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Home My WebLink About0165 GREAT MARSH ROAD - Health 165 GREAT MARSH RD., CENTERVILLE A=210-130 �y YCI�caC UPC 12534 o- No. 2 �'�ST•CON'Ja� HASTINGS, MN No.�TI 22 Fee$ 50. 00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Mfi5paal *pgtem Construction 3dermit Application for a Permit to Construct( )RepaAX)o Upgrade( )Abandon( ) O Complete System El Individual Components Location Address or Lot No. 165 Great Marsh Road Owner's Name,Address and Tel.No-5 0 8—7 7 1—0 8 6 5 Centervill ,Mass . 02632 Frances Gonsalves 165 Great Marsh Assessor'sMap/Parce Road Centerville ,Mass . 02632 Installer's Name,Address,and Tel.No.b U 8— — Designer's Name,Address and Tel.No 5 0 8—7 7 5—3 3 3 8 J.P.Macomber & Son Inc . J.P.Macomber & Son Inc . Box 66 Centerville ,Mass. 02632 Box 66 Centerville ,Mass. 02632 Type of Building: Dwelling X X No.of Bedrooms 2 Lot Size sq. ft. Garbage Grinder(n o) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 355 gallons per day. Calculated daily flow 2 x 110=2 2 0 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank 1500 gallon tank. Type of S.A.S. 2-500 gallon chambers . Description of Soil Loamy sand to boney fine sand Nature of Repairs or Alterations(Answer when applicable) Omitting cesspools adding 2-5.0 0 gallon chambers packed in 4 ' of stone . There is an existing 1000 gallon septic tank. Also adding 1-Distribution box. 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 nd not to place the system in operation until a Certifi- cate of Compliance has been issu d by this o o ealth. Signed 1 , Date 4/19/9 9 Application Approved by DateC Application Disapproved or the Mowing4asons / Permit No. - Date Issued ter• �r No�Y., l "''.o.:- ` ► 1 '.Fee$- 50.00_ �• THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: _ PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACWUSETTS Yes 01pprication for Mi5po,5af *p.5tem (fon.5truction Permit Application for a Permit to Construct( )RepaiQX X)Upgrade( )Abandon( ) ❑Complete System ❑Individ6al Components Location Address or Lot No. 165 Great Marsh Road Owner's Name,Address and Tel.No.S 0 8—7 7 1—0 8 6 5 Centor'erville ,Mass. 02632 Frances Gonsalves 165 Great Marsh Assesss Map/Pazce Road Centerville,Mass. 02632 Installer's Name,Address,and Tel.No.-,) — 7 5—3 3 3 8 Designer's Name,Address and Tel.No. 0 8—7 7 5— J.P.Macomber & S'on Inc. �J.P.Macomber & Son Inc. Box 66 Centerville ,Mass. 02632 Box 66 Centerville,Massi 02632 Type of Building: Dwelling XX No.of Bedrooms 2 Lot Size sq.ft. Garbage Grinder(no) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 355 gallons per day. Calculated daily flow 2 x 110=2 2 0 gallons. Plan Date Number of sheets Revision Date Title SiZzof Septic Tank 1500 gallon tank. Type of S.A.S. 2-500 gallon chambers. Descrip ion of Soil Loamy sand to boney fine sand , Nature of Repairs or Alterations(Answer when applicable) Omitting cesspools adding 2—5 00 all n chambers packed in 4 ' of stone. There is an existing 1000 gallon septic tank. Also adding 1—Distribution box. Date lyKnspec' ted: F Agree..��,,ffffnt: e undersigned agrees to ensure the construction and maintenance of the afore described on-site'sewage disposal system in acc, dance with the provisions of Title 5 of the Environmental Code 2nd not to place the system in operation until a Certif- cate of I ompliance has been issued by this oa-rd-of jJealth. Signed Date 4/19/9 9 Application Approved by Date Applic Lion Disapproved or the owin asons Permit No. - fi Date Issued --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNsTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY, that the On%site Sewage Disposal System Constructed( 1) Repaired(fX•)Upgraded( ) Abandoned( )by J.P.Macomber & Son Inc . at 165 Great Marsh Road Centerville ,Mass. has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. -J.. 0 dated Installer J.P.Macomber & Son Inc . Designer J.P.Macomber & Son Inc . The issuance of this permit shall not be construed as a guarantee that the Sys will function as de igned. Date --^ — Inspector- T ��►r-� --------------------------------------- No. - Fee$ 50. 00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE. MASSACHUSETTS lwigoal *p.5tem (Construction Permit Permission is hereby granted to Construct( )RepaiAX X)Upgrade( )Abandon( ) Systemlocatedat 165 Great _Marsh Road Centerville,Mass. 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 this permit. Date: Approved by Q� ' i TOWN OF BARNSTABLE d'7— LOCATION iMAC il^ J2,U SEWAGE # T'7, VILLAGE �e-&Ae-P V ( ( t- ASSESSOR'S MAP'& L0T2rd-/3,6 INSTALLER'S NAME&PHONE NO. A C-n !E e-/ SEPTIC TANK CAPACITY JnVD- > A LEACHING FACU-rrY: (type)--Ir OP C�Dt=��.S (size) O .,r NO.OF BEDROOMS BVIEDER OR OWNER .09'-�4� 5 PERMITDATE:_.0//-- 4;�- 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) tc Feet Furnished by �4t— Gr sr�G,212/L # - < r, � - I . � I �� ; , .. ,: �( ��` h�� a �' _- :.-gz ., , � � _ � 1, sS ` - ' ��—a� 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 .i r . , hereby certify that the application for disposal works construction permit signed by me dated 4/19/9 9 , concerning the property located at 165 Great Marsh Road Centerville ,MA Meets all of the following criteria: The failed stem is connected to a-'residential system dwelling only. There are no commercial or business uses associated with the dwelling. Y/I 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 There are no private wells within 110 feet of the proposed septic system `V There is no increase in flow and/or change in use proposed There are no variances requested or needed. The bottom of the proposed leaching facility will not 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 not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(cuing GIS information) B) G.W. Elevation +the MAX. High G.W. Adjustment. DIFFERENCE BETWEEN A and B SIGNED : / / DATE: 4/19/9 9 [Sketch p o ed plan of system on back]. q:health folder.cen Distribution box l 2-500 gallon chambers packed in foiur feet of stone . Existing 1000 gallon septic tank 3, f i TOWN OF BARNSTAa�E LOCATION �,(� '�, SEWAGE # t1� VILLAGE _�� , ASSESSOR'S MAP & LOT2�dr/��j INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) �'O NO.OF BEDROOMS_ �?z BVEED R OR OWNER PERMTTDATE: /0'4/-- 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