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HomeMy WebLinkAbout0549 STRAWBERRY HILL ROAD - Health 549 STRAWBERRY HILL RD.,CENTERVILLE A=249.012 E k QECrt[Fp Sill ,� `°ti„ o llll UPC 12543 o- No. 53LOR o�°p57•C00" HASTINGS, MN i� No. Fee$ 5 0. 0 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: • � Yes PUBLIC:HEALTH DIVISION -TOWN OF BARNSTABLE. MASSACHUSETTS " 0[ppYfcatifon for ]Di5pogal bpgtem Con5tructfon Permit Application for a Permit to Construct( )Repair(X 4 Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.5 4 9 Strawberry Hill Owner's Name,Address and Tel.No. Road . Centerville ,Mass . 02632 Elizabeth Marshall Assessor's Map/Parcel Gy Q /c� 549 Strawberry Hill Road Installer's Name,Address,and Tel.No. 5 0 8—7 7 5—3 3 3 8 esigner s ame, drests an e.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 X X No.of Bedrooms 2 Lot Size sq. ft. Garbage GrinderX X ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 330 gallons per day. Calculated daily flow 3 x 110 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Loamy sand to medium fine sand . Nature of Repairs or Alterations(Answer when applicable)R e p 1 a c i n)z c a v e d i n c e s s p o o l . 1-1500 gallon tank .. 1—Distribution box , 2-500 gallon chambers packed in four Feet-of stone . Date last inspected: 1 2112 /a2 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 th and Healy . Signed Date 12/2 3/9 8 Application Approved by _ Date 1 Z Z 3 Application Disapproved for the following reasons Permit No. ' 107D i Date Issued I Z Z 3 9 TOWN OF BARNSTABLE LOCATION c y 9 S W 6e4 arc'�e #/CL X09 SEWAGE # O VILLAGE h Y A AI-Al/ S ASSESSOR'S MAP & LOT -d INSTALLER'S NAME&PHONE NO. J-/f IM 4 C O l'! elf -V s d,e SEPTIC TANK CAPACITY _4.-:Co- D LEACHING FACILITY: (type) .2- FZOcyCA/AA/:°et;2 (size) <S 60 NO.OF BEDROOMS ;L BUILDER OR OWNER PERMITDATE: l :1 -'L-% -QSl 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 y t . .e No. -/? , .. Fee $ 50. 00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 0[pplication for M-4pogal *pztem Construction Permit Application for a Permit to Construct( )Repair(X Wpgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.5 4 9 Strawberry Hill Owner's Name,Address and Tel.No. Road . Centervittle ,Mass. 60032 Elizabeth Marshall i Assessor's Map/Parcel © /o� 549 Strawberry Hill Road it Installer's Name,Address,and Tel.No. 5 0 8—7 7 5—3 3 3 8 Designer's Name,Addressland TV IVo. J.P.Macomber & Son Inc . J.P.Macomber & Son Inc . Box 66 Centerville ,Mass . 02632 Box 66 Centerville ,Mass . 02632 Type of Building: Dwelling XXNo.of Bedrooms 2 Lot Size sq. ft. Garbage Grinder�X ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures t Design Flow 330 gallons per day. Calculated daily flow` 3 x 11''0 gallons. Plan Date Number of sheets Revision Date.- Title t ` Size of Septic Tank Type of S.A.S. Description of Soil Loamy sand to medium fine sand . z Nature of Repairs or Alterations(Answer when applicable)Replacing caved in cesspool. 1-1500. gallon tank] 1=Distrubution box, 2-500 gallon chambers packed i in four- feet of stone. Date last inspected: 2/2 2/0 a 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 the `EWard,,oHe_al Signed Gr Date 12/2 3/9 8 Application Approved by Date /ZZZ7,SZ9 Application_Disapproved for the following reasons Permit No. _ to ` Date Issued 2 Z 3 9 --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired(XX)Upgraded( ) Abandoned( )by J.P.Macomber & Son Inc . j at 5.49,.,Strawberry Hill Road Centerrille ,Mass . 02632 has been constructed in accordance / with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer J•P.Ma,comber & SoptnInc Designer J.P.IIacomber & Son Inc . The issuance of this permit shall not be construed as a guarantee that the systenp will function as designed. Date _ - Inspectors No. 9� --------------------------Fee$ 50. 00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS 1=i5Po.5a1 *pg;tem Conotruction Permit Permission is hereby granted to Construct( - )Repair(X�Upgrade( )Abandon( ) Systemlocatedat 549 Strawberry HIll Road Centerville ,Mass . a 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 pe t. � s Date: Zl?3/9� Approved by C Q l or9197 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) l,' J.P.Macomber Jr . , hereby certify that the application for disposal works construction permit signed by me dated 12/23/98 , conceming the property located at 549 Strawberry u; i i Rd rcnror.,; A , meets all of the 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 V There is no increase in now and/or change in use proposed V 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 II4!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 Elevation(according to Health Division well map) _ SIGNED DATE: LIC SEPTIC 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:een r �-o-�� -� TOWN OF BARNSTABLE !� LOCATION 72 W ri e A'X 62' Z X Q SEWAGE# o- x VILLAGE / S ( C ASSESSOR'S MAP&LOT -•Q INSTALLER'S NAME&PHONE NO. A4 A C 0A /9 elf 4' s a c/ SEPTIC TANK CAPACITY 4-00 O LEACHING FACILITY: (type) ,',- ,rZ0a1e'11AA,6efV (size) L�GQ" NO.OF BEDROOMS . BUILDER OR OWNER PERMTTDATE: COMPLIANCE DATE: l a-219 -79' 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 � � �� , � � .. e ���• `� � e s ,, �, - . �I�e�a�®�' - - - `' i ��