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Home My WebLink About0018 FERNDALE ROAD - Health 18 Ferndale Rd i 269-139 Hyannis \ i TOWN OF BARNSTABLE LOCATION 1 '�`� f�'' SEWAGE # VILLAGE /7�Q'f�'/� ASSESSOR'S MAP &LOT,20-131 INSTALLER'S NAME&PHONE NO. � ��> �� J`�` 7�r✓�� SEPTIC TANK CAPACTTY /S-00 4y, C LEACHING FACILITY: (type) Gl/,c W or& 3m Cq� (size) $ 3`/ o NO.OF BEDROOM 3 BUILDER O WNER PERMTTDATE: I Z -� COMPLIANCE DATE: 7 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility �f 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) 6 Feet Furnished by W uJ 1� i T rA cna4 v A � f No. 1l�0 FEE S THE COMMONWEALTH OF MASSACHUSETTS MASSACH USETTS &AVylt`ration for t`s II$ttX stem (fons#rnrtion jhrmit Application is hereby made for a Permit to Construct( ) or Repair(/an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No. of Bedrooms Garbage Grinder Other Type of Building 4e No. per Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow /!�QJ gallons per day. Calculated daily flow 33 gallons. Plan Date Cad/�!q Number of sheets l Revision Date Title Description of Soil Nature of Pyrirs or Alterati��(Answgr hen ap lic ble) �� $ �q �O e o x ?-_3 3 Alp 41 IF Date last inspected: Agreement: The undersigned agrees to ensure the construction cs of the aforedescribed on-site sewage disposal system in accordance with the provisio of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has bee ue b th' d of Health. _ / / Signed Date (7,//`g� Application Approved by Date Application Disapproved for the following reasons Permit No. l:� ��J�S Date Issued -No. " r 6 - " 1 FEE �xJ 4p THE COMMONWEALTH OF MASSACHUSETTS s MASSACHUSETTS-,- -� - Appltration for Pispvsal ,,Sgotem Tonstrurtiun jhrmit Application is hereby made for a Permit to Construct( ' ) or Repair(V� an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. Installer's Name,Address,and Tel No Designer's Name,Address and Tel.No. �Z e4 4fal:�5 "ell 1 Type of Building: I Dwelling No. of Bedrooms Garbage Grinder(AW Other Type of Building No. per Persons Showers( ) Cafeteria( ) . , Other Fixtures I . Design Flow ///0 gallons per day. Calculated daily flow gallons. Plan Date `�l �A? ti Number of sheets l Revision Date Title B Description of Soil It Nature of Rre irs or Alteratio s( nswer hen ap he ble) ` •�� of 1 Date last inspected: Agreement: ` The undersigned agrees to ensure the construction # ` of the aforedescribed on-site sewage disposal' system in accordance with the provisio.s of Title 5 of the Environmental Code and not to place the system in operation until a 3 Certificate of Compliance has be;n/i ue b th'sf od°`of`Health. r ! Vq Signed 1 Date Application Approved by Date Application Disapproved for the foll w g rea funs :` 1 i Permit No. C 1 ,'✓ `.5 Date Issued /a / 40 THE COMMONWEALTH OF MASSACHUSETTS Z �/�� MASSACHUSETTS (fPrtifirate of Cfumpliatire r THIS IS TO CERTIFZ, that the On-site Sewage Disposal System installed( ) or repaired/replaced(�n by ®/�Te�p /�4/t' YuC�`/'®,� for at �C�� `� r r has been constructed in accordance witl�the�,provisions of Title 5 and the for Disposal System Construction Permit No. :P*Pi- 1$�55 dated € �+� Use of this system is conditioned on compliance with the provisions set forth below: The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. This Certificate expires on -�+ � 4&A4Zej1�__ 6X - — , DATE ` .