The URL can be used to link to this page

Home My WebLink About0331 PITCHER'S WAY - Health 331 Pitcher's Way Hyannis A = 290 - 113 I TOWN OF BARNSTABLE LOCATION 3,3/ yiz°6,f5 4Zg v, SEWAGE# RQ)rf-L/S( VILLAGE ASSESSOR'S MAP&PARCEL .2C(o— //3 INSTALLER'S NAME&PHONE NO. 'ToA,?W1.101 7Zac SEPTIC TANK CAPACITY eXi Snf i�c'� c:a 1Ira�1 LEACHING FACILITY.(type). (size) NO.OF BEDROOMS 3 OWNER d OQ PERMIT DATE: / 2 /'r'J COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility S 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 facili�ty)� Feet FURNISHED BY �D, IN o ,4 O cT� w w ro No. <, Feeu/ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 0(pplitation for Misposal *pstrm Castration 3permit Application for a Permit to Construct( ) Repair(`Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 351 'R tc 1V t-5 W c.,,l Owner's Name,Address,and Tel.No. dy",ji5 Assessor's Map/Parcel D^ 4C ro J x Installer'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 No.of Persons -Z, Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) !K 3 0 gpd Design flow provided 3 1/0 gpd Plan Date 0/21; Number of sheets / Revision Date Title Size of Septic Tank r�Ityn o/ /P/J/rr�wo/ /P/J/rr�w�Type of S.A.S. a() ('�°�PT Description of Soil Nature of Repairs or Alterations(Answer when applicable) jIona -1Gn1 t 611 16016,- a&ihf IG.N f lend, lv _&dl / 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. Signed Date // Application Approved by Date - (a ' C Application Disapproved by Date for the following reasons Permit No. 'O( l�'5/ Date Issued No. o( 51 a � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSAC DSETTS Yes 01pphration for Misposal 6pstem Construction vermit Application for a Permit to Construct( ) Repair(✓Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. S 3/ V t c K-(5 W o�j Owner's Name,Address,and Tel.No. Assessor's Maptcel v '1 `C�U✓`X Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. R q J&cwto -r,,x 01�b aSO,)r, Type of Building: DwellingNo.of Bedrooms '?, Lot=Size sq.8. Garbage Grinder( ) Other Type of Building Noof Persons''' Showers( ) Cafeteria( ) Other Fixtures Design'F1'ow(min.required) 2!3 0 gpd Design flow provided I i/,/) gpd Plan Date 1 r2/9 E3//q Number of sheets Revision�Date Title -- Title Size of Septic Tank04 Type of S.A.S.�_,eld n 6 0' Description of Soil Nature of Repairs or Alterations(Answer when applicable) 1-2E, 3 A PVic /000 (rjl�41e 6&/ .h 4ft) /�2 - �s//.tea��5��E ��„i/, i /!/� rt-�' � �4i�1 a x�10 Ze,4- 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. ` Signed Date i Application Approved by Date Application Disapproved by Date for the following reasons * ; Permit No. ;�LOI / 1 S1 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 �+ � ��T11� at has been constructed in accordance with the provisions of Title 5 and the or Disposal System Construction Permit No. dated Installer,A 7, 7/ti,o r G Designer #bedrooms Approved design-flow�A and The issuance of this,pe t shall not be construed,as a guarantee that the system wil fug nctio as desi ed. Date Inspector 11 --------------------------------------------------------- ------------- ---------------- ------------------- ----------- No. a�� ( - 5� Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem onstruction Permit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at ?z5,i� ai�t��,, „ G/i,,,,,,,i s 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 III ��,,� f i Town of Barnstable Regulatory Services Richard V.Scali,Interim Director • ��atvstnatE, Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form .Date: I� Sewage Permit# Assessor's Map\Parcel Designer: Ll ID Installer. Address: �,4 A 9 C.3 1 Address: . On 14 was issued a permit to install a (da ) (installer) septic system at l WW based on a design drawn by (address) ��• � �� dated (designer) 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. -tOrtify 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 cons��_� �liance.with the terms of the IAA approval letters(if applicable) �' Zt10F�14As DAVID'. 8. c IVIASON m staller s Signature) _ ;� , . No.toss a . �GrSiE�� ' ,S4< �� (Design s Signature)--' (Affix Designer s Stamp Here) PLEASE RETURN TO BARNSTABLE-PUBLIC HEALTH DIVISION. `CERTIFICATE OF COMPLIANCE MRL NOT BE ISSUED UNTIL BOTH_ THIS. FORM; AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. . Q:\�Septic\Dcsigner Certification Form Rev 8-14-13.doc ORS MAP : ASSESS �.�, .. __. _ __.._..___..._ _ . TEST HOLE LOGS 1) The installation shall comply with the State Environmental Code Title V and Town ol(tC'v, PARCEL d' '� _..__. .. _. .._._. .._. _...-. ..�._ ._.__ .w;.. ._.,... _,_.__ , , t � Board of Health Regulations. . 1 i installer FLOOD ZONE: $6�d L EVALUATOR: Z� The septic system as proposed on this plan shall not be installed until a licensed town _ .... W I THE S S Gam, receives approval and an installation permit from the applicable town. REFERENCE: � :a'"` ,r ,-- _. ._. . �....: .` ..� . BATE: _ 3) Prior to installation,the installer shall verify the location of utilities, sewer inverts,sewer lines PERCOLATION RAT and existing septic components prior to installation. ,l 4) All gravity sewer piping is to be 4 Inch schedule 40 PVC at 1/8" per foot The first 2 feet out of TH- 1 ------THw 2 the distribution box shall be level. All piping connections to be glued. 5) This septic design plan is not to be utilized for property line determination or for any other purpose other than the proposed septic system installation. j 6) All Title V components are to meet Title V specifications. tQ I ,� °' + 7) Parking shall be prohibited over Title V components unless components are H20loaded. LOCATION MAP " ' 8) The existing leaching or cesspools shall be pumped and filled with material per Title V ,, � - � ° abandonment procedures. leaching and cesspool(s)and contaminated soils within the -e2 proposed SAS shall be removed and replaced with dean sand per Title V specifications. l, �, 9) Septic components are to be 10'from a water service line.Sewer lines crossing a water line shall ' � be sleeved with an appropriately sized schedule 40 PVC with ends grouted. The water service �cq „� ) � t line or the septic line can be sleeved with the sleeve being a distance of 10` on both sides of crossing e s g the line. r 10) If a garbage grinder exists in the structure, it is to be removed if the septic system is not �^'� '"' - -,7 designed to accommodate a garbage grinder. 11) The installer is responsible for care of excavation around all utilities on the property and fIV SEPT I'C SYSTEM DES I G protecting the structural integrity of all structures during the installation process of the septic 1 system FLOW FST l MATE 12) This plan only represents that a septic system can be installed on the property meeting Title V requirements. REDRf OMS AT t Al.lI AYJSEDRO{?M! COAL/DAY property g Pp 13) Theowner shall review design criteria to approve the total number of bedrooms and design flow. Installation of the septic system as proposed and receipt of payment for the design t _ - TANK shall be deemed approval of the design criteria b the property owner or agent of, + �. SEP7( Pp g Y P Y g aka+ � ) "- -��__ ,�t _ .�- 14) The validity of this plan sh.,all expire with the expiration of the town installation permit issued for __- N GAL/DAY x 2 DAYS GAL �- - " use this plan or the validity of this plan shall expire on the expiration of the Certificate of Compliance 1��GALLf3N SEPTIC� TANK . n. issued for the installation of the proposed system on this plan. SORP 1 ,, S -* TE _ ! �SIDE AREA: - ' 6�JT"�""OhR AREA: t-7 LP S SEPT I SYSTEM SECTION M - _k �r _. . BO GAL )��" ' - : � SEPTIC .TANK ',` ' `� --Za XZ3 I 414rze OF ...:_CF SITE AND SEWAGE PLAN !r Zb!f PREPARED FOR SCALE : ZeD a DAV I D B , MASGNX DATE: \0 ry a DBC ENVIRONMENTAL DESIGNS W DATE HEALTH ANENT I