HomeMy WebLinkAbout0037 WILLINGTON AVENUE - Health 37 WILLINGTON AVE, MARSTONS MILLS
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TOWN OF BARNSTABLE
LOCATION �i✓�- E i6-- �� SEWAGE #
VILLAGE /� , /��� ASSESSOR'S MAP & LOT O
INSTALLER'S NAME&PHONE NO. 2 % S-- ST'7 7
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) S"t 7 4,7 . 4 (size) I)-
NO..OF BEDROOMS 3
BUILDER OR OWNER _-0 e T/: ,c
PERMITdATE:�d COMPLIANCE DATE: /�'-2-`� 'y
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
Efige of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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TOWN OF BARNSTABLE
LOCATION ��s�. c SE AGE # --
VILLAGE. /-92, ASSESSOR'S MAP & LOT
. N S._ �� 7
• INSTALLER'S NAME&PHONE NO. . e i'- 6 •""•
E SEPTIC TANK CAPACITY
LEACHING FACII.ITY: (type) �"r. '� W C (size)
.NOlt O BEDROOMS 3
BUILDERbk OWNER 01 c 7//Z ,c,<
PERMITDATE:/0,`:/s 1 COMPLIANCE DATE: //'2-'9
Separation Distance Between the:
Maximum Adjusted Groundwater-Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facihty9(If any wells exist
on site or within 200 feet of leaching facility) . Feet
Edge of Wetland and'L-eaching Facility(Ifany wetlands exist
within 300 feet of leaching facility)/r Feet..
Furnished by '
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e =No. c �--6 7 / Fee $50
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01pplication for �Ngonl *pgtem Construction 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.
37 Willington Ave . , Marstons Mills Joanne Dietrick
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_� 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 pp Type of S.A.S.
Description of Soil Ct YLCA
Nature of Repairs or Alterations(Answer when applicable) Title-5 leach system.
D-box and 2 stonenack d chambers, w/ 4' 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 this B ar f Health. Q
Signed r Date 0 V l
Application Approved by Date
Application Disapproved for the following reasons
Permit No. 6 Date Issued l C) 1?
�r�r�
Fee /
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓ �,/�
_PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS Yes
0(pprication for ;Diopoar *p.5tem Congtruction Permit
j f- r
t 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.
37 Willington Ave . , Marstons Mills Joanne Dietrick
Assessor's Map/ParceI
v`
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Wm. E. Robinson Septic Service
P 0 Box 1089, Centerville
i
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 ot_rLCA
Nature of Repairs or Alterations(Answer when applicable) Title-5 leach system.
D-box and 2 stonepacked chambers, wl 4' stone all around
Date-la t 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-
f
cate'of Compliance has-been--issued-by this-B-ar �f4.Health. ` Q
Signed Date/O
Application Approved by Date
Application Disapproved for the following reasons i
i
Permit No. 77—i; 7 a Date Issued
---————
THE COMMONWEALTH OF MASSACHUSETTS
Dietrick BAM18TABLE, MASSACHUSETTS
.� Certificate of Compliance
THIS"IS-TO-CERTIFY that the On-site Sewage Disposal Systeip Constructed( )Repaired (X )Upgraded( )
Ab ndoned ,)bl Wm., > FwRobinson Septic Service ,
at �37 Wi ling o.n_,Rve. , marstons IVIIIIS
has een constructed 'n acgordance
with the provisions of Title 5 and th`for.Dis`posal System Construction Permit No. 7 7 /dated- /4 �s
Installer Wm. E. Robins" Sr.� Designer
The issuance of this permit-s all not e_construed as a guarantee that the system will,functio as desig ed.
r t U f d � j0"" ,
Date _ ill ' Inspector �V/t.til
----------------------------- --
No. / / —t0 /
THE COMMONWEALTH OF MASSACHUSETTS
' Dietrick PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
;0igpo.5a1 *p5tem Con!6truction Permit
Permission is hereby granted to Construct( )Repair(X )Upgrade( )Abandon( )
System located at 37 Willington 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 completed within three years of the date of this t.
Date: �O/ / / Approved by
_ t
• . 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 . Robinson,S mereby certify that the application for disposal works
construction permit signed by me dated /0—�S- -9� 0 , concerning the
property located at 37 Willington Ave . , 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 percolation rate is less than or equal to 5 minutes per inch. .
Mere are no wetlands within 100 feet of the proposed septic system
There are no private wells within 150 feet of the proposed septic System
"ere is no increase in flow and/or change in use proposed
l�There are 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
r4 groundwater table elevation,
Please complete the following: g r�
A) Top of Ground Surface Elevation(using G1S information) `
B) G.W. Elevation +the MAX. High G.W. Adjustment
r DIFFERENCE BETWEEN A and B
SIGNED : t ' (��.. DATE:
ti
[Sketch proposed plan of system on back).
q:health folder:cert
N:� (�
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LO CAi10 5�� SEWAGE PERMIT NO.
