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HomeMy WebLinkAbout0654 STRAWBERRY HILL ROAD - Health 654 Strawberry Hill Road Hyannis A= 249-087 I © P / FRs... .....17......`.. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliration for Di-lipwial Wor1w Tomitrurtion Vrrnfit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: �.7`- .------5-.�•�p`-`-'•Qe �--.......---...fir..•--- ------------------- W�,. ..�------------------------------ Locat... -Address --------------------•----.................. Lot No. Q�) lti � Vl1' ..... ........ ... ... Owner Address W �c4Cc�� °��w -------------------------- ------------------------------------------------------------------------------•-----•---•--------- Installer Address UType of Building Size Lot.................... Sq. feet Dwelling— No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder (. ) pa, Other—Type of Building ............................ No. of persons-.--.----..--------..--.---- Showers ( ) — Cafeteria ( ) Other fixtures ------------------------------- - - W Design Flow--------------------------------------------gallons per person per day. Total daily flow--------------------------------------------gallons. WSeptic Tank—Liquid capacity-/Swgallons Length------/-U---- Width-.S7--..._ 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........................................ a Test Pit No. I................minutes per inch Depth of Test Pit------,............. Depth to ground water..---....--............. GL, Test Pit No. 2................minutes per inch Depth of Test Pit--..---------------- Depth to ground water...----..--............. --------------------------- ----•----...--------------------------.......--••----•-••-•••--•---•----......................................................... ODescription of Soil........................................................................................................................................................................ x U ............................................................... ----------------••-------•...-•---•------•••-•--•---•-------------------••------•-------•---------------•••-••-----•••-------------. x ----------------- --- -------- -------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable � I'. -_ .v-.-.6�-----_-.S�'-d:�--�------------------ i // p� �...... ..................... er ---------t--f...................................................................... 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 the board of health. / Signed ------6? .. .21.2A7_ r -- ------------........------ -----------------........._ Date --'--------- Application.Approved BY - -.�.c<'' ---------- - - ---` ^�e- 5 Application Disapproved for the following reasonr- --------------------- --- ------------- ------------------------------- ------------------------------------------------------- ----------------------------- ----------------------------------------------------------- ---------- -----...---------------------...........------...--------------------------------- ---------- .................----------- Permit No. ......... -------._... ..'.......i.� / Issued ..... .... . . ...................... ..... 1e...... Dare - _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH --TOWN OF BARNSTABLE Allpliration for %p mial Wvrk,i Towitrnrtinn Permit Application is hereby made`or; a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ++ I lvJ`~Lf. ._._...5.--..-Rpw6� Y--•-J�(-•�-1-----.--�r •--------------------------C� ............................... ........... Location-Address or Lot No. Owner.[ Address ........................... -----_---•------------•--- Installer Adcress UType of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms_....______---------------------------------Expansion Attic ( ) Garb-age Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) aI Other fixtures _______________________________ _ _ d ----•-------•------------- ---------•-------•-•-----------•-••-------•----------------•- W Design Flow--------------------------------------------gallons per person per day. Total daily flow--------------------------------------------gallons. WSeptic Tank—Liquid capacity_/ �?_gal Ions Length___-�v____ Width---57-------- 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........................................ Test Pit No. I................minutes per inch Depth of Test Pit-f"�__,___ ------ 4___ Depth to ground water...................... (i Test Pit No. 2________________minutes per inch Depth of Test Pit.........------------ Depth to ground 'water........................ a ---------------------------------------------------•------5...---------=-------•----------------------•---------------------------------......---...--••--.. 0 Description of Soil--------------------------------------------------------`-•--••-•---= f' ' x , , c, W ............... ------------------------------------ ---------------------------- --------------------------- U Nature of Repairs or Alterations Answer when applicable_ '" 'd�_ --_� if, U_-_6A ______ _ .................. rD 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 beeVis e the board of health. Signed ------P_vt -------------------- --------------------- 1...Dare/7�.......-- - i APPlcaton APProved B 3-� - 1 Dare Application Disapproved for the following reasons- --------------t-..-.------------......----------------------------------------------------- - -------------_. .---.-..---._------ ----- -- -----------------------------------------.---- ^ —7 Date Permit No. ............ ....-----.----. S� cl, t / Issued .. - . Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE QLIT r#ifi atr of (11ja tpiinure THIS IS O CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) b In: L at . - �.. . .. --------- ---- r .•°C ------------------------------------ has been installed in accordance with the p visions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. .._35— 7-.....p�- 7-... dated ._........._......................------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.. ----------- Inspector --- --------------- _ '---- ..... `. ....-. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . TOWN OF BARNSTABLE Uispnutt Workii Tomitrurtion f amit Permission is hereby granted---------- `.. .'............... Construct ( ) or Repair ( I an Indiv��idual Sewage Disposal System at No............. --`� � ^ `� 1-1 1 I�` ....._.C1-� •x� ------- ���L/ Street �y _ as shown on the application V Disposal Works Construction Permit No... J-_ �� Dated......... �.�_-.-�-5...._.. f `-------- -------------------------------------------- _ Board of Health DATE..................... .---•_______________________-__._._. ._..-----•--- FORM 36508 HOBBS&WARREN.INC..PUBLISHERS TOWN OF BARNSTABLE LOCATION ltAc.jeie Ry /4/S SEWAGE # - I VILLAGE VtJ - !'?CJ( ASSESSOR'S MAP & LOTVY9�,OO ' YaY INSTALLER'S NAME & PHONE NO. 9��j S X Ci40 l C SEPTIC TANK CAPACITY f�d LEACHING FACILITY:(type) Pi T (size) 16, 0 0 NO. OF BEDROOMS PRIVATE.WELL OR PUBLIC WATER A BUILDER OR OWNER DATE PERMIT ISSUED: *' l DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No c �