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Home My WebLink About0060 RASPBERRY LANE - Health 60 RASPBERRY LANE M ARSTONS MILLS A = 102 097 j J i TOWN OF BARNSTABLE C ° LOCATION bD �a54A)-ey 1n SEWAGE # ��l�D✓�� VILLAGE �'ll�I 7`��15 ��/s ASSESSOR'S MAP &LOTA')Z INSTALLER'S NAME&PHONE NO. &1't Co 11"1 6"r-$ ` 7,'/ `P.�RZ SEPTIC}TANK CAPACITY LEACHING FACILITY: (type) .f.�.�'f�.� !yl�(size)lof X-3d 2 I NO.'OF'BEDROOMS K 3 BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: 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 facili ) Feet Furnished by S jea/^ vGy ,1bb O 1� . lit �'*. 3vjO•r�i�' 4 i. No. C`�°y 'o!'m'- �f, Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: vs PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 3pprication for Mie;p0al bpgtem Construction Vermit Application for a Permit to Construct( )Repair(✓)Upgrade( )Abandon( ) O�Complete System El Individual Components Location Address or Lot No.�® �e`5� ',!y/n Owner's N�e,A ress�pdTel. � Assessor's Map/Parcel 1/J y elf M S� S Installer's Name,Address,and Tel.No. 1 �,^ns Designer's Name,Address and Tel.No. A9f- D-7 7 � Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( � Other Type of Building e.-%j eX^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 is Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 is B ardo H th. Signed Date l Application Approved by - . Date Application Disapproved for the following reasons Permit No. - l.110" Date Issued A 7 Z.k 491, Z 0,, / TOWN OF BARNSTABLE LOCATION D'.S,��zi' y!rI, SEWAGE # ZdD/ VILLAGE ASSESSOR'S MAP & LOTA:�2- —D�7 INSTALLER'S NAME&PHONE NO. 1,41"7`0 .0 ! 67e-5J_` 7 14399 TANK CAPACSEPTIC ITY c— q LEACHING FACILITY: 1•>�C�� / ' (type) / size l0¢ 3o JI�Z _ iw. OF iiirlltCUUMS J BUILDER OR OWNER PERIMITDATE: !-Z3 0/ COMPLIANCE DATE: Separation Distance Between the: I S Maximum A fdjusted 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 ofaeaching faci.li. ) Feet ,. i Furnished by C t 1 I� L�elk 4 6+ 9`►r �lr ;Pf s E hw, «�7 l,�tg > , Fee ,.. THE COMMONWEALTH;OF MASSACHUSETTS Entered in computer: s PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS 0(ppIication for Migooar bpotem tonotruction 3permit Application for a Permit to Construct( )Repair('' )Upgrade( )Abandon( ) [�Complete System ❑Individual Components Location Address or Lot No. /.��//n Owner's Name ress a�d�CONo. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. f Con 5�` Designer's Name,Address and Tel.No. G�D!`7D�� '3" Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( � Other Type of Building �tNo.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. .9 f✓��'� � Description of Soil AD Nature of Repairs or Alterations(Answer when applicable) 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 b j'� .is BB ardpf H lth. Signed Date Application Approved b Date Application Disapproved for the following reasons Permit No. 11::;11P1l Date Issued THE COMMONWEALTH OF MASSACHUSETTS Z_O 7 BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CER ,that thy�On-s' e Sewage Disposal System Constructed( )Repaired(1/)Upgraded( ) Abandoned( )by ��7 d G(% � Cc 5 at h el� 4?1910 16erfllv /11' �lS �'� / etas been•constructed in accordance or with the provisions of Title 5 and the Disposal System Construction Permit N TJ7 --�'+7;dated Zlc:�76 f Installer Jer�]'c�a �� / Designer `j A n The issuance of this permirt1sh I��otb co strued as a guarantee that the s�y'st m will functionas desgned��. // Date III` rl r Inspector)r7l / V l r v y ------------------------- ------x� ------- ,sue No. � J•'" ��!i `-C/e 7 FeeLrr E� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS 30i.5po0at 6potem -on0truction Permit Permission is hereby granted to. onstruct )Repair( Upgrade )Abandon( ) System located at M, �S/%��" >' �4 • �/�✓� ®�5 �'� /~� 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 mustbe completed within three years of the date oft ' t. Date: �� ✓� �� Approved y� 7�f" ti calfo k l ITey obo �GD<< � 60 V" NOTICE: This Form Is To Be'Used For the Repair Of Failed Se •tic Systems.Only. _ CERTg'ICAnON OF SKETCH AND AP PL ICATION FOR A WORKS CONSTRIICTION PERMIT CEMOUT DESIGNE A D PLNSI� 6 e/' hereby certify that the application for disposal works construction permit signed by me dated lllg1Ol concerning the property located..at . Q 5 E/"�� Le & l"W-9 -t/J/1 meets all of the following criteria:. VO The failed stem is cone r;ed to a residential dwelling otuv. Thee are no cotttm_.cal or business /Uses associated with the dwelling. Y i ae soil.s c:assined as c ASS I and�e�:coiation ate i �- s lrarr or e�uai :o mmules per inch. /7herz are no we•,lands within lop mt of the proposed septic; stem / v ine:e are no p-11vale weUs witbin.1:0 of he-proposed s",tic P • :ae:e is no increase in flow and/or c an;e in se propos,-d. here are no vwr=C=s.,.guested or needed. The bottom of the proposed leaching facility will not be l e m_ located less than Eve- ,above sae nixdmum adjusted groundwater table elevration. (Adjust the groundwater table.using the=imptor Method when applicable]. if.the S 4.S. will be 1 2 5 - _located with�_0 tee,of afro vegetated we:iands. the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the ma:amum adjusted groundwater table elevation, Ple2se complete the following: A) Top of Ground Surface EIevation(using GIS information) 7 0 3) G.W.Elevation +the MAX High G.W.Adjustment. D17—FERZENCE BEEN A and B 1 . V— SIGNED : % ll ` DATE: [Sk=h prop05ed plan of system on back]- 4;heath rokkr oM1 .