HomeMy WebLinkAbout0067 FIRST AVENUE (HYANNIS) - Health L
FIRST AVE.YANNIS= 267 013
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�-<.. TOWN OF BARNSTABLE
LOCATION 6? F� ,Jva SEWAGE # 28nl- 0 6 2
2.6 7-dl3
VILLAGE W a-s9" ASSESSOR'S MAP &LOT
INSTALLER'S NAME&PHONE NO. V41,/
SEPTIC TANK CAPACITY /S"a 5 C.,L
LEACHING FACILITY: (type) size) /Z' X 2d''x 2'
NO.OF BEDROOMS .3
BUILDER OR OWNER C dA a l r�- acle ad gz:
PERMUDATE: c.. /•- o/ COMPLIANCE DATE: ,44-o/
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
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No. V" ' �l Fee ,/
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Zd
Yes
PUBLIC HEALTH DIVISION - TOWN OF.BARNSTABLES MASSACHUSETTS �
0ppfication for �Digozar *p6tem Cow5truction 'Permit
1/�p Upgrade Abandon p y p
Application for a Permit to Construct( 'Repair( )Upg ( )Abandon( ) �Com lete S stem El Components
Location Address or Lot No. L�r Owner's Name,Address and Tel.No.
'rrpSi ✓r, bJ. lyf1 n/N�SPo �' Cd$ROc L��CA'/f%d k T
Assessor's Map/Parcel 2GA n� 04—S g4C'�� :� o'
// I QCC L o��j "7cry .ACOL�9 FLA 329
Installer's Name,Address,and Tel No Designer's Name,A res and Tel.No.
Y;94 R¢�r l-1®Gr✓1GQEI✓
Type of Building:
Dwelling No.of Bedrooms _ Lot Size P66 ^/sq.ft. Garbage Grinder( )
Other Type of Building 50 ' _ RIM No. of Persons r Showers( I ) Cafeteria( )
Other Fixtures LAua/n-P_V 4z4
Design Flow 33 D gallons per day. Calculated daily flow �-g' gallons.
Plan Date Number of sheets / Revision Date f f I F f
Title
Size of Septic Tank i 6lo& G•4A_ Type of S.A.S.
Description of Soil .4ebIl�i ar- _5�,Av P X�Sg`
Nature of Repairs or Alterations(Answer when applicable)
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 Certifi-
cate of Compliance has been issu by thi BAar f H lth.
Signed C Date Z s f 4 t
Application Approved by Date Z—/- D
Application Disapproved for the following reasons
Permit No. Date Issued
h��T> a ;j� ° -j"s .k 3- 't5` ".4u �a��'�->^g�',�f� a y',— � -a'- 7 .a• t � �ss Iry "�"C. �i�' >—mi,. ^'- �:
TOWN OF BARNSTABLE
-LOCATION 6'7 Fik�iE SEWAGE# 2-0r,1`- 0 6
VILLAGE W Fs~i" Y �,.. Ate. LG ?-Gt3
}J �,.•,,js�n]" ASSESSOR'S MAP;& LOT .
INSTALLERS NAME&PHONE NO. E�i�4d)
SEPTIC TANK CAPACITY
LEACHING FACILITY; (type) "C_"sr Z",,4 /Z' A zS"x z '
NO. OF BEDROOMS 3
BUILDER OR OWNER c 4Aa1-F
PERMITDATE: Z -- / o/ COMPLIANCE-DATE: l,��f —o/ . :
Separation Distance Between the:
is 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 ;t
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F/A.57 v15,
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No. � — V lj \ Abu { - Fee
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<° THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:.'
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
Application for 30igw9ar *p5tem Construction 3permit
Application for a Permit to Construct �Ke air Upgrade )Abandon pp ( p ( ) pg ( ( ) 'Complete System ❑Individual C ponents
GLocation Address or Lot No. L6T Z 8�3 O Owner's Name,Address and Tel.No.
F�43: la✓r. W. NY4N,115'Po127 C4Aot. LocX.4AQ7-
Assessor's Map/Pazcel _ �ly S/QKENZ�— D k -
2(,7 PR2CL7C. Ol Eiv AcotA to S15 .0
Installer's Name,Address,and Tel.No. Designer's:Name,Ad ress and Tel.No.
