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Home My WebLink About0087 DOLPHIN LANE - Health 87 DOPHIN LANE HYANNIS .A.,,.= 268 182 a TOWN OF BARNSTA.BLE LC.(--A'iZfJN 10 pd ltpl,�a SEWAGE # VILLAGE-03, AVjAA3rJk'S ,t0n-tA- ASSESSOR'S MAP & LOT_c �a INSTALLER'S NAME&PHONE NO. M AZO✓k ,6V-K. '7,7 S - 3 3 SEPTIC TANK CAPACITY ' C� LEACHING FACILITY: (type) 171-Y fA3V-\,S (size) L5PO NO. OF BEDROOMS..'...- BUILDER OR OWNER PERMIT DATE: a ' ' COMPLIANCE DATE: IQTI-� 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 M Furnished by e �, '� `� .�� s-- � � �� ,(�:. v � v dl �� . s � `� � t r— �" � s 1 ��i � ,. i, TOWN OF BARNSTABLE LOCATION LoT (47 97 jo s cMry LA - SEWAGE # VILLAGE W• N 7 A NA/Zr-Po&T ASSESSOR'S MAP & LOT P INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACIL=: (type) (size) NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 0 W tie I a n h 0 'R .vim b R . Cb No. Fee 50 0 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for Mtgogal bpgtetn Con9truction 3permit Application for a Permit to Construct( )Repair( )Upgrade(�/)Abandon( ) ❑Complete System El Individual Components Location Address or Lot No. 87 Dolphin Lane ^ Owner's Name,Address and Tel.No. Paul Rosenberg We stM I iagn poor � , 87 Dolphin Lane W Hyannisport Assessors ap ce Installer's Name,Address,and Tel.No.Joseph P Macombel Designer's Name,Address and Tel.No. Box 66 Centerville 775-3338 Joseph P. Macomber & son Box 66 Centerville 775-3338 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.F3 4,_ Description of Soil: T.namy t-n mech um fi np- -,and Nature of Repairs or Alterations(Answer when applicable) Tristalling 1500 gallon tank 3—5 0 0 gallon leaching chambers 1 - Distribution box. 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�Ydealth. Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss by thi Signed Date Application Approved by AZZDate Application Disapprove or the following reasons Permit No. Date Issued TAN of B AxNSTAs aOCATiON � ?•O�� .J . SEWAGE #. ! , K j !II AGE C3 V A 1%'�V►S �C�t :. ASSESSORS MAP & LOT INSTALI:£R'S NAME:& PHONE NO. .E1�I I DANK.CAPACITY:. . LEACKNG FACILITY: (type) 1�L�r LJ£\�S (size) S� NO. OFSEDROO.MS . BUII.pER.OR OWNER - c FERiv1ITD�TE: �� f �-�i ��OMPLIANCE DATE:rj � Separation Distance Between the Maximum_Adjusted.Groundwater Table to the Bottom of Leaching Facility `.Feet Private:Witec..Supply Well and Leaching Facility (If any wells,exist - "`'. on.site 6Y'within:200 feet of leaching facility) -Feet ; r Edge of Wed"d and aching Facili" If.any wetlands exist' g. iy�( t - : withAi 300 feet of leaching faciLty) Feet f Furnished by � ` / •�� ,r 4 xy�a fir{ .. .>.. No.`` v w Fee 50.00 ;. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: — _ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS ap"PYication for ;igpogal *pgtem �tCongtruction Permit r - Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System El Individual Components Location Address or Lot No. 8 7 Dolphin Lane Owner's Name,Address and Tel.No. Paul Rosenberg West vanni port _- 87 Dolphin Lane W Hyannisport Assessor's ap arcel Installer's Name,Address,and Tell..No%OJOseph P Macomber Designer's Name,Address and Tel.No. Box 66 Centerville 775-333 Joseph P. Macomber & son Box 66 Centerville 775-3338 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showersj( ) 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: Loa-my to medium f i ne sand Nature of Repairs or Alterations(Answer when applicable) Ins to l l is g 1500 gallon tank,3—5 0 0 gallon leaching chambers 1— Distribution box. MIX 1 Ix At 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 iss d by thi d ealth. Signed 41) Date �� , Application Approved by -Iate 67 o/ Application Disapprove or the following reasons Permit No. V J r Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( x) Abandoned( )by Joseph P. macomber & son Inc ` at 87 Dolphin Lane West Hyannisport r : , beqn constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit N .Y ated Installer J.P. Macomber & son Inc -Designer J. Macom r & Son Tnc The issuance of this permit � hall of be construed as a guarantee that the s ste e will funct' n designed. Date �� I Inspector C � L.-6.�u 4 .. _: -------- --------µme--- No , I Fee t50_ 00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS =igpooar *pgtem Congtruction Permit - Permission is hereby granted to Construct( )Repair( X)Upgrade( )Abandon( ) Systemlocatedat 87 Dolphin Lane West Hyannisport 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:C nstruttio Ist be completed within three years of the date of thisPt Date: 01 A roved b a- �, r PP y r r 1/6/99 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) I, Joseph P.Maeomber Jr, hereby certify that the application for disposal works construction permit signed by me dated 6128101 concerning the property located at 87 Dolphin Lane West Hyannisport 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. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. • There are no wetlands within 100 feet of the proposed septic system There are no private wells within 150 feet of the proposed septic system • There is no increase in flow and/or change in use proposed • There 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) • Jif the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will m be located less than fourteen(14) feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) B) G.W. Elevation S +the MAX. High G.W. Adjustment . DIFFERENCE BETWEEN A and B SIGNED : DATE: 6/28/01 (Sketch sed p an of system on back). q:health folder:een . r 3-500 gallon :: 1 =Distribution box leaching chambers p ck�d ]7 in 4 ' of 1 '-z" stone. y 1500 gallon Septic tank. f i z