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HomeMy WebLinkAbout0117 OLD TOWN ROAD - Health u117 Old Town Rd I 268-074 Hyannis f S o � 1 e TOWN OF BARNSTABLE LOCATION l/% ©/—/.) :&tP V I ,6 SEWAGE # 6 - VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME Q PHONE NO.��,/�,�=s f�rl3 /Y-77�97-14 SEPTIC TANK CAPACITY 4 LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED:��Z Z2 DATE COMPLIANCE ISSUED: /a� 4�- VARIANCE GRANTED: Yes No 9V ! J � f P4,410 ' O _._... A l01 bg �_ v 1 LI No. Fee$5 0 . 0 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE. MASSACHUSETTS 01pprication for Miopogal *pgtem Construction Permit Application for a Permit to Construct( )Repair(x)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 1 1 7 Old Town Rd. Owner's Name,Address and Tel.No. 7 7 5—8 61 3 Hyannis, MA Lucia Small Assessor's Map/Parcel 1 1 7 Old Town Rd. , Hyannis, MA Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. Bum E Robinson Sr Septic Srv. PO Box 1089 , Centerville, MA 0263 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(n9 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) Installation of Title 5 septic system consisting of 1500g tank, d-box, & three #330 cultex inflitrators. 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 oar of Health. Signed o Date —/9-9 � Application Approved by 0 Date Application Disapproved for the following reason Permit No. —1,9L Date Issued Y4 I\Y N U L1 Fee$50.00 No. _ i THE COMMONWEALTH OF MASSACHUSETTSEntered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZippYication for Oigogai *p5tem Con!5truction Permit Application for a Permit to Construct( )Repair(X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.. 117 Old Town Rdf Owner's Name,Address and Tel.No. 7 7 5—8 61 3 Hyannis, MA Lucia Small Assessor's Map/Parcel ^ w -117 Old Town Rd.., Hyannis, MA 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 Septic Srv. PO Box 1089, Centerville, MA 0263 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder(nq 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 l Nature of Repairs or Alterations(Answer when applicable) Installation/of Title-"5 septic system consisting of 1500g tank, d-box, & threef 330 cultex inftitrators. r Date last inspected: rf 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 Boar of Health. nn Signed o Date — "7 Application Approved by Date Application Disapproved for the following reason Permit No. " LZ' Date Issued /iz/ THE COMMONWEALTH OF MASSACHUSETTS Small BARNSTABLE, MASSACHUSETTS Certif irate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( )Repaired ( X)Upgraded( ) Abandoned( )byWm E Robinson Sr Septic Srv. at 117 Town Rd, , Hyann s has_hap constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. "- dated Installer Wm E Robinson Sr Septic Srv. Designer The issuance of this permit shall not!!e construed as a guarantee that the system will function as designed. Date Inspector <Z". --—��— --------------------------Fee$50.00 No. 120 t THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Small 1=i$ ozar *pztem Cottetruction Permit Permission is hereby granted to Construct( )Repair(X )Upgrade( )Abandon( ) System located at 117 Old town' Road, Hyannis, MA by WM E Robinson Sr Septic Srv. and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to 'f comply with Title 5 and the following local provisions or special conditions. Provided: Constructi mu be completed within three years of the date of thi permit. 0 C Date: Approved by a CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT OITHOUT DESIGNED PLANS) I,William E. Robinson, Sr.,hereby certify that the application for disposal works construction permit signed by me dated 12/17/96 ,concerning the property located at 1117 Old Town Road, Hyannis, MA meets all of the following criteria: * There are no wetlands within 300 feet of the proposed septic system. * There are no private wells within 150 feet of the proposed septic system. * The obseved groundwater table is 14 feet or greater below the bottom of the leaching facility. * There is no increase in flow and/or change in use proposed. * There are no variances requested or needed. SIGNED: Z� t G DATE LICENSED SEPTIC SYSTEM INSTALLER IN TIE TOWN OF BARNSTABLE NUMBER 4 (Attach a sketch plan of the proposed system. Also if the licensed installer proposes a certification plot plan,this plan should be submitted). i - \_ 1—' o O� I . I i TOWN OF BARNSTABLE :LOCATION l/� OL.l� �iN hI SEWAGE b^ 6 VILLAGE /� �i✓/1�/-r" ASSESSOR'S MAP & LOT :'<:I,NSTALLER'S NAME 6t PHONE NO oe, 10a 6 ZdLfOIY-77jr- 771 SEPTIC TANK CAPACITY ''LEACHING FACILITY :(type) —(size) ,. ":; NO: OF BEDROOMS PRIVATE WELL OR PUBLIC WATER . .BUILDER OR OWNER DATE PERMIT ISSUED:�ii2,�/7 ;:..BATE COMPLIANCE ISSUED: VARIANCE.GRANTED: Yes No Yf t* t� y