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HomeMy WebLinkAbout0064 CYPRESS POINT - Health 64 Cypress Point Barnstable •- — - A 349 063 a f o P u. i J TOWN OF BARNSTABLE UkAIInON (a el e!�OJL"' P. r n'' SEWAGE # VII,I:AGE C .���, cr. �c�.rJ� ASSESSOR'S MAP & LOT -9 Y 63 x nn �nj nn INSTALLER'S NAME&PHONE NO. 2 y..('(3 0,v. Co �c 401-13:) -O rlo SEPTIC TANK CAPACITY /.S D 6 LEACHING FACILrrY: (type) JO- A D5 13 (size) 3 2 A 12 NO. OF BEDROOMS BUILDER OR OWNER MlA r4ej �g- PERMIT DATE: 3 1kil l a- COMPLIANCE DATE:- Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility y� 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 fa ility �� Feet )) Furnished by _ •, 3 5 o76 lvi R H No.t e THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN G� BARNSTABLE., MASSACHUSETTS ZippYication for Miopogal *pgtem Conotruction Permit Application for a Permit to Construct( )Repair( grade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No. C I C� Owner's Name,Address and Tel.No. 771/. ,a2)L' Assessor's Map/Parcel 3 E(ct 4_( Q Installer's Name,Address,and Tel.No. a Designer's Name,/Address and Tel.No. <9 81g c� R L t e� t�, ,® sAh. Cc, o214, A,, 4 Svc 13a-D 5 3 0 Type of Building: Dwelling No.of Bedrooms Lot Size '19 40 A40 sq. ft. Garbage Grinder(� Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow c, gallons per,day. Calculated daily flow gallons. Plan Date i y b 2 Number of sheets Revision Date Title Size of Septic Tank / 5 rI1J Type of S.A.S. 11o1Q /S z-n Description of Soil —S. d . Nature of Repairs or Alterations(Answer when applicable) A RZ 0 R Q(9 d(U A 0,5 6 'n VV wti a 5 � Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore descri /-n-s/i a sewage disposal system in accordance with the provisions of Title 5 of the Environmental C d not to place a ste to operation until a Certifi- cate of Compliance has been ' sued b this Board o Health. "� Signed ate Application Approved by Date31;W9Td___1 Application Disapproved for the following reas s Permit No. Date Issued No. / `, Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: =amjb Yes PUBLIC HEALTH DIVISION - TOWN Q .,BARNSTABLE., MASSACHUSETTS 2pplication ffor -Mizpool *p!6tem Con.5truction Vermit Application for a Permit to Construct.( )Repair( /-YUpgrade( )Abandon( �) El Complete System El Individual Components Location Address or Lot No. G 1, C X r r7 Owner's Name,Address and Tel.No. '7711. �9 Assessor's MapMarcel' 3 Q �+ y Installer's Name,Address,and Tel.N6. �'a' — •-Desigif6i's ame,Address and Tel.No. v8` S G Type of Building: Dwelling No.of Bedrooms 7 Lot Stze "/g`42-4 sq. ft. Garbage Grinder Other ' Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures x Design Flow 6 gallons per day. Calculated daily flow /`��' gallons. ` Plan Date '� r /`I d / a.- Number of sheets 1 Revision Date Title Size of Septic Tank 0 i1ZJ ly.pe}of S:A.S. 0 -- a Description of Soil 1 '=' i }% t 4 7 Nature of Repairs or Alterations Answer when applicable Al /? � c,, A 1S rJ i�s cp ..�.c.a a.�.- -140t. rN� hw` VV 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 sy/stem;in operation until a Certifi- i- ate of Compliance has been j1 sued by this Board of ealth. Signed C'1'ilt '� (�e u Gsi ;i' ` �! G'G1 GrDate i Application Approved by '�� ✓ _J. D"a°te1' 6j Application Disapproved for the following reas� r v Permit No. Date Issued 1 ————————— —————————————————.———f——t—----- THE COMMONWEALTH OF MASSACHUSETTS i BARNSTABLE, MASSACHUSETTS Certificate of Compliance ` THIS IS TO CERTIFY,that the On-si Sewage Disposal System Constructed( ` )Repaired(/--')Upgraded( ) Abandoned( )by R00%` (?. � tC. at G-,t." a sconstructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ` Installer 66 Designer Ceo The issuance of this permit s all .of b cos d as a guarantee that the s stem'will unc `onus desi ned. P g Y g Dater `Inspector No.