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Home My WebLink About0071 FOREST HILLS ROAD - Health 71 FOREST HILLS RoA.tCOTUIT f Y �a U No. 7 — 7 tj'/ � i'. Fee / THE COMMONWEA t`H OP MASSACHUSETTS Entered in computer: v/ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Application for W5poml *pgtem Conotruction Vermit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual.Components Location Address or Lot No. . 7/ /—Dy is .[ J l� Owner's�N"aame,Address and Tel.No.. box Q Assessor's Map/Parcel o .15 0 b-7 Co O 8� ,�'IIfil C)/! O� � l �!e 7e0► �� a�� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size Id,F�y sq.ft. Garbage Grinder( ) Other Type of Building I?cS No.of Persons Showers(7) Cafeteria( ) Other Fixtures Design Flow 3� 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 JE, e, a �@ / 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 EnvironmeA Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this azd o e t Signed Date /Vd✓q Application Approved by Date 7^fir Application Disapproved for We foll ing reasons i c,r Permit No. / 2— Y 5:/ Date Issued _ a Fee THE COMMONWFrL MASSACHUSETTS Entered in computer: $ i Yes L.y PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLEMASSACHUSETT(S application for Otoogat * gtem Congtruction Permit. Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 7� r-�Y�� N1� ,_ / /, __rr / �a t Assessor'sMap/Parcel 0 � � U 0 1 COS 0 g�F //l Y dsl e 6-A4T Za + G,T,"Ile a� g'�� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 9f .,�"s/,ins �� f Type of Building: / Dwelling No.of Bedrooms 3 Lot SizeA F 6 y sq.ft. Garbage Grinder( ) Other Type of Building J?rs 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. I Description of Soil s d� ?r•r_1� Ad / t Nature of Repairs or Alterations(Answer when applicable) . 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 Environmepq Code and not to place the system`in operation until a Certifi- cate of Compliance has been issued by this and o e t . y Signed DateO PIV ✓ Application Approved by A Date?— 9 Application Disapproved forge klskving reasons �l Permit No.y q— ��/ Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS ` Certificate of Compliance THIS IS TO CE 1IFY,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( ) Abandoned( )by'1 M 1! J A Al ' at �/ e Vie C 3 1� :4 y/A 'P�� I C AU+VL A-1/1 XoY has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer Designer e /V 'i The issuance of this erihit a t be construed as a guarantee that the sy em ill function Vs'esi necl Date Inspector No. — I- Fee I h GL THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Digpogal *pgtem Congtruction Permit Permission is hereby granted to Construct( -)Repair( )Upgrade( )Abandon( ) System located at d/,Lf 4,4 P,a +�,r�i 1LoOA A sf Y 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:Co ust be completed within three years of the date of this permit. Date: Approved by `r ; � SE74:: -7 , p ,� TOWN OF BAMSTABLE c, LOCATION Lod- 8 r6,r 5� I'li'IS SEWAGE # I 'ys VILLAGE C Otu i� ASSESS0 'S MAP & LOT rQ0 'W� i j INSTALLER'S NAME&PHONE NO. MAIM— Cnh5 �f ZS'S$c50 SEPTIC TANK CAPACITY /�bO :f � r LEACHING FACILITY: (type) C�Am6!e6 M (z) (size) SOO NO.OF BEDROOMS I BUILDER OR OWNER PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by s e d 121,�z - hg 1 , S ' � Z ^ ar I y - 13�,6 v I-A 1 ram, ` INN 5 1 OV59 �f Ps P d lw .