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Home My WebLink About0131 CASTLEWOOD CIRCLE - Health 1 CA . _ 13 STLEWOOD RD. ,,;HYANNIS `I A:~272 049 . o I a TOWN OF Br ARNSTABLE r��. 1✓ LGs CATION , C�sfi�(.�CX)fY c� SEWAGE # �t 000— 16 -Vl,�AGE J'\i K►^n S ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. `7?S 3Q9 9 SEPTIC TANK CAPACITY (0 0 0 LEACHING FACILITY: (type) �9-rnQ (size) 1-i NO.OFBEDROOMS t q �� BUILDER OR OWNER��'C. C_ PERMITDATE: r2 hkR (V COMPLIANCE DATE: . ' lG U Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility 0 Feet Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facili. -(If any wetlands exist within 300 feet of leaching ty) �U�� Feet Furnished by t VIC ._( . {w No. ' -` Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIppYication for Mie;pooal *p5tem Congtruction Permit Application for a Permit to Construct( )Repair( �)Upgrade( )Abandon( ) O Complete System O Individual Components Location Address or Lot No. (� Owner's Name,Address and Tel.No. Assessor's Map/Parcel `� ` Crn�,W__U\wll ? (j G Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �s 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. wPlan'•Date. Number of sheets Revision Date Title Size of.Septic Tank XhS� k000 Ge:.� AxAt. ,U_- Type of S.A.S. Description of Soil: Nature of Rep or Alterations(Answer when applicable) (Al'��i . 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 FWkonmental Code and not to place the system in operation until a Cer ifi- cate of Compliance has been is ae by this Bciard o He Signed Date ) /A U o Application Approved by Date Application Disapproved for a following reasons Permit No. Date Issued • TOWN OF B ARNSTABLE . . ._ LOCATION t CC,S ' J C, - G VILLAGE �� SEWAGE # O � ti5 ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY ( 7 (J I LEACHING FACILTIy: (type) (size) NO. OF BEDROOMS BUILDER OR OWNER cal C c,rZ, I PERMITDATE: 11 W I 00 COMPLIANCE DATE: G C I Separation Distance Between the: I Maximum Adjusted Groundwater Table and Bottom of Leaching Facility (�i Private Water Supply Well and Leaching Facility ((If any wells exist Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Faci �U Feet within 300 feet of leaching (�any wetlands exist Furnished by ty) .., ,-: .:: .. ..::...., . . fv CE, • i I i Ct , deb i ` ''iv-_ , "3-- "-C.. T' z�+LL.�_ , .��.1:� •� 1- ._ .. r r - �a '^--.... :,..,-r, Ay; -;r�ti..wa�rw.,y.• �r; Fee i THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pplication for Miopo!gal *pgtem Com5truction Vermtt Application for a Permit to Construct( )Repair( V)Upgrade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No. (� _ C��fn n Owner's Name,Address and Tel.No. Assessor's Map/Parcel 1 ` CG L (lJU(� `c J � �{ C 7 "U Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. SCo k� " S Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder(l 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 0 kiSA IC>OCO Gc.� Type of S.A.S. Description of Soil: Nature of Rep * or Alterations(Answer when applicable) Date last inspected: F 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 onmental ode and not to place the system in operation until a Certifi- cate of Compliance has been is ued by this B the o He Signed o Date / v Application Approved by Date Application Disapproved for tVe following reasons ` Permit No: Date Issued ---------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( ) Repaired(V )Upgraded( ) Abandoned( )by en C _ at s q 3 has be9p constructed in accordance with the provisions pf Title 5 and the for Disposal System Construc 'on Permit No. ated Installer�f'n M ��_ Designer The issuance of this permit shall not be construed as a guarantee that the system ill unction as designed. Date ,� _ a.3. /X7 Inspector --1� -------\-------------------Fee---- N.A THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mizpoal *pgtem Congtruction Vermit Permission is hereby granted to Construct( )Repair( )Upgrade( )A andon( ) System located at_ _ l ? 1 �c.S+- !C C�0 dci 2 � uYC.n!` and as described'in the above Application for Disposal System Construction Permit.The applicant recognizes 's/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction mi st e c m eted within three years of the date oft s permit.. m p Date: Approved by ��'�;"�� C U6i99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - CERTIFICATION OF SI<ITCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOTTI' DESIGNED PLAYS) I, CxA M `Ctlra�ereby ce:ti y that the application for disposal works construction permit sided by me dated Q concernins the property located at c..D oa meets all of the following criteria: (The failed system is conne^ed to a residential dwelling only. There are no commercial or business uses associated with the dwelling. / T-he soil is classified as CLASS 1 and the percolation rate is less than or equal to 5 minutes per inch. There are no wedands within 100 fee;of the proposed septic system 4 There are no private wets within 1f0 fee;of the or000sed septic srsem There is no increase in flow and/or change in use or000sed r T'nere are no variances requested or needed. l The bottom of the proposed leaching faclie,will not be located less than five fee;above the tna.-dmum adjusted groundwater table eleradon. (Adjust the Q*oundwa[er table using the;=rimotor method when applicable] If the S.A.S. will be located with LM ;of any vegetated wetlands, the boaom of the proposed leaching facility will not be located less than founeen(141) fee;above the rna.cimurn adjured uoundwater table-!evaL1on, Please complete the Following: A) Too of Ground Surface Elevation(using GIS information) < - S) G.w. Elevation [he�L�_(. gh G.bV. .�djussrtent � J D +CL E E T tiVEEv.a.and.3 3 SIGNED : D ATE: I« �� (Sk=.ch or000sed plan of s s-zem on back). ;,..- -� � � � !�. d I + �� v �.�„ r i