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Home My WebLink About1090 MAIN ST./RTE 6A(W.BARN.) - Health 1090 Main Street/Rte 6A (W.Barn) W. Barnstable A 178 012001 IM ' I . 0 "TOWN OF BARNSTABLE, � LOCATION J 1 CIO l'lt.T It � SEWAGE# 2- VILLAGE -ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NCO. l 1,L�A'1►� '[QI,tC� �bS—?? � 2l' SEPTIC TANK CAPACITY c! DO Z6 T� LEACHING FACILITY.(type) e) 3L X, 7-83 NO.OF BEDROOMS OWNER 1D ,4 PERMIT DATE: (P It 3 y COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility S 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 . i -3 -7, ' //��/p 1 ` Fee / THE COMMON WEALTH OF MASSACHUSETTS Entered in computer: CO Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipplication for Zizpozaf 6peum Con6truction Permit Application for a Permit to Construct( . )Repair( )Upgrade X)Abandon( ) El Complete System ❑Individual Components Location Ad ress o Lqt No. 2. Owner's Name,Address and Tel.No. IdI6 mam. t rn5f0k:� Sharon 5cherm-'rhot'n Assessor's Map/Parcel ' 7 2— O -707 Installer's Name:Address,and/Tel.r� UY� Designer's Name,Address and Tel.No. 9-0 S( '6463' 119 4 R•J v'i jq. _ . ,-15�ruc�1 1,�.O y&j- �ox �- F=or�5�bc101� , rnt� ,Boxs -74 q� o Type of Building: 7�e-sidenCp- �D S Dwelling No.of Bedrooms _ Lot Size U _sq-€E Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 C gallons per day. Calculated daily flow 44 (o gallons. Plan Date Number of she Revision Date _ Title Q n Size of Septic Tank Type of S.A.S oR Description of Soil 50C, _PLrl Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees io ensure the con"ss uction 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,-this Board of Health. Signed Date ff Application Approved by Date Application Disapproved.,for a following reasons n Permit No. Date Issued 1 'r ... G.,..,:.. Fee Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS p Yes # PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Yication for ig ozaY pgteut Coot Permit rade Abandon ❑Comp lete System ❑Individual Com vents Application for a Permit to Construct( . )Repair( )Upg ) ( ); p� Y Po__. Location Address o Lot No. �. Owner's Name,Address`and Tel.No. / `qq� I�InStr -1n( �arrlsfa harvn 5cherr�-per hog n Assessors Map/Parcel )�_ I'(Q X O'7 r QQQ / W C b`6 Installer's Name,Address,and Tel.No. '' .+Designer's Name,Address and Tel.No. 50 Sf 'S/o�' 1�9 4 Rd:,�2 0 uLt 10 02 4 1 ��y �5soc . t0X�Gcvwre spaj. ► Boxs9 W A oZ5 Type of Building: 'Ae5jden(Q, 1 S "- Garbage a Grinder( ) Dwelling No.of Bedrooms Lot Size!� sq fit. g Othei Type of Building - No.of Persons Showers( ) Cafeteria( ) Other Fixtures �j, Design Flow 3 3 0 gallons per day. Calculated daily flow 44 VJ gallons. Plan Date 2`' umber of sheets Revision Date Title . 1 0 5C Wnoe I (CQ y Size of Septic Tank 1.5' -1 1 lnn Type of S.A.S(�Z),50G G. rhra n�11�P YS Description of Soil; PLnnJ i Nature of Repairs or Alterations(Answer when applicable) ` r Date last inspected: Agreement: _ The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system`t� in accordance with the provisions of T,itfe/5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issue&br�this Board of Health. Signed . /' Date Application Approved by / _ _ i Date .. Application DisapprovedAor he following reasons ol Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that he On-site Sewage Disposal System Constructed( )Repaired( X UpgradedAbandoned( )by �' �� at has beeiD constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No '� dated Installer Designer The issuance of th}'/s perrpt shall not be construed as a guarantee that the syste al to "igned. ;, Date 212'7 �3 Inspector .', R j s THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE., MASSACHUSETTS _,,. _-- N Digpozar pgtem Con5truction Permit Permission is hereby rant d tgCon ct( )Rep ' Upgrade( ) ndon System located at (J Y✓ 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:Cons ct ��i n must be-completed within three years of the date of this petmut. f Date: � LP Approved by / , V TOWN OF B STABLE 1� LOCATION ' q O SEWAGE #2dd3"D-7 VILLAGE kSL __ _ S�_ASSESSOR'S MAP LOT I OIZ-661 INSTAL ER'S NAME&PHONE NO. JU, .5�08 - 8'631 91S-0o �{ I� SEPTIC TANK CAPAC 2— LEACHING FACILITY: (type) 2` S 0 0 A 1® (size) I Z 10 x 2 NO. OF BEDROOMS BUILDER OR OWNER J� r c o f-mff vy-)r n PERMITDATE: c2 ' 14 ' !� COMPLIANCE DATE: 3 Separation Distance Between the: h 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 facility) Feet Furnished by n , r 3 . .ZZ � i� " 3- r g 3 s S � 3� 6 tt TOWN OF B STABLE LOCATION t Q nW SEWAGE #2_00,�'��r7 VILLAGE_ � � ASSESSOR'S MAP LOT-1 612-001 INST,!SS ER' wnijin rgm-,-�u- S NAME&c PHONE NO. r TANK g� SEPTIC TA w 9 j SOO I K GAPACT LEACHING FACILITY: Z` S-o O t-� I® 1 Z '10 v 2 i (type) (size) X' .� NO. OF BEDROOMS BUILDER OR OWNER PERMTTDATE: C2COMPLIANCE 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 facility) Feet Furnished by r z A. r 6� SD/G S TEsT S'UL TS SE1t/.'�GE s-ys`r�M P�oGlLE A sArvaY 2,SY/z, �g G oqM - w�Roo.Ts p• f/�/. 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