The URL can be used to link to this page

Home My WebLink About0200 CASTLEWOOD CIRCLE - Health � a 200 Castlewood Circle. i' Hyannis: A ;7,Z 0Q8 E� r r a � o i - /6op-) _ 00 2 �Z ^ �� Fee - No. d �, _ +a THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 0(pplication for Migool *pgtem Congtruction .permit Application is hereby made for a Permit to Construct( )or Repair( )an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 200 CAR Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No. of Bedrooms 2 Garbage Grinder Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow Z 0 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Description of Soil Oh Nature of Repairs or Alterations(Answer when applicable) 010 G C do A-- �� 2 0 cS%Oly', 4717 S IAN- 1 r S fOPI� a t/1 Cs� 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 Boar ea],tl� Signed Date Application Approved by Application Disapproved for the following reasons Permit No. �� ' Date Issued — �S o .; i.. G Z U ��:ems► F No. ee ' THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Zipplication for Xig ogal gtem Congtruction. ermit Application is hereby made for A Permit to Construct( )or Repair( )an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 20o e ?L-c c,.00l) 9OLLPRt Yf-5- BVZ Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. W,q L x ER 1443 me 19 f AY R i o 1-1ti 190 Z y 2 IV Type of Building: Dwelling No.of Bedrooms 2 Garbage Grinder Other Type of Building No. of Persons Showers'( ) Cafeteria( ) Other Fixtures Design Flow 2 2 0 gallons per day. Calculated daily flow gallons. Plan Date ' Number of sheets Revision Date Title Description of Soil, 1 . h l2 7 Nature of Repairs or Alterations(Answer when applicable) Oo 6-19,c 12 do All 'S�oa� r,e, S i/7e 1 S font n✓f rss 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 BoarTe:ae Signed Date Application Approved by Yr Application Disapproved for the following reasons Permit No. Date Isksued �s THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS I i Certificate of Compliance - THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced(. on by .S for 6,vL&RA'0 y ask. has been constructed in accordance with the provisions of Title 5 and the for Disposal System eonstruction Permit No. dated Use of this system is conditioned on compliance with the provisions set forth below: «` No. Fee 30 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS xl gpogal *pgtem Congtruction Permit Permission is hereby granted to k1/1 L k F K f to construct( X)repair( )an On-site Sewage System located at 200 e w oo P ci/{ 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. All construction must be completed within two years of the date below. Date: 6, - 9s Approved by a CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) i j, ��fi, F_S h//jl_k R , hereby certify that the application for disposal works construction-permit signed by me dated — 9 S , concerning the property located at g®® C s C t 6✓0 e a L/ 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 Y ' • There is no increase in flow and/or change in use proposed ? • There are no variances requested'or needed. SIGNED : E DATE LICENSED TIC 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]. $ 1 1. :..•' } y r Vl- 1 S h p6pxCD i 1 ' Z 0 O C i9 S- r R woo 0 � G / u 2- tut/1-0 o-*7 _ � TOWN OF BARNSTABLE LOCATION 20a Cgs��e.tvoa.� SEWAGE # 4G912. VILLAGE �f'/��/N��s ASSESSOR'S MAP & LOT21;Z,C0-1, .INSTALLER'S NAME & PHONE NO. 7� ki,gL fCER Jv1 g/- 2 912 f� SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) Pop r NO. OF BEDROOMS PRIVATE WELL OR UBL ;ATER BUILDER OR OWNER At?p tlgLt_#gD DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: " VARIANCE GRANTED: Yes No `.. e i _ � � � � � n 0 -1� � �