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Home My WebLink About0429 PINE STREET (HY - Health 429 PINE ST. CENTERVI_L_LE A = UPC 12534 ' No.2•,-1153LOR 9 jo HAVINOS, UN AUG-14-2004 11:aS CENTURY 21 SEASIDE 01H AG 15094204024 P.02/09 y7i23�195T 04:�3 rKun woa .•nr> — 757.,� 0�6— 00 ) QN roe CL NZ 1 ppat•It btz lax transrnNtaI memo 7F71 }y Hr G il, A i so") R" 7 /f-5' I that this provertY. is l.00atad CERTMED PLOT PLAN in flood hazard Zone C I outside the 5001: year flood) as identi.fLed by 'the Dep t- LOCA'ri0N �6Ns eC iu ) men o� Hpusin and 'Urban Devo: omen}.Wjv) SCALE DATi RAN 14FERENG r+ :.I'`.r,... oor Re /r tCfATIFYYKATTHB .•.••••••••••- I certify to its -tzt3e insurance 001zpu zy S?{QWN QPF THIS PLAN 15 LOCATED ON TKL. GR90ND that there are no visible amrvawriments as swowN HEREON. or easements exoept as shown and that this plan was prepared under my j aamecii ate DATE �..rj-"Jr 1 ? supery Lsion. 7'/iyo P• �/Y� aNE G'7'�&jje — Pe AEGISTERED LAND SURVE R �y . flows _! _.._ _�__ __ µ _ cal , ►- zq - � �� _� _ __w . TOWN OF BARNSTABLE o . LOCATION L SEWAGE # /"c T2 VILLAGE (51�1+ 7—+ ASSESSOR'S MAP & LOTS -'b ®_mil INSTALLER'S NAME&PHONE NO. ��i �� PI 7 S 17 �e SEPTIC.TANK:CAPACITY LEACHING FACILITY: (type) �-��`�"� �- �' (size) p� -NO.OF BEDROOMS...:-3 BUI DER OR OWNER S A-zS ]z PERMPTDATE: ' 5- 9 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of L/Fsacility' ., Feet Private Water Supply Well and Leaching.Facility (If anyon site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands e -- . within 300 feet of leaching facility) Feet Furnished by _ r f'. �6 i l 7 - 3® , � r•w�VY `� .� 0 No. � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 2pprication for �W!6paar *pgtem Congtruction Permit 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 Pine St . , Centerville , MA Kathleen Mahoney Assessor's Map/Parcel -o9 1 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 S and. Nature of Repairs or Alterations(Answer when applicable) new Title-5 septic system tank, 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 thi B�cd�of He It . @ Signed /�c�d t x��-�✓ Date 9-0 Application Approved by %0, Date Application Disapproved for the fo lowing reasons Permit No. �9 - Jf / Date Issued TOWN OF BARNSTABLE LOCATION ' I SEWAGE # VILLAGE— ASSESSOR'S MAP & LOTIII' b�acd INSTALLER'S NAME&PHON,E+NO. 1 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) - `�s —�` L' (size) NO. OF BEDROOMS 3 BUILDER OR OWNER " c � :� PERMIY'DATE: � 7 7 COMPLIANCE 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 Feet 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) y Furnished by oez No. _ �. .. Fee $50 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: � Yes l PUBLIC HEALTH:DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Application for Migozal *pgtem Construction Permit Application for a Permit to Construct( )Repair(X)Upgrade( - )Abandon( ) O Complete System O Individual Components 4 ocation Address or Lot No. Owner's Name,Address and Tel.No. 9 Pine St.., Centerville, MA Kathleen Mahoney Assessor's Map/Parcel .091 09 / r 6 G / 1 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 iT tl� ,-5. Septic system tank, D-box and. 2 leach chambers fa r Npi. Ff.� S Date last inspected: Agreement:', The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance w�t��h the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Complia4i'ce has been issued byy its B and of Health. r/ Signed �I,[ `''f1" Date Application App/roved by Date—!? - ir- 2C( Application Disapproved for the following reasons 0 } Permit No. g5? - 5'? ! Date Issued ————————————-——————————————————— THE COMMONWEALTH OF MASSACHUSETTS Mahoney BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired(X )Upgraded( ) Abando ed bg Wm. E . Robinson Septic Service - at 2� IRine . , enTervi e has been const cted in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 4 dated " $l Installer Wm. E. Robinson S r. Designer The issuance of this ermit shall not be construed as a guarantee that the system will function as designed. Date -T! Inspector �\ CT JIQ --- No. --- e50-- THE CQMM NWEALTH O MASSACHUSETTS PUBLIC H .TiH 81 NSTABLES MASSAC.sHUSETTS° C Mahoney f4 MtsSpOar *p6tem Conztructton Permit � Permission is hereby gra ted to Construct( )Re air(( X)Upgrade( )Abandon( ) System located at 429 Pine St. , Centerville, MA 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 this permit. Date: �'., -y� Approved by Q 1/6199 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) 7 William E . Robinson,S,rhereby certify that the application for disposal works construction permit signed by me dated �- g' % concerning the property located at 4�9 Pine St . , Centerville , MA meets all of the following criteria: • The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • VThe 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 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 There 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, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) B) G.W.Elevation +the ivtAX. High G.W. Adjustment . �— I DIFFERENCE BETWEEN A and B � i SIGNED : DATE- -1�--= [Sketch proposed plan of system on back]. q:health folder:arc iF�`' - l i _ �/�/ �./ i In a 'V � v 'n J If4 � �1✓ tJ 1 v d a