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HomeMy WebLinkAbout0101 NORTH PRECINCT ROAD - Health (2) 101 North Precinct Marstons Mills A= 148-135 t TOWN OF BARNSTABLE00 LOCATION,' OJ L C i 9A.0' Rd SEWAGE# / ©'��� VILLAGE ASSESSOR'S MAP& LOT /Wr— I INSTALLER'S NAME&PHONE NO. C7 r A- 6 P', SEPTIC TANK CAPACITY 6-ems � LEACHING FAcmny: (type) .. (size) 14 a NO..OF BEDROOMS BUILDER OR OWNER 9:f o—, t, io JW n PERMITDATE: 9 F- COMPLIANCE DATE:r2-".— Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Lea ng Facility Feet Private Water Supply Well and Leaching Facility (If wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching.Facility(If any w ands exist within 300 feet of leaching facility) Feet Furnished by 1 fi 4r. nJ', LOCATION / SEWAGE PERMIT NO. VILLAGE 7�/11/ INSTA LLE'JR'S NAME i ADDRESS BUILDER OR OWNER o DATE PERMIT ISSUED Z_ l DATE COMPLIANCE ISSUED �2/G /�_ 00l A/0 i6 3F /1-010711 �a�o TOWN OF BARNSTABLE C,�Q LOCATION /O /e/• PA L G�' '�4�� ��� SEWAGE # i VII LAGS �� =-��L /�'1�'l y ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. :�-•� 0 %"-- '1..�' `� SEPTIC TANK CAPACITY LEACHING FACILITY: (type) 3 (size) / NO.OF BEDROOMS BUILDER OR OWNER 4f -r-, Z 2 .y PERMIT DATE: —COMPLIANCE DATE: — Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Lea ng Facility Feet Private Water Supply Well and Leaching Facility (If wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any w ands exist within 300 feet of leaching facility) Feet Furnished by f,. No. Fe,$5 0 .0 0� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 0(ppitratton for 30tgposml *pgtem Congtructton Vermtt Application for a Permit to Construct( )Repair(xx)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 101 N .Precinct Rd Owner's Name,Address and Tel.No. 428—5 2 73 ei4M Jack Creavan 101 N Precinct Rd Assessor's Map/Parcel Centerville 02632 Installer's Name,Address,and Tel.No. 7 — 7 7 j Designer's Name,Address and Tel.No. W E Robinson Septic Service Sullivan Engineering Inc P 0 Box 1089 Centerville 02632 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder(rD) 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 Re airs or teratio s(An er whe applicable) Install tgt# Title 5 Leaching . �'accoraing o e pans of Sullivan Engineering Inc . a D-Box and three stonepacked precast leach chambers Date last inspected: G 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 Environmen al Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by thisoBo.4dof Health Signed Date Application Approved by Date Application Disapproved for the following reasons Permit No. t' Date Issued �'� � '°� � .. n..:A' ..-,-.- ._. � _.... ,rm ♦r• a ._ .. .- _ -. _ �p No. ;Fee$50.00 / ` _ 3�-.,a.- .. . fi THE COMMONWEALTH OF MASSACHUSETTS Entaeed.ea&omputer: r Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZIppYication for Mi5po!gar *potent Construction Permit Application for a Permit to Construct( )Repair(XX)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 101 N Pr e e inc t Rd Owner's Name,Address and Tel.No. 42 8—5 2 73 Ge4te-rr�e r'lm Jack Creavan 101 N Precinct Rd. Assessor'sMap/Parcel X of,07,0, Centerville 02632 Installer's Name,Address,and Tel.No. 775-8776 Designer's Name,Address and Tel.No. W E Robinson Septic Service Sullivan Engineering Inc .. P 0 Box 1089 Centerville 02632 IS Type of Building: Dwelling No.of Bedrooms 3 Lot Size / sq.ft. ! Garbage Grinder(PD) Other Type of Building �a.of Persoffs 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 Voil sand. »max 1 � Nature of a airs or terat4s(An�yr whe�applicable) Install ttl t Title 5 Leaching � r ins o e p ans of ul ivan Engineering Inc. rig 01 a D-Box and three stonepacked. precast leach chambers 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 thi n oLHealth. Q )/ Signed _ Date&—/Application Approved by r Date / 'r+R % Application Disapproved for the following reasons (" Permit No. Date Issued /I- f __ _ TH.E°j�OMM V WEALTH OF-MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Creavan (tertificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired(XX)Upgraded( ) Abandoned( )by at 101 N Precinct Rd. Centerville has been constructed in accordance with the vi 'oq_�of£Title 5 and thefor DDis osal S ste Construction Permit No. � °'°hated p�UJ t(OD1nson SeptI Service ' '�° Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date 1 2 - - �SZ Inspector ;�N -.,, --f A— ----------------------- --- Fee$50.00 No. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Creavan Mi.zpotal *potem Construction Verntit Permission is hereby grantfc�tP gnsttu t @,A R dM�Upgrade( )Abandon( System located at UU 1 iv Yr Installer : W E Robinson Septic Service 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 thisspermit. Date: a^� Approved by 't.� "�. t o 4�0 "," ' f ti 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 ENGINEERED PLANS) I, William E. Robinson. Sr. ,hereby certify that the application for disposal works construction permit signed by me dated&— /,;z.-�� concerning the property located at 101 North Precinct Road. Centerville, meets all of the following criteria: * Th re are no wetlands within 100 feet of the proposed leaching facility. FThere are no private wells within 150 feet of the proposed septic system. s no increase in flow and/or change in use proposed. are no variances requested or needed. roposed leaching facility will be located with 250 feet of any 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 Elevation(according to the Engineering Division G.I.S. map) B)Observed Groundwater Table Evaluation(according to Health Division well map) q SIGNED: �/� DATE " off'' LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER 20-1998 (Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted). lift � i -- - 1�6 �6 tvuwSvV*forri+lsrialiriopal MMsr N sY ON'.CA-C-- Cots$"If W4 CWMGN DATA i � 2ledlow4fi113risi�rwaTlsPbnM+1vP ROtiP trrmg 1NOFlGT� PhVI /�►�1li�lAwiLLaoGartiGAl taw YZ Ilwra Pcir►1s AnvEwe"aiw for T►:s LOL175 3 rEuc pw%ve: <i WNl I 1 Nc 04 al ib.r-114 a 3=3"GroA"A �GP�9.14-NiSFYