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Home My WebLink About0091 PLEASANT PINES AVE - Health (2) 91 PLESANT PINES AVE., CENTERV. A=233/055 I i 1 UPC 12543No. 53LOR �a HASTINGS, MN r TOWN OF BARNSTABLE V c N LOCAnON 17/e�ZeASA er Awes Ai/ SEWAGE #, VILLAGE C C'Al 2 eX V///a ASSESSOR'S MAP &LOT - c S INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY ®O A� LEACHING FACMITY: (type) f CAtO (size) %n 06 NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: 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 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 'Ile lo 00 r Ale tA) `. r,4 o A s Al i i f 1 No. 2 7—3 0 Fee n a� �w 4Cf+ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01pplication for Mizpozar *pgtem Construction Permit Application for a Permit to Construct( )RepaiAX4 Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 91 P e s a nt Pines Ave Owner's Name,Address and Tel.No.E S t a t e of Olga V. Centerville,Mass. 02632 Pearson. C/O Greg Pearson Assessor's Map/Parcel ;3j 0 �-d— 206 Red Fawn Road Brewster,Mass Installer's Name,Address,and Tel.No.5 0 8—7 7 5—3 3 3 8 Designer's Name,Address and Tel.No. 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(NO) Other Type of Building RES No. of Persons 0 Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 3 0 gallons per day. Calculated daily flow 3 x 1 1 0 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank 1 500 gallons Type of S.A.S. 1 -1000 gallon pit. Description of Soil Loamy sand to medium fine sand. Nature of Repairs or Alterations(Answer when applicable)Removing cracked 1 000 gallon septic tank. Replacing it with a 1500 gallon septic tank. Date last inspected: 5/2 7/9 8 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 of place the system in operation until a Certifi- cate of Compliance has been issued y this Boar of a Signed Date 6 2 5 9 8 Application Approved by _ Date —Z(w Application Disapproved for the following reasons Permit No. - r 7 Date Issued Gs — 7 �2 No. :1 .3 Fee 5 B THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH 61VISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYicatfon for ;Digpogar *pztem Construction Permit Application for a Permit to Construct( )RepaiiK(XXj Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 91 Plesant Pines AVe Owner's Name,Address andTel`No.EState Of Olga V. Centerville,Mass. 02632 Pearson. C/O Greg Pearson Assessor's Map/Parcel S �"- 206 Red Fawn Road Brewster,Mass Installer's Name,Address,and Tel.No.5 0 8—7 7 5—3 3 3 8 Designer's Name,Address and Tel.No. 02631 J.P.Macomber & Son INc. J.P.Macomber & Son Inc. Box 66 Centerville,Mass. 02632 Box 66 Centerville,Mass. 02632 x Type of Building: Dwelling XX No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(NO) Other Type of Building RES No. of Persons 4 Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 3 0 —_g g gallons per day. Calculated daily flow 3x110 � gallons. Plin Date Number of sheets Revision Date Title Size of Septic Tank 1500 gallons Type of S.A.S. 1 -1000 gallon pit. Description of Soil Loamy sand to medium fibersand. Nature of Repairs or Alterations(Answer when apglicable)Remov91g cracked 1-:0:W gallon septic tank. Replacing it with a 1500 gal on sent c- an . Date last inspected: 5/2 7/9 8 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 a/notplace the system in operation until a Certifi- cate of Compliance has been issued y this Boar of a Signed Date 6 2 5 9 8 Application Approved by Date Application Disapproved for the followingxeasons 00, -- - -- - - - .. Permit No. Date Issued l --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS s. Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( r)Repaired(XX)Upgraded( ) Abandoned( )by J.P.Macomber & Son Inc. at 91 Pleasant Pines AVe Centerville,Mass. has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 7 r- ?' 7 dated 6`'� g� Installer J.P.Macomber & Son Inc. Designer J.P.Macomber & Son 1m. The issuance of this permit shall not be construed as a guarantee that the syste ill function as designed. Date Inspector- ----------------------------------------1� �O No. Fee $ THE COMMONWEALTH OF MASSACHUSETTS } PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Dig;pogal *p5tem Construction Permit Permission is hereby granted to Construct( )Repair )Upgrade( )Abandon( ) System located at 91 Pleamrit Pines Ave 031bamille.MaEs. 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 thi e t. �^ /� D Date: o — 16 - 57 Approved by � � 'v"✓�. /J `4 `P. 1 10/9/97 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 Macomber jr-, hereby certify that the application for disposal works construction permit signed by me dated 6/2 5/9 8 , concerning the property located at 91 Pleasant Pines Ave meets all of the centerville,Mass. 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 • There are no variances requested or needed. • If the proposed leaching facility will be located within 250 feet of any wetlands, the bottom of the proposed leaching facility will=be located less than fourteen (14) feet above the maximum adjusted groundwater table elevation. Please complete the following: s' A)Top of Ground Elevation(according to the Engineering Division G.I.S. map) 6)Observed Groundwater Table Elevation(according to Health Division well map) SIGN;SE;SEPTIC d l DATE: 95/98 LICE 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 Rau&g 1000 g llm tarn. Tcykiscradgga. l%taLUM 1500 gaUm tank. �I . PIeaSaxt�-. �he5 �vz c.�n�erv�l�, (s•vi••C Gt/JS/97) Pay• 9 of 30 �, o76 LOCATIO SEWAGE PERMIT NO. VILLAGE rc _el/iL-Lrz- A & B CESSPOOL SERVICE 128 BISHOPS TERRACE, HYANNIS, MA 02601 BUILDER OR OWNER DATE PERMIT ISSUED //✓ �� p'� DATE COMPLIANCE ISSUED (� e � _ _ � I Ce- I ,` r� O a� � ,� a� � _� `: �, `� ,� .s .� �� , � � ., I No.$37/l® Fic 9!...o.....0........ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH - oF.... 4i /S.T.. �4 .................................. Appliration for Uiipnaal Workii Tomitrnrthin jJamit Application is hereby made for a Permit to Construct ( ) or Repair V� an Individual Sewage Disposal System at: . � r��E0..P..Jrv! s...d! r......cv72�� ........................ .... •............... Location-Address or Lot No. :... .t /tR�s-cal ---------... Sl sh►�y_r__-_-,rv �s fi''i ....... "reu' _ Owner Address ..................... xlq✓V // ,,.1..' Installer Address Q Type of Building nn Size Lot............................Sq. feet UV Dwelling—No. of Bedrooms___.._P� Expansion Attic ( ) Garbage Grinder ( ) ---..._----- ---•----- p�, Other—Type of Building ____________________________ No. of persons......Z_________________ Showers ( ) — Cafeteria ( ) a Other fixtures _________________________________ _ ______ W Design Flow............................................gallons per person per day. Total daily flow......................._....................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No..................... Diameter____________________ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 0-4 Percolation Test Results Performed by.......................................................................... Date----------- ............................ 0.4 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water................... (i, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.....-.................. a' ---••-••-••-•----------•-------------•--------......---._....._......_._....._.......----.......----......................................................... ODescription of Soil-----.&!-9/U/2--•------------------•---.....----•--------------•--------------------------------------•..------------------------------•------._...__...---- V ..............................-..............................................................................................................----•--- ................................................. W •-•••------•--- -----------------------------------------------------------------------•---------------•------•----------------------•-•---•-----•••------••-----------------•-•-••••••--•----._..._._. U Nature of Repairs or Alterations—Answer when applicable.___!!ASS/7't—L...... 000....... i_ :T A --------�� _ O._v C �1l�F#-5r A�r��!�!J-- ?J ------•------------------------------------------------------•---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITl1L 5 of the State Sanitary Code— The undersigned further agrees not o place the system in. operation until a Certificate of Compliance n 'sued by the b a h 1�lzi Application Approved BY �� .......A../j- -.................. Date Application Disapproved for t f oll wi g reasons-----------------------------•--•------------------------------------ ............................................ -•------------------------•----------•----•--------•-------- -•------•--•---••---........._._._.._•-•----------•••.__..----•--- -----------------------------------------------------.._._.._. Date PermitNo.....0 V?5-- ..................................... Issued....................................................... Date l C>0 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..............OF..... f)! f.: .................................. ApplirFatiun for Disposal Works Tonutrnrtion Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: - - -----....--•-------------------------------------•-----•------------............_--••-- /' Location-Address or Lot No. /.............................. ..-...Cc.....Tr�pv`r_� Owner Address •-•-•--.5Y--- Vt.C:ra'..................... Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms....... .................... Expansion Attic ( ) Garbage Grinder ( ) —� Other—Type of Building ............................ No. of persons_____ _..__._...___........ Showers ( ) Cafeteria ( ) a Other fixtures _es ................ ......-------•-------------------•••--••--••-•••----••--•---•---- •- d Design Flow...................... ...............gallons per person per day. Total daily flow............................................gallons. . .................................................... � Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ W Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. x Seepage Pit No--------------_-_-- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ W •-•-••-•--•--•-•-•-•••.._...-•---••..............•----•----•---.......--------------••-•-•-•--............................---•-•-••-•-••-••-......-----..---- DDescription of Soil....... --------•..........................•--•-•---------•-•------------------------------------•---------------------------------------•-----...... x U ------------- ----------------- ------------ •----------------------------------- -.-.------------------------------- •---------------------------- •--------------- --------------------------- W UNature of Repairs or Alterations—Answer when applicable.__1_ti!: �/�1—t-..._........o_�_ '= 7-5 � il. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITTIE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance n 'ssued by th 5f health. S n L 7" ✓E Application Approved By..............-•---- •-•---••--•-•-------------------•••••----••-•••--•-................._..-- ...f...._..... - --------------•-- Date Application Disapproved for following reasons---------------••----...----•---•------------------------------------------------------------------._....-------- ---------------------------------------••--•......---- ....-••••...-••--------.......-•-----------•--•-•----.....--•---------------•-----•-•-•••-•••-••-••-•---...--•-••......-•••--•--....-•--- Date PermitNo.--- -4..- ------------------------------- Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....� ...............OF.......,� gl`/5%- :................................ (Inrtifiratr of TontpliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (�() by...P.:?_ L :......----.:/.2:�....f'.n/: ?! ' .S.._/ r>= .... .-�,,4/v�//S Installer at..... ..... ......................r ' ?...... t�/n1�S ....ZC...--•-...L/.� .. wi ------------------- ... --- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Codas escrlbed in the application for Disposal Works Construction Permit No.___ 3..-- .ern............. dated&AV'-_- --__--_------__.----- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH o wN 7d <f. �'/D7 ..........................................OF...... i9, 1..� r.. �'� C .......................... No.-u--'.............. FEE....... ....:............. Disposal Works Ountrurtion rrmit Permission is hereby granted../9--.R.-- C_f`<- 2(2.. .....5Z! _.. ....................•••...... to Construct ( ) or Repair ) an Individual Sewage Dis osal System 9 klis at No.... � f L J _ .% = /�� ., ....... ............ P =.... r '_ ...... = �` Street as shown on the 5pplicoon for Disposal Works Construction Permit No, --- .......... Dated�,.r__ !':.e?---------------- ......... Board of Health DATE t� Ile --------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS