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HomeMy WebLinkAbout0057 TOWER HILL ROAD - Health 57 TOWER HILL ROAD OSTERVILLE a i i TOWN OF BARNSTABLE LOCATION eta cCt,', L-L 1� SEWAGE# VILLAGE j,�[�i ra i t LT ASSESSOR'S MAP&PARCEL $y— INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY.(type) I%?-keN (size) �{�-l�f:I�•��)C�- NO.OF BEDROOMS S" la C�4,,:LIJA`l 4A-t. C_V-A:0 t.IZJ OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility .4=b 3 Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) ai A- Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) /4�_ Feet FURNISHED BY_ t3ogroLOW, I [et-'_ 14-t a. r k� lo I � � i vs I&S` I0 0 - O p Bf3 33 7 No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in com4.t ,� � PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes appfitation for Misposal *pstrm Construction 3permit Application for a Permit to Construct( ) Repair( f Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. S7 TCy(.8x Owner's Name,Address,and Tel.No. JwU� ah - 94y cA,WeiL tl- -ass L1nco in�e Assessor's Map/Parcel / 9 115 9 - ;X,53 a I staller's Name,Address,and Tel.No.5©6.,7��' 93 9 Desig er's Name,Add ess,and Tel.No JW-533' 21" �r�slottt. Ctcrxson,lr�C �S�rx�4��r�-j R�' �i`c�l I?�, ( -'�t�Ci:nvlmmiY�etn'��5i i oaG hQ..- �= 9 isN A oas-317 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building Sc.►"m No.of Persons Showers( ) Cafeteria( ) Other Fixtures Cs 5djC80 0�z� Design Flow(min.required) cf6kO gpd Design flow provided gpd Plan Date q I 1 7;� 140a,0 Number of sheets / p`,Revision Date Title .vv�&tz QL �iP �21Y1 5 r)-T 14i 1 &ACn , 0 S bexplYl Size of Septic Tank 1+,26 i"at1 Type of S.A.S. .1 (H.-Pe,56&Qfflj(tomb LbQM40 AA VAX -VLO Description of Soil -Z& Nature of Repairs or Alterations(Answer when applicable _1490 1,SfycS 1 W>AisFrlX 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 not to place the system it operation until a Certificate of Compliance has been issued by this Board of Healt Signed Date Application Approved by Date 3 Application Disapproved by Date for the following reasons Permit No. 4 Date Issued -J N - No. t 1 4 Fee Entered in com uter THE COMMONWEALT ;0'F MASSACHUSETTS p t-`J PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS - Yes application for Misposal,OpSteiii Construction Permit Application for a Permit to Construct(-,r)!,'Repair(;) 'Upgrade( ), Abandon°(�)❑Complete System ❑Individual Components Location Address or Lot No.Jr Uf t/"�l�.1 >° Owner's Name,Address,and Tel.No. '2 f7V'9 SIEl' ... tl, jtvL i,�r✓L 3%C it,coIre1,40-2 %e Assessor's Map/Parcel j�'� '! . . `ZU = , !� sr�� 1 ;',1! Ca a Y a Installer's Name,Address,and Tel.No. `!")6,'71)/ ' cr3I`Y Desig er's Name,Addkss,and Tel.No: • j.�yr-I.�,��r'�t�r�sl-r •iartif:�r'+�M1t^`'�{S�;t�r�tt��t's.��1" �.Uio� 1?. �d7�—��`��.lwnv3ryzmil�t�'�rsl? d,.`�-'�'��ti.a.� rt'444.S�1d qua xbItA u4k1t 0,:+Gg 9 111A [J r Type of Building: Dwelling No.of Bedrooms._ �., 'ff, Lot Size sq.ft. Garbage Grinder( ) Other •Type of Building 1 CT1'l No.of Persons Showers( ) Cafeteria( ) Other Fixtures (5 J-),nJ Design Flow(min.required) gpd Design flow provided (F,f gpd Plan Date 13cL3 Number of sheets / Revision Date l �,9 Title c -tt 4v,-- Y}stil. 4e ,J+`t' par;-) eJ (UPS r i U C fG�'i>`!F 6 J r Size of Septic Tank (�;���l`xan��.{� Type of S.A.S. (hf aio 5i�aQJx 4 f11fXest110 r,,a Description of Soil �n 2 ,` Nature of Repairs oorrAlterations(Answer when applicable)'090 1506Ce&O K. I��A is�(; 7 0171 / �i�taa(YA4 �`1�/I �r6 ! //.��YPf,'�� •�' /cJ Jrf�•�3fr�s /� r f �.cr. ,1,tPa/J �tt..�° �lC .f.✓J�.Gl. .f?'C..C•� !°�?AAReifi.7�.� ,.�`Je',S�Ci .fd�J� fs/f�d P , 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 Certificate of Compliance has been issued by this Board of Health. f Signed Date - = Application Approved by Gig Date 3 ) _a Application Disapproved by Date for the following reasons " ;A: Permit No. �C,�`�✓ J �/ Date Issued f THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(X Upgraded( ) Abandoned( )by at 1'rl _AliM 40, 4 f4.)i lif.. has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ?'q ated /rid Installer �,E'j,l�}}�y ( ( ntl��ttt�1 FflY1. .Y1t. Designer JOB �nyUiP��JZfttS�ef,�Ll�Sie•�x,�.� #bedrooms . �(l .ra � t Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system will%f u J�tion as d/e�sign�ed. f Date 1� It ID Inspector �G1 (JI ✓ (t"�"" �t No. ' �A 'Ti - Fee THE COMMONWEALTH OF MASSACHUSETTS -PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Disposal *pstem Construction Permit Permission is hereby granted t Construct( Re air( Upgrade( ) Abandon(r ) System located at j 1 olwe2 /1 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must belcompleted within three years of the date of this permit. Date 1 /, ) J Approved by . NOV-24-2020 02:13 From: To:15087906304 Pa9e:1,'1 Town of Barnstable Inspectional Services i ! )Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 506-862.4644 Fax: 508-790-6304 Inst ller&Designer Certification Form Date: I �3 Sewage PermitN 07020- 3a ? Assessor's MapT.arcel J Desfgner: a?f2. � Installer: Address: '�/��'��'6��G Address: q.L On 00 r/1i was issued a permit to install a ate �n(installer) septic system at* 1 M, ©7' ' based on a design drawn by (a Tess I Q.. dazed 9 .►Z 6 QV. ID 121CIZO designer I certify that the septic system referenced above was installed substantially according to the design, Which'may include minor approved changes such as lateral relocation of.Ihe distribution bo* and/or,septic tank. Strip out (if required) was inspected and the soils were found satisfactory.' I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State&Local Regulations. Plan revision or certified as-built by designer'to follow. Strip out(if required)was inspected and the soils were found,satisfactory. I