HomeMy WebLinkAbout0165 KNOTTY PINE LANE - Health _ -65 Knotty Pine Lane, Centerville
_ _ A= 191-091
No. / * / Fee $ 5 0. 0 0
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION v TOWN OF BARNSTABLE., MASSACHUSETTS
0(ppYication for �Dizpozal 6potem Congtruction Permit
Application for a Permit to Construct( )RepairTX)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 165 Knotty Pine Lane Owner's Name,Address and Tel.No. 5 0 —43 3—
Agegg�forpy41lle,Mass , 02632 John Kimble 21 Heald Street
Pepperell,Mass . 01463
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—77 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:
DwellingXXXNo.of Bedrooms 3 Lot Size sq.ft. Garbage GrinderW0 )
Other Type of Building RES No.of Persons 4 Showers( ) Cafeteria( )
Other Fixtures
Design Flow 330 gallons per day. Calculated daily flow 3 x 110 gallons.
Plan Date 1 29 97 Number of sheets Revision Date
Title
Size of Septic Tank 1 nnn existing Type of S.A.S. existing pig
Description of Soil
Medium sand.
Nature of Repairs or Alterations(Answer when applicable) Adding 3-330 Rechargers Packed
in a minimum of 3 ' of 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 issue by this B h.
Signed o d .44,j4a Date 1 /29/97
Application Approved by Date
Application Disapproved r the llowi reasons
Permit No. 7— Date Issued
TOWN OF BARNSTABLE
LOCATION ]Rzo+iV Pi n-e Sc) _ SEWAGE #
VILLAGE ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. nr-o M b e-r
SEPTIC TANK CAPACITY'��
LEACHING FACILITY: (type) Kf Innn 3-3-An (size) qq
NO.OF BEDROOMS 3
BUILDER OR OWNER't I��w►�J�1
PERMTTDATE: COMPLIANCE DATE: i • 9 :2
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
•om
�� . i.
$ 50.00
No. `� - '" Fee `
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: V
Yes,
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS
r
' 01pplitation for Migpogar *pztem Conotrudtor ertnit
c _
Application for a Permit to Construct(' )Repair'-X)Upgrade( )Abandon( ) O Complete System ❑Individual Components
Location Address or Lot No. 16,5 Knotty Pine Lane w er's N e,,an el.
n— — o
Centerville,Mass , 02632 �0 l3:Mjle �� %ald Street
Assessor'sMap/Parcel Pepperell,Mass . 01463
Installer's Name,Address,and Tel.No. 5 U — — Des i ner's Name,Address and Tel.No. — —3 3 3 8
J.P.Macomber & Son Inc. J.?.Macomber & Son Inc.
Box 66 Centerville,Mass . 02632 Box 66 Centerville ,Mass . 02632
` Type of Building:
DwellingXXXNo.of Bedrooms 3 Lot Size sq. ft. Garbage GrinderTjo )
Other Type of Building No. of Person Showers( ) Cafeteria( )
Other Fixtures
Design Flow 330 gallons per.day. Calculated daily flow 3x1 1 0 gallons.
Plan Date 1 /29/97 Number of sheets Revision Date
Title
Size of Septic Tank 1 000 existing Type of S.A.S. existing pit.
DescripYtion of Soil
Medium sand.
Nature of Repairs or Alterations(Answer when applicable) Adding 39330 Re chargers -Packed
in a minimum of 3 ' of 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 E.vironmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issue by this o d,,`r th. 1 29/97
r Signed �/ Date
Application Approved by Date �-�1' 7
Application Disapproved for the ollowing reasons '
Permit No. 7— 3 Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
(Certificate of (tompliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( )RepairedI�XX)xUpgraded( )
Abandoned( )by J.P.Macomber & Son Inc.
at 165 Knotty Pine Lane Centerville,Mass . has been constructed in accordance
with the provis ons of Title5 and the fo Dispo al System Construction Permit �Y dated
Installer J.1�'.Macomber & on nC Designer? �' `I acomner & on VC.
The issuance of this petal of be c�sed as a guarantee that the syste._ will nct'on as designed.
Date Inspector
� ---------------------------- --
No. �7- 3
Fee�
50-00
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
Migpotar *patent (Construction Vermit
Permission is hereb" granted to Construct( )Repair�X)U grade( )Abandon( )
System located at T65 Knotty Pine Lane 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:Constructions must e completed within three years of the date of this permit.
Date: _ — ` r / Approved by ~)
i
{ 'ti
CERTIFICATION Or SI<li'FC11 AND APPLICATION FOR A DISPL.,
WORKS CONSTRUCTION PLR-N'1IT (tiV I'll IIOU'I' DESIGNED PLANS)
I Joseph P Macomber Jr., i. , .h, ccrtily that the application for disposal works
construction permit signed by n1C d::tcd 1 /29/97 , concerning the
property located at 165 Knotty Pine Lane Centerville Matneets all of the
following criteria:
• There are no wetlands Nvithin 300 fcct of the proposed septic system
• There are no private wells within 1 5U tact of the proposed septic system
• The observed groundwater IaUle is •1 feet ur l;rcatcr below tlic bottom of the leaching facility
• There is no increase in flow und/or change in use proposed
• There are no variances requested or needed.
SI
DATE: 1 /29/97
LI D SEPTIC SYSTEM INSTALLER IN'I HE T01YN OF BARNSTABLE NUMBER
__�//
(Attach a sketch plan of the proposed s)stem. Also if the licensed installer posesses.a certified plot plan,
this plan should be submitted).
I
3-330 Rechargers Existing 1000 gallon
Leaching pit.
New Distribution box
Existing
1000 gallon G
septic tank
165 Knotty Pine Lane
Centerville ,Mass .
a j
TOWN OF BARNSTABLE Q
SEWAGE#
LOCATION � � I��r�t��� pi
n o Act
ASSESSOR'S MAP & LOT
VII.LAGE
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY size)
LEACHING FACILITY: (type)
NO.OF BEDROOMS
BUILDER OR OWNER----
Io
PERMIT DATE: -t �j • g 7
q f 7 COMPLIANCE DATE:
Separation Distance Between the: Feet
maximum Adjusted Groundwater Table and Bottom of Leaching Facility
1 Well and Leaching Facility (If any wells exist Feet
private Water Supply facili
on site or within 200 feet of leaching tywetlands exist Feet
Edge of Wetland and Leaching Facility(If any
within 300 feet of leaching facility)
Furnished by
40
� l