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Home My WebLink About0231 BEARSE'S WAY - Health 231 -BEARSES WAY, HYANNIS' ___ - - - --- ----- -- --- A=309-02,1 o e i TOWN OF BARNSTABLE LOCATION 23/ BFXelt5 wT SEWAGE # VILLAGE ASSESSOR'S MAP & LOT Id?"U2t INSTALLER'S NAME&PHONE NO. 19--- /g�"j"9 SEPTIC TANK CAPACITY /Mo 6Ao� LEACHING FACIL TY: (type) .`/lyIOXI PR115Pg (size) USX q NO.OF BEDROOMS 3 / BUILDER OR OWNER !yI s S PERMTTDATE: COMPLIANCE DATE: I 1 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 � `� Nk 1 rl ' .• No. v _ Fee2 'V v Sri THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01ppYicattou for Mi!6pogal *pgtem Comaruction Verna f Application for a Permit to Construct( 4�-)4epair(. )Upgrade( )Abandon( ) Z<omplete System El Individual Components Location AddressAddress or Lot No. 2 3� tr�rS rS �v/3 Owner's Name,Address and Tel.No. Assessor's Map/Parcel � D t7 v I/�j !7 !C Installer's Name,Address,and Tel.No. �1'!`!—v3y9 Designer's Name,Address and Tel.No. ✓as�� D� /,3nr�os Type of Building: Dwelling No. of Bedrooms 2 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 /.SoO Type of S.A.S. Description of Soil a� Nature of Repairs or Alterations(Answer when applicable) �125'Ti�l/ /S" 0 (,g/ �S"r y ltii�xi�l.�rs cult/ 3'Sror�i7 ,�radh 2 " f�/'� Yrohi- /yI 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 Health. _ Signed Date 9�' Application Approved by Q Date Application Disapproved for the following reasons Permit �� Date Issued �� ti �� •j��^.:- . ..�,,,",;�.sTF��"�.7."`` '�y _ ��._.i{`-r.*sFtfr;,}`ryn`— —"-----r-"--�`-`•.--•«..—sw+.-.�._'...s%-.:;.:�.m�f u'._ .. � ..::=wrf..wdw"." J ,. .`No. A' Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS tlYication for 65po5al 6p`mem Congtructionlpefmit ti. Application for a Permit to-Construct( 44-Kepair( )Upgrade( )Abandon( ) Zromplete Syste 1 O Individual Components Location Address or Lot No. 2 3/ QrprS cS u/�y Owner's Name,Address and Tel.No. r yyAnh/s /y/isS �oi</ • Assessor's Map/Parcel �� d t �o� _ Wo V ' Installers Name,Address,and Tel.No. W71—D.�y4 Designer's Name,Address and Tel.No. F Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. j 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 /So0 / Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable)Fi%/ F_X/St/s94 Ce-ijroDol w1d l'// '�•� S.yq� ThSrrg// /S00 G/�/. .Sl. �- dyi*x rs W.,r1 3'Sronr /a /3,wt/c oG l�o�s Date last inspected: Agreement: i 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 f Health. Signed Date Application Approved by Date A-- z ')Application Disapproved for the following reasons :•.:W., > Permit No. Date Issued --------=--------- ---- ..---------— k THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewaget Disposal System Constructed ( f_-�Repaired(. )Upgraded( ) Abandoned( )by ./n54,PA U-, �.arrOS at / e u/ has been constructed in accordance' with the provisions of Title 5 and the for Disposal System Construction Permit No. ® :o dated Installer ,/as,62, Pie- 80rrd S Designer ✓as e44 The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date I �. _ �>� Inspector �• _. No. ho — O _O ————Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 1=i0po2;al'*pgtem Construction Permit Permission is hereby granted to Construct,( /impair( )Upgrade( )Abandon( ) System located at ,Z J/ dF_19tzz enS Gl/64 c1 Hc/AnH/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 QerjMt. ! ' Date: �'`� Approved by 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) I, J,4p./ D{ 09rr0 S , hereby certify that the application for disposal works construction permit signed by me dated f' ?s , concerning the property located at 3/ l3F�rscS Gd�+� meets all of the following criteria: /There are no wetlands located within 100 feet of the proposed leaching facility, VThere are no private wells within 150 feet of the proposed septic system d ere 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 uW 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) B)Observed Groundwater Table Elevation(according to Health Division well map) SIGNED: DATE: /— 9 —.�T LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER 741 [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 � r i wa S 0 nl S y 3 r = ' a N v s S X Vl Vv e o � 4 � 1 TOWN OF BARNSTABLE LOCATION 23/ � 74Y9�S G!/�r/ SEWAGE 98' VILLA VILLAO ASSESSOR'S MAP& LOT 34Q O�� INSTALLER'S NAME&PHONE NO. JoXt,104 0-c 9, �Wry S SEPTIC TANK CAPACITY ISDo . LEACH 4P FACILITY: (type) I'#10X!!0i/=-l"3 (size) 3sx �j NO.iO ,BEDROOMS 3 BUILDER OR OWNER PER)4iTDATE: / — 9 -9� COMPLIANCE DATE: Separ400h Distance Between the: Maxum,Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private.Water Supply Well and Leaching Facility (If any wells exist oil:sift 0r within 200 feet of leaching facility) Feet Edge'o.f'Wetland and Leaching Facility(If any wetlands exist `�... w thi:[t 3.00 feet of leaching facility Feet _ Furnished by s ��s