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HomeMy WebLinkAbout1119 PHINNEY'S LANE - Health r u 1 19 Phinney',s Lane _ Hyannis A_ 273 —020 d �1 M BAD yv 5-r �.� :TOWN OF LOCATION: VILLAGE: ( AP N, S 2� 02d- L / � PERMIT#: Z O 2- D ' 1,93 INSTALLER'S NAME: ��✓�1? 5 EA �.L G INSTALLER'S PHONE#: S-n^ 6 3.� J S�`� I . z SoOh'QG C.0 LEACHING FACILITY: (type) Ly:4,c 9 C IJ4A 42 S (size) zq Y l S nn NO.OF BEDROOMS: BUILDER OR OWNER: L S"t ? . OF ko ct K �IA UE JA PERMIT DATE: COMPLIANCE DATE: oLa "A D. i DRAW DIAGRAM ON BACK t 3 T $ O �S a -3 > T I . No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye_� PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ppfitation for his sai 6psterrt (Construction hermit Application for a Permit to Construct( ) Repair Upgrad ( ) Abandon( ) El Complete System Individual Components Location Address or Lot No. I of I� Owne 's �Iis, TelyD Assessor's Map/Parcel [. `7j j 4 ©� Installer's ddres, s,pnd Tel.No. Desi e A s, el��lpi �•{[ -4111 I Type of Building: Dwelling No.of Bedrooms `r``J Lot Size �/ sq.ft. Garbage Grinder( ) Other Type of Building 1 No.of Person 11 Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.rec aired : gpd Design flow provided gpd Plan Date r u 6IZ&0 Number of sheets Re sion Date Title Size of Septic Tank ' Type of S.A.S. Description of Soil Nature of epairs orAlterations(Apswer 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 ncno place the system in operation until a Certificate of Compliance has been issued by thi o ealth. I Si Date I Application Approved by Date Application Disapproved by Date for the following reasons o_ Permit No. 7—d'2 Date Issued It C1z a3, No. U V r U 3 Fee - THE COMMONWEALTH OF MASSACHUSETTS Entered in co puteni r: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yication foris sar 6pstem Construction Permit Application for a Permit to Construct Repair U rad Abandon ❑Complete System Individual Components PP ( ) P Pg �( ) ( ) P Y P Location Address or Lot No ( Owner's Nt e,Ad ress,an Tel o zcz T Assessor's Map/Parcel Z v i a Installer's Name,Address,and Tel.No. Design Name,Ad �ess,y 1 Type of Building: -�_.,D,� ;,'J ( P' Dwelling No.of Bedrooms Lot) Size ® sq.ft. Garbage Grinder( ) Other Type of Building No.of Person Showers( ) Cafeteria( ) e, Other Fixtures Design Flow(min.re ire d gpd Design flow provided gpd Plan Date Number of sheets Re 'sion Aate Title Size of Septic Tank Type of S.A.S. i Description of Soil Nature of epairs or Alterations(Apswer when applicable) L b. 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 no to place the system in operation until a Certificate of Compliance has been issued by thisBor2eHealth. Siga o "Date Application Approved by Date f Application Disapproved by Date _ for the following reasons Permit No. '� d Z — 3 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( �, Upgraded( ) Abandoned( )by at ` }9 P h P.t n < has been constructed in accordance with the provisions of Title 5 and the for Dispos I System Construction Permit No. d),a"/ Lted t; J Installer t Designer t -w— •t r--/#bedrooms 2 Approved design flows(] gpd 10, The issuance of this permit shall of be construed as a guarantee that the system wiQfftuinctions ane . Date _�t'j,J� � Inspector - _ - -.�--_ _ - 7 - ---- -, ,- --- ---- ------------ .- -. No. D Z y (x fee /fir THE COMMONWEALTH OF MASSACHUSETTS , PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pste Construction Vermit Permission is hereby granted to Construct( ) Repair V)� Upgrade( ) Abandon( ) System located at IN I L& 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. fJ Date ( Approved by /_ J l` ( v v Town of Barnstable Inspectional Services Public Health Division • iARNSfpgIE, • Thomas McKean, Director ° 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 �fr e u 3 Installer& Designer Certification Form Date: 10 l Sewage Permit# 2-07-0- iO3 Assessor's Map\Parcel� ®� Designer: Installer: Address: ''`" Address: On '' g Z° — �`-� �E4e�X, was issued a permit to install a (date) (installer) septic system at 1 l based on a design drawn by (address dated ib (designer) 1�. V I certify 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. 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 constructed in compliance with the to nns of C e IAA approval letters(if applicable) s g DAVID q�tie- (Installer's Signature) MASON n No.1066 z, �I..T P�a 4, ( sign s ignature) (AffixAA 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. WoAdeptAHEAUMSEWER cormcASEPTIO1Designer Certification Form Rev&14-13.DOC TOWN OF i i LOCATION: I/ ! / ��"I '" 'V e VIL G �Ar� J11� s L Q.�d PERMIT#: Zo D g 3 INSTALLER'S NAME: Den n i S EA e L INSTALLER'S PHONE#: SoUtiQ�Gc- LEACHING FACILITY: (type) LGAC C NIOM �eS (S' e) y 4 NO. OF BEDROOMS:J, BUILDER OR OWNER: S'r� 0 PERMIT DATE: O j COMPLIANCE DATE: n '2 DRAW DIAGRAM ON BACK vloT �7 A e 1 1�' 2 30' �`' of e� k3 00 6 3� iP ��!/ ,3 _ . ._ _-:yam' _ ., -a.,• _. l Thj instailation shall caniply 'nr Uh Vc, j'Late Environmental �.ode Title V and Town of. 1 D--,Yard of Health Rvgt,I':!VG%-,s. Z'Q-N E septics stem as PC poseuiir-� this olan shall not be installed unzil a licensed town installer 4. -ec.eives approval ins, ne-,ind ii �iilatior; j -rmiL from the applicable _ow. . ;r.Z. —hi r+ P, or to -Installation,th:� )N vefify the location •ol sP-,tjE-- :nve ts, sewer iirie.-s 0'. existing Septic r:,,I.:)( tc- installation. t( Vs` � I ,ki gravity sewer piping:% -, bez' in: schedule 40PVCat.L. ner foot, The first 2 feet out rf ,4 N-Z_ the distribution box shall b�� lf�w:d. AN :.iping connections to b.-- glued. -j.; This septic design ular is oz.-�t t� 6e �.&IV7ed for property line da-e rr-nioatic-n Dr for any other a L C7b -i the p -ose, , -�pti J cpose other thi: Prot, s( W system installation. Ali Title V compo I.ents a re 1 C) rnv et Tifl e V specifications. ..............0 .............. tedo,�' V COMPOTIents unle.,:,t ;—npor;,,�nts t,.rte H201,oaded. 77, Parking shall he P:ohif--i' J --all be pumped and filler with ;7ia-Ii-erial per Title V 81 Ti existing leaching c,,r ILA. abandonmentprocedu#-e.s L;,-achlnigand cesspool(s)and cc-nta!-njnaiej soilis within the -Proposed SAS shall be fem)ved anr!' re laced with clean sand pet, "itie V specifications. optic components are to I..se 1%Y water service line. Sewer a water [it sleeved with an approp., si,Zr:,,i schedule 40 PVC with P^d�g.-C-Oed. The water service' HO WO W4 ";"-Ortle septic linp(:an tae sipr-•,izr the sleeve being aa ,,iisUawce of '-,(" on botk Sidese" )t to M rlgthe line. !f garbage grinder pxistsin Tiie it ist b-.. r 0 C rernov---d if the se, stem is not ri�,.Jgned to auonitnodtea garba?,- .2.!r4iler. e,,�,Iavat,,on arour- I I ii- or thp property arid installer is re�,powibl, oi ca: - -uctura ;,tfUCtJreS CfLir;ng process of the seplit. prrAecting the sti S,,,sterrl. Tr plat)only represefits thai a -.ePti--. systein can be installod on Ols, ;)rcp�:rty meeting Title \,: M �`,�'`� -_ / CE!quirements. V '7 .1 '.. Pie propertyowner �haP rl,viekv dez-`g- criteria to approvP ti'l�t',-)ZF0 r"LIMbfN of bedrooms ant-ji -ceipt pivi.--nent for the desigi, lesign flow. Instaflaticii of lh:� sp I r, , -- ;,)*L - -.-,tern as proposed and rc 00 rIa:l be deemed apprcv f Ow �ritefia bv the properly �*,--nt of, -�allat;or, permit Issue--; i 'T7vi validityofthis pian-2�1- Al Opire W�tt the.,expiration of the town id it,: to ill i plan or the val. Piar :L-wed for the i,7iszidle! t,'*:'le, :d ,--yVFtr: t',-I Pi 4-0 L-,7) J\j A N� \0 3 C x z,5 'T 10 NI- A ,AJ( tt \7 —7- 7--< 74 Zz A� 4 V 5. J f k 44, DAVID P 0 NI 0.A S- 7, No.10 0 'IT 10 -,2 V kj z zlz"17