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Home My WebLink About0064 CINNAMON LANE - Health (2) 1G�" ®a� -� 7 a ___ . No. �J Fe �m rco THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Zippfitation for Disposal *pstrm Construction 3Prmit Application for a Permit to Cons t( ) Repair( ) Up rad X Abandon( ) Complete System Individual Components Location Address or Lot No. Owner's Name,Address, el.No. j1 Assessor's Map/Parcel e�j�O Z 0 61VIX U60MI Installer's Name, d re s and Te Igo, cOL Design Naie�s,.�nd �y Nom 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.req 'U!, �j� gpd Design flow provided M�) gpd Plan Date Number of sheets + Revision to Title �, S ` Size of Septic Tank Type of S.A.S. — ��✓ Description of Soil S i .l -3 Z d Nature of Repairs or Alterations(Answer when applicable) �b!y F— 6 -� z5op Z�23 oc) W 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 sys m' operation until a Certificate of Compliance has been issued by this g—oa7r —o OtA Sig Date G Application Approved by Date Y Application Disapproved by Date for the following reasons Permit No._&Z-p 33'� Date Issued �Q�� -70Z4 No. ZDZ1 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOfti OF BARNSTABLE, MASSACHUSETTS Yer,� 01pplitation for 33isposal'6pMrm Construction Permit Application for Permit to Constrict( ) Repair( Upgrade Abandon( ) ®Complete System F ❑Individual Components Location Address or Lot No. ( �11 V �/ Owner's Name,Address,anfl Tel.No Assessor's Map/Paccel Z �i" lt,/ t Installer's Name Ad re s and Te-No. Designer' ame, ddr_ess;._and No Type of Building: Dwelling- No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures I �, Design Flow(min.regJired) gpd Design flow provided H9 gpd f Plan Date qI ZA I ZbZ_) Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. -^ C ��Q1 '� ✓ Description of Soil 'j ' ( ��L ce,n e� 4 / / /� b V y Nature of Repairs or Alterations(Answer when applicable) ��✓ CO Date last inspected: 1 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 i9t operation until a Certificate of Compliance has been issued by this 'oB and ofMalth CA Signed Date Application Approved by ,. ;, Date v Application Disapproved by Date for the following reasons _1 Permit No. 7-0 7? "f,� Date Issued Zt THE COMMONWEALTH OF MASSACHUSETTS .BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed ) Repaired( ) ` Upgraded�) Abandonedr I )by at �ra�-k _I I j kJ 141 JA 01 kJ t J has been constructed in accordance f ' with the provisions of Title 5 and the for Disposal System Construction Permit No.�� dated Installer l�a�L01k1 'G L., (DA4 Designer J—AAADMIA W #bedrooms �' Approved design flow ,_ q gpd The issuance of this permitfshall'not be construed as a guarantee that the sy Cem will lion designed. a r Date Inspectors, No. ��r ��7 FeeMy THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal ,*pstem Construction Permit Permission is hereby granted to Construct( )�^ Repair( ) Upgrade O Abandon( ) System located at i ( I1AJ Ix 10i t X A O I t 1 and as described in the above Applicati on for Disposal System Construction Permit. The applicant recogniz ed his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Constructio must be completed within three years of the date of this permit. Date ��l t{ �Q�1 Approved by TOW�Ny OF BARNSTABLE LOCATION �O �� M `JJ SEWAGE# VILLAGE_� y�UACASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. C SEPTIC TANK CAPACITY (� LEACHING FACILITY:(type) "' ize) Z��,IZ, Zi NO.OF BEDROOMS OWNER Ong , —r-erv-Q 04 PERMIT DATE: qLl' COMPLIANCE DATE: 2 Separation Distance Between the: q Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility Of 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) �-1 Feet . FURNISHED BY l' c ; nn 1 � �o e r �' Town of Barnstable W ', Inspectional Services Public Health Division 3AM9rABLE. _ 16 Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Installer& Designer Certification Form Date: ; &Sewage Permit# �' Assessor's Map\P=1b Designer t D �J- mgto1� -Installer: C Address: • `�-1'gl�� Address: l r On °"'�� was issued a permit to install a (date) (installer) septic system at �i14q ov-I • �0 aced on a design drawn by (address) j, 101l�9 Q� dated q �� (designer) I certify that the septic system referenced