HomeMy WebLinkAbout0275 CASTLEWOOD CIRCLE - Health 275 CASTLEWOOD CIRCLE, HYANNIS
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TOWN OF BARNSTABLE /
LOCATION 73' GAR, SEWAGE#
VILLAGE ASSESSOR'S MAP.&PARCEL.?
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type)
NO.OF BEDROOMS
OWNER
PERMIT DATE: -1/S/ COMPLIANCE DATE: 17
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
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) / / Feet
FURNISHED BY
M � M
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A01No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
appliLatlon for 30isposal 6pstem Construrtion Permit
Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑Complete System , Individual Components
Location Address or Lot No.,:2 73'Gift 0a0 L/,� Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
TI pe of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of BuildingJ� No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) d Design flow provided gpd
Plan Date Numb of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations.(Answer when applicable) ���� '00 � / o
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 Certificate of
Compliance has been issued b ' Board of ealth.
gn 6' Date
Application Approved by pl Date
Application Disapproved by Date
for the following reasons
Permit No. Date Issued
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Saes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
2pplication for Misposal-6pBtem Construction Permit
Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑Complete System Individual Components
Location Address or Lot No.,;!7-1- G/,� Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel
Installer's Name,Address,an Tel.No. Designer's Name,Address,and Tel.No.
o
Type of Building:
Dwelling No.of Bedrooms 1Z Lot Size sq.8. Garbage Grinder( )
Other Type'of Buildinga e r No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) d Design flow provided gpd
Plan Date Numbe of sheets Revision Date 44
'r
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) ��.�s�� .J'G��l/` '00 °ids /4—a ol-A,
hest To' i •�.��T /w'1'�'�7` d �- �.��►'�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 provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
gne a Date
Application Approved by /p^ / Date
Application Disapproved by v / / � I Date
for the following reasons
Permit No. Date Issued
TH E COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( f Upgraded( )
Abandoned( )by G
at ml. � G.4✓'T1z� Lri oO,b G/off ,�7 has been construc d in ac r nee
with the provisions of Title 5 and the for Disposal System Construction Permit No dated
Installer Sri y L 4&0 e !/t - Designer
#bedrooms E� Approved design / gpd
The issuance of this permit al con _ ed as a guarantee that the system will cti n as designe . C
Date Inspector
---------`-------------�---------------------- ---- ------------:----------------------------------------------- - --------
No. . . Fee-_
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS
-isposal *pstem Construction Permit
Permission is hereby granted to Construct( ) Repair(k<" Upgrade� ) Abandon( )
System located at �, 7 �,.�(y��'l�/oaf G/eta W$
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction t be bmp eted within three y ears of the date of this permit.
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Date Approved by
� r r
TOWN OF BARNSTABLE
LOCATION A-yS `4sTG-w sDaA t— SEWAGE #
VILLAGE ' � N•�C ASSESSOR'S MAP& LOT 2 3
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY S ',
LEACHING FACIL=: (type) Q—J-0A\(x0 OCA (size) ka
NO.OF BEDROOMS
-
BUILDER OR OWNER
DATE:_�� COMPLIANCE DATE:
Separation Distance Between the: 1
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility 2-® Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility)
I 1(?s Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leachin facility) . Feet
Furnished by �-�
:y
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LA
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TOWN OF BARNSTABLE
LOCATION A 15 CAbUkeex C Le SEWAGE # J. ,)-G
VILLAG>r H Vatr10 t S ASSESSOR'S MAP &LOT 273 -6!t 7
INSTALLER'S NAME&PHONE NO. i a CGwe �eo�iC 77 S"668L(
SEPTIC TANK CAPACITY f QOb qa I
LEACHING FACILITY: (type) L'- 91 �4 p� � �°r,� (size) +( X 15
NO.OF.BEDROOMS _
BUILDER OR OWNER
PERMTTDATE: �j�-5 -J� COMPLIANCE DATE: Y —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
e �
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Fe-
e
�4 C O
B Q
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Dri
v. V
No. 76 Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 'Yes
Application for rlig aal 6pelem Con!6trurtton Permit
Application for a Permit to Construct( )Repair( Upgrade( )Abandon( ) O Complete System ❑Individual Components
Location Ad�d,�resso-t�o�__Rt wood ^ rrC� Owner's Name,Address and Tel.No.
