� 0 3 i - 1 t TOWN OF BARNSTABLE L(k-ATION a2::J� \ L1V SEWAGE# V fl.. AGE �U*V�1 N kS ASSESSOR'S MAP& LOT v2 ® O INS'TALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY V4�,\ <; fl� LEACHING FACILITY: (type) (size) (In K �p NO.OF BEDROOMS BUILDER OR OWNER DATE: ��.i'L\CA!j�, COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) 1 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by OR CK. b; a t^ ap qj- t c 1 \ I OCL�T10 /J SEW&CIE PERMIT MO. ago - � 'VILLAGE — — � - - - - - 29 I IV ST AL , R IJ �� h A D D R E S S BUILDER 5 1.1 &MF- ADDRESS DIaTE PERNAIT I55U D '— - y' 7,i— — —� D ATE COKAPLI WaCE ISSUED -X �- , I, � �� t� �. . `', ,, � j � .. / ~:� ,�� ,, No. ................ ................. THE COMMONWEALTH OF MASSACHUSETTS BOARD/4?LFHE4ATH r),V * ------* OF....k.)... .. .. ............. Appliration -for M-4paiial Vorku Tonotrurtion Vrrmft Application is hereby made for a Permit to Construct or Repair (47an Individual Sewage Disposal System at ..................... . .. ........................................... ............. Location-Address or Lot No. -_----------------_-------- —------------------------------ -----------_---—------ ......... .. .. .... .. .. ...................................... ................... ............ ............ I.......... ................. w r ---- -- Instal ler Address Type of Building Size Lot----------------------------Sq. feet U Dwelling-LNo. of Bedroorns-.------------------------------------------Expansion Attic Garbage Grinder ( ) P-1 Other—Type of Building -------:.................... No. of persons..--____----______---____-__ Showers Cafeteria ( ) Otherfixtures -------------------------------------------------- ---------------------------------------------------------------------------------------------- Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons. P4 Septic Tank—Liquid capacity------------gallons Length................ Width-.-_--.__.._--._ Diameter__.__:..-_-_--- Depth-___-._--_--- Disposal Trench—,No..................... Width--- Total Length._._......._ Total leaching area--------------------sq. f t. Width-___._ below inlet_l� Total leaching area------------------scl. it. Seepage Pit No...4------------ Diameter.....lo..� ---t Z Other Distribution box Dosing tank Percolation Test Results Performed by.......................................................................... Date............. ----_------------------- Test Pit No. 1----------------niinutes per inch Depth of Test Pit-.._-_____________-- Depth to -round water.---_--.__-_-----_..._.. f14 Test Pit No. 2................minutes per inch Depth of Test Pit-.---_-__---.______- Depth to ground water------------------------- P4 -------- ------ Description - ........................................................................................ 0 ------ ................... -------------------------------------------------------------------- -- - ption of Soil-. ----------- ------ U ------------------------------------------------- .....................................................................................................I----------I---------------------------------- W -------------------------------------------------------------------------------------------------------------- ------------- U Nature of Repairs jbr Altera . .Pris—Answer w en ayplicable------ ------- ------ --- ------------------------------------------ ---------- -------------------At!�� 0 ;2 ---—------------ ---------10.....4 # ------ -------------------------------------------------------------------:------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is by)he V boa of a h. .......t� Sign --- ....... ..................................... ------------D-ate------- Application Approved By.---- -- --------------------- .........?..- - Application Disapproved for the following reasons:......................1�..........................................................Date------------- . ......... ...... --------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------- ------------ Date Permit No........................................................ Issued...- —---------- Date Fizz N..k. ............................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEAL_ T ---------OF.....B... .... . .. ............-....---- -----............-------- Appliratiun for Di_qpniittl Marko Cnonutrnrtion Verntit Application is hereby made for a Permit to Construct ( ) or Repair ( ,410'an Individual Sewage Disposal System at: Addres )f or . ... oc Owner Address F W N° . PQ - Address UType of Size Lot.............................Sq. feet Dwel In o. of e .- ----_.....;•..._...---••--•-•••--- ------•-E i� G age Gr ro ) p� Other—Type of Building ____________________________ No. of persons---------------------------- Sowers — a ., ---------- Other fixtures . . ==='== ------------------------- Design Flowr---------------------------_________'__:_-_gallons peer-person per day. Total daily flow............................................gallons. P Septic Tank—Liduid tcapacitv-__..'.___..gallons_ Length________________ Width...... Diameter---------------- Depth___--_-_"__._. W x Disposal Trench . 0._______________�: Width._._____._..__.._... Total Length___________________- Total leaching area Trench.. ft. 3 Seepage Pit NO____________________ Diameter.................... Depth below inlet____________________ Total leaching area-------.------_---sq. ft. z Other Distribution ox ( ). -- "Dosing tank ( ) a Percolation Test A4ults Performed&, --------------------------- -- - ---- Date________----_-----•--------_---------_.. --_- W Test Pit No. 1_________-------minutes per inc Depth of "Pest Pit.................... Depth to ground water--_-____-_______-___-._- ; (14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water............__--_____-_. P4 ---------------------------------••----•-------•-•-•-----•-•--•---•-••-••-----------•-•--•-----•••-..-----••------•-------••------•------------------------ 0 Description of Soil............................................................................................................................. ______------------------------------------ x U ---------------------------------- ............--•- W ------------------ ----- , UNature of Repairs or Alterations—Answer when applicable------------------------------------------------------------------------------------------------ ---------------------------------------------------------------------------------------------------------------------------------------..........................................---_.---.._..------- Agreement: _ 0ta" ed ag&o ons scribed Indio dua4ewe Disposal System in cor c the provisions of Article XI of the tate 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. a f Sig ... ..... •- ••------•-•-----------------------------------•---•-•----------------• --------------------------- Date Application Approved BY_ -x ---- ------- ,aty. Application Disappr ed for the following reasons: ..........•....:-...._-••-----•--•----•--•--._._..._-•-•-•-•--•-•-----•-•------------------------------------- ----------•---------------------- -----•-•---.. -------...__--•-•••_-----••------_. ..................................................................... - Date PermitNo......................................................... Issued...................... ................................. Date THE COMMONWEALTH OF MASSACHUSETTS t BOARD O HEALTH <.. ..� 0 ...............................O F.......................:.....:...... ...:..... ............................... Tirtifirate of f."Untplianre TH,ITORTI Y, liat the Individual Sewage Disposal System constructed ( ) or Repaired '. { --�.,.. t g �/ _.. Installer Y. _r at............................... ... = 1�� . •--------------- ------- ---------------•-----•---------.._____..-•-•------•----._._.._..---••------ has been installed in accordance with the provisions of Article f The State Sanitary.Code as described'in;.the application for Disposal Works Construction Permit No_____________?s"'__--__ dated_.-.___.Z.---...�..._'��-_7_�:____'__ THE ISSUANCE OF THIS (CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEErTHAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................. Inspector-----'--------------------------------•-------..................................... THE COMMONWEALTH OF.MASSACHUSETTS BOARD f�F�� o�GZr ✓.......OF......�.. ..................... -.....-.....-..---------.... N0.... . : T FEE ............ Diri:Pofittl n Cn,nnitrnrtion f amit Permission is hereby granted --------�4L -------------------------------- a. to Construct( ) or epair an ividual Sew Disposal-System ..jr . ------- �J ;;V-a `^- as shown on the application for Disposal Works Constructio mlt •o.___ '______________ Dated__ ___-.--____________-_ 's..._____ i �' Wit.. - -- - /j��, ^�►S Board of H th ~ DATE "`------------------------ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS • -