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Home My WebLink About0060 SUMMERSIDE LANE - Health xfr..i✓s�yy,a•`'+Y�' -+.x r '} aaye �t. s 2+ avi•.�5 1 Ail' ( y '•ry qn• •1�t !1`> NJl [s !0 n" x� lt•�!' 1 ,�., i P � x jr i� fir ��i�°ya,'� . �,W Sumnierslc�egr Gi1et i = ' rP4C i. < r� 3, zM q Hyannis i5 +�w. "4�r�v5'i^:akf:1S'; �.�t;4°�'1 v}XS'fii's�i., ' � '��i'r��+4��j��`�},J" f,�!•f rrf�'' a 0 a a -� ASSESSORS MAP N0: ,,_ PARCEL NO: 072, No...../�.'� Fizs..... .C�1...:.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Dhip aal Works Tunitrurtion thrutit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal �(( ( ^ System at: / vim," "S l Looition-A ress or Lot No.is. T f � -z ' .........---•-•-•...---....•--.....----••...............•-••.........•.. er Address nn y M Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.............................. .. .Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons............................ Showers — Cafeteria P4 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. 3 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......................... Test Pit No. 2................minutes per inch Depth of Test Pit...:................ Depth to ground water........................ •---•---•-------------------------------------------------------•---.................._..._-----•---......................................................... ODescription of Soil........................................................................................................................................................................ W U ----••-------------------------•------....-••-•...--•------•---•-•..............••-------•--.._....-•-•-....••------••--•••---•----------------•---...•••••-----------•.........---•--------•-••------•- UW ............................... ----•------•----------•••-•--•------•-----------••---•......--••--••------------ - �7- ............................... Nature of Repairs or Alteratio —Answer when applicable......f�................. ....C�� R.�/�'lS........................... .Xt 7- 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 be o Signe . �........�lss!u!e5��t .................. ...................... .......Dace................. ApplicationApproved By ...................................................................................................................................................... .....................e.................. Application Disapproved for the following reasons: ........................................................................................................................................ ................................................................................................................................................................................................................ .................................... Dace PermitNo. .................................................................... Issued .................................................................... Dace No.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF 'HEALTH TOWN OF BARNSTABLE Applira#ion for Dispwial Works Tonstrurtilan ramit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: _ ...........—..........................�---..._�..,................................./T ... -... ....•-••--.....--•---......---•_....----------------•----------------........------••. ' Loc tion-Ad ress or Lot No. O er Address �✓ r✓ / Installer Address Pq d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons............................ Showers — Cafeteria d 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......................... fi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ..................-------------• ----------------------------••-------••------------------- .._. 0 Description of Soil.................................................................:�--•--•----------------------------------------•-------------------------------------••-•--•-•----- x W Nature . ------------- 1 - U Repairs or Alteration ;Answer when applicable______.� ...._...... �J..._.��A_`! %S rT E Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disp�sal 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 issue -by t�&lo d o ealt . -�— Z/ Date ApplicationApproved BY ...................................................................................................................................................... .............•.....-................... Date Application Disapproved for the following reasons: ............................................................................................................i.......................... ................................................................................................................................................................................................................ ........................................ Date PermitNo. .................................................................... Issued ........................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C11er#ifirate of C�ontialianve THIS IS TO CERTIFY, That the I dividual Sewage Disposal System constructed ( ) or Repaired,( bY ......................................�GZ e 1--,e ST at ........... ............ ..................................................................c............ ---Installer............................... ................................................................................... has been installed in accordance with the provisions of TITLE 5 Qf The Sate Environmental Code as described in the application for Disposal Works Construction Permit No. ......../....�...............5..... dated ................................................ . THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY.DATE................ � ..--------.................---.....--- Inspector ----.......4:�..........................------...........----......----------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 2 l -� TOWN OF BARNSTABLE FEE�.....�. ...... ................ i��r�a ttl nrk T.>ano#rndion Vrrutit Permission is hereby granted........... .� 0v to Construct ( ) or Re air ( n Individual Sewage Disposal System, at No.. v. 2S /�/' Z_ .v F� /.9_."V •S ...--•-•-• -••...........-••............••••--••••----•••---•-.---•-•....-------•--•••••-••••----•-••-•-••••-•••••••••-••••••-••-••••......-•--•.............. Street � -/s-/I as shown on the application for Disposal Works Construction Permit No..............�. Dated.......................................... DATE. 7..............................................•----........ Board of Health FORM 3650a HOBBS&WARREN.INC..PUBLISHERS e Z TOWN OF BARNSTABLE LOCATION IS cSuaM�jeyz S 1 b-e SEWAGE # 7k7_ -? VILLAGE ASSESSOR'S MAP & LOT —S INSTALLER'S NAME S& PHONE NO.---�L SEPTIC TANK CAPACITY p- j rg �,ltry`, LEACHING FACILITY:(type) yr-r- CAST `AT (size) w NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No � O o O O rt n 'O T L jZkAQA cw_X'11- 'Y THE COMMONWEALTH OF MASSACHUSETTS BOARD - OF HEALTH '��.. .. .. -.....OF.........!�.. .!!.`` 5.�lv-�j ..............................•..... 6 Appliratinn for Disposal Morks Tons rnr#inn Vvermi# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 2 S P�'J 2. "� ...... ------•...j -��-! wt�r�............................................... ................