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Home My WebLink About0141 PARSLEY LANE - Health (2) pS7er �L � c. No. Fee / t THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:Yedam _ _ Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ftpULation for MispoBal 6pstrm Construction 3dermit � Application for a Permit to Construct( ) Repair(✓<Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Addresss�or Lot No.j#f 4tj,0CT " Owner's Name,Address,and Tel.No. 05K-CV)llt' Assessor's Ma /Parcel L.GN p Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 'D-.At 13(wxaoz- s -YCO-7/65 06,01Z) 4C.05ra� Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date tol Number of sheets I Revision Date Title Size of Septic Tank) Type of S.A.S. 2 SCE Q.%N C 11&M'�rQ Description of Soil Nature of Repairs or Alterations(Answer when applicable) L4 Ic"11 A '500 8416-0 Cccc 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 Certificate of Compliance has been issued by this Board of Health. Date Application Approved by Date Application Disapproved by, Date for the following reasons Permit No. )� �� Date Issued F No.} L t 1 y 1> Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes� PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE,'MASSACHUSETTS 9pplitAtion for INspo$A', Opstem ConstCUttiull Permit t Application for a Permit to Construct( ) Repair Upgrade(w.) Abandon( ) ❑Complete System ❑Individual Components c X Location Address or,Lot No./hP 1 '415)r� L-rJ. �� 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: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 gpd Design flow provided gpd Plan Date 1 f?� ,�(1 Number of sheets Revision Date Title Size of Septic Tank } Type of S.A.S. SUC3 C{G))ON � �CAM'�r(3 v Description of Soil 't Nature of Repair or Alterations(Answer when applicable) 5.14 y Ick.11 q G 1)" f; -r 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 oTitle 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. / Sign �....- ,�-ti...._ .., Date A / /6 Application Approved by - f Date / { Application Disapproved by Date for the following reasons Permit No. L Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE*,MASSACHUSETTS Certifirate Df COttYphanLP THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( e) Upgraded( ) Abandoned( )by�, ,�j1Uti,� Try _ at l Nl c,,S)r`/' t nJ 051-el11111Y has been constructed in!accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.�I\\ �iN� dated Installer D, Ik R f.oy,),% Designer u o 1 U c,. #bedrooms Approved design flloow� �3 o gpd The issuance of this permi shalln t be cons ed as a guarantee that the syste ill function as designed. Date � Inspector% ,. �n} f'''� Fee ---_-"---- �------------ ----- --------------------- -t----•-- -"---•-------•--------------•--.-- -�---"-•--"----- -•-- �---- No. �hJ� - _ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS - mi8tlD8Ar 6pBtrm onstruction Permit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( . ) System located at J N t• �Po/S!t,! tA) and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her:duty to.' ly,with Title 5 and the following local provisions or special conditions'T: w, i't ` Provided:Construction must be"completed.within three years of the date of this permit.r ,.... Date 1? (� �l Approved byif,��'` I - ;� ', '.y � . •- � .�_,!�/ TOWN OF BARNSTABLE LOCATION SEWAGE# VILLAGEn<+KU 11!re ASSESSOR'S MAP&PARCEL/(,S' INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY �C� "�" LEACHING FACILITY. (type) 5�C-JI�C_161 C..1rYPf W-4y!S (size) NO.OF BEDROOMS LACG�U41a OWNER G � PERMIT DATE: 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 BYf -BAct4 50 M 4 OOT- jib � � S i i i Town of Barnstable ; iegulatory Services Thomas F.Geller,Director s Public Health Division a°sr Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862.4644 Fax: 508-790-6304 Date: Sewage Permit# Assessor's Map/Parcel Installer&Designer Certification Form Designer. A/UlAi Installer: flSt9.An� n�f Address: �4!9 (501140"40'� Address: .6 COSY: f y is f � ik b cam►a-e�v 1`.I�' M 6TG 3on ata� (installer) was issued a permit to install a — septic system at / `// c4�5�� -v 6s+Cd'A based on a,design drawn by (afldress) _ dated f (designer) —2f-1*'Cer*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 didtribuhon box and/or septic tank. Stripout (if required)was inspected and the soils werb Found satisfactory. 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 p- `-eons. Plan revision or certified as-built by.designer to follow. Stripout(if rP• •qated and the soils were found satisfactory. DAVID y ' nst ler's ignature) � u � e I i(r 1) The installation shall comply with the State Environmental Code Title V and Torn of IG assE550R5 AP: TEST HOLE LOGS Board of Health Regulations. PARCEL: ( / i �� septic system as r 2) The se c proposed on this plan shall not be installed until a licensed.town SOIL EVAtUATOR. installer receives approval and an installation permit from the applicable town. i REFERENCE: � � �'�► WITNESS: 3} Prior to installation,the installer shall verify the location of utilities sewer inverts 7► �Y , Q sewer lines and existing septic components prior to installation. DATE: ff94) All gravitysewer piping is to be 4 inch schedule 40 PVC at 1 r r p p 8 / per foot. The first 2 PERCOLATION RATE i ` < feet out of the distribution 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 for'any T.H.#1 ELEV. �s T.H.#2 ELEV. other purpose other than the proposed septic system installation. LOCATION MAP s) All Title v comp onents are to meet T"rtle Y specifications. I,p ip �jy,,l� 7) Parking shall be prohibited over Title V components unless components are H:20 A 1 i loaded. 5r�{� -' Y,ID S) The existing leaching or cesspools shall he pumped and filled with material pe;r Title V �,� �� \ abandonment procedures. Leaching and cesspool(s)and contaminated soils within the proposed SAS shall be removed and replaced with clean sand per Title V specifications. "�/ G 9) Septic components are to be 30'from a water service line.Sewer lines crossinjg a l 1 ?j,T1 y �n f-1 water line shall be sleeved with an appropriately sized schedule 40 PVC with ends I t � grouted. The water service line or the septic line can be sleeved with the sleeve being a distance of 301_on both sides of crossing the line. __. 10)If a garbage grinder exists in the structure,it is to be removed If the septic system Is .Z not designed to accommodate a garbage grinder. : 11)The installer is responsible for care of excavation around all utilities on the property and protecting the structural integrity of all structures during the installation processSEPTIC SYSTEM DESIGN CALCULATIONS of the septic system. FLOW ESTIMATE: 12)This plan only represents that a septic system can be installed on the propertyr i� meeting Title V requirements. BEDROOMS AT GAL/DAY/BDRM= GAL/DAY I 13)The roe owner shall review design criteria to approve the total n (( property�Y >In ppro umber of SEPTIC TANK: bedrooms and design flow. Installation of the septic system as proposed and receipt GAL/DAY/BDRM K 2 DAYS= GALLONS of payment for the design shall be deemed approval of the design criteria by the . property owner or agent of. USE 1 CJ�O GALLON SEPTIC TANK ! 14)The validity of this plan shall expire with the expiration of the town Installatioin permit i (GARBAGE GRINDER IS PROHIBITED) Issued for this plan or the validity of this plan shall expire on the expiration of,the IV 117 SOIL ABSORPTION SYSTEM: Certificate of Compliance issued for the installation of the proposed system on this ec) Z Ip r f SIDEWALL AREA: Z I X X �1q ;7 111 19 BOTTOM AREA: a o 4D. f SEPTIC SYSTEM SECTION BENCHMARK W t�.1 w ►'',16► �T 1AL1Q6 uA b" �.' TOP OF FOUNDATION 1 �-t�'� ►�bF r � � F G q_7 q 7. r � 81 t ��"�� os 4k �g DATUM ASSUMED) s STONE BASE A. _ N H�0 o-BOX � , � � 25 x!7, -�,�` V STONE BASE OR COMPACTED BASE WATER TEST FOR LEVELNESS 16 GALLONS SEPTIC TANK SITE AND SEWAGE PLAN DAVlD y� LOCATIONMA . 10 - , 06o1rZV1 ULC twl 01 • �' ,� Flo.��f i j t i'r� V PREPARED: SCALE: DATE.• 1 119 Zb2 r