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HomeMy WebLinkAbout0004 TOBY CIRCLE - Health 4 Toby'Circle Hyannis A= 325 - 160 �) EWER 0 LOCATION z. " 5EWo,GxE...PERMIT UO. o WS A LE &5 ►J&NAE ADDRESS BUILDER 5 tJ &"E ADDRE. Dts,-TE PERMIT 15SUED D h.TE CONIPLI A aCE +-i � r v 'r.d� ^ .i .i. No. l l!/ `� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for Misposaf 6pstrin Construction Vermit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon(L4__<Complete System ❑Individual Components Location Address or Lot No. j� `� C' R �a` Ow er's Name,Address, Tel.No. Assessor's Map/Parcel GL. ,5 Lt lt"at)u Installer's Name,Address,and Tel.No. Designer's Name,Address,and WI.No. W'►►3, 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) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance a afor described on-site sewage disposal system in accordance with the provisions of Title 5 of Env' o and not to place a system in operation until a Certificate of Compliance has been issued by this Board o ealth Si Date 3 DC!p �2 Application Approved Date Application Disapproved by Date for the following reasons Permit No. ��� �` �� �J Date Issued 6 . ,...,�,..:�,�. .. .. -...:.. -d - .. ... --........._.�-.--awl.;,--�...........,.��..:W.•�:.,..�..,b............+�w._.,.:u,,....,,r,�..,.,.,�.-.-.-,.-'�...:<--- _ .�-,� .�.R.....•- � _.-+� ----Yz. .. No. V 1 "_C J V 9. ..r sn�. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:. PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 0[pplication for Misposal *pstem Construction Vermit Application for a Permit to Construct( ) %Repair( ) Upgrade( ) Abandon( Complete`,System ❑Individual Components Location Address or Lot No. C 1 R ����' Ow er's Name,Address, d Tel.No.� , Assessor's Map/Parcel / a_v� ,5 V. Installer's Name,Address,and Tel.No. Designer's Name,Address,and Yll.No. Type of uilding: ' Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type ofBuildiiig No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date k Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer,when applicable) Date last inspected: Agreement:' The undersigned agrees.to ensure the construction and maintenance he afore described on-site sewage disposal system in accordance with the provisions of Title 5 of t ee,Env M enkal-Co•e and not to pl Ice t•'e system in operation until a Certificate of ' Co tri liance has been issued by this Board of l ealth. Sighed N Date 3 �� Application Approved by \ Date Application Disapproved by Date for the following reasons i Permit No. 70 6 _ Date Issued t; THE COMMONWEALTH OF MASSACHUSETTS _ rrl c�nVyRq Y BARNSTABLE,MASSACHUSETTS - _ Certificate of Compliance _ - THIS IS TO-CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( at 1 To b lq �A:l Q has been constructed in accordance with the provisions of Title and the for Disposal System Construction Permit No._I�o I D G 69dated' Installer Des�igner ii #bedrooms 1 i� Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system wi!11:funcct1ti�Jas desi jned. Date �;I �X't 7- Inspector f No. Fee /��----y�-�------_-----=--=----=----=-------=------==-------------=------=--------_---- Fee=-=��------- THE COMMONWEALTH OF MASSACHUSETTS (` PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction 3permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon System located at !'� c- b, C 1r rl � 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 completed within three years of the date of this;p it. -- Date `cam` Approved by No. ---- Fas.. fd:............... THE COMMONWEALTH OF MASSACHUSETTS ---•_ _ BOARD OF HE�A Z5 _.. - ..........OF...........