VILLAGE
IN.STA LLER'S NAME & ADDRESS
uAMRB:DOLLAWAY
?.0&2 Old Stage Road
re�['14�E E��P-ii1�9cS noa2o
B U I'L D E R OR OWNER
7-4-,-
DATE PERMIT ISSUED
DAT.,E_. COMPLIANCE. . ISSUED
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THE COMMONWEALTH 'OF MASSACHUSETTS
BOARD OF HEA TH
............. -.......OF....... ... ....... .. . .........................
App irFation for UhiposFal Works Tonstrnr#iun Vautit
Application is hereby made for a Permit to Construct 01 ) or Repair ( ) an Individual Sewa a Disposal
System
....... a-.7 ............. � ...... y�
...............................................................
,. Location_Addr s or Lot No.
L. a. -s.. ............................................
•--
.�9�I Own ------•--•...............•------Address
Installer AddressPQ ��
Type of Buildin Size Lot.!.....,�..................Sq. fqpt
Dwellingy No. of Bedrooms...........................................Expansion Attic ( ) Garbage Grinder
Other—T e of Building No. of persons............................ Showers — Cafeteria
Q' Other tures ......................................................
W Design Flow.....______________________________________-gallons per person per day. Total daily flow__-____---._.___.__-........................gallons.
WSeptic Tank Liquid capacity./ .gallons Length___-___-_.._.. Width----•_-____-____ Diameter________________ Depth................
x Disposal Trench—No- ------------------- Width---•-----------.._.. Total L th Total leaching area--.--'.____._:_.___ f t ��
3 Seepage Pit No----------- iameter......i°10_______ Depth below inlet__._ .... Total leaching area................sq. ft.
Z Other Distribution box ( Dosing tank ) a ^ iz- Z 3_ 7,0F.
Percolation Test Resul s Performed by...._..____ tl-- - Date... .._
z�- 7a- .
Test Pit No. 1. ._1a.4....minutes per inch Depth of Test Pit.................... Depth to ground water........................
(z, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
R+ r --••••• T-------- ---------•- �/°------- ---
Description�p TSoil -0' _ � .. ...................••---
U ..............Y, -•.........---......_. �� . --•..._•----------------------•-•-•---•-_-----•--••-•••••-----••--•-•-•--•----------•-..........•--
W .._..-•-•-••----------------••--.......---...........--•-----------•--------•-----•----•••-•-•••-•----•-•--•-•••---•-----•--...•----••--.....•---••-•--------••----•••-•-••......-••--•-•-...._.......•.
VNature 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 iITL U 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issu by e b rd ot health.
ed•�. ........ ..... ... _. ...Da
A lication A roved B / 41-7i
...--••. ......._... . ----------/77..??�,•---- 'PP PP Y .........
Date
Application Disapproved for the following reasons---------------------•--•-•-----•------------------------------...--------------•---------------••----........._
....................•••---•---•-------•-••••-•-•••--•---••---------------•----••.....--------•------•....••----•----•-•-•----••••-----•••-••----•••-•--•--••-••------••--------•• ......................
Date
7 �
Permit No......................................................... Issued------- .........................
Date
FEB
1 THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
�L
. ...._.....-- l.�rtytT, .. OF.,...... .................
Appliration for Dhipoii al Works Tomitrur#iun Famit
Application is hereby made for a Permit to Construct (A') or Repair ( ) an Individual Sewage Disposal
System a
Location-lddrOSs or LcrRo. �V
......., __......... .1.... .......... ........................................... ..-................... .........--.----
Own Address
W .. �
a a; ........ ._...... �...G !/ .{--- ----------------------------------------------- .............
Installer (J Address �� ���•••-•--
T.�ype of Building" Size Lot.-••_ i -,...........Sq. feet
U Dwelling V No. of Bedrooms...... ......... .......................Expansion Attic ( ) Garbage Grinder (1Y 1
Other—Type of Building ............................ No. of persons............................ Showers — Cafeteria .(
Othetures •--•--•---•-••••••-----••.......................•••-•-.•-••••••-•---•••••......-------------•-----•-•-
W Design Flow...v2!R _•-_------------ _gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank I Liquid capacity./.•---.-.gallons Length........0......Width................ Diameter.................. 136pth................
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area--------------
Seepage Pit No----------- ------- iameter....../10....... Depth below inlet.........._----- Total leaching area.._
Z Other Distribution box ( Dosing tank ( ) �,,�y�. �1C � -
'� Percolation Test Results Performed by............. _.._........_.. Date_._..._......_
a1 �
Test Pit No. 1.._..... minutes per inch D e t . ................. Depth to groun4 water........................
fs, Test Pit IN 2...............Minutes per inch Depth of Test Pit:...........:....... Depth to ground water........................
x -•-• -----• .............•-•- •• •-• •-- -••--•---•-- ..............................
O Description of Soil..... ............................
w Z .
U Mature of Repairs or Alterations-Answei when applicable................................................................................................
Agreement
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iIT?,%, 5 of the State Sanitary Code—The undersigned further agrees not to place.the system in
operation until a Certi "ate of Compliance has been is su by e"b rd o health.
Si ned � . :. .
- .r g
Application Ap roved By....
/ -- --
Applieatior ' isapproved for the following reasons........-- •------------•-------------------------------------••---
.............•----•-•--••..........._.................-•-••-••-•-.....••--••------•--•-••••••••.................•-••••.......•-••---•----•---•---•--••-••-••----•--•--•-•--•••••••--------•-••-•••-•••-•-
Date
PermitNo.......................................................... . Issued-.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BJ:ARD OF- HEALTH
OF.............. :,.,
rftftr t e Ftnr
THIS IS TO CERTIFY, That(e)In vv ual Sewage Disposal System constructed (,j: e) repaired ( )
I taller
r -
at......- :. -` -------- -4—A..•�' L
j,
has� fi d� ance with e rovons f e tatA-1y Code as described in the
application for Disposal Works Construction Permit No. .. dated_."..__. ---------------
THE ISSUANCE OF„THIS CERTIFICATE SHAL OT BE CONSTRUE_ ® AS ArG�ARANTEE ThIAT THE
SYSTEM WILL FUNCTION SkTISFACTORY.
DATE...............:............ .. .._.._.. Inspector.....:..............................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
......OF....._. . �
ts aasa1 nrk.0 Tonstrnriion
rrT
Permission Is hereby granted......... .. ... ...-- --- -- � �. �...
J�--�•--•-------•---•-••---�....
to Construct ( or Repair ( ' ) an n a Se spos ystem
at No._r:.: _.. -- ...... ....... �... . -• -A- ---------- ----•--
as shown on the application for Disposal Torks Construction er it�1Vo.................. Dated_._._. __ �y
DATE-----I2... = U 4.
FORM 1255. HOBSS & WARREN. INC.. PUBLISHERS
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A— ` AGENT ry' SCALE1 r'/ "=40� DATES ��C„ 7 y:7.
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__ I CERTIFY THAT THE PROPOSED
�Ai� i:R'EFI REGt3rEE0 J08 FIO. BUILDINQ SHOWN, ON THIS
Xfi O1Vil LAND"' CONFORMS TO THE ZONING LAWS
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L- -- PRECAST SEF-PAGE
0 0 • • • • • • • � • • a o P/TOR �LOlV _
/AWCA/ T eLEVAT/ONS
1AWCRT AT;al//LD/NG FT4
/NLET SEPT/C' TANK ! ` 9-s,S FTi-C�sEE rABULATICN,
0�7LET SEPT/C TANH _AFT. ti -
/t�L,ET OISTR/BUT/ON BOX 9 S.� FT. GROUND W,4 rER TX84,15 '
SECT/ON' O F
O lJTLET D/STR/B!/T/oN BOX 9 g.9 FT. . ' t
�ltLETSEEPACsE Pi-r 9 -S fT SEN/AGE O/SPOSAL. SYSTEM
' _ L EACHt'/VG P/T " ABL/LAT/O/V
DES/GN CR/TER/A I _ SCALE . %a" U/MENS/a Al A' 4 FT. r =
6
D/A�.ENS/ N 8 '
L D/MENS/ON C�—FT. A-f/N, -
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'TaTAL E,ST/M.4TEli°F'LOIIV' � _ SD/L TEST a,.w
. _ GAL.�DAY SOIL. TEST #/ So/L TEST�2. rt :•�'� '�
_ NUMBER AFSEEPAGE P/TS=` < fF[Ey, 98•p 4 --ELE✓. DATE OF SO/L TEST{ •./L�z3 / 77
S/OE LEACH/NG PER P/T SQ, P'T. 24 • Ld�+� RESULTS W/TNESSED BY R. P.
49Qrr0/NL6AC/•//NCrPERP/T �$Q. FT. PL`RCOLAT/ON RATE / /• MIN INCH `
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71=44 LEACH/MG AREA ZGi' SQ. FT. P1EkCOLAT/GN RA7E/�k2 MIN.�INCH
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