certify that.the system referenced above was constructed in compliance with the to rms of the p al letters(if applicable) OF O I!ID cy� tal er s Sign ) MAB,S'pN rn ONO.t coo `�1A11R $�Pi! Here { s is Sig nature Affix. PLEASE RETURN TO BARNSTABL PLJBLIC HEALTH . C ICATE OF COMPLIANCE WILL NOT BE ISSUED-UNTIL B T I 2RM AND AS BUILT CARD ARE REQIVED BY THE BARNSTABLLE P H[DIVISION. XJJk4N`JK YOU. TOWN OF BARNSTABLE LOCATION :�-7 Z £2"r is a /� " SEWAGE # VILLAGE 0STF.(W//--E,- ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO..G4t?V /1 GPf�,� f SEPTIC TANK CAPACITY LEACHING FACILITY:(type) � (size) NO. OF. BEDROOMS 4PRIVATE WELL OR PUBLIC WATE BUILDER OR W -EEk DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: x VARIANCE GRANTED: Yes' No -� i 1<-<� � �1 v ti �; ��_ r -_��..e �,es ._.. _.-. .s,•y-•_v.yv^:+.Tr-eraYa�e+K.i'. - .. = v ...a_.K:sa.T �:.vro ...� 6. - ... ..� -.. _ _.--. �a i. - . - -•....�. .wsR<..a ....ew.w...._'rM'+r:�.1.'_^_M ^t.._ �..x...,y;�us......._._..—_......__ ..-. -.r- _fir ...:_.w.s.1. _ ..._. �4..,-e:t� 1 ` T a.. �" _t�-,,." _�\ �? irTS 'i 'irr �h�ili ., ..' •.r.;;�ni'.. n,� ,t-A t ! ,' T"' r� �t�ii= - t` G •,; ,.ate E i►'n;� , _nta _ . ,.,r�rt c+ ;� - TCsept;C sys-en-,,`j ari S':afi ri $i1t� ,OA . �" V�Y 1/ ✓`-'� � I t- not ', ' rcva; n4 I:,::i .. rn,i,. r..i.t r. . r,.�rr+(t �.. �,. -�/i } yy .;. �j�T���'t +,/t^a ` .2'�F r• a '' f ��' ,� �r�•��t.��-.- J�� / �1 {..� Sept, OMO ,.:+1_ , .r•. . nst �i �, c alia-'o s , 7��i) , �L/•-1 i' ��� v 1��✓ ...._ ' Y `✓" �r` 1�/ + gi Vit 5Ca'.tVt'r pipit f,.), % n: edule 0 PVC at .�.`ii' :i: ".. -. ! }t i. t4G� L) distributio, box5!i�3i 1 : [+ln,E'fJililE'('}1GT?S to be , If"t1 I n,,� .1 ,r G•p cic P L _;� r, n�j t�, I �• ' i rfC!an o'th, 1 , ! :` s ti;_Je_. n uia , for„r'. er_ [in y' 1 •. b ''';.stern installation. � Wo - "�.+ � •_ rl � % Low - I . •, _ �- ��. t. . ii � T i f-�1O tta�o `1D PtPKC ik . '' ' _c � lel Ki Stio l be l.?'oh;* s - - C ' ;Tt:Tlf^t5 ,ink . ('� / lJ"POO �vlJ IKX F + CivL'r„J '6 '111/ 'T fQ, t ����/ � '��/� ex StI!ig ._�1t1 TP, }ip pi.anned and €ill, ; 'S;., ;tje V cl I� r,dur'ment f nr ced j C2SS:CG`!(5! andr !a fi}I iv' =C`. within the t. posed SAS 5E =ti CtiE 1c+C2L� ''�t;li!.'f'dC� St-i!+ ° ,. 1 i�jf3t'!i115- i(1j ltilt�' (': _ L•i�}t'i ser':F_E' E4r=t'. nig a Witf�r Fiw .'ATh aTt ?!i);. _ ' 1C'i Uit:' Ifl p,v`i_Wi`i ti!?(: �) t2 iVcii?£ S�"V= r 1ii v I 77+ - ,1F ;i i !4?F' }t.�•! _ I`i=? .li trt=':ji(;'`V£ iTL' >1$lrj"eo (i3 l? ':{�(� l =_ 11 Is tot}C r@'}�Llt'? i tf ir:'_' se," 't�t@r!1 is not 1 r)a-e ,i in der � � � nr` r l%�1fi•ce�`+1r ��( tTT.rtc�? tr,;, 3i;tl�ilTT1l �:r•ysr. /Y "" r,�► ,Cl�[ i V ir?si rotvr stru:_rt.. .trL'.t,jves ot,ring,ti ct �t— A+ ttr t� :t _ P t+ u t a� j± o. , !V1CP ;T1 �id" / ly re:.r s 5 ei. i.:an tr° �St..:•�' , : �yICU � r'1 f 3i' . F' - r,� C� �jf ti'l Dili. 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