HomeMy WebLinkAbout0032 WILLINGTON AVENUE - Health 32 WILLINGTON AVE. , M. M.
A = 103 031 - - -
i
i
I
i
i
1
I
I
TOWN OF BARNSTABLE
LOCAi ION SEWAGE # O
VILLAGE ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) h �►'S (size)
NO.OF BEDROOMS
BUILDER OR OWNER
PERMTTDATE: COMPLIANCE DATE:
Separation Distance Between the: ;
Maximum Adjusted Groundwater Table and 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
6 `9
T
OQ-
r No. y�✓ ' Fee $ 5 0
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
V
4 .
01pplication for Zi!5po$aL*p9;tem Con!5truction Permit
Application for a Permit to Construct( )Repair(X)Upgrade( �1)Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.
32 Willington Ave . , Marstons Mills Richard. Lohse
Assessor's Map/Parcel y
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Wm. E. Robinson Septic Service
P 0 Box 1089, Centerville
TType'of Building:
Dwelling No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder( )
..-Oiher 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 leach system, consisting
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 En ironmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issyd by this d Health.
Signed Date
Application Approved by Date
Application Disapproved for the following reasons
Permit No. 10 41-1 0 151 Date Issued /`"
1 •
5
4No. f/i{/ y�'✓.✓ � Fee �
t THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
-PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS
\1,
Zipplication for Zigoal *pgtem (Congtruction permit
Application for a Permit to Construct( )Repair(X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.
32 Willington Ave . , Marstons Mills Richard Lohse
Assessor's Map/Parcel
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 4 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 leach system, consisting ��
of D-box and leachc __ _ L rwl-✓
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 En ironmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been iss d by his d Haalth.
Signed Date
Application Approved by Date /'� ,�� i&Wit'
Application Disapproved for the following reasons
Permit No. 0 40 `� Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
Lohse BARNSTABLE, MASSACHUSETTS
?(Certificate of (Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired (X )Upgraded( )
Abandoned( )by Wm. E. Robinson Septic Service
at 32 Willington Ave . , Marstons Mills has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.40.- 0.0 7' dated /,'
InstallerWm. E. Robinson S r. Designer /11e .1
— 5
1 A \ �/1.
The issuance of this pe i�tha�l n t be�cro�j strued as a guarantee that the system ill function s design ��
Date y r� �'/ t J Inspector T �� l ✓/I i �l . "M
0
No. �� "' If /Y � -------------------------Fee $50
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
Lohse '
Mi.gpogaf *pgtem (tongtruction permit
Permission is hereby granted to Construct( )Repair(X )Upgrade( )Abandon( )
System located at 32 1illington Ave . . 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:Construction must be cQrjVpleted within three years of the date of this emit.
Date: f Approved b
l
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 . Robinson,Srhereby certify that the application for disposal works
construction permit signed by me dated t��f �J , concerning the
property located at 32 Willington Ave Marstons Mil smeets all of the
following criteria:
• The failed systern is connected to a residential dwelling only. There are no commercial or business
uses associated with the dwelling.
e soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch.
ere are no wetlands within 100 feet of the proposed septic system _
ter are no private wells within 150 feet of the proposed septic system
x
ere is no increase in flow and/or change in use proposed
ere are no variances requested or needed.
ttom of the proposed leaching facility will not be located less than five feet above the
maximum adjusted groundwater table elevation: f Adjust the groundwater table using the Frimptor
method when applicablel
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 G1S information) _
B) G.W.Elevation +the MAX High G.W. Adjustment
DIFFERENCE BETWEEN A and B 21
01
SIGNED : `` DATE.
[Sketch proposed plan of system on back].
q:health folder:een
•`
G �
1 J
k.
� bGI
��. �\ �
,�-
TOWN OF BARNSTABLE
.LOCATION � �� � n.qnj 4ain SEWAGE #. o
VILLAGE ASSESSOR'S MAP &LOT " -
INSTALLER'S NAME&PHONE NO. /�f �G��.-►sorb �er��- ��5=2�710
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) hCs.(��►�� 3 �oc6 (size)
NO.OF BEDROOMS
BUILDER OR OWNER
PERMITDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table Bottom of beaching 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
i
� 9
Q <t>
0
I
e
a
L0CATI0N 3 SEWAGE PERMIT NO.
L6t 71 Willington Ave. 83-712
VILLAGE
Marston Mills _
INSTA LLER'S NAME i ADDRESS
Robert .B. Our Co.Inc.
Great Western Rd. North Harwich, Mass. 02645
B U I L D E R OR ' OWNER
Barnstable Holding Co. Wm. Dacey Jr.
,NDATE PERMIT ISSUED f-3
�DAT E COMPLIANCE ISSUED
L
y
1 �o
r
No.. ' Fps... .............
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® F H E/A° L
Appliration for Disposal Works Tonstrurtinn Prrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Ind' ' ual Sewage Disposal
Syst at
.... .._._� ....... ...._.... ...............Ar.. ._....._.. __ .._..._ ...._.._..........__..
^ ation-Add "ss, p C or t X $
.. . . _. .- � .... ......... - ..._n:. ......... ..%'' ............... ........ .
r.. s
ryner, �..� Address a
a
Installer Address
QType of Building ze Lot_ `.•_._Ae'c�'._..Sq. feet
U Dwelling—No. of Bedroom ___.._ -- _Expansion Attic ("'I
Garbage Grinder ( )
aOther—Type of Building 0.._ !_.� of persons.._....�!................. Showers ( ) — Cafeteria ( )
Otherfixtures -------------------------------------------------------------------------------------------------------------------------------------------•---.------
W Design Flow.../ Z�.•......... ..............••._gallons per person-Per day. Total daily flow------_ .........•. _...........gallons
WSeptic Tank—Liquid capac ty/Z ---gallons Length. °"_----... Width4'-7:AC.P... Diameter................ Depth...I.......
Disposal Trench—NO. ......_.. Width_...�--......... Total Length......__,._._. Total leaching area................sq. ft.
x .,
Seepage Pit No..... Diameter........?'�.... Depth below inlet....... .... Total leaching area...i_ E .sq. ft.
z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date.......................................
Test Pit No. 1...I_ ._.minutes per inch Depth of Test Pit......%_Z...... Depth to ground water..-
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
0 ------------•---- .. ...=:. ----. ----------------------------••-
Description of Soil •-- � �'
_
W ---------------------------------------------------------------------••••••••-•--•--•--...•-----•-----•--•--.........--•--....._._...............•••
UNature of Repairs or Alterations—Answer when applicable_____________________________________________________________________________________________
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TI HE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has en iss ed by the boa f health. .
Application Approvened
d •-• ----. -•--•-••. ••••.................•--------• ` Y-' ..
Date
Application Disapprov the following reasons:-------•--------------------------•-------------...............................................................
...........................................•-•••...------•----------•-•----------•-------......•-••--....._...•-•-----•--•----•--•--•••••••-•--•---•------------•---•-•-•••-----•-------•-•-.•--...._..--
Date
PermitNo......................................................... Issued.......................................................
Date
No...'�p ` F�s.._.1� .............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HE�AL/a/"
..........................................
Applira Lion for Uhipos al Works Tnnitrurtiun Frrutit
Application is hereby made for a Permit to Construct ( ) or Repair .( ) an Indiidual Sewage Disposal
�'---� /
Sysf / � f/r� !-c3•mot/ G Zr
... .............-- - ---- .... - ... - --•••---.....------ -••_. .._..........-----
�� cation-Add2
r4!,, ° or t Nam° J
• ... te;q 'oZ i3/ f'.S'/F�'/Y !t x o /`//7.�e✓/r",G�,
....................... ................. ..............................................................
� Installer � Address
Type of Building ize Lot_i l:/)90-_&_..Sq. feet
Dwelling—No. of BedroomJ.z_,,2_ ._.._Expansion Attic ( J Garbage Grinder ( )
Other—Type T e of Building -� /�r ersons________ __________________ Showers
Pa YP g ------------------•--------• >�. of p ( ) — Cafeteria44 ( )
Other fixtures - ----------•--------------------------------
W Design Flow.__./2..............................gallons per person per day. Total daily flow......__-a�__�✓__0_________________________gallons.
WSeptic Tank—Liquid capacitvAt gallons Length_"I'':.K_ Width__2'_-_/�_ Diameter________________ Depth....'_......
x Disposal Trench—No._:`�________ Width......_-- Total Length_________ ______ Total leaching area........':.........sq. ft.
