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HomeMy WebLinkAbout0020 WESTON CIRCLE - Health 20 WESTON CIRCLE j HYANNIS A = 271 186 TOWN OF BARNSTABLE aa�� LOCATION o�®�����^� �/4�' : SEWAGE# VILLAGE /�� �' ''�� ASSESSOR'S MAP&PARCEL',-7-7/— INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: wag (size) (tYPe) , �2 � ,r*� ) NO.OF BEDROOMS OWNER PERMIT DATE: +���3�"'`�3` COMPLIANCE DATE: 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), I Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet ofleaching facility) Feet FURNISHED BY CT-" r-_ I I _ I e . I1 cl M J No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pplitation for Disposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair(/<Upgrade( ) Abandon( ) ❑Complete System 2 ndividual Components Location Address or Lot No. r /� Owner's Name,Address,and Tel.No. Assessor's Map/Parcel e- I e _/v `j , 7, ` •-3 3� Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. -,_e" Lt- o .,, F 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) gpd Design flow provided 3 _C3-5— gpd Plan Date Number of sheets Revision Date Title Size of Septic Tanker BLS �' /00 29 Type of S.A.S. PF 2 /��' / /✓� Description of Soil �� R /'z 2 y C b t U Nature of Repairs or Alterations(Answer 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 not to place the system in operation until a Certificate of Compliance has been issued by this Board o Sign Date l Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued A a• •^.. --..-.ror�-..��.•-•..-.tw-.�. �.-,.....•n..«-...•nX.,c;,srir 4{ � �r�.p,iH...-...••M.:-'` r ,. 1`^ ";, � .i i� t�,,*� r.,��•��„wo +. y. � -,r�'S 1R. 7-7 w,. No. /7 Fee �© THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION.- TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftplitatlon for -Misposar *pstem Construction permit Application for a Permit to Construct( ) Repair( Upgree Abandon( ) ❑Complete System ndividual Components Location Address or Lot No. , 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. f/ Z_C 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) _ gpd Design flow provided 3 _,3 , gpd Plan Date Number of sheets / Revision Date Title Size of Septic TankL,,Y S r / !6 40 Type of S.A.S.}-°: 't ►F ,Q iC Description of Soil 5�F C /fir" Nature of Repairs or Alterations(Answer when applicable) �a Date last inspected: Agreement: ` The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in ,x- 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 o eal . ti s' Sign d °"...-....n"'" �,, Date cr_ /,6S- Application Approved by �. Date (I�,�/' Application Disapproved by Date for the following reasons Permit No. ;�?Lu � C7---- Date Issued fi r/ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed,( ) Repaired(,-5- Upgraded( ) Abandoned( )by 7.; r+I 4- r a ✓ _ �a r 4' at_*�, C) �U t, ate'' i Q r Jam. /"/,,i has been constructed in accordance with the provisions of Tither 5 and the for Disposal System Construction Permit N�o dated (O �5 Installer Designer r�) f _ r✓ #bedrooms Approv�-desig flo ('" gpd The issuance of this p rmi shall not be construedas a guarantee that the system will function de igpn dd. Date J� j Inspector No��Y2 —1 9 0 FeeA�C.�'2C.C� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal stem Construction 3permit Permission is hereby granted to Construct( ) Repair(' ) Upgrade( ) Abandon( ) System located at 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 co Yed within three years of the date of this perm'. �/"-- / 1 Date /� ` � Approved by Town of Barnstable Regulatory Services Richard V.Scali,Interim Director sursresue. Public Health Division Thomas McKean,Director 200 Malin Street,Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Desi_vner Certification Form Date: ` Sewage Permit# ®J�" IF_zAssessor's Map\Parcel Designer: " ) l g . Installer: Address: i ( CSi Address., Ll 1J On U was issued a permit to install a (date) (installer) septic system at W�"J tiw�+ � i �i/based on a design drawn by O (address) _ t�A�� dated � 12D�J (designer) ' I certify that the septic system referenced above was installed subsiantially 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 (Le. 