The URL can be used to link to this page

Home My WebLink About0104 OLD TOWN ROAD - Health 104 OLD TOIPM RD. HYANNIS c TOWN OF BARNSTABLE -: :LOCATION.LOCATION./w alw SEWAGE # E ��°'A.:- VII.LAG ASSESSOR'S MAP & LOT t J INSTALLER'S NAME&PHONE NO. , , SEPTIC`TANK CAPACITYZS0--V LEACHING FACELITY: (type)- - (size) NO.OF BEDROOMS_, BUILDER.OR OWNER PERMIT DATE: 0 "9 2 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table<to the Bottom of eaching Facility Feet Private Water Supply Well and Uiching Facility any wells exist, on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If wetlands exist within 300 feet of leaching facility) . Feet Furnished by � ., ;, ;, � i "� s�, �� _ � Y �� _-� �� ,, �, � . ,. `�/a �. No. ��✓i ': Fee 5 0 THE COMMONWEA i MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Yes 0(ppricatton for �Dtgozar 6petem Construction Vertu Application for a Permit to Construct( )Repair(X )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 104 Old. Town Rd.. , Hyannis Jack Byrne Assessor's Map/Parcel 6 8- 8 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E . Robinson Septic Service PO Box 1089, Centerville Type of Building: Dwelling No.of Bedrooms 4 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 S and. Nature of Repairs or Alterations(Answer when applicable) new Title-5 septic system. Tank D-box and 3 lesch chambers . 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 and of Ialth. qq Signed ��`-- Date T`Oi6�'- Application Approved by Date 7,1T.419 Application Disapproved for the following reasons r OF Permit No. Date Issued Fee $50 tr THE COMMONWEO MASSACHUSETTS Entered in computer: . Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 0[ppYication for 33i6pogar *p.5tem Construction Permit Application for a Permit to Construct( )Repair�( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Ln Address or Lot No. Owner's Name,Address and Tel.No. M 0ld Town Rd . , Hyannis Jack Byrne Assessor's Map/Parcel 6 $- 8 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Service PO Box 1089, Centerville Type of Building: 3 Dwelling No.of Bedrooms 4 Lot SVe sq. ft. Garbage Grinder - •- Other Type of Building No.`of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. J Plan Date Number of sheets Revision Date Title 7 f r• { Size of Septic Tank Type of S.A.S. . .... � ,�.; Sand. Description of Soil Nature of Repairs or Alterations(Answer when applicable) new Title-5 septic system. Tank, 'D-hox and 3 l pnt,:h nhnM'hPr�q , 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- it Cate of Compliance has been is//sued by this oard of Ijpalth. JJ Q G Signedl�u • — Date YV2 / 4 Application Approved by Date T.r1 Zu Application Disapproved for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS Byrne BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( X )Upgraded( ) Aband tied( � Wm. E . Robinson Septic Service at 10 Old)'1'Own . , yanrils has been constructed i-h'accordanice with the qNM is�p s ITt-5 and the� r Disposal System Construction Permit No. �Z dated ZG aU xo inson aar. g f Installer Designer The issuance of this je t shay not construed as a guarantee that thes�Ce. ,will fulncti n addesr e v 004 Date �` / Ins ector to ( 7 �� Wlei 1 i f 1`' -�Z -- --------------------------- _ No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS — -_ Byrne Mwi5po5af *pgtem Construction Permit Permission is hereby granted to Construct( )Repair(X )Upgrade( )Abandon( ) System located at 104 Old Town Rd. , Hyannis and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her du(}0o comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of thi e it. f Date: �/ / // Approved by �. 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, W i 11 iam E . Robinson,Szhereby certify that the application for disposal works construction permit signed by me dated 7��V—q 7 , concerning the property located at 104. Old Town Ed.. . Hyann i -,, mA 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. o e s 1 is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. are no wetlands within 100 feet of the proposed septic system — r re are no private wells within 150 feet of the proposed septic system tier is no increase in flow and/or change in use proposed • ere 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(1.1) 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 +the MAX, High G.W. Adjustment . =. /® DIFFERENCE.BETWEEN A and B l SIGNED : G , ✓ — DATE: 17 g [Sketch proposed plan of system on backl. q:health folder:cen I i r TOWN OF BARNSTABLE S� LOCATION �!/ 6,Lv ^I �Q r SEWAGE # �= VILLAGE 4Vd,0-x- � ASSESSOR'S MAP & LO INSTALLER'S NAME&PHONE NO. 7"2 SEPTIC TANK CAPACITY/CSC-e LEACHING FACILITY: (type)3-- j4**�-9—Z �-C (size) NO. OF BEDROOMS,_ l� BUILDER OR OWNER S V ti L PERMIT DATE: ` COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of eaching Facility Feet Private Water Supply Well and Leaching Facility any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If an wetlands exist within 300 feet of leaching facility) Feet Furnished by I i 1 � t � t