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Home My WebLink About0252 MEGAN ROAD - Health 252 Megan Rd 291-271 Hyannis TOWN OF BAMSTABLE l "= 00, C ; SEWAGE # "96 L ��A'itON VU+AGE ASSESSOR'S MAP & LOT f INSTALLER'S NAME&PHONE NO L�C-6`RLC ?rA SEPTIC TANK CAPACITY tow &e k— e> (s LEACHING FACILITY: (type) (siiJze) U-1 ft. /1 NO.OF BEDROOMS p 7 rJ V BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 Facili s exist within 300 feet of leaching a ili Feet Furnished by x� o o l � t7 x .I No. 6^ Feed^^ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Rpplication for Mig Oat *pttem Conotruction Permit Application for a Permit to Construct( ,(Repair )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.Q m k� Owner's Name,Address and Tel. o. Assessor's Map/Parcel vac n \P. Dg-Q mt C (/t\ U r� Installer's Name,Addres�nd Tel.N Designer's Name,Add less and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder(��) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Na e o Repairs or Alterati ris(Answer when ap 'cable) All L t ' 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 provision f Title 5 of the Environ to ode an t to place the system in operation until a Certifi- cate of Compliance has been issu b this Boar of ealth. �r Signed Date o Application Approved by Date Application Disapproved for the fo wing r sons Permit No. SUD Date Issued _ T _ _ i �,. 9 � No. F(e\5�—� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: �/ Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZippYication for 33io5al *pgtem �tCongtruction Permit Application for a Permit to Construct( /Repair7)Upgrade( )Abandon( ) ❑Complete System El Individual Components Location Address or Lot No. C" �� Owner's Name,Address an`Tel.No. J of �j() Map/Parcel Assessor's Ma l.5 . �s Installer's Name,Address and Tel.N Designer's Name,Add less and Tel.No. Type of Building: ,ra Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder(Nv) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets j Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature,o Repairs or Alteratio s(Answer when app cable)..-At) ^ 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 Environ al ode—and not to place the system in operation until a Certifi- cate of Compliance has been issu ' by this Board of ealt . �� Signed Date Application Approved by Date u9 -:7 Application Disapproved for the fo wing r sons Permit No. - Date Issued _—————---——————————————————— 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 has been constructed in accordance with the provisions of title 5 and the for Disp sal S stem Construction Permit No. dated Installer M Cu / Designer The issuance of this permit sha 1 not be construed as a guarantee that the system 'll fu cl~tion as designed. Date /V - 7 1,� Inspector�7 E r - --------------------------------------- No. Fee��- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS t. ligogal *pMej CowAruction Permit Permission is hereby anted to Construct( )Repair(i )Upgrade( )Abandon( ) System located at 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 must be completed within three years of the date of this permit..'` Date: 0 - 9/17 Approved by y CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) hereby certify that the application for disposal works construction permit signed by me dated�� 7 / 6 , concerning the .. property located at �Citnw�- �(\�//!1' G_,�.�5 meets all of the following criteria: wetlands within 300 feet of the proposed septic system here are no p Po �Thereiare no private wells within 150 feet of the proposed septic system The observed groundwater table is 14 feet or greater below the bottom of the leaching facility 1 There is no increase in flow and/or change in use proposed l• There are no variances requested or needed. SIGNED : DATE: &[71�� LICENSED EPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted). 1 , L � 1L VO I J� or ZZ .....................................i a � o OCATION may, ( SEWAGE PER IIT N0 VILLAGE OL --h ' INSTALLER'S A 'E D ADDRESS G Cd BUILDER 0 OWNER DATE PERMIT -ISSUED DAT E COMPLIANCE ISSUED -,?-3 -,� � I vl a 0 a t - r F f No. ... ., .... Fins... ...... THE COMMONWEALTH OF-MASSACHUSETTS BOAR® WH .............. ..........OF...... .. .. .................................... App irafta t for Dispnant Works Tonstrurtion ramit Application is hereby made for a Permit to Construct (�() or Repair ( ) an Individual Sewage Disposal System at: r. ...I` .-- ll� 1 Locati .. -T . Address J r.Lot �� •caner •- •----.•Address w ..........•..... -!.............................. .................................................. � Installer Address Type of Building Size Lot....1_ ,. ® ...Sq. fe t Dwelling—No. of Bedrooms.......... ..................................Expansion,,AAtic ( ) Garbage Grinder ( ) Other—T e of Building ....... No. of persons.......5.................. Showers = Cafeteria a Other fixtures .----------••......----•.......... Design Flow.................... g P P P Y Y � gallons. w .. .�i gallons per person per day. Total daily flow.......................:................. -------------- WSeptic Tank/--Liquid capacity/®R4Dgallons 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.