HomeMy WebLinkAbout0120 RASPBERRY LANE - Health 120 RASPBERRY LANE
MARSTONS MILLS
A = 102 091 ~
TOWN OF BA.RNSTABLE
LOCATION '/-� D /�AS�,B PRR Y LAeVP SEWAGE #1000- 4f y/
VILLAGE &A'e-516,41S &-S ASSESSOR'S MAP & LOT 2 f
INSTALLER'S NAME&PHONE NO. ;Al A fa Al A e t .5—O.y
SEPTIC TANK CAPACITY A X-6 4
LEACHING FACILITY: (type),%-/e`®G/C�f'1A9,���P�� (size)
NO.OF BEDROOMS sZ
BAR OR OWNER dell, ��� d's z X 9
PERMITDATE: �Z-2 A<"�Z COMPLIANCE DATE:
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 A
r
e � ��� e
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R•
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No. .z� '7 Fee $ 5 0.0 0
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
Zippricatfon for nigogaf *p5 to Cougtruction Permit
Application for a Permit to Construct( )Repair( )Upgrade(-v Abandon( )X®Complete System ❑Individual Components
Location Address or Lot No 1 23V Raspberry Lane Owner's Name,Address and Tel.No. Ceci1le V. Cohen
Marstons Mills,Mass. 02648 84 Roosevlt Road Medford,Mass.
Assessor's Map/Parcel l 4 9 ® 02155
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—3 3 3 8
J.P.Macomber & Son Inc. J.P.Macomber & Son Inc.
Box 66 Centerville,Mass. 02632 Box 66 Centerville,Mass. 02632
Type of Building:
Dwelling XXNo.of Bedrooms 2 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 Loamy sand to medium fine sand.
Nature of Repairs or Alterations(Answer when applicable) Omitting two cesspools- Installing
1 —1 500 ga 1 1 nn septi n tank, 1 —Di ai-r; bliti an box aL.d- tG79 50-0
Qa 1 1 an 1 Parhi nrr r hamhers acked in-4 ' c)f rtan.g.
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 issue by this o of alth.
Signed Date 7/1 7/0 0
Application Approved by _ t Date 7 ZG 7
Application Disapproved the following reasons
Permit No. ✓ f Date Issued 7 Z� Z"-O
`No. 46 '�7'`f/ ` 4 Fee 50.00
/�
THE COMMONWEALTH OF MASSACHUSETTS
Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
01pplicatiori for Misspogal 6t m Con!5truction Permit
Application for a Permit to C®nstruct( )Repair( )Upgrade( Abandon( )X®Complete System El Individual Components
Location Address or Lot No. 1 2 P Raspberry Lane Owner's Name,Address and Tel.No. Cecil le V. Cohen
Marstons Mills,Mass. 02648 8.4 ROoseVlt Road Medford,Mass.
Assessor's Map/Parcel /a 02155
Installer's Name,Address,and Tel.NE — 5—3 3 3 8 Designer's Name,Address and Tel.,No. 5 0 8—7 7 5—3 3 3 8
J.P.Macomber & -Scm nc. J.P.Macomber & Son Inc.
Box 66 Centerville,Mass. 02632 Box 66 Centerville,Mass,: 02632
Type of Building: �.
Dwelling XXNo.of Bedrooms 2 Lot Size'y sq.ft. <,Garbage Grinder( )
Other Type of Building .. No. of Persons Showers( ) Cafeteria( )
Other Fixtures A
Design Flow f '' "�j ,X� f gallons per day. Calculated daily flow / gallons.
Plan Date r Lmber of sheets Revision Date
Title '
- Size of Septic Tank Type of S.A.S.
Description of Soil Loamy sand to medium -fine sand.
Nature of Repairs or Alterations(Answer when applicable) Omitting two cessgools. Installingl—
1—1 500 gallon septic tank, l—ni sf ri bution 'ho-x and tux6 500
gallon lc�ac•_hing rhamhe,rc packed in 41 of 'stone_
Date last inspected:
Agreement: a�
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*issue boar of alth.Sig Date 7/17/00
Application Approved b DateZGApplication Disapprove reasons
rr
Permit No. L'14 1 Date Issued 7 Z,6.' Z4-VW
THE COMMONWEALTH OF MASSACHUSETTS
£¢ BARNSTABLE, MASSACHUSETTS
#,t ` *Certificate of Compliance
,THIS IS TO CERTIFY,tha ifie On-site Sewage Disposal System Constructed(XX)Repaired ( )Upgraded( )
Abandoned( )by- H.P.Ma,eombee & Son Inc.
