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Home My WebLink About0058 CHESTNUT STREET - Health 58 CHESTNUT ST., HYANNIS A = 0 0 TOWN OF BARNSTABLE LOCATION < Y 1 u :5 1 SEWAGE # VVILLAGEi ASSESSOR'S MAP & LOT I �— / INSTALLER'S NAME&PHONE NO. i ti `�—� SEPTIC TANK CAPACITY r i i i LEACHING FACILITY: (type) — S A- L (size) j NO.OF BEDROOMS 3 I BUILDER OR OWNER PERMITDA' ` 2i `7 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom otteaching Facility Feet _, Private Water Supply Well and Leaching Facility Jdany wells exist on site or within 200 feet of leaching facil ty) Feet Edge of Wetland and Leaching Facility(If dhy wetlands exist within 300 feet of leaching facility) Feet Furnished by j } j i rt l � , e. c I - TOWN OF BARNSTABLE LOCATION.<-V C A`s Tie,! < ) SEWAGE # VILLAGE —WIAA ,( S' ASSESSOR'S MAP &LO �^ INSTALLER'S NAME&PHONE NO.,/�k ti J d SEPTIC TANK CAPACITY LEACHING FACILITY: (type) — S + `� G C (size) /2—25— NO. OF BEDROOMS BUILDER OR OWNER /l a# , SOWS 6 PERMTTDATE: �/—3 ` g �COMPLIANCE DATE: ` Separation Distance Between the: I Maximum Adjusted Groundwater Table to the Bottom oofZeaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching faciliWr Feet Edge of Wetland and Leaching Facility(If KY wetlands exist within 300 feet of leaching facility) Feet Furnished by 1 No. 7 _ Fee $5 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYtcation for Otgpogar *pgtem Congtruction 3permit Application for a Permit to Construct( )Repair(X )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components L tion Address or Lot No. OwneVs Name,Adcjress and Tel.No. 9b Chestnut St . , Hyannsis Sid. Davidson Assessor's Map/Parcel o'? Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E . Robinson Septic Service P 0 Box 1089, Centerville 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 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil S and. Nature of Repairs or Alterations(Answer when applicable) T;t l e_K s e t; c mete m tank, n—box , and 2 c'�nc rP .P l e h �h mb r with 4' of stone all aro,and . 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 this B ar Health. )�a Signed 6I V Date// v Application Approved by Date T Application Disapproved for the following reasons Permit No. '+ -7 Date Issued �� Air ._ No. i Fee $5 0 1 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION-TOWN OF BARNSTABLE., MASSACHUSETTS 0[pp tcatton for Mtopw6al *potent Congtructton Vermtt Application for a Permit to Construct( )Repair� )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components L ation Address or Lot No. Ownef's Name,Address and Tel.No. Chestnut St . , Hyanns is Sid. Davidson Assessor's Map/Parce��roQ Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm,. ' . Robinson Septic Service PQ ox"-1689,, C�-_4tNville 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 gallons per d:��jjjed�c,}ai�y�,flow gallons. Plan Date Number of sheets f Revision Date Title Size of Septic Tank ype of S.A.S. Description of Soil Sand , Nature of Repairs or Alterations(Answer when applicable) Title—TSeTt i n S,%/stpm tank. D-box , and 2 concrete leach chambers with 4' of stone all around . . Date last inspectep- Agreement: l The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance wit the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliafice has been issued by thisjooaros6f Health. Signed / Date,_ L",7-6 Application Approved by .spate Application Disapproved for the following reasons !,Permit No. ^ Date Issued --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS Davidson BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired )Upgraded( ) Abandoned( )by Wm. V . l nb i n g on 1;P nt i n S P ry i n a at 58 Chestnut St, HyannMF*g has been constructed in accordance ' with the provisions of Title 5 and the for Disposal System Construction Permit No.?19• 70 9' dated/ Installer Wm. E . Ro)binsoa Sr. Designer The issuance of this pe Vhall no ly, � ^onstrued as a guarantee that the system w{ill funtcMasg ed. � KISDate � -/"l� Ins ector /(i��/E is / No. Fee $5 0 6 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE. MASSACHUSETTS Davidson Mtfspooal *pztent Conotruction Vernttt Permission is hereby granted to Construct( )Repair )Upgrade( )Abandon( ) System located at 58 Chestnut St. , 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:Construction must be completed within three years of the date ' rmit. Date: ��' ,�-- Approved bp! l/6/99 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 (WITHOUT DESIGNED PLANS) l W i 11 ianl E . Robinson,S,zhereby certify that the application for disposal works construction permit signed by me dated ��,3- 9 concerning the property located at 58 Chestnut St . , Hyannis meets all of the following criteria: • The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. • � here are no wetlands within 100 feet of the proposed septic system ere are no private wells within 150 feet of the proposed septic system b-Aere is no increase in flow and/or change in use proposed _ ere are no variances requested or needed. The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. (Adjust the groundwater table using the Frimptor method when applicable) If the S.A.S. will be located with 250 feet of any vegetated wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: -z A) Top of Ground Surface Elevation(using GIS information) J B) G.W.Elevation +the MAX. High G.W. Adjustment. = al DIFFERENCE BETWEEN A and B � SIGNED :�j�l ,�`,�.� DATE: (Sketch proposed plan of system on back]. q:health folder.cert 4t b