�.. 44� Inspector THE COMMONWEALTH OF MASSACHUSETTS No. �' 1 5SY , MASSACHUSETTS FEE Visposal Sgot ra Q-Tanstriirtion jJermit Permission is hereby gran d to �� ® �'' / ` ��S�`/�✓C.��a�l to construct( ).o�r.repair(7n On-site Sewage System located at t and`'as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction must be completed -within three years of the date below. DATE �'�- '�T`� Approved by FORM 1255 Rev.3/95 A.W SULKIN CO.-BOSTON,MA i CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) hereby certify that the application for disposal works l construction permit signed by me dated /Z//l¢j� , concerning the property located at f relxdo le I'd, meets all of the following criteria: • There are no wetlands within 300 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system • The observed groundwater table is 14 feet or greater below the bottom of the leaching facility • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. SIGNED : DATE: / LICENSED SEPTIC SYSTE INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. 73f a..'„„t y. �i,$t �Ckx£ �.,�4+v +ytS,; ii N '`' ii',na iM'e 4 � ��47. i, � ,,yr� v ; �: � l 1�;✓ 6" r t;'=� 4..itN. y :J�z- "'rY�.•; T314 ' 't`t�` 'L: < M- t 1 -� •,'-'�` �' •''' $ ^'i s_"f ts.,�;,� y+i .:7, pv 6�.4�d.-`''l'`a `s r f^•+5: t, ?-' .�. ? .5f=%,.i b"�iL. ,. {# `?t f•�`�:. :'!F '�` .h s �' fil.',,..;s �.t t ^" x �A '#W �:.,�1+ d u d•4 `�F�.. "ij=;y�' "+'�� ,f.�� . >r '�,r .-_x., -:r ;.{-,_ �' ..�$� ,,r'; -,':. :..�'� �t'r�:.1�w ,�.<y�. ,� :«°� # a�}1-�.,«�sza�"��,,,* e� ��a-xr'�Ya�r ,' y.w� � N� i�x �,�-�•a�t:E��- ��, a =E .. �: - .,.:�. ��$ ".'�.al`�.-. "1 .rc,'r';.n ....,• '.. , Nf: "'cY;fi,.:l 'tit,. ::w a£ l '4': `. x fi.�= .Ye' -.},:i k'4' i,1- r'> � J. 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AT EL MINIMUM 1' OF COVER OVER PRECAST /J1117 71&_ RUN PIPE LEVEL -'-FOR FIRST 2' 2" PEASTONE `LLJIr _ _ (DR-) PROPOSED k —_ Z-7 h`� } GALLON SEPTIC TANK (I�) i�-- _ l �� "�00o a�� EL ' —----� ''� < 'WIDE I - ------ - ,— -- 3 LONG_ 8Y ---- - -- — DEPTH OF FLOW = ¢_ -------- �-- ----- -- _ -- CG�TECfs P�C�AeErr�s t`'� 3�0 TEE SIZES: � - - — - � INLET DEPTH = 2 �•2 ? � D HED E _ 3/g' TO 1-1/2' WASHED STONE OUTLET DEPTH 5. � FOUNDATION--- /J --- SEPTIC TANK ----- -- � - D' BOX LEACHING FACILITY I 1 i GoT 9i t ` ?O aG a 97 G.dT s / A ry o /A.j:51- i � •-- I ),Ae 2 2c, Z il- 42 e.4 n S SEPTIC DESIGN: ,47- /� �L � .4L` � — (GARBAGE DISPOSER IS ��^ Ate'• DESIGN FLOW:__'_ BEDROOMS ( "'J GPD) _ _?_"I _� GPD USE A = GPD DESIGN FLOW SEPTIC TANK: Z -/_ GPD ( �_) = _� GALLONS USE A �?'__ GALLON SEPTIC TANK /tea 176 S LEACHING: S 7Z) SIDES: ,/6.�3 -q }=103 7� /o 3 GPD / - (-=-) _ ---- BOTTOM: 3� X��' ZSs.� (— -74 ) GPD vim- ts- TOTAL: ` . S.F. GPD 21 c AJ�r-�.3i�1 /.; � 6 �#. 34