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0041 OAK LANE - Health
41 OAK LANE, OSTERVILLE A= E i I i a 9 TOWN OF BARNSTABLE AL LOCATION / 0 Lai SEWAGE # VILLAGE ASSESSOR'S MAP& LOT 1' ®a INSTALLER'S NAME&PHONE NO. .,C RmP - SEPTIC TANK CAPACITY`oo 's LEACHING FACILITY: (type) (size) 't NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: `Z 0 - COMPLIANCE DATE: ? —31 -Q ' 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 1 � F 13 i3 �- A2 12�� No. � Fee t � THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for ]h6pont *pg;tem Construction Permit Application for a Permit to Construct( )Repair(,,/Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 0 A.� C�,(!�, Owner's Name,Address and Tel.No. Assessor'sMap/Parcel P J ` a\_� ro J�%LA->e4 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. F-)Od,I'Y v 12vbaA-s 2 0 92akx+e ✓ let)ad 44- a In v\is 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-31-� gallons. Plan Date Number of sheets Revision Date Title _ Size of Septic Tank 5]V?4_4_ 71 Type of S.A.S. Description of Soil Nature of Repairs orjAlterations(Answer whe ap Iicable) 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 o the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been ' th' aard4f4WaUb Signed 7Date T7 Application Approved by Date —i c. Application Disapproved for P follo ' g reasons Permit No. Date Issued No. V (f/ FeeQ� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pprication for Miopoar *p9tem Construction 30ermit i cr.,r Application for a Permit to Construct( )Repair( Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. ` Q P 0.6%.0 Owner's Name,Address and Tel.No. Assessor's Map/Parcel , O` Ot''��wC ra`s��'.�Q (J l Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. ROL-Al-eV K200etA- 5 2 C f e 1/ W o a A L, Cn lA to is Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No. of Perso s ! Showers( ) Cafeteria( ) Other Fixtures ` Design Flow Tic , gallons;per day.'`Calculated daily flow-3 -n gallons. ' Plan Date Number of sheets Revision Date Title Size of Septic Tank �� J,n w�-- //�. Type of S.A.S. Description of Soil Nature of RC irs oMIterations(Answer whe. ape licable) �-- U�G Cv � Cli nv L( rU7-of2. 1 r wti-C� k A,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 the Environmental Code and not to place the system in operation until a Certifi- cate of Compce has been IN d-ef Signed Date Application Approved by �,�.. Date "JL'a^ 7 c. t follo g Application'Disapproved for reasons a, r Permit No: Date Issued / THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS _ ..------ ertffi rate.of..0 p[iance }. THIS IS TO CERTIFY, that On=srt -Sewag Dtspersal System Constructed( )Repaired ( )Upgraded Abandoned( )by p i>A!'f Z* K f 0�j J at �� Q/1 �L LA 0t 67-;,f ry Le... has been constructed in-accordance with the provisions of Title 5 and the for Disposal System Construction Permit N G dated Installer Designer The issuance of this permit shall not be construed as a guarantee that the syste will function as designed. Date '1'` Inspector __ _ ---- No. �-- -------------------- -------Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS lwizpogal *p5tem CQongtruction hermit Permission is hereby granted to Construct( )Repair(✓)Upgrade( )Abandon System located at I CJ�i (.C� �'► U'�{ U I 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 com letteedd within three years of the date of this permit. Date: o o�-d - b Approved by 1019197 f NOTICE: This Form Is To Be Used For.the Repair Of Failed Septic Systems Only. 4 1 CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) + hereby certify that the application for disposal works construction permit signed by me dated "a concerning the meets all of the property located at a L La v� following criteria: V e There are no wetlands located within 100 feet of the proposed leaching facility (/e There are no private wells within 150 feet of the proposed septic system There is no increase in flow and/or change in use proposed There are no,variances requested or needed. of e If the proposed leaching facility will be located within 250 fee of any et wetlands,the b tmu ofthe ad'usted will be located less than fourteen( ) proposed leaching facility 114t groundwater table elevation. Please complete the following: A)Top of Ground Elevation(according to the Engineering Division O.I.S.map) 50 B)Observed Groundwater Table Elevation(according to Health Division well map) DATE: SIGNED LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system.Also If the licensed installer posesses•certified plot plan, this plan should be submitted]. q:health folder:cent .� �,�. •=--, �� e�.�' C� d � _ 1 NOTES ZONING DISTRICT: RC JOB NO. 1307-05 1. LOCUS IS A.M. 141, FRONT YARD 20 FROST.DWG.PARCEL 23. � SIDE REAR YARDS 10' 2. LOCUS IS IN FLOOD ZONE C ON FIRM DATED JULY 2, 1992. 13. OFFSETS SHOWN ARE TO THE CORNERBOARDS ON EXISTING BUILDINGS, OR TO FOUNDATION ON NEW CONSTRUCTION. C p,K LANL r 0 E a N 82'22 25 J J 79.95' N/F U %K KRUEGER - o z Q! J N I T 3 LO 11 , 020± S. F� . i I I 26.8' N r, i .... O it i i 131,6' ca Z II N EXISTING HOUSE Ut I NO_ 41 m 11 0 I ;'I I basement 28 4' JII LI J I i? :::.�:..::.. . .. I i I Existing bulkhead < i14' x14� j Deck b0 _ U fl I .p shower LL}.--- o z SEPTIC LOCATION FROM 7 SEWAGEAS=BUILT 98-169 /j N PROPOSED 4' N I P W ADDITION TO a DECK 101.555 W S 82'22 25 N F , ORBISON ASBUILT PLAN I CERTIFY THAT THE LOCATIONS SHOWN ON THIS FOR PLAN WERE MEASURED IN THE FIELD ON 8/01/07. . BERND A. & CAROLYN B. FROST P�,\\A OF 41AIS LOT 3 41 OAK LANE, OSTERMLLE, MA. QI' �c r AUGUST 23 , 2007 SCALE: 1"=20' JA ' A RONALD J. CADILLAC, PLS, IRS, P.C. PROFESSIONAL LAND SURVEYOR do REGISTERED SANITARIAN SURti P.O. BOX 258 WEST YARMOUTH. MA 02673 ©2007 BY R:J. CADILLAC (508) 775-9700