Loading...
HomeMy WebLinkAbout0024 MYRTLE DRIVE - Health a �V myr�-lam D3 TOWN OF BARNSTABLE LOCATIONt0� / X Ille 'Dg'i N/<. SEWAGE# -C,-'/-2©t VILLAGE l V��A/,� ASSESSOR'S MAP&PARCEL 9y /®� INSTALLER'S NAME&PHONE NO.�f4Q®j�y,4L CLfiySToS- SEPTIC:TANK CAPACITY /5��V Qsli4v / —/v if'►K LEACHING FACILITY:(type)g (size) NO.OF BEDROOMS OWNER /4&e4glilV PERMIT DATE: 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 � � v N S �S �.� Drz.,, y No. .20 v 1 Fee ��� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes� PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 4pfication for Misposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) Complete System ❑Individual Components Location Address or Lot No.2f f f X111t, Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 0q,3 /I>3 1,%A hk Installer's N atlre,Ad4ssaryd Tel. ter; Design's Name ess, .T[p,,,�`O �,��/6N 7 Type of Building: 22 Dwelling No.of Bedrooms Lot Size O�V sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.require gpd Design flow provided gpd Plan Date 1517,S Number of sheets Revisi n Date 1/ Title / Q� 0 .0 Size of Septic Tank Type of S.A.S. Vc:5 O Description of Soil Nature of Repairs or Alters ons(An er when applicable) (,�,� ogqw Ile—�11 to4P� C Date last spected: 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 C e and not to place the syste in operation until a Certificate of Compliance has been issued by th o ea Si Date � ,�Z Application Approved by Date 16 Application Disapproved by Date for the following reasons Permit No. a 1 ( —.2 0 y Date Issued d`•�. s, - .�....,r _,/� fe?`+-r t'"",�. 0 inn „r .� y.^�.. +e.. a..,,. . . 'r.�,.p.•• . •x•M 01+16 4� t�rt�a4j a " No. 6:i ( • •�G k . nFee oc), THE-COMMONWEALTH OF MASSACHUSETTS Enteeedutcomputer: PUBLIC'HEALTH DIVISION -'TOWN�OF BARNSTABLE, MASSACHP�SETTS rk::v 01pplitation``for Zisposal i�pstem Construction 30ermtt Application for a Permit to Construct( )` Repair( ) Upgrade( ) "Abandon( ) 0 Complete System ❑In`dividual Components 075 Location Address or Lot No.;Z I !l/t Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 24,. Q ,� (C e Installer's Name,Address, d Tel. 'o. P Designer's Name,Address,and Te1.-No ee Type of Building: Of r Dwelling No.of Bedrooms Lot Size /i sq.ft. Garbage Grinder( )_ Other Type of Building 1 No.of Persons . Showers(•„ ) C?feteria( ) ' Other Fixtures Design Flow(min.required) / i gpd Design flow provided ''" ! gpd , Plan .Date c /� 5/�C -,f Number of sheets / Revisifbn Date , �°-�' 4. kh 15v; r '« Title V / Size of Septic Tank ,�`�' (.J c Type of S.A.S. Description of Soil f Nature of Repairs orAlteratilons(Answer when applicable) [ 1 {� 41 Date last inspected: Agreement: r Y F The undersigned,agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance witli,,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`Bo�of Heath.• ' i Signed _ Date �'e Application Approved by / �(� 1 ' Date ~Application Disapproved by Date for the.following reasons Permit No er 1 C •�0 Date Issued 4/? 5 -...,...w.....-.�:.:e...�.v�.. �_._:.. -:k -..: -. - _ - ear..-:.-......�cs::cv-a�-a-e c- -� _ram__._.__._.;•--•_- _•-•--_.-•--•---.-.- -......... THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS . (Certificate of Compliance THIS IS TO CERT�yI_F�Y,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded .. Abandoned y( )by atG" �`� .rC , ' C has been constructed in accordance with the prooviisioonss) f Title.5 and the for Disposal System Construction Permit.No. 20 -2 ri�",r� dated Instal ler +, #bedroo s., Approved design flow ., : - , p gpd The issuance of this/permit shall not be construed as a guarantee that the system will function as designed. �y`�/ Date- rt F0/!� i_a-A Inspector AVj,4jAeq. 7 aies No. o Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS:, Btsposal *pstem Constructton� ermit . Permission is hereby granted to Construct( ) ' Repair( ) Upgrade(V Abandon( f„ System located at ,) ¢ W F, 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:Construction must be completed within three years of the date of this permit! Date Approved by /3� ( , f J f *. r t�j�' �Vir�d1 �U••f �—�U C l.v��lr �. �l,��e _ A ?r� fJ TT r a Town of Barnstable Inspectional Services $ Public Health Division NAM Thomas McKean,Director 0s�. .� ++ph. 200 Main Street,Hyannis,MA 02601 Offii e: 509862-4644 Fax: 508-790-6304 /_ Installer& Designer C fication Form 22 Date: Y l9 �� Sewage Permit# •� Assessor �'s MaplParcel 7. wJ Designer: Installer: f(�+ Address: Address: �� r On V ; W ` was issued a permit to install a (date) (installer) septic system at !"s' based on a design drawn by ( dress) 'ZW1 '• dated l , 6 (designer) I certify that the septic system referenced above wag installed substantially according to 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 certi that the system referenced above was constructed in ce with the to rms of the approval letters(if applicable) N OFNjgs o� DAVID �9�y B. c. (I er's Sig ature) o MASONrcyni c� No.1066 1 c/STEP /. tS',q ti Wsi)y1h1§Signature) (Affix De 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_ Y THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. \koaWeptsUiEALTtMEWER cormecASEPTICOesigncr Certification Form Rev 8&14-13.0OC _� ,aa+.r-rr-.u.tvc-.-....a.+na�ey t-:tsz+�s:r-•n.u�.�.*._.+..u.'.'•�afsaxa..ara,+rr'asa_:.r-i�r..:!� ., .:-r"e.�a•,•sn,er�a:.r-•-�..xa•�.v.rs...r� .. ..y.�,ea..�.=ryr�wwr. .�M�. .,,.,.�,�..,..•.,_._...-.-_ —'_.__ V ST r,tc iti5tdl ail` i} Shs11 C:i.1 i;i ��:ith the:,fate Environmental r_odr !1Cfc ':':l' �fJih�R Ot' 1 y � y� y� ` _4 y [^,�y-��( / ? td of Heeitf7 4�"`� �� t� Vi� ,l i � �_Cn��t{d�i�+� IV (i '; 'S'''septic system as p,'oposer.:C+f-this Man shall not be insta'tE'. d zinSI ii 4k;: iced town instailer t _- _ �'itE� oh , ,:ei es approval.and � , i;isle iati:3r, ;,Ermit from the H V -+or to installation,tr7�` n:raila, siir); ,'@rift'the location d. L...1-ie.,. y_r�E 1-we , sewerlitlinz� Y V it 'Q -� ' � ` d existin septic= om o ei�_5 .t:�r l installation, ,Li't f zj _ _.___ _ ' t ✓' -I'r All$ravii`sewer pipli; is tc ae inn �cheti�ile 0 PVC at 1%, " ;; `ot c. i!e first z feet ojX. of IL THW1 2- th;l distribution box shall b�� 4ovel. ,;}l ojping connections to br gkjj,t-. This septic design plan is o:lt t �c t r r_d for property ling do'-p;"ii ?ti�?n or for any other • < it ' `=i3Yp4Se Other ihz tt,8 j,rc;�oSej: I36,:system installation. AN foie V compor:ent:art. t,rneoi IWe b soecificattons, i i Parking shall be p.ohibite-' ar;- -.ilc k c", pcments Unlen,,^ .•��i nfis aio H20loaded. WCA ! ON �) �� existing leaching cr ce>:,�`t.c;i sf-;;O be pumt)ed and €i1€e:�Urith; .ateri.ii per Title V a t ; abandonment procedui=; '::aching. and cesspoolis) and t �=ia rinat�d sr>'is within the P.-.posed SAS shall,be remv,,ved r;j� .?-eolaced with crean said pe t ifie V,,i:eci irations- - LP-ptir ca mportents are tr) i10 ti ti Ci' water service fine. Sewe 6:ieS Li[.'.sing a water line sil:: t b,=• Sleeved:vith an aps?rt� ;. � •:siz:.�. :cheduli, 40 Pb'L With?`'.d 31?e i'VaLir?r SefV=:t' yy :r,;�or the septic fire ca, .a 3i.'' ,�.F :i ii.h the sleeve being:. t ."Ssing the idle. Ci garbage grinder exisi:s i"1 it isto be removc s f i-he s,=p':c G'istem is not 'J'^�f� c1.'signed to accommo:_.tc Y�r-�� gCnder, ��.b /� I ���. V l/ _. - { - ..____--.,.� ..«�._ _ _'ih a r y S`_ rat �i'�' :9 i .:�el t•.+�:� wlf. ?l lt' rO / 7 .� -;i�. ' installer is test;>�n;;k i_ .1s ,:� x_ ova :ort around aii � t+erty and L /Y protecting the strs ct4 ai �trurtores Curing ,s pri.!Cess '. , the sppli; plOn cilly represents tl,�r arepti,- rystem can be instalic meetingTitie V Properly owner,}:v1;re ri4w ties",.;;: cr iteria to approve i l._,tcitat:;tie�t ;sser of bedrooms anti Q - r design flow. tristallatic;) r.=f ti:z.,-p6c :,;stem as proposed ar:ci receipt ui ,_,avinent for the design r, ir1e :-ritefia by the propel, mvnef'0, •,;y rt of. I --_ p ,� � J X ;! ,� 0 r:tP validity of ziiis plat;.# Alixj.ru !i thf:expiration of tli Lu+rlr,;ii:t,llat:o>r permit isSU?c: tc;i c plan or the valid ii+ f hi p'•ar• sYs:;#i eXn'trP oil the eXplrat;on o'• `;ire t.fir1,rcate of Complit1nc = !!� Q v, ' t' ,/' d f issued fortthe osr-mic,: .i ;s q ..` u r r 1 , :�i s , left• r, i :f .,i ..." ° --- OF Z l XZX 1`7 a i L. 1 « :_r: � MASON DA ID �,, I rr� -1066 STE 5 -700 1 p - fit i •i zi?(',t , 03__ 67 59 xi --7 e OML OF SST MUG vtoyZ_17r v - •.1a�S='!e•sll+i_--rt�^cwc--M4x,a»-T�1l.rw/wIhilPslw'/[1Ssrw•...x .-..:.a,,•.4'.�a�Rs-.;:, k SITE A f .7 BAR f7cf, Coaa W qu