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Home My WebLink About0032 WASHINGTON AVE EXT. - Health 32 WASHINGTON XT., HYANNI� A=327=0321 Alf,, EsK TOWN OF BARNSTABLE LOCATION Sr o,.,k SEWAGE # o0 VILLAGE ASSESSOR'S MAP & LOT 3--Q 2-6 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY iJa LEACHING FACILITY: (type) Y LdA-1,f" (size) NO.OF BEDROOMS 3 BUILDER OR OWNER PERMTTDATE: �.•I�o �/ COMPLIANCE DATE: q I ' 7f 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 i Furnished by C ate. r� �3 ��3Z TOWN OF BARNSTABLE LOCATION 0- �.,�-� SEWAGE # VILLAGE,.— La� ,,z4 ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) ��t .a/ (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: �-•� -:J�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 t+llo� tom `-' ' �a No. b "�go Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZippYication for Mizpogaf *p5tem Con6truction permit Application for a Permit to Construct( )Repair( )Upgrade($C-)Abandon( ) 25Complete System O Individual Components Location Address or Lot No. Owner's Owner's Name,Address and Tel.No. Assessor's Map/Parcel u-eo 3 L 3 2- Installer's Name,Address,and Tel.�NNo. Designer's Name,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 330 gallons per day. Calculated daily flow _3�A C� gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank 1 s� /��'^� Type of S.A.S. A "!j3 Cra.DCA r,�O �>t Description of Soil Nature of Repairs or Alterations(Answer when applicable) S \ S S' �� dJ-2 Ct L.`, vc` 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 provisio .de 5 of the En ' I Code and not to place the system in operation until a Certifi- cate of Compliance has4%G_i,sued by this oar alth. Signed Date Application Approved by Date f� Application Disapproved for fol ing reasons Permit No. &®,:p Date Issued .,. � _ -.. �.,.- .a•..r•:++"«. ..,..y�.w/ ., r ,a.. r ....YM:.,y:nh,M?.fm- .s� .ry -^r_.«+..'.o.,y.�> .__... r n..i, y.y,.. w�,..rt.;.. ( �t No. 1 6,90 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS r Rpipricatton for 30i-qp0ar *potem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade(� J Abandon( ) P5Complete System ❑Individual Components Location Address or Lot No. tg;;L W f+S XZ�\4 4e 1 —owner's Name,Address and Tel.No. zF Assessor's Map/Parcel _,eb QD Vlt-av^ -3 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 No. of Persons Showers( ) Cafeteria( ) Other Fixtures ` Design Flow g p y. y-33� gallons per day. Calculated daily flow �� gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank i 0 Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) a\-. 51 W-4A t S rp S• r ��7P O ti-- ►tom/ �- Lyr r v V. j a=c �3 a , 'A 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 provisions4LILtle5 of the Envi al Code and not to place the system in operation until a Certifi- cate of Compliance hasee.en issued by this$ ar lth. Signed �' Date 6` Application Approved by Date - Application Disapproved fort follwing reasons 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 ( )Upgraded(X) Abandoned( )by 1r S ►= at 1 1 1 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. - &06 dated Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will functionas designed. Date C - _ `7 V, Inspector \'\ ———————————————--- ---------------------- No. — 41 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mi.5pogar *poteffi Congtructton Permit Permission is hereby granted to Construct( )Repair( )Upgrade(,Abandon( ) System located at *7Z7,)k 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: Approved by f 4 S � t NOTICE. This Fo rm 1s To Be Used For the Repair. Faded ' septic Systm Oiy. x k t, . , - ON OF SKETCH AND APPLICATION FOR S CERTIFICATION ITHOUT I ISPOSAL WORKS CONSTRUCTION PERMIT D ENGINEERED PLANS set � L cettifjr that the epplicetion for dispo . ' + concerning the } dilpe"Itsigriedby ine dated - S� Meets e11 of the lasttcd It Inching WHY I fi <ire no weth meow 00iM lob het ettl+e p�Pesed j t a wells within I het of theion Pad IWIC system , • are ne p ' 3 4d Meow M fl w and/or dwge In ass"pro' w whhM 2S0 fleet*ill wetland the button+ � ,/irAte aov+ holehi fkiligr will be lodited 1han�tSuKeen(14)feet above the maximum adjusted - wed Inching frcllitX will gd be located kss ;.�, Y `�O,nndwtlet{sbk elerntieo. � � 'Pleiwe eMolt%the Me"m h i r aeeadM to the Englneerleg Dlvisten+d.1.3.Mop) 14-4 A)1*of 61bak l?levatlen t g >h toHealth DIvbhM Well map Toble ,. (accod F x DATE: - y 1ir$`1'A OF 8A1tN3TA M h Alin It IIeM�ed Iwrdn�►OeoMMo a aerll1w old elm. ddA""a rk�e�+qua ex'�t lb IfiOdid be aabinittedl �� ;�,��,� a " ` I ' Q f