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Home My WebLink About0015 PEPPER LANE - Health 15 PEPPER LANE,HYANNIS A=294-035 TOWN OF BARNSTABLE °G LOCATION SEWAGE # qq' vWL VILLAGE � � ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. t Q C&Le- SEPTIC TANK CAPACITY LEACHING FACEL=: (type) Gr[ (size) NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE:- 3(j Lq I 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 ® o LJ 0 a � i No. Rr Fee F J THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pphration for Migpogal *pgtem (Congtrurtion permit Application for a Permit to Construct( )Repair( )Upgrade(P*)Abandon( ) 2Womplete System ❑Individual Components Location Address or Lot No./ Owner's Name,Address and Tel.No. Assessor's Map/Parcel �, /ems�'�� \!{�- �fvc�V d v Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Gt7 Type of Building: Dwelling No.of Bedrooms�_ Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures ` c l f_ Design Flow 1-��10 gallons per day. Calculated daily flow 't`c gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank I SC- ®nab1 �e .�/-TT-ype of S.A.S. C Description of Soil Nature of Repairs or Alterations(Answ r when a le) '�� St�� C? C-?�Cf�`T 1(�7J7� �b C, Date last inspected: � -�,,4 I a`` veu-'a,t��( 0 " 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 o 11 e Epuir-o ent�C`ode and not to place the system in operation until a Certifi- cate of Compliance has beep issued'b oar of t �'r �y Signed ` Date Application Approved by Date 3 �� Application Disapproved for th following reasons Permit No. i Date Issued No. Fee , THE COMMONWEALTHaltered in computer: 'OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN"OF BARNSTABLE., MASSACHUSE�17S 0 Ipplication for Miopooal *rqtem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade(Abandon complete System 0 Individual Components Location Address or Lot No.15 Owner's Name,Address and Tel.No. Assessor's Map/Parcel 3L!P1 7-5- (A PI-C 4(_ "�O "( q_C Installer's --- Name,Address,and Tel.No. Designer's Name,Address and Tel.No. YY\,0-cA 0"59- S-ePT\,-__ rz_ 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 tlec( gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Y.0067 ,e,G Type of S.A.S. Description of Soil 4p Nature of Repairs or Alterations(AnsZ!r when a le) -1 _- =., UL Ali_1CQ_ 6 U J x K2 ry Ddte last inspected: 5n(;t\r, A �,6 Agreement: The undersi4n'e�l'agrees to ensure the I construction and maintenance of the afore described on-site sewage disposal system with g th e provisions of Title 5 o e rmi enta ode and not to place the,system in operation until a Certifi- cate &v.E, of Compliance has bSQP_4'S oar of t . ck9, Signed- Date Application Approved by Date Applicatiofi Disapproved for the following reasons. Permit No. -Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance Z THIS IS TO CERTIR,that the Oli- te Sewafe Disposal System Constructed Repaired Upgraded X) Abandoned b at ha&bimn constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. (4r dated Installer Designer A The issuance of this pprrm h 1 not construed as a guarantee that the stern wi uncti s depig"hed Date Inspector, 07 &S No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mizpoal 6potem Con5truction Permit Permission is hereby granted to Construct Repair Upgrade(V�Abandon System located at V 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 permit. Date: Approvedby\ . i 1/6/99 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) I, ✓ hereby certify that the application for disposal works construction permit signed by me dated —( `Ci� -----, concerning the property located at /spwk�V meets all of the following criteria: V• The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. There are no wetlands within 100 feet of the proposed septic system There are no private wells within 150 feet of the proposed septic system There is no increase in flow and/or change in use proposed •/ There are no variances requested or needed. �XThe bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] ,XIf the S.A.S.will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) �� B) G.W. Elevation �� +the MAX.High G.W. Adjustment.�_ C;? ' DIFFERENCE BETWEEN A and B SIGNED : DATE: [Sketch proposed Zp,a/nf system on back]. q:health folder.cent F , c� 6 d /TOWN OF BARNSTABLE LOCATION Z-2 �4 SEWAGE # qq' I VILLAGE ��' ASSESSOR'S MAP & LOT�i�L�Pi5 INSTALLER'S NAME&PHONE NO. C SEPTIC TANK CAPACITY / UP LEACHING FACILITY: (type) /y ``4�t CK�i Y (size) NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: COMPLIANCE DATE: Lq I 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 bL .......................................................................... ��OJ� r'1 '= TOWN OF BARNSTABLE LOCATION IS Aeppei' L1Y SEWAGE # >34f3 VILLAGE ��cara�'>-s ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY f�O LEACHING FACILITY:(type)4*e rb3-J (size) Mw 571 NO. OF BEDROOMS PRIVATE WELL O UBLIC WAT BUILDER OR OWNER �iPcz DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No n-- s C3 En It . r � • 1