� c C� X ;a • S YS TEM PROFILE NOT TO 'SCALE TOP FNON. FINISH GRADE OVER FINISH GRADE EL . 53-S FINISH GRADE 52 -E FINISH GRADE OVER DIET. BOX SZ. 3 OVER TRENCHES .;.,. SEPTIC TANK S2 . O'aOp :g`v AaA� T�d . 2" MAX. • e 4e.47 .o;I o.0'•4. e 3 if OUTLET PIPE LEVEL TO TA L ENGTH OF TRENCH 25' a FOR 2 FT MIN. • Q. 0. 00 l� Q . G A� a -Oq b, O O e.'�A9. 49.�� 0 11. f'ro•.°'e:. •s`:!:e.•; 00• :o � a� J 4 C. I. OR PVC TEES o B es• b. ...oa o ,D• b 149.E o� .�• � BSMT FL . e• b: Ir-'i 150 0 GALLON b` DIS TRIBU TION BOX EL . �I-� -O o 9a INSTALL ON LEVEL BASE „500 GALLON DRY`'✓ELLS " ., PRECAST CONCRETE w I'v4::•'i _.. H- 10 REINFORCED a A• b0 � � I b:o,b.d,:y�•.Op•d'no 4::D:+.:a•p a••Q YQ' Dp»•�;�'•fr4•°' •°•C7p�: i �:' •.•p.pr.p. .p, .D.•e:.a. .0.•Pr0•ob, :4•'► .p.4. SEP TIC TA NK TRENCH SECTION INSTALL ON LEVEL BASE NO TE: EXCA VA TE TO EL EV. M OR LOWER TO REMOVE ALL IMPERVIOUS MA TERIAL BENEATH THE LEACHING AREA a" DIAM. 12" MIN. REPLACE EXCAVATED MATERIAL WITH .v o.aop, b'� ,b:o;. oaf;}1 3" OF 1/8"-1/2" — CLEAN. CLAY FREE SAND WASHED PEAS TONE o p:o••.• o00 314" - 1-1/2" WASHED CRUSHED STONE ;<$• pN s'-2" GENERAL NO TES � W FOREST HILLS RD TRENCH WIDTH — - - -- -.-__. _-----___-- -- ----- --- 1. A L L EL EYA TIONS 53HOK I ARE BA SED ON A SSUMED NUMBER OF TRENCHES 1 2. AL L PIPES IN THE S YS TEN MUS T BE CA S T IRON NUMBER OF DRYWELL S 2 R-575.00 . OR SCHEDULE 40 PVC. O,gSERVA TION, � PIT'. -- � 3. THE BOARD•-OF HE-., L TH MU ST' NOTIFIED WHEN CONSTRUCTION IS COMPLETE PRIOR ------ __ � , TO BACKFILLING PERCOL A TION RATE: I1 ' <5 MIN./IN. a J 4. ANY CHANGES IN HIS -PLAN MUST BE APPROVED WITNESSED BY* - BY THE BOARD OF HEAL'TH AND CAPE G ISLANDS CO., SURVEYING IlC 1 . TOM McKEAN - 5. MA TERIALS AND IRS TALLA TION SHALL BE IN COMPL LANCE WITH THE S TA TE SA NI TRAY BARNS. BRO. OF HEALTH to 10, DESIGN DA TA b — 0 mt CODE - TITLE V - AND LOCAL APPLICABLE DA TE.' JUL Y 16, 1999 I RULES AND REGUL A TIONS # - --- r�r T ► p(T 2. NUMBER OF BEDROOMS �_ 6. NOR TH APROW IS FROM RECORD PL ANS AND o .w 1�, _ 3 IS NO T TO BE USED FOR SOL AR PURPOSES � n 2 � GA RBA GE DISPOSAL NO -- m Clt a 7. .FLOOD HAZARD.; ZONE O (NON-HAZARD> I� � �Z '� DA IL Y FL OW SA 330 GAL . N LOoMY D LOL�M`� 8. WA TER SUPPLY TOWN WA TER SEPTIC TA NK REO 'D. 1500 GAL . -- - N T o SEPTIC TANK PROVIDED .4500 GAL . •+ a N opO�Eo 61' - N °' s LEACHING REQUIRED 330 GPD. � h �U LL• t"L�` �? ML_l71UM MJ=D(Um SAND c�pNt7 ( SIDEWALL AREA = 152 S.F. I QYrz 152s. F. X 0. 74G/S.F. = 112 GPD. 3/g IBOTTOM _ LEGEND 329 S. XD. 74G�S.F. F. 243 GPD - L 8 - a .. ►�2, No NDW� 4_,-' Ile I LEACHING PROVIDED = 355 GPD 50 PROPOSED EL EVA TION 50 — EXI STING CONTOUR ® oesE va rloN PIT SINGLE F A MIL Y RESIDENCE G O DIS 79IBUTION BOX �, , •'' 116.48 N 68' PROPOSED SEWAGE DISPOSAL S YS TEM � 59'21 NW '�tea *` TRENCH 71 T PREPA RED FOR v {n. ro-0-1 SEPTIC TANK MC SHA NE CONSTRUCTION IS� LOT 8 (HSE. NO. 71) FOREST HILLS PD. RESERVE AREA MqS fay BA PNS TA BL E MASS. DA PIPE', INVERT EL EVA TION ' ,05 `:l DATE: JUL_Y I S), 1��9 CAPE 6 ISLANDS ENGINEERING PLOT PLAN n, SCALE A S NOTED " 00 7_ rF,_ �!,Tt_Ft�� SCALE.'-? i 20 �� g 7I f 800 FALMOUTH ROAD - SUITE 301 MAP` SEA' rlCL LOT HSE PLAN NO 999 - O7 I MASHPEE• MASS __ <02