HomeMy WebLinkAbout0073 FLEETWOOD PATH - Health 73 Fleetwood Path
- - Marstons Mills - -
A= 047—053
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Lc,%"c QTION SEWaCkE PERMIT 1.10.
IMST LLER ADDRESS
BUILDER 5 Q &MF- DDRE SS
D1QTE PERMIT ISSUED
D ATE COMPLI &MCE ISSUED;
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TOWN OF BARNSTABLE
LOCATION 73 �'�a�w��L �,`S SEWAGE # ofat)
V�r' AGE .///iS ASSESSOR'S MAP & LOT OC/7 tl 3
INSTALLER'S NAME&PHONE NO.�i'�/ i�iP �0+�1S�izrJliavJ y1�'S926
SEPTIC TANK CAPACITY dod "C
LEACHING FACILITY: (type) SOD G<l ��A�,�oryt �.�� (size) 1-2.
NO.OF BEDROOMS 3
BUILDER O OWNER _Z/e 64
PERMIT DATE: G a 7-0/ COMPLIANCE DATE: t12b` U
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility �f 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 E}G I-
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No. � ��`" � Fee-i--
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
Application for Mi.5ponY *pgtem Cow5truction Permit
Application for a Permit to Construct( )Repair(V)Upgrade( )Abandon( ) El Complete System IJ Individual Components
Location Address or Lot No. Q Owner'XNe,Addre and Tel.NNo.Assessor's Map/ParcelU/
Ifyro
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
ive I
Type of Building: 2
Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(�
Other Type of Building�,•.&A _Ade*2!C.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow /lam gallons per day. Calculated daily flow 3 c30P gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S. 40 ®`r
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) zd nle, /�/�r
i
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 is Boar He h. /
Signed Date
Application Approved b r Gi?�� Date " l5l
Application Disapproved for the following reasons
Permit No. �%' �'' Date Issued �/
No. � 6' �' , ¢ .^ Fee 4.
THE COMMONWEALTH OF MASSACHUSETTS ' Entered in computer:
Yes
=PUBLIC HEALTH DIVISION- TOWN OF BARNSTABLE., MASSACHUSETTS
application for 3k5p dal *p$telu Congtruction 30ermit
Application for a Permit to Construct( )Repair( 1/)Upgrade( )Abandon( ) O Complete System IJ Individual Components
'''Location Address or Lot No. Owner's Name res,Add and Tel No.
73
Assessor'sMap/Parcel e1151el//y�/%�1111_S
Installer's Name,Address,and Tel.No. , Designer's Name,Address and Tel.No.
7
Type of Building:
r' Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder
Other Type of Building A,9 STyep CAo.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow 3 gallons.
Plan Date Number of sheets Revision Date
Title _
Size of Septic Tank /DDG'�Q� 1" 5�`/'�9 Type of S.A.S.
Description of Soil C�IOI�1e✓S /� � C—
Nature of Repairs or Alterations(Answer when applicable) Ole /efzr
r
Date last inspected:
Agreement:
s .
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 t,is Board f Heal h. /
Signed / Date
Application{Approved b I�' �_ Date
Application Disapprove for the following reasons r��
Permit No. Date Issued
THE COMMONWEALTH OF MASSACHUSETTS �� -0 5 3
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CE_TIFY,that Ihe On-site Sewage Disposal System Constructed( )Repaired( Upgraded( )
Abandoned )by D'G1S
at --IA4PZSrOdl�^14ias been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permito ' gvl dated 7
Installer Designer
The issuance of this permit shall not be construed as a guarantee that the system will/function as designed.
Date 1-)l (�� Inspector_ i),-,, `/ �✓_� , .�`t—
No. ——-----—_——— —— Fee . .. -
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
Migogar 6potent Construction Permit
Permission is hereby granted to Construct( )Repair �jUpgrade( )Abandon( )
System located at ✓ � Z`'��ti'� f'p7`h /�Q�S�D/75 ✓�/%/$
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 must be completed within three years of the date of this it.
Date: � �'� � � Approve - ?
. U5'49
NOTICE: This Form Is To.Be-Used For the Re pP a.ir Of wiled
Septic systems. Only. _
C-r—R=I CATION OF SY—VTCH ArND APPLICATION FOR A DISPOSAL
WORKS CONST UMON PERhIlT RY=OU DESIGNED PLA.NL)
'Rere byo w
y C zrdfy that the applica�0a for dis7csa1 works
corsu-u=ca permit sued'oy me dated 6/Z��/ concenin� tie
properly located:at �`1 (/ G!`✓ . ✓9ilf���era all.of the
19 .he?wile_^ s-'m l is conn=--d 1we o
IO.3 i 1C_:.GcI �.o_ n i :L'c _ no corner cial or busies. --ss
lases?_SsociaC d wi--h} :,;It dwe lizz.
0-si.L.is as CLASS i and the"-^clarion--aLe :s :`s m-an or _:ua :o . imc._
� Ti 71I" �� 1.
..a
ae._ are no wc- ds wi:�;,l 100_.._.of:he�rapes�
are no pmmc wcil-s wi**:n.1-70 .__.of ae pro=sed s
9/ ��IIC Y 7��e�.
E ae - is no in= � m`
l� flow and/or.cL.n-e in'se propose--
'*' _SL._`c no YaaI:2IIce5.=i—=Te'd or Tn=—
�+ !Ile borlom•ot the prD?Qsed!=aging:aciiiry wt!I not'a-iocated lx, dip,, 1ve=�:3Date thema 4min �
n adl= ,,-mmd-ate:table elaadm (Adjum Lhe ---t undZamr.taole.l'Slna he i r!LLiWtor
method when applicabl=j. -
'f the S-A ill S.w be loctt'nzta--s0 f=t of any vegetated we lance. tie beacrt oI one r0
vcsed
lenching mcaiity will not be located l=s thou faun==(14) above the r::u-num adilsL°-
grounc%ate:table elcvarion,
Pleax complete the foilomnb
A) Top of Ground Sm a-e=Ic anon(� '-g GIS information)
3) Craw.Marion 3 ;the �h G.F1. Acii3-nne�t. _ Z,0
Dtrr �-ENC BEY—WEE A and 3 t /
SIGNED : d1 ;7 .
DATE:
(Sk=r�ProPcscd pl=.of s ^'n an back].
�bes?th Sir.cat
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15 a o/c�a dens
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TOWN OF BARNSTABLE
LOCATION 73 SEWAGE # o��/J�-y3�✓
VILLAGE ./�J��� ASSESSOR'S MAP & LOT ak dr3
INSTALLER'S NAME&PHONE NO. 1 ,'
SEPTIC TANK CAPACITY /,D,V GEC
LEACHING FACILITY: (type) S Od (size)
NO. OF BEDROOMS
BUILDER 0 0 R
PERMITDATE: G'o27-01 COMPLIANCE DATE: 6 a
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility �f 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 DC T
--77
RQAr
38
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