— -- -- 0�0 --------—,-------------Fee �t THE COMMONWEALTH OF MASSAC4USETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS ;igpozal 6pztem Con.5tr c'tion hermit Permission is hereby granted to Construct( )Repair(I U grade(?W onSystem located at (e `/ OL-,jn, t n-t t Pz r r � r \, and as described in the above Application for Disposal System Construction Permit.The apRlicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Constructio r must a c'q pleted within three years of the date of thi ,ermit; l Approved by Date: • \ O T L = S o+ 1 qt h&I-O M Town of Barnstable of eY-cqVq4k'0V\ W q,5 p qrc- +95* Regulatory ServicesqWA e sue : Thomas F.Geiler,Director ""H& Public Health Division �- �"'�" Thomas McKean,Director M1V1 PQr l 11C� . 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508.790-6304 r Installer&Designer Certi fication r rcatron Form Date: _ P$ r. Designer: �kv i o n. (DOGH 1}NOW)Z- j Installer: Address: 7- l A-U6 L C C(2 Address: )Y k/ ,Q,,,, On 3 �� �aw � was Issued a permit to install a (date) installer) septic system at Cy pI'e sS d 1 n 4 based on a design drawn by (address) 94VIp D. COVG4WOW1, dated ll>At C• l°l, ZD(Z (designer) /,"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. N OF MgSs c 9 DAVID y�N o D. staller s ignatume) COUGHANOWIRCn No. 1093 STEV- • �� SgNITARk (Designers Signature) Affix Designers tamp Here PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION MNK YOU. TOWN OF BARNSTABLE LO`-ATION 64 LYPR654 PeTNr SEWAGE # -.5` - VII;LAGE f-(o✓1aM8QUrQ p� ASSESSOR'S MAP & LOT-3y -06 INSTALLER'S NAME&PHONE NO. R lAH INM6 ���i Fi SFS3 SEPTIC TANK CAPACITY �SC� LEACHING FACILITY: (type) '3 6%# C ize) /3X.3 Sf X Q s NO.OF BEDROOMS BUILDER OR OWNER P t;C- 1-01-16 PERMTTDATE: /0�-,5 aO COMPLIANCE DATE: 1,04 7 -00 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 . . . . .. - � .'r' �, f, � �S �" �' �t f J�a ' ° �:��' �, �®� TOWN OF BARNSTABLE LOCATION �, �� y 'SEWAGE # M VILLAG ASSESSOR'S MAP & LOT 31 "OE 1 INSTALLER'S NAME'&PHONE NO. SEPTIC TA k CAPACITY /SO 0 LEACHING FACILITY: (type) -54 6ize) /3X34Y. NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: /�©-1�-00 Separation Distance Between the: Mazim.um'Adjusted Groundwater Table to the Bottom of Leaching Facility Feet 1 E. u J " Private Water Supply Well an d 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 ; i r` c L �r i r 3-5, 06 CI862v �• �. y No. ✓ ': FEE/�� COMMONWEALTH OF MASSA'1 HUSETTS Board of Health, MA. PP, DISPOSAL SYST�M CONSTRUCTION PERMIT Application for a Permit to Construct( Repair( ) Upgrade( ) Abandon( ) - ®,Complete System ❑Individual Components Location C Y P5 S ® � �' Owner's Name Zon nq d, rnic—he,.-�jLon. Map/Parcel# Op-tV104 `y Address L. o l(0 Fi 1A CLY R 8, �'v v��,�/idl Lot# C9 Telephone# �y ' ZD- 94®S Installer's Na e q, ` h Designer's Name � � vP�/Fj/Cal;S U Address �th h Oa ( Address Q Nam/ ?OA/� /y(GifJo'./rlcl Telephone# a 193 Telephone# 0,0 LiQ op„ OeSS Type of Building T---CS e '1 Lot Size g131 C246 t sq.ft. Dwelling-No.of Bedrooms % Garbage grinder Other-Type of Building No.of persons Showers ( ),Cafeteria ( ) Other Fixtures Design Flow(nu .requi•ed) gpd Calculated design flow Design flow provided 5 gpd Plan: Date 26 -Y Number of sheets 2— Revision Date Title s�" �' ��,4�F_ f�f�� � PAQ � 1CU t't'IICe4AE 6- Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator Ay///Q Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agr tJ- e e above scribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to pst ration until a Certificate of Compliance has been issued by the Board of Health. Signed Date l®4^ey I 67 ' EE r 'C®MMQNWE 4lLTH OF MASSAC14US ETTS : Board of Health, X" gk a rik 6 LLn MA.! ; P, DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( Repair( ) Upgrade( )tAbaridon(,) - lJ Complete System ❑Individual Components Location C e T k Owner's Name � A h tl rn►e.kQ jzi L011 / Map/Parcel# i3 L{ q 3 r ! Address 4 C)t d Fi e'cu R 8, fv^ew!,_h Lot# to , ''Tel°ephone# .