HomeMy WebLinkAbout0019 DELTA STREET - Health 19 Delta Street
Hyannis
A = 292 - 211
a
I
TOWN OF{�BARNSTABLE
LOCATION /C SEWAGE#
VILLAGE ` 6' C\lS ASSESSOR'S MAP&PARCEL
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY J--PS
LEACHING FACILITY.(type) �p !`�p �size) c�sSac l
NO.OF BEDROOMS J
OWNER
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 BYl .
CZ) �
� 1 C�o
P � s
� fi
� SFee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2pplication for Misposal 6pBtem Construction permit
Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑Complete System 41ndividual Components
Location Address or Lot No. ) \�cc k1NrC� Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel" 1 rA 0.t'
Inst5e`ss NW,Mret an`T o.t l 3� �f�6U esigner's Name,Address,and Tel.No.
F' p`oc1 32.u,
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) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) Gl
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 Healt
gned_ Date
Application Approved by Date
Application Disapproved by Date
for the following reasons.
Permit No Date Issued
No. Fee 7S
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yestf'
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
Rpplication for Disposal 6pstem Construction VPrmit
Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑Complete System [�Il d idual Components
Location Address or Lot No. , ��; 1r� M1 Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel Vl
Installer's Na e,Address,and Tel.No. Designer's Name,Addrtss,land Tel.No.
Hly
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) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
`Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer,when applicable) c-R� Ck A(SET r I I
7
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.
kgnee Date l
Application Approved by X Date a
Application Disapproved by Date
for the following reasons
Permit No Date Issued
---------------------------------------------------------------------------------------------------------------------------------------
_ THE COMMONWEALTH OF MASSACHUSETTS
' BARNSTABLE,MASSACHUSETTS r
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired Upgraded( )
Abandoned( )by
at ,- has been constructed in accordance
with the provisions of Title 5 and the for Disposa System Construction Permit No dated /r�
Installer r t a[ f� Designer A
#bedrooms Approved design flow fV gpd
The issuance of this pe it shall not be construed as a guarantee that the system will c 40 as designed.
Date (J Inspector � Q �
No. B T' C Fee .
) THE COMMONWEALTH OF MASSACHUSETTS
UBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS
�&
�aC'� Disposal *pstPnt Construction Vertu
OPermission.is hereby granted to Construct( ) Repair Upgrade( ) Abandon( )
System located at
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 ust be c mpleted within three years of the date of th' 6��
stpermit.
Date Approved by
o vTE 2s LO U
R
WAYLAND
l > A`s 7
t.
LOT 2
3 j
A.M. 292-209 ° -
3300„
x •
cv
o CIS ; LOCUS MAP
Q st�1,
LOT 10 LOT 3 ASS SSORS MAP zsz—zll
A.M. 292-212 A.M. 292-211 2st 3• „ ..
ZONING: ,
SETBACKS.- 20 —10 —10
ARE=10012�S.F.
Q•
PLOT PLAN OF LAND
Q SEPTIC COVERS ;; jg;;;;; L ED AT
PER HOME OWNER --#• • '� 19 DEL TA STREET
BLOCK ............. HYANNIS MA.
PAD
PREPARED FOR.•
�► MARY E' KENNEY
e�
.z ti
SCALE: 1 "=20 '
JUL Y 29, 2004
REV _
a i
�Ov"pO' ►,,,XAAAA,4 REV
OF MAIS;,s -REV-
LOT 4
F •
s EP
A.M. 292-212 :=� f
�' ; � oovt= s YANKEE SURVEY CONSULTANTS
-tea UNIT 4 40B INDUSTRY ROAD
^Q • P. O. BOX 265
rs `4 su v� MARSTONS MILLS, MASS.- 02648, ,
w ' TEL- 428—0055 FAX 420—5553
SHEET I OF I JOB ! °$3732 . JP '
-