HomeMy WebLinkAbout0021 STUDLEY ROAD - Health 1 STUDLEY ROAD
tlyanni.3,0,6 - 023
- r
4
m
i
o
1
/No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
ftpliLAtion for 30ispoSA'f 6pstem Construction Permit
/ItIAIPP lication for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon(�El Complete System ❑Individual Components
Location Address or Lot No. .� ; (S `Q,� �." Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel
Installer's Name,Address,and Tel 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
Design Flow(min.required) 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
Nature of Repairs or Alterations(Answer when applicable) Poo !�-S � 01' SICA }-C/
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 Certificate of
Compliance has been issued by this Board of H lth.
d 0 Date
Application Approved by o G Date
Application Disapproved b Date
for the following reasons
n
Permit No. Date Issued
j
No.' - - Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: L
' Yes 1
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS'
_� Replication for Misposal Opstem Construction permit
�AC� a�lication for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon(�❑Complete System ❑Individual Components
Location Address or Lot No. n t S j�`��/ (Z Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel OL t�yC^!v`�S M {(/� `JCS I U/'d
Installer's Name,Address,and el. o. (� 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
Design Flow(min.required) 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
r
Nature of Repairs or Alterations(Answer when applicable) C�4 006
V
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 Certificate of
Compliance has been issued by this Board of -alth.
Signed C� /) Date f .
Application Approved by 4 _ Date
Application Disapproved b Date r
for the following reasons '
t+
Permit No. Date Issued
----------- ------------L/ ---- ---------- ------------------------------- --- ---- ------ ------------------------
r
f TH E COMMONWEALTH OF MASSACHUSETTS
v r f P r1 i� BARNSTABLE,MASSACHUSETTS ,
w e Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) ;Upgraded( )
Abandoned by —�'
at _ has been cony cted in accor ce
i� 0
with the provisions of Title 5 and the for Disposal System Permit No. ated
1 '
Installer Designer
#bedrooms Approved desigrl'flU/') gpd
The issuance of this permit shall not be construed as a guarantee that the system will function/as design d.
Date ( � , I"�..- Inspector ✓—
-------- ------------------------ - - - - -
(! / � � � Fee
THE COMMONWEALTH OF MASSACHUSETTS Lz I
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Misposal 6pstem Construction i3ermit
Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon
System located at
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.
f
Provided:Construc ion mbst be completed within three years of the date of this permit.
Date Approved by
TOWN OF BARNSTABLE
LOeATIONW SEWAGE # SI Lf 4
,f
VILLAGE ASSESSOR'S MAP & LOT
INSTALLER'S NAME 6t PHONE NO. A & B CANW 775-6264
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) __(size) /Ar A5�
NO. OF BEDROOMS PRIVATE WELL OR.PUBLIC WATER_4/6
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes Now/
r ��
5
� �
�� F' '
i
t �
•i '�} .�
P' f5,
r. � f
t ` � .!
• .. � I .M
� � i
♦, J
• t.
a�
^k` ��
3
Nof?"�{.'.�.,,t'. FE$.....rr :.."..........
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
otun.........-----0 F.... .........................................................
Appliration for Ui,spas al Works Tomitrurtiun rumit
Application is hereby made for a Permit to Construct ( ) or Repair (*) an Individual Sewage Disposal
System at:
-•...................................... ..•--••-----------•---........-------..----•-••-------.-...---..-......------.---...--------------
��lj Locn-Address or Lot No.
t fo ..�.,.-..! �itSrk!¢ Qt.. s.l�n.,..... .. !. �as Qrnt�........ -
Owner Add ess
a ►�..C_°, .. �Sd._ ln...�...�,....U_i���.-----ram! ------------------------
� Installer Addr
Type of Building Size Lot............................Sq. feet
Dwelling_.—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
Other—Type T e of Building ............... No. of ersons..........................._ Showers — Cafeteria
f-la YP g ------------- P ( ) ( )
a' Other fixtures ---------------------------------
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
04 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter-------_........ Depth................
W Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area--------------------sq. ft.
x
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. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water.........................
Gz Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--__-•_____-_-_---___-_.
►x -•-•---•--•••--•-••--••----•-••--•••-••--------•--•-•-•.................•--•-•------•------••-----•......_..-----------------•-----•......------------..-----
QDescription of Soil........................................................................................................................................................................
x
w --•-------------------------------------•---------...--•---•---•----••----•----------••--------....---•-•-•---••---------••-•----------_------ e� r• .-----•--
UNature of Repairs or Alterations—Answer when applicable.__in$ __IoOQ_-(?, __ __�J.�. T!4a._QaS.......
---------•---•---•-•----•--------•-•--------•-•--------------------•-.----••----•-----------------------------------------------------------------------------------------------
Agreement:
The undersigned agrees to install the aforedeseribed Individual Sewage Disposal System in accordance with
the provisions of iITI.i� 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the boar of health.
Signed .. ---8--`�•-��------•----
I Date
Application Approved By............ ` • Y.tic.• '' --Y--------•---•----•--••--••----. ............
Date
Application Disapproved for the following reasons-----------------------------------------------------------------------------------------------------------•••---
......................................-•----•-------•-••------------------•--------•--------•--•----•---•--•---••-------------•••----••••--•--•--•-••••••••••--•••-•••-••---•••--------•---•-----•-----
Date
Permit No. . — - --------------- Issued-........................................................
Date
No.F? t�.` r..t—... FRa..... ....`...........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
_,
. `
Appliratilan for Eligpn,a al Workii Tonsfrurtiun Prrutit
Application is hereby made for a Permit to Construct ( ) or Repair (-)e- ) an Individual Sewage Disposal
System at:
•-•-•--•----...._.........-•---.....- „ .. ...
\ Location-Address -� or Lot No.
�c.•,(sb,1(_.1� f - 1,..rf•t -0 i - Il ( !l :AI, I<' ! V fir_ i`
.............. ...._..:.........._.__............_............ .................... _.._ ...
i Owner \ Address
_
Installer Address
Type 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........................................
a Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water_-___--.-__-____---__---
r3 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
9 -----------------------------------------
•----•-••....................
•---------
•-•-•---------------
-------------
---...........
.----------
•------------------
0 Description of Soil...........................••----......---------------------.....-•---•---•--------.....-----------------------------------------------•-----------------•-----•-----•.
x
U -----•---------------•-----••••----•----------------•-•---------------------------•----........--------------•••-•-----•----•--•--•-••-•-----------•-•-------•------------------•-----•----------------
W
U Nature of Repairs or Alterations—Answer when applicable--
--------------------- r -- ` .... ................
.........................-..............................................................................................................-...............................................................
Agreement:
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 agiees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
1
{, T ! , l
Signed = = _ - - i---- :._...
Date
Application Approved B C`
Date
Application Disapproved for the following reasons:................................................................................................................
..........................••-•---....------. •-....._._...-----------------•..._........------------'--------•-----•--------•-----------•---•-•----.......•-----.....•----••-----.....---•--........
� -• 4/ -/ J Date
PermitNo.............•-/..................... .5---------------- Issued----------••------------------------..._......-••-_--•--
Date
f l�tF = THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...........!.........:...................OF.... ,:.! ..........................................................
%T�rrtifirate laf Tuntphattre
THIS I�, TO ERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by ,.... ......... ..•--------------------------------------------------------------------•----------------------------............-•----....---------
•. I ( Installer ,
at............. ...... it ` ---••--•----•---•---•---•---•-------.-
`�
has been installed in accordance wifti the provisions of _7 "� 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No--- .._. dated................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATEDATE-•--••--•-••--•---•-•�.-=....�?--'.�_I--............................... Inspector.................. ."D. ..................................................
j - THE COMMONWEALTH OF MASSACHUSETTS
y BOARD OF HEALTH
OF.. i
No ...................... FEE---.:`..__.............
