The URL can be used to link to this page

Home My WebLink About0060 ALICIA ROAD - Health "7 .h.^ 60"-Alisha-.Road:k�` A= 292=263 ;.. p e 0 0 0 o a o ° ` v e o 0 d o . a o ° e TOWN OF BARNSTABLE LOCATION lao 14/ cjoq "llep SEWAGE VILLAGE . 4 /U/U,-5 ASSESSOR'S' MAP & LOT �Z INSTALLER'S NAME & PHONE NO. A & B cANcb 775-6264 SEPTIC TANK CAPACITY A� ��X W /vr2 LEACHING FACILITY:(typee %Jf�/n pt.S� (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER y/ e5-g DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: �� 7 � VARIANCE GRANTED: Yes No t/ f c 0 l No.2 Fee Q THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 3! Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pphratton for ;h6poml *pgtem Congtruetton Permit Application for a Permit to Construct( )Repair( -l'u"pgrade( Abandon( ) O Complete System ❑Individual Components Location Address or Lot No. A 1 c Owner's Name,Address and Tel.No. Assessor's Map/Parcel J A n A l k ri QSa sA Installer's Name,Addres*A'IB 'NCO Designer's Name,Address and Tel.No. 350'Main Street A11A W. Yarmouth, MA_02673 Type of Building: Dwelling No.of Bedrooms 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 3,3 G gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank I000 Type of S.A.S. I Description of Soil Nature of Repairs or Alterations(Answer when applicable) 6M A-X(evli Z r rS LJ O t 3 f_6y 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' onmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by thi ar f lth. Signed Date c� Application Approved by Date �-O Application Disapproved for the following reasons Permit No. Date Issued TOWN OF BARNSTABLE LOCATION�� /4/�✓�I SEWAGE # : VILLAGE . 4AJV ASSESSOR'S MAP 6� LOT INSTALLER'S NAME Gz PHONE NO. A & B cmzb 775-6264 SEPTIC:TANK CAPACITY LEACHING FACILITY:(type) �jUf�/r�A�o4L.S��X�Cs(ze) NO. OF.-BEDROOMS PRIVATE WELL OR PUBLIC WATER w BUILDER OR OWNER V/ DATE PERMIT ISSUED: 3 'a`✓-' DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No ✓ ') r -�-,end/ 'II�3 O OF , Z '! No. 9 Fee w j r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MAS.SACHUSETTS. y 01ppYication for IDigpogal 6peum Congtruction Permit Application for a Permit to Construct( )Repair( --l"Upgrade( Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 6 v A+i c i cL Owner's Name,Address and Tel.No. M 1 Assessor's ap/Parcel 1•� / v O�o A(4e r + ..�` Installer's Name,Addres TS Dt NCO Designer's Name,Address and Tel.No. 350 Main Street W. Yarmouth, MA 02673 Type of Building: Dwelling No.of Bedrooms_1 Lot Size sq. ft. Garbage Grinder( ) + Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow ?i(„ gallons per day. Calculated daily flow 3 G gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank I nbh Type of S.A.S. T Description of Soil -� -� t Nature of Repairs or Alterations(Answer when applicable) � A 64// Date last inspected: Agreement: r' ,g ` a 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- rate of Compliance has been issued by this arNf t1th. Signed KA I LWA 1, Date Application Approved by Date - -� Application Disapproved for the following reasons t . Permit No. Date Issued -----.— —.-- — ----- ——— ----------- THE COMMONWEALTH OF MASSACHUSETTS -% BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO,CERTIFY,that the On-site Sewage Disposal System Constructed( ).Repaired'( ,-Upgraded ( ) Abandoned( )by �"tZ4�-4 � at has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. Z' dated V-" Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. ' Date_ Lj Inspector No. A Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS 1migpogat *pgtem Congtruction Permit «, Permission is hereby granted to Construct( )Repair rade( )Abandon( ) System located at ��i�,i42 k �. 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 t ' it. Date: -" 2�� Approved 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 — a j- 9 7 , concerning the property located at _1� D ( t,C 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. 1 SIGNED: \ �C�...��_ DATE: J - q 7 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]. i O 6 �. O, � � +, �� w � � �� x � a SEPTIC -SYSTE-M DESIGN FLW..� DSD MS AT .Q GAL/DAY/DAD � _ .. ��/DAB SEPTIC TANK: , . GAL/DAB' x z DAYS GAL USE GALLON SJrFT'IC TANK LEACHING ARZA.• USE s INFILTRATORS j[AX I MI ZER CHAMBERS WITH 0 Off' STONE ALL AROUND (3V x If x Z DEEP) SIDX AREA: Iso + ?1 z z 164 SP (o74) _ • GAL/DAY - BOTTOM ARZA.• XT � I _ ��'�) � GAD/DAB' CAPACITY GAL/DAY