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Home My WebLink About0084 BARBERRY LANE - Health 84 BARBERRY A = 102 157 . � - TOWN O`F/BARNSTABLE LO >ATION A It &'R Y SEWAGE # �/f VII LAGER r � � l� ASSESSOR'S MAP & LOT 1 �J' INSTALLER'S NAME&PHONE N0. /[ ®,�? SEPTIC TANK CAPACITY LEACHING FACILITY: (type) "S'1 2 4 L (size). A iX—g2 NO.OF BEDROOMS 3 ` BUILDER OR OWNER PERMUDATE: 41 9"G-CS COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Ground,Vater Table to the Bottom of Leaching Facility Feet Private Water Supply VW611 and Leaching Facility (If any wells exist on site or within0 feet of leaching facility) Feet Edge of Wetland a(td Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by • » :1u� _,. �o �, a� - 3r' �,.-' �✓" �. �'� ,f -- !: 4 No.�`� 23 Fee$5 0 THE COMMONWEALTH_GF MASSACHUSETTS Entered in computer. Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pprication for Digozaf bpgtem Cow5truction Permit Application for a Permit to Construct( )Repair(x )Upgrade( )Abandon( ) El Complete System El Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 84 Barberry Lane , Marstons Mills Bradford. Jobling Assessor's Map/Parcel 10 2-1-5-1 Installer's Name Add sp,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. ''�obinson Septic Service P 0 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 septic s vs t e m consisting_ of a tank, D-box and 2 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 thi o of Healt . , a, ' & Signed ,� Date�! Application Approved by t Date Application Disapproved for the following reasons Or Permit No. Date Issued + No. ' _ Fee $50 THE COMMONWE4LTH. �"�IAASSACHUSETTS Entered in-computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 3pprication for Mgoal *pztem Congtruction Permit 'Application for a Permit to Construct( )Repair(X)Upgrade( )Abandon( ) ❑Complete System El Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 84 Barberry Lane , Marstons Mills Bradford, Jobling Assessor's Map/Parcel /o e- l In��e.'s re,Add�sl and Tel.n8 OnN Designer's Name,Address and Tel.No. IN Ko `peptic Service P 0 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 septic system c ons is t ink of a tank, D-box and. 2 leach chambers with stone all around . Date last inspected: Agreement: f` 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 o of Healt . ' , Signed t� Application Approved by / ' C� t Date — Application Disapproved for the following reasons h Permit No. Date Issued --------------------------------------- - r THE COMMONWEALTH OF MASSACHUSETTS Jobling ' BARNSTABLE, MASSACHUSETTS Certificate of Compliance ,,:THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( X )Upgraded( ) Abandoned )b Wm. E . Robinson Jeptic service at 84 Barberry Lane, Marstons Mills has been constructed in accordance with the provisions of Titl 5 and the for Disposal System Construction Permit No.7�—2 3 4 dated. Installer Wm. E.. R O�ins on Sr. Designer .O ;t The issuance of this,,permit hall of be construed as a guarantee that the sy t wjjill fu t nc;ottn s d'e`signe4/ Date 7 Inspector fb`1 %> A V,f e -- —----------------- --------- — No. Z(f Z Fee /o Z" /S 7 THE COMMONWEALTH OF MASSACHUSETTS Jobling PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS mizpogaf *potent Construction Permit Permission is hereby ted to Construct( )Repair(X )Upgrade( )Abandon( ) System located at Barberry Lane, Marstons Mills 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 must be completed within three years of the date oft ' p t. Date: y � Approved by ' 1/6/99 s,. 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) hereby certify that the application for disposal works construction permit signed by me dated �f/ g•—�J , concerning the property located at 84 Barberry Lane , Marstons Mills 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 percolatio 'rate is less than or equal to 5 minutes per inch. • There are no wetlands within 100 feet of the pro sed septic system • There are no private wells within 150 feet of a proposed septic system • There is no increase in flow and/or chang in use proposed • There are no variances requested or n ded. • The bottom of the proposed leachi facility will not be located less than five feet above the ma..dmum adjusted groundwater ble elevation. [Adjust the groundwater table using the Frimptor method when applicable] • If the S.A.S. will be locate with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not located less than fourteen(14) feet above the maximum adjusted groundwater table elev 'on, Please complete th following: A) Top of Ground Surface Elevation(using GIS information) B) G.W. Elevation +the MAX. High G.W. Adjustment DIFFERENCE BETWEEN A and B `/ SIGN19- ED :Gt✓ t', DATE. [Sketch proposed plan of system on back]. q:health folder.cert 1 t ar .. � �� I � 1 Y �v \ �� 1 � i n �y I TOWN OF BARNSTABLE j L A/R R �.b SEWAGE #!i G''�3 t LOCATION VILLAGE ��• /�/' S ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. 2 O /�"�� dL 1 23�`879 7 SEPTIC TANK CAPACITY �cS✓G� _' ` LEACHING FACILITY: (type)a-,Y 2-2 L-L ,(size) NO.OF BEDROOMS 3 BUILDER OR OWNER PERMITDATE: ��"�>''�-o COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Ground: ater Table to the Bottom of Leaching Facility Feet Private Water Supply W41 and Leaching Facility (If any wells exist on site or within0 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 ifeet of leaching facility) Feet Furnished by _V7 P I 1 I e r _.,J t6 a- )6---7 ASSESSOR'S MAP NO. PARCEL 7 Y LSCkATI SEWAGE PERMIT NO. 17 VILLAGE I N S T A LLER'S NAME i ADDRESS -pa to- S U I L D E R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED i /eac ti e�1 • nS•.Vn• Ace r No.._ , , S Fxs.....25-0....._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for B44Vniial Mirkg Tomitrnrtion Vantit Application is hereby made for a Permit to Construct ( ) or Repair (6<an Individual Sewage Disposal System at: .............. :.`�..... .............................. !L . . -- - .......--- ocation((Address or Lot No. ........••....... 1 L— -ltic�............................................... ... ........................................................ a Address �o 5- owner ........... ..... .... � --... � ........................ Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.-_,............. _....Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) G" Other fixtures -------------------------------- . W Design Flow.._....S�=..................----gallons per person per day. Total daily flow...... _C�..................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-------I------------ Diameter....AQ._....... Depth below inlet...&�........... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fZ4 Test Pit No. 2................minutes per inch Depth of.Test Pit---:................ Depth to ground water........................ P4 -----------------------------------•----•---------------------------......----------••......•.--•-••......................................................... 0 Description of Soil........................................................................................................................................................................ x U ------------------------------------------•----...-----------------------------------..........-----._...--------------------------------------------------------------------------••-•...-------------- VW ---------------------------------------------------------------------------------------------------------------------------------------(--------------------------------------------------------------- Nature o Repairs or Alterations—Answer when applicable._-__�k-'d`- T. �`..._. .... e�: _.p ............ sC -------------------------------------------------------------------------- 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 bee4 issued b i the b rd of health. Signed .. ..:... ....... ......... .. ...._..----.............----- -------... 5 -�-- Dare Application Approved B - pP PP Y t ........ - ..-........ - �-e-------- Application Disapproved for the ollowing reasons: .. ------------------------------------------------------------------------------------------------------------ ........................................------------------------------------------------- ......------------------------------------------------------------------------------..------------------ -----...............................--- e PermitNo. .. ..................................................... ..... Issued ---- ---------------------------...------- ------------. Dare I THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Diipuual Works Tunutrurtiun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( lean Individual Sewage Disposal System at: --------- oeation-(Address or Lot No. ....---•------.... � LrCn t_ tut e Owner Address -------------- .lt.� -s...L EA. . .__ . -..�?...t.�.,�_,......... ............ Installer Address Type of Building Size Lot.............._.............Sq. feet U Dwelling—No. of Bedrooms....3...................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons____________________________ Showers — Cafeteria QI Other fixtures ________________________________ _ W Design Flow........ X'_ .......................gallons per person per day. Total daily flow...... _Ct..................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-------.I------------ Diameter-----1.0._.__.__ Depth below inlet...(a.f........... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ rZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --------------------------------------------------- •--- -.............. --•------------------- •------------ •------------------------- •-•-------•---•---•••--- 0 Description of Soil........................................................................................................................................................................ x UW ----•---------------------------------------•-----•------..__....-----------•-•---------------------------------------------•-•...----•=--------------••-•-•-•---•••••--------••-------•------•-_-•---- Nature of Repairs or Alterations—Answer when applicable.____ .(.t....__._ ?___._ . 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 been issued by the bo rd of health. Signed.. ® ...... -...�G 5�1 ' Date ApplicationApproved By ----------------------------------------------------------- --- -----------------e----------------- Application Disapproved for the allowing reasons- ------------------------------------------------------------------------- ------- --------------------------------- ------------ --- ------------------------------ -- -- --------------------------------- -- ---------- ---- ------------------------------ ------------------------------ ---------- --- -- - --------------------------------------- Date PermitNo. ---------- Issued ----- -- -- --------- ----------------------- ------------- --------------------------------------------- Date h THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Ter#ifirate of Tu,c>: plianre THIS IS TO CERTIFY, That the Individual Sewa e Disposal System constructed ( ) or Repaired ( Lj___/ by------------------------------------------ - -. ..--`-`n�" ' } --------------------_-_---- f Installer I !�( , t` C at ---------------------------------------�-`! 2 4-V`r----`-CA- -C:_._..... Y..�� V""..`...1 ------------------------------ 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 No. ............� ---...-�-7-5' dated ----.-.....-.----.---.......------..--..--...--. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------Q'..�. � - ------------------------------------------- Inspector ......... ----- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No....l.��.. qq _'_�7� TOWN OF BARNSTABLE - FEE..-.. ....... Viupuual Works duns rnrtiun Vanfit Permission is hereby granted.......C-�__ .� �-__` ..! .___S ' ~� ..- to Construct ( ) or Re air ( w- dividual Sewage Dispo al S, stem at No..................-------------- «�..-....--->5�i -.Vv.k /---�``` - ( `- v `.., .... Street q as shown on the application for Disposal Works Construction Permit No.__/ K�9 K_ Dated.......................................... l J Board of Health DATE................V�-�--v-----....-�-- -- FORM 38SOB HOBBS 6 WARREN.INC..PUBLISHERS