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HomeMy WebLinkAbout0070 RUDDER ROAD - Health 70 RUDDER RD. HYANNIS A = 247 1073 s I I WIN a Tom larelfsJe�me681�aL rM r� J �l A`'0 l J '�� / .I� L� �+ - Ir� r4adfM 4 d1l RB@491®�1'DA O ME�EI!EiAI�I6M'49d1�WiEl11$AII�Nf . PA-r 4n VZ-V9'1Vjr ?MY h��RN!`5 6 iX Melvin 11®eq®aiklll!Oa.lese®elnep4P!ii�eai9i�eequrap® nldf�RV4�PP191dP + a e� f It v - Cc� + A'Ar�ff�#.�.• A+ J rA.�+rrrAii#J,a01 i Q> r.�lr��rrr.r r a. r �r r rl1rr 1�+r +rrrr rr f W; rr�r► CCrr r+.rr rr. 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Mir { i 16 60/10 1•T'1LIM�N �' � 11N. hm 1 f- 4. 4/',1:p a?�R�f ter' �1 r+ liefif � >ted+tindf � �u+n`s�'iiliH'I�en�� �� �� Mif�!�Pl �•'r1.1'oa •. !� �xl IYw" ;=�nl�rep tli�r;41MI! . ..r .:; .-!��_�{W"IR,M,�!/illrptl OB xAiy�mohtdt!!I!;L�r ia,�u i+t' ra 1iaa+hr '��n .•ltr6 •.Iliac + 40MAN 14"I it r rq v e�/ese9�'l10+ . griell r�ra rr Ip � rl@li�el •,+ L�.+� �of a l• 4�1 'Y4OJ.Q l�a�+�4►aF'ij,'',I�..dl��,i +7:n pl,e{ ,� l�+P�f� r� TOWN OF BARNSTABLE LOCATION / ® �vD�k'� %C�/ SEWAGE #0�10/• 036 VILLAGE F�� NyA�1X/ifi'd�'i ASSESSOR'S MAP & LOT,�ffiZ`� INSTALLER'S NAME&PHONE NO.1 hC�-CCd r,s SEPTIC TANK CAPACITY I 'O d Gi fl 1. LEACHING FACILITY: (type) =Soo 6f�/ CMAlyt a-RS (size) `3 X NO.OF BEDROOMS BUILDER OR OWNER CA PERMIT DATE:�I-A M . (C�- 0 C 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 A w' J V Y i tA N� t No. `Fee 1 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS t 3pphration for Dtgooal *p!tem Construction 3dermit Application for a Permit to Construct( )Repair (t- j'Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. `)O o D cr t Co Owner's Name,Address and Tel.No. 1�41.�Rnn;,��r`T G � Sk.11rc�ie.2 Assessor's Map/Parcel p 2� o ef— ihi ay>/»3 w , \d �ann�c u`T 790 ^ 0Y93 Installer's Name,Address,and Tel.No. , Designer's Name,Address and Tel.No. c_e k"A 0-c-C-� q Os der-', plc. Cta Lkag`ssa Type of Building: Dwellin 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 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) 4 ra r� l 0 1 So o ��- S ep_jl � 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 this Board of Healtif. Signed Date 7 , < f'e0 Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued Vl No. "" ee THE COMMONWEALTH OF M'1or CHUSETTS Entered in computer: Yes .-PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS o * ongtructior hermitZipprication f C Application for a Permit to Construct( )Repair(1,. Upgrade( )Abandon( ) ❑Complete System ❑Individual Components ' Location Addressor Lot No.}: o p cC `�Zl, Owner's Name;Address and Tel.No. S VC Assessor's Map/Parcel J / �3 90 Installer's Name,Address,and Tel.No. Designer's:Name,Address and Tel.No. 0S1�i Type of Building: Dwellin No.of Bedrooms Lot Size sq. ft. Garbage Grinder( ) Other Typeaof Building No.of Persons Showers( ) Cafeteria Other Fixtures Design Flow gallons per day. Calculated daily flow 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) t}0 G r•os n<_ l c> 1 S o 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- If cate of Compliance has been issued by this Board of Heal . �Signed ` /J/ /l Date T �►. 1 Q-oO Application Approved by /! B Date 111Q101 Application Disapproved for the following reasons l 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(/-'')7Upgraded( ) Abandoned( )by G R R-, S"��c` h;ame.�at .�, o�� 'mac w e�T kAti N o o, 4constructed in accordancecc with the provisions of Title 5 and the for Disposal System Construction Permit No. � sted Installer Designer z The issuance of this permit shall not be cons ed as a guarantee that the system will function a 'sign , G % r 1 1 � l�A Date ! 1 Inspector 'l�i{t C,� _. , .a --IT ---------------------------.-------- No. - I FeeZi:21� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS 'igpogar *p5tem (Construction-hermit Permission is hereby granted to Construct( )Repair(KSUpgrade( )Abandon( ) System located at '7 0 f�v v,ti 'Z.o( - l u e h1 ti w.-%, s De c- -- G A r-, 5 ., c 7 1 r r 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:Construc '6n must 'e com leted within three years of the date of th's ermit. Date: Approved b / PP Y � / To� OF BARNSTABLE = LOCATION O Rv0de-7? SEWAGE # 01- 0.38 VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO.'! ,h000-CZ-1 ' iv- - 4 a 8�ss aS I SEPTIC TANK CAPACITY i So a fl 1. LEACHING FACILITY: (type) 2- Soo 6r�l CHAl1-t LL —/(size) NO. OF BEDROOMS I BUILDER OR OWNER `j A f S V'r cc- PERMIT DATE: A N .(CC 0 t 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 wi&un.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 EEE-� IN -� ,n V —�- '\ eg �7q p r. ( 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. Mr}aa47 CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL harms \1 3 WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS a-c-C.( l s i c, , hereby certify that the application for disposal works construction permit signed by me dated , concerning the W Est property located at '7© 12v c,pc.-'RoA<U 14 aA o7� meets all of the following criteria: • This 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. • The 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] • If 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) 3a o 6 B) G.W. Elevation +the MAX. High G.W. Adjustment. DIFFERENCE BETWEEN A and B j �D SIGNED : '4� 7 DATE: TAA4 [Please Sketch proposed plan of system on back]. NOTICE Based upon the above information,a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:cert a -� O 0 63 I � � 41