The URL can be used to link to this page

Home My WebLink About0041 STETSON STREET - Health 4.1 Stetson St b � t 306-234 Hyannis �r 6 ` o e e i r No. r5 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZippYication for Disposal *pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon GY ❑Complete System ❑Individual Components Location Address or Lot No. 5 6r-, Owner's Name,Address,and Tel No. le17.79>- la �tnnls ��-3�11�» /a� cod'• Assessor's Map/Parcel &q, /93Y 1 c>&V Installer's Name,,Address,and Tel.,No. j00--2 7% 9�JJ Designer's Name Address,and Tel.No. �0 / Yato% ov�str 'F/m,?�c yS usFo�l ,t-):y ge t" �' rs ,Zr� 93irZLairt Sf- 5 Qs Type of Bu ding: 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) Or— gpd Design flow provided in� 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 Cod not place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signe /" -- Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued vedG .! ;��b q 6b No. `;i Fee ° THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: k �" •' Yes :. PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppYitation for 0sposal 6pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon(,* ❑Complete System ❑Individual Components Location Address or Lot No. y 5`�- a� Owner's Name,Address,and Tel No. !Pi 7.7� Assessor's Map/Parcel 36(tl '0�3 y H H llC1n r1 ISM acid � /U& ,`��- * /'J�1 L d 4,y Installer's Name,Address,and Tel.No. 5-0 t-�?7/ 3 j�/ Designer's Name,Address,and Tel.No. _'20iS 66r41/1-1z CrGrSfrC.C�%cr,�iic ys lus�oy �Cb"ge hYtei rg s '1�'! 5 r911 O 41Z VKIJIA-1,71,,411� r B'i Gam')S Type of Building: J� w - Dwelling No.of Bedrooms /' Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures oA Design Flow(min.required) gpd Design flow provided IA� gpd Plan Date Number of sheets Revision Date Title € Size of Septic Tank Type of S.A.S. . Description of Soil A Nature of Repairs or Alterations(Answer when applicable) G,n A pC Date last inspected: Agr ee ment: The undersigned agrees to ensure the construction and maintenance of the afore described on-site se.ge disposal system in accordance with the provisions of Title 5 of the Environmental Coo -t'p ace the system'in operation until a Certficate,of=— Compliance has been issued by this Board of Health. "A Signe - Date Application Approved by Date fl ! Application Disapproved by Date for the following reasons � I Permit No. Date Issued ----------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,th%t the On-sit Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandon )by at y� �SY��SA h S T N!1l r7/)I has been constricted in f/accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.�1� T dated Installer Designer nn j #bedrooms f Approved desig�o / 1 gpd' The issuance of this peg it shall not be construed as a guarantee that the system will functio i, designed. Date 1 , Inspector ------------------------------- -----------------------------------------------------------------------------------------"---------------- No. 0 [ d) Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction Vermit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon(0 System located at S kr,0 ,/e N1,W 1 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 mustbe completed within three years of the date of this permit. _ Date � ' e Ie9 — !S Approved by V 1 iv i .B FEZ Q S , .Z�f E .E�c Az .Z.L 1 F .6,E Z. .6.51 .1.5 1 .LZL Z Z 1 ry .E�Z m � ' C.ZL ,6Z N N .LLI i .119l .o.s .s 1 .Z.E .Ol£ F I l.6 9 S 1 a I.OL LEI i Z 9.9 .L l.ZZ O O �s N C 4] r � ZZ m .Z.S iti• .5.6 R L dZ I .E.BZ C N a� N M� W No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01pp ratton for Mtg ool *pgtem Con5trurtton Verna Application is hereby made for a Permit to Construct( )or Repair( �an On-site Sewage Disposal System at: Location address or Lot No. Owner's Name,Address and Tel.No. dwovT744 4-IL', Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 1#kck4=k -0 771 YPZB Type of Building: Dwelling No.of Bedrooms Garbage Grinder Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Description of Soil / S/� Pam` ✓ �°��`� Nature of Repairs or Alterations(Answer when applicable) Wf-4 d` `� 1-0 2L*1 A204— .T" '�iC d2 �C YO 4. 4 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 this Board of Health. r \ Signed �o..�- Q Date Application Approved by — Application Disapproved for the fo lowing reasons Permit No. Date Issued ... ..-_. -.-.-w,r:.•.<�...� s`....-.f...`a1>y. .{...k, ..-.w,,,;/ M''� y�." "..�A-:J,��,—"` �..�0'."'`'...-^.+L.,.*., i-+ �,�.'.- } M, _}-`..ri..—.-+si 1 No. Q Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS TIPPItcation for &&pool *patent CCon.5tructton 3permtt t Application is hereby made for a Permit to Construct( )or Repair( an On-site Sewage Disposal System at: Locations�dd ss or Lot No. . Owner's Name,Address and Tel.No. j GG �.�' s Tx��. w�,��. � �a �_k) rz-(«4 dolrv/ F' S/2.06.4-Al OmAa eY ass-6s�� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Yiz9 Type of Building: Dwelling No.of Bedrooms Garbage Grinder( ;i Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow # gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Description of Soil S '" eart-o o co'mir Nature of Repairs or Alterations(Answer when applicable) �� 'd =�! tea 4Vt,'T7y4- I NSii'tl, t, SAD C'• C 2Qp1 is YG - t Ale— ►..,� 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 this Board of Health. f \ Signed ► S Date OV/0,P/99 Application Approved by — y" Application_.Disap;proved,for the following reasons Permit No. 1610 / Date Issued THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS CCerttftcate of Comphance - THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced( )on by KL�* Rde�Sr" for W ti-f sr`k/0/4 ter A— INN 0_0T a' l r has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. !?S'-MO � dated Use of this system is conditioned on compliance with the provisions set forth below: 4 No. 1 t/O/ Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS xtoogar *pgteut Com5tructton Veruttt Permission is hereby granted to to kce,4 evp w c 1 to construct( )repair(e)an On-site Sewage System located at 6/6 /°mlo' S 6y' cv77/,= 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. All construction must be completed within two years of the date below. Date: - g — / Approved by AsBuilt Page 1 of 1 TOWN OF BARNSTABLE LOCATION l ST-E'156/V S-iP'9'? SEWAGE # qJ —l73 VILLAGE h�e"/,s q,�.S SO S MAP & LOT ;L3 J AIE MEDEIR08 •YSon.SST/ INSTALLER'S NAME & PHONE NO. 78 LINDEN ST. HYAN MA 02601 7 f D SEPTIC TANK CAPACITY -<-d a a / ;C LEACHING FACILITY:(type)rya e/-j!iye NO. OF BEDROOMS PRIVATE WELL OR UBLIC WATE! N BUILDER OR OWNER M Qr� p l ° �I!!,l�ERS nAl DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED• �/��1 =-- VARIANCE GRANTED: Yes No L 7 v N jT U l d vie , i 00ar http://issgl2/intranet/propdata/prebuilt.aspx?mappar=306234&seq=1 11/2/2012 L m t � TOWN OF BARNSTABLE LOCATION ] S 1 J50 I S-1keg 7' SEWAGE # VILLAGE AS SSOR'S MAP & LOT �- 8RAIG MEDEIROS $Son,eTrl J� INSTALLER'S NAME & PHONE NO. 78 LINDEN ST. HYAN MA 02601 7 7 S SEPTIC TANK CAPACITY S^�0 / / e {' LEACHING FACILITY:(type)a--0z e/-//IV (size '*X NO. OF BEDROOMS. PRIVATE WELL OR PUBLIC WATE� BUILDER OR OWNER M �71yzsT5 Di DATE PERMIT ISSUED: 2ZLY Z2 DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No` f ` beef fig cA Ln y �& / � V No.?, 17�J Fxs... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .. TOWN OF BARNSTABLE k .,� Appliration for Mirp ind Wor1w Tomitrur#tu rp"#3 1 1995 � Application is hereby made for a Permit to Construct ( ) or Repair ( ) an I dual osal System at: / ��Y% 14 le �NN[ �u ........................... . `. x ------..........................................-- -• -- .................... Loc n i =ss �"' t No. e .._ .. _. ...---.. .. Ohner � r ss I ista er ddress Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- ,Y howers ( ) — Cafeteria ( ) p-' 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. 3 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. I----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water______._.__._------__._. Test Pit No. 2................minutes per inch Depth of Test Pit_................. Depth to ground water........................ --- •--- --------- -•-----•-••--•--------------------•••---•-••••--------•--•-•-•.............------------•-----•-•--------•------•-•-----...••........._. 0 Description of Soil.......... .. ... ------------ - ------------------------------------------------------------------------------------------------------------------------------------ x W ••••-------•-----------------•----.....---•---•------------•----------------•-----------••---------•-----•-- __ UNature of Repairs or Alteratio —A swer when appl'ca -.__.__ j_. __�............... greeme t: The undersigned agrees to install the aforedescribe 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 Compiia ce h een issued by the board of health. Signed11 A -- _.................... ....'..�.........._....... ...... � �! Date ApplicationApproved .... ------------------------ --- .......... - --------------------------------------------- Z � Dam Application Disapproved for the following reasons: .................................................. -------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------- -------- .....----------------------------- ----------------------------.----------- Permit No. r �4J �._ ............. Issued ---------- .::... `_ ...... Dace rl 1 • No.9 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Uin•Vuiittl Wurk,6 Tomitrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at Fi ... •--�� A__,,,� '•nLoc ion-ildd-ess J �•`� r(r" ---..._ . Lo� �.,�._ ) .,/�!v�:. elf '✓-.y`• `,-_J- -�!2_vim---4�----------------- t./.�x.� --- /-� -- -�_!t.,. _ r-.e _.,��`. -.�... 10 ner _Address � C1 w Installer Address V d Type of Building r Size Lot............................Sq. feet UDwelling—No. of Bedrooms-------- ---------------------------------Expansion Attic ( ) Garbage Grinder ( ) 4 Other—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 ( ) 4. aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I----------------minutes per inch Depth of Test Pit---_--___..____--__- Depth to ground water........................ r, (i, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ '-----------------------------------------------------------------------•-----------•................................................................ xDescription of Soil-----------rE"'rt -------------------------------------------------------------------------------------------------------------------•-•-.......----- U ••-•-•-•-•-----•----•--••••------•--••••--••-•-•......-•••••--•-•-.--------------••••-•---••••----•-------••---•-...---•••••-•••---•------•-------•....•-•--••••••••-•----•-----•-•••.................. W ............... ------------••---.............---- ------------------------------•... •.•• ---.._... _ UNature of Repairs or Alterations—Answer when applicable _ � .._ �X �__ _.'%��-_ .. . .... 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 -.1. : -a t'�tr--- �' ` �^--w'' -------- /.. ? r'f:? Dare, Application Approved Y� /..J./^�.' �� -- .. " '"�"�"'�'� ....._. ............ .. ................................ Application Date 11 - Application Disapproved for the following reasons: ........................... ------------------------------� ..... ... ............................ --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- - -------------------------------------- �•-� Dace Permit No. .�� .. "... �., .-'r.._............... Issued - pr`...,� .�........ ` THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Trdifi.rate of Tomplialare THIS fIS TO-GERTIFY,.Ti�Iat the Individual Sewage Disposal System constructed ( ) or Repaired ( �) by . G---o �� Wei.: � - -------------------- at ..... 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. dated' dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUA ANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. CJJ DATE.........................1.)........_I.......... �.7--------------------_-_--------- Inspector .......�..*, ... -------_ ----- ---------------------.....- -------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE FEE......................... Ropotial orkiia,�C�/ nu#rnrtion "amit Permission is hereby granted _!_---!�-,_A_.-_�!-"--fir. + rz. -------------------------------------------------•---------........ to Construct ( ) or Repair ( c,,I n Iv dividual�Cage Disposal, stemat No. -- �- t _ _ Stree as shown on the application for Disposal Works Construction Permi /??X�. Dated " '�/��:r/ �? - �� ,� Board of Health ..... DATE._ _��...".---------------------•--_._....-------------•-------------._..... FORM 36508 HOBBS&WARREN.INC..PUBLISHERS CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) 1 r�eJ.--s CV o 6 , hereby certify that the application for disposal works ' construction permit signed by me dated �711 r , concerning the property located at C"'e" 5 o H S 74 �'j meets all of the following criteria: • There are no wetlands within 300 feet of the proposed septic system • There are nor private wells within 150 feet of the proposed septic system • The observed groundwater table is 14 feet or greater below the bottom of the leaching,facility • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. SIGNED : DATE: LICENSED PTIC SY M INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system. Also if the licensed insu;ller-posesses_a certified plot plan, this plan should be submitted].