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HomeMy WebLinkAbout0125 LONG POND CIRCLE - Health 125 LONG POND CIRCLE Lighthouse Group a llll oa��o UPC 12534 No.2153 pR HASTINGS,MN TOWN OF BARNSTABLE LOCATION LONG 1 OA/tee C l/P SEWAGE # VILLAGE C /i/ Z�P 11 f�`' LT' ASSESSOR'S MAP & LOT ag 7V.!�- INSTALLER'S NAME&PHONE NO. ✓ " �L �4' C O .�2�e� s oA1 `77S--3 3 3 ' SEPTIC TANK CAPACITY �e��aR�'�R 3 3® LEACHING FACII.TTY: (type) /� (size)•S� _ ,1 NO.OF BEDROOMS BUILDER OR OWNER Gy = PERMITDATE: COMPLIANCE DATE: - 1 I Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Fete Private Water Supply Well and Leaching Facility (If any wells exist #1 on site or within 200 feet of leaching facility) i'eet r Edge'of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by f 11.' .. �� �� �. �you��o �G` i, �� . �®\ / \� �9�. .�s� � ` 77 :� � 1" j f -- y --_ _. --- _ ___ �_ _ .. i No. Fee$` 0.00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS �} rication for Miq u al b item Cori!gtructiou Permit Application is hereby made for a Permit to Construct( )or Repair(XX)an On-site Sewage Disposal System at: �� Location Address or Lot No. Owner's Name,Address and Tel.No. 7'71—3 3 6 8 Centerville,Ma19oS b2 �2Pond Circle JohnRowland 125 Long .Pond Assessor's Map/Parcel Circle,Centerville,Mass . 02632 Installer's Name,Address,and Tel.No. 5 Q 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 XXXIo.of Bedrooms 5 Garbage Grinder tT0) Other Type of Building RES No.of Persons 6 Showers( ) Cafeteria( ) Other Fixtures Design Flow 550 gallons per day. Calculated daily flow 5 x 1 1 0=5-5 Q gallons. Plan Date Number of sheets Revision Date Title Description of Soil Loamy sand to medium fine sand, . a %Rea or Alterati qs(A swer when applicable) 0m' ga` on sep�ic ank: 1-Distributionbox: 51330 Rechar ers racKeU in a minimum or 2. 5 , 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, of to place the system in operation until a Certifi- cate of Compliance has been issue bhsBVd th.Signed / Date 9/3 0/9 6 Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued /P/) It PY65P -•�No. t. cs,f Fee .0 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE,, MASSACHUSETTS 0(ppitcatton for Migooal *pgtem Congtructton Permit 0��` Application is hereby made for a Permit to Construct( )or Repair KX)an On-site Sewage Disposal System at: Location Address or Lot No. _ - Owner's Name,Address and Tel.No. 7 71-3 3 6 g 5 Pond Circle Centerville,Ma b ' 2- JohnRowland 12.5 Long ..Pond Assessor'sMap/Pareel Circle,Centerville,Mass . 02632 Installer'sName,Address,and Tel.No. 508-775-3338 Designer's Name,Address and Tel.No.508-775'-3338 J.P.Macomber & Son Inc. J.P.Macomber & Son :Inc. Box 66 Centervinlle,Mass. 02632 Pox 66 Centerville,Mass. 02632 Type of Building: Dwelling XXNo.of Bedrooms 4 5 Garbage Grinder ji0 ) Other Type of Building RES No.of Persons 6 Showers( ) Cafeteria( ) Other Fixtures Design Flow 550 gallons per day. Calculated daily flow 5 x'1 n=5 5 gallons. Plan Date Number of sheets Revision Date Title Description of Soil Loamy' sand to medium fibe sand, . 1�ature of Repairs or Alterations(Answer when ap licable) i n 1 ai __ _g 1-1500 gallon septic tank: 1-distribution 'box: 5-330 Re-chargers Packed n a m nimum of 2. 51 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 Bo d He ith. Signed Date 9/3 0/9 6 Application Approved by Date Application Disapproved for the following reasons r Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced(XY on by .T P Ma n n m e r & Son Inc , Installer at T. 1 e C t 9r 4_ 1 a s h constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Date t JJ Inspector /C/ !n THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED/AS A GUARANTEE THAT THE SYS- TEM WILL FUNCTION SATISFACTORY. " ---- --------•-- }No. I A Fee $40.00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE,, MASSACHUSETTS Mtgpogar *pgtem Congtruction Permit Permission is hereby granted to J.P.Macomber & Son Inc. / to construct( )repairXX)).an On-site Sewage Systeyn located at No.# 12 5 L,3o Pond 4 a Cente. e M 4. Sweet and as described in the above Application for Disposal System Construction Permit. No. pp 4a The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special cdnditions. All construction must a cibm.pleted within three years of the date below. //yy Date: / Approved by !I� f � Board ealthV CERTITICA'hi IANND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WI'm0UT DESIGNED PLANS! I Joseph P.Maeomber Jr. certify that the application for disposal works construction pernut signed by me dated _9/30/96 , concerning the property located at 125 Low Pond Cire�.� Pnt arvi l ll g KA meets all of the following criteria: There are no wetlands within 300 feet of tile pr0posed septic system There are no private wells within 150 feet of the proposed scptic systcrtl Tile observed groundwatcr table is ,.t feet or t realer below the bottom of the !caching facility There is no increase in flow and/or ch.1118c in use proposed There are no variances requested or needed. SIGNED , ✓ 1 DATE: 9/30/96 LICEN SEPTIC SYS"fENI ,1NS"f'FLI.EIt IN'1'-iEBT01YN OF BARNSTABLE NUMBER (Attach a sketch plan of the proposed system. Also if[lie licensed installer posesses.a certified plot plan, P P p this plan should be submitted). l 5-330 Rechargers Distribution box 1-1500 gallon septic tank. DATE: HOUSE NUMBER CONFIRMATION TO : ASSESSORS DEPT. FROM: D-.RW/ENG. PARCEL ID: MAP PCL. 0.S7 - DEV LOT: FORMERLY : . NO. I O RD. MAU,) SZ RD. NO. FRONTAGE: NOW : NO. i as RD. LavuC, Prnv(� Ci12 RD. NO. 4-6 FRONTAGE-. SEC. RD. k C'-" RD.N0. - FRONTAGE: 20 2 VILLAGE: THANK YOU, . Id, c Date: G �J TOXIC AND HAZARDOUS MATERIALS REGIST ATION FORM NAMEOFBUSINESS: L /6,VT90ces e nn 6lUC,( P BUSINESS LOCATION: /a S Loyo /`Oti® C 0_ C ,F MAILINGADDRESS: e Mail To: TELEPHONE NUMBER: SOS-- -,77/-- 33Cc?' Board of Health Town of Barnstable CONTACT PERSON: P/I/irJc�_ ©c�� w r� P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: SOd'-72/- Hyannis, MA 02601 TYPE OF BUSINESS: Does your firm store any of the toxic or hazardous materials listewLw, either for sale or for you own use? YES NO --f'-� This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site otherthan your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator_flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, . Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Paint brush cleaners Any other products with "poison" labels (including chloroform, formaldehyde, Floor & furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS