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Home My WebLink About0090 WHIP-O-WILL DRIVE - Health 4 ' . . 90 Whip=O-Will Drive A= 289- 142 Hyannis a I J TOWN OF BARNSTABLE LOCATION SEWAGE / f VILLAGE ASSESSOR'S MAP 6a LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY _ LEACHING FACILITY:(type) (size) �O�D NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No , 4 . N N, i�y, ��a f�•5ti, 7�� ASSESSORS MAP NO: No.GyQ.� PARCEL N0: Fis....3.0............. THE COMMONWEALTH OF MASSACHUSETTS I � BOAR® OF HEALTH TOWN OF BARNSTABLE Appliration for Disposal Works Tnnstrurtion Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (,'�an Individual Sewage Disposal System at: c-• ...... �1....------------------------------------ --------•------...................------ ooat' Address t or Lot No. • ••---•-•-•---•------••----...----•--.:....-•-••-••. ....................................................... -•- ... ._....... ..._-......... O er A r W •••.--_. ... s --- ..... _ . ........................................ .a'7sZ _... - Address d Type uilding ins Her Size Lot----------------------------Sq. feet v Dwellin No. of Bedrooms------------------------ ------------------•Expansion Attic Garbage-Grinder per, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) WOther 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 ( ) `-� Percolation Test Results Performed by........................................................................... Date..------------•-•-------------------- 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.................... Depth to ground water......................... 0 Description of Soil................=..............................................................----------------------•---------------...---...-----•---------•-•-••-•-.............._.. x W -•-=---------------------------------------•-•---••-•---------------•----------------•------••••---•-----•---••- -- - - --- ----- U Nature of Repairs or Alterations—Answer whe p licable________ __________ ---•---------------------•--•---------------------------------------------------. ......----•-------•--•----••••----------------•----------------.......................................... 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 .0 system in operation until a Certificate of Complia e has been issued by h bo4ofth. ---------------------------------- Applicationigned ------ - - �I VD ace YI V A roved B t =t>.'.,r Application Disapproved for the following reasons: NCR:g.:•-'. ............................... r< Dare r Permit No. 152. .--... Issued ----------------- Fizz y4 3 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r t - TOWN OF BARNSTABLE Apjj firatiou for Disposal Works Tonstrnrfiun ramit JApplication is r?hereby made for a Permit to Construct ( ) or Repair ( V� an Individual Sewage D sposal System at:. ......_....4. . .. ..A - . ... - ocati -Address / '. r or Lot No. a ---- --- ........................................... Inst ler Address Type f uilding Size Lot............................Sq. feet U DwellingNo. of Bedrooms.............................. .....Ex Expansion Attic— --------- p ( ) Garbage Grinder ( ) `k Other—T e of Building No. of persons............................ Showers Pk Other—Type g ---------------------------• P ( ) — Cafeteria ( ) 0 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........................ GXI Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... a ----------------------------------- •---------- ••-•-------------------------------------------------- ---------------- ------- "--------------------------------- 0 \ Description of Soil........................................................................................................................................................................ x W ......----•-----------------•--•--------•-•-•••••••-•-----••--•-•--•---•-•-•-•-••-•--•--•-••---••----•-•----•..... -- ----- ----------------------------- ------ U Nature of Repairs or Alterations—Answer whe a icabl---------- /�� ---/0-00 ---- -----•••---••-••---•-•----•••--•-----•-••---•-----------•------•-•-------•-••---- -•--•----•-------------------•-•-•--•-----•-----•--•---••-••--••----•-•---••......---••---------------- Agreemen't: 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'�tlndersigned further agrees not to place the system in operation until a Certificate of Complian has been issued by t e board of h alth. Signed ........ ...... ........-------- ......---------------------------------/ 41_- - --- / Date Application Approved By -:---- ............................................ Date Application Disapproved for the following reasons- ..................................----------------.............................------------------................... ------------------------------ -------------------------------------------- ---- ---------------------------------------------------------------------------------------------- Date PermitNo. �� ,`2�........... ...................... Issued ----------------------- ------------------------------------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of (fuxnyltttnee THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( r- . I�n stall er/- 1- � mr - W 1 - at ........<..O-------( tfr_0 has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. -4� - ,� dated -Aj /P ---------------- ","-P "- . ------- ; , f-------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRiJED AS A GU RANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....... --------------------------------------------------------- �'- 'd .. --------------------------- ------------ Inspector !ff.. :�.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �' //pp TOWN OF BARNSTABLE No...% '/E— FEE.. 7... Disposal Works Tons rnr#ion an it Permissionis hereby granted.....•<...................................................................................................................................... to Construct ( ) or Repair ( �an Individual Sewage Disposal System atNo....C � .� �c1 //...�74i!.--... , ., .¢r/w:--......------------------------- ---•-------•---.....................----------------•-•-----........ r / 1 / Street as shown on the application for Disposal Works Construction Permit No. _�;L'. - Dated.....•!..-�' -? i------------ ------------ ----- tom d •- - Board of Health DATE---- -------•---••---•--•-----------•----•--------------- FORM 36508 HOBBS&WARREN,INC..PUBLISHERS - - J Assessing As-Built Cards Yage I or .1 TOWN OF BARNSTABLE LOCATION� 1�`% SEWAGE# VILLAGE ASSESSOR'S MAP&LOT INSTALLER'S NAME& PHONE NO. JtP "oiA& SEPTIC TANK CAPACITY !J` LEACHING FACILITY:(iype)__f&_ (size) IOdo NO.OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED�� VARIANCE GRANTED: Yes No 1 ME iP Ue�:f PEE ;NNE: OUTLE 1 ST PC r p `PIT TT PRIOR PUMPLIU l TODAY'S DATE �.:1.. C> .rya Q +� e r f �! 1 http://town.barnstable.ma.us/Assessing/IIMdisplay.asp?mappar=289142&seq=1 10/29/2013