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HomeMy WebLinkAbout0051 GREAT MARSH ROAD - Health 51 GREAT MARSH RD. CENTERVILLE A = 210 125 t+ f ° UPC 12534 No.2 1_5Lo .� MA*TIN96 ON No. M_3,�3 Fee $ 50 .00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for �Digool *pgtem Cow5truction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) Complete System ❑Individual Components Location Address or Lot No. 51 Great Marsh Road Owner's Name.Address and Tel.No. Centerville,Mass. 02632 _ Helene Grace--Alence Centerville MA Assessor'sMap/Parcel A /© / A S _ 51 Great Marsh Road Centerville, MA Name,Address,and Tel.No. 7 7 S= 13/$ ?l Designer's Name,Address and Tel.No. 02632 09 bx-i6 c e*re R vine Type of Building: Dwelling XXXNo.of Bedrooms 2 Lot Size sq.ft. Garbage Grinder(VO) Other Type of Building No. of Persons 1 Showers( ) Cafeteria( ) Other Fixtures Design Flow 340 gallons per day. Calculated daily flow 2 X 1 1 0=2 2 0 GPD gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Loamy sand to medium fine sand. Nature of Repairs or Alterations(Answer when applicable) Omitting home built tank. ( Cinder blocks and one cesspool Installing 1 -1500 gallon septic tank, 1 -Distrihut ion box and 2-500 gallon leaching chambers packed in 4 ' of 12" stone. 25 'X13 'X2 ' 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 issue by this ar f He lth. Signed to Application Approved by ate Application Disapproved for the following reasons Permit No. Date Issued $ 50.00 No. Fee 73 JHE COMMONWEALTH OF MASSACHUSETTS Entered in computer: l PUBLIC HEALTH". re/ DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS tion for i� ogal stem Construction Permit ���Ycca � � p � Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( )r Complete System O Individual Com ponen�ts� Location Address or Lot No. 51 Great Marsh Road Ow,ner'sName,A"�ddressandTel No.. tly� Centerville,Mass.02632 yd ��� Assessor'sMap/Parcel �+ d Sy r; ' r beat" " M ars itenterville,MA h Road Installer's Name,Address,and Tel.No. 7 S Q Designer's Name,Address and Tel.No. 02632 C eA/T e /Q vi//e Type of Building: DwellingXXXNo.of Bedrooms 2 Lot Size sq.ft. Garbage Grinder( O) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 340 gallons per day. Calculated daily flow 2 X 1 1 0=2 2 0 GPD gallons. J Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Loamy sand to medium f ine • sand. Nature of Repairs or Alterations(Answer when applicable) Omitting home built tank. ( Cinder' blocks and one cesspool.Install n 1-1500 gallon septic tank 1 -Distr'ibtxt­; ion box an 2-500 gallon leaching chambers packed in 4; of 1j" stone;-,-, X Date last inspected: F Agreement: The undersigned agrees to ensure the construction andmaintenance 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 issue by this ar f He lth. Signed ate ✓r"���� Application Approved by 'bite Application Disapproved for the following reasons t Permit No. ` Date Issued ----------------=-----�=--------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS 4.. Certificate of Compliance X - THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded�XX� Abandoned( )b J.P.Macomber & Son Inc. at ST Great Aarsh RoaciCenterville,Mass. jhs he, construct in ccordance with the provisions of Title 5 and the for Disposal System Construction Permit N . dated 'S o Installer J.P.Macomber & Son Inc. Designer J.P.Mammbp_l Son Inc. The issuance of this pe .t s all not be construed as a guarantee that the sys will f ctis cedes. . ` Date y ?� o/ Inspector f / --------------------------------- No. � Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS wtsposar 6pstern ionotruction Permit Permission is hereby granted to Construct( )Repair( )Upgrade�X ))Abandon( ) System located at 5 1 Great Marsh Road Centervi lle,klass. and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply g with Title 5 and the following local provisions orspecial conditions. Provided:Cons d on must ee completed within three years of the date of i %pe v Approved Date: pp by � 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 CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) );,Joseph P.Macomber Jr. hereby certify that the application for disposal works construction permit signed by me dated 5/18/01 concerning the property located at 51 Great Marsh Road- Centerville,MassMeets all of the Mowing criteria: The failed system is connected to a residential dwellingonly 4 y. There are no commercial or business / uses associated with the dwelling. V The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. / There arc no wetlands within 100 feet of the proposed septic system Y There are no private wells within 150 feet of the proposed P p po d sepuC system There is no increase in flow and/or change in use proposed . There are no variances requested or needed. !� The bottom of the ro sed leachin facili will n P po g ty no be located less than five feet above the maximum adjusted groundwater table elevation. (Adjust the groundwater table using the Frimptor method when applicable] If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will M be located less than fourteen (14) feet above the maximum adjusted groundwater table elevation. Please complete the following: y, 4/ A) Top of Ground Surface Elevation(using GIS information) B) G.W. Elevation a` ., +the MAX. High G.W. Adjustment, _ W#-7� _ // DIFFERENCE BETWEEN A and B � 7 SIGNED : DATE: 5/1 8/0 L (Skete posed plan of system on back). Q:health!older,em ^ r . �� e/ e/' . � / ��, e' �+ k 1 t 4 ' � , � � .,4_ \� TOWN OF BARNSTABLE C,(:,I, 1 LOCATION G 9 eAZ /A A KSte« SEWAGE #2061— 333 VILLAGE Ce`lfle& Vide ASSESSOR'S MAP & LOT 0j.0-/ZS— INSTALLER'S NAME&PHONE NO. —T Z AA C OM IS eK 5 e-IV SEPTIC TANK CAPACITY A S-O !� LEACHING FACILITY: (type)2",&ZQ w cAl AmISee`S (size) S'pd• C NO.OF BEDROOMS �A BUMDER OR OWNER (9,te Lp-u AI t,,u— PERMITDATE:- —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 leaching facility) Feet Furnished by A/ 1 / � J C4 , k TOWN OF BARNSTABLE LOCATIONpA/ AA A 9 S/V 912— SEWAGE'#-1 0--al 3 23 VILLAGE Pe A'f>oR ViOf G� ASSESSOR'S MAP & LOT Z10 /Z INSTALLER'S NAME&PHONE N0._ 1p /S� A C 0/4 A e !- D N SEPTIC TANK CAPACITY �• Sd O LEACHING FACILITY: (type) G(JCffig1yf6eZ,$ (sine) 5'00• G I NO.OF BEDROOMS` �Z BUILDER OR OWNER l PEI ITDATE: �( za/a/ COMPLIANCE DATE:_ ���d/�/ Separation Distance Between the: Maximum Adjusted Groundwater Table to.the Bottom of Leaching Facility Feet Private Water Su 1 Welt and Leaching Facility PP Y g (If any wells exist on site.or within 200 feet of leaching facility) " Feet Edge of Wetland and Leaching.Facility.(If any wetlands e)Ust within 300 feet of leaching:facility) Feet _ Furnished by -- _._. 0 , t y� i W, may, , �