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Home My WebLink About0120 SUOMI ROAD - Health 120 SUONIIROA:D Hyannis.. - - - - - -- -_ - - - - d i i ,i, TOWN OF=BARNSTABLE `LOCATION SEWAGE# CP- `wILLAGE }��i�/"'"i� ASSESSOR'S MAP&PARCELo7 67— INSTALLER'S NAME&PHONE NO. cr.! /,& SEPTIC TANK CAPACITY LEACHING FACILITY:(type) ' /"C11 (size) NO.OF BEDROOMS OWNER PERMIT DATE: /®-o'2 COMPLIANCE DATE: ® — Separation Distance Between the: Ai4. *Oef� Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility lot Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) -Z Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY `` ,�.� � � � , � � � Wv � W� �,. � � � � ° � � � � � � � .. � w �' �; • � „! .. � .. I't No. 31 ' 1 Fee l THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for Woogal 6, gtem Congtruction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) EP Complete System ❑Individual Components Location Address or Lot No.�� v G�� 2� Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �.7 f��07 mid v�0 8, 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(min.required) 3 gpd Design flow provided 3 o gpd Plan Date /� �� " f� Number of sheets f Revision Date Title Size of Septic Tank �CfW �s`�" �� Type of S.A.S.T��`N<.� Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: j 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 1�_ e Date Application Approved by �� V�-C�(mot�ti'��-�� Date Application Disapproved by: Date for the following reasons Permit No. Date Issued '' - -ems X No. Fee A 00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 0[pprication,for -Mi%iOaf patent Congtruction errrtit I `t Application for a4Permit to Construct( ) Repair( ) 'Upgrade( ) Abandon( ) 5 Complete System ❑Individual Components Location Address or Lot No.�� G O�� 2�•' Owner's Name,Address,and Tel.No. Assessor's Map/Parcel oo�O Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 7-7<-0 J 07 <n>,4 0 B. /!ml✓ra . 2 J' -,5—v 6' Type of Building: Dwelling No. of Bedrooms Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building ®Z cam/' No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3310 gpd Design flow provided O gpd 9 Plan Date 'C7 Number of sheets Revision Date Title Size of Septic Tank /1/44-1,9- /To a 6�,{f Type of S.A.S.T�?E`yc/� /ro'E.diill�o^� Description of Soil /3 XeZ�X� Nature of Repairs.or Alterations(Answer when applicable) 1 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 VV\ ►A-C Date /P 1"4` — ) Application Disapproved by: Date for the following reasons Permit No. Date Issued I THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of Compliance I � THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired Upgraded ( ) Abandoned( )by at /or c J--" G/o/>7 f OF tl> has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 91.0) —3 L(y dated Installer lT/�J �Gd�Oc�U/ Designer .di9li/d /j!/f' !'o^-' "R e- #bedrooms 3 Approved desi n flow ,� gpd The issuance of this permit sha not be construed as a guarantee that the system1 f 'o a de gned. Date ( Inspector �tn�jy 0 f r' No. a V l �>Ci Fee_ i L b { THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS lwigoal *pztem Con5trUction Permit Permission is hereby granted to Construct ( ) Repair ( Upgrade ( ) Abandon ( ) System located at I 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 conditions. Provided: Construction must be completed within three years of the date of this permit. Date (� (( Approved by Tows. of Barnstable Regulatory Services Thomas F.Geiler,Director 16 Public' Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA, O2601 Office: 508- 62 644 Fax: 508-790-6304 Date: 10 ly ZO1 Sewage Permit# Assessor's Map/Parcel 170 Installer&Designer Certification Form Designer: �p �' t t� Installer: a 1 V�Jl L Address: OAf 9- f0t-A VW&4 Address: On —��—�1 14 tWF ✓O.V(I was issued a permit to install a (date) (installer) septic system at (2Q O�addr!�q�' ►�1 ased on a design drawn by dated (designer) . .. I certify that the septic system referenced above was installed substantially according to the design, which may include r=* Or approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (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'R- .t�+ions. flan revision or certified as-built by designer to follow. Stripout(if m- cted.and the soils were found satisfactory. N OFMgss .� . fl g(D q� * nstaller's igrxature) g MASON m� SST ��(D�4gs Signature) A t PLEASE.RETURN TO B.A,RNSTABLE PUBL., ...