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HomeMy WebLinkAbout0129 MEGAN ROAD - Health EMEGAN RD. ,HYANNIS 92 283 ToWN OF BARNSTABLE k LOCATION �©�� e�� �'� SEWAGE # � ®3 VILLAGEj'tr/5 ASSESSOR'S MAP 6z LOT D 'INSTALLER'S NAME & PHONE NO. A & B CANCO 775-6264 .SEPTIC TANK CAPACITY x/��/"j'► 000 9AII04 . lelto� , LEACHING FACILITY:(type)19 500 411 1(_'WAr S (size) NO.OF BEDROOMS PRIVATE WELL OR PUBLIC WATER �UILDEOR OWNER DATE PERMIT ISSUED: 190 ` DATE COMPLIANCE ISSUED: 'VARIANCE GRANTED: Yes No �y i dL®� � -x LA Q3"Z- No. �a •� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yess PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS I ZIpprication for Dtgogaf bpgtem Congtruction Permit Application for a Permit to Construct( )Repair( grade( )Abandon( ) D Complete System D Individual Components Location Address or Lot No. /a q ,44 7W, Owner's Name,Address and Tel.No. Assessor's Map/Parcel 0) 9 1 � p� _ / — p)8 36 Installer's Name,Address,I K.go.CANCO Designer's Name,Address and Tel.No. 350 Main Street W. Yarmouth MA 02673 Type of Building: Dwelling No.of Bedrooms O�l Lot Size sq.ft. Garbage Grinder( ) Other Type of Building IZcS . No.of Persons a Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 1 r gallons per day. Calculated daily flow 3 O gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Altera 'ons(Answer when applicable) 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 ea r. Signed ► 1 y1 Date a• t 7-OV Application Approved by Date a—f 7 - Application Disapproved for the Yollowin4 reasons Permit No. Date Issued No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Application for Mi5po.5al *pgtem Construction Permit Application for a Permit to Construct( )Repair( <Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. /a O�is Name,Address and Tel.No. rc-)r � Assessor's Map/Parcel 0 13 ) J p Si44 Installer's Name,Address,Ad&TVcC,ANC0 Designer's Name,Address and Tel.No. 350 Main Street W. Yarmouth, MA 02673 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft.' Garbage Grinder( ) Other Type of Building No. of Persons. Showers( ) Cafeteria( ) Other Fixtures sue'• Design Flo'w$: S gallons per day. Calculated daily flow C) gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. I Description of Soil r 1 x Nature of Repairs or Alterations(Answer when applicable) 111SYA�� S UD Pi�9 !ecec Date last inspected: , Agreement: 1 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 I ea Signed Date off' 7 - DU Application Approved by Date ( 7 "n,; Application Disapproved for the YollowiYg reasons 1 J Permit No. G _nx� — �O � _ Date Issued —— —— —— -— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( graded( ) Abandoned( )by 014- 10 C U at{ P .4A,--' has been constructed in accordance with the provisions of Title 5 Zd the for Disposal,�ystem Construction Permit No. d /p�' —dated Installer ` Designer n The issuance of this.pe all Jot be construed as a guarantee that the sy ill unction as igne�. Date Inspector �� 1 � ----------------------------------- No.��Mllf� 19 3 Fee 5 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE: MASSACHUSETTS 1wi!5pozat 6potem Ppt)gffrade Otruction Permit Permission is hereby granted to Construct( )Repair( ( )Abandon( ) System located at /r���9 / /F'c�aq�-I Z2� 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 of this permit. Date: Approved by TOWN OF BARNSTABLE LOCATION SEWAGE # AL 03 1 VILLAGE 4 Al?rl ,� ASSESSOR'S MAP & LOT INSTALLER'S NAME S& PHONE NO. A & B CANCO 77 —6 64 _ I SEPTIC TANK CAPACITY �,Yi,5Ai AO00. igA110,�j LEACHING FACILITY:(type)„ (size) S ,e 1� ' NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER UILD OR OWNER f DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED; t'— ---------------- VARIANCE GRANTED: Yes No O p � I � i I 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, C�4�rt,a✓� , hereby certify that the application for disposal works construction permit signed by me dated , concerning the property located at Me�4✓L 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. / 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 fThere 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: E- A) Top of Ground Surface Elevation(using GIS information) V B) G.W.Elevation the MAX.High G.W.Adjustment.a 1 = (S DIFFERENCE BETWEEN A and B SIGNED : V \ DATE: [Please Sketch proposed plan of system on back]. NOTICE Based upon the above information,a repair permit will be issued for �j bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:cert T f, 'I T' l C