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0075 PINEWOOD AVENUE - Health
5 -PINEWU D AVENUE Hyannis' ..� A = 288 67.6 TOWN OF BARNSTABLE LOCATION 7S_P,,4rcywd ,4,r c SEWAGE# .2020 /3' VILLAGE 4/y""f i S ASSESSOR'S MAP&PARCEL I&I-- 7-4 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /6-0 0 LEACHING FACILITY:(type) �00 l C (size) 1.2.BX.9r NO.OF BEDROOMS 3 OWNER ye<Na.Jye_?_ PERMIT DATE: -,A0.20 COMPLIANCE DATE: $—/920t 20 Separation Distance Between the: /vO"e Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility (r'C 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 Z _ G1 1 2-0 i31- No. c, Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in — Z/ computer: PUBLIC HEALTH DIVISION - TOWN Of BARNSTABLE, MASSACHUSETTS Yes ftptitatlon for Misposal 6pstrm Cons ULtlon i3ermit Application for a Permit to Construct( ) Repair(,✓Upgrade( ) Abandon( ) Complete System ❑Individual Components Location Address or Lot No.7S P vc w ved A j a Owner's Name,Address,and Tel.No. I7{ap i Assessors Map/Parcel rcel `�0�G /tP/.,Jc'S Ii!nsstalllA / JJ ler's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building /e.5 aje,41t 1 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) ry gpd Design flow provided 3 yy gpd Plan Date 3 Number of sheets Revision Date Title J " Size of Septic Tank /5"CZO /f-/Q Type of S.A.S. $'oo�g/��•/ /6�Mpr/S Al-le, Description of Soil Nature of Repairs or Alterations(Answer when applicable) y,j$n/1 ei /ti u0 4G611e rw /sf /L) S/'�.�!< %ewk /--ZU 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. Signe - Date-;_ 7-;20;10_ > Application Approved by Date Application Disapproved by Date for the following reasons Permit No. �� Date Issued G No. tiT a 2- Fee f THE COMMONWEALTH.OF MASSACHUSETTS Entered in compute t Yes PUBLIC HEALTH DIVISION - TOWN Of BARNSTABLE, MASSACHUSETTS 01ppYication for Misposal 6pstrm Construction Permit Application for a Permit to Construct Re air Upgrade( Abandon Com .lete System Individual Components PP ( ) P ('� PPS' ( ) ( ),...:® P Y ❑ P Location Address or Lot No.7,s- Ami F Owner's Name,:Address,and Tel.No: eT Assessor's Map/Parcel Installer's Name,Address;and Tel.No. Designer's Name,Address,and Tel.No. f e of Building: g: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building fe" � e�.JIFe F� No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) '7 3e 5 gpd Design flow provided y gpd Plan Date :I 1 Al•P,0a© Number of sheets e4 Revision Date` Title Size of Septic Tank /500 #-//I Type of S.A.S. add q.//W ./-X vAels Al/'O Description of Soil s Nature of Re airs or Alterations Answer when applicable) G,s{cf// ,� /S-00 a/;/4 J A1-10 c-o/y rr,.41 1�tC• P ( PP ) 1 1` �1 , Vic) V60 �s�J �� ���/:� rr,� r. l6A)e .410,4 A" i k. r � �I �tgreeinent: e���last inspected:F The undersigned agrees tdtensure the construction and maintenance of the afore described on-site sewage disposal system in ; t accordance with4he provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance•haeen issued by this Board of Health. Sign need....:, �[ _ Date 5" /-;go 90 Application Approved by Date Application Disapproved by �. r �' r' Date for the following reasons Permit No. � 0 f� Date Issued ' °" THE COMMONWEALTH OF MASSACHUSETTSp�� BARNSTABLE, MASSACHUSETTS Certificate of Compliance A S43 °� THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(00' ► Upgraded'( 1 ,1/-I ) Abandoned( )by , T3to ro-rr iE- at `a g �D rot*Wrt ; A d e 11 yr"nit')r x has been constructed in accordance r� with thcrrovisions of Title 5 and the fo Disposal System Construction Permit No. #1 -,g3 dated Installer A. l,�E`n.r�eS SAY Designer .I..C�pto/ #bedrooms "A Approved design flow,.'-13-�C�, gpd The issuance of this permit shall not be construed as a guarantee that the system 11 fun ti r nd as desi"geed. ` Date �!l �� Inspector - - -, - --- -_> -- --------- -------------------------------- v THE COMMONWEALTH OF MASSACHUSETTS a ` PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstrm Construction Permit Permission is hereby granted to Construct( Repair(Y) Upgrade( ) Abandon( ) System located at 7S 'A/'%)t-wa r3 A x H x""t% r A. 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 olldwing local�proisions or special conditions. . t Provided:Construction must be completed within three years of the date of this permit. Date .•�r w,- roved A PP b Y r'"' �r 1 � ✓ t 'fe "" 410 Ir • -. - i' �.p��_�gg ys�■pge'�"p'Ax d i,y� - VyJ ,�k���a��F♦1crutii�r ;er tP 1bff�( � ��� '�P. 11' w 'Dili �IVeCe6r' d Dvw' ' �' I�fJ ,, i� `ti" �h' A YCSR s � �ewl�h1 E1 p �F� AA'dr4rfi?�� 'h '- .'�ae7 � ,�- � �"`•.. = - �. na '�. v • w - z o- 9 i` r li1Y�, ',iifc li c y k ' A fX... (IMF h�r� y� �tr#�l� {a re ��LCf gg « +a i' � += 1 +#It WE 6 cm,rm �I im imu Its alull if IN bit"I ft" ft vUbft _The li�i r i ^ .n r,Ai D CA -J, r «P y/1ARVIS a. " _ s ,, � ., ------^�--, --— - - .....•a-..-..- �.. �r .arm r The insta`12!ion shall czrnply with the Mate Environmental rude Title Vand Towrl Board of Health Regui3tions. 'OD Z N 2) Tl,.,e septic system as proposed op this iJan shall not be installed until a lice:used town in%ta"i-er xiev 6Ct;)& e eCeives approval.and an installation permit from the applicable town. ✓ A AN Prior to installatioti,the installer shall verify the location of utilities,sewer inverts, sewer lines _71 and exiliTing septic components prior to installation. -11 All gravity sewer PIP ?'YeAMP ifigis to be 4 inch schedule 40 PVC at 1.18"per foot. The first 2 feet ou'of tie distribution box s!i;.:Ii bn, lF,vej. All piping connections to be glued. his Septic-design ulan is riot to be utilized for property fine deterrrfl?7aticin or for any other 111 114 purpose other tn: .i the proposed septic systen-. installation. Ali Title V,.ompo.,;ents are to meet Title V specifications. 'j Parking shall be prohibited over Title V components unle.,L,t,�,npoot�nts are H2O ioaded. T_ t p 8) Thi?existing leaching or ces4iocisr strap be Pum -na ped and filled with 52 ridl er Title V abandonment proceduces Leaching and cesspool(s) and cf,t itarninated soiii within the proposed SAS sh.4111 be ?ernoved and refaced with ciean sand per Title V specifications. cl: 91 Septic components are to be 10' from ;- water service line. Sewer lines crossing water Ene i) , be sleeve:! with an app;opriatety sized :schedule 40 PVC with ends grouted. The ,eater service ser-ti-c line can :be sleeved the s:eeve be7rg a distance of 10' or t:*1- F:dp: crossing I)e !ine A/0 ZIA�O ero4o t tpu_ 1:" If a garbage grinder exists In tine structure, it is to be. removed if the septic system is not Zi-7 desigr.,Pd to ac:-ommodate a garbage grinder, ------ I A, Th�- installer is ie-,ponsible for care of excavation around allutilities on the propervy anid, R T 7 41 : "I . Y Dr tecting the structural integrity of All >,tfuctjres during the 'installation prucess of-he sepii SYS71FEW. MATE 12i Thiz pia,i only represents that a septir systern. can be installed on the property mleet:ng Title V f 12-0 requirements. AT 1)0Uiij>AY ;;, E_DRWM �?50GAL/�),tv A The e pr o perty owne r -ha I! rev lew de sign c r iteria to approve tl,L-total number of bedrooms a n 6 v' ;": I r" T AIN K design flow. 1nsta;laIic;, of the septic sytem as proposed and receipt of payment for the desipc shall be deeiied approval of the design criteria 6V the property owner or agent of. :141 The validity of .his plan st at;expire with the expiration of the town installation permit issued fc, A- 1);.YS C;,�L A ! this plan or the validitv of this P130 shall expire on the expiration of the Cert-ifIcate of Comolianc;, LA `! t TANK l ' 0.4 issued for Une rist-Ale: of the proousfrd sysTp Irm. plan. I WA kk OF A�, IV 1,97 DAVID Q B. �7 J MASON No.1066 (1 03 1 q A • 0 r3CIM(D 0 0 V W&C, 44 0 7 ri T� AL. D. � - [ =---,-I j�� i 6�!!�� )F 0 7'r— r- ;0 0 A N -75 -PI tA4 E L E OAV i D B . MASON 58C ENV I RONMEN�AL DE.S : !4f. '_TLj A