HomeMy WebLinkAbout0135 COTUIT BAY DRIVE - Health ,
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Ginty seat Rd., Hyannis
14
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No. 4210 1/3 RED
10
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l � ; -WAGE PERMIT NO.
L 0 C�T
VILLAGE
INSTA LER'S ME i ADDRESS
BUILDER OR OWNER
DATE PERMIT ISSUED I - 4� �.
a
DATE COMPLIANCE ISSUED
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No...... ... _ . Fss. .....
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
----- ......OF.........
Appliration for Ui�vaa al Works Tontitrnrtion ami#
Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal
System at:
Tv�`T ��` .. - �e�Tv l�o ' '------------------------••-------------............------
.................. ....... f ` ._.....
Loca.tigan- dress r ® or Lot�xo.
Owner dddress
Installer Address
Type of Building Size Lot-----L_4 Q_-to........ eet &,
U Dwelling—No. of Bedrooms.......?......WO. _.. _Expansion Attic Garbage Grinder
aOther—Type of Building ............................ No. of persons___--_-__-__-___-__._______ Showers ( ) — Cafeteria ( )
Q' Other fixtures -------------------------------• -
Design Flow............—4-0.......................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.___/P"CV.... Diameter.................... Depth below i> et. _ ............ Total leaching area..................sq. ft.
Z Other Distribution box ('() Dosin t ) 07-- C �- a J--7�-
'-' Percolation Test Result Performed by._ �-- _ ,�t__ �1?4__________________ Date..l.-_2�—.'7�:
W
Test Pit No. 1.... .........minutes per>nch Dep h of Test Pit.................... Depth to ground water........................
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
.A
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Description of Soil............
Q� Z u " �...
x
V ------••-----------------------•--- ----------
•---------------------
... --------------------
•-----------------------------------------------
•-----------------------------•-----------------
W
UNature 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 iITLL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issue by the oar of eal
b
D to
Application Approved B ..=.- '..........--•••- - --•7-�y. .....
Date
Application Disapproved for the following reasons:----•...............•--•-•--•--•----•--------------------------------------------------•-------••-••......---•--
...................••-••-•-••-------.....••--••------••••......•-•-•......----•-•----•-•....•-----••-••-.....-•-•-•-••--••••-----•••----•-•••---••--•••--••••-••••••••-•••-----••---•......-•-•----•--•-
/ Date
Permit No......................................................... Issued._.. [_G g
---------------------/•---...------••----•--
Date
♦ r ti
No...... ..... Fss..a`.�r.. ....
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...............OF....... l^ 7�`s� ....,..
Appliration for Diipnua1 Works Tonstrnr#inn ramit
•
Application is hereby made for a'Permit to 'Construct ( ) or Repair ( ) an Individual :Sewage'Disposal
System at
..... _ ..................... ------. a
Location-A§ress or t -----
kt :. :.... _ ! ..................... ..........!� ?�. �ra y..- : 3 . '
Owner Address
a ..� . g-. �.t tC,. _ '" ► 1 ...
. . � � 6 ................
-------- -------- ------ --------------------------------------------------- -------- � --�=----- fir.: �------ - -•---- I
Installer Address f;
Q Type of Building Size Lot.....: :!ems-:' --:--:STwfeet
Dwelling—No. of Bedrooms....._.X....T ................Expansion Attic ( Garbage Grinder ( ;)
Other—a Type of Building ... No., of persons....:...................... Showers YP ' g -=,----'-----------:---- , -P , ( ) — Cafeteria
Other, fixtures ---------------•-------.....--------•-----------------••--••......._
....Design Flow......... 0 ......................gallons per person per day. Total daily flow......... ..................gallons.
W .
C4 Septic Tank—Liquid capacity.- APgallons Length.......:..:..... Width................. Diameter................ Depth................
Disposal Trench No .......... Width:................... Total Length..................... Total leaching ee a e Pit No: ��+ area..._......._........sq. ft.
p g ... Diameter.................... Depth,belp, i et.. __._.. Total leaching area................... ft.
S
Other Distribution box ( ) Dosin . t
Percolation Test Result Performed b �: . .........:.... Date__ "`"
y t
.............
Test Pit No. 1 minutes. er inch Dep h of,Test Pit.................... Depth to ground water..........................
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to round water.........................
-Description'of Soil............. A - ...........................
x
W ......--•--•----------------•-----•---- •--••------------- -••---•--••-•-•-•••--•---------•----•-•••-••.
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 I I LL 5,of.the State Sanitary Code- The undersigned further agrees not to place the systernA,in
operation,until a Certificate.of Compliance has been'issuea by the board of alth.1gn ;
:�eF1' :weer - •-• ---- E""�
n D e
Application Approved BY ,� �!�! ""�',/ l --' '
Date
Application Disapproved for the following reasons:............. . ...._..- ...___._- ........: ._.._..._ ......._ •._.................... ...__..�,
.................:...•---.......--•---------------•------------•-•---•---•-••-•--•---.._......-.-------- ••-••---•-••-•-••---•• .................................... ...............................
Date
PermitNo......................................................... Issued....................................................
Date
r THE COMMONWEALTH OF MASSACHUSETTS
, `I� , • ,� BOARD OF HEALTH
: ..OF.. ...BA 0!� .164 .tv..................................
• � , _ Y�px#i�irtt#le �f f�nm�rlt�nrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (X) or Repaired ( )
by...-----=.. Fj�.&. . !-1 .. _.T:zj,a,.-4............................... - -=--_...:.........---•--................---....-•-......._.....----•-•-•-•--
Installer
at ...... ......1. A+j.........N,9_!. ................. C= ----'--� r..................... ..............................
has been installed in accordance with the provisions of.TITLE 5 of The State:Sanitary Code as described in the
application for Disposal Works Construction Permit,,No-----.................:..,.:__.,;_,_.:... da.ted_..................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A'GUARANTEE THAT THE
SYSTEM:-WILL FUNCTION SATISFACTORY.
DATE................................................................................. Inspector......-............................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
7
Dinpna1 Workii T1111mitrudion Virrutit
Permission is hereby granted--------.Ak.r;� .Nt .... ; =' '" -------------------------------------------------------------------------------
to Construct ( ) or Repair ( ) an Individual Sewage Disposal System
at �To... '. .. ....: ......... .... +r _4_+3_ .......... "" C.C" 'i3Aw .. -----
t Street
as shown on the application for Disposal Works Construction P it ZI - Dated. --2"--- �1�....................
s �/ -
Board of Health
DATE..................................................................................
FORM 1255 HOBBS &.WARREN, INC.. PUBLISHERS
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- ?c '�F:-.TEF�JIAII.OE. •- t.+n'd` -- 1_11JE; .� _.. ...-__-_ _,.__. - _ I APPI.IGAWT:
No. �n / z Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: i
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
RpPlitation for 0sposal 6pstent Construction j3prinIt
Application fora Permit to Construct( ) Repair( grade( ) Abandon( ) &/Omplete System ❑Individual Components
Lo`cation Address or Lot No. I Owner's Name,Address,and Tel.No.
As Aso s Ma4a� l ~y `^ �(/Gri ( ri�N►QN
Installer's Name,Address,and Tel. o. Designer's Name,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 bate
Title 02
Size of Septic Tank �1 Type of S.A.S. /
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) /d G 'L I.7 'f �/ � f 0*1 d
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 He
Sigied, Date 7 L
Application Approved by Date 7
Application Disapproved by Date
for the following reasons
Permit No. d 3 Date Issued Z
c
_ Z 7
No. �.o l(i I Fee
r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2ppliration for Disposal ,4pstem Construction Permit
Application for a Permit to Construct,( ) Repair(`)"'Upgrade( ) Abandon( ) V[a°Complete System 0 Individual Components
Location Address oLot . y l f Owner's Name,Address,and Tel.No.
e�� � , U -
-Assessors Map'`/Parce () r
Installlerr's Name,Address,and Tel.Iro' Designer's Name,Address,and Tel.No.
9
Type of Building:
F.
}� r
Dwelling ),
No.of Bedrooms j{ , w / Lot Size sq.ft. Garbage Grinder(
• ti
. . Other . Type of Building No.of Persons Showers( ) Cafeteria
x. a
Other Fixtures .
Design Flow(min.required) gpd Design flow provided NJ / gpd
Plan Date Number of sheets I Revision Date
Title
Size of Septic Tank Type of S.A.S. ��t
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) h
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore'described on-site sewage disposal system in
r
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
Signed 8 Date 7` f
f A .
Application Approved by 1 i` (a Date //1 7 ,�
Application Disapproved by (. Date
for the following reasons
s
Permit No. 4 u0 3 Date Issued
w ----- _ ,- R .,- :.4- -, - - -- - -------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(,<' Upgraded( )
Abandoned( )by 1 �.W h 4 "� Pi.-✓ r 4= /�K,, 1 tC�+ ,,
at A (n 1 Ln fi has been constructed in accordance
with the provisions of Title 5 and the for Disposal S.yste(m�Construction Permit No. I _ Wdated 11
Installer�I'd a o 0 15G�.l a•�cam"• 4/ Cam' to Designer { d
#bedrooms Approved design flow,
rr s ,� �J� gpd
The issuance of this permit shall not be construed as a guarantee that the system will:6&tiow as designed.
Date ))l o b t Inspector t�� r14 A
_ --------- t
_-.------------,----.-------------:-------------..-_..__.___.____.__._.___.___:-_.-.--
' . No �_U ;-t-- "!r Fee .
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS
Ucr Disposal *pstem Construction Permit
Permission is hereby granted to Construct(L ) Repair( Upgrade( ) Abandon( )
System.located at C- 7'c., / L 7 C)
and r'as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty n
to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit.-------- ,
Date A
F 1
roved by
PP
l f