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Home My WebLink About0087 OLD STRAWBERRY HILL ROAD - Health 87`Oldistrawberry Hill Rd Hyannis A = 249 - 124 75 No. l� ` Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 0[pplication for Misposal ,pstrm Construction permit Application for a Permit to Construct( ) Repair(X Upgrade( ) Abandon( ) ❑Complete System X Individual Components Location Address or Lot No. 97 dt-0 S r&-0WX-AZY ( IL4- Owner's Name,Address,and Tel.No. Nb &v1Li-IAr-t -t- MhL)AA Gas:5160,i Assessor's Map/Parcel d C/9 W*xts k? ow S PAr;Qc2RV Wa_pa> HY4fj"1s Installer's Name,Address,and Tel.No. JrO$- 7Z�� Z 7 Designer's Name,Address,and Tel.No. CAA Dc a-c- 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(min.required) gpd Design flow provided gpd 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) C—1 /V 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 Certificate of Compliance has been issued by this Board Hea Signed Date ° O/ Application Approved by Date L) Application Disapproved by Date for the following reasons Permit No. 1A r r/ Date Issued y ' ' No. �y / �-, " x c„_.•,�.. Fee 75 i' THE COMMON_WEALTH OF MASSACHUSETTS Entered computer: Yes E PUBLIC HEALTH DIVISION`= TOWNOF BARNSTABLE, MASSACHUSETTS' \ 2pplication for 33t`sp iB`Al �&pstrm (Construction Pffmit Application for a Permit to Construct( ) Repair A Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No. 97 Oc.n S f A4uJXAQ-y tflu- Owner's Name,Address,and Tel.No. Assessor's Map/Parcel d q9 Lia hY4MIs $-7 OeX 57RAk*c329V I&L.P-D f4V40JI-5 Installer's Name,Address,and Tel.No. :�08-4-7Z—Ss 8 Z7 Designer's Name,Address,and Tel.No. G4 DE�'rCts�u.G C_:9d 1 7SM /"1r4CWISC Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) s Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures j� Design Flow(min.required) t- gpd Design flow provided gpd 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) Cif Ai 6 C 41C1lJ�iC i J Date last inspected: . Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in w accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board offleajth.Signed Date /r4` 0f Application Approved by Date Application Disapproved by Date for the following reasons Permit No. (] ' G C) Date Issued L-- --------------------------------------------------------------------------------------------------------------------------------------- �; 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 0APEGJIOE Gj76-;* 1SE:S u-C'- at 97 60 S"i''RAW�y N/L " � has been constructed in accordance J with the provisions of Title 5 and the for Disposal System Construction Permit N01� —/0 U dated Installer(2APC-U_ADE1 CWra_i7Ai_-,S5 Designer NIA #bedrooms Approved design flow A � gpd The issuance of this pe it shall not be construed as a guarantee that the system will functi )�l�/esigned. O r Date � ' I? Inspector --------------------------------------------------------------------------------------------------------------------------------------- No. ��'� '��C) Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *pstrm Construction Permit Permission is hereby granted to Construct( ) Repair()() Upgrade( ) Abandon( ) System located at �j 0(—I) ST/Qi wj3EA� P♦'u-- P—o Ab H1/54AW(S I and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with t Title 5 and the following local provisions or special conditions. Provided:Construction mu s b/e/co le d within three years of the date of this permit. Date L/ `7 / , Approved by-, f AsBuilt Page 1 of 1 TOWN OF BARNSTABLE LOCATION_& &-D S`F✓--t-1£.Iig< H '/ --/ SEWAGE # VILLAGE_ C),9v77i4,,//& ASSESSOR'S MAP LOTJ�yJ, r�2.y INSTALLER'S NAME& PHONE NO. 771 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) �Nr��n..r Z)�� (size) NO. OF BEDROOMS PRIVATE WELL O P�UBL:IC WATER > `�-----T---------- --- BUILDER OtWN _ DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No V - f I http://issgl2/intranet/propdata/prebuilt.aspx?mappar=249124&seq=1 4/12/2016 TOWN OF BARNSTABLE �1 LOCATIONR7 ley' SEWAGE # , VILLAGE 141111E ASSESSOR'S MAP LOT INSTALLER'S NAME. 6& PHONE NO. I*c.-6,r j�dsq= 7 7 f - (//u; SEPTIC TANK CAPACITY LEACHING FACILITYAtype) �. rv./ r M�� (size) NO. OF BEDROOMS PRIVATE WELL O PUBLIC°WATER BUILDER 04� WNER —` 'R LF�c4_ DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: / VARIANCE GRANTED: Yes No V �---- 0 bD: -�\ � :� ` ` C 9 � 1 �� i Mti �b � � �-�k- ,� � A !� �� l f-' �, i � � � � � a _ . ► ASSESSORS MAP NO: PARCEL NO: �' c No.. ._.. Fss...... ......_ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH '��'�•••`..I TOWN OF BARNSTABLE Appliratiun for Diupuuul Works Tunutrurtiun t# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Location-Address or Lot No. `�'��......._-----�5&�A'1. :..................................... ........ N......2f�i/Zl............. .........•................ ................ Owner Address W K\C ItL ,a �Q tic. e drJl 3 ,-a •----------•------�..... -•---•----• ---------------•---------•--- ........ e.... ✓..mot s 14 Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.................................. .Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons____________________________ Showers — Cafeteria 04 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........................................ ,..a Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water......................... Gi, Test Pit No. 2................minutes per inch Depth of.Test Pit---................. Depth to ground water........................ 04 ........................................................;...........................................-----------•--•----•----------------------•---•••---••--- Description of Soil Q'`Z. ._... J . `Z --------�Q =s -- . Q x UNature of Repairs or Alterations—Answer when applicable.... U%......!- _^.____<!✓t�� ?' 'c1 __________ (,gT7•vL.--------s�PTiC,--•---...4.r J�............................................................................................................ 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 Com ce h een issued by the board of health. Signed ........ . ............ ` ---- s � ........... ce ApplicationApproved By .... ......... -- ----- -------- -------- ------ --_ ------- - --- ------------------------_ ---------------------e----------- Application Disapproved for the following rear ----------------------------------------------- ------------ ---------------------- ------------------------------------------ 9 ..� Permit No. .. --------------- Issued ... ----- -- --------................ice ' Dace No. - FEs......``. ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE / T- j 4 . pptiraatilaaa for Diiplas ai Worko C ontitrurtion rantit . Application is hereby made for a Permit to Construct ( ) or Repair'( ) an Individual Sewage Disposal System at: L----•�O...`p....................... t 1 t,.1 l J 11. .............-----....-•----------.......... Location-Address f / or-Lot No. �., `1....0 S .. � ...................................... ...................Eiv ..........................E ( i `L ------.......................................... Owner ddress W H c K-t=JaE _Q K ., c T7 dkl 3 �bs�[v�-`< ............................ -----------•------•-----------------------------•- --•-----•--•-•--- ....----•---- ................................................. Installer Address d Type of Building _ Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aa Other—T e of Building .... No. of persons............................ Showers YP g ----------------------= ---------- --- ( ) — Cafeteria ( ) Otherfixtures r = ` --,•---------------------------------------------------------------------•--•-•------- 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=^......r.___ Total Le'ngth.................... 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 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........................ 9 .........................................................r...................................................................................................O x rDes�ption of Soil....D--2........... J `A` mo- � �% xS 1 - "ra-01`-- .... . - • -- ; , Nature of Repairs or Alterations—Answer when applicable..._ _ _.__..Y_----_—IAIF/-7"^rOw-�_..-..••..-�•.•..•.•-.- -- •... l i'V�....----s r P i/C, SY...S --- • -••---•-•••--••----•-••-•................ 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 Compliance has-been -ssued by the board of health. Signed . - f- \ ................................ Application Approved By .Jl-. . '_ .... --------------- ........ -' ..., - . /--� Date Application Disapproved for the following reaso - --------------------------------------------------------------=---------------...................................................... ..................................................9..... ........... ..................... .......... .-----.--......................................--.......Dare.Permit No. .............. Issued Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Tertifirztte of Tomplia re THIS IS TO CERTIFY, That the Individual Sewage D sposal System constructed ( ) or Repairedf(r--�) vU S' Y Installer at . .@-7------------!;;..----..... --------vAA -------`1_��-------------------------------- ................................................ALC has been installed in accordance with the provisions of TITLE Ql�The 4tas nvironmental Code as described in the application for Disposal Works Construction Permit No. .... �.( dated .....................:........................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT E CONSTRU'ED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.............................. '"? �'..-,...-............. Inspector ........................ ..... ------------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE i No... .......... FEE........................ t Utopos al WorhD Tonstrudiatt. thrmit Permission is hereby granted......-. k:.............°t!-i ••sG ... �-----•-----•-•-••••••••••------•-•------•------•----------•........---••----•.........---•--... to Construct ( ) or Repair ( an Individual Sewage Disposal System at No......-eo---•--...!;-...... •-`gym w�2,VaVVA.... -V k5\ 4c: __ � Street / v n as shown on the application for Disposal Works Constructi'�//�h'.�P._�ermit No.ql�JC _.__. 1 aXed/._r_._.......................:�............ o ad of Health DATE.-- ///.............................. FORM 36508 HOBBS 6 WARREN,INC..PUBLISHERS Fa