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Home My WebLink About0023 INDIAN TRAIL - Health 23 INDAIN TRAIL, CENTERVILLE �f � i No. y 0(0 — Fee $ 50 00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Rpp tcatton for �Dtgpool *p!tem Cougtructton Vermtt Application for a Permit to Construct X X XRepair( )Upgrade( )Abandon( ) ❑Complete System O Individual Components Location Address or Lot No. 23 Indian Trail Owner's Name,Address and Tel.No. Centerville ,Mass . 02632 Walter McKenna Assessor's Map/Parcel j ® / 23 Indian Trail Centerville,Mass/ Installer's Name,Address,and Tel.No. 5 0 8—7 7 5—3 3 3 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 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 Loamy sand to medium sand , Nature of Repairs or Alterations(Answer when applicable) d fiwn 9no (,a11nn rhamhersnarked in 4 ' of 1,ItI stone 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 iss ed by t is o d of He lth. Signed 9 Date 12/16/9 9 Application Approved by Date /,7--/7— f 9 Application Disapproved or the following reasons Permit No. !�` Date Issued t' 7— TOWN OF BARNSTABLE � LOCATION -�.ZQ/Q 1,Al :fAd �� SEWAGE # 9 VILLAGE C "Lee V1Ile ASSESSOR'S MAP & LOTI ,-o . INSTALLER'S NAME&PHONE NO. 1 1 , ,M A C Q M is Ce SEPTIC TANK CAPACITY J-0 LEACHING FACILITY: (type) WC'11A44®ee'J° (size) 00 NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: —Z:Z::'� � COMPLIANCE DATE: l -7U l, 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 of facility) Feet Furnished by R f,�'!2 4 e f ® o �p h [No. 1-.i0 t4 ` Fee � 50. 0O THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS x� •K ZIpprication. for Migpaal *potent Congtruction ertnit Application for a Permit to Construct 9 X)XRepair( )Upgrade( )Abandon( ) El Complete System • ❑Individual Components Location Address or Lot No. 2 3 ,I n d i a n T r a i 1 Owner's Name,Address and Tel.No. Ce'nter.ville ,Mass. 02632 Walter McKenna Assessor's Map/PareeL,. 23 Indian Trail Centerville,Mass,/ Installer's Name,Address,and Tel.No. 5 0 8—7 7 5—3 3 3.8 Designer',,Name,Address and Tel.No. 5 0 8—7 7 5—3 3 3 8•"` J.P.Macomber & Son Inc . J.P - 1acomber & Son Inc. Box 66 Centerville,Mass. 02632` Box 66 Centerville,Mass . 02632 Type of Building: r° Dwelling XX No.of Bedrooms 3 Lot Size `Sq. ft. Garbage Grinder( ) Other, Type,of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures f , Design Flow r gallons per day. Calculated"daily flow gallons. Plan Date r Number of sheets Revision Date 1e Title c �. 4" Size of Septic Tank Type of S.A.S. Description of Soil Loamy sand to medium sand . Nature of Repairs or Alterations(Answer when applicable) Omit tink—c'irssn'"o.ls. Imstalling 1-1500 gallon tan1 1—Distr'ibu ion box and -- two 50b 'Gallon chambers parked in 4�' of---,W' stone Date last inspected: ° .rr ,r' "e: /I/--- , Agreement: i The undersigned agrees tto"ensure'the construction and;main(nance of the afore described on-site sewage disposal system in accordance•with�thesprovis ons of Title 5 of the Environmental Code and not ttsplace the system in operation until a Certifi- cate of.Compliance has been issued by t}iis.B:o d=of Health Signed Wtte 12/16/9 9 App)�i a ion Approved by- - ;. Date f,?—/7 P7 A ion Disapproved for the following reasons Permit No.. Date Issued f _ 7- -------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance ~ THIS IS TO CERTIFY, that the On site Sewage Disposal System Constructed�(X )Repaired( )Upgraded( ) Ab doned( )by J.P.Macomber & Son Inc . at n Indian r a t e n e r v e,Mass. d pas been constructed iti acc dance with the provisions of Title 5 and the for Disposal System Construction Permit No. G► dated l 7— "7 Installer J.P.Macomber & Son Inc,,- Designer J.P.Macomber & Son Inc . The issuance of this perm it shall not be construeds a guarantee that the sys will function as d�ecs..igne . Date -�'~ ."" 7 l Inspector .G�'tf-�+L.rL �r' � .>/ S o -------------\--------=----Fee so oU— _ ,. THE COMMONWEALTH OF MASSACHUSETTS ." PUBLIC HEALTH DIVISION :- BARNSTABLES MASSACHUSETTS Migogar 6p5tein Congtructi-on Vermit Permission is hereby granted to Construct;X )Repair''(=°= )Vpgrade( )Abandon(. ) Systemlocatedat 23 Indian. Trail Cent,-erville,Ms.ss. and as described in the above Application for Disposal System Construction Permit. The;applicant recognes�his e/h"�'r duty to comply with Title 5 and the following local provisions or special conditions. f Provided: Construction must be completed within three years of the date of thi Mit. Date: Approved by � 4`r _ d 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) I, Joseph P.Macomber J r ., hereby certify that the application for disposal works construction permit signed by me dated 12/16/9 9 concerning the property located at 23 Indian Trail Centerville ,Mass . meets all of the following criteria: • The failed system 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 • There 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 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(using GIS information) `T B) G.W. Elevation d +the MAX. High G.W. Adjustment.�L'f_ DIFFERENCE BETWEEN.A and B , SIGNED : DATE: 12/16/9 9 i (Sketc proposed plan of system on back]. q:health folder:cat ,, :. ,- � _ � N ® .� o L iL TOWN OF BARNSTABLE I' LOCATION 29 3 AI QQ1 AI f X A iL SEWAGE # �- i VILLAGE C ASSESSOR'S MAP & LOT —C� INSTALLER'S NAME&PHONE NO. J -M A C U tit S e SEPTIC TANK CAPACITY LEACHING FACELITY: (type)"f lo;�l e, A,v��:�'S' (size) 'S,dB e .9 NO.OF BEDROOMS BUILDER OR OWNER PERMIT DATE:1;0'LL9T_COMPLIANCE DATE: ZZ— G 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 of leaching facility) Feet Furnished by -./ l)? i L4! b £i` Y