(Sby) 41 2 fl— q 4 OS Installer's Na e r L n Designer's Name �le�r S vwc-1 re-xC;$uLTAXA Address f N a2 Address /,* it N(5Tj2 r �oAD ntoo-l-",Mul Telephone#• ( 0 p PS=: '9 93 1 Telephone# LTO Lta ap 00ss Type of Building Tt Lot Size Lfc3t C26 sq.ft. Dwelling-No.of Bedrooms "/ Garbage gririderk(4),):. - Other-Type of Building No.of persons tv,'S Sliowers'(t),Cafeteria ( ) Other Fixtures _ a Design Flow(mi .requi ed) �y V gpd Calculated design flow De sign flow provided gpd Plan: Date l� 2� U "``• Number of sheets 2.- Revision Date i A. Title S(TE t .S Ek>AG i�`i}/(J 7L1 aFo ry R_ wl I,-td A C l_ ,,... Description of,Soil(s) Soil Evaluator Form No. Name of Soil Evaluator C /y(//Q Date of Evaluation 0 .r' DESCRIPTION OF REPAIRS OR ALTERATIONS rAl x. 5 • a.:tip;.., z , J -,,,,,,The undersigned agr tjhjs �bove escribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to p ration.until a Certificate of Compliance has been issued by the Board of Health. i Signed Date I isp-e-.etrons t: No. P f FEE COMMONWEALTH OF MASSACHUSETTS Z , Board of Health CERTIF!K rTE OF COMPLIANCE Descnpdon of Work_ Ll In'dividual Component(s) Complete System The undersigned hereby certify that the Sewage Disposal,System; Constructed ( ),Repaired ( ),Upgraded ( ),Abandoned ( „_ at Ile" has been installed in ce with thqrovisions of 310 CMR 15.00 (Title 5) an the approved design plans/as-built plans-retating to application No.2 "' :datedApproved Design.Flow/._` , �,. (gpd)" Installer ! i ,� A16 Im A f DesiTMR gner: 'Inspector: 4`, `4 - o D f ! Il 1 7 4 00 The issuance of this permit shall not be construed as a guarantee that the syste 'Z function as designed. No. 0,40, FEE i y COMMONWEALTH OF MASSAC14USETTS Board pf Health,Sl�,c" f J S r"Pa 9 L►E— , M.A. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( . ) Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system at ��+ i-1 as described in the application for Disposal System Construction Permit Not -50, ted f A, . _ a •,4 Provided: Construction shall be completed:,, hin;hree years of the date of this permit. All local conditions must be et. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date tBoard of'Health j4 1 TOWN OF BARNSTABLE LOCATION 6' !� jqtas 1hiNT SEWAGE # M —_ VILLAGE (-,MM1 1JS® ASSESSOR'S MAP & LOT 3y2-013 j INSTALLER'S NAME&PHONE NO. ry PCC1'Ti �- qd,0— P!a-8 SEPTIC TANK CAPACITY /50- 0 LEACHING FACU-rrY: (type) 3 —5Q0 L 0-f/X#_C ize) f 3 3 qX Z2 NO.OF BEDROOMS BUILDER OR OWNER P1 kC— 1-01,4 PERMITDATE:/0--3=CYO COMPLIANCE DATE: /®—B 3—®0 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 o 4 ` T° S�® i e e n. . ., r .. :. "� - ���BAD• .ly •`�. PLAN REF 2351149 �'� olo DEED REF. 2926/34 e FLOOD ZONE. »C„ ZONING.. „RF—I so • . - v ,� ASSESSORS MAP. 349163 ' ,�° �� OVERLAY PROTECTION.• AP o N �' TAB HOLT OF HYDRANT cyP �ilc i ELEY = 100 (ASSUMED yr for o i CGS ) , \ \ AP \ PRd SED LOCUS M \ 4- HOUSE i LOT 62 AS „ Jb WATER pp - \ NOTE" !*NAL GRADING AROUND HOUSE >t E'Y CONTRACTOR/OWNER SI Tl_/ .& S�WA L PLA N ' .I j 10, 9 — PREPARED FOR � / ' / i / I 0 SYSTEM Cf;ADINC � ---- -- - NADE _ r h � MICH AE_ L LOG TPt FINAL CRADE 96 k. f ,F LOCATED TP2, a . /AS 'LOT 63 i 9 - •64' CYPRESS POINT AREA= 49626f• sq/ft AS LOT 64 10 ; / ' ToN WATER a CUMMA Q UID,PAM (BARNSTABLE� MA K y- -�� N . Y Y EY ONSUL TANTS r _ NK E �, T THIS SURVEY AND PLAN WERE MADE'' V 'q� E'� PUO.vBOX 26J� IN ACCORDANCE WITH THE PROCEDURAL AND TECHNICAL C, �� U%V%T 5. 40B INDUSTRY ROAD 4A .%' __�� / STANDAR:gS F17R THE PRACTICE OF 1..4ND SURVEYING !N -- �� THE . AarMONWEALTH OF AlASSACHUSETTS ``; '' ", MARSTONS M/LLS, MA. 02ti48 7 od PH.(508)428—0055' FAX(508)420—5553 PAUL A. '�MERITHEW, P.GS. , T ��w►�a GRAPHIC SCALE o�.� .fGa to 0 20 so so 160 IC+ LlE,BERMAN d. - —— �' No. 23971 p DOJO •.. • IN FEET ) jS9 '?' u �F WNA 1 inch - .a LOT 206 ��, - ao rt~ JOB ,f 52386A CB LOT 205 - �1 SHEET I OF 2