Seepage Pit No___ ______________ Diameter......../!2_._ Depth below inlet......... Total leaching area... _- �.sq. ft.
z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. 1.... _._minutes per inch Depth of Test Pit______/ . Depth to ground water.._��...........
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
----------- ....................................
•--•--•-_-•--••f--•--.._..•--}-- . -•----•---------------------- ----•••••-••---------
•----_-----
O Description of Soil...........��....":__-_�•-.-----••� --`•?.......�C✓��'�'�� ���-�ar�jon`C� ..........................
--••----------•--•-----•---•------• --- f ' i i
W -••-••-----•----------------•----•-••••••--•------•• -- .
U Nature of Repairs or Alterations—Answer 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 been issued by the board 9f health J e
5
ter'!i ne, --'}
-------------
�....-___, �,+•—r � Date
ApplicationApproved`BY-Y '"= . f'_ ------------------------•---------•--•--------------------•--••--•-- • -----••-•-•---•--
Date
Application Disappro -' the following reasons:--••••••-••-••••-•••-•-•----•••••••-----------•-----•-•----•-•••--••--•••------••---•-•-•-••-•-•--•••-.._....._
--------------------•-----.....--•-•----....._._....-------------•-------•-••----•-----.....-•-----------..__..---•--•-----------•------------------------------•-----------------•---------••-----------
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS -
BOARD OF HEALTH
..........................................O F.....................................................................................
TrrtifirFa#r of ToutpliFanrr
THAS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (,-I or Repaired ( )
�)�fI
by------.._. _ -- -•••-•.......••-----------•-----•---------------
�� Installer
- ..---
has been installed in accordance ith the provisions of TITI 5 of �jhe State Sanitaryod as scribed in the
application for Disposal Work" Construction Permit No �.�__-•7_.!�1—_.______._ dated_-. �_ __.��;__._�3
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST AS A GUARANTEE THAT THE
SYSTEWI//WI",#UNCTION SATISFACTORY.
/0 DATE---Ar l_1� --•--•-----------------------------•-•------•------------- Inspector
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
n
.........................OF..................._._....___-..._......._.._..-_••• �!�
No.l..........�:�.. FEE........................
Bisposs nrkii Tnni#r ion rruttt
Permissionis h by granted-----------= '...�1. ...... ----•-- -••••••--------•------•---•-•-••••••••-•-•--•----•••••••-•••••--•-----•-•-_._..
to Construct ( v or, ( ) an Ino vidu e Disposal System
atNo. ---------------------------- -- ---- �---/--...........
Street '
as shown on the applicatio for Disposal Works C struction Permit No___________________ Dated_f!...,_%/.�_._____._.___.___....
Board of Health
DATE---- ---------•---------•-----------------------------------
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
L.c�T S .
t � �µ OF13 M�ssq i
j its
SLUS N
!ta 2N74
4;
Suit"
i 20 , 00 ;S.;F'
L_ cj 7 -1 o I{I
4xi2• \ i
I CPACHiW! P i r 1 �E— 3 'y �a C - (•l
j /000 SAL, ;� 1 O
Tic Tj
V _o NF
j UI
Ira I
_ IQ4.5 N
3z'
1.0
O
1 ( ►i Ll
�c M
1 A I aaI
I µyp. v
ro
Imo_
WILL �N� To„l ,� v >__
j�/t'�r/�1U7'E Q ,v✓r ��`=' AEA
F1T PrT 150' FRcx rrtici_
PK Fnrp iN PvenT
TAM EL. .00.o ��• F"� �•
- — hs�uAA PObia i101�1 G1fQ l�rt4�.T yT�q G T' .
