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Home My WebLink About0310 BEARSE'S WAY - Health 310 BEARSES WAY HYANNIS, s A .3310 O11 i 1 e I ° ° C\d fpy TOWN OF BARNSTABLE LOCATION al-T HEARSES WAY SEWAGE # 2000-585 VILLAGE H Y A N N I S ASSESSOR'S MAP & LOT f INSTALLER'S NAME&PHONE NO. ELL IS BROTHERS CONST . CO , 362-6237 SEPTIC TANK CAPACITY 1.60o �' I�1..►G- LEACHING FACILITY: (type) H(-CAP I 3 3x to Flab NO.OF BEDROOMS Z BUILDER OR OWNER S U E' C H A R L O N N E PERMIT DATE: 9/2 8/0 0 COMPLIANCE DATE: LILO-6 Separation Distance Between the: f Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet i Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) -T Feet 4 Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet ' Furnished by - 1 a3' 3`( a r �45 f No Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZippYtcatton for Mig;paal *pgtem Congtruction Permit r Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System O Individual Components Location Address or Lot No. ' Owner's Name,Address and Tel No J OS Z Assessor's Map/Parcel ?/ _ C) / � Installer's Name,Address,and Tel.No. ��—adz—�3� Designer's Name,Address and Tel.No. G s i3 r�, xJ - 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 LL V gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Rrvision Date / Title � e AA Size of Septic Tank Qks.— /S Type of S.A.S. Lt7� Description of Soil V/ Nature of Repairs or Alterations(Answer when applicable) -/� �� `< G /✓ `� Date last inspected: Agreement: The undersigned agrees to ensure the cons Zion and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 e Environmental Code andpot to place the system in operation until a Certifi- cate of Compliance has been issued by t ' o of lth. v Signed Date Application Approved by Date 2°p� Application Disapproved for the following reasons Permit No. Date Issued X 2 ff 1; TOWN OF BARNSTABLE LOCATION SEWAGE BEARSES WAY SEWAGE # 2000-585 ; VILLAGE H Y A N N I S ASSESSOR'S MAP & LOT � INSTALLER'S NAME&PHONE NO. ELLIS BROTHERS CONST . CO. 362-6237 SEPTIC TANK CAPACITY _i6C) ex1�)y� LEACHING FACILITY: (type) q(. CRP 1�.:H1-� ��-(size) �� 3 3x +o'rtC<o NO.OF BEDROOMS Z BUILDER OR OWNER SUE CHARLONNE PERMIT DATE: 9/2 8/0 0 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. �,trr►� sue-'s�� •, ,• No. �u F`r _ Fee .. Entered in computer, THE COMMONWEALTH OF MASSACHUSETTS Yes -PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS Application for 3Digpo9;al *pgtem Conttruction Permit Application for a Permit to Construct(. )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.75 y. titij wlA ve ell- 1✓1ti/ve %�✓ Assessor's Map/Parcel /U _ v :�z I / �,)� / �c IvAJ " > Installer's Name,Address,and Tel.No. 3`-� V Z 3-7 Designer's Name,Address and Tel.No. h. Type of Building: Dwelling No.of Bedrooms 2 Lot Size sq.ft. Garbage Grinder K/r) y_✓' Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Desigp,Flow y gallons per day. Calculated daily flow gallons. Plan Date Number of sh is evision Date Title .-_" Z S Z�// /, (ky Size of Septic Tank 4L- /s Type of S.A.S. /J- 3--� --5/F Description of Soil ! t: N tore of.Repairs or Alterations(Answer when applicable)---/- �sf� �l /v�i✓ 4- `�• , G_�� i � 11�� q /�r=�' Sci/�v:� �i' �/i�/�� r c�-� , i �,�- � ' S�� "�.aGt.�—. Date last inspected: Agreement: The undersigned agrees to ensure t4tion and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Titlnvironmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued byf alth. �I7 • Signed � 2---�/L� Date Application Approved by Date Application Disapproved for the following reasons 0 Permit No. "S Date Issued Z 8, ?mod---------------------------------------- 4 f a, THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed paired ( )Upgraded( ) Abandoned( )by LG�i✓ at . has been constru led in ccordance with the provisions of Title 5 and the for Disposal System Construction Permit No'.O -J_,rS dated 9 Z F Z�Q Installer �G�✓ ` Designer The issuance of this pe A shall 'ot be construed as a guarantee that t �syAW- 0 will function as Asigneld. /� /� Date �- "Inspector ! / ®� .. ✓ l 1 */71N -- — i; No.�� '�� --- Fee THE COMMONWEALTH OF MASSACHUSETTS' , a, 2� PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS lU- L �l 1=i5po0al *pgtem Con!gtructton Permit Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon( ) System located at �A'7 1-1 ,4,c,^ ' /74 po ' and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to i comply with Title 5 and the following local provisions or special conditions. Provided:Constructio must b completed within three years of the date of t ' ermit. a Date: �12�� ' Approved by t + c 10/9/97 NOTICE: This Form Is To Be_ Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) 1 �N; , hereby certify that the application for disposal works construction permit signed by me dated 28-- , concerning the property located at to � tis-� b4 -A W meets all of the following criteria: NJ • There are no wetlands located within 100 feet of the proposed leaching facility • There are no private wells within 150 feet of the proposed septic system //V • There is no increase in flow and/or change in use proposed A/2 • There are no variances requested or needed. 1W • If the proposed leaching facility will be located within 250 feet of any wetlands, the bottom of the proposed leaching facility will=be located less than fourteen(14f feet above the maximum adjusted groundwater table elevation. Please complete the following: 11 A)Top of Ground Elevation(according to the Engineering Division G.I.S. map) B)Observed Groundwater Table Elevation(according to Health Division well map) 2 p 4 . SIGNED : � DATE: LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER (Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. q:health folder:ccrt �� , �,� ��P��I � T � 3w � ��;w� � L- 133.10 - -d=- EL 13Z.o , 91 MATN- S 5 AF%Q ND tj.Gt� EL EKISTING GR. EL 12�•0 E�S yS rTFM o t,L-? t—o z" 6 SLOPE ELv_ )2a ►.�_ ER ' o►=GRZ , I S MtN.�3'MAx CovG�� I ��l27.3 CCESS W t v ry —2 LEY EL N O r�1 Coy 500 GAL TOR,LE4'E',—^—�• / �2"pEt�ST�uE r' /-ACCESS po3�5t i Izool I2T.o R c. ccwc. , SG-7 SE►71 C TAh1 K H' ) q5 f e 1 25.S uZ;ice '0 '1• c . 8q� lZ )25,7 .cb � � �5�-_� e. ' ..r�t � 3v 49 }zS.D �o�s. EL-,)23.0 ' ��o..a. •moo e s o4na. e � 3/ '�,o) 2 D +�B►-t �tE ) 5roNE 'DR Co►NPACIV F, 20'MiN. � W/�SNFD STONE DF?nA oT- 119viQ M1N . L0G U S INFER' TEt DE?M - Iri ( �1-I 0 BIELOV/ EL 1 2_p NOTES: I j /. 015PO5AL SYSTEM ro eS C8K5TRUCTED ttv STRICT INCCDRDANCE j o': COMM. or MASS . ENV)RDN. CODE.- TITLEy . I PROF1 LE o} DISPOSAL SXSTE N\ 2 . SURVEY DATA rzoM"PLAN'OrLAND 1N R PNJ 3TAa F-j MA FOR (Nor roSU•tE) - Sag. D� MMJWCJ avA,1- '�. EA31� 33A>JDWILH 7- 3. ST?1 -P OUT / M?ER1U'U5 )�1�TERJ(�L ;° EL`J IZI. O 3EFCRE BACk F )LL- wI ni GLEAM IMEI—) MAP88 Pc. 9-3 - 7-O )\JIM6 'R0- 5. B EN C H M KTF K - C.33 . 1=11','o1.I3-P 10 HT U)rR)J'�--Kor LG� E LV 131 . 0 S. U 5t 3- S'xb',r G ' P_ C. C01.1C_ LEAC14 CHPA'RERS w,r14 -4-` of 3/4.'' To I IJ2" WASAT-'b STONC w,rN 2 " of -PrA STo0C o�jTop. I T. UT,"T s A ji GA S r3AT-T-LES iN 3EPT► C TAN R PErP. TITLE Sr_ j lira 3G 22 124 1 3 4a ' �✓ 3,M. 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