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Home My WebLink About0398 PITCHER'S WAY - Health 398 Pitchers Way 290-018-001 Hyannis ° I a TOWN OF BARNSTABLE LOCATION baou SEWAGE # 17'3 �f VILLAGE ASSESSOR'S MAP&LOT . vat INSTALLER'S NAME&PHONE NO. V.t-.=V4v SEPTIC TANK CAPACITY I !$--n o LEACHING FACILITY: (type) ,t (size) o X LJ X NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: `Z-;3® - 7 -7 COMPLIANCE DATE: 9 7 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by- .. , 61 o Z� J � No. Fee .6,0 `THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pplication for Mgogal *p$tem Con5trUCtion 3permtt Application for a Permit to Construct( )Repair( Upgrade( )Abandon( ) El Complete System El Individual Components Location Address or Lot No. �� p/C/l//j S I-dig wner's Name,Address and Tel.No. Assessor's Map/Parcel �o /t G� Installer's Name,Address,and Tel.%No. J Designer's Name,Address and Tel.No. �iLn�l fferoo 0tcxx /� 2S!o Ce),6AILA/ /Iu Type of Building: Dwelling No.of Bedrooms Lot Size ,P4Y/9 C sq.ft. Garbage Grinder( ) Other Type of Building..��_CWONo. of Persons / Showers(/ ) Cafeteria( ) Other Fixtures Design Flow 2TO Z dJ¢lj_,� gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) V %A 4&d 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 by this Boar of ealth. Signed Date Application Approved by IZ,4 Date 7 LJ)7 Application Disapproved for the following reasons Permit No. Date Issued 7 -fo ...-...n.r.. ,a ,.+�?'n,... _ s �..-.r.....-s - ... ,' -i - T. y •, -m. :r..^f r... .r4'."....-r.i ( +'.,Ci +q a.�i ^"z+ - � - i r/ No. Fee SHE COMMONWEALTH OF MASSACHUSE4� Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS 3pplicatton for Migogar *pgtem (Congtruchon Permit Application for a Permit to Construct( )Repair Grade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. -34?lf C Ih AT Aj (,I Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and el�No. Designer's Name,Address and Tel.No. '411PI&/Y/-)o V(C CA ILA( /? � P si/Z t1l Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) , Other Type of Buildin ACA)o No. of Persons Showers(i ) Cafeteria( ) Other Fixtures Design Flow 9120 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank of S.A.S. Description of Soil l Nature of Repairs or Alterations(Answer when applicable) oPee L. i , ! Date last inspected: Agreement:i `xy ;he 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 issu by this Boar of ealth. * n c Signed s �.�7 " Date / - �', Application Approved by t ' Date Application Disapproved for the following reasons Permit No. 7 �3 Date Issued 7 ~3U t 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 14C .f 6C a--t/ G/ J— has been constructed in accordance with the provisions of Title 5 and the for Disposal Syste Construction Permit No 7- ,�F dated7'—3O " 2 Installer Designer The issuance of this pe t shall not b�rc trued as a guarantee that the system 11 fu ction as designed. Date / Inspector -------------------------- No. ! 9' sely�r Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS lwigpozaf *paem Congtructton Permit Permission is hereby granted to Clos ct )Repair(Y Upgrade( /) bandon( ) System located at ! ! 9 w 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 must be completed within three years of the date of this permit. Date: ' .�'0— q 7 Approved by 1 CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONS'I'RUC"PION PERMIT (W HIOU'I'DESIGNED PLANS) hereby certify that the application for disposal works construction permit signed by me dated �� , concerning the a property located at ape ��%G, �S crjq�/_ meets all of the following criteria: • There are no wetlands within 300 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system • The observed groundwater table is 14 feet or greater below the bottom of the leaching facility • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. 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). 1 ------------ 1. (Z' se o c C� �d 0 r � 0 6� c: 13 q TOWN OF BARNSTABLE LOCATION SEWAGE # 7-3 .' VILLAGE ASSESSOR'S MAP& LOT INSTALLER'S NAME&PHONE NO. V SEPTIC TANK CAPACITY I sn o LEACHING FACILITY: (type) (size) 60 k LY X 2 NO.OF BEDROOMS a BUILDER OR OWNER �S_yr. ecd PERMITDATE: 3D 7 7 COMPLIANCE.DATE: a - 6 - 27 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) poet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Furnished by