Loading...
HomeMy WebLinkAbout0017 GENERAL PATTON DRIVE - Health 1 GGENERAL PATTON DR., HYANNIS A=292=165 1 i N �lq Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pplitatlon for MispoSal 6pstem (Construction Permit Application for a Permit to Construct( ) Repair(X Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No. I Ip eG&*aAc_ A 4T v AJ Ok Owner's Name Address,and Tel.No. L� (3dlzt& 5? IYOcO�'(dvC /4v i HL Assessor's Map/Parcel 56V-1 15M 1 AIJC Installer's Name,A dress,and Tel.No. 50E-4�77-FS`77 Designer's Name,Address,and Tel.No. CAQ�t pC�R©,f��L�Type of Building: I Dwelling No.of Bedrooms ! Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number 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) J (_5E21 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 qfHea Si Date 17— 7jX— X l g Application Approved by Date Application Disapproved by Date for the following reasons Permit No. �C;� Date Issued No. F+'/ -/ �" / �1. Fee . THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Ye ftpliration for Disposal *pstem Construction Permit Application for a Permit to Construct( ) Repair(V Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No. M 0k Owner's Name,Address,and Tel.No. �L 13�R,�STi�I� E�OVStn�Gr �Qt�"T f"'1�7R.t't� Assessor's Map/Parcelaq�jjggk , 15e5UT9 Installer's Name,Address,and Tel.No. R501?-477-8$T7 Designer's Name,Address,and Tel.No. .,. 1:2AF w1 0457/RcaBsr—X7 t3 0,, . N 1A_ I c. �.. �'I)rpe 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(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil i Nature of Repairs or Alterations(Answer when applicable) �A r C-r�! [ � h��� U,2 j Date last inspected: ,Agreement: a� 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 h Compliance has been issued by this Board of Hea . r Si d--y--- Date P7— 21 .. S e t Application Approved by Date Application Disapproved by Date r � r for the following reasons S ��` { Permit No. Date Issued f} THE COMMONWEALTH OF MASSACHUSETTS �}e(!' J ?X 'tic BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the n-site Sewage Disposal system Constructed( ) Repaired(x) Upgraded( ) Abandoned( )by at � t;=�� � T77�ta _ {��/ has been constructed in accordance / with the provisions of Title 5 and the for Disposal System Construction Permit Ii/ � dated Installer Designer #bedrooms Approved design flow gpd The issuance of this p rmit s lall no a construed as a guarantee that the system will nctton designe Date 2�1 Inspector i • ; - ------ - - - b ----- --------------- No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS MIsposal �6pstem Construction Permit Permission is hereby granted to Construct( ) Repair(4) Upgrade( ) Abandon( ) System located at 143 C-6067AAc� ) DPLL j ` 14YAx)A)o5 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 must/be completed within three years of the date of this penqit. Date ''�/ � Approved by TOWN 'OF BARNSTABLE BAR-W 431 Ordinance or Regulation $ r }` WARNING NOTICE Name of Offender/Manager PGr �rvr-k,b14og Address of Offender p`� �� e�c-.� ,( � h /1 ,-i ;jitO MV/MB Reg.# Village/State/Zip. 1�4 , r IJA 0 Business Name �` dam gp , on .v 197�� Business AddressI AA it ignature of Enforcing Officer Village/State/Zip Location of Offense ' Enforcing Dept/Division Offense UGC 0-4,1 -f 12e-:(fI Facts Paa,4"9 v - L2 This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary . compliance. Subsequent violations will result in appropriate .legal action by the Town. TOWN'OF BARNSTABLE BAR-W 431 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager r' ,.I ) '�-:-Lt L bp Address of Offender r \m,,4 MV/MB Reg.# Village/State/Zip r ai, r I j Business Name V / .�`� arm/pm, on j ,b 19 Business Address / r/"=" Signature of Enforcing Officer Village/State/Zip Location of Offense Enforcing Dept/Division Offense , U k'' nn � Facts 1'�t' .J U d nx l 0 Cl P This will serve only as a warning. ,At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary. compliance. Subsequent violations will result in appropriate legal action by the Town. TOWN „OF BARNSTABLE BAR-W . 431 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager . ` �. �"i,64r J. Address of Offender . l MV/MB Reg.# Village/State/Zip � � , 4 �, i�� �� �"�F.? (, _' J Business Name am/pm; on Business Addresstrl1 � w�;. �'; Signature of Enforcing Officer Village/State/Zip Location of Offense t` `1, . ie ." "�"'4 � Enforcing Dept/Division Offense t Facts This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary_ compliance. Subsequent violations will result in appropriate legal action by the Town. TOWN OF BARNSTABLE LOCATION i� C �,� l_p � Ova SEWAGE # VILLAG ASSESSOR'S MAP& LOT INSTALLER'S NAME&PHONE NO. VAA 0-C A(te SEPTIC TANK CAPACITY l G`Z LEACHING FACILITY: (type) f (size) NO.OF BEDROOMS BUILDER OR 0 PERMITDATE: 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 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 �I ► 'v l 'C 1�� . 