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HomeMy WebLinkAbout0042 LONGFELLOW DRIVE - Health 42 Longfellow Drive, Centerville A=188 - 39 �Mf__ nq �J��EcrttFoo'T UPC 12543 No, 53LOR �OOn eoNS�� HAS71NQS,MN 1 TOWN OF BARNSTABLE L():ATION. SEWAGE # ` VLLAGE C reASSESSOR'S MAP &LAT0 .a INSTALLER'S NAME&PHONE NO. (1, �;4 ,5;4V- .G�• 'P©/.D SEPTIC TANK CAPACITY 15-dO �T L2 Ino efl LEACHING FACILITY: �0 L!>D��,/��S•S (type) � (size) !4 )'x q1?n NO.OF BEDROOMS _ BUILDER OR OWNER /3I2 `L�i RTG� PERMITDATE: on( `J�/ " L- COMPLIANCE DATE: 17161 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 l6 � l 1 b No., >_. FEES COMMONWEALTH OF MASSACHUSETTS tom, Board of Health, ;6.44v5 �/ . , MA. APPLICATION FOP DISPOSAL SYSTEM[ CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair*) Upgrade( Abandon( ) - kComplete System ❑Individual Components Location Ee&W C` Owner's Name e' 4-14?7 Map/Parcel# Address cJj Lot# s0 Telephone# Installer's Name se Designer's Namezy_�V// Address 67� -�P' 6A &4 W/G Address Telephone# —.?O✓O Telephone# Type of Building UlslG' �� f �//!� Lot Size sq.ft. Dwelling-No. of Bedrooms Garbage grinder ( ) Other-Type of Building No.of persons Showers ( ),Cafeteria ( ) Other Fixtures Design Flow (min.required) 33y gpd Calculated design flow 3t/ - V6 Design flow provided 3, ! ,X6 gpd Plan: Date Number of sheets 1 Revision Date Title Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned grees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agr e' o oft lac a system in �er tion til a Certificate of Compliance has been issued by the Board of Health. Signed Date DESIGNING ENGINEER MUST SUPERVISE INSTALLATION AND CERTIFY IN WRITING _�� THE SYSTEM WAS INSTALLED IN STRICT N.o.} - '.' e, FEECOMMONWEALTH Ok-- v p. Board of Health, &1ZIV-5%/./ MA. / v APPLICATION, FOP, DISPOSAL SYST EM-C-3ONSTRUCTION PERMIT Application for a Permit to Construct( Repair,( Upgrade( ) Abandon( System ❑Individual Components Location j_ellj!it/ (�2,�� c'd/t` Owner's Name ee%11, Map/Parcel# / �3 Address ��Q Lot# 5_0 Telephone# Installer's Name Designer's Name Address S14171 w C/ Address e le / Telephone# 7 —2.0 o Telephone# a 6 Type of Building SJ le e �"l Lot Size sq.ft. Dwelling-No.of Bedrooms Garbage grinder ( ) Other-Type of Building No.of persons Showers ( ),Cafeteria ( ) Other Fixtures Design Flow (min.required) 33o gpd Calculated design flow 3 q5- y(-;- Design flow provided�L�_gpd n. Plan: Date 7— 1iry Number of sheets / l Revision Date Title Description of Soil(s) - Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation e' DESCRIPTION OF REPAIRS OI-AL-TERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and Y further agrees/to.,oft lac a system. Rerafio til a Certificate of Compliance has been issued by the Board of Health. tgned Date 9�- No. 7 COMMONWEALTH Of MASSACHUSETTS FEE Board of Health, 0*1-_i S_714 2/Q MA. . CERTIFICATE OF COMPLIANCE Description of Work: ❑Individual Component(s) XCompleteSystem The undersigned hereby certify that tb,.Sewage Disposal System; Constructed ( ),Repaired*),Upgraded ( ),Abandoned ( ) by: at has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the apr ved design plans/as-built plans relating to application No. '7Y /dated Z Approved Design Flow 3 (gpd) Installer �e �c� C�J J, Designer: Inspector: 'i , l I. ate: The issuance of this permit shall not be construed as a guarantee that the system XtIction as designed. No. FEE COMMONWEALTH OF MASSAC14USETTS Board of Health, �/�/1/S�T/f /� ' MA. DI SPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) RepaiX) Upgrade( ) Abandon( ) an individual sewage disposal system at �� f/ Glsfr, `ffIld z, :7,ew-en as described in the application for Disposal System Construction Permit No. �9 —7Y , dated _���5 Provided: Construction shall be Ompleted within three years of the date of this permit. All local,conditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date f Board of Dealt 0 r C3 F�,E r Town of Barnstable CAB Board of Health ' s� P.O. Box 534� Hyannis MA 02601 Office: 508-8624644 Susan G.Rask,R.S. FAX: 508-790-6304 Ralph A.Murphy,M.D. Sumner Kaufman M.S.P.H. December 1.6, 1.998 Mr. Stetson Hall 28 Rambler Road Osterville, MA 02655 Dear Mr. Hall: You are granted variances on behalf of your client, Mary McCarthy, to construct an onsite sewage disposal system at 42 Longfellow Drive, Centerville,Massachusetts. The variances granted are as follows: 310 CMR 15.405(11(il: To construct a leaching trench seven (7) feet away from a property line in lieu of the required minimum setback distance of ten (1.0) feet. 310 CNM 15.405(1]_(al: To construct a leaching trench seven (7) feet away from a property line in lieu of the required minimum setback distance of ten(10) feet. 310 CMR 15.405(1)(b1: To construct a leaching trench fourteen (14) feet away from the cellar wall in lieu of the minimum twenty feet separation distance required. B.O.H. PART VII. SECT.10.00: To utilize an application rate of 0.74 for designing purposes in lieu of the required 0.50 application rate. The variances are granted with the following condition: + The designing sanitarian shall supervise the construction of the septic system and shall certify in writing to the Board of Health that the system was installed in strict accordance with the submitted plans dated September 18, 1998, revised December 6, 1998. The variances.are granted because the existing cesspools are located closer to the cranberry bog and are, in all probability, sitting in the groundwater table. It is the opinion of the Board that the proposed replacement system will alleviate a source of pollution to the groundwater in the area. Sincerely yours, Sumner Kaufman, MSPH Acting Chairman Board of Health Town of Barnstable hall/wp/q/Is I TOWN OF BARNSTABLE LOCATION SEWAGE # — VII.LAGE e ASSESSOR'S MAP &L T INSTALLER'S NAME&PHONE NO, SEPTIC TANK CAPACITY r'o �� L l'�,,d� LEACHING FACILITY: (type) O >>1?��i s (size) 1g,X NO. OF BEDROOMS BUILDER OR OWNER `Z41?7-� PERMIT DATE:�,�' ./ Ttf('IOMPLIANCE DATE: 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) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by Feet 00. 8 91 Of 0 711.1 Stetson R. Hall 28 Rambler Road Osterville, MA 02655 (508) 428-6367 Barnstable Board of Health Attn: Donna Miorandi P.O. Box 534 Hyannis-, MA 02601 Dear Donna, Please be informed that I have inspected the Septic System installed at 42 Longfellow Drive, Centerville, MA by Paul G. Bousefield, installer. The property is owned by Mary E. McCarthy and is shown as Parcel 139 on the Barnstable Assessors Map 188. I found the Septic System , -as installed, to be substantially in compliance with the Title 5 Site Plan I prepared fro Ms. McCarthy. Sincerely, �gH OF Mq 0��� gcti STETS Gn W No. EVALO'\ Stetson R. Hall FIMET � Town of Barnstable BARNSZABM = Board of Health v Mnss. � `b i6�� .