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Home My WebLink About0213 LAKESIDE DRIVE WEST - Health 71�213 Lakeside Drive , CentervilLQ A = 232 062 I� TOWN OF BARNSTABLE `+ LOCATIONC� /3 40 .// !N SEWACE # 7S !f VILLAGE-t" .11f LL E ASSESSOR'S MAP 6 LOT INSTALLER'S NAME & PHONE NO. 62dzwwN �Gfr SEPTIC TANK CAPACITY, LEACHING FACILITY:(type) (sire) xt NO. OF BEDROOMS _PRIVATE WELL OR ((JBLIC, BUILDER OR OWNER DATE PERMIT ISSUED:� DATE COMPLIANCE ISSUED: 7 16 ✓!7-7 2,�RIANCE GRANTED: Yes No 33 ' � � � �t�K� ID�d� . 1/� 7- i 3 � 0 No.....` ... � Fss.. .... .Q....Q.Q.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appfiration for Diti-Vniial Wor1w (nl mitrurfinrt run it Application is hereby made fora Permit to Construct ( ) or RepairXkX) an Individual Sewage Disposal System at: 21.3....L.akea lde...Dri�re��rati rmille.............. .............................................................................•----•---...----•-... Location-Address or Lot No. LindaCrtorl-------••-••----•-••-•---•--•----------------•--•••----------••-- --••••---•----------•------•••-•-••--••---••-•-------•-----••••--•••--••-----.........•...--•-•--- W J.P.Macomber Jr. Owner Address Installer Address UType of Building Size Lot............................Sq. feet Dwelli4X-XNo, of Bedrooms-------------3---------------------------.-Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building --------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) p-' 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 ( ) W Percolation Test Results Performed by-------- -------- --------------•-•--------------•---•---------------- Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit_----------------- Depth to ground water--_---.---___--__--_-. W -----•--•-------------------------------••--------------••-•-----...-----•-•---••-•-......--•---••-••-•••--••----•-•....................... .••--•------.---- Descriptionof Soil.....Sand...&...Gxavel....-•---------•.............••-•••-------•---.----•-•----•••-•----------•••-------•.....•-••-•----•-••-••----................ x U W UNature of Repairs or Alterations—Answer when applicable.-Omit---ces-s-pools._-__Install....1,150.0.._gallon tank...1_-distributian_.b_ox...A...infiltratnrs...packed---in.--s tuna_........................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the ed the b Ord of health. Y system In operation until a Certificate o om lance as e n i su �� Y PP Signed ...... .. .. . .... ... .............................. .. .... 3./1.6./.9-5----------- Date Application Approved B -- - --------- - ------------------------- � - — PP PP Y ................. llare Application Disapproved for the following -------- reasons: ----------------------------------------------------------------------------------------- -------- ----------------------_.................----------------------------------%�-✓----...................._... ---------------------------- -------------...---------------------------------- -------------------------------------- Permit No. � Issued - � ....1.2... Dare No..��''F�._.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Apphratiou for Uit.-ilinattl Wor1w Tomitrnrtinn runfit Application is hereby made for a Permit to Construct ( ) or RepairXkX) an Individual Sewage Disposal ,. System at: �L�� ' 21.3...I,. lk s_i�? :...? r isr ._ nt.arv"'lle.............' •--•----•---------------------------•....--•---•--•--------------....---------------------------•- Location-Address - or lot No. Linda Carton ......................------•---....................................•-----...................... -••-•---------------•--------------••-•-••-••--•-----...••-•----.....---•-•------.....-------•-- Owner Address W J.P.Macomber Jr. r Installer Address Q Type of Building Size Lot............................Sq. feet DwellingxuNo. of Bedrooms............3�_____________________-_-__Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons-_-..-_-._____-________._. Showers ( ) — Cafeteria ( ) Q Other fixtures -_--------------------- ---------------------------- W Design Flow............................................gallons per person per day. Total daily flow------------------ W Septic 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 ( ) 1.4 Percolation Test Results Performed by-------------------------------------------------------------------------- Date........................................ Test Pit No. I----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water__._....._.-_-_____-._.. Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ a -----------------------------------------------------------------------------------------•-•--------•-------------•-----..._..... ---.....----.......... D Description of Soil...._.San ...&...Cra��e-1••----•-------•-•-••-•-•••---••--•--------------------------••------------•-•----.........._...---•-•-•-•--••-••..........---- x U -------------------- ------•-------------------------•---......---•-•-•-----••--••------------•----•-------•------------•--••---•-----•-----•--••--•-------............................................ UNature of Repairs or Alterations—Answer when applicable.O.m k_..Ce.5-59-001..$-.____Tna-tall---1_.-1.aQQ...gallon tank---1---d.iatri,bu.ti.an••-k�ox....4....inti1tma.tor6---aaoked...in---stone-............................