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HomeMy WebLinkAbout0449 BRAGG'S LANE - Health 449 BRAGG'S LANE Barnstable A = 298 - 027 C-)6S I R I i i t i i 3 TOWN OF BARNSTABLE LOCATION SEWAGE# oZ0 VILLAGE ASSESSOR'S MAP&PARCEL - INSTALLER'S NAME&PHONE NO. , ],Kafm !0_.L�C S-09-VX-YS3y SEPTIC TANK CAPACITY LEACHING FACILITY:(type) a-6'00 q UN ki-10C�W(size) NO.OF BEDROOMS 3 OWNER PERMIT DATE: COMPLIANCE DATE: H-&-510 0 Separation Distance Between the: ^'rvC Q+- frM r Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility OF PPrC 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 D ,A ,D26CX,04 lid - 17 co C - - e �f4`19PPI H` Fee THE COMMONWEHLTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZippYitation for Misposar 6pstem Construction Permit Application for a Permit to Construct( ) Repair( "Upgrade(�') Abandon( ) ❑Complete System ndividual Components Location Address or Lot No. 14 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 72 Z, hrt,$ �r � '� F �� Instal 's Name,Addwd Te o. ' Designer's Nam e,Address, d 1. o NO '�2 L Type of Building: �7 Dwelling No.of Bedrooms Lot Size L-1 5� sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures ??����.,,� Design Flow(min.regdred) c_ � gpd Design flow provided J gpd Plan Date Z 2C) Number of sheets Revi 'on Date TitleW Size of Septic Tank Type of S.A.S. Description of Soil ' Nature of Repairs or Iterations(Answer when applicable) ,- � G Y� U-�GIJ 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 Certificate of Compliance has been issued by this Board of Health. S' Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued D c�— Fee THE COMMONWEr,fLT'Ti—1 F MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS applicatio# for 33Isposal *pstpm Construction Veimit Application for a Permit to Construct( ) Repair( Upgrade/ bandon,( ) C,ompl t System ©-I dt'i ividual Components Location Address-or Lot No. ��y Owner's Name,Addre�ss,�and Tel.No. Assessor's Map/Parcel `( ( sk f Installer's Name,Address, dd Tel 14o. Designer's Name,Address and Tel.No. i IC) k �A Type of Building: i Dwelling No.of Bedrooms Lot Size Z sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( Cafeteria( ). Other Fixtures Design Flow(min.required) � gpd Design flow provided 4 gpd Plan Date l Number of sheets ( Revi ion Date !�. Title �K( Size of Septic Tank l ��_ Type of S.A.S. . 4_ Description of Soil f EF, 62MI Iti Nature of Repairs or Alterations(Answer when applicable) 1 1 A yi Date last inspected: Agreement: The undersigned agrees to ensure the constructikon 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 Certificate of Compliance has been issued by this Board of Health. Si_ ed Date Application Approved by Date Application Disapproved by - Date for the following reasons Permit No. Date Issued --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Dis osal system'�``Constructed( ) Repaired( Upgraded( �� Abandoned( )by . �� _[�\ ,/�A l .►'�.1 at � J ( 4 JA] has been constructed in accordance t^� with the provisions of Title 5 and the for Disposal System Construction Permit .o dated Installer aL, 1�.fl�-�(il}lV Designer. —JA V1►Q #bedrooms L Approved design flow c gpd The issuance /f t is permit shall not be construed as a guarantee that the system wil�ncti as designed. Date (D2101ZO Inspector --No.------ ---------------- ----- ------------------------------------------ -------------------------------------------- 19 Feed i THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Bisposal *pstem C nstructio n ermit_ Permission.is hereby granted to Construct( ) Repair( V , pgrade( v` Abandon(� ) System located N6 �-- i and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. .- - Provided:Construction must br co feted within three years of the date of t is permit. Date ��f/�r Approve by r I own olf, Barnstable i R. ifi "cri rm i i Addl � I On 7—C -,-,q L7 __ _ ' . a �.min.��� ae� 1.1 to, Rik% dued 26.J za �: 11 t 1 '� F� .D 'k# g 5 1�0 �° mccordilm`go t'hs �d'��na wi ii b i�J04e. 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