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Home My WebLink About0991 OAK STREET (CENT./W.BARN) - Health 991 Oak Street 4w I�VogAble A= 216 -- 041 -r TOWN OF BARNSTABLE LGW TION �l G�A/�57L SEWAGE # T61 !G Y ^7 VILLAGE- �/ • ASSESSOR'S MAP LOT L-y INSTALLER'S NAME 6i PHONE NO. �G�� e'cr'L S SEPTIC TANK CAPACITY law ��-- LEACHING FACILITY:(type) iL (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER W BUILDER OR OWNER Vh 4CC DATE PERMIT ISSUED: DATE COMPLIANCE.ISSUED: VARIANCE GRANTED: Yes N1 L e 3 TOWN OF BARNSTABLE -.LQCATION OA K 5 1, SEWAGE#6 c� VILLAGE ASSESSOR''S�MAP&PARCEL INSTALLER'S NAME&PHONE NO. N SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO.OF BEDROOMS OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the 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). n feet FURNISHED BY I --------------------------- A _G y ► c D ASSESSORS MAP N0: A PARCEL NO: 6� ;? Noj.�..:J THE COMMONWEALTH OF MASSACHUSETTS 0-1 , ApnTflWD BOARD OF HEALTH:ull "'�� ..!!C�`��C ►a�TOWN OF BARNSTABLE,� ltrtt#tla�c f�tx i� n �gl xk Cn a� iuu amt# � Application is hereby made for a Permit to Construct ( ) or Repair (t/jan Individual Sewage Disposal System at: ................_....�.................................... .'..s%c..`....� ....................•---•-•---•-•--•------- ------------.........................---- Location Add or Lot N -••••-••--•-•---• ---------------------------- ........ .......--•-..... ............• - Owner Address ........................................... . . 0J ----- --------- --------------- .................................................... --...•-----•••--••--•------•---............ Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.__.....�3..................... .....Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures .................................. 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1-___---_____-_-minutes per inch Depth of Test Pit.................... Depth to ground water........................ LT4 Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................ a .......... ------------------------------ ••...... ........ .--•........ ....--------------- .--------- .--------------------------------------- ....-•-------------- 0 Description of Soil....................................................................................................................................................................... W U -•--••••••-•---....---•-...••-••••-•--•----•-•--•--•-••••-••-••---•••••-•-•----••---...••--•-•••---•-•-••••-•---•••••••-•--••--•-•-•••••••-•-----••---•-•----•.......-•••-..........-•-•••......----•••- UNature of Repairs or Alterations—Answer when applicable----------%y1_____. /...... .......!_. ..OP.vyf Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complian fbn issuue/e��d by the boa d of health. Signed ................ .... ...C/...�.. .. -- - .................. .---. .o1 Date Application Approved By ---------------- V...�.. ...-----------------... .---.-- -- -----. --.............. .- 7J0.....-% Application Disapproved for the following reasons- -------------------------------------------------------- - ----------------------------------------------------------------- --------------------------------- ------ ------------------------------------------------------------- ------------------------------------------------------------------------------------------------- ---------------------------------------- Permit No. .... -...----- --------_................ Issued ...---.....................................---....-----Date Date N o.T�;L /F Rz THE COMMONWEALTH, OF MASSACHUSETTS BOARD OF HEALTH _ "TOWN OF BARNSTABLE Appliration for Uiiixonttl lVerkg Tvnstrnr#inn rrmff Application is hereby made for a Permit to Construct ( ) or Repair (t,�''an Individual Sewage Disposal System at: Location-Address or Lot No. •.• . ... �x.Q� ..,t�.1.�1.� .............................. ........ �1.. � 5..s�`.....1v...1. .........---- Owner e—" � � _... �A.lddre.ss I ....�._ ................ ! G......... Installer Address Type of Building Size Lot............................Sq. feet V Dwelling No. of Bedrooms ................. ...__Ex Expansion Attic� g— --------- p ( ) Garbage Grinder ( ) a`4 Other—Type of Building No. of persons............................ Showers g ---------------------------- P ( ) — Cafeteria ( ) 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................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........................ P4 •-----•-----------------------------••-•------••--••--••-•-••------••-•----•----..............--•-•-......................................................... 0 Description of Soil........................................................................................................................................................................ x w x ---------------- �. U Nature of Repairs or Alterations—Answer when applicable........./,I.S ..........t -r_s...._Nir-�l .................................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complian as b n issued by the board of health. Signed .......... . . .............. 3------------------------- Due3 0 .. .. ------------------------------- Application Approved BY ... �t2 Application Disapproved for the ollowing reasonr- -------------------------------------------------------------------------------------------------.................................. -------- -------------------------- PermitNo. .........��--,.....�....--.../�.............................. Issued .................................--................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE CEex#ifi ate of 011oxttjiliartc.e THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by------------------- ' - I ----------------------........................nstall-.er.-.............--------------------.....------........-----. ....-------- --------------- -- ----.......---.. at ------------ --.5P'...----- --- --.... i/a� -1 .............................................................. -- ------------------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. .../ ..-....1.3-:f................. dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ` t DATE..............................�,` ,.:.........`................ -----------...... Inspector , ..... ... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 9 TOWN OF BARNSTABLE No...,...�:...s�:�.. FEE.�.................... Roposal Workii ®rmonotrudion rrntit Permission is hereby granted--------)n_!diividual pl c----- `-------------------------•- -------------------------------------------------------------- to Construct ( ) or Repair) an Sewage Disposal System r. { , y as shown on the application for Disposal Works Construction Permit No�.=_h_/.._.__ Dated......................................... y -- •---- .. ------ ( Board of Health DATE...........K...... !?=�1 lJ FORM 36508 HOBBS h WARREN.INC..PUBLISHERS TOXIC AND HAZARDOUS MATERIALS 13021STRATION FORM NAME OF BUSINESS: djlcha ,v f jiw Mail To: BUSINESS LOCATION: 1/ Oi K S-f Board of Health MAILING ADDRESS: W-eo't I.SAZV,, '*' a' z---Gly Town of Barnstable P.O. Box 534 TELEPHONE NUMBER: SAX 3(o Z `�9.0� Hyannis, MA 02601 CONTACT PERSON: - EMERGENCY CONTACT TELEPHONE NUMBER: SA✓KX— Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO I/ 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 I 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 64 \N. O�A-Zr)-kl. ,r. -• . TOWN OF BARNSTABtE PRESERVATION —- ( LU EC'e CC � O O �.L Q. 3YU ov ton - ;FHI I� i - 6,464E i f S i oo � � 3'1 �l Alp ; — oc o E I I I I ' M0 EU i I. 344�=0.". I ---- ..,..----....__. .. ------._. _. ....... --------- - I i ...... _.. - —-- — 37-6 • i f� N c.rna� i• 1 1 a� .......... 7F CDE 1 1 PRO n31 , a - --- j --- i I Al PH -RIYPOPP 2°X IOu �F� i TI-I WDU17 z x 4" 4-5ruAs • � 1Z-19 DNS, € I 2°x8 �Tol&T p ' (15"/Nja �ouN,�-TioN�B'Syr9�l/ 26°X lo" -Fool'iNGI x S"T++k colic. w Ai l- e i 20"x 10 -Foa;,N A � CoN�i. WAIL ( I Ir d — I htES �N S bl. i_a BuMp OUT E F E C v k t 1 i T Iluppoom 5-A 5T_7AT+4.P-OaM + ',P�VMF CUT air 1-0 ,T�o $ mP 90T . a C A 1 s 0 3