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with ' the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be n i sue d y the b and f health., Y P P _...._Signed -------- -- ................... ......(/1 ..... ...3.1.1..6.�.9.`�.....:..... Application.Approved BY ---- --------- ---------------- .- ... ....................................-.. Dace Application Disapproved for the following reasons: ---------------------- - .....................-----------------...._...----------------------------_-- ....... ................................................—...-.�.................... .. ............ ............ ................... .......... . ........ ........_- ---------------------------------------- Permit No. .. .....' .............. .... Issued ......- �6 .................Dace ..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE CIlex#ifi a e of C�nmpliance THIS IS TO CERTIFY, That the Individual Sewa e Di posal System constructed ( ) or Repaired (XXX)X by - --- -1411-IIA--- -- - . at .21..3...Lakeside Dr1VP....Centervil.le..------.._-------------------------------------- _--------'---...-------.._,......----------------------------- - ---------------------------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No2,�... '-.. �j�.. dated -- - � 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 C TOWN OF, BARNSTABLE FEE ••30..00 Uiiploal Nara Tanatrur#uan "rrmit Permission is hereby granted `..�....Macomber Jr. to Construct ( ) or Repair)(X�Xan Individual Sewage Disposal System at-No.21 3 Lakeside Drive Centerville - - - - - --------------------------------------------•..-------------------------------------•-----•----••-•-- str as shown on the application for Disposal Works Construction Per `.__1��7�__ Dated.. ----- ......."...... � DATE.......cam........ - ----'-4-. e j.1-_.-•-•--_---- Board of Health FORM 36508 HOBBS 6 WARREN,INC..PUBLISHERS CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) , I, Gl. � U� , hereby certify that the application for disposal works construction permit signed by me dated�'2v 9 concerning the property located at 41ZE51� � �rL/c'��' meets all of the following criteria: • There are no wetlands within 300 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system • The observed groundwater table is 14 feet or greater below the bottom of the leaching facility V • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. i SIGNED: L '� DATE: I LICENSED 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]. jl v JJ Ll U-60 (,�(a'` TOWN OF BARNSTABLE LOCATION -- SEWAGE VILLAGE ASSESSOR,'S MAP 6r LOT 2 J� 4� f 114STALLER'S NAME PHONE NO. ► SEPTIC TANK CAPACITY j LEACHING FACILITY:(type) � (size) J NO: OF BEDROOMS_ '3 _PRIVATE WELL OR UBLIC WATER f .. BUILDER OR OWNER DA.T.E:.:PERMIT ISSUED: DATE COMPLIANCE ISSUED: ? r a k VARIANCE GRANTED: Yes No i � 71�213 Lakeside Drive , CentervilLQ A = 232 062 I� TOWN OF BARNSTABLE `+ LOCATIONC� /3 40 .// !N SEWACE # 7S !f VILLAGE-t" .11f LL E ASSESSOR'S MAP 6 LOT INSTALLER'S NAME & PHONE NO. 62dzwwN �Gfr SEPTIC TANK CAPACITY, LEACHING FACILITY:(type) (sire) xt NO. OF BEDROOMS _PRIVATE WELL OR ((JBLIC, BUILDER OR OWNER DATE PERMIT ISSUED:� DATE COMPLIANCE ISSUED: 7 16 ✓!7-7 2,�RIANCE GRANTED: Yes No 33 ' � � � �t�K� ID�d� . 1/� 7- i 3 � 0 No.....` ... � Fss.. .... .Q....Q.Q.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appfiration for Diti-Vniial Wor1w (nl mitrurfinrt run it Application is hereby made fora Permit to Construct ( ) or RepairXkX) an Individual Sewage Disposal System at: 21.3....L.akea lde...Dri�re��rati rmille.............. .............................................................................•----•---...----•-... Location-Address or Lot No. LindaCrtorl-------••-••----•-••-•---•--•----------------•--•••----------••-- --••••---•----------•------•••-•-••--••---••-•-------•-----••••--•••--••-----.........•...--•-•--- W J.P.Macomber Jr. Owner Address Installer Address UType of Building Size Lot............................Sq. feet Dwelli4X-XNo, of Bedrooms-------------3---------------------------.-Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building --------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) p-' 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 ( ) W Percolation Test Results Performed by-------- -------- --------------•-•--------------•---•---------------- Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit_----------------- Depth to ground water--_---.---___--__--_-. W -----•--•-------------------------------••--------------••-•-----...-----•-•---••-•-......--•---••-••-•••--••----•-•....................... .••--•------.---- Descriptionof Soil.....Sand...&...Gxavel....-•---------•.............••-•••-------•---.----•-•----•••-•----------•••-------•.....•-••-•----•-••-••----................ x U W UNature of Repairs or Alterations—Answer when applicable.-Omit---ces-s-pools._-__Install....1,150.0.._gallon tank...1_-distributian_.b_ox...A...infiltratnrs...packed---in.--s tuna_........................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the ed the b Ord of health. Y system In operation until a Certificate o om lance as e n i su �� Y PP Signed ...... .. .. . .... ... .............................. .. .... 3./1.6./.9-5----------- Date Application Approved B -- - --------- - ------------------------- � - — PP PP Y ................. llare Application Disapproved for the following -------- reasons: ----------------------------------------------------------------------------------------- -------- ----------------------_.................