000 vl TOWN OF BARNSTABLE LOCATION `) 6QJsfkt—Pt�V Ova SEWAGE # VILLAGE A G-V1- S ASSESSOR'S MAP & LOT Aqa'I INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY `S b 1���u► ) LEACHING FACILITY: L� 1h L��Ci1 't •� �0?d<(type) �' (size) I` NO.OF BEDROOMS BUILDER OR 0 v oL A"-1 YQS k PERMIT DATE: 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 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 �J � � � � � (v 1� � �� �..�__.� f r y� O 0 0 �� No. C o-7 •T�` Fee V yVes ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for Mooaf *pgtem Cone;truction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) �*omplete System ❑Individual Components Location Address or Lot No. �� �etJ((GS--�(`��� l t Owner's Name,Address and Tel.No. Assessor's Map/Parcel 09 (N 2\ S Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. CA 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 3g7� gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. ` a �LhL 16y Description of Soil 1 g oy Nature of Repairs or Alterations(Answer when applicable) 0—6 o i2 Eci' GI Gc t' 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 an of to place the system in operation until a Certifi- cate of Compliance has been is C Signed �+ Date �'�` L 15 Application Approved by - (,� Date Application Disapproved for the following reasons Permit No. ' Date Issued No. ' m:a; .. Fee S7<' are. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 1 .11 PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTSes 01pprication for Migponl *pMem Congtruction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) omplete System ❑Individual Components Location Address or Lot No. C7 Owner's Name,Address and Tel.No. 7 l� "r.,&4 Assessor's Map/Parcel G Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. CA C— 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 C gallons per day. Calculated daily flow �� gallons. Plan Date Number of sheets Revision Date b Title Size of Septic Tank C40Gvv Type of S.A.S.A.S., 4,V �t en� t 6 Description of Soil Nature of Repairs or AlterptioT(Answer when'applicable) ��`" CJ 12 crjc i E LT lie >° j R _ Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-si a sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code an not to place the system in operation until a Certifi- catl of Compliance has been ish' ea . ` C Signed I Date Application Approved by C Date Application Disapproved for the following reasons Permit No. '~ Date Issued —_—__——— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded Abandoned( )by — C_ Y}, at I C--., 1= 44L, ATT-0t4 b 1 I has been co strutted in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. "Jff1 7 da edL ; :Installer Designer The issuance of this/vle t s 1 of be construed as a guarantee that the s ste will function s deign . V Date d/' Inspector yr _ q �....o...-- No. /C�/ —/O—3 --�" Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION — BARNSTABLES MASSACHUSETTS Mfi6poe;ar *p5tem Construction Permit Permission is hereby granted to Construct( )Repair( )Upgrade(j/ Abj don( ) System located at A [it,,_ U( and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of thMt Date: - 5 /! / Approved byC ` z°/t-,/ �'�✓� A. r - ` M 1/6/99 i a 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 disposal works constriction permit signed by me dated ��-�`-�5 concerning the property located at �� �� �L-Tk� "Or V-e meets all of the following criteria: B VIThe failed system is connected to a residential dwelling only. There are no commercial or business .uses associated with thedwelling. The soil is classified 3s CLASS I and the percolation rate is less than or equal to 5 minutes per inch. (/There are no wetlands ividdn 100 feet of the proposed septic system There are no private wells Niithi.n. 150 feet of the proposed septic system ere.is no increase in now uid/or charge in use proposed 7• ere are h(s variances requested or nF--ded. • The bottom of the proposed leaching facility will not tv located less than five feet above the �cimum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method where applicable] • If the S.A_S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility%frill not be located less dum fourteen(14) feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) L —( B) G.W.Elevation CU,0+the MAX. High G.W. Adjustment 221 _ DIFFERENCE BETWEEN A and B __ I SIGNED : DATE: ` [Sketch proposed plan of system on back]. b' q:health folder.cent A �; Cep �� 1