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HomeMy WebLinkAbout0065 WOODLAND AVENUE - Health 65 Woodland Avenue, Hyannis _k A=269-059 - - 4+ s` i l TOWN OF ARNSTABLE LOCATION �5_ ��// �G`e SEWAGE # VILLAGE ASSESSOR'S MAP& LOT � 7P INSTALLER'S NAME&PHONE NO. APOI��0/P;`/ �4�c� ��/7? IP� SEPTIC TANK CAPACITY _ �►�3 Gam G,a LEACHING FACILITY: (type) /-m / �y (size) X NO.OF BEDROOMS BUILDER OR OWNER Ry erg PERMTTDATE: 7�$/l� V COMPLIANCE DATE: B'" 15"— d� Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by '� ti ���yy�ry►p a a,� � � � � � � � � a � � �. �� x s . � 77 F d No. Fee �~ THE COMMONWEALTH OF MASSACHUSETTS :v PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pplication for Migoal *p$tem Cow5truction Permit Application is hereby made for a Permit to Construct( )or Repair( V))"an Sewage Disposal System at: Location Address or Lot No. 114 Owner's Name,Address an el.N 7, z' 4 W 6 "&/e® i��� Installer's Name,Addr ss,and Tel.No. `Z��43& Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Garbage Grinder( D Other Type of Building GS� B�l4C,40 No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 1117 gallons per day. Calculated daily flow 3-30 gallons. Plan Date Number of sheets Revision Date Title Description of Soil Nature f Repairs or Alte tions(Answer whe a plicable) �5 ZD ' 1 01-f ®il v 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 Certifi- cate of Compliance has been issued e Signed Date p1,-7 � Application Approved by Application Disapproved for the following reasons Permit No.q�2 1 Date Issued ,•- v f No. Fee ` - THE COMMONWEALTH OF MASSACHUSETTS , PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pplicatton for W5pogal 6p$tem Cowg#uction Permit 1� Application is hereby made for a Permit to Construct( )or Repair( V)an On-site Sewage Disposal System at: Location Address or Lot No. 114 Owners Name,`Address an Tel.N . 75' dy(�i f,( A/ CI rl Gv'4o LyreA;' e Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. gyp/`��G®r � G0n5I ?/ ���� i c1�1/��� y0 ���u51C/' ��• �I,Nf, t Type of Building: `� ' Dwelling No.of Bedrooms "Garbage Grinder(1 0 Other .Type of Building A4e5/ 'ell40- No. of Persons Showers( ) Cafeteria( ) Other Fixtures } t Design Flow gallons per day. Calculated daily flower gallons. G Plan Date Number of sheets Revision Date Title Description of Soil s Nature f Repairs or Alterations(Answer whe applicable) .AY3 "/ i _ Z ®"Ve .Date last inspected:, f Agreement: A . e� The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with�'he 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 t ' o He Signed Date Application Approved by �' a Application Disapproved for the following reasons I '` T Permit No. r " Date Issued __ ____=__ =_ �- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Certificate of Compliance _ THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaiJ�d/r placed( n by D DCd GDrls for ekte -IG', /T y��'I''9 as f.✓O L N ' has been cons ruct d in ,cco rd nce with the provisions of Title 5 and the for Disposal System Construction Permit No. ^' O dated `?' Use of this system is conditioned on compliance with th provision'§set forth below: f---___ No. �.�, Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mt pogar *pgtem Congtruction Permit Permission is hereby grante to to construct( )repair;+V)an On-site Sewage System located at j and as described in the above Application for Disposal System Construction Permit.The applicant reco nizes his/her duty to comply with Title 5 and the following local provisions special conditions, e c All construction mu leted within two years of the date below, a r Date: Approved by 1 I N CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION TION PERMIT(W.111I0U'I' DESIGNED PLANS) hereby certify that the application for disposal works construction permit signed by me dated �lZ���� , concerning the property located at 6� �o�Ga���� meets all of the following criteria: /Thcrewi hin n0 feet of the r sed se tic em / arc no wetlands 1 3 proposed p sYs1 ✓ here nre no private wells within ISO feet of the proposed septic system �Tj're is observed groundi�'ater table.is 14 feet or greater below the bottom of the leaching facility is no increase in flow and/or change in use proposed There are no variances requested or needed. SIGNED: DATE: Ol G gr R, LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER IAttach a sketch plan or the proposed system. Also if the licensed Installer posesses a cerlifled plot plan, this plan should be submitted]. #T ���$'. s. uwuus�.: n. nt r;,r,{i�i S S'..?z�. h2 y •< a N P.^�,-N`r7af} .k`y d s -5: � x 4''�'S�w �r,.�+ .`y� '�^� ti: s E y�c'# ht • sr s� 5 J` w �1 J y ig�;is„. $.��.tm s�',�7�,'„-c' ✓ „,v�"iv` �"`P} x �t �`-`� y-6 4�y^a� vim, 3,�' g"�f..w x r 4 sa v�'r .�,,;� '•° ��,4 a'r 1 d � $�� _£° < , .r ;��r F t6 ',,. �k �' ..t, �",• r,K. ,, A �t is a°63n�ry��„ .�'r t gam- t �,Y,.: g. s }+`ems �_•� 3� `'<' �'�t. C���,"j5%,� 5.,.. .i.°`' �"��ros# F � :,3� F Y� � .� d� k«G`� ,. .. � �.��..``�.. w ,.,��,� ,�'�'+.�` dr V LOCATION SEWAGE PERMIT NO. -k:,4 VILLAGE INSTALLER'S NAME D ADDRESS J BUILDER OR ow N ER �. DATE PERMIT ISSUED -5 -� Z DAT E COMPLIANCE ISSUED -.� ���� � � C�y � � � � p O ��- � i d - � �_ ypGf � � � J � d � � � t � �� � 7� �, � `. � � ��� � 1 -�.-s� � � 1 � 1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........................T.01M. ........OF.............3armzta.ble.................................. ............... Applira#ion for Diopoottl Works Tomitrudion rrutit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: ---6•�A•-Woodland Ave. ,-.....................................................Hannis, MA 02601 .........••••-••.............•----•......----•-••-----••-••••--••--------------...........---... --• 61 Location-Address I Florence Ryberg 65A Woodland Ave. or, lf' finis, MA 02601 ----------------------. ...........................-•------••.........._..........•--•••-•-----------•----•............. Opner Address W A & B Cesspool Service 128 Bishops Terrace, Hyannis , MA 02601 Installer Address dType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............2.............................Expansion 2Attic ( ) Garbage Grinder ( ) Q, Other—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 ( ) 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........................ ODescription of Soil..8a d-•--•••-•-...••••-•-•--•-•--••-•-•-•-•.............•-••-•-•-•-••-••-•••--•••--••••-•••••-•--•-•-•-----•--•----•••--••-•••••-•••-...----......_.._........... x U ..••••••--••--•..................•---•-•••-••-••-•••-••--•--•-----•-••----•••--•-•--•.......••--•••-•-•-••---••--•---•--••--•----•-•-----•••----•-•----•-••-••••••--•--•-•--•.........----...---•••••- W UNature of Repairs or Alterations—Answer when applicable...installation.--of..a--.1-,-QD0..gall 1.Qn..aep t.ic-. ... ank•and..a-1,000--gallon••leacli.-pit+ e - Faye-max. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TLIHE 5 of the State Sanitary Code—The undersigned further agrees n t to place the system in operation until a Certificate of Compliance has b en-'ssued by to f iealth. Signed✓ . . c--• .-• ............••••--•••• -- . •••••--• .... �...5/82........... Da e Application Approved By..............� . ---- •-- --s 82-.......... Date Application Disapproved for the following reasons:................................................................................................................. ---------------------•----------...-----............-------------•---........---------.....---------------••------•--•••••--•••-•-•-•••••••-•••...-•-------•••••-••.....•---•--•-••-•••--••---•-._..... Date Permit No.....82-: ------------------------ Issued......�,..5'.82 Date No. 2-. t.. .... FEs.. ....5..��......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............ ....Town.........OF.............Far a-table--------------._-...---------------•------------- Appliration for Dispasal Works Toniuttrtion umit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: ...65A.J1.4.Qd1anc1.Ay.P....... 41....... ...-..• . ................. Location-Address or t No. FA 02601 E........................................................... .65A..'