HomeMy WebLinkAbout0050 REGATTA DRIVE - Health 50 Regatta Drive
Hyannis
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TOWN OF BARNSTABLE /
LOCATION SEWAGEwt-
VILLAGE ASSESSOR. & L`OT -�
INSTALLER'S NAM1 Si' PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) /DDT (size) lD 01
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NO. OF BEDROOMS.. PRIVATE WELL OR PUBLIC,�W.ATER
BUILDER OR OWNER_
DATE PERMIT
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DATE COMPLIANCE ISSUED: .� ✓i J� �� •
VARIANCE GRANTED -Yes No
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1 LOCATIONS ���',�'I �`�e�� SEWAGE #
VELLAGE ASSESSOR'S " & LOT V�rg/0C1/
INSTALLER'S NAME&PHONE NO. -0"'k-7�a✓ V.A1n,",E .7 - —R�W,
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T SEPTIC TANK .CAPACITY
LEACHING FACILITY: (type) ? (size)
NO. OF BEDROOMS
W.a rR OR OWNER
PERMITDATE: 5— 9"f 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 le hing facility) Feet
Furnished by
HOMEOWNER RECORDS
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TOWN OF BARNSTABLE
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LOCATION SEWAGE4
VILLAGE . . ;2_
ASSESSORS MAP
INSTALLER'S I PHONE NO.
SEPTIC TANK C`AP?,�iCITY 10446 Gat `
LEACHING FACILITY:(type)
NO. OF BEDROOM$ ,a PRIVATE WELL OR PUBLI .WATER
BUILDER OR OWNEit F a,,u
DATE PERMIT IiiA,tJEDs
DATE COMPLIAN-0i ISSUED_T
VARIANCE GRANTED: Yes No '
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ASSESSORS MAP NO-
PARCEL PARCEL NO- �� ( / - Oa �'
No..---•l-•-63.-7-3 V Fas ......
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliratiutt for DiuVuua1 3Vur1w Toutitrurthm ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
Sys t
l So
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ocati -i�ldress Lot No.
weer Address
a ................. -----••----•-- . -----• .................................................. ................................ -----------------------------------------------•-•---------
Installer Address
PQ d Type of Building Size Lot___tz� E._JQ�f....Sq. feet
Dwelling—No. of Bedrooms.__... �_~_____________________________Expansion Attic ( ) Garbage Grinder W6
a Type giLlTll�f�rc No. of persons............................ Showers ( ) — Cafeteria ( )Other—T e of Buildin �
a' Other fixtures. .......................................
--------------------•------------ ------------------- -------------------------------------
W Design Flow...................��U...............gallons per p per day. Total daily flow---------. .....!0......................gallons.
WSeptic Tank—Liquid capacity_Z -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 tt�k
~' Percolation Test Results ` Performed b '�- 'l y.......................................... Date........................................
a y.._
Test Pit No. 1---- __......minutes per inch Depth of Test Pit........ Depth to ground water...A.14) ..
44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
L� n... L^ ••--------------------•-••--•--•---------•--••----------------......------•------•--------------------••--•••.------------
U .......................................................................................................................................................................................................
O Description of Soil..... ---/ 1-----------------------------------------------•-----------•----.......----------------•------------------............----
x /
W
. ..... ..................................................................................................................................................................................................
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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compliance been i sued y the board of health.
Signed --- -------------------------------------- --
^ Date P—
Application Approved By .................... ........... ................... .—
Application Disapproved for the following reasons: ............................... ... -- . . --. ............................._ ---..................
... .. ........................:............................_.................................................... ............---------------------------------------------------------...._ -------------------............
Permit No. ....... . - ------ Issued .. .
Da,:__
aze
0/ P t��/
No...... U r� Fr�s.. ...14.2......
THE COMMONWEALTH OF M'ASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
AV' firatiou for Dbrip t ial Work,i Tomitrur#tun thrmi#
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal-
System at: -
----------
_Locati n-t\ddressW_..__o'r Lot No.
wrier Address
---- ••• ----------------------------
Iustaller Address
U Type of Building Size Lot...r a; .....Sq. feet
04 Dwelling—No. of Bedrooms______ _______ _-Expansion Attic ( ) Garbage Grinder (Alv
p.l Other—Type of BuildiiiglLNJ �1e No. of persons---------------------------- Showers ( ) Cafeteria ( )
a' Other fixtures --------------------------------- -
W Design Flow...................��U
-------- ---- per pc�rsa per day. Total daily flow---------- 3.4�_............_.._._.___gallons.
Septic Tank—Liquid capacityl _gallons Length---------------- Width---------------- Diameter--.-..--_..__..- Depth................
W Disposal Trench—No. .................... Width-------------------- Total Length.................... Total leaching area....................sq. ft.
'Seepage Pit No--------.---_-_---- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z r •Other Distribution box ( ) Dosing tafik ' \ _
Percolation Test Results Performed by......�_-�' "�!---y----------------------------------------- Date-----'I........__........__....._...__..
a
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....................
P4 v,,..--�� ........----........A...----..---.._.._.._._.._......---.............._..._...........................................................................
0 Description of Soil--• n,/_2- /) '.j_•j h(wt--------------------------•-----._....--------------...----
v -------------------------------- ------- ------------------------------------
•-------------------------------------------------------------------------------------------
-------------------
W
UNature 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 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 sued y the board of health.
Signed ----
/ % -------------- ------------------------
Application Approved By .......` ... - .��
Date
Application Disapproved for the following reasons: . ........................... . ......... . . . ......................................
......... .................................................... . ............ ......................... .--........ . . ----------------------------------------
Date
Permit No. �
---- --- -------
��. 1 Issued - - - .:�a
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
(11ertifi ate of Tomplian.ce
THIS I TO CERTIFY, That the Individual Sewage Disposal System constructed ( ✓ ) or Repaired ( )
by. ------------- --:._ .....fit J' �.. k �'r --..... _........................
✓� f Mutt
------ ....
V .4. ...! .....1.1N�."f -...... .. .._... -----y! a --------------------------------------------------
at . .. . . ..
has been installed in accordance with the provisions of TITLE 5 The State nvironmental Code as described in
the application for Disposal Works Construction Permit No. ...... o "...-.._y4.l.... dated ................._....._.....-.-___ . ..
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY
DATE. . -.... 7Z�- r -, .. ------- Inspe tor...-_. '. '.:�25 `°
le.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
"� TOWN OF BARNSTABLE �r�qq
�!!� FEE.....�!J ...
Permission i��hereb ranted................. ........................L--
V hereby
to Constar ct ) or Repair r ( ) an Individual Sewage Diisposal System
at No.•-... j'._.... - ----•- --,---.... 4 j Streetcc��.. ��jj//
as shown on the application for Disposal Works Construction Permit No.!_ `\\�`�?I-- Dated--------- .� f ..^ � ....
-------•-•---------------------•--- -r- )--------------------------------------------------••-
/ �f•� ( J Board of Health
DATE.....................
FORM 36508 HOBBS✓!WARREN.INC..PUBLISHERS /
SING F�G11L`( 3 $EG? 7►t�
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TOTAL v65166W = 5¢9, carp,
TOTAL: DA I Ly rL C)yV = 3-30 6f'D TA av_
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