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HomeMy WebLinkAbout0047 KENNEDY CIRCLE - Health 47 KENNEDY CIRCLE, HYANNISPORT _ A=267=051 a 0 TOWN OF BARNSTABLE [NO. CATION `ry / lie4 0 V C`k d'' SEWAGE # 7- LAGE �A ���•�`. 5 10 0e, ASSESSOR'S MAP & LOT TALLER'S NAME 8c PHONE NO. � PTIC TANK CAPACITY I,d®o ACHING FACILITY: (type) v� �n�Ae ize) OF BEDROOMS BUILDER OR OWNER PERMTTDATE: a`1 j COMPLIANCE DATE: 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 Wedand'and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by - �� ' . � �. .. , , -, . � r .�- , � � .� ,���M t. O �► �- .. �� - ��I - . . . ._ No. Ts E COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppficatiou for &.5pogal 6potem Conttruction Permit Application for a Permit to Construct( )Repair(grade( )Abandon( ) ❑Complete System EJ Individual Components Location Address or Lot No.Lk-7 QuG �t���D Owner's)Name,,,Address and Tel.No. Assessor's Map/Parcel1,kS Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. NttQ���S�p-r�L a�Q�-�✓ 2Q Type of Building: Dwelling No.of Bedrooms J� Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow --T30 gallons per day. Calculated daily flow 3�0 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Rtij ecl!nq0_ Description of Soil S lA h� Nature of Repairs or Alterations(Answer when applicable)-=rig-ST F9-(r 1670 5;r/7�crG -rWfK �Lrs C� tc.A SA%_SnU --t—[mkt Uc_ 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 Signed I Date Application Approved b Date . Application Disapproved for the following reasons Permit No. Date Issued _j�el�. �-� TOWN OF BARNSTABLE 78 LOCATION Q SEWAGE# / J)m rl AS MAP&LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY I.dOb LEACHING'FACI ;ITY: (type)y— oze) NO.OF BEDROOMS BUII.DER OR OWNER i >.::•'.':PERMITDATE: a� .. ... COMPLIANCE"DATE: :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 :, . r j i ,No. �`+ J I Fees' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01pp iration for igpogal *pgtem Congtruction Permit Application for a Permit to Construct( )Repair(grade( )Abandon( ) O Complete System O Individual Components Location Address or Lot No. 4-7 Owner's Name,Address and Tel.No. Assessor's Map/Parcel �"1 ` O Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 0Ma� @�s�0-kkc. aC) 4 w.4t-e,6- QQ Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) »•, , Other Type of Building No. of Persons '✓ ? Showers( ) Cafeteria( ) Other Fixtures ` Design Flow 33d gallons per day. Calculated daily flow.. gallons. ' �~ Plan Date Number of sheets Revision Date Title ��Si e'of Septic Tank I Ovll Type of S.A.S. tf�, CG �c I !a_-s �cL-- Description of Soil Nature of Repai/rj�or Alterations(Answr er when appl c �W able) l4-�( � Sn 1 LSD CXJ t Ek C,, 6C 1T 0 t (ti, 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 ed-by-t ' -dal Signed Date Application Approved b Date Application Disapproved for the following reasons 'Permit No. '` Date Issued P "� THE COMMONWEALTH OF MASSACHUSETTS -3 3 ,t BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( )Repaired( )Upgraded Abandoned( )by D co>,� Se T"L. at G.i-e-k— has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No e _Z.5'� dated J/—;2;F' �. Installer Designer The issuance of this permit shall not be construedas.a guarantee that the system\yqvil)function as designed. Date 4 j �`� / Inspector .lam b 1 " No. ; 4f, 5?ti./lk- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migpogai *pgtem Congtruction Permit Permission is hereby granted to Construct( )Repair( U grade(_ )Abandon( �) System located at V_�e v-w��...SSS���vU_ 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 e it. Date: `^' ✓ ° Approved byL�' "".L . 1 TiBe Used For the Rep air.Of Failed NOTICE: his Form Is To Septic Systems Only. • 1 F SKETCH AND APPLICATION FOR A CERTIFICATION 0 ITHOUT DISPOSAL WORKS CONSTRUCTION PERMIT (w ENGINEERED PLANS) i lication for disposal works ` hereby certify that the application construction permit signed by me dated concerning the meets all of the located p at prj r'oP�Y 1 following criteria: � proposed teaching}ircility � are no wetiands located within 100 feet of the , . are no private wells within ISO feet of the PoPosed /1%ere l h no Wreese in now and/or change in use proposed Thera are no verianas requeed or needed' the If the proposed leaching facility w ill be located within 250 feet of any wetlands.the bottom Ofad'usted 4 proposed leaching facility will po be located less thanfourteen(14)Feet above the maximum ' groundwater table'elevaft. Piease complete the f011owier. Engineering Division G.I.S. A)Top of Ground Elevation(accord Mg to the Bng g ' { ter Table Elevation(according to Health Division well map) a)observed(Irottndwa DATE: SiaNED s LiCENSBO SE VMM INSTALLER iN VE TOWN OF BAiWSTABLB NUMBER 1m ordo plepewd .Atrs Itd�11een»d Inrtellet peree eerrlMd plat plan, eh this plan should be submhtedl- 1 . k t�lfbl.r._"•.eut . �6 1 I' L, Y TOWN OF BARNSTABLE �� -2 LOCATION '7 7 a CAA C`k SEWAGE # 7- 65-1 VILLAGE S ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. � e. -©G LI SEPTIC TANK CAPACITY. LEACHING FACILITY: (type) �N y-t 4 u- -A ze) NO. OF BEDROOMS_-3 _ BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: ,U 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 1