LEGEND
EXISTING SPOT ELEVATION 0,�0 ��H.OF �n, CERTIFIED PLOT PLAN
is EXISTING CONTOUR ——— 0 -- v `r� W/LL/nILsTON AvEv��
FINISHED SPOT ELEVATION S 7.t;=?r•`Ll-Y
FINISHED CONTOUR 0 ""—" of ORSE ti
APPROVED , BOARD OF HEALTH �No los51�° IN
FSS/ON��
DATE AGENT SCALES / r,_. 30 ` DATE s Fs 3 r 18-3
LOREDGE ENGINEE'RIIVG CQ ING � wsT
--_ . CLIENT ' I CERTIFY THAT THE PROPOSED
EGISTERE REOISTERED. Joe NO..R-3: �5.. BUILDING SHOWN ON . THIS PLAN
CIVIL LAND CONFORMS TO THE ZONING •LAWS,
DR.BY t ~� ' M A S S.`.! c:��
ENOIN ER OF.PARNSTAS E
7P2 Ni Al N STREET CH. BYv J R.
HYANN I St MASS. gHEET„1. OF 7 DATE .REa. LAND SURVEYOR.
. :.•�¢T /'I/AI '�•IOTF = /f E/T.Y�R S-FAp C TA.,V� OR
_EACH/iVG ?/T- 4,4E A10,2E T,y,�;•� /2'9ELOiv
/0 Fr'ACIAL 1.�ADFi�q ?4 •O/AAf 4=7,= ' CayC,P6'T E CCt�E o
• 'PYC P SJrAGL BF Q.TOUG,NT TO Gt?A.OZ.
GO/VCRBTF f P/ Q AV e,4YY CA 57- /leoly C Y�.�
104.S C'OYEI�.� M/AI IRrTCM f Sid,�T L 3 r
2 0
I" Par
MIA
- • I• • • _• • •• • e�• • /8- mid
i�i �Eit I7: SmPTlc T.l4Ni ' O/S7: 1 • e�e s • e • i iYR SEED Tv,
} g,' ,. --'� `.a A{?TLC IM,LQ� OFI,.CylLNM(�/ e e • • ••
V Tv Gc ft'-G , LAvee of , / •O�f�CT/1/� • • • �/a - �2
LOAM. 0.CON O ♦ f • ! '
r" 0 a s � i got p • WASirED STJ,V
p �i6kL;�DA i e0 • • o • • o a• • m •� ACECA5T SnsrwaE
IJVVlei97 E�a� ' C/FG�FC/7�l or. • • o • • • s • i' a e P/7 C.4
1,VYYZ47 AT ARIMAD 9IS 607:O/ j �L= �c.•3
l/t�tE1r. .Ti D neC' mivic fT_ 4PA4jw.
a t
AIr
1AffcrmjvQ j alto u1vA P447Ejq 7A
I,YL ACXIAR P+1T J .�YST�I� - -
t
_
mm"SER OF QEAR46",S .3 -
G.�RaAG.E'�isPosAl u�Y�r Div j✓E 'SOIL. L.045�
TOTAL Zr 17/~rF.D JP—LOW-3 3 0 GAS 1AAvP SOIL TEST API Solt.msroZ SO/AL TF5r
°Nt/r�BFi? 4F L<,tCXavG OlT3 � OX SO/
/ gl�! I�LFY.
S/DE[1'ACH/N6 PER IS-' I•T_ dr , DA 7- ° L TFST
-jaT7 pM L6�1CK/NG•PER PIT 113 SO fT 0- 3 AESULrs i�/IT v&sSED BY�/RE i c 0 g/
Lv .q >vt �.. 'OeWCOLAW .
iOT.1L tEACN/A'G AREA ZL'4 Om t,4T SQ AT. --aAl �,q c7�:� E / LCS.S M//1,�/INCH
1 ESEf v,6 44E aC"N1,Yd AREA �6 4 54. A7.' P6,tC04.4T/401V R,47-x,&2 -Ya«c �> ,f/�v.//,ycl,►
-ram
OF Ahl � -V1 OFMAsj �MC-Dr cJi
a3, s9c• � o`• A�Bp�p'�_,t ti� � /� i �=G� 7I
U � 'HORSE v, �7 rl Fi✓�. L
p No.10951�O
�►�9874. `: �A�Fc cIsTE�'���```` EL DReDGc cNG/NF..F. cl— CO INC., �
N►3TE��p �/ ryONAkL- .0 NO Ci11CNiV0 wV,4TG•R 7/2 1"A/" ST. , VY-7,t,'.vrS. —,q 1J.
_ o suR" �NG'DUNTE.e=O CL/EA/T,-
Lti
1 0 GM0LI.VO .ATE,�' AT- FL.EV. �i owe c�nib
Z OF