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Home My WebLink About0628 SCUDDER AVENUE - Health i 628 SCUDDER AVE i HYANNIS A = 287 O11 i 1 1 0 FILE No.806 02'01 '01 PI'l 03:11 ID:BORTOLOTTI CONSTRUCTION FAX:508 428 9399 PAGE 2 Z. r l TOWN OF BARNSTABLE LOCATION \1['ca ,�uZ.. SEWAGE 0 VILLAGE ASSESSOR'S MAP &LOT S NAME&P ONE NO. SppTIC TANK CAPACITY`, LEACHING FACILITY: (type) (size) NO,OF REDROUN.S. tit n1_n.Frt.oR.OWNER PERMITDATE: COMPLIANCE DATE'": Separation Distance Between the: Feet Maidtnunt Adjusted Qroundwater Table and D(A%Qnt of Leaching Facility mate 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 FAcuity(B any wetiat uS ex1si Feet within 300 feet of leaching facility) i-urnistteu uy ---� TOWN OF BARNSTABLE LOCATION 6z .sG�fGf�v°✓� SEWAGE # 2®4/—""Ey VILLAGE I�XQf/�9%SD®!"?� ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. �Ol/ 1 COeSy` 7 7/`23y5;W SEPTIC TANK CAPACITY J5oe LEACHING FACILITY: (type) ,l`" 4�l (size) �EBUELD>ERO OOMSOWNERE: 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 �/� l 00 a s 71 :I r! ` TOWN OF BARNSTABLE LOCATION S ��L 00 .Ile r SEWAGE # VILLAGE ASSESSOR'S MAP & LOT era ez.�at NAME&PHONE NO. Ii•�o 0161 /ts-i.N.Y-tmn SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO. OF BEDROOMS �) BUILDER OR OWNER /d::tW PERMITDATE: 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 �0 wt �1 C7 � • �© .� ' tr_ G� c ' V �.� �� i >�� ---- �� a r ((�� f, L ry � J " s. �i .�. +f. �ni / 1. \ r' �� No. O`�I V Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Rpprtcation for Migogar *pgtem Cow6truction Permit Application for a Permit to Construct( )Repair(/)Upgrade( )Abandon( ) 2n Complete System ❑Individual Components Location Address or Lot No. ev me Owner's Name,Address and Tel.No. Assessor's Map/Parcel a141?,e.J Installer's Name,Address,and Tel.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 o. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow /Ay gallons per day. Calculated daily flow 13v10 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank /5110 Type of S.A.S. 7— Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 b this Board of Health. l Signed Date Application Approved by lcoeull Date 0 / .0 Application Disapproved for the following reasons Permit No. Date Issued ..,ns. .... w3wr..... .. .... i h ,n. . a .. y ..... .Y .,. � r i •. .=Wan•._. `t. /vv No. ! 'cfiJ' Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: '' Yes v PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 5pprication for Migpogar *wm' Congtruction Permit Application for a Permit to Construct )Repair ✓�Upgrade Abandon [m Com lete System ❑Individual Components PP� ( P ( ) Pg ( ) ( ) P Y P t Location Address or Lot No. L Owner's Name,Address and Tel.No. 4 l�° Assessor's Map/Parcel Installer's Name,Address, gnL), Designer's Name,Address and Tel.No. 7 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder Other Type of Building of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow /.0 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank f�`7�'O Type of S.A.S. Description of^Soil ;: l4 Nature of Repairs or Alterations(Answer when applicable) /I-I-e r' r 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 b his Board of Health. �� l Signed Date Application Approved by 1L0A!!: n & l� Date Application-Disapproved for the following reasons Permit No. Date Issued " q O ---------------------------------------- - 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 at � (Gf '/��!!