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Home My WebLink About0451 SOUTH MAIN STREET - Health 451 SOUTH MAIN ST., CENTERVILI `,• UPC 12543 �a No+ 5_ 3�� HASTINGS, MN 'TOWN OF BARNSTABLE LOCATION L��3 ✓fie /i/�i y" 5 SEWAGE # �� VILLAGE J ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. 70 6 d ,4 j` 7 9 ? SEPTIC TANK CAPACITY 6-c� ~/ D GL� S LEACHING FACILITY: (type) (s i ze) NO.OF BEDROOMS BUILDER'OR OWNER,��./� �— s PERMIT DATE: /J 7?4 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 'j.. 1 1 ) b eti�'' No. $ T3b Fee$50. 00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pplication for rhgogal *pgtem COnmruction Permit Application for a Permit to Construct( )Repair(xX)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 451 S Main St Owner's Name,Address and Tel.No. 7 7 5—8 9 5 8 Assessor's Map/Parcel Centerville Steven Aiken PO Box 2938 Ha nnis MA 02601 Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. W E Robinson Septic Service PO Box 1089 , Centerville, MA 02632 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(no) 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) Title 5 Leaching consisting of a D-Box and three precast 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 iss d by t '�of Signed n j _ Date Application Approved by Date :57- Application Disapproved fo a fo owing reasons PM Permit No. 73 O - Date Issued ~ �eMn,...w»�� ;.4.... s.„.�... . ... „ .-.. .. ._. -,. �. ..i..... „_ „ _. a- �..+'•� _,..y,�_;# ...:k` ire..:.; 0`7 No. - 30 7 Fee$50.00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pprication for Mioogar *pmpm Construction permit Application for a Permit to Construct( )Repair�KX)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 451 S Main St Owner's Name,Address and Tel.No. 7 7 5_8 9 5 8 Assessor's 1vIap/Pazcel Centerville Steven Aiken; PO Box 2938 Ha nnis MA 02601 Installer's Name,Address,and Tel.No. 7 7 5—,8 7 7 6 Designer's Name,Address and Tel.No. W E Robinson Septic Service PO Box 1089, Centerville, MA 02632 Type of Building:, Dwelling . No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(no) Other Type of Building N2�5 Je6onQ ,f Showers( ) Cafeteria( ) Other Fixtures V 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) T4tle 5 Leaching consisting of a D-Box and three precast leach chambtbws. z f a E� Date last inspected: Agreement: The undersigned agrees to ensure the cons uctiopp and'aintenance o e afore described on-site sewage disposal system in accordance with the provisions of Title 5 Pf a Environmental Code not to place the system in operation until a Certifi- cate of Compliance has been issged b s d 3f'I� 1 Signed ' Date t Application Approved by (J�,..... � �....... :� Date _ _Application Disapproved fot'the following reasons 4 ^' Permit No. VV d —7 o Date,I`sye�� t /1i/ i TH CO MQNWEAL OF MASSACHUSETTS /BARN[SUME,CMASSACHUSETTS 1 ' Aiken Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( ) Repaired (KX)Upgraded( ) Abandoned( )by at 451 S Main St, Centerville has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.2,5-30 7 dated Installer W E Robinson Septic SrV Designer The issuance of this ermit shall nb construed as a guarantee that the syst 11 function as designed. Date Inspector oZ ------------ No. Fee$50.00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Aiken ligogal *pgtem Construction Vermit Permission is hereby granted to Construct( )Repair(xx)Upgrade( )Abandon( ) System located at 451 S Main St Centerville Install&r: W E Robinson Septic Service w 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: S Approved by 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, William E. Robinson, Sr. ,hereby certify that the application for disposal works construction permit signed by me dated S�!�`!� concerning the property located at 451 So Main Street, Centerville, meets all of the following criteria: * There are no wetlands 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 propo!,�d. * There are no variances requested or needed. * If the proposed leaching facility will be located with 250 feet of any 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 Elevation(according to the Engineering Division G.I.S. map) B)Observed Groundwater Table Evaluation(according to Health Division well map) SIGNED: DATE /9— LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER 20-1998 (Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted). V J O �v �� _ I � � J � � �� .�� ... -- �� t, ,,. vI0 OF BARNSTABLE LOCATION f '�t ��0 r" s SEWAGE # VILLAGE. ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. U SEPTIC TANK CAPACITY �`� _ LEACHING FACILITY: (type) �5 ��'a ,-r (size)/0 NO.OF BEDROOMS . - BUILDER OR OWNER Af et= S PERMTTDATE: �� n 4 COMPLIANCE DATE: <� Separation Distance Between the: Feet Maximum Adjusted Groundwater Table and Bottom of Leaching Facility 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) Furnished by I_ � I