HomeMy WebLinkAbout0011 PAINE AVENUE - Health 1 PAI`NE AVENUE
Flyannis
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i
No. L��I ( � 7:� Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
2pplication for 30isposai *pstem C truction permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon X ❑Complete System ❑Individual Components
Location Address or Lot No. i 1 PAime AvG iAj( vJP15 Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel as i j d "&- RVAM&n
Installer's Name,Address,and Tel.14o. 56 9>(f-j'7_81R'7-7 Designer's Na/me,Address,and Tel.No.
GAD��r� E fal . C `�` A
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)
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 of Health-, /_
Signed Date G- 1 ri -a
Application Approved by Date - 4
Application Disapproved by Date
for the following reasons
Permit No. ;L C) — f Date Issued —'7 - (q
No. G Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION `TOWN OF BARNSTABLE, MASSACHUSETTS Yes
application for jaisPosaY 6pstem qnstruction permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon X ❑Complete System ❑Individual Components
Location Address or Lot No. J ( PRIM G QVC 1H yATJ Nt 5; Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel 8 A N6 vE
Installer's Name,Address,and Tel.14o. 56 c--crj'?_g g17 Designer's Na/me,Address,and Tel.No.
GdDE�cJt� ElJYt2t5�S CZc F
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
r
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
D�ign Flow(min.required) gpd Design flow provided Al fl gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil X. t
Na ur f R �j r--X C
t e o Repairs or Alt ( saver when applicable) rat$ >J�yk� G SZ��� S 1 G J l►�
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
S a accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
_ r -
Compliance has been issued by this Board of Healt
Signed Date G— _r 'aQ
Application Approved by Date , -4 G
!i Application Disapproved by M Date "
for the following reasons
t
" 'Permit No. � �I L� � f� Date Issued � — r L�
TH E COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CCERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( )
Abandoned W by �IrJV
at It PAt�� y C YAN M 15 has been constructed in accoLdance �
with the provisions of Title 5 and the for Disposal System Construction Permit No. LI hated ated — ( —/
Installer CA?Ew b9 U�C_ Designer N
#bedrooms A/ Approved design flo i�� " gpd >
The issuance of this permit shall'tnot be construed as a guarantee that the system will f tion as, esig dd. r f }2 a
Date.. !/�l �'a' �� Inspector �� l �1.0 t -
---- ---- - -" p-,• --- - -- -- - ----- ---- ---- ---- - ------------ --------------------/-------.,------------
No. C? G I L 1 Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS
Misoosal 6pstem Construction Permit
Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon
System located at ` C A t Q 6 A V M HYMN(!;
and as described in the above Application for Disposal System Construction Permit. The applicant recognized 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 7 L Approved by 111`
r
� •
is Complete items 1,2,and 3.Also complete A. Signat f
item 4 if Restricted Delivery is desired. ElAgent
X
o Print your name and address on the reverse / ❑Addressee
so that we can return the card to you. If.Received by(Printed Name) C. Date of Delivery i
® Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to: D. Is delivery address different from item 17 ❑Yes
if YES,enter delivery address below: ❑No
RICHARD WRIGHT
.11 PAINE AVE
HYANNIS;-MA 0260.1
A 3. S1e�ice Type
Certified Mail ❑F�cpress Mail__-
{ ❑Registered Wetum ecel t for Me rc dise
❑Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number —•)
(Transfer from service tabe# 7 012 10101 !0 0 0 0 2 8 4 8 0899 it
PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540
E j
I I
I UNITED STATES POSTAL SERVICE First-Class Mail
I Postage&Fees Paid
I LISPS
Permit No.G-1.0
I
• Sender: Please print your name, address, and ZIP+4 in this box
Sewer Connect _
ate, Public Health Division I
Town of Barnstable
O� 200 Main Street
Hyannis,MA 02601 J I
I
I
I
I) llill1tllflliit►liaj )Jill III)'I'll Ild"lJlll,arllJllr�rjl
MaptipMadom
p fYW11 _- .
cr a �1J�1L��1 .-.
O"
O
cp Y I
ti' Postag ,
M Certified F �6®
f o cc p.
cPosimark
� � Retum Receipt Fe (n
O (EndorsementRequire l Here
Restricted Delivery Fee 1Lk
O (Endorsement Required) 0)
C Total Postage&Fees $
r�
ru
RICHARD WRIGHT
j ram-, I 1 PAINE AVE t
HYANNIS, MA 02601 +
Certified Mail Provides:
o A mailing receipt a
e A unique identifier for your mailpiece
n A record of delivery kept by the Postal Service for two years
Important Reminders: '
o Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®.
o Certified Mail is not available for any class of international mail.
o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables,please consider Insured or Registered Mail.
o For an additional fee,a Return Receipt may be requested to provide proof of
delivery.To obtain Return Receipt service,please complete and attach a Return
Receipt(PS Form 3811)to the article and add applicable postage to covar the
fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for
a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is
required.
o For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent.Advise the clerk or mark the mailpiece with the
endorsement"Restricted-Delivery".
e If a postmark on the Certified Mail receipt is desired,please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed,detach and affix label with postage and mail.
IMPORTANT:Save this receipt and present it when making an inquiry.
PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047
Town of Barnstable Barnstable
.� Regulatory Services Department iedcaCfty
f BAMSI'ABM
, S �" ' Public Health Division m
f° 200 Main Street, Hyannis MA 02601 -- 2007
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
CERTIFIED MAIL#7012-1010-0000-2848 -0899
March 28, 2013
RICHARD WRIGHT
11 PAINE AVE IMPORTANT NOTICE
HYANNIS, MA 02601 Map & Parcel: 289- 124
The Department of Public Works informed us that public sewer lines are now
available in your neighborhood. According to our records, your property has a septic
system. This letter directs you to connect your dwelling, at 11 Paine Ave, Hyannis,MA,
to public sewer on or before 3/30/2015.
The old septic system must be either removed or filled in due to future safety
concerns. This may be done by the same contractor who connects you to the sewer.
Septic Abandonment Permits ($ 25) are issued at the Public Health Division, 200 Main
Street, Hyannis.
Failure to comply with this Board of Health Order may result in a complaint
against you, in a court of law.
For additional information pertaining to the sewer connection, please see the
reverse side of this page.
PER ORDER OF THE OARD OF HEALTH
T omas A. McKean, R.S., C.H.O.
Agent of the Board of Health
Cc: Barbara Childs,WPC/Roger Parsons,Town Engineering, DPW
Enc.
QASEWER connect\Letters Stewart Creek Sewer Connects\MAILING LetA Sewer 2Pgs Merged 3-28-13 Yr2015.doc
Public Health Division March 28, 2013
ADDITIONAL INFORMATION AND REMINDERS FROM OTHER DIVISIONS:
SAVINGS AVAILABLE/GRINDER PUMP:
A reminder to those of you who need a grinder pump for your connection:
Department of Public Works (DPW) sent you a letter in December 2012 stating the town,
for a limited time of two years, only from the receipt of the DPW letter, would provide
you with the pump at no charge. (This can save you thousands of dollars.) Please note:
You must pay the installati3n cost through your own contractor. Please make your
contractor aware of this, if interested. Also be aware: this is a shorter deadline than
the Public Health Division's deadline on the reverse side of this page.
SAVINGS AVAILABLE/PERMIT FEE:
The Town offers a waiver of the residential sewer connection fee of $420.00 for those
properties that connect within two years of the receipt of the DPW December 2012 letter.
LOANS:
For loan(s) available,please see the enclosed brochure, or see the town website:
http://www.town.barrlstable.r.ia.us/cdbg (under the "CDBG Programs", see "Sewer
Connection Loan Program). For loan specific questions, you may contact Kathleen
Girouard, Growth Management, at 508-862-4702.
CONTRACTORS:
Information on Licensed Sewer Installers is available on our web site at
www.town.barnstable.ma.us/P_1blicWorksTecl/sewerinstallers. Contractors, approved to
perform sewer connection work in the Town of Barnstable must obtain and file a Sewer
Connection Permit with DPW-Water Pollution Control Division 17 Bearse'6 s Way,
Hyannis—contractors, please call Dave Anderson at(508) 790-6244.
FOR ANY QUESTIONS /ASSISTANCE:
Len Gobeil at the Town Manager's Office is available to provide you with direction you
may need in reference to the Stewart Creek Sewer Connections. You may contact him at
508-862-4701.
QASEWER connectEetters Stewart Creek Sewer ConnectAMAUNG LetA Sewer 2Pgs Merged 3-28-13 Yr2015.doc
LOCATION SEWAGE PERMIT NO.
VtLLAGE
I N S T A LLER'S NAME & ADDRESS
S U [L" D E R" OR OWN ER
DA T E PERMIT . ISSU E D I� 9.S
.. t
x
DATE C0M'PLIA .NCE ISSUED a
zz
�i
i
No.�g....... ..:.r�.ZV Fans..../.... .........
THE',COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALT
...---_..../P..W.�.1,0F......
ApplirFatio .fur R v"oli al larks C9nwitrurtinn ramit
Application is hereby made for'a Permit to Construct ( ) or Repair (�an Individual Sewage Disposal
System at .. .
oc on- --or.
Lot No.
......��k v.
- ---- -...
W �/�_BOwner �� Address
a _... ------•._. . .�//,�"..��//.. . �d........ /�1 .:.......................................................................................
