HomeMy WebLinkAbout0409 WAKEBY ROAD - Health 409 WAKEBY ROAD
MARSTONS MILLS
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TOWN OF BARNSTABLE
LOCATION CIO 9 g� SEWAGE # 9�—
VILLAGE _ a ASSESSOR'S MAP & LOTtw w--017
INSTALLER'S NAME&PHONE NO-
SE
PTIC TANK CAPACITY Vo0c9 3700 —
LEACHING FACII.ITY: (type) / (size) V
NO.OF BEDROOMS —"k 4
BUILDER OR OWNER
PERMITDATE: G— 13 9(Re 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
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pARCELN� � � � ,
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THE COMMOt44ww EALTH OF MASSACHUSETTS
MASSACHUSETTS
cNppfi attun for Pisposal ,*Votem (guns#rnr#tan jJerntit
Application is hereby made for a Permit to Construct( ) or Repair(man On-site Sewage Disposal System at:
Location Address or Lot No. Owner's Name,Address and Tel.No.
Ll 0 0( WO-kt AY j,%D Lc,..vv
Y®q �O-ke Ry Rv°��
Inst ler's Name,Addre s,and Tel.No. Designer's Name,Address and Tel.No.a y r4-9 : eC S u r u� C.&vA s c.CT b9 0
s 4 y 0.�9 P .e�P Y��vt v s Y ' R�°4 L —oo$.
ia� s
Type of Building:
Dwelling No. of Bedrooms v Garbage Grinder(I�)
Other Type of Building No. per Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 0 1_/ gallons per day. Calculated daily flow 880 G-P!] gallons.
Plan Date B I I— C76 Number of sheets I Revision Date
Title S It42//9 N O F Z-A U 5 — S_eAA-cat d2 i s
Description of Soil See n l 4N' Perk-4 870 S
Nature of Repairs,or Alterations(Answer when applicable)
a�000 S e -fi c `rA MJ4 15'00 X�y!�j? e nem v 1) . Aou
c�• ow S of 6 t 1 t~t c 1214 h12s c�,�11 z�' S 7'�1,Q ej H Sa. st E� S w 157cMQ
Date last inspected: v,4,c(,encee4_/ ,
Agreement:
The undersigned agrees to ensure the construction and maintenance of the aforedescribed on-site sewage disposal
system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a
Certificate of Compliance has been issued by this Board of Health.
Signed Date
ApIlication Approved Date
Application Disapproved for the following reasons i
Permit No. �" Date Issued
No. FEE 71' C�-
THE COMMON EALTH OF MASSACHUSETTS
MASSACHUSETTS
: � �.��lt�tt#tIIr� fIIr;�t'B�IIStt1 �5�s#ez�t �II�$#r�x.c#t`IIrc �er�tt#
f
Application is hereby made for a Permit to Construct ( ) or Repair(4-j'an On-s:te`Sewage Disposal System at:
Location Address or Lot No. I Owner's Name,Address and Tel'N'o. '
y p 0( uja- y R
fld>4� L�✓✓ �t pi•e Z.
ol.f S'v"t S M ,l S &A eL r Tv-S .: n1 t 1/ �.- 0 S-1 gf3
Ins
ler's Name,Addre s,and)T_ e1.No. Designer's Name,Address`and Tel.No.
- ��,�-� � �•. .f►4 N 1Cr� S u�u D cu�n s�c.Y w/.1T
S Ly l7 L/O TIACu S' 'r 2 A�
'7� M4.fss M, 1
.Type of Building: '
0
Dwelling No. of Bedrooms Garbage Grinder('
Other Type of Building �- No. per Persons Showers( ) , Cafeteria( )
Other Fixtures v- 4 0-11
i` Design Flow O 1-1 O Y.�_7 rf K1%ns per day. Calculated daily flow 88 G gallons.
Plan Date 8— � � cJ" Number of sheet's Revision Date
Title 5 �F//a o F L t� S�e we�o 40/ro Iy
Description of Soil 70�e �'1'o4N' �� S
'Nature of Repair r•or Alterations(Answer when applicable) �t
000 S-a C -r'A N8 1 S OO C30^7? C' 41 r I^'► /- 1' • bcy
13, (ZOW S of 6 t n F I c �2W ;2S r� I l/' sl�ra aH S ��s+ c��S w•� 1 ESQ
Date last inspected:
i
Agreement:
The undersigned agrees to ensure the construction and maintenance of the aforedescribed 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.
Signed Date
ApAication Approved z Date -
' Application Disapproved for the following reasons
11
Permit No. "' 7 A +-+✓ Date Issued
; THE COMMO WEALTH OF MASSACHUSETTS
MASSACHUSETTS
CEer#tfirat.e of (gontylianre-,
THIS IS TO CERTIFY,'that the On-site . wage Disposal'System installed( ) or repaired/replaced(� on
w.w La ✓rc
at LIO 1WCIL: 0,4 7 �a.�S�'�^� �f ofl -----has-been constructed in' -
accorddpce with the provisions of Title 5 and the for Disposal System Construction Permit No. dated
"� �� Use of this system is conditioned on compliance with the provisions set forth below:
The issuance of this certificate shall not be construed _ ' guarantee that th ystem will function as designed.` 'his
Certificate expires on o
i
DATE '�_ Inspector0.
- --
1�d:1` `.
THE COMMONWEA W TH OF MA�,S • r. ,, r i
c.>.✓v+ Su l e M FEE AS �TTS r '�%
No.
Piere-al 5g8 Qm onstrur#tII x Patti#
Permission is hereby granted to
to construct( -_ or repair(L�-an On-site,Sew ge Sy A to ated at
�-/O `�' (-UK ra,�( M 4✓Ste^ �M r
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 ithin three years of the date below. e� /,.
DATE ,- '� fle- Approved bye"
FORM 1255 Rev.3/95.A.M.SULKIN CO.-BOSTON,MA
TOWN OF BARNSTABLE
LOCATION V09 �� � SEWAGE #
VILLAGE ASSESSOR'S MAP &LOT
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY voocq • /�r) Uo
_ LEACHING FACILITY: (type) / , (size) z/
NO.OF BEDROOMS_ - >3
BUILDER OR OWNER
PERMITDATE,: �1— 13'3 Ce 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€ leaching facility) Feet
Edge of Wetland and Leaching acility(If any wetlands exist
within 300 feet of leaching facility) Feet
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Furnished by `
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