HomeMy WebLinkAbout0016 DEVON LANE - Health 16 Devon Lane, Lot 1, Cotuit-Barnstable
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OWN OF BARNSTABLE
LOCATION LVT— 1 �40a,J _# L SEWAGE#
vII.LAGE C'�� ASSESSOR'S MAP&1,45 P
INSTALLER'S NAME&PHONE NO. _ NICk(.Q-ti Mv,�ST -S f?9
SEPTIC TANK CAPACITY 1 .-SZ O
LEACHING FACILITY: (type) -Th.'�-AJC 1-U (size)
NO.OF BEDROOMS
BUILDER O OWNER
PERMTTDATE: rm 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 leaclong facility) Feet
Furnished by �.
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ASSESSORS MAP W0:
�, * PARcaNa�l � �� FEE/%A!C"No. ;t v-,.
THE COMMONWEALTH OF MASSACHUSETTS'
Barnstable MASSACHUSETTS
�Xpplirativn for Pi6jjv!aaj �$Vstem Tonstrurtion Permit
Application is hereby made for a Permit to Construct(X ) or Repair( ) an On-s:te Sewage Disposal System at:
Location Address or Lot No. Owner's Name,Address and Tel.No.
Lot #1 Devon Lane 14C L7,QVIO The Irene Trust
Cotuit-Barnstable-MA /may Don Preistly, Box 599, Mashpee
508 477-0023
Installer's Name,Address,and Tel.No. /^-- "" Designer's Name,Address and Tel.No.
Ferreira Associates
131 Spring Bars Road
Falmouth, MA 02540
Type of Building:
Dwelling No. of Bedrooms 3 - Garbage Grinder("g • --
- Other Type of Building No. per Persons Showers( ) Cafeteria( )
__"— "tiOthe'r�F�iixttu.,r�es
Design Flow 5 '"` t gallons per day. Calculated daily flow 330
gallons.
Plan Date 4-3 0-9 6 �-0'` _Number of sheets 2 Revision Date
Title Sewage Disposal Syslt-em Plan prepared for the Irene Trust
Description of Soil Test#1 : 0 "-1 " (0)\san.dy loam, 1 "-8 " (B) sandy loam, 8 "-120 "
(C) sand. Test #2: 0 "-1 " (0) Nsandy loam, 1 "-8 " (B) sandy loam, "-
120" (C) sand. No groundwater encountered.
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected: i
t 4 Agreement:
The undersigned agrees to ensure the construction and maintenance of the aforedescribed on-site sewage disposal
system in accordance with the provisions of Title 5 he Environmental Code and not to placthe,ys min peration until a
Certificate of Compliance has bee e y th' bard f He /Q
Signed Date / r
Application Approved by Date
Application Disapproved for the following reasons
c
Permit No.
� '"�! .G Date Issued
No. FEE 1_4014�m
V THE COMMONWEALTH OF MASSACHUSETTS
'Barnstable MASSACHUSETTS
41ppliration -for Visyvsal Sgetera Tonstrnrttun-FPrrait
Application is hereby made for a Permit to Construct(X) or Repair( )an On-site Sewage Disposal System at:
Location Address or Lot No. Owner's Name,Address and Tel.No.
Lot #1 Devon Lane 16 L"7�vd� .aVr The Irene Trust
Cotult-Barnstable-MA Don Preistly, Box 599, Mashpee
+, (568) 477-0023
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Cb\A �cdlV�rc� Ferreira Associates
131 ,Spring Bars Road
FAlinouth MA 02540
ly -Typ o Building s
"" ''' -r Dvvelli7ig` To of~Bedrooms - 3°�- ---•Gar-bage•Grinder(P_?4��
-- �..__ ___,Other Type of'Building No:per Persons Showers( ) Cafeteria
�� ( )
Other_Fix_ tures
Design Flow 55 gallons enda . Calculated dailyflow
_l p y 330 gallons...
Plan Date 4-3 0-9 6 \ —Number of sheets 2 Revision Date
Title Sewage Disposal System Plan prepared for the Irene Trust
Description of Soil Test#I : 0"-1 " (0) `'sandy loam, I "-8. (B) sandy loam, 8"-120"
(C) sand. Test #2: 0"-I " (0)`sandy loam, .1 "-8 " (B) sandy oam, "- "#
120" (C) sand. No groundwater encountered. R°?
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned,agrees to ensure the..construction and maintenance of the aforedescribed on-site sewage disposal
1 , system in accordance with the provisions of Title 5 of the Environmental Code and not to place th sys em in operation until a
4 Certificate of Compliance has been issued ,y this Board of Health. r � ,
•.,� ��$ �,Slgned ' ' Date s ~^� `l
�..+.-+u^•%a ,•a="�r�a...E Qy.x �,sf-h.p. .. '�"" „. .:;.—w,,,,_.cy.�„ >, —g�
7 efApPlication A•Ppiovecl by e- -• - '-Date
'
�Applicatiori Disapproved for the following reasons
Permit No. "" Date Issued �`� f
K. '_- ��
THE COMMONWEALTH OF MASSACHUSETTS
iW 19KAWWWA%4 , MASSACHU.SETTS
i
<!!! Cler#ifi ite of C9jamplinure
THIS IS TO CERTIFY that the On-site Sewage Disposal System installed O or repaired replaced( ) on
•0"
by �• for`7°".�
at has been`constructed in
•h.
accordance with the provisions of Title 5.and-the or Disposal System Construction Permit o. . — _ dated
°Vse'of'this system is conditioned on compliance with the provisions set forth below:
-The issuance f this certificate shall not be construed as a guarantee that the system will function as designed. This
Certificate expires on
1 , DATE'
.-- THE COMMONWEALTKOF MASSACHUSETTS
No. /, MASSACHUSETTS _,FEE "
ATuixs#rixr#iux� �exmi#
Permission is reby granted to aQ tA ' 10
to construct or re air( )an On- ite Sewa a S,yst m located at � T � - �r''`�✓t< '
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. .
All construction must be completed within three-years of the date,below.
\ DATE 7) Approved by
FORM 1255 Rev.3/95 A.M.SULKIN CO.-BOSTON•MA
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