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Home My WebLink About0405 BRIDGE STREET - Health 405 BRIDGE ST('�STERVILLE A =093 058 001 II o i 4 TOWN OF B'ARNST'ABLE :.OGATiON ®�': 'L sa �T SEWAGE # 9 — 7-7 VILLAGE— 0 _nASSESSOR'S MAP & LOT 9 5 `Sf—001 INSTALLER'S NAME&PHONE N0. "`��y ("� ^"` Qr "``� 3✓,0 -y<-71 SEPTIC TANK CAPACITY U LEACHING FACILITY (type) �`"� '� (size) � iL PdO.OF BEDROOMS BUILDER OR`OWNER PERMIT DATE: j"/' ///g" COMPLIANCE DATE: �D Separation Distance Eeiween`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 D } P/ P o�rUDeQT/one I / F 1' l�,ti No. �7 Y Fee O / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for ;0igoga1 *pgtem Construction 3dermit Application for a Permit to Construct( Repair( )Upgrade( )Abandon( ) J<Omplete System ❑Individual Components Location Address or Lot No. �(�J �! Owner's Name,Address and Tel.No. 9dl ?� 77af—lQYU 05� 2✓!�� ,�?a� tGl�� Assessor'sMap/Pazcel Installer's Name,Address,and Tel.No. �(�C� 1?(1?y Designer's Name,Address and Tel.No. if g! 3 Type of Building: Dwelling No.of Bedrooms AW Lot Size I !,3 tlC sq.ft. Garbage Grinder(A/0 Other Type of BuildingW (ZW 7`✓lia* No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow ��d gallons. Plan Date �'" �"� Number of s4eets Revision Date Title Size of Septic Tank IS Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 ertifi- cate of Compliance has been issurd by this Board of Health. Signe _ _ v,t,r��L� -�� °— Date Application Approved by Date Application Disapproved for the fo owing reasons Permit No. p' g Z�:Z Date Issued 77 TOWN OF BARNSTABLE LOCATION SEWAGE # VILLAGE ASSESSOR'S MAP &LOT 9 5 INSTALLER'S NAME&PHONE NO. RP>,, ,q 9<L 7# SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) OF BEDROOMS BUILDER OR OWNER 3/,ovs ,7 e -fL3 u, PERMITDATE: COMPLIANCE DATE: OD 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 77- C&Cal O Jr, tj x 7 1 t 41 No. 7 7 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:. Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS - 21ppricatiob for Mt5po!6al *pgtem Congtructfott1pern t Apolication for A Permit to Construct(1/I/Repair( )Upgrade( )Abandon( ) C9�omplete System ❑Individual Components Location Addressor Lot No.YO S 6R/D6 5 T Owner's Name,Address and Tel.No.CU&f !/ 77t—/o$10 057r�✓/� Gf/ ` Assessor's Map/Parcel os� Installer's Name,Address,and Tel.No. `; , (��C� Designer's Name,Address and Tel.No. 9/ 31 Type of.Building: Dwelling No.of Bedrooms 4W Lot Sizet/' 1?j RC_ sq.,ft. Garbage Grinder(A/0 Other, Type of Building VDMI f✓I.I.N No. of Persons Y Showers( ) Cafeteria( ) Other Fixtures` Design Flow h gallons per day. Calculated daily flow® gallons. Plan Date " qqNumber of s eets Revision Date Title Lf�� 44&4L. ytJ 4 Size of Septic Tank Type of S.A.S. Description of Soil COA /L'G /1-CGLri —� f / Nature of Repairs or Alterations(Answer when applicable) 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 issupd by this Board of Health.. Sig ned' ,�/ G�"". v�'r�"�-J ��f�ti� Date ( d 0 Application Approved by- Date q-7 _2!5� Application Disapproved for the fo lowing reasons Permit No. J.