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Home My WebLink About0007 GARTH COURT - Health 7-GARTH COURT-CENTERVILLE_ A = 149 085 S__ eame 0 UPC 12534 �g No.2.�.�5� I' 4mos HASTINGS, MN No. i- Fee , THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0(pplication for Migpogaf *pgtem Con5trurtion Vermtt Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System Kqdividual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/Parcel ?qf e Gs Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title it Size of Septic Tank Y_V A Type of S.A.S. C La L Description of Soil Nature of Repairs or Alterations(Answer when applicable) �—ST 0-� 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 Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued Si d A Date4-1&-507 Application Approved by Date 6--16- Application Disapproved for the of owi g reasons Permit No. ?g- -_a"S 2 Date Issued No. .1�, �, Fee _ / ?r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 'PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETS Yes Zipplication for ;Diopooar *pgtem Cottgtruction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System 014dividual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/Parcel /LIiP QO y Installer's Name,Address,and Tel.No.� Designer's Name,Address and Tel.No. VA Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow L gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank S(, v46 I CUj 1�,,t4 1 Type of S.A.S. ��.c � Q ECG C 1 l 'a '�t ti.l4 L Description of Soil tr - 14ti Nature of Repairs or Alterations(Answer when applicable) vt--n'W-k t ".C. -" 4 U_ G9 Date last inspected: y 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 Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued th;&,B-oard.- _ lth. -+ Si ed Date !lb` ' Application Approved by Date_gro -/4- Application Disapproved for the fo low g reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS t BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( )UpgradedQV Abandoned( )by at `"r C r,,r' %_(Z4-,N;(LK- has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 91- _-S? dated A _".� ^ ' Installer Designer -14 The issuancSqf4iiems,percm hall not be o sgrued as a guarantee that thr�mr,, ill function a§.=designe. Date Inspec�or t`, , No. f �— ��7 7 ---------------------------Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Mizpool *raem 6ongtructiotulpermit Permission is hereby granted to Construct( )Repair Upgrade(Z)Abandon( ) System located at 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 /f 1/6/99 NOTICE: This Form Is To Be Used For the Repair. Of Failed Septic Systems Only. - CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGt D PLANS) hereby certify that the application for disposal works construction permit signed by me dated (Ap-kl� concerning the property located at —� � ��vuC meets all of the following criteria: V l ne failed system is connected to a residential dwelling only. There are no commercial or business �es associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. There are no wetlands within 100 feet of the proposed septic system ( There are no private wells within 150 feet of the proposed septic system (X There is no increase in flow and/or change in use proposed &-/There are no variances requested pr needed. • The bottom of the proposed leaching facility will not be located less than five feet above the ma.dmum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor ethod when applicable] • If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14) feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) (z B) G.W. Elevation 9516 +,the MAX. High G.W. Adjustment.3�� _ `E' DIFFERENCE BETWEEN A and B c9 SIGNED : DATE: [Sketch proposed pl 'of system on back]. q:health folder.art P�--� . .. .; _"` • -:• Cam: ✓ �� — / r LO _ SEWaCIE PERMIT uo. IWS LL-ER E ADDRESS BUILDER 'S Q Q . E ADDRESS DW,TE PERKAVT ISSUED DATE COMPLI &t ACE ISSUED : , ^ �� a j - 52. 7 3 � VD TOWN OF BARNSTABLE r LOCATION :Z C®yt-Z_ SEWAGE # '" V MLAGE ASSESSOR'S MAP& LOT a'O f INSTALLER'S NAME&PHONE NO. lln i joT_. SEPTIC TANK CAPACITY f 0160 LEACHING FACILITY: (type) / Z 164 7474,2 (size) !i &Z 1.5 NO.OF BEDROOMS OR OWNERS �l PERMTTDATE: °''' '� _ 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) Feet Furnished by /& r z 1� o'er '�� r't��` 13 ILL `t M s LO SEW&C-xE PERM- 1 Uo. IWS LL_R & E ADDRESS BUILDER 5 Q & E ADD�R/E SS 4 DATE PERMIT ISSUED D ATE COMPLI &11,dcE ISSUED : 7-C j y y r� 3 A VD y� <. ,L