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Home My WebLink About0050 BIRCHILL ROAD - Health (2) sa &WO6&L P�- 1�dG-62b - 7 No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2ppl cation for )Disposal 6pstem Construction 3pPrmit Application for a Permit to Construct( ) Repair(upgrade( Abandon( ) ❑Complete System ❑Individual Components Location Address Lot No. Owner's Name,Address,and Tel.No. Assessor'sMap/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. -yoo-7` , zbo - K60, Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building (azli No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) :1'5C) gpd Design flow provided U c( gpd Plan Date cl t fL, Number of sheets Revision Date T Title Size of Septic Tank J;I (M a IO Type of S.A.S. Description of Soil r Nature of Repairs or Alterations(Answer when applicable)'__T_,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 Certificate of Compliance has been issued by this Board of Health. Sig Date �G Application Approved by Date Application Disapproved by Date for the following reasons Permit No. l ,.- ��Cj— Date Issued _ Gb No: � " � '". 1. Fee rr--/(�J J THE COMMONWEALTH OF MASSACHUSETTS Entered in computer PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Y-r RpPlitation for btspo1` 1 , Opstem Construrd n Permit " Application for a Permit to Construct( ) Repair(�pggade ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 54 Owner's Name,Address,and Tel.No. }__�•� �l p �rcYl�� c� Asse�soJr'r apArrce Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: i Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building C� o No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) :0 gpd Design flow provided gpd Plan. Date GA 1 t` 2\ Number of sheets Revision Date { Title Size of Septic Tank T � la - � Type of S.A.S. g� r Description of Soil Nature of Repairs or Alterations(Answer when applicable) s, <' r h s�rxv�_ Dec j V,/\N 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. Signe Date 4 Application Approved by Date 400 Application Disapproved by Date for the following reasons Permit No. i � Date Issued v�— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(V< Upgraded( ) Abandoned( )by at r` has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated tol'ZIT Installer t\fin Designer #bedrooms mil, Approved desi ow and The issuance of this permit shall not/be constfued as a guarantee that the system will cti n designed. Date ,�J (� , Inspector ------.--•----- --- -- ----- -------------- - - - No ! — Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposar 6pste onstrUttion Permit Permission is hereby granted to Construct( ) Repair( V� Upgrade( ) Abandon( ) System located at So � 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 be completed within three years of the date of this permit;= Date /9 f B )� t Approved by ` — — J --; Town of Barnstable Regulatory Services Thomas F.Geller,Director NAM _ Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 O"flce: 508=862-4644 Fax; 508-790=6304 Dates 19-1 z Sewage Permt# ot21 Assessor's Map/Parcel Insfaller&Designer Certification Form Designer: T- ` .�� i'/��{J"y' Installer: - Address: l C� ''�c,�il•�G 'f Address: ,( s nY On ��,� ,� �G was issued a permit to install a (date). (installer) septic system at SO 13t(ch)l 2� e-_Pt-44 f d, f 1 e based on a design drawn by (address) dated ! 2` (designer) I certify that the septic system referenced above was installed substantiallyF according to the.design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were-found satisfactory. I certify that the.septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic systeni).but in accordance with State &Local u- --ions. Plan revision or certified as-built by.d'esigner to follow, Stripout(if rP 'cted and the soils were.found satisfactory. ZH OFMgs DAVID Sys nstaller's Signature) M j -- - ----.-. --- -- — - - ---.. _ ......... shall comply i) e instalE ply with the State Environmental Code Title V and Town of ASSESSORS MAP: TEST HOLE LOGS � Board of Health Regulations. 4 d_ ( 'PARCEL: 01a SOIL EVALUATOR: �..r 2) The septic system as proposed an this plan shall not be installed until a licensed town Installer receives approval and an installation permit from the applicable town. S� REFERENCE: '� G�� r WITNESS. - - 3) Prior to installation,the installer shall verify the location'of utilities,sewer inverts, VA sewer lines and existing septic components prior to installation. 1 DATE: Z 4) All gravity sewer piping Is to be 41nch schedule 40 PVC at 1/r per foot.*The first 2 PERCOLATION RATE• Z' V feet out of the distribution box shall be level Ali piping connections to be glued. �{ �" T.H. 2 ELEV. � 5) This septic design plan is not to be utilized for property line determination or for any T.H.#1 ELEV. other purpose other than the proposed septic system installation. LOCATION MAP 6) All Title V components are to meet Title V specifications. r 1 q {� 7) Panting shall be prohibited over Tide V components unless components are H20 , loaded. 8) The existing leaching or cesspools shall be pumped and filled with material per Title V I Q�C, r✓s �b } �� abandonment procedures. Leaching and cesspool(s)and contaminated soils within the proposed SAS shall be removed and replaced with clean sand per Title V specifications. f 9) Septic components are to be 3(Y from a water service line.Sewer lines crossing a T water line shall be sleeved with an appropriately sized schedule 40 PVC with ends grouted. The water service line or the septic line can be sleeved with the sleeve being } a distance of 1(Y on both sides of crossing the line. 10)If a garbage grinder exists in-the structure,It is to be removed if the septic system is ��r - not designed to accommodate a garbage grinder. 11)The Installer is responsible for care of excavation around all utilities on the property SEPTIC SYSTEM DESIGN CALCULATIONS and protecting the structural integrity of all structures during the installation process of the septic system. FLOW ESTIMATE: 12)This plan only represents that a septic system can be installed on the property BEDROOMS ATGAt,/DAY/BDRM= ` GAL/DAY meeting Title V requirements. 13)The property owner shall review design criteria to approve the total number of SEPTIC TANK: bedrooms and design flow.installation of the septic system as proposed and receipt �A( GAL/DAY/BDRM x 2 DAYS= � GALLONS of payment for the design shall be deemed approval of the deign criteria by the `u '- - - Property owner or agent of. USE GALLON SEPTIC TANK 14 The valid ity of this plan shall expire with the expiration of the town installation permit (GARBAGE GRINDER IS PROHIBITED) issued for this plan or the validity of dus.plan shall expire on the expiration of the Certificate of Compliance issued for the Installation of the proposed system on this 2 Val o +Ml ► T SOILABSORPTION SYSTEM: plan. Lo oo I + I -� SIDEWALL AREA: 2 Z.U ''�"" I Z+ Z �C ,- = 1 11 q 7 BOTTOM AREA: � Z, Q1<1 SEPTIC SYSTEM SECTION c �a� BENCHMARK _ i b U .1 L►t. 11 'Wt TOP OF FOUNDATION 6 .._- �... . ' ELEV. �, + 17, , ICI (DATUM ASSUMED) 6 STONE BASE Hto o-Box V STONE BASE OR COMPACTED BASE WATER TEST FOR LEVELNESS' ... ... ._,_____ _. . . . . GALLONS _ SEPTIC TANK SITE AND SEWAGE PLAN �'C1\OFMqS T - '441 , 13A 9� LOCATION: r �20 - ' o� VID s B. MASO rn sp No.'1066 PREPARED. SCALE: DATE: 1 # !