Assessor's Map/1).el `( an
i3 �273 rd 6eiL—, M a,rew has
Ins ler's Name,Address,and Tel.No. n„ ,( Designer's Name,Address and Tel.No.
rts
to� -C ;L'��-Ia,-1 n 45
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 3�a gallons per day. Calculated daily flow `3 gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank i`� w e��✓ Type of S.A.S. di t&r ,ram,DCf 7-1-alri-�' �--
Description of Soil
Nature of Repairs or Alterations(A swer when applicable)- V-S5'SYV A `
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 gode and not to place the system in operation until a Certifi-
cate of Compliance has bee ' `
Signed Date
m
Application Approved by Date
Application Disapproved for the following reasons
Permit No. � Z 7,6 Date Issued _ - 9
TOWN OF BARNSTABLE
LOCATION S '�►-����. SEWAGE# �S 12-
VCA nn 1 s __ ASSESSOR'S MAP &LOT�27 i -a 7
VIII;AGE N �—�'
INSTALLER'S NAME&PHONE NO. ./ ) a C60C Eeo�G 77 S 668y
SEPTIC TANK CAPACITY 160041.
I EACHING FAciLr Y: (type) y� M� C4p._____��"` (size) /XIS
j NOs,OF BEDROOMS
BLTII-DER OR OWNER
Pjr TTDATE: COMPLIANCE DATE:_�I�� �-1 -917
Spaation Distance Between the:
"urnAdjusted Groundwater Table and Bottom of Leaching Facility Feet
Privace,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
Famished by
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7o4 / ....
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ak
No. " — A Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
01ppYic'ation for &!gpo,5al *proem CCongtruction Permit
Application fora Permik tp.Construct( )Repair( pgrade( )Abandon( ) ❑Complete System El Individual Components
Location Address >�ot .i.�+' ^��UCI�''r� Owner's Name,Address and Tel.No.
Assessor's Map/Parcel �X Pl a ra n h aS
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
rxl rye qc.�_)e r-�s Zo 6�kp Lc rAve,
_�qa t,0
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 - ,3[� gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title .,
Size of Septic Tank a��a, el Gw�`���J Type of S.A.S. jt,&( rG DGl - = a"'h�o �--
Description of Soil _��y.e C�. S"
Nature of Repairs or Alterations(Answer when applicable) - -u�S S ✓J l� k=CN ��'k Cc A( 7, �,,_
L. ��.`� trVf C CA-, ��� S'CAe CJ\A -Si
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 ode and not to place the system in operation until a Certi�;;
cate of Compliance has been issue B �>
,---" -�
Signe� Date
Application Approved by Date
Application Disapproved for the following reasons
Permit No. Z Z r r !Date Issued
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-———————— ———
THE COMMONWEALTH OF MASSACHUSETTS y
BARNSTABLE, MASSACHUSETTS
Certificate of [Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( Upgraded( ✓�
Abandoned( )by Ar V4 p r i
at 4 C ;Y'o has been constructed in accordance
with the proy�sions of Title_5 and the for Disposal System Construction Permit No. -GZ w dated
l .
Installer l- . r y Designer
The issuance of thi permit shall not be construed as a guarantee that the systn will function as designed.
Date U Inspector
1
_ --------------- —————————— --
No. Fee ��• ./�
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
Mi5po5ar *p5tem Construction Permit
,\ Permission is hereby granted to Construct( )Repair 1f J Upgrade( )Abandon( )
System located at i s 0 12 0 AkJO n n f,f)
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 perm' r �
Date: / - 7 Approved by
1"/97
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NOTICE: This Form Is To
Be Used For the Repair.Of Failed
Septic Systems Only.
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CERTIFICATI ON OF SKETCH AND APPLICATION FORA 1
WORKS CONSTRUCTION PERMIT (WITHOUT
DISPOSAL i
ENGINEERED PLANS)
fY that the application hereby certify for disposal works !
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I' concerning the
construction permit signed by me dated
meets all of the
property located at 9�7
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following criteria:
'rhm ere no wetlands located within 100 feet of the proposed teething facility
septic system
Private wells within ISO feet of the proposed ( ;
There ere no pri 1
f Is no increase in flow and/or change In use proposed `
(1' lime
as no varianc or neededVariances � r the I {
nd the bottom o
If the Proposed
Inching heility will be located within 250 reet orar wetlands,
ed leeching f8cilitX will�be located less thanfourteen(14)feet above the maximum adjusted1 '
groundwater table elevation. {
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please eomplete the following:
In to the Engineering Division O.I.S.map)
A)Top of Oreued Elevation(accord g .�'0 i I
B)p ()MMJweter Table Elevation(according to Health Division well map)
7 ,
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DATE: '
SIGNED
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LICENSED SEPTIC
INSTALLER IN THE TOWN OF BAIWSTABLfl NUMBER
tart stow Pia •AM*It"110m9W tn.utr.r pol""s•ow"I a plot plains
lAltat►a aleNeh p .. 1
Ibb plan should be submitted). ;
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�:; �hesMr tMAa:eat {