HomeMy WebLinkAbout0014 SEA STREET - Health vl
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TOWN OF BARNSTABLE
LOCATION S e f{ -9 r SEWAGE #
V)T.LAGE C O 7'U If y� ASSESSOR'S MAP & LOT A311Z6
INSTALLER'S NAME&PHONE NO. �/ 4 A G U 44 9 Of R S 0A1
SEPTIC TANK CAPACITY _A a0 o
LEACHING FACILITY: (type) .yew X V X v We-1-1 0.7(size) -�Oe e,+c v
NO.OF BEDROOMS
BUILDER OR OWNER
PERMUDATE: [ -`o/°� COMPLIANCE DATE: :�5
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
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No. Fee $ 5 0-/
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THE COMMONWEALTH OF MASSACHUSETTS
Entered in computer: �
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PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
3pprication for �Dfigpaal *pgtem Congtruction Vermit
Application for a Permit to Construct( )Repair(XX)Upgrade( )Abandon( ) O Complete System XX Individual Components
Location Address or Lot No. 14 Sea Street Owner's Name,Address and Tel.No.
Carl Floren
fYssQesoIJIa�/Pa�icls • 14 Sea Street Cotuit,Mass . 02635
Installer's Name,Address,and Tel.No. 7 7 5—3 3 3 8 Designer's Name,Address and Tel.No. 5 0 8—7 7 5—3 3 3 8
J.P.Macomber Jr. J.P.MAcomber Jr.
Type of Building:
Dwelling XX No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder(10)
Other Type of Building RES No. of Persons 2 Showers( ) Cafeteria( )
Other Fixtures
Design Flow 3/110 gallons per day. Calculated daily flow 330 gallons.
Plan Date 3/1 1 /9 7 Number of sheets 2 Revision Date
Title
Size of Septic Tank 1 000 existing Type of S.A.S. 1-1 000 pit existing
Description of Soil 2;;d
Nature of Repairs or Alterations(Answer when applicable)
Installation of of 2-500 gallon leaching chambers
Date last inspected: 3/8/9 7
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 issue4 by this B ar &fhj6tje11
Signed ! Date 3/1 1 /9 7
Application Approved by Date 3—It- ?7
Application Disapproved for the f lowin reasons
Permit No. 7 - Ito Date Issued
TOWN OF BARNSTABLE
LOCATION Iy S ef{ s rSEWAGE # �Q
VILLAGE' C o T lJ /r ASSESSOR'S MAP& LOT
INSTALLER'S NAME&PHONE NO._ �� �V1 A o U� /3��' �' So,✓
SEPTIC TANK CAPACITY /el/7
LEACHING FACILITY: (type)etgow U/ell-
NO. (size)
OF BEDROOMS--
BUILDER OR OWNER (0-A.P F,0—M .
PERMITDATE: OMPLIANCE DATE: '?S
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
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