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Home My WebLink About0124 MONOMOY CIRCLE - Health 124 MONOMOY CIR. CENTERVILLE A = 191 199 SIII JaRECYCLEpro UPC 12534 No.2153 blR HASTINGS.UN I No. ��.•e' e" _ Fee 5 0.O 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: s - PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 0[pprication for Miopooar *p5tem Construction Vertu Application for a Permit to Construct( )Repair(XX)Upgrade( )Abandon( ) El Complete System 0 Individual Components Location Address or Lot No. 124 Mo nomo y Circle Owner's Name,Address and Tel.No. — es Joseph ) 'Brien ACe ors�apVAAe1e Mass. 0 2632 124 Monomoy Circle 02632 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—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 XX No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other ape of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 355 gallons per day. Calculated daily flow 3 X 1 1 0=3 3 0 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Existing 1 000 & box. Type of S.A.S. 1 -1 000 pit existing Description of Soil Loamy sang to boney fine -,and. Nature of Repairs or Alterations(Answer when applicable) Adding two 500 gallon leaching chambers packed in 4 ' 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 iss d by this Bo d o Health. Signed Date 7/1 7/0 0 Application Approved by — DateApplication Disapproved Disapproved for the following reasons Permit No. Date Issued TOWN OF BARNSTABLE LOCATION /,2 MII n Al b M 6 SEWAGE # 000 - VILLAGE CeNtee yl&,e ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. A C 6 Iq t?.eX. 4" S C/ /, SEPTIC TANK CAPACITY 6DO f' /pAr C/ O LEACHING FACILITY: (type). W C11A A4 r> el- 5(size) NO. OF BEDROOMS .� BUILDER OR OWNER PERMITDATE: OC7 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 - —,--z r �. � � � � �t.' .. 's y i� ` � � � . � b' �o ` �, ` � � o,6 ,�, �, u.. ; , ,��, �� ;. 3� ��' �.<.�. No. ti"*' t �31G..r.�c / �►' , ..�; Fee; 5 0.®0 - •-.,THE COMMONWEALTH OF MASSACHUSETTS Entered in co uter: es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIPPrication for Migozar *p.5tem Construction Permit Application for a Permit to Construct( )Repair(XX)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 124 Monomoy Circle Owner's Name,Address and Tel.No. — Cenivevl�e,Mass. 02632 Joseph ) 'Brien Assessors ap arce � / , 124 Monomoy Circle Installer's Name,Address,and Tel.No- 5 0 8—7 7 c5—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 XX No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 355 gallons per day. Calculated daily flow 3 X 1 1 0=3 3 0 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Existing 1000 & box. Type of S.A.S. -1000 pit existing Description of Soil Loamy sand to boney fine sand Nature of Repairs or Alterations(Answer when applicable) Adding two 500 gallon leaching chambers packed in 4 ' 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 issued by this Bo d o Health. Signed Date 7/1 7/0 0 Application Approved by Date 7-_Y —Z4 Application Disapproved for the following reasons Permit No. ofelr Date Issued �" S THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (tomphance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )RepairedX(XX)Upgraded( ) Abandoned( )by, J.P.Macomber & Son Inc. at 124 Nonomoy Circle Centerville,Mass has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Pe (��' dated_' J.P.Macomber & Son Inc. J Macomber & .S n Dic Installer Designer \• ,, The issuance of this. t, rtl 1. /I C\ p rrri�it cs�hal noxYbe construed as a guazantee�that th�,+�te`m wryll:function as desrgned. �1&/ Nw Date Inspector V l �t l �' � D _V _ r 1 No. 4&6 /47 —-----------------Fee ' 50.00 - THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS 33igpogar *pgtem Construction Permit Permission is herebygranted to Construct( )Repair(X�Upgrade( )Abandon( ) System located at 124 Monomoy Circle 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:Construction must be completed within three years of the date of t ' rmit. Date: :.—,-7 Approved b r 1f ` r' w t/6/99 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 DESIGNED PLANS) I, Joseph P.Macomber Jr hereby certify that the application for disposal works construction permit signed by me dated 7/1 7/0 0 concerning the property located at 124 Monomoy Circle Centerville,Mass-meets all of the following criteria: j�The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. e soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. There are no wetlands within 100 feet of the proposed septic system Y There are no private wells within 150 feet of the proposed septic system i° There is no increase in flow and/or change in use proposed There are no variances requested or needed. The bottom f o the proposed leaching facility will n t be locat ed ted less than five Po g tY 2 fi feet above the maximum adjusted groundwater table elevation. (Adjust the groundwater table using the Frimptor ethod 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 Iess than fourteen (14) feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) B) G.W. Elevation I d +the MAX. High G.W. Adjustment Z2 . -1J&Vts DU ERENCE BETWEEN A and B SIGNED • r DATE: 7/1 7/0 0 (Sket oposed plan of system on back). q:health folds.ccn I0 L � TOWN OF BARNSTABLE LOCATION /V1I t�dL�/ �Y 1/Q' SEWAGE # oedA- ri VII LAGS ��,1VP/1P V/�l e ASSESSOR'S MAP & LOT4 INSTALLER' S NAME&PHON E NO. 4 S'0 SEPTIC TANK CAPACITY Ir de0-f / /r Z 0 LEACHING FACILFrY: (type)ZAoid C11A ed r> PA (size) NO. OF BEDROOMS BUILDER OR OWNER PERMIT DATE: O 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 �.n J \