__ .................--.-...1 -•---• - .......----... Location-Address or Lot No. ............... .......... .AA....�....WS .................................. .......................`..... ........................................................ Address Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms....................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building No. of persons............................ Showers Pa YP g --._...-•----•-------------• P ( ) — Cafeteria ( ) Other fixtur W Design Flow..............5._.__________..............gallons per person jg day. Total daily flow...-P--�.47........................gallons. WSeptic Tank—Liquid capacit�.�-gallons Length................ Width.....y....... Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area...................sq. ft. 3 Seepage Pit No......../.......... Diameter....J(D—....... Depth below inlet......�Y......... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a' Percolation Test Results Performed by.......................................................................... Date........................................ 1.4 a 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........................ a ------------------------------------------------------------ ----------------------------------- ODescription of Soil......................................................................................................................... W W •••••••--•••-----•-------••----------•--•------••-•-•-•---•-•••-•--•••••-•-•--------••---••••--•---•---•--•-•-•-------•-.....--•---••-•--•---•••--•-....-••-•-•-••---•-•••......-•-•-•--••-•••....... U Nature of Repairs or Alterations—Answer when applicable..- ' ` -N_-�.............1_6� SP•PT ic--:�'�� _.. .............. �_sa_....`-j---- �' ` Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLL 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 and of health. ^� glied ..- Dat ApplicationApproved B -•••-•••...---•-•. ••---•••_. ...................................................................••... . ��. . Date Application Disapproved for the following reasons:--------•-------------------------------------------------•-•-------------.......----....................... . ......................................•-•---••-•.........._.�.��..................••-••-•----•.......•-•-•••••-•-••........•-••--•••••••-••----•-•-�-•----/--......Date•;*--...-•---- Permit No.. !C....--•-•••..._.... .... Issued_........ U j .................... Date No c=.l �. --7---��- ICJ? b7`� Fss �..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ' ....-7-`0...W... -.....OF...� s.` - '" ------------------•--•--.......... Appliration for Disposal Works Tonstrurtion rrrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................__ ..... ....... ----.....-•---........._..... s Location-Address or Lot No. .......... ......._ rz.!�.V11 vWt pVL =-•---•-•-•-----••...... ........•---.....---............. 1!` .................... ........................... ........................................ / . Address _....--•-•----•.. ............................. u ..! Sh..'� ....._.. ._.......... Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.....5.2...............................Expansion Attic ( ) Garbage Grinder ( ) a'4 Other—T e of Building No. of persons............................ Showers YP g -•-------------------------- P ( ) — Cafeteria ( ) 04 Other fixture --------------------------------------------•-•-------.----•-••------•---•-••....••------•--•-----•-------•-•-----•-........---•••--•-•--••--•--...... W Design Flow.............. .................gallons per person !er day. Total daily flow---s�r-�.U........................gallons. WSeptic Tank—Liquid'capacity'_ .gallons Length................ Width.....q....... Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 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. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ rZ, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a - -------------•----------------------------------------------------------------------------•.......--•..... _...... ••-._.....•---------------------------...... 0 Description of Soil------•-•-----------------------------•---••--------•--..........••------•-----•---------------------...------------...-•--------------------••-•----•-•-•-....•--••---- W V ......----•••---•---------•...............•------•--..._.-•-••......--•--••.........-•------------•-•----.....•••-•------•-•--•-•.....•••-----•••-••-•----••-•---••-------•---._....._........_......•--- W ----------------------------------•-----------------------------------------------------•-------------......-•---••---•-........... _.------------------••-... U Nature of Repairs or Alterations—Answer when applicable..- H-S? .�_....._.....1.. ..5 Y c T 1,�_4. .7...-.....��.. ------------- G.._ f....�<-1 = .51- .................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITL is 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 oard of health. Signed-------- _.. = - ��- /,�a Date Application Approved BY /% '�/--•- ��-_?.�: ........... ..............................• Date Application Disapproved for the following reasons:.............................................................................................................. .....................................�.......----------------•-....---•-----------............------....--.-----------------------------------------•-I---------------------------•-----------.........._.. Permit No.. r? -•--� �-.- •-•------------- Issued........_L�' � Date .. —.-•----...---Da ........ ___ ...... ---------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH( - ........... .....�'�'...O F'.........1.5 Tntif rate of Tuntphanrr THIS�LS'_TO CERTLE-Y- That the Individual Sewage Disposal System constructed ( ) or Repaired }L ........a_.._. .... .bye:.............. ....... ... . Installer �( at......................... ......... •`�-W�_vin�e(�'._.9 T_p`E ........... .------------------d=Alt----•---.........................--•----••-•----........ has been installed in accordance with the provisions of TITS ` of The State Sanitary Code-as described in the application for Disposal Works Construction Permit No..- ..... dated.......�-Z�. ._�.�I.f`-��........... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUA ANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. �- DATE..................1....... .: = . ......_............ Inspector K 1--------_..----- •-_._•__-------------_• ....... —;------------------------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7 -....OF...�.C .r!•v� 5 ..Ir,.....�... `...................... _— No......................... FEE..... ..... his u tt1 urk-g-Tuns#rnr#ion Wrmii Permission is hereby granted........ --•-==-•--•- v �s�-----••--•-•--•••----•-••......................•-•-•.................._•••••- to Construct ( ) or Repair (e•)-aT Individual Sewage Disposal System atNo................`� .. ........ -------------------�6� ..................................................... Street U as shown on the application for Disposal Works Construction Permit No ......... . Dated.................:.. .... Board of Health ...................DATE-----� �