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Home My WebLink About0339 RIVERVIEW LANE - Health (3) 13 It & v'7 L I 2 7 J I } a 1 f �� +.../ �` :�� e ,,� _. i No. U 3 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Y—� PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS es Zipplitation for Disposal 6pstem Construction 3permit ,kaK Application for a Permit to Construct( ) epair Upgrade( ) Abandon( ) ❑Complete System ndividual Components Location Ad ress or Lot No. 33q i4/(� 4N Owner's Name,Addres ,and Tel.No. tcrv,i�/�j])� � Assessor's ap/Parcel $' _a �{� �i �w RT (lwin Installer's Name,Address,_aAd Tel.No. Designer's Name,Address,and Tel.No. ,. r• Type of Building: Dwelling No.of Bedrooms F Lot Size sq.ft. Garbage Grinder( ) Other Type of Building JCGIbN�,) No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) ` -3 Q gpd Design flow provided j gpd Plan Date I 1 yi Number of sheets I, Revision Date Title Size of Septic Tank Type of S.A.S. U:' ," j_-- -7 / Description of Soil Uord Nature f Repairs or Alterations(Answer when applicable)� Kc[j GL11 ri 16� a tja( ( t 0 M4010 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. Signe Date 6 'L_ Application Approved by , 12 Date t Application Disapproved by Q Date for the following reasons Permit No. 9—o�E (� Date Issued TOWN OF BARNSTABLE LOCATION 32j1 ►f�IUPSQft-,J L.Q SEWAGE# VILLAGE ASSESSOR'S MAP&PARCEL, /9S6Q;L INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY )[/6��n/r _LEACHING FACILITY:(type) 4-20 Gt C,dh a, (size) '6 CL- X a S NO.OF BEDROOMS OWNER- PERMIT DATE: 1kh COMPLIANCE DATE: a,17 -2-2— Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility tO a t" Ot�COt6nl4et 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 BY71 Iv- A cor tier A RC � -%,�. • w °�= Lf3,fir:' low G �+ �� ► A. No. �'" Fee THE COMMONWEALTH OF,MASSACHUSETTS Entered in computer: K�A PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes � 4plitation for ;Disposal Epstein Construction Permit Application for a Permit to Construct Repair(i*)�Upgrade( )r Abandon( ) ❑Complete System ❑'Ind vl idual Components 't Address or Lot N Location Ao. ' d�sopj jj� 3ibff Owner's Name,Address,and TeL No.. Assessor's Map/Parcel �19'S_.00 91 �e�n11 r, t ' P r�' Eli Installer's Name,Address,and Tel.No. Designer's Name,,Address,and Tel.No. Type of Building: Dwelling, No:of Bedrooms '3 Lot Size `sq.ft. Garbage Grinder( ) Other Type of Building tmom t No.of Persons Showers( Cafeteria( ) 5 Other Fixtures • Design Flow(min.required) 'S 3 0 gpd Design flow provided ? gpd Plan Date I,)- f Number of sheets Revision Date Title +.•`Q e Size of Septic Tanker K , Type of S.A.S. ��Ck(,c tl ( GJ�'7b(�l' J Description of Soil r ? .` —� v - ,� r V`"� y Nature of Repairs or Alterations(Answer when applicable) il,*W C)140-K &Ar) I,. Aire 061 4 (IMM61-) As Q Q r Pit a,J-d 77� d w o 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:, Signed Date Application Approved by ( to, ,Q.32 Date 1 7 J� Application Disapproved by Date for the following reasons Permit No. .e7- G r _ 13 Date Issued - - - ------------- - - THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance /, THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( hj Upgraded'( ) Abandoned( )by •0, N 1jf{'lr Y\ T Ar at `�'� -,r Utz'✓Ut f t t? (0AA-ef%)J)*e has been constructed in accordance f with the provisions of Title 5 and the for Disposal System Construction Permit No. dated 1 �o� Installer� ,A . n.V►S�l� Designer _I �U thCJ U 3 n) #bedrooms -?, Approved design flow n gpd The issuance of this permit shall not be construed as a guarantee that the system wilkfunction as desi nedw. P g Y g Date f ( Inspector f /I —-No Fee \ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS 01 o•tJ" Disposal 6 Ste Construction Aerniit r Permission ishereby granted to Construct( ) Repair( Upgrade( ) Abandon(`• ) k Sysfem:located at ?yCf ,�t of/Utptj I III �F/iif PfAJr/f Y r N . and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with/ Title 5 and the following-local provisions or special conditions. '' Provided:Construction must jbe comply ed'within three years of the date of this permit. . Date 111 7/d ;1 Approved by LY `` ��. . .. ., . .. , .. V .. `. a ,. .. ,a ��, F� wt 3 � ,.. � ,' r �. � ' ' , , i ` - � , �.1� ' ' - fI r .�j �. � � �� - ,T . . ?' .r �- � .. ` � f .^ r.'` �L 4 + ��` .. 