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HomeMy WebLinkAbout0271 WAQUOIT ROAD - Health 271 WAQUIT R;C)v COTUIT A = 018 004 Pr 44, TOWN OF MRNSTABLE �. LOCATION i// Yie� / D ; SEWAGE # %V-J .VILLAGE ASSESSOR'S MAP &LOT 0017—45haX INSTALLER'S NAME&PHONE NO. 4�,44�e//. ` s4ze4e�? A�2?-Q'i1d SEPTIC TANK CAPACITY LEACHING FACII,ITY: (type) T��L /ad al a i��(size) /,R �<2` NO. OF BEDROOMS BUILDER O 0 R' PERMITDA : S"�ylJ/ COMPLIANCE DATE:_ Z9 v 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 31° No. Fee Cl- THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: iv Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 1.1�" 01pplitatiou for ' Migooal *pztem Conotruction Permit Application for a Permit to C nstruct(V)Repair( )Upgrade( )Abandon( ) ❑Complete System EJ Individual Components Location Address or Lot ® � L.7/ WajW4lf1)` Owner's Name,Addressagd Tel.No. -- �P�L*�r"tyGC4 � CCcc (cii+�t7y Assessor's Map/P elm p t �� ? ® �` C©� L(20 ,31 o (/ Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Aqf-/-?/, dIvJ` 14 7e-C e4 �e Y Type of Building: n Dwelling No.of Bedrooms T Lot Size q3joev Isq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers(3) Cafeteria( ) Other Fixtures Design Flow P,62 (7LAA gallons per day. Calculated daily flow Rig ?yE,t gallons. Plan Date �'Zfi'�=S f Number of sheets I Revision Date Title CAS vt c6 !M`C s-CC4£© cI Size of Septic Tank 1�10 O Type of S.A.S. 44 ?LA''% Description of Soile 2 P�'9 Vi Nature of Repairs or Alterations(Answer when applicable) 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 hi ar o He h. /y Signed Date Application Approved by Date 1—9'q Application Disapproved for the ollow g reasons Permit No. Cl0 Z 70 Date Issued Nd "�tesFi ,' "sa3k ; ',. f T �.. r u✓{ t-�.ws. _�F` ;� �*`...-�, '�5�' '.S' f +^ �. ,'�� t 3sHM `'' ', y,�° j TOWN OF BAR .... I LE / I . ' LOCATION -2/� Gt�gc1✓r 7` • SEWAG)✓k# : /'�7U �?; � ,' C' j;�- ASSESSOR'S MAP &LOT VILLAGE /gJ� INSTALLER'S NAME&PHONE NO. SEPTIC`TANK CAPACITY. . �= LEACHING FACILITY; "(type) s`��G l Lti�y (size.) NO:OF BE 'B—0ER 0 O r / � ; PERMTTDA S/y.dV COMPLIANCE DATE I Separation Distance Between the �f Feet Iviax�mum Adjusted Groundwater Table and.Bottom of Leaching Facility �4 Private Water Supply.We11 and,Leaching Facihty (If any wells exist Feet on site or within 200 feet of leaching.facility) Edge of Wetland-and Leaching Facility:(If any y� wetlands exist Fe et withip 300 feet of leaching factLty Furnished by - r° a v' A2-7 le1V �3. - j yY, " Ems...--••-i - - � ._. , Al No. Fee- 0 ;<7 ti THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS Zlpplication for Xkgogar bpotem Con!6truction Permit Application for a Permit to C nstruct(V)Repair( )Upgrade( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot ( Z 7 1 N/aa&11,1- Owner's Name,Address d Tel.No. Assessor's Map/P el ��(//T AW,��L� � - 0 f8' DO L a*7r W , Coll -cT c{20.3io 7- Installer's Name,Address,and m Tel.No. Designer's Name,Address and Tel.No. /" Type of Building: Dwelling No.of Bedrooms Lot Size dbD f sq.ft. Garbage Grinder( ) Other Type of Building�Air.