-2.0.0....sq. ft. Z Other Distribution,box Dosing eta h ) Percolation Test Results Performed by....._.°'..(-�� i _._ _ Z-- Date_. _ .............. minutes per inch Depth of Test Pit-----.............. Depth to ground water.'....._......._.._._. Test Pit No. 1._��___ (z, Test Pit No. 2._.�............minutes per inch Depth of Test"Pit.................... Depth to ground water........................ a' ••••• :----.. ..� ... . ... •... �.......... .._................•-•-•.••-•-- . y� ® Description of Soil...... --- - -......�' L --------1- - -- ---- P -11:4 �L---- - x w 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 TIT I.;.;. 5 of the State Sanitary- de—The un signe urther agrees not to place th system in operation until a Certificate of Compliance has b s d by th bo rd ealth J, igd. .. ..... .......................... r ?... :. �` Date Application Approved By.. .: W-14-4 ....................................... --77•• •...... Date ^ Application Disapproved for the f ollowin asons:-----•---•............................................ - -•................................•---------•------------------------......------.........--------.•.....-•••-•-•---••••--•---•-•-•••-•--------------------------=-----...------•-----••----•-•---•----- Date Permit No......................................................... Issued.....`-�-43 -- 7�. ---• --------------- Date J-0 ....... CA3-. F>s............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD F. H A H �p 4 , Appliration for Btsj 1 parks C ottstrurtinn Pruitt Application is Hereby made'for a Permit to Construct ) or Repair ( ) an Individual Sewage Disposal System at . ... .... •; ..... , 17t,: ..... ........4 es _ ✓ --- , Locati Address r Lot 4. ..�:. ------_ a�e� _o, �`"�- r�"�3 ...1 _._. r f� �jowrie �l_ Address ^ W � y / l+�j t� `J' ............... ................................._...... .. ......_..... .- ..................................... ... .........._. S Installer ' Address Type of Building. Size Lof___ . ...Sq. f t Dwelling—No.:;of Bedrooms _ ....................Expansion�ttic ( ) Garbage Grinder ) Other` °'Type;of Buildiii a g _____._ No. of persons_____ :___ Showers d N Othei fixtures .�, ••- W Design Flow__................... gallons per person per day Total daily flow gallons Cd Septic Tankk1Liquid capacityl,"P gallons Length Width Diameter Depth Disposal Tsrench 'Vo Width_ Total.Length ` Total.Ieaching areasq, ft. Seepage Pit j._. plameter ._..;r ____:._ Depth Uelow inlet:__._ ..:...: Total' leaching area=:21t._.___sgj ft. Other Distrib' tion box ( Dosing to r Percolation Test Rlts Performed;by f� : _. _ _._ ,_. Date._ a " a Test Pit Flo 1 �,�, 'minutes per inch Depth of Test Pit Depth ryto ground water _____________ Vest Pita No 2.. _......._minutes per inch Depth of Test Pit ____; Depth to ground water _____________ Raix �w x r, ._. f -- s Q �I)escription of.Soil .-",. Ilia � '" 'f V _ e ...................... •---------------------••......---•-----•••......-£- --•-•-•.............. U Nature of Repairs or Alterations=Answer when applicable ....................................................... .___________ .- Agreement ` .w The undersigned`agrees to, install the aforedescribed Iidividiial:"Sewage`Disposal`System in'accordance with, the provisions of Tm':.L 5,ot the State Sanitary de.. .Tlie un signe urther agrees not to,place th ,system'in_ operation until,a'Certi$ficate of Compliance has l 1 s` d by tti ,:board ealth _ K igned � .<, �k 4��b_1 ' ...N.. Date 'Application Approved By_ Wit. s ;:Application Disapproved for the f ollozvin asons: :. ................................ - Date :. s---- ---------- -•-•-•----•••... =-•-•-•---------•----•--•--••- -- = ;.• .. , r�Date r Permit No .......................... Issued --__: ` Date THE,COMMONWEALTH OF MASSACHUSETTS �. BOARD OF HEALTH .......OF.... .. s � .............. -C>�c:� ...i.. _. ._..;- Cluntifiratr of lautoltattrr THIS IS TO CERTIFY, That the Individual Sew e Disposal System constructed (Z_!or Repaired ( ) b r t' t r z i t. Y Aen _•• ............. ---- •-•-•--•- � �Z__.__ Insall � +______..has binstalled in accorda ce with the provisions of j of The St Sanitary Co�-as described in the application for Disposal Works Construction Permit N 7 ____ /'____.. dated_... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS ED AS A GUARANTEE THAT THE f SYSTEM 1lYI UPICTION SATISFACTORY: ,. • `�`� DATE.: ... r "�, � �; Inspector........ THE COMMONWEALTH OF MASSACHUSETTS • BOAyyR, D OF HEALTH t. Cif2 No..... `...�'.�_.. l..' .. FEE.r .I!_'" ' :? Disposal Works Tvnotrudion . rruttt: -.:Permission is hereby granted:_.__ (:!��':L�-: --'___.:__.___ ___ to Con ut ( r Repair O an n idual SeT ge Disposal S `� .. r Street � '. as shown on the application for Disposal Works Construction Permi No d"__.; Dated._ '"Xt,. - ` Health A DATE.. •• r' FORM 1255 HOBBS & WARREN, INC., PUBLISHERS c,�i► J�t_� �a�nnt��{�- 3 TsL=_l:>eooAA UU ��Arc •al;� Ur« ' fro % * •-95 6-R0. r um-WALL A2 S # O new.= sY=. �� msa *' T61-,&L .425 'G°.#ti1� o' TbTA t-• �a•t i_..�(� Firo� = 330 �F'p- -D � � F�Ef"1GDl.4Tit�c 1 U'INTE : 1".10.7.mIQ' oiz I." OF /1 MA MWAM G i PM 419334 Tot-Fwe �14;>o.o._._._.... . -r("�� .•�- -� _ .ECG; Q: 97,0 iuv DST Iw. 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