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Home My WebLink About0417 FALMOUTH ROAD/RTE 28 - Health 417 Falmouth Road Hyannis A = 292 225 e o e � e o o TOWN OFBARNSTABLE .`LOCATION` ° N%7 F��dht9A _R6A SEWAGE # U®I a A,-2(4 VILLAGE 4sjA N►J► :S _ ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. aEr1Z50 P SSC,At�C -77.5-IE776., SEPTIC TANK CAPACITY i S G O j LEACHING FACIL=: (type),q-T) C- S (size) yZ Y(3-A —L NO.OF BEDROOMS f' BUILDER OR OWNER 5&4 14A I I G-ft- t PERMrFDATE: 512y 10 a- COMPLIANCE DATE: Separation Distance Between ih(k�. Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet _P."te 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 G• r �� o � �. � `c O � ,,, O ct� G � 0 �.. ® � 6� � a v` ,� "- � G r w T 9 �� .. � 4 yT6"OF BARNSTABLE LOCATION T'417 &INMo iJ� 12ca SEWAGE # V :LAGE' ASSESSOR'S MAP& LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY oZ Ole S5 LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER gL�J tt A PERMIT DATE: 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 M7-jUa5ty �� a � � + _No.'—dr Fee $5n f THE COMMONWEALTH OF MASSACHUSETTS bEntered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ZIpplicatton for Mii tpoml bpaem Comarurtton Vermtt Application fora Permit to Construct( )Repair( X)Up e( )Abandon( ) ❑Complete System 0 Individual Components Location Address or Lot No. j(qAAo;JY b �N,n Owner's Name,Address and Tel.No. 417 Falmouth Rd. , yarinis Jeff Hallett Assessor'sMap/ParcelU Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm/ . E. Robinson Septic Service Dan Johnson P O Box 1089 Centerville 804 Main St. -, Ostervillp Type of Building: Dwelling No.of Bedrooms 5 Lot Size sq.ft. Garbage Grinder( ) Other Type of Buildin esidential No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 550 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: med—coarse sand Nature of Repairs or Alterations(Answer when applicable) Replace cesspools with 4 dry wells 42L X13 'H X 2 ' H / '�!� F'n�� ►� 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 Board of Jkalth. _0-7/ T d 2 Signe Date Application Approved by Date Application Disapproved for the following reaso Permit No. Date Issued ... Fee �S 0 THE COMMONWEALTH OF MASSACHUSETTS Y'Entered in computer: s/, Yes r PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 4_" ,2ppficatton for Zt5po.5al *pztem Construction Permit Application for a Permit to Construct(- -)Repair(- X 9Upgrade( )Abandon( ) O Complete System ❑Individual Components �AAouyh Owner's Name,Address and Tel.No. Location Address or Lot No, x. �,� � . 417 Falm uth Rd. ri ` ` Assessor's Map/Parcel p , ya nIs Jeff Hallett < 1 129� - ass Installer's Name,Address,and Tel.No. _ Designer's Name,Address and Tel.No. Wm/. E. Robinson Septic Service Dan Johnson P O Box 1089 Centervi*le 804 Main St_ Ostervillp Type of Building: �- Dwelling. No.of Bedrooms 5 Lot Size sq.ft. Garbage Grinder( ) Other Type of BuildingResidential No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 550 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: med—coarse sand Nature of Repairs or Alterations(Answer when applicable) Replace' cesspools with 4 dry wells 42 'L X1 3 'H X 2 'H 5- -6 Date last inspected: Agreement: ,,The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system R 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 Bo d of Lk%1th. _ Signed Date 1:r PZ1- d v Application Approved by _ _ / /�_ �l 1 k' `) Date Application Disapproved for the following reason r Permit No. .d Date Issued ———— ——— —————————— _ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,- MASSACHUSETTS Hallett Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( X)Upgraded( ) Abandoned( )by Wm. E. Robinson Septic Service at 41 7 Falmouth Rd. Hyannis ..asbeenlonstructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ® �' ated Installer Wm. E. Robinson Sr. Designer Dan Johnson The issuance of this permit shall not be construed as a guarantee that the sy j w4lgunction aUp ned. Date � - 1 Inspector- - I -. —1.—.--_--_.— --__—___—..---.--.—.---- i Fee(50 THE COMMONWEALTH OF MASSACHUSETTS Hallett PUBLIC HEALTH DIVISION - BARNSTABLEs MASSACHUSETTS =i6pooar *p!tem Construction permit Permission is hereby granted to Construct( )Repair( N Upgrade( )Abandon( ) System located at 417 Falmouth Rd. , 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 st be completed within three years of the date of thisi� $ ^ Date: Approved by t , ,s TOWN OF BARNST aF fir}} c LOCATION __Nl7 -PA1 At)tjf4 (26A SEWAGE # VILLAGE t sjj!fV i'S ASSESSOR'S MAP & LOT �)e1'a2� INSTALLER'S NAME& PHONE NO. r i a,,1Se 0 'tC. ?75-F7 7(y SEPTIC JANK CAPACITY l S G O LEACHING FACELITY: (h'Pe),q�"b P—V w 6 (size) yZ X NO. OF BEDROOMS A BUILDER OR OWNER I+Pt PERMITDATE: S�� I O�- COMPLIANCE DATE: Separation Distance Between tom;. N 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 Akio a O s- Q �♦ 0 NOTICE:f This Form Is To Be Used For the Repair Of Failed r K-Septic Systelais:Only. .1 r*. PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM 0 4"`J° hereby certify that the engineered plan signed by me dated_ �'ln/oa concerning the property located at AQ meets all of the '. following criteria: _ • This 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. The applicant may use historical data to conclude this fact or may conduct preliminary tests at the site without a health agent present. • 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 fourteen (14) feet above the maximum adjusted groundwater table elevation. (Adjust the groundwater table using the Rimptor method when applicable] Please complete the following: A) Top of Ground Surface Tlevation (using GIS information) ST B) G.W. Elevation 3' +adjustment for high G.W. DUTERENCE BETWEEN-A and B r )Ya sy,c. �J7'/9�tiFo�-ram�'6✓ SIGNED : DATE: rI r-,�o z ' NOTICE Based upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder.pemexmp