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HomeMy WebLinkAbout0027 WEST HYANNISPORT CIRCLE - Health 27 W. HYANNISPORT CIR. HYANNIS A = 267 125 u; j 6 I I 11 i TOWN OF BARNSTABLE OVA_ LOC.AnON 7 4 C/ j' 1,<, er �'rLIA' SEWAGE # 00-- SAS VILLAGE %r are' �Pr�r7" ASSESSOR'S MAP & LOTIl4�?-/A2,S' INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /5-00 LEACHING FACILITY: (type) -°,,SDO t1o."I 3'_ NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: S 3 D^ 00 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 faci 'ty) Feet Furnished by 0� 4 { ' ('� ,� � �� � � � ' � -. .�� a / ., Q `�, � I. :1 { y' `�� �� r,.;9;� � ., •_ s� �� .�;r i� 11 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Zipprication for Migaal 6pgtem Construction Permit Application for a Permit to Construct(e--)-Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.,?7 a rr �'%i i Owner's Name,Address and Tel.No. A?r7'dt' S-rewres Assessor's Map/Parcel ? 1Z.1'— Installer's Name,Address,and Tel.No.4(7-/—03q f Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( ) Other Type of Building 3 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil: Nature of Repairs or Al rations(Answer when appli able) Z�4 541g` Z��o t�,y Date last ins ted: 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 8 Application Approved by � Date Application Disapproved for the following reasons Permit No. Date Issued = '% � - n . .^}. 5' i'M1 si 3: -r i,. s-r...,,.. _ K z d r _ BARN — - r TOWN OF ..�s.....-+ +o».^ .. LocATloly �7— -h� , ��s �� �r'��i T - LOT >' >. SEWAGE # 0 VILLAGE f��� ,�r�er�rT ASSESSOR'S MAP & _ . �47 /.� y ;__ �'Y� F t / k INSTALLER'$NAME&PHONE NO �fi? O �/4 Jo���� D� 1 ��o s - � __ _ ..f.� E SEPTIC:TANK CAPACITY 1S DO 1 , .- 4 4 a E t 1 LEACHIl�iG FACILITY 6A, �f y lU/�l� X 2: — t (type) 1° G�DO ize) /3 _ :. ��. F NO OF BEDROOMS -�.: -- --- - --- -- —I_— -' -- - -- - -- -- r�s�r t;xh u 74 B:UII.DER OR OWNER:.:`li/h j'! ., . - . I. . PERMIT DATE t 3 4 00. . . o `p D D MPL IANCE DATE: O 3 1 ` - Separation Distance Between the s } i .,, :Feet a 3 S Miki*Eum AdJusted Groundwater-Table to the Bottom`of Leaching Facility Y - 'S ( - ' � ��-�` t: .} PP.Y_ g ty (If any wells east nvate Water Su 1 Well and Leachun FaciL `�Mr : ? � , "� i s ti or t tihvri 2Q0:feet of leachtng factLty Feet t .� , },�,tr �r Ed tr of Weil d azid Leaching Facihit (If any wetlands ezis� � , '� t s - ',� " Feet [ss b ems`-'} YY y r + { J L 1 a., r.Ck��((� r t C A+E� F . ,r 'Fyn m r r t Gsa "a's`W : r J. ) --:n w. �^}, S. S^N P "'€ ia' F, -'--. �.+ {;."M'j'S',. ' aa_ 'rs 4 r s_ t - t 5 -z a s" .t st r q. _ r t �. r 1 t 4 C t �.i - i s' 4 K,r: n Ys+rx 1 t t , _ .� V 3+.�.rr 54r - f.zr! j mt .4ts••. v i st ..t i + z E J b ! < Z + c; , d:ir'Wf h 5 -- l ki,A3 r 7 9 5 t r - ^ c a ..jj .. . � 7 ' '"}"sty k S �p-u' a n '. .;; ;. r r :_- r t µ 1 1 ti 3s. k - -I,art 2,L: J L + if 1.i ykA ,w 7 t -T;,}- - d ,,�Y •.•-a-.: :7 s yN F f 't S�rL.} { y a f n ,�„ t r:. t ., 7 r�'r rd h-�i.. 'efi f'"c 'iL '4 ;, s{ .._.r .� :n, f '"1T as'�.n y. -3.ppr�r S'Et,- cP"t T'��'�,,.q —�L'"i-1-K'�i+-�,1IM! I .5� {`.Ea'p`'.4'`h�r Wr...�4'u2.r. t,„e"#$�E� 4�r ct Y� a f"#b 1 S 2rs �� 4 :+ :3 r,,1 lt:-t. 4> t F. w - rt 144 1—1 s.. .t.Y1i"" t i P!n,.crW y SK�Lx S �. 4t?'d"s, '(r s�F. .4 - 'ems a {-r4 X `- t yL i ' -? - -�{x '° .t r^.,�.s,.«a- kY �t r rt x f. s- >;-" 4 �S t ,. d' .e, e r. r4 .-'!>^ -, '{. �Xe t .� i. + fs r z. tr.S..?�a+. gtz57,` , + 7 r.. -- .�k.+ a -t .t~ w j _ tys cis v 4 r� a , r .. Y {'{'��'� ' *Rem } &i'{ F` a d`0'1e, s K ,�� - w . r T f '� vn(v ' _ .. kk-- .. - cl _ _ xk t, is h -- - - n_— 1 - ---- - - _ -__ -.a k. t . . ,- ! 3 i�'-i { ' - — v - ` -� — . - Y�„ .. _- .� _ _ .. .. . .. - , --- _ : - I- _�...-_. - - ._._._... .-_ -- _ - r _ - .. x, +rig - __ - —._- _ _... - t' 11 �—--�--�-,Z.-,­J,.—,,-1,4—-��� ._ _ ,��IM�.,; `iL,9-7°w'-,. -''�'--•....s� ' .`-'�„ ;5� .. .y .s ue s:; z _ x :ram.'', °ate �. ;•_.. -, Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipplication for 33igpooar *pgtem Construction Permit Application for a Permit to Construct(4.-)rItepair( 1 Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.17 Owner's Name,Address and Tel.No. I?rr&jr Assessor's Map/Parcel 47 /Zr Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 6 '0X -1-' %/ Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building 3 No. of Persons Showers( ) Cafeteria( ) . Other Fixtures r Design Flow gallons per day. Calculated daily flow gallons. 