HomeMy WebLinkAbout0082 GREENWOOD AVENUE - Health 82 GREENWOOD AVE., HYANNISMEN
A= 289 - 139-002
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TOWN OF BARNSTABLE
CF SH E p0
6,vP�' wo OFFICE OF
i gAHHSTM 'r BOARD OF HEALTH
MA &
1:59 � 367 MAIN STREET March 27, 2000
HYANNIS, MASS.02601
Mr. Charles Markarian
P.O. Box 2227
Hyannis, MA 02601
RE: Lot 9, Greenwood Ave., Hyannis
Dear Mr. Markarian:
You are granted a variance from 310 CMR 15.214, restricting sewage flows to
one bedroom for every 10,000 square feet of land within Zone II districts. You
are granted permission to construct an onsite sewage disposal system at Lot 9
Greenwood Avenue., Hyannis, with the following conditions:
(1) The house plans shall be revised and submitted to the Board of Health
designed for three (3) bedrooms maximum. Dens, study rooms, finished
attics, sleeping lofts and similar-type rooms are considered "bedrooms"
according to Massachusetts Department of Environmental Protection.
(2) The applicant shall submit a monitoring plan for the proposed FAST
system.
(3) The applicant shall record a properly-worded deed restriction at the
Barnstable County Registry of Deeds limiting the dwelling the number of
bedrooms authorized. The deed restriction shall be signed by the
property owner. A copy of the recorded deed restriction shall be
submitted to the Board of Health Prior to obtaining a disposal works
construction permit.
This variance is granted because the application meets the Board's policy of
approving (3) bedrooms if nitrogen reducing alternative-type systems are
proposed on lots of less than 18,000 square feet in size.
Sincerely yours,
Susan G. Rask, R.S.
Chairperson
Board of Health
Town of Barnstable
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Ramitaam Mw nsyic�
SEAM.INC
RtSPL_ CTPi AND IMjy
pANT
This InspcctiOn Agreement is entered into by J&R UW&
SYd9m OWNER(haein called OWNER),for the fie,Inc-(hutin call I&R)and the FAST
J&R's Obligations to inspect OWWRR's eqa >id below. &I'thtermand COnMiOnS nomning
Ole acmeptame of this Wit,JAR will weer the fnlbwing services only:
Equipma Will
�I ected at ksst, -ham Per yew that ft Ag��remains in e
These in iOn will i cbAe: ffect�with the>ha
be
i) T49 ft of the sludge depth in the septic tank.
2) i iM Power testing and cleatdmplace inudm filter of the air bower.
3) Inspection Of the alarm system,
4) hOPOU Over-all condition of P'ASTO Sys
5) Notify OWNER Of any probkms cnmuntgrgd.
6) Service other than mineUmintenme will be billed at an howly rate phis travel and
muerarl,
JAR ill notify the>ocal board ofheakh and tPse
hours of a"gem failure or alarm event
ittcltd` Q�nt of Eaves prom in writing within 24
mg COtteetive +es thM have been taken.
It is understood:by this A J&Ri"Oct Obligated to
svWly
will be bid to OWNER at d labor rates of$ "��..perhonor.any
Pam' Any addiRiOAW labor thm
gay service between regal ins will be
business hews,a8er 5:00 PM and an P'°"d m rtaes for labor doting
minimum four(4)hours SAS t�anal One.hsl4 and dwtbk time on Starch
causie
� o Parts plus au�age and travel charges, Th 3 S°dnT hohdaYs.not include c to m does by of akering the e * . J&R shall no be ab accidea�t,tlu:8, ofa tbind Petsou.l req of naturt,cbatro4*tuding st&es and labor dbputo L sespOns�le for ihue to render the service f causes beyond
its
N cep SL
MA MV
rya.V*4n%m
WI5E ,, MEN 5T1 LL SEEK ' ' H I'-M ,-
1t t• �,I� a: ? '
-r; •r`'""iy '`�t� 4�♦ � n�" J ,Y,.�� Po.' -ti a +r .. ir.��t '� i �b,�'� � * r ..n '
t
I'f�/ r j+t � �� � .4 \. _f�„ ss wt 4a r� .��. �.- S � e�.ks.:•: • ,. - ,
' v '�.�« � .+ ' �1 ��S r+Yr. ��' >r•�C. .. ,.1. 1 � {' - .-y .. ,.