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 canstrucc,+��__ zliance with the terms of the AA approval letters (if applicable) `����t1 Q=� DAVID - s , NIASON m Install 's Signature) ;� No.1066 c s't11 l�ARNN"' �t (Design' s Signature (Affix Designer s S p Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF CON PLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. QASepti6DesignaCertification Form Rev 844-0-ioc a P.- TOWN OF,BARNSTABLE LOCATION e SEWAGE # 33;;>: VILLAGE ASSESSOR'S,MAP & LOT INSTALLER'S NAME&PHbNE NO. e"f K 3es SEPTIC TANK CAPACITY fx �, LEACHING FACILITY: (type) d 7-.O�_fs i;E e NO. OF BEDROOMS BUILDER OR OWNER PIS Q 7— 44 PERMITDATE:,0 COMPLIANCE.DATE paration Distance Between the: Maximum Adjusted Groundwater.Table to.the Bottom of LeachingFacility: Feet SUP ly Well act ty- (If any wells Private Water and:Leaching F ­lj P s eXlSt'r p 0 n �j n site or within 2bQ'feet o eac ng facility.) Feet E4dge.of W tland and Leaching Facility{If anywetlands exist. within 300 feet of leaching facility) F Fur nished d b Feet 4 F F �C) e Town of Barnstable P# 16,381 Department of Regulatory Services ]public Health Division MASS. Date, 200 Main Street,Hyannis MA 02601 11� ' rdrb M611 A (! Date Scheduled Time _ Fee Pd. Sail Suitability .As essment for S e Ills ®sal Performed D ?A,)4P y' Witnessed By: LO ���,�✓TION& GENERAL INFORMATION Location Address � �� 011140e�. Owner's Name Address Assessor's Map/Parcel: OC 7. ®_10�p6' Engineer's Name�6 NEW CONSTRUCTION REPAIR Telephone# 3d-g Land Use Slopes(9'0) Surface Stones Distances from: Open Water Body_ft. Possible Wet Area ft Drinking Water Well f[ Drainage Way ft Property Line ft Other ft SIMTCH:(Street name,dimensions of lot,exact locations of test holes&pere tests,locate wetlands in proximity to holes) W � Parent material(geologic) Depth to Bedrock Depth to Groundwater. Standing Water in Hole: Weeping from Pit Foce z Estimated Seasonal High Groundwater DETE RNUNATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: 7 In. Depth to soil mottle.9' _ in. Depth to weeping from side of obs.hole: In, Groundwater Adjustment ft. Index Well# Reading Date: Index Well levnl � Adj.factor A:q.(7tVu11dwater Level PERCOLATION T +'ST Date_._.,..._,..,, 'rime Observation Hole# Time ae9" _ Depth of Pere Time at 6" Start Pre-soak Time @ Time(9"-6") End Pre-soak Rate Min./tuch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back---------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1) week prior to beginning. Q:\S EPTIC\PERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil . Other Surface(in.) (USDA) (Munsell Mottling (Structure,Stones;Boulders. onsistency.%Qravel) IFU <� Gf t, DEEP OBSERVATION HOLE LOG Mole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsisten %Uravell DEEP OBSERVATION BOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Con i to c O ' c DEEP OBSERVATION HOLE LOG Dole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency. )!lood Insurance Rate Map: Above 500 year flood boundary No_ Yes ._._____ 'Within 500 year boundary No f/X's Within 100 year flood boundary No T Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring perv'o terial exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pery us material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Envir nmental Protection and _hat the above analysis was performed by me consistent with the re Wired training,a tise d e erience described in 10 CMR 15.017 Signatur Date Q:\S EPTIC\PERCPORM.DOC f ` 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) hereby certify that the application for disposal works construction permit signed by me dated / , concerning the property located at lZ`yAOViv1s meets all of the following criteria: This failed system is connected to a residential dwelling only. There are no commercial or business u es associated with the dwelling. The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. There are no wetlands within 100 feet of the proposed septic system There are no private wells within 150 feet of the proposed septic system There is no increase in flow and/or change in use proposed • There are no variances requested or needed. :4___ The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] f the S.A.S.will be located with 250 feet of any vegetated wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) B) G.W.Elevation +the MAX.High G.W.Adjustment. _ Z6 DIFFERENCE BETWEEN A and B 3 G1 SIGNED DATE: [Please S etch4roposed plan of system on back . NOTICE Based upon the above information,a repair permit will be issued for bedrooms maximum. No f additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:cert `� r„ `, I �� o� o `� o �� . 1 TOWN OF BARNSTABLE � LOCATION ,,--,?, � SEWAGE # VILLAGE /� ��� S ASSESSOR'S MAP&LOT Z-7 1 INSTALLER'S NAME&PHONE NO. /412Gn I) SEPTIC TANK CAPACITY LEACHING FACILITY: (type) "���A� /.y ,�T4Bio2 ize) NO.OF BEDROOMS 3 BUILDER OR OWNER k f,/e 2 'T A�Ie-At,21/ PERMTTDATE:�l';I- COMPLIANCE DATE: 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 Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by /7 S� 33 No. �� �� 7 s " Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS V/ ZippYication for Miopooaf Opotem Construction Permit Application for a Permit to Construct( Repair( )Upgrade( )Abandon( ) O Complete System D Individual Components Location Address or Lot No.G % G Xr �Y����S Owner's Name,Address and Tel.No. A W,6sT0 ,gas i'►-1` 1/vs Assessor's Map/Parcel -7—-7 1 C $ 67 WE S T O.✓ L /Z f/ Installer's Name,Address,and Tel.No. Designer',s Name,Address and Tel.No. 7 7 s' -5 � 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 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or-A��jterations(Answer when applicable) i y� i��?s► T y 2 T. 471 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 5p4 and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Boar ea Signed 11 Date Application Approved by Date O Application Disapproved for the following reasons er Permit No. Date Issued NO. 337 3 _V .. ,.. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered`in computer: Yes PUBLIC HEALTH DIVISION `TOWN OF BARNSTABLE, MASSACHUSETTS v/ ' Zipprication for Migpolol 6pelemc Construction 3permtt Application for a Permit to Construct(4,, Repatr( .)Upgrade( )Abandon( ) ❑Complete System El Individual Components Location Address or Lot No.G /e Owner's Name,Address and Tel.No. ldE5740 ti - /„1y�,t/,r/�S of O Assessor's Map/Parcel Z 1 Installer's Name,Address,and Tel.No. l iP Designer's Name,Address and Tel.No. 77s' ��G2- 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 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title .. ,r f F k Size of Septic Tank Type,.of S:A.S. Description of Soil Nature of Repairs or A terations(Answer when applicable) �'i y f i�T?a r v.Q s, '33X /v. 4F F�- Date last inspected: 'may Agreement: The undersigned agrees to ensure the construction and maintenance:o4e 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 Certifi- cate of Compliance has been issued by this Boar -oHea Signed - G Date Application Approved by Date 6 / O 11 Applicatioq'Disapproved for the following reasons i - r .g Permit No. 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 s ? at d s T o..� . 2 e /P /"�Y/)�. S has been constructs i accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 7i4Z/"f 37 dated G / 01 Installer Iq/L R- r% "Designer The issuance of this p rmit s o,fi6i be construed as a guarantee that the syst . ill fu �e X sign Date DI Inspector .. No. '�?/U 33 ! Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS =iooal *pgtem Construction permit Permission is hereby granted to Construct( )Repair(grade( )Abandon( ) System located at '"�C'�� S ° ri 2�' and as described in the above Application fo'r,Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local p vjsions or special conditions. Provided:Construction must be completed within three years of the date of this permit. i Date: Approved by r T vcM �► 3 3 x / 0. C � Q G A N 2 i/f n N � a a 0 � I n �C N do N N 114/0 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable ................................... ......OF.................... Appliration for Bilpnsal Works Tontitrurtiun ami# Application is hereby made for a Permit to Construct ( x) or Repair ( ) an Individual Sewage Disposal SystA LO't ` — s , # Hyannis MA uiai corn ReajtYdrfrust 765 Falmouth°%aM Hyannis ......»