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HomeMy WebLinkAbout0107 SECOND AVENUE (HYANNIS) - Health 107 SECOND AVE., HYANNIS A = - I i TOWN OF BARNSTABLE LOCATION e C 6,41aC A tom SEWAGE # — 0� VILLAGE A AIW/S ASSESSOR'S MAP& LOT —�06 INSTALLER'S NAME&PHONE NO. /' A4,4 C 0,4,f !S 2!!k 4- 5-0 Z/ SEPTIC TANK CAPACITY Z�B c, LEACHING FACILITY: (type) e9 u1 C�/A�f��iti'�� (size) �d® 6" NO. OF BEDROOMS BUILDER OR OWNER C�� PERMITDATE: — e 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 Wetland and Leaching Facility,(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by i f � ago o� ! i No. G y Fee $ 5 0•0 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Application for �Digoal *pgtem Cun!6truction Permit Application for a Permit to Construct( )Repair( )Upgrade(X)�Abandon( ) 0 Complete System ❑Individual Components Location Address or Lot No.10 7 S e c o n d A v e Owner's Name,Address and Tel. 7 7 5—5 3 7 4 WEst Hyannisport,�ciass . 02672 107 Second Ave • Hyannisport ,Mass Assessor's Map/Parcel Robert Clayton US OO 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 . 0.2632 Type of Building: Q Dwelling XXNo.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 440 gallons per day. Calculated daily flow 4 x 110 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank 1500 Type of S.A.S. Description of Soil Loamy sand to medium fine sand V Nature of Repairs or Alterations(Answer when applicable) 1-15 0 0 gallon tank 1— distribution box and 3-500 gallon chambers packed in 4 ' of stone . Omitting cesspool and one leaching pit. 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 is by t ' ar f lth. Signed Date 9/14/9 9 Application Approved by Date?—/ Application Disapproved for the following reasons Permit No. Date Issued No. �J� 50.00 / �� � �' Fee $ / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: P. - Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS application for Oigogaf *pgtem Con.5truction Permit Application for a Permit to Construct( )Repair( )Upgrade(X X Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.10 7 rr�Second,, Ave Owner's Name,Address and Tel. o. 7 7 5—5 3 7 4 WEst Hyannisport,�Yass. 107 Second Ave • Hyannisport ,Mass. Assessor's Map/Parcel � " Robert Clayton ZG-7 Q0 G Installer's Name,Address,and Tel.No. — — Designer's Name,Address and Tel.No.5 0 8—7 7 5—3 3 3 8 Ro9eV&cG1hVto& Son Inc. J.P.Macomber & Son Inc . Box 66 Centerville,Mass. 02632 Bot 66 Centerville,Mass . 02632 Type of Building: v Dwelling XXNo.of Bedrooms 4 Lot Size sq. ft. Garbage Grinder( ) f Other, Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 440 gallons per day. Calculated daily flow 4 x 110 gallons. Plan Date Number of sheets Revision Date Title tl�, Size of Septic Tank ` 1500 Type of S.A.S. Description of Soil Loaiiy sand to medium fine sand _J Nature of Repairs or Alterations(Answer when applicable) 1-15 0 0 gallon tank 1— distribution box and 3-500 gallon chambers ,p`acked in 4 ' of stone. Omitting cesspool and one leaching pit . y 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 th ar�f H lth. Signed- r/�/ Date 9/14/9p9, Application Approved by C` Date —� .Application Disapproved for the following reasons r .. Permit No. ,0 Date Issued ——————— ------------------------------ ... THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired(X X)Upgraded( ) Abandoned( )by J.P.-Macomber & Son Inc . at 10 7 Second Ave West Hyannisport ,Mass. has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 9 /5©Z` dated ' Z—.l./--7. Installer J.P.Macomber & Son Inc. Designer J. .Macomber & ,S6n Snc, / The issuance of this permit shall of b nstrued as a gtarantee that the syst m if1LYu etionlas eQ ed. Date Inspector (�' � r'` y , V ----------------------------- ------ No. �1�— I(,,C Z Fee$ 50.00 THE COMMONWEALTH OF MASSACHUSETTS Z 67_ 006 PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migooar *pztem Construction Permit Permission is hereby granted to Construct( )Repair X X)Upgrade( )Abandon( ) Systemlocatedat 107 Second Ave West Hyanni sport ,Mass . 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 mustbe completed within three years of the date of this it. _ 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) LJoseph P.Macomber Jr. , hereby certify that the application for disposal works construction permit signed by me dated 9114199 concerning the property located at 107 Second Ave West Hyannisport ,MA. meets all ofthe following criteria: i✓ The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. 6' The soil is classified as CLASS Land the percolation rate is less than or equal to 5 minutes per inch. There are no wetlands within 100 feet of the proposed septic system V There are no private wells within 150 feet of the proposed sepdc system There is no increase in flow and/or change in use proposed JThere 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 M 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 "/Q +the MAX. High G.W. Adjustment. 71.9 _ 1 7- `{ DIFFERENCE BETWEEN A and B 41- SIGNED DATE: 9/14/9 9 [Sketc oposed plan of system on back). Q:health folder.cent r l Q I i ���� � . / TOWN OF BARNSTABLE LOCATION 1 rI �5 e C d A16nl- A 1l 17 SEWAGE # 0 VILLAGE ��'A�N!S ASSESSOR'S MAP & LOT —UJ INSTALLER'S NAME&PHONE NO. /'AA f1 C O elk SEPTIC TANK CAPACITY -Ld O LEACHING FACM=: (type) 3'��c`�u C�1�4.�t���ys (size) J�D o 61G NO. OF BEDROOMS :f i BUILDER OR OWNER 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 on site or within 200 feet of leaching facility) Feet j Edge of Wetland and Leaching Facility (If any wetlands exist i facility) Feet within 300 feet of leaching i Furnished by i i O \ �Q1