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Home My WebLink About0088 VANDERMINT LANE - Health 88 .Vande"i"'Ca't.ke ,rti _ Hyannis;' A= 250- 055' , i TOWN OF BARNSTABLE LOCATION L SEWAGE # Y7. VILLAGE Ck N 0 ASSESSOR'S MAP & LOTjA�jJD INSTALLER'S NAME & PHONE NO ��M lt1A('IdLS . 197 883 SEPTIC TANK CAPACITY (-n a LEACHING FACILITY:(type) on C ) �R. (size) /onz) NO. OF BEDROOMS kIVATE WELL OR PUBLIC WATER BUILDER OR OWNER Ot��C': Cca. ��yyN - DATE PERMIT ISSUED: f DATE .CO24PLIANCE ISSUED: VARIANCE GRANTED: Yes No 4� C� G IM VpLC)ty 00 F , !l Or t� i THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH au...OF.................. . '.. .................................... Appliration for Di-4patmi Workii Tomitrurttun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: -- 65 � ...q.4._. VY e........ 0nfts---------------------------- -----------...------...--------•--------•------. 4c ti ,dress V or I-: No. . - ._ -=------------------- --�`-------- . . ::�..........�...----•---------------- Owr. Address ..............•--. ...._� �... ..••----......�`(�....-S...... - Installer Address - Q Type of Building Size Lot............................Sq., feet U Dwelling—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( ) F � Other—Type of Building ............... No. of persons....._.._._..........._.__.. Showers — Cafeteria Q' Other fixtures ................................. d .----•----------•------------------------------------ - ----- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Gd 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........................................ 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' ° Description of Soil_________ ^' - -- =- - - ----- ----- ---- ------------------ ______:...__. . . -.- x U --------------------------------------------------- •----------------------------------------------------------------------- ---------------- ------------------ - -------------------------------------------------------------•----------------------------------------------- ------ U Nature of Repairs or Alterations—Answer when ap icable.___--_--.. _! _ ......................................... ---------------------- --------•----.........11 'A ---1;� .......... .0 n �i-`-- ........'-............................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of ij L: of the State Sanna. Code The undersigned 'further rees not to place the system in operation until a Certificate of Compliance has n issued by the board of hj. Signed- •-• `� l �y O 6 "i'. .................... K ............... ..... =_j Date Application Approved B Date Application Disapproved for the following reasons:............................................................................................... ---------------------------------------------------------------------------------•---........-------------------------------•-••-•------••--•----•---------------------------------------------...._..._ Date PermitNo........................ ...... ...... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .. --........_...OF................ . ApplirFatinn for Uhipas al Works Tonotrurtiun Frrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at �............. -. ..... ..................... ...................... - -•-•---...._................ Lo- tion-1 ddress ( or Lot No. ............... ! �'t._ .�5 �...C�., �•%.. y'Y :_ ......................... *.. .... .....""_'�:._Vic-Y'v+=-�'...............-a�.....---•-------......--- f Owner Address Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ---------•--------------------------------------------•-••••-••-----•--•••••••-•••-------•--•-••--•---•••-•-•-••-•-----•-••-••-•-•-•---•••--••-----•-- 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-.--_--_____________---. fX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ W O Description of Soil........ _.' �__ . x ---------------•----......-----------•-----------------------------............................................................ U •-•••••••-•••••••••-•-•••••••••••--•-••••-•-•-•-••----•-••••••-••••.....•-----••--•-•..._....••••••••••--•---•••-•••--•-•-•••-----•--•••--••-•-••-- W V Nature of Repairs or Alterations—Answer when applicable.._...._ .�...... ._� — I_______________________________________ - `�' `� y---��c-----?___-- -- ' ``� �-= ^ -' ---------=----------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with TT�'14 the provisions of 1 _, ..•. `of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance hds' een issued by the board of health. � � � 4 _ j� Signed; .�J.J V+ 4+ ...(_.....i a _tA 1 - � Date _.... Application Approved By-------------- ......--- - ,�..=la'=f- . .... -- -----/ r �.`.... Date Application Disapproved for the following reasons:...............................................................I---------------------------------------------- ...--•--•-•-•---••--•-•-••--••--••---•--•--•-•••••-....••-••-•••-•••••••••••--•••-•--........-•••---••---••--•••••••--•---••----•--••----•••-•-•---••-------•--•--•--••••••-•••-----••-•-•--•-•......._. Date PermitNo................................. .. ....... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Tnrtifiratr of (ClUmpliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( 7 ) by t. ''".r r '�;.:`:rE J/f(•c':-i -----------------•---•---- . ..... . .__. ................................................... Installer .-----•... C_'l•fi _�t !1� r L h 1__�.y aG n n%C has been installed in accordance with the provisions of T i T IZ 5 of The State Sanitary Code as describedrin the application for Disposal Works Construction Permit TNT o`."�-'7------7;_�-�.......... dated......1__�._- -�?_�--�_----t_•------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTI N SAT SFACTORY. DATE. =--��--•................. Inspector -----------------•---------------•--•-----.....------•----------- THE COMMONWEALTH OF MASSACHUSETTS ---- _ BOARD •OF HEALTH OF.............. ......... . .. ................................. NO.. .............c�_.> i� FEE... Rapp sat Workv T nstrurtion rrntit Permission is hereby granted { ._'...... -•••--.......••. .......:......c_tiC--....---------..............---------- to Construct ( ) or Repa}r ( '�) an Individual Se�rage Di posal System r 1f c � 10M tn .f tG+✓Ia1 ``� at iVO.. ?:...,, -.._.. --------------------------•------------._-_--_-__----.--•--•--•-•-•-----•--------•------- •" Jtreet ,- j - as shown on the application for Disposal Works Construction Permit No -_/:_-� �__.Dated------l- _ ...� �.....__..... _ _ f �•y c Board of Health DATE. ? ---•--•-. t.._{/ . 7 FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS �G AsBuilt Page 1 of 2 pp TOWN OF 13ARNSTA15LE �y 7 LOCATION R8 �Gr rn w 1 Lt,i SEWAGE VILLAGE_J i (X N W S ASSESSOR'S MAP & LOVA- L-02 INSTALLER'S NAME & PHONE NO.C'a-j-jLrJ jtg (Jl-S. Y97 A83S SEPTIC TANK CAPACITY -dR*==lft I tat.S- LEACHING FACILITY:(type)_ 10C) O GQ, G I. (size) /QQQ NO.OF BEDROOMS ,3 `PRIVATE WELL OR PUBLIC WAER BUILDER OR OWNER DATE PERMIT ISSUED: DATE .COMPLIANCE ISSUED- 1 7 VARIANCE GRANTED: Yes No w I � • lA 1d60I-P a ►caa �Q. fittp:Hissgl2/intranet/propdata/prebuilt.aspx?mappar=250055&seq=1 12/7/2015