�tp Date Issued . J. THE COMMONWEALTH OF MASSACHUSETTS ;�. BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( 1")Repaired ( )Upgraded( ) Abandoned( )by�X/i }� C" mte �U- at M S EW I M 57• (15Tt. ✓164-F has been constructed•nn accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 2F°'-,:Z 7' dated "` T, 571 Installer . Designer t The issuance of thi pe it hall not be construed as a guarantee that the sy will function as -esig ry Date Inspector f%�.� i N 1 fr �� No.—7 ' 7 Fee I CJ. CO THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS 'Wi5po5al *p5tem Corigtruction Permit Permission is hereby granted to Construct(V)Repair( )Upgrade( )Abandon( ) System located at Vas 13,e/t)G0, 57 057E AC ✓/t-LE 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 ermit. Y Date: �" ' C Approvedgb w"v ( A A 45 b , PATA Np Gar'ba3c Grwidcrr Daily Flow e x 110 9pd/,4,., 550 —_--- -... ----- ---- ._ 5c ile- 7anlc = 20- x zoo7, = �LQ�_.w 121 I .._ p PvcE� USlr 15oo G A L!_t+4 TA► V- LwRCNUJG 5VISTEM DE'SIG►+! Applecahorn Area Rciysrxr-Q 550 GPt3 : 0,74 GPD/SF 7-: 744 SF ApplAcahe,, Arca pcs-47ra CYY rIC-4, ? Dt>It>L,5 Be t6.n Arcat IZ' x h 2" > -744 Sr b r.,,n 3G'',„a c -r:. Total Arca 744 SF -- --- P<reel.+thorr Rsfie 5 w»+4/finch Z P�as � �qu_I%Z lJzs�tcd 51tr �`...Y _� GIAss -1 S.:IS w OF M 0,9 of— --- STEPFIE f-Al LY m .IOHN I 1 4 J I L ZZ No.30216 I�4 oq q 12 rvicr �r /STER ISZER FSSiONAL 5 7, Z-`1ci L L t !ZG— 3"rsw i - ---- - . 7,7 MST '• lnc�H Flt.c.p r. c es 7.5_ sox 7,q GAL. T'A•alc. 'r 1-%-,0 b L7evL�L,�PH'D PRAF��..ts Gcf-1s lhal The Pt`.pes<:l Uu.•e►itn�j jlte�u��i STTC r 5C:F'TXC - PLAN ►1<nen Cer,.FlyS Wr�fi 71ic 5+0telinc Ao-tc( Set- LOCATION 405 Z"rIcQIac St-r�e-k ►aQGtC Rce}vw wvcr is Of -The ►;n c..%n o - SCALE' A-. 1.1okk Di11"E= : 7 • 10 • 99 Bar-"stal6IG A.Ad aSs A PLAN REFERMIPIGF' LcG 41S463 � Spc.c�ni F1,�o�JR Nay a�Q, -c ASSL�550RS MAP : G3 PnRGE.L_: .58 A'PPLTCAAI"r. R.L. WW5Mt BAXTER NYE,14G. = fT��ay rKs/ �enr/ Svrvc er �� LAND 5vRUea'?0Rs - C101t-- 1=QG1"1CnRS Qs.-MQViL.LE, MAs-,Ac"OSET-rz C?ffs. s 3rem boilderlj5 !31eeuko1 ktet br- iusc—n Xe ILA Me, : q 5 13 3 - 10 - 0 FL.bOp zc ae cc t of L'' 3;. �� • Sr. Co o. 2W74 / �fG1STV ! WO v A`tN OF,IIgs �,STEPHEN cc rm No.30216 yFc.vi�� Q v' PC) T•a G/S TEOVAL RM` 3� /�°p�HoU'� �•�- ._ 25/ dbstN2�7.ort v �� g•SN '�iz.v W�ll '.� . woi O Tr 1'1 9.77- V 4)c r a tl Z.0 a I ;Z� TP-i D.E.P. F L nb el LOT 1® ` �e.o 49,;IL s.F �Vif,z O SITE f Sr.PTK PLAN, 405 Slrtct 6 1 SCALD t I 4d� SAY-TatR ; My, TNc. DATUM /V-G.v D. 5 �'vi I�G /nai55.