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Home My WebLink About0082 OLD OYSTER ROAD - Health 82 OLD OYSTER RQVCOTUIT A=021 - 010 I I r f �ti No. ?— 391 Fee TH!_'COMMONW EALTH OF MASSACHUSETTS"" A Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Rpprication for �5i!V)upgrade at bpmem �tConotruction Permit Application for a Permit to Construct�Zepair( ( )Abandon( ) O Complete System O Individual Components Location Address or Lot No. 0/ o ysll r 4 - Owner's Name,Address and Tel.No. y,2 8_5/l Assessor's Map/Parcel O rU! / aI- 0l ® / � Installer's Name,Address,and Tel.No. 41-71—0 rf elf' Designer's Name,Address and Tel.No. Jos-e_p4 U_e, 13;4i9<-o s 8/ Cl vl�! Ae3rOOS PRIM- Igym. 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) �'— -,s'e0 J / t=f2/�-e 5 GUi Ill L/` 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 Poard of Heal h. Signed Date 7 S — 97 Application Approved by Date Application Disapproved for the following reasons Permit No. 7 7' Z 9 Date Issued C� (4 No. / h ! E Fee �C/ ` . 0-T".EtCOMMONWEALTH OF MASSACHUSETTS':'J..-,t Entered in computer: / i `' Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Z(Ppr%cation for MioUp ar *pgtem Construction Permit v Application for a Permit to Construct Repair( grade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No. g 2 t7/ 6 ySr/%r k • Owner's Name,Address and Tel.No. y1$—S/7 5' Ora r Assessor's Map/Parcel t / Off/— Ul v 0 ";V/ r �� Installer's Name,Address,and Tel.No. 4/707—01 elf Designer's Name,Address and Tel.No. 8/ 6,4r.f .a a ups / v Type of Building: Dwelling No.of Bedrooms 3 ' 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) j T,V1 - ,S`OU G,J/ 'Li�odl,, ��r5 tf/.l" y' Sroe9l� l4ryyN 1 " P,:0 _.14rOyy E, Date last inspected: Agreement: 1 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 issue by this oard of Health. Signed Date Application Approved by / Date Application Disapproved for the following reasons Permit No. Date Issued 7- .3/' 97 --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS . BARNSTABLE, MASSACHUSETTS Certificate of Compliance ` THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( 4-)"lepaired( )Upgraded( ) Abandoned( )by___, LA',s t `i at kol L'-o re,11'r has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 3 9 dated 7--3/ - 9-7 Installer ✓65-dp� y, �3�rvt�S Designer Ss9 The issuance of this permmit shall not be construed as a guarantee that the system will function as designed. � Date / / -7 Inspector — r ------2--------------------------------- No. 9 /— J 9� Fee 5`0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS lwigool *pztem Construction Permit Permission is hereby granted to Construct( pa' ( )Upg ad�j( )Abandon( ) System located at �.� /`��a �/i r' M4. 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 Alt" NOTICE: This form ig to be ood for the tepallf of fhiled septic Systeim-g billy CEMPICATION Ot•WETCH AND APPLICAILION Wit A DI VOA j WORKS cONSTRUCTION PLMIA11t#bt1fi.DESIGNED PLANS) I, �/0,5 e J�� i2n'_vS hereby+ceftit'y that the application for disposal works construction permit signed by tn6 dated , 7/3//. V Z s concerning the property located at $2 �l. Tim�.,.,. �i0U/f meets all of the following criteria: f�There are no wetlands within 300 feet of the ptopo§ed Septic§yste l There are ho private*6119 Within l�0 feet of the ptopdsed septic voeni The observed grouhdwater table is 14 feet of gteatet be10W the bottom of the leeching facility 6�'�There is no increase in flow attd%ot change ht tine proposed cd There are no vatiance§requested of heeded: SIGNED: llA p —zz �� LICENSED SE 1 IC SYS EM IN TALLP1 IN b4t TOWN OF$AM' TALE NUMBED, [Attach a sketch Platt of the ptopdsed§ystttti.Also lt'th@ BcmW histal let pose§ses tt cet[itied plot plah, this plan should be§ubihittedl. q:health folder:cent � II $2 loom G rvN a �P 0 2a ,s TOWN OF BARNSTABLE LOCATION Sez QU D•ys�`er ZW _ C°Q 64,'9' SEWAGE # VILLAGE /�Wit," . ASSESSOR'S MAP & LOT02/ —D/D INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) /a /C + P`� (size) NO.OF BEDROOMS BUILDER OR OWNER Oa rO I . Cur y-i S 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 TOWN OF BARNSTABLE K, / LUCAr10N O/d 6e1Jr e &aaez SEWAGE # F7' 39l VILLAGE ��QtL T ASSESSOR'S MAP &LOT QZ Ot0 INSTALLER'S NAME&PHONE NO. Jorte64 5 SEPTIC TANK CAPACITY /60,0 ro�• LEACHING FACILITY: (type) lwlo d Ck;Ab sll NO.OF BEDROOMS BUILDER OR OWNER C !S PERMITDATE: ,- V- g 7 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 leachi g facility) Feet Furnished by .•- / 61 4 TOWN OFIBARNSTABLE f 9cio LOCATION SEWAGE # VILLAGE ASSESSOR'S MAP & LOT U INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO. OF BEDROOMS -3 PRIVATE WELL OR PUBLIC WATER , BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No ( e I � i - � F � M � � Clz� - aI , rA