HomeMy WebLinkAbout0025 KEEL WAY - Health 25_:KEEL WAY
HYANNIS_-__
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TOWN OF BARNSTABLE
LOCATION �� /� E,� �a 7✓ ` ` SEWAGE 06 0 4
VP LAGS
'�( V��i✓1 S�. - , M.ASSESSOR'S MAP. & LOT Z�7 —��.�
INSTALLER'S-NAME&PHONE NO. 2,7 7,7 Z
SEPTIC TANK CAPACITY
LEACHING FACIL.ITy: (type) �7 ,(size) �-''� •�
NO. OF BEDROOMS `+
BUILDER OR OWNER ��cf�s='ES
PERMITDATE: .!r`W' COMPLIANCE DATE:
Separation Distance Between the:
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Maximum Adjusted Groundwater Table toathe Bottom of Leaching Facility Feet
d..co...- ..
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet offl lea hink facility) Feet
Edge of Wetland and Leachi. Facility (If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by b '�
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LOCATIOK SEWAGE #
VILLAGE
h ASSESSOR'S MAP& LOT
-44W
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size)
NO.OF BEDROOMS J o
BUILDER OR OWNER S Tc��� c � i D UVOS
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
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No. Fee 5 0
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes /
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
Zippfication for Migponl *pgtem Conotruction permit
Application for a Permit to Construct( )Repair( Upgrade( )Abandon( ) 0 Complete System O Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.;No.
25 Keel Way, Hyannis Cindy Kolnos
Assessor's Map/Parcel
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Installer's Name,Address,and fel.No. Designer's Name,Address and Tel.No.
Wm. E. Robinson Septic Service
P O 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 Sand
Nature of Repairs or Alterations(Answer when applicable) Title-5 leach system consisting
of a D—box and 2 precast leach 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 issued by thi§Bgard of He lth. J l
SignedL. Date U( `//' f5 ✓
Application Approved 9 e5,rf Date s,����-6OF/
Application Disapproved for the following reasons
Permit No. Date Issued -- 4�'
'""",r�ty- t-vu'�1>!�+--�1.J.j!•iiil ,.�JR�.yAr'L'.h•viti93Knr�fQr7� '�.✓r-�tJnEYfir.Xv�tigem�y"'. -'p'r`Fi"v�JT:{4d1t}rR.<-.•. r r '1 s .t�rbr .h • t.� . .
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TOWN OF BARNSTABI.E �C/ - t
r� :LOCATION
: .. r SEWAGE
VII-LACE_ /�!�i✓I S ASSESSOR'S MAP & LOT 7-4 7-l6o
„ INSTALLER'S NAME&PHONE N0.'_ lSo
? '7
SEPTIC7ANK,CAPACITY ld 6 6
LEACHING FACILITY: (type) '.r S ` `Z :Z L (size) --:�NO. OF BEDROOMS /
r. 'BUILDER OR OWNER
' PERMIT DATE: !'— d/
COMPLIANCE DATE: S
Separation Distance Between the:
Maximum Adjusted Groundwater Table tofhe Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site.oc within 200 feet of leaching facility) . ,
Feet'
Edge of Wetland and Leaching Facility (If any wetlands exist
within 300 feet of leaching facility
Furiushed,b ) Feet
by
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71
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No. ���°� Fee 5 Q
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS1. ✓
0[pplication for Mi!6pogal *pgtem Construction Permit
Application for a Permit to Construct( . )Repair( Upgrade( )Abandon( ) O Complete�System ❑Individual Components
Location Address or Lot No. Owner's Name,Address d Tel No.
25),Keel Way, Hyannis Cindy Kolnos K.
Assessor's Map/Parcel , r�
k ZAZ
to
Installer's Name,Address,and Tel.No. Designer's Name,Address•and Tel.No.
Wm. E. Robinson Septic Serv(bd:e
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
f Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
r
f� Title
t� J, Size of Septic Tank lype,14 S(A.S�
f�
Description of Soil Ranti
Nature of Repairs or Alterations(Answer when applicable) Title-5 leach system consisting
Of a D-box and 2 precast' leach chambers with stone all around.
i
r Date last inspected: '
. i .
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 d of Health. l
Signed
Date
Application Approved Date
r
Application Disapproved for the following reasons
1
.�'G/I Date Issued
Permit No. �� �1.�
———— ..-———— ————————————————————————————
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Kolnos Certificate of Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( X)Upgraded( )
Abandoned( )by Wm. E. Robinson Septic Servibie
at 25 Keel Way, Hyannis has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Peitd0l/� °°� dated�;��-,/�,��
Installer Wm. E./ Robinson Sr. Designer
The issuance of this permit all not be construed as a guarantee that the syst 11 fu do esig g r
Date �-r Inspector
-----------%-�: `-==---------- --- -
No �O/ ` <� Fee $5 tl
THE COMMONWEALTH OF MASSACHUSETTS
�
PUBLIC HEALTH DIVISION - BARNSTABLE S MASSACHUS£TTS
Kolnos Migooal 6potem Construction Permit .
Permission is herebyantted to Construct( )Repair(X )Upgrade( )AbandonKee ( )
System located at L ay, Hya is
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
' r comply with Title 5 and the following local provisions or special conditions.
,14 Provided:Construction must be completed within three years of the date of •s�rmit.
t, Date: Approvedby
r • 1(ti194
NOTICE: This Form Is To Be Used For the Repair Of Failed
Septic Systems Only.
CERTMCAIMN OF SIMCR AND APTLWATiON FOR A DISPOSAL
WORKS CONSTRUCTION PFRHIIT(WrfHOiTT DFMGNED PLANS)
William E_ Robinson,Sy cmifY tm the:application f.►r disposal works.
consaucuon permit sighed by me dared ,S—//— O I ,conceming the
property (ocated at 25 Keel Way, .Hyannis, meets all of the
Mowing criteria:
• The failed system is to a teadeatial dwelling only..There are no commercial or business
uses associated vAth dwelling.
The soil is dmi6er CLASS I and the percotimm rate is less than or equal to:5 minutes per inch
Theme arc no Within 100 feet of psoposed scpuc k"Mem
There arc no wdh within 150 f=ui thr proposed scpt[r system
There is no i m Soar andAor chaom m use propomd
• There are no negtr —or•ocedod
The bottom the 'wog faality►aria nw—r be lacamd`hm than five fem above the
ma dmum ed table eimuo i f Adjust the gtoundwater table using the Frimptor
mabod w applicabk{
If the S-k _will be lotmed with 250 fm of any vegmated walards,the bottom of the proposed
leaching will nM be hxafed less thin fourteen 114)feet above the ma,
ittutm adjusted
gnowtdwater table ckvdaM
Please compkae the MWwimr
A) Tip ofGround Sairfam Elevation,c»sing Gis irk ool l
a l G.W.Elevation +the MAX IfO G.W.Ad tint _
DIFFERENCE BETWEEN A and 6
SIGNED: DATE:
(Sketch proper pion of system on barckj.
T Health tolaer�cn
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