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Home My WebLink About0040 SEABROOK ROAD - Health 40 SEABROOK RD. HYANNIS A = 307 019 I TOWN OF BARNSTABLE LOCATION T�/�ff �E� l��k SEWAGE VILLAG ASSESSOR'S MAP & LOT 9 -!3/ INSTALLER'S NAME&PHONE NO. OMX6 SEPTIC TANK CAPACITY �5 X t.S��N�i f'FS:S/167j LEACHING FACILITY: (type) (size) NO.OF BEDROOMS Re"4140e /'A;e r-916M � 1(ouve k 10 BMDER OR OWNER PERMIT DATE: COMPLIANCE DATE: ®� 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)s Feet Edge'of Wetland'and Leaching Facility(If any wetlands exist within 300 feet ofleaehing facility) Feet Furnished by r __ _ _ � - zn_ 6_ ._....�... O N No. ®1 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppIiration for Disposal *pstem Construrtion Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon(q ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. Yore+ C-kAkK Assessor'sMap/Parcel o(9 4o !9C _ V -YI1W1 Installer's Name,Address,and Tel.No. 5()8-4-11—FS%71 Designer's N me,Address,and Tel.No. 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(min.required) gpd Design flow provided gpd 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) r4 r undue S`�t�c.lcl S TTIQ, S4STE1 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 Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by Date 1 Application Disapproved by Date for the following reasons Permit No. ® Date Issued —� � m ', No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for -Disposal 6pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon(A ❑Complete System ❑Individual Components Location Address or Lot No. L(U S'&48Qcx,-%_ P D Owner's Name,Address,and Tel.No. TcwcotMy C.,c,a4RlG Assessor's Map/Parcel 3o o( - U S Pb ,Installer's Name,Address,and Tel.No. 5002—4-71 "�71 Designer's N me,Address,and Tel.No. ''. cAp�wtuC- blr�..p/�csc5 �L� 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(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil a i Nature of Repairs or Alterations(Answer when applicable) ADrf1 D00 U-Xls'ZIXJn 5(F?T1Z SySTE1 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 Certificate of Compliance has been issued by this Board of Health. s Signed Date • ?4 X0 Application Approved by Date Z Application Disapproved by Date for the following reasons Permit No.soQ �- � Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On�siterSewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned(k)by CI APaxp e G(v �4uce, u-c—_ at qn sa48&0&;Q) N y X) has been constructed in accordance l with the provisions of Title 5 and the for Disposal System Construction Permit No /�j dated 6/ Installer dME&O!bg ��2P2(S UA- Designer N1A #bedrooms Approved design flow gpd The issuance of this lfperm it hall not be construed as a guarantee that the,system will tilojn'as design d. Date �o( Z�C ��) Inspector v W�• i ----- -------------------------------- - --------------------------------------------------------------------- No. Fee U� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Bisposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( System located at �tO PDX f- yA tJAJ(5 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must bte�compl ted within three years of the date of this p Date 7 Zr- - �D Approved by r_)' rru .. ru ru OFFICIA .- LUSE S [C3 Postage $ ��" Q'� Certified Fee � Postmark Return Receipt Fee a (Endorsement Required) to Hete Restricted Delivery Fee y (Endorsement Required) NV Total Postage&FeesSent To -------------------------------------------- Street,Apt No.,. �\or PO Box No. ---�v----�ea(�}�C--�-----fLc------------------ Ciry,State,ZIP+ c-o r\ s in/A- 6 2-0 61 Certified Mail Provides: _ o A mailing receipt n A unique identifier for your mailpiece n A record of delivery kept by the Postal Service for two years Important Reminders: j a Certified Mail may ONLY be combined with First-Class Maile or Priority Mail& o Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Retum Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT.Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 I UNITED STATES POSTAL SERVICE ir%tQass WAN ... :.... t Postage&1=ees"Paid w LISPS-- I `Permit No .G40. ..., I I ' Sender: Please print your name, address, and ZIP+4®in this box" I I Town of Barnstable 6 Health Division 200 Main Street I Hyannis,MA 02601 ' 1.1,1I1��1 1h.11 Ili IiIIII I i ® Complete items,j,2,and 3.Also complete 7A. Signatur- item 4 if Restricted Delivery is desired. �j ❑Agent q Print y2pr,name and address on the reverse ./G ❑Addressee s that we Can return the card to you. B. Received by(Printed Name) C. Dat of Delive� H Attach this card to the back of the mailpiece, or on;the front if space permits. on,the Is delivery address different from item ? Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No I v Sea boo , 1OL ' 1 3. Se ice Type O Z I certified WOO 13 Priority Mail Express'"' ❑Registered ❑Return Receipt for Merchandise { ❑Insured Mail ❑Collect on Delivery 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 1`2OOi'OOO1 0358' 2226'V"�� (Transfer from service fabeQ-. . _ _ PS Form 3811,July 2013 Domestic Return Receipt t Town of Barnstable Barnstable Regulatory Services DepartmentRARNSTASIX MAM Public Health Division oD f°N1P�A 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7014 1200 0001 0358 2226 February 9, 2015 TIMOTHY M. CLARK 40 SEABROOK RD IMPORTANT NOTICE HYANNIS, MA 02601 Map & Parcel: 307-019 DEADLINE APPROACHING According to our records your dwelling at 40 Seabrook Road, Hyannis, MA, should be connected to public sewer on or before 3/30/2015. This is a reminder that all permits need to be in place before this date to be in compliance: 1) Septic Abandonment Permits ($ 25) are issued at the Public Health Division, 200 Main Street, Hyannis. The old septic system must be either removed or filled in due to future safety concerns. This may be done by the same contractor who connects you to the sewer. 2) Contractors, approved to perform sewer connection work in the Town of Barnstable must obtain and file a Sewer Connection Permit with DPW-Water Pollution Control Division, 617 Bearse's Way, Hyannis—contractors, please call Dave Anderson at (508) 790-6244. FOR ANY QUESTIONS [ASSISTANCE: Len Gobeil at the Town Manager's Office is available to provide you with direction you may need in reference to the Stewart Creek Sewer Connections. You may contact him at 508-862-4701. Thomas A. McKean, R.S., C.H.O. Agent of the.Board of Health UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box • 'Public Health Division SEWER CONNECT: Town of:Barnstable 'J., i 2001VIain Street I' Hyannis, MA 02601 I I w I I I • I I E THIS�S�C ■ Complete items 1,2,and 3.Also complete A. Signa u1�e item 4 if Restricted Delivery is desired. / ❑Agent X ■ Print your name and address on the reverse l ❑Addressee so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery ' t 14 Attach this card to the back of the mailpiece, n/ �, C or on the front if space permits. / I.,o h l 1. Article Addressed to: D. Is delivery address different from item 17 ❑Yes If YES,enter delivery address below: ❑No Timothy M. Clark 40 Seabrook Road ch ti Service Type MA 0260 4 o i ❑Certified Mail ❑Express Mail d92� ❑Registered ❑Return Receipt for Merchandise � ❑Insured Mail ❑C.O.D. —� N(--" &a�kmk 4. Restricted Delivery?(Extra Fee) ❑ 2. Article Number i 7012 1010 OODCI 2848 1483 (transfer from service PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 LqA*UMWD M I. a ccPostag 1 S s d Certified Fe �� .� C3 -Postmark O Return Receipt Feq, Here O (Endorsement Require o APR-1 20.,3 Restricted Delivery Fee O (Endorsement Required) C3 / O Total Postage 8 Fees $ Sent ru To To _____ Timothy M. Clark .y � Street Apt No.; �,. or Po Box No., 40 Seabrook Road city sure,"zip+a' Hyannis, MA 02601 . Certified Mail Provides: o A mailing receipt a A unique identifier for your mailpiece G Arecord of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Maile or Priority Mail& o Certified Mail is not available for any class of international mail. a NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. n For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 ?HE Town of Barnstable Barn T Regulatory Services Department erica0v > SrAS V ,e� Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7012-1010-0000-2848 -1483 April 1, 2013 TIMOTHY M. CLARK 40 SEABROOK RD IMPORTANT NOTICE HYANNIS, MA 02601 Map &Parcel: 307-019 The Department of Public Works informed us that public sewer lines are now available in your neighborhood. According to our records, your property has a septic system. This letter directs you to connect your dwelling, at 40 Seabrook Road, Hyannis,MA, to public sewer on or before 3/30/2015. The old septic system must be either removed or filled in due to future safety concerns. This may be done by the same contractor who connects you to the sewer. Septic Abandonment Permits ($ 25) are issued at the Public Health Division, 200 Main Street,Hyannis. Failure to comply with this Board of Health Order may result in a complaint against you, in a court of law. For additional information pertaining to the sewer connection,please see the reverse side