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HomeMy WebLinkAbout0046 MARIE-ANN TERRACE - Health (2) 46 MARIE ANN TERRACE, CENTERVILLE A=189-094 llll UPC 17534 No.22-1153COR KASTiN©S,UN I I 41 No. / --6s7 Fee 50 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Application for 30i6tlo!9ar *pgtem Con!6trurtion Permit Application for a Permit to Construct( )Repair PM Upgrade( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No. 46 Marie Ann Terrace Owner's Name,Address and Tel.No. 771 —3 6 8 4 Centerville,MaSS. '02.632 Thomas Walsh Assessor's Map/Parcel — ® 46 Marie Ann Terrace CEnterville Installer's Name,Address,and Tel.No. b U b— —JJ J tsDesigner'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 Type of Building: Dwelling XXNo.of Bedrooms 4 Lot Size sq. ft. Garbage Grinder( ) Other Type of Building Res No.of Persons 4 Showers( ) Cafeteria( ) Other Fixtures Design Flow 4 x 1 1 0 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 coarse sand Nature of Repairs or Alterations(Answer when applicable) Adding 3 500 gallon chambers to an existing system. 1 —Distribution box. Off existing tank. ( 1000 ) Omitting two vblock cesspools 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 issu d by hi B d of ealth. Signed Date 1 1 /1 -1/9 7 Application Approved by Date Application Disapproved for the following reasons Permit No. -6 Date Issued "13- 27 --------------------------------------- / i —o No. / 7-6S7 f _ Fee $ 50 k; THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLEs MASSACHUSETTS Zipprication for Mfgpogaf *pgtem Cott!5tructton Vertu Application for a Permit to Construct( )Repair(X4 Upgrade( )Abandon( ) O Complete System El Individual Components Location Address or Lot No. 46 Marie Ann Te rra c Owner's Name,Address and Tel.No. 7 71 —3 6 8 4 Centerville.MaSS. (f M� Thomas Walsh Assessor's Map/Parcel ��'1�- Q 9 � 46 Marie Ann Terrace CEnterville Installer's Name,Address,and Tel.No. — — 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 Type of Building: Dwelling XXNo.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building Res No.of Persons 4 Showers( ) Cafeteria( ) Other Fixtures Design Flow 4x1 1 0 gallons per day. Calculated daily flow �y� gallons. Plan Date b Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Loamy sand to coarse sand Nature of Repairs or Alterations(Answer when applicable) Adding 3 500 gallon chambers to an existing system. 1 -Distribution box. Off existing tank. ( 1000 ) Omitting two vblock cesspools. 3 ec+ (.,,C <-b[1e. Date last inspected: Agreement: ti 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 Envirorimental Code and not to place the system in operation•until a Certifi- cate of Compliance has been issu d by thi BVd cf lth.ea_ Date 1 1 /13/9 7 Signed Application Approved by ► Date Application Disapproved for the following reasons Permit No. 7-6 S 7 Date Issued 3" / 7 ———' ——————— ———————— ———— —————————�— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired�X )Upgraded( ) Abandoned( )by •P.Macomber & Son Inc. at 46 Marie Ann Terrace Centerville.Mass. has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 9 7-C T 7 dated 11'/3~/ 7 Installer Designer The issuance of this permit shall not be construed as a guarantee that the syst 11 fu tiq'a a esigned. Date ! —9 / Inspector �w ��� 4 --------------------------------------- No. ? -6 S_ Fee $ 5 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLEs MASSACHUSETTS MtZpOal *pgtem Construction Verutit Permission is hereby ranted to Construct( Repair(XX)Upgrade( 11 Apbandon( ) System located at T6 Marie Ann Terrace Centervi"lle,Mass and as described in the above Application for Disposal System Construction Permit. The appliq'ant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of thi .ermit. Date: �l�1 27 Approved by ' s 1 I0/W97 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 ENGINEERED PLANS) I, Joseph P acninintar j ,hereby certify that the application for disposal works construction permit signed by me dated 11 /13/9 7 , concerning the property located at 46 Maria Ann mQrrAE Centerville meets all of the following criteria: There are no wetlands located within 100 feet of the proposed leaching facility 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 .6'/There are no variances requested or needed. 4�-1f the proposed leaching facility will be located within 250 feet of any wetlands,the bottom of the proposed leaching facility will II_QS be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation. Please complete the following: A)Top of Ground Elevation(according to the Engineering Division G.I.S.map) B)Observed Groundwater Table Elevation(according to Health Division well map) ` SIGNED: DATE: 1 1 /1 3/9 7 LAI LICE ED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. q:health folder:cert - o O . o pJ , k TOWN OF BARNSTABLE LOCATION AI R L e AAI-✓ 7"e R• SEWAGE # C900 S 19fy800 VIL,LAGE r- e&7 P R V/1 L -e -r ASSESSOR'S MAP & LOT ®� INSTALLER'S NAME&PHONE NO. J 4 A C o Al e e K 4 S o 41 SEPTIC TANK CAPACITY /. ,S-a_D Al e Gy a LEACHING FACILITY: (type) - 12 ey uj e Z L .S 0U.)(size) NO. OF BEDROOMS 9 9 7 BUILDER OR OWNER PERMITDATE: lkau i COMPLIANCE DATE: Separation Distance Between the: g Maximum Adjusted Groundwater Table to the 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 t i ------ --- a---.,�-.�wf:,,.ter __�� .. -- �.f- .� _ � � /� e w � ��� 6n � ..,,`:9 .,, �c� 7� r�� �k3 � � ® �" ,� 6(? �. { C�� y � -_� TOWN OF OF BARNSTABLE L/ LOCATION yG loa4A-�U &ot /-eA44C4— SEWAGE # 02o0S'— ,�ILLAGE �� ) ASSESSOR'S MAP &(,LOT 1?9— 09"' INSTALLER'S`NAME&PHONE NO.J to SPA SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS OWNER /O,W PERMIT DATE:_��/oZ�O S COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the 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 ,Feet-is c.c.•F �`^ Vec4 �/ O r Sera r ti 5 l lod O-O-L— TOWN OF BARNSTABLE ATION d�` M A X l e A" fQ l SEWAGE # 27 -(a-5 7 LLAGE L P/i/r eA yl LL g ASSESSOR'S MAP &LOT k'INSTALLER'S NAME&PHONE NO._1 ,"?/VI A C 0,M�'3 f A + 5ely SEPTIC TANK CAPACITY D 6 D Q Z Q LEACHING FACILITY: (type) 3.A"QZQW 01AAifeX5 (size) .SOB i NO.OF BEDROOMS y BUILDER OR OWNER PERMTTDATE: Jf— /3 97 COMPLIANCE DATE: C/ —/ 21 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 Ilk. �y 0, O .4e-cLi}. ct.-+ Eo �-*S��S ti� flacf ASSESSOR'S MAP NO. 226 PARCEL Lot134 L-O CAT ION SEWAGE PERMIT NO. 4(o Lot 7 MARIE AVENUE 86-292 .V�ILL INSTALLER'S NAME i ADDRESS BCK 97 TOWN BROOK ROAD - WEST YARMOUTH, MA �0 HOMES BY D.M. WARD. "�- SUILDER OR OWNER 1000 GST D-BOX 600 GLP 3' Stone D A T E P E R M I T I S S U E D 9/22/86 DATE COMPLIANCE ISSUED i e f , t. . TOWN OF BARNSTABLE LOCATION lUI M A X l e A NN �e l��� SEWAGE # VI LAGE C CAN rele Vi LL ASSESSOR'S MAP & LOT . INSTALLER'S NAME&PHONE NO. -7. Ad A C 0A 16B/C t Saw SEPTIC:TANK CAPACITY s=' LEACHING FACILITY: (type) 3,A4 Lou, C 11A�9exs (size) .SOo NO :OF BEDROOMS BUILDER OR OWNER PERMITDATE: ��- /3 ' rl 7 COMPLIANCE DATE: Separ-ation Distance Between the: Mainhum.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 O ^Ek(.��fr�Q'11w� I