Installer Address
Type of Building Size Lot............................Sq. feet
Dwelling ` No. of Bedrooms............................................Expansion Attic ( .) Garbage Grinder ( )
aOther Other—Type of Building ............................ No. of persons........_._....___..._______ Showers ( ) — Cafeteria fixtures . -----•----------------------
__•-------------------
W Design Flow................._.........................gallons,per person per day. Total daily flow......_.....................................gallons.
WSeptic Tank—Liquid capacity............gallons Length-______-___-_- Width................ Diameter---------------- Depth................
xDisposal Trench—No........... .:__ :Y,(,.Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No..............::.`.. Diameter..................
:: Depth below inlet..................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dgsing,tank
aPercolation 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........................
O Description of Soil........ -- - - - -- -- -
x
U -=--•-------------------------------••••-••---•-•---
VW ------------------------------------------------•- -------------------------------------------------------------
Nature of Repairs or Alterations—Answer when applicable__.._^ _e___OL . ! ..........................
-----------------------------------•------------------------------------•--•--•---------•------_...-------••-•-•- "------f4!o--- t' ,.....--...--------•--___•_.....---
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal-System in accordance with
the provisions of iITLL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been sued by the oard h 1 _
F a •, _
Ns ..:....Signed �._._...
......--•--•-•...._.....--
A Application Approved B �— ate
PP PP Y = --...._._... /Ski
ate
Application Disapproved for the following reasons----------------------------------------------------------------------------------•-----•--•-- •----............
.................•------------•-------...•--••-•-•-•••-•--------••-•-•-•----•-•--•--•---.....•-----....-----••---....---•---•----•---•-•---•••---••----------•-••••••••---------•-••-•••---••---------•-
Date
Permit No.---•--•___.1�)..r� - -------------- Issued.......................................................
Date
Fim ........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALIIA
.................. '. ...:OF....:
Applirtatilan for Dispao tl 19orks Tamitrnrtion rrntit
Application is,hereby made for a.Permit to Construct ( ) or Repair (4e,)"lan Individual Sewage Disposal
System at ,
....{ ,.....}:.:.n. .fX:. �':....... .........� Y,
b. f... ............_........_.._6!. '!.T ....--•------...._..........---...............................
t �iit �c ' Ad�re�s or Lot No.
......................a ..... ��
................................
_owner!, Address
.................................................
.._. ..._.._.r ................................ '..................................................................................................
Installer Address
d Type of Bu>lding Size Lot.................... .....Sq. feet
Dwelling L No. of Bedrooms....... ......... ......... ..:......Expansion Attic ( ) Garbage Grinder ( )
a`4 Other—T e of Building ------------- No. of ersons_....._......._.._.......... Showers
YP g --------------- P ( ) — Cafeteria ( }
Other fixtures . ------------------••------------
WDesign 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. I................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........................
D Description of Soil...... ....... .........
x --- --------
U ••-•-----••--------•----------------------••-•----•---............... . .
.................................................................-- -•-:...................................
t r `
-Natureof Repairs or Alterations Answer when applicable ¢ �V -------------------------
Agreement.:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of T I T U 5 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( of health.
-071
S>gnedp t.
. - ,�.-`.r•s[•-�.r- �_ L�j?�,�i�,-I ...��t
Application Approved BY...----- ------ -------- --•--- ---...._. ......---.........._. -....._.._. --------
Date
Application Disapproved for the following reasons:-,---------------••---------•------------------------...------•-•-----------•---------.........................
-•--------------------- -------------------------------------------•------•-•--•--------------------------•--------------------------
Date
Permit-No.............S?.. � "Cry`7(:
- - . - -- - --------- Issued_--------•-------- - ---------------------•-------
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
......... ........ ......... .................
wrtifirate laf (91amplianrr
TW IS'T E TIFY, That the Individual,Sew age Disposal System constructed ( ) or Repaired
by - . . �+ , t
�... °i .......�Si 4 ..... t! J t 1 xr. ......._
f v
Installer f
.-___.-_-- s wrt
has been installed in accordance with the provisions of TI"' " 5oj-►e State Sanitary Cog as decr�iean the
application for Disposal Works Construction Permit No..... ................. dated_ ..._ ------------------------------
THE
ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUN TION ATISFACTORY.
DATE Z L Inspector.. =
THE COMMONWEALTH-'OF MASS XC' HUSETTS
BOARD OI, HEALTH
OF.......:_ ._.!_? _.� r�"r 2 _ �. :........... l
FEE.! .
Y
�r
Permission i hereby granted. 1�L_.. ..:.,...-- - ................................................ .......� ' � ...
IVL to Construct o e alr an Indio al wa a Dis os stem
t No.. _.. E
- Stre t 4.
a -
a shown on the application for Disposal fit# s Construction.Permit No Dated. ... ...............................j 1
DATE )Y ................. I.... __ ..............................................................
` ! C( Board of Health
i�,:;-- - --- .....................
FORM 1255 A. M. SULKIN, INC., BOSTON
:' ;