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Home My WebLink About0005 HINCKLEY CIRCLE - Health 5 HINCKLEY CI OPOSTERVItLE A = 141 021 a k� i 0 N. Fee 5 0, 0 0 s THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pplication for Miopool *psstem Con!5truction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 5 Hinckley Circle Owner's Name,Address and Tel.No.4 2 — Osterville,Mass. 02655 David Hinckley Assessor'sMap/Parcel / O A 1 5 Hinckley Circle Osterville,Mass Installer's Name,Address,and Tel.No. 5 0 8—7 7 5—3 3 3 8 Designer's Name,Address and Tel.No. 5 0 8—7 7 5— J.P.Macomber & Son Inc. J.P.Macomber & Son Inc. Box 66 Centerville,Mass. 02632 Box 66 Centerville,Mass. 02632 Type of Building: Dwelling XX No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 5 5 gallons per day. Calculated daily flow 3 x 1 1 0=3 3 0 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Existing 1 000 Type of S.A.S. Existing 1 000 Pit. Description of Soil Loamy sand to medium fine sand. Nature of Repairs or Alterations(Answer when applicable) Adding 1 —Distribution box and 2-500 gallon leaching chambers packed in 4 ' of 14 " stone. 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 C e and not to place the system in operation until a Certifi- cate of Compliance has been issu d by this o of Health. Signed Date 5/2 6/0 0 Application Approved by Date Application Disapproved for a following reasons Permit No. Date Issued TOWN OF BARNSTABLE LOCATION S J�/AI C k l e y CIA' SEWAGE # VILLAGE () S Le 2 V/// ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO._ /�. iVl A C d M R,P k SO Al SEPTIC TANK CAPACITY / 000 vlT LEACHING FACILITY: (type) 2'F'L o ry C fail d 1J ee-(size) SS Oo• G- 4 A- NO. OF BEDROOMS 2 BUILDER OR OWNER i PERMTTDATE: COMPLIANCE DATE: 00 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.ezist 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 i i y t i 6Joco U50.00 No. 1$ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered-in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS RMication for Migozal 6potem Consstruction Permit Application fora Permit to Construct( )Repair( )Upgrade( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No. 5 Hinckley Circle Owner's Name,Address and Tel.No. 8—8 3 2 5 Hinckl - Osterville,Mass. 02655 Davidyyy Asses sor'sMap/Parcel /t�/ A / 5 Hinckley Circle Osterville,Mass Installer's Name,Address,and Tel.No. 5 0 8=7 7 5—3 3 3 8 Designer's Name,Address and Tel.No. 5 0 8—7 7 5— J.P.Msaamber & Son Inc. J.P.Macomber & Son Inc. Box 66 Centerville,Mass. 02632 Box 66 Centerville,Mass. 02632 Type of Building: Dwelling XX No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 S e gallons per day. Calculated daily flow 3 x 1 1 0=3 3 0 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Existing 1 000 Type of S.A.S. Existing 1 000 Pit. Description of Soil Loamy sand to medium f ine sand. Nature of Repairs or Alterations(Answer when applicable) Adding 1 —Distribution box and 2-500 gallon leaching chambers packed in 4 ' of 1' stone. Date last inspec.ed: 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 C de and not to place the system in operation until a Certifi- cate of Compliance has been issu d by this oax�l of Health. Signed .�/ Date 5/2 6/0 0 Application Approved by / Date Application Disapproved forte following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliancr7. THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed(XX)Repaired( )Upgraded( ) Abandoned( )by J.P.Macomber & Son Inc. at 5 Hinckley Circle 0eh6eir*11&e,Mass. has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ted Installer J.P.Macomber & Son Tnc_ Designer J.P.Naeombd-r & Son The issuance of this permit shall not be construed as a guarantee that the s ste will f nct'on as desi i nedj /i'All-,13m, / ry � g �./ �l y�Date M7 !, �no Inspector [.a'�� /1 411 ,� C/� No. ®� Fee 50.00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migooai *p5tem construction Permit Permission is hereby granted to Construct( )Repair(XX)Upgrade( )Abandon( ) System located at 5 Hinckley Circle Ostervi lle,mass. 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:Constructi n must a completed within three years of the date of this ermit. t /Date: 0 Approved by / E M99 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 DESIGNED PLANS) LJOSeph P.Macomber—JE, hereby certify that th'e��' ,pplication for disposal works construction permit signed by me dated 5 2 6/0 0 concerning the property located at 5 Hihck 11,ey Circle Osterv'lidle,Ma5' s. meets all of the following criteria: /The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. /The soil is classified as CLASS I and the percolation rate is less than or equal t(o 5 minutes per inch. i ;"�Thcrc are no wetlands within 100 feet of the proposed septic system V/ There are no private wells within 150 feet of the proposed septic system There is no increase in flow and/or change in use proposed rf There are no variances requested or needed. The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. (Adjust the groundwater table using the Frimptor method when applicable] lif the S.A.S. MU be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS infomiabon) B) G.W. Elevation + the MAX. High G.W. Adjustment. DIFFERENCE BETWEEN A and B SIGNED DATE: 5/26/00 (Sketch proposed plan of system on back). q:health folds:ccn p Existing 1000 Tank. 1 2-500 gallon D-Box leachinh chambers packed in 4 ' of 2 stone. Existing 1000 gallon leaching pit. TOWN OF BARNSTABLE LOCATION . - &U C k l ey CIA- SEWAGE # VILLAGE---a-5 1"-f R V/l/'9 ASSESSOR'S MAP& LOT INSTALLER'S NAME&P14ONE NO. A4 A C O M /3 P X S'O A-' SEPTIC TANK CAPACITY I o u r P l r /.a o o nG,o LEACHING FACILITY: (type) 2"A'L O W C&,1 d 1S e Qs(size) OO. q�. NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: 1A, OO 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 .I 177' o s S i 61,00, TOWN OF BARNSTABLE LOCATION rJ OIWCL. � C.I.MC-t-E SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY I000 C��+t► LEACHING FACILITY:(type) C�N-C Pil (size) (CM GA ,7 NO. OF BEDROOMS 2� PRIVATE WELL OR PUBLIC WATER FU UC- BUILDER OR OWNER _C�40W ICE �CQC.L��i DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No l� S9 ?g,6