Disposal lVorks 0031ntrudivn "permit
Permission is hereby granted.........A..!_L.l......a.=K!.7...--------------------••----...........................................................
to Construct ( ) or Repaid (- ) an Ij} ividual Sewage Disposal System
atNo. _�.? 4_s .._..... °------. -------------------------------•---•-•--........
Street rh
as shown on the application for Disposal Works Construction Permit Nc3....=. Dated..........................................
a ---------------------------------------
DATE................................................................................
Board of Health
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
8p-
L ® eiTION SEWAGE PERMIT NO.
WET AGE
r)r)l 5
INS-TA LL UN'S NAME & ADDRESS
5 � c .
BUILDER OR jtnl
DATE PERMIT ISSUED
DAT E COMPLIANCE ISSUED C
., V}
1
._
'� ��
�- � Q'"r
r� _ L / .,F
k
� � � v�� ���e � -
� °'� _ / `�
� \� E
----
�,
2
'�
;.
C
No...82.-.. 8�� Fps..._...$..5.00....
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
.........................T.o_w....OF.........Ba .s.t�b e... ..........................................
Appliratton for Diopog al Works Tonitrurttun rrutit
Application is hereby made for a Permit to'Construct ( ) or Repair ( X) an Individual Sewage Disposal
System at:
-21 .Studle ••Rd •,--Hyaniis, MA 026o1........ r :
----•---------- ---------------------------------------•----------....-----------------------------............---
Location-Address or Lot No.
M.E. Berglund .- 21 StudleY...Ra:-, Hy-a.-nnis,.-•MA••---0?�-4
....-------•------_.. ..........-•-
owner ° Address
a A & B Cesspool Service 128_ Bisho-Ds--Terracea__Hyannis-,---MA 02601�.....
. ........ .
Installer Address
dType of Building Size Lot.... .....................Sq. feet
U g— _Expansion Attic ( ) Garbage Grinder ( )
Dwelling No. of Bedrooms___________________________________________
Other—Type of Building ____________________________ No. of persons...............1----------- Showers ( ) — Cafeteria ( )
Q' 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........................................
aTest 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........................
�+ -----------------------------------------------------------
--•-•----------------------
-....
---------
-------------------------------------------------------•-
ODescription of Soil.......0AIA.......................................................•---------------------------------------------------------------------------------•-•-----•-----
x
W ---------------------------------------------------- --------------------------------------------------------------------------------------------------------------------•--••-•••••--•------------•-
U Nature of Repairs or Alterations—Answer when applicable.__- ntallatz.Qn.__Qf__a__ ..00D._.gallan_,.__pPe-cast,
strne... acked leach pit (overflow) .
..................•------•••-••-•-•---•----••----••-•---•-•-••••-----••------•••••--••-----•--•----•-............--•-
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITILZ: 5 of the State Sanitary Code— The undersigned further agrees no to place the system in
operation until a Certificate of Compliance has en issued by the b/oDd th
- .. -• .-•-.Signe . j .... 9/ .a2........
t Date
Application Approved By................ _e11_-..��--__-_.------.----_------------ ...............91 2/a2--------
Date
Application Disapproved for the following reasons:..................................................................................................................
Date
82
Permit No.................... -
............................... Issued...----------------------------•91..V.2------
Date
r
5.
No. -= Fes$....... ..._.....®Q.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
ToyTX1....OF.........x' 32?.ata}Ae.... ...... -
,��r�lirtt�i�a�.-,�nr• �i��,a��i �xk� C���,>��x�r�t�n; r�uti�
Application is hereby made foi a Permit to,Construct ( ) or.Repair (X) an,Individual Sewage Disposal
System at: \
21 Studle Rd. l� anmi,s' r,A 0260 y .
................__..Y.. - -' -Y s.......--•••--••_.....I............... ..................................................... ........--•-
Location Address or Lot No
M.2. Eers�lund 21 Stuc�lPX. ?dr..ti__H`r�nn,_�- t a n9
......................--- ._ ....
