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Home My WebLink About0088 CINNAMON LANE - Health 88+CINNAMON I,A�165 023 OSTEI�VILLE A = t u o TOWN OF BARNSTABLE LOCATION �l&ZV-4/YIt1 A/ L AEI/ _ SEWAGE # VILLAGE l'7.S-1-E i (/1 ASSESSOR'S MAP & LOT Y INSTALLER'S NAME&PHONE NO. e SEPTIC TANK CAPACITY S a 0 `LEACHING FACII.ITY: (ty ) IA/ 'i/ T/?i*/Q (size) 110.OF BEDROOMS a BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: 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 . a - __ - _ - � ' 'r � � ,. ,y � _. �- v .� I �3��3�, �. No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIpplitatton for Miopool bpotem Conotruction 3ertnit Application for a Permit to Construct( , )Repair( )Upgrade(t/Abandon( ) "Complete System ❑Individual Components Location Address or Lot No. C-1 NL1 C.WnO N Pr pc,t� Owner's Name,Address and Tel.No. Assessor's Ma /Parcel ` p Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. y - �hr'o Type of Building: j Dwelling No.of Bedrooms 7_ Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures 3 Design Flow 75 C) gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank \5(1D 5:) Type of S.A.S. t4k CAA CsaAGCIT!gt E!:�-4 Description of Soil ` CQ'A 2 b e --IYWAO Nature of Repairs or Alterations(Answer when applicable) _—X%A,Co-M(( vs op Se. cu o'er� ,( ��C,�v�.��Q S w Vets dam- 5��rJ r 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 ha ssue o Health. Signed Date 713 Application Approved by Date 7 a / 7- OCj Application Disapproved for the follo ing reasons Permit No. `�'t1l� I�`� Date Issued No. ocQ3b (J� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ZIpprication for Migool *pgtem Congtruction Permit 4l Application for a Permit to Construct( )Repair( )Upgrade(t Abandon( ) `ViComplete System ❑Individual Components Location Address or Lot No. t tiw p.tAo N it 051 Owner's Name,Address and Tel.No. t Assessor's Map/Parcel �, 0 d \1 t tis Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. r;a\-p-,, p-ei 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 D gallons per day. Calculated daily flow 3 yC1 gallons. Plan Date Number of sheets Revision Date - Title Size of Septic Tank 1 S c)4 Type of S.A.S. `�,ky\CA oc�C'I Description of Soil \ Cr-)VA r2 S-C-- C✓;�,IJ2 i 14ature of Repairs or Alterations(Answer when applicable) t< kAyucNc,tl S ar-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 Environmental Code and not to place the system in operation until a Certifi- cate of Compliance ha e�issue�yB 9 Health.Sign Date 7�J Application Approved by Date - /7- c5�, Application Disapproved for the follo ing reasons Permit No. 249AG - if C_S� Date Issued —————————————————————————————--- —————— a THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded(V--) Abandoned( )by !V1 n G An l:-:- S�10 t (i at 00 X `^V_C'- O-)TEt2 `, has been constructed in accordance with the provisions of Title Sand the for Disposal System Construction Permit No.JQX- !X1,S_ dated Installer Designer The issuance of this e •n shall 'ot e c.nstrued as a guarantee that the s st ^p tl ,�j g y 'fil�function as designed.run I�Date t(t� Inspector C1/( // 0 -- -- tt__,--------------------- No. 000— J / Fee 1:�o THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Miq;pogar 6pgtem Congtruction Permit Permission is hereby granted to Construct( )Repair( )Upgrade(Abandon( ) System located at �G� C kU-y-C-"C' -- u P 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: 7 7- A) Approved by _ 1 1/6r99 j NOTICE: This Form Is To Be Used For the Repair Of Failed Septic temsonly. - CERTIFICATION-OF SKETCH: `�� .APPLICATION FOR DISPOSAL WORKS CONSTRO:T ON'PERN__Qt ;, 'TT-gOUT DESIGNED PLANS) her e+cv ce:tiry that the application far d' . , isoosal works construcrion pe.-rut sio*ie� by me dazed r/'/�01) conce,--, inQ the prop etry located at V�,e,- dtav,_ v27(— meets all or the following c:-itena: � T"ne failed s;sent is tonne-ed to a resi ' ' o aeana!awelan,oniv, i hate are no cZ;mmerC;a,or business e uses asscciated with the dweLns. V The sail is classified as CLASS 1 and the percolation rate is less d=or e� goal to j rrunutes oe:into. T • a aer e are no wetiands wzrhin 100 fe"of the orocosed s=ic s�se n !/Tnerc arc no orivate wets within lf0 fee;of ncc orocosed septic srsc:n Tnerc is no incase in [low and/or change in use proposed �Taere are ao variarica rc-uesed or needed i ne I boaom of the proposed lcacain;iacliry wiil not be located less than five Eec;above the ma.,dmura adjusted—oUndWaMr table e!eradon_ (Adjust the goundwater table using die Frimucor ethod when applicable] if the S.A.S. will be located with 210 e :of an-r vegetated wetlands. Lhe c.oaorn of the proposed lave wing a Hit. will net be locate an!ss th .'cureea(1 4) tee; ,hove Lhe nz cimurra zdius ed zoundwater table e!evadon, Please comolete the followin;: A) Too of Ground Sur ace =:ration(using CIS iniormacion) ` 8) G.'N. Ec acion -the H-igh G.`,V. Adjusrnent , ! _ -1 a and 40 r D a:i c: �J y (Sketch orocosed elan of s.sem on cac'1:1.. �� .0 •�, 9 J •. �', ,• i � '� r .� \� ti • � ; - � ti 4