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Home My WebLink About0020 RED LILY POND ROAD - Health 20 RED LILY POND RD., CENTERVILLE A=227-057 llll � UPC 12543 Now �� HASTINGS, MN + TOWN OF BARNST BLE G` LOCATION rO C. /Lam) Y SEWAGE # W'3O VILLAGE „�,_ ASSESSOR'S MAP 6z LOT 7.1-1 . Q,<:2 INSTALLER'S NAME PHONE NO. A & B CANCO 775-6264 ? SEPTIC TANK CAPACITY r / LEACHING FACILITY:(type) ,?N1 AX 1 I I0yS (size),90 X X NO.OF BEDROOMS_ PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER �lk,ru�� . x DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED:' G -I7 VARIANCB GRANTED: Yes 4 No tr-► B Q a 4� I alo -� RO 0 No. Fee V / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: c/ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pplication for Mt!6po$a1 *pgtem Con!gtruction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.a.o /t %/ �'t Owner's Name,Address and Tel.Igo. sy,9" y Assessor'sMap/Parcel DQ7 X;40fe 77f__ /S�3 Installer's Name,AddresAa&13.FAANCO Designer's Name,Address and Tel.No. 350 Main Street /04 W. Yarmouth, MA 0267.3 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.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 Number of sheets Revision Date Title Size of Septic Tank ( S0 y " Type of S.A.S. IK 19X i nv c!' Description of Soil Nature of Repairs or Alterations(Answer when applicable) ..Tn rf.411l /- /SOD V-19Z / 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 Board of ea Signed Date 7 Application Approved by Date .g'-1 Ct -�!1 Application Disapproved for foll g reasons Permit No. t7 g Date Issued I, TOWN OF BARNSTABLE - -) _ LOCATION ; U _E0 L -�- �L)N'E �� SEWAGE # 1/ ASSESSOR'S MAP & LOT :VILLAGE • INSTALLER'S NAME & PHONE NO. A & B C1�i�1C0 775-6?64 .SEPTIC TANK CAPACITY Z 6,KS (size) •"`.. LEACHING FACILITY:(type) PRIVATE WELL OR PUBLIC WATER NO. OF BBDROOMS_y._ BUILDER OR OWNER DATE PERMIT ISSUED. DATE COMPLIANCE ISSUED-: No t VARIANCE GRANTED: Yes i i 00, hE I { I 4lP Ili i No. ��yyJJ(( D Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS ' ZIPpYication for. Miquar *pgtem Conotruction j3ermit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) Complete System ❑Individual Components Location Address or Lot No.02 0 / ' 4,11 1 G Owner's Name,A dress end Tel. o. Assessor's Map/Parcel ao?.7 Ir 1 Q I 77Sr- �573 Installer's Name,Address,acid rj Ig. CANCO Designer's Name,Address and Tel.No. 350 Main Street /A W. Yarmouth MA 02673 F Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.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" `< ° r Number of sheets Revision Date Title Size of Septic Tank JU O Type of S.A.S. x "'^ '2 c s' ' Description of Soil /lC4 j-,4.11&12 Nature of R a'rs or Alterations(Answer when applicable) / • i�� 0 3 h-i.�X.'r-,,'Z�r' /��/ cG«��> >p i.r c-✓/ `ram ^.1"/o rr{ 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 Board of "e Signed �� .�.<-- Date f Application Approved by Date u_" i Application Disapproved for t e follo ing reasons Permit No. 3 17 Date Issued . ————————————-—————————————————————————— f THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance I THIS IS TO CERTIFY that the On-site Sewage Disposal System Constructed ( ) Repaired(Upgraded ( ) Abandoned( )by at �U / i�� '� l` has been constructed in accordance ` with the provisions of Title 5 and the for Disposal System Construction Permit No. 3G dated f Installer Designer The issuance of this permits all not be const ued as a guarantee that the system will ftlnction as designed. \� ' Date Inspector — �— ��---------------------------Fee SO _ THE COMMONWEALTH OF MASSACHUSETTS e PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS winig0oal 6'elem Congtructton Permit Permission is hereby granted to C nzstruc ( �,�epair( Up de( andon System located at �� ''j'' �dY+ 02i,a y u; �� . 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: Jt" ' Approved by Al 11 ) } 10/9/97 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 ENGINEERED PLANS) ro+ln VL a,1 , hereby certify that the application for disposal works construction permit signed by me dated S -/?- `� , concerning the property located at c2o ('1/y 10 4�L . meets all of the following criteria: -, • There are no wetlands located within 100 feet of the proposed leaching facility 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. �/ • If the proposed leaching facility will be located within 250 feet of any wetlands,the bottom of the proposed leaching facility will=be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation. Please complete the following: A)Top of Ground Elevation(according to the Engineering Division G.I.S. map) old r B)Observed Groundwater Table Elevation(according to Health Division well map) SIGNED : �I, C DATE: LICENSED SEPTIC SYSTEM INSTALLER IN THE 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]. q:health folder:cert s , t ao` y poy.LCQ log 000 az. SEPTIC SYSTEM DESIGN .,�.._ BBD,tMA(S AT GAL/DAY/BEDROOM _ GAL/DAY SEPTIC GAL/DAY z 2 DAYS GAL USE / GALLON SKPT IC TANK - LEACHING AMA.' USE 3 INFILTRATORS MAXIMIZER CHAMBERS WITH 4' OF STONE ALL AROUND (�' z if z Z DEEP) srDX ARCA.• (30 + 2 .z 2 = 164 SE' (.74) _ _ GALI DAY _._ ROITOH ARRA- W z If _ 330 SF 04) GAL/DAY CAPACITY =w___s GAL/DAY