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Home My WebLink About0060 HITCHING POST LANE - Health F 0 HITCHING POST, CENTERVILLE A = 173 040 /N 3 UPC 12534 � No.2�153LOR NAATING9,YN TOWN OF BARNSTABLE LOCATION d "7— SEWAGE # � VILLAGE_ Ce...,ieA'�le., ASSESSOR'S MAP & LO INSTALLER'S NAME&PHONE NO./21b c�9' e SEPTIC TANK CAPACITY A o c/ LEACHING FACILITY:( pe) fM /r #7c.,X 4 (size) NO.OF BEDROOMS BUILDER OR OWNYf PERMITDATE: �� COMPLIANCE DATE: 00 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 f. G r 6 2v2�- � 3a3 Y3 � . No. 242422 � �'�' Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipplication for Wood *pztem Con!5truction Permit Application for a Permit to Construct( )Repair( )Upgrade(X bandon( ) ❑Complete System )�;,lndividual Components Location Address or Lot No. (20 1A1AC) \w& 0 SI Owner's Name,Address and Tel.No. Assessor's Map/Parcel 1 ?3,_ O 1 O"' eA Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms e-3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow (7 gallons per day. Calculated daily flow _3�n� gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank �"g--mil`S-E r V!a- k 0C)o Type of S.A.S. G�.IJaG a Description of Soil — Nature of Repairs or Alterations(Answer when applicable) (JAI 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 bee of /s, Signed Date `'� O`—00 Application Approved by Date u Application Disapproved for the Ilowin easons Permit No. 1 l�'S' Date Issued a C F:, No. Fee 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es,, PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS E • Zipplication for ]3i.5po!5al *pgtent Construction Permit Application for a Permit to Construct( )Repair( )Upgrade(V)Abandon( ) ❑Complete System Individual Components Location Address or Lot No. (20 0 51 Owner's Name,Address and Tel.No. f, Assessor's Map/Parcel 1 Z_ nt 10 s t ✓ v'l Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. ' �s` o.:,s s� t-{ �. Mtr Type of Building: Dwelling No.of Bedrooms .J Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers(- Cafeteria( ) 'F Other Fixtures t Design Flow ® gallons per day. Calculated daily,flow 3 gallons. ` Plan Date Number of sheets Revision Date Title 1 S"C Size of Septic Tank 11` y l c)co Type of S.A.S. CtiI3u c q Description of Soil ` Nature of Repairs or Alterations(Answer when applicable) ��+� ��`� � Cat�aL��►�a--:��'�-.?�C.. C ��i� 2 S Cy� �l tJ l G<-E'- C3 v�.� S1:� � �`' "t�,.dam._..- v�,,e� � t•,, 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 begn_issued-by-thi f : Signed -3 Date a_0 ' Application Approved by *` Date L/ — 3 Application Disapproved for the, ollowintg reasons r: t Permit No. q�/ Date Issued ' --------------------------------------- k: " THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS 4 G k Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded(V< Abandoned( )by E at (7 wAt c-.N,K vS ,�Q -�'l�'T `� has been constructed in accordance ", with the provisions of Title 5 and the for Disposal System Construction Permit No.aw—/ `/91 dated Installer Designer �( The issuance of this:permi�shall not be construed as a guarantee that the sys e f w�ll'functio de ed. < " Date �. Inspector 1 .: r Y* � No. [.DOD— � 99 ———- ———————————— 3,� ----� ''.,..� Fee 679 THE COMMONWEALTH OF MASSACHUSETTS '. PUBLIC HEALTH DIVISION - BARNSTABLE, MASSA&AE S q Oiopooal 6potem Conztruc "ott W ,it-, Permission is hereby granted to Con c ( )Repair( )Upgrade( Abandon( ) J System located at tq . (zk S 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: 1"� 3 �� Approved by .� gy j t i TOWN OF BARNSTABLE i LOCATION (od SEWAGE # VILLAGE Ce-A,ie/N�// ASSESSOR'S MAP & LOTI INSTALLER'S NAME&PHONE NO. ,('e- [' I SEPTIC TANK CAPACITY /0 00 LEACHING FACILITY: (size) )(2 NO.OF BEDROOMS BUILDER OR OWNqy PERMITDATE: COMPLIANCE DATE:-TO Q� 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 9 � � I i i I i 7 1/6/99 NOTICE: ThIs Form Is To Be Used For the Repair Of Failed L_— Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITJHOUT DESIGNED PLANS) h ✓ , hereby certify that the application for disposal works construction permit signed by m.e dated L—�`OD , concerning the property located at_ � �n41(y C C---3f,. l f meets all of the following criteria: (� This failed system is connected to a residential dwelling only. There are no commercial or business l uses associated with the dwellin,. (/. The soil is classified as CLASS 1 and the percolation rate is less than or equal to 5 minutes per inch. • ,here are no wetlands within 100 feet of the proposed septic system There are no private wells within 150 ieet of the proposed septic system "There is no increase in flow and/or change in use proposed '�• ere are no variances requested or needed. • The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. (Adjust the groundwater table using the Frimptor method when plicablel • If the S.A.S. will be located«•ith 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be !:o:!tcd !css t^an fourteen (14) feet above the maximum adjusted groundwater table elevation, Please complete the fo!!owinY: A) Top of G;u,i!rl Su!r.*.cc Elevation Win- GIS information) r(3 3i C.W. Elevation .�u *:o h,'AX. 1-:igh G.W. Adjustment 3`� _ ��r DIFFERENC E BUWEElt A unu 13 -) e`T SIGNED :.--- - - -- -- - DATE: — -60 [Please Sketc.) pry se plan of s.. e!n o 1 -- Based upon the abotve, !'.h'C[Z;! ii0:1, :'t C hi!''1'eY(n!f 9/I" '?i: !j�+;d fi)." __ brdroonhs maximum. No additional bed 1-onm Et(' ,l;!C!i:;f!Zed t!: il:'C f ff f`1'.Y!t.''.C'tt c! !.ii7e:.red st:ptic system plans. l__..._ --.___—._..._.___........._ —_-.-- q:health foit er.Cot �. j\ `� �� 1.� O 1 i I i I , / —P' lllo D_vR_£ FIEPDEfL-- VOVOLE. 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