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Home My WebLink About0062 PINENEEDLE LANE - Health 62 Pineneedle Lane, Hyannis ?i l0 L 9 u�co-1 No. y Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Miopooar Opgtem Cono uction Permit Application for a Permit Construct( )Repair( )Upgrade( )Abandon� Complete System ❑Individual Components Location Address or Lot No. >��j�� , ��, Owner's ame,Ad_��ss and Tel.No. Assessor's Map/Parcel;Z g—Y, AO 74 Installer's Name,Address,and Tel.No. 3—av— !�/��5 g,� Designer's Name,Address and Tel.No. 14414A1 G Co��rnc�Ov 5 5 . Type of Building: Dwelling No.of Bedrooms Lot Size0, q.ft. Garbage Grinder( ) Other Type of Building Zr�p 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) 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 issued by oard of Health. Signed l v Date Application Approved by Date 6 J` Application Disapproved for the following reasons Permit No. Date Issued ---------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS VO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( ) Abandoned( )by at �^ has been constructe in ac ordance with the provisions of Title 5 and the for Disposal Syst m Construction Permit No. -r4&-1'9 Z Z dated Z� D Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. _ Date Inspector S' . r Fee 2 t f P THE COMMONWEALTH'bF MASSACHUSETTS Entered in computer. y/ Yes _,-PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01pphrat on forpi5pont *pgtem �tCon,5t urtion Permit Application foe'a Permit to Construct(.�)Repair( )Upgrade{ )rAbandon( Complete System ❑Individual Components . . Location Add1*or Lot No: 4( P5nFp/. �I L p^,,. Owner'sj4arne,Addgss and Tel.No. ` Assessor's Map/Parcel G� 9 y/d a g Installer's Name,Address,and Tel.No. !6 r 7pZ® 5 grq Designer's Name,Address and Tel.No. ��ip t,L 'CO�f��G�A✓5 �/ � t f ' / rv�lli- . Type of Building: Dwelling No.of Bedrooms Lot Size _sq.ft. Garbage Grinder( ) Other Type of Building o No.of Persons Showers( ) Cafeteria( ) Other Fixtures 5 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 whenfapplicable) rs� Oh Date last inspected: r Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system r" 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 issued by Board of Health. Signed Ov Date / Application Approved by ( '` Date Application Disapproved for the following reasons Permit No. Date Issued --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IfTO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( ) Abandoned( )by 6 at 'enGr` has been constructe in acF or dance with the provisions of Title 5 and the for Disposal System Construction Permit No. ZOU /'y Z Z dated 2r D -thstaller + Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date. t Inspector t , -7- --- No. �V/ ytz -----��L�=O ��-------------FeeCsJr THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS 1=i.5pogar *p! tem Construction Pe Ift t Permission is hereby granted to Construct( epair( )Upgrade( )Abandon System located at 99 ,I�i 4/, 6a i4 /lew"6.5 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:Constructi n mu t be completed within three years of the date of thi t. Date: TI10/ Approved by I ip � I TOWN OF BARN STABLE LOCATION G �l�'ll�/�� Lt3l�1-� SEWAGE # 9r-y18 VILLAGE ASSESSOR'S MAP LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /Sod n LEACHING FACILITY: (type) 2-1600 Lo' .� o, (size) ,2-� �6o�iya 12,r NO.OF BEDROOMS BUILDER OR OWNER Josh 92Trg -PERMIT DATE: 3 17 - COMPLIANCE DATE: 97 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 leac 'ng facility) Feet Furnished by i�� - 4 ,+ N �� ,'1S o R � � P„C'� `��,�� f ,,. � � . �� s , � ..� s, .� No_ ... ........... Fss.......... ............. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE ApplirFation for UlspwiFal Workii Tatty rndion Frrutit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: - - � ...................................L e qa ............... 4! 1�.1os .....-------•------•..............•----•----.......-----------•------------......_..... Location.Address or Lot o ...`.�r. - - - � ....------•--•--. — =.1 ...__..Qc? ±�+ ..1`!`� �°", °S v ?.'.........` Ut iS .'�. ......... - Owner Address _ .- 41e ..----.....�'-.`-------------�1�1................. I'me. ------ C-'�'`o ---------------.1.r`r�3r�'+�-�............................................ Installer Address "Q 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 W Other fixtures ----------------------------•--- . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 4 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ W Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. x 3 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........................ GC4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •------••-••-----------------•--••-••--•••--••......---•••-••--•------•.._._.......-----------------........................................................ 0 Description of Soil...............................................................................--------------------------------------------------------------------------------•------- x --------------------------------------------------------------------------•------•------------------••-•--------------------------------•-- ----------------- ----------•-------------•--------- W U Nature of Repairs or Alterations—Answer when applicable-��r"` ..._'E'_ _��____S!!