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HomeMy WebLinkAbout0146 LINCOLN ROAD - Health 146 LINCOLN ROAD Hyannis A = 270 - 053 i TOWN OF BARNSTABLE LOCATION , � � J-hv SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME PHONE NO. - SEPTIC TANK CAPACITY , i LEACHING FACILITY:(type) d?i (size) /©Od NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER. BUILDER OR OWNER DATE PERMIT ISSUED:."." ,. /'� DATE COMPLIANCE ISSUED: `; �( X VARIANCE GRANTED: Yes ((ro l 73 ASSESSORS MAP N0:'�' . Lruro(uJ oit/��_►._ PARCEL NO: THE COMMONWEALTH OF MASSACHUSETTS BOARD. OF HEALTH . TOWN OF BARNSTABLE Appliration for Disposal Works Tonstrurtiun rr-mi# Application is hereby made for a Permit to Construct ( ) or Repair ( t4an Individual Sewage Disposal System at ........... - __... ...................... .................................................... .................•_-......-- --••-••--- Aocattii n-Add s or Lot No. w f� - Add s ..._ z'... nstaller Address Q T f Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms____________________________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) - Cafeteria ( ) P 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. Seepage Pit No............._........Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by ------------------- Date Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................ 40 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 Description of Soil.........................................------.._....--------------•-•--••------------------------------------------------------------------------------•-----------•- V .._..--••----•-...•-•-•-----•••-•---------•---•------•------------------•--•-----•------......••----•...---------------••••-------------•-•--•---------•-•------------------••--•------------•---•---••- W UNature of Repairs or Alterations—Answer hen pplicable --!� '.' . ..:�-------- •-••-----••------••-•-••-----•----••------••-•---•---•••----r C00---- .: 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 ComplianVI has been issued boy the board of health. ined ----- ------_- - ----------------- --------- ---- ------------------ '-. �.. Date Application Approved By ---------------- ------- -_-.` `- rJ-- -----......------. ------------------------------------------------------------------------------------------------- Date Application Disapproved for the following reasons: .... --------------------------------------- ----------------------------------------------------------------------------- ---------------------------......................................................... ........................................ PermitNo. ------------------------------------- Issued ------------------------............................... Date �51 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Disposal Works Toustrurtion rumit Application is hereby made for a Permit to,Construct or Repair an Individual Sewage Disposal Syst tem a * We /4 ........ _6 . .......................................... .................................................................................................. cation-Addre s or Lot No. "e ............ ........ ............................................... .......... ---------- wne ........... .......... ..... 4.......................... .. 75.. Add ................. .......... . ... Installer Address Typte,O_f?Building Size Lot............................Sq. feet UI Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder Other—Type-of Building ............................ No. of persons----.--.................---. Showers Cafeteria r- I Other fixtures ..................................................................................................................................................... Degign Flow.......................................7---gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity..---.......gallons Length.................Width................ Diameter-------.-------- Depth................ Disposal Trench—No..................... Width.................... Total Length............_._..... Total leaching area....................sq. f t. 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------------------_---- Test Pit No. 2................minutes per inch Depth of Test Pit.--......_.......... Depth to ground water..----......_.......--.. -----------------------------------*--------------------------*--------------------------------------------"--------------------------*-------------"-------- 0 Description of Soil...................................................................................................................................................................... W ........................................................................................................................................................................................................ -------------------------------------------..................................................................... ---- n 1_­............ ........ hen pp ica Nature of Repairs or Alterations U ons—Answer 1* ble.------ ... ....... ........... ........................... ........ .. ...... ......................... ......................................................................................................................... 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 Complianc has been issued by lt�ie board of health. Date Application Approved By / ------------ ---------I........................................ ----X�!t Application Disapproved for the following reasons: ....................................................................................................................................-- -------------------------- PermitNo. ...........------------------------ Issued ............................ ----------------_---- -------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (fertifirate of Q-11omplinuric THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by................70.1e / Installer at ....../416---- .. .................................................................................................................................... ....... 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. ................. dated ....y- �,f,=,---6--------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST V'ED' AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE , . .­1......... Inspector z� --------?�---------i --------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ' TOWN OF BARNSTABLE No.. ..... FEE.... Disposal Works Permissionis hereby granted.............................................................................................................................................. to Construct ( ) or Repair ( 4,.�K�n Individual Sewage Disposal System at No....... /L-1 Z�u... q -" ....1..4 .................................................................................................. ...7.. .... Street as shown on the application for Disposal Works Construction Permit Dated.... ........... .............................Zge"', ­2........................... DATE.... .................................................... Board of-Health FORM 36508 HOBBS 6 WARREN,INC..PUBLISHERS AsBuilt Page 1 of 2 TOWN OF BARNSTABLE LOCATION 14(� � ( _• �_�SEWAGE r VILLAGE ASSESSOR'S MAP& LOT INSTALLER'S NAME & PHONE NO. aL3 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) ( (size) /ood at NO. OF BEDROOMS— _PRIVATE WELL OR PUBLIC WATERA&� BUILDER OR OWNER DATE PERMIT ISSUED- DATE COMPLIANCE ISSUED; ( i VARIANCE GRANTED: Yes ! ro � t � 0' eJ .r V 0 �I 3S http://issgl2/intranet/propdata/prebuilt.aspx?mappar=270053&seq=1 5/8/2017