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HomeMy WebLinkAbout0091 HARBOR ROAD - Health qj #4rbo( Rd., nni s -I i rr i k \\\\VV1111 1 Vat i T ersal oneTM www.myuniversalop.com phone:1-866-756-4676 UNV10524 MADE IN USA __ - -- JNJ Holdings, LLC 269159 000 West Main Street 325 ecial Permit Sp Hyannis, JV�A n, y Hearing Due Date: 05-20-18 Hearing Date: 04-11-18 Decision Due: 07-10-18- r. i i �i P r i i i I i I SlUU '' )ogae I° H lb Tv,,r. �twer Mael1 1�,_. TOWN OF BARNSTABLEai 1�Gracm��y9� �6 a LOCATION 1 SEWAGE # � .VILLAGE R &&2l___,ASSESSOR'S MAP LOT 34b s I73o001 INSTALLER'S NAME & PHONE NO. Q� SEPTIC TANK CAPACITY , JJ 19 UA 919 3 u LEACHING FACILITY:(ty ) , (size) 9�8 $' <!nnv ram . NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: 3 - VARIANCE GRANTED: Yes No _ - f- �� . i �• j � �i �- ��, _ �_ �, 1 ° fy) 6eJ C CIO) ® V W v i}1 � ;7 ui � 4+sJ M air to n { UN � t � 1.1 11 �3 or. �-jj �-- so„ ©R—!si—, ^ -:N ."..... `� • s �S' 1FBs........ ..... f THE COMMONWEALTH OF MASSACHUSETTS •' BOARD OF HEALTH Cr --...... ,OF.............................. ... .................................................. Appliration for Uisvoiia1 Works Tonotrurtion rantit Application is hereby .made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System a ........... ..-/. . - .... .... ................... ..... . . •..... ..-• ..... `N•, Location-Address n or Lot No. 1 y. �F Uv i!!!.4 4LV Owner Address K�...Xn.CA�}.............................................. . --------------------- ....------..................................... T3 11er Address /� Z- d Type of Building Size Lot....�.._l. -.L...Sq. feet V Dwelling—No. of Bedrooms.............:...........................Expansion Attic ( ) Garbage Grinder ft Other—Type e of Building ............... No. of ersons..................._.______. Showers — Cafeteria f-� YP g ------------- P ( ) ) Other fixtures ---------------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity,M—.gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—!�Ljo..................... Width.... Total Length.._.. ..._-_....... Total leaching area....................sq. ft. Seepage Pit No.___.o'/ ._-.___--• Diameter.......... ...... Depth below inlet...�....... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed'by.......................................................................... Date---------------.................-----... aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......................... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ",a**,"* -----------------------------------•-------------•-•-••..........••-••---••--•-•--....•••......•-•--•--•---......-------•------•----- 0 Description of Soil..... •......................•--------•-----------------------------------.---•------------- ---------------------....._... .._.. x 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 iI'LU 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued by the board,of health. Signed:.-.- . .. ... .... :. .•--••-••--•-•-••--• Date ApplicationApproved By............ ................. I .................................................... -•---- ----.............. Date Application Disapproved for the following reasons:-------••••-•-•-••-•----••-•-••--•-•••-••••---••----•-••---•-•-•-••••••-•---•-••-••--•-•---•••-•.........-•--•- ....•••-•-••••••••-•••-•-----•-•--•--•-•--...-••••-•-••-------------••-••--••-•--------...-•-------•-.....-••---•-----•-•••-•••--....••-•-•-••----•••-•••••••••-••-••--•••••-•-....--•-•---••----•------- �-S s Permit No........ �� ................................. Issued Date i PaB....... + THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH I Appliration for Disposal Marks Tonstrurtion Prrntit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage- Disposal System Location Address r or Lot No .. 4A f C �?.tF_►n i .... lt..... , t �!:#; I r tsS a a --�' Owner • ----Address...........�a4 '!.I...y!I�+.. . ............................ -----------------------------•--- ----....------••---,.....--•---............._.. 1T1�taller Address Cl:Type of Building Size Lot.... ... f:rC-....Sq. feet Dwelling—No. of Bedrooms--_-__1_��___---------------_------____•-_-..Expansion Attic ( ) Garbage Grinder ( j aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ) dOther fixtures .----•--•_______________•----------•-------____-------.___---••------------------•-•----.-_-_.--•---------___________---•-•-•------•----------•-••---- Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid capacityAW..gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—>o. -------------------- Width.................... Total Length.... ......... Total leaching area....................sq. ft. 3 Seepage Pit No..-_4dL........ Diameter................. Depth below inlet...ff_......_Q..... 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........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water............_........... . ................................................................................................................_........................ O Description of Soil ....... ...................................•--•--...------------•-••---•-------------••-------•--•------............-••••••-•••-••--••. W ........... .......... -------- UNature of Repairs or Alterations—Answer when applicable.......: X_'!'�U'_--'! 'td :fuser:.....:..:.................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions_o fTITIF 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued b the bo I�rr4cJ.of health. ¢/ Signed..... ..... .... :.... P� �W c .� C�(o Date Application Approved By.......... ...................._ Date Application Disapproved for the following reasons:....._....................................................................................................--- .............................................-........................._..........................................................................................------------------------------------ - ,.-- Date PermitNo.., 6 :.......... �..--- --_.... Issued.. .......................................Date....... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............rh ...........OF...... :.............................. .......... Tntif iratr of Tontphtt"t THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) l o 'tr/✓!7 le-C-ez"k.c by......... :�..........--•---.l..------------------------ ...�sii�......-.......`/.�,.,--------....................... •---•-----......... -_...._ y at................ .0..;Y_......- •---- J AL-=-----_.._. .. .. ...---•----------•---------.•------•-----.........._._....._._..... .._..........__...... has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..........716.........:LL;...... dated............. .......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............. "�•a;-7-- -- �• --•-- ._.. Inspector. ...�f.... THE COMMONWEALTH OF;,MASSACHUSETTS BOARD Of HEALTH -r �, .S 'P .....................J..`:r�'°:......0F.......... .4�..S f�i`.c...... .........................................:: � No....... FEE. ... —. Disposal Varks Tonstrudion Prrntft Permission is hereby granted........._:� u......`.`.. .���`.....�e.......yt•---•-.�:`.... to Construct O or Repair ( ) an Individual Sew Disposal System at No....................9-1--..... /�h_�4a�� wz�. ''_ .....nz:ey� 4- .; • 3` ..............................................._-- g .. Street ✓ 3 as shown on the application for Disposal Works'Construction Permit No..................... Dated............................ - .____ �� Board df Health L• � -,.,.,-.--•----'--� DATE.......- - m ............... � FORM 1255 A. M. SULKIN, INC., BOSTON i 1 0 A� Z / o, 0 �y Y 4 / ................... :a THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH OF............:.........................................•----------------_-_---_-------_-_- .� lir fiu�t for Uiipm W Works Toutitrurtion Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal System at: �1.....r=-14,3aa.n n:o s..................... ........................................... .................................. Location-Address or p e Lo N gl r.o n°a ..................... a jy ... ! Address wner -••---....--- --•-------•----•-•---•••-•--------•----•• --•---------------•--------•-•••••------•----•-••••---•----•--•------------•---•-•--__------------ Ialler Address 4 Type of Building Size Lot_.____�� a*... feet Dwelling—No. of Bedrooms_____________r_�------------ ....._..........Expansion Attic ( ) Garbage Grinder ( ) P4 Other—Type of Building _V0Dd_ 4 K!_r_•No. of persons........(-_Z.......... Showers ( I ) — Cafeteria ( ) a Other fixtures --- :f,�g1 rv__ovn._Sl`:k1 �•= lam �� �G1�en_-SI_n_K............................................................ � dons. WDesign Flow________x�__-„�`___________________________gallons per person per day. Tonal dai� flow........ ........................../___ WSeptic Tank—Liquid capacity/bDOLgallons Length..... Width._.__._ Diameter________________ Depth................ x 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 (7() Dosing tank ( ) Percolation Test Results Performed by................._...................................................... Date------•••----------•------------------- '� Test Pit No. I_______________ inutes per inch Depth of Test Pit.................... Depth to ground water......................... (i _��nutes Test Pit No. 2_______________ per inch Depth of Test Pit.................... Depth to ground water........................ w --••---•-----------•••-•••---•--••-----••-•-•..._.......••-••------•--._....-••-••-•.............•-- 0 Description of Soil.....•-�'---- -� �� �--=--------------------------=------------------------------------------------------•------•-------------------•--••-•---------- V ......................I...•----•-----•--------•-------•-•--•---•-•--•-----------------•-•--••-•-------------------•--•----...••••-----••-•-••---•--••------------••---•-••- .. , -------- ---- ------.,'=..................................................................................................................................... W .............g.____.___. __.__ �.__. _ U Nature of Repairs or Alte� e_ tions—Answer when applicabl ______________________________________________________________________________________________- ......................................-...... -----••-•------••-•--------••-----•----...•--••----••••-•-•-•----•-------------------•----•------------•-•--•-•-------•------•••--------•-•-•--.....--•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TME 15 of the State Sanitary Code—The undersigned further agrees not to place the system in ope tion until,a Certifi, Ite of Compliance has been issued by the board of health. g , Date Alication Approved B •--i -Ile = •---------•-------------------•-•- -•------••-• Date Application Disapproved f r the following reasons:................................................................................................................ ••---•....