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Home My WebLink About0381 WILLIMANTIC DRIVE - Health 1 181 WILLIMANTIC 'I;W4 MARSTONS MILLS i A = ®' bo to - L TOWN OF BARNSTABLE c LOCATION i2y/V., 4-141L-/t c. OrL SEWAGE # 7 �� VILLAGE_,owy �� ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY r LEACHING FACILITY: (type) —s�"��'o''- C (size)-, f NO.OF BEDROOMS Z BUILDER OR OWNER PERMTTDATE:%5 — S COMPLIANCE DATE:-/— P 1 Separation Distance Between the: Maximum Adjusted Groundwater, ble and Bottom of Leaching Facility Feet Private Water Supply Well an aching 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 0 �� f 1. " . TOWN OF B A—R..'�T�TABLE ✓ LOCATION _3g 17/ 4-14/f✓/� D Z SEWAGEE# VILLAGE��y ,, ✓� ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. r`C� /�S'6 � � ��77 SEPTIC TANK CAPACITY/6G� LEACHING-FACILITY: (type) —S+ (size .� NO. OF BEDROOMS BUILDER OR OWNER S T )!? %ram PERMIT DATE:,"6 v COMPLIANCE DATE:,//---"" 9 ' Separation Distance Between the: Maximum Adjusted Groundwate ,rTlble and Bottom of Leaching Facility Feet Private Water Supply Well an aching 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 w a AIL ,o No. ( ( . .. Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 1/ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pplication for Digaar *pe;tem C on!5truction Permit Application for a Permit to Construct( )Repair(x)Upgrade( )Abandon( ) 0 Complete System ❑Individual Components Lo�Vof Address or J.,ot No. Owner's Name,Add ess and Tel No. Willimantic Dr. , Marstons Jeanne St . Peter Assessor's Map/Parcel [ o 3_O o, mills 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: 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 S and. Nature of Repairs or Alterations(Answer when applicable) Title—5 1 P a c h s u s t P m, o n n s i s t i n g of a D-box and. 2 heavy duty leach chambers with 4' of �tnne 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 this B and Health. Signed Date Application Approved by Date /O—Z Z Application Disapproved for the following reasons Permit No. _�1919 Date Issued 16 ^ 1 Z No. Fee t 50r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Zipplicatiou for ME; 45al *pgtem Con!5truction Permit - -,, Application for a Permit to Construct( )Repair(X)Upgrade( )Abandon( ) E]Complete System O Individual Components L o Add;e s r�of No. Owner's Name,Address and Tel.No. , � Wi llmant c Dr. , Marstons- Jeanne St . Peter Assessor's Map/Parcel /® !Q v` M i l l s .. Installer's Name,Address,and Tel.No. (p Designer's Name,Address and Tel.No. Wm. E. Robinson 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 A& Title 70 Size of Septic Tank Type of S.A.S. V Description of Soil Sand. Nature of Repairs orAlt_eirations(Answer when applicable) Title-5 l p?aeh system, consisting of a D-box"'and 2 heavy duty leach chambers .with 4' of stone all around . 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 been issued by this B �ard/_HalthSignedDate b �' Application Approved by4&MZ: Date /U-F Application Disapproved for the following reasons Permit No. !� Date Issued 16 - 2 7 -7- 7 ,h, ✓"` THE COMMONWEALTH OF MASSACHUSETTS St . Peter BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that tbe.On-site Sewage Qispos 1 S stem Constructed( )Repaired(X )Upgraded( ) Abandoned( x Wm. E. Robinson S e pt is ele vice at 381 Wi�timan 1C Dr. , V arstons Millshas been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. �',9 w �p dated /0—2 Installer Wm. E. Robinson Sr. Designer The issuance of this permit 9611" t bejc�onstrued as a guarantee that the s�tem-will function as d/esignedj� Date _ f Inspector l 1,_1V_L 1C _...! n l �fUlf, / ,.0 Vv v , No. / 1 '(> / j , — _ — ` — -------------Fee $50 THE COMMO�LTR/-OF MASSACHUSETTS St., Peter PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mi5po5al *pgtem Conotruction Permit Permission is hereby granted to Construct( )Repair(X)Upgrade( )Abandon( ) Systemlocatedat 381 Willimantic Dr. , 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 dr special conditions. Provided:Construction must be completed within three years of the date of this permit. Date: �6" -2 ?- �/ Approved by t \ L ` 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, William E . Rob ins on,S,zhereby certify that the application for disposal works construction permit signed by me dated / L concerning the property located at 381 Willimantic Dr . , Marstons Mills meets all of the d� following criteria: The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. oil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. ere a no wetlands within too feet of the proposed septic system _ "Tli e are no private wells within 150 feet of the proposed septic system -1 zere 'ono increase inflow and/or change in use proposed • re 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] • If the S.A.S. will 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 information) B) G.W. Elevation Z +the MAX High G.W. Adjustment DIFFERENCE BETWEEN A and B - SIGNED ICJ t DATE: [Sketch proposed plan of system on back). q:health folder:een -P)- � r