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Home My WebLink About0191 CASTLEWOOD CIRCLE - Health 191 Castlewood Circle . - -— - - --- Hyannis ✓ A= 27M45 I I i P . a ° l TOWN OF BARNSTABLE LOCATION / J I 6/leS SEWAGE # ` VILLAGE ASSESSOR'S MAP& LOT U INSTALLER'S N &PHONE NO. I�tO l� � 2� Z 7/`� SEPTIC TANK CAPACITY I&Lav LEACHING FACILITY: (type) 60 (size) NO.OF BEDROOMS BUILDER OR OWNER PERMIT DATE: I ��COMPL DATE- "'3 29 2 Separation Distance Between the: i 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 w 4 � d t � 0�5 NO. -jI cr Fee I TH�'COMMONWEALTH OF MQSSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., M'ASSACHUSETTS 2pplication for Miqual 6pelem Construction Permit Application for a Permit to Construct( )Repair OO Upgrade( )Abandon( ) ❑Complete System El Individual Components Location Address or Lot No. !// 4*,54t z tom.oo♦~)J L,/j Owner's Name,Address and Tel.No. Assessor's Map/Parcel yanni,SMap/ParcelL/ S y t'h Jl y Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. v_'i9y,n�s I� k,04 E!Z 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 ?0 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank /eno 6-A-L Type of S.A.S. Description of Soil X h-4 O S� fi Nature of Repai 'orAlter tions(Answ r w en applicabl )��L--,dr7,4 S 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 d Signed Date Application Approved by Date Application Disapproved for the following reaso Permit No. Date Issued - J O No. .Fee l�� THE+C`COMMONWEALTH OF 1008/$KC USETT�" t' Entered in computer: .� -i PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLEi MASSACHUSETTS Yes 0(pprication for Migpogal *pgtem Congtruction Permit Application for a Permit to Construct( )Repair()0 Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. J�j/ L rtS4 t t tr oo p Li/l Owner's Name,Address and Tel.No. y /yyA.,r„s 141 L q,5�}Lc I-nol7 e,n VYAftNrS Assessor's Map/Parcel L/ s H rh n Installer'JName,Address,and Tel.No. !Designer's Name,Address and Tel.No. �f1 J-�s I� /➢C E IZ i J Ocrt7 `riaRw,a,t� RfJ' 771- 2Y�y Type of Building: Dwelling No.of Bedrooms -3 Lot Size sq. ft. Garbage Grinder( M49 J,•nry Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures lo Design Flow 2.70 gallons per day. Calculated daily flow. gallons. Plan Date Number of'sheets Revision.Date Title Size of Septic Tank. ho o (•ItC Type of S.A.S. Description of Soil S A-A 9 y Nature of Rep ai or Alter tions(Answ r en applicabl ) P L t*4r*G �� Date last inspected: y Agreement: w The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system ri'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 issue b thi's o d , . Signed Date Application Approved by Date Application Disapprovedlor the following reaso Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS r Certificate of (compliance THIS IS TO CERTIFY, thatth EOn-site Sewage Disposal System Constructed ( )Repaired ( �)Upgraded ( ) Abandopv ) y at / eFV�(e► zr- ash96n constructed in accordance with the provi 'on ofTj�f the for Disposal System Construction Permit No. �dated —�J7 q Installer Designer OF The issuanc of this pe t shall not beconstrued as a guarantee that the system will function as designed/ / !� Date 07— 3 / Inspectors�i� J//�G! �i�/r — ---------\---———————————— No. ' \ Fee, --- THE COMMONWEALTH OF MASSACHUSETTS } PUBLIC'HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mwigpogai *pgtem Congtruction Permit Permission is hereby granted to Construct( ' )Repair( 'K)'Upgrade( )Abandon( ) System located at 41 t t-o 0,9 0 CI R and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his er duty to comply with Title 5 and the following local provisions or special conditions. l Provided:Construction must be completed within three years of the date of thi 42 Date: " 1 S"9'� Approved by D r - ry, 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 disposalworks construction permit signed by me dated , concerning:th— property located at ) g'/ �,r��C ti oo X� c�o2 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. SIGNED: DATE: 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:pt4.plan, this plan should be submitted]. 4 TOWN OF BARNSTABLE LOCATION 5 /»S0 Jrry SEWAGE# ` VILLAGE ASSESSOR'S MAP.& LOTd 79` O INSTALLER'S NAI &PHONE NO. /( SEPTIC TANK CAPACITY r LEACHING FACILITY: (type) (size).''. NO.OF BEDROOMS Z BUILDER OR OWNER PE RMTTDATE: ` 9 � COMPL DATE: .��` 3 ' g Separation Distance Between the: Feet Maximum Adjusted Groundwater Table-and Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist Feet_ on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by a