•-----•••------•-------...•--_....--:•--•----•----------------------•----•......•------•-•--•---•-•-•-----•-•-•-----•••-----• •----••-------------•----•-----•--•-•-----------••---•-•------ Date � 3 PermitNo........�.:�-•------•�--=........................... Issued-.....................................................- Date a �r Fss................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........I........O F......................................................................................... Apptiraatiou for Disposal Works Tunutrnrtiun "rrmi# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at:: 1�...!k.lV�/nr" C11(I —��nlrrl t 5 1..�i... 2 ............. ._»...... ..................... ..........__. ...................... Location Address ( '/ for Lot No. / t PY ilr nrA ne �a- 1 iG^.. ✓ ��� »J ✓1r�F r(yI v/I �If• YI ja, bo r' Roo it ......................»__.......•..._.......___-_... _______..__......._...i. .•------^-_'_____.._........_....._..___.........................................._...... Owner Address a F..... f n n r_f1 Ln •...........................•••-••••••••. -•--•---------------------...-•••-----•--._.._._.. In�taller Address Type of Building f Size Lot._--_� _Qf U.....Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) pI Other—Type of Building -uh�Azft a!I.`_•No. of persons-_____•_�__-?----_------- Showers ( / ) — Cafeteria ( ) dOther fixtures -•---sou hryorn•cr-n-W. --`--L 1A-... ............................................................ Design Flow______-.!�_ _________________________gallons per person pe^r day. Total daily flow........I O...__-__-.__..•-•____.-__--gallons. WSeptic Tank—Liquid capacity/nK?fa_.gallons Length---•............ Widt I...--.............. Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area--.----__-----_-____sq. ft. Seepage Pit No....Z.............. 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........................ (s. Test Pit No. 2..........._----minutes per inch Depth of Test Pit.................... Depth to ground water...-------------_-_--.-. •--•----------------------------•-••------------•---------•---------------------•------.....----._...-•--•-••-----._...---..._.......--•......._..•-•--....-- O Description of Soil........ ...............'-'Y f x U ----------- ----........ ----------------- •------ •------------------------------------------------------------------------------------------------- _-_____-----•--••----•-------------- ---------------- ----------------------------------------------------------------------------------------------------------------------------------------------------•----••••---••----••-----•••-----•- 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 TITLi p of the State Sanitary Code—The undersigned further agrees not to place the system in cz issued by the board of health. f / Signed-------• "fi� �,�1 �P�------•-------•- •--•.%`�l�•�-------- oper, ti�until Certi��to o Compliance has been f�a�� - a� - • Dat-e ApplicationApproved By.................................................................................................. ........................................ Application Disapproved for the following reasons-------------------------------------•---------------------------------------•--•-----------•----•-._.....__-••-- -•-------•------------------------------------•-----•----•---------•-•-•--•--••----------------------------•-•-•--------------------------------------------------------------------------------------- Date PermitNo.............- ---•-==-...................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r ............................................Of f�Ont�liaanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.................................. at .... S . = - / . ---•-----•--------------=--•---------...-•••-. ..---------•--•-•------ --•----- ---------------------•-•------•--------------------------•---._....-•---•---------•-- has been installed in accordance with the provisions of TITI j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No-------t......---------------------•_ dated_-------`.....-- ........................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILLl �F NCTION SATISFACTORY. '7 DATE................ __ �_ .................•-----------.._._.... Inspector.__-__�7_�_-•_---•--------------------------------.....----•--•-•--....----...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ("[y / r/ I » No.....Z=-•-<:...._._. FEE' .......... Disposal Works TwOnutr ion rrmit Permissionis hereby granted....................-...........................................r•-••-•-------•--•-•---...................................................... to Construct ( -) or Repair ( ) an Individual Sewage Disposal System at No ' -----•--------•••-_.._...--•---•--•---•.................•-------•------...-.........._.....--.--•--------------•-----•-------- Street as shown on the application for Disposal Works Construction Permit_No..................... Dated........................................... f ••-------------•---•-•-----------------•-------•-•---._ r , Board of Health DATE i.___...:_••:--.�_._... ._! r'...._•---•----------- FORM 1255 HOBBS & WARREN. INC., PUBLISHERS �"� r o—'j V Awe- /ooa r A � (l