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Home My WebLink About0139 AUDREYS LANE - Health �� , (AD ASSESSOR'S MAP N0. '� PARCEL LOCATION SEWAGE PERMIT NO. VILLAGE .t�INSTA LLEJR'S NAME i ADDRESS _ /V'iG� .a6 e- IJeUILDER OR OWNER ' DATE PERMIT ISSUED __ DATE COMPLIANCE ISSUED AV tAAC r �- 1 0 - CIS!- J� PARCEL M. FizS......................... _ THE COMMONWEALTH OF MASSACHUSETTS ;BOARD OF HEALTH 4".1.1y..............OF.....3.!ez, S��.%3t ....................................... Appliratinn for UiipnaFal Workii Tunotrurtiun ramit Application is hereby made for a Permit to Construct (/) or Repair ( ) an Individual Sewage Disposal System at: ... . .....& kii ..mars �-- n'1-((s=----------- ---------------------------------------- ----------------------------.........._.....--•- -_.Location-Address A. •.---o )'.gt,No. .... .......................•-••--....-------•------......-- �(. .. �� ..- ..................... y�,, ,t pg Oaner PA p Ad 3 ress Installer Address d Type of Building Size Lot.... _----.Sq. feet Dwelling—No. of Bedrooms........................................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—Type of Building No. of persons............................ Showers — Cafeteria 44 Other fixtures ....---•-•..... --•---•----•--•••-••••-••-••••-••••---•--•-••-•-•-•-•---•---------------•----••-••-•••-••••••--•-••...............••-••.....-------- W Design Flow..........................`----._..........gallons per person per day. Total daily flow.... ............................gallons. WSeptic Tank—Liquid capacity.je`- gallons Length Width..... _.A Diameter-----_"------- Depth...?.. ".. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No............. Diameter......�6`_..... Depth below inlet....G........... Total leaching area..aG7-_,..sq. ft. Z Other Distribution box ( ✓) Dosing tank ( ) _ '~ Percolation Test Results Performed by....bo�✓!�....G?! !=.. _^!e�z 2............... Date.... ...-�.�'b�.............. ,tea Test Pit No. 1......?.......minutes per inch Depth of Test Pit.... 3......... Depth to ground water................................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a .................................-........................................................................................................................... O Description of Soil.......' .. ...� .............................. W 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 TLITALE 5 of the State Sanitary Code The under igned further agrees not to place t system in operation until a Certificate of Compliance has b n ' d b arch health. _ r / -�� 2n Signed. .•••••• ••-•-•••-• -- -- ----- --------••-............................. Y� Dae, Application Approved By................ --••..-• -----•-•-I .-� ------r........ ........-•-----•............... ...................•---••----- Date Application Disapproved for the f of ing reasons:-----•---------------------------•---...------------------------------....------------------------------•------ -•------------------•---........-•---•------^----•------------•----------................-•-------•----•..---•-----------..........--------•---......-----------------------------'- -•••••--•-•-- Date PermitNo......................................................_.. Issued....................................................... Date a r.� No......................... Fza........._._...._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration for Uhipaoal Works Tnnitrnrtion rrrntit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................_....................• .. ..................................•-_. ..........._............................. : - ....... ...--•--........»........-- Location-Address or Lot No. ----•--•........................................................................•••.......--•---.. . ..............................................•-•.....»................................».»..... Owner Address W ...................• .......... ..- .......... Installer Address U Type of Building Size Lot.... __fi a2 2......Sq. feet �-, Dwelling—No. of Bedrooms......�*�'...............:....................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—Type e .of Building _.____. No. of persons............................ Showers c�.l yP g ..............•-•-•-- P ( ) — Cafeteria ( ) Q, Other fixtures . :....... ............ d w Design Flow...........................'>...........:.....__gallons per person per day. Total daily flow.___. ..............gallons. WSeptic Tank—Liquid capacity_Z� "gallons Length__��_.G.'. Width__.�__ �: Diameter......7....... x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching are�?._.._._.........sq. ft. Seepage Pit No.___.__._._�____... Diameter....... �_..... Depth below inlet..... 1.__........ Total-46 r area__;24 e......sq. ft. Z Other Distribution box ( v) Dosing tank (f ) Percolation Test Results Performed by...__ a - ... _�'✓� ? �Q-S/a .�..................... 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........................ ------------ Description of Soil.........$.'......... -•-----• .... :.... '', Y- - `mil= x 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 TITLE; 5 of the State Sanitary Code—.The under igned further agrees not to place t system in operation until a Certificate of Compliance has b n b ard, health. Signed. --• --••• -0 ~' - ll ............... � ty� Date Application Approved B ........ ....... -- QY PP PP Y - �. - • • �� , Date Application Disapproved for the f oll ing or ..........._________________________________________________________________•__.._._....___...________....»»» .........................................................._..................._........................_ ..........................................................-................................ Date » PermitNo...................................................»»_ Issued................................--•----•-----...... Date *. ,» THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �0. +.......OF.......... / �Z----�---.......... f9rrtif irate of Tontlrlianrle THIS IS TO CERTIFY, That the Individuo Sewage Disposal System constructed (>f or Repaired ( ) ''by............................................M►1?.:1................ .. dp 'c' ...........•.............................................................. QA r^ n taller y_... t 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...... ..... ___ dated..........4,__r`�._r:. ,�........... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTVON SATISFACTORY. _ DATEj " •- ..._.. Inspector.......................................................0.-•---------..........-----• �vi�lhef t'` 1�VS I c �^�•t�� THE COMMONWEALTH OF MASSACHUSETTS ('-er'r V% Tt,�S4A11^4ivN) -a4.`�"lJ If Ai-tONis BOARD OF HEALTH :1 vV w r'%i-r;"j t 6 - ? ................................... ..OF.................._._.....................-------------................._.......... No..... .............. Fn.... .... 3lisposal Worko Tunstrnrtiun rlermit Permission is hereby granted..............N-j;-Jt_m..........&_4-Yk__e r_--1Ejn.-----......_.....---._..............---..............:.........._. to Construct 010 or Repair ( ) an Individual Sewage Disposal System atNo....................................... - x.-ty------------- kyl:.x_ ...! Street as shown on the application for Disposal Works Construction Permit No. ...._ . . Dated......... f Vqj e • DATE.... _--- �C alth ..........................•----•-•-•�-' Q Boa o H FORM 1238 A. M. SULKI INC., BOSTON t fat 29 vccup4,ed . Jot 42 n uo'ccapied G3,4 L24 PK 0.00 9•l b anda abt e, nra to t tat 4,4 to »,copoaed ,A Cbe aenroued 10 awund pact and Audae�a � -t ptaced with ctean ?�,U. �yi '�. ,Pot 30 40 wide unocaup-i a :64.z P, W12 4tone PRo,?ose o 20,000 ',9. VA f 267 =549 9�.p.ai. 343 ,o. 1501. " E 0.07s .tot 3! occupied .4.c� ico4.Qo Lj O �K 59.3 v i �•,o unoccupied E ��co ilz No Scale t-'� Scate l °-30 z �n ro Da-te 2-10-86 V , 1500 -6 !�G 6 Pit 'r rat 4 �,•��{ qU-Cape £n94nee44nF .y.y 49 14aabo2 , oad Id yavrrti4, Ma. 02601 L.----_ ,o' ——� I i . Sketch P a4 'o?- -Pand in Hat ton. ;`ittd., Ma. }o�c teewaut Ilea t ty 9,c. i i'e'Af tot 43 as aAown on a p.tan oi- `'Wake)q Catatea''' and te.co&d ed in ,k.272 ! §� 92• { I Resat io► i dlwwn a ce ba4:ed o4 an ay.u' d datunt. ' Jedt Pit 4j)-602 Sate,`---- --- errt:`R `i oair� o `l� th--- &de 7-30-81 I ! Wit.6aan, lad, o Rea t th No wa te�c encoueAzd i Pe&c, date tee. tha4 2 nun.�/ rr i " do an i 59iG , nzeclucm. { r j ; 1 to ... .. - __..._ ...... cocvti e ,, . . .. . �/Gall(.t dF!/C WILLEAA H.! FARDIE p o.-8095�O S T E $O.G TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: Mail To: BUSINESS LOCATION: \ `ajixu Board of Health MAILING ADDRESS: (?-0 ®�`� , �� (� Town of Barnstable P.O. Box 534 TELEPHONE NUMBER: ITS D,o• \04QL Hyannis, MA 02601 CONTACT PERSON: 62&-ki EMERGENCY CONTACT TELEPHONE NUMBER:`5L)18� •L1vX0A0Lk9- Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalp<at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business