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Home My WebLink About0031 VINEYARD AVENUE - Health 31 VINEYARD AVE.,HYANNIS A=291-131 P TOWN OF BARNSTABLE LOCATION ' r SEWAGE # VILLAGE os ASSESSOR'S MAP & LOT Z9 INSTALLER'S 4AME'&' PHONE NO. 16 SEPTIC TANK CAPACITY J LEACHING FACILITX: (type) (size) NO.OF BEDROOMS " 3 BUILDER OR-OWNER PERMTTDATE: Q. 1 COMPLIANCE DATE- I�"j 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 Feet within Meet of leaching facility) 4P v Furnished by a. { I i l , No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ZippYication for nigaar *p!tem Comaruction i3ermit Application for a Permit to Construct( )Repair 0)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 31 ,.Tine.Vard. Hyannis ,MA Robert Conrad, 771-3152 Assessor'sMap/Parcel 02601 31 Vineyard Rd., Hyannis, MA tall s Nape, ddress,and Tel.No. Designer's Name,Address and Tel.No. m o, inson, Sr. Septic Service P.O . Box 1089 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. Install a 1 , 500 gal septic tank `t' o �airs�woltstto e(paceen� acilecriambers 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 Bo4 of Health Signed ' Date S b Application Approved by g Date Application Disapproved f r the following reasons ZZ Permit No. r Date Issued -'. r , ..M�-Y 1., •;....ty t. .♦ h"I"w...°`.r,.Fa"^1. Y•.N fn-.,.- ... tea. ,fir .. .,.�..R sf- . ,K.-P..`� •'.n,.r . .y.t. r .. n .w No. Fee $50 .. r" THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: .s Yes f PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Application for �Digpoml *pztem Cott6tructiott Permit Application for a Permit to Construct( )Repair )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 6 Owner's Name,Address and Tel.No. 3i7 Vineyard. . Hyannis ,MA Robert Conrad. 771-3152 Assessor's Map/Parcel 02601 31 Vineyard. R d , H�a.nnis , MA Vtalle 's Name, ddress,and Tel.No. Designer's Name,Address;andbel"No. m Roinson, Sr. Septis Service. P.O. Box 1089 r -, ' nR Type of Building: V Dwelling No.of Bedrooms 3Lot Size; sq.ft. Garbage Grinder( ,)` Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons poitc a'y @a"tc`ulated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank. Type of S.A.S. Description of Soil Sand. Install a 1 , 500 gal septic tank N t e" Re rs r Alterations(Answ when licable) -"�o° aid: �°wo stone -pa ,ea � 7acn Wi 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�Health.Signed I __Date a— Application Approved by 4 Date Application Disapproved Signer r the following reasons t r. ( `1 '` Peririit No + .. 6�2 - . 4M Date Issued THE COMM.ONWEALTH_OF MASSACHUSETTS Robert Conr d BARNSTAB E;'MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( X)Repaired I; )Upgraded( ) Abandoned( )by Wm. E. Robinson, Sr. Septic Service , P.O . Box 1089 Centerville at .31 Vineyard. Ave , Hyannis, MA ben constructed in accordance ',.with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer Designer The issuance of this permit shall not be construed as a guarantee that the sys d � ll fun Date Inspector_ _.- -� Y No. -------_—---------------- (72'`�//_Z(/) Fee ✓�W v Y� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS . . Robert Conrad Piopooai *pztem Cott!5tructiott Permit Permission is hereby ranted to Construct( )RepairM( X)Upgrade( )Abandon( ) System located at 3'1 Vineyard Ave . , Hyannis, MA 02601 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 b (comple� within three years of the date of this Date: ��/ %� Approved by 0 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 ENGINEERED PLANS) I, William E. Robinson, Sr. ,hereby certify that the application for disposal works construction permit signed by me dated concerning the property located at 31 Vineyard Ave.. Hyannis, MAmeets all of the following criteria: There are no wetlands within 100 feet of the proposed leaching facility. * There are no private wells within 150 feet of the proposed septic system. * There is no increase in flow and/or change in use proposed. * There are no variances requested or needed. * If the proposed leaching facility will be located with 250 feet of any wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation. Please complete the following: A)Top of Ground Elevation(according to the Engineering Division G.I.S. map) B)Observed Groundwater Table Evaluation(according to Health Division well map) il SIGNED: ��v ./ DATE LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER 60 (Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted). \ � �-� J ' �, F� � 8 n e� Y ` TOWN OF BARNSTABLE LOCATION I / !t/ = SEWAGE # 9 V' VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. 6 SEPTIC TANK CAPACITY /C t LEACHING FACILITY: (type) —�__� (size) [1�b �—•r NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE:1 T —1 COMPLIANCE DATE-J,, `— f 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 3-1JQLfeet of leaching facility) ` d Feet /v.� Furnished by I` i I i I II ` r D -...._. + J'