The URL can be used to link to this page

Home My WebLink About0035 SUMMERSIDE LANE - Health ppp- 35 Surnrners�cie�L F-A' Hyannis�� i o TOWN OF BARNSTABLE v ` LOCATION5u^^r4S'i ti Z' Zl',?s ;P- / SEWAGE # l,oC' � OY VILLAGE ASSESSOR'S MAP & LOT30q"'07/ INSTALLER'S NAME PHONE NO./0A bf e;~ �C SEPTIC TANK CAPACITY �' x rsCf,MAI C J V It h tV I LEACHING FACILITY:(type) �Al� s. �� (16 size)/d NO.OF BEDROOMS PRIVATE WELL OR PUBLIC WATER�a,G/c �J BUILDER OR OWNER'�D�i,S ,e•.�;- 1/,SS/T DATE PERMIT ISSUED: % c„ DATE COMPLIANCE ISSUED: VARIANCE GRANTED:. Yes No ✓. t � J Kv C F1. i s� . -. N A. -... o , �t ,off I37 : o3o 09 A 0 Fim.3 . ... .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH APPROVED TOWN OF BARNSTABLE eern:uwCopMwaldaaDIp t /o -2L�L" 5� Appliration for Uispnstt1 Works ToUll a�. Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal STst9w at .......... -�'..-.............t. ................... .............__ .....---------------•-------.........------.........................------•- n L_ovation- ddress i Lot No. .............. .................._.a........_ ............................... _ A_•___.._._..._.__._................... ............................................ 2G/J Owner Address Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms...................................... .Expansion Attic ( ) Garbage Grinder ( ) �+ Other—T e of Building ............... No. of persons....•....................... 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 ( ) aPercolation Test Results Performed by••--••---••••••••••••-•••••.............••-••-............-••-•-......••• Date........................................ Test Pit No. I----------------minutes per inch Depth of Test Pit.................... Depth to ground water......................... f1--q Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ RS -----------------------------------------------------------------------------------------------------------•---•--------••••••••........--••••......•. ODescription of Soil........................................................................................................................................................................ x W -------------------------------------------------------------------------------------------------•---------•---------------------------------------------------------- --------------------- U Nature of repairs or erations—Answer when applicable�:r�.. ....06-.... ...s?.L� .�'s...... Z' -------------•..... c�r� --•----•-----------•...............................................................•----------------...............•••-••...._............ 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 Cer ificate of Compliance has been iss ed y tWlb a of Ith. to / Signe ...��/...... - f�1... .:� Dare Application Approved By ........... . .. .. .. . ......-...... .. ........ ................. -- ---- ................................ -- ................Dace --.............. Application Disapproved for the following reasons: ...................................................................................................................................... ............................................... .. .. ,�.r........ .. .. ................................................................. .�.. .. Dace------------------- Permit .......... No. ......--�f ............. Issued ................... --Da-e ..... Fxz 3b No. -- -- .... "7 / ............_............ _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appfiration for Disposal Varks Tn nstr7an rrmit Application is hereby made for a Permit to Construct ( ) or Repair dividual Sewage Disposal* Systel� at: �ci�r t 2 ri � �✓ p Location-Address / o Lot No. t/o�� Gv�.�s "' S_T ....................L.... �..7................__...........----•----•--.-..-...-.--...--.-.... ..._R....__........-.._.......................................................................... / , O G G Owner —..Address Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................ .....Expansion Attic ( ) Garbage Grinder ( ) a Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures ......................... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid'capacity..._.._.....gallons Length................ Width................ Diameter................ Depth................ 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. 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........................ x ----------------------------------------------------------------------------•-•-•-----....................................................................... 0 Description of Soil........................................................................................................................................................................ V -----••-•----••••---•-••-•-•••••••-•--•-------•••----•--•-----•---------•---•----•-•-•--•--------------•--•--•-•••••-•----•••-•---•=•-•---•-----•----•-•-••-•---•-•-•-----•--•-------•-•-•-------...... UW -----•••-------------••--------•---•--•-•--•------•-----:---.......---•-••----•-----------•-•-•••----'-•--•--...... ----------------••--------------......... ---:--.-..... Natui�.of Repairs or Alterations—Answer when applicable ._._....._sr;-J��.4.1�?.�1!s......7�.................. Agreement: ` The undersigned agreesto 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 Ce ' icate of Compliance has been iss ed y t e oa of h lth. _ Signe - .. .............................. .1� '�/... ..... ce Application Approved By ------------------------------ ----------------- -L------------...----------...---...----...-------- :.................................. ........................................ Application Disapproved for the following reasons: ........................................................................................................................................ ..................... . .... .. . ..... ... .... _ .----...---...-----------...----------........------------------------------ Permit No. .......... Issued ....../..... ...---.... .. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (ger#ifiratE of Tontyliance THIS IS TO CERTdFYY, That Individual Sewage Disposal System constructed ( ) or Repaired ( ) by ---- --------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------- - Installer at ....�.�!!..r.'. ...2... ....... ........................... .."' 7'................................................................................ has been installed in accordance with the provisions of TITLE 5 ob} he S roIn en al Code as described in the application for Disposal Works Construction Permit NO. ... ... T4. �� . . .. ..... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE AS A GUARANTEE THAT-THE SYSTEM WILL FUNCTION SATISFAC'TO Y. DATE............ .......... ...................1... . ... .` ............................. Inspector .................................... ......................... THE COMMONWEALTH OF MASSACHUSETTS .err r, BOARD OF HEALTH TOWN OF BARNSTABLE No.....,,......... ... FEE........................ Oftipoott1 Works Tonotnution rrrmit Permission is hereby granted.............. 1 .--.-•-....--••-•--•--------••--------•----•-•---•----•-••----.................................._.. to Construct ( ) or Repair (A,,<an Individual Sewage Disposal System at No...._......7 �^� a �„�ft-- .s l/ ................................... �s f/u as shown on the application for Disposal Works Construction I mk et L}�a a ..� •.l.,�l%/ -- Board of Health FORM 36508 HOBBS&WARREN.INC..PUBLISHERS f TOWN OF BARNSTABLE 5 • N�c,s c ' "S- �' Q LOCATION, 5 , t SEWAGE # VILLAGE ASSESSOR'S MAP & LOT B 2 INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY �sCy LEACHING FACILITY:(type) /K/ ( sl , (sue) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC- WATER r BUILDER OR OWNER DATE PERMIT ISSUED: �l`l-� `7 DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes J _, �_-._ ___.__ L _ C � _ _ � a '�1. ,� :. .�.. ,,.., � .., 1 � � � \ `�. I ,e ` '� � ti s . __ ,,