above was installed substantially--according to the design, which'may include mi:tor 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,systern.referenced above was installed with,major changes (i.e. greater than. 10',lateral relocation of the SAS or any vgrticat Telocation of any component of the septic,system) but"iwaccordance 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 constructed in compliance with the to rms of the 11A a oval letters(if appli ble) 0 F�'tS s DWD 9�,c (Installer's Signature) fidIASUN No.10 8 ; , r�P (Designer's Signature) (Affix• �� -p Here) PLEASE RETURiV'TO BAUNSTABLE 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. MtoaldeptAHEALTMEWER connectlSEPTlC\Designer Unifloat tm Form Rev 814-13.DQC. ASSESSORS MAP: TEST HOLE LOGS 1) installation shah comply with the State Environme Mal Code Title V and Town of ��► ' Board of Health-Regulations. �- PARCEL: - 2� Th 54tt EVALUATOR: �% " ", ' M' ! '��►! e c�as proposed on this plan shall not be Installed until a lire'nsed.tower Installer receives approval and an installation permit from the applicable town. C �3P REFERENCE: I �..,.�" WITNESS. 3) Prior to Installation,the installer shall verify the location of utilities,sewer,inverts, DATE: I.LJ� sewer lines and existing septic components prior to installation. ` 4) AN gravity sewer piping Is to be 4 inch schedule 40 PVC at 1/8"per foot. The first 2 PERCOLATION RATE: � � hAlki, 11�. feet out of the dlstrlbution box shall be level. All piping connections to be,glued. 5) This septic design plan is not to be utilized for property line determination or fbf any TAXI ELEV. T.H.#2 ELEV. other purpose other than the proposed septic system installation. LOCATION MAP 6) AlrTitle V components are to meet Title V specifications. �.p ) 7) Parking shall be prohibited over Title V components unless components ane H2O loaded. b, B) The existing leaching or cesspools shall be pumped and filled with material[ per 'Title V I abandonment procedures. teaching and cesspool(s)and contaminated souls within i - Va the proposed SAS shall be removed and replaced with clean sand per Title V" specifications. tl' 9} Septic components are to be 1A Y from a water service line.Sewer lines crossing a water line shall be sleeved with an appropriately sized schedule 40 PVC with ends grouted. The water service fine or the septic line can be sleeved with the sleeve being 1 ' ) a distance of 2W on both sides of crossing the line. - -- "- 10)If a garbage grinder ealsts in the structure,it is to be removed if the septic system Is not designed to accommodate a garbage grinder. - - 21)The installer is responsible for care of excavation around all utilities on the property . SEPTIC SYSTEM DESIGN CALCULATIONS and protecting the structural integrity of all structures during the installation process ' of the septic system. FLt?W ESTIMATE: 12)This plan only represents that a septic system can be installed on the properrtY - . meeting Title V requirements. C� BEDROOMS AT ill GAL/DAY/BDRM= GAIJDAY` 13)The-property owner shall review design criteria to approve the total number,of SEPTIC TANK. bedrooms and design flow. installation of the septic system as proposed arnd receipt GAL,/DAY/BDRM x 2 DAYS= GALLONS of payment for the design shall be deemed approval of the design criteria by the . _ USE GALLON SEPTIC TANK property owner or agent of. �d R� 14)The validity of this plan shall expire with the expiration of the town Installation permit (GARBAGE GRINDER IS PROHIBITED) Issued forthis plan or the validity of this plan shall expire on the expiration of the - Certificate of Compliance issued for the installation of the proposed system on this o o Mp ' SAIL ABSORPTION SYSTEM: o o iS t ?- plan. z sl DEWALL E►REI►: Z.�a 1 Z - / //, i DAVID - l.� _ BOTTOM AREA � 01 s � m �QQD jSTP Qom ' I SEPTIC SYSTEM SECTIONAD - BENCHMARK u'�l b' �� 7 r 1 � TOP OF FOUNDATION N �37i7�J ►►per " 4x' ELEV, VZ 00 D!� TEN - 'r 6"STONE BASE DATUM ASSUMED �"� � u •Chi' - Hear D-BOX 2��X IZ��3 6"STONE BASE OR COMPACTED BASE f--- WATER TEST FOR LEVEWESS TCXD� �. JA PI N-/ /,IXh GAUONS \' 0'1"�'t) C F 1 r� 4az ,�j_ SEPTIC TANK — �� S TE AND SEWAGE PLAN L '17\ , LocATiOr�: � O�ilk u1 I— PREPARED: Go''iz..� SCALE: - f - -,-