Owner Address'
W A & F Cesspool Brace 128 Discfops-'fez^xae ,.,-t; "- , _,t._MA_._.a2 '�-•--
a •---....•-------------•--- .._..t...........------.......--••-
Installer Address <a,
Q Type of Building Size -Lot............................Sq. feet F
U Dwelling—No.`of Bedrooms____________ ____________________________:Expansion Attic ( ) Garbage Grinder ( )
Other—Type e of.Building No. of ersons___________ _____________ Showers Cafeteria
P� YP g --•-------------•-•••--•••• P ( ) — ( )
P-' Other fixtures -----•------•-----------------------------------------•••--••-•••••-••••--•••-•-•---••------•----••-••-•-•-•--•--------•--------•••---••-•----•------ ' e
Q
WDesign 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........................................
Test Pit No. 1.........:.. ..minutes per inch Depth of Test Pit.................... Depth to ground water........................
f= Test Pit No. 2__;:_,_;. :_::.minufes per inch Depth of Test Pit________________:___ Depth to ground water........................
•--------------------------•- -------------------------•---•-------------------••--------•--•---•----•-•----•---------...._..-•-----------------•-•-----=----
ODescription of Soil......Sa,nd...................................................................................................-.....................................................
x
W ------------------------- ----------- ---------------------------•---------------••---------•-----------------------------------------------...-------------v-------------!--....----•---•----t.
UNature of Repairs or Alterations—Answer when applicable.__lt4taliat�LQP,---of-A—]¢00.0.- 1.1npi -•• _ ,
stone packed leach pit;_ (overfl cnr)
• --------------------------------------•----------------------------•-•...•-•--•--__----
Agreement: ;
The undersigned agrees to, install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of T IT ;< ..5.of the State Sanitary Code— The undersigned further agrees no�ito place the system in
operation until a Certificate of Compliance has n issued by,the board o -1`talth.
Signe plc t_t �uL ' ' ..--- ........................... --.:..- ----- 2 ---------
Date
Application APProved BY z0............
r' Date
Application Disapproved for the following reasons:---•-----------•-------•----•--------------------------•-----•--------------••-•-------------•••. --
•-------------•-----...------------...-=---.............................................................................................----------....................................................
Date
PermitNo......................................................... Issued 9�.21.82_•-•-•-
Date
THE COMMONWEALTH-OF MASSACHUSETTS
BOARD OF HEALTH
.....................`i own..........O F......Barnsf.�le
Trrtifiratr of Tontplionre
THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed ( ) or Repaired
)
A & B Cesspool Service, 128 Bishops '�exTace&
by--------- --- ---
Hyannis,--nTA....Q26• 1.........................................
Installer
21 Studley Rd. , Hyannis►- `--A 02u01 - I. E. Perdund
at---•-----•--••---.._..-•-----•-•-•. . .
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit NoA2_-_._Vf._ ___________________ da.ted_.............9/__2/82.................
THE ISSUANCE.OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTIONS TISFACTORY.
DATE :..:.:......:. or/k' Inspector........ .................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
:..k... < ................: T own
.......0F............ ' t k::e...... ...
N ......................... .00
FEE......
Disposal Vorkii Tonotrttrtion amit
Permission is hereby granted----A & Cesspool__ServiCp----------------•-•-------------•-------.......------------........._.......
to C t ct ` ) or Repair (X ) an Individual Sewage Disposal System
tutLLev M. , Hyannis' YA- 02601...--Y= ri. Tler,�lu-11d
at No..---...-••••--•---"---- •-
Street 82— A/ 9/82
as shown on the application for Disposal Works Construction Permit No..................... Dated..........................................
......:.... _.. �--------------------_------------ --------
^�L -------•-•••-----•----•••---------•---•--- Board of Health
c .
DATE-----------------------�----------•-
FORM 1255 HOBBS &WARREN, INC., PUBLISHERS
-