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HomeMy WebLinkAbout0013 PRAM ROAD - Health 13 PRAM ROAD HYANNIS A 268 ,189 R r TOWN OF BARNSTABLE � y LOCATION IS I'MM R&A-D SEWAGE # Rao _ VILLAGE Vts1N its ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. i2D C,I& (C _77 S F7-14 SEPTIC TANK CAPACITY 1 5 O LEACHING FACILITY: (type) a IY W��,� (size) NO..OF BEDROOMS 3 BUILDER OR OWNER t/tiG� PERMITDA"TE: t. ;�OCR I COMPLIANCE. DATE: -7/,9 E Lo?G p 1 Separation Distance Between the:.,- Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility .(If any wells exist ion site or within 200 feet of leaching facility) Feet_ Edge o:We and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Fret Furnished by E r -- i V va C+ 1 No.GJ � J 5 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLEs MASSACHUSETTS Zipplication for Mig ual *p5tem Cow6trurtton Permit 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. Assessor ap5arRp. , Hyannis Edward ( Bud ) Paduck S Installer's Name,Address,and Tel.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 S a n d Nature of Repairs or Alterations(Answer when applicable) Title-5 septic system Con s i s tiny of a 1 ,500 gal. tank, D-box and 2 precast leach Chambers wit s c e n e—cai-r-Ca eTind.. 7 �— 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 B rd o Huth. Signed y Date o j Application Approved b Date Application Disapproved for the following reasons Permit No. �,o — Date Issued ZF7 4;rl/A '+� Feed 50 / leg _ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: _n Yes / PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS ✓/ ZippYication for Mioo.5af 6potem Construction Permit 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. Assessors Rarced. , Hyannis Edward ( Bud ) Paduck Z6 F-M Installer's Name,Address,.and Tel.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 Cn r-7 Nature of Repairs or Alterations(Answer when applicable) Title-5 septic system consis ting of a 1 ,500 gal. tank, D-box and 2 precast leach chambers wit `around. l—j .;L S 2 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 Bpard o)I-leith. r• Signed Date G Application Approved bye101_ Date Application Disapproved for the following reasons r Permit No. iR�04r::P/` 7 Date Issued THE COMMONWEALTH OF MASSACHUSETTS ` BARNSTABLE, MASSACHUSETTS Paduck Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( g )Upgraded( ) Abandoned( )by Wm. E. Robinson Septic Service at 13 Pram Rd. , Hyannis has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Penn-WZ' dated Installer Wm. E. Robinson Sr. Designer The issuance of this pqrrnit shall not be construed as a guarantee that the syste 1 functiop- sidesbg Date 7 LS LG / Inspector R 1�/""" �� ------------------------- No. Fee $50 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS lwizpozar bpztem Con0truction Permit Permission is hereby granted to Construct( )Repair(2 )Upgrade( )Abandon( ) System located at 13 Pram Rd. , Hyannis 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 Approved � (/`�' z. • 11609 ram, ._ NOTICE_Thies Fora Is To Be used Far the Repair Of Failed septic systems only_ G �.- cmrraRca.T OF SKETCH AM APMCA—MW FOR A WARS OSAL WORKS CONSTRUC RON FE t"M(WTMOUT DESIGNED PLANS) L William E. Robinson, y certify that dwapplicamn t.Ar mamucgim 4mmix 4sped by we dated_(. =: Z �� ..On cer u W the prapetty located at 13 Pram Rd. , Hyannis nmm all of the following taiteriw • The failed system is econacmd to a r+esudeond dvmomg ady. Thcm are no counnemial or business uses assoc Wcd wish the dweUin& sail is classified as CLASS 1 and the peroolaan rare is t=n m or equal Zo 5 minus per inch. c 3rc RD wttl8rcds wubin 100 foes of the p[Gposed sepDC aWUM ar M - c oo wivalx wdls wkwo,l j1 dX2 o tbc proposed swic*sue, is no increase in&wv andlor in use pa gmmd • are on vanmm d or availed. bmom of the prop , I bftgr wilt gm 6e incmed less than five fen abwa the vmm adJusmd FOORdwato table ek aboa.fAirpu ddw gmw dww!r rabic using the Fnmptor when appkal el the S A.S.will be located with 250 rm of any vcgmlc d wedands.the bosom of the proposed ewhumg fad►will ost be kcatcd kss than founaen 114)foot above the n ammum add graundwater table do adW the d'a0awea6' ) Top of Ground Stray Ek. (tasasg GiS iadocma unj B) G.W.lr7etrdtion +Wt MAX fth G.W_.fit = �� DIFFERENCE BETWEEN A and B SIGNED:__ ), 1 DATE: (S MIch proposed pdan of system on badcJ_ +F 6e�Nh folds_.vt �, - - ��. ` ._ �, �N a i, S / '� ' o _ -� �----� � . . . � � �, -V4 =LL TOWN OF BARNSTABLE =s RLOCATIN - SEWAGE # o�ao VILLAGE .. NVA NhJ'6 ASSESSQR'S MAP & LOT Z6�- INSTALLER'S NAME&PHONE NO. Ab kA 6 V SEPTIC TANK CAPACITY 1 S O 4 LEACHING-FACILITY: (type) SI yu `t (size) aZ A 13 5 NO. OF BEDROOMS 3 BUILDER OR OWNERC�P f PERMITDATE: t�la�::'l Gov I COMPLIANCE.DAT'E, Separation Distance Between the: Maximum Adjusted Gr o undwateiTable to the Bottom of teaching Facility. Feet Private Water Supply We11 and.Leaching Facility.-`(If any,we.11s_.ezist on site or.within:200 feet of leaching facility). Feet Edge of Wetland and Leaching Facility (. Y If wetlands exist . .. .an . within 300 feet of leaching facility) Feet Furnished Eby 4 � t 1 o L"0-C A T ION S.E W A G E PERMIT NO. VILLAGE + ' N}S.14 LLER'SS NAME i ` ADDRESS B U I L D E R OR OWNER I^ DA T E PERMIT ISSUEDALL 1-1,14K DATE COMPLIANCE ISSUED _ � , S� � �i i I <: I No......J�.............. F�s 5.Q Q............ THE COMMONWEALTH OF MASSACHUSETTS IO� BOAR® OF HEALTH ...... ..........T.QWn.....OF.......Barest.abl.e---.-..-.........-.....-----_-----_-----_-_. Appliratiun for Disposal Works Tunstrnrtiun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: f �.. S ---------•-- .i..S........................................................ Location-Address or Lot No. ..Edward adu .......................................................... 13 exam Ri ,.... .e s t-..Hy-anniapost------_.... Owner Address --A-�--8 . -------------------------------- --128--3iahnpa...T.erxaee.r...Hyanni-s.............. Installer Address dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms........3.................................Expansion Attic ( ) Garbage Grinder ( ) pa, Other—Type of Building ............................ No. of persons........3.................. Showers ( ) — Cafeteria ( ) Pa Other fixtures ------------------------------ ._. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid'capacity............gallons Length................ Width................ Diameter.---_._-.--_-- Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit. No-_----------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) - '-, Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (s Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -----------------------------------------------------------------------------------------------------------------------------------•----------...------------ ODescription of Soil...............SIand........................................................................................................................ U -•--•-......-••--•••-•-----•••-••-•--•-....-••-----=----••••--••-----------------•---..........--••--•------•••--------••--••-•-•----••----------••--•••••------•-•----•------•----------•---•-•-------- -------------------•-----•-----•-------•••••. _ -... ••-g--•-••---•-•---•------•-•. U Nature of Repairs or Alterations—Answer when applicable.... :y�QOQ___(_QT1G__.t11QAj5$nd ____ga.12.0.n............. stone:.P.acked•. gverflow..---•---------•--•.........................•-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iI:IE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued b the boa- of >salth. sig �---.............................................. -- / /} 8..__..._ �y L Application Approved By....... -- ----------------------- Date Application Disapproved for the following reasons-------------•--------------•------•-•-•---------...--------------------------------.....-------••........------ ....................•----•-•-----•---------------------------...-•-•-•----------------.....-•--------------••-•--•-•-----•------••-•--------•----••-----•-•---•••-•----•--••••---•--------•------------ Date PermitNo.......................................................- Issued........................................................ Date trt _ No................- FR .................... r THE COMMONWEALTH OF MASSACHUSETTS ..: h BOARD OF HEALTH ;R�i , r firiaari furival Works Cnrittrinri eruti# Appl>caUoriis hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal ^ Systemt �q�t �t Y " -... Y 2 10W rI !! v or Lot No N u s I S Owner Address ` ... I P, ': �8_ a� . r c+ .�: I,................. irr1Py s Installer Address ' Q. Type of B ldiigy� '} r Size Lot_____ 3;{ � j..Sq. feet U D ell in r No 'of.Bedrooms........ ................................Expansion Attic ( ) Garbag&,6 der0-4 ( ) ? 7� ro x hr p, Otlier 1T `Building ............................ No. of persons___.__._ ...-_...--......_ Showers y.,p f ( ) Ca#&ria ( ) I ��Other fixtures 44 Designlow ..................gallons per person per day. Total daily flow...................... .gallons. W x,Fib'l . �,r t W . Septic�an ' Liqu>d'capacity__...__-_.-.gallons Length________________ Width.__......._.__.. Diameter___..__ _epth x Disposal TrencI I d. ............... Width.................... Total Length.._...._............ Total leaching area F; sq. ft. °a+ + a. Seepag lit No�- ` ��--- -:-. Diameter____________________ Depth below inlet.................... Total leaching area :....sq. ft. Z Other �as" >buhon box'`( )' Dosing tank a }ti9WX 0"t,I�6,4't Performed by Date ........................... Percolat ----- - - Test lP l�No ] _ ,...minutes per inch Depth of Test Pit.................... Depth to ground water ___.............. f=, Tesf aPI N,o 2 minutes per inch Depth of Test Pit____________________ Depth to ground water 3 nay e t. w Ms'I �t3I f ra�s 1t�a5' r2 '................................................................................................................ ...................... DDescrl Lion of Soll S-a-d------...•...-------•----......--•--------------------------------------------------------------------- ---- ` ................. ........................... ------------------------------------------- .......____. U x' z W ��r -• - = UNature Hof 2epairs or Alterations—Answer when applicable._.. v 00 W21 _._thOUS&.... .... _�...... ------ �tQ11e= Rdt�@E3...oe '1®V------------------------------------------------------ -------------- -------------------- ....... ---- --•---•-- TtOT der'signM.'agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions Fof TIT I E 5 of the State Sanitary Code' The undersigned further agrees not to place the'system in operarioi°>:iritilf SCertificate of Compliance has been issued b the boar f alth. s Sig d a^". •--•- Ql fi ... Application,,Approved.,,By....• tr �!° r! y Date APplicaioii DI approved for the following reasons:. ---•••-- -•••---- - ' ......... 3 '- t�ryV Date Permit No Issued.. -._ ............. ......... Date...................................... NAMMV 4. }q� THE COMMONWEALTH OF MASSACHUSETTS BIRD OF HEALTH , p t;a �3✓ k� e`' ............. ...::� O.W.n . OF........P rar ittc"�ble..... k} ` Tirtifiratr of Tutripliattre l ;Ae 4 r T '�5WS TQ CERTIFY, That the Inch vidual Sewage Disposal System constructed ( ) or 'Repaired by A r . � � .C4?�.. ;2$- � h4 ...Terace; H�'�3n, S... arc c Installer { at #j' �� � a._.�� _: '. 1.-Rd...s.-__�f-a_ j4naxw.appor-Ts-.................................... . , has bee �lnstallW'm accordance with the provisions of T ` Sanitary Cod as described in the applacaion for Disposal Works Construction Permit�Nohe State dated 9 • f- r THEr`ISSuANCE OF TH'i,S CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEIZ+I,IA/ILL FUNCTION SATISFACTORY. DATE --••••---••-...: Inspector-•••-- -----•-- '' r ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH F 4f ....:.........Town.......OF..............�3 .MP.m e s 4 No. 3 :� FEE.__....:?.'0.0..... � xbi1 �r� VIMtttrUari rrnti , Per�rrllss>ori Is.Hereby grante -- B Cesspool Service •---.--• u y to Cons r ct� ' 'or�$epair (� a Individual Sewage Di_posacAard pS�,E�u le atNo...- �... ............3t -- ......�. ---•• ----------•-• ••--- -•-•----••--•-•--• •---- s�ti `rtlY' Street 9/1.4%78 as shown'© ithe!application for Disposal Works Construction Pyr}fr"�t No. Dated ` _ k -------•-•-- do_ I/ • 7 0 Boar of Health g 4 DATE `= ........................................ ----.� ---•-- ------------- ----- , 4i [ FORM 12�5��`WQBBS &`,BVARREN,_INC.,-PUBLISHERS N jot