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Home My WebLink About0062 STARLIGHT DRIVE - Health�- 62 STARLIGHT DRIVE MARSTONS MILLS wA=100-046 J 4I TOWN OF BARNSTABLE LOCATION 6 2- 51ar/1 s'T el-, SEWAGE# P —2c Z VILLAGE ��l� f®�S i`l ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY I~ ��L LEACHING FACII.TTY: (type)YarfvL�^.b.�iary (� (size) // �X 3 3 � A,2 � NO.OF BED ROO BUILDER, OWNE PERMITDATE: 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) All, Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by � �1 -� RAN � y3 ASSESSORS MAP NO; PARCEL N0: F -= , No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS r 0(ppYtcation for &9;poga1 *pgtem Congtructton i3ertnit Application is hereby made for a Permit to Construct( )or Repair(' an On-site Sewage Disposal System at: Location Add&ess or Lo No) Own is Nam ,Address and Tel No. ZQ.y�U✓?� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. G4�25` /t1�7'f Type of Building: Dwelling No.of Bedrooms 3 Garbage Grinder(41,110 Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow /�/® gallons per day. Calculated daily flow 3_200> gallons. Plan Date Number of sheets Revision Date Title Description of Soil Nature of Repairs orAlter4tions(Answer l Z jJ wh ,", 1 ffeV 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 of alt . Signed Date Application Approved b _ Application Disapproved for the following reasons Permit No. Date Issued No. N Fee s 'r THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Zfpprication for Zigogal *pgtem Construction Permit Application is hereby made for a Permit to Construct( )or Repair( an On-site Sewage Disposal.System at: Location Address or Lot No. Own is Name,Address and Tel.No. ('.�a '/ ,j�" b Z 5 7'`v✓ /j��' �� //� Co/P�tr'�t ` Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 17 Garbage Grinder( � Other Type of Building ✓ �IC,G'No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow // /.) gallons per day. Calculated daily flow �'.�� gallons. Plan Date Number of sheets Revision Date Title Description of Soil Nature of Repairs or Alterations(Answer wh n ap licable) // �X �'X Z D G✓i r- �(f��J.D� ��i/�-rr�`®�''s �4i.�r.'or��' � . � N � � � fakir r,Pn� / � „�,�'•r,®� ..� - � 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 this B l d of -ealth. Signed Date e/ Application Approved by _ f� Application Disapproved for the following reasons . i Permit No. �/ O Date Issued fJ -°^- �. -----i--------- —--- ------------- — THE COMMONWEALTH OF.MASSACHUSETTS �00 PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CE TIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced( on by Y7I' for rid 0,Wx;i j9 as has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. . dated .;2 Use of this system is conditioned on compliance with the provisions set be ow: 17 No. �"' .� t� 00 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Migozar *�cp! tem Construction Permit Permission is hereby granted to construct( )repair(Van On-site Sewage System located at 47 -95 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. All construction must be completed within two years_of the date below. Date: -r'" Approved 6� Q� J C5. Dkl>,,-A �6 G� L.3 �,�J D n� O 33 o Vi AA t t-LS w N da'-sik-tiS�17'^d*' r. -�.,- ...a� i•h Y k'',. S'C. ..,F; p I' e r ,� s... ;' OEM x- t *�v 3. :a:�:'�. k* -<-i' 4r;g.,a r '':.^�'�✓'� k'�"2F?fir „4+.' ,"".y�►^`I � --,�'4, lk,.P S' 'c'r CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CUNS1111LICT ON I'EK(19CI'OVITIIUUT DESIGNED PLANS) I, �� l�J • �0/" `o reby certify that the application for disposal works construction permit signed b me dated h"" concerning the p B Y 6 property located at Z J��>� y`' �� meets all of the following criteria: /There are no wetlands within 300 feet of the proposed septic system �Thcrearc no private wells within ISo feet of the proposed septic system //The observed groundwater table is 14 feet or greater below the bottom vrlhe leaching racitily There is no Increase In flow and/or c an a in use proposed �/ There are no variances requested or needed. SIGNED: DATE: LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER JAltach a sketch plan orthe proposed system. Also irthe licensed installer posesses a cerlilied plot plan; this plan should be submittcdl. ,zE+rF x �1b��%'t a, r �� "f•1 +•�L,i. �,� yat� Y:4 a'- �Y'F;�,.s �,(' y�' �scc5 .` a'' n � •' �,»:.-: "�a �:�.'w _ x 1 � .,��{sa b t�' �i:" �- a'"x�.'i;�S`' '�`'t�+'�,�,r ��-r„t�•v, t r��za�� 5 ,.-ram -Uzi""yr