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HomeMy WebLinkAbout0200 SIXTH AVENUE (HYANNIS) - Health �o a Si4 Ave. TOWN OF BARNSTABLE LOCATION 2�ta � ?� �V�. SEWAGE# ?y- 7� VILLAGET ASSESSOR'S MAP &-LOT . INSTALLER'S NAME & PHONE NO. . '-Ck-P_X 6wx54- 771-W7 3 SEPTIC TANK CAPACITY BLEACHING FACILITY:(type) ��v 3f�5� (size). f NO. OF BEDROOMS-PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED:_ DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No i� : s l f IV �/ �� � 16 ' No..9 _.�1.7 v Fxs..... ......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiou for Di-npoti tl Vork,i Tomitrur#inn runti# Application is hereby made for a Permit to Construct ( ) or Repair ( Pp-j an Individual Sewage Disposal System at: o'0C) Z -AV% C�`ice . ..........................:. ........... ........---.......... ... •------•--•-•-•----•-•-•----04a-mis--.----.---------------------------------- Location-Address or Lot No. ......................_.......................................................................... ----------------......----------------------•-----------..._...•---_........_..................... Owner Address W ,6"le lc c�'1 tea?S �?�Ci 3!'cYL`t Installer Address UType of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms......... Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' 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........................................ 0_. Test Pit No. I----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ G%, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ---------------------------------------- • ------------------------•---------------------------------------------------------------------- .... ..... ..... .---' 0 Description of Soil...............................................................................................--------...------------------ ......................................... �4 U W x ---------------------------------------------------------------------------------------------------------------------------------------------------•--------------------•---------------•--•--••-------- U Nature of Repairs or Alterations—Answer when applicable.k?p ' ........- ---TF �___._ !ej__4-?.`_i S7',Jk___.!`t^�b_._.I+`NP`� .---- ��©��...... °`!� -_.` - ® ....._... ...... ............... �`d�` ` ``------� ------- �� .................................................... Agreement: SGTu. _.........--•-•- 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 iss ed by the board of health. Signed -------- ------ ..:..............................--------------------------------- .... .��� � --------- ApplicationApproved By -------------�" ... ------ ---------------------------------------------------------------------- Application Disapproved for the following rearons- -------------------------------------------------------------------------------------- --------------------------------------------- ............ .. .....q............... .. ....................... ..._._........... . . ..................................... ......._... -----"'------- -------------------- Permit No. ............ ..... .7.. -------------- Issued Date...._ Dace No..I.` ....--` 7 v FRs......�.r ......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE App iration for Di-vipmial Workg Towitrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: �o S I wyk A Av t= C ..s.z_'c'-'' `_ ! ..... .-•••••--•- , Location-Address or Lot No. ......................Y_.......................................................................... --•••••----•----•-••-----••---.....•-----•------•....------------......_._._...................... Owner Address W �..lCC`1 OS 5 Installer Address UType of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms____.__..________________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons-_------_____-___._____--.-. Showers ( ) — Cafeteria ( ) Q' Other fixtures ............................... . . W Design Flow............................................gallons per person per day. Total daily flow_.__---_____---___---L-1---I...............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---------------------------------------- ,.a Test Pit No. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water........................ fZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •--•••-•-•••-----------•--•-•---••••---•--------•-••------•••-•••-•-•-•-•-•-••......••....................................................................... ODescription of Soil............................................................................................-------------------------------------------------------------•--...__•••... x w Nature of Repairs or Alterations—Answer when a hcable._kq!"``- ' -�.�...__. .!_"?__E_Y!.5i.'`! ^'^ b � Z. P PP NFL..L..�?.-�°7e-------•�-"-'-�------.l��a... -.P`.� --------- -----x......--SllJ,.................................................... 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 by the board of health. , Signed -- ----_ ......U.�....--------------------------------------------------- Application Approved By ............. ------- ���,t. .. .............. ...... tee' L� Application Disapproved for the following reasons- --------------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------........._....-------------------- ------------------------.....------------------------ Dve Permit No. .. ...........L17-d Issued Dare ---------------- ---------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE TQrtiftratr of (11omptianve THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed ( ) or Repaired O t tine � CbN by------------------------------------ -------------------------------- ------- -------------------------------------------------------------_..-....... Installer at ..2oU._.......51 X (mil �`►.�/.. C+ w7 �!/i ---------------------------------------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. -----7-y.-.--LI..7..0...----- dated _............................... ...... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..... 9 - ).`, --l. f..... -- ---- Inspector .................. ----------------------------_----------------------V .... r --------------------------- --------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C. FEE Eiiynsat prkii Tn otr ian "amit Permissionis hereby granted------ :(C lL�--•-------cki n1.S ••••••-•-•--------•---•-•-••--•---• -••-••--•••-•••-••-••••-•-••••......••................ to Construct ( ) or Repair scan Individual Sewage Disposal.System at No �--�..............�S.1lc __... v eL" -C Street • as shown on the application for Disposal Works Construction Permit No./.. �_. 70_. Dated........ _---` - -........ --•----•---•---------•----------- 5� c, Boards of Health•----•-------•.................. DATE.............. '.�. _-.1 .................... v FORM 36508 HOBBS R WARREN.INC..PUBLf�ERB