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Home My WebLink About0210 BUCKWOOD DRIVE - Health 210 BUCKWOOD RD.,H ANNIS 'A' =`271 106 , i i yi TOWN OF BARNSTABLE LOCATION 'a(C-, (36c� ,,_10a 2 OR-LU C- SEWAGE # a7000• `3 4�7 VILLAGE 4Vj*1,,w1'S ASSESSOR'S MAP & LOT 9►'/ INSTALLER'S NAME`&PHONE NO. Rcs ii�sor.J SEPTIC TANK CAPACITY L Soo - LEACHING FACILITY: (type) Q_(Z%4 t�E(k$ (size) i X A A o"tS- NO.,OF BEDROOMS - BMM15RR OR OWNERl> '� �!"t��L`� �� -- PERMIT DATE:S-j 90 a 00 0 COMPLIANCE DATE: F/0100 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) t Feet Edge of Wetland and Leaching,Facility(If any wetlands exist within 300 feet of leaching facili _ Feet Furnished by 'kt+/ ,lFfsi rk.S4}a ' * 4, � i., �. 'C` �` s-�-' � �� , � � `, .l - sue,,�. .. �, ,�,;M ,� ,i ��. p� 9 at f `' } � "x i _ s ®v M1� .� � �.'l. ` { Y J �. .�° k 1 � - + , . '._ � .4�g i� a {3i ,'F �� h � �� ,i {R f . � } �W� ' No. D Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: . Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pplication for ]3t5poga1 *pgtem Com9trUttion 3permtt Application for a Permit to Construct( )Repair )Upgrade( )Abandon( ) El Complete System ❑Individual Components on ddregs or LotI�o. Owner's Name.Address and Tel.No. �Uc WOOd. Dr. , Hyannis Lee Sarkinen Assessor's Map/Parcel Installer's Name,Address,and Tel.No., Designer's Name,Address and Tel.No. Wm. E. Robinson Septiv Service P 0 Box 1089, Centerville Type of Building: Dwelling No.of Bedrooms 2 Lot Size, sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title 0 Size of Septic Tank Type of S.A.S. Description of Soil S and. y Nature of Repairs or Alterations(Answer when applicable) Title-5 septic system cmnsisting of a tank. T)—box and 2 ronrrptp C.,hqm'hprq with stone @11 3-row 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 thi B xd of Health. /� Signed - o o Date 4 —�O Application Approved by Date Application Disapproved for t e following reasons —t_, Permit No. —1 Date Issued silty No. ee $50 �: THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Application for Digoml *potem Construction Permit Application for a Permit to Construct( )Repair )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components �?gt°nb(dER dbr6�o Hyannis tees�a.,Vldr s an Tel.No. Assessor's Map/Parcel ller' am dress,and Tel. Designer's Name,Address and Tel.No. Mu . o�insonept1v Service P 0 Box 1089, Centerville Type of Building: %t Dwelling No.of Bldrooms" 2 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow. gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. 'y Description of Soil Sand. 1 ifli-5 septic system cmnsisting s Nature of Repairs or Alterations(Answer when applicable) 1 of a tank, D-box and 2 concrete chambers with stone all around . 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 issu d by t ' Bo of Heal Signed Q oja n Date —"2 O r Application Approved by Date ' Application Disapproved for the following reasons,,.. ^' ' �n•L E Permit No. `Ill Date Issued >s �' -----' -------=----------- -------------- THE COMMONWEALTH OF MASSACHUSETTS Sarkinen BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired (X )Upgraded( ) Abandoned( )byWm. E. Robinson Septic Service at 210 Buckwood. Dr. , Hyannis ha a constructed in accordance with the provisions of Title 5 d the for Disposal System Construction Permit No. dated Installer Wm. E. Rob ins on S r. Designer The.issuance of S permit shall be con�.ge�a guarantee that the dl function as �egipepd Date G r Inspector C s No. � � � ----------------------Fee $50 THE COMMONWEALTH OF MASSACHUSETTS Sarkinen PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Xi$pOgal 6peum Construction 'Permit Permission is hereby anted to Construct(( Repair(X )Upgrade( )Abandon( ) System located at T 10 Buekwood. )r. , Hyannis 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:Co sst ru�tiionn r n t be ompleted within three years of the date of this p t. Date: Cl/ V V 6 Approved by � . �• '� "tr i/til99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WTrHOUT DESIGNED PLANS) I, William E. R ob ins on,Sglereby certify that the application for disposal works construction pernut signed by me dated �- Z O � , concerning the property located at 210 Buckwood. Dr . , Hyannis meets all of the following criteria: • The failed system is connected to a residential dwelling only. There are no commercial or busituss uses associated with the dwelling. The soil is classified as CLASS I and percolation rate is less than or equal to S minutes per inch. There are no wetlands within 100 feet of the proposed septic system _ There are no private wells within li50 feet of the proposed septic system There is no increase in flow and/or change in use proposed There are no variances tegttesied or needed. a The bottom of the proposed leaching facility will got be located less than five feet above the ma.Kimum adjusted groundwater table elevation.[Adjust the groundwater table using the Frimptor method when auDlicabiel • If the S.A.S.will,be located with 250 feet of any vegetated wetlands,the bottom of the proposed leaching faci�,-vill not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following ?. To of Ground Surface Elevation(using G1S info n P �,,/) ( g rtnauo ) B) G.W.Elevation �Jl'./ +the MAX High G.W. adjustment DIFFERENCE.BETWEEN A and B SIGNED :,,.,, / � i DATE: �D liCJ 1. .-�. � [Sketch proposed plan of system on back]. y:health foldcr:cert 1 01. f TOWN OF BARNSTABLE LOCATION SEWAGE # aoo- 3 VII.LAGEl�y��tv�`S ASSESSOR'S MAP & LOT / i INSTALLER'S NAME&PHONE NO. 775- P77 4+ SEPTIC TANK CAPACITY l Sc c LEACHING FACILITY: (type) 0 t_� ,1 E l(S -Z (size) (9-xR,XaS NO.OF BEDROOMS . I BVM15ER OR OWNER h'!t> s PERMITDATE: f�lao a oo o --T—I COMP_LIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Welland Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Edge of Wetland and Leaching_Facility(If any wetlands exist Feet f within 300 feet of leaching facili Furnished by ay/ Feet ` I i �` 'r D 1 i 1