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Home My WebLink About0121 EAST BAY ROAD - Health 250 WIANNO AVF4f L rr� A = 140 161 0 TOWN OF BARNSTABLE ►� SEWAGE # VILLAGE V,fffj-ir,11-1 ASSESSOR'S MAP & LOT/-/V/O INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY "Ti.a f.S�n LEACHING FACILITY: (type) 1 (size) e 7 X/.2 X _ NO.OF BEDROOMS 7 BUILDER OR OWNER e-e _ PERMTTDATE: -2 - _COMPLIANCE DA'IE: �3 1 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 s i C R lip -`. i No. Fee40 THE COMMONWEJ4LTH OF MASSACHUSETTS Entered in computer: f Yes j7C HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS plication for Migomf bpttem Construction Permit Application for a Permit to Construct O Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. c Owner's Name,Address and Tel.No. Assessor'sMap/Parcel MAO 1 1'� 1(01j dQ1 c% AL'8�T sc,Mu[_.2 �� Z�^�� 1 v i t._t-ts Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �A4T z_ 1,4 �w 14 C I7- A4A04 ST S--;_J o i �?01 Type of Building: r Dwelling No.of Bedrooms Lot Size 1,01 AG -1-4 Garbage Grinder( ✓r Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow ''� gallons per day. Calculated daily flow 5Sn gallons. Plan Date ,�1Ral1_ )o, Iggp, Number of sheets 22_ Revision Date Title C,FP &A7E5_vjL4 s MA. -5e-Ar�r C"=�� f64.t, n Iss-a& _3aXT� " 4YT- iNe— Size of Septic Tank '� eQ� J'Z �A gwr Type of S.A.S. 1-EA',*w 6iA,%4R�2r 1'Z' x 6-7' Description of Soil 5 Lt to M en)Un-, C,AN n 10`/JZ- Nature of Repairs or Alterations(Answer when applicable) `_w y 4,-0 -S-T_ 1 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 is a his Board of Health. Signed Date Application Approved by Date Application Disapprove or the following reasons Permjt No. Date Issued ��- TOWN OF BARNSTABLE LOCATION `l SEWAGE # VILLAGE_ ASSESSOR'S MAP & LOT)'/-)i I INSTALLER'S NAME&PHONE NO. Jai,, & //"•g �. SEPTIC TANK CAPACITY ';2 % I7 0 �1 LEACHING FACILITY: (type) I. _ (size) L'7 X/,2 X Z NO.OF BEDROOMS J j BUILDER OR OWNER PERMIT DATE: 9-„L,!'7 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 4' , 'Furnished by _ -7 G Al p {"�� - E 1140 001 d No. Fee �d Entered in computer: ALTH_.O THE COMMONWE MASSACHUSETTS - '� Yes P B C HEALTH DIVISION -TOWN UP BARNSTABLES MASSACHUSETTS 6lication for &.5pont *patent Cottgtruction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. II AL&W 4. -r4er?E5A Mc IZAF_ Assessor's Map el Mw i rAIACIT� QQ� alo Lz3k2�^ SCr-!u[..� �� XV3-pcl5o Gi C:rL✓�C.(..r Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 'Gr P-3l'L MAI>d S-r- GSi /lzf1-Cj13) Type'of Building: _ Dwelling No.of Bedrooms `D Lot Size 1,p 9 QG -scf>. Garbage Grinder( ✓) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow - 550 gallons per day. Calculated daily flow SSo gallons. Plan Date tr-lzic. )o, !elgX Number of sheets - 12- Revision Date Title MA. �;,cac-c I"=e� A°?zu, to,►g% _4,cra , i icya: b4c_ Size of Septic Tank '2200 -QL_ 12 4aqvmmrType of S.A.S. LE&g JG l4A#,Fi'62,5 Description of Soil T7I L1E t0 iU v� Unn. S!1 t4D IV`l F-'7 AB bf Nature of Repairs or Alterations(Answer when applicable) �w d '1`'�+le 1 r.� .��'"� +j (*_e t qc, y a.t.iw.P•h--f ✓�► v(w�r'vti- /52 A f- /Oo 01 aT/ S•T S 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 is e b is Bo d of Health. Signed Date Application Approved by Date Application Disapproved or the following reasons Permit No. Q�i1' -- G 3 0 Date Issued ------------` -------------------- ---- THE COMMONWEALTH OF MASSACHUSETTS .v BARNSTABLE MASSACHUSETTS Certificate of COMVIiance THIS IS TO CERTUZ. that the�n-site Sewage Disposal System Constructed(X )Repaired.( )Upgraded( ) Abandoned( )by t' I n h � 11 !L_�1 at i rn 4-(PAar) NA Qi > AA, �2-✓OLA -'� has been constructed in accorda e with the provisions of Title 5 and the for Disposal System Construction Permit No. `1�r��Zja dated .�/7 97. Installer Designer The issuance of this�pe} �'t hall not be construed as a guarantee that the sy m wil function as design / �jA Date ; '�/ I f �) Inspector 1f1 /V !1j 1(�`Jt� t v �rrL"eIV ————————————————————————————— r—--------- 47 ....� No. 4 a Z� Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS lwigoza[ *pztern Con truction Permit Permission is hereby granted to,Construct(X )Repair( )Upgrade( )Abandon( ) System located at La7T-. (Ejaorr) W I A-J l b A W_ 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 a t. n Date: -t Z Z�� Approved by m, �.�5 F F ! 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P 88q 4 UVS: Ma1?t-N 4, n9 15cAt- 4 o Il2s f Zo no ?eo?osrb 1 fY TVAT Tor= CT1 PLAI�1 t Y.E - 4zzwN CXMPL46 wtT;A -t-AE sltA—=ulJE A►>a LoT �. L,C. (? �� -z S A(Pe-nvmq� J;MBJIG{L 12WVI2rMGWr OF T149 IDYJNI OF MAP 114 o Pam- RoizTiok3 of Bq WJ 5TA P�L_l: A'* t 5 Q oT LOCATEDW I TU I N A 'SPt�aQl. FIsnD HAZ�It� ZONE, BAXTER,NYE & HOLMGREN,INC. C�iIQ /2ocx '� �r•S 812 Main Street ` Osterville, Massachusetts 02655 , �-FS�� t-Tzo t(.Dt PIl1 -190 JP Nor B li APPV CANT: P.6 eRT 5 H I EL.D.5 u6CD Tb GxTA15L-IHby PROp=T-/ LiQL94. of Z • ,. A r ;. IIae.Z° Ioo.S ) , I I � • / '� � •/ov.5� Zv��/o��lp ' AP 1 i UskLl LY lor.o tov 4 too v •S 144, 100.4 r Propos�� r 5. H.ouSC. o �` ?sy ^Its V n , >r t 1 n .. 0 h t , :7,��`� /J��G�� _ � V1 � �.. 3 yeas ,r�4 ...�• �C �/•1 ass / 0.7. SCALE 1 14Lo si