'P .. � ._ .. is ' ., r �a .. t .4 . p i t , � .. , � � f ,+ ^ q � : k� e ... ��Tom,``.S. a. �, �� Ri_ . ��:�" _ - L A. , Town of Barnstable Regulatory Services Thomas F.Geller,Director Public Health Division a6ja Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-044 Fax: 508-790-6304 Dater SewagePermltQgat�—1 Assessor's Map/Parcel .228 /7.5 06 2. Installer&Designer Certification Form Designer: is. Installer: t�ct lr Address: Address'. 2.o , C tit On 3 al- was issued a permit to install a (dite) (ms er) septic system at a 2/U1,/6rtPie1 r� based on a design drawn by (address) Ok dated (designer) l Cert►fy 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. Stripout (if required)was inspected and the soils were found.satisfactory. I certify that the..septic system referenced above was installed with nbajor 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- '-+ions, plan revision or certified as-built byAcsigner to follow. Stripout(if rP• xted and the soils were found satisfactory. �ytA OFF s DAVID �y , ns er's Signature � ' ' u � e t 8 1 AF: -A TEST HOLE LO.GS 1) The installation shall comply with the State Environmental Code Tale V and Town of ASSESSORS M tom; _ �JY�.�-�� Board of Health Regulations. PARCEL- SOIL EVALUATOR: ✓ �'C.� 2) The septic system as proposed on this plan shall not be Installed fiailed until a licensed tow installer receives approval and an installation permit from the applicable town, tx ` REt~ERENCE.� WITNESS. Tbp- LrLj 3) Prior to installation,the installer shalt verify the location of utilities,sewer,inverts, 5` DATE: sewer lines and existing septic components prior to installation_ � s � � I 4) All gravity sewer piping is to be 4 inch schedule 40 PVC at 1/8"per foot. The first 2 PERCOLATION RATE: 4 feet out of the distribution box shall be level. All piping connectlom to be,glued. S) This septic design plan is not to be utilized for property line determination or for any T.H.#1 ELEV.- T.H.#2 ELEV. other other than the proposed se purpose ptie system installation. LOCATION MAP 6) All Title V components are to meet Title V specifications. A 7) Parking shall be prohibited over Title V components unless components are H2O * t 1D loaded. t � LDDti G��`J 8) The existing leaching or cesspools shall be pumped and filled with materials per Title V i abandonment procedures. Leaching and cesspool(s) and contaminated.soils within / Cv the proposed SAS shall be removed and replaced with clean sand per Title V i specifications. r ; '� �. �,� -r up lD .7 l 9) Septic components are to be 10'from a water service line.Sewer lines crossing a water line shall be sleeved with an appropriately sized schedule 40 PVC wilth ends grouted. The water service line or the septic line can be sleeved with the sleeve being \A a distance of 1W on both sides of crossing the line. -- '---- 10 If a garbage 'n aa ) ga ge grinder exists in the structure,it is to be removed if the septic system is not designed to accommodate a garbage grinder. 1 + 11)The installer is responsible for care of excavation around all utilities on the property . l 1 SEPTIC SYSTEM DESIGN CALCULATIONS and protecting the structural integrity of all structures during the Instailatiion process of the septic system. FLOW ESTIMATE: 12)This plan only represents that a septic system can be installed on the property N. l BEDROOMS AT GA DAY BDRM= Ci GA DAY meeting Title V requirements. 13)The property owner shall review design-criteria to approve the total number of C x _ __ _� ! SEPTIC TANK: bedrooms and design flow.Installation of the septic system as proposed and receipt -}- .GALJDAY/BDRM X 2 DAYS= (VIOD GALLONS of payment for the design shall be deemed approval of the design criteria Iby the . property owner or agent of. USE 1 GALLON SEPTIC TANK -`� �� ].4)The validity of this plan snail expire with the expiration of the town installation permit W �� j (GARBAGE GRINDER IS PROHIBITED) �� issued for this plan or the validity of this plan shall expire on the expiratiom of the (� � Certificate of Compliance issued for the installation of the proposed system on this' . SOIL ABSORPTION SYSTEM: / 'J lC)) ror C� �} plan. SIDEWALL AREA: Z=X z. I 2 r x 2. x\ 111197 -�" � � �� r t NYC_-��.�' 4 M'0 o ' BOTTOM AREA: 25 / Z, � trI = G J7• ✓� ___ V WAD F'S'Fe 'P� 5`7 V- SEPTIC SYSTEM SECTION t BENCHMARK 16 s�6 64 tv TOP OF FOUNDATION (250D "�JF r ail r O ELEV. 1�5r �b r_>-�_ [ r,n4 t>Lq a ) = :--/I I (DATUM ASSUMED) _ �'� _ V STONE BASE H2O D-BOX �vrX IZ• j J" V STONE BASE OR COMPACTED BASE � WATER TEST FOR LEVELNESS !Q GALLONS VF-feV1 SEPTIC TANK SITE AND SEWAGE PLAN .L CA i o .N• O 'r `� OF DAVID 0 8. MA ON ch m o o 6 PREPARED: 1 z SCALE: =ZC)j DATE: Z- Z