of this page. PER ORDER OF THE BOARD OF HEALTH Tho as A. McKean,R.S., C.H.O. Agent of the Board of Health Cc: Barbara Childs,WPC/Roger Parsons,Town Engineering, DPW Enc. QASEWER connect\Letters Stewart Creek Sewer Connects\MAILING LetA Sewer 2Pgs Merged 3-28-13 Yr2015.doc Public Health Division March 28, 2013 ADDITIONAL INFORMATION AND REMINDERS FROM OTHER DIVISIONS: SAVINGS AVAILABLE/GRINDER PUMP: A reminder to those of you who need a grinderpump for your connection: Department of Public Works (DPW) sent you a letter in December 2012 stating the town, for a limited time of two years only from the receipt of the DPW letter, would provide you with the pump at no charge. (This can save you thousands of dollars.) Please note: You must pay the installation cost through your own contractor. Please make your contractor aware of this, if interested. Also be aware: this is a shorter deadline than the Public Health Division's deadline in our enclosed letter 3/28/13. SAVINGS AVAILABLE/PERMIT FEE: The Town offers a waiver of the residential sewer connection fee of $420.00 for those properties that connect within two years of the receipt of the DPW December 2012 letter. LOANS: For loan(s) available,please see the enclosed brochure, or see the town website: http://www.town.bamstable.ma.us/edbg (under the"CDBG Programs", see "Sewer Connection Loan Program). For loan specific questions, you may contact Kathleen Girouard, Growth Management, at 508-862-4702. CONTRACTORS: Information on Licensed Sewer Installers is available on our web site at www.town.bamstable.ma.us/PublieWorksTech/sewerinstallers. Contractors, approved to perform sewer connection work in the Town of Barnstable must obtain and file a Sewer Connection Permit with DPW-Water Pollution Control Division, 617 Bearse's Way, Hyannis—contractors,please call Dave Anderson at(508) 790-6244. FOR ANY QUESTIONS/ASSISTANCE: Len Gobeil at the Town Manager's Office is available to provide you with direction you may need in reference to the Stewart Creek Sewer Connections. You may contact him at 508-862-4701. QASEWER connectEetters Stewart Creek Sewer Connects\MAILING LetA Page Two Sewer 3-28-13 W2015.doc 9]ft5• cc .. • tr 0 \ ,\ I Postag ru C3 Certified Fe Postmark Retum Receipt Fe e O (Endorsement Require �r0� c» Restricted Delivery Fee O o to O (Endorsement Required) Q t3 Total Postage&Fees 6 N Q a SHIRLEY M. CLARK 43 SEABROOK ROAD HYANNIS, MA 02601 Certified Mail Provides: a A mailing receipt n A unique identifier for your mailpiece r' n A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. a Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 '( Barnstable �'THE I, Town of Barnstable Regulatory Services DepartmentEAMSTABM 1 1 ` ,� Public Health Division !E.2 ----- -- - --- - ------- - --- 200�1VIain Street, H annis MA 02601 2007 Y Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7012-1010-0000-284 -0 4 March 28 2013 6 r< 0 �N TIMOTHY M. CLARK �,c 40 SEABROOK RD �,N�" IMPORTANT NOTICEo �t, HYANNIS, MA 02601 Map & Parcel: 307- 019 A <� The Department of Public Work informed us that public sewer lines are now Cf available in your neighborhood. According to our records, your property has a septic system. This letter directs you to connect your dwelling, at 40 Seabrook Road, Hyannis,MA, to public sewer on or before 3/30/2015. The old septic system must be either removed or filled in due to future safety concerns. This may be done by the same contractor who connects you to the sewer. Septic Abandonment Permits ($ 25) are issued at the Public Health Division, 200 Main Street, Hyannis. Failure to comply with this Board of Health Order may result in a complaint against you, in a court of law. For additional information pertaining to the sewer connection, please see the reverse side of this page. PER ORDER OF THE B ARD OF HEALTH Thomas A. McKean, R.S., C.H.O. Agent of the Board of Health Cc: Barbara Childs,WPC/Roger Parsons, Town Engineering, DPW Enc. QASEWER connect\Letters Stewart Creek Sewer Connects\MAILING L.etA Sewer 2Pgs Merged 3-28-13 Yr2015.doc Public Health Division March 28, 2013 ADDITIONAL INFORMATION AND REMINDERS FROM OTHER DIVISIONS: SAVINGS AVAILABLE/GRINDER PUMP: A reminder to those of you who need a grinder pump for your connection: Department of Public Works (DPW) sent you a letter in December 2012 stating the town, for a limited time of two years, only from the receipt of the DPW letter, would provide you with the pump at no charge. (This can save you thousands of dollars.) Please note: You must pay the installation cost through your