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HomeMy WebLinkAbout0440 LINCOLN ROAD EXTENSION - Health 440 LINCOLN ROAD EXTENSTION Hyannis -A = 271 - 030 i i 0 TOWN OF BARNSTABLE LOCATION�7O /N ®° �� SEWAGE#Z D O/ d-57O VILLAGE44 4 4,1 L5 ASSESSOR'S MAP&PARCEL ,7�—©�® INSTALLER'S NAME&PHONE NO.I vI 40 J9a 2 f /0 Reel 4�P SEPTIC TANK CAPACITY �`S/CU(' LEACHING FACILITY:(type)� Ae4rdZ-5 (size) NO.OF BEDROOMS OWNER 4-c N PERMIT DATE: Z r 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 Z 300 feet of leaching facility) Feet FURNISHED BY � p � O 9.a a N FEE 16c) Board t f Health, � MA. PPLICATIO FOR DISPOSAL SYST�[ �0� NS7� TION PERMIT Application For a Permit to Construct(. Repair( ) Upgrade( Abandon( - Complete System. ❑Individual Components �� Location 141§01 . Owner`s Name Map/Parcel# Z—� 1 Address Lot#: Telephone# Installer's Name �,� GOV� Designer's Name Address Address Telephone# ti Z Telephone# J Type.of Building _ _ __ Lot Size sq;ft... Dwelling-No.of Bedrooms':... Garbage grinder:( Other-TYP e of Building .5 t y-.d 1 tei No4 of persons _ Showers ( );Cafeteria ( ): Other Fixtures Design Flow (min. equi ed) gpd Calculated design.flow Design flow pro�7 d gpd ii Plan.- Date f � � Number of sheets_ Revision;Date •` Title Description;oI Soil.(s)' .. Y1 ''A 5 .Soil Evaluator Form No., Name of Soil Evaluator w\ T Date of Evaluation ` Z' DESCRIPTION OF REPAIRS.OR ALTERATIONS � � WIc l t . . . �.® N LOT " D The undersigped agrees to install.the above described In ual Sewage.Di•posal ystem in accordance with the provisions.of TITLE 5 and further:agree o not to pla _ e:sys in oper lion Certificate of omp'ance has been issued by tiie.Board of Health. Signed. Date Z i Inspections . ----------------------' No: J • FEE` Cz - COMMONWEALTH OF M ASSACHUSETTS t ' Boe&d of Health, . , MA. APPLICATION FOR DISPOSAL L . SYSTEM ONSTRJ�TION PERMIT Application for a Permit to Construct Re air UPtride Abandon 'Com lete 5 Stem ❑Individual Components:m o. nents: Location �,,�� . `. Owner's Name Map/Parcel# -� ' nc) Address Lo.t# Telephone# �--> Installer's Name G - � . (�,C?Lf� Designer's'Namej ,YV ✓ • `^' """T-`� .. .� 1 { Address 1 Address � _ IYT Telephone# � _ Imo-? Telephone## �.� G---'C> IC=>j V Type of Building ; Lot Size. sq,ft. Dwelling-No.of Bedrooms, l Garbage grinder( ) Oilier-Type of Building S I v.�(.(' _. _ No,of persons _ Showers ( ),Cafeteria. I Other,]Fixtures Design now(min. ieZ -eryd) j(�, gpd Calculated-design flow c__�w Design flow pr'o`cnd�edt�C gpd Plan Date i ! Q 1 J Number of sheets_ � Re-vzsioit.Date Title Description of Soil(a}' i .-y Soil Evaluator Form No:. Marne of Soil.Evali:tatorD° V+4( _ Date of Evaluation • / DESCRIPTION.OF REPAIRS OR ALTERATIONS The:undersigned agrees to install the above described Individual Sewage;Disposal System.in.accordarice with the provisions:of TITLE 5and further agree to not to pla. a the system m operation nthu l Certificate of Comp ce has been issued-by the Board of Health. Signed 1 cry _ Date L / _ r Inspections. e 50 FEE( COMMONWEALTH Of MASSACHUSETTS Board of Henit -� �'�'^" .P MA. CERTIFICAT11,0F COMPLIANCE. j .. Description of Work: ❑Individual Component(s) D�Complete System The undersigned here certifV.that the Sewage Disposal System; Constructed O .Repaired O Upgraded ) Abandoned liy:: at has been installed in accordance with the provisions of.310 CMR 1:5.00 (Title 5) and,.,theta proved design plans/as-built plans relauitg.to, application;No. dated; Approved Design Flow (gpd). Installer �� Desigrier� 't'1 1 � Inspector: _ % `�.. Date: r�—!/-� l .. ter. ,tiJ , The issuance of this.permit.shall not be construed as a guarantee that the system will function as estgned. rr,, !! '" �j �V 1 FEE _ COMMONINTALTH Of MASSACHUSET TIS Board of Health,pw , MA. DISPOSALS STEM CONSTRUCTION PERMIT Permissti't is hereby t:anted tc Construct ) Re air( ) L?pgrade� ) Abandon(` ) an itidividual;sewage disposal system �} at.. �l s' �U �.. ` as described in the application.for Disposal System Construction.Permit No. b dated.. _. Provided: Construction shall be completed within three years of the;date of this permit. All local conditions n al be metFori'1255 Rev.5/96 A.M.:Sulkin Co.Chadestown,MA Date I Board of Health C lfl /.4g.,1 / - rom: 02/22/2019 12:14 #014 P.001/001 Town of Barnstable Regulatory Services Richard V.Scab,Interim Director NAM Public Health Division Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& DesiLyner/Certification Form 2 Date: Z-- 26 Sewage Permit# f"1—0LJ sessor's Map\Parcel 2 1 Designer: �(,��� Installer. �- Address: l��j"f l7►" lV C.i'l Address: 4L_� _ On l� �� �t11 Cmo114 was issued a permit to install a — - —�— (date (installer) septic system at � L -� , ET , based on.a design drawn by (address) dated Za 11 . ( esigner) r✓ i certifythat the septic stem referenced above was installed substantially according to P Y y g the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (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 Regulations. Plan revision or certified as-built by designer to follow. Strip out (if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was tonstru _u____-nliance with the terms of the IAA approval letters (if applicable) i`�Zt%OFAq,��_ ` DAVID c'y"c (Installer's Signalize MASON m f ),066 a, (Designe s Signature)-/ (Affix De s S p 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:\.Septic\Designer Certification Form Rev 8-14-13.doc Town of Barnstable THE Regulatory Services OF Tp� ivy ti� Richard V. Scali,Director , AB Public Health Division 639. ��� Thomas McKean,Director ATFD MAC a 200'Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Homeowner(Certification Form for Alternative Systems Property Address: �1L`���� � �• Assessor's Map\Parcel: Property Owners Name: In accordance with Massachusetts DEP alternative system approval letters, the following certification information is required by the Owner of record. The Owner of record must place an "x" in the applicable box next to each line certifying the information. Yes bAA 2/1" D I have been provided a copy of the Title 5 UA technology Approval letters. (15 page Standard Conditions letter and the specific technology letter) C ❑ have been provided with the Owner's Manual ❑ Q I have been provided with the Operation and Maintenance Manual / p p C� ❑ For Systems installed under a Remedial Use Approval, I agree to fulfill my responsibilities to provide a Deed Notice as required by 310 CMR 15.287(10) and the Approval V/❑ For Systems installed under a Remedial Use Approval, I agree to fulfill my responsibilities to provide written notification of the Approval to any new Owner, as / required by 310 CMR 15.287(5) [H" ❑ If the design does not provide for the use of garbage grinders,the restriction is understood and accepted zo Whether or not covered by a warranty, I understand the requirement to repair,replace, modify or take any other action as required by the Department or the LAA, if the Department or the LAA determines the System to be failing to protect public health and safety and the environment, as defined in 310 CMR 15.303 1 , �(� agree to comply with all terms and conditions above. rope Owners printed name Z 1 Z 7,() Prop Owners Signature I D to Note: This form must be submitted along with the septic system disposal works permit application for all RA systems including new construction, repairs\upgrades, with and without aggregate (stone) and with conventional design criteria or credited design criteria. Q:\Septic\IA homeowner certification 2.doc \via Town of Barnstable Pit ' Department of Regulatory Services ; I i Public Health Division Date. i•e�p 200 Main Street,Hyannis MA 02601 • lEl►MK1� ^:� Date Scheduled / Time _ Fee Pd.A 00 Te:: Soil Suitability Assessment for S ge Dzsposa Porformed•By:P 4 IM �W�I Witnessed By: / LOCATION&.GENERAL INFORMATION \ Location Address *4D U vv,`lt �� 4 V�D CAT, Owner's Name Address u'uu VVV����lll Assessor's Map/Parcel: ` ✓ Enginaer's Name 1�)� t,/l kA ezVIJ�.� NEW CONSTRUCTION REPAIR 1� Telephone 1k cJ Land Use• Slopes(96) Surface Stones Distances firm: Open Water Body ft Possible Wet Area ft Drinking Water Well fl: Dmlhngo Way i ft Property Lino ft Other fi SI CH:(Street name,dimensions of lot,exact locations of test holes&pera tests,locate wetlands•?n proximity to holes) Parent material(geologic) _. Depth to edrook Depth to Groundwater. Standing Water In Hole: Weeping from Pit Roe Estimated Seasonal High Groundwater DETERMINATION FOR SEASiONAL11IGH WATER TABLE Method Used: Depth' Observed standing in obs.hole: In. Depth to soll mottles: Doilth to weeping from side of obs.hole: __In. Groundwater AdJuetment tt• Index Well-# Reading Date: Index Wall level Adj fketor,,,,,_,_,,,r AdJ_arautldwater-Level,.,_ i Observation Hole fl Thno at V Depth of Pero Time At 6" Start Pro-soak Time @ 'I Tima(9"41 End Pro-soak Rate Min./Inch qz Site Sul tabillty Assessment: Sltd Passed Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observ*dtlon Hole Data To Be Completed on Back-------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:ISEPTICIPERCFORM.DOC DEEP.OBSERVAiTION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Shcl Color Sall. Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stoned;Boulders. a rsistency.%13ravol) DEEP OBSERVATION HOLE LOG Hole# Depth from Sall Horizon Soil Texture Soil Color Soil Other 5urface-(Iml .. ti (USDA) (Munsell) Molding (Structure,Stones,Boulders. o sl en f DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Sall Other Surface(In.) (USDA) (Munsell) Mottling '(Structure,Stones,Boulders.. Consistency, DEEP OBSERVATION HOLE LOG Hole# Depth from Sall Horizon Sall Texture Sall Color soil Other Surface In. (USDA) (Munsell) Mottling (Structure,Stones;Boulders. ' a i Flood Insurance Rate Map: Above 500 year flood boundary No Yes ,.,..,,. Within 500 year boundary No!/Yes Within-400 year floc d baurdary No-�,-- . Depth of Nattlfallv Occurring Per Material Does at least four feet of naturally occurring pore 0 'oriel oxlst in all areas observed thrpughout the area proposed for the soil absorptibn system? If not,what is the dept of aturally occurring pery ous maCarial'1 Certi °;l t the I certify that on CQ a (date)I havapassed the soil evaluator examination approved by Department of Environ ental Protectlop and that the above analysis was performed by me consistent with . the required training, a 's an ex Tien escribed in,�10 CUR 15.017 (Q Signatur Datts t G` (� Q:\SBpTl0PBl1CPORM.DOC it No. Zii + I l- Fee U THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION —TOWN OF BARNSTABLE, MASSACHUSETTS Zipplitatlon for Vsposal 6patem Construction Permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System Yndividual Components Location Address or Lot No. 111-10 . , Owner's Name,Address,and Tel.No. 6xr it(A Assessor's Map/Parcel _ 0 30 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. W'Cb N Type of Building: Dwelling No.of Bedrooms N Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank 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 Eliviroriwental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boar f Signed Date Application Approved by Date J 6 ! Application Disapproved by Date for the following reasons Permit No. -2 o l 1 Ll Date Issued 1041 11 - - - - ------__----- -- - _ -- - ----- ---- -- t , No. ZU I I N-7 Fee d U THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes 1 PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE.-,"MASSACHUSETTS application for Misposar *pstem Construction permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No. ^ Owner's Name,Address,and Tel.No. A, /I Assessor'sMap/Parcel -47 - 030 tt P^q! 3UCtanc� Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Cf w`cb N Type of Building: Dwelling No.of Bedrooms LottSize sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) L 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 E viro ental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boar of Signed a Date Application Approved by 441Z Date S +Application Disapproved by Date _ for the following reasons `Permit No. ° I l'7 Date Issued V !i THE COMMONWEALTH OF MASSACHUSETTS "PP BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,tha the On-site Sewage Disposal system Constructed( ) Repaired(X) Upgraded( ) Abandoned( )by Wi at y 1 U ti^( bl n 15jrkN1'(1n has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No D 11 dated Installer Designer #bedrooms 1J & Approved design flow ��/�,/9" gpd The issuance of this permit shall notV nstrued as a guarantee that the system/will- ction. designed. Date 511,1 t Inspector i No. 'a t) I 1 ' 1 t�'7 Fee- /l/u THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal *- pstem Construction Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located at U 6'(��� U` )r4l f"P 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. i Provided:Co stru tion must be completed within three years of the date of this permit Date S �6 (/ Approved by �^'� ,e4 /ep - TOWN OF BARNSTABLE LOCATION SEWAGE # O f VILLAGE ��`,�j ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. lyl SEPTIC TANK CAPACITY V� v LEACHING I FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER a BUILDER OR OWNER T7 j- , �// DATE PERMIT ISSUED: 1� DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No - � r .: ,.` �. �'"- - b - -n, \ � � ��� � � � I w �q �� �. � � m �� �' � � �.s � � i � / , i s �, _ _ _ � ', I 1 r;F SSESSORS MAP O: / A.70 .OQ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ............OF....... �7 ............................... Appliration for llispniial lgorkii Tonotrnrtinn rami# Application is hereby made for a Permit to Construct ( ) or Repair (Ao�'an Individual Sewage Disposal System at• I �f Loc 'o -rA ddrre or Lot No. -----Aw----------- -•!_7 ,tYl�[ ........ ......... •--•---------•---•..................-•---^--- �� � .I)//��J�J Address a ------ ®wy�_ ...........'......v9EW"!..... .......... ......-----••-----•-----•-••--. Installer Address dType of Building/ Size Lot............................Sq. feet U Dwelling i—/No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons........_.__._.............. Showers ( ) — Cafeteria ( ) a' Other fixtures ............................... .. W Design Flow............................................gallons per person per day. Total daily flow;...........................................gallons. 1:4 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ Disposal Trench—No. .................... Width.....:.............. Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No--------------------- Diameter____-___-___-__...__ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-� Percolation Test Results Performed by........................................................................... Date........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................ Gr, Test Pit No. 2................minutes per inch Depth of st Pit.................... Depth to ground water........................ .- - - --•---------------•--••----------------•--------•-----------------------------•---- • --- 0 Description of Soil---------- --......x W -----------•-------------------------------------------------------••----•----------••-----.--•----------•--------- VNature of Repairs or Alterations—Answer when applicable___________________ _____'- ............................................ -------------------------------------------------------- •---------------------------------------------------------------------------------------------- •------------------------------------------------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'T`l L i of the State Sanitary Code—The undersigned further agree not to place the system in operation until a Certificate poi,Compliance has been issued by b d alth. Si ned.. . 7 --------------- Application Approved By...........C---= ........-..... - -- ----- -•------• -f . - -- ---._.Date-------•--•--- Application Disapproved for the following reasons-...............................................--............................................................. ......................................-•••--••-•- ....-----•--•---....----•-•-••----•----•--........-----------•-------••-•-•--......•----•-----•---•...--•-•-•--•-----•----------'---•--------. Date Permit No.----------- f 2 .ram. . Issued..-•--••---------- _ •----------•------------------------- --------------------•-------•-_....Daze THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -------✓.LJrr, ..........._OF......s.6!'.�'.!'�.h.,�--:ya;_ � �--C'c�..........................••----- Appliration for Uhipoottl Workii Tonotrurfiutt rrut-it Application is hereby made for a Permit to Construct ( ) or Repair (a'.-r an Individual Sewage Disposal System at: , f R , ........... ,.�... r`m..✓'�'.. ...<,A'f ./I .. ,... r' l.`i �................................... _•_..__---___.•___........................ !� Lo.`Ltion-Address or Lot No. ...........-�._.._.-_. 4✓: � •,.'�`_^��s...c ........... ..................... ............................................. ...... •.....................•..........___---..__..-------------------------------_------- !�y vi Owtie1 �� Address ...... der tf� �s� d_ Installer Address Q Type of Building Size Lot............................Sq. feet Dwelling4`No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) A4 Other fixtures ............................... .. W Design Flow.............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid*capacity- _______-gallons Length................ Width................ Diameter................ Depth___-__--_---__-. Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. 3 Seepage Pit No..................... Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ ,.� Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water_--__---__--_-__-------. (iN Test Pit No. 2................minutes per inchDepth of bTest Pit.................... Depth to ground water........................ � i < A �p f _•_ ......................................................................... O Description of Soil..........-•-.����'•�= "........` --- �t�`�. .. +, w ------••---•----------------••---•-••••••--------------•---•-•--•-. --•- x .-- - -----.��s��.. U Nature of Repairs or Alterations—Answer when applicable._______ _________ `=____ _.:___..__.._..._.._.... ............................ --------•------------------------•...----------------------•---------------------------......................----------------------------------------------------------------------------------...--•-•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TT % p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by-the board of health. Signed. A. - Application Approved,By-•-••--•---•-•--• ........ ' . .. .. .......--•-•--•-- Date Application Disapproved for the following reasons:-----•--------------------------------------------------------------------------••-----•---••-•---•-••------.. ...•••-•--•---•--•-----••-••••-----•--••••...•-•••...---•••-••-------------•--•-••--•---.._._..._........--•••••-•-•-••--•••-•-••-•--••--••-•----•--•---•-•----•••-----•-•-----•-----•-•------•••--..... ---- Date — � � 11 �� PermitNo.......... ..... .........................•----- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH r.�' r t' .... g f ✓mil r �i �,✓ ... fitrr�ifirtt#� of f�o�t�rli�nr�e , T,W--I;r IS TO gERTIFY, That rthe wInu vid sewage Disposal System constructed ( ) or Repaired 01;by. afi�t ' �$ f �' ''�` ........-•--•--•-•-•---•-------------------------------------- ................. .... �f ✓O' �lex,lew+�`� ? f� Installers has been installed yin accordance wl i the provisions ---•-- --•-•-• ---•----•-----••----------•--•------------------•----------•---•-------------------- at -• ......--• --- - "*� p s of %:4 5 of The State Sanitary Code as descried in the application for Disposal Works Construction Permit No.':..='_^_ ............... dated-....... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. ��DATE........... ' .. .N� •--•.......................--...----- Inspector.---. ..- •------------------------------•-..._--------........_ THE COMMONWEALTH OF MASSACHUSETTS BOARD�,�OF' HEALTH d . �I_� •'�! ..... .....OF...s 1 r�-,�' ' - .......................... ���;% Nam............. .•--- FEE,-.--. . .. Biopo Ivor (9p g 0, Wn nti Permission a hereby granted...�� �=-=--- ----------=----=---------------��--------•...b.......... .............................................. to Cons�`c .( ) o}� Repair ( an IndivipialSevctaIj sp Syste ,/ - Street 71 as shown on the application for Disposal Works Construction Permit No ...... _ Dated......--- L� ....---•--•-- . „ , Board of Health DATE........•I- ' - FORM 1255 HOBBS & WARREN. INC., PUBLISHERS •.` � , s r Health Complaints 04-May-01 Time: Date: 4/20/2001 Complaint Number: 2804 Referred To: Taken By: DANIELLE ST.PETER Complaint Type: CHAPTER II HOUSING Article X Detail: Business Name: Number: 440 Street: LINCOLN ROAD EXT. Village: HYANNIS Assessors Map-Parcel: Complaint Description: NEIGHBOR HAS CHICKENS THAT SMELL. SHE IS UNSURE OF THE AMMOUNT OF CHICKENS. THERE ARE ALSO 2 DOGS IN A CHAIN LINKED AREA OF THE YARD AND IS NOT SURE IF THEY ARE CONTRIBUTING TO THE SMELL AS WELL. SHE SAID THIS HAS BEEN AN ONGOING PROBLEM WITH THIS HOUSE. Actions Taken/Results: No odor encountered from porch of#440 Lincoln Rd. Ext. I went over to rear property line of#183 Buckwood Drive. Odor of chickens &dogs were encountered but was not strong enough to be considered objectionable. discussed results with occupant of#183 Buckwood Dr. and left it that I would like to speak to the owners of#440 Lincoln Rd. Ext. prior to issuing a warning. The occupant said that I would be notified if they were home or if the problem returned. Investigation Date: 4/23/2001 Investigation Time: 3:30:00 PM I 1 Health Complaints 04-May-01 2 C� the un tnt n-uj WO.n inn o& ih 2 w l ,,k)A �,utciclnO- E �� � � J � Health Complaints 20-Apr-01 Time: Date: 4/20/2001 Complaint Number: 2804 Referred To: Taken By: DANIELLE ST.PETER Complaint Type: CHAPTER II Article X Detail: S�Z Business Nam _ V O A Number. 4 HO Street: LINC N ROAD EXT. (i Village: HYANNIS Assessors Map-Parcel: Complaint Description: NEIGHBOR HAS CHICKENS THAT SMELL. SHE IS UNSURE OF THE AMMOUNT OF CHICKENS. THERE ARE ALSO 2 DOGS IN A CHAIN LINKED AREA OF THE YARD AND IS NOT SURE IF THEY ARE CONTRIBUTING TO THE SMELL AS WELL. SHE SAID THIS HAS BEEN AN ONGOING PROBLEM WITH THIS HOUSE. Actions Taken/Results: Investigation Date: �/Z�/o Investigation Time: o 1,4` �' �t�'j 1 f,✓� �- (� �!� Lam � a, !¢e ASSESSORS MAP >ITES j11] 0L E i l_0 S 1 P42�2 PAIICEL i 0. �____- n'- _._ — ,,, •:,+,,, ,�; ;+/ =r,"� I) The inslallnllon shall comt�y with Title V rani 'l'own of , ► � Iloord of c so I I;;;9VAL' T00 4' ' lealili e n ations 1� • L� FLOOD ZONE;_ Via✓ _ 4p,$ � 1, :. — w�Ti�E9a y p' :1 2) .The insialler'shnll verify the localioo of titi111iesf sewer inverts anti septic ' md2REFERENCE: _ � Cyr <'zC � PATE 1 ss,�; ': � •, - �4' 1 � components prior to Installation and selling base elevations. i 27/t��-A z ! pERCOL Ol� ATE: lf�ll , 1 , 3) All gravityse tic' i in to be q Inch Scil,li) PVC at 1/8 'per foot.Tlie first t - f' IvVo lest oilt of the d-box tQ the leuel)ing shall he level. 4) ,'phis plan Is not to tin itlilized for property line determinalion nor any other ( , ITi(- I , ::a ; , . TN"2 purpose other than tlia proposed system lgslallatJon, ! �-Kj Q t i 5) 'All seplic components must meek Ti11e'Ll speclficatitins, ; I 6) Parking shall not be constnicted over t t Q septic components, �j\, r 1 ,_.lti ,p �'• ` !j 7) The property is bounded by property corners Atttl properly lines. j / 4 fl` 8) The properly owner shall teyiew desigq considerations to approve of total ! t le si e e � n !low a n1 b f U d o0 i. n 1m r ms to be'co et i g d s e to' �'P. n id r I far design, ace . LOCATION MAP / , gn, R ipt I , l �► I '. of payment for•the plan and installation based on the plan shall be deemed ; I (A `v 0, ( 1 9), apperoYal of flit#design flow py'the owner, i `I It existing leaching pr cesspools shall be pumped and filled whir material ' I her Tide V abandonment procedures. Those ivilhin ilia proposed SAS shall ; ' be removed along with contaminated soil and replaced whit clean sand per Title �J specs, , 1 T"� i ` • ` ( 10)System components IQ be IQ feet from walcr line. Sewer lines crossing the i ' r ---- water line shall be sleeved Willi q Inch SCIi 40 i'YC wilh ends grouted if ( �' [ applicable. The proposed SAS Is being (nslnlled below ilia water service ! �; U `� � ° ' ' line.: line Is to be sleeved as o o „� ' 1�) p S S Tl.e aforementioned and maJhlained in place. S E 1 ;T ! `C S �M D N l 1) if a garbage grinder exists it is to be removed and is ilia responsibility of the ' ttnQ owner to ensure such. � � ri ` FLOW ESTIMATE l2)3'he installer Is to take cantion Jn excavation around ilia gas line ifsul:h i i \ BEDROOMS; AT�GAL/DAY/SEDRcIO�i -�GAUDAY i 13)Tne Installer shall verify the locations quantity and elevation of the sewer lines exiting the�iweliln rior to ilia Installation. ', g � i ' I t I 14)This la is re resbntative only Ihat a system can fit on a co art meeting SEPT l e TANK i plan p yp p y g ' 1 ,. T i ti 1 i Jlle V requirements. • AMC GAMAY x 2tpAY3. ���GAL a� 1D1 G�% � _��_tiY�-� J�yd�l 1 usE GIILLop� SEPTIC TANK �,E,i' ( r.. ` , ' I 0l l;� ARx�511RPT I of YgTE i , R r; 1Dkt 0�3' lt S I DE,�, tEA: lit 'f' fl ZX�7 a 1 l BoTToM AREA: '" -6 -1 '� ~�((� MASOPI n �Nn1 = 1 I ' t- `c� No.lase —I 157 STEM . SECT I ON60 y I — — -- . + / b �j VIASEPTIC TA�JK � x i�. l.�� Yam._ __ � �� 1�t G►��' _ _ � 7, hTNIz ; • ___._._-__ . _._.._ _.t7 ._�►�J_'✓_1.�.__ '--SIN_----_----------. SITE AND SEWAGE PLAN l_OCAT I ON I 0 �� ( xvi e, • 1 , PREPARED FOR : ii P �,�C�I vV� God�, I ; COT 1 N 1 SCALE: ( - i DAV I D n M 50NIR5 DATE I Z _ DUIC ENV I RONMEN fAL DES I GNS DATE HEALTH AO:f IT FAST . A CAW CN MA x 1500 ) 0 3- 17 , t