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Home My WebLink About0007 ORR'S AVENUE - Health 7 ORRS AVE., HYANNIS A — I o �llll J�aKY��Oco� m UPC 17734 No.2-1_R t� HASTINGS.UN �AAll R� c J l Y � \\ � v \T J I //� � o •� J '� 3 S J G � � �. --� s � e ,� ,� 0.1? jajl:�WN OF BARNSTABLE LOCATION 7 D�.4�= �ye SEWAGE # 9`" tS 7 VILLAGE -oVVI-S _ASSESSOR'S MAP.&.LOT INSTALLER'S NAME&PHONE NO. 64 S'e r, i 21_n6 SEPTIC TANK CAPACITY _- LEACHING FACILITY: (type) In4 7-QA S' (size) rr NO.OF BEDROOMS B OR OWNER � � PERMITDATE: !9--,?— COMPLIANCE DATE:/Z,-X— .:Separation Distance Between the: Maximum Adjusted GiWfidwater Table and Bottom of Leaching Facility Feet Private Water Supply Wei;,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 lS#ching facie Feet Furnished by �'`� t �J w I No. g® Fee C7 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipplication for Migpoar *pgtem Con!6truction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) complete System El Individual Components Location Address or Lot No. "? v aA5 P4I -e_ a.` Owner's Name,Address and Tel.No. ' Assessor'sMap/Parcel a o—0! L_�� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. (V+,0-e-0 Pa e- P`Q\C 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 �0 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title _ Size of Septic Tank I',� — 1-�*CT( � Type of S.A.S. L- Description of Soil �/( tt g Au� Nature of Repairs or Alterations(Answer when applicable) Ct _ ij r C h C' Tc ,-07-, IS (( f 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 �althh. al Code�andnot�toplace the system in operation until a Certifi- cate of Compliance h ssue y and f Signed Date Application Approved by Date Application Disapproved for the ollowi g reasons Permit No. �f Rae Date Issued No. r��- � Fee C7 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: (� Yes j` PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ZIpprication for Migoml ip`�temn Construction i3ermitY Application for a Permit to Construct( )Repair( )Upgrade(. )Abandon( ) complete System ❑Individual Components Location Address or Lot No. `7 v � � Ir".e Owner's..Name,Address and Tel.No. Assessor's Map/Parcel aG U_0/ Installer's Name,Address,and(Tel.No. r' Designer's Name,Address and Tel.No. Avg 0--c-0(2-e- 5-ept\C� 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 73 gallons. Plan Date Number of sheets . Revision Date Title 4 Size of Septic Tank I a t c Type of S.A.S. ss fn r,-. co (a�•� c` g-< (. Description of Soil A me S A r� � f . Nature of Repairs or Alterations(Answer when applicable) 6a1.9-0 /5 S'-e( ��`' 0 -K7- i / T + ® ` 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 haste een-issue oard f Healt . Signedi- Application Approved by Date Application Disapproved for the llowi 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( )Upgraded Abandoned( )by ` --� at in CC-_ has been construct d in accordance with the provisions of Title 5 and the for Disposal System Cons ction Permit No. ��i_ ?�7� dated 1,97 Installer Designer The issuance of this permit shall not bad nstmed as a guarantee that the syste. i flitnct n s led. Date Inspector --------------------------------------- No. _ Fee r- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mtg;pozar *pgtem Conztruction Permit Permission is hereby granted to Construct( )Repair( )Upgrade(L)Abandon( ) System located at "-7 t3 L24G A _ and as described in the above Applicatioji 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 1i6i99 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 DESIGNED PLANS) I, hereby cert' that the application for disposal works construction permit signed by me dated `� _ f concerning the property located at —7 Q a 0 S meets all of the following criteria: The failed system is connected to a residential dwelling only. There are no commercial or business mouses associated with the dwelling. / - The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. •/There are no wetlands within 100 feet of the proposed septic system here are no private wells within 150 feet of the proposed septic system • /There is no increase in flow and/or change in use proposed •/There are no variances requested or needed. •/The bottom of the proposed leaching facility will not be located less than five feet above the ./ ma:amum adjusted groundwater table elevation. (Adjust the goundwater table using the Frimptor 1od when applicable] 1f the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14) feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation (using GIS information)_ B) G.W. Elevation 00- —the i'vfA'(. 1iigh G.W. Adjustment . D97ERENCE BETWEEN A and B SIGNED : DATE: / tl �� Z (Sketch proposed plan of system on back]. q:health folder.cert rd � � � � o'G� �J -�� o 8 a _. � � f 44 0-Rr�,$ .0v�TOWN OF BARNSTABLE LOCATION i D fd fi S .4cft _ SEWAGE # 9 31— i?61_ VILLAG . ASSESSOR'S MAP &LOTe9� INSTALLER'S NAME&PHONE NO. 44 Z4 C,.f n /,Z, SEPTIC TANK CAPACITY LEACHING FACILITY: (type) I-y lel 7-oA S' (size) !Z ,�(°-2— NO. OF BEDROOMS BUMMER OR OWNER PERMIT'DATE: COMPLIANCE DATE. .Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Welland Leaching Facility (If any wells exist Feet on site or within 200 feerof leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of le Ching facili Feet. , Furnished by r F1 ,/2rL.