�►ooaland Ave:a...�yannis, r ......................... Owner Address ,Wa --A--`.........Cesspool._Service........................................... .12.?.•.. shope.'�e S�4.► . �!sx]z� x.. A._..92�01.... Installer Address UType 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................ xDisposal 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. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Pz Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 04 ...---•--------------••-•••---------------------...---••---•-•-•-•-•----..............•-••-•......--......................................................... ODescription of Soil.Sand..............................................................-•------------------------•--------------------•-•-•---------------••-----•---......•------•-- C) ------------------------------------------ ---............................................................................................................................................ W -------------------------------------------•---------------------------.....----•-------.----•----•-----------------------------•-- .............................................................. U Nature of Repairs or Alterations—Answer when applicable_.Jngtj_3,&tj n__af..g--lrOp0--�a1� ©x�--8®pt14- ax�k._arn3.a__1,A0�_. allon_leach_.git ._atone_-Pack®el*•_ta.re ................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with f'1T+T1�^ the provisions of IT..:_. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b en-ssued by t�o f Iealth. Signed � r.--..-• •-••-.--•--- = --------•--•----- ....4/_.5/82------------ Date Application Approved By...... --•-----•---4/--5/8Z---_----- Date Application Disapproved for the following reasons:----•• ...... ....................•-----•...----...._....._.......---------.....................--•---••....------•-••---------------••-•-----•-------------•-•--.................................................... Date Permit No.... ................................................ Issued..... /-.. /82 •--------•-•----------^------• Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........................T.wn......OF..........Barnstable................................................ Tntifiratr of Tontplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (X ) ,by.......A &..B Cesspool..Servic3e.-_128_Bishops Terrace .Hy rani .1 A 02b01...................................... at 65A 'Woodland. Ave. , liyannis� IAA 02601 Installer has been installed in accordance with the provisions of TITER 5 of The State Sanitary Code jj��s described in the application for Disposal Works Construction Permit No.._82'/.. .......................... dated.......... ....____�'/._Wy.�?..................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT'BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. 4/ 82 1,�t f g f ` `� DATE......... �._.. �� z... ....•-- Inspector..............•-•---•---.....--•---� --------•..•----•-•••-•-•-•-••-•••-. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town.........OF..---••b,rnste ble................................................... No...... Is-/...... FEE.....�...:�.00.... Disposal Workii T-1omartuton rrntit Permission is hereby granted._.._.-A & B Cesspool Service---------------•-----•------------- to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at No.......f.�SA..W oodlan Ave.., k yAj ni s,-- A 2601. -Ry r --------------•-•---•--------•• Street •�.�.., as shown on the application for Disposal Works Construction Permit N ..o.8...-............. Dated...V_51.?..................... -•- ----- ---------•-•------ :d ---------•-----•--------.----••-•------------ DATE------------4/------./82-------•-•-•--•............................................... alth FORM 1258 HOBBS & WARREN. INC.. PUBLISHERS F. i - T - � 3 : I I , _ �o At .......... I , Cal - I , I , I 1 - i r- + iI _ I , I i I 4 : , I : r I Q I _.1 : � L• I - - I � ' I .. _ - I �. tires,• ` i Qj. I I I I. : I : I I : I _ I LO l : I _ I: I : : I I : I I I I I I I I , ' I