----------------------------------%�-✓----...................._... ---------------------------- -------------...---------------------------------- -------------------------------------- Permit No. � Issued - � ....1.2... Dare No..��''F�._.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Apphratiou for Uit.-ilinattl Wor1w Tomitrnrtinn runfit Application is hereby made for a Permit to Construct ( ) or RepairXkX) an Individual Sewage Disposal ,. System at: �L�� ' 21.3...I,. lk s_i�? :...? r isr ._ nt.arv"'lle.............' •--•----•---------------------------•....--•---•--•--------------....---------------------------•- Location-Address - or lot No. Linda Carton ......................------•---....................................•-----...................... -••-•---------------•--------------••-•-••-••--•-----...••-•----.....---•-•------.....-------•-- Owner Address W J.P.Macomber Jr. r Installer Address Q Type of Building Size Lot............................Sq. feet DwellingxuNo. of Bedrooms............3�_____________________-_-__Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons-_-..-_-._____-________._. Showers ( ) — Cafeteria ( ) Q Other fixtures -_--------------------- ---------------------------- W Design Flow............................................gallons per person per day. Total daily flow------------------ W Septic 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 ( ) 1.4 Percolation Test Results Performed by-------------------------------------------------------------------------- Date........................................ Test Pit No. I----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water__._....._.-_-_____-._.. Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ a -----------------------------------------------------------------------------------------•-•--------•-------------•-----..._..... ---.....----.......... D Description of Soil...._.San ...&...Cra��e-1••----•-------•-•-••-•-•••---••--•--------------------------••------------•-•----.........._...---•-•-•-•--••-••..........---- x U -------------------- ------•-------------------------•---......---•-•-•-----••--••------------•----•-------•------------•--••---•-----•-----•--••--•-------............................................ UNature of Repairs or Alterations—Answer when applicable.O.m k_..Ce.5-59-001..$-.____Tna-tall---1_.-1.aQQ...gallon tank---1---d.iatri,bu.ti.an••-k�ox....4....inti1tma.tor6---aaoked...in---stone-............................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with ' the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be n i sue d y the b and f health., Y P P _...._Signed -------- -- ................... ......(/1 ..... ...3.1.1..6.�.9.`�.....:..... Application.Approved BY ---- --------- ---------------- .- ... ....................................-.. Dace Application Disapproved for the following reasons: ---------------------- - .....................-----------------...._...----------------------------_-- ....... ................................................—...-.�.................... .. ............ ............ ................... .......... . ........ ........_- ---------------------------------------- Permit No. .. .....' .............. .... Issued ......- �6 .................Dace ..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE CIlex#ifi a e of C�nmpliance THIS IS TO CERTIFY, That the Individual Sewa e Di posal System constructed ( ) or Repaired (XXX)X by - --- -1411-IIA--- -- - . at .21..3...Lakeside Dr1VP....Centervil.le..------.._-------------------------------------- _--------'---...-------.._,......----------------------------- - ---------------------------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No2,�... '-.. �j�.. dated -- - � 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 C TOWN OF, BARNSTABLE FEE ••30..00 Uiiploal Nara Tanatrur#uan "rrmit Permission is hereby granted `..�....Macomber Jr. to Construct ( ) or Repair)(X�Xan Individual Sewage Disposal System at-No.21 3 Lakeside Drive Centerville - - - - - --------------------------------------------•..-------------------------------------•-----•----••-•-- str as shown on the application for Disposal Works Construction Per `.__1��7�__ Dated.. ----- ......."...... � DATE.......cam........ - ----'-4-. e j.1-_.-•-•--_---- Board of Health FORM 36508 HOBBS 6 WARREN,INC..PUBLISHERS CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) , I, Gl. � U� , hereby certify that the application for disposal works construction permit signed by me dated�'2v 9 concerning the property located at 41ZE51� � �rL/c'��' meets all of the following criteria: • There are no wetlands within 300 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system • The observed groundwater table is 14 feet or greater below the bottom of the leaching facility V • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. i SIGNED: L '� DATE: I LICENSED 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]. jl v JJ Ll U-60 (,�(a'` TOWN OF BARNSTABLE LOCATION -- SEWAGE VILLAGE ASSESSOR,'S MAP 6r LOT 2 J� 4� f 114STALLER'S NAME PHONE NO. ► SEPTIC TANK CAPACITY j LEACHING FACILITY:(type) � (size) J NO: OF BEDROOMS_ '3 _PRIVATE WELL OR UBLIC WATER f .. BUILDER OR OWNER DA.T.E:.:PERMIT ISSUED: DATE COMPLIANCE ISSUED: ? r a k VARIANCE GRANTED: Yes No i �