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Home My WebLink About0018 TANAGER ROAD - Health 18 Tanager Road Hyannis A= 268 - 022 r �a r I� i u a � I TOWN OF BARNSTABLE LOCATION A SEWAGE # C/7—6 Fr 1: VII.LAGE /ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO.� ��/i �— b4s SEPTIC TANK CAPACITY ru,� LEACHING FACILITY: (type) /�-I�� o 64a e i_ (size) ��`/fK NO.OF BEDROOMS /- BUILDER OR OWNER �'/f'1- &1r,J �j hi PERMTTDATE: COMPLIANCE DATE: �IZ 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 i 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 b. r - a � TOWN OF BARNSTABLE LOCATION I l ais^ QQ E7'8UGC SEWAGE # VILLAGE U-)k y"n ictx' C" ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY Od LEACHING FACILITY: (type) th I 4 (size) CC�C�J NO. OF BEDROOMS BUILDER OR OWNER �Jt 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! Faci .ty (If any wetl ds exist within 300 fee V f le chin fac' ty _ Feet Furnished ' ?� �J �1 // �vw`` ^� \�°� �� \\I � � �r� V �\� �f� 1 J . ' o � J � I � I I �� «. I `� _ ` .I I No. 7 74 47 9 , Fee A7 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: • ' Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pplication for 33i!5paal *pftem Con0truction Permit Application for a Permit to Construct( )Repair(4pgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Tp� Ef- Owner's Name,Address and Tel.No. 0 Assessor's Map/Parcel Z�� 0 21 Installer's Name,Address,and Tel.No. �$ Designer's Name,Address and Tel.No. l� —C-AeG SC-0-TiC- ?� �� -rc-2 2vt�D Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( ) Other Type of Building Re.Sj d e4 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 w. n Type of S.A.S. 7 u L Description of Soil 51A-- Nature of Repairs or Alterations(Answer when applicable) -'-rW \SGL-�, e)e_\\ow �✓�P'TN C j 1_`t-v-,,I vei wT •{ re- 01A S%ticS -t' l q tt ' 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 Healt _ Signe Date I HO-Cl / Application Approved by Date 27 Application Disapproved for the following reasons Permit No. — e Date Issued Z d 97 % 64� 7- 19 e.' NO. FeeA THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. PYes UBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pplication for Mfi5paal *pfstem Con5truction Permit App4c/atibn for a Permit to Construct( )Repair.(-V)"Upgrade( )Abandon( ) D Complete System ElIndividual Components Location Address or Lot No.figi plk 6 E- Owner's Name,Address and Tel.No. .Assessor's Map/Parcel Wy 2 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. C.- tZ o AD J4 N A Yt\3A- I)rpe of Building: -3 Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder Other Type of Building ad No.of Persons Showers Cafeteria Other Fixtures Design Flow 33 gallons per day.-Calculated daily flow 3149 gallons. Plan Date Number of sheets Revision Date Title — wo, i Size of Septic Tank 1'5 QD F::��o V_� Type of S.A.S. r t,fe-q 13= m6:4K t L 1.� V Description of Soil VVA_,d,0 _5V"_Q 4 Nature of Repairs or Alterations(Answer when applicable) _�VJ5TOA k!5&j Q yk 0�f IA,b�\ c-,Pro i—m±1C I O'k S L4-.,l -Pl "vi W---e- ov,; C,69eS -t- I q4k K,,e.A- N 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 ard of Heal Signer:�� Date c(7 Application Approved by tr AAA�0 "1 Date - Application Disapproved for the following reasons Permit No. 7--G Z6 Date Issued ---------------------------------------- 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 M 16— C f N PG, SE V T i C, 7 at cr r=- K U�Awulsqb (z has been constructed in accordance with the provisions of Title 5 and the for Disposal System&nstruction Permit No. 97-6'y* dated 97 Installer C64Ae Designer r The issuance of this permit shall not be construed as a guarantee that the syst dl funcli 2 _,,,_24ade�sid Date 7 Inspector ———————————————————————————————————--- W_ No. '917-OF/V 6 Fee#7� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION . BARNSTABLE., MASSACHUSETTS Mfigpoal 6potem ConfStructton Permit Permission is hereby granted to Construct( )Repair( vieupgrade )Abandon( ) System located at 19 :JRLIAC,_c- 0AjN H � A-tJpjish (?_-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 t. t 12 Date: �'7 Approved b. 10/9/97 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 ENGINEERED PLANS) i a ,hereby certify that the application for disposal works j construction permit signed by me dated concerning the i property located at 1 �`�`� ��'2— ��'/ °V meets all of the following criteria: �• There are no wetlands located within 100 feet of the proposed leaching facility `�• There are no private wells within 150 feet of the proposed septic system I • There is no increase in now and/or change in use proposed r/• There are no variances requested or needed. / 1 �• if the proposed leaching facility will be located within 250 feet of any wetlands,the bottom of the proposed leaching facility will pQt be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation. i Please complete the following: **�� A)Top of Ground Elevation(according to the Engineering Division G.I.S.map) J' ' Y B)Observed Groundwater Table Elevation(according to Health Division well map) o�G``0 03, 1 SIGNED: DATE: 4 LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. I I x q:health folder:art C 5 `I f� O - J ^ ' ell V wt 9 •� i t TOWN OF BARNSTABLE LOCATK3b1 A-J rAIVniV - e.r A SEWAGE # VILLAGE_ z� d0 ASSESSOR'S MAP MAP& LOT INSTALLER'S NAME&PHONE N0. -- C�'•'4'S SEP'ITC>TANK CAPACITY LEACHING FACILITY: (type) /�i�, VI L 4� (size) NO::OF.BEDROOMS Bt-MD:ER OR OWNER PEKMITDATE: 1/- - COMPLIANCE DATE: II-IZ -� Separation Distance Between the: MAumum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Pi vate..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 I i � 00 � .. a• r yo � ::.j j A. a Q• d1 �`