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HomeMy WebLinkAbout0010 OLD TOWN ROAD - Health 10,ON Town,-Road Hyannis; i I/ A = 267 067001 li `I ?3 LOCATION 9 n 1 SEWAGE PERM/IT NO i �, � G cYr �•Cry ae.i ��✓i o�6� ��?` �' �V d�" VIlLAGE A .& B CESSPOOL SERVICE 128 BISHOPS TERRACE, HYANNIS, MA 026 1 BUILDER OR OWNERROE ' ,3�3 f-, Y1� PERMIT ISSUED DATE COMPLIANCE ISSUED � \ >' � j a .�s �_ \� �\ A A q�{y,� 1 1 �` \� �' ,/ =- �� 1 TOWN OF BARNSTABLEC LOCATION �� �'�� ���'"'� �b' SEWAGE # VILLAGE ASSESSOR'S MAP & LOT��� INSTALLER'S NAME&PHONE NO. " �• '� r�°�`�'`� ��1's °fc� SEPTIC TANK CAPACITY LEACHING FACIL=, : (type) fff"e o (size) y3 XJ8 X ,2 H NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: 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 Furnished by '1 n y e 0 IV a �61 '4rft � �'ya � � � � , No. 4),00q •-'—�� Fee �® THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: s l/ ' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS OfppYication for Of 6possal bpztem Cottgtrurtion Permit Application for a Permit to Construct( . )Repair('<Upgrade( Z)Abandon( ) ❑Complete System ,O Individual Components Location Address or Lot No. �'� ����,;/ _40 Owner's Name,Address and Tel.No. Assessor's Map/ParcelB�.;;' — e>,f7_,,, "'n 0 ZQ j�«, X,-0 , y` Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 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 gallons per day. Calculated daily flow ® gallons. 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 Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued y this Board of Health. Signed Date Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued J�0 O / r--- V No. �—/ '..��, s Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 1 PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Yes 2p pl catton for MtzposW *pztem Congtruction Permit Application for a Permit to Construct( . j Repair( LfUpgrade( ' Abandon( ) ❑Complete System ,❑Individual Components Location Address or Lot No.,,o�2 p�,� �/�/ �� Owner's Name,Address and Tel.No. 7 — ��, yba� ri 'G CV y Assessor's Map/Parcel0 © QC "-0 O LO TGGv/ -0 • Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 0 707 P, Type of Building: Dwelling No.of Bedrooms S Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated-dail-yffow S T gallons. Plan Date i=, Y— o Number of sheets / Revision Date Title .. to Size�tif�Se tic Tank /Too ,g,{Z • Type of S.A.S. r. De criptio'n f Soil Nature of Repairs or Alterations(Answer when applicable) { a Date last inspected: ! N. Agreement: / The undersigned agrees to ensure the constriction 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 b' this Board of Health. ` Signed _ ` - 4 Date Application Approved by 1 1 •' I Date Application Disapproved for the ffollowing`reasons Permit No. f j 'Y �' Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( !if Upgraded( Abandoned( )by L c� at /o O L,6 t!i w /? /J / y a r✓/"/J has been constructed4 .accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. UU - 1 dated 3 �-n q Installer L7esigner .etl�fi/lJ t .B. /27.1!'o The issuance of this permit shall not be construed as a guarantee that the sys a wi function as designed. Date *.--- �t 110 Inspector <(J h✓. c S. _.. . _ . --------------- ------ --. . No. r _oo�'"�' Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS ltgogal *p.5tem Con5tructtonPermit Permission is hereby granted to Construct( )Repair( Upgrade( &-jAbandon( ) System located at Xf 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 conditi ns Provided:Construction must be completed within three years of the date •f this pie t Date: 3 a2-,/0 Approved by TOWN OF BARNSTABLE LOCATION /p OL�,b y"G�r•' /Pb• SEWAGE # VILLAGE y�""' 'r ASSESSOR'S MAP & LOT°�-P L? INSTALLER'S NAME&PHONE NO. 1' '" � - SEPTIC TANK CAPACITY LEACHING FACILrrY: (type) (size) ,Pr 4CC7,we&EBteJ NO.OF BEDR60M5 ��/•J, „yes-,,��oy,•.d. ®2_N�o BUILDER OR OWNER PERMTTDATE: COMPLIANCE DATE: e Separation Distance Between the: • , Maximum Adjusted Groundw ble to the Bottom of Leaching Facility / Feet Private Water Supply Well andng 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 Feet within 300 feet of leaching facility) Furnished by A /2 3� a � 0 0 Ho i 1� ' 0 sre'��. Town of Barnstable Regulatory Services Thomas F.Geller,Director Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Fax: Sob.790-6304 Office: 508-862-4644 nstaller&Desi ner Certification Form Date: Installer: Designer: Address:. Address: was issued a permit to install a On v (installer) datet6 _ - �-7 U►y �, - on azesng drawn based - septic system at �� �`^l �`•��""Y � -�— (address) dated (designer) I certify that the septic system referencedg above was �such as lateral alled substantiallyf the the design,which may include minor approved distribution box and/or septic tank- or changes (i.e. I certify that the septic system.referenced above was installed with ma component c . greater than LO' lateral relocation of the SAS or y vert►cal rel°cons° pan revision or ten but in accordance with State&L of the septic system) to roan certified as built by design 01 NPID (Tiistaller's Signature) At (Designer's Signature) (Affix Designer's Stamp Ilere) PLEASE REjF0 AND AS- TURN TO BARNST�� PUBLIC gEALTH DIVISION. CERTIFICATE OF COMPLIANCE WH�L BOTH NOT $ $ASTABUED L E iJBLIC�HEALTH DIVISION• BUILT CARD ARE RECEIVED BY THANK XOU.. Q:Health/Septiamsigner Certiricarion Form ASSESSORS MAP : �'2:; 1 _ -7 --------------- TEST HOLE LOGS ►" � PARCEL : ' SOIL EVALUATOR: '��Yl t3 FLOOD ZONE: G :.._._._._.__ ____,.._.._ .._. ..__. o� ' NOTES: WITNESS : /N le,9 631, REFERENCE: ��G Ate-/ D •�- ^/0 ''�IcS �e DATE:. <..��G•1 U��-Q, !� '00411 7H6-&� R4-5 297160 PERCOLAT 1 ON RATE G / 1 The installation shall comply with Title V and Town of Barnstable Board� � ) p Y of 1 Health Regulations. --------- 2) The installer shall verify the location of utilities sewer inverts and tic Q� �vIG TH- 1 , TH-2 septic , 1 components prior to installation. 3) All gravity septic piping to be 4 inch Sch 40 PVC at 1/8" per foot. 4) This plan is not to be utilized for property line determination nor any other 1 f purpose other than the proposed system installation. 0 ` ; '��Ot� J ► - - 5) All septic components must meet Title V specifications. LOCATION MAP (h.,t'T,S), 6) Parking shall not be constructed over HI septic components. _.._ 7) The property is bounded by property corners and property lines as depicted, 5l f 8) The property owner shall review design considerations to approve of total Cj number of bedrooms to be considered for design. Receipt of payment for e Z� plan and installation based on the plan shall be deemed approval of the y number of bedrooms. 9) The existing cesspool/septic components shall be pumped and backfilled per a Title V Abandonment Procedures. 10)Proposed leaching is to be within 36 inches of grade or provide venting or cut grade as permitted by the Board of Health. t^ 11)System components to be 10 feet from water line. 'i SEPTIC. SYSTEM DESK CALF 4- FLOW; ESTIMATE 61' ! �o LOT 58 9BEDROOMS AT I I0 GAL/DAY/BEDROOM - C� GAL/DAY l ° SEPTIC TANK GAL/DAY x 2 DAYS - ( GAL os USE ii- GALLON SEPTIC TANK LOT 3 >. ° iL ABS ON SYSTEM MELB0 URNS e�L• t ROAD� �--mil.,1 ' Y ZX 132��6 =6=-===-=_=-_=-`� .- 1 DE AREA: ter , , w►. >. �, �" 13 =-___=-__--_ BOTTOM AREA: 2, ,Y ,-� -------------- -'46___________` 6�- �; x bra -------------------- SEPT I C SYSTEM SECT I ON (------------ 05 s :` ` N tT i 4 O o � G o � D DL%Ulu �� 9rl,Z ti LOT 1 0 illt4 Ctte�PODILS 650 � �. / ) GAL Ib, '�' � �.'�. $ 1= 6 �•� �; 5 �� Y � 1 SEPTIC TANK p} NOTES: v SHAPE OF LOT IS TAKEN FROM NEW ROAD LAYOUT PLAN ( 06149). PRE-F,XISTINC NONCONFORMING SITE AND SEWAGE PLAN LOOAT I ON '- )O O i`�: ) R0lc�p U4kt , V\ P PREPARED FOR , G T a SCALE: I DAV I D 8 MASON- DATE 12 0 J DBC ENVIRONMENiAL DESIGNS z EAST SANDWICH . MA DATE HEALTH AGENT � 30$ � . - 177 Z 2 i