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Home My WebLink About0170 EAST BAY ROAD - Health .£i Al hA`i 1 is ft OSTERVILLE A 140 167 J U 11 t.s No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ! Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pplicatfon for &!spool *p6tem Construction Vermit Application for a Permit to Construct(' )Repair(" )Upgrade( )Abandon( ) ❑Complete System El Individual Components Location Address or Lot No. v? C,'-� G. R. Owner's Name,Address and Tel.No. ��kcr'v y Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name, ddress and Tel.No. Type of Building: EX Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder('U� Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Y M Plan,Date b 30 o a Number of sheets Revision Date _ Title Size of Septic Tank Type of S.A.S. '� �� Description of Soil ` 9000 &Uk OX key-s 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 Certifi- cate of Compliance has been issued by this Board A Signe Date Application Approved by Date l Application Disapproved for the following reasons R Permit No. Date Issued e TOWN OF BARNSTABLE l LOCATION 0 �,�� SEWAGE # 000— 2 Y VILLAGE, �V �� ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO.S� G - `�?C_<V"I SEPTIC TANK CAPACITY Q00� LEACHING FACILITY: « c �U� (type) �l-� (size) W • 2.�L'�'=` . NO.OF BEDROOMS Cro BUILDER OR OWNER SrV PERMITDATE: ` I4t COMPLIANCE DATE: t I I O Separation Distance Between the: n Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility e ``W` 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 t O)t cc Jr N-- a+--j g h y Q z C,� 9c k5 Q+ s TOWN OF BARNSTABLE LOCATION SEWAGE # X0 b .' VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. _SCb, =C-61 of iSEPTIC TANK CAPACITY ��y LEACHING FACE:ITl': (type) � « cttijCl3 (size) NO. OF BEDROOMS nir" TT` nn ram.■T1 Dvu.LER 0R vrrivnl2 J J J/' 1 �� 7 •�r PERMITDATE: I{%4 COMPLIANCE DATE: 6 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility r`Q-^ 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 LeachingFacility.(If any wetlands exist within 300 feet of leaching facility). Feet Furnished by 0 � j A '�� ► - ! r No_ Fee ✓ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS 01ppfication for Mgogaf *pgtem Cougtruction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System vEAndividual Components Location Address or Lot No. C, 1 , G.�/ (� 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. Type of Building: EX+�'f j be Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder(1113 "Other` Type of Building No. of Persons Showers yp g ( Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date 0 ( .o d a Number of sheets Revision Date Title i Size of Septic Tank C�� d Tt�yzzp��e of S.A.S. Description of Soil t a V 0 �SS 6^` �- ti y)( k �k �n n-Q r,.ro Nature of Repairs or Alterations(Answer when applicable) R f f. 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 Certifi- cate of Compliance has been issued by this Board A Signe Date Application Approved by / Date Application Disapproved for the following reasons Permit No. Date Issued --------------------------------------- - THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certifi rate-of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( ,1Upgraded( ) Abandoned( )by (- LA, f\ at \" r , �r T L ti u Q {� c� v t��- has rate structed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. Installer Designer r The issuance of this permit 1hai'llrot be c�nstrued as a guarantee that the sts-1, will funct o asiesig" Date Inspector r P ( v - 74 ------- -- -------------------------�—/-- No. J/��/� Fee THE COMMONWEALTH OF MASSACHUSETTS T� PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS �Digpogal *pgteiu Cottgtruction Permit Permission is hereby granted to Construct( )Repair Upgrade( )Aban on( �1 ) System located at 1 r 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 a co 1 ted within three years of the date of t e t. Date: Approved by J 7v F-A, 512 PC fl. TER' "GENERA L, ' 'ACCESS CO 9":MINIM M. N EL� ,VA V R VERS':MUS T:BE wl SIGN FLOW: 3 �'MAXIMUM 6 OF F COVER', T BUILD DE NVERT A NO -AND IRST 2`,TO 'PER 102.9 97.2.5 7_BEDROOMS.A T,, 10',G.�P.D, THIS�`PLAN IS:FOR �THE:DESIGNI ,,_C6NST. RUCT1ON,, INVERT xJN lEPTIC' TA NK. -P ASTONE� --�SYSTEM'ONLY. EQUA '770 G.P.,D' BE-LEVEL MIN :2' OF E �O OF THE-SEWAGE'DISPOSAL RT '6UT SEPTIC 9 B DR INVE 96, 7 2 4' M pf s �314* -":I :112*,.DIA. VERTICAL ,DATUMJ$ ASSUMED.' FOR BENCHIMA K NO GARBAGE GRINDER, R S RT�OUT DIST.',BO X DOUBL 98 0 iN SET. SEt:Sl TE,PLAN. .0 E WASHED.�SrONE JNVE 96.03 ilN 'LEACH tHAMBER: VERT� R 9 .'25 TANK,REQUIRED -95.2 4540' AL�. STRUCT ON ME X 2 3.- 'ALL' CON TH6DS AND MA E IALS AND SAFFLE) OOX I -OF LEACH-CHAWER ,,.: ;tOTTOM 776 G. H1614',CAPACITY INtiLTRATOR , 3 OUTLET, MAINTENANCE OF,�rw SEPTIC sysrtm ,,SHALL ADjUS'tEDl`6ROUND WATER.', CHAMBERS W13.5*1 STONE AROUND NIA PROVIDED PIN., D BOX ; , SEPTIC 'TANK, Lce CONFORM, TO MASS.,l�,D.E.P. -5 AND 2600 'GAL� O'd WA TER C 'NIA 10'r X, 89'/ X OBSERVED GROUND R GULATIONS SHED STONE OR POTrOM OF TES T-HOLE,: SO W.ABSORP TI ON, S YS TER REQUIRED: SEPTIC TANK BOARD :6P'HEALTH E 6 CRU 90 2 COMPA C TED, BA$E 'CRIDN `P Tt 5 DESIG ERC RA INII 0 U AL, ALL SEPTIC ,SYSTEM COMPONENTS lOCAl`ED�U/VDE T R CLASS, 4. NOT TO SCALE, U8 PROFILE SF AREAS S � JECT'�rO 'VEHICULAR ,,,rRAFFtc,.OR GREA TER, EFFL UEN T LOA D I NG RA TE 0,74 GPD1 7 0 GPD 0.74 GPDISF -, 1041 S.F., REQUIRED THAN J IN DEPTH SHALL;,Bf CAPABLE.-OF41TH. 7' -20, W14EEL:LOAD$.STANDING H 6H CAPACI TY INFIL TRA TOR PROVIDED: 12 �CHAMBERS W13.5'1111STONE AROUND.' "A-1055, S.F. 5, �ALL :SEWER PIPE'SHALL BE,SCHEDULE 40 OR, EQUAL. APPROVED -1055 S.F. x�,,O.74 781 GPD `BE REINFORCED 6. SEPTIC,TANKAND D40Xl SHALL ,.. -BOX $HALL PRECAST.CONCRETE AND"'WATERTIGHT. D DATA SO L TES T P, 1 T" BE WATER 'TESTED TO CHECK,FOR LEVEL WHEN THERE- JVD CA TES �7 INDICATES PERCOLATION OBSERVED I S MORE 'THAN ONE OUTLET, TEST GROUNDWATER ow 28'Wf 7. N,CALL 'DIO-SAFE'. Tp THE LOCAL WA TER DEPT. FORLOCATION OF,UNDERGROUND UTIL t TIES. ' COLOR HOR ZON TEXTURE 0* 1 100.2 PEASTONE .6. EWi�NG CESSPOOLS 'TO BE PUMPED DRY AND BACKFILLED. 5. . ........................... 99.8 IOYR LOAMY 4-CEDAR AND 311 ' ' *HO S 0 LLK 12*— 99.2 IOYR SAND, 516 30 .97,7 h(ED-COARSE IOYR $AND 616 4 ———— TOF :,0.1,CESSPOOL NO WA TER , 90.2 t20 7, CESSPOOLS", " DATE: SEPTEMBER 20. 2000 T EST BY: $`TEPHtN HAAS' 8'HOLLY WITNESSED BY.- 'DOtVNA MIORANDI. w , C�r 10'OLUE SP#,UCE PERC RATE: e 2 MINIINCH RED MAPLE 101.21 C81DH +101,7 L ioHr 26*MAPLE $EPTI)C IANK r CAPACITY P T INFILTRATOR cwksm 24'MAPLE jV13.5'* STONE.AROUND -A S.7- SA Y ROAD "AP 40 PA R C�EL 70 E 99 8 CS 7 ,ER V L�L A -PA R ED F-OR ,: PRE lk Ilk 98.6 L OCUS 5 A 0 'EAST BAY CENTERVILLE 0 0 0, HAROOR �,5 CA L_ OC,770SE-R '0�0 C81DH �,,,�2 0, c "I N E ' ''S U_�R"V; ,E: N G 3 C3 -t M 0 rrna u t h p a r' 7 5": 3 6 2 5 —5 33'3 5 0 8�) 2 LCO 4 W/ 0 20 07 F 0§: 1OCUS_� MA ---±.:.p�Mpl� rT=98- O, fg'�:2�51