The URL can be used to link to this page

Home My WebLink About0047 LONGFELLOW DRIVE - Health 47 LONGFELLOW DR. CTRVILLE A = r S'u ' IN UPC 12534 No.2�153LOR MITING9.UN TOWN OF BARNSTABLE 1 ` LOCATION '1 SEWAGE 0- VILLAGE stir ASSESSOR'S MAP & LOT O INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) J—�d (size) NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: U — ��`" l� COMPLIANCE DATE: ,2 --9 Separation Distance Between the:. , Maximum Adjusted Groundwater Table to.the Bottom of Leaching Facility Feet i Private Watetply Well and Leaching Facility (If any wells exist V on site or within 200 feet of leaching facility) Feet i Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by t v r> No. Fee$5 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: J Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 0(pprication for Oigogaf *pgtem Cottgtruction permit Application for a Permit to Construct( )Repair(x)Upgrade( )Abandon( ) O Complete System ❑Individual Components L cation Address or Lot No. Owner's Name,Address and Tel.No. 7 Longfellow Dr. , Centerville Claire Indresano Assessor's Map/Parcel Q�— ®3 ) Installer's Name,Address,and Tel.No. V Designer's Name,Address and Tel.No. Wm E. Robinson Septic Ser. P 0 Box 1089, Centerville, N!A Type of Building: Dwelling 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 Sand Nature of Repairs or Alterations(Answer when applicabUenew Title-5 SPpts system tank, D—box and 3 cultex 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 issued by thijBo30 of Health. Signed r Date , Application Approved by Date �t~ � Application Disapproved for the following reasons Permit No. ` Date Issued r �' No. Fee$50 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 1 Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS1 0[ppricAtion for ;3tgpo.5ar *pgtem Condtructidn Permit Application for a Permit to Construct( )Repair(x )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components L0L c ion Address r o No. Owner's Name,Address and Tel.No. Longfellow Dr. , Centerville Claire Indresano Assessor's Map/Parcel ?"F- V V Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm E. Robinson Septic Ser. P 0 Box 1089, Centerville, NIA Type of Building: Dwelling 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 .r /.. 9 pe of S.A.S. 1 Description of Soil Sand.,? CY ` Nature of Repairs or Alterations(Answer when applica (ej ew',T itle-5 s 4t 1C `system tank. D—box and 3 cultox. Date lastjidspected:a - f t Agreement: 1 ' 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 issued by I sBo4dofHealth. Signed Date Application Approved by Date Application'Disapproved for the following reasons € Permit No. ` Date Issued ��" ' ———————— THE COMMONWEALTH OF MASSACHUSETTS ` r Indresano r BARNSTABLE, MASSACHUSETTS (Eertificate of (Compliance THIS IS TO CERTIFY that the On-site Sewage Disposal System Constructed( )Repaired (X )Upgraded( ) Aba ned bum. f. Robinson Septic Service at - i�ngf b ey loW Dr. 0 Centerville has been constructed in accordance with the prIWonsef TiAeOVII %e0fRr%p?sal System Construction Permit NoYff dated ?` tO Installer Designer The issuance of this permit s. of be o s ed as a guarantee that the to w'I�ug io as ig _ Date CC� Inspector r 7_ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Indresano rhgoar 6p.Mem (Construction Permit Permission is hereby 't IV s t )I pair( e�n ' v�d .i(11e )Abandon( ) �o°ng e 'go�w ^ System located at and as described in the above Application for Disposal System Construction Permit. The applicantle�cog es his/her duty to comply with Title 5 and the following local provisions or special conditions. t# Provided:Construction must be completed within three years of the date of thi . rmit. =r, Date: �� 'f 5p Approved b � r 1/6/99 ' fF d it j. NOTICE. This Form Is To Be Used For the Repair O Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I, William E . Robinson,S,zllereby certify that the application for disposal works construction permit signed by me dated /'' L� , concerning the property located at 47 Longfellow Dr. , Centerville meets all of the following criteria: • e lassociated ed system is connected to a residential dwelling only. There are no commercial or business e with the dwelling. • The soil classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. • iere re no wetlands within 100 feet of the proposed septic system re no private wells within 150 feet of the proposed septic system t • e s increase in flow and/or change in use proposed • T, ere 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, a Please complete the following: A) Top of Ground Surface Elevation(using GIS information) is B) G.W.Elevation +the MAX.High G.W. Adjustment. _ DIFFERENCE BETWEEN A and B SIGNED : �� i DATE: [Sketch proposed plan of system on back]. q:health folder:cert r r TOWN OF BARNSTABLE LOCAT10N SEWAGE # VILLAGE �c. I�-� ASSESSOR'S MAP& LOT -0 INSTALLER'S NA &PHONE NO. .Co A !� "a ME .s z SEPTIC TANK CAPACITY LEACHING FACELITY: (type) 2E"7/�c) (size) NO.OF BEDROOMS-,-?- BUILDER OR OWNER PERMIT DATE: U `� COMPLIANCE DATE: JP j-9 Separation Distance Between the:,�; { Maximum Adjusted Groundwater Table to,the Bottom of Leaching Facility Feet Private Water Well and Leaching Facility (If any wells exist ' t on site or within 200 feet of leaching facility) Feet f Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by l 1044