own contractor. Please make your contractor aware of this, if interested, Also be aware: this is a shorter deadline than the Public Health Division's deadline on the reverse side of this page. SAVINGS AVAILABLE/PERMIT FEE: The Town offers a waiver of the residential sewer connection fee of $420.00 for those properties that connect within two years of the receipt of the DPW December 2012 letter. LOANS: For loan(s) available, please see the enclosed brochure, or see the town website: http://www.town.barnstable.ma.Lis/cdbg (under the "CDBG Programs", see "Sewer Connection Loan Program). For loan specific questions, you may contact Kathleen Girouard, Growth Management, at 508-862-4702. CONTRACTORS: Information on Licensed Sewer Installers is available on our web site at www.town.barnstable.ma.us/PublleWorksTech/sewerinstalIei-s. Contractors, approved to perform sewer connection work in the Town of Barnstable must obtain and file a Sewer Connection Permit with DPW-Water Pollution Control Division, 617 Bearse's Way, Hyannis —contractors, please call Dave Anderson at (508) 790-6244. FOR ANY QUESTIONS /ASSISTANCE: Len Gobeil at the Town Manager's Office is available to provide you with direction you may need in reference to the Stewart Creek Sewer Connections. You may contact him at 508-862-4701. QASEWER connect\Letters Stewart Creek Sewer Conr.ectA MAILING L.etA Sewer 2Pgs Merged 3-28-13 Yr2015.doc P OF IKE*qy�0 Town of Barnstable U.S.PbSTAGE>>PirNEY soWEs Public Health D ivision ((/' .��d RgRMSTBLE. ' 200 Main Street L � cv�® �"tfOlMy�`� Hyannis,MA 02601 ` ZIP 02601 $ 00b`.1 0 0001383424 MAR. 28. 201.3. 7012 1010 0000 284 0974 _ r- TIMOTHY M. CLARK 40 SEABROOK RD ` a� �(� HYANNIS, MA 02601 Ili Hill � j (�( tI t r 4 I �1 r- UNITED STATES POSTAL SERVICE First-Class Mail - Postage&Fees Paid LISPS Permit No.G-1.0 I I I • Sender: Please print your name, address, and ZIP+4 in this box • I I -Sewer Connect I Public Health Division Town of Barnstable Main Street . 200 M . Hyannis, MA 02601 I . I ■ Complete items 1,2,and 3.Also complete A. Signatu item 4 if Restricted Delivery is desired. ` 7E3 Agent e Print your name and address on the reverse ��Addressee so that we can return the card to you. B. ecei e`by(Print ame) C. Date of Delivery ■ Attach this card to the back of the mailpiece, � or on the front if space permits. 1. Article Addressed to: D. I del'w"ery a ss diffe rom item 17 ❑Yes I ,enter livery a ii s below: .No N Ce) TIMOTHY M.CLARK '2'�'6► 40 SEABROOK:RD '�N HYANNIS, MA 02601 3, Seqylce Type O'Certifled Mail ❑ press Mail eurncei o❑Registered f dise - - ❑Insured Mail ❑C.O.D r-v o 4. Restricted Delivery?(Extra Fee es 2. Article Number 7012 1010 0000 2848 0974 (transfer from service label) PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 MCI-k` Vl� ,THE ram, Town of Barnstable Barnstable Pzwwmftcw ti .�. Regulatory Services,I)epartment P tARNSfABM O D` � Public Health Division s 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7012-1010-0000-2818 -0981 March 28, 2013 SHIRLEY M. CLARK 43 SEABROOK ROAD IMPORTANT NOTICE HYANNIS, MA 02601 Map & Parcel: 307- 012 The Department of Public Works informed us that public sewer lines are now available in your neighborhood. According to our records, your property has a septic system. This letter directs you to connect your dwelling, at 43 Seabrook Road, Hyannis,MA, to public sewer on or before 3/30/2015. The old septic system must be either removed or filled in due to future safety concerns. This may be done by the same contractor who connects you to the sewer. Septic Abandonment Permits ($ 25) are issued at the Public Health Division, 200 Main Street, Hyannis. Failure to comply with this Board of Health Order may result in a complaint against you, in a court of law. For additional information pertaining to the sewer connection, please see the reverse side of this page. PER ORDER OF THE OARD OF HEALTH Thomas A. McKean, R.S., C.H.O. Agent of the Board of Health Cc: Barbara Childs, WPC/Roger Parsons, Town Engineering, DPW Enc. Q:\SEWER connect\L.etters Stewart Creek Sewer Connects\MAILING LetA Sewer 2Pgs Merged 3-28-13 Yr2015.doc Public Health Division —. March 28, 2013 ADDITIONAL INFORMATION AND REMINDERS FROM OTHER DIVISIONS: SAVINGS AVAILABLE/GRINDER PUMP: A reminder to those of you who need a grinder pump for your connection: Department of Public Works (DPW) sent you a letter in December 2012 stating the town. for a limited time of two years, only from the receipt of the DPW letter, would provide you with the pump at no charge. (This can save