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Home My WebLink About0070 ACORN DRIVE - Health 70 ACORN DRIVE OSTERVILLE A = 120 028 I ' I G e TOWN OF BARNSTABLE U-)CATION �0 ACae2,x Dt, SEWAGE # 260 y�6 VILLAGE �S�.e�'��t c ASSESSOR'S MAP & LOT d -,o INSTALLER'S NAME-&.PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) -SO°6'0( f'-r (60 (size) /3 x NO. OF BEDROOMS ff BUILDER OR OWNER PERMITDATE: 6 'a f� -of 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 ' c#ex 172 A e la 1 d f 0 13 T R.ti�c� a0 6 �6 � r y8P '� s'17 C,�P�G No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS ZIppYitattou for Mopogal 6potem Conotructton i3ermit Application for a Permit to Construct( )Repair(!/Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. '7 p A CO ea,-D e'v c. Owner's Name,Address and Tel.No. A Sv.i= 3,7/t-Y,3 Assessor's Map/Parcel /a a '70 A co P., r. Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �1`oec Q�,e-Cr��b(Cc 05�� 5�8- a8-�sssa 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 /5_6 D Ce( Type of S.A.S. a.—S00 6W Description of Sort Nature of Repairs or Alterations(Answer wen applicable) /,5 a ;�OC�� — A 04 a- 5606al C11AM Tk—eS of j/-6/1e 5ro s!p ,e'�-1 J we 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 iss by this Bo d of H th. Sign Q Date 3Z n c 2?-0/ Application Approved by Date Application Disapproved for the following reaso 4 �f Permit No. Date Issued UZ- N Fee o. _ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ' es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS - 0[pplication for Migpogaf &p.tem Construction Permitu Application for a Permit to Construct( )Repair U rade( 0'bandon ❑Complete System ❑Individual Components PP P (� Pg .� ( ) P Y P CO n -D Owner's Name,Address and Tel.No. Location Address or Lot No. "70 0 fi 051ell 0 1 Assessor's Map/Parcel l .� -rc) Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 3 tgcc_.11.5ic� 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 /5_0 0 CA Type of S.A.S. SOO 641 D Description of Soil: Nature of Repairs or Alterations(Answer when applicable) ;s%A/� /5 00�r�l MHO//sue— A.s7 2 ti a 5O(j 6AI. C An-1 2 — / Id Y 7-0 a C a� 1't Q,v i 51(;.I r-. to �e72 y Luc•//t Date last inspected: Agreement: .a 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 issu d''by this Board of H h. Signe _ o Date 3Z,n c j 0-cy Application Approved by Date Application Disapproved for the following reaso Permit No. ..� Date Issued---------------------------- ••�p, ` .✓ THE COMMONWEALTH OF MASSACHUSETTS ' BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS.IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired(Upgraded( ) i Abandoned( )by .5, C',►T. � .�I.7�c� G��l�4 h�,o% o �L'r/ at '7 0 o ha ee constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No ated Installer''L,a c e V(c c(j1 '.s Te r- Designer The issuance of this permit sl not be construed as a guarantee that the sy1w'll function as d ne Date r f Inspecto ---------------------------------------- No. a J Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS �• lwiopogaf *proem (Con6truction Permit Permission is hereby granted to Construct( )Repair Upgrade( )Abandon System located at '7 O A cu 2 n i)et i and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 andthe following local provisions or special conditions. Provided:Constructio //must be om leted within three years of the date of th Date: 1Aqr Approved by l l i •— ,i 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL AQ 1a� WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) n_� �8 I, l E-v c.e 6CL.ee U T, CQ , hereby certify that the application for disposal works Yo ~ , construction permit signed by me dated Sc.» d 7 -o , concerning the property located at ~/0 1)co 2A OS-1 c ,l l meets all of the following criteria: v- - This failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. F ✓• 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 �• There are no private wells within 150 feet of the proposed septic system 1 �• There is no increase in flow and/or change in use proposed ✓! There'are no variances requested or needed. y ,/• The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] • If 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) 10 B) G.W.Elevation +the MAX.High G.W. Adjustment. 1/Q t DIFFERENCE BETWEEN A and B -' SIGNED :�. /` C��^%� DATE: 1 U/1 e [Please Sketch proposed plan of system on back]. NOTICE Based upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in-the future without engineered septic system plans. q:health folder:cert �f �ff 1 oA. � _ , � O T ��a� S•�e n C c Cil R m ill TOW OF BARNSTABLE LOCATION 0 A Cu # )0 f- L�3 0.VILLAGE ASSESSOR'S MAP & LO : .INSTALLER'S NAME&PHONE No. �_Q_C__k(7,,S 4-( S E M. , C J., K:CAPAC /6-, e: P,)4—cr ..LEACHING'FACILITY:,(ty fP 9 6,P (type) (size) 13 x ze) -N - QFBED BEDROOMS R BUILDER OR g_WNF_R I. : PER COMPLIANCE IJA� M.F.FDA epara qn'Distance.36vwm'the. ,,; ' Facility axiihtim. Adjusted' Groundwater'TM6 tolhe cil Bottom ef. Private Water Supply Well and Leaching 17�1111ty (If any wells s exist on site o ityy,r:wi h200feeiorf leaching act Feet Edge of Wetland and Leachin g Facility., any wetlands e,xist:. within 300 feet of leaching facility): Feet Furnished by a,+_-'Y-C_ M:9 olj� )C 1.n 9 0 e TOWN OF BARNSTABLE A i Z® � ®Z'� -LOCATION ;f ZD A C 1Q" D A SEWAGE # 57,9" a �76 � LLAGE 0 SfeX IV6&e ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. J/9 AA A C o/41 igele t To)y SEPTIC TANK CAPACITY ZC, 6 0 r /190;r LEACHING.FACEL=: (type) IrZ, Q W C (size) 6 Cr A NO.Of BEDROOMS 3 ._. BUII,DER OR OWNER PERMITDATE: COMPLIANCE DATE: _ Separation Distance Between the: J 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 s J� \ i AID /