HomeMy WebLinkAbout0218 ARROWHEAD DRIVE - Health (2) Drive
15`1 Arrowhead
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,Hyannis
M70.80
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TOWN OF BARNSTABLE
LOCATION I Sl A R A O w//c AGE SEWAGG C,�_ E It
VILLAGE //vA -,V elS ASSESSOR'S MAP & LOT ��7U—lSb
INSTALLER'S NAME&PHONE NO. �� stir A e O-/+L CAR, �` 5°0 A�'
SEPTIC TANK CAPACITY .S�o o
LEACHING FAca rry: (type) 2— DR v ty eLL.-C (size) I S- /1 e Z
NO.OF BEDROOMS
BUILDER OR OWNER C01100t4VI
PERMTTDATE: G v COMPLIANCE DATE: U
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
Al
w• �
L(1 ' v0 -
No. l Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: '
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
01ppYication for Mi.5pogar *p5tem Construction Permit Il
Application for a Permit to Construct( )Repair('4 Upgrade( )Abandon( ) El Complete System O Individual Components CC
Location Address or Lot No. i �r-r�►a3 Owner's Name,Address and Tel.N
aycvl�� 1'1A.0,. oaf et-.�.h
Assessor's Map/Parcel D�7 I
Installer's Name,Address,and T•el.. o. �s�`b Designer's Name,Address and Tel.No. "I)
CSCS 3
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 IZI_t10 gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank I Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations Answer when applicable) or)rn ts0,0
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 this oar Health.
Signed Y Date
Application Approved by 12 4, 0 a Date It
Application Disapproved for th ollowing reasons
Permit No. o�_Vu y— y-12 Date Issued 6
No. dv L — I M Fee o
THE COMMONWEALTH OF MASSACHUSETTS
Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
ZppYication for Mis ppaar *pgtem Construction Permit VP
Application for a Permit to Construct( )Repair(1YN Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot o. cr-o W Owner's Name,Address and Te�.`N,�
Ht t 6 1AQ� �fo 1 .�p GQ V Cl�h,VAJ
Assessor's Map/Parcel D�7 ^'
Installer's Name,Addre and Tel. o. ��� 7 Designer's Name,Address and Tel.No. I $
S'P. 0 Soh 1 ill Q,� r
n' �vl IBC flit, Data� Dlu x`�uu'QgtYl;� �.—
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 3_170 gallons per day. Calculated daily flow �S� gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank 0 Type of S.A.S. c �•
Description of Soil
Nature f Repairs or Iterations Answer when ap icable) Q 'I � 5 oft L_.N4�1I 5flQ
q��n -1''CII,�►�r. br5��-tb� +�� o k �,, SRO c�, ✓�
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 issu d-by AisoarrW ealth.
Signed o r Date
Application Approved by 0 2 Date 6 D
Application Disapproved for th following reasons !
Permit No. Ud V' y.�2Date Issued 6 U
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
i
(Certificate of (Compliance
THIS IS TO CER FY, that the On site Sew�ag�^e D�'isposal Syste Constructed( )Repaired (/K) Upgraded ( )
Abandoned( )by �� t' �i 4 95o n Y r_
at 15 rr�W u �S has been construct d i accordance
with the provisions of Tit 5 dthe for Disposal System Construction Permit No.a Y ya°z dated �6 U
Installer FIT� y'l� Designer
The issuance of his p rmit shall not be construed as a guarantee that the s tem nction as e ' net�
Date U( • Inspector W✓
I
No.—�UU,7J— (��---------------------------__Fee
10
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
;Di$po!5a1 *pstem (fongtruction Permit
Permission is herebgInted tp Connstruu`ct�(^•)Repair ) grades(l�Abandon( )
System located at
i
1He..
and as described in the above Application for Disposal System Construction Permit.-The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided: Cons //uctio must be completed within three years of the date of this ee it.n
Date:_ / U Approved by ./ �`�1 ��
f
r
TOWN OF BARNSTABLE
cc
LOCATION 1 SV A R A O W IIC AQ+C
�. SEWAGE #. .'0d — a�
VILLAGE -11v A.A-I&YS ASSESSOR'S MAP & LOT U—i
INSTALLER'S NAME&PHONE NO.. �' -M A.0 a oll Aff elf- So A-,
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) cy PLL.S (size) .2 • /.3 t dZ
NO.OF BEDROOMS
BUILDER OR OWNER O J V1
P$RMTTDATE: 6 v COMPLIANCE DATE: U
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 wetlandkxist
within 300 feet of leaching facility) Feet
Furnished by
0, %5F
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Regulatory Services
yvP O�
Thomas F.Geiler,Director
snaWsrnete.
MAE& Public Health Division
Arena Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office:-508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
Date:
Designer: 4 ARRM Installer:
Address: . q o� Address: (Q(�
On N1 C- was issued a permit to install a
//� (installer)
pp��
septic system at { �� MOW W.I+ `-0 012LVe based on a design drawn by
/ (address)
G ��� ated Lr12 2-,0 00�
(designer) �—
I certi� 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 c ges (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of an component
of the septic system)but in accordance with State & lions. revision or
certified as-built by designer to follow. ����H OF
A R
U N
- N 1140
(Installer'sSignature) �o Q
/STEM V ��
i S'9NITAR\P
(Designer's Signature) (Affix Designer's Stamp Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH 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/Desiper Certification Form
bill
ASSESSORS MAP : TEST 'HOLE LOGS NOTES:
iY N
NI � �''� PARCEL : I�'(D 1) THE INSTALLATION MUST BE IN SUBSTANTIAL COMPLIANCE WITH
` a SOIL EVALU TOR :_ t l � 5, �� TIfiS PLAN, 1995 MASSACHUSETTS TITLE V & TOWN OF
3 FLOOD ZONE : No fJ � -� P '° 1SPli^__ BOARD OF HEALTH REGULATIONS.
W I TNESS �l�` 'w'X
a C SiSC 3 DATE: 10 �� ,ZOt;�4 2) THE INSTALLER SHALL VERIFY THE LOCATION OF UTILITIES,
Ou``G 5 o REFERENCE : ejY-. SEWER INVERTS AND SEPTIC COMPONENTS PRIOR TO
M ?(k. 2 PERCOLATION RATE : ?,�rnf 1�nlGt}
�,r INSTALLATION.
gulf RI,
-s wY n 3) THIS PLAN SHALL BE USED FOR SEPTIC SYSTEM INSTALLATION
s u p. . v• ,, TH- Il.'. I9.So TH-2 ONLY,
Rp AND SHALL NOT BE USED FOR PROPERTY LINE
DETERMINATION.
.: � C]r �„ ;s ro" ��•'� 4) ALL PIPING TO BE 4" SCHEDULE 40 @ 1/8 "/ FOOT. (UNLESS
^d� Sq tJ oy UY R SPECIFIED OTHERWISE)
PJ S
AM 6 17DESIGN OF THIS SYSTEM DOES NOT ALLOW FOR THE USE OF A
� 5) THE
LOCATION MAP (O.-T-5) M F-Pt W GARBAGE DISPOSAL.
6) SEPTIC TANKS AND DISTRIBUTION BOXES (WHEN INSTALLED)
CI 2 6/ C' 1q,6 7 MUST BE PLACED ON A MECHANICALLY COMPACTED BASE OR ON
l A BASE OF 6"OF CRUSHED STONE.
7J �CIST7ry C SS P��`Z ? U� GUSI�£bi
, r2,E y
SEPT I C SYSTEM DES I Gi Iv� ��V_ CG .s_ M__T 7LE V e*_ `"09/
�1t24a-as''c �sb f. a
_ FLOW ESTIMATE
�j BEDROOMS AT 110 GAL/DAY/BEDROOM - �GAL/DAY
GrSs{'or�c.S CE�2T`►P� C�t-i tan.i ,
\Q_ t/Na1--e -J7 SEPTIC TANK
\ �\ ' 30 GAUDAY x 2 DAYS (060 GAL
S N )
� USE �Sov GALLON SEPTIC TANK — 1V4It�/
\ SOIL ABSORPTION SYSTEM
Tb
�l - 7bP 6Av�C�nJ �fI- G-ASi t
v F STS '
f}sSUp _ JD 19 I� SIDE AREA
I �CtSr1Nl� 562 EOTTOM AREA:
25 ' 13 � U,��( - Yb
I I�u�wIrQ a
L) r F = Iq,S STEM SECTION
7 SEPTIC SYSTEM
1 /i,ZSo6-z'
J L75.0 ' S t Z-4 7'3S ,�"
140.1 o{' 6
�}J��DGUf��A�'✓ ��( " `` �� �lir .,f Ik7.! ,�^ —_•. ��� 2''_—___�/g" bDub A51+ � ne. ��
(L7 �' C +QSP_ s,n D`DOX
1�S_00 GAL I(� .° i"ke, r
SEPTIC TANK �P/I(/vtlocs 15. 75" 1� t._L 1� E� = /3.7V
a�
ZN OF M,4ss9c
E G l a7"rGw, Ur- 16S7 y�� ��So
� DA
1 � } "Rows owwww"
E N SITE AND SEWAGE PLAN
1 No. 1140
LOCAT 10N : /r �, ma")"&Ao L iQ
FcisTe
PREPARED FOR :
Tarr �riG/fL 4_"J
•
SCALE:
DARREN M. MEYER, R.S.
9 �IA-N 1C �u¢ Cor�S Ut rr1T5 3 `SINE STREET DATE: D
' DUXBURY, MA 02332
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DATE HEALTH AGENT (781) 585-0293
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