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Home My WebLink About0435 OLD MILL ROAD - Health 435 OLD`MILL ROAD, OSTERVILLE" I �L3 -0 � j 1d(mdi- -� TOWN OF BARNSTABLE » 4 LOCATION O �l<• d R�� SEWAGE # VILLAG fL6ZAL, ASSESSOR'S MAP & LOT' '_1a-"® �/ INSTALLER'S NAME&PHONE NO. t1 �� "o"�� SEPTIC TANK CAPACITY 1000 Get l -- LEACHING FACILITY: (type) 2aS0- ��ZOC- AV > X l NO.OF BEDROOMS i { BUILDER OR OWNER zAre014-4 PERMTI'DATE: ` '° 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 Feet } within,300 feet of leaching f ility) Furnished by 01 ---------------- F � ' &--iL! D�-D TOWN OF BAQRNSTABLE LOCATION OldW;// , ke--A SEWAGE # VILLAGE ASSESSOR'S MAP& LOT y32y O a •,. .. INSTALLER'S NAME&PHONE NO. LIW�e,04 SEPTIC TANK CAPACITY !D 00 LEACHING FACILITY: (type) 2-A? Gl9l�FIaGG� �Lra i ) S X`� NO.OF BEDROOMS // BUILDER OR OWNER 4150014 Arloly41L7 PERMTTDATE: F—12- 17 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 fapility)� Feet Furnished by Old M . w %k'k �r. A / y� No. 9 / 3 91 Fee `e✓'►/ `�� 111 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS u a � 01ppricatiou for �Digpoga[ *pgtem Cougtructiou permit Application for a Permit to Construct( )Repair(c_�pgrade( )Abandon( ) O Complete System ❑Individual Components / Location Address or Lot No. ra 0 o p//lf� Owner's Name,Address and Tel.N �� 9/ VfMal Assessor's Map/Parcel 05ra et Old W,11 �S/ Los"a ' / Installer's Name,Address,and Tel.No. Z/71._!1 //f, Designer's Name,Address and Tel.No. t/®S C/9/1 (/-G 641w w J�►�'1-G Type of Building: Dwelling No.of Bedrooms :5 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 Type of S.A.S. Description of Soil S'.ecy1 Nature of epairs or Alterations(Answer when applicable) DO4,01, / O 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 isiled by thi Board f He Signed Date l/- Application Approved by Date 9 Application Disapproved for the following reasons Permit No. Date Issued f ' 9 � f No. P // �5 �4� Fee ��c'G� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS ZIpprication for Oizpool *pgtem Construction Permit Application for a Permit to Construct( )Repair(4--y'Opgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 0 6'>y%lr R Owner's Name,Address and Tel.No �2�• 33 9/ 3� 05rr,-- Vi///Z Assessor's Map/Parcel / Installer's Name,Address,and Tel.No. Q 71—a `/� Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms :5/ 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 Type of S.A.S. Description of Soil Nature of Ftepairs or Alterations(Answer when applicable) l DO /. 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§Rej by this oard f Hea . Signed Date %—//-97 Application Approved by Date Application Disapproved for the following reasons .-7 l� Permit No. / R ✓ Date Issued ————— ——____————— —------------------ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance - THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed(e4lrepaired ( G)J&pgraded( ) «Abandoned( )by >G at = l/= has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer as-ealj 0Z.,e /4,4,rew Designer ,f afep4 12,e The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date 1 1 G( '1 Inspector 1- --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Miopogal *pztem Construction Permit 'ate Permission is hereby granted to Construct(BB )Repair(C_+-t*Jp rade( )Abandon System located at and as described in the above Application for Disposal System Construction Permit.The applicant recogTzes his/her duty to comply with Title 5 and the following local provisions or special conditions. PY g P Provided:Construction must be completed within three years of the date of this t. Date: Approved THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I M A� L DATA F , .r} { Ct)115�tItf',,11flil (1et1N11 p4gi.wtl by im'i1€iiF'tl ...y .,, /�.. Z i ��tif ��iii►A 1110 l�`ti�9f`t1j' 1('kfllt.c� tip _ 1 LE ,kG' 1� f31i �4 Ei11 fi 1llE' to11t+ 4fg t9II�f� 1. . � I I,�aM nits ilti t�iei9iiticl.v t4itltllO�i}fJ�'�rrl t>�ili��il�s��t�9�?�ili��}�It6ll V ,I}fcix flo,Itr jAvW tkolh tailildo 1 WWI 61 i6t8 iri P -4.06M I4 i=kms 6ci ptni1f0kt 6I4141A 1414, 1,04 oi.P'taI4 btldik 016,fie tolii of 114 WCJ1160, I'c A11,y 00 � a I�:er�itte.a►i t��ils9tict�41��1t1�4t�t1 gib Il�~3cfcl: - • C . 11t`131tI?fii I' C 100,fit MINI Att iJtliittllt- y-- ,x. Mitch 040,16 161i1 tit iltP Alai It 114 lleew j Itt§IitIla 1160,06,4 A t otlihol 11101 p1do ,� tiii�hltin shtitiltl be 4uhlitltt�d j ';: . ij�hcnilN Piidcl:cell �l e e O i hLA , s a 51YO �- ol'i