HomeMy WebLinkAbout0170 FIFTH AVENUE (HYANNIS) - Health 170 FIFTH AVENUE
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TOWN OF BARNSTABLE
LOCATION /?O /;` %� /1� SEWAGE # 'Q'3- 197
VILLAGE4Cc�'In�,S /�or% ASSESSOR'S MAP 6i LOT
INSTALLER'S NAME & PHONE
SEPTIC TANK CAPACITY J,l/00 GCc�
LEACHING FACILITY:(type) P, (size)
NO. OF BEDROOMS PRIVATE WELL O.R PUBLIC WATER
BUILDER OR OWNER ��
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DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: eI'3
VARIANCE GRANTED: Yes No l,J
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No... - I. .. / /Fmc._.: ....30..00
THE COMMONWEALTH OF MASSACHUSETTS
APPROWO BOAR® OF HEALTH
Barnstable onservatim
,JOWN OF BARNSTABLE
Sirlied Viri wial Workii Tomitrurttnn Prnttt
Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal
System at:
170 Fifth Ave West Hy rt annispo --•--------= .........................................................................................
-
Locatinn-Address or Lot No.
Smart
...........................................••-----•----------...-----------•----------•----•-----
W J.P.Macomber Jr. Oemcr Address
,a ----•••-...--- --••----•--•--------•----...----••-----•----•••• ................................. -------------------•-------•------•-------------•---•-.._...••--------•----.._.-..---------_-_....
p Installer Address
UType of Building Size Lot............................Sq. feet
.,, DwellingX-No. of Bedrooms---------3--------------------------------Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ___________________________ No. of persons............................ Showers ( ) — Cafeteria ( }
a' Other fixtures _______________________________ __
W Design Flow..........:.................................gallons per person per day. Total daily flow............................................gallons.
9 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 ( )
Percolation Test Results Performed by........ ------------------•------------ --------------•-•---------------- Date........................................
1.4
1.4 Test Pit No. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water........................
ti,, Test Pit No. 2....._..........minutes per inch Depth of Test Pit.................... Depth to ground water........................
a ---•-•----•------------------------•----•--•--••--.._..----•-------•-••-••••••-----......._.._...---.........................................................
0 Description of Soil........................................................................................................................................................................
W Sand & Gravel
V ...............................................................••••-•-••-.....-•••-----------------•----------•-••---------...•------••-•------------------•---•-•--------------------•••-•------•••••-
W
.--•-••-••--------- .............................................................................. ----------•-------......•--•----•••••-----------------------•--•-----•------•---••-•-------------•-
U Nature of Repairs or Alterations—Answer when applicable Omit... -••--•-••-•-•-•--•--
ga_1.ton...tank...dis_trib.Ut_ion...bflx._and...1-.1 J0-___gallors_..Ieach.._Rit_-.......................
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 ce has been ' sued by the boar of health.
Signed
��� 6/22/93
p Dace
Application Approved By ............,h+'�^ �.e +--- ................... ... Date
1�
Application Disapproved for the following reasons: ...................................... . ..................................................................................
............................................................................................... _ _
� ...................-....... ... ......-----.......--.... �..Dare�.....---�..� Dace ............
Permit No. ........... .............. ..-----...... ...-.....-....--. ...- ......
........:...........
e� 9 Issued Z
91 9? 30.00
THE COMMONWEALTH OF MASSACHUSETTS /Fiz...........................
BOARD OF HEALTH'
TOWN OF BARNSTABLE
�AA:ppftrafivn for Diri ooaf Works Tomitrnrtion Prruid
Application is hereby made for a Permit to Construct ( ) or Repair J, ) an Individual Sewage,Disposal
System at:
.170 Fifth Ave West Hyannisport
.. -•--------------------------••--•--........ ... •--••••--- ............................
Smart Location-Address or Lot No.
J.P.Macomber Jr. owner Address
Installer Address
� U Type of Building Size Lot...........................S q. feet
., DwellingX No. of Bedrooms.........3................................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building -_-.--.-----_______________ No. of persons---._____---_--_--___-_-_-_- Showers ( ) — Cafeteria ( )
a' Other fixtures ............................... . .
W Design Flow............................................gallons per person per day. Total daily flow................................._..........gallons.
WSeptic Tank—Liquid capacity------------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 ( )
~" Percolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................
f? Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
04 ----------------------------.................................................................................................................................
0 Description of Soil-----•-••-----•--•----------•--------•--•-••--•----------------------------•--...
� Sand & Grave 1 ---------------------------------------•-------------------•-•-•--.....----------------
v .....--••---•--------------------------•-•...........-----•••---•---------••-••---•----•------------------•---------------••--------------•••--....-------•-•--•.
W
U Nature of Repairs or Alterations—Answer when applicable.Omi t-_-C e S 5�001 e.„In s rya 11...on-P-_.....................
1Q00..gallqn.--tank---dis.tributJLon...hoa...�nd...1--10.�J-.-O fal:l9n...leach...p1t .......................
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 ce has been issued by the board of health.
Signed ......t,,_Otjv --- .. ,---- .:v�.�.!• °.................... ......6....22...93..:......
Dace
ApplicationApproved By ............( ..—----- -,..., —� ....................... ....1.-. .-`1 .-.............................................................. Dace
Application Disapproved for the following reasons: . .... ......... ........................... ......................................... ---- .............
................ .............................................................................. .................... ......... ... . ...................------......................... ........................................
Dace
PermitNo. .............7... ........ .............. Issued ............................................................. ...
Dace
-- cam------ --.:r----...=as® a---- -. >--._..
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
(tertifirate of IL,om fi�tllTre
�Hg M TO CERTIFY That the Individual Sewage Disposal System constructed ( ) or Repaired�XX )
by .........� _�.... --..acomber f.
.................................................. ........... ...... . . -- . .................. . . .......... .........
at ......170 Fifth Ave West Hyannisp- ort
........... . -..... .._........ . -........I_.... - -....................... ............. ...-. .............. .-- .........
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. ........r�,?�..-..a_. _7_----- dated ...__..............__.........
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE .........._........ _...-e.... ..-. � _.. Inspector -- ....- C1_`
...............................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
No...... :
93 2 77 TOWN OF BARNSTABLE FEE.. ...
$ 30_,.o0. ...
... ......•---•--- .. ...........
DtoVooaf Workii Tomitrurtton '"amit
J P Macomber Jr.
Permissionis hereby granted...............' .....------•--------------•-----------------------•---------------•-----...----------...------.......................
to Construct ( or Repair (X ) an Individual Sewage Disposal System
at No... 1M F--f th Ave_-W—--1- Hyanni spgxt. ...........................................................
.
street
as shown on the application for Disposal Works Construction Permit No Dated Dated_____.-..h:'. .�1.'.Ef .....
....-._
C/ Board of Health
DATE............../..-r�- - 1.. � -------------------------
FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS