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Home My WebLink About0238 BUMPS RIVER ROAD - Health 238 •BUMPS RIVERS_ "� OSTERVILLE A = 120-101 qv i i 1 J TOWN OF BARNSTABLE' LOCATION ` tR. S i +, c -� �ei SEWAGE� VILLAGE 0 J l ASSESSOR'S MAP& LOT — ` INSTALLER'S NAME&PHONE NO. :i b SEV C TANK CAPACITY l Slr- LEACHING FACILITY: (type) • S� r9—2- (size) NO.OF BEDROOMS 3 BUILDER OR OWNER �COMPLIANC�EDAT�E-J=�Z— SeparationPERMITDATE: C �6 Distance Between the: Max_mum Adjusted Groundwate(' able to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist cn site or within 200 feet of leaching facility) Feet Edge of Wetland and aching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furushed by ]I � I b l .`vAyp- ' 4 I No. `t0U0 — —]l.o'-j Fee 5 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0[ppYication for Migozar &patent Congtruction Permit Application for a Permit to Construct( . )Repair( X)Upgrade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 238 Bumps River Rd. , Osterville Donald Crowley Assessor's Map/Parcel 11 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Service P 0 Box 1089, Centerville Type of Building: 3 Dwelling No.of Bedrooms 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 Re airs or Al ratiops(�n swe when applica lel Title-5 septic service consisting o a Lank, —box an L C011CI-e e criambers witri 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 issu d by thi ar f Health. Signed I I . d Date ��'°� t 1n Application Approved by lC.t7�.c SCk- f- .e, Date Application Disapproved for the following reasons Permit No. �00 0 — 7(O c{ Date Issued lI /a 9/O O TOWN OF BARNSTABLE LOCATION c .�. 5 y r ' �� SEWAG �T 44 VILLAGE__ (5 .5r ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO._Z6 k SEPTIC TANK CAPACITY _/S!--e� LEACHING FACILITY: (type) ;L — 5 ci- -'• L C (size) l v� BUILDER OR OWNER �16C�OMPL�IANCE PERMITDATE: 6 DATE�. ' l Separation Distance Between the: j Maximum Adjusted GroundwatefTable to the Bottom of Leaching Facility Feet Private Water Supply Well and Leachin Facili any wells exist " on site`or within 200 feet of leaching facility) Feet Edge of Wetland and beaching Facility(If-any wetlands exist within 300 feet of leaching facility) ;. : .Feet Ftuii shed by f; r No. � � _ �=� Fe,S 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. Yes PUBLIC-HEALTH DIVISION TOWN OF BARNSTABLEs MASSACHUSETTS L 0(pplicatiou for Migogal *pgtem Construction 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. As�e �'Sr River Rd. , Osterville Donald Crowley Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Service Conterjrjlle 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 septic s ery i ee consisting of a tank, D-box and 2 concrete chffimbers with —9E-ene- a!1 around. ..� .Date Est inspected: x 4 Agreement: "r 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 f Health. Signed T ` Date�4�L 2 4 -GL Application Approved`by - Date 1-a 1 Application Disapproved for hefollwin reasons Permit No. Date Issued i� I i i /7! THE COMMONWEALTH OF MASSACHUSETTS ` BARNSTABLE, MASSACHUSETTS Crowley Certificate of Compriance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired(X )Upgraded( ) Abandoned( )by Wm R. 'Robinson Septic Service at 238 Bumns River Rd- , Osterville has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.j dated -3 Installer Designer r The issuance of this permit shal not a construejd as a guarantee that the systemrwill function a�esignedh Date l� I ,� b Inspectors sir; h it AV) A '�� kj --- ` ---- No. v Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLEs MASSACHUSETTS Crowley xlhgpogar *pztem Construction Permit Permission is hereby granted to Construct( )Repair( X)Upgrade( )Abandon( ) System located at 238Bumps Riyergd. ,, Osteryil e 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: Approved by i tl6199 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DLSPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) 1, William E. Robinson-5 eby cenify that the application for disposal works construction permit signed by the dated .�� '" � , concerning the property located at 238 Bumps River Rd. , Osterville meets ail of the following criteria: • The failed system is connected i a residential dwelling only. There are no commercial or business uses associated with the g. The soil is classified as CLASS I and the percolation rate is lass than or equal to 5 minutes per inch_ . There are no wetlands within 100 feet of the proposed septic a}stem • There art:no private wells within 1i0 feet of the proposed septic system There is no increase J flow and/or change in use proposed • There are no requested or needed. • The bottom of proposed leaching facility will ngt be located less than five feet above the ma.�imttm ad' ed grourtdarater table elevation:[Adjust the groundwater table using the Frimptor method when pplicablel • If the S.A. will be located with 250 feet of an)vegetated wetlands,the bottom of the proposed leaching f "lily will not be located less than fourteen 114).feet above the maximum adjusted grounds er table elevation, Please complete the following: ?►) Top of Ground Surface Elevation(using G1S information) B) G.W.Elevation _ �Z-- +the MAX High G.W. Adjustment. DIFFERENCE BETWEEN A and B SIGNED : DATE: �a�—o�7'' [Sketch proposed plan of system on backl. y:health folder:cen c f� =--F. 6 �� 1 � y I �� i