�.....l.... . --- -' Appliration -for Bitipuiittl Workii Totwtrurtion Application is hereby made for a Permit to Construct ( ) or Repair (/)an Individual Sewage Disposal l� System at, , � Loc ion- ress r0 SN 5 �iQ �or Lo o. Owner Address Installe Address Q Type of Buildings Size Lot----------------------------Sq. feet Dwelling t—�No. of Bedroo ______________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons..______-_______---_._------ Showers ( ) — Cafeteria ( ) Q' Othe fixture d ------ ------------------------ -------------®--.--------------------------------f W Design Flow.,.rJ�.v.G!¢�/��4. ,� gallons per person per day. Total daily flow...... ________________________.-.gallons. WSeptic Tank Liquid c pacitv/.__ .______gallons Length................ Width--------- ...... Diameter_-_-- ------ Depth___.-----.-._ x Disposal Trench—No. .................... Width._....__.... ._.... Total Length-------------------- Total leaching area------------.-.-----Sq. fI. Seepage Pit No-----a-------------- Diameterji?—V __ eptfbelow inlet.................... Total leaching area ---- . -_ IT. Z Other Distribution box ( ) Dosing tank ( ) �� �/,7 ��/ �'a a Test Results Performed bY________________________________________________________ Date....._..:.____--------------- Percolation a Test Pit No. 1----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water-..-_--.-----.------_-- (i Test Pit No. 2................minutes per inch Depth of Test Pit______ _& th toT un water_-.---_--_-_- IV— - ----- - v -^ay..---o;------ ----- ----c- ��9, ,�..J9--,•�. -- ----- ! v�c.---Descriptionoo _.. �---------------- --------------'----------- -- --�-- - W r � --------------- 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 Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ' sued by the board of health. Si ----- ------------ ..., --- ----------------- ..Vi D ez c= j 7� Application Approved B ate Application Disapproved for the'-following r ons: .................•-•-------------------••-----•------------------ .-------••----------------------------------------------------•:•------------------------•--•--------•-•-•----•---------------------------------- •---------- ----------------------------------------- / . � Da Permit No.................................... Issued...... 1-. _.. -a Date No. ._. j .Q ............... THE COMMONWEALTH OF MASSACHUSETTS ' G _ BOARD, O F 'L-B E.A .--------.O F._........ ....... Avp iruflon -for UfsVoiitt1 Marks Tonstrgrti n - rrmit 4 Application is hereby made for a Permit to Construct ( ) or.Repair ( ) an Individual Sewage Dispos.1l System at µ , ... ffc} 4i::6---- -------- �" `�d , �dr_-g ... �+�' �+ p _ = _��� ���`"L.ocation-.A d ss �Q /►/OB.f/S C/e �K•�/�.or Lot ' _ .y/ -•�/'d ner Address W (l✓C l /LC(tn i c.. t -----------------------------------------•----- --•------------------------------•------•----------------------•-•--•--••-------•-•-----------•--- InstallV t Address d Type of Building V. Size Lot............................Sq. feet Dwrelling-pKo. of Bedrooms.... ,(�A____________________tEYpansion Attic ( ) Garbage Grinder ( ) per, Other—Type of Building a------------------- No. of persons____________________________ Showers ( ) — Cafeteria ( ) P-4 Other fixtures _____ ........ W Design Flow.... .. ��t �pgtllons per person per day. Total daily flow------.-_ .................___gallons. Pd Septic Tank iquid c acrtyl_ _ allons Length--------_------ Width..___.......... Diameter___- :---_____- Depth--------------- W x Disposal Trench—No- ____________________ Width..-•_______-___ -. Total Length-------------------- Total leaching area--------------.-----sq. ft. Seepage Pit No...... i ......... Diameter"- ,y . elow inlet_______ _________ Total leachin-area_.--__--_________ z Other.Distribution box ( ) Dosing ank ( ), � ,�� ., ��r '' W Percolation Test Results Performed by.................................................................._...... Date---------------------------- Test Pit No. 1................minutes per inch Depth of "Pest Pit.................... Depth to ground water-.___--_____:__.___- G4 Test Pit No. 2..........."_..minutes per inch Depth of Test Pit......._-AL► DADth to�rLoitn ater.............. D Description of W SoilSo_�tla -••1 (It;.� .���d ,: �'s� �e �--.--.-_ -,-r-�-------.z--;-�-- "` , '' ---------------- -------- . U ,Nature of Repairs or Alterations—Answer when applicable.._--------------------- ------ ___f______________ _____________....................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the.State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been sued by the b and of, ealth. Sie - .. ..r ....................... . ........A.- Date Application Approved B --------------------------- „ . .lea e Application Disapproved for the following a sons-------------- -••••-••••-•--•-••••-••-. ...................................................................... --=-------------------------•--•------------------ ------------------------------------------ -----...-- ........y, Date Permit No......................................................... Issued.................................. ............... Date k {> THE COMMONWEALTH OF MASSACHUSETTS r. BOARD OF HEALTH E** ..t0tf4i OF......i4aoow �. drrrtifirate of �uut�liaurr THIS IS_T'0 CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by F :r! -' ................................................. ..................................................., /C Installer • - �:^at has been installed in accordance-with the provisions of :Article XI of The State Sanitary C de- tas des abed in the - application for Disposal Works Construction Permit No--------- . dated... .. � �.. � Y..... . THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM'WILL FUNCTION SATISFACTORY. 14 - DATE--------�_ -. `' .................. Inspector . '".... "' "L- .. THE COMMONWEALTH OF MASSACHUSETTS - SO ARD HEALT P'J �/ 4 a+; No. 't FEE . � .. D vgfittt a1rk,i T �c r� ion rrmiti u(� .s: t cf Permission is hereby granted - ..... ;2%�ti ..... -------------------------------- ------��/ . ¢ to Constru ( b r Rep i ( ) n I ividual Sewage tsaosal System ��! at No. Lei I� f�yf"�, j//,/Q�' _ per. s Street =� as shown on the application for Dispoo Works.Construction' it N ._ Dated__ .._.- ___-�� DATE. ;.:`_ /� �"d. . �/ �'. 2d /' .. f Hea �.:. :-•.. ........ ........................•... " FORM 1255 HOBBS & WARREN. INC,. PUBLISHERS -- �yr4r j I 1 f i C)F 'iP1NfZ45 B QI�N ST'P) b LE- �L 1• t F�ti.T f�k A VQ C r"o ur'r-1 •� L �• � "'fie,.-�( y, LA . �a su �+� x PV �17 �--- 00 A 3 J{ar - L,. 5 � .. •4. O � ,� � t W/Z, CcoarBf 3U IMF �2'�" Wort' 1.Lv 7. Ile r .�,w- r- / GEN k R H L NOTES i 1.7T��777�.�i�i1�7T / ``,. %� •) Grvde I) E level_\\or,9 Cs'�ar To g3.t"1 w SS V rtic^f`�� C�v��C v`CYl 11 ( See P\O-r P\an� 1 oca�c� AL - + :.1' ..rt„rt,rtr rt�, r l �' VIT. fZC! 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' 0 © V O 41 1 �IRZN St REET .p WEST YRRf5�0UTH , �1gSSt�cNUSETTS 0 � 0 (D 0 ,0 0 .6 0 , - Per of M4 3,� 3k, Syr✓,, SCHEDULE OF ELEV R T10NS ss�ar+�j RE ERED oFESSZON ENGYNEER ---- - -- J ® ® CQ (D Q F ,r,rs�a Gr"e above- j�•uccvre Top Founcl LTI­ _ -� �p'� anvarT Gr v�8tf�bi Tlc ri Tnlc=T = (c7_ o__Tvwa,•r of P,Fe aT Foo ,-.T,ar, e� T YC I( CAS C PI RL R 7 LE R HING PIT 1 ,J�cT 1.T �ieFrr,c Tor,k- .l,ler = \2_�2 E �,r, o{ �oTr rn Lenck„r,9 F51r = 0 -- — DRTE BORE-,0 OF HERL:T-H 9GE.NT O� N O SCf t.-F. -T.n Vo r',' vT Sf PT,r Tor,k emu,-1eT — �\• •✓� L-212