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Home My WebLink About1455 HYANNIS-BARNSTABLE ROAD - Health F ,1455 Hyannis Road Barnstable f _ A= 298 = 035 &P-1-P L O CATION SEWAGE PERMIT WO. 0,f - A VILLAGE 92�&/L,6 I N S T A LLEA'S NAME b ADDRESS VETolemo OR OG1p EQ _ DATE PERMIT ISSUED DATE COMPLIANCE ISSUED - � r eX` �5 1 I ( i . r (2T D No 7r`... • FRs..-f - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......... - -:......OF........,r / //(% .r ........................... Appliration for Diiipwial Workii Ganstrnr#inn ramit Application is hereby made for a Permit to Construct',( ) or Repair ( ) an Individual Sewage Disposal System at: ............ 5�.........0?!�l.._._.... ........ sT/3,0 Location-Address or Lot No. •---•-•••••.A. � ,� ...0........................................... ............................................. -------------------- )06 0 r Address ----• fl F .<. ...: � .,.__... .............. ---------------------------------=------•---- Installer Address d Type of Building Size Lot......_.....................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No. of ersons____________________________ Showers C4 YP g -----•---------••-•--------- P ( ) — Cafeteria ( ) n" Other fixtures . ----.•-••••••••••• t Qa 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...........4........ 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......-................. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ----------------------------------------------------•-----------•--......-•-•--•-•---....-------............._........---.........._..•----------....._.._.-- ODescription of Soil.........................................................................................-------------•----•----------•---...--••--------•••••••••..._•-••••••-•---•-•- x U •-•--.....--•-••••••--•••••••-•••••••....................•-••••-•••••••-••••••.._....••-----•••-•••...--•-•-••••••••-•--....._........-••-•-••••••...•••--•••-•••••••••••••••--•-----•-••••.-.......... x ---------------------•--•--------------------------------- ---------------------•----------------...-------•-------------------------------------------------------...-.---------------------------_.... U Nature of Repairs or Alterations—Answer when applicable.......&46/04 ....... T-.I .....V.Gd-•••,SYSj' . lelis`_ ..........IdDO....4F ....4!4 0 .. ff...�P.......f d OC!• C` ` ........................................................ 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 undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is e by t e o d o ealth. ed �_ lv 7 . ... .. .. //o- D� ApplicationApproved BY--...----.` ...... --•.............. ...:....................................................... .1 ..._...------------ Date Application Disapproved for he owing reasons:-------••---•-------•-------------------------•-----._....----•---------•-•-•-------------------....._......... .......................................................•••-•...--•........••••••---•---•-••-••........--••••••••..........._........---••••••-••-••••••-•-••--....•-•-•••••••••••-••••-•-•-••-•--•-•--- Date PermitNo....................................................... Issued-....................................................... Date _---- -- - — - --- ------ - -- --- -- - -- -- - ___ _ - - - --..�.�...... ........� No.K. ►. ....f FE$....1 .................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH /* G 5 OF......... . ........................r-.�f � ....--------..........------ Appliratiun for Diipus al Workii Tomitrnr#iun Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .................. -•--.....--- ...................... ...•----••...--•--••-•--...--•----•---.... /__ Location.Address or Lot No. ........... .:...!r:.,.�.c..�j —w� Q......-•-•--......•........................ W ..............• Owner ...................................................Address........................................... Installer Address d Type of Building Size Lot....................-------- Sq. feet V Dwelling—No. of Bedrooms----------------•----.--_-.--. .. _Expansion Attic ( ) Garbage Grinder ( )�+ aOther—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............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........................................ W Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ GX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ W •--•----------------•-•--•--•---•-------•---•-•-.....•---------...-•--•-••-----••---------...__.................-••---............._......•---.....•-•....... 0 Description of Soil........................................................................................................................................................................ x V --------------------------------------••--•----•---••----------•-----------------------------------------------•-------......-------------------•-•-----••-•-•-------••---••---•-••......---•--......... W .•-------------------------------•---•-•--•----------••.•----......•-------•---•.•.•--...----•--••.---•----••-•-------------•-•.•---••------•-••--•••-•----------••----•-•-....._------•---............ U Nature of Repairs or Alterations—Answer when applicable.......��-4-W4,<1- `...... ��1'(ycE _ 04,0 sYsr r T ------....bwu.....�E �.... Sf:?t' 7 !`!'...14e......... ......... J Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITL L 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is ed by t4 bo rd iealth. Application Approved BY -------------------------- ---- f ... _D_. _.. Date Application Disapproved fo4heowin�e9 reasons: -------------•--------•----•-----•----------•---------------••---------•-----•--•-•-•------••_-•--••-••...............--••--•-----------•---••-•-•---•-•-•-••---------•-•...---•-•---•---•-.-•--••---•••. Date PermitNo.......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF............................................................I......................... (Irdif iratr of Toutplittnrr 4E__R-T_-ZIFY, That the Individual Seew ge Disposal System constructed or Repaired (few by.....__..........C /--%---� - :' -•------------------- . �. ..•.......-----•--....----...........................•................/" L ' Installer at-----•.................f. . ............... has been installed in accordance ith the provisions(of TITLE 5 of The State Sanitary Code d cr'bed in the r application for Disposal�'Vor Construction Permit No... .._-__- � -..._... dated._e2 .-J...... ...................... THE ISSUANC HIS CERTIFICATE SHALL NOT YCONST AS A GUARANTEE THAT THE SYSTEM WIL�UCTION SATISFACTORY. DATE.....,//... . 1.--••-•.................•--•---••-•-•----.......•... Inspec THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH V(/ ...........................................OF...........................................................I.,....................... 0 P...� FEE./.................. �io�o,�ttl.- 'r� �uirtion rruti# Permission is hereby granted------------- :-- 'T.. ... ...........................'" -. .......................................................... to Construct ( or Repair (+�`) an Individuar e gage Disposal Syst Street I as shown on th/applica 'on fo isposal '"'orks C struction Permit No...... .-..... Dated.......................................... Beard of Health DATE-•--• �= ....- ---•-------------•--------------- FORM 1255 A. M. SULKIN. INC.. BOSTON TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS yol ASSESSORS MAP NO. PARCEL NO: 479Z., �`- ADDRESS: � j ,�P VILLAGE a CONTACT.PERSON PHONE NUMBER JZ - G LOCATION OF TANKS: CAPACITY: TYPE- OF- FUEL. AGE: TYPE: LEAK OR CHEMICAL: DETECTION 5 Do SYSTEM fLLd DATE OF PURCHASE OF EACH: 1. 2. 3. 4. 5. DATE OF.FIRE DEPARTMENT PERMIT: 1 S TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD. 0 vle FT oUSf t �6 LCR Tank Services, Inc. - P.O. Box 765 Marstons Mills, MA 02648 508-420-3365 Storage Tank Removal Receipt Date: �y Z/ O L TYPE: OH #2 Gas Other Owner: Bruce Jerauld Jr. Address 1455 Hyannis Road Barnstable, Ma. 02630 _ Tarok Size: -~ .-5.00_Gal!on Date Removed: Q - 2 7— FDID #: 01919 LCR Tank # 209-88 Dig Safe # 88411665 LCR Project # T 2143 Tank Transported To: LCR Tank Services, Inc. 381 Old Falmouth Road, Unit #5 Marstons Mills, Ma. 02648 Inspector: Comments: Approved Scrap Yard: James G. Grant Co., Inc. 28 Wolcott Street Readville, Ma. 02137 Yard #03501 r L Tank Se ices i