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Home My WebLink About0029 NOBADEER ROAD - Health 29 Nobadeer Road A= 250-131 Centerville UPC 12534 ' No.2.153L R �, HASTWOS,UN `;No. — Fee $5 0 F THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIpplitation for Mtzpaal *pgtem Com5truction 3permit Application for a Permit to Construct( )Repair(X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 29 Nobad.eer d.. , Centerville , NIA om Antosca Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Service PO Box 1089, Centerville , MA 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 applicable) new Title-5 leach system. D—box and. 2 leach chambers . 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 o of Health. / ✓ Signed Date ` Application Approved by Date 7-34 .pf C Application Disapproved for the ollow g reasons Permit No. Date Issued S Fee $50 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: �q y .- ' 0 PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS es 01 plication for Migpogal *pgtem Congtruction Permit ' Application Ptfr a Permtt to Construct( )Repair((X)Upgrade( ) ib iton( ) ❑Complete System ❑Individual Components Location Add o Lot No. Owner's Name,Address and Tel.No. 29 Nobadeer Rd. � Cente, ville� MA Tom Antosca Assessor's Mt cc j 0 - ' Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Service PO Box 1089, Centerville, MA, 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 { „n Title Size of Septic Tank Type of S.A.S. Description of Soil Sand. Nature of Repairs or Alterations(Answer when applicable) new Title-5 leach system. D-box and. 2 leach cham ers. 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 thisJloard of Health. Q . Signed �, t ` �� Date s Application Approved by Date '?-I(- 9 cf Application Disapproved for the ollow g reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS Antosca BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal SysterU Constructed( )Repaired(X )Upgraded( ) Abandoned( )by Wm. E. Robinson Septic Service at �9 No acleer Rd.. , Centerville has been constructed in accordance with the rpyision f T• a and the for is oral S stem Construction Permit No. - t dated / } 55 inson Installer WD1. �� "'cb �� y Designer The issuance of •s e t a t e construed as a guarantee that the s st function as de4 neck Date Inspector �I �r d --------------------------------------- No. — r., aZl $ Fee $SO THE COMMONWEALTH OF MASSACHUSETTS Antosca 'PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS x Migpoaf *pgtem Congtruction Permit Permission is hereby granted to Vssyct,� *p it�eri��V i( Abandon( ) System located at and as described in the above Application for Disposal..System Construction Permit. The applicant recognizes his/her duty to ` comply with Title 5 and the461lowing local provisions or special conditions. Provided:Construction must"be completed within three years of the date of this permit. Date: — �. ( — I Approved by 1/6/99 r A 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, William E . Robinson,S,zllereby certify that the application for disposal works construction permit signed by me dated (� , concerning the property located at 29 Nobad.eer Rd.. , Centerville , MA meets all of the b following criteria: The failed cyst is connected to a residential dwelling only. There are no commercial or business uses associated 'th the dwelling. The soil is cl sified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. • There are o wetlands within 100 feet of the proposed septic system There no private wells within 150 feet of the proposed septic system • Ther is no increase in flow and/or change in use proposed Th re are no variances requested or needed. e 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, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) B) G.W. Elevation +the MAX. High G.W. Adjustment . _ . 11 DIFFERENCE BETWEEN A and B SIGNED : DATE: [Sketch proposed plan of system on back]. q:health folder:cent i ' ' J 14/ e bG�2 jlr� �1 ., �` i J • � �� c p TOWN OF BARN�SAT/ABLE LOCATIO SEWAGE # VILLAGE 4f—d- ASSESSOR'S MAP & LOT 5 1 INSTALLER'S NAME&PHONE NO. 76 ,tix -7 S` SEPTIC TANK CAPACITY LEACHING FACILITY: (type) '^ �"" �� (size) NO.OF BEDROOMS J BUILDER OR OWNER At, T(sC X PERMITDATE: COMPLIANCE DATE: 97 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) d Feet Furnished by i ................ ra W