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HomeMy WebLinkAbout0134 OCEAN VIEW AVENUE - Health 134 OCEAN` COTUIT Fee----- - -- BOARD OF HEALTH TOWN OF BARNSTABLE ZippCicationArVelr CongtructionPermit Application is hereby made for a permit to C struct ( 4T,-Alter ( ), or Repair ( )an individual Well at: Location — Address Assessors Map and Parcel ----------------- -- - ----- --- ------------------------------------- ----------------- Owner Address ��------ -- - �3 oXQ SG ��•�t�f�c G�.g� ------------------------ --------------- ---------------------- Installer — Driller Address Type of Building Dwelling-------------------------------------------------- Other - Type of Building--------- ---------- No. of Persons---------------------------- T e of Well— Cwec YP .T---------------_--- - Capacity------------------------------ Purpose of Well-------� Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation untilA Certificate .of Co pliance has been issued by the Board of Health. Signe ---- — zoo PP PProve A lication A d B Y / Application Disapproved for the following rea ns•----------_------- —---_------_—________—________—___—__—____—_ ------------- — Gate ----- Permit No. -- Issued--- -- -- - - -- ---— ---- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) by----- -------- --_------ --- - -- - Installer at--— ----------- --has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. --------------Dated----THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE_---- -- - -- Inspector-- - ---- ---- —--_—___ BOARD OF HEALTH TOWN OF BARNSTABLE ~ Mel[ Con5truct ton Permit No. -1��+�-- -� —©/I Fee-- Permission is hereby granted _ _ JV to Construct ( ), Alter ( ), or Repair ( ) an Individual W a No. - --------—- -- - - --- - - Street as sho o the a plication for a Well Construction Permit No.- ©� � ---__ Dated- ----- ------------------------ oard f Health DATE __ ,#, f IVO.----=�-- � BOARD OF HEALTH Fee'---- � J TOWN OF BARNS.TABLE� '' � ' ��pCication,�or�eCr �ongtruction�errYit Application is hereby made for a permit.to Co sfruct ('Alter ( ) or Repau ( ':)an individual`Well at: w. . 3.4_0 44 t Location Address r' a Assessors Map and Parcel * ^ —=—Owner Address i �l„�-,�r-.� ------ -------- oar------ Installer.. Driller Address Type of Building Dwelling------ -- =------------ ------- ----------------- Other - Type of Building No. of.Persons--- Type of Well^�_ d - ------ — Capacity=--- -- - --—- - -- Purpose of Well -=`<It—d" -- ------ Agreement: The.undersigned agrees to install the aforedescribed individual well in.accordance with the provisions of The 1 Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to_ place the well in operation,until,; Certificate of C mpliance has been issued by the Board of Health. x, Signe --- A h - - --- 'L'- ---- /. date r Application Approved By l P f ate Application Disapproved for the following rea ns -=-----------------__ ____- _ _—_ t t date Permit No. q — Issued'=---- ---- p date — -- t el T�if+ w4i�eTi.iil?iflir�ilOildlit61►0a0iPi!bMSPilbo'd$4� 4v9iHsTifi9.iY4tifiTOiMilitsM4$sYlY�6MlQ'�iliRBl8N1ilt7!$ti4iHKMeC'itSliF61i4iti�/i40lsif_ilMifbR$Pile4i�rT.Ow4l4�i�i BOARD OF HEALTH TOWN OF BARNSTABLE ' (tertif rate ®f comphance - - THIS IS TO CERTIFY,'That.the Individual Well Constructed ( I, Altered ( ); or Repaired ( } i by-- —_ _-- --- -- - - - - - ----- --= -- — —Installer at —---- - -- -- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction.Permit,No. -------------Dated---- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS-A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE------------- —- --. Inspector-- - ---- ----- —------ - �i?+��iaPw"Mr�gRi?IeAiN.«9alO�T"R$�44i?R!Y4i4'8ai4.4T5lis+q�bRi9iRit?inlbCiE*4d'S446ii.8flii R&.!fi9398'SiT84NRi16�i±t(ii!i�..I�,iT.l;i�omi4,$?.oaB'td�iTN3ir.li'_°drmi!i4i.!.i'`?iFfbT.Sf'$Qi^4r!.i BOARD OF HEALTH TOWN OF BARNSTABLE e[C Con0ruct ionerntt �. No. - A) �00 --0 C Fee- i t Permission is hereby granted to Construct Alter ( . .), or Repair ( ) an Individual We, atl No. --- ------ - =----- - - - - - - street as shown o the a plication for a Well Construction Permit v %C� -- O No.-- ------- Dated-- - — ----- - - ®� oard of Health DATE -_ TOWN OF BARNSTABLE L(')(:ATION�� .-SEWAGE, VILLAGE " ASSESSOR'S MAP &c LOT INSTALLER'S NAME & PHONE NO. U04_-? SEPTIC TANK CAPACITYr LEACHING FACILITY:(tyFe) /12v-a (sire) NO. OF BEDROOMS / PRIVATE WELL. OR PUBLIC WATER��1. BUILDER OR OWNER DATE FER..MIT ISSUED: �-�`� /`/ $7 DATE COMPLIANCE ISSUED:-- VARIANCE GRANTED: Yes __� No I ; 71, _ 73 1 1� TOWN OF•"BARNSTABLE LOCATION " 3 �t l. `:6.�. e—SEWAGE # �5 VILL1fiGE` � Gt{f f ASSESSOR'S MAP 6z LO &63 0�� INSTALLER'S NAME PHONE NO11&a--V SEPTIC TANK CAPACITY Z�I,pr v �� LEACHING FACILI Y:(type) - L- (size) NO. OF BEDROOMS PW- *HE-�LL OR PUBLIC WATER BUILDER,OR OWNER � z DATE PERMIT ISSUED: • �� " ' DATE COMPLIANCE ISSUED• VARIANCE GRANTED:des- No ;�- !� f f �� � � , .� �� �� � i � ,1 tea r � .. ��� y n =� �� V I �_ 1<�G A- No......lt�... Fins THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................................OF.........'... _Z....--------------------------------------- Appliration for Dispasal Workii Tonstrurtion ramit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: A,.e-(V.......ait,6t�.. ..............w.............................................. ...... Lee t' n,Addressj Dr/Lot No. gleew4� .....full .... ...............VjW- - ---------------------------------- . .............. oA_ Addres A- 71h Installer Address Type of Building Size Lot.......P_CY&___.Sq. feet U Dwelling—No. of Bedrooms.__..._.................................Expansion Attic Garbage Grinder ( ) 04 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria ( ) 04 Other fixtures ...................................................................................................................................................... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity............gallons Length_............. Width---___-____.-___ Diameter__._:-_--___-__- Depth..__.__.._...__. Disposal Trench—No. .................... Width....__.............. Total Length...__............... Total leaching area....................sq. f t. Seepage Pit No--------------------- Diameter.._.........___..... Depth below inlet.._............._... Total leaching area..................sq. f t. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Per-formed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit._______............ Depth to ground water.._..................._. rZ4 Test Pit No. 2................minutes per inch Depth of Test Pit__._............_... Depth to ground water------------_---------- 9 ............................................................................................................................................................. 0 Description of Soil........................................................................................................................................................................ U ................................................................................................................................................................................................. W .................................................................................................... ............ ------ lc� -- ----�Ii­l..... eT ;;;:.. . . ....A U N of Repairs, ;�e,,AT .Aure ef irs,or Alterations—Answer when applica-bl . . ........ .................. Agreement 9 - ------- The undersigned agrees to install the aforedescribed I;dividual-Se age Disposal System in"ac�� the provisions of TL I1.1i LE. 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be(n-')lsued th oard of heayhW. Signed---..— .......... .... ......... .......................... ..... ........I.................Date .... .......... ApplicationApproved By...... ...... .... ...................L. .......................................... ........ Da Application Disapproved for the followin easons:................................................................................................................ .........................................................................................................pp .......................................................................I........................ Date PermitNo......9.2..... .................... Issued....................................................... Date No.....Sk .. Fnim ........ THE COMMONWEALTH OF MASSACHUSETTS BOARD, OFHEALTH .................. ------------ ......OF..._.. Appfiration for Disposal Works Tonstrurtion Prrutit Application is hereby made for a Permit to Construct or Repair (� an Individual Sewage Disposal System at: 1 12 'r lew O'K41 (�ra4' ....Ia. ... .....-----------------41(L1.0----- -------------------------------------------------------------------------------- ........ Lo 'on Add Lot N 3 & A /T-'t /...... 'e I a , ..I.&&Z ......6.4�!L 26 tj................................ .... ...... .. ner Add f ZA��.......U&............................. ....Oil ......FA.....0............................................... .....bi Installer Address Type of Building Size Lot--------6-7aZ.......Sq. feet U Dwelling—No. of Bedrooms......../_1................................Expansion Attic Garbage Grinder P4 Other—Type of Building ............................ No. of persons..........._._..._...__.___. Showers Cafeteria 04 Other fixtures ..................................................................................................................................................... Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity------------gallons Length................ Width.........._..__. Diameter_____......._._. Depth_._..__..._..... Disposal Trench—No..................... Width_...._____...__..... Total Length___...._.__......... Total leaching area....................sq. f t. 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_---------------------- r3LI Test Pit No. 2................minutes per inch Depth of Test Pit.__.............._.. Depth to ground water-..---__.__-____---_____ x --------------------------------------- '--------------------------------------.....---------------......................................................... 0 Description of Soil......................................................................................................................................................................... x ................................................................................................................................................................................................. U ....... ------------------------------------- ......................................................................................• .............. .............. U gure of Rep,airs or Alterations—Answer when appliqable_1,_ --------14.j . .....I......... -----------IS----------- .................... AgreementO The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 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 'ssue I t e oard ofhe4th. - ; C4 .Signed..... ..... --- - -------------*---------ram ........Da.t e............. .. Application Approved By.... A------------------------------------------ A ------------------- Application Disapproved for the followino reasons:................................................................................................................- ........................................................................................................................................................................................................ Date PermitNo.......................................................... IssuedL....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH .........................................OF...........41.._ ............................................. THIS 19 T161 CERTIFY, That the Individual Sewage Disposal System constructed 0) or Repaired by------------------------UL............................. ......................................................................................................................................... nastall at.... .......0.1 .1, .............................. ................!��......4��..... .............................................. has been installed in accordance with the provisions of 'i" ' if The State Sanitary Qade as d crib d * the -rl ...s.S.. . d application for Disposal Works Construction Permit No. ate, ------U...I......... ............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE................ ............................ Inspector...............6-J__/------------------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH z .............. ......................OF..... ......................................................... N ................... FEE...............`........ M111111s ork JII strudian "pamit Permission is hereby granve i......V! T�11 ----------- ------------------------------------------------- ..........­.............*.......to Con lStrup* ividual Sewage Disposal System or Repair an Individual C).<_R e_j...........U aL N 0. ..........(/ . ......................................................................................................... Street ......... as shown on the application for Disposal Works Construction ............. Date Armit ...... ...........N.A-��p.. .................. .......................... DDATE........... ....51?.................................. Board of Health.. .... .. ...-- FORM 1255 HOBBS & WARREN. INC.. 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