HomeMy WebLinkAbout0158 THIRD AVENUE (HYANNIS) - Health 158 Third Avenue J
Hyannis,
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TOWN OF BARNSTABLE
LOCATION �S� 'T'y�'P� �� SEWAGE #
VILLAGE /�����"�' ASSESSOR'S MAP & LOT-2�g_6__�o>
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size) / x a k X X
NO.OF BEDROOMS
BUILDER OR ONn R
PERMITDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility / Feet
Private Water Supply Well and Leaching Facility (If any wells exist /
on site or within 200 feet of leaching facility) / Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) io Feet--- .
Furnished by
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.No. a6o J�'�®V '' � � -' • Fee 00
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEAL H DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
Application for Miopozar bpgtem Con5tructfon Permit
Application for a Permit to Construct Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. � �/T/��,y��/� Own is Name,Address and Tel.No.
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Type of Building:
Dwelling No.of Bedrooms -s Lot Size sq.ft. Garbage Grinder( )
Other Type of Building or No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 5��� gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets / Revision Date
Title
Size of Septic Tank 50o .9A Z 1--XG Type of S.A.S. ,42
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
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 Certifi-
cate of Compliance has been issued by this Board of Health.
Signed Date
Application Approved by 44- Date ma`s S-d 3
Application Disapproved for the ollowing reasons
Permit No. 'AO03-,U--) Date Issued S=�—y 3
---------------------------------------
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Fee J oU
Entered m computer: ✓
�¢ THE COMMONWEALTH OF MASSACHUSETTS Yes
PUBLIC HEALTH DIVISION-TOWN OF BARNSTABLES MASSACHUSETTS
.7
Z[PPricatior Adr �Mtgogar *proem Congtructton 3derm tt
Application for a Permit to Construe Repair( )Upgrade( )Abandon'( ) O Complete System El Individual Components
Location Address or Lot No. / e3� Tj�/. �j�,�//C�` Owner's Name,Address and Tel.No.
Assessor's Map/Parcel
Installer's Name,Address,and TeL No. Designer's Name,Address and Tel.No.
Type of Building: f
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building lslP` '- No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow -1- � gallons.
Plan Date Number of sheets Revision Date
Title g
Size of Septic Tank /soo 5,AL /y-JO Type of S.A.S. �-1"00 ,(e
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected: It_ (A'
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 Certifi-
cate of Compliance has been issued by this Board of Health. ,
Signed Date �'d3
Application Approved by 1(p 4V- _ Date 'S—S_-03
Application Disapproved for the following reasons
Permit No. 9,0o3-0;-Ot� Date Issued S'S U 3
-----------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
(ferttftcate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed(X)Repaired ( )Upgraded( )
Abandoned( )by J"ino G FBUCy/r
at �S� Tiles/20 .4 has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.R003-.200 dated
Installer /tea G�`dG*1`"y/� Designer AgL!!,54A✓140 �,/7r6 ✓P r.
The issuance of this permit shall not be construed as a guarantee that the syste '_ , ti C n de gned.
Date 7� —i(— b3 Inspector
--n---------------------------------- /---
No. a 003-9Go Fee /VQ THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
1=t9;poga1 *pgtem Congtructton Vermtt
Permission is hereby granted to Construct-5)Repair( )Upgrade( )Abandon( )
System located at �r� ����'� ��� �!'00! .VZA'A'�J"/�`'��r
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided: Construction must be completed within three years of the date of this perm
Date:_ Jam' —d 0 03 Approved by
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TOWN OF BARNSTABLE
/T y%Pm .�d GE # �ca3 :•cao
LOCATION SEWA
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VII ,LAGE ����'�"� ASSESSOR'S MAP &LOT: � ooJ
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type). /�''�6 (size) 9,g-
.2
NO.OF BEDROOMS 3
BUILDER OR ON NI R
PERMTTDATE: S`— COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility / Feet
Private Water Supply Well and Leaching Facility (If any wells exist /
on site or within 200 feet of leaching facility) / Feet
Edge of Wetland and Leaching Facility(If any wetlands exist iy o Feet
within 300 feet of leaching facility)
Furnished by
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183 LONGVIEW DRIVE
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PALTSIO'S E SON CENTERVILLE, MA. 02632 SCALE y APPROVED BY: DRAWNBYf 3y�s
DATE: IC/8 a2 REV�SEO
771-1410
ILDING & REMODL� LING
LICENSE # 006653 DRAWING NUMBER
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DATE: REVISED
771-1410
BUILDING & REMODELINGLICENSE # 006653 DRAWING NUMBER
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Cm E : SON CENTERVILLE, MA. 02632 SCALE: C APPROVED BY 12
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DATE:/o F'u 2 REVISED
771-1410B ILDING & REMODELING
LICENSE # 006653 DRAWING NUMBER
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DATE:1018102 REVISED
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ASSESSORS MAP :
--- -- _ - ----- TEST HOLE LOGS` %_.:_._._ ._.-. ___._.__._ - . _._..._. -_-
` --- -� PARCEL
FLOOD ZONE p Y-� SOIL EVALUATOR : �lii'7 �J, m
• � � \ _._. WITNESS : 1�{�t —'l
REFERENCE l I. DATE: "'� �` � _,:__' 1°t ` �-' ✓ -._. . ��h
PERCOLATION RATE: 2iot! lam.
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SEPTIC SYSTEM DESIGN
1J s% 0. FLOW ESTIMATE
t� BEDROOMS 'AT I �� GAL/DAY/BEDROOM - MGAL/DAY
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W DATE HEALTH AGENT
EAST SANDWICH . MA
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PALTSIOS E . SON 183 LONGVIEW DRIVE r�'
C. CENTERVILLE, MA. 02632 SCALE: n APPROVED BY: DRAWN BP r Q� S/OS
DATE /O �< OQ REVISED
771-1410
BUIL-DING & REMODELING
LICENSE # 006653 f DRAWING NUMBER -
!NEW ENGLAND REPROGRAPHICS b SUPPLY CO. -