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MARSTONS MILLS
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7. TOWN OF BARNSTABLE
LOCATION a� 3 l /\ ON Ul D O d RQ SEWAGE # dao_ 6,8 6
VILLAGE 114 A R sTn NS ,Q/(//I S' ASSESSOR'S MAP & LOT
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j INSTALLER'S NAME&PHONE NO. / 1Y A C 0"41 I3 @ 8 + T y ti
SEPTIC TANK CAPACITY Ao oO - fir* �L �,
LEACHING FACILITY: (type) W C 9A.bli3P,e s (size) rOO G d L
NO. OF BEDROOMS 1 J �1
B1 m DER OR OWNER e _ r 4 rs ! ,
PERMITDATE: 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
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Wo_t7 �1 ' TOWN OF BARNSTABLE
LOCATION aC 3_Z ON LTD a Ct% RD SEWAGE # oaf $w
VILLAGE A R SLO NS A f//S ASSESSOR'S MAP & LOT 1�1'OR
INSTALLER'S NAME&PHONE NO. f /- Af A C O/n I3 e R as O it/
i
SEPTIC TANK CAPACITY Z.O D D d ®%r r 0 G 1-2r
LEACHING FACILITY: (type) '��4 O W C11A.109Ae s (size) J DD G'41-
NO.OF BEDROOMS
BUILDER OR OWNER
PERMITDATE: Q 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
w
Furnished by
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No.iV'm Fe 50
0 0
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01pplitatfon for �Digpogal *pgtem Congtruction Permit
Application for a Permit to Construct( )Repair�X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.23 Ironwood Road Owner's Name,Address and Tel.No. BobDykes
-Marstn Mulls Mass. 02648 23 Ironwood Road Marstons Mills
Assessor's ap arce i � O 02648 4 2 0-1 9 4 8
�ns:P auers Name,Addddress,and Tel.No. 7 7 5—3 3 3 8 Designer's Name,Address and Tel.No. 7 7 5—3 3 3 8
�1 .Macomber & Son Inc. J.P.Macomber & Son Inc.
Box 66 Centerville,Mass. 02632 Box 66 Centerville,Mass. 02632
Type of Building:
DwellingXX No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 477 gallons per day. Calculated daily flow 4 X 1 1 0=4 4 0 gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil Loamy -,a n rj t o f i n e sand
Nature of Repairs or Alterations(Answer when applicable) Adding 3-500 gallon chambers ]2acke
in 4 ' of 1 "' stone With a pea stone can 1 —DistribPtion bax
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 issuVd by thi o Health. 1 0/31 /0 0
Signed Date
Application Approved by Date
Application Disapproved for the following reasons 7 61
Permit No. 06 Date Issued
50.00
No. ,;, , Fee$
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
Zipplication for Migpoml *pgtem Construction Permit
Application for a Permit to Construct( . )Repair(XX)Upgrade( )Abandon( ) EJ Complete System O Individual Components
Location Address or Lot No.23 Ironwood Road Ow er's Name,Address and Tel.No. BobDykes
Marstons Mills Mass 02648 21 Ironwood Road Marstons Mills
Assessor's Map/Parcel 02648 4 2 0-19 4 8
0f7 a g7
r ame A s an Te No. 7 7 5-3 3 3 8 Desi ner's Name Address and Tel.No. 7 7 5—3 3 3 8
.tact3m s re Inc. J. .Macombe, r & Son Inc.
Box 66 Centerville,Mass. 02632 Bog 66 Centerville,Mass. 02632
Type of Building:
DwellingXX No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria(
Other Fixtures
Design Flow 477 gallons per day. Calculated daily flow 4 X 1 1 0=4 4 0 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 3-500 gallon chambers packed
in 4 ' of 1 'j" stone. With a pea stone cap. 1—Distribution box
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 CerLfi-
cate,of Compliance has been issu-d by thisB V o Health.
Signed .fa Date 10/31 /0 0
Application Approved by v Date
Application Disapproved for the following reasons
Permit No. 66000 Date Issued—JIN2 1 on
THE COMMONWEALTH OF MASSACHUSETTS
BA"STABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired(XX*Upgraded( )
Abandoned( )by J.P.Macomber & Son Inc.
at23 Ironwood road Marstons Mills,Masse. h n constructed 'n ccordance
with the provisions of Title 5 and the for Disposal System Construction Permit No dated �1 �ti �
Installer J.P.Macomber & Son Inc. Designer J.P. acorn er & won ,Jr>c.,
The issuance of this pe t shall not be construed as a guarantee that the sysyt�eemm will,function s designee
Date I Inspector `1� Jii.%� �
_— P� ______________________ 50.00
No. Fee
- THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Miopoml bpztem Construction Permit
Permission is hereby granted to Construct( )Repair`f(XX)Upgrade( )Abandon( )
System located at 23 Ironwood Road Marstons Mills,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 Aust be ckmpleted within three years of the date ofA-Y*"\ - 0
s e
Date: Approved by
< l/6/99
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 1 0/31 /0 0 concerning the
property located at 23 Ironwood Road Marstons Mills MA meets all of the
following criteria:
• The failed system is connected to a residendal dwelling only. There are no commercial or business
uses associatcdrwith 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 npibe located less than five feet above the
maximum adjusted groundwater table elevation. (Adjust the groundwater table cuing 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 DM be located less than founeen(14) fect above the maximum adjusted
groundwater table elevation.
Please complete the following:
A) Top of Ground Surface Elevation(using GIS information) s-�/ • S
B) G.W. Elevation 'IS— +the MAX. High G,W, Adjustment. 7, 1- _ :z A
D=RENCE BETWEEN A and B 5 �'
SIGNED : DATE: 1 0/31 /00
(Sketch proposed plan of system on back).
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