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Home My WebLink About0157 STEVENS STREET - Health 157 Stevens Street Hyannis A= 309—240 Q No. ?' -1 65 Fee �� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: _Z PUBLIC HEALTH DIVISION - TOWN OF BARN STAB LE, MASSACHUSETTS Yes Rpplitat1DU for Disposal *pstrm �Ocomplete UttIDU Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( System ❑Individual Components Location Address or Lot No. 15_'7 STe"z;,r gS S T Owner's Name,Address,and Tel.No. X Assessor's Map/Parcel 3 Installer's e,Ad e§s,and el.-No. /' Designer's Name,Address,and Tel.No. Nei �A Type of Building: qvt Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers Cafeteria YP g ( ) ( ) Other Fixtures Design Flow(min.required) pit— 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 n 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 it operation u ificate of Compliance has been issued by this Boar th. ^ i Signed - l Date 3- Lf Application Approved by ` - Date 3 -,Lr- f C-r Application Disapproved by Date for the following reasons Permit No. 9Date Issued ty - No. �c' Gqy. Fee �J THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Applications for Disposal_,*pstrm Co trUction J)Prmit Application for a Permit to Construct( ) Repair( ) Upgrade( )., Abandon(L4 ❑Complete System ❑Individual Components- �[ Location Address or Lot No. �S`� �jTt vt i7S 5 T Owner's Name,Address,and Tel.No. X '\ � Q - Assessor's Map/Parcel Installer's e,Ad e,§s,and el Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures 4" Design Flow(min.required) gpd Design flow provided gpd ,,Plan Date Number of sheets Revision Date Title Sze`of Septic Tank Type of S.A.S. ! ,Description of Soil Nature of epai'rs�pr Alterations(Answer when applicable) 4 r.. 5 Date last inspected: 1 Agreement: r _ 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 systerri -operation un ertificate of Compliance has been issued by this Boar f th. ,.. - r Y R, Signed Date Application Approved by Date 3 -mot �C_f Application Disapproved by Date for the following reasons Permit No. O Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO C TIFY,t o the n-site Se a e osal system Constructed( ) Repaired( ) Upgraded( ) Abandoned j�_)by -t< at / 74l W F has been constructed in accordance / with the provisions of Title 5 and the for Disposal ystem Construction Permit No��y—6 dated 3 -0 �' 1 -- Installer A Designer #bedrooms Approved des' flow N gpd) The issuance o thi�PrVmit Wbe construed as a guarantee that the system 1 fu c deign Date - Inspector /� Q I ' -----No.--------------------------------------------------------------------------------------------------------Fee------------------- 0.0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstem Construction Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) }t System located at f 5 7- 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 3 a f— I q 12�) Approved by i LOCATION SEWAGE PERMIT NO. S,� / =ems VILLAGE f yLg s INSTA LLER'S NAME & ADDR� S UGHN A4 AAcro BACKROE SERY ■ West Barnstable, Mass. 02668 BUILD}}��ER ,OR OWNER ,7J(Pa I�AIVIe 'fj/o,�+e ,�.� bovl`ri✓� s �e�a/sfs DATE PERMIT ISSUED 2/3_79 DATE . COMPLIANCE ISSUED G_7 � �1 , � � 1 1 � � 4� � 1 I 1 O 1 � � ` 1 � � I 1 � � � 1 � i� \ � � 1 1�' ` � l�' �' 1` � . 1 1 � e � , � � � `f 1 � r_ T�i' ` � �� \` . � �� .� � ` �b J Noel79 ` 0 ... Fxs.....11r. :7. .... THE COMMONWEALTH OF MASSACHUSETTS ,/� BOARD OF HEALTH Y -- � - P aq 3 ApplirFa#ion for Dispngal Marks Tnnitrn.rtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ._ ---Loca�ion-Address - _ •-•-.----••----.or.Lot No. J�1.t .,Qf�e%ie 11.5. X fFl!_' .... ............ ................................................... Owner Address ------------------------------------------- ............-..................................................................................... Installe = r Address Type of Building Size Lot.................... .....Sq. feet U Dwelling—No. of Bedrooms...._._�.....................j,...__.._..Expansion Attic W_ Garbage Grinder `4 Other—T e of Building No. of persons......._Y Showers ' — Cafeteria P4 Other fi res ----------------•--------------- - e.W Design Flow.._..:--...................................gallons per person per day. Total daily flow... yB..............................gallons. WSeptic Tank L Liquid capacity 15A.gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.... ............. Diameter..`!d------------ Depth below inlet.-::..�..'......._.. Total leaching area-.YPt.-? ._sq. ft. Z Other Distribution box (Y�- Dosing tank ( ) 1-.4 Percolation Test Results Performed by------------------------------------- ------------------ •................. Date........................................ 04 Test Pit No. 1................minutes per inch Depth of Test Pit.._............._... Depth to ground water........................ f? Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ O Description of Soil_________________________ ...............`�-=--------•--•-----...-------•------------------------------------...--- ---........----------.-------- x c, - U Nature of Re irs or Alterations— saver wheriap licable..� ._.... :. .... .......... .. ------------- - -•-••- A eemeny. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be n issued by the boar th. Sign . .-•--. � � ....... Date Application Approved By..r the �-�------ ............ Date pp cation Disapp owed for following reasons:.......................... ....................................................-.................................................................................................................................................... q Date Permit No: ..................•.. ....----••-•••-.' Issued.-...y:......_..7.L!.----••......•--•-•--•- Date No................ ....... ............................. Al� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - ... ........ ... --....OF.......................................................................................... Appliration for. Disposal Works Tomitrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or' Repair ( ) an Individual Sewage Disposal System at t y� ....................................................................••-- Loc i dress or Lot No. CIA 6 f �` Owner Address a p 7 ' Installer Address ------ ' Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms................................................................. .....Expansio .Attic ) Garbage Grinder . `�� aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures .--•-•-•------- •---•--•--••--•.............••--•-•-•---••••.....-•-••-----••-•-•••-••-•--••-•••-•-• . . J Design Flow_______________________________ ___________gallons per person per day. Total daily flow----___-_...................................gallons. W Septic Tank—L-Liquid capacity-P ggallons Length................ Width..:............. Diameter................ Depth................ x Disposaf4`trench—No....:...........:.... Widt _..._......_._._.___ Total Length____-_.�........ Total leaching area..... . sq. ft. Vdi � Seepage Pit No.....a?.....___... Diameter..... ........... Depth below inlet....... ......... Total leaching area..............,...Sq. ft. Z Other.Distribution box ( Dosing tank ( ) ~' Percolation Test Results Performed bY......................................................................... Date........................................ Test Pit No. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water........................ (s, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ _� .f Lei ...............................;;-,•----••-----•...........•---------.....--•--........-•------_..._........ ............................................. ODescription of Soil_.....--••--------------•---••------.....-' -................................................. -•---------.....-----•--...._.__.....-------•----........-----•..--••- V = -- - W ----••-------------------------- �-A � x // -- �� U Nature Qf ; airs or/?It a�ions n yver v en'a lic�----�-- :r�;-----•----------------- . . -----•----...---•-------------.. #rt (,f Agreement: The .undersigned•agrees to install the 'aforedescribed Individual Sewage Disposal:System in accordance with s ; the provisions of,',IT , .5 of the State Sanitary Code.—,'The;undersigned further-agrees not to place the system in operario> �unt>l Va Certificate of Compliance has be issued by t ,boar frealth lg v . Da Application A roved B __:__. PP Y ._._ ...... .................. ....................................... -,x«w• _ - - Date - - Application'Disappr 7_4d or'the,following reasons:......................................... { t Date ' PermitNo......................................................... .., Issued............................ ....................... Pr jf THE COMMONWEALTH OF MASSACHUSETTS '` --- BOARD OF EALTH: V 900 .........................................OF...... j:.:..:........... :..._..._...... ._........... / Trrtifiratr of Tompfi anrr ,. � �- - TH I.��.i 0 C F hat the Individual Sewage Disposal System.c structed ( ) or Repaired ( ) at........ ............................................. _. p--- _. ...................................... has been installed in accordance with�the provisions of T 1 �jrThe State Sanitary CAAC-41 49st in'the application' for Disposal Works Construction Permit No.............................. ;,,dated . _:_: THE ISSUANCE OE THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WIL FUNCTION SATISFACTORY. 7 , DATE........... ........................_.. Inspector.. ................. THE COMMONWEALTH OF MASSACHUSETTS 07f yd,�,BQARD O :. ,. 6W;L...4H .1 No......................... FEE................................... Lis 1 nr r�� #rnr#ilan rrmiI Permission hereby ranted ,.... _______________ ......... to Constru ( or'lZ pa> ( a n >vidu e sa l ................................ -................................ Street.............................................. ;.-`/ as shown on the application for Disposal Works Construction Perm* - - -' --------------- ... ..... :.. ....� 2 7t Board of Health DATE.....:• . /- ----- •-------•-•-•--•-----------•-------------------- " FORM 1255 HOBBS & WARREN. INC..; PUBLISHERS