• P.O. Box 534 H annis MA 02601 °' � Y Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Ralph A.Murphy,M.D. Sumner Kaufman M.S.P.H. December 1.6, 1.998 Mr. Stetson Hall 28 Rambler Road Osterville, MA 02655 Dear Mr. Hall: You are granted variances on behalf of your client, Mary McCarthy, to construct an onsite sewage,disposal system at 42 Longfellow Drive, Centerville, Massachusetts. The variances granted are as follows: 310 CNIR 15.405(1)(il: To construct a leaching trench seven (7) feet away from a property line in lieu of the required minimum setback distance often(1.0)feet. 310 CMR 15.405(1)(al: To construct a leaching trench seven (7) feet away from a property line in lieu of the required minimum setback distance of ten(10)feet. 310 CAM 15.405(1)(bl: To construct a leaching trench fourteen (14) feet away from the cellar wall in lieu of the minimum twenty feet separation distance required. B.O.H.PART VII.SECT.10.00: To utilize an application rate of 0.74 for designing purposes in lieu of the required 0.50 application rate. The variances are granted with the following condition: • The designing sanitarian shall supervise the construction of the septic system and shall certify in writing to the Board of Health that the system was installed in strict accordance with the submitted plans dated September 18, 1998, revised December 6, 1998. The variances are granted because the existing cesspools are located closer to the cranberry bog and are, in all probability, sitting in the groundwater table. It is the opinion of the Board that the proposed replacement system will alleviate a source of pollution to the groundwater in the area. Sincerely yours, Sumner Kaufman, MSPH Acting Chairman Board of Health Town of Barnstable hall/wp/q/Is d SENDEM A utter Notice 2 08 98 V ■Complete items 1 alr d/or 2 for a it ri services. I also wish to receive the rn ■Complete items 3,4a,•and ab. V b H4 H e a r i n p-/Mc C a r t hhy following services(for an ■Print your name and address on the reverse of this forms that we can return t is extra fee): card to you. , '. ■Attach this form to the front of the mailpiece,or on the back if space does not , ❑ Addressee's Address ` Permit. �� d d ■Wnte'Retum Receipt Requested'on the mailpiece below the article numbei: 2. ❑ Restricted Delivery to - ■The Return Receipt will show to whom the article was delivered and the date .. delivered. Consult postmaster for fee. o 0 -o 3.;Article Addressed to: 4a.Article Number d dcc James Jenkins A Trust Z 392 978 863 C Ic Jenkins `Nominee Trust 4b.Service Type 0 _ 227 Pine Street ❑ Registered Certified C In W ` Bar>hstable , MA. 02668 ❑ Express Mail ❑ Insured w K ''� ❑ Return Receipt for Merchandise ❑ COD e \ 7.Date of Delivery a � o z 4 5.Receivetl>121'y:(Print Name) 8.Addressee's Address( miff eq ested c and fee is paid) t 6.Signature?;.,(Addressee or Agent) o Ps Form 3811 Deceinlier ass 102595-97-B-0179 Domestic Return Receipt UNITED STATES POSTAL SERVICE �, y w, First-Class Mail Postage&fees Paid Usf'S'_ w pM v, -PermitNo.G=jp • Print your nam ,'a8dAkS,�fid ZIP Code.in t.is a ox• ' Stetson R. Hall , RS 28 Rambler Road Osterville , MA. 02655 ` [Ikill d SENDER: 1 McCart y Hearing Ialsowishtoreceivethe •o ■Complete items 1 and/or 2 for additional services. ■Complete items 3,4a,and 4b. B O H following services(for an q ■Print your name and address on the reverse of this form so that we can return this extra fee): 2 card to yoy. d • it this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address perm Z ■Wdte'Retum Receipt Re uested'on the mail piece below the article number. d d p 4 p' 2. ❑ Restricted Delivery (A r ■The Return Receipt will show to whom the article was delivered and the date .. c delivered. Consult postmaster for fee. °• d 3.Article Addressed to: 4a.Article Number 1 Judith D. Prizzi Z 392 978 861 E �! 35 Longfellow Drive4 .4b.Service Type d ❑ Registered fk Certified ¢ W Centerville , MA. 02632 g 0 W ❑ Express Mail ❑ Insured 5 c ❑ Return Receipt for Merchandise ❑ COD ` 7.Date of Delivery z 1)21 — _ � 5.Receive y:(Print Name) 8.Addressee's Address(Only if requested to _ — and fee is paid) t s.s+ T ,} PS{ receipt UNITED STATES POSTAL SERVICE i,. A First-Class Maii, �Piistage&Fees Paid 1d Permit No.G-10 cz. ^TC • Print your name,',addrgs an,fzlP Code in this box Stetson R. Hall , RS 4 28 Rambler Road Osterville , MA. 02655 I I I d SENDER: u 2 io adi,o i c s - 12/0 8/9 8 I also wish to receive the o ■Complete ite an or R■Complete items 3,4a,and 4b. V V7 C a r t h y Hearin following services(for an (0 ■Print your name and address on the reverse of this form so that we can return this extra fee): card to you, ■Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address Z dperm .eit ■ Retum Receipt Requested'on the mailpiece below the article number. 2. O Restricted Delivery N C ■The Return Receipt will show to whom the article was delivered and the date a delivered. Consult postmaster for fee. .3 0 0 3.Article Addressed to: ,e 4a.Article Number d d Monica Grace Z 392 978 864 C E 32 Longfellow Drive { 4b.Service Type «'� 0 Centerville , MA. 02632 ❑ Registered W)Pertified - 0 co ❑ Express.Mail ❑ Insured S ¢ ❑ Return Receipt for Merchandise O COD c 7.Date of D i w ary z d2 0 5.Received By: (Print Name) 8.Addressee's Address(Only if requested c W and fee is paid) 0 iC g 6.Signature: Addressee or Agent) C � X k t t 1 tt4t itt tt� itlttf ai PS Form 3811, December.1994' { 102595-97-B-0179 Domestic Return Receipt l 1 1 1 ' !i !t ItttktI tt .'t �^. First-Cla UNITED STATES POSTAL SEss. it RVICE S 4 PostageF,&ees<Paid 44 LJ. 'USPS`.. ,.. Permit No:d'4aO' • Print your name;saddr'ess,and ZIP Code in this box;• Stetson R. Hall , RS 28 Rambler Road Osterville , MA. 02655 c�q Illtttttitttlit,tltitt $1tlll o SENDER: u e r. Notice - . McCarthy I also wish to receive the o ■Complete items-1 and/or 2 for additional services. ■Complete items 3,4a,and 4b. �2/0 g���q � � following services(for an ■card your o name and address on t e reverse t is orm o w n extra fee): ■�Atttracc?this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address ■Write'Retum Receipt Requested'on the mailpiece below the article number. 2, ❑ Restricted Delivery N •The Return Receipt will show to whom the article was delivered and the date, .. C delivered. Consult postmaster for fee. a v 3.Article Addressed to: 4a.Article Number d ; Loretta. Ahern Z 392 978 865 C E 2820 Bryan Street 4b.Service Type U Alexandria , VA 2z-3O ❑ Registered �] Certified W- rn W O��A V,q ❑ Express Mail ❑ Insured y c ❑ Return Receipt for Merchandise ❑ COD w 7.Date of Del z iv ry w w 2 0 a 0 p 5.Received By:(Print Name) 8.Addressee' Ad ress(Only if requested 5 and fee is paid) t 6.Signat •(Addressee orA ent) ~ G tl1 PS FoRn 3811' December 1994 j i 102595-97-8-0179 Domestic Return Receipt I First-CI ail UNITED STATES POSTAL SERVICE e�0 �� Paid I 0 P �o _ 3 sPs � � PermitNo • Print your name, address, and ZIP Code in this,boa 0a43 I �r Stetson R. Hall , RS 28 Rambler Road Osterville , MA. 02655 I 04 fill„I,IIIIIIII III IfIIII:,III till 11111-1 1I„„111111Itit1I11 ei SENDER:12 08'-98 BOH Hearing Abutter lalsowishtoreceivethe ■Complete items 1 and/or 'for additional services. O t 1 C e—M C C a T t rn ■Complete items 3,4a,and 4b. Ilowing services(for an ■Print your name and address on the reverse of this form so that we can return this extra fee): card to you.. ■permit.ac this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address y ■write'Retum Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery N •The Return Receipt will show to whom the article was delivered and the date . a delivered. Consult postmaster for fee. 3.Article Addressed to 4a.Article Number d ; Claire A. Tnpresano Z 392 978 862 C E 63 Paine Street 4b.Service Type NWinthrop, MA. 02152 ❑ Registered p 'Certified W ❑ Express Mai \�� red CO c ❑ Return R Merchandise ❑ a 7.Date of D iv DEC 4 998 is 5.Received By:(Print Name) 8.Addresse 's dress(Only if reque to and fee is i t I t- 6.Sign e: (Addresse rAgent , X U4pf3 r PS Form 3811, Decemb6r 1994 { 102595-97-B 0179 Domestic Return Receipt UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 0 Print your name, address, and ZIP Code in this box• Stetson R. Hall , RS 28 Rambler Road a Ostervill.e , MA. 02655 4 C1'.d, (��lEii3lii!1�3ii13�!!�t:iti!iEi!3ii�33Ft73�t3.ftl�?iE43ii34{I�! REC40VEO AM t x OCT 9 TOWN OF BARNSTABLE own ®f s R tMe I?;C. BY Bard of ea` 367 Main Street, Hyannis MA 02601 Office:.508-790-6265 Susan Q.Rask,R.S.FAX: 508-790-6304 Sumner Kauflnan,M.S.P.H. Ralph A.Murphy,M.D. VARIANCE REQUEST FORM LOCATION Property Address: 42 Longfellow Drive Assessor's Map and Parcel Number. 18 8/3 9 Size of Lot: . 25 acres Wetlands Within 300 Ft. Yes X Subdivision Name: No Business Name: APPLICANT CONTACT P . SON Name: Mary McCarthy Name: Stetson Hall/Edward Kelley Address: 42 Longfellow Dr. , Centerville Address: 28 Rambler Rd. , Osterville, MA. Phone: Phone: 4 2 8—6 3 6 7 FAX: FAX: VARIANCE FROM REGULATION(t.ist flog.) REASON FOR VARIANCE(May attach if more space needed) -Barnstable BOH Reg. Sec. 1.15 Limitation of property Local upgrade approval requests: 310 CMR 15.405 1 i At maximum elevation without retaining wall 15.405,: 1 a Property limits setback from property line 15.405 (1) (b) Property limits setback from cellar wall Checklis (to be completed by office staff-person receiving variance request application) Four(4)copies of plan submitted(including septic system plans and/or restaurant floor plans) Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variances only) Variance request application fee collected(no ree ror ii&p.,d modirntfmr renewals,grease trap variance renewals(acme ownerneaaee enq],"ide dining variance renewals(acme ownerAmee only],and variances to repair railed Sewage disposal systems(only it no enpwion to the building prwosedn Variance request submitted at least 15 days prior to meeting date 1 VARIANCE APPROVED Susan G. Rask,R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Ralph A.Murphy,M.D. Q:/WP/1/ARIREQ i �kLO CAT ION SEWAGE PERMIT NO. VILLAGE } Ce,,-)°Fu ��,' t1� I N S T A LLER'S NAME i ADDRESS R UILDER OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED ---------------------- LeACk l001yo �ReHJ€ ei4 a;r-= � ►��s „� ;8aeV), Pump STAT on) PPOFIL E OF WSY '��SE AGE � T E M � /.✓.�rAtL ,��� ����� !, .,r r, ,. . . :r l/c V'� x - , ,, . , ,, / .. , ""Y'r-^v' t / ,✓" /�'✓L3v✓��/✓C•/�%)� C.EA�.Cit/7T�' 9" " - -.LQJ -�v1 --�- ' - Lt?.- -��? ��_ .__.tP� -Is='1- -ice.=. ..,�� �_" `4 ,,�p �t/E4 6. B" � 1 , �,/•/'' . ��� 7..3L , 1 AC7 g _.._ q0 EG6.a' CI ��0 , � �?pQ� c �� 2•. , , , �''�.`L�iA/✓I C-.5t„�` E-L�O' �-_____. +___._._____ _..�_. _-____._---- - I U cpC3. 0�` p ai����g`V-?1'� �0 1J'�'Oo �!'� '?•y'.- , ` FL 0 49 / /,z9 ! 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