-,fE OF COMPLIANCE WILL NOT BE ISSUED UN r xL kiV x tx A•.titaa r�OR AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. q;\ofFice fomwldesign—ztification form.doc LOCATION SEWAGE PERMIT NO. X) A) VILLAGE )Ien zz;z 1 TA LLER'S NAME i ADDRESS S UILDE R OR 0 ER G DATE PERMIT ISSUED DATE COMPLIANCE ISSUED ImIrl ti r r o i o -r 7��7 ��u S No. Flm$.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................OF.................... -� lirFation for Disposal Works Tom5�� urtuan runfit Application is hereby made for a Permit to Construct ( ) or Repair ( ), an Individual Sewage Disposal System at: .. 0 m Il .��. .l� ............. ............................... _....._..--------•--- ....�.� - O ------------------•---............. Location-Address 1 or Lot No. _YZ. �?,c-....... Y1, ... Q w..-- S-----r�-�-------------------------------- ..... O Address - ----------- ------------ ................. ....--P ....................... Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures Design Flow.............. ....�..........._..._._gallons per person per day. Total daily flow._........�,.,ZZL0.................gallons. Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area--__--•----_.-------sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ') aPercolation Test Results Performed by.................................-........................................ Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......................... rZ. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 -------------------------- -.... •... •------------ •-•----•-••------... 0 Description of Soil................................................................................ = W U Nature of Repairs or Alterations—Answer when applicable__._.: .P7 :... J5_,�.___C4 1_--_ .._._�Ca:�^�...... -------•-- -----------------------••-----------....-------•---------------••••-----......----_.....••-••------•_-••---•••••....-•------••-•-----••••--•-•-•---•••-----•-•-••-----•-•••...._........•••. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLi, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance h by he boar Signed. -•--• •... •- .. - - ' cam` . Date Application Approved By.......................... .................................... Date Application Disapproved for the follow' eas .---••-•---••-•-----•-----•-••••--•-•----•--••-•-••-•-•----•--•-•--•••------•--•-•-----•-•-----•-••----....•-•--- Date PermitNo......................................................... Issued_....................................................... Date Nof._.....~�� . •:..«� Fxs........................... _. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....................................I.....O F................................................ Appliration for Disposal Works Tonstrur#inn Itumit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ....1.a.a_.._.< L1XA-1. ` ----------------------------------- --------------------------•....------C' Location-Address or Lot No. fir^ n Orvne Address p ............ ........... .?. L �_2 vi.t t> _....i �. t ( Installer Address UType of Building Size Lot............................Sq. feet ., Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) QOther fixtures .....---•----•--------------------•-----------------•---•••---...._.....-••••....•-•-._........---••••-•••••••••-••-•-•-•----••......-•---•--•--•-•-- W Design Flow.............� -V`._ .................__gallons per person per day. Total daily flow---------- ..................gallons. WSeptic Tank—Liquid'capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 1.4 Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water-.-----_____:-__--_____. 0:4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....._.................. 04 ...---••-•.........-•---••-----••--••-•••••-•-•••-••••-•--••-••.....----••-•......•-••••••••--•-•-...•-••••••••--........•-••---••--•......---•-•........--•- 0 Description of Soil.................................................................................................................................----------------- ------------•--••- x w x ----------------------------------------------------------------------------------------------------------------------------------•--•---••-------••-•-••• ---•••......••-•••......•-•••-•---- Nature of Repairs or Alterations—Answer when applicable__....lc_P7. _...__ ,. -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•-•-•••--...... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance by he boar�l, . h. �of� y . g ..-...-� Date • Application Approved BY .--- -------•-- rr Date Application Disapproved for the follow* re :................................................................................................................ ... Date PermitNo........................................................ Issued-....................................................... r� Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... Trriifiratr of Tontpliattrr THIS 0 CFIfTIFY, That th� ivid al Sevgge Disposal System constructed ( ) or Repaired by... -•....._....�. '� _ ..✓..:.._.._.was 4 's'.�t r-----.•-••-....._ ..• --------•--........•----------------------- Install has been installed i> accordance with `rovi�..s of T � Y w 't p I 5 o T i- State Sanitary Code as described in the application for Disposal Works Construction Permit No................ �. --_.__...... dated................................................ THE ISSUAN E OF THIS CERTIFICATE SHALL NOT BE CONSTRUE AS A GUARANTEE THAT THE SYSTEM WILL T N SATISFACTORY. DATE.........! . ............... Inspector..... _. ---------•-----------------------------------------------•-••••-••.•.... U THE COMMONWEALTH OF MASSACHUSETTS i BOARD OF HEALTH ` —'��U .....OF..................................................................................... No.. .........:............ FEE......................... Disposal Vorho Q-11 - trt iori rrntit Permission is hereby granted. ----- -- - - -------------------------•------------•---------------------------......------............---•--•----- to Construct ) or ( ) an„�fidividu rage Disposal System at No. �7air - ....----- ------- --------------. Street as shown on th/appli../tionfo Disposal Works Construction Permit ...._..._._ Dated.......................................... Board of Health DATEl------------------------- FORM 1255 A. M. SULKIN, INC., BOSTON jai ASSESSORS MAP : ��-' NOTES:- - TEST HOLE LOGS PARCEL : � /-7O FLOOD ZONE: �� Y� "l� c� ��c. �L,�C�� 1) The installation shall comply with'1'itle V and Town of Board of _- SOIL EVALUATOR:WITNESS : I�' Yv�V�(L1 Health Regulations. REFERENCE: �F- /J DATE: :: l I AM2) The installer shall verify the location of utilities, sewer inverts and septic PERCOLATION RA1 Z E:� 1 / components prior to installation and setting base elevations. 3) All gravity septic piping to be 4 inch Sch 40 PVC at 1/8"per foot. The first two feet out of the d-box to the leaching shall be level. TF I_ I TH_2 4) This plan is not to be utilized for property line determination nor any other A L04V L-0 purpose other than the proposed system installation. �If. /O 5) All septic components must meet Title V specifications. 6) Parking slial l not be constructed over H 10 septic components. 7) The property is bounded by property corners and property lines. LOCATION MAP J 8) The property owner shall review design considerations to approve of total 5 design flow and number of bedrooms to be considered for design. Receipt j► � of payment for the plan and installation based on the plan shall be deemed �I3 approval of the design flow by the owner.3 I 9 The existing leaching or cesspools shall be pumped and filled with material ) g g P p P per Title V abandonment procedures. Those within the proposed SAS shall d ' I 040. 1AW I ',� � W be removed along with contaminated soil and replaced with clean sand per O 1� Title V specs. 10)System components to be 10 feet from water line. Sewer lines crossing the water line shall be sleeved with 4 inch SCH 40 PVC with ends grouted if applicable. The proposed SAS is being installed below the water service SEPTIC SYSTEM DESIGN line. The line is to be sleeved as aforementioned and maintained in place. 11) if a garbage grinder exists it is to be removed and is the responsibility of the owner to ensure such. /-- FLOW ESTIMATE I 12)The installer is to take caution in excavation around the gas line if such 835 - - 7--- ----- -------- - �_BEDROOMS AT //0 GAL/DAY/BEDROOM -� AL/DAY 13)The installer shall verify the location, quantity and elevation of the sewer �� lines exiting the dwelling prior to the installation.EPT I C TANK 14)This plan is representative only that a system can fit on a property meeting Title V requirements. � .j�GAL/DAY x 2 DAYS - 66 / GAL �o p O �� l- 1 USE/C GALLON SEPTIC TANK SOIL Ai3SORPTIONSTEoM OFMq ., v O O O i ; (. ". ,�Z J �X �j � �� DAVID ssNO?e , --��-�C-51 , , MASON fi I S I UE AREA: Z �C Zy �'- /3 x-2 x . 7 = ��5.7, 1; .. / G/STEPc. BOTTOM AREA: Z X �v �S di = Z�, SEPT SYSTEM ; SECT I ON /Of Q� wW��1 Li o "�<<. I ,\ ' I 3Z SEPTIC TAIJK ILI— 1 . fit V �cytt S�w�i Xv v ,3 3 1 TE AND SEWAGE PLAN LOCAT I ON : 4110 '--Vcly'Il � � I 3�x1to PREPARED FOR : �011q LCECt 10, W � SCALE : / DAV I D B . MASON K12 DATE: DBC ENVIRONMENTAL DESIGNS , W EAST SANDWICH . MA DATE HEALTH AGENT ( 508 ) 833- 2177