....Y..�. ....y...... .......•----•--------.....---------•.--... .............-------•---•------------.........._......-•----..................----...._•---....... Sieve Y,e'�eY Owner Address w Installer Address Q Type of Building Size.Lot.............................Sq. feet Dwelling—No. of Bedroom 3 :_Expansion Attic ( ) G bage Grinder ( ) a —anch--------------- a, Other—Type of Building ............................ No. of persons............................ Showers ( — Cafeteria ( ) Otherures •••--•--•---•••--••-----•-•••--•-•.................•--•-------•--•-•-•------.........•._............••-•-•. Design n Flow---------------------------•-- JJO•---•-••----...---...-•--•-••---.. W 1f)fl0..gallons per persor$p%day. Total,� 11&ow..................................•.........�l� s. 1:4 Septic Tank—Liquid capacity............gallons Length................ Width-----_.......... Diameter................Depth......_......... Disposal Trench—jNo..................... Wid&s------------------ Total Length......6#......... Total leaching area........ .66....sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosingkfll2 eage Engineering 11-25-81. Percolation Test Re tat.0 . Performed by............................................ Date..........-_.---_ _ iZ ---------------------- �Ton�''•AnCounte Test Pit No. I....N�1A__..minutes per inch Depth of .Test Pit__N fA......... Depth to ground water____----------- Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ O ......•0-+-•--_--2-+----•-----16tm-&- 0p 0 1................ ,... .; .x Description of Soil_...------.•--•-•- �. 1Q•9---••.mgL�im--ye•-law---saw&---------------------------------------------=---------------------- - w •••••-•----•----•-••--•---••-••-•----••• 1 fl= Z� gyred:...white---sand/traMd-ts�' ravel no' vo ter at 12' ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•----•- U Nature of Repairs or Alterations—Answer when applicable....................................................................................... ........ --------•---------------------------------------------------------------------------•--............---•••-•--•-•---•-•....-•-••-----•-----•--•--•••-••----••••••••--•-•-••-•-••-......-•-.._....•---•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iimL: 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Comeigne been issued by the board of health. ----••••-- .... ateApplication.Approved By---- Z' ...................................... ••----�........... ........ Date Application Disapprove or a following reasons---------------••-------•--------------------------------------•-----------=•--=----------------------....--•--- •.............................•--•---••---•-•...--•---•-•-••-•--••------•-----•---•••----••-••---••••-----•--•-•--••-••••-••••-••-••----••-----•--••----••-••-•-••-••---•---••-----••---••......--•--•. Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......... .......TOWn...--..._OF.......Ba.rnstabl,e--------------------..--._..--------------.-..----- Appftra tiou for MipuuFaf Workii Tongtrttrtion ramit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal \ System at: w Lot ' Location-Address or Lot No. Capra Q_QM..R0a1. Trust-••-•--••--•...--------••-- ..... \ Owner Ad ress w Steve Lebel Installer Address Type of Building Size Lot......................:.....Sq. feet Dwelling—No. of Bedrooms...............3..........................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ...x`anch......... No. of persons............................ Showers ( 2) — Cafeteria ( ) QOther fixtures -------------------------------------------------------------------------------------------------------------------•--------•----•-----------------=• W Design Flow..........5,5.............................gallons per person per day. Total daily flow.....................330..........•..._gallons. WSeptic Tank—Liquid capacity.10.0Qgallons Length..B.'.(-"... Width......L 'I.QDiameter................ Depth...JrC!$!!.:.. x Disposal Trench—No..................... Width.................... Total Length.....................Total leaching area....................sq. ft. Seepage Pit No.......1------------ Diameter......6.......... Depth below inlet-.