��.. No.of Persons Showers(3) Cafeteria( ) + ' Other Fixtures '. n Design Flow Ee-/,A P4� gallons per day. Calculated daily flow gallons. Plan'.Date &IfZ$It S ci Number of sheets I Revision Date Title A'd CA Li r"&4 c E Itit`C y r c 4 Co 91 Size of Septic Tank (Sq O Type of S.A.S. �ba ?L4, Description of Soil 14 Nature of Repairs or Alterations(Answer when applicable) J Date last inspected: Agreement: The undersigned agrees to ensure they 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 oar He h. Signed Date Application Approved by Date Application Disapproved for th ollo ' g reasons Permit No. q'9 — -7/2 Date Issued ----------------------------------•----- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CER,JFY,that the On-site Sewage Disposal System Constructed Repaired ( )Upgraded( ) Abandoned( )by at has been constructed ' ac rdance with the provisions of Title 5 9d the for Disposal System Construction Permit No. dated �'?_c7 Installer Designer The issuance of this p rmit sh 1 not be construed as a guarantee that the syste 1 fun c ' n a ,esigned. Date 2 U Inspector --------------------------------------- No. 17 Fee g� THE COMMONWEALTH OF MASSACHUSETTS Df 0 PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS l ZiOpOar *p!5tem (Con5tructiott permit - Permission is hereby granted to Construct(- Repair( )Upgrade( )Abandon( ) System located at '] i ,ram �126 � t-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 ust a compl ted within three years of the date of this PP Date: Approved by i Q71 TOWN OF BARNSTABLE LCC:ATION Z 6f /2/ l/ A 'V0i`' SEWAGE # -- VILLAGE Gn ,JL r ASSESSOR'S MAP LOT INSTALLER'S NAME & PHONE NO. t -. SEPTIC TANK CAPACITY 1000 LEACHING FACILITY:(type) �, %� (size) / Mks NO. OF BEDROObIS- PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER �., ;,'U( �- U �� !� . ' 0 i DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED; VARIANCE GRANTED: Yes No ✓" �. C i! ae , � -. .. _. . ___ _. _�___..p__.�--�..�� . _ \\ �, �' � � \ �. � � + �� �� � i `F \` �� ��` `� �.-. M1' - ,. ._s�..:.yam -.. :.. ♦�, ... 9 PO%v43D9TIOQ LOCATION) -T44 CChI 90M A PI A U Sy :YAuZer-- 5,j"cy Cas stCj4nTS T t o I fL.IW- tq 143 A6SESSo2S fya-P I$ -4Rzeu 4— LoT 15 mcT wi-nAik) �P, 'TaowN -+rw�� � -- �?ESIGNA?EIS �ovJ� ,oF Co�T12.�j�,�v'�7•dJ �2 �T1�►T1E �P PTV� �aAuE YS b8' +E+ct�T,wf� rii "T!oo EwNU yoc,t13A1,, tR � 5tiGt� z MVT LOT ,crsh�lt: � Boti aZ \ -M7-A L LIEA--04 ItO Er A c- 044 s,F. TOTAL PA1L-)I FL _ 3�c1Ib -5 , 8► T-ML T>�\� IFIo� - 441(-.P,f, 132• Y3 f'ERCalAT7o,0 TC tS CESS, 'Pf4t Sti 2 "!fQ TEj AJ C,4 PdsE +� Cn h s-rrzTr3 P- 494 1 \0 - t3�h i2Do tit — '00 Tt sT I-}oj► sT t{o1L 2 C o'-�--v '-- t `� vE S�Gf�1 o�,J 8 11 fJ ,f�.D. 3 E�. S'i EL Sa TrTT, ,.� - �M2 S�T►c TA k f 330 G,p.U, x Zoo +r.f>-D. LABlrE lC - i C 11 'PTA C TYFhJ 1� PAN '6rNL� 1''= -Sol ��►�C �-8,f5�t� IIT SAID - 33o 6-F>D,/O.4 G�S.F/Q = 44¢4 s, >_. 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SZ'-f �4LL CovEEe 7b Be La cAIX-� w�TN�nt 12" 01= f,C ---r,.; 777-7 { 4"P.V,c. P,PE /uV 48.8 Pft4po st't, f Z I.Soc GAL. W%/= IAl✓.=462' r�J. (�1Z-o oS�D lo' W. IC- ¢8,o L.E�Cy '-Tq t:N9MB- 'Bo'1f o M taZ' = 4E�.o` � .o.�►l(�✓!- C_ � ti A$'ra?- T+TtE7SZ DtST. Rio f, Lb No SCALE $oTom of -rtA ' 2