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HomeMy WebLinkAbout0056 NORRIS STREET - Health 56 N® D 306-038 ". yan s ; i 0 I ° 5 4J TOWN OF BARNSTABLE LOCATION 5J� did p/p/s 5�,- SEWAGE # l VILLAGE Al/yzr ASSESSOR'S MAP & LOT306—D%3 INSTALLER'S NAME&PHONE NO. 7 7S°r-$ 77r- SEPTIC TANK CAPACITY e (a LEACHING FACILITY: (type) �/ Oe�L7�� ( ''fie) 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 134 � h ZVIL �, O � = $40 .00 No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01ppricatton for Migogal *p5tem Construction Permit Application is hereby made for a Permit to Construct( )or Repair(x )an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 7 7 8—91 5 9 56 Norris Street, Hyannis Donald Sutterland Assessor's Map/Parcel 262 Elliot Rd. , Centerville Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. Wm.E.Robinson Sr. P.O.Box 1089 , Centerville Type of Building: Dwelling No.of Bedrooms 2 Garbage Grinder( no 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 Description of Soil sand Nature of Repairs or Alterations(Answer when applicable) install 1500 gal. tank, D-box, and three #330 stone packed infiltrators 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 eafjdf Health. Q Signed r o la Date/ �'::;I' - / Application Approved by n Date Application Disapproved for the following reasons Permit No. Date Issued M,142=�&6 r ,i. :r . + /yL fir.''.. - '..r ..�.�, .-,ti...ti-. '.•� ,.+ #1 ff. ,.,....n. .._ . O� Y 43 $40.0 0 1liR:• i 4 _'A Fee THE COMMONWEALTH'OF MASSACHUSETTS +.t.- i PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS r 01pprication for Miopool bpotem Cow6truction,'Vermit t Application is hereby made for a Permit to Construct( ),or Repair(X )an On-site SewagDisposal System at: h� Location Address or Lot No. Owner's Name,Address and Te1.:fTo. 778-9159 i 56 Norris Street, Hyannis Donald Sutterland Assessor'sMap/Parcel 262 Elliot Rd. , Centerville i� Installer's Name,Address,and Tel.No.. 7 7 5—8 7 7 6 Designer's Name,'Address and Tel.No. .w Wm.E.Robinson Sr. f r P.O.BoX 1089, Centerville Type of Building: C Dwelling No.of Bedrooms 2 Garbage Grinder(no FOther Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures i j Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title ' Description of Soil sand y- ?. Nature of Repairs or Alterations(Answer when applicable) install 1500 gal. tank, tD-boX', and three #330 stonepacked infiltrators r � , .. Date`last inspected: -. "Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system v,< 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 ar f Health. d_ Signed 1 1 o Date/ �` Application Approved by © Date Application Disapproved for the following reasons Permit No. Date Issued —————————— ——/_——————————————————————--7— E COMMONWEALTH OF MASSAC USE- S ! f BARNSTABLE, MASSACI9l�SI Sutterland Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced( X)on by Installer WM.E.Robinson Sr. Septic .Service at 56 Norris St. , Hyannis s been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Date Inspector a= "7 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYS- TEM WILL FUNCTION SATISFACTORY. ———————— ——— -—————————————— No. 10 Fee$4 0.0 0 f THE COMMONWEALTH OF MASSACHUSETTS' PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS I Sutterland lizpooat *paem Cou$truction Vermit Permission is hereby granted to Wm_E=Robinson SrWm E Sr�Seotic Service to construct( )repair( X)an On-site Sewage System located at No.# 56 Norris Street Hyannis, MA Street and as described in the above Application for Disposal System Construction Permit. / • o. F Date 1 -, The applicant recognizes his/her duty to comply with Title 5,and the following local p ovisions or special conditions. All construction must be co° eted within three years of the date below. /J ` Date: Approved by Board of Health /✓/ ,l CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I,William E. Robinson, Sr._ hereby certify that the application for disposal works construction permit signed by me dated concerning the property located at 56 Norris Street, Hyannis meets all of,the following criteria: 5, * There are no wetlands within 300 feet of the proposed septic"system 4. * There are no private wells within 150 feet of the proposed septic system * The observed groundwater table is 14 feet or greater below the bottom of the leaching facility * There is no increased in flow and/or change in use proposed * There are no variances requested or needed SIGNED: DATE'' LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER r (Attach a sketch plan of the proposed system. Also if the`licensed installer posesses a certified plot plan,this plan should be submitted) FP' . `\ i m �.\ � r ,. � I� • �� 1 1 © �� � � ` � � I ,l � _ �4 f L. N �. ;`4 r. - - - - -- III