��c��-� IC�'s� � Sficrr2 yr1 f�o4Al6Qfi✓
$1Z 414, S7
—C4VILt 4= /rIA—
Type of Building:
Dwelling No.of Bedrooms Lot Size 8'006 sq. ft. Garbage Grinder( )
Other Type of Building Si 't' No. of Persons Showers( 1) Cafeteria( )
Other Fixtures LAAw ✓ u�9
•j �
Design Flow 1I to gallons per day. Calculated daily flow 33 y gallons.
Plan Date Q-7-Do Number of sheets / Revision Date
Title
Size of Septic Tank l<OG G h r- Type of S.A.S.
�,N
�r �..
Description of Soil ,vi- �AN7 P ESQ
Nature of Repairs or Alterations(Answer when applicable)
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 Certifi-
cate of Compliance has been iss=�Vcr
� Health.
Signed zk_l t 1 ' _, 1` Date ?-' 1- 01
Application Approved by vW ♦ Date 2-/- 0
Application Disapproved for the following reasons V
Permit No. Date Issued Zw_ 2 ' 71 "/
-----------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of (Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( )
Abandoned( )by
at / 74 t 3 0 )%;1-G 7 ;rl,-JV Awe 44a,.jru%o has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 74W-UG Z dated Z -✓ ' U
Installer Designer
The issuance of this nbrrn shall not be construed as a guarantee that the sys 'll fun c inn design
Date ( D Inspector
---------------------------------------
No. Z,07/ " Q 9 Z Fee IRi
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
ligpooar *pztem Conotruction 3permit
Permission is hereby granted to Construct( air )Upgrade( )Abandon( )
System located at L of Z t 30 (f �1��4,1_�7
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 mus be completed within three years of the date of th's�pe ' 't.
i
Date: 7i a Approved by
�6N"� R.B. 92o'/soy/�Of . • .
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Apphca�aon Arca. RcV%rceV � Z
. "33 A446 p GPD= .6/74 t3PD� = SF '
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Tei+.l Rrca 448!5F ` �.. f
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bade Re4wncw�ew�'S of '11�e To�rl .e f. SCQLE 1 ' 4o DATE •417fao;!Zt�1_/"k
B�s♦"lc Arid So NotLocs+Qee hS%Wso% A PLAN REFERENCE= P.a, s9,.PG.Z- WFS2W3o
S�cst:I. Flea N23w-f Zoq� A5SIESSORS MAP: e,67 PARGEL; /3
APrUCANT= cARoLF L-acifkt tTj -zs, .
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Baxter,Nye &Holmgren Inc.
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812 Main Street
I� Osterville, Ma. 02655
O stets �r°M bo�tdl.�gs tsihe�lJ "h.t be use.t 3'oh No s
'� GsillrillSh �ro�cri� /Mc3- 9500�
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s. k 1:a n l`� � S-dr�oor,r
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CW.Iy Tow Ilia 914AM&.r
epi>ic Tank- _ 330 x zooTo `
USE 1 500 G A i. om uic. �
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L,�kc1fWG SYSTEM Da=Sr6N """ ���
App
3 bo GPD e.74 GPOAW = J 46 SF
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Q�l,cafw . Arcu V-11" 1Zx 7-sx 2 hwitii/,
5'Ar-wi/) Arro Z(IZ+2s� x z'. 148 SF. P, o ff. lw�4, I
121. 14 57 .
Be ffi*,V" Arcst f z,x 2z = 306 S F
Tsfi.l Arcs 448 ,FF
Pcrcci.�s, R•fc 4- 5 rnm f 1-d+
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7 43,WA
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Tha4 T11c Pr.res" Vwe11,w.1 SLvwr, $fTE € 5EPTTG PLAN
Hcrycen Gs�..P1AS W�ih 'f1.c 5.1cl,ne Aral Sct= LOCATION F%RSr Ave , W+ r .H emo4fj,s�1�T
badt R .4 - - _ _ - -� INC- .T��W�t1►�rl A. PLAN REFER, NGE� P.3p�E.PCa.�zjf3-� /j
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Spccsl Flee.A Hazotcf Zowf. . ASSttSSORS MAP e.67 PARGEL= /3
APPLTGANT= CARocE L_b4CWHtA7j rC5, _
Baxter,Nye &Holmgren Inc:.
812 Main Street
Osterville, Ma. 02655
Osc+s. from bu;ldvlgs_s{�,ev{� n.t !bc usc.f ?eb No'
9500�
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