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HomeMy WebLinkAbout0043 PLEASANT PARK AVE - Health (2) 43 Pleasant Park Ave � . , ._ , Hyannis A = 249 042001 t No. -- Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Zipplitation for Mig;pooal bpgtem Congtruction Permit Application for a Permit to Construct( . )Repair( )Upgrade 2�)Abandon( ) El Complete System El Individual Components Location Address or Lot No. 5! �_1e54j_X aT /Q�((/��� Owne am A dre s Tel � Assessor's Map/Parcel Installer's Name,Address,and Tell..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 �'i c°.l' No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flower® gallons per day. Calculated daily flow Q gallons. 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) A— rlvf�Y c1. CQ,,.G4C?C'�/!�4, 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 this Board of Healtb. 4 Signe R Date O�—,>© o'er Application Approved by Date 1191 Application Disapproved for the following reason Permit No. Date Issued yam*. No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYicatton for Mtgpogat *pgtetn Congtruction Permit Application for a Permit to Construct( )Repair( )Upgrade Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. U 4 A,,r,4e4er Owneys 4,aUOVdreTeA Assessor's Map/Parcel. Installer's Name,Address,and Tel.No.. Designer's Name;Address and Tel.No. ' �f�-i,. G��6°'U/r 7�S'" o, O> �idL/D !�/�•1J'O/+�//E'-t' Type of Building: Dwelling No.of Bedrooms a Lot Size sq.ft. Garbage Grinder( ) Other Type of Building 0 ,1,r' No.of Persons Showers( ) Cafeteria( ) ;Other Fixtures Design Flow 2_z® gallons per day. Calculated daily flow gallons. r Plan,Date /O-1 p•,;o X Number of sheets / Revision Date i/Title !` Size of Septic Tank Type of S.A.S. Description of Soil +. I -Nature of Repairs or Alterations(Answer when applicable)�/ti- ,(�1 �� Gov„9�1• Go�.CPc�7a��•���Q<!' �J/� Date last inspected: f ' 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 bM this B�ooaard of Healt Signe y� /v<ili Date �,p J-P _ Application Approved by _ /V/ D !/l Date _ Application Disapproved for the following reason Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS------ Certif icate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded(�) Abandoned( )by &//yi L 4W.0 at 3 .�f' wT' ,.� rf' ilis�'�i1', —haLbeeA constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No dated Installer cTi r+ Designer .A,r AIj The issuance of this permit shall not be� strued a a guarantee that the sy(S�t-e-r-n�•�W�,�A441,�function as de/sAignedqf Date Inspector` A //�1/� i-A �1f�� `L•1 — — -------------------------------- 71 E I No. ( r Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE: MASSACHUSETTS Iigpogat *pgtem Congtruction Permit Permission is hereby granted to Construct( )Repair( )Upgrade Abandon( ) System located at A".* h L.lJr/Y/.P 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:Constr ction mu t be c mpleted within three years of the date of this er fi . Date: �. Approved by TOWN OF BARNSTABLE LOCATION �3 .��C'C`fial'�" ' '[°�'� SEWAGE # ®�' `• � VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. �r'�" ��1s1 77 1' 9','07 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) -71;e NO.OF BEDROOMS yj fi `�� 'r, f• ��lrs�rlf3 BUILDER,OR OWNER '°� ►�� V'� PERMIT DATE: /�—�o � 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 Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility,(If any wetlands exist Feet • within 300 feet of leaching facility) Furnished by A nd " A7 ,A G ell I lilt \\ i CMC� b PA- F-D.Q I I � 1 QE:lED Tff D I I ; }, ID i.a i _Q I� I f = `T r' ,------- ._....--- -----....................------—.__-1.......... -....._._.._.... .. ND i� 11 0 h ___1lLis[LTL'�i111 .2h92 J --e f ooN �l�➢{i a /\�� oll QIfl�IS� z>: Inv n1hk-7 ,jam R ., 7dR�_ --i cL" 11D %illTQIITj Q 5.01 Q m ro sh✓rnu �— 0£l ,,o tir = aot� 3r o;ze r 1 - 'a m 9Q9.9M/ 1 ASSESSORS MAP _ TEST HOLE, LOGS PARCEL: D � _— SOIL EVALUATOR: , �l� __..�...._._ _____.-1 - 7, FLOOD ZONE. y .� ---- �MQ I WITNESS : � PLI( _ ;-6 i 2l PW-. 0 REFERENCE: ;% -'� (gCjZC "i Zlil DATE: L'�'S?1'�( PERCOLATION RATE': G UU�I ► I _ ice_�._�-�_ �. G7 ✓ `!v_..__.UC� :1 ./ - ---- ,o - -- — - — - LOT r - TH LOCAT ION MAP 7J L— vQ 64 he w&e SEPTIC SYSTEM DESIGN -- - 01 '✓1 FLOW ESTIMATE v - �7 BEDROOMS AT �� GAL/DAY/BEDROOM - GAL/DAY A _ 6 SEPTIC TANK ----- p GAL1f >Y x 2 DAYS GO GAL V 3 USE I GALLON SEPTIC TANK(Ex os—�lw SOIL ABSORPTION SYSTEM SIDE AREA: Z-k Z q f'� I?a �G, Z?C \-Itr ' .109,52 BOTTOM AREA: I X b-1 ro - . I C SYSTEM SECT I ON -lbl pp o /000 GAL SEP I C TANK . ' �yc � ,;� to ��1 -.• , � _ '. i, _ "V!.7 lt-.= _ f f DOW bIto S I TE AND SEWAGE PLAN LOCATION : r 1 �. I t PREPARED FOR : �j _ ��r-M - ---- SCALE: !' DAV I D 13 . MASON, � DATE: / 2 W o DBC ENVIRONMENT L DESIGNS W DATE H ALTH AGENT EAST SANDWICH . MA Z ( 508 ) 833- 2177