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Home My WebLink About0006 RAYMOND STREET - Health 6 Raymond St,. , Centerville A- 226-105 i No. 42101/3 ORA so Milo ESSELTE 10°6 0 0 a a 0 TOWN OF BARNSTABLE Y LOCATION Q SEWAGE# Zz- //6 VILLAGE ASSESSOR'S MAP & LOT 106- INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY I( C1 LEACHING FACILITY: (type) 1'/ lml� -- (size) Y A- S`V►-w NO.OF BEDROOMS BUILDER OR OWNER LAVA.,,.. h&AV,, PE..RMTTDATE: 1 -1 -q 7 COMPLIANCE DATE: Ig 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 4 f ° el• `• No. —' l I Fee `' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0(pplication for Migpozal *p!tem Cow6truction Permit Application for a Permit to Construct( )Repair(Agrade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No. (Q � � .� 5T � -� Owner's Name,Address and Tel.No. Assessor's Map/Parcel �w ryvrec�c cr. a cti v�; Instnaller's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 8Z 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 3 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank 15-O'D Type of S.A.S. Description of Soil 0& to_ S4,1b Nature of Repairs or Alterations(Answer when applicable) 6j59j1e--T4—K_. A'gep- JZ�ov- 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 by this Bo Signed Date 3-Id -5 7 Application Approved by Date Application Disapproved for the llowing reasons Permit No. 72 - 11,6 Date Issued No. 7-- 1 /[In Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ' Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS ZIpprication for,Migaal *p5tem Cougtruction Permit ti A lication for a Permit to Construct Re air �/U grade Abandon ❑Com Complete System El Components PP ( ) P (t/1 Pg ( ) ( ) P Y P Location Address or Lot No. (a ,A-f*,0,, sr c Owner's Name,Address and Tel.No. � �.r ;Assessor's Map/Parcel ewu_ Installer's Name,Address,and Tel.No. `" Designer's Name,Address and Tel.No. o f ao 00N-"t Wit/ �. Type of Building: Dwelling No.of Bedrooms yZ Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow cam'"ICJ gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of S ptic Tank 1'CT t Type of S.A.S. S'wW t---r t--G r�s Description of Soil Im to <'� i, q Nature of Repairs or Alterations(Answer when applicable) wS� 'U�✓ 1 c (n r� n0 L!-r'vs.i iaS 4t-�L/�5_tY -4-9 1 Date last inspected: , ..� \. w 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 ifie system in operation until a Certifi- cate of Compliance has been issued by this Bo f-Health i rSigned Date Application Approved by Dater .:�j Application Disapproved for the llowing easons 'i Permit No. � Date'Issued w THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CER IFY,that the O - ' e Sewage Disposal System Constructed( ) Repaired ( )Upgraded Abandoned( )by at �„ 1 W. r vt�„� ST"� r r.sat has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 9 7_//G dated Installer Designer ! The issuance of this permit shall not be construed as a guarantee that the syste will unction as designed. Date 9-7 Inspector 6 I �----------------------------- No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Mitpooal *p5tem Cougtruction Permit Permission is hereby granted to Construct( )Repair( t oYlpgrade( )Abandon( ) System located at �V9 y tM.dwl�C i and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to LP omply with Title 5 and the following local provisions or special conditions. ovided: Construction must be completed within three years of the date of this permit. Date: — — / Approved by r f' V NOTICE: This Form is to be used for the Repair of Failed Septic Systems Only CERTIFICATIO ' OF SKETCH AND APPLICATION FOR A DISPOSAL WUItICS GUNS'I'RUC'I'IUN I'EItM['I' (WI'I'IIOU'I llCSI(�NGU PLANS) 1 6�o ,2— , hereby certify that the application for disposal works construction permit signed by me dated w-- r--17 , concerning the property located at (w Vw-:/,,N0wl) Si meets all of the following criteria: • There are no wetlands within 300 feet of the proposed septic system There are no private wells within 150 feet of the proposed septic system • The observed groundwater table is 14 feet or greater below the bottom of the leaching facility There is no increase in flow and/or change in use proposed • There are no variances requested or needed. SIGNED: DATE: LICENSED SEP'rIC SYS"rEM INSTALLER IN T'I-IE"TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. j:ccrt y. � � D O � � rj i � � (� i "��rvK- � f �. C �L i `� � ._ -- (, TOWN OF BARNSTABLE LOCATIONS SEWAGE # ZZ— VILLAGE Q) ASSESSOR'S MAP& LOT - IO INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY ri D!S LEACHING FACILITY: (type) (size) yIA- 6tT-L-11ri NO.OF BEDROOMS BUILDER OR OWNER 1 �,..cQ�. M (�t.+�.►, PERMITDATE: 1 -7 7 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 TF 90 OPO LOT 86 \ ®® \ � LOT 86 ,o _ A TANKC 6s O o TANK ' Ep" SEPTIC Oc.� ,moo DBOX O � TANK ® O � ® D'BOX O '`• �� a. !y� ,tip Sao iS F 61 EXIST.DWEUI_ 7 �0' EXIST.DWELL {f LOT 87 LOT 87 h�0 �► 5,414t SF p DENOTES STAKE SET x 5,414t SF p DENOTES STAKE SET NOTE: LEACHING FACILITY LOCATION UNCLEAR FROM TIE CARD NOTE: LEACHING FACILITY LOCATION UNCLEAR FROM TIE CARD DCE a11-297 DCE#11-207 BUILDING PLOT PLAN BUILDING ELD.B.l\G PLOT PLAN 6 RAYMOND STREET PREPARED FOR: PREPARED FOR: LOCATION WEST HYANNIS PORT,MASS. JO5EPH QUE N LOCATION : 6 RAYMOND STREET JOSEPH QUE%N WEST HYANNIS PORT,MASS. SCALE : 1" = 20' DATE : JANUARY 22, 2012 SCALE : 1" = 20' DATE : JANUARY 22, 2012 is REFERENCE : ASSESS. MAP 226 PCL 105 REFERENCE : ASSESS. MAP 226 PCL 105 PLAN BOOK 76 PG 1 _`�S j� PLAN BOOK 76 PG 1tH 1 HEREBY CERTIFY THAT THE STRUCTURE 'y 'o SHOWN ON THIS PLAN IS LOCATED ON THE I HEREBY CERTIFY THAT THE STRUCTURE j: �_ GROUND AS SHOWN HEREON. ( _ •�,`;� SHOWN ON THIS PLAN IS LOCATED ON THE . 6; Y ;_+ GROUND AS SHOWN HEREON. '`�A.Cj 1� m s�°m aa-�ae�m, •--_�` �40S'tPO 'A'� . o:40C I i �� oa:40_S L Iµ ! SSdown cope engineering, in c. L`. r� dawn cape engineering, inc Y C4WL ENC/NEERS r/j 2 Y�• GWL ENO/NEERS ` `Z '^� ,I ss SURVEYORS I Moan so--e A.NDYARM_ou�r.Naa&K MnSs_.._ DATE ___-... _ -_ REG: LAND SURVEYOR s�Main Sl'..NOYA?M 0J7T,MASS DATE REG. LAND SURVEYOR I"d f brl 1 1 �r —� ---�---- � � }•ter„ N 1 L (;l t 1 {- ��J��1'JEIJ 1- aa- 1 . f f � fl li V ST1�►U 1kou SE � j