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Home My WebLink About0040 HOLLY HILL ROAD - Health E= l8'8 Hill Road 107 ti No. 42101/3 ORA Pendaflexo 10% No. 3 " �O �� a Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes ✓ PUBLIC HEALTH DIVISION -TOWN OF. BARNSTABLE., MASSACHUSETTS 01pprication for Migaal *p5tem Congtruction Permit Application for a Permit to Construct( )Repair 4)Upgrade( )Abandon( ) Complete System ,Individual Components Location Address or Lot No. �d /f't/(y Owner's Name,Address and Tel.No. Q Assessor's Map/Parcel / P� /0 -7 �,�� lnst s N Addre s,ap4 Tel.No ,.. Designer's Name,Address and Tel.No. 1�S ov t t:l J EI,ns�'.�✓,.c t. l6f C_ �� N✓ a x 9 Z EA-,$'-7 S v - e'� �v-es vac eke v'L z®1 v �'3 3 2/7 7 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 46,0 gallons per day. Calculated daily flow s ? gallons. Plan Date (Z —/ —b 3 Number of sheets L Revision Date A-f C ale--e Title Size of Septic Tank Type of S.A.S. Z Description of Soil �5-P Q_,je/,4 4 Nature of Repairs or Alterations(Answer when applicable) RLP 114c-4— ;,C , !4 W 01-9 S,G��d/J 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 be y this d of Si ned Date t Z 3 3 Application Approved by Date Application Disapproved for the following reasons Permit No. D� 3 b j c'� Date Issued ` g 15 0 No. 3 / Fee { 5c� !� ."h THE COMMONWEALTH OF MASSACHUSETTS i;ntered in computer: Yes PUBLIC HEALTH DIVISION -.TOWN OF BARNSTABLE, MASSACHUSETTS Application for Mi0pogar *p.5tem Construction permit Application for a Permit to Construct( )Repair(0k)Upgrade( )Abandon( ) kcomplete System /Individual Components Location Address or Lot No. V() H1/t y /1,Y/ Owner's Name,Address and Tel.No. 6�1 Q &,e� Assessor's Map/Parcel F y /a -7fr SAVYZ.e Instal 's�Nam Cd is,anrlTel.No�A✓� Designer's Name,Address and Tel.No. sl 3344' i �P/vitt y/VC- �� /VV (fax ��.e s {�a l p r►+� uz:'mayCI �A,S? s-4.14) M rler 2 i 77 Type of Building:11 c" Dwelling ' No.of Bedrooms T Lot Size sq.ft. Garbage Gri /der( ) Other Type of Building No.of Persons Showers;( 7) Cafeteria( ) Other Fixtures �� )r Design Flow {o gallons per day. Calculated daily flow 03 gallons. y Plan Date /Z -/ - o 3 Number of sheets 1 Revision Date /V G il/-P Title Size of Septic Tank /S0� Type of S.A.S. -a.., e..-_r Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 be y this B d of e Si ned Date (.2-3--O Application Approved by Date a 520 Application Disapproved for the following reasons Permit No. �. 3 / Date Issued 9 )5 0 -------------- ————————————————————————— THE COMMONWEALTH OF MASSACHUSETTS / BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired(.�)Upgraded( ) Abandoned( )by. 1r'S i � SA-,n,�doc..� .S'e r✓,c e ---zN c- at y0 Nv/lu W, // k d (C 0/1,Le" , ft-t has been constructed 'n acc rdance, with the provision of Title 5 d the for Dispos 1 System Construction Permit No. d03-�JL dated z I d Installer _66A I 41 r �46=� P i y i -e_ Designer 06 C _ The issuance of this permitt sha11 not be construed as a guarantee that the stir will nction Aig""ne. Date 1 -;) t r) Li Inspector ru F' --------------------———————— .x ——————————— No. R M ', Fee --THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mizpogal *pgtemc Congtruction permit Permission is hereby granted to Construct O Repair(k)Upgrade( )Abandon( ) System located at Q C' Q cir -e yi 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:Co truct/ion must be completed within three years of the date of this permit. Date: 12. �S�/v Z� Approved by 1 I TOWN OF BARNSTABLE LOCATION / m SEWAGE # Z-- VILLAGi✓ CPN�G U r�s'�� ASSESSOR'S MAP & LOT S 7 INSTALLER'S NAME&PHONE NO. 940 C&511'4°� lm SEPTIC TANK CAPACITY LEACHING FACILITY: (type),& (size) 33 x' l I X 2- NO. OF BEDROOMS ' BUILDER OR OWNER lr hl, PERMITDATE: lj T703 COMPLIANCE,.DATE: -lo 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 l d� i �+Y4id TOWN OF BARNSTABLE LOCATIDN &10 &11v 4L'11 L6c-d - SEWAGE # ZZ-10-� ! Z- VILLAGE C&61�6V ,��'II,� ASSE/SSOR'S MAP & LOT s �7 INSTALLER'S NAME&PHONE NO. rr,5 F'l'P,I Z y f!y SEPTIC TANK CAPACITY 9 a cam, r 1 LEACHING FACILITY: (type).3~5 'o�d, (size) 33 X l k X Z NO.OF BEDROOMS t BUILDER OR OWNER V �� PERMTTDATE: COMPLIANCE DATE: 0 Separation Distance Between the: r 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� 6 tsl- r i0 lYcS�� ,V �J �i i�Y Phis ASSESSORS MAP : � _ -__________ _ __ TEST HOLE LOGS PARCEL : vJ FLOOD ZONE: �ltild -._ _► � SOIL EVALUATOR . , VA NOTES: R •ERENC � JL..� � � WITNESS : 1A; �,, • G REFERENCE : __.. 10)-1 __�� DATE: 0 _ 1 PERCOLATION ATE: G, M t 1) The installation shall comply with Title V and Town of Barnstable Board of Health Regulations. %4" ,Y7 cit2 TH- I TH-2 2) The installer shall verify the location of utilities s -- L_ . components prior to installation. ewer inverts ands is ,r ."�. 1_ '.� __.. j t ► __._. (; ��(J� " 3) All septic piping to be 4 inch Sch 40 PVC at 1/8" per foot. 1j y 4) This plan is not to be utilized for property line determination nor any other II purpose other than the proposed system installation. �-1 5 5) All septic components must meet Title V specifications. LOCATION MAP C 6) Parking shall not be constructed over H 10 septic components. r p ` 51510 t( i4 1DI l 7) The property is bounded by property corners and property lines as depicted. n / 8) The property owner shall review design considerations to approve of total number co i ( "J V / � `� of bedrooms to be considered for design. Receipt of payment for the plan and installation based on the plan shall be deemed approval of the number of J✓ / ,t bedrooms. If Lit 9) The existing cesspools shall be pumped and backfilled per Title V Abandonment k Procedures. w 10)Proposed leaching is to be within 36 inches of grade or provide venting or cut 6 ,� X .µ. :flee- grade as permitted by the Board of Health. 1 Y SEPT I C SYSTEM DES I G N 11)System components to be 10 feet from water line. 12)Existing plumbing to be re-routed to location shown on plan. FLOW ESTIMATE / ✓ \ I(0 BEDROOMS AT GAL/DAY/BEDROOM - GA L/DAY SEPTIC TANK 1 O GA+_/DAY x 2 DAYS - GAL I r USE `` ZGALLON SEPTIC TANK �IJ ) SOIL AQSORPTION SYSTEM Oti, 0- S I DE AREA:4) BOTTOM AREA: C�'c`7 �- =cJ�� SEPT T E I C SYSTEM SECTION 10 .r//ryy 2�°f 3 _`dc� ..�u�t`?iWrrti /3b ��k 1 t \ k SI V Zoo. yt,A-BGAL 37, 00 � , SEPTIC TA L �I Il ► e -y, z,OD t / fV _.�.. n •�` .� �, ,� � � � •� SITE AND SEWAGE PLAN O y tf LOCATION : �Aj M 6 PREPARED FOR : JL6? 1 SCALE: I�= z DAV I D B . MASON 12", DATE: 2 r o DBC ENVIRONMEN AL DESIGNS w EAST SANDWICH . MA w DATE H=ACTH AGENT ( 508 ) 833- 2177