Loading...
HomeMy WebLinkAbout0126 SHEAFFER ROAD - Health 126 SHEA-VER RD., CENTERVILLE A=172.026 lIll ��aEcvato�o UPC 12543 o- No. 53LOR ��9�n.cO HASTINGS, MN f TOWN OF BARNSTABLE LOCATION 1*2 _ RO& SEWAGE # VILLAGE d ex) ASSESSOR'S MAP & LOT v —Oaf INSTALLER'S NAME&PHONE NO. Im Ado err ge g— ' S 3`tl" SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (s (size) NO. OF BEDROOMS BUILDER QlfOWNER PERMITDATE: 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 100, "ool ' 1: No 4 '7 a •� Fe,$ 5 0. 00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: I / Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zippricatiou for Zigogal *pgtem Congtruction Permit Application for a Permit to Construct( )Repair(X X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 126 She at e r Road Owner's Name,Address and Tel.No. — Centerville ,Mass . 02632 James Starck Assessor'sMap/Parcel C 126 Sheaffer Road Centerville ,Mass Installer's Name,Address,and Tel.No. 5 0 9—7 7 5-3 3 3 8 Designer's Name,Address and Tel.No. 5 0 8-7 - 338 J.P.Macomber & Son Inc . J.P.Macomber & Son Inc . Box 66 Box 66 Centerville ,Mass . 02632 GenteFville ,Mass. 02632 Type of Building: Dwelling X No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 330 gallons per day. Calculated daily flow 3 x 110=3 3 0 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank 1000 existing Type of S.A.S. 2-500 gallon chambers . Description of Soil Loamy sand to medium coarse sand,. Nature of Repairs or Alterations(Answer when applicable) Adding two 500 gallon chambers packed in 4 ' of stone . To the existing stem.septic s P P Y 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 n t to place the system in operation until a Certifi- cate of Compliance has been issu d by this an�oeal Signe / Date 2/17/9 9 Application Approved b - Date / Application Disapprove for the following reasons Permit No. - 7 Date Issued Z'"f 9 r No., -7 k,. y FeS 5 0.0 0 � 'r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: I / Yes V PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSE TS ZIppYication for Migogar *pMem Construction Permit Application for a Permit to Construct( )Repair g X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 12 Sheaf e r Road Owner's Name,Address.and.Tel.No. — 2022 Centerville ,Mass. 02632 James Starck ". 1 Assessor'sMap/Parcel � 7 _Z d � 126 Sheaffer Road Centerville,Mass Installer's Name,Address,and Tel.No; 5 0 9—7 7 5—3 3 3 8 Designer's Name,Address and Tel.No. 5 0 8— — 3 3 8 J.P.Macomber & Son` Inc . J.P.Macomber & Son Inc . Box 66 r Box 66 Centerville,Mass . 02632 Type of Building: Dwelling X G To 1 of Bedrooms./b, Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures n t '- Design Flow 330 J igallons per day. Calculated daily flow 3 x 110=3 3 0 gallons. Plan Date �,F" Nutyber of sheets Revision Date Title Size of Septic Tank 1000 existing Type of S.A.S. 2-500 gallon chambers. Description of Soil Loamy sand to medium coarse sandd Nature of Repairs or Alterations(Answer when applicable) Adding two 500 gallon chambers packed in 4 ' of stone. To the existing septic system. 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 Wdntto place the system in operation until aCertifi- cate of Compliance has been issu d by this andrealt rSigne Date 2 17 19 9 Application Approved b Date Z// Application Disapprove for the following reasons ¢ Permit No. / — 7 S_' , f Date Issued Z `/F--�9 7 R f, --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (tompliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired X X )Upgraded( ) Abandoned(/ )by ,J. P.Maramhar X Son Tnr _ at 126 S h e a f f e r Road C E n t e r y i l l a ,Mass has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer J.P.Macomber & Son Inc. Designer J.P.Macomber & Son Inc. The issuance of this pe `d shall no be.construed as a guarantee that the sA ill function as des .l'bd.© Date L�I Inspector' . ,� s ---9 "— ------------------------------ ----- No. / — Z_�— Fee 50.00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mi5pogar *pgtem Construction Permit Permission is hereby granted to Construct( )Repair(X X)Upgrade( )Abandon( ) Systemlocatedat 136 Sheaffer Road 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 bcey completed within three years of the date of this permit. Date: Z./���/ / Approved by 1/6/99 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) ✓� .