HomeMy WebLinkAbout1555 HYANNIS ROAD - Health 155n5 Hyannis Road
Barnstable
A=298 =011
7
TOWN OF BARNSTABLE
['),CATION �'�� 6 yJA)t5 -/ SEWAGE#
,:TILLAGEAM/VS?n 1, ASSESSOR'S MAP&PARCEL
T
INSTALLER'S NAME&PHONE NO. 0271"O ��Q
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) /Cs'Qo) 07 r/Crd)(size)
NO.OF BEDROOMS ,3
OWNER/vl ArSA17CT` (/C V0AI A/ O
PERMIT DATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Q 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 / `;A (�Q4C>/? AI C2
s6 �dg 30' Mach '�2e�nclt `
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PM. .USA POSTP.GEm
Margaret Vetotmo HID
t'. .» PO Box 234''s QAB AFLE.MA
k r . u4 Ci L 02630
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Barnstable.MA 02630-0234
POSTALSER 9261
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�. Barnstable Fire Department — o i 1B
. 3249 Main ST
Post Office Box 94
Barnstable, MA 02630
Permit Certificate - General with .Seal
Date: 05/17/2006
Business Name: VETORINO, MARGARET
Address : 1555 Hyannis RD
Barnstable, MA 02630
Phone:
The following permit has been issued:
Permit No. 980562 '
Type: 01 Removal of tank(s) from property
Issued Date: 05/17/2006 _
Effective Date: 05/17/2006
Expiration Date: 07/17/2006
Notes : Removal and disposel of underground storage tank.= ' .Under the
provisions of M. G. L c 148,a or 527 ,CMR i9: 07 (K) (2)
Cm
It is the business ' s responsibility to ensure -that conditions are�_ n +"
accordance with applicable State and Local fire regulationsT.�:* _
Please ntact Barnstable Fire Department for more informatfori.
r 1 Jr 14
Inspector: Christopher J Olsen Date
05/17'/2006 14 : 02 , Page 1' .
Find Map/Parcel 298011 , Town of Barnstable , y
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Map/Parcei� 298011
dank Nbr 01 aglbr 00036 Tnst111ed 01/01/1976 Location B
/ Alf I � S 3tus 06 07/1996
fsTestNotification Date 08/23/1996
Rem`ovaFNofif canon Date 01/05/2006 g ��
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NO `yFuel 5�tored FO ` Euel Stormge�Reason
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Capacity Constructs Leak Detection Cathodic Detection
Stoag Tank Info 001000 IS
Additional-DetailO No release at time of removal
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7 '
THE COMMONWEALTH OF MASSACHUSETTS
BOARD HEA H.
Appliration -for Di-gnsal orL) or
Towitrurti Vrrmit
Application is hereby made for a Permit to Construct,( Repair J( an Individual Sewage Disposal
System at• � � �e_
• -----•c•. •Ad r s �r Lot No.
--- •---- --�- ' 't -----_• �--- ----- . %...............................................................
wn Address
Installer Address
Q Type of Buildin Size Lot----------------------------Sq. feet
U Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ---------------------------- No. of persons....._---------------------- Showers ( ) — Cafeteria ( )
Otherfixtures ----- ---------------------------------------------------------------------------------
WDesign Flow_ _______________________________ __________ _llons per person per day. Total daily flow............................................gallons.
WSeptic Tank Liquid capacity���lons Length_______________ Wi 11...__........... ll ameter--.------------ epth----------------
N Disposal Trench—No ____________________ ��/i th....... T e o e chi _____sq: ft.
Seepage Pit No.__-_---�------_ Dia> �t _.__ 1Tep el tnlet_____ __________ otal a ng area..._.__._.__._____sq. ft.
z Other Distribution box ( ) Dosing tank
aPercolation Test Results Performed by-------------------------------------------------------------------------- Date.......................:------------.---.
Test Pit No. 1................minutes per inch Depth of "Pest Pit-------------------- Depth to ground water..---------------_-___--
�14 Test Pit No. 2................minutes per inch epth of Pest Pit.................... Depth to ground water.-.-..---_------_----_
---•-•-----•--------- ------------------ • •• --------••- ----------------------------------
DDescription of Soil---------------n-------- ------------------ ---- ------ t--- ------------------------------------------
U ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------
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 Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
ned. -------------------- ----------- ---------- --------
l Date
PP Approved
Application A d By. _.( __ . ... .....
-----------
Application Disapproved for the following reasons---------------------------------•--------------___-___-__-_------___.-----•-------------------------------------
--•-••-•-•-•--•-•-••-----•--•---•-----•--•------------------------------
Date
PermitNo........................................................ Issued........................................................
Date
..••••••..••a-•••.•e•....-•..............r....-.....-.•v.e.r..-.•.r.-•...w...-.-.-••..-....•....e•.-..••-e•.........•......................r............a•e.1
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF EALTH
�.. .......OF................ . . .. .. ..
Tntifirate of COmpliattre
%HI I TOCERT FY, T e Individual SewageDi al System constructed ( ) or Repaired
b --•-
Y � � `� ;
t nstaller
at � 2 .f --•---- ••----- l! � -! ---...----••--•--._.___.---
has been installed in accordance with the provisions of Article XI of he State Sanitary Code a described in the
application for Disposal Works Construction Permit No... ______________ dated..-._1�-�.�
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................................................................................ Inspector....................................................................................
- - - - - - - - -- -
No._- 7A/ -. Fly$.. ...................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD 'H EA H
Appliratiou -for M_qploiial Workii Tongtrurti u Prrutit
Application is hereby made for a Permit to Construct ( or Repair ( an Individual Sewage Disposal
System at
— r .. --
c n•Ad r s y r Lot No.
wn Address
--------------------------------------------------------------------------------------------------
Installer Address
d Type of Buildin Size Lot____________________________Sq. feet
U Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building ---------------------------- No. of persons.--------------------------- Showers ( ) - Cafeteria ( )
dOther fixtures ------------------=-----------------------• --- ---------------------------- --------------------------------------------
W Design Flow_ .......................................gallons per person per day. Total daily flow--------------------------------------------gallons.
WSeptic Tank -Liquid capacity/ llons Length_______________ Wi h_-____.___..-_._ D•ameter____--.--_.-___ epth.__-__-______...
x Disposal Trench—N ----------------
Wi th__ .____(_________ T e __.. of e chi e -_- _ __ sq. ft.
Seepage Pit No..______-,�_-__•._ Dia> ter_ __ '! -___ LTep el. mlef__.__ _ .___ a ------ 1
otal ea n� trea_________________sc It.
z Other Distribution box ( ) Dosing tank
aPercolation Test Results Performed by-------------------------------------------------------------------•---- Date-----_----- ---- ------
Test Pit No. L_______________minutes per inch Depth of "Pest Pit-------------------- Depth to ground water__-___---___--__-_-___-
rX, Test Pit No. 2................minutes per inch Depth of Test Pit____________________ Depth to ground water-_-_______________._
IxI -------------------------------- ------•••-- -----— -•--.:__._...-----•-----------------------------------
D Description of Soil---------------"---------- --- ---- ------------�1 =- �" �✓
v ----------------------------------------------------- -•----•••----•-••-•--•-•-•--------------•-----------------------•----•-•-•----•-••-•---•-•-•-----------------------------------------------------
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 XI of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
tied ------------------------•---------------•--------- -
Date
Application Approved BY '•�"� '--"''-'
Application Disapproved f or the following,reasons:............................_---------
_._.___..•---•-------•-•------------------•--•------••—•---••--•------------------------------------•---'---------------•-------•--•----•-------------------•--______-_-•- _____---- -
Date
PermitNo........................................................... Issued----------------.......................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF EALTH
- .. ......
err#if iratr of fuumpliatta
TH1 1 TO CERTIFY, Th t t e Individual Sewage Di osal System constructed ( ) or Repaired ( �f
bY------- - ---- --f ,` - ... C 'w.. . ``' '. t9 --....---------------------------------------------.._..----••------
nstaller
at-
has been installed in accordance with the provisions of Article XI of The State Sanitary Code as describ d in the
application for Disposal Works Construction-Permit No........ _� _______________ dated...._ _ - _ - ...
,�
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE__"". ...................... ------------------------- ---------------------••--- Inspector............................................................................•--•=-=
's THE COMMONWEALTH OF MASSACHUSETTS
BOARD O HEALTH
! .:..... .....OF........
No. - --. FEE---Z.............
Di>ipofia rk,i Clomitr ti rrrmif :•
Permission is hereby granted_ .......... - r------
to --------
Construct or Repair ( ) rival Sewage Di sal System
a
at No.. = - - -�'�3.•�.I. ------
. - - trect •.
as shown on the application for Disposal Works Construction r it No--- _ ___:_ -____ ate d___�-:Zr
-- -- _ ..... Board -- -- alt ------------
DATE--- ---------------------- e `/ /�
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS