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Home My WebLink About0042 KEEL WAY - Health 42--KEEL-WAY Y Hyannis A 268 = 208 TOWN OF BARNSTABLE LOCATION Y-Cpl Oc,y SEWAGE# 001d r VILLAGE ASSESSOR'S MAP&PARCEL ��- INSTALLER'S NAME&PHONE NO.D, A SEPTIC TANK CAPACITY /00 ht-/() _ LEACHING FACILITY.(type) A�500GGr O�ld CIMJA(size) A OAR NO.OF BEDROOMS 3 - OWNER PERMIT DATE: -v COMPLIANCE DATE: -(D-.,A0,R0 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Ae t 7l if O(Pek 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�Z.j,�(W,3 • B AC K � � •�q'�' ( 30 ' . Deck �. 23 No. 7 zo Fee X1100 ap THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC`HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 2ppIitation for Misposal 6pstem Construction i3ermit Application for a Permit to Construct( ) Repair(_,,"Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. q j 1/ee/Oda y 11y&Vr4<% Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 2-Co P 10 d Installer;;'ss1 Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 1 n1C. 50�j�/C2�71 C v l/VtAG sooj Type of Building: ) Dwelling No.of Bedrooms 13DP51� ),ftVV(Al Lot Size . ,2g Actrs sq.ft. Garbage Grinder( ) Other Type of Building IM16 y-{ ,) No.of Persons ! ; Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 30 gpd Design flow provided '3y`1 gpd Plan Date 3'z "a02Q Number of sheets ! Revision Date Title j/ Size of Septic Tank /ADO Type of S.A.S. $O� qc�[G� 4-,J ck- ers Description of Soil Nature of Repairs or Alterations(Answer when applicable) !0 d/c a - .. 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. Si Date -ApplicationApprovedby Date /t-1 Application Disapproved by Date for the following reasons Permit No. 000o — III Date Issued i 1 _ No. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye--E� PUBLIC HEALTH DIVISION -,TOWN OF BARNSTABLE, MASSACHUSETTS ' Zipplicatlon for ;DIsposaY.6pstem Construction i3ermit Application for a Permit to Construct( ) Repair(✓<Upgrade( ).Abandon( ) [:]Complete System ❑Individual Components Location Address or Lot No. //Y&vJ I t Owner's Name,Address,and Tel.No. Assessor's Map/Parcel G, 2 �( 10 r Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 2.A 1to�N. 1�c 50(�j-�/CD 7/SR ✓� MG SG�1 Type of Building: Dwelling No.of Bedrooms p &f NUS Lot Size 2_&1Pc— sq.ft. Garbage Grinder( ) —3 Other Type of Building { ti 1q�t�v. No.of Persons / Showers( -).Cafeteria( ) t Other Fixtures ' -Design Flow(min.required) gpd Design flow provided 3 yq gpd Plan Date 3-2 5''e20a0 Number of sheets Revision Date Title Size of Septic Tank j{gyp Type of S.A.S. 5220 uL,��C,.! !r°•�� r Description of Soil `4 Nature of Repairs or Alterations(Answer when applicable) t4wi f _14 t 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. - i :;Sign ' Date ApplicatioriyApproved by , r i s •_ Date N Application Disapproved by -for the:following reasons Permit No. 2070 Date Issued -------------------------------------------- ---------------------------------------- --- - -------- --------------- L--------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( "Ir Upgraded( ) y, Abandoned( )by'—I-) at IV k 1(, e 1 / 14 has been constructed in accordance with the provisions of Title 5 and the �0 j for Disposal System'Construction Permit-No.; j- . dated Installer_ Designer #bedrooms Approved design flow ?l) gpd k The issuance of this permit shall not be construed as a guarantee that the system will ctio as designed. Elate �( �) Inspector _ No. - �V ----- -----_---- .-- -- - - --- --Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS �Bisposal &pstem Construction Permit Permission is hereby granted to Construct( ) Repair Upgrade( ) Abandon( ) System located at . ,�;`•.,,may 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:Co trulion must be completed within three years of the date of this permit. _ Date y. Approved by Town of Barnstable �t r Regulatory Services Thomas F. Geiler, Director BARNSTABLE, ' Public Health Division 9�°rE&639. a``� Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 5 8-790-6304 Date: Sewage Permit# — Assessor's Map/Parcel Z6� Installer &Designer Certification Form Designer: ` � Installer: Address: Address: On w s issued a permit to install a (date) `(cost er) septic system at Kw./ Wv"o- 46 based on a design drawn by (address) V. y, - f�'1g 4,�� dated ,fin . V V5 702-6 (designer) �ertify 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. 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 system):but in accordance with State & Local u�- ^tions. Plan revision or certified as-built by,desi"gner to follow. Stripout (if rP --cted and the soils were found satisfactory. OF Mqs� DAVID B. c: ignatre) MAS y :;��nstalleCs S u t Th,,, installation shall cornply, with the 51ate Environment I C. d Titl V rd T w a 3,*Yard of Health Regtjiations, z L Tire septic system as proposed on this olan shall not be installed until a licensed town insta' W N,1E receives approval and an instailatior.permit from the applicable town. Prior to installation,tha >lalle, Midi!verify the location of utilities,sewej- :riverts. sewer sines V 71 1AA j%,tt-4 -�X7 L ' raod existing septic coniponesits,prior to installation. 21 '(4:2 4 h ) All gravity sewer pipirigis to be 4 inch schedule 40 PVC at 1'8",jer foeft I P_ firs feet C)l J' refT, the distribution box shall be level. All ,,ping connections to be glued, -ds septic design olar is n:�t to be utif-i—cl for property line determination c,,r for any other purpose other the n the proposed septic system installation r Ail Title V components are Io rneet Title V specifications, f L4-- Parking shall be w ohibited river ,itle V components unles,i_"npoiltf nts are H2O loaded. IY4 61 As shall be pumped and filled 8) The existing leaching or cesspoc with material per Title V abandonment procedui-e!, Leaching and cesspool(s)and contarninated soils within the proposed SAS shall be removed an;J replaced with clean sand per Title V specifications. Septic components are-to tle 10' from a water service line. Sewer lines crossing a water Vne siv: I V P be sleeved with an appropriately sized schedule 40 PVC with ends groutea. The water servict• line or the septic line cat! be sleeved with the sleeve being a distance. n.f1r" or, bots--sides C', 0110 Crossing the line. 11)" if a garbage grinder exists In the structure, it is to be removed if the septic system is not designed to accommodate a garbage grinder. Thf: installer is reWomible for Care �)f excavation arout!i2 all Wities on the property and cam' e2 tn —.L-a. p otecting,the structura I ipv�griti of all struct ii res of uring ti:�2 installation process of the se pi r C�l sys-ern 10( tl 12;' This pian only represents that a �eptir systemcan be instalik�d on prol,rly meetmigTirle requirements. C, 13 The property owner shal! ;reviiaiv design criteria to approve tie total number of bedroorns an%J C. 0 .4 design flow. installation of tint Septic system as proposed and receipt of pa-iment for the desigi N shall be deemed approval of the design criteria by the property owner or agent of. ti) Mile validity of this plan st all expire with the expiration of eie town installation permit issue.-A 0 0 this plan or he vanditv of this plart shah expire on the expiration of the Certificate of Corn 1. t . rci 0 �Mof3,4i issued for the irjst;illa; -Al Lx) C, I S A7 )K_ I/- VP rv�kyclla4, 4L� ------- 10 i L4 (V4W �5�A)Rk� 0, 04 tt 1 T 0 A 4 'A EC V_ZZ-1- D 20 -1 kk F J DAVII Vz- 1 MASON 1P No.1066. �5TOULAO �A L) 3 FE `W A LE P L N 4 LA 9 f1i C-t IZ!S 8 E,INV R r" 1,1;15, "A '4FALTH