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Home My WebLink About0084 WINTER STREET - Health 84 W inteSr:StreetY . Hyannis A= 309 — 187 i No. p to s Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes 0[pplitation for Misposal *pstrm Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon ) ❑Complete System ❑Individual Components i,,, Location Address or Lot No.` $� #A rAn"iS Owner's Name,Address,and Tel.No. "5 �°V'116) Assessor's Map/Parcel o ^ / G //V� 1^ —Fir,-(, , rsneg S g 8 e Installer's Name,Address,and Tel.No. Designer's NaAe,Address,and Tel.No. 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) e 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 Certificate of Compliance has been issued by this Board of Heal. Signed Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. ,,i r� �� Date Issued % c No. 2 o to - Y 7 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes f 4plication for Misposal *psfim Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon ) ❑Complete System ❑Individual Components Location Address or Lot No. $tl Ili-,, ec 151— YAn h L5 Owner's Name,Address,and Tel.No.5 „y Ile Assessor's Map/Parcel r el — 17 s,98 —10 e Installer's Name,Address,and Tel.No. Designer's N;dic,Address,and Tel.No. Type of Building: r Dwelling No.of Bedrooms— Lot Size sq.ft. Garbage Grinder( ) Other Type of Building � t 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 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 Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by ,� Date Application Disapproved by Date for the following reasons Permit No. 9 0 Date Issued (� 6111,0 A 7-�^ �m f THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS AV4 ' age Certificate of Compliance T TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned y at t i n{Q has been constructed in accordance with the provisions of Title 5 and the for isposal System Construction Permit No. a U I 0` y 7 Z dated f 3./h a r• Installer Designer #bedrooms 1-4 Approved design flow gpd The issuance of this shall not be construed as a guarantee that the system will n tii—as desig d. Date f 1 3�,ermit Inspector _"" ' ----- ---2tiro Fee--------z------------------ ---- ---}-:-_ _ = ---- --, ----,- ;-------------,- -- off- S =-------=_ No. THE COMMONWEALTH-OF MASSACHUSETTS, PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstrm Construction permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon System located at Ini ;fb ( 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:Const ctio must be completed within three years of the date of this pe Date /e Approved by D)11� r LOCATION! : SEWW:CE PERMIT UO. INSTQLLER5 W&ME ADDRESS —. �/BPS /cGL�•�w,'.�' — — — —., —. — — — — — 5UILDER .S Q &"F- ADDRESS .QQTE .PERMIT 155UED - - - - - i D ATE COMPLI MICE ISSUED : � J'l P x a v 4 iF �/i,v7pi1 5 T THE COMMONWEALTH OF MASSACHUSETTS"' BARNSTABLE,MASSACHUSETTS' Certificate of Complianie, THI O CERTIFY,that the On-site Sewage Disposal system Constructed,('° ) Repaired( ) Upgraded( j Abandoned y W n .VsL A N i has been constructed in accordance with the provisions of Title 5 and the for isposal System Construction Permit'No. JO 10—Y 7 z dated i 3•/(� Installer Designer #bedrooms Approved design flow A/ gpd The issuance of this /ermit shall not be construed as a guarantee that the system wil ti as desig ed. Date ! /D Inspector y � � —� 1 '� -- i � ``�`. a _ , � ?�' ;� ,` �� t . � ��. LOC&.TION : SEW&(StE PERMIT MO. NALLAGE IBIS-TNLLER 5 U&NAE ADDRESS BUILDERS V J &MF- ADDRESS DATE PERIAIT 155UED - - - - - - - D ATE COMPLI &MCE ISSUED; - - - �1 O x . i 9 a � N �' �vi�-Z s,— 4� 69 No......1.73........ Fps.../V............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....... .. ..........OF......:` ....... ------------_.................................... ApVtiration -for 43iiipmal Narks Towitrurtion Vanift Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: t Z n, .....................W ......................U......A '?,/ f ........S ----------- ................................ . . ........ catio Add Lot No.0,--------------- .... .................................................................................. .t..... 7-------------- Owner ddres� . ......... ..... .... .. . ...... Zef-------------------- ..... .. ....................... I n's't'al 1'e Address Type of Building Size Lot..._/_a.. :.Y...Sq. feet U Dwelling—No. of Bedrooms_________I___----------------------------Expansion Attic Garbage Grinder Other—Type of Buildmg'D_IVIF�-14m.5--- No. of persons---------_Z............... Showers Cafeteria Other fixtures --------------------------------------------- -------------- --------------------------------------------------*----------*---------------------------Design Flow_..._.._% .�r ..........................gallons per person per day. Total daily flow-------------/04-5............. ....._gallons. 9 Septic Tank,/-Liquid capacity/404-gallons Length________________ Width-._-_.----..._.. Diameter.... ----------. Depth_------I------ Disposal Trench—No_ -------------------- Width.................... Total Length__________________-- Total leaching area--------------------sq. f t. Seepage Pit No-------/-------- Diameter__&�'�_�PDepth below inlet.... ....... Total leaching area------------------sq. f t. Other Distribution box Dosing tank h 7- 7 4 Percolation Test Results Performed by------- ----------------------•-----•---- ........................... Date___------------------------ ------------ Test Pit No. 1................minutes per inch Depth of Test Pit__-.______________-_ Depth to -round water.--___-__-___-__-__-. �14 Test Pit No. 2----------------minutesper inch Depth of Test Pit.________.._.__._.__ Depth to ground water---------------------- Ix ---- .......................................................... ............................ ---------- -------------- 0 Description of Soil--- -- - ------------- ----------- ;Z U .......... ----- --------- - -------------- /-—----------AV44:v--------------- - - --- ---------- ------------------------------------------ U Nature of Repairs or Alterations—Answer when applicable________________________________--_____________------------------------------------------------- --------------------------------------------I------------------------------------------------------------------------------------------------------------------------------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 ha en issued by the and of heal#i. . ............... 5. 6-------Signe,d... at .................. ---- Application Approved By...... ....... .. ..... Gatt e Application Disapproved for the following reasons:. --------------------------------------------------------------------------------------------------------------- .............................................................................................................I...............................................................I........................... Date PermitNo......................................................... Issued...................... ................................. Date ..`. No. �.7.3........ F��..,� ...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ----------------OF...... ........ .-..----------...---------------------------------- Appliratiun -fur 13iipooat Marko Tonotrnrtiun Permit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 4t��F--- Iv,. t�. .........5:1...... r:�,�s... ................................./. ! ocati q Add s ... or Lot No.' O OIM /Yf `� ✓�GYl/tG�- .. W --•-----•--Owner �� / Address T n t Installer Address Q Type of Building Size Lot...?_ ___2-._Y.._.Sq. feet U Dwelling—No. of Bedrooms---------/----------------------------------Expansion Attic ( ) Garbage Grinder ' Other—Type of Building ,D ?� /_ ,� --J~_.• - ---- No. of persons..____._�................ Showers (/ ) — Cafeteria ( ) QOther fixtures ------------------------------------------------------------------------------------------------------ W Design Flow------- ��__________________________gallons per person per day. Total daily flow............./.t1-0.......................gallons. WSeptic Tank 4 Liquid capacity/_lJa4Q__gallons Length---------------- Width................ Diameter---------------- Depth.__.__--._._.- x Disposal Trench—No. -------------------- Width.................... Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No....../------------ Diameter-M—0-S_R Depth below inlet________ _____•._- Total leaching area---_.--.--.-_-____sq. ft. z Other Distribution box ( ) Dosing tank ( ) 4 - Pe L/- T- 74 , aPercolation Test Results Performed by------- ---------------- ----•-•---•-•-••-----------------------•------•- Date------------------------------------._.. Test Pit No. 1................minutes per inch Depth of Test Pit----------------_--- Depth to ground water------------------------ GLI Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water--.--.-.---.__-..---._.. O Description of Soil_-_ P - ------ -------- �IJ _ , -----�t----�- �C---------••-------• - -�--�- --------------- V Nature of Repairs or Alterations—Answer when applicable..---------------- _-____--.-_ ------------------------------------------------------------------------------------------------------------------------:-------------------------------------------------------------------------_----- Agreement: i 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 h s.b een issued by the oard of health. 1 Sig d-. _-z •p-f% a ems- /� -•---- ate Application Approved By----�C.4- _-- •---•--------- � � �� Date Application Disapproved for the following reasons:...........................................•---•-------••----------................_......•---•-•---•--•------•- .....................•-----------•--•---------------------------•-...------------••-•---•-•--•-------•••-............._----•----•--..........--------------.......----•---•-•.---•-------------......... Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT t'(J... .....t.................OF....... ... .. ....... ... .... ......................... Qrrtifiratr of 0111amptlaurr T I S TO CE FYI , T ,at the Individual Sewage isposal ystem constructed (4.� or Repaired ( ) - �-. by---- - ---.---- _t??.._.. ,ems --------------------- ---------------------- ----------------------------------- at.. er -° �ff�lY�-- ..� . -- 4itry b s been installed in accordance with the proisions of Ar XI of The State Sa Code as described in the application for Disposal Works Construction Permit No.�.../.:y?.............. dated...... ............. THE ISSUANCE OF THIS CERTIFICATE SHALL. NOT BE CONSTRUE© AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION. SATISFACTORY. { // ------------- Inspector.... . DATE- ---------`--- �' ,�,� THE COMMONWEALTH OF MASSACHUS BOARD OF HEALTH No--------------7--��----- 1 DT`r/.1�/...............OF......� .........------- -------..........1..... FEE_. � �.1•----........_ Bi-spuiittf Workii C110 utrnrtion Permit Permission-is ereby granted._,j-_1-_� ----------- EI to Cons uct ( ) or Rep ' ( ) an ,ndiv dual Sew ge Did sal Sy'temt� � t^ 7 at No._. .- r- R :_ - -------------------- --- ----- treet as shown on the application for Disposal Works Construction Per- pit No -'___,_l. __... Dated._. r:: �+_'_. �....:.......... } • ................................ DATE................................................................................ Board of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS - 4w�,u'i6tk °M� 40 _ ? [ t -F^{ r a .^ a�,{r(" �' kL.N �'.'''t-S�:ytr r S` � ha.t•F `k'r}. e t'i S�j ✓ tea_ '� A<' �� °.Y J4 ' 9 $ y _4 •-#-' ,£��r�`�St`F�tYt ''�L.�xa'.g-.� ta'{� �` L� I ;� •t { — � �, � T t ��aE'�'.� }+P!„4y P�,3#? ".L F+7�, iYf C�. �� /\ � h r !� .. r• t�¢ $ f' ,4 A • S,ce}+'�. fit ,•,. q r�t._,y� � �S", �. - .. ..rt, t. a �� f - ��i.�.st ps h L ` tpt t ,x SS �' r T*'• t.. ' 7J I�D C,�/+0/ a I'/asr g oev: E$ �� '� •l � ' '� - ,. .. a �i_ram i Li �31._� ON ne { 9Av ' ao, NoT PAvC(J N Jj •� ' kWu 1afy { 'HEREBY-10ERTIFY -THAT THE f STRUCTU'RE SHOWN HEREON WAS LOCATED PLAN OF LAND a STRUCTURE BY AN' ACTUAL FIELD SURVEY ON ON t, - k� i MaY G-,197 E -AND ' CONFORMS TO THE ""= `i ZONING: BY-LAW OF THE TOWN OF Z0. WAY OFF " iI��' '4 BA STD 6�� MASSACHUSETTS. IN �r} �r t h ` � t REGISTERED LA URVEYOR BA O- /S TA r3 L6 MASS. ' M1 - SCALE • 1 40 MAY 6 , 197( F f� t DATE P�SN OF I�4 C_ j 18 CAPE COD SURVEY CONSULTANTS YOUNG v A DIVISION OF BOSTON SURVEY CONSULTANTS,INC. - ROUTE 132 ' 9096 @I8-r�P�O HYANNIS, MASS. ' SURV�� Y.