-..at 121 Raspberry Lane' Marstons Mills,Mass. has been constructed,in accordance
with the provisions of Title 5 and the for Disposal System Construction PermitNo. dated
"Installer J.P.Macomber & Son Inc. Designer"��•P.Macomber '&.; Son Inc.
The issuance of this permit shall not be construed as a guarantee that the s tern will function as�deSig d.
Date Inspecto
}
No.7iCyzr�j ' �Ll f t Fee$ 50.00
THE COMMONWEALTROF MASSACHUSETTS
A • f
PUBLIC HEALTH DIVISION - BARNSTAB'LE} MASSACHUSETTS
Miopozar &pMem Cott.5truction Permit ,
Permission is hereby granted to Constructgl Repair( )Upgrade( )Abandon( ) r
Systemlocatedat 121 Raspberry Lane Marstons Mills,Mass.
and as described in the above Application for Disposal System Construction Permit.T e 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 pe t.
Date: 7 Z G Lz Je7 y Approved b - ZLe,`
...:k
116/99
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)
I, _Joseph P.Macomber Jr., hereby certify that the application for disposal works
construction permit signed by me dated 7/2 4/0 0 concerning the
property located at 120 Raspberry Lane M&M 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 to 5 minutes per inch.
• There are no wetlands within 100 feet of the proposed septic system
• 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
• There are no variances requested or needed.
• The bottom of the proposed leaching facility will 2Lbe located less than five feet above the
maximum adjusted groundwater table elevation. (Adjust the groundwater table using the Frimp(or
method when applicable)
• If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed
leaching facility will M be located less than fourteen (14) feet above the maximum adjusted
groundwater table elevation.
Please complete the following:
A) Top of Ground Stu-face Elevation(using GIS information) y 0
B) G.W. Elevation '-3 '- +the MAX. High G.W, Adjustment. 711 a `�
DIFFERENCE BETWEEN A and B y
I
SIGNED DATE: 7/24/00
(Sket ;opAosed plan of system on back)•
q:health folder:cm
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{ TOWN OF BARNSTABLE
72
LOCATION A, 0 X 14SO,B PRRY 44 Al-e SEWAGE #,2000- 414'/
VILLAGE &,4 Ay-5 16,41s A4I&s ASSESSOR'S MAP & LOT S
INSTALLER'S NAME&PHONE NO.sJ. P A J A C i 14 9 eR S-ON
i
SEPTIC TANK CAPACITY A.S_b 4
j LEACHING FACILITY: (type),Z-FLaWC�. A-fA5eR `-' (size)
j NO. OF BEDROOMS
B4Rt1Y2'R OR OWNER .Z
i
PERMITDATE: POtEOMPLIANCE DATE:�%p •�
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 orwithin 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 eY �
O
2'J y �,'A
LO-CAI ION SEWAGE PERMIT NO.
L-e �- 72
VILLAGE
e
INSTAL�LR� NAME & DDRESS
BUILDER OR OWNER
DATE PERMIT ISSUED 0
DAT E COMPLIANCE ISSUED
I
/2 r
?j Zy��ie
OV
No......... ............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF_fjFALTH
..............OF.... .......................................
Allpfiration for Raposal Workii Tontitrurtion Prrutit
Application Alise y kTa(j for a Permit to Construct or Repair (L-) an Individual Sewage Disposal
^*L0 Systin . A
M a4j�;�
. " ... &F-V . . /_
.. . ......... .... ............. ... ................. ............. ............. .....L............................
ocation-Address or Lot No.
........................ .......... ----- ----------—------------------------------------------------------------------ --------
in Address
< Owner....az
............................. ..................................................................................................
Inst; ler Address
Type of Building Size Lot............................Sq. feet
U —No. of Bedrooms.__.__ Expansion Attic Garbage Grinder Dwelling ... ...........................
ok Other—Type of Building ............................ No. of persons............................ Showers Cafeteria
Otherfixtures .......................................................................................................................................................
Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
1:4 Septic Tank—Liquid capacity............gallons Length................ Width.__.._.._._..... Diameter.___............ Depth_._..._..___.__.
Disposal Trench—No..................... Width....._.._....__.._.. Total Length.............._..... Total leaching area....................sq. f t.
Seepage Pit No_____________________ Diameter.........._..__.___. Depth below inlet........_........_.. Total leaching area..................sq. f t.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date...------------.........------------....
aTest Pit No. I................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.___._.............._...
.............................................................................................................................................................
0 Description of Soil........................................................................................................................................................................
x
U ................................................................................................................1�................................................... --------------------------
W * -------- - _ __ ------------------------------------------ ..........*------------
Z r or teratio L�2� ...------------------------------------------------- ---------------
U Nature of Re Al ns—,Answer when applicable... ------- ..........................
...... CL... .................................................................................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of i1'1 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has beet�sued 4blhe board of healtV)
. ........ ---Signed. .. ............
Date
Application Approved By........... A.1 ......................................................................... ........................................
1- Date
Application Disapproved for the following reasons:...............................................................................................................
........................................................................................................................................................................I...............................
Permit No......43 3 /�-
-.77 Date
Issued... ...7!...r....................
Date
----------------------------------------------
}
x ..
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF WE LTH
C
...........
Appliration for Disposal Marko Toustrurtion prrutit
Appheat,�o is h y made r a Permit onstruct• ( ) or Repair (7"an Individual Sewage Disposal
Sysemat,® d
*)------. .._ _ .... .......... ........ .. z............................ k
x
o tion-Address or Lot No. ,
^ ^'�.- .... .... ... --•- ......•••---. -------•----- -------------- '�
Ow er z Address
W
L — -------
„* Ins ller Address
d Type of Buildin*'g" s Size Lot............................Sq. feet
Dwellin —No. of Bedrooms............................................
V gExpansion Attic O . Garbage Grinder ( )a Other. Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
p-' Other fixtures .. �' `§
--•-----------------••--•--•------•--
W
Design Flow.............................. ^ _gallozi per person per day:` Total,-daily flow...... ...........14..............gallons.
G: Septic Tank—Liquid'capacity. .....__._gallons ",Length.........' :_._ Width . Diameter_____________bepth................
Disposal Trench—No................ Width :..iTotal Length � Total leaching area...., sq. ft.
Seepage Pit No---_--------------- Diamet*g ..n7 ^s;. Depth below inlet...................
...._ Total leaching area:: �x"sa. ft.
z Other Distribution box ( ) Dosing tank ( `) � x " "< ,. y 'z
'~ Percolation Test Results Perfbrmeifi by �...: ................." r _._: Date._.
a Test Pit No. I................minutes per inch Depth of Test Pit ................. Depth to ground water
Test Pit No. 2................minutes per inch Depth!-of�T sts;,Pit.._.............._.. Depth to ground water.....____--
............................................................... __.................
_____-----------O Description of Soil......................... ..°...
------------••------•-------------------------------•••---•--•-•-••••........_..
x
U Nat , ....] — 0.00.0- ---------------------------
u e of Re i or Alteratio s—A�swer when applicable ...
-. --••--•----••••-••••••••........----••--•--•--'--••--••-..
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has be •slued b the board of Whepalt/, j •Signed �.. +' ! -_.�.
Date
Application Approved By........... ................
"'. h:
,., Date
Application Disapproved for the following reasons---------------------------------------------------------------''-•.....---•------------- .......-_-__----•-
M4
Date
PermitNo..... ---- .......... ................. Issued_.........................................................
Date
f
THE CONI•MONWEALTH OF MASSACHUSEyiTS D WA Fte'"r . s
BOARD OF HEALTH
tc.r... .......OF..� ��° !.� .....:... ......
s
r Tntifirate of Tomphaurr
T CERTIFY, hat Individual Sewage Disposal System constructed ( ) or Repaired(
by .... .......r t_ ----•-... ---•--•--•-...•. ..........-•----••••---••--.....--•--•-•............. .....................
Installer M
� 7.771.
-------- ........
dated_-.._, .' ......---.....................
4
THE ISSUANCE OF THIS CERTIFICATE,SHALL NOT BE'CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCT ON SATISFACTORY l
�" o
DATE........... ..�...... ' ..._....... .....-•-•----•----- ----•-•--� Inspector... .............................................
THE COMMONWEALTH OF MASSACHUSETTS ;.. xl '
�' ...OF... .:d :.....` . ....................... e+0
No................ ,„,a, {
Bill s 1 xk io amit
Per sio is gra a ............................................
+ . .
}} _
to Con v age Dispos Sy�t
atNo. ...... . ........ •-- -•••• _. ----•- ..•-• ' ------------- -------•... .............
Street _ q
as shown on the application for Disposal Works Construction Permit No..__.�_.�'� ...._._ Dated �..................a
............
Board of Health
DATE............................................................................... � -»
t,
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
t