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Home My WebLink About1067 PITCHER'S WAY - Health (2) or ljPitchers Way Hyannis A= 273 - 198 f i i oLOkCATION -,1I0 � SEWAGE PERMIT NO. VILLAGE INSTALLER'S NAME & ADDRESS B UILD R OR OWNER �6 ,� 7- cuoz Cad DATE PERMIT ISSUED �� / 7 l DATE COMPLIANCE ISSUED �� ,, � �'i �I � �` �� i �' av ` �a �� 1 a� _� `� .V' � � a TOWN OF BARNSTABLE LOCATION_/OG`1 SEWAGE# Z O 14 -.19 3 ,�UILLAGE �ua,r,nr$ ASSESSOR'S MAP&PARCEL Z`13 - 148 INSTALLER'S NAME&PHONE NO. .[� {� ExcoLuo.ai on y'11- OGS 3 SEPTIC TANK CAPACITY lSOO ' LEACHING FACILITY:(type) S00� LI C (2� (size) 13 x 2$x 2 NO.OF BEDROOMS OWNER F:10o l O Co S4 cx L PERMIT DATE:�S'-30- '9 COMPLIANCE DATE: G•3- 9 Separation Distance Between.the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching F i y(If any w tlands exist within 300 feet of leac ' g c' ' ) Feet FURNISHED BY A l- `3"b 39'4 AZ- 1`1 ' ,5Z- 33'$- A3 25'Io r 63- Z013 . O O 3 Ay- 2$ ` O 23"1 ' A, 3 rrrot�+ 1 .c No. Fee V`-� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pplitation for Misposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No./0&-7 ,tdrvS VJA O 7 er's Name,Address,and Tel.No. Assessor's Map/Parcel I 11 s Nam Address,and Tel.No. Designer's Name,Ad ress,and Tel.N�D'e Co! X Ga vojlon 513� /Y77 J)a V/�J�f 0'5 07) v Type of Building: Dwelling No.of Bedrooms �!!3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3a 0 gpd Design flow provided 3 1' gpd 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) 10 s"f' j l o (Z)hlza 6D®c ( L• c-hambP(5 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 Boar of e t . igne Dates Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued 0 `ti. .0 z No.� /� 4 Fee THE COMMONWEALTH O F MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ipiication for Misposal *pstem Construction Permit Application for a Permit to.Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No., j 007 ��J ��`( Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 05 1 c(.— Installer's Name Address,and Te.No. Designer's Name,Address,and Tel.No. ,Qt� xcc,Va.f fob. 569- 1,177-L,5 "Dnvlo X405 an Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures p� Design Flow(min.required) 3 gpd Design flow provided j gpd Plan Date 4 7 u 14 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) 1 D 61-111 T)O'/. I I`1 A Lo Z IN 2t� 5a�a� l L t_.I�arnh(�t 5 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 Het . rgrted Dat Application Approved by \ \ ,F Date, r Application Disapproved by Date for the following reasons � 4 Permit No. t- Date Issued d --- ---- ._,---------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,thatthe On-site Sewage Disposal system Constructed( ) Repaired( Upgraded( ) Abandoned( )by { 1 !:)( ! /t at I ()(,—I :P 1 r inol!�) W A y has been constructed in accordance with the pro 'sions of Title 5 and the for Disposal System Construction Permit N hi dated G Installer t-I Designer #bedrooms Approved design flow _ 0 gpd The issuance of is pe it shall not be construed as a guarantee that the system will nc 'on ,)designed. Date 3/ ? I Inspector „ � 1/ P 1 No. � Fee 00 y. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair(�` Upgrade( ) Abandon( ) System located at ) Q -7 t' 1 _ F f G. 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 Oithin three years of the date of this per .it—.\7 Date �t- 3o l 1 Approved by Town of Barnstable VE WE FTo Regulatory Services Richard V. Scali, Interim Director uxtvsrnst.e. Public Health Division "0 tea ° Thomas McKean,Director 200 Main Street,Hyannis, MA 02601 i Office: 508-862-4644 Fax: 508-790-6304 i Installer&Designer Certification Form G Date: Sewage Permit# Assess is ap\.Parcel Designer M) Installer. Address: 1 �"f �7V �(�1 Address: On J %� 20� ±% " _ ! L-wvewas issued a permit to install a (date) (installer) septic system at based on a design drawn by \I (address) Y r Y 1 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. 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 construc,+wy---� �liance with the terms of the IAA ap r val letters (if applicable) ��P�-�t1 OF�l9gs�. t o� DAVIDB. MASON m (Installer' ignature) No.toss a p`=_ (Designs s Signature (Affix Designer s Stamp 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. QASeptic�Desigaer Certification Form Rev 8-14-13.doc ASSESSORS MAP : TEST HOLE LOGS 1) The installation shall comply with the State Environmental Code Title V and Town of*11410.t PARCEL: f-Z5 /��-' Board of Health Regulations. FLOOD ZONE: SO I L EVALUATOR: /� �- .• 2) The septic system as proposed on this plan shall not be installed until a licensed town installer --� _ receives a roval and an installation ermit from the applicable town. WITNESS d� l.� pp p pp �J REFERENCE: C � �l DATE: f7e744,1, 00, 3) Prior to installation,the installer shall verify the location of utilities,sewer inverts,sewer lines PERCOLAT I N ATE: .4 % / and existing septic components prior to installation. �✓ - — /`�.�� f V. l� . I 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- I TH-2 the distribution box shall be level. All piping connections to be glued. 'OLp < 5) This septic design plan is not to be utilized for property line determination or for any other 1p � / purpose other than the proposed septic system installation. 6) All Title V components are to meet Title V specifications. 7) Parking shall be prohibited over Title V components unless components are H2O loaded. 8) The existing leaching or cesspools shall be pumped and filled with material per Title V LOCATION MAPleo, ,, - - abandonment procedures. Leaching and cesspool(s)and contaminated soils within the S D proposed SAS shall be removed and replaced with clean sand per Title V specifications. C9) Septic components are to be 10'from a water service line.Sewer lines crossing a water line shall ! n C G be sleeved with an appropriately sized schedule 40 PVC with ends grouted. The water service line or the septic line can be sleeved with the sleeve being a distance of 10'on both sides of 10 crossing the line. ` ' i 10) If a garbage grinder exists in the structure, it is to be removed if the septic system is not designed to accommodate a garbage grinder. 11) The installer is responsible for care of excavation around all utilities on the property and `\ S E PT I C SYSTEM - DES I-G N I protecting the structural integrity of all structures during the installation process of the septic P g system. FLOW ESTIMATE 12) This plan only represents that a septic system can be installed on the property meeting Title V nn - GAL/DAY requirements. BEDROOMS AT f'y GAL/DAY/BEDROOM 13) The property owner 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 ` SEPTIC TANK shall be deemed approval of the design criteria by the property owner or agent of. 14) The validity of this plan shall expire with the expiration of the town installation permit issued for 'DGAL/DAY, x 2 DAYS G L this plan or the validity of this plan shall expire on the expiration of the Certificate of Compliance USE GALLON SEPTIC TANK � 'EV� ;n, issued for the installation of the proposed system on this plan. to-11"Ifts, 7� A.1 s Wx ��',yQ/Vpp��s. r•}• P -rz .' .I LAJ SIDE AREA: lz 4 ✓-�- ZS 2 r�. _ i \ / ) ,._ BOTTOM AREA: . )C 2 01 �f�vl 57.L HOf qss DAVID B. �G �2 ` ✓ `�' MASON m I L5 io o ro►�, SEPT I C SYSTEM SECT 1 ON No.1066 0111i� N sr IGl-i �q12 I o / , ° f � V 1?C� _ �o'' ly' '� Ato ` u O \j b -6=Bb lPl �' I / GAL �� 2l L, ,DU s � 1�"( 1 S�,DO / SEPTIC ANK TZ I \ / - , `a,_ _ w ._. 4 ',.?;� �� ►4Si? __ ' - SITE AND SEWAGE PLAN LOCATION : - 1Oh 1TG'��2.5 /4V PREPARED FOR �D6I F7 I V, M 0 SCALE:/ it DAV I D B . MASON IRS DATE: 5 DBC ENVIRONMENTAL DESIGNS 3 DATE HEALTH AGENT 1' W Z 'I i'