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Home My WebLink About0110 OAK HILL ROAD - Health 110 OAK HILL RD. HYANNIS A = 248 061 i J o , 0 a TOWN OF BARNSTABLE / SEWAGE #c�G�O L-PCATION I,O/ Of3lt �Y�2� VILLAGE N -S ASSESSOR'S MAP& LOT r;,-, INSTALLER'S NAME&PHONE NO. &P-M //- �fa8' a� SEPTIC TANK CAPACITY o2" /S�6g� %,/fiS LEACHING FACILITY: (type) �'�17cc -33o s Cs(size) /0 'X Y NO. OF BEDROOMS BUILDER OR OWNER Ea%gTc o--.-1-AKcSr9.a-tpSoA PERMIT DATE: 2_30 —O/ 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 Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by z ; t— ir � W Gu A e O � � CA) `� TOWN OF BARNSTABLE SEWAGE #o�00/7 ,58 . LOCATION IIO 09�c ,s// n� VILLAGE h'��'A�N�-S ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE N0.�, i/0.cc_/��T I SEPTIC TANK CAPACITY LEACHING FACILITY: (type) �'L" cc (size) /d X �f NO. OF BEDROOMS .,.T,; 7-NED nD nwTMV E_k%7c mosa/1 PERMITDATE: �J 30 —d. 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 Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by is ;I a ~' G A 2p, C B 1 q'6 tt1 TrvnLr L :23 .... � 33 , _ e 3o ` C. TTcc ya ` �* No. 0 V Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS application for Migpogaf *pgtem Congtruction 3dermit Application for a Permit to Construct( )Repair(VSUpgrade( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No. //D 0/9 11,FJ/1/J Owner's Name,Address and Tel.No. 'Fr TFj-%c aF r3�/t'S6jN�PSarl Assessor's Map/Parcel y O 6 /1 p o ly k (-f It Q-4 t-� 0 n . Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. J3rvCe h&C0.k1,Vic( 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 Nature of Repairs or Alterations(Answer when applicable)T�,-h?n-c - X,1AA!(A-1Sno g i3��` 5T1y,ks -3u�L — SCE-ITCc 3 J� 3t aY1e fir` O�7- J oAC. pn Tcp . 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 d by this Bo of Heal Signed Date 3A-Vl•aq-0 Application Approved b 1 Date /�', - 0,OZYLI Application Disapproved for the following reasons Permit No. a Date Issued i Fee No. ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: s � PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 0(ppYicatiou for Migpogal *pgtem Cottgtruction 3permit Application for a Permit to Construct( )Repair( P<Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. w o ooq r/ d ' 6J Al)n Owner's Name,Address and Tel.No. Assessor's Map/Parcel a y 0 61 , Ca f A �� `/f� t 1a„,. . Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 41 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 Nature of Repairs or Alterations(Answer when applicable) (�0 fforac - X r� (t �-1Soo N(- ;CD 1 3 '-730 4, 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 provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issuo by this Boar/d of Healt . Signed Date 3 A-11,q qi-O Application Approved b Date �'"'�� ! Application Disapproved for the following reasons Permit No. Date Issued '`' THE COMMONWEALTH OF MASSACHUSETTS 1= BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired(!/rUpgraded( ) Abandoned( )b,Y at //o D to k 11,7 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit N aO fAd� dated ��` :70 ?ffe17 Installer _� UC c No c a k-2-e- Designer The issuance of this pemijt sh ll not be construed as a guarantee that the syste--y'/-ill fun ti?n esigned. ^ Date Inspector -off/�X(��(� u, ✓J ——————————————————————————————————————— No. 47 Fee 44 �, ' THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION:- BARNSTABLE, MASSACHUSETTS 'Wigpogal *pgtem Conotruction 30ermit Permission is hereby granted to Construct( )Repair( Upgrade( )Abandon( ) System located at //D 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 thi "e�tnit. Date: /y' � � �l�� Approved b 1� J• 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. aH0/0'61 CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL VET!_.)RKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLAN' I, r vice 1(`(0.c�11',ler , hereby certify that the application for disposal works construction permit signed by me dated a 9- O/ , concerning the property located at //O (�/� /�`°/�/�/ �1,f1�/x//-S meets all of the following criteria: J • This,failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. Y • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. • There are no wetlands within 100 feet of the proposed septic system `l • There are no private wells within 150 feet of the proposed septic system 1 • There is no.increase in flow and/or change in use proposed • There are no variances requested or needed. . • The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] �1 • If the S.A.S.will be located with 250 feet of any vegetated wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) Jr aj B) G.W.Elevation +the MAX. High G.W.Adjustment. = ova DIFFERENCE BETWEEN A and B 3 5~ SIGNED : L/ 9- DATE: -2' -oZ O [Please Sketch proposed plan of system on back]. NOTICE Based upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:cert a ry D ' c ri1 J iT> G Vim_ V f I i J O � C cl/ o n • 1 -7 W S � BLOC&TION 5EW&C.IE PERMIT UO, - �/ILLpGE - - - - - - - - WST&LL..ER 5 l &14/5 ADDRESS 16UILDER 5 Q &MIF- ADDRESS Ot � L � D�,TE PERKA T ISSUED '_ �!�✓�� - -L a- 3 � 17r- D �.TE COMPL_i ,L�,t�ICE ISSUED � - a � r �. � _. �. �'� - _ i • r Vj N �. a ., j N O�L . ...... F��..., .......... THE COMMONWEALTH OF MASSACHUSETTS BOARD o F HEALTH .'' 6 •gyp-pg 1 Apffirativu for Application is hereby made for a Permit to.Construct ( ) or Repair ( ) an Individual Sewage Disposal yst t .. t om .. A :_`� - LiWat o A dre r t No. ; -•----•--•--------------------- ••-- .---- z ! vU caner 7 Ad r Q 1 Installer �� , Address Typ of B ding Size Lot............................Sq. feet H Dwelling—No. of Bedrooms......................... _.........Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons..-------------_- ------ Showers ( ) -- Cafeteria ( ) W 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 ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit...---.............. Depth to ground water..........---........... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---•-••-•------- -- - . O Description of Soil.... - c' !.........�-.. .-:.....>. ......_ ---- -------------- ------ U ---------------------•--------------.......................K........................................ ------------------.---•----•••--•--•----••-•..----------------------------•-••-- II M ------------------------•---.........•--••-......--------------------••----------------•----------------••----------------- ----- -- n----------------- • ... V 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 Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the boar f health. r - `-- ��-- - Date Application'Approved By......... / - = f Alt Application Disapproved for the following reasons----------------•-------. .................................................................................... •.........................•--•--••-•------•-•--------------......--•------•-------------••-----••----------------------------------------------------- ---------.... ------------ Date Permit No. ........ Issued •---- `-5----- , Date i _ F N . .41- .. Fs�.... THE COMMONWEALTH OF MASSACHUSETTS .BOARD E HEALTH e -- - ......................OF..r .... Applicattla t for rrmit Application is hereby made for a Permit t'l onstruct ( ) or Repair ( ) an Individual Sewage Disposal Ai System at Location 'Adtlre 02 t No, } (:CID caner __ Ad s `- a ...... _ nsfall'I .� AddPess 41 Typ• mg �. w 'a Size Lot•.. ---•-- ----....Sq. feet V - Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) ~ •_ -_--•----------------- No. of ersons-___-______._.-___---__---- Showers — Cafeteria pa., Other—Type of Building p ( ) ( ) P4 Other fixtures _----- W , Design Flow............................................gallons per person per day. Total daily flow............................................gallons. P Septic Tank—Liquid capacity............gallons Length-----------_-- Width................ Diameter................. Depth................ 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 ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit Nc`' 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........................ ----•----•------------------•-•------- ODescription of Soil--f .......... . -------------------------•--•------.-•----•••---•.------------------- x x -------------------- -- /.` V Nature of Repairs or 1?,lt,rations—Answer when applicable.----------------/._ -----� -- ^' --•---•-•-•------------•••-------•--. -••----•-•--•---••--•....---- -••---••-----------••--•••-•--• Agreement: = The undersigned':agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions'of,Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until.•a Certificate of Compliance has been issued by the board f health s Signe 1 r "r. Date a Application Approved BY.......`-. k ----- V ..... ate " Application Disapproved for he following reasons------------------------ - --••---•-----•----------•-----•----••-•-•--•--.....•-•------•-----------......---•- .......................................................-- ... -•-•-------- ----......................................... ......•..... . ......-- ......-•--•-•--- Date ; .Permit No.---•................ _. Issued.--•••--•-----•----......--_..... . .......................... ...•-^ Date --.......... .. .... .a y THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH ...............oF..:.. : .'; ......................... HIS ERTIFY, That he iv'du ewage Disposal System constructed ( ) or Repaired by ,.. ----- -•-----------------------------•-----•-••••••-•--••-_-----• at_._ --•-- ....................................... has een installed in accord Lice with the provisions of Article of The State' SanitarAM, e as described in.-the application for.Disposal Works Construction Permit No.. . ........... . ��--.............. f� THE ISSUANCE OF THIS CERTIFICATE .SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE ? SYSTEM WILL FUNCTION SATISFACTORY. ' y DATE... Inspector r ;�.�•ym.,,.y,.�.0...:45L 4w�..vtfa%a.a�3 w+..,a Ju..Herat.,:lr.r°..::,-:.P+w..rs•:f+Cv',r_..t.w.+,.rw�,..«....,.... ... ... .. ... .... .. a�. � Y THE COMMONWEALTH OF MASSACHUSETTS t BOARD HEALTH ............OF........... :. .. ................ U ...... FEE.: ............. IN It's 1 �t-k Tnin r 'gat ranfit Permission is hereby granted_,,. . ...:� ---------••----------- ........................................ to Const t @r Re. it ( n Ind>vidual a age , spos I y at No. ot .............................. T4- r �`•�... treet as shown on application fX Disposal Works Construction Ear9t No.. .. ........ . oa o Heal ,.. DATE- '. aR ' 1 . ' FORM 1255 HOBBS. &-'w RREN. INC., PUBLISHERS.