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Home My WebLink About0158 SIXTH AVENUE (HYANNIS) - Health 158 Sizth Ave t is r� h 245-098 . r ,West Hyannisporfi z ; �'�� TOWN OF BARNSTABLE LOCATION 1 ` i }� AUL SEWAGE# !R VILLAGE L3csJ77 ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. s '7 Sm SEPTIC TANK CAPACrTY t Sert� LEACHING FACILITY: (type) CU 14- (size) '7A 3"7°46r4i-9-,2A i) NO.OF BEDROOMS J.YftD R OR OWNER / PERMTTDATE: 9��' COMPLIANCE DATE:3/ -3Ig W Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 �JLJ s . No. - 30 00 f:.. ..;es Fee l� THE COMMONWEALTH OF MASSACHUSETTS .,. PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Application for Migoai *p$tem C1Lon5trurtton Permit Application is hereby made for a Permit to Construct( )or Repair(X )an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 158 6th Ave W. Hyannisport Barbara Welch 330 E. 39th St Installer's Name,Address,and Tel.No. signer s Name,Address and Tel.No. W.E. Robinson Septic Service P.O. Box 1089 Centerville Type of Building: Dwelling No.of Bedrooms 4 Garbage Grinder( ng 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 Description of Soil sand Nature of Repairs or Alterations(Answer whp ap 1' abJ 1 , 500 al tank d-box and l 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 Board.4 Health. Signed x Q Date �' —7 Application Approved by Application Disapproved for the following reasons a I Permit No. Date Issued ��/��.Tk , 1�' ��2�4fi. ��t'�vifY°'-,w a -.� _.r , :..,. .. r..- - ..._ �-ri r. .1 �" ,.,.r^'r"t`.rr .... i - � .. Y1 30.00 No Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC-1-It'ALTH-DIVISION -TOWN OF BARNSTABLE., MASSACHUSETT 01pphratton for Mtg;po!9a1 *p6tiiri (tone;truction Vermtt ---------- Application is hereby made for a Permit to Construct or Repair k an On--site_Se�Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 158 6th Ave .W. Hyannisport Barbara Welch 330 E. 39th St Installer's Name,Address,and Tel.No. 'UsigM.Name,Address and Tel.No. W.-.E-..,,Ro1Anson Septic Service O. Box. 1089 Centerville Type of Building: 4 Dwelling No.of Bedrooms Garbage Grinder n(? Other Type of Building No.of Persons Showers Cafeteria( Othei Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan 'Date Number of sheets Revision Date Title Description of Soil sand ti Nature of Repairsor-Alterations(Answer whep ap h ab 1 500 ga 1 tank d-box and Date last inspected: ;Agreement: The und.ersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system lace the system in Operation until a Certifi- " in accordance with the provisions of Title 5 of the Environmental Code and not to p 6at6 of Compliance has been issued by this and Health 00 Signed K25f_., I Q Date Application Approved by Lt"qil A Application Disapproved for the following reasons PermieNo Date Issued f ------------ ----------- - -------- ---------------- THE COMMONWEALTH OF MASSACHUSETTS t PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS ti Cerfiftrate of Compliance THIS IS TO CERTIFY,that the On-site Srwa e Disposal System installed or repaired/replaced x on by W.E. Robinson Septic for158 6th Ave, W. Hyannisport as a constructed in accordance --- m with the provisions of Title 5 and the for Disposal System Construction Permit Nog� ated Use of this��ni.is conditioned on compliance with the provisions set forth bqjo_,Z z10�2 W---4'P Z oz, C,-1 30.00 No Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION =BARNSTABLE, MASSACHUSETTS x1h5poal *p!Aem Con!5tructton Vermtt Permission is hereby granted to W.E. Robinson Septic Service to construct repair(X )an On-site Sewage System located at 158 '6th Ave W. Hyannisport and as described in the above Application for Disposal System Construction Permit. The applicant reco izes his/her duty to comply with Title 5 and the following local provisions or special conditions. .All construction mu ted within two years of the date below. 0 Date: st'M'7111 Approved by 'w& CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) I, A., hereby certify that the application for disposal works ' construction permit signed by me dated g—,7-4---q , concerning the property located at G w �Iy Y'0m 7 meets all of the following criteria: • There are no wetlands within 300 feet of the proposed septic system • There are norprivate wells within 150 feet of the proposed septic system • The observed 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: DATE: LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. s I �___ � �.,��_ I✓ \� E � � ,� \ _ �' � \� �� Q � � � � \ \i � a � � `� f r 1- 4+'