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Home My WebLink About0115 SAINT CATHERINE AVE - Health 115 ST. CATHERINE ST., HYANNIS 'A=291.068 i i I D I 9 TOWN OF BARNSTABLE� J7X1_1 LOCATION C CCfF C/o n a S°SEWAGE # VILLAGE ASSESSOR'S MAP & LOT 1 l 6 INSTALLER'S NAME&PHONE NO. (V-V A CeAX cSe C1 , 7 7,R-068-y SEPTIC TANK CAPACITY 1,114na LEACHING FACILITY: (type) y' lmf1 d" I iW.) 6 NO.OF BEDROOMS BUILDER OR OWNER I .- ,r PERMITDATE: -15 d :' COMPLIANCE-DATE:_.. Separation Distance Between the:.- FF . Maximum Adjusted Groundwater Table to the 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 • a C1S bo 4 r No. Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. Yes /PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE. MASSACHUSETTS , (pplication for Miopogal *r6tem Congtruction Permit Application fora Permit to Construct( )Repair( )Upgrade(Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.)' _cJ • f Z 1 Owner's Name,Address and Tel.No. ,.I9 /S Y �-N-b j �.. a E'.e.. Assessor's Map/Parcel)Q/_/t/ S Installer's Name Ad�dreLss,qjud Tel.No. Designer's Name,Address and Tel.No. 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. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of Description of Soil S Av— Nature of Repairs or Alterations(Answer when applicable) _T!�19TPAt IS;di) el a tn/ c�_13�T� v r 4t,C ion Zen urec_ L-Ai Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance the afore described on-site sewage disposal system in accordance with the provisions of Tit he E nmental Code t to place the system in operation until a Certifi- cate of Compliance has been ' e by this Bo a th. �, e3A Sign e Date ��!v Application Approved by Date Application Disapproved for the follo ng reasons Permit No. Date Issued - Q)1 i b � O f TOWN OF BARNSTABLE� LOCATION 1 c G I�� O��C/i A s,'SEWAGE # VILLAGE H 1. QAA iS ASSESSOR'S MAP & LOT a- / - INSTALLER'S NAME&PHONE NO. Mt ('� � � 7 aG y SEPTIC TANK CAPACITY —/S 6Qa LEACHING FACILITY: (type) y.,11 NO.OF BEDROOMS 3 BUILDER OR OWNER PERMITDATE: -13 -9 _COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the 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 / D No. .r Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yess PUBLIC HEALTH DIVISION TOWN OF BARNSTABLES MASSACHUSETTS Application for IDigpogal 6pgtem Congtruction Permit Application for a Permit to Construct( )Repair( )Upgrade(744 Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 5 v , V.51 Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address, d Tel.No. Designer's Name,Address and Tel.No. u vx. 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 �3 gallons per day. Calculated daily flow �u ! gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank U te / Type of S.A.S. C R C i Z [ Description of Soil M-C- Q S AV-0 Nature of Repairs or Alterations(Answer when applicable) . , ST PLA '�al (ice � n'r t C p u it l c° e c ✓C - C li✓ t It t l r !:_ Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance the afore described on-site sewage disposal system in accordance with the provisions of Tit olbe E • ' onmental Code a d ' t to place the system in operation until a Certifi- cate of Compliance has bee >issicreil by this Boar lth. SignetDate 2�70 Application Approved by Date x Application Disapproved for the follo, ng reasons a_ Permit No. Date Issued ------------ ----------------- -------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY that the On-site Sewage Dis osal System Constructed( )Repaired( )Upgraded�) Abandoned( )by �'Q--G L at ST t-V \N has on onstructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. Installer Designer The issuance of this e t shall not be construed as a guarantee that the sys em wil function as designed. Date Inspector No. �✓.J ----------------------_---Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Mizpaat *potent Congtruction Permit Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon( ) System located at 1 1 `ST r cN`y v- 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:Constructio must be�o�np. d within three years of the date oft ps�e'rmit. f/ �J Date: ! Approved by ni I nA !� V , --•��,mod_ NOTICE: This Form 1s To Be-Used For the Repair.Of Ffl.iled Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITH-OUT ' ENGINEERED PLANS) S j hereby certify that the application for disposal works ins the concern comtwlon permit dated signed by me da meets all of the located at 1 5TiC fo owing criteria: , • are no wetlands loeeted within iM feet of the proposed IeechMs flteltlty ere he private wells within 1.30 feet of the proposed septic system HIs ne increase in flew and/or ehahge in tm proosedale n v�ianas regtrestetl or heeded.proposed leaching fknky will be k+eated within 250 feet of any wetlinds,the bottom of the proposed leeching facility will not be located less than fourteen(14)feetiIwve the maximum adjusted groundwder treble elevatlert. Fr Please eem lete the fenewing. p A)top of Orennd Elevmlen(a wwIng to the Engineering bivtaion O.I.s.map) / G�B)Observed tfretlndwater TableEkvatlon(according to Rnahh Division well map ' �. !- DATE: C s L110EMED SEP11C SYV M RMALLER fN THE TOWN Of BARNSTABLE NUMBER,, i j [AtUete•1An1e11 pin or ow ptspsafad aret«n.Ain INh•lleu+eod ItAN11w p•eeeeea•e•rtlA•d Plat Olen. Ihia plat dmM be atbmMed). «AetIA�b1Aar aR i i qfj _ s / i d 3 1 d