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Home My WebLink About0065 ELM STREET - Health 65 EIm .Street 'Hyannis A = 309 062 I� �l l f I j i �I i I I I Nay •s�wrawew .y f 3 V op"Maw �I ------------ i li TOWN OF BARNSTABLE LOCATION 57" SEWAGE #cg2D2:/77 VILLAGE ASSESSOR'S MAP & LOT — INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /S`oD cqc i LEACHING FACILITY: (type) T eha h (size) NO. OF BEDROOMS BUILDER O OWNER PERMTTDATE: S-�fo�- COMPLIANCE DATE: � YL� Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Jet 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 D54, Aaj,., X. S. I ��-� . � i i �� O -�. .� w �, No. _ � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Application for Migool *p!tem Construction Vermtt Application for a Permit to Construct( )Repair( )Upgrade(✓)Abandon( ) complete System ❑Individual Components Location Address or Lot No. l � Owner's Ng/am ,Address and Tel.No. Assessor's el ` ��i�" r/`►'�� Installer's Name,Address,and Tel.No. 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 gallons per day. Calculated daily flow 33z9 gallons. Plan Date _1_9Z Number of sheets Revision Date Title e Size of Septic Tank / Type of S.A.S. X Description of Soil U� Nature of Repairs or Alterations(Answer when applicable) 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 is Boar f all Signed Date Application Approved by L- Date Application Disapproved for the following reasons Permit No. Date Issued c7-- �� Fee No. �� J' ' ,. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓" Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZippYication for �Mie;pooal *pgttm Construction Permit E Application for a Permit to Construct )Repair( )Upgrade �� pp ( ) p ( )Upgra (V) ( ) LJ'Complete System El Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's/Ma / cel :.56 71c1(a2 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: ? Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder(A0 Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow �Ji� gallons. Plan Date Number of sheets Revision Date Title S'f J ;* z�l!//J9 P_ Z�,Z& i� c�5� Size of Septic Tank �' Type of S.A.S. Description-of Soil ✓P�`4/1z' �!`��G� ( � QG�t, (�`rV� Nature of Repairs or Alterations(Answer when applicable) � l� " L/��tom' 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 •,is Boar of H-alth. Signed 'ZG-w / Date Application Approved by Date 4-1 C n. r h4 Application Disapproved for the following reasons Permit No. rC�C C�CJ �i Date Issued Q to ————————— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY. that the On-site Seyoge Disposal System Constructed( )Repaired( )Upgraded(0.4 Abandoned( )by at J`" y has been construct d in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No i`1-7 dated — (c Installer Designer The issuance o thihg� ermit shall not be construed as a guarantee that the system will fjunction asAd igned. Date 1) ( Y Inspector K No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTIIVLSION - BARNSTABLE, MASSACHUSETTS Migpogaf *pgtem Con5tructign ermit Permission is hereby granted to Construct( )Repair(• )Upgrade(P')Abandon System located at 175 zF/w S� �// 5 and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to t 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. ii Date: ��//��' Approved by f ASSESSORS MAP : - � _ TEST HOLE LOGS - PARCEL � � � � .` ,` T�� 5 -f,�, f�' -f;' She-1 � �c. v..`� 1� C✓ i�l FLOOD ZONE: �'/� %' /_' , )� �G"_ !� SOIL EVALUATOR :_ - \� 7- WITNESS : c r / l/5 DATE : M bN1,G� l-?REFERENCE : Z2:- Cj � PERC LAT ON RATE 21 4 Z G f- s& 41 � TH- TH- G � c LL C..I7ki TS LOCAT I ON MAPLE �) !- �1 -;) ,0 C_ecj(-, c � .:'� SEPTIC SYSTEM DESIGN '// .-. ...^.^ C/ c 71 7Z ;7/ A-: FLOW ES i i MATE BE_ .DONS AT//O GAL/DAY/BEDROOM -23OGAL/DAY SEPTIC TANK �3U G', _/DAY x 2 DAYS .CGG GAL 1 USE;"- ",GALLON SEPTIC TANK sal k';;1 ,F i I ON SYSTEM rl ` o `-J- __ _ v�1 �1 � •� i .l AREA JS.o . X '� ,�, c _ SEPT1 SYSTEM SECTION c I � Ll�2L 2, 1 01 + (�vaTv t �`�1>E9 419 1 GAL 3 q7 D-BO SEPTIC TANK re4OF c/ � tA11� ' ` '�jo ,`rbP�) �i� �� 1,t✓ �/�E�l, 3`� _ - - � 1096 r; SITE AND SEWAGE PLAN LOCAT I ON : PREPARED FOR : o „ SCALE :/ - / z DAV I D B . MASON �5 DATE : z DBC ENVIRONMEN AL DESIGNS z z EAST SANDWICH . MA 3 DATE HEALTH AGENT ( SOS ) 83 3- 2 17 7 w Z