HomeMy WebLinkAbout0019 TEVYAW ROAD - Health 19 TEVYAW RD. , HYANNIS.
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TOWN OF BARNSTABLE aLK
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LOCATION fe V)Y A UZ 910 SEWAGE #-I Doo
VII:LAGE��T Ail/A//aS' ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. ! ^ ,✓J[) A C d 41 RL',[� T" `sS o�✓
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type),, L®ABC e A d 19 Of iS (size)
NO.OF BEDROOMS
BUILDER OR OWNER
PERMIT DATE: ®� COMPLIANCE DATE:
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
on site or within 200 feet of leaching facility) Feet
Edge of Weiland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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No. leomf del Fee 50.0
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
es
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
Zipplication for -Miopos�af.*pztem Construction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) XRComplete System ❑Individual Components
Location Address or Lot No."19 Tevyaw Road Owner's Name,Address and Tel.No. O n Ke0 an
Hyannis,Mass. 02601 11 Preseident Road
Assessor'sMap/Parcel ;2� 69 Dl+s. Hingham,Mass. 02043
Installer's Name,Address,and Tel.No-5 0 8-7 7 5—3 3 3 8 Designer's Name,Address and Tel.No. 5 0 8—7 7 5—3 3 3 8
J.P.Macomber & Son Inc. J.P.Macomber & Son Inc.
Box 66 Centerville,Mass. 02632 Box 66 Centerville Mass. 02
632
Type of Building:
Dwelling X No.of Bedrooms 2 Lot Size sq.ft. Garbage Grinder( )
Other 'I�ype of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 355 gallons per day. Calculated daily flow 3 X 1 1 0=3 3 0 gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil Loamy sand to medium fine sand.
Nature of Repairs or Alterations(Answer when applicable)
Omitting cesspool. Installing.2-500 gallon leaching chambers packed
in 4w ot s one, l -Di.stribution box and 1 -1500 gallon septic tank.
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 issu by this of ealth.//.,—
V $/28/00
SignedDate
Application Approved by Date ` ` fiTTTj
Application Disapproved for the following reasons
Permit No. Date Issued_ E��—0,9 a
TOWN OF BARNSTABLE -
;:
LOCATION �P 1•e V Y Aa K� SEWAGE t Ovo
VILLAGE
_//4 Nei//S'
ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. T
SEPTIC TANK CAPACITY �O d
I ,
! LEACHING FACILITY: (type)x• �ail.e7 (size) �dd
NO.OF BEDROOMS s'L
BUILDER OR OWNE
i
PERMITDATE: COMPLIANCE DATE:
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
I 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
... .. ......
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_ Or, I.
A No. !/F✓ 4 x� Fee 5 0.0
.. THE COMMONWEALTH OF MASSACHUSETTS Entered'in computer: 1
Yes
_ ✓,�%"PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE.,VASSACHUSETTS
�Xh
01pprication for ]Digpogaf *pztem Congtruction Permit
�O*Z'� Application for a Permit to Construct( )Repair( )Upgrade( )Abandon(- .) X3CComplete System ❑Individual Components
19 Tevyaw Rohn eo an
Location Address or Lot No. yaw Road Owner's Name,Address and Tel.No.
Hyannis,Mass. 02601 11 Preseident Road
Assessor's Map/Parcel 'n, 6 � D Hi ngham,Mas s. 02043
r` �"s ler's Name,Address,and Tel.N6.5 0 8—7 7 5-3 3 3 8 Designer's Name,Address and Tel.No. 5 0 8—7 7 5—3 3 3 8
.t .Macomber & Son Inc. J.P.Macomber & Son Inc.
Box 66 Centerville,Mass. 02632 Box 66 Centerville Mass. 02632
Type'of Building:
Dwelling X No.of Bedrooms 2 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 355 gallons per day. Calculated daily flow 3 X 110=3 3 0 gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil Loamy sand to medium fine sand.
Nature of Repairs or Alterations(Answer when applicable)
Omitting cesspool. Installing.2-500 gallon leaching chambers packed
n 40 or stone, I -Dlstribution box and - 500 gallon septic tank.
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 isswA by this To f ealth. 8/2 8/0 0
Signed Date
Application Approved by Date J a•
Application Disapproved for the following reasons
Permit No. ,0-0b I / :ZZ Date Issued r' f—
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( )UpgradedPX)
Abandoned( )by J.P.Macomber & Son Inc. 1 , 1 1
at 19 Tevyaw Road Hyannis,Mass. has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit .9 "`" dated
Installer J.P.Macomber & Son Inc. Designer J.P.Macomber & SI9N Inc.
The issuance-of t s De 'It s all not be construed as a guarantee that the s ill func io asi�!o
ne
Date / InspectorJ�w W
No. ` "" Fee $ 50.00
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Mizpogat *p5tem Construction Permit
Permission is hereby ranted to Construct( )Repair( )Upgrade�X�Abandon( ) 0�
Systemlocatedat 19 Tevyaw Road Hyannis, .Mass.
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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 ermit.
Date: '�11 C51! Approved b �,
Y
11&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)
Joseph P.Macomber Jr. hereby certify that the application for disposal works
construction permit signed by me dated 8/2 8/0 0 concerning the
property located at 19 Tevyaw Road Hyannis,Mass. 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,
The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch.
JThere are no wetlands within 100 feet of the proposed septic system
t! There are no private wells within 150 feet of the proposed septic system
There is no increase in Dow and/or change in use proposed
There are no variances requested or needed.
The bottom of the proposed leaching facility will nQt 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 =be located less than fourteen(14) 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 1_0+the MAX, High G.W. Adjustment.3-7f L= r
DIFFERENCE BETWEEN A and B
SIGNED : , DATE: 8/28/00
(Sketch posed plan of system on back).
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