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Home My WebLink About0142 BACON ROAD - Health 142 Bacon Road Hyannis A = 310 - 037 9 I I I TOWN OF BARNSTABLE C LOCATION a C K U SEWAGE # S VILLAGE �SO..NNN(<, ASSESSOR'S MAP & L�OTT.J/ -d 3 INSTALLER'S NAME&PHONE NO�Cc:�{{ SEPTIC TANK CAPACITY Q (size) G3 LEACHING FACILITY: (type) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: j�I tR7 ! J COMPLIANCE DATE: 1 Separation Distance Between the: //�� Maximum Adjusted Groundwater Table and Bottom of Leaching Facility O'y A+ /( Feet Private Water Supply Well and Leaching Facility (If any wells exist ,� 1 on site or within 200 feet of leaching faci ' /y Feet Edge of Wetland and Leachin�ty sexist `within 300 feet of leaching '1' Feet Furnished by ,F`_ c 7 � ISE- � h e T'JW*7 'OF I}ARNSTaAB?E i OCA'TION� 6k-gu) SEWAGE.#_ VILLAGE �-f rtl( t A.3SESSOR'S MAP & LOT, /O�7_ 7- INSTALLER'S NAME-F! PHONE NtJ.�edr�: SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size)— --- NO. OF BEDROOMS—PRIVATE WELL OR PUBLIC WATER tUOWC BUILDER OR OWNER_ ?8UI® _ � - °i - - ------,—. — DATE PERMIT ISSUED: 0 DATE COUPL1ANCE ISSUED__ —_ VARIANCE GRANTED: �.� 3s V r ®` rM 7 e ,y - • I TOWN OF BARNSTABLE l c J -.LOCATION Aa `' 1-1 Q CJ SEWAGE # • is VILLAGE t ASSESSOR'S MAP & LOT 10.Q NO _ r� INSTALLER'S NAME&PHONE NO:`:LCO ��kk SEPTIC TANK CAPACITY COX LEACHING FACILITY: (type) (size)^� — NO. OF BEDROOMS--EL-- -_ _ �.._ BUILDER OR OWNER c1 COMPLIANCE DATE: PERMITDATE:-�� Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility O/y r'+ /V Feet Private Water Supply Well and Leaching Facility (If any wells exist N Feet on site or within 200 feet of leaching faci ' Edge of Wetland and Leaching Facili w s exist Feet within 300 feet of leaching ili r f V_ ' � v v d a �= 4:7 No. Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0.pplication for 30i000f &pgtem Construction Permit Application for a Permit to Construct( )Repair(V/)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. ®� Owner's Name,Address and Tel.No. Assessor's Map/Pazcel ' Wyj 1 MGM. 6Ok6(1\ JQj Z c& A.. Q6 �A w,&IS Installer's Name,Address,and Tel.No. _ C1 Designer's Name,Address and Tel.No. ( 6�s 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 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank QQn h.&A_vt_ Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) S Y 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 dy this Bo of H a /�j Signed _ ��\ Date Application Approved by Date g�b^, —9 '1� Application Disapproved for the ollowing reasons Permit No. - Date Issued No. �:J Fee - THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLEs MASSACHUSETTS j3� 0(pprtcatiou for 0i5pozal *pttem Construction Permit Application for a Permit to Construct( )Repair(VUpgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. O^ n Owner's Name,Address and Tel.No. I (/ Assessor's Map/Parcel t 1 PACE Q3(SdC�G1 t ��cUn � c�kS sCU Installer's Name,Address,and Tel.No. F� - JLC Designer's Name,Address and Tel.No. -- Type of Building: Dwelling No.ofBedrooms _ Lot Size sq.ft. Garbage Grinder(Mo Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank � V CA A. Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore descri 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 this Bo of H 44 _)G Signed �t�X�- Date bS / ! 7 Application Approved by Date—Sr-1 C -9 ApplicationjDisapproved for the ollowing reasons Permit Nog'` - L/ . Date Issued ——————————————————————————————- - 'f THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of QCompliance THIS IS TO CERTIFY}that the On-site Sewage Disposal System Constructed( )Repaired:(V )Upgraded( ) Abandone ( )by \ M at C CnM has been constructed in accordance with the provisions of Title 5 and the for Disposal Sys em Construction Permit No. r - dated Installer Designer The issuance of this pe_ t shall not becconstrued as a guarantee that the system will function as designed. Date - `5 . ! Inspector ^1 V ——C————————————————————————————————————— No. / 145 l/ Fee C�THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLEs MASSACHUSETTS Duigooal 6p5tem (ton!truction Permit Permission is hereby gr ®d to Construct( )Repair( Upgrade( )Abandon( ) System located at pig 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: - '7. - Approved by CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL NVOItKS CONS111100JON PEItM1T' (WF1'IIOU'F DESIGNED PLANS) CM hereby certify that the application for disposal works construction permit signed by me dated concerning the t it property located at Iu � � ✓' « 1meets-all of the following criteria: i There are no wetlands within 300 feet of the proposed septic system " k 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 i There is no increase inflow and/or change in use proposed There are no variances requested or needed. 1 4 i SIGNED: DATE: �(a l t 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). c s k� t I BARNSTABLE TOWN OF ^„ ' LOCATION Q _ SEWAGE # VILLAGE ASSESSOR'S MAP & LOT IO.O 3 INSTALLER'S NAME&PHONE NO.-ti:,CO-A� SEPTIC TANK CAPACITY CO LEACHING FACII.ITY: (type) �� L (size) NO.:OF BEDROOMS BUILDER OR OWNER PERMITDATE: /l I I�1 7 COMPLIANCE DATE: Separation Distance Between the: 1 l� //L� Maximum Adjusted Groundwater Table and Bottom of Leaching Facility �1Q /'1 ��( Feet Private Water Supply Well and Leaching Facility any wells exist N Feet on site or within 200 feet of leaching faci ' Edge of Wetland and Leaching Facili w s exist ' / \ within 300 feet of leaching ili 'Y Feet Famished by f�r Q� �� l� a �Ic�✓' 10 v t '