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Home My WebLink About0004 CENTERBROOK LANE - Health (3) 51 NOTTINGHAM DR. CENTERVILLE A = 172 250 J�gECYC(Fp�a2 /N p z z UPC 12534 �a No.22�1533L�OR k°osrcoNS°� HAS71NGS.MU I fii No. ��'cb- �• Fee J D THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprtcatton for Mt.5pool *pztem Con!tructton Permit, plication for a Permit to Construct( . )Repair(X )Upgrade( )Abandon( ) 0 Complete System 0 Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. / QQ Nottingham Dr. , Centerville Dave Silva Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Service PO Box 1089, Centerville 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) Title-5 leach system consisting of a ID-hax and 2 Oon6r®tA leaGzti-r-Erhamberg—y'vith stone all around _ 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 this/�Board of Health. /� Signed _,4 u�t e..:..., Date;//1 d'.G. Application Approved by Date:2*-(12-w Application Disapproved for We folio mg reasons r®, - Permit No. 2&2�2 - Y:�.� Date Issued i ———————————----------------------------- No. Fee 5 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes UBUC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 0[ppYication for 30izpoml *p! tem Construction Vermit Application for a Permit to Construct( )Repair(X )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components L�,ationAOdtr�Y1 Main Dr. Owner's Name,Address and Tel.No. 11 t1Vv g � Centerville Dave Silva Assessor's Map/Parcel Installer's Name Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. 'Robinson Septic Service PO Box 1089, Centerville 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. EA" Description of Soil Sand w Nature of Repairs or Alterations(Answer when applicable) T ltle-5 leach system consisting Of a D-box and 2 concrete leach chambers with stone all around.. 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 W�s �and of Ijealth. Signed AV L Date Application Approved by �ts-+-'- - -. ,M "" Date 7" Application Disapproved for the following reasons 'Permit No. dt 7 Date Issued f� ——————————————.————————————t———————————— THE COMMONWEALTH OF MASSACHUSETTS. Silva BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO RTI�,that the,On-site S wa a Ibis osal System Constructed( )Repaired (X )Upgraded( ) Abandoned( )by me �' xobl.nson % tl.cp Service at 51 Nottingham Dr. Centerville has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. - 2 7 dated 7— Installer Wm- E. Robinson S r. Designer The issuanc, o this P hall not,.- -construed as a guarantee that the 4t '11 functio a d Ins Date zoo Inspecto ' ` --- -- -------------------------- -- 50 No. Fee $ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Silva '=igpo!6al *pgtem Construction Vermit - Permission is hereby granted to Construct( )Repair(X )Upgrade( )Abandon( ) System located at 51 Nottingham Dr. , Centerville 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 his permit. Date: 7- 1 7- 00 Approved by ' �• v it 1 t/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(W=OUT DESIGNED PLANS) I, William E. Robinson,5�Iweby certify that the application for disposal works construction permit signed by me dated �"`U 1 , concerning the property located at 51 Nottingham Dr . , Centerville meets all of the following criteria: • failed system is connected to a residential dwelling only. There are no commercial or business // uses V aced with the dwelling e oil is classified as CLASS I and the percolation rate is less than or equal to S minutes per inch. ere are no wetlands within 100 feet of the proposed septic system — - ere are no private wells within 150 feet of the proposed septic systen) ere is no increase in flow and/or change in use proposed . There are no variances requested or needed. e bottom of the proposed leaching facility will nee be located less than five feet above the maximum adjusted groundwater table elevation.f Adjust the groundwater table using the Frimptor method when applicablel If the S.A.S.will be located with 250 feet o1 any vegetated wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(1.1)feet above the maximum adjusted groundwater table elevation, Please complete the following: A To of Ground Surface Elevation(using GIS inf p t g ortnauon) ��11,, /310 B) G.W.Elevation +the MAX High G.W. Adjustment. = DIFFERENCE BETWEEN A and B s SIGNED DATE: {Sketch proposed plan of system on back). y:health folde cen G-1 C2 J V TOWN OF BARNSTABLE LOCATION �J JXd SEWAGE #64-tr" VILLAGE ASSESSOR'S MAP & INSTALLER'S NAME&PHONE NO. 16 N,$,r 1— '?? 5— ?-7-7 r~ SEPTIC TANK CAPACITY Z0-0-0 LEACHING FACILITY: (type) (size) �' o�� •)NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of aching Facility Feet Private Water Supply Well and Leaching Facility any wells exist on site or within 200 feet of leaching facility Feet Edge of Wetland and Leaching Facility (If wetlands exist within 300 feet of leaching fa Furnished by 1 li 1 Cd 4J 3G � 1 � OF BA.RNSTABLE LOCATION �b �'" �7 jD`'�` h SEWAGE #64-a �� VILLAGE ASSESSOR'S MAP & LOT/ - 2' INSTALLER'S NAME&PHONE NO. +��b a Z SEPTIC TANK CAPACITY Z&,Co - LEACHING FACILITY: (type) L 4— (size) IX NO. OF BEDROOMS BUILDER-OR.OWNER 01 y h PERMITDATE: COMPLIANCE DATE: �'" ►�`Q'U Separation Distance Between the: Maximum Adjusted-Groundwater Table to the Bottom of aching Facility Feet Private Water Supply Well and Leaching Facility any wells exist on site or within 200 feet of leaching facility Feet Edge of Wetland and Leaching Facility(If wetlands exist within 300 feet of leaching fa ) X Feet Furnished by ____ �� _. r c '�,..�=, - � � W � � G,r►� I � £ e (' rj,�.� j !� .. �, �, / � / LOCATION SEWAGE PERMIT NO. 1r'ILLAGE c. �.�INSTALIER'S NAME i ADDRESS BUILDER OR OWN ER d Ge�,�eSVLI�' DATE PERMIT ISSUED DAT E C 0 M P L I A N C E ISSUED �L_)s _05 l .J J l C 1 r1ief i . .c I'� Ive,