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Home My WebLink About0030 WAKEBY ROAD - Health 30 WAKEBY ROAD, MARSTONS MILLS A=060-017 l 1 . TOWN OF BARNSTABLE LOCATION �� l �LLV '/- gl SEWAGE o ! VILLAGE h%? k4 ZO/Vk ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO._ M �Sllallc, CQ/l.S— SEPTIC TANK CAPACITY es LEACHING FACILITY: (type) Mk k M?aci Pit (size) NO.OF BEDROOMS BUILDER OR OWNER OeZ 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) Feet Edge of Wetland and Leaching Facility(If any wetlands exist ' within 300 feet of leaching facility) Feet Furnished by r l�-ovs� hl YO o � Tit"1 � �S 3 y d `l No. .✓ Fee 4 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYtcatton for Mtgogal *pgtem Comaructton J)ermtt Application is hereby made for a Permit to Construct( )or Repair( j, a n-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. `�3 G w 4: e—\0 -/ W c il��`��;� ry(.._ tom- -t�- Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: �// Dwelling No.of Bedrooms f Garbage Grinder( ) Other Type of Building T No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow J gallons per day. Calculated daily flow qqo gallons. Plan Date Number of sheets Revision Date Title Description of Soil ytt-eY-S\"c. !) Nature of Repairs or Alterations(Answer when applicable) I `L 1 ✓�-- �" `� L 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 t to place the system in operation until a Certifi- cate of Compliance has been issue t . Signe Date�¢ Application Approved by Application Disapproved for the following reasons Permit No. !'' �^ Date Issued �1��° .� ��#��+�.; � . .. r - •-- - +Y: No.ri, L (� t Fee T' , /� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLEs MASSACHUSETTS ETTS 0[pprication for Migonl *p.5tem Construction Pernf t f Application is hereby made for a Permit to Construct( )or Repair( �),awOn-site Sewage Disposal System at: Location Address or Lot No. Owner's Name;Address and Tel.No. ? Installer's Name,Address,and Tel.�No. Designer's Name,Address and Tel.No. LA Type of Building: �~ 'f Dwelling No.of Bedrooms Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria(, ) Other Fixtures Design Flow S gallons per day. Calculated daily flow VY0 gallons. Plan Date Number of sheets Revision Date Title Description of Soil VAL sw Nature oURepairs or Alterations(Answer when applicable) ,`� 0�) 0'r s.., k-G lA i' Date last inspected: Agreement: l 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 Apt to place the system in operation until a Certifi- cate of Compliance has been issue the Signed Date 3 Application Approved by Application Disapproved for the following reasons Permit No. Date Issued ��' I_—__ ——— ---_— ---------- --_-- — -- ! THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLEs MASSACHUSETTS Certificate of Compliance THIS IS TO CER }}Yat the - ' e Sewage Disposal System installed )or re aired/replaced(�' )on -� by- �C for W as -:3b LL V 1M lI has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit N . - 2:27 ated Use of this system is conditioned on compliance with the provisions set,forth below: - w . No. � � Fee �1 THE COMMONWEALTH OF MASSACHUSETTS y PUBLIC HEALTH DIVISION - BARNSTABLEs MASSACHUSETTS Migonl *pgtem Construction Permit Permission is hereby granted to to construct( )repair construct( )repair(��—a�n��S�eyvge System located at 3(� c A r)S�eyvge System located at 3(� c A 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: G✓'.�7 �!/��APProved _x _ ll' <-a' I It l _- • Y4 ) kR t t Et�r,ry4�` 'cKn �'qp.y'7Yt'�.? :� a: < 1 N] b � 5 p gr��t t � �� j, x��t ��5•y�y 9 8ts`d^�'�� n 4(7y�,,t h . CERTIFICA TION OF SKETCH AND APPL C WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) 3 t r.'`s•,'Faz �tPv� � � ,`k �' r '. �„� +,�A� F�7A T� r'�s V-1 1"��,s'�'v`�t I� U�. (�/.�� hereby certify that the it jilictiit o>i for d t " construction permit signed by me dated= _ r property located at �� l✓ X't , } R , following criteria: �kt� �.�,t ry 5�:'Y,�b�� 2� �,a�� r .t��'`,�f'�25P: �i�ap�kfi!t'- >�•� t.• . There are no wetlands within 300 feet of the proposed sgrtic gdeer • There are no private wells within 150 feet of the proposed *k system • The observed groundwater table is 14 feet or greater below the bottom of the leNching`fAtcliit�► • There is no increase in flow and/or change in use proposed y ,'� �tT`�i• �s� 'r e There are no variances requested or needed. a k t� t h 4 yr`y, CtF a* )iFn T �YFti• � `a Ali � 1i •� e3'S�'�• �N Fr` yM,�i` t y4Pr � 9� . af+�' , .;� i' c4,,� r k+�j.� Tn�' "z. 4*•�1�" 5 � a '�`f"•ts�kk � t't � i•��°'+4p'�. �44" �,r �''` •"� /� ` rt �a, +.�sT��Ts�% •��., SIGNED LICENSED SEPTIC S STEM INSTALLER IN TM TOWN Op BARWAOU [Attach a sketch plan of the proposed system. Also if the licensed instiller it ti Ng this plan should be submitted].. 4 ' y 7 'ila i' 0.r"tM1 ..- i01,5 `rr+"'-+'a�'C*�' 41 4. � %rsa jS�L,-r��`�{u tr ot�•^��}�'�tke '� rosy, ,�� a��' °"��'�' -,•3 d .. i:y .. Y'yt "y ;x, rxtN 'k7� �� _ C =010