HomeMy WebLinkAbout0241 LONGVIEW DRIVE - Health 241 Longview Drive
Hyannis
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TOWN OF BARNSTABLE
LOCATION . SEWAGE #
VILLAGE ff4ff
ASSESSOR'S MAP & LOT 2L L l`3�
INSTALLER'S NAME&PHONE NO. I/ �.��
SEPTIC TANK CAPACITY 1 m Rita
LEACHING FACILITY: (type) L.4� (size)
NO. OF BEDROOMS_ 2)
BUILDER OR OWNER
PERMUDATE: ' l'L - 01 7 COMPLIANCE DATE: l —9 1
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
Co
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M
v
No. Fee N
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
Zipprication for dig og r 6potem Construction Permit
Application for a Permit to Construct( )Repair( Upgrade(' )Abandon( ) El Complete System ❑Individual Components
Location Address or Lot No.*.'�q LQf►�c U(r a�v�i Owner's Name,Address and Tel.No.
Assessor's Map/Parcel ZYs I '791G{_Wu h/f
Installer's Name,Address,and Tel.No. 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 gallons per day. Calculated daily flow 330 gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank 5T�12Z�?) Type of S.A.S. lSkCQoc;ram
Description of Soil
Nature of or Alterations(Answer when,applicable)
Seep-ST vet t t-{ itrS�'t BOG iT�1— NaG/L�rk70!?�
Z SOU arw, -Sl d e1 •1- 4 Lf/r ---
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 lace the system in operation until a Certifi-
cate of Compliance ha Health.
Signed Date a�1
Application Approved by Date ( - 7
Application Disapproved for the llowing reasons
Permit No. 7-7 - Date Issued
No. / / 41 Fee 0
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION —TOWN OF BARNSTABLES,MASSACHUSETTS
Zpprication for Mig og *pgtem Congtruction i3ermit
Application for a Permit to Construct( )Repair( Upgrade( ' )Abandon(/ ) Complete System El Individual Components
i
Location Address or Lot No.z)�4 LDS Utrv— Owner's Name,Address and Tel.No.
Assessor's Map/Parcela--
Installer's Name Address,and Tel No. 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 gallons per day. Calculated daily flow 3�� gallons.
Plan Date Number of sheets Revision Date
` Title
Size of Septic Tank I QV-?) Type of S.A.S. S h CkT�� ;r�'L-
Description of Soil __ 1�'�� ` D
Nature of Re irs or Alterations(Answer when applicable) L4 �`��ri
S,0�
f 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 thelEnylLonmental Code and not to lace the system in operation until a Certifi-
cate of Compliance 11rssu2ti-bq-t ' ealth. C
Signed Dated ' a��
Application Approved by Date r- (� - 7
Application Disapproved for the ollowing reasons
V,
Permit No. 7 -7 - Date Issued
--= --------- —————— — 1-- ------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
(Certificate of (Compliance
THIS IS TO CER he qhrsit �age Disposal System Constructed( )Repaired( )Upgraded
Abandoned( )by C �✓
at Ut e cv (Jr _ C.e�,Tcw a\ has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 9 7 dated
Installer Designer
The issuance of 's permit shall n t.b construed as a guarantee that the syste will f n i as designed.
Date L/ v e5 Inspector
———————————————————————————————————————(
No. % 7 L/ i i-i Fee 1-5-0
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
lwigpogar *pgtemgtruction permit
Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon( )
System located at V-
0,C
C-e w'z—
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty 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: - 7 Approved by
ro +
NOTICr: This Form is to be used for the Repair---of Failed "
Septic Systems Only
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
1VORKS C ONSTItUCI'ION PEItMI'I'(W1'I'I1QU'1'DESIGNED PLANS)
1, 7--
hereby certify that the application for disposal works
construction permit signed by me dated concerning the
property located at meets all of the
following criteria:
• There are no wetlands within 300 feel of the proposed septic system
• There are no private wells within 150 feet of the proposed septic system
• The observed groundwater table is 14 feet or greater below the bottom of the leaching facility
There is no increase in flow and/or change in use proposed
• There are no variances requested or needed.
SIGNED DATE:loe
LICENSED S IC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER
of the proposed stem. Also if the licensed installer senses a certified plot plan,
(Attach a sketch plan p po system. Po
(his plan should be submitted],
�#
c�
" TOWN OF BARNSTABLE
LOCATIQN. . c
SEWAGE
_` Ce•• r
AS
VILLAGE' SESSOR'S MAP & LOT Z:v d ^ l3
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY ¢'
LEACHG.FACILITY: (type) N �-� � (size)
IN NO.OF BEDROOMS
BUILDER;OR OWNER
PERMIT DATE: i a
C
- - 7 OMPLIANCE DATE:
Separation:Distance Between the:
Maximum:Adjusted Groundwater Table and Bottom of Leaching Facility
Feet
Private WaterSupply Well and Leaching Facility (If any wells exist
Feet
on site::or:within 200 feet of leaching facility)
Edge of W.W.And and Leaching Facility(If any wetlands exist
Feet
within;:300 feet of leaching facility)
Furnished:by:
A
A - ,3 '-
LOC-QT_IO.N_ '_ � 5EW n C E PERMIT WO.
577TAL_LER 5_1J�NlE_�_AD_DRESS __
el
5U:I.LDE�jR_5_t.1_&M-FE— AS,D.DRE 55__
---D�►TE_P_ER►v�1T_1_SSU.ED;.—.—_—�—_--- —,— --
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THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal
System at* 4/00
Address
.(.e
Installer Address
Dwelling—No. of Bedrooms........... ....................Expansion Attic Garbage Grinder
Other Distribution box Dosing tank J Z7e
1.4
----------------------------------
----````````----'``---`----`—`-`—`--`--`---------'—'---'----'----------`---`
A&rccoeot:
The undersigned agrees to install the uforc6cocribe6 Individual Sewage Disposal System in accordance with
the provisions of Article %Iof the State Sanitary (o not mplace the system in
operation ^
liance has been ed 4e board of health.
»"te
Application Approved uy---'.. . —. .~ .o..,c . . ------'- --'�
�
Application for the reasons:—_.,—'-__'_ Date
--'___----_---.--._---_'-_..-......
---.-------.—_.'—_'-'--_-----.__-----'' —.---_------.---._----.—._-_'-
Date
Permit Issued.....................
---
_______'___—________ _ _
? --,.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F HEALTH
_....-.. ..._OF........ 1 '' .
...fly .........................
Appliratiou -for Uiopoottl Workii Tontitrurtion Vrruiit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:,
...........................................I................. -----------•---------------•--•-----•--••---•------•-------••--•--------......---------...----•-.
'Location.Address/ �p i� or Lot No.
/" 7
•---------•-----•-----•.......................•----•-------------•------------------............. ..---....-•--•-----....•-----------..............................•..............._............----
Owner Address
Installer Address
Type of Building Size Lot___________________________Sq. feet
Dwelling—No. of Bedrooms------------ "`"_____________________Expansion Attic ( ) Garbage Grinder ( `)
Q, Other—Type of Building ---------------------------- No. of persons.._____________________._.__ Showers ( ) — Cafeteria ( )
dOther fixtures ------------------------------- --
W Design Flow---------n�..............................gallons per person per day. Total daily flow............................ ........gallons.
WSeptic Tank—'Liquid capacity-------____gallons Length------------- Width................ Diameter___._..._...____ Depth_.______._.--.
x Disposal Trench—No. .................Z Width--------------------- Total Length-------------------- Total leaching area--------------------sq. ft.
Seepage Pit No.........1........ Diameter.Z:=........... Depth belhV mkt.... ............. Total leaching area......--_..__.._.sq. ft.
Z Other Distribution box ( ) Dosing tank ( ) 0/✓� Q'G
'-� Percolation Test Results Performed by ------- •----------------------------------•----------------•--••-•- Date---------------------------------------
i.-I
Test Pit No. 1................minutes per inch Depth of "Pest Pit.................... Depth to ground water.-----------------------
rZq Test Pit No. 2................minutes per inch Depth of Test Pit___________.________ Depth to ground water-.._..._____._.___-----
Ix 1 ,1 rr _ b- •� - -----
Description f Soil L�- j = r° - Z �'= ----- ZJ---= �`d 2wr-r ru., e
( --• ----------C_';I,:- I -._....-----•--- -..._7_�.--_`-..---.....2 ------=-=-T==•�-- ..-•w✓.Jl 5-�—�r
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 \I of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has beenjs'sued by the board of health.
Ac----------- --------------------------------- `
Date
4APPlication Approved By------ 644�-4�
-7 .2 .
7
Date
Application Disapproved for the following reasons:-_..-------•----•--------------•--------------------------.--•----•---------------•----••------------.-.--------
.......----••-•--•----••----.._..--•-------------------------------------------------•-•••-•••-•-•---•------------------•--------••------•------•- --------------------------------------------- .------
Date
PermitNo--------------------------------------------------------- Issued........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.......►.... .... ................OF............ .. .......................:..........................................
�rrtifiratr of Tlimpliaurr
T I--,,IS T C. RT That the Individual Sewage Disposal System constructed ( Z) or Repaired ( )
Installer
at --- --- `�� `
has been installed in accordanc with the provisions of Art' I of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No.-...._'.......1i_;............... dated-.......�=.Z_'. G___________--.._.._.
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE---------- ....... ........................ Inspector.O ---• ........................................................
THE COMMONWEALTH OF MASSACHUSETTS
�b BOARD
/ ... O ...HEALT
No. / ......OF.......... ......................
FEE.... ..................
Di ivo 1Work,-q iit , �tort rrrmit
Permission is hereby granted = •-•--Z
--•---••
------------------•.........------..........---.---
to Construct or Repair n Individual ew���}}Disposal S stem
Street
as shown on the application for Disposal Works Construction P `tit N .... J /f_ Dated_____- 7�
!/ A - -- -
---------------- ---
Board of Health
DATE----` ... •. (/
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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