�__-._.....1"!� _.._..._`�� _.___.. 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 issued b the b rd of health. Signed ----- -- ---- �t g Application Approved By ....... ... ... . .. ....- -..10----- ------------------------------- Application Disapproved for the following reasons ------------------------------------------------------------------------ --------------- -................. ................................. ............................................. ......................................................................................... -- ------------------.....---..........----- - Permit No. . . ....... - -------------------_--- Issued ..... V .. ......................Date...... t 1 No... ..... Fss.......................... 4 THE COMMONWEALTH OF MASSACHUSETTS I BOARD OF HEALTH ' f _ TOWN OF BARNSTABLE Apphration for Disposal Works Cnnnstrur#inn Frrntit f 1 • Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal 'f System af •....-.`f-4�NN S. Location-Address or Lot No �U ..... y-2 3 20... .. ......................................................... --..... � j Owner Address 13(ra I^41 C C`c�� Ste. --------- •�--•-••----...O�J.....4 ....... .....................r .A,! ............................................. Installer Address d._ Type of Building Size Lot............................Sq. feet a' Dwelling—No. of Bedrooms...........................................Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ____•_______________________ No. of persons............................ Showers ( ) — Cafeteria ( ) al Other fixtures ..----••......•-•-•-----------•- . W Design-Flow............................................gallons per person per day. Total daily flow............................................gallons. W Septic 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........................................ a Test Pit No. 1................minutes per inch Depth of Test Pit...!............... Depth to ground water•-_•_---__--_-_-__--__.- Lil Test Pit No. 2................minutes per inch Depth of Test Pit......_i........... Depth to ground water........................ x ----------------------------------------------------------------------------------.......................................................................... QDescription of Soil.......................................................................--------------------------------------------•---------------------------------------------••--•- x U •---•----•-•---•------•...-•••••-•----------•••-•---••-••••••-••-•-•--••••--••-•••••---•-----------••-•----•-•-•••--•-••--••••••-•••••••...----•-----••••••-••--•••••-•-••..............•--•-•-•---•.... w ----------------------------------------------------------------------------------------------------------------------------------------•----------------------------------------------._.............. U Nature of Repairs or Alterations—Answer when ____---E,c1_��_w�..........to°,A.......... !Ns`m`•-t-••••---•••� 'a°.............--- -----D.°�a7�.....----•-�:-..-!t oo-------�---------.-. ----------------�arv�------------------ Agreement: E 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 issued by the board of health. Signed ------�� . 1 � .... --��r--------------------•--- --3 . - -------- Application A roved B "�.---. --_d.---__. ! PP Y -----------�........................... � f r Application Disapproved for the following reason : .............................----------------------- --------- -----------------------------------...................... ----------- -------------- ------------------------...------------------------------------. . i --------- - --- -- -------------------- Permit No. -------------- -------- --- --------------------- Issued ------ / �fe Dale i i• THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE - �e>r�t�i�ctt#E o� C�om�itttrc�Q , THIS IS TO CERTIFY, That the-Individual Sewage Disposal System constructed ( ) or Repaired ( ) --------------------------------------------------------------------------------------------------------------------------- nscaller I [ �Z Pt�+��fF-�... has been installed in accordance with the provisions of TITLE 5 f e Si e ronmental Code as described in the application for Disposal Works Construction Permit NO. .----.. s dated .............................----------------- THE ISSUANCE F THIS CERTIFICATE SHALL NOT B9CONSTRUED AS A GUARANTEE THAT THE O SC C U SYSTEM WILL FUNCTION SATISFACTORY. DATE--------------I.7771? -�7-----------------------------------------------.. x1^+spector''✓.... ... --7> Cl / r ---- 1 f r �OR THE COMMONWEALTH OF MASSACHUSETTS J i BOARD OF HEALTH TOWN OF BARNSTABLE No............. .... FEE.....`._... Disposal Works 0.1,u"n trnrtion f rrntit Permission is. hereby granted.....N 1C K ' C?O?'�-•.--•----------------------------- ................ ------ to Construct ( ) or Repair,,(---' ) an Individual Sewage Disposal System at No..... Z..............Q ►....rN EE..L;,ks- -C:?d ......... --� .....trAW_ !l �... ••.......---........---•--........------.... Street � as shown on the a licdtion f;r Disposal Works Construction P mi No._ ...._!`:/Qated.......r n....................... Pp p U 1 J i Board of jith DATE.................... `. -•-•------------------•-------- FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS