HomeMy WebLinkAbout0061 STUDLEY ROAD - Health 61 STUDLEY ROAD
Hyannis
A = 306 — 009
a
O o
Fee
/ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
• Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
0(ppYication for Misposal *pstem Con truttion 3permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ❑Complete System ❑Individual Components
Location Address or Lot No. C'j 7-0 Y Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel 3 DZ-001pCkS'fC.t
Installer's Name,Address,and Tel.No. 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) A loavj e)e, tob 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 Health.
Signed Date
Application Approved by Date✓ �7
Application Disapproved by Date
for the following reasons
Permit No. l �` 1 Date Issued
i �, .�G„ - +�,�., •... ,�. `ems au�:.` .,
No. V� v
Fee
THE COMMONWEALTH:OF MASSACHUSETTS Entered in computer:
Yes .
PUBLIC HEALTH DIVISION -TOWN OF�BARNSTABLE, MASSACHUSETTS
01ppIicatio'n for Disposal *pi tem Construction Vermit-1,
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon Complete System ❑Individual Components
Location Address or Lot No. 4r /Py �d Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel 3 � �
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
lDoo$I c, s A Tito ysv c
{
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) A In"cl,,, ) So yQ 4` C 5 V S
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 j
Compliance has been issued by this Board of Health.
Signe Date /0
Application Approved by Date
Application Disapproved by * Date
`for the following reasons r
Permit No. ^ l�-� Date Issued 4
THE COMMONWEALTH OF MASSACHUSETTS
low^ BARNSTABLE,MASSACHUSETTS
f �,Q (Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( )
Abandoned(V)*by E-TA 9(0,,zN r,n7C'
at �, r 6 ,�, 2�� ( has been constructed in accordance
with the provisions of Title(5 and the for Disposal System Construction Permit No�G/z/ 1 dated
Installer Designer
#bedrooms Approved design flow //�� gpd
The issuance of this pTM/
it shall not be construed as a guarantee that the system will fun{ti0 flesigned.
Date ��/ (/ Inspector CIA
-------------------j--------------------------------------------------------------------------------------------------------------------
No. '
/ ) Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS
Disposal 6pstem Coustructiou permit
Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon(V
System located at r S % / 7 y 6A,,AV C
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 oompjleted within three years of the date of this permit.
)
Date / /�/ "� Approvedb �'
l<l� 2t L'O �3✓/3
SEND E • • • • • DELIVERY
■ Complete items 1,2;and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. X _ ❑Agent
IN Print your name and address on the reverse �! 1`�r'� ❑Addressee
so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery
■ Attach this card to the back of the mailpiece,
or on the front if space permits. %�— S 7' y —/ —/
1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes
— � If YES,enter delivery address below: ❑No �
M =NADINE BASTA, TR.
M �NADIN'E BASTA TRUST
117 EL'MWOOD ROAD 3. �Se/'ryJ'CeType
I WELLESLEY, MA 02181 ®liertlfied Mail ❑Express Mail
❑Registered 2 eturn jR q ndise
❑Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes `
2. Article Number
(transfer from service►abeq 11 ;7 012 1010 ;0 0 0 0;,12 8 j4 8 1223
PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540
UNITED STATES POSTAL.SERVICE First-Class Mail
Postage&Fees Paid
I LISPS
Permit No:G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
I
I
Sewer Connect
Public Health Division
a Town of Barnstable
I 200 Main Street.
I Hyannis,MA 02601.
E
IIj #lli 1! 11111.11'DI!'3li,lid,ii11liji1i,l1i,o,I'11111 1111dl
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co Postage $
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Certified Fee N� SS
mark
C3 R Receipt Fee He o
C3 (Endorsemsem ent Required)
C3 6>
Restricted DeliveryFee
(Endorsement Reuired) O
C3
rq
O Total Postage&Fees 1 $
ru NADINE BASTA, TR.
o NADINE BASTA TRUST
O r` 117 ELMWOOD ROAD
WELLESLEY, MA 02181
Certified Mail Provides:
o A mailing receipt
n A unique identifier for your mailpiece
a A record of delivery kept by the Postal Service for two years
Important Reminders:
o Certified Mail may ONLY be combined with First-Class Maile or Priority Mail®.
o Certified Mail is not available for any class of international mail.
a NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables,please consider Insured or Registered Mail.
o For an additional fee,a Return Receipt may be requested to provide proof of
delivery.To obtain Return Receipt service,please complete and attach a Return
Receipt(PS Form 3811)to the article and add applicable postage to cover the
fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for
a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is
required.
o For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent.Advise the clerk or mark the mailpiece with the
endorsement"Restricted Delivery.
n If a postmark on the Certified Mail receipt is desired,please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed,detach and affix label with postage and mail.
IMPORTANT:Save this receipt and present it when.making an inquiry.
PS Form 3800,August 2006(Reverse)PSN 7530-02-000.9047
IME Town of Barnstable Barnstable
AM
Regulatory Services Department 'caC j
. BAxrtsrABM
- -
$ 1639. .� -Public-Healt - rvision----------__---
200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
CERTIFIED MAIL#7012-1010-0000-2848 -1223
March 28, 2013
NADINE BASTA, TR.
NADINE BASTA TRUST
117 ELMWOOD ROAD IMPORTANT NOTICE
WELLESLEY, MA 02181 Map & Parcel: 306- 009
The Department of Public Works informed us that public sewer lines are now
available in your neighborhood. According to our records, your property has a septic
system. This letter directs you to connect your dwelling, at 61 Studley Road,Hyannis,
MA, to public sewer on or before 3/30/2015.
The old septic system must be either removed or filled in due to future safety
concerns. This may be done by the same contractor who connects you to the sewer.
Septic Abandonment Permits ($ 25) are issued at the Public Health Division, 200 Main
Street, Hyannis.
Failure to comply with this Board of Health Order may result in a complaint
against you, in a court of law.
For additional information pertaining to the sewer connection,please see the
reverse side of this page.
PER ORDER OF T BOARD OF HEALTH
--- - —
.1VIcKean�R:S:;C:H:O-__— ..------------- :..._.__ -------- - - - .._
Agent of the Board of Health
Cc: Barbara Childs,WPC/Roger Parsons,-Town Engineering, DPW
Enc.
QASEWER connectEetters Stewart Creek Sewer Connects\MAU-ING L.etA Sewer 2Pgs Merged 3-28-13 Y0015.doc
---Public-Health-Division _-_- _March_28,_201.3—
ADDITIONAL INFORMATION AND REMINDERS FROM OTHER DIVISIONS:
SAVINGS AVAILABLE/GRINDER PUMP:
A reminder to those of you who need a grinder pump for your connection:
Department of Public Works (DPW) sent you a letter in December 2012 stating the town,
for a limited time of two years, only from the receipt of the DPW letter, would provide
you with the pump at no charge. (This can save you thousands of dollars.) Please note:
You must pay the installation cost through your own contractor. Please make your
contractor aware of this, if interested. Also be aware: this is a shorter deadline than
the Public Health Division's deadline on the reverse side of this page.
SAVINGS AVAILABLE/PERMIT FEE:
The Town offers a waiver of the residential sewer connection fee of $420.00 for those
properties that connect within two years of the receipt of the DPW December 2012 letter.
LOANS:
For loan(s) available, please see the enclosed brochure, or see the town website:
http://www.town.barnstable.ma.us/cdbg (under the "CDBG Programs", see"Sewer
Connection Loan Program). For loan specific questions, you may contact Kathleen
Girouard, Growth Management,-at 508-862-4702.
CONTRACTORS:
Information on Licensed Sewer Installers is available on our web site at
www.town.bamstable.ma.us/PubIicWorksTech/sewerinstallers. Contractors, approved to
perform sewer connection work in the Town of Barnstable must obtain and file a Sewer
Connection Permit with DPW-Water Pollution Control Division, 617 Bearse's Way,
Hyannis—contractors, please call Dave Anderson at(508) 790-6244.
___..__._______.—_FOR_AN_Y_Q-UESTIONS._/_.ASSISTANCE: -
Len Gobeil at the Town Manager's Office is available to provide you with direction you
may need in reference to the Stewart Creek Sewer Connections. You may contact him at
508-862-4701.
QASEwER connectEetters Stewart Creek Sewer Connects\MAIL.ING L.etA Sewer 2Pgs Merged 3-28-13 Y0015.doc
LOFCATION ( SEWAGE PERMIT NO..
VILLAGE
INSTA LLER'S AAME & ADDRESS II
B UItDE R 'OR OWNER
DATE PERMIT ISSUED
DAT E COMPLIANCE ISSUED
"�
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W��
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1
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THE COMMONWEALTH OF MASSACHUSETTS
BOARD F•'-H - ALTH
........*17_ouu.............OF.......... ...... .. . A4--"--........_.......................
Appliration for Disposal Works Tontrnrtion ramit �.
- Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal '
System at:
..... i ..... ..........� ---------Qfa-.........-•--------, -•......•......................................... a
••• cation :ess Lot No.
•
� �. _.... 5' � ..---- 1�7 ._p..a�. ................
... - -
owner f l ddre' s
a ................ -------•--•-------------------------------------- ---------- �----------✓t.-..__-pe_._._....-------•--•--•-••-•-•-•-•-----•--•--....
Installer Address
d Type of Building Size Lot_............... t
V Dwelling—No. of Bedrooms__.__ ................................Expansion Attic ( ) Garbage Grinde
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 0gallons Length................ Width................. Diameter................ Depth.................
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No_____________________ Diameter.................... Depth belo inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank /t.. C{—S `-7
F" Percolation Test Results Performed by.....�-'.U...................................................... Date.__.
Test Pit No. 1....Z......minutes per inch Depth of Test Pit_................. Depth to ground water_. p.......'
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water____'_.___.____.._.____.
�+ a ..........
O Descriptio of Soil _.Q�.�?.- S .�....' - to °` 1
j I
U Nature of Repairs or Alterations—Answer when applicable...............................................................................................
----------------------------•---•--...--•--•--...-•---------------------------------.........................••-••••--------•----•-•--•-------•----........---------•--------•-------•••--•--•..........
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TI'i U 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been • sue by the boar of health.
S• ned. .; ... -•-------••----•--- ----•••........................
Date
Application Approved By...... .____ . ..._lam___ _ __l� __. ,1_ '_7.7_______________________________ .E_............
Date
Application Disapproved for the following reasons____________________________________________
... ...............................................................
..................................................L...........................................................................-._•---------..............................................I...............
r
-:•-Date
.
Permit No......................................................... Issued_..... 6�. ......7J-- -------•---
Date
° �• THE COMMONWEALTH OF,3MASSACHUSETTS
%. BOARD# F•--H ALTH
�. +� .................
Ap,plikatinn for BiipnFal ,arks Towitrurtion ;permit
Application-is,,hereb made for a Permit to Construct'( or�Re air an Individual Sewage Disposal
PP Y t ( ).. P O g1�,... .,
System at: ,«
r.
T ocatio - dress ell " or I of b
i t.... -• ; ... red'. S .� + .. 1.P� -' ------------- -
Owner ¢ ddr s f '4
* Y i ,t
a 'C-�--- !c:...............
.'E._L^.....----.....-----...._.......---._........ ..... _.... et':'� .__ #. ...,..7... ..-_•----•--••-------..........................•.--•-
Installer Address
TYPe of Building Size Lot............................Sq. feet
U Dwelling No. of Bedrooms-_::.- ............ .... .Expansion,,!Attic ( )• Garbage Grinder ( )
Other—T" e of Buildin _.._.p 1 . yp g No. of persons_ _.____..__.. Showers ( ) — Cafeteria ( )
` Other fixtures - ............................------...._•-•-•- •-•-- `.. =-•-----------------------------------------
F-,I
Pa gal
per person per day. Total daily flow........................
W
Design Flow.............•-•---•-•-•_---•- .......g P. P, P Y Y gallons.
WSeptic Tank—Liquid capacitypo-.0 ns Length ............... Width................•Diameter.................Depth................
x Disposal Trench—No. .........._ _....�?Vidth.... ............. Total Length............__...... Total leaching area....................sq. ft.
Seepage Pit No....__.__:-._-____. Diameter.................... Depth below inlet......._ ._._. g q.
` ___. Total'leachin area _________s ft.
Z Otl r Distribution box ( ) Dosing tank ( ) off✓• '�� e { 3 7.Ce.
'—' Percolation.Test Results Performed by- C 141�.................. 1 Date_..` ".S% 70 _
Test Pit No 1'__:+':..._._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________________________
_ L,�
O Description of Soil-••----_Q'�_ ? �. ' " r-p r d` l..........................................
x .-'....___..._._•_. "- tJ•-bi-6��_-"�v�i':_t('T'!_=�,•.__ tk-_.b'"...................
.�:.......................... ........ __.__. ................. ......._............____........_..__.--____....______..._......._......__._......_......_.....
U Nature of Repairs or Alterations 4 Answer when applicable.______---__-•_______________________•-_--.---__--__-__-___-_____:_____ -.___•s -•---•-•.
----•--••--•••---•-------•--•-..._...-•••-•••--••....................
Agreement: ' +. ... � Y
The undersigned agrees to-'install the aforedescribed Individual Sewage Disposal-System in accordance with
the provisions of iITL% 5 of the.State Sanitary Code-The undersigned further agrees not to place the system in
ioperation until a Certificate'of Compliance has been issued b the board of health.
Date
`Application Approved BY =- j°� J d ................................ _.. ar .• r, • � Date
Application Disapproved for the following reasons............_____________________________________________�__:_
....................•••----........... .. •-••------••••••• ---------
��-•...........................
X Date
Permit No..........: .................... :: Issued..................' �e Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH`
t 1... OF.......... r�.eEd� !c ... ..........
T tifirate of f ILImpliFanrr,
5.. THIS IS 0`,CE UFY, That he IndividualtSewage Disposal System constructed ( orlRepaired't )
by = ', ` > ----------------------
,,�nslaller
has been installed in accordance rtli the provisions of 5 f� State Sanitaryde �d ed in the
a lication for. Disposal Works Construction Perrnit'No:_'_.. 9 � ..., $'1` dated............. ..... j
PP P
J ;
THE'ISSU;ANCE OF THIS CERTIFICATE SHAkI.'NOT BED .-I RUE® AS A GUARANTEE THAT THE
SYSTEM
1AlILL��FUN °I SATIS FACTORY.
O
6,
DATE !�_. Ins ector
........................................
k_ eo g
t.`. THE COMMONWEALTH OF,.M•ASSACHUSETTS
BOARD F HEALTH
-
No._........ t FEE.....`................
lion Permit
•. 1
to Conrmission i ereb granted •••--...--•••-••-----••
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atNo..• •• ...................................... ..' ._•..-....:.................................------------ -------- .......
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1� •Street �,;u'
r Disposal VVo>ks•ConstrucCii "_ mit "'o�- > ---._ ye
h"
as shown on theJapplication fo r, ^!'• � � � � t I
..- ......................... --•--......r Board of
a DATE.'
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