HomeMy WebLinkAbout0039 APOLLO DRIVE - Health 39 APOLLO DRIVE
WEST BARNSTABLE
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No. 4210 1/3 BLU
ESSELTE
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TOWN OF BARNSTABLE
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VILLAGE W PST. ,t� R1 7-,�G�LpC� ASSESSOR'S MAP & LOT 13/-C)t/
INSTALLER'S NAME&PHONE NO. .l-!- /ICJ A C 6 A- P ekt Sd
SEPTIC TANK CAPACITY Z- OOD ,- O L /J
LEACHING FACILITY: (type)A-FLQ W C114,g6Off``S (size) J �X Zr X 2 LT
NO. OF BEDROOMS
BUILDER OR OWNER. -�SUvi
PERMITDATE: /S- & _COMPLIANCE DATE: 7— 10 Z�/
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
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" TOWN OF BARNSTABLE
LOCA ON /4</� !� ��O �R SEWAGE #J ool- s117,6
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VILLAGE IV eS .e ASSESSOR'S MAP &.LOT l 3/-n
INSTALLER'S NAME&PHONE NO. J- /- In A C 6,141 6 fR:t S-a
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type).`Z—�'j0 U) .ge ORS (size) X Zr X Z.
NO. OF BEDROOMS _
ILD„ER OR QWNER /U- SUvi
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PERMITDATE; -7
/S_- ZZf6/. COMPLIANCE DATE..-
Separati:on.Distance Between the.:
Maximum Adjusted Groundwater Table to the:Bottom of Leaching Facility Feet
Private Watiq Supply Well and Leaching Facility (If any wells exist
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on site or wil n 200:`feef of leaching factLtyj eet
Edge of Wetland and Leaching.Facility(If any wetlands exist .
within'300 feet of g leachin facili �' Feet
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Furnished by ";.
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No. ���`✓ �� Fee$ 5 0.0 0
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
es
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
ZIpprication for Miopozal 6peum Cow5truction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 39 Appo l o Drive �L L D Owner's Name,Address and Tel.No. 39 Appo l l o Drive
West Barnstable,Mass. AP Mark Nelson West Barnstable,Mass.
Assessor's Map/Parcel 1 3 I (V c/ 7 5 0 8-8 3 3-6 6 0 0 02668
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 XX 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 Loamy sand to f ine sand
Nature of Repairs or Alterations(Answer when applicable) Adding two 5 0 0 cla 1 1 can 1 Pa rh i n r
chambers packed in 4 ' of 1 "' stone. Existing 1000 tank & 1 -1000 ;it.
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 n t to place the system in operation until a Certifi-
cate of Compliance has been issue by this B gpeal
Signed f Date 6/1 2/01
Application Approved by Date
Application Disapproved for the following reasons
Permit No. O *' Date Issued r g�Z5-
'a �/7/r �� - $ 5 00 0
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No, f/l "-✓ Fes
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS
A 21ppfication for Mi0pool *pgtem Congtructton Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 39 Appolo Drive Owner's Name,Address and Tel.No. .3•9,' Appollo Drive
West Barnstable,Mass. Mark Nelson WestrBarnsta6le,Mass.
Assessor's Map/Parcel J? 7 5 0 8-8 3 3 7r,6 6 0 0 02668
Installer's Name,Address,and Tel.No.5 0 8—7 7 5 /33 8 t Designer's Name,Address and Tel.No.5 0 8—7 7 5—3 3 3 8
J.P.Mabomber & Son Inc,. - � J.P.Macomber & _Son -Inc.
Box 66 Centerville,Mass'.0�f.632 Box 66 CenterviYle,4ziss�.'02632
Type of Building: r
Dwelling XX No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) f
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Y 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 fine sand.
Nature of Repairs or Alterations(Answer when applicable) Adding two 500 gallon leaching
chambers packed in 4 ' of 11" stone. Existing 1000 tank & 1 -1000 pit.
