HomeMy WebLinkAbout0033 AMANDA COURT - Health 3 A m Q f?GHQ co u -
Cl
ors-- a 35
0
• ,�j' TOWN OF BARNSTABLE
LOCATION 3 3 A9 t';O Oe 7- SEWAGE # '5 3 f 7
VILLAGE ASSESSOR'S MAP & LOTO �95
INSTALLER'S NAME & PHONE NO. Gc-r^ /C4p�va" d ��
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) ��L C.��S (size)f� 6
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
i
BUILDER OR OWNER Ry
DATE PERMIT ISSUED: 5
DATE COMPLIANCE ISSUED: --1
VARIANCE GRANTED: Yes No /
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GPI
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P t�ROVJED��
DW
E COMMONWEALTH OF MASSACHUSETTS
7/J 'L
BOARD OF HEALTH o'
�a
S
TOWdN OF BARNSTABLE 0
igned 35
Appliration for Diti-Vitittl Works Towitrnrtion ramit
Application is hereby made for a Permit to Construct ( ) or Repair (A an Individual Sewage Disposal
System at:
JJ..4 M. ,g-f1.Q ...... t. ----------------------------------------------------------------------------------------------
cation-Address or Lot No.
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 ( )
d 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........................
44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a ------ --------------------------------------•---------------------------------------..---.........................................................
DescriP tion of Soil...... �7
U •-••••••••••••••••••---••••----•-•-•-•----••----•••-•--••-•----•••-••••-••----••-•------•••••••----••-•••--••-------•••••••••-••--•-----•-•--•-•--------•----••-•--•••••••-•••----•-----•-••-----•---••.
.................................... -------------------------------------------------------------------- -----------
U Nature of Repairs or Alteration—Answer when applicable._._l/��111�,1-.G ..__f� .Y/.._... �f ....._
ra .
_2 .........
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
system in operation until a Certificate of Compliance has bee ssued y tMarhealth.
Signed -----------
Da te
Application Approved By .. ....... .. ....... --�� ------------ -- �
eq�'/4� Date
Application Disapproved for the following reasons- ------------------------------ -----------------------------------------------------------------------------------------------------
....................... . .................. .
Permit No. .P. / �-�. _..................... Issued ------------- -------� . . ,
Date
No... ................. YmZ3 ev.... ................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH 0_1�s
6 1,Q-19 TOWN OF BARNSTABLE o 35
_"c yurliratiun for Dhi-paiial Workri Towitrurtion Prrmit
Application is hereby made for a Permit to Construct ( )\or Repair an Individual Sewage Disposal
System at:
Jj... ........... . .................................................................................................
cation Address r Lot No.
... ....
.. 0
.............................................. ... . ................... ... ..........................X.........
.........................267.1___..CffA ..... .
Installer Address
Type of Building Size Lot............................Sq. feet
U
Dwelling—No. of Bedrooms----------I?_---------------------_Expansion Attic Garbage Grinder
a
Other I Type of Building ------_------------------- No. of persons----_-.-_--_______--_--._.-- Showers Cafeteria
Otherfixtures ......................................................................................................................................................
Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquld capacitv------------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. f t.
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........................
44 Test Pit No. 2................minutes per inch Depth of Test Pit--.-_--__..____----. Depth to ground water........................
.............................................................................................................................................
0 Description of Soil-.... ..................................................................................................................................................
x
U .......................................................................................................................................................................................................
..................................................................................................... ------- ........................ ... ...... .
U Nature of Repairs or Alterations—Answer when applicable.--. ......................
........... ......
................................................. ......................................................................
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
system in operation until a Certificate of Compliance has bee ssued y th at health.
1 Signe
d d --- ...... -- ---- --------------------------------- -----
-----94Z��.
C �- '�' --
ApplicationApproved By ... ............:......... --------------------------------------- --- ....................
6;te
Application Disapproved for the following reaf 0 ns: ........................................................................................................................................
------------------------....................................................................................................................................................................................... ----------------------------------------
Permit No. ------------------------ Issued ................/5 -- /Y—
...... ..... ----- ------------------------------------------------ ..
Date
———————————————————————— ————————————————
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certifirate of Camplianrr
T S TQ C I That wage Disposal
Individual Sew Di I System constructed or Repaired
-------------- - -----------------------------------------------------------------------------------------------................
by ------- -at ----------------------0,r""A a, .f --------- ----------------------------------------------------------------------------------
has been installed in accordance with the provisions of TITLE of 19-The State Environmental Code as described in
the application for Disposal Works Construction Permit No. 10 1_
------ ___ _747
- - dated
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISF4�CTORY.
DATE ----------- ............. ----------------------------------- Inspector ---------------------
---------------------------------------------------------------- ----------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
No...._ ............... ....................
Utqvvoq �Arhpinn
Permission is hereby granted! (4.!�.,.........ahj !�Igl).......\'5.�le9t)C., 6�&) c
I--------------------........................................................
to Construct or Repair (111") an Individual Sewage Ppo al stem
14n . - .*- --, ........................................................................
at No..37...... ..... ............. et -
Street,
as shown on the application for Disposal Works Construction Permit IZOV!�ft F_?17 Dated.._.__,___._.._
.............................
Board of Health
DATE------. .....................
FORM 36508 HOBBS 6 WARREN.INC.,PUBLISHERS
LOCATION S WAGE PERMIT NO.
��--(-- ��3f2
VILLAGE
�-f t a
I N S T A LLENis NAME & ADDRESS
IUIL0ER OR OWNER
6C.4 N Z t
® ATE PERMIT ISSUEDz27
DATE CUMPLIAyCE ISSUED .
�7 - .
�7�
� � �� s�
�� ,�.
IRON-�
Fps.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD
��F HEALTH
J� rY_
_f...... ..................OF.............................................................
Allphration -fur 13hyuuttl Workii Tatudrurtion Vrruiit
Application is hereby made for a Permit to Construct (k) or Repair ( ) an Individual Sewage Disposal
Syst �: n at: �C k
Location-Address or Lot No.
............. --- ......... ................... ------•-•-------•--------_..•-----•-------------------•--•---•--•-------•-------`-------•-...••---
W O r ' Address
..............................Z9--
� Installer Address � � �„� n q
Q Type of Building Size Lot--- ................S feet
V DwellingNo. of Bedrooms-------------3_-______-__— ______________E;tpansion Attic ( ) Garbage Grinder (W)
aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
d Other fixtures . ---------------------------
W Design Flow....................... ...........gallons per persert per day. Total daily flow----------------------
_3_ ....-...gallons.
WSeptic Tank—Liquid capacity/gGKgallons Length--------F_____ Width---1`....--.... Diameter................ Depth..--�_.--------
x Disposal Trench—No. .................... Width.................... Total Length........... Total leaching area............... sq. ft.
Seepage Pit No------_ ._______ Diameter____________________ Depth below inlet____..__________.___ Total leaching irea_ -_ ._sq. it.
Z Other Distribution box ( Dosing tW k )
WPercolation Test Rer1q, , Performed by------ `-----------------------------------------------------• •- Date---- --
Test Pit No. 1_� _�_____minutes per inch Depth of "Pest Pit.................... Depth to ground water-----------------.......
f14 Test Pit No. 2__ .r�t.....minutes per inch Depth of Test Pit.................... Depth to ground
a
---- -- water--.--.---------.__-__--.
�-» A -TV - A --....----- - ----�--
c ; . _ °p Description of Soil--------------- -- --- � ----...-- -- ---------------_-.._..-------------------------•-----
V -------------•••----------•--------------------------•••••---•--------------------•••------•----•--•--------•------•------•-------•-----•-----------------•-•-•-----------------------------------------
W
x ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------
V Nature of Repairs or Alterations—Answer when applicable..-----------------------------------------------------------------------------------------_--
-------------------------- -------------------------------------------------------------------.
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 has been issued by the Moa f heal
Signed�_�._-- - --- - ----•-- --_- - - - ---•--------------
Date
ApplicationApproved By--------------------------------------------------------------------------_-------
Date
Application Disapproved for the following reasons---------------------------------•------------------------------•----------------_••-----------------•-----------
........................•--•_....------•---•-•-----------•--•-- ..........................•--------------•---•---...----•--------•--------•-----_._...._•-----•-------_.•_----------_-•--------------
Date
PermitNo......................................................... Issued..................... ------------------------------••--
Date
y• /
FEE
THE. COMMONWEALTH OF MASSACHUSETTS
BOARD .JF HEALTH
Y./..................OF......... �..... .5 /� �
--...F- ....
AVVliration -fur Bhipuiittl Works Tomitrurtion Prrmtit
Application is hereby made for a Permit to Construct O or Repair ( ) an Individual Sewage Disposal
Syst at
--------•--•------------------•-----•----•------.....--•----•-------•--............-•••••••....... ................................................................................................
•Address- or Lot No.
{� -.�t f1
-•--••-•----- ...............C�-°•---*••^ •..........---••---.....--••-••--•-•••.....-••••-•••..........-••-••..........................••..
...............................9..I O er ✓ ...............................•--..._......Address
Installer Address
Type of Building Size Lot--- _ ....................Sq. feet
Dwelling—No. of Bedrooms--------------__-------------------.--------Expansion Attic ( ) Garbage Grinder (h0)
per, Other—Type of Building -------------------- No. of persons...........------------------ Showers ( ) — Cafeteria ( )
dOther fixtures ...............................
W Design Flow....................../Z F------------gallons per prr per day. Total daily flow......................... _- .'............ allons.
WSeptic Tank—Liquid capacity/ _gallons Length..._...tr�..... Width..aL`.`.......... Diameter................ Depth_._ __._..-.
x Disposal Trench—No. .................... Width-------------------- Total Length-----------. .......
Total leaching area-------------- sq. ft.
,�3 Seepage Pit No........ --------- Diameterr.................... Depth below inlet--------
.._..... Total leaching area_ �!_�___sq. it.
z Other Distribution box ( Dosing t k
a Percolation Test Reju�ts,r Performed by------ °... ....... .............. •--. -----._._...__...,� Date......_-__---____-- -------------
Test Pit No. l j;Y ,.-__--minutes per inch Depth of Test Pit____________________ Depth to ground water_.___.___.._.___:_..._
ri, Test Pit No. 2.-;-,_p------minutes per inch Depth of Test Pit.................... Depth to ground
wact.err_s_._.c..._____-.
' - 3;-
,
O Description of Soil 6 �
--- ----- -•---- ----------• ••-•-• •-••.................._.--- ... ----- . -------- -----
W
V Nature of Repairs or Alterations—Answer when applicable...................................................................................... .........
------ ---------------------------------- ------- --------------------------------------------------- •-------------------------------------------------------------------------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article YI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of.Compliance has been issued by theboard of health.
Signer --- Date
ate
D
Application Approved By-------•---•-----------------•-•------•----•--•----•-••--------
Date
Application Disapproved f o`r the following reasons----------------•------------------------------------------------------------------------------------------------
Date
PermitNo......................................................... Issued.............. ......................................... _
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................................OF.....................................................................................
Qkrrti$iratr rrf,-01,11MVIiatta ,/
THIS IS T ERTIFY, That the Individual Sewage Disposal System constructed (t/) or Repaired ( )
,,
at------------�'i _�I`.. - 6..............-!"X y,'31. !",.--- -------- er---------.........._....._..-•---•----•-----------------••-•--•--•--•--•-•--•--._...-----•---
has been installed in accordance with the provisions of Artic e..YI. of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No ------- dated................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL. NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WIL U CTION SATISFACTORY.
DATE ? Inspector
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF....................................................................................
N •--• •-••••----• FEE--•-•.!�.. •••..••....
rk, nunptrurtion rrrmit
._
- ..-
Permission is hereby granted-------- , ............ � _ -------------- - -
to Construct ( ) or Repair ( ) aIndividu Sewage Disposal S tem
�" � -:_
Street
as shown/t/he;pation for Disposal Works Construction Permit No_____________________ Dated--__.---.--._._.._ ___.__..____........
----------------------------------------------------tBoard of Health
DATE.. ----------------------•-----------•--......•...
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
Cl)VI AN N 1—D/4, Al
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LEGEND z . r
EXISTING SPOT ELEVATION , 0 CERTIFIED PL T ".
x0 0_ � PLAN ,.
EXISTING CONTOUR -- - O o T �9" � �, .v��,4
FINISHED SPOT ELEVATION 0.0 '
FINISHED , CONTOUR 0 -----CO T U.. .T
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APPROVED = BOARD OF HEALTH
s ' DATE , AGENT u — SCALE / �— �U� DATE 7 /317
r� LOREDGE ENGINEERING C.O. INC? ' `-'`'
€"4" _ 1 CLIENT._..___...__. I " CERTFFY ' THAT THE PROPOSED
E.GISTERE REGISTERED JOB NO � >>.1�. BUILDINQ S�HQWN ON THIS PLAN
t : CIVIL LAND AN
TO THE ZONING LAWS
c 4 ENGINEER SURVEYOR DR.BY - r -_ .n�_.__/�J.
---- -- - — OF BARNST BL A S.
I.33 NO. MAIN ST 712 MAIN ST. CH. BY _ ��� �� = J 7
SG YARMOUTH,-MASS. q' ```mod' , r
r
HYANNIS, MASS. - DATE - _
SHEET L_ OF —._ REG. LAND . SURVEYOR
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E/-rV R 7'NE SEpr/C+TANK OR s'
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SL�CT�QN 4F f GROUND// N/�ITER TABLE .
oUTtErA /erNBOx8 FTrI SEy1/AGE YSTEM
INLET I_rACH/IVCr �/T, `/ • 3 FT. TigBl>LAWON
OIMENS/ON A ' •� FT.
_ SCALE %4 /
DES/G/V CR/TER/A" ALENSION . 8- —F'T...
N4VI►9BER 10F BEDRQOMS
GiAR¢AGEDISPOSAL UNlT A10 SOIL LOG
3 3 . SO/L TES'7` SOIL TEST
TOTAL E3TMlJW7,6D FL06V G.4t./DAV SO l 4 TEST # #2.
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yeESERVE LEACHI "A G SQ. PT.
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