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Home My WebLink About0030 POND STREET - Health 30 POND ST. v�TElOWILLE A = 118 105 TOWN OF BARNSTABLE COMPLJANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY �'z- � (see"Orders") 5.Retail Stores - 6.Fuel Suppliers ADDRESS / 64h4,zR_ Sl—V Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors; OUT-outdoors) MAJOR MATERIALS Drums Above Tanks Underground Tdriki IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoli ,Jet Fuel(A) Diesel, erosene, #2 (B) Heavy ls: waste lotor oil (C) new m or oil (C) transmi sion/hydraulic Synthetiq Organics: degreasers Miscellaneous: DISPOSAL/RECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply4gjf�,eA4L4�' 24 O Town Sewer Public jr V ✓ ,''On-site OPrivate p 3. Indoor Floor Drains YES NO O Holding tank: MDC O Catch basin/Dry well , O On-site system " 4. Outdoor Surface drains:YES—NO- 0 Holding tank:MDC 7� - O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product &14441 2. Person ( ) Interviewe Inspector Date TOWN OF BARNSTABLE LOCATION a / SEWAGE # Zt,0 1. �a VILLAGE �(L �I:I-0 ASSESSOR'S MAP & LO r-/V INSTALLER'S NAME&PHONE NO. �y�tit'/' �/a� a... ��•a i�� SEPTIC TANK CAPACITY_1� LEACHING FACILITY: (type) Z `S'� (size) (1 k Z 5 Z. NO. OF BEDROOMS BUILDER OR OWNER PERMPTDATE: �� 7-01 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 7' , 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 ' VA � J No. � i 50 � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: v i PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Yes Yitation for 30i5po.5al *p5tem Con!Aruction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abando ) ❑Complete System ❑Individual Components Location Address or Lot No. 3 Q 0►v d s T_ ner's Name,Address and Tel.w-, No:f P Ab ( Gr4( h n e, `l% %. `Assessor's Map/Parcel3 p P o i,r) k T— d S 4.f u t /I `(, Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. l R v JJ s SC�/�°t�-k-I w� ti-(1t 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 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when appl able) 0 t u O no C !�� C. W-`rt e ok W,'t A y' o s+0 w-JL- 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 bee issu d by t ' Boar ealth. Sign Date AliA 61 01f Application Approved by Date—all Application Disapproved for the following rea _& Ob Permit No. Date Issued TOWN OF BARNSTABLE L- LOCATION SEWAGE # VILLAGE ASSESSOR'S MAP & LO-Vl -- INSTALLER'S NAME&PHONE NO..- SEPTIC TANK CAPACITY LEACHING FACIL=: (type) (size) 13/ Y-7 5" NO. OF BEDROOMS BUILDER.OR OWNER t ra d, r)"Y" T /!--I PERMFrDATT-7: Z 7 ii —COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Peet 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 Facil-ity (If any wetlands exist' within 300 feet of leaching facility) Feet ''Furnished by ........... Iq A (7" ' %%6 +.�.No. 5Q + Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes , PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS 2pplication for Dtgw6ar *pgmem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon ) ❑Complete System ❑Individual Components t Location Address or Lot No. 3 U 0 Yv O S T w er's Name,Address and Tel.No,/ `l Assessor's Map/Parcel Gv4fhn cel .... % a d l o a f �T' 0 4,(u r f'f'ti Installer's Name,Address and Tel No. Designer's Name,Address and Tel.No. ac� u rk-l k soh A f kr Type of Building: Dwelling No.of Bedrooms 3 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 Repairs or Alterations(Answer when appli able) �/w f 4 A.�� S`o� �A � S P ?�/c D C3 c� 4 7-cu o 'N y Co At 1 P M LGr C/y AM Ine A X i Ca S+0 w-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 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by th'�'Board-of Health. Signe I/ �� ✓ Date ( oI/ Application Approved by Date f,qr7 1 Application Disapproved for the following reas n .. Permit No. --� Date Issued --- ------ —.----- ---- -------� ---- ——— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Cam fiance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( ter Abandoned( )by ?O hj f 5ua.� f W C at c) O n1 P S7- has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ated Installer Q 0 ku � �� /" U e� 1 Designer � The issuance of this,permit shall not b coZ0, ued as a guarantee that the s ste will fu to so: The Date � / g Inspector y r -------- ------------------------ No. Fee V THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Di6po.5ar 6pgtem Construction permit Permission is hereby grant�o Construc (� R�e 'r( Upgrade )Aban. System located at L� JJ�f JAR/IJ � � A� �l 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 be co feted within three years of the date of this Date: nt Approved by y A �;Q. U6i99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. ASSESSORS MAP NO: PARCEL NO: CERTIFICATION OF SKETCH :k`+-D APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERIITI' (WITHOUT DESIGNED PLANS) v� .�ovlw e kV,, hereby ce:ary that the application for disposal works construction per-nut signed by me dated t �.(o�(� conceruniz the property located at `�U�o S meets all of u�le following criteria: • Tne failed system is canner ed co a re-sideaaal dwelling only. i here are no commerc-'al or business uses associated with the dwellins. • Tne sail is classiue as CLASS I and the percolation rate is less than or equal co 5 minutes per inch. • There are no wetlands within 100 Fee;of the proposed septic system v, • There are no private wets within 1d0 Fee;of the proposed septic s;stem • There is no increase in flow and/or change in use proposed • There are ad variarct requested or needed. • The bottom of the proposed leaching[acilitq•will not be located less than five Fee;above the maximum adjusted- undwater cable e!evaacn. (?adjust the zound-water table using the Frimntor method when applicable] • If the S.A.S. will be located wictt'_-50 of an•�Yegetaced we lands. the bottom of the proposed leeching faclicy will not be lccaced less than,Gureea(1-) Fee;above the ma-imum adjusted zoundwacer cable e!evadort. Ple2se complete the Fallowing: A) Top of Ground Surace =!cvaaon(using Gi5 iruarmaaan) —� v 3) G.W. Elevation -the H:;h G.',V. AdjuTmeat . _ l� D IF ERE-i C= 3 E,VEEti ?.and 3 SIGNED : j ��`� Da.i�: (Slcecch proposed plan of s.s;ern on bacl,* q:nuth;aide zcn - �a ! i ,a s k Q C: t iw t3 � r— C U c� r � � G