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Home My WebLink About0044 CRESTVIEW CIRCLE - Health 41 CRESTVIEW CIRCLE, CENTERVILLE A=252-51.02]. �1I1� �aoo ll1l � s UPC 12543 �° No. 533LOR Nr000 HASTINGS, MN P No. � Fee THE COMMONWEALTH O ASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Zipplication for Mis;pozar 6pgtem Construction Permit Application for a Permit to Construct Repair( )Upgrade( )Abandon( ) ❑Complete System • ❑Individual Components Location Address or Lot No.�y y ORC67 u f l=f,G/' GQ Owner's Name,Address and Tel.No. —7 71` (v 7 G CG'iv rF_/L ty/", 0/9 Y5 f M_ .RG AG Assessor's Map/Parcel , 3 5/. f $O X Y S L �vT��✓1 CC_E Installer's Name,Address,and Tel.No. 30 Designer's Name,Address and Tel.No. Ygs— 91 3/ �� g ,�A£CU A fix ar,4r,uYe Type of Building: Dwelling No.of Bedrooms Lot Size /3,`0 7sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 330 gallons per day. Calculated daily flow gallons. Plan Date L/',:�.q " 4 Number of sheets .1 Revision Date Title Size of Septic Tank /,5-00 Type of S.A.S. Description of Soil /'�5 ACOR ?1-19/t/ Nature of Repairs or Alterations(Answer when applicable) 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 Envi onmental Code and not to place the system in operation until a Certi t- cate of Compliance has been issued b t o o ealth. Signed I Date Application Approved b Dated Application Disapproved for the following reasons Permit No. 7� Date 1&6ged J w i l � I.' v TOWN OF BARNSTABLE `f LOCATION _ F"r `;7 I ; E w , SEWAGE# VILLAGE I,r 1k).,a L,,; % ASSESSOR'S MAP & LOTS(/ r t r INSTALLER'S NAME&PHONE NO._ i E'"�'= :,iy Z" SEPTIC TANK CAPACITY / LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER PERMIT DATE: - .�—CI k COMPLIANCE DATE: 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 P `� , No. �� l Fee THE COMMONWEALTH OF ASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION'TOWN OF BARNSTABLE, MASSACHUSETTS ZIpprication for Mi!60aal *pgtem Construction Permit Application for a Permit to Construct(Repair(u )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.441 y 0X_C57 V t r w Coe L Owner's Name,Address and Tel.No. -7 7(" t Q yG C CAI rE,e✓/Ll- E !3NY5JD,g- 34136 Assessor's Map/Parcel )5-.11 � Sax 4 s C��vJ�,e.✓/LC.,yE Installer's Name,Address,and Tel.No. 7 tl F. 30-F Designer's Name,Address and Tel.No. Ll a 0 — 9131 JGC b IG MAIV 7 �r9XRrk rA/Ye Type of Building: 3 Dwelling No.of Bedrooms 3 Lot Size , "'Iq.ft. Garbage Grinder( ) �- Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 330 gallons per day. Cy daily flow gallons. Plan Date 4-1-�q — 4 Number of sheets i'r Revision Date Title Size of Septic Tank Type of S.A1.Sg:. ` Description of Soil 1049 J Nature of Repairs or Alterations(Answer when applicable) 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 Envi nmental Code and not to place the system in operation until a Certil r cate of Compliance has been issued by7 i' o f ealth. �+ Signed Date* - / ?__A1V 11 `r Application Approved by Date,. Application Disapproved for.tlie4ollowing reasons Permit No. - -07 77 Date Issued ————————————————— - ---- f------ ----- — THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed(V)Repaired ( )Upgraded( ) Abandoned( )by V UC b(C mAlo at ,0 YY CRE5T✓1AFW C/der-1.6 C EA176A VIDE has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. s' dated X '5111"-o'. Installer Designer O 6)(Tr_k The issuance of this permit shall noctbe construed as a guarantee that the systefn will functio as designed. Date Inspector --------------------------------- No. Fee/yv •10Z THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS 'Wi5po.5al 6potem Congtructiou Permit 11.1 Permission is hereby granted to Construct( ✓)Repair( )Upgrade( )Abandon( ) System located at -#qY C,E E'5TV 1 C uJ C IM,c E. e4C�.u*47R✓/Lt 4= 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: $ —�— Approved by �.5,t4A--L T;>aTa 'St"4rLs F,(1MIV` t w2a- A rrE pt�t, ot.! B u6�J�-ELF qo GA¢►3A`Q oi;QWPOIL VAt t_y Fw w = 5 -Zito LOT cfz i v 1EJk) v I ,00 GAt_• 05E 3 Cul.1•FG A-sTOJE vIST• — n N AFFU G4110N A>2EA 960 5W Qn> 0-W .5f= 44&SF 2s' AM DN&W PLaIJ Vl�1d/ - LI=AGN•it� cI�AM8Ee5 SirEwAc.i. Nz�A= 3� x�x2=1� sf J3OTTOAI ALMA �300T lrpV- Ate, 4¢S sF s PE21�0LATW4 I7d'TE L 5'Kr��t 2° 3 Max ,; soft✓ c .s; 15gr ye Cut.TK t o a 3l -I E'h wNs+I6D ESN OF ,� 330 o ° 9 _ ENE A. ALLYI BAXTER v' r MtilSON 4o 24048 No.U216 4F-o%-SEe--'naN OF NAMT ;7- Ep �..y Vf S�gSUits p� IMt iw 64,5 S Lz" CHAAABEM5 I" � Ue.4, ter 1- 4¢ 6 aolr, • hut=WZ 'LAW- FACktZ— Set.=ii � AlED ('U6 � GaA� , CEri RGl) ROT RC!A 41® w.a� �"- De-KTICX4 ^j 15 vim a vi,� peas-� .5CAM— I = �' �1E A•,-zq C)f, I G F`1 TVAT ToE t}�pN CeMpc.`K Wrtu T StDEUNrz AID A- "TSJ►Gv oWut2�tnl�"r DF T�I: 'V t KI OF t—C- ?I-a ' 3&&G`I MAP 2 72 PAJZ . r5t �Zj W t r4 i N A Al. Ftstao �4AzA,v ZONE. f NyE lt.tG LAUD St1ev6^ItP�S • t�l�t�.t6�S �►�:r, �,o�� I�t�� C9� �,�,%�� oSTrtzVtt�.rs Mt�Ss. a--F se ";, VV-oAM DV I C.D►WOS st buta t or e rx, AMLI 4AN4 (�'StD Tb �TAEu�y PRCpEa'fy bQ64. ---- ------ a ys lay �V 1�D►!J �O �c-r, F { i �v►c.r�rti3y Cc, o' AP`elL Zq im ape SPPGE Sue oPEr.1 �aA�� , 30 /Ic MAP 252 Pc4_ A�Z4 � N 7o- - 4-S l / =DWELLIQ& \ \ i \ / b 10` ` \ CSLAB) '2 1 c / I °�� LEA !a' D.8: C►4Am>3 � � N I m �X>4A ALLY?d rsr> WKc ��'�-- , , � T'OWN OF BARNSTABL_E LOCATION 1',Qw 6, :t SEWAGE # - a- of VILLEIGE Nlst • `r; r` � �,/�rs+re r`.`S ASSESSOR'S MAP& LOT1� 0--�A INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY J `0 LEACHING FACILITY: (type) `" 0.8l�a'e�,�! (size) NO.OF BEDROOMS f �� BUILDER OR OWNER �.� � t 'PERMTTDATE: COMPLIANCE DATE: it y p� 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) FeetT- Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by ` M i l / Sol 36 .k,i