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Home My WebLink About0078 WEST BAY ROAD - Health (2) i 8 West Bay R6ad Osterville A= 117 - 120 �. {.fir �,( C"..s':."tr�N -SEWAGE # �C�.� -! — ;✓Ei;:�AG�� ASSESSOR'S MAP & LOT INSTALLER'S NAME&:"HONE NO. VtoLe-CM,6 c-r- SEPTIC TANK CAPACITY ASOa G4, LEACHING FACII.TI`Y: (type) 60064 UJA (size) 33iX 13P NO.OF BEDROOMS BUILDER OR OWNER 1'3. rw, -BA PERMTTDATE: 5,-ao ` ®5' COMPLIANCE DATE: "3' ®�^ 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 l+ . �r ee.� � i I. i 1 �o u� �r,'6�`a�a�r' �a6 � � —.. ._. �_�.. . '��6" I � �� . � � � e No. C�P��r1�5 c-;-/C Fee ?':THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 1— Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pprtcation for ;Dt5pogal 6p6tem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade(k Abandon( ) 0 Complete System O Individual Components Location Add s or Lot No^ /,_/ Ow s Name,Address and Tel.No. Gc/ES NJ i�0' S/c�ec/r G " �v�E-�� S�_yae- 5�9s' Assessor's Map/Parcel ) 1 7 Z&S 11 �j Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. / V �`inc l 1 J cr ® 'RA✓hb�dZ rdY Sr'8_�i'o S5a� �c'i •.,etc S�8 6367 Type of Building: Dwelling No.of Bedrooms 7 Lot Size �8�a I sq.ft. Garbage Grinder( a 56 Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow yy� gallons per day. Calculated daily flow gallons. Plan Date �9l u2-02 003- Number of sheets Revision Date Title Size of Septic Tank BG0 Type of S.A.S. `5-0 v 619 + Description of Soil! D 9 Nature of Repairs or Al erations(Answer Zn applicable) �- 6�B l —r C3 I 0 d S 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 Boar of Healt S' e Date Z d ~� Application Approve Date o S Application Disapproved for the following reasons Permit No. iQ�_005 a—) Date Issued 5 oS --------------------------------------- �t�1 Q� i N. 00,5 I 6 V•4 Fee THE COMMONWEALTH OF MASSACHUSE Entered in computer: iyt . tr' Yes it . 4 PUBLIC HEALTH,-DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Z(ppliatio Miqoal pgtem CC'gtruction Permit Application for a Permit to Construct( )Repair( )Upgrade(Abandon( .)4. Complete System ❑Individual Components Location Addressor Lot No.� ` j Own s Name,Address and Tel.No. Assessor's Map/Parcel- C j Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No '�rl r'Yt J�c2 ( •J C��a cr-v S.1 8 9lAcq-5: 7 s;«. , +c 636'� Type of Building: ,„„ �. Dwelling No.of Bedrooms L� Lot Size sq.ft. Garbage Grinder x OtLer Type of Building No. of Persons Showers yp g ( ) Cafeteria( ) Other Fixtures ��Design Flow gallons per day. Calculated daily flow gallons. Plan Date �/�t 003' Number of sheets 1 Revision Date Title Size of Septic Tank /6-0a6, Type of S.A.S. 3` So U csi ft]— Description of Soil A) A'>' 42 l!o 7 i _ 'l le- J I �v ('CS I o 0 S Nature of Repairs or Alterations(Answer when applicable) /h�� i j l r)/l /5G o 0 __5nd , 2 G G e t r Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system to 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 bee�issqpd bythi's Boar of HealtS•gnedDate o)0 rUs^ Application Approve — / K Date Application Disapproved for the following reasons C-J r _ r Permit No. `Q—C)05 Date Issued U�' --- ——————————— ————————————————— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (fertif icate of (tompliance THIS IS TO CERTIFY, th4 the On-si�ewage Disposal System Constructed( )Repaired ( )Upgraded(� Aban orted( )by c,(d I Cc ( at has been constructed in accordance with the provisions f Title 5 and the for Disposal System Construction Permit No.&,00 5 �-/Idated Installe?Erucc C`C C�_�� STcc Designer �SU The issuance of this p rmit hall not be construed as a guarantee that t e syste n 'o as designed. Date Inspector ------------------------ ---------- _ _No. 5- _ - _. _ _ .Fee �✓� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS Mfi6pogal *p! tem Con5tructiou Permit Permission is hereby granted to Construct( )Repair( )Upgrade(✓)Abandon( ) System located at G�JPji— ?, 1<<VI /I ft 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: Construct' nmus be completed within three years of the date of0tlus per 't Date:_. � a�� O S Approved by Town of Barnstable �QptHE Tp�� Regulatory Services NAP �T Thomas F. Geiler, Director ( t BARNS-rABLE. _ MASS g Public Health Division 039• ♦� AIE0 MA+5i Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: Z�'Koz L woos Designer: Installer: 1 IAc dL 11— � Address: Address: 8+`( ?oaaY a On.�='Qo-c�5- �a,e,cv din ,iL ts?F ' was issued a permit to install a (date) (installer) septic system at �8 bjes,—sr 'I", C�sT u,ll,� ' _based on a design drawn by (address) 5I orsr.,.c dated aQQ:� (designer) Z- 1 certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. _ 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 Regulations. Plan revision or certified as-built by designer to follow. OF G 1p tal er s Signature) a . W HALL 140.627 Q s �EDSP��P esigner s i ure) (Affix De p Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q: Health/Septic/Designer Certification Form i _F A41Al 41✓ s."�4 tl�5.Goa Zoe ' i i 4 LLj -LV�,/ 1. I'✓.s ,k �`sEv �,� /7�sV � ��-v.,; I', ce- a, DEEP OBSEPVATION HOLE L. CG i ?' v✓rGl? e L!'9^i5�r '�'a'1 � ,C --roll r e.�J 7Zx 7 o I r we -t,o6 vla / f,Ar1 '' J ' � 1 � ► i • �n/✓Q-.�L `. f� ,.- i � /��, _� U1'�mad;:.,_. ter.��,�r�-�r1,•�- TOP OF FOUNOATtON S' U .:r cottcREr covERs , Q 4 CAST IRON 9 r , OR SCHEDULE 40 4"SCHEDULE 40 PV , J � P.V.C.PIPE MIN. C. �ONLY� 9. i�11N LEACHING TRENCH / REO. t P PIPE-MIN. " „ � � 3 " ITCH 1I4 PER.fT 1 6 12-WAS MAX. r ° a a �` `{.,. k PITCH .1 j4 tT ✓ NIC? S7dN1^ r� f•,..'�. rw�7^ I'• t F.,�7/d� ,•t�i i.+J• r 1�..:7'{ r( „� tt :, . ti� v INVERT Y (; ., .,,;H�> • 4 C'L� hp8 rr, �. 1 j 1—I. t� j� .•� ELe&< l. INVERT INVERT „ �� . ., .' a rdi / r r r ,4 ��7 Lr # Lb 1�1 24" ,•• �� - SEPTIC 'TANK QiST, 4�, r ,4 � I Lam:c9 , ,.. 1N� r �0 X •da,I.�i,t�,�r,L, tom.-tom r tom, t 1 <. \ /`r%+rt/ r�r'=oz_ , ., / "OG?: . GAL.. INV RT r. .r p , 3s ---- , � ,� 1tIVI;R,_ ,rm �Z �,�. ��'1�x_ � �_� ..� E�I��'. Precast 504GaI,Leach eta 1/2 --/ - r ELc., ?c O REQ, .( z,% r1s� l y t ,. C U5HE;D 5TONl .,� Chamber :,}WASHED STONE 1'I" PROFILE Or ,AM 6� ,e,,,. � -_�+-may;-^-,-'--,— � I , r ao� � ✓ - `. ✓ , . r TAaL��✓ Y l y SEWAGE-. DISPOSAL ., .. ,. . .. SYSTEM FI' 'fYPIG�L CRbS� Sc : ION : NO SCALE L.EACH'�NG TRENCH' BAY - POAD 0ATEIle!?r 't�-T1toE '1 o,�T�s E H NO sr'll Ls WES . TEST HOLE E I TEST :.HOLE Z „ L ELEV. i fiJT"� fI8 I/2 f E ._aMNE a 1at5r1E0 MAX. ., .t IOTA , . E5Ti1tA1�p FLOW GALLON _.., -. „ fir_ 4 _. 80,'I`Ot,1,L.�iCHINCI.AREA � _ r _ ol SIDE LEACHING <A1t�A .. f - eaaeAc� a,� c TRENCH I7CSi�OSA ,.•, Gk... C3�, '< A INCR..ASEl ,. �" 'tpTAL �.,.ACr1i11G AR / ; . t, . ,. }} t . AT10N RATc .. it E L.,.ACNIt�IG AR A « . L ICIt RAT O ca , E fGROU'N , APPROVED".... 7 „ SITE 8 DES BAY >�l� OSTEPVILL�E : MAaEE bA .. OF AGENT e T OR lt{ ?s - S . ,TO YY�`fI�C ES �� , _ FOR - ' p� _ EDlf�ARU.: OF_?1cALTl1BPUCE B' 1,,� KE R 2 Io .:fTION 0