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HomeMy WebLinkAbout0263 PINE STREET (HY - Health 263 Pine Street Centerville ' A = 248 012 k { No. 42101/3 ORA o Q D ig GE 100 { © O ® p ��� �l'�f k.�k-CC�1�,L� Q TOWN OF BARNSTABLE OP LOCATION Z 6 3 /i/JQ SEWAGE # 2003 �® y VILLAGE C]64-711- c/, ASSESSOR'S MAP& LOT A112 - INSTALLER'S NAME&PHONE NO. G.."d"V �fd✓eLf.S 9,.r SEPTIC TANK CAPACITY C-0 n LEACHING FACEL=: (type) T) r A n 4f,,rf (size) NO. OF BEDROOMS BUILDER OR OWNER S• ���' PERMITDATE: / 0-1--COMPLIANCE DATE: C©I/O 3 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 faciliitty)- Feet Furnished by .C.�el;X �r ►AZ� 2 � I 1 r0No. ' Fee /no THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIppliLotion for Migozo.r *p5tem Conotruction Permit Application for a Permit to Construct( )Repair( )Upgrade(/ Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Z�y'3 i/! ( �� Owner's Name,Address and Tel.No. Assessor's Map17 41-l Z 7 Installer's Name,Address,and Tel.No. / (v Z z y Designer's N�/`_ Address and Tel.No. Type of Building: Dwelling No.of Bedrooms � Lot Size Z/ y sq.ft. Garbage Grinder _ ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 1" gallons per day. Calculated daily flow ��� G gallons. . Plan Date Number of sheets Revision Date Title Size of Septic Tank Z C) Type of S.A.S. Description of Soil / ram/ Nature of Repairs or Alterations(Answer when applicable) 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 Certi - cate of Compliance has been issued_W this Bo of Hralth. d /r Signe Date Application Approved by Date Application Disapproved for the following reason Permit No. Date Issued �4 J a No. C ,°"" Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS ZppYication for Mie;paal *pgtem Congtructton Permit Application for a Permit to Construct( )Repair'( )Upgrade(Xbandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. (y3 i/7 f Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,anddTTel.l.No. / .7 4-7 Z Designer's NN .Address an Tel.No. / / r�c� Ssa _ � r . :�` �� Type of Building: Dwelling No.of Bedrooms Lot Size Z t/ 6 Pa.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow L g"allons per day. Calculated daily flow / G gallons. Plan Date // 7 D Z Number of sheets Revision Date Title Size of Septic Tank C, Type of S.A.S. ^; ' Description of Soil :t Nature of Repairs or Alterations(Answer when applicable) a � Date last inspected: Agreement: ` The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system „ r 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 issuedW this Bo of alth, i Signe 1 Date / Application Approved by Date - Application Disapproved for the following reason Permit No. Date Issued ----------------------------- THE COMMONWEALTH OF MASSACHUSETTS ' BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTI Y,that the On-site Sewage D' posal S stem Constructed( )Repaired( )Upgraded(�() Abandoned at ZED �i! �,�. r—��� �_ has been constructed 'n a cord nce with the provisions of Title 5 and the for Dispos 1 System Construction Permit No. 2..GY03-aI S dated 2-1 � Installer r v Designer The issuance of is pe `it shall not be construed as a guarantee that the system L` n t' eah Date l Q..? InspectorJ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Mtgogal *p.5tem Con.5 r coon Permit Permission is hereby granted to Construe ( )Repair( )Upgrade 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:Constiuction ust be completed within three years of the date of th permit Date: / Approved by r i TOWN OF BARNSTABLE ZOd3 -® r LOCATION 24 3 i/le SEWAGE # y VILLAGE C �fi�✓y� L ASSESSOR'S MAP&LOT ��V12— INSTALLER'S NAME&PHONE NO. ��%% %� �'v©'�-S 3&Z 4-?-9c-r SEPTIC TANK CAPACITY / C® LEACHING FACELITY: (type) 3) f - --(size) NO.OF BEDROOMS BUILDER OR OWNER S• �t�� PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Feet Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility. Private Water Supply Well and Leaching Facility (If any wells exist 101/1007 Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist . 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Z -- t Q co Ln fill I III III fill ] 111111111111 �n LLJ LLJ ATTACHEDT© EXISTWG H Q J �' GARAGE o Q � O Z z O C < Q LEFT 51 DE ELEVATION w --� w w w w Q C� w V w � W fill z �- w w a w W ow wfill —EjicL j24 M O Q N RIGHT 51 DE ELEVATION i • V� � o 3U-0" �`— Z _ Q � o LIVING ROOM PATIO r, �' w O . � � O SVNROOM O DINING ROOM ° ° FAMILY ROOM — O O O EXISTING LL- BEDROOM KITCHEN •J REMOVE WALLS Z TO MAKE 1 O BEDROOM DN CZ, Ll. GARAGE - -- - - I W EXISTING U BEDROOM O EXISTING — — — — — - - - - -- W IW BATH BEDROOM EXISTING cis L_l O BEDROOM � z 0 c~n O cc Q N PARTIAL FLOOR PLAN SHOWING EXISTING HOUSE AND PROPOSED WALL CHANGES C1 Ott 90'-0" w t 4'-0" ?:4`0° < O. _ a ^t LIVING ROOM $ PATIO I I u , a Uj DECK § I LIVING IROOM I - - - O SUNROOM Q Z / ON DINING ROOM FAMILY ROOM EXISTING SUNROOM BEDROOM KITCHEN Y-0.� REMOVE WALLS I I \ I \ I cz KITCHEN TO MAKE 1 I I I I ISBEDROOM - - - - - O O DN ( � - I/ �' BEDROOM GARAGE L4UND V2 I I O EXISTING - U BEDROOM EXISTING 7'-0•' - 5'.0" O BATFI BEDROOM - - - - ( - - - - I I O EXISTING O I I I I I I BATHCLOSET BFI O BEDROOM 7 cL �- i II I I I I 4 O Lr 0' -��1 'C 0- ci. 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