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HomeMy WebLinkAbout1295 SHOOTFLYING HILL RD - Health 1293 Shootflying Hill Rd Centerville A = 190 109 I UPC 12543 • No..�LOR HASTINGS. UN A TOWN OF BARNSTABLE LOCATION ` ��©off t�AG �� SEWAGE JtQws-0l VILLAGE � �E2veL�'� ASSESSOR'S MAP & LOT 0,0( O INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY ` So 2 LEACHING FACILITY: (type) SQL CAl` t�AM+���S (s�ze) !x« NO.OF BEDROOMS ` BUILDER OR OWNER PERMIT DATE: ` b 2 �i 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 t. Furnished by y � � a3, 1 -- Sy,�•� ►7f' 6g2A�& i C � 1 Ll _ g� uw �I r 3 � No. �/ �`!!� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ti Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 2pplicatton for Ztgpogar bpgtem Con.�trurtion Permit Application for a Permit to Construct( . .)Repair( )Upgrade Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 3J� ®a 7 �'j �` Owner's Name,Address and Tel.r4o. C � �t ti aui� 63 Assessor's Map/Parcel 196 7 (ii,ti1 Installer's N e;Add ss;and Tel.No. Designer's lame Address and Tel No. n� Type of Building: Dwelling No.of Bedrooms Lot Size A/600 sq.ft. Garbage Grinder(M Other 'Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flows gallons per day. Calculated daily flow gallons. Plan Date�i-4 S�^O Number of sheets Revision Date Title Size of Septic Tank lam® ,&1, Type of S.A.S. Description of Soil Ai per- Nature of Repairs or Alterations(Answer when applicable) 6'9,� �� 1��� �'3 C X '� _ a3�X131 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 iss d by this Lrd of e e r Signed Gr.0 Dat 0 'US. Application Approved by Date Application Disapproved for the following reaso s Permit No. Date Issued e THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS -01ppYicatton for Miopooal Opgtem Congtructton Permit Application for a Permit to Constrict( . )Repair( )Upgrade Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. /3 V 6S 1"C r / 'y Owner's ame,Address and Tel. o. C ,W rC ,1�R 1'ryt 0.tR^U Assessor's Map/Parcel '��I�p C� �I (^!tS �l�a-h c c�S'_ ®6 63 Ce�K Installer's N e,Add Tess,and Tel.No. Designer's 1iame Address and Tel.No. , r�,ce� 0_r_QAk" c- Type of Building: Dwelling No.of Bedrooms ! Lot Size sq.ft. Garbage}Grinder Other 'lj pe of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow / yyo gallons per day. Calculated daily flow gallons. Plan DateZl)N,�t Ob Number of sheets Revision Date Title Size of Septic Tank J$po ,( Type of S.A.S. 3' ,� 0 Description of Soil f3J Oc' /�i► v b Nature of Repairs or Alterations(Answer when applicable) 15O LI C- &I=? ��c «� °X D l...c_lV G S� �c l�S �aJ 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 ad of tlSigned w/i l A " Datee �fyS Application Approved by �t/lit_ 111 Date _ r! -51 T Application Disapproved for the following reasons Permit No. �. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (certificate of compliance THIS IS TO CWTIF i', that t e.On-se Sewage Disposal System Constructed ( ) Repaired ( )Upgraded Aband .e (3 )b /fig at � ��'� �? � 1. htas b en construct d in accordance (. with thep visions f Title 5 and the for Disposal System Construction Permit No. (� dated Installer�� �C� C�1�, cr Designer-S7_eS�1-\ H r�1 The issuance of this permit s all not be construed as a guarantee that the syst� <114 nu ction as designed. Date 'k/N C) S Inspector. ----s--�' r '} ��—— D Fee _✓� v THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 30i5poe;al *pgtem Construction Permit Permission is hereby granted to Construct( Repair� )U r de(( )Abandon( ) System located at ..S{1 7c007 /' �� , (,I and asAescribed 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:Constructior}� st `e completed within three years of the date of thi permit. // �'" i ` Date:_.� t U,PID Approved by / P-,5 TOWN OF BARNSTABLE LOCATION ��©� l�lC SEWAGE #aMS VILLAGE—�w�'Z ERv eLl ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. A�`C�s�tz(Z— yd8 SSa-�t SEPTIC TANK CAPACITY_. , So c� LEACHING FACILM.Y: (type) C�C� (size) `�� `/• NO,OF BEDROOMS BUILDER OR OWNER PERMIT DATE: ` b COMPLIANCE DATE; Separation Distance Between the: Feet Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Private.Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Ed$e of Wetland and Leaching Facility (If any wetlands exist Feet within 300 feet of leaching facility) Furnished by j . ► r7 ` C. I` - LJ - 11A 0 r Town of Bar stable ,oFIME l°w� Regulatory Services Thomas F. Geiler, Director BARNSTABLE, ' MASS. g Public Health Division �p 1679• 1m renr,��°' Thomas McKean, Director 200 Main Street, Hyannis,MA 02601. Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: -ac—o 5 Designer: N��I Installer: �t-uc.e �0.CQ��,s r g S 1,�TSo�n Address: a g RArn &,e ';?41 Address: I �_ �aOO�-''� 01 cs` On �' 6- o s- -- c not �'lQ.ea�l.s l�r was issued a permit to install a (date) (installer) i9U///0/� septic system at _I based on a design drawn.by (address) SI-e dated _�_ tAr, - (designer) _v,'�_ 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. OFIM,� /► a ON ( taller's Signature No 2 S ' Q� EVALUP O ( es g 1 ig ature) (A fi Designer s Stamp Here) LEASE RETURN TO BARNSTABLE PUBLIC ALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q: Health/Septic/Designer Certification Form I � �I�/6ET� RGcc�s?•�� i��9�/'✓, .C<lN1S Llh�T y� LO 7-W22 I ��G,En/C� / EX/.S'TiNG ���✓i�dt?,S"/�"�" 1 � � � ^EL LoT' 2G r er�bT �LG✓itTiGyr✓.SG o �. ' I i j r I i ,; F��✓A ria.✓s B/�J-� D../ �`vYJ� I�9Tv/''/. ZoC4S' /` 4401 77­ Ice -� -A e x, 8'�£/Ac�i/ // i `- ` . �n/. ss/✓frPt''�'`/9G t�io9 a q9 DEEP OBSEPVATION HOL E LOG . - �q � °�'A�c,4 �-- -- — � =� , .�i/ I �"�F� �za✓ !T,E�cT�� G',o•c%e rr��..`/�� Dr� — "'e/ ;• o�of,��f/���� /.S,'pG�p r�r� "-ee" S �D .✓rs �a yi;z p v2 . y � y -:�✓`.� ® i 28+ C ' er a i�yR-6- �..... . oo /cam"-�Zs• �t FD �o y� ,�lo u cc' r / �iiRc . ♦ i /,2S /Af" C� Co.9�CE•i'�eV1 /a yam' 7lZ aLPL '^'! �/� p� ,-r✓D ' Z _ej ,� ; , pI 440 6:.Ix 000 �,.�.:f4.si 7z u ' /f,�,>� � �� �✓QT<<: - l/.f� ovL•':.E �it//�%s.r-ra„rr i 1 ., TOP OF FOUNDATION , I /S �. Ex.Cf i 7.✓G GF..c.f000� T .;� CONCRETE COVERS LE✓�L Fi�JP 4"CAST�I N ,9 " .. /i✓/. i9L1G a� ice- ��.. i J , OR SCHEDULE 40 ) LEACHING TRENCH (/ I ' P,V.C.PIPE MIN. 4»SCHEDULE 40 P.V,C. (ONLY) 9. MIN, )REQ. „ /�SGb ►.. - PIPE-MIN. » . 3 MAX. ,,, PITCH I/4 PER FT PITCH 1/4"PER.FT. WASHED STONE » 11Qs 8 � �'. INVER � CI � Qr•?,bfd7.41','b;,�. X 4�9G.os �� , •► ELC(.'l'y.r/.. INVERT INVERT ���;A%��� ' '•�':R�4;�i I�TiO'Zo i A O SEPTIC TANK �•-� DIST. �f , _ ,tl` t�,• 24 t 2 ,:. 1NVcRT EL-.fzJ . 60X �I•.li/� ,Da��11CJ�Cfi� 'i'`�'� �Cjt� ! A�' O , p ...�.� .. GAL.. INV RT , i �G9 .65 I ��, EL..fe,....... EL.T2.�. INVERT Precast 500 Gal.LBach 3/4"-1 V2" 6"CRUSHED STONE EL-f�o.</. ( )REQ. Chamber .'.WASHED STONE .� �s-�-'--�-I i► PROFI LE OP 9 ' /Ob GROUND WATER TABLE E411- SOIL L013 ' SEWAGE DISPOSAL SYSTEM TYPICAL. -CROSS SECTION SITE /_ � A /� TDaTE��.��?� Tlr�c.!!.'r-z�!�A.L. No scALE LEACHlNG TRENCHL I V SHOO FL YINCY HILL RD, NO SCALE- TEST HOL E. 1 TEST HOLE 2 DESIGN DATA : '� � y 9 ELEV.0 7.. ... .. ELEV. .. . . .. . . . . UM 9. LAIN, WASHED . '36"MAX. Gr NUMBER OF BEDROOMS-.?,CQ re V0'?' ;t�/V, CEN TER V I L L E MA O 8 r ,F9i✓Q� M . . 1/e svr+E 2» .•.v.. .t�. . • 9- TOTAL ESTIhtaTEO FLOW ....iw. ...'GALLDNS/DAY ,`' - 8» o• E4.f737 BOT T'OM LEACHING AREA .-fPVi�... Sa.FT./TRENCHL1"Q!L1:•�� 24" FOR. SIDE LEACHING AREA 9Z981� .5�-SOFT./TREFICH %��j' !b�5t.• `, `` 'G . ���l�• �Sr33.S�-/Ld'.Sr�LRS x� = df32 y LA, �. �� GARBAGE DISPOSAL ...A✓v...(50°c AREA INCREASE) , KAR EN PA L T HA Z/ , R D " TOTAL LEACHING AREA • /,.5,fz,•,; SQ.FT: /ZS pctSE.t ' PERCOLATION RATE`.. . .�6i.!��!,✓... 'PER.INCH #6 ' �'pgKIG�An/o LEACHING AREA PER PERCOLATION RATEj-9,✓,gSO.FT." r /:y= 37 9" 0 GROUND WATER ThBL.E �✓G APPROVED .. . . . . . . . .... .. BOARD OF HEALTH j f0/✓ R S, ../Q.WATER ENCOUNTERED DATE..... .. . TM . s�P���ED OF RD� 0 28 fZ/a/✓1F+I I<0.9© WITNESSED 'BY . AGENT•OR. INSPECTOR • • OF o� �,. o Q£ic ViLL. � " (� � 1� .,1�1 ✓�¢. T. �Y� �7�!: BOARD OF HEALTH . . . . . ..� ELLEY No.26100T ENGINEER Eris PETITIONER : : . !�� �✓. ��!!:'9.Z'�RLS ���� EVALUP�4 "