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HomeMy WebLinkAbout0496 STARBOARD LANE - Health 496 Starboard LRO.Vr- Osterville A= 167-025-001 TV,, QUI =1711 6�i 31, 'I,'N LOT T. 14"'1,1!. . 64,2. PAW N�' VIKOINIZZ K I �'s A MEE All"'�i R A "!Wl 010"Y'lap, IV I �q 'r , " '- . i� IV,��'9" - % ET.Z' '1' 6 '-", ,-�'t-1, 'ry, �4 A `� M% M k"0�0 q,r* �..hv 7 'U W yy gw-m-Arm- aw "a W It 1W., ".if, A W4 �11q"gmf'v go*;; �j' �'qx'A ,- C4�i�' % T, , ,W2 W Komi (N" �'!'011!1�1 "WO.P. 1 a iW1,11 44'._ �W4'p� f, - ' ''_ AW "A New MGM f. IWARM y� 5M Tv N ;O" 1 0111%14111 wi cgi X 6"', goo A A- '514 05104 jA j,:P 'A"I Owl", No VIA �'m 1 14 ANA 0 wif, 10 1, g);- ME "Y14 mftl N P 44,f UOM )"A' X711 �'i: 'su MAT Uff 'p;t p 4 ,�4 ' 'A '.f, 1�4Z 11" MON 'RIVAT"'i-1 A 174�' It CPO 9A .1 NW, 0" Tv kg Ing _V CA ; -0'- - ­� .1 ' "Y 1'g MIN 4A If i I w"Aw 1 Aqi K, Tat& w, I la, Al' !!ITT "MR 0001 4, '6 IiVl I V�j 011 out 41 1 �"V�1"' ty 1.3H "M fi '- - `,`''? , w Cv. V!.N Amw 1� IgNA j�g ;jg A Q!4 '%rj Kv gw g*vt P PAWN TOWN OF BARNSTABLE LOLA-!`ION q 7 4604 iJ LiWL SEWAGE # - a o VILLAGE O'S'l-59 021L ASSESSOR'S MAP& LOT /6 a - 061 INSTALLER'S NAME&PHONE NO. / / i fO GI�f�L` SEPTIC TANK CAPACITY /J 49 TigN k f LEACHING FACIL=: (type) (size) NO.OF BEDROOMS BUILDER OR.OWNER IYNS c� PERMPTDATE: Ll COMPLIANCE DATE: Separation'Distance Between the: Maximus&Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist or.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 Furnis!ed by Soo POI,[IVNI"V- 0 ao r (mil .�ivn�l� / No. Y Fee y THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 0[pprication for ]3igpoga1 *p.5tem Cou5truction Perron Application for a Permit to Construct( )Repair(Vru"pgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.��b �Q O -� Owner's Name,Address and Tel.No. Assessor's Map/Parcel t,�7 s 0c,-*�,oo Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: rr � Dwelling No.of Bedrooms T 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 I y gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank r� �¢ Type of S.A.S. et.�r�.fo 2S rn Description of Soil av Nature of Repairs or Alterations(Answer when applicable) rX-611,1 57-41I 5':­'D Q!//�1 •. S G.T a Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the fore described on-site sewage disposal system in accordance with the provisions of Title 5 of the E ironmental Code and.lri ;p ace the system in operation until a Certifi- cate of Compliance has Bo ea Signed Date 7 v' Application Approved by Date e.4-2 7 Application Disapproved for the following r asons Permit No. ® Date Issued No. 9/' d 0 r—,— Fee GJ d THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION-TOWN OF BARNSTABLE,MASSACHUSETTS Zipp[ication for Migpogal *Pgtem Congtruction Permit Application for a Permit to Construct( )Repair({/)Upgrade( )Abandon( ) O Complete System O Individual Components Location Address or Lot No.A�b Sj"A'Q to AQ.6 LN,05T, Owner's Name,Address and Tel.No. Assessor'sMap/Parcel (&7 _ DaS,Cbj GiIYNS Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. mi o-cap.e,�a0yt���-br�.S 14Y Type of Building: Dwelling No.of Bedrooms T Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow yyQ gallons per day. Calculated daily flow yyy gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank OZ Type of S.A.S. T w�i LTr�.lO 2S Description of Soil w Nature of Repairs or Alterations(Answer when applicable) 71'✓�ST►aa j���OD�QO�yf't,a.-K- .a L t_S TL P_e_ pr2ev Lyrt t�`.8.,� w. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the fore described on-site sewage disposal system 'n operat ion until a Certifi- an n'"to'"lace the system t o n 1 Code d�offitle5r nme to oin accordance with the provis p Y PCate of Compliance hasea . ! .gyp Signed Date 7 1 7 Application Approved by Date / Application Disapproved for the following r asons Permit No. - Date Issued BARNSTABLE, MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTI ,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( � Abandoned( )by at T = 2V 1 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 9 7-;)R;—dated Installer Designer jThe issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date r- / 7 Inspector ` ——————————————————————————————————————— No. �7 Fee yJ� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS ]igpool *pgtem ong;truction Permit Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon( ) System located at �1(/0 �S"T-ti(2-0),A 2 O �57�lLJ I E 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 Approved by O . LL 1.. Omit ceaapools. A11 solid Sch., k0 4n. PVG pipe,• x oI 2.• 1-1500 gal?oncO G tank, 3 . o Garbage B sp o sal - ?-Pumpb e u - g ch a� F f ar . U;p t a ., . Pvc P p$> For gain ca w J .a 2 Distribution a _Box _ n �a�asr ; gars. 7 invert,.,. t with a . two foot 3areaof atone Le_ching Q13,. around. 36 xSl ',Er Perforated `Pip; a is r un four. rachar within tha. gars, .. P. 1 COMMUNICATION RESULT REPORT ( SEP.16.2003 2:11PM ) TTI BARNSTABLE BOARD OF HEALTH FILE MODE OPTION ADDRESS (GROUP) RESULT PAGE ---------------------------------------------------------------------7------------------------------ 012 MEMORY TX 95087906325 OK P. 3/3 ----------------------------------------------------------------------------=----------------------- REASON FOR ERROR E-1) HANG UP OR LINE FAIL E-2) BUSY E-3) NO ANSWER E-4) NO FACSIMILE CONNECTION D Fee No. ETTS Enteredsn camputcr' �/ THE COMMONWEALTH OF MASSACHUS yBa PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE&MASSACHUSETTS 2pplitatf au for MOPO I &POttm C onotructian Permit Application for a Permit to Construct( )Repair(Vioupgrade( )Abandon( ) ❑Complete System ❑lndividual Components Location Address or Lot No.AJ b '-66"16 LA 1 Owner's Name,Address and'�l.No. Assessor's Map/P=01 7 - InstaUnr's Nme,Address,and UL No. L/LJ Desiper's Name,Address and'col.No. Type of Building: fl, Garbage Grinder( ) Dwelling No,of Bedrooms�,_ Lot Size��aq• $ other Type of Building No.of Persons Showers( Cafeteria( ) Other Futures Design Flow gallons per day, Calculated daily flow vq gallons. Plan Date Number of sheets Revision Date Title /I W Type of S.A.S. =* 'Try. ,BLS Size of Septic Tank L4 Description of Soil 0i Nature of Repairs or Alterations(Answer when applicable) ` L � � ti tr TlotP Isat insnaCted' No. ": - E �'w�-.. ' `_ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes _ PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Digool *p5tem Con.5truction j3ermit Application fora Permit to Construct( )Repair(�pgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.A b SrA e to AV-6`N. 05T0 Owner's Name,Address and Tel.No. Assessor's Map/Parcel. 7­; .Oa�,�'•Coj G11YN5 Installer's Name,Address,and Tel.No. ` Designer's Name,Address and Tel.No. • Type of Building: sr Dwelling No.of Bedrooms T Lot Size sq.ft. Garbage Grinder( ) Other Type of Building) No. of Persons Showers( ) Cafeteria( ) Other Fixtures i Design Flow �/!Z 19 gallons per day. Calculated daily flow ter' gallons. Plan Date Number of sheets Revision Date Title Y Size of Septic Tank />QD -!n�) _ Type of S.A.S. n tl Description of Soil cv _ Nature of Repairs or Alterations(Answer when applicable) ' Y Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of theAfore described on-site sewage disposal system in accordance with the provisions of Title 5 of the E vironmental Code and.,n' to place the system in operation until a Certifi- cate of Compliance has been-rssua'd-bill Bo ofIea Signed -'f Date Z/-CP?-�7 Application Approved by Date LJna 9?7 Application Disapproved for the following r asons Permit No. - a© Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compl-tance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired (- ) Upgraded Abandoned( )by at `A g& ST'14 e=Z6 A-'l Lf) (_Ar.i= 4D 5%it RQQ l l�e has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 9!?-:)6;L dated Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date - i5 c/ 7 Inspector No. ! Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Xigpo!m1 *pgte'm Construction Permit Permission is hereby granted to Construct( )Repair(VI"Upgrade( )Abandon( ) ✓' System located at �A&o S T'14rZ A,,)A-2 0 LGJ_ 2 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: Approved byV 3 1 TOWN OF BARNSTABLE LOCATION y 9�i '�Tr ��l�� � t`l�"�' SEWAGE # O 2 VII;LAGE OL-7 L K 1ZI IL ASSESSOR'S MAP & LOT Z! • OQ INSTALLER'S NAME&PHONE NO. /Y)i 'L /'� 5f/ �C— SEPTIC TANK CAPACITY / JDl'l�U1y 7 �' I LEACHING FACILITY: (type) (size) -, r // NO:OF BEDROOMS C71 "''491t� BUILDER OR OWNER G /yNS q PERMIT DATE: L4 a ' 'TT—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 or.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 ti ��t-1,A j l � , rig �� --- O N0 'ICI+.: "I'llis f�urnl iS to lac Ilsed for the Repair of I�s�ilc(1 Septic Systems Only C[ It'I'lhl 'I'IUN Ur_SIC.I�'I_Cf_I_ANU AI 'L14A'I'I N h NV(�IZK�( ( N,"1'R C 1'I_UN 1'1?It�9i_I' 0yrlI(()U_I_UL I�;NLU PLAN�1 hereby certify that the application for disposal works construction permit signed by me dated , concerning the " at �! L vS% meets all of the property located 1611ow.ing criteria: 'I lICI cal c no.vvetlands wilhiu 300 text of the proposed s l..a�rvl 5cw'1 • 'there are no private wells within 15o feet of the proposed septic system The observed groundwater lable is 14 feet or greater below the bottom of the (caching facility There is no increase in flow and/or change ili use proposed There are no variances requested or needed. DATE: SIGN.: (.ICI NSGI)Sf h'I'IC SYS'I'I;fv1 INS"I'AI_LI:R IN'TI-1E TOWN O1'BARNs'rABI-E NUMBER IAtlach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, Ilds plan should be submilledJ. ':ccrl n 1��� SCE ,S 1�-