The URL can be used to link to this page

Home My WebLink About0193 BUCKSKIN PATH - Health 193 BUCKSKIN PATH CENTERVILLE A = 170 068 Owiford, NO. 1521/3 ORA ;�� ' 10% No. t/✓ Fee$5 Q THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Vs PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01pplication for Digool *p5tem Congtructiun permit Application for a Permit to Construct( )Repair( X)Upgrade( )Abandon( ) ❑Complete System O Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 193 uckskin Path, Centerville K. Moberg Assessor's ap arcel /] Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Service P O Box 1089, Centerville 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 Nature of Repairs or Alterations(Answer when applicable) Title-5 leach system consisting of a D—box and 2 concrete leach chambers with stone all around. 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 bee ' ued by 't oar f Health. Sign:1 Ab ct Date a Application Approved by Date Application Disapproved for the following reas&n _ Permit No. Date Issued '_No. Fee $5— THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ites PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS r Zpplication for Mizpooal *pgtem CoRkruction Permit , 4 Application for a Permit to Construct( )Repair( X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 193 Buckskin Path, Centerville K. Moberg Assessor's Map/Pazcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Service P 0 Box 1089, Centerville 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 Sana Nature of Repairs or Alterations(Answer when applicable) Title-5 leach system consisting of a D—box and 2 concrete leach chambers with stone all around. Date last inspected: Agreement: r The undersigned agrees to ensurl,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 beeTr 1w' ue by thi oar f Health. Sign e Date Application Approved by Date Application Disapproved for the following reas Permit No. i Date Issued --------------------------------------- - THE COMMONWEALTH OF MASSACHUSETTS �\ Moberg BARNSTABLE, MASSACHUSETTS u KCertificate of Compliance THIS IS TO CER ,that the On-site Sewage Disposal System Constructed( )Repaired (X )Upgraded( ) Abandoned( )by Wm. Robinson Septic Service t 193 BuckskiV Path, Centerville has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. '' dated eInstaller Wm. E, .Robinson Sr. Designer � The issuance of this permit shall of b constmed as a guarantee that the system1'wtll ction as designe,. j Date Inspector / '�A/ 1r9 , .. � S r ----------------------------- Nt Fee '"THE-COMMONWEALTHfOF MASSACHUSETTS Moberg l PUBLIC HEALTH!bIVIS�T0__N -BARNSTABLE} MASSACHUSeftS,--� _u Mwiopoal 6pmem Construction Permit Permission is hereby granted to Construct( )Repair( X)Upgrade( )Abandon System located at 193 Buckskin Path, Centerville ` 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 pe Date: Approved b le PP Y NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTMCAMON OF SKETCH AND APPLICATION FOR A DLSPOSAL WORKS CONSTRUCTION PERMIT MMOUT DESIGNED PLANS) r, William E. Robinson,S�eby certify that the application for disposal works construction permit sighed by me dated 42- XG— 0--w , concerning the property located at 193 Buckskin- Path, Centerville meets all of the following criteria: • The failed system is connected to a residential dwelling only. There are no commercial or business uses associated wi the dwelling. t The soil is as CLASS I and the percolation late is less than or equal to 5 minutes per inch. There are no i ateds within 100 feet of the proposed septic system • There arc no prNate Wells within 150 feel of the proposed septic system . There is no t in flow and/or change in use proposed • There are no requested or needed. • The bottom the proposed leaching facility will nW_t be located less than five feet above the m&*,d groundwater table elevation:[adjust the grotmdwater table using the Frimptor method en applicable) • If the S_. will be located with 250 feet of any vegetated wetlands,the bottom of the proposed leaching ty will m be located less than fourteen(1-tl feet above the maximum adjusted ground ter table elevation, Please complete the following; a) Top of Ground Surface Elevation(using GIS information) B) G.W.Elevation! +the MAX. High G.W. Adjustmeni _-- DIFFERENCE BETWEEN A and B SIGNED: Lev — ,�f✓ � DATE: a- [Sketch proposed plan of System on back[. y:health War:ccn v s i i TOWN OF BARNSTABLE l e5gLOCATION 1'7 7 S �G � SEWAGE# oo 7- S� VILLAGE GE; / ; ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. a 1-5 6 -17Joo_/?q 7 T 3 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) 2--S`t� L. C (size) NO. OF BEDROOMS J BUILDER OR OWNER —' t_�t .�✓ PERMIT DATE: L v d -6 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of L ing Facility Feet Private.Water Supply Well and Leaching Facility any wells exist f « on stteor.within 200 feet of leaching facility Feet Edge of Wetland and Leaching Facility (If wetlands exist n 7 within 300 feet of leaching facility) Feet fy -71^ ADD NEW V FRENCH DOOR 0" ISULATE WALLS AND INTALL SM GWB WALLS R-20 CEILING Rag RENIC 1001 It, HALL TO KITCHEN 0 ONE STEP DOWN N N —3'0" i iv 13'10" REMOVE WINDOW ADD DOUR ADD NEW SHELFS FIREPLACE IN LIVING ROOM FLOOR 6 MIL POLY OR DRYLOCK PAI\CCO 2 X 6 PT FRAMING IS-OC INSULATE R 30 GATT 314-T&G PLYWOOD UDERLAYMENT T,8" NEW BOX OUT WINDOWS Print scale: 114" = 1I VINCENT MARCANTONIO NEW LAYOUT 212 BUCKSKIN PATH ' l BARNSTABLE, MA . o TOWN OF BARNSTABLE n LOCATION --� SEWAGE # ao °- / �• ` VILLAGE C- 6 s^-T d ASSESSOR'S MAP& LOT0:od INSTALLER'S NAME&PHONE NO.�b,0/i�S �- �� I SEPTIC TANK CAPACITY /C"b- 0 LEACHING FACILITY: ((type) (size) d a- � 0—G NO.OF BEDROOMS BUILDER OR OWNERS PERMIT DATE: 6—ci a COMPLIANCE DATE:f 0 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of L • ing Facility Feet Private Water Supply Well and Leaching Facility any wells exist on site or within 200 feet of leaching facility Feet Edge of Wetland and Leaching Facility(If Kwetlands exist within 300 feet of leaching facility) Feet Furnished by ru�L 31 9