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HomeMy WebLinkAbout0191 SOUTH MAIN STREET - Health 19V'South Main Street Centerville A = 208 081 003 UPC 10259 No. H1630R o_ NASTINQS ON No. Vaal--, r 7;� Fee s THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: - s PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01pprtratton for ]h5poeal *pgtem Con%trurtton Permit Application for a Permit to Construct( )Repair(X )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 191 South Main Stkeet, Centenvitte Roben.t Mettey ssessor's Map/Parcel Same Lot 31 208-081.003 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Raymond W. Catetino, Nonthet.n Paving P 0 Box 995, DenniApont MA 02639 Type of Building: Dwelling No.of Bedrooms 4 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 Nature of Repairs or Alterations(Answer when applicable) Rv .Pn ao P_ gaited teaching pit with T t�e V S. A. S. 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 ed by this Board of Health. Sign- Date 5122101 Application Approved l- Date jam: Application Disapproved for the following reasons \ Permit No. Date Issued 6 TOWN OF BARNSTABLE . LOCATION Z—V /�'1A/,J S"tet-67 SEWAGE #c)G0� 3 70? �4 VILLAGE aQrl- &b6l, ASSESSOR'S MAP & LOT � Uf(1—D0 3 INSTALLER'S NAME&PHONE NO.4Jne62Ee 3 g C?V 7V SEPTIC TANK CAPACITY S '•�' — /o c © rP✓ i ►� LEACHING FACILITY: (type) & Oyi rVc- ��� /3 (size) '%--le c9'' 2- NO.OF BEDROOMS 4" BUILDER OR OWNER PERMIT DATE: 1 3 X i COMPLIANCE DATE: N w 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 71�7 SLi. fTOWN OF BARNSTABLE F LOCATION _�9� S, SEWAGE #o706/ 3 7oZ VILLAGE I� � ASSESSOR'S MAP & LOT Log-lJf�l—00 3 INSTALLER'S NAME&PHONE NO. ealr� �' (572Z), 3gF- "—?Sf 7V SEPTIC TANK CAPACITY 's " �" _ ✓®o° d✓ac,a a JK i LEACHING FACILITY:,(type) ��'-mac- 33'� �� (size) 47-)e 49 2- NO. OF BEDROOMS BUILDER OR OWNER �Y i PERMITDATE: "3 °> COMPLIANCE DATE: 2�3- 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 i within 300 feet of leaching facility) Feet Furnished by &Alt �► Ar4 S �- �i 2,0 � (o Fee `✓ Sri ''•�-� THE,COMMONWEALTH OF MASSACHUSETTS ntered in computer: s v It?UBLIC HEALTH DIVISION;TOWN OFRBARNSTABLES MASSACHUSETTS 1pplication for Migpo!5ar *p,5tem Construction Permit - Q a Application for a Permit to Construct( )Repair(X )Upgrade( )Abandon( )°° ❑:Complete System ❑Individual Components Location Address or Lot No. • Owner's Name,Address and Tel.No. 191 South Main Street, CenteAvit2.e Roben.,t Mette.y Assessor's Ma /Parcel Same Lot 3/ F08-081.003 Installer's Name,Address and Tel No. Designer's Name,Address and Tel.No. Raymond 0. CReA-iao, Nonthen.n Paving P_ 0 Box 995, Denn.uspon..t MA 02639 Type of Building: Dwelling No.of Bedrooms 4 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 Nature of,Repairs or Alterations(Answer when applicable) . ."Reptace jailed teaching pit with T.t tte V S. A. S. Date last inspected: 1 ' 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 issiied by this Board of Health. Signe Date 5122101 Application Approved Date / '' Application Disapproved for the following reasons Permit No..Z? Date Issued .W,0 6 ---------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS ,BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( X)Upgraded( ) Abandoned( )by Nonthenn Seatcoat.i,ng 9 POA i,nq, Inc. at 191 South Main S-tneet Cen.tenviUe has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction o dated Z - /�..�'AFe 0 � Installer Ray Cate,%i,no, NonzheAn Paving Designer The issuance of is pe t shall not be construed as a guarantee that the systemZ 11 function as designed. Date M I)h()`-� ! 1007 Inspector A^'Zli`ny --------------------------------------- Fee` THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS 1=i.qpooa16potem Construction rmtt 1r Permission is hereby granted to Construct( )Repair( X )Upgrade( )Abandon System located at 191 South Main Staeet, Centen.y.itte ' i 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 a t. Date: '� '' C3� Approve � - 5/25/01 NOTICE: This Form,Is To Be Used For the Repair Of Failed Septic Systems Only. PERCOLATION TEST AND SOIL EVALUATION EXEMPTION l FORM hereby certify that the engineered plan signed by me dated '/� , concerning the property located at 151 �1'�tJ's7:� � .N e Ti'"�ra L ut- meets all of the- -- following criteria: his failed system is connected'to a residential dwelling only. There are no commercial or business uses associated with the dwelling. •�e soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes-per inch. The applicant may use historical data to conclude this fact or may conduct preliminary tests at the site without a health agent present. �re is no increase in flow and/or change in use proposed ere are no variances requested or needed. w"The bottom of the proposed leaching facility will not be located less than fourteen (14) feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] Please complete the following: A) Top'of Ground Surface Elevation (using GIS information) S 0 B) G.W. Elevation + adjustment for high G.W. DIFFERENCE BETWEEN A and B 3 SIGNED : DATE: 9 NOTICE Based upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:percexmp it 1 E ; l i f i i �( cJ i �� - f`i'7/3•... J r � `t' �-S Wiz"'. NO' tl i 49 I 1 i I I I I • i } i �� � i I i i •� � s i , I E I ( • r ' I i I� i i i i I ..� i � i /V U�lr� v� .`.v V(,ram' C.0 a�►' .. .er i `/i ✓!.i�,•= _ _ I i + i i I� • P�Ti �O fcJ C�°•�I�� 't _ .I � i � � ;. _ i � I __ ; fir_ f VOCATION SEWAGE PERMIT NO. ILLAGE a �� Po�tr�o 3 izy///:5- INST A LLER'S NAME ADDRESS . 0 U I L D E R OR OWNER DA T E PERMIT ISSU E D DATE COMPLIANCE ISSUED r ;. .� ; �� d `�� � 3 1.�i 3 No.. Fizs.......��d. .`.�...�..�. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH To .......OF............... ... . ............. .. ....................... Apptiration for Diapos al Works Tonstrnrtuan ramit, Application is hereby made for a Permit to Construct ) or Repair ( ) an Individual Sewage Disposal system.a. �� .��............ ,....2 ?� -�Z........... . Location-AddresrYdr o. Own a , ... ...S. C ._-------La _ --6%l--740 . ............ �.......�f. --------- In ler Address --py�� Type of Building Size Lot--- J346---Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type Other fixtures _:-'---------------'-.--_--_ No: of persons............................ Showers ( ) — Cafeteria ( ) W Design Flow............................................gallons per person per day. Total daily flow -- -----••• .................. Design WSeptic Tank—Liquid capacity%eJWgallons 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. Other Distribution box ( ) Dosing tank Percolation Test Results Performed by________________ _----- -._--..-_-- Date........ W Test Pit No. 1....... minutes per inch Depth of Test Pit.................... Depth to ground water-._•---_________•--_-._. Gz, Test Pit No. ? minutes per inch Depth of Test Pit____________________ Depth to ground water........................ W --••--•-•-•••-•--•--•...----•---••............... ----- --------•-- ----•----•-••-•----•--•---•---•-------•-... --------- •-••-•---.----- Description of Soil__... s!�`' �� -----•---•------------------------------------••----------- x U W x ••••••--•-------------------•------••-•---------•••---•-••------•--••••-......--•---••-•---•••-••-----•-•-•-••••----•---•-•••--••••---•-•-••------•-•-•----•-••--•-••--•-•......-••.........--••.....•- 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 7"I1PI.1 5 1 the State Sanitary Code—The�ders rther a not to place the sys em in opeI97 n, it a tiff e Co has been iss cY_ the b' rd o ealt r Signe .--- ••--•• •-•.z�.. r. Date Application Approved By..--------•---- ----.�------• ---..... _ .. -•--•-- -••--•-•--------•-- -••--._-•--•• ��..ZS Date Application Disapproved for the f oll ng reasons:.......................................................... ....... ............ --------•• ................... .......................................__..__._.._........._._.___...._._...._____...._...._.._...___......_.._................. Date PermitNo......................................................... `, . ------------------------ Issued..----------•------------------•--•----------...------- Date ;$?,.s•K' THE COMMONWEALTH OF MASSACHUSETTS BOARD OFr HEALTH Appliration for Disposal Works Tontitrurtton Vautit Application is hereby made for a Permit to Construct ( /) or Repair ( ) an Individual Sewage Disposal System at: ...............� jf.l.! .tf /?.! t:-` `� __ t/ Location-Address 7 r j • e �!..f r�` e �ft�r Lot No Owner> 'A W � t dress I.!soler d Type of Building Size Lot..,-Lot.._;t f,r.....Sq. feet Dwelling—No. of Bedrooms.............. ,, .....................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Buildiii a. yp g ............................ No. of persons............................ Showers ( ) Cafeteria ( ) t1lOther fixtures . . �.s......•------------ W Design Flow............................................gallons per person per day. Total daily flow........................ .....gallons. WSeptic Tank—Liquid capacity.-TM.. allons 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................ ._,-.-- �.-�:IIUI0,R)........... Date........ _.. 1.4 Test Pit No. I................minutes per inch Depth of Test Pit.................:.. Depth to ground water•-_---_________------__. fS, Test Pit No. 2.1 5ominutes per inch Depth of Test Pit.................... Depth to ground water........................ x � �- '------------------------------------------------------------------------------------•'---------......................................................... O Description of Soil.............................................. dj /�---- = U -•-----------------------•-----------•-------------------•--------------.--- 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 TITLL 5 the State S pnitary Code—The dersigg urther agr not to place the system in ope it a C tifi e Com a has been issu the board o ealth,/ r Signe f Date Application Approved B V .............. .............. ate Application Disapproved for the f of ing reasons:----•---------------•---------------'--•---------------•------'----•-••------------•--- ..._.. ......-----•---------'--....-'---------------------------------------------------------•-•-------••-----'•-----------....--------------------•---.................................................... Date PermitNo......................................................... Issued----•------------------------------•'-•--•--••'•---••-- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....................................OF..................................................................................... (9rdifirate of Tuntptiattrr Y t the Individual Sewage Disposal System c nstructed �,}') or Repaired ( ) b .------•-.-------:`. � _,r�.� -G'• ............2Z44J�_ �r a E HIS IS CERTIFY, That . �„ Insta ler Chas been installed in accordance=wifh the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No_____ . dated 1 --- - THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE 7 10 Inspector -- ........ ........................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH c ................ �.. Disposal Works %onstrntr"�n �rrit Permission is hereby granted - _4............................................... to Construct ) or Repair ( ) n Individual Sewa a Dispos ystem atNo. ......... =-----------------•----------------------------------------- - reet as shown on the application-for Disposal Works Construction Permit No Dated.... � iz.......... ............................. ------------------- ----' •---.---------...- Boa ea DATE.......... j'"-It-""c ..✓�` �............................................ = m.. FORM 1255 A. M. SULKIN, INC., BOSTON • -��"'" 0_re *-/Ar .et7WCoT 7N&-5!,=Pr1C 7-AN* AC OR r.0IjVa 4CPtr COP&A-` ' SWA z &,F 9,qpovaie7, To arA Ame. 4 .41O/pE11I VY C-A 5 7- /,VO,,V C 0 V,--.,R' 57,oY,�q,4 i- BE U =,o Z,0 CODERS Al lAl- W'0"rc X8 /,v zwl V�-WA r . co PFR Pl- c5A CAe 4,L Iq 17 sasa mrs 40. IRE2*,LA re R WA 5AY C-0 5 r--, C -0 Affm PT. S4P r/C rA.AW BOX V4 • WASAF0 577,14',6 t 3 7 7 6- pRII r Ssz,-A a e P17 -OR ZVU/60' Zw 4,E A77 S. INY45AT AT OUIZDIN6 q,9,. r 71/ INLET4� . 7WWWLA rJ OA�) P* r.<- r.4)VK 97r'- *r ZP 7/C 7A'N H AT /JVLFTSECTION CROUND ?447�6.Ar 7A6LC say S KS TI L ASA CHIlVa Arr DIHENSIOAl A JCAJ-,- DRS1,drAf, Ciq 17`1 1A Dlxetivslory go 'Fr. "V. A.L� SOIL LO&::. r07I ArSrriA%4-reAD 4-i-aw'- 194 L.IAOA Y SOIL TEST AF/' SOIL.. 7.=S7-,*2 765r 5 T, I- WsAZrrJV ' OA 7',E OF 5.0/,L 7,64 &7. r Lo A2E/�COZ.A rION AA 770.0 1-61�s MJAIIrJVCH -07,4.' ICACHf1Y0. A'qA--AZ�y Sy rt 4PLl1rCO3LA'r16,V RATE 02 7 AREA &AA" 3 9=-/ s �A,'4 of sow r,-,, OF ALBERT :; c, A. MORSE:- A,1.3 as 5t. eat DAR'lepat cat,Ise- - 7. MA 7. AJAJ'IV _v-r_ - Vi • S- - 4-4 _r.:a max4 e 3 k-,. Z P7 7z =-Ka e4 /VTe 14 o jw,✓�3yLn�v ti�\ ,�5 �58 (, s,F, Df t, Sil 0 LSERT. 01 A. � 0. ?S T AV tK 'r/ 7J"z' D S fit/ Y LEGEND_ : F. 4EXISTING - SPOT ELEVATION -: DO �.c„ ... •. I�SISTIN9, CONTOUR 4-- p_ -- 'r ,.1 CERTIFIED _ PLOT PLAN' nN1SHED SPOT ELEVATION ; ^ / flgliMEO- COhiTOUR O LU T 3' SovTfi '`�A i,v:: sr `NOTE::The location of _any =existing un crj� sewerage, wells, or:other utilities shown on tl is plan is approx- SA I N 3� imate'only:..as determined from records .and/or verbal � _1 g , informationr .The contractor is respons"ible_for:the , Al ,J ld ►4riF3cation__of.'.tha..�_existing_locations in _the field. SCALE!.- �:�'= 40 .'.-D:ATE1 7 %0%3� F 1:DREDGE- ENGINEERING- _-INCI CLIENT 1 :CERTIFY THAT THE PROPOSED'; t `acAt '; BUILDING--,'SHOWN.- 0N, TNi3-' PLAN >a EOISTERE. RE3ISTER�O JO8 NO ' d'so8j f� ' CIVIL , . �. LAND _ CONFORMS==TO =THEN;ZONING' LAWS.' ;' DR:BY� �'`A pF.' BARNSTABLE• : .-MAS 712 MAIN STREET. , CH. BYE H YA N N I S" MAO 8.9 9HEET_L OF OAT REG. LAND SURVEYOR THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA n I \ a r-5 vw v � ( / t i i 7 ' s MELLEY RESIDENCE 191 SOUTH MAIN STREET CENTERVILLE CIA FRIST FLOOR PLAN � $ E V � o I s rz `ING i 14, cL i B ° 191 SOUTH MAIN STREET II i CENTERVILLE, MA BASEMENT FLOOR PLAN