HomeMy WebLinkAbout0060 CIT AVENUE - Health 60 CIT AVE., HYANNIS
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TOWN OF BA,RNSTABLE V
LOCATION__ �iL _ 4 ._SEWAGE, #
VILLAGE_--��` `-' C ASSf SSO'R''3 MAP LOT 3( Z— 0Z�t/
INSTALLER'S NAME & PHONE NO..",T , �! C
SEPTIC TANK CAPACITY 2L g ('J _
LEACHING FA.CILITY:(type:)^��
NO, OF BEDR00MS___>�, _PRIVA' E WELL OR( UBLIC
BUILDER OR OWNER�M� `�,p"- .
DATE PERMIT ISSUED:_ SIR
DATE COMPLIANCE ISSUED:
r
VARIANCE GRANTED: Yes CO" No�_^�_____i
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THE COMMONWEALTH OFjMASSAZHUSETTS
BOARD OF HEALTH
.................0F..< ...............................
.7.... .
Tatifiratr of Tomplianrr
THI._,�_I, —TA-URTIFY, That the Individual Sewage Disposal System constructed (V,) or Repaired
by........J---:.j.........j2k_1LA.CQ1j..............................................................................................................................................
ihst:aller
at.....4. _-_C_Z�l .....Pw-:��------i......... /.,.0..............................................................................................
has been installed in accordance with the provisions of TITIE '5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No...........?3_�`...ize-.V./..... dated________________________________________________
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................................................................................ Inspector....................................................................................
.1
No....Ix Fx$....../s ......- ...
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH li
__77T&C0_^_.................OF... S A6
Applira#ion for Mipmal 30nrkii Cnnn,> trnr#inn tIrrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
-- ----- E........-- ----- ---------------------•---.._......-•----•--------- .----•----------.......--•--................
a —� � LoGca�1tji_q�!.. dd—r�ess 3L ot
.. ....� _ ----------- -------- , ..._
/ / Add ss
Z-`
/
Installer
Address
Ga
Type of Building Size Lot---------------.............Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building -- No. of persons.................•.......... Showers ( ) — Cafeteria ( )
QOther fixtures .---•--------------------------•---•---•-----------------------------------------------...--------•----------------------------•----------------------
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity420#).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........................................
aTest 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______---.-------_______
x ------------------------------------------------------------------------------------------•-•-•--•--........................................................
ODescription of Soil................../------- ---...--•----- ..-----------•---------•-----------------..........................................................................
x � n !�-
W -•-----•------------------------------•------........---••----------•---------------•-•-----.....--------------...------------._...-•-•-------•-••--•-------------•...................................
V Nature of Repairs or Alterations—A swe when a�licable...............................................................................................
---------------------^�-7 c----� . ---h -.Tuity.. .nK..--------------------------------------------.....-----------------------------------......----
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iI::.L- 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance h n issued y the rd of health.
Signed•. --•-•--...................................... _...
Date
Application Approved BY --- •. --•-••••................. = '
Date
Application Disapproved for the following reasons----------------------------------•------------------•-------••-----------------•----------------------•---------
---•--••-•-••-••---••----•-----•-..........••-•-•-•--•--•-----------------------------•-._.._..-•--•-•-•--•----•--------•--......--••-•-•------ •-•-•--•••--•--•--------•-------•--•...................
Date
PermitNo......................................................... Issued-.......................................................
Date
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TOWN OF BARNSTABLE
LOCATION_ c ; SEWAGR #
VILLAGE ASSESSOR'S MAP & LOT
INSTALLER'S NAME Ec PHONE NO. � � ���� c)
SEPTIC TANK CAPACITY QL ,cC�D
LEACHING FACILITY-:(type) (size) �, -
NO. OF BEDROOMS PRIVATE'WELL O RllI,IBLv
BUILDER OR OWNER ��
j
DATE PERMIT ISSUED:��
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes C/' No
v� t
No................y. / Fmc..........� ..
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Allp irFation for UhipwiFal Works Tomitrurtiun runfit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
..._... .................. -------------------------------------------- ----Lot ----------------------------------------------
Lac tion-Add s *� or No.:�•1._:._ 1ztJ.C`GL�1. ............................ ---•
Owner r Address / !�
---------------------------------------- ...........
Installer Address
Type of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( )
/ _ No. of persons............................ Showers — Cafeteria
a Other—Type of Building � �_.�.. p ( ) ( )
Otherfixtures --------------•-•-•-------------------•-----------------------------------------------------------•----•-••----••---••-•-----.------
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. I................minutes per inch Depth of Test Pit.................... Depth to ground water.........................
(i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_--_-__--__--_------_-_-
P4 •---•-•--••----•-••-••••-•••••--•-•••••••-•--•--------•--•-.........--•--•--•....................................................•----------------------
O Description of
x . . .... , ' - ------.e . - - - - - -....-
W
UNature of Repairs r Altera ions—Answer whe apf li able....___.................:.. ....................................................................
K ......................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iT
p of the State Sanitary Code— The undersigned further es not to place the system in
operation until a Certificate of Compliance een issued th and of heal
Signed- •-- - ... .. .................. ..........................
D to
Application Approved By............... . --- . ... r1 :. ..........a-._-_-�._�_. S_`6
'.........i�-----•----••------••----•---•-----•----------------------•---Date.....---------
Applieation Disapproved for the f ollo ing reasons________________
-----•-•-•-•.............................................•--.................------..........-------••--••--•------••---------••-----••---------••----•---•--•---•----••-•----•••-•••------••------_..._
Date
PermitNo......................................................... Issued........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..P'1 .................oF...' F1 �3 .�11 be...................................
Tntifirate of TompliFanrr
TH-S I&_TO-�CERTIFY, T the Individual Sewage Disposal System constructed or Repaired ( }
by .�...:4�._ '..... !.r-•-1--•----•--------------------••------- . ----------•--------•----.....-•-------•------•-•----------------...........----•-------•-------
,�/ Installer
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........... ___Lf ! .. dated------..........................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................................................................................ Inspector....................................................................................
THE COMMONWEALTH OF MASSACHUSETTS 1
BOARD F HEALT
.................OF............................s-- ,...-...------......-•---.......---
.75
No......................... FEE........................
�in��an l,. n �nn�#rnr#Uan �rrmit
/csPermission is hereby granted..... -�-'................... .......................•--------....----•-•-••-------------...._..------............_......._..-----
to Construct (%t) or Rf pair ( an Individu Sewage Dispc System
at No.................. rrr ........0..--• ..L'----------••-J_V� /7./f U
Street
as shown on the application for Disposal Works Construction Permit No............... . :..
•
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...............•-•-...-•-•-••-•-••--•---••-• -••-•-------•....---•••......-•-•-•-•----•-•---••--
^ Board of Health
DATE-------------------------•--��-... ........................
FORM. 1255 HOSES & WARREN. INC., PUBLISHERS
HYANNIS. FIRE DEPARTMENT 91170
95 HIGH SCHOOL ROAD EXTENSION Z
HYANNIS, MASS. 02801
Paul D. Chisholm
CHIEF Sni(�l�e �BteCtl�zd Sage ,C'iaed BUSINESS: 775.1300
EMERGENCY: 775-2323
PERMIT FOR;
OR REMOVAh AND'TRANSPORTATION OF. STORAGEAN-TANKS t r
FDID NUMBER 01922 DATE OF APPLICATION
PROPERTY OCCUPIED BY—:. --.-. �' =J �; : _` '.
-�• ` tI PHONE.
LOCATION ��oB C_CT-" �r�t 1. -: `� --. �/I f� `"`r
PROPERTY OWNER �+? -k«�g p� __-PHONE
TANKS TO BE REMOVED
ALL TANKS SHALL BY INERTED BY THE USE OF DRY ICE AT 1.51bs Per 100 gal
QUANITYSIZE:--( S) FORMER PROD-UCT� STORED
PROJECT SUPERVISOR CActr��wl PHONE
COMPANY NAME
ADDRESS: 11 A16&
EXCAVATION COMPANY PHONE
ADDRESS: ton r T' �►t� f� .nrnS MA-
DIG-SAFE NUMBER IH_5 ' START DATE.
COMPANY REMOVING PRODUCT A LE PRRO CT FROM THE TANK(S)
NAME r �/-�(vd PHONE 7
ADDRESS : %t rnw_r r,;?crk-_ Atxe0c.,. �G6L y'7A
COMPANY CLEANING THE T NK(S) AND REMOVING THE HAZARDOUS WASTE
NAME : 4-1 A, 1k 5 S0 L PHONE
ADDRESS : l
D.E.Q.E. LICENSE NUMBER: Ex=�pp 11 22 q EXPIRES :
MANIFEST NUMBER: t,n�
COMPANY TRANSPORTING THE TANK(S)
NAME: MetJ 3oc - PHONE ADDRESS : c,e Q Alrc_
THE TANKS SHALL BE TRANSPORTED TO
YARD NAME PHONE
ADDRESS . :
MASS . FIRE MARSHAL' S APPROVAL MBER 5b
DATE OF ISSUANCE : 2.0 Iqq( HYANNIS FIRE DEPART14ENT USE ONLY
DATE OF EXPIRATION : f�(F_ 1A S11 [� HAZARD FOUND - SEE LEAK REPORT
M-""REMOVAL WITtdESSED NO"HAZARD
SIGNATURE OF APPLIC T SIG111TURE OF HYAN44S F.D. OFFICIAL
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