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Home My WebLink About0037 GLENEAGLE DRIVE - Health 37 GLENEAGLE DRV., CENTERVILLE A = { • UPC 12534 ' Mo.2.153L R HASTINGS,UN a �sr-- l No. � l l t Fee Q a d THE COMMONWEALTH OF MAS SACHUSETTS Entered in compute s PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0(pprication for W9pogal *pgtem Congtruction Permit Application for a Permit to Construct( )Repair(16 Upgrade( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No.3 7 CL L-1-161 I C� �R' Owner's Name,Address and Tel.No. Assessor's Ma /Parcel [.E'��jG-�l/-1�1-� C��y LDpE� p / j LOT-`3 790-ql a8 Installer's Name,Address,and Tel.No. Q R//,yN A g0'7&f &a1Y57. Designer's Name,Address and Tel.No. aO7Ac'67UF COZ. M()�,-&5 M a5 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building la No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 3o gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank `00-4 Type of S.A.S. Description of Soil () -a' C.OA-M -$(_/&SdtL Q'-/,) _rll SUE L Nature of Repairs or Alterations(Answer when applicable) I/t/.ST�-L/ Hfir,✓Q 601C I7 Q l �O .SOo CuaH L,Z/7a� C 4,1,,�5 (AwTli 4' 51-0hz-, 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 Env' ental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by thi oard o alt Signed Date /O Application Approved by Date Application Disapproved for the following reasons Permit No. n Date Issued `` No. I l s� Fee Q —— - THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: s PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS 0[ppitration for ;Digpogal 6pgtem Construction Permit Application for a Permit to Construct( )Repair Upgrade( )Abandon( ) ❑Complete System O Individual Components Location Address or Lot No. 37 6L1-'--/54([E Owner's Name,Address and Tel.No. • Assessor's Map/Parcel CE�74Q1r•�� /'l�y t!pp�� / _ / 1 7%o-�f1�8 R( Installer's Name,Address,and Tel.No. Q R l,q//i9 g0TTL C0/`%57 Designer's Name,Address and Tel.No. a0-TAll7vp CIA. 1Y11X5,,,1'1S '""L5 Type of Building: Dwelling No.of Bedrooms_3 Lot Size sq.ft. Garbage Grinder Other Type of Building �5, No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 30 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank /000 Type of S.A.S. Description of Soil n- o L OPM -SU ASdi L Q '-1. ' 4i9mD -(/2/lt&[_ Nature of Repairs or Alterations(Answer when applicable) 1&57:4 .tc✓ f).l�nK A41' Tw/3 04 6&1o1-1 ! 1174a64-14 Q-4&4eVY �J' 57-,rV1C 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 Enviro.mental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this azd of alth. _ Signed f , Date Application Approved by Date �f �v Application Disapproved for the following reasons Permit No. Date Issued �' 6 ---------------------------------------- - THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance 2� v THIS IS TO CERTIFY, that tlfti-site Sewage Disposal System Constructed( )Repaired (Upgraded( ) Abandoned( )by -rZ 6ox1:1 at has been constructed in accordance with the provisions of Title 5 and the fo Disposal System Construction Permit No. ® dated f Installer Designer The issuance of this a 't sh /I no be construed as a guarantee that the 79mffivill function as✓ sign . �- Date t/1 Inspector - IV --------------------------------------- - � Oo No. � Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH.DIVISION - BARNSTABLES MASSACHUSETTS Migpogai *pgtem Construction Permit Permission is hereby granted to Construct( )Repair Up rade( )-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 corn leted within three years of the date of this tt Date: �' Approved by - / i/ TOWN OF BARNSTABLE LOCATION ..37 GLZ-AIL-161LL�--hP, SEWAGE # VILLAGE CC-1-1T/d.LUC-L( ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. 15P1,-4N/2 yonr- CG/y,-s-F, SEPTIC TANK CAPACITY 1 CCp0 LEACHING FACILITY:(type)a ,,S00 GILL 01"661��size) 13 NO. OF BEDROOMS_ PRIVATE WELL OR PUBLIC WATER fCt fY BUILDER OR OWNER Gay L o(a�2 DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No F6� q, ISO TOWN OF BARNSTABLE LOCATION `7 GC�/yCi�G� SEWAGE # VILLAGE Cc--/-/i-( ✓C-LC ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY /Gav LEACHING FACILITY:(type)a Y(jo Gl}L,L ��fC1 - xsize) �3 A L �- NO. OF BEDROOMS . _PRIVATE WELL OR PUBLIC WATER f �/ BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes Na / R 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 DESIGNED PLANS) hereby certify that the application for disposal works construction permit signed by me dated /0--Zq concerning the property located at :3 ' (,L&i 4 ,4 n/2, meets all of the following criteria: �• The failed system is connected to a residential dwelling only. There are no commercial or business uses 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 �• There is no increase in flow and/or change in use proposed �• There are no variances requested or needed. �• The bottom of the proposed leaching facility will not be located less than five feet above the mammum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method 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(ld)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) �C°J•Clo B) G.W. Elevation 36 +the MAX High G.W. Adjustment. DIFFERENCE BETWEEN A and B 260 SIGNED : DATE: (Sketch proposed plan of Vstemon back]. q:health folder:cent ��srlrG /o ao Cl�uo'f Tir/t� v d Spo C LtOl L /