--..__6........ Total leaching area......246....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by....EldeeUe...Engineering............ Date---11.25. ..81........ --:-. Test Pit No. l:_ .r Q..minutes per inch Depth of Test Pit.........L2'... Depth to ground water..Mne... enepuri @r fs, Test Pit No. 2---Nlk...minutes per inch Depth of Test Pit......K/A..... Depth to ground water-------- �, e ........-•--••-•--------------•----•-•-••---•-•---........................-----•----•-.....................--•---....-----.................- O Description of Soil..............� ...-...Z..............loam...&-tapsQ].1-----------------•----•--••------- �. U ............................................. ...... gip. •-----.me.dlioum--y'allow..sand - W ......................................... ` -----------medA.... lAte---sand/traces---af--grausl/no---water--a t 12' UNature of Repairs or Alterations—Answer when applicable............................................................................................... •---------------------------------------------------•------•-----•----------------------•-•--.......-••---•-•-------------------•••-----•---•--•------••••••--••••-•••--•-••.....----•--•••-••--........ r. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'T'111, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Complia cr} e�hals been issued by-the b oar of health. ✓�" Sig�neeA C:........................ !.....�='' °t ----------------- `:�.3.. Application Approved B - `------.. �.... PP PP y---•--•�. Date � Application Disapprove ,f or he following reasons:................................................................................................................ -•------------•--•--•---•------------•----•--•......................•--••------•------•-•--•---.•.....---••-•-••------•---••-----•----•-----•------------------••-••-•--- .... Date � \ PermitNo......................................................... Issued..................................................... i Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........Town..............OF.......Bar218t3ble.............................................. QI"rrtifiratr of Toutpfianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (g ) or Repaired ( ) by----------------•-----------------Steve ,Leb_e1------ °'---=----.-------------.----------------..-.---.------- - Installer at.... #.----• • .......... A t --- ='`-�- ---� --- ----- ---------------------------------------H,� -.]MIELf--.MA.---.- ------------ has been installed in accordance with the provisions of T " ~ 5 o The State Sanitary Cod-a� desc abed in the application for Disposal Works Construction Permit No.... _._....._..��f................. d-ated.Z/�. Z THE ISSUA C F THIS CERTIFICATE SHALT. NOT BE CONSTW6 AS A'GUARANTEE THAT THE SYSTEM WIL FU TION SATISFACTORY. DATE . .._:1 ----••-•---------------------------------------- Inspector THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......To�...............OF.........Barnstable_....._................ [� No��.....••�•.•..... FEE........................ MiVoo of Vorkv ODonu#r ion antic Ste ye Lebel Permission is hereby granted .............. -------------•---------------------------------------------------------------------- ------------------- to Const uct ) or 'epair ,- --- nc1u 1vidual/Se;Wage Disposal System � f atNo. ��0't #------- .....................£ '1 tA-4....................................H xmis.....Da....-- ..................... Street as shown on the application for Disposal Works Construction Permit No._--- ,-''' Dated.......................................... ....................._._..._..._ _._.. r- . ...... __.____....._...._.____....._._._._..� oard of.Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS F7 I p .l A uL Z93S(o l,u iv/- sBT- PQuL iNE - 3[s- K cos 3 I X3 FAi p /7'1I.�, r /o/ 12± 38, /40 I / or o�• NI 99.5 T of �oo wtCrH Alp r3x -- Q S2 so/ S s a u SET —- -1r-- m LoT Cv�. Lo I�• 4 d I U, _.j lot. 04 z ati� R e ln/ STnN C IRC L E io,000 s.F Al2asq (/ ,P-ATC 2a FS.