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HomeMy WebLinkAbout0141 CASTLEWOOD CIRCLE - Health J41 CASTLEWOOD.CIRCLE -,HYANNIS i I I. ° y I, r e a — o � ° ° E,Go ` TOWN OF BARNSTABLE LOCATION ` ` Gw`<��C. C,- SEWAGE #JC-^-5a3 VILLAGE_I�-r�J Cc d-bll S ASSESSOR'S MAP & LOT U INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY e't STa t066 QAA 0 YO LEACHING FACILITY: (ty ) �� V- Ck r (size) 30 �L,=.If NO.OF BEDROOMS BUILDER OR OWNER I f ari AJO PERMTTDATE: COMPLIANCE DATE: ®d 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 of Wetland and Leaching Facility(If anywelands exist w300 feet of leaching facility) Feet LEdgei urnished by a C st I i No. ` Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIpplication for 33igo5al bpotem Construction Permit Application for a Permit to Construct( )Repair(V)Upgrad�Abandon( ) ❑Complete System [Xbdividual Components Location Address or Lot No. QKMF— Owner's Name,Address and Tel.No. Assessor's Map/]Parcel _-17�2L-O y iQ, •j�t I �y r t vzj Installer's Name,Address,and Tel.No. Y Designer's Name,Address and Tel.No. 1j �OL.1S 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 a gallons per day. Calculated daily flow 7�lqc�lk gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank "r`e M Type of S.A.S. trG P Cr Description of Soil; nwQ5► Nature of Repairs or Alterations(Answer when applic ble) ILSTa(( ��� I )utz /4s h '1,G���L.21�-s:.L•T��7'G(1 S �,��j,�� S'7�Lo-P o'G�Si/),e r /1-r� /�� !.r tt C�'�.��c�, 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 prov• • itle 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has bee • ued by this Bo ea Signed Date Application Approved by Date �� Application Disapproved for the ollowing reasons Permit No. e) rQ�_ Date Issued .41 s fNo. P�� ��� ,6 x r •�-t Fee V THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: h. Yes `'-PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS t M . 01pplication for 3k�pooal bpotem Con$truction Permit Application for a Permit to Construct( )Repair(" )UpgradAbandon( ) O Complete System Individual Components fill Location Address or Lot No. ' Owner's Name,Address and Tel.No. H � Assessor'sMap/Parcel Prt �.. Installe',barnetAddress,and el. q T4 Designer's Name,Address and Tel.No. 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 b gallons per day. Calculated daily flow � gallons. Plan Date Number of sheets Revision Date Title ' Size of Septic Tank y S' �' ZJ 1° Type of S.A.S. Y� CC, C` �`:fi X, Description of Soil Nature of Repairs or Alterations(Answer when appli ble) _:rf _5T Q( ,a-�U� Rutzl4 CAW ff-Crl`.�Zs_f l LTA ci7G(1s w�L f 1 i/,-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 pc otts-of-Title of the EnvironT al Code and not to place the system in operation until a Certifi- cate of Compliance has been issued y this Boar Signed Date Application Approved by Date Application Disapproved for the following reasons Permit No. ��© �T— Date Issued y ----------------------------------------- ' THE COMMONWEALTH OF MASSACHUSETTS t BARNSTABLE, MASSACHUSETTS Certificate of Compliance g PSystema ( )Upgraded( )THIS IS TO CE that the f�+n=bite'Se a Disposal Constructed( )Repaired Abando d )b U� 1,�. � °�, r6 l a at Wo MKNhas been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Pe dated Installer Designer J, n The issuance of this perrnitz Vt b ron-trued as a guarantee that the s e rl t£',ct n a ld sign ' Dater..__ Inspector ' �� r �` No. - "� Jr0 3 _ _� - - Feed THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Iigpool *p.5tem Congtruction Permit Permission is hereby granted to Construct( )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:Construction must be completed within three years of the date of this permit. Date: y Approved by 1 r j1i 1/6/99 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 DESIGNED PLANS) hereby certify that the application for dis posal works construction permit signed by me dated �-�`� , concerning the property located at ,�� �G" - meets all of the following criteria: "• This failed system is connected to a residential dwelling only. There are no commercial or business P mouses associated with the dwelling. ld • 'The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. • There are no wetlands within 100 feet of the proposed septic system ✓• There are no private wells within 150 feet of the proposed septic system There is no increase in flow and/or change in use proposed P There 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 ap�pli �ble] •— If the S.A.S.will be located with 250 feet f an vegetated o y wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted ,groundwater table elevation, Please complete the following: --7 A) Top of Ground Surface Elevation(using GIS information) l B) G.W.Elevation'72s +the MAX.High G.W.Adjustment 3`� _ 3 DIFFERENCE BETWEEN A and B SIGNED : DATE: [Please Sketch propo plan of system on back]. NOTICE Based upon the above information,a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:cert I i TOWN OF BARNSTArBLE ; LOCATION I \ CWSl� (J 'C�SD Cl lC1 e SEWAGE #aCtZ— 6f3 VILLAGE Cc ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. -rc i SEPTIC TANK CAPACITY ee-et[SQL l 66 A qc3- LEACHING FACILITY: 12c, U (size) 1, r NO.OF BEDROOMS ` BUILDER OR OWNER yi ►J 0 PERMITDATE:—Z/J4/1-1a) COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet . Private Water Supply Well and Leaching Facility (If any we 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 J