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Home My WebLink About0058 FOURTH AVENUE (HYANNIS) - Health v 0 �` i5 a o TOWN OF B ARNSTABLE LOCATION ✓1 �;� � SEWAGE # ids VILLAGE ASSESSOR'S MAP & LOT -' INSTALLER'S NAME & PHONE NO. Q. A,, SEPTIC TANK CAPACITY �GNJO LEACHING FACILITY:(type) l C�0 c,c, !. (size) NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER � /L BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: � -�-`�- 97 No VARIANCE GRANTED: Yes ✓_. \�'S. / Yam• " Ile �u /off s a c� p�L 7 ��LE✓ �O� l�3 Fss 7��. ......No.................. .... _ THE COMMONWEALTH OF MASSACHUSETTS _ BOAR® OF I-IEALTI-I i QW..!h................OF... ; S C ........................... Appliratiou fur,DhipasFal Works Toustrurtinn thrmi# Application is hereby made for a Permit to Construct (k or Repair ( ) an Individual Sewage Disposal System at: ........ �?S2.1�—__ .. �1...... .1 1.... f1cN►11SQQ'C...................�� I lee on Address or t N M.R_.. lN......� c,c . OJ7 �.11..( 0.�C N ..d es ..._ �'�! i � 0!C/Y1:...1.... Installer Address Type of Building ,1 Size Lot..r�..1 A2._..Sq. feet t, Dwelling—No. of Bedrooms..._.3..................................Expansion Attic (4�p Garbage Grinder AP aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ------------------------------- -- d ----------------------------- W Design Flow......5�.............................gallons per person per day. Total daily flow..._.�30..._........._.._.......gallons. WSeptic Tank—Liquid'capacity.l=..gallons Length-"-G.... Width:4_-10... Diameter______ _______ Depth..5:7.8._.. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.....VZ......... Depth below inlet...3:ti?--...... Total leaching area.26-3....sq. ft. Z Other Distribution box �� Do si ank'(4)j `\ ` _ Percolation Test Results Performed by +4►_1?l1-s1}. r N� -1 DateQ i .......... O - — ��j Test Pit No. 1_L 9.......minutes per inch Depth of Test Pit___`Q........... Depth to ground water. 9�.c►-*4 � n Test Pit No. 2.......:........minutes per inch Depth of Test Pit.................... Depth to ground water........................ x --•- O Description of Soil .-_2..►-ate!- Su ....................................N .J =....&-ta.p......................................... V C4.NT!.f�.S?QS2ST __1M_ f QG� iCS� a�-�LC. 1` ... W1 6 A�MjE }---------`5910 73 Loj3 --------•------- UNature 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 TITI.i� 5 of the State Sanitary Code— The undersigned further agrees not t ace the system in operation until a Certificate of Compliance has been issued by the board o lth. Signe '?? -------------------- •-- Application Approved By............. ��G�'� - '- _- ! `l.._ ate 7.............. Date Application Disapproved for the following reasons:-•-•--.....----•-•------•-•--------•-----•-------•-•---••-•---------------------------•-•--••---•---------...-- --------------••--------......-----------••-----...---------------•---•--------•----..........-----------•----------••................................................................................ / Date Permit No...... .. •..... Issued....................................................... Date T --- k ;7 2--A Co No. .. C 41 i — C, OCR i C7� t O�j....../ �ZC c� Fps............. •---.... THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH ................OF.... .'2•u!! !:T..•l..r L..(—=............................ Aliptiration for Dhipos al Works Tonutratr#ion trruti# Application is hereby made for a Permit to Construct ( or Repair (. ) an Individual Sewage Disposal System at: .............clU.? -�... �(......�!.1 S i �`11.f.1►S�SPO<<�' �o ............................................... Location-Address or Lot No. ........................................................ ! . .r L .................................................................................................. Owner ................................................ ....... ........fin1-................................................................ Installer Address U Type of Building Size Lot.........15-�...----_..Sq. feet t Dwelling—No. of Bedrooms............................................Expansion Attic ( l �j Garbage Grinder ( P aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtures ----•--------------------------------------•----------.••-----•-•-••-••-••-----------••----......-••••-•--• W Design Flow...... ._.............................gallons per person per day. Total daily flow...... . 3 .......................gallons. WSeptic Tank—Liquid*capacity_ASJr_W-.gallons Length-.Q�_..'�... Width=IQ... Diameter................ Depth.5_'. ... x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.....1.Z......... Depth below inlet.._�15 ...... Total leaching area..2 .3....sq. ft. Z14 Other Distribution box � � Dosin tank (] � _ _ Percolation Test Results Performed by. .v�ta.�lA1.$)3Ak1=�'.-_..!vl �tiL Date. �-�'._!_...1�.... 9S_� Test Pit No. ......minutes per inch Depth of Test Pit....IU.......... Depth to ground water._49 *IEIILou,.;,E;.ti) �, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-.----_-_-_--__.---.---. P4 , ....--•.........................-----.........•--•••..•-•-•- ••_... ---•-•-----•......••------...............-•.--..........----••-•............----....-- ,10 Description of Soil-- Q.-.�--....h ! !.!..�..:?vr3SQ�e_.----z-1.�..--.M.�.....T.--5 ......................................... C�_.:__..! z•u '`'S �-c--r4. 3...��,a �Zi=...t' tc.�=� �. .. `?! '1 �.1�'7�= tom' W I f=_._..•'�F M........._)- N_Fxf 1�1.• r�--►�......L_ .` . 9C�C�..:_L U;_.Z.. ............................ L.................7 3 x -_..._ )-------•------- 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 TITL% 5 of the State Sanitary Code—The undersigned further agrees<ppla system in operation until a Certificate of Compliance has been issu by the bo d ofSigne _. _..-- ---. •��- -- ----- --- - ---Application Approved BY-•----- C- -' t/ --•-------------- ..... ----- .....-------- Date Application Disapproved for the following reasons:------•--------•----•----------------------------------•-------------------------------.._...--••-•---........_ -----------------------------•-----•--•-----•---------------•-----•------••------•--•-----.....---------•••----•-•---•----•••••••---------••------••-------•-•-•-••••-----------•••---------••••••.-•--- Permit No. ...� ....�-----------•••--- Date .. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............... e.�.x..N.........OF......�.°`^.'.'.... ................................._.............. (Irdifirate of �ompliFanrr THI I TO CE TTI�FY, That the Individual Sewage Disposal System constructed (✓f or Repaired ( ) by..--•..VA*.... LQ.................•--...-----........_................•-•-•••••---------....-•-•-•••---•-----•----._..........---•------........---.......--•••....---•-• Installer at........... ...T�l.. U� Q_l_...1--------CJ� l ` , r ------------------------------------------•-•-•-------------•--...-•---------------- has been installed in accordance with the provisions of TITIE 5 of The State Sanitary Code as de-cribed in the application for Disposal Works Construction Permit No._�v...�..`....�_�........ dated_...__...��-�? ?................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............ [.. ..�3J..................................... Inspector---•--- '_" .."`�---------.--.-----••--- -�,�--�Ll / 1C)'3 THE COMMONWEALTH OF MASSACHUSETTS �••� BQAR9 OF HEALTH No ... ................OF................. ........✓.r...................................................... r---7 . aiupoli al ur u wonutra ion .rrmi# Permissionis reby granted..._.._^.. .._.... d_..................................................................................................... to Construct r Repair an Individual Se stem Sewage Disposal S �•�—P• ( ) g P Y atNo.•...................4--•;.......I...........I......... ............Street................................................................................ as shown on the application for Disposal Works Construction Permit No ated.. / 197............... r— Board of Health cf (CC DATE..--•---------------------------••---------------.................-•••-•-------• FORM 1255 HOSES & WARREN. INC.. PUBLISHERS ��i✓GG� ��d/L�/ -- � 3�L7�,cry � � 3Z /L}/,��.� = //O �! 3 = 330 lo,P.D. �-�•• vox � 1 �> .., USA /,�� c�-L. � 0 � 5c�� 3Z • 3 . �7.IE >e �tb :r� ' 2 3Znr; 3 T `,,'ra.�_,• ,arc.::.. -53 �J -IAR i 3'>O -;: GAri i E R H OF i.� �t d _ 1 1STf: NJER - yGN 1� ��,�v SU!LIVAN � l ~ � No. 29733 " 7XX,-4o,/o/.E �5y70 A?o ��, srEa 3 2-o FG. _ �/• v .�G. ,Q 32.n ,'i;i Ta.��.s�d= 33 v ram.. z95. P17- i✓_ /mow• ' 3�S�f�;• 29 Z��JG',E.2T/F/EO PG or- p4:44/ t sTa�E •,b Zr,v dam" �.c,7- � �-o r 7N47- /I/..�2r.-1 pia yw�mac_ �- � Z- 77 .4".fETl//�G� ,2�QV/.eF.NI�N/.S O� Tf,1� ,C�E6isr�,ecl.Gorvo slieY�yo,� Toxic/aF�4.2�/sTdn}� Avl� /S Ivor- - Goccr�.o a446�9 .4N -d��yr-sve�/EyA�t/O Tf/E a•�FS.�r�.S�l f/�/yE.eEGN�S.4�DUG p yQT p.�c U.SEp �oo' lJ r{ TOWN OF BARNSTABLB SBgiAGE # �s LOCATION ��~1 � _ •. ASSESSOR'S MAP LOT VILLAGE �• `'""'t" LL uu INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY'Atm) NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER ,/, " OF BUILDER OR OWNER S r e l DATE PERMIT ISSUED: DATE •COUpLIB.NCB ISSUED. VARIANCE GRANTED: Yes No i 1 \ i -1 t t