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 F
vironmental Code and ilot to place the system in operation until a Certifi-
cate of Compliance has been issu -by.this 11 z ar Wfea
Signed { Date 6/1 2/01
Application Approved by Date
Application Disapproved for'thee following reasons
Permit No. ' �° Date Issued '
THE COMMONWEALTH OF MASSACHUSETTS
.. �BANSTABLE, MASSACHUSETTS
Certificate of, Compliance ` '
THIS IS TO CERTIFY,that the On-site SewagelDisposal System Constructed(,9-)Repaired�X )Upgraded( )
Abandoned( )by J.P.macomber & Son Inc.
at 39 Apollo Drive West BaSastable,Mass. has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Pe N , ' � dated J�- 12C5
Installer J.P.Mac&aber & Son Inc. Designer J.P.Macomber & Son Inc.
The issuance of this t shall of be construed as a guarantee that ihes eyst ill fu do design
Date .7(9 Z�ov Inspector
� - —————————————— ---------i----------
No. l _✓ Fee 50.00
3
- THE COMMONWEALTH OF.MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
1
Iiopogar bpotem Construction Permit
Permission is hereb ranted to Construct( )Repair�X)Upgrade( )Abandon( )
System located at H Apollo Drive West Barnstable,Mass.
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�' it.
a Date: y ` � �"� � Approvecfb_y_r
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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)
r
LJoseph P.Macomber Jr. , hereby certify that the application for disposal works
construction permit signed by me dated 6/1 3/01 concerning the
property locatedat 39 Appollo Drive West Barnstable meets all of the
following criteria:
a`
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 ore equal to 5 minutes r inch.
9 per
There are no wetlands within 100 feet of the proposed septic system
l There are no private wells within`150 feet of the proposed septic stem
P Po P sY., it
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 not 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 M be located less than founecn(14) feet above the maximum adjusted
groundwater table elevation.
Please complete the following:
A) Top of Ground Surface Elevation(using GIS information) 3 67-, '-z-
B) G.W. Elevation +the MAX. High G.W. Adjustment
DIFFERENCE BETWEEN A and B 3 ,
SIGNEDWA / DATE: 6/1 3/01
100,
(Ske h opcsed plan of system on back).
Q:health folder.cm
® Existing 1000
lgallon septic tank, '
Distribution box.
Existinq 10
Two new 500 ga 1 �„ w W_. b, Leachin
leaching chambers
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Page:. 1
�- CERTI 'ICATE OF ANALYSES�:.
BarnstibleCounty Realth Liboratory
Report".;Dated: Ol/07/2002
Report 'Prepared For:
'Or
der <G0213029
Gordon'Nelson
39 Apollo.Drive
WestBamstable, MA 02668
Laboratory 'M#: -0213029-0.1 Description: 'Water-Drinivng'Water
Sample#: 13029 Sampling Location: :39 Apollo Drive, 'West`Barnstable MA Collected:. 01/02/2002 .
,Collected"by: -GordonNelso :10/42067 Received: 01/02/2002
Routine
ITEM RESULT 'UNITS `MCL Method# Tested
.LAB:IC Lab
`Nitrates 1.3 mg/L 10 EPA300.0 01/02/2002
LAB:Metals
Copper 0.1 mg/L 1:3 SM3111B 01/07/2002
Iron <01 mg/L 03 SM31.1113 01/07/2002
Sodium 1'S mg/L .20 SM3111B 01/07/2002
LAB:Microbiology
Total IC61iform Absent P/A _ Absent P/A 01/02/2002
LAB.PhysicaLChen fishy '
'Conductance 150 umobs/cm EPA 120.1 01/03/2002
pH 6 6 pH-units EPA 150.1 01/03/2002
Note: Water sample meets the recommended limits for drinking water of.all:above tested'parameters.
Approved 'By:
(Lab'Director)
/f71Zao 7
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Superior=Court House., PO.Boa427, Barnstable, MA-�02630 Th:308 37.5-6605