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HomeMy WebLinkAbout0066 INWOOD LANE - Health (2) LaAc ;Ll M � a S7 � � o v - s � �t 1i f \` I J - -- -�- 1 4eyy �1 i j 1 a TONdd'N-(1F PARNSTfULE LOCATION 2n) woncA Ln) . SEWAGE - aOoS - 3l y VILLAGE JA.Z. N c an ri i S por i ASSESSOR'S MAP &. LOT.0146 - 119 INISTALLER'S NAME&PHONE NO. Ro,S cr i Q'ffimw S0 S- W77- a4s R SEPTIC TANK CAPACITY /_. Ob 9 I LEACHING FACILITY: (type) Fi'c I of (size) eP O x 3 D NO.OF BEDROOMS_.. BUILDER OR OWNER T c-Acr ESI1.5aUc��, PERMITDATE: `7 G -DS COMPLIANCE DATE: 7 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 _ E m > (m W U) N N - 00 O 4J W W N D � No. _ 3/ 7 ` Fee V 1p. THE COMMONWEALTH OF MA$SACHU,}�Em Entered in computer: PUBLIC HEALTHIVISION TOWN OF BARNSTABLE, MASSACHUSETTS Yes Z(ppIication for Mi.5pooY bpztem Con5trurtton Permit Application for a Permit to Construct( , )Repair( )Upgrade(✓)Abandon( ) ❑Complete System O Individual Components Location Address or Lot No. 4 4 71--f1W CEO D L KI• Owner's Name,Address and Tel.No, 5 D$ - _7 15 W. h\jMAAGP0Vr -PETC-e �5n 6/tL)&H Assessor's Map/ParcelMRp 24(a VAeLl✓L z19 6 (0 1 KW COD L 4 j W•by 03u1590ZT-,MA Installer's Name,Address,and Tel.No. Designer's Name,Address and IA.No. RoG0Z-r U1LFDy-Bt-B EXLANATIW4 -DAia ek AIE\.Ec fIt L,JI),FaQf;5TDALf_ 917-D03 X 98 I 5D8 -3�2- 2922 Type of Building: Dwelling No.of Bedrooms" Lot Size sq.ft. Garbage Grinder( ) Other Type of Building RESI QfN LE No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design.Flow 4 gallons per day. Calculated daily flow gallons. Plan Date (v 13105 Number of sheets I Revision Date Title 51-r E t- SEW kb E' -;)LPrO r Size of Septic Tank I QQQ Type of S.A.S. 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 been issued by this Board f Health. S' ned Date 7- Application Approve Date .2 b S Application Disapproved for the following reasons Permit No. C� — Date Issued FeeNo.ci-30 ` + ' Entered in computer; THE COMMONWEALTH OF MASSACH ,UlET-�Srt" Yes r PUBLIC HEA H DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 0[oplitation for Migpogal *pgtem Con!Aruttion Permit °. Application fora Permit to Construct( )Repair( )Upgrade(✓)Abandon( ) El Complete System ❑Individual Components Location Address or Lot No. ©o L N• Owner's Name,Address and Tel.No.,, 5 i� -7-1 5- `"I$ ".., w, M AANA CzPURr WTFe f5116AL)6tI Assessor's Map/Parcel°M P 2 y!o I�Q L F L 21�1 66 1 N LV C )D L N W • t 1\�A U)J 15 PO R.T,,14 A Installer's Name,Address,and Tel.No. t 4 AIEyCTel. Designer's Name,Address and Te.No. RUGC- i2l C-r1LFo\J - 91a EX A\iATICKI -DA2_� ICI ►�3Ee�Z.y LAJ,FU� S�UAI ��17-��53 ,� 9£31 509 -362- z922, . . A Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building � l LE' No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design.Flow 0 gallons per day. Calculated daily flow gallons. Plan Date 13 IU 5 - Number of sheets I Revision Date ' Title 51 T E S E IN A(`I E i�1 A(� Size of Septic Tank, I C` On Type of S.A.S. 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- catd'of Compliance has been issued by this Board of Health. gned � _ ) Date Application Approve 'T y Date Application Disapproved for the following reasons Permit No. C9<Dn S /If Date Issued 71b 5— __ ----------------' 1 L------------------— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS j Certificate of Compliance f THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( ) Repaired( - )Upgraded( ✓� I Abandoned( )by (�u b �-- t C_ i I-CO i - G t 13 F x t (A U Ci A � at &(a tN LUpUC) l A M F , W N`I A AJ P(D?_T- has been constructed,in accordance � 5 3/q �G15 with the provisions o�Titi` nd the for Disposal System Construction Permit No dated ,T Installer \ i Designer , . The issuance of this permit shalt-not e.construed as a guarantee that the system till unction as designed. Date 7/r 9/ InspectorK� t No.�� 5 ��� ., ----—----------- r=-Fee - _ rl�+u7v"v"v'tpLIH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mgogaf 6pgtem Cottgtruttion permit \` Permission is hereby granted to Construct( )Repair( )Upgrade(f Abandon( ) System located at N L.y U 01-) 0W E \N . N,1 A AJ N 1`a` P U?-7_ 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: Constructii�n m t be completed within three years of the d teo this p . i � � -,. Date:_ _ Approved by "`� 9/16/03 Notice: This Form is To Be Used For tlib Regair Of Failed Septic Systems Only PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM I,�� N` M Me ,hereby certify that the engineered plan signed by me dated 1 d S concerning the property located at meets. . all ,of the. following criteria: • This failed system is connected to a residential dwelling only. There.are.no commercial or business uses associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to S minutes per inch. The applicant may use historical data to conclude this fact or may conduct deep test holes and percolation testss at the site without a health agent present. • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • Thee bottom of the proposed leaching facility will be located no less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] Please complete the following: 2 ° A) Top of Ground Surface Elevation(using GIS information). ram.° _ LH-A B) G.W.Elevation +adjustment for high G.W. �ERENCE BETWEEN A and B S�S�M SIGNED A DATE: l"q 0) NOTICE Based upon the above information-,a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. . q ASeptic\percexemp.dcc ., Town. o stable P ,Regulatory Services Thomas F.Geiler,Director + L1RN$1ABLE, + Public Health Division Qjp i63.9• �0 rEO ;�a Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-862-4644 Fax: 508-790-6304 Installer & Designer'Certification Form Date: �J V tr Z l� Ms Designer: v- Installer: o )-_H G, )�'ou -p Address: . Address: Iq "FeaScrru 00 _ - SA-,.J)®VV i at (92-537 F rc.s-1Ja1 t r7A On 7-G -OS- RC)Sz r) G'l-0o j was issued a permit to install a (date) (installer) septic system at (D6 )J h)-W)O LA7,J / based on a design drawn by �((gad�dress) f �;�' !� ►"l•� �� V�',-dated (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. 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 system)but in accordance with State& Local Regulations. Plan revision or certified as-built by designer to follow. H OF kASsq DA REN o tQL}1 MEY co (Installer's Signa re) N . -1 o 0 /STE�� S4 NI IT R1 ' A 1 esigner's Signature (Affix Designer's Stamp Here) PLEASE RETURN TO B STABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTA.BLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form r e. / b I I � � I TF .,fit Spe\ �Sa 1pl"° / 7-91/a" 2, 5'-31l3"— 7-V 7I1"— ,' D D o CA m00 z 8 �m / `J �nmoil Om 9 ,.A � Z�7 0"o h , GC*'m o pm-a s r O om�cn °m C rC mm o°o^� Zm gym+r c m� �`��•,•� I I_, m rn �,z ,� / �,. r o y° o\ v �s \� m C �\ L7 11 x m O \ i° mz,, v W o°1 4 6 R y e � 6 O'KEEFE RESIDENCE THE HOUSE COMPANY 66 INWOOD LANE P.O.Box 1166 WEST HYANNISPORT,MA Bamstable,MA 02601 Tel.(508)771-0303 Web:www.thehouseco.com Fax.(508)771-0384 Email:houseco@cape.com - t N 0 rn o Ul V z O0 rn x z G> rn O � 7 z � rn rn x_ _ � N O O � c O Z rn 3 � Y —i O ' Z ' 7 1q� { D O ?3� d' 8 P" 3 � � o d T m �a 13 y 8 15,_Z.. LA c 73 c 1 r C O 9m O ddd 713 LA z Q V O'KEEFE RESIDENCE THE HOUSE COMPANY 66 INWOOD LANE P.O.Box 1166 WEST HYANNISPORT,MA Bamstable,MA 02601 Tel.(508)771-0303 Web:www.thehouseco.com • • Da[c Pay.(508)771-0384 Emti1:houseco@cape.com j t ASSESSORS MAP : TEST HOLE LOGS NOTES: f ke y PARCEL : 1) THE INSTALLATION MUST BE IN SUBSTANTIAL COMPLIANCE WITH �y SOIL EVALUATOR :�. 1"IP.bIQ�f( ,'���- CSE THIS PLAN, 1995 MASSACHUSETTS TITLE V & TOWN OF I liza FLOOD ZONE: Koo �kZA � LE BOARD OF HEALTH REGULATIONS. AY (ST WITNESS : � REFERENCE : 1�07 DATE: UNE Z' 2) THE INSTALLER SHALL VERIFY THE LOCATION OF UTILITIES, z t l PERCOLATION RAT z- 2 M 111114 G f f SEWER INVERTS AND SEPTIC COMPONENTS PRIOR TO c Q o I INSTALLATION. j y I-{ CLASS -T SOILS LTA-IL 0114 �jpq v 907 - L= THIS PLAN SHALL BE USED FOR SEPTIC SYSTEM INSTALLATION G Covell TH I E Z(p,�a TH 2 3) / ONLY, AND SHALL NOT BE USED FOR, PROPERTY LINE A Lt)hM t LAB l��'PE ► hyR'4r DETERMINATION. j 51TV y Seri Y ° fl F.0 I�1 7 Z�.22 4) ALL PIPING TO BE 4- SCHEDULE 40 @ 1/8 "/ FOOT. (UNLESS D ►'4 la ��/ S Y SPECIFIED OTHERWISE) LOCATION MAP 1/ T S NIF.fJi U'M 5) THE DESIGN OF THIS SYSTEM DOES NOT ALLOW FOR THE USE OF A 1 e GARBAGE DISPOSAL. , S d`► 6) SEPTIC TANKS AND DISTRIBUTION BOXES (WHEN INSTALLED) T 18 91 MUST BE PLACED ON A MECHANICALLY COMPACTED BASE OR ON " I �► CZ 5�j 10�({2.'�I6 7) A BASE OF 6-OF CRUSHED STONE. (.o�crc i4,3o ►• 3 2 5y /y � 15T1 Nl� ( hrt-H/v4 70 13c PVNt fl5 �t v/ G - 1fG� C 1 MoV60 PE -11Tt E ( �c,�z,� v�J�t, 1IeD- �V �b ( Uk) 0$%12Ut;0 dO K,NOWN PP-1 MTE W6LL,yVV /� /0 0E-eme, (,6&tp )4 E � AIa W 105 w/1") 10' a-F Pkap• (6ALKI NCB. I SEPTIC SYSTEM DESIGN Fn- m TITLE\/ OR- w� OF F S 1 140 VA-PA-N &�, 7� y FLOW ESTIMATE 1g4-L,14�" 1264 vL1t-p olvS ; RO BEDROOMS AT GAL/DAY/BEDROOM - 440 GAL/DAY p,GN SEPTIC TANK 26 GAL/DAY x 2 DAYS - G \ GAL 16°°° \ LOT 7 USE ( OCO GALLON SEPTIC TANK-EX/STINK - 12E�(„kc� vV/ 1V00 6Q#0o'j 1 27 . AREA - 43668 sf •- 5E f/C 1 rl i le— I!" F)-►L-C i °�p) O EiO " SOIL ABSORPTION SYSTEM 28 a a i_ t ► r l� s N y5 3� W K � L X D lx�cG!'f'1 F 1 F,1.L7 ; 1 ► - .. SIDE AREA. t BOTTOM AREA: 444 X b.7 4 PD x = 71ggo 6PD re V ` — 26 - SEPTIC SYSTEM SECTION \ it's Tt2M`= T 30,22 \�2 ---------------- 28 PW r E�O s`0 20 a i' "MIA/;% 2 } mN o� nrsh yrod� 9q /o /4 �, I M,.� o o w�, z EX►ST7 // �L'2� o� �„ - '� 2 levc l o N Z G� ( ;' 2 A <. _, � •� n N Z �, �. \ � \ �u s ,B�►ffle�: 26.3 S" . � - Z y+ f �r►� C �trroF / 3 1►� , 6 D_BOX d 5a,� u D ub li23. 1 \ OUp GAL17 1 :,,. - heater fesf SEPTIC TANK �-- 30 L X 20 tJ r �euelPssar STOW DRNEMAY 127 4' IW J I �1✓ I' �wtil o 28 6 6—b oi- CT�/ L No whr z E(, l3-9,0 BENCH MARK TOP OF FOUNDATION �N � OF SD3�USM "As c DAR ti� SITE AND SEWAGE PLAN h aq Rcn .k LOCAT ION : 6 IAIWOO No.1140 c a \ S ►sTE � I ANITAR\P ,l V PREPARED FOR & SCALE . _ W DARREN M. MEYER, R.S. P.O. BOX 981 - DATE: 3 Or EAST SANDWICH, MA 02537 W DATE HEALTH AGENT Ph. (508) 362 2922 Z