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Home My WebLink About0038 CEDRIC ROAD - Health 38 CEDRIC RD. CENTERVILLE A = 172 128 No. 4210 1/3 ORA 1000 Nor ""_ / ' Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Digozal 6pgtem Con6truction Perrin Application for a Permit to Construct( )Repair( )Upgrade(✓)Abandon( ) 0 Complete System PKlividual Components Location Address or Lot No. 73 Q�e &JC Owner's Name,Address and Tel.No. Assessor's Map/Parcel (! ! ear117 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �p/�L4l�J CD�s� Type of Building: Dwelling No.of Bedrooms .3 Lot Size sq.ft. Garbage Grinder(._j4P Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures e Design Flow gallons per day. Calculated daily flow 33,6p gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Z�S Type of S.A.S. ` Description of Soil IZ .S'-All Z6'il'Z Nature of Repairs or Alterations(Answer when applicable) 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 b his o of ealth. Signed Date Application Approved by Date 61TI 0 Application Disapproved for the following reaso s Permit No. 7,�" 1 1-/0 Date Issued 'L 0 y }f� a k t✓`� 3 ' times Y3ye f; z 8L 1.0ff -4R` TOWN OF BARNSTABLE f � LOCATION , $ C /�C ,. SEWAGE # VILLAGE C�/� �^yJ/1 ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. 17 742 7 l SEPTIC TANK CAPACITY 1 XS LEACHING FACILITY: (type) `7�D61 G�11I' 'l� (size) NO. OF BEDROOMS 3p BUILDER ORl9W PERMIT DATE 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,o.f leaching.facility) Feet �-^ Furnished by,, C o -33 No. .-� � _ "Sri-.�=.�..::M�io Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppricatiou for Migo5al *pgtem Cougtructior� Permit Application for a Permit to Construct( )Repair( )Upgrade(✓)Abandon( ) O Complete System lk�Kdividual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. /L / C Designer's?Name,Address and Tel.No. -7 - ° - 191 7>i Type of Building: Dwelling No.of Bedrooms .3 Lot Size sq. ft. Garbage Grinder(._mod Other Type of Building 61 15jO(geCe No. of Persons Showers( ) Cafeteria( ) Other Fixtures a Design Flow gallons per day. Calculated daily flow 3 3 Q gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. i Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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;tiot to place the system in operation until a Certifi- cate of Compliance has been issued b,,hhis Board of Health. % Signed ✓ s' > Date Application Approved by C Date 6 Z t 0 � Application Disapproved for the following reasoffs Permit No. 7XV I q0 H Date Issued THE COMMONWEALTH OF MASSACHUSETTS // ,7 f . BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTJFY,that the On-site Sewage Disposal System Constructed( ) Repaired( ' )Upgraded Abandoned( )by at has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.7-COy4 L dated 2/ 0 f Installer Designer The issuance of this Pr/ t s all not be construed as a guarantee that the syst I fu � s esigne . Date i Inspector No. 7it�0� vv� ——————————————————� 72--/z$ Fee 501�_.. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mioogal *p!tem Construction Permit Permission is hereby granted to Construpt( )Repair )Upgrade(k")Abandon( ) System located at :?_7 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 muq be completed within three years of the date of this pe t. _ G Date: G�Zf � Approved by G� e � NOME: this Foam Is To Be-Used For the Repair Of Failed Se • tic Systems. Only: - CERTIFICATION OF SFCETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PER FF'(WTI'HOUT DESIGNED PLAINS) / hereby certify that the application for disposal works com=uction permit signed by me dated �/ concerning the aropert-y located:.at 3: R CM f lr Gf w&A° Illle meets all.of the following criteria:. ne Paled system isconn=,cd to.a resid=ndal daedina oniv_. _-here;ire no commcrc:al or T es assoc.ated with the dwe T.in�. Y 'ae soil.is c!asziaed _as Cl_r1..S i�.trd me^c�oiauan mte is :e s ti��t or _�t�ai :c.� :rtiuutes per inc:t: /71acrt are no wedands whh�ln !00=mt of me oroo_es=s=uc 7_751ent b' -ae...are no prn-ate weas wiMi Mimi 1-40 _.0177ht worosed sc-,tic,-rs-Lem. $/=se:t is nc incise in flow and/or.c:.annze n ase proposed. no v"ri nc-zs.r- ues-L-_d or ne-,^_� 6+ The Zmnom.of the proposed leaching faciiiry will not' less a�Ixa.ea 1_ son live:__:above the Ina.Lmunz adjusted,gsound-AAter;able ele-.atior: fAdjum the and ester. abie.esinQ he:=, utor method when applicable]. if:the S. S. will be located with.260 feet of airy veseated wetlands, the bona'ni of the proposed leaching facility will not be looted I_ss than four teen(14)feet above the rta.:imttm adh2ste;:+ ground- ester table eirvation, y Please complete the foilowinb A) Top of Ground Surface Ec-,ation(tang GIS ituorrnaLion) 3) G.W.Elevation 79 -the AdAX Eggh G.W.Adjustment D 7r—=_Zr"TTC BEiWa-N A and 3 Z !f 6 SICNrD :_A4�2�� DAir.: (Sk=h propcscd Pion of Vst^-n on back]. TOWN OF BARNSTABLE � r CATION 31 ��De ✓� , SEWAGE # 2CW/—WD l VILLAGE �did fffy11le aASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. 61e5L) 7 71 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) C,&wel (size) 1."f�of NO. OF BEDROOMS 3 BUILDER ORtet WNE 1 PERMITDATE: 117,11P1 COMPLIANCE DATE: Separation Distance Between the: r� 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 G L t a- 33` a� r— DATE:--g13L9..---- PROPERTY ADDRESS:38-Cedric Road -- -------------------- Centerville ------------------------ __Mass ._ 02632 ---------- On the above date, I inspected the septic system at the above address. This system consists of the following: A. 1 -1000 gallon tank. B. 1 -1000 gallon leaching pit.- Based on my inspection, I certify the following conditions: A. This is a title five septic system. B. The septic system is in proper working order at the present time. C. The cover on the leaching pit is more than 12" below grade. Cover on pit should be raised. Present depth 2 ' 8" . D, Septic Tank did not have to be pumped. SIGNATURE: �'i_/;G � Name: J.P.Macomber Jr. Com pan y:,s`P,ffa-combe-r & Son Inc. IRE Address:_ Rnx ............... CEIVEg) --Centerville,Mass.- 02632 APR 1 0 1995 E"DEPT. Phone:---80$=775=3338....... TOWW OF STABLE THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY 11 Mi-E-A i0m JOSEPH P. MACOMBER & SON, INC. Tan ks-Cesspools-Leachfields Pumped & Installed Town Sewer Connections P.O. Box 66 Centerville, MA 02.632-0066 775.3338 775-6412 a tom. r r 04/04/1995 12:46 508-428-3508 C.-.0.P9M. WATER DEPT PAGE 04 t. KEY NUMBER <4468 > NAME <MARKHAM, FRANCIS E > B-C 1 B-C 2 B-C 3 B-C 4 STREET 12 CARLINGS ROAD CITY FRAMINGHAM ST MA ZIP 01701-4147 REF 1 REF 2 PHONE ( ) - REF 3 REF 4 METER NO. < 4190> DATE READING CONS STREET <CEDRIC RD NO, 38> 12/31/94 132 9 CITY CEN D L7A ST LOC 06/30/94 123 5 PHONE ( } - 12/31/93 118 7 06/30/93 111 2 ROUTE NUMBER 28 12/31/92 109 10 SERVICE DATE 11/24/72 06/30/92 99 5 METER DATE 09/03/86 12/31/91 94 15 CAPACITY 7 06/30/91 79 9 STYLE T10 SIZE 1 RATE SCHEDULE KEY PIT PLASTIC NOTE RR LEFT SIDE ADDITIONAL CONS 0 ALTERNATE MIN 0 r ' draft 1113195 SUBSURFACE SE«'AGE DISPOSAL SYSTEM INSPECTION FORM , Address of property 3 C' QrZ�c ��!� L�en17erQv% �� D�i4 y S D"�ba Owner's name (and/or resident) Date of Inspection ,�3/yS PART A CHECKLIST Check if the following have been done: Pumping information was requested of the owner, occupant, and Board of Health None of the system components have been pumped for at least 30 days and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. J R rn 4 iWv& 4-f- UOW iE�W,0 As built plans have been obtained. 0 V The facility or dwelling was inspected for signs of sewage back-up. The site was inspected for signs of breakout. All system components, excluding the SAS, have been located on the site. The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the SAS on the site has been determined based on existing information or approximated by non-intrusive methods. The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of SSDS. draft 1/13/95 9 SUBSURFACE SENVAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEN1 MFORAIATION FLOW CONDITIONS If residential 3 number of bedrooms 2 number of current residents Y5 garbage grinder, yes or no Ifs laundry connected to system, yes or no yFs seasonal use, yes or no If nonresidential, calculated flow: 6�3°193 -�Qav 6A4, 6/30lQ3� J� 4�0 Water meter readings, if available: !2J3))q 3 7� 2-/3119J� y 0w Last date of occupancy (A/ fCfZ tr////' ' t/ ��c� ��t �I A'0 Ly GENERAL INFORMATION '. -,nping records and source of information: /Uv System pumped as part of inspection, yes or no if yes, volume pumped Reason for pumping: Type of system D " DX l;T t/ Septic tank/d ution ox/soil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) Other (explain) Approximate age of all components. Date installed, if known. Source of information: ' y Sewage odors detected when arriving at the site, yes or no i draft 1113195 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SEPTIC TANK: V" (locate on site plan) depth below grade: 6 material of construction: concrete _metal _FRP _other(explain) dimensions: u 7 sludge depth 3 Z " distance from top of sludge to bottom of outlet tee or baffle G '/ scum thickness f distance from top of scum to top of outlet tee or baffle �t distance from bottom of scum to bottom of outlet tee or baffle Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, recommendations for repairs, etc.) DISTRIBUTION BOX: ncN c— (locate on site plan) depth of liquid level above outlet invert i Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, recommendation for repairs, etc.) • 11 " PUMP CHAMBER:_ , draft 1113195 ate on site plan) r pumps in working or er, yes or no i Comments: (note condition of pump ch mber, condition of pumps and appurtenances, recommendations for maintenance or repairs,etc.) SOIL ABSORPTION SYSTEM (SAS):v (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type leaching pits and numberTJr ,y-� �s'i leaching chambers and number �/� >f1'Yu 2 -e— . leaching galleries and number leaching trenches, number, length leaching fields, number, dimensions overflow cesspool, number Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc.) /�%� �(/l/�L7vC-.fG. UT ,2.c�i'�ir�•;�C,� �.-A //Ui'� - 1-'i� CYl7�:�7_r�, •-7v � Ln draft 1113195 2 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued CESSPOOLS: (locate on site plan) I number and configurati n depth-top of liquid to i et invert depth of solids layer depth of scum layer dimensions of cesspool materials of constructio indication of groundwat r inflow (cesspool must a pumped as pan of inspection) Comments: (note condition of soil, Sig s of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc. PRIVY: (locate on site plan) materials of constructi n dimensions depth of solids Comments: (note condition of soil, Sig s of hydraulic failure, level of ponding, condition of vegetation, recommendations maintenance or repairs,etc. draft 1113195 13 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FO INI PART B SYSTEM INTORAZATION continued SKETCH OF SEWAGE DISPOSAL SYSTEM: ' include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' 17,5 ; `- �.,NG `,. -", �,� I Cyr' /��/ cl�'w•� DEPTH TO GROUNDWATER depth to groundwater ✓/ C 3 method of determination or approximation: 6� 34 draft 1113195 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORA? PART C FAILURE CRITERIA Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If "not determined", explain why not) Backup of sewage into facility? /VU Discharge or ponding of effluent to the surface of the ground or surface waters? A, Static liquid level in the distribution box above outlet invert? i �v Liquid depth in cesspool <6" below invert or available volume< 1/2 day flow? /Vv Pumped 4 times or more in the last year? number of times pumped D /VO Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank, failure imminent? Is any portion of the SAS, cesspool or privy: below the high groundwater elevation? within 50 feet of a surface water? IV6 within 100 feet of a surface water supply or tributary to a surface water supply? Na within a Zone I of a public well? iJV within 50 feet of a bordering vegetated wetland or salt marsh? 4Jo within 50 feet of a private water supply well? less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis? If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. draft 1113195 15 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART D CERTIFICATION Name of Inspector R01-mllal . , 641 `/�'CJ f�C��{ i Inspector Number IZS /066 Company Name I Company Address (3a u. Z�S 6 , to Certification Statement I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true, accurate and complete as of the time of inspection. Check one: I have not found any information which indicates that the system fails to Norte y .�w adequately protect public health or the environment as defined in 310 CMR useay�. 15.303. Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. I have determined that the system fails to protect public health and the environment as defined in 310 CMR 15.303. The basis for this determination is provided in the FAILURE CRITERIA section of this form. Inspector's Signature Date Original to system owner ,U Copies to: Buyer (if applicable) proving authority TOWN OF BARNSTABLE LOCATIJN._7Z13 GAic- Pa- SEWAGE # VILLAGE LLD ASSESSOR'S MAP & LOT INSTALLER'S NAME 6s PHONE NO. SEPTIC TANK CAPACITY ( o o o LEACHING FACILITY:(type) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANT • Yes No • 9 ova ,/ �10, w� C