-B pith OF � e f g PHI �? o I t ERG No. 366�O nci oC/STEM LEGEND ryaLE"`' CERTIFIED PLOT PLAN EXISTING SPOT ELEVATION OxO S1jOFMq EXISTING CONTOUR --- O --- FINISHED SPOT ELEVATION FINISHED CONTOUR 0 y. IN APPROVED i EOARD OF HEALTHzo �SI4 k� su ..d DATE AGENT SCALE, / - 3o DATE , irLDRE®GE ENGINEERING CO. IN CLIENT �RANcv I CERTIFY THAT THE PROPOSED EGISTERE REGISTERED JOB NO. 8/2 BUILDING SHOWN ON THIS PLAN CIVIL LAND CONFORMS TO THE ZONING LAWS ENGINEER SURVEYOR DR:BY' '! OF BARNSTAI kE. ASS• CH. BYE 712 MAIN STREET cm®► �a3 _. _..� . , . NYANNIS, MASS. SHEETIL_. QF 2 DATE LG. LAND SURVEYOR MAI Q � o mrn3 D � ►yn � ,, �tt 77 o10 o .� � y pj oN n a �, � y � aaAylb " 3 An as com4fO � m � � � L 9G iww� C m v x —I � L �f•n �f f� � ^ M "1 rw r W W w W Q M7 m Q - L LA 0 O �� � �I � m b N � c� to O '• y p � o � AOD y OD. > Z rh G - C Z .�ja� o1rn b d 4 � \a �► P C Z� �� C 'A p y tq o•. . o a -- ,.. � 0 '• COS b O P � 0 � �' `° b _ - - - - - - 141ti o � to • - - - - - • - aa � r � C oon y 0 �: . . . .1n. . . . mv► Q' � � � ,. rn y �o �► o h m tl o v � oy 3 T �� � oG1 � � � H `I h 000C goeoo %': .` js �11q COyOP fit Aq � to w ro , A N Z � � bu0 � � � � � r 1. •'11 � � O � I n � � ASSESSORS MAP : 2 TEST HOLE LOGS PARCEL: 410(, _.. ( The installation shall coma�I with 'Title V and Town of ,aid of �E' SOIL EVALUATOR: 4 I�cvl G ) t �A6 '� + FLOOD ZONE: Uat�l u�������� � IleullhReg;ulnllans, • _ WITNESS: M 2) The installer ~hull verily the locution ol'utililies sower inverts uu(l a ptie I J� REFERENCE: DATE: components prior to installation and setting; base elevations. 11�> � PERCOLATION RATE: .G, I 3) Al( gravity septic piping to be 4 inch Sell 40 PVC at I/8" per tool. 'I he first Z 1 / , �jq, two leet out of the d-box to the icaching shall be level. �I ,Y _ `" �� 4) This plan is not to be utilized for property line determination nor an other TH 1 TH-2 y purpose other than the proposed system installation. • ,� I _ ►a 5) All septic components must meet Title V specifications. Io 6) Parking shall not be constructed over H 10 septic components. j 7) The property is bounded by property corners and property lines. b _ � I� 6 "tom 8) The property owner shall review design considerations to approve of total LOCATION MAP v ` Z' ��` design flow and'number of bedrooms to be considered for de i g design. Receipt I of payment for the plan and installation based on the plan shall be deemed N ;► approval of the design flow b the owner.., pp g Y r. 5 rJ G 56-1 9) The existing leaching or cesspools shall be pumped and filled with material per Title V abandonment procedures. Those within the proposed SAS shall { be removed along with contaminated soil and replaced with clean sand per �1. Title V specs. p O „ � � 0' 10)System components to be 10 feet from water line. Sewer fines crossing the �A (� I water line shall be sleeved with 4 inch SCI 140 PVC with ends grouted it 174.(a4 I J applicable. The proposed SAS is being installed below the water service line. Tile line is to be sleeved as aforementioned and maintained in place. 01 ►o' Mrs SEPT I C SYSTEM DES I GN 11) If a garbage grinder exists it is to be removed and is the responsibility of the owner to ensure such. FLOW ESTIMATE 12)The installer is to take caution in excavation around the gas line if such ' 7i I exists. hr- BEDROOMS AT GAL/DAY/BEDROOM -'�GAL/DAY 13)Tile installer shall verifythe•location, quantity and elevation of the sewer I l(1 lines exiting the dwelling prior to the installation. -� °0 i SEPTIC TANK 14)This plan is representative only that a system can fit on a property meeting oP I Title V requirements. Szi I �o \�; i4. 10 I 10 p�- Q CAL/DAY x 2 DAYS - GAL _ Oi) 3a �• t T III I t USE � 000GALLON SEPTIC TANK .� 1f1 IQp I�UILDN G, � �1y^�����-� t00 ETA ��u� S01 L ;ABSORPTION SYSTEM to N t / ' n - E .w i P6 \ +T �Jt" Zt10F44 I h r SIDE AREA: , �4—`7 )x'?, � O,�? D gVID G F BOTTOM AREA: MASON I J t No.loss i � C i Ct--� `���•('� `pis a� ' �' pQ,vA-1� SEPTIC SYSTEM ` SECT ION Ud Icy ��t 6t A I PION Li N t 3l vR. f' 1M1 l 10M GAL ✓'� �6 B - SEPT I C T NK 1 e A Z Y'' ( I I �� b �"�� °`��° SITE AND SEWAGE PLAN j LOCATION : 1 PREPARED FOR M SCALE DAV I D B MASON R DATE: (o DBC ENVIRONMENITAL DESIGNS I DATE HEALTH AGENT EAST SANDWICH . MA ( 508 ) ' 833 2I77 i