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Home My WebLink About0664 YARMOUTH ROAD - Health 664 YARMOUTH RD., HYANNIS 0 TOWN OF B STABLE LOCATION >':.vwl, yar412,1 SEWAGE # cf 9 6Z� VILLAGE ASSESSOR'S MAP & LOT?96' o!y INSTALLER'S NAME&PHONE NO. 47 mil-D 34 9 Josf�-i d� lo�hoS SEPTIC TANK CAPACITY /YDD LEACHING FACILITY: (type) 2-;5-00 ru l3ri /!S (size) ZS k /.3 NO.OF BEDROOMS 3 r Ir BUILDER OR OWNER L• � ��. PERMIT DATE: 9 2 2-9 9 COMPLIANCE DATE: 2 - 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�ffaacility Feet Furnished by f- �,_�a { -� � 1-y a � �, . � � � J 5�� 0 v } - ;, ."' b ' .s r r � ' r f ,'c �✓ 99--6 No. �. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYfcation for �Diopool *pgtem Congtructiou Permit Application for a Permit to Construct ep )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. li rr 4 r Owner's Name ddress and Tel.No. Assessor's Map/Parcel // V1,917f� Installer's Name,Address,and Tel.No. 7,7 —�� Designer's 14me,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms � 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 Nature of R airs or Alterations(Answer when applicable) /=xl.1rsl1cr 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 ued by this oard of Health. Signed _ Date q— F' Application Approved by Date 2 21 Application Disapproved for the following reasons Permit No. Date Issued ��JJAA ��.J l'` �I '� � "�-�"'ram , �X Fee No. 99__6 (� �), 1 v_ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Z(pprication for Migool *potem Contruction Permit Application for a Permit to Construct Kqep )Upgrade( )Abandon( _) ❑Complete System ❑Individual Components t Location Address or Lot No. Ye/��jz40U1' Owner's Name, ddress and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Z/7"J —��/� Designer's N e,Address and Tel.No. D� ,ter,-os .wrS �bs�p has�fo� O-� G' ` I &If'wool A Type of Building: ` Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) f r Other Type of Building No.of Persons Showers( ) Cafeteria( ) ' x: 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 I A-0r^ Nature of Re airs or Alterations(Answer when applicable) K/Z 'EXI jT«av Cii:SS,9DvI 4ell i l'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 is ued by this 40ard of Health. Signed _ Date r Application Approved by - - Date Application Disapproved for the following"reasons Permit No. Date Issued 2 9' THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( G. epaired( )Upgraded( ) Abandoned( )by aS- ,4 pr at z` i has been constructed in accordance with the provisions of itle 5 and the for Disposal System 6onstruction Permit No. dated Installer Jotted, l?i &00103 Designer o d, e a� The issuance of s ermit s a t construed as a guarantee that the st' ' ill Date function as.de/signed!� f �j Inspector --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE; MASSACHUSETTS misspu ar *p5tem Construction Permit Permission is hereby granted to Construct( r( )Upgrade( )Abandon( ) System located at li�/ v-4 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:Consiruction must be completed within three years of the date of this permit. t Date: 7i Approved by TOWN OF BPNSTABLE F 4 LOCATION SEWAGE # VILLAGE ASSESSOR'S MAP & LOT�SrSS-a/,/ INSTALLER'S NAME&PHONE NO. q7 7-0 3�q 9 Jo s�1�-; /,f. / ��•h� - SEPTIC TANK CAPACITY /rDD LEACHING FACILITY: (type) 2 F11 (size) ZS k 13 NO. OF BEDROOMS 3 BUILDER OR OWNER PERMTTDATE: 9 2 2- 9 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 leachin�gfacili Feet _ Furnished by i i i i i L� as a 1 � I t ,t h 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 CC1r%;$TRUCTION PE11L)M MITHQUT DESIGNED PI.ANSI hereby certify that the application for disposal works construction permit signed by me dated 9—2 2 —?5P' , concerning the property locate d at meets all of the following criteria: e failed.,stem 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. There are no wetlands within 100 feet of the proposed septic system '%1 here 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 t-ariances requested or needed -The-bottom of the proposed leaching facility will not be located less than five feet above the ma:timuun adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] If the S.A.S. Isill be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facil;:ty 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 EIevation(using GIS information) B) G.w, tilevation f -_+the MAX. High G.W. Adjustment . DIFFERENCE BETWEEN A and B SIGNED DATE: [Sketch ropospo'plan of system on back]. 9:hWth folds:ceent � y��oG"�d/� _---. � ��Y ►.� a, 6�� e 0 �X�ST«e� Gti'S'9; o o a