/' / �/ �9�/5�0/' has been constructed 'n acco dance with the provisions of Title 5 and the for Disposal System Construction Permit No. CX0i lE 7 dated C? b Installer Designer The issuance of this permit shall not be construed as a guarantee that the systirm will function as i __e/d�. Date � e" r� �-' �` Inspectors f/ . � No. t9V�� " � / ------- — � Fee + THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS ltgogal *pgtem ConstructionPermit Permission is hereby granted to Construct( )Repair( V Upgrade( )Abandon( ) System located at 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:Construction must be completed within three years of the date of this permit. Date: 01 �I C� I Approved by ` a,6 Lo NOTICE: This Form Is To Betsed For the Repair Of wiled Sep-tic Systems. Only. - CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRIICTION PERMIT (wITHOIIT DESIGNED FLANS) �� • �O�/� ✓ hereby ce " that the application p n for or disposal works construction permit signed by me dated Z 13101 concerning the property located.at meets all of the following criteria:. ,/71ae failed system is connected to a residential dweit' Q otu . .n-v 7'cro . ,n� . .„are no commercial or business 7es associated with the dwelling. ae sail.is c.'ass - - / 'oleo as �?� I .nd he e�olaIIon�Le 1s :tip -non Jr -z a.l ,o �Ilnutes er ncl M/ -her:are no wetlands within 100 of me propcse—s=ric:rstem F/ i ae:a are no ot:. e w lls wi- i 4o t _0 t hin art me proposed szIIc nse:n. / ae:e is no inc:use in flow and/or change in se proposed b� here are no vai anc�.=usted or Herded` e bortom of the rOIIQ ,p sod icnlnv,tac:Itty wtlI not be located less ran five t above the tnarmum adjusted,g oundaater table tiiv ration. (Adjust the -m•oundwate:.table using the :imptor method when appikabirj. if.the S.kS.will be looted with 230 fee;of airy vegetated wetlands. 'tee bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adit sled groundwater table elevation. Please complete the following A) Top of Ground Soriace'EIevation(using GIS information) B) G.W.Elem"on 4/2 -the MAX!Ego g DIFFERENCE BETWaN A and B 4 y SIGNED DATE: (Sketch proper plan of systern on back]. ¢haft skiw.� 05 LAB 1 / , �J r v�� jam, f Town of Barnstable ►"� Department of Public Works Engineering Division 367 Main Street,Hyannis MA 02601 Office 508-862-4088 Thomas J. Mullen,Director Fax: 508-862-4711 Robert A.Burgmann,Town Engineer SUBJECT:-Numbering,of Buildin S M - ""ap" 8 '7 Pa . No=- nel No �' Date: - I c v Dear Property Owner, Notice is hereby given in accordance with the General Ordinances of the Town of Barnstable, Chapter III,Article V, Numbering of Buildings, adopted March 3,1931, revised July 21,1994, public convenience and necessity requires the assignment of numbers for your roperty located on ��s� A-UL-2 Q (-� VILLAGE v A VIL LAGE s PozT�- . STREET NAME ' This number should be affixed to your building so that it is visible from the street as outlined in Exhibit"E",Town of Barnstable Rules and Regulations for Numbering of Buildings. Please contact the Engineering Division at(508)862-4088 to verify E-911 records when the change is made. Robert A. Burgmann, P.E. Town Engineer encl.: ✓T O.B. Rules&Regs. �ommon Questions ✓&ire Map Assessors Change Form ,JTOWN OF BARNSTABLE LOCATION 'r1Z� SC�/�tcf ✓ SEWAGE # 24G'/--O�y jVILLAGE 1�YCP�3��%5G��T ASSESSOR'S MAP & LOT Z 9,7 INSTALLER'S NAME&PHONE NO. �Qll� I CC�ylSl 7 SEPTIC TANK CAPACITY LEACHING FACILITY: (type)' Z-3i0yglCGrQ� (size) N BEDROOMS BUILDER O OWNER f�6 ire f ATE: COMPLIANCE DATE:. Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom.of Leaching Facility Feet, Private Water Supply Well Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Ir Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) xik Feet Furnished by �r d ._-_.-_.._ I .e s9 57 I I I I i -- -- - -- —--- --------J