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 apply able) 4A52%gll /S UO 6m ) / • ems" "' � ' •�'`' (y may° Date last inspe ted: /t 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. �1 i Date 8 -,fa- 490 Application Approved by � Date Application Disapproved for the following reasons e Permit No. Date Issued -------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY;that the On-site Sewage Disposal System Constructed(e--•)-Repaired ( )Upgraded( ) Abandoned( )by at Gfi=.ST N��HH/S /mot 7"" C'ii^Gl' has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer bla s,_/oti `,I. Designers The issuance of this permit sha 1 of b construed as a guarantee that the s ste wi11 fun t' n s�esigJ, Date Inspector �1� �• /IIN' ? ,( ----------------------------- -------- No. Z-10-� Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migooar *pztem Construction Permit Permission is hereby granted to Construct((,)impair( )Upgrade( )Abandon( ) System located at 2:2 Gl/i=ST 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:Constructio must be completed within three years of the date of thi e 't. Date: Approved by l/6r99 ;i, NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIF'ICATION OF SKETCH .k. -D APPLICATION FORA DISPOSAL WORKS CONSTRUCTION PERIDT (W=OUT DESIGNED PLANS) I, ,,as4:V0, /0, lf*,,Oras hereby ceaiiy that the application for disposal war'-s cons cnon pe= signed by me dated concer tins the property located at !�7 Gt/ �}y�NN� dart �relr— meets all of the following criteria: �Tne failed system is connected to a residential dwelling only. There are no commercial or business uses asscciated with the dwelling. •�/I"ne soil is classified as CUSS I and the percolation race is less than or equal to 5 minutes per inch. Z-VII-Taere are no wetlands within I00 Fee;of the proposed septic srse.n �Tnere are no private wells within l-50 feet of the proposed se?tic sysem There is no incense in flow and/or cllartge in use proposed There are no variances requesed or needed. i fie ooaom of the proposed teacaing facility•will not be located less than five feet above the maamum adjusted groundwater table-!evarion. (Adjuss the groundwater table using the Frimptor me;hcd when applicable] • If the S..a.S. will be located wick 2-50 feet of any vegetaced wetlands, the bonom of the orocosed leaching facility will not be located !ess than puree t (I,) fee;above the maximum adjusted groundwater table elevation, Please complete the rollowina: A) Too of Ground Surface =ie•iadon(using Cis intormatian) 1;(0 6) G.W. Elcvat on _=the ",La.:(. high G.W. Adjuscrnent D T.-.-ERE`+CE a,and 3 � 1 l (Sketch proposed plan of system on bac:c]. c I 1i d ;ti TOWN OF BARNSTABLE LOCATIOR 'L/e S T ffv .�/.�is � v? G r� _SEWAGE # VILLAGE_ � �� �y- ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. jr/,�' _,4 ,4 CO.Gt���' a S oxl SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) /, pod NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: 2r DATE COLIPLIANC t ISSUED: VARIANCE GRANTED: Yes No Cam' . . �\ 1 ♦� � \ � � O' � �� �.r+ � ^� � �� ` 4 � �,� f, � � ?°� � �. N � a v p r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........T.own...................OF......Rarnetab.1.e..-----------------•-------------------------------- Appliratinn for llhyviiaal Works Tonstrnrtion antic Application is hereby made for a Permit to Construct ( ) or Repair �X) an Individual Sewage Disposal System at: ............2Z_e t...H�tax�x� s .Q. ...C�.x. �. ..:i� .anr��.. ...............•----..........---•---------•---•-------------------•-•--.....--...--•------• Location-Address or Lot No. ............ .......................................... ••---....-----•-•-•-•-----.....................................---................................ Owner Address Wa�•.- ,p4c2COFFF33�K--•c.r-r..............................•.......... Installer Address dType of Building Size Lot............................Sq. feet U DwellingXXNo. of Bedrooms.........a................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type 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. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.---.................... r-T-4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ..........................................•........................................... ..,............................................................ 0 Description of Soil.-------•.--•-•.....................•----.....--•---------•------•--•-----.....----------------------------------------------------•----•-----------•-•----•-••---•---•. x S.and...&---Gz avaI ....----••-•------------------------------------ V W U Nature of Repairs or Alterations—Answer when applicable........................................................................................._...... -------------------------------------------------•----------------1....1_©.OD...ga.1,1Qn...leaalli nrg..-Iai•h-- ..... ............................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITU� 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has ben issued by/jthe board of 1 alt g ...G/ /..8.9............. Si ne - - WA6"�� ! ................ �^ Date Application Approved By................ . ...... •. •-•d� .r.........` ............................ -•--•-•--- r1........ Date Application Disapproved for the following reasons:................................................................................................................ -----------------------------• --••-•--..........--•••-----...•••••---•------•-•-•-•••-•-•--------...•• ---•- Date PermitNo......... ...-�-�?--�---------------------- Issued_....................................................... Date . No-da....249 FEB vv THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............ ...................OF.- ................................................ .I.-I ov,n r n-S ......... Appliration for Disposal Njarkii Towitrurtion Prrutit Application is hereby made for a Permit to Construct or Repair X(X ) an Individual Sewage Disposal System at: 2.- ..................... ...... Q-4-eLol-&—Hy'ailn Ji ------------------------------------------------------------------------------------------------ to'c'a.tfo�i'•,16dre'ss' or Lot No. ............ ----------------------------------------- ----------------------------------------­----------------------"--------------------------- :7 Address ........ . ............................................ ............................................................................................................. In' l rl I& Address Type of Buildifig Size Lot............................Sq. feet U Dwelling,, No. of Bedrooms..........>.................................Expansion Attic Garbage Grinder ( ) CX P4 Other—Type of Building ............................ No. of persons._...__...__......_..__...._ Showers Cafeteria ( ) a4Other fixtures ...................................................................................................................................................... Design Flow...........................:................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid*capacity............gallons Length................ Width..............__ Diameter---------------- Depth................ Disposal Trench—No..................... Width.....__............. Total Length.................... Total leaching area....................sq. f t. 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.___.._....._........__. f� Test Pit No. 2................minutes per inch Depth of Test Pit..._._......._.._... Depth to ground water._____._....___......_.. 1:4 ............................................................................................................................................................ 0 Description of Soil........................................................................................................................................................................ W .............................................. jZ...nm=::Zma................................................................................................................... U W �V ...................................................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... .............................................................. ................................................................. A Agreement: 'Z­7-6�ee tA -A, The undersigned agrees to install.the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T I T iS 5 of the State Sanitary Code—The undersigned further agrees not to plate the system in operation until a Certificate of Compliance has been issued by I the board of li'ealth. Signed...d... ?!/ ------------------------- ------------- /I Date Application Approved By..............v............L .................. .........."Application Disapproved for the f)owing,7 sons:............................................................................................................... ......................................................................................................................................................................................................... Date PermitNo........ Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........TA, ....................OF.........Ra�a r n 9-t al,.1.8.............................................. Tbrrtffiratr of Tautpliana THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired)(K by.........r-,4.1a ro ................................................................................................................................................. Installer at..........23...hi-o=t---Pya.rjf,,.a ------------------------------------ has been installed in accordance with the provisions of TITIE, 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..... A_X-------- dated------------------------------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL'N6'1 B TRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.......... .......................... Inspector.....---._.....THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......................................... ......­ ................�OF........... N Agf FEE$... 0 7'" ' Diopasal Workii TDomitnutivit Fautit Permission is hereby granted................. ................................................................................. to Construct or Repair�. X ) an Individual Sewage Disposal System at ti .... .....................I.............................. .......................................................................................................... Street as shown on the application for Disposal Works Construction Permit No Dated.......................................... DATE................................................................................ ............................... Health FORM 1255 HOBBS & WARREN. INC., PUBLISHERS