you thousands of dollars.) Please note: You must pay the installation cost through your own contractor. Please make your contractor aware of this, if interested. Also be aware: this is a shorter deadline than the Public Health Division's deadline on the reverse side of this page. SAVINGS AVAILABLE/PERMIT FEE: The Town offers a waiver of the residential sewer connection fee of $420.00 for those properties that connect within two years of the receipt of the DPW December 2012 letter. LOANS: For loan(s) available, please see the enclosed brochure, or see the town website: http://www.town.barnstable.ma.us/cdbg (under the "CDBG Programs", see "Sewer Connection Loan Program). For loan specific questions, you may contact Kathleen Girouard, Growth Management, at 508-862-4702. CONTRACTORS: Information on Licensed Sewer Installers is available on our web site at www.town.barnstable.ma.us/PublicWorksTech/sewerinstallers. Contractors, approved to perform sewer connection work in the Town of Barnstable must obtain and file a Sewer Connection Permit with DPW-Water Pollution Control Division, 617 Bearse's Way, Hyannis—contractors, please call Dave Anderson at (508) 790-6244. FOR ANY QUESTIONS /ASSIST_ANCE: Len Gobeil at the Town Manager's O-ffice is available-to provide you with direction you may need in reference to the Stewart Creek Sewer Connections. You may contact him at 508-862-4701. QASEWER connect\L.etters Stewart Creek Sewer ConnectAMAILING LetA Sewer 2Pgs Merged 3-28-13 Yr2015.doc Nos '' Z Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes • PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipprication for Migpogal bpgtem Congtruction Permit Application for a Permit to Construct( )Repair(�pgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. y� St�rp U8�e 14yWVP15Owner's Name,Address and Tel.No. Assessor's Map/Parcel 330—U 1 ` 2-OT Ll o S P—gx Zae ol/` Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Conc0 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 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)&D U 0._tSL_ mp \sN R we y, 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 f e nvironmental Code and not to place the system in operation until a Certifi- cate of Compliance has been i ue and f Health. Signed Date (C)•a�'ZOOC! Application Approved by Date �✓� Application Disapproved for the following reasons Permit No. Date Issued / TOWN OF BARNSTABLE LOCATION �� G�k SEWAGE # �D'✓� r�22 VIILAGE f7�I/giV1Jl,� ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE N0. Az6 SEPTIC TANK CAPACITY. r�X�.S��S eess/►pa LEACHRENG FACILITY: (type) NO. OF BEDROOMS . . BUILDER OR OWNER I IA4 G21#fz'k PERMITDATE: fib-rI bU COMPLIANCE DATE: 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 206 feet of leaching facility) . Feet Edge of Wetland and Leaching Facility(If any wetlands exist Within 300 feet of leachingi facility) Feet Ftunished by;..; 1&Z eq t 1 Noyes'"''A 17 Z Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pprication for �Mpoe;al *pgtent Construction Permit P d � Application for a Permit to Construct( )Repair(V Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 0 SChbluore 14Y0111111Owner's Name,Address and Tel.No. Assessor's Map/Parcel 3U-7 U/ ( Ldr 1 l (n� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. S T Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures s` 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) Date last inspected: ti 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 XardIHealth. ironmental Code and not to place the system in operation until a Certifi- cate of Compliance has been i ue , Signed �'� Date K ' l__?'Z COO Application Approved by Ale Date r'fe - Application Disapproved for the following reasons F Permit No. 's Date Issued 1o01P o�742n " --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance 000, THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( Upgraded( ) Abandoned( )by A C6 C. at 4/0 a vk o 0 o a �`,f� v\ , S has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Pent e>l AC,'Z dated Installer A3 CcAnt•c f 1 Q� Designer A � The issuance of this permit shall not be cSnsstttrued as_a guarantee that the sy tem will function/gas desilgned i O - D- 00 1 '1 �� Inspector •- )ate ! No. 24�,� ` r* ,e ————————————————————— — Fee .-� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS lwiopooal 6petem Cc ng;truction Permit Permission is hereby granted to Construct( )Re air(' Upgrade( )Abandon( ) System located at 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 ermit. Date: Approved 0,e--eg! ��t�/ 4 t