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Home My WebLink About0763 OLD STAGE ROAD - Health 763 Old Sage Road Centerville A = 191 169 � 'fO NO. 1521/3 ORA It 10% J o TOWN OF BARNSTABLE ®-�� LOCATIONrl C� eo(4c) SEWAGE # f�D �3 VILLAGE ��" �'LV� (l�^ ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILrrY: (type) v�'� `3A� =+✓+�� (size) NO.OF BEDROOMS ��++ BUILDER OR OWNER—. "S PERMIT DATE: 0,9 COMPLIANCE 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 J � r fC20T rl ! 'OC NoK I r 77 _ No. d L� Fees THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: vye PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pplication for �Digozal *pg;tem Construction Permit Application for a Permit to Construct( )Repair( grade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. �� Q�� .QG)� O n is Name,Address and Tel.No. [! l`AYI Assessor's Map/Parcel /6I _(W7 SSA^A-e- Installer's Name,AddrAs&(9eftNC0 Designer's Name,Address and Tel.No. 350 Main Street me yCr erlc W. Yarmouth, MA 02673 Type of Building: L/ Dwelling No.of Bedrooms l Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures �-q Design Flow Lt<<U gallons per day. Calculated daily flow 4/J / gallons. Plan Date 9-3-3 Number of sheets / Revision Date A;Z42 Title Se ,.41C_ Size of Septic Tank i sfi n' / Type of S.A.S. Description of Soil r' p4l, I Nature of Repairs or Alterations(Answer when applicable) Pe P V'/Awl 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 by this B of al Signed 6 Date 9 - 3o - 3 Application Approved by Date 1 o r -0_, Application Disapproved for the following reasons Permit No. 0 r�'� Date Issued l 1)- 1-0 *W NO. a��' h J w' Fee THE COMMONWEALTH OF MASSAC SETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN_*0F BARNSTABLE, MASSACHUSETTS Yes ZippYication for Migog--al 6p.5tem Construction Permit Application for a Permit to Construct( )Repair( 'Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. O ner's Name,Address and Tel.No. p / q `cl/� Z'f/,�11 1 Assessor's Map/Parcel, f 1 1 - /10 t C e�� TA rl L r/ t -2. Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. j1�ey�r 00) 9 3 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 U gallons per day. Calculated daily flow y.S/ gallons. Plan Date 9-3- .3 Number of sheets / Revision Date .Q-14 ` Title Si!c se&A A 4C Size of Septic Tank /o y» Type of S.A.S. Description of Soil A't- 19f4 J a 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 been issued by this Boatd of al�h. Signed + a.P Date 3U Application Approved by Date 10 - t - 01 Application Disapproved for the following reasons Permit No. 7 n o Z�� Date Issued It)- /-o 7 t THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired(t11)<pgraded( ) Abandoned( )b r�luc p at 7 1 j A�, has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 2 UU 3 dated /U- /- U 4 Installer Designer r t The issuance of this permit shad riot be construed as a guarantee that the system will function'as designed.0 Date Inspector )'tr`'I . i `q A �U!1 1 MrIj irk,�U_ r V --------------------------------------- No. .2 U 0 3 -q$ Fee THE COMMONWEALTH OF MASSACHUSETTS ' PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mie;pozar *p.5tem Construction Permit Permission is hereby granted to Construct Repair( Upgfiradre� )Abandon Systemlocatedat 763 O)� JI44,, 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 permit. 4 D Date: 10 - - 3 ApprovedY b t`--5 TOWN OF BARNSTABLE LOCATION I (03 .OLD STA CK, f 04D SEWAGE # VILLAGE �� f i�� ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. � CO SEPTIC TANK CAPACITY rK r LEACHING FACILITY: (type) c '5—aQ1A(0XYt,-. ((S- (size) /3 NO.OF BEDROOMS BUILDER OR OWNER C /� PERMIT DATE: COMPLIANCE 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 i 0 v i I ( I � � f ASSESSORS MAP : jq ( TEST HOLE= LOGS NOTES: � 4v PARCEL : ((oQ-I U 1) THE INSTALLATION MUST BE IN SUBSTANTIAL COMPLIANCE WITH FLOOD ZONE : N(A - � p SOIL EVALUATOR : I� ��e.IIP� THIS PLAN,_ 1995 MASSACHUSETTS TITLE V & "TOWN OF T� WITNESS : �I 7�,��5, (,1: BOARD OF HEALTH REGULATIONS. Qj REFERENCE :$� '1 2� DATE : � ( _ ( ' 2 20' 2) THE INSTALLER SHALL VERIFY THE LOCATION OF UTILITIES PERCOLAT 1 ON RAT!_ : 2"^'^ 41co SEWER INVERTS AND SEPTIC COMPONENTS PRIOR TO (_L =�s J_ SO I1, `tY = 0,7 Y' INSTALLATION. TH- I P,�,-��.1� Olt TH-26L-. n1q.?0 3) THIS PLAN SHALL BE USED FOR SEPTIC SYSTEM INSTALLATION (J /, Y ONLY, AND SHALL NOT BE USED FOR PROPERTY LINE !1 �S ��yR�(� S �l7 I°Y�?�� DETERMINATION. 4) ALL PIPING TO BE 4" SCHEDULE 40 @ 1/8 "/ FOOT. (UNLESS LS D lak SPECIFIED OTHERWISE) LOCATION MAP (W'T'�' SA�o /� Y� 5) THE DESIGN OF THIS SYSTEM DOES NOT ALLOW FOR THE USE OF A gat A4 GARBAGE DISPOSAL. �q 6) SEPTIC TANKS AND DISTRIBUTION BOXES (WHEN INSTALLED) G SA'iU D IU�R � 3y MUST BE PLACED ON A MECHANICALLY COMPACTED BASE OR ON 1 I A BASE OF 6"OF CRUSHED STONE. 7.ly I'1L Zg' F�c, r?_ 1� ►?- _'(I � _ r✓A4 Flo �'vj m%g) 6p No 6w O zZVWd - _ _ _ V__v 1 \ No KrlvwN FWu4r1-t- wfau.,s_w/r1I ,lam pF_PR�PUSED_Lcfl�� _ 11 � ` 'N, �x,� SEPTIC SYSTEM DESIGN FLOW ESTIMATE BEDROOMS AT 110 GAL/DAY/BEDROOM - /� GAL/DAY \� �0 SEPTIC TANK I ° '�V U GAL/DAY x 2 DAYS - � GAL I USE I (,60 GALLON SEPT I C TANK -EfIST'A� - ol, w�/ �GSEP T'l-dt.- F \ // SOIL ABSORPTION SYSTEM UnpE'�tzEJ- 64�wN PR-�::c.�4ST I_J6 H COAMRt_P-5 CX�- I 't w y 1 A L.L, S I DES I I V SIDE AREA: _ 33.5 2t �r3 2 xZ x O. )�,/ / 37. 6 L/ I ti i BOTTOM AREA: 33.5 x �✓ x CJ• �'� = 322.2 7 SEPTIC SYSTEM SECTIONUGf�I, rP0 -) 0 lecc) f Al r„ -- f '`� �X1S77�U' �1,�/rrie OX GAL qS ttr,�g, sf 3 y, l8 3Y, s 8 r� I_Z t� 1p1 y Tp-2- SEPT I C TANK [f G r /�°%'/►►�°S_<, ------ yo , 70, --- 33- s- r x l 3 w x 2 () —� 27 c SITE AND SEWAGE PLAN 0 l / /� No. � °� U • 7 ' S OL f J C,, ..� J � /�/) -� LOCATION : � � / C/� 0 7 lCr� � �J S Q�BTE' � � //� /7 VITA � l/ PREPARED FOR : o ,_ a P F ° DARREN M. MEYER, R.S. SCALE RA IJ OF �NnlD - C3y C PAK�� 11 ��v��Q�, INC.. 43 VINE STREET DATE : � 3 03 �- DUXBURY MA u 02332 J)Ai ZI 12��yj DATE HEALTH AGENT (781) 585-0293