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WE HAVE SEEN H15 STAR IN THE EAST,AND ARE COME TO WORSHIP HIM"
MA17H E W 2:2
Mar-10-00 01 : 58P P.03
OWNER understands and agrees that J&R is not responsible for special or consequential damages, including
loss of time, injury to person or property unit or equipment failure.
This agreement is not assignable without the consent of J&R and will remain in force until canceled by either
party through written notice.
This is a one-year service contract to be billed annually in compliance with State regulations. Failure to comply
will result in cancellation and nullification of any warranties.
MANUFACTURER MODEL 1�C , SE R ALI NO. LOCATION ANNUAL RATE
Bio-Microbics Home FASTED Hyannis. MA $350.00
EQUIPMENT OWNER J&R Safes& Service-, Inc.
*Signed by: Signed by:
Charlie Markarian 44 Commercial Street
*Address: Raynham,MA 02767
Lot #9 Greenwood Avenue Tel: (508)823-9566
Hyannis MA 02601 Fax: (508) 88(}-7232
*City: State: Zip:
*Telephone: Effect Date of Agreement
fllnent Testing
Effluent sample taken(1)one time per month for the first 6 months and quarterly thereafter, delivered to a
qualified testing lab for evaluation and with results being sent to State and local Agencies as well as the owner.
Owner is responsible for providing acceptable access to effluent to enable a grab sample to be taken for
laboratory testing performed:
PERMIT.
'(PLEASE CHECK ONE) ( ) GENERAL ( ) REMEDIAL ( X) PROVISIONAL
*SPECIAL CONDITIONS PER LOCAL BOARD OF HEALTH (Y)or(N)if yES,please attadwd copy of permit
( )BOD5.TSS,pH (X)BODs,TSS,pH,Nitrate/Nitrogen,Ammonia,TKN ( )Other:
Coat for testing $210.OQ/visiq
Operator assigned: William Everett *Engineer: e Engineering'
Telephone: 5U 243-9566
*Approval for Effluent Testing
Homeowner's Signature
I
IWi5E MEN STILL SEEK HIM
` , a •��, rilr�dlJi�f f •
14.
21,
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"WE HAVE SEEN HIS STAR IN THE EAST,AND ARE COME TO WORSHIP HIM'
MATiHEW 2:2
Mar-17-00 10_47A Atlantic Glass Co P_01
I
Match 17,2000
Nicholas CaraDomm Jr.
15 Bryn Mawr Ave.
Worcester,MA 01603
Tom McKean
Health Dept.
Town of Barnstable
Hyannis,-MA 02601
Re:Lot#9 Greenwood Ave.Hyannis,MA
Tom,
lam tlnteutly the dead holder on the pmpeny currently up for a septic size increase review,on Monday
M mb 20'b.
According to my daughter Ludo Marlcarmk she and Charlie Mmiotirian are requesting a permb to increase
system.to a 3 bedroom opacity.
I approve this mews,with the wdwgwmft that this is only a permit,not a toquest to install this system
now.
Regards,
a
icatolasCa=D&m Jr.
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SOIL TEST P-6182 DATE: 10/21/86
WITNESS: S. MURRAY —� l
#1 ELEV 21.6 +
0-12" A,B TOP&SUB
\ DRIVE
12-12" C MED—COARSE SAND I
NO WATER ENCOUNTERED 3.00
PERC RATE <2 MIN/IN ', I 5.00
6.40
DESIGN CALCULATIONS T 1
NUMBER OF BEDROOMS 3 j 30.0 3. 0 9.90 0
GARBAGE DISPOSAL UNIT UQj ALLOWED SCALE: 10=2(Y
DESIGN FLOW '
V8L 'T46.4
3 BEDROOMS x 110 GAL/(BR-DA)=330 GPD•
0.00 �o
REQUIRED SEPTIC TANK CAPACITY (MIN)1500 GAS, ~''
ACTUAL SEPTIC TANK CAPACITY r' t o p�-A OF
1500 GAL 10. 0 s
LEACHING AREA REQUIREMENTS =�03 eFRINAR0 y`ti
--BOTTOM 2�00 2 JNo. 0078
4�Z4 GAL/(SF—DA) \ L No.3GG78
--SIDE 04 GAL/(SF—DA) ` \ 9ARCH-MARo C
LEACHING CAPACITY
c F ,
((30'xi 0') + 2x(30'+10')x2') w
x0.74 GAL/(SF-DAY)= 340 GPD
RESERVE 340 GP
6,� MAX ` . .
2.00 10.00
HCE
1.00.' MIN, 3.00' MAX
25 3" SEEDED TOPSOIL, 2% SLOPE
0.17 LEVEL 30.00 MIN 2" PEASTONE
29.5j 732.00 MAX
29.25 29.00 ,_. . r 29.00
28.87 I` 28.70 - c o o �.: aa 3 4" TO 1-1/2 WASHED
DISTRIBUTION BOX 28.50 - r.. '
tjDB-3 H-10 `�'` "�"'; '`'""x� .�'` ' '_�,,• STONE
..
WATER TEST 26.50
SINGLE HOME FAST 6" GRAVEL ON NATIVE SOIL OR 3.00 24.00 MECHANICALLY COMPACTED BASE
6.60
BOTTOM OF TEST HOLE 19.90
BJY 30x10 LOT 92GGREE/NWOOD AVE
SHEET 2 OF 2
1 INE DATE: F R —30—
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BARNSPABL&
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A Town of Barnstable REC. BY
\ SCHED. DATE: ���
Board of Health
367 Main Street, Hyannis MA 02601
Office: 508-862-4644 Susan G.Rask,R.S.
FAX: 508-790-6304 Sumner Kaufman,M.S.P.H.
Ralph A.Murphy,M.D.
VARIANCE REQUEST FORM
LOCATION
Property Address: 4o T 7 64eExA tVO D +1G _
� o� a
Assessor's Map and Parcel Number: O'7 a 9 Size of Lot: l , 001
Wetlands Within 300 Ft. Yes ✓ Business Name:
�Nt,o/ Subdivision Name:
APPLICANT'S.NAME:ICI��L>� � �/�fL/ Phone -Off - 77,5'S 7,3 3
Did the owner of the property authorize you to represent him or her? Yes V No
PROPERTY OWNER'S NAME / CONTACT PERSON
Name:C�r,`}I 5 /oTT�AA,,4 l/ Name:CA d/t' T/���/e .
Address: O . B a Y g r9}7 , #WANK S Address: f' 6 Uk C3'd-054-7
Phone: ]7S— S,7 3 3 Phone: S 3
—7 6 v
VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed)
-3/to cm 6-1 C91ZA
A11r1Z &6 La1tDi�v6 G/�ir�hi�Ns
APO rRz7h ?71 e Tn&uN
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inv
5-!f-A C- � Ws 716 330 Go /5
PChec list(to be completed by o ice staff-person receiving variance request application)
Four(4)copies of engineered plan submitted(e.g.septic system plans)
Four(4)copies of floor plan submitted(e.g.house plans or restaurant kitchen plans)
Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting
date at applicant's expense(for Title V and/or local sewage regulation variances only)
Full menu submitted(for grease trap variance requests only)
Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same ownerAeasee only],outside
1
dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed])
Variance request submitted at least 15 days prior to meeting date
VARIANCE APPROVED Susan G.Rask,R.S.,Chairman
NOT APPROVED Sumner Kaufman,M.S.P.H.
REASON FOR DISAPPROVAL Ralph A. Murphy,M.D.
Q:/WP/VARIREQ
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TEST P-6182 DATE: 10/21/86
'WITNESS: S. •HURRAY W I
#1 ELEV 21.6. ,
0-12" -A,B.` 'TOP&SUB I \ DRIVE
12 -12" • C MED—COARSE SAND
NO WATER ENCOUNTERED 3.00
:PERC RATE <2„MIN/IN 5.00
- I
6.40
DESIGN CALCULATIONS
- T1
NUMBER OF BEDROOMS 30.0 %3. 0 t9.90 p
GARBAGE DISPOSAL UNIT NQj ALLOWED SCALE: 10=20'
DESIGN FLOW '
V8L&ER IT46.4
3 BEDROOMS x 110 GAL BR
/( —DA)=330 GPD. 11 =° 0.00
1500 G
REQUIRED SEPTIC TANK CAPACITY (MIN) AS, \
ACTUAL SEPTIC TANK CAPACITY 1500 GAS t o `���� OF
'�SSs�,
LEACHING AREA REQUIREMENTS 10• 2 00 o EEP14A EE?dJkRD. tiG
--BOTTOM Q A GAL/(SF—DA) y JOHNYOUNG m
--SIDE \ \ p�c3
�Z4 GAL/(SF—DA) � ` �
LEACHING CAPACITY
CID
((30'x10') + 2x(30'+10')x2') w 4z
xO.74 GAL/(SF—DAY)= 340 GPD \ \
RESERVE 340 GPD \
6" MAX \
2.00 J_ 10.00 -
1.00' MIN, 3.00' MAX
1.25 3" SEEDED TOPSOIL, 27 SLOPE
0.17 LEVEL 30.00 MIN 2" PEASTONE
29.5 32.00 MAX
29.25 29.00 29.00
DISTRIBUTION BOX 28.70 28.50 ,;: �"� ,: : ' ;. 3 4" TO 1-1/2"WASHED
DB-3 H-10
�,cr.�:.�fir ��:. ` �: �r STONE
- WATER TEST 26.50
SINGLE HOME FAST* 6" GRAVEL ON NATIVE SOIL OR 00 3.00 24.MECHANICALLY COMPACTED `BASE 6.60
BOTTOM OF TEST HOLE 19.90 BJY 02/05/00
30x10 LOT 9 GREENWOOD AVE
SHEET 2 OF 2
Flu'e!aue' i 1 i . file` 10-21 86I - Till
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Entered in computer:
THE COMMONWEALTH OF MASSACHUSETTS Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
zippYication for �Digool *p5tent CottWuction Permit
Application for a Permit to Construct Upgrade U Abandon( ) ❑Complete System El Individual Components
( )Repair p ( ) Pg ( )
Location Address or Lot No. �� Owner's Name,Address and Tel
� ��Wo a AUE,tf r4Nnt�s C aec X a`�a�t�-F, �{ 4/lNNJ�,�s 7�3
Assessor's MaRPP4r 1
installer's Name,Address,and Tel.No- DIA�U4f)�eres�GiNE�NU 77S-O0 9
y�
Type of Building:
Dwelling No.of Bedrooms Lot Size UO sq.ft. Garbage Grinder( )
Other Type of Building 5. M E No.of Persons
Showers( ) Cafeteria( )
Other Fixtures
gallons per day. Calculated daily flow gallons.
Design Flout Revision Date
Plan Date Number of sheets
Title
Size of Septic Tank Type of S.A.S.
�1
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) Q 999 c3�
TOWN OF -
% UEPT
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afo3 e:a tf�5�d bn.site sewage disposal system
de 5 of the Environmental Code and not to place iliesystem in operation until a Certifi-
in accordance with the provisions of Ti
ca�e of Compliance has been issued by this Board of Health. Date
Signed Date
Application Approved by S o�1
� �
/�Application Disapproved for the following reasons
"�
c�ra nn
we d ✓ o(a ,ten
—PermitNo�---Gv,�" —gin -fie_ --!�/9� -- Date Issued -------------
THE COMMONWEALTH OF MASSACHUSETTS
^ BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded( )
Abandoned( )by has been constructed in accordance,
at dated
with the provisions of Title 5 and the for Disposal System Construction Permit No.
Installer Designer
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
E Date Inspector
4
r ---- ---
------- Fee
No.
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
=iopogal 6POUM (Construction 3permit
Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon( )
„ System located at
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
r
12 A-01
pF THE Tp� �O a DATE: / Z- 30 9- 9
M �999 FEE: � ��
Y iAMSTAS ; a, DEC
C 3 0
MASS
9� i639• ,0� 10oOFBARNSfABLE REC. B ./,V t
ATEDMA'�� o of Barnstable
SCHED. D
9 g oard of Health � {
Oro
367 Main Street, Hyannis MA 02601
Office: 508-790-6265 '" k ask,R.S.
FAX: 508-790-6304 'aa° an Sumner Kaufman,M.S.P.H.
ft&dg2�'0 Ralph A.Murphy,M.D.
VARIANCE REQUEST FORM
LOCATION (�
Property Address: LET 7 6AE`/(oLllacjl7 41ZE l��4AI N z ; MA
Assessor's Map and Parcel Number: L;2 9 '" g y?• Size of Lot: O o'/ S. •
Wetlands Within 300 Ft. Yes V1 Subdivision Name: /
No
Business Name:
APPLICANT CONTACT PERSON
Name:CMMIE S MCI RS` 14^/ Name: $
Address:F--a • BoK a-a} IANI S Address:
Phone: 775- .57 33 Phone:
FAX: FAX:
VARIANCE FROM REGULATION(List Res.) REASON FOR VARIANCE(May attach if more space needed)
-yo e aA47-Atl e r %77Rc-C 3&P2061" ,pfrz-'fr-
3 to
CIiorcklist(to be completed by office staff-person receiving variance request application)
Four(4)copies of plan submitted(including septic system plans and/or restaurant floor plans)
Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting
date at applicant's expense(for Title V and/or local sewage regulation variances only)
Full menu submitted(for grease trap variances only)
ariance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals(same owner/leasee only(.outside
dining variance renewals(same owner/leasee only],and variances to repair failed sewage disposal systems(only if no expansion to the)uilding proposed])
)once request su m) east 15 days prior to meeting date
OL)'�q Pis
VARIA Susan G. Rask, R.S., Chairman
NOT APPROVED Sumner Kaufman, M.S.P.H.
REASON FOR DISAPPROVAL Ralph A. Murphy, M.D.
Q:/WP/VARIREQ
i
Became effective November 19, 1983, after being published in the Cape Cod Times.
Rr vised June '.3,1986. 17
i TOWN OF BARNSTABLE
Cf TM[Tp`
OFFICE OF
D'RI"�'$`'NAA& BOARD OF HEALTH
°o i639• 367 MAIN STREET
�oViso HYANNIS, MASS. 02601
REVISED REQUEST FOR VARIANCE PROCEDURE
The Board of Health, of the Town of Barnstable, Massachusetts, in accordance with, and
under the authority granted by Section 31, of Chapter III of the General Laws of
Massachusetts, adopted the following revised rules and regulations after a public meeting
of the Board of Health held June 3, 1.986. The original rules and regulations were adopted
after a public meeting of the Board of Health on November 1, 1983.
(1) All requests for variances from the Board of Health or State Regulations will be
submitted fifteen (15) calendar days prior to the scheduled Board meeting. The
variance hearing may be held at a later date if the Board has scheduled eight (8)
hearings prior to submission of the request.
(2) The variance request shall be made on a form prescribed by the Board of Health.
(3) Plans clearly showing the details of the request must be attached. Plans for onsite
sewage disposal systems must be prepared and certified by a Professional Engineer
or Registered Sanitarian for all new construction.
(4) No variances from 310 CMR 15.00, Title 5, of the State Environmental Code,
Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, shall be
granted for a new sewage disposal system, nor for an enlargement to an existing
system which increases capacity to accommodate additional flows except after
the applicant has notified all abutters by certified mail at his own expense at least
ten (10) days before the Board of Health meeting at which the variance request
will be on the agenda.
(5) A non-refundable filing fee of $ 0 is required. No fee will be required for filing
a variance request upgrading existing onsite sewage disposal systems unless the
rading involves approval of a building permit.
T s r ul tlon is o ffect on the date of publication of this notice.
ert L. Childs, Chairman
1
Grover . Farrish, M. D.
BOARD OF HEALTH
TOWN OF BARNSTABLE
6/3/86
Fee
a�
I THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS
0ppYication for Miopooaf bpotem Con!5truction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System ❑Individual Components
Location Address or
Lot No. t-0,t� t Owner's Name,Address and TWA
j
Assessor's Ma Par elG��r WO 8 MVE/ OWA � c /�}"� s �/ A
Installer's Name,Address,and Tel.No. signer's Name Address and Tel.No. S 8
LU H � t GENE N�
Type of Building:
Dwelling No.of Bedrooms Lot Size UO sq.ft. Garbage Grinder( )
Other Type of Building aD/h C 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;SA�.S.
Description of Sod 11
MUM
Nature of Repairs or Alterations(Answer when applicable) Q 1999
IWI
iH D€PT
Date last inspected: tP g•. '�
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore e rr, n=si"te 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 Board of Health.
Signed Date
Application Approved by _ Date
4 Application Disapproved for tyh`e-following reasons
^ Z_ ' f b co,1Se � �)DaY�J �S jon c� ..
?-F A rP G
Permit No. COj0Wha;n 7,4ie 3vfgq Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
(Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded
Abandoned( )by
at has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. dated
Installer Designer
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
Date Inspector
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
MiOpogar 6potem Construction Permit
Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon( )
System located at
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
Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES.MASSACHUSETTS
f01ppl°ication for Diopoear 6potem Conotrurtion Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
a
Location Address or Lot No. 0'r Owner's Name,Address and3el. �f
Assessor's Ma ar el Gplea/ WO b U��r`VIA �s C f� 5 rj��. /
Installer's Name,Address,and Tel.No. D signer's Name Address and Tel No. 7 S O0 .
�LL P)Ve ENG/NE€,�iNG N� 9
44 fftA-B0k Ra, tJAa
Type of Building:
Dwelling No.of Bedrooms Lot Size UO sq.ft. arbage Grinder( )
Other Type of Building 5� ME No.of Persons dowers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow ``r. gallons.
Plan Date -Number of sheets Revision Date �r
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
,
Date last'inspected: r —
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 Board of Health.
Signed Date
APPlication Approved by` _ . 1_._ Date
-> /�Application Disapproved for the following reasons, aN ' be ca o 52 `� p j S o�►(
)to,al sIt2 jacaleck -.n is-�c'a Sp Q d , �A
— 1hArU 6M , draOM'S �c nropas;cq .. AA s UJ&4l C_44a i�.i��� a
Permit No. �^�" rd 'n �''�e �0/99 Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certif irate of Compliance h
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( )
' Abandoned( )by
at has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. dated
Installer Designer
The issuance of this permit shall not be construed as a guarantee that the system will function as designed:
Date ,i` Inspector
---.------�=------------------ ------Fee----- -_ ..
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLEs MASSACHUSETTS
'Wi0pogar *p!5tem Con!6truction permit
Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon( )-
System located at
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: t Approved by
' ?,er�� fix.,;io-- •r���i+i�;3�+���,.:�-