�hA hereby certify.that the application for disposal works construction permit signed by me dated v��� concerning the property located at 4Wmeets 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. /The 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] b' 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) to B) G.W.Elevation +the MAX. High G.W. Adjustment. 7,l = DIFFERENCE BETWEEN A and B SIGNED : DATE: [Sketc oposed plan of system on back]. q:health folder:cert 1 . c= -� ,�. �.,� � � 0 Ld TOWN OF BARNSTABLE LOCATION lam_ Gk EAj�ls—e, Ron SEWAGE # VILLAGE dcoa p Q,r,j If, ASSESSOR'S MAP & LOT -Oa INSTALLER'S NAME&PHONE NO._ M A eo e»,6 t,4- 1)1 s, 3� SEPTIC TANK CAPACITY Jekonn LEACHING FACILITY: (type) ik,3r G�;F-[(S (size) NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: COMPLIANCE DATE: L Separation Distance Between the: l 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 i - rr Pr. \ Brewster No...... .... Fin$.....��......... .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable .................. o F.......................I............. -- ....................... Appli ation for Bigposal Vorks Tons#rudion Vantit Application is hereby made for a Permit to Construct ( } or Repair ( ) an Individual Sewage Disposal System at: \$b ...................Center.Y. iie................................................ ..�o ...........111 S......r,-Drive.................................. Norme$t L O&S drfs . Lot °'Ashley Drive.-.ten erville .......................•---•---..................................................................- -----•----•--••..................... w James Dollowa Five Corners R( ,'. edenteriville a -------------- y ..--• --•-...........---------..a...--•- ---•-•----••......--......-•-..-•-•-- Installer Address UType of Building 3 Size Lot..1.5-OOQ........Sq. feet Dwelling—No. of Bedroo s............................................Expansion Attic ( ) Garbage Grinder ( ) a Other—Type of Building.-story wd of persons.......................... Showers ( ) — Cafeteria ( ) G4 Other fixtures -••-•--••----------•••--•--••• -• • •- W Design Flow............................................gallons per person per day. Total daily flow......._.......NP....................gallons. WSeptic Tank—Liquid capacity_./iO.gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... W6i8 p�e.._ Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter..........OWDepth below inlet.................... Total leaching areal02.........sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ ,-4 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ CX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.......-__-_--_______- P' .-•--•------------------•-•-----•••-•............-•-•----•---------......--•••----•-........................................................................... O Description of Soil SaY1C1•& gravel V@1-••••---•-----------------------•--••••••-•--••--•-•-••-••••-••-•--•--•--••-••............... W UNature of Repairs or Alterations—Answer when applicable................................................................................................ ..--••-•-•---------------------•-•---•••-----•-••-•-•-••.........---•••--•--•••--•••--------..........-•-•-••-••------------•-••----••••••••---••-•----•---••••••-••---•-••--•••---•.....-•--•-......_.. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Cod The undersi ed further agrees not to place the system in operation until a Certificate of Compliance has been ed by th oar of h. f Sign .............. ................. . . . .•• ..........�-... ..fl..'4?. . I ' ,,� Date Application Approved By... ... -••-• FVl- crr 7- ����■e� �/ Da e Application Disapproved for the following reasons-------------------------------------------------------------•-------------------.................-•-•----------- ..........................................--....•-------••-••-•-••-•----•-••••-••------••-•••-•-•----•----••---••--•-•------•-•-•-----•----••-------••-•-------•------•--.......-•-........•-•.......-- Date PermitNo......................................................... Issued........................................................ Date Drewster t THE COPAMONWEALTH<OF MASSACHUSETTS BOARD `OF HEALTH` Torn . barns table ..........:..... .................... .F.......i.............................._,....................------------....------------ Appliration for Disposal darks.tot0trurtion Permit Application is hereby made for a Permit to Construct (' ) or_Repair (. ) an Individual ,Sewage Disposal System at ................ .. $ �A".'...�3 ........................................... ...Lot...131...101haaf f ar..Dry vdL...............:.:............. ...•., Lo tion-Address o Lot No. ...............�I4��J.e .. S a s... c.1........................... ...A.shl.ey.� jY e .:.:...,.:.............. 14 Owner Address � Installer Address U Type of Building Size Lot... 159M.......Sq. feet L—I Dwelling—No. of Bedrooms..........:......3......................... Attic ( ) ' Garbage Grinder ( ) WOther—Type of Building 1...St0;m,'..W4 TV of persons......E1................... Showers ( ) — Cafeteria ( ) Otherfixtures :...................... .. .----•--------- -----------••••--•----••-•--•--••........--•-•• •--------•- •----------- W Design Flow............................................gallons per person per day. Total daily flow...............3Q ...........:._gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench ' No..................... Wit Total Length..................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter...........Agrepth below inlet.................... Total leaching area.302..........sq. ft. z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by,..-------------•-.....- ;,......------------- .---•--......••.--••-- Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-.--------_-_--_-_-__--. G� Test Pit No., 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •-------------- --------•-----------.--------------.---•--.........---•--...................... ... -.......... -....... •.......................... ........ S r Description of Soil and & age....................grave ••-----•----•--•••--•-••------•-••--•-•---•---•------•-•••-----------. ---- V .....................i................................................................................................................................................................................. W -------------------------------------------------------------------- ---•------------••---..................---------------------•-••------------- ---------•--•-••--••-••--------•--.......--------_.. U Nature of Repairs or Alterations—Answer when applicable................................................................................................ ...............................•-----••-•--•-•--•------------------------------....------------...------------------------------------......•••..-_._.. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed .----•---.......-•-•....................•--:-....----••......-••-•--•--•-••• ................................ •Date Application Approved By.... .••' .4 ✓.................... r `• Application Disapproved for the,following reasons:.. .............................•----•-•--...__._.Da(e ., .. • ...................................................................................................................._..... Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town terns ta.bl<e ..........................................OF..................................................................................... f9rr#ifutttle of TompliFnur THIS IS TO CERTIFY, T�aatt 8S Indwidual Sewage Disposal System constructed ( ) or Repaired ( ) b 1.+ l Y ---------------•---•-------..... ----------...------•-----------------..........----------......._...--•-----••-•......---•--.......... Lot 131 Shaeffeilns%lq Centerville at............................................................................. -- --------- ------ -•----.....----•-------------•----••-------•---•---••••--------•---••-•---••---•-•-• has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No-------------------- --_- dated....... •. ?__ __ %. :...._. THE ISSUANCE OF THIS CERTIFICATE,.SHALL NOT BE CONST UED AS.A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ' DATE......................................................................... Inspector......... -.:./fit- -.....:...:...... 0 ............ THE COMMONWEALTH OF MASSACHUSETTS ,BOARD OF HEALTH Town Barnstable No...... .. ..../.. FEE.. Dispinal Marko Tonotrttrtion "[rrtnit ames Dolloway Permission is hereby granted.............. .......... •... -.....-•--••••••-------•-------••--•.............. to Construct ( ) `or Repair J0E tjnd c��&g#ge ;p Ag 3%lle at No............. . ...................... ............................_ .. ..... .......... ........ ....... .... ..... ..... • Street F �f ,/. as shown on the application for Disposal Works Construction Perri •t-,, 0.. 1 .. ated........{ /.... .....;;. Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS