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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 ._,� �. , \/� wl R• y � 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 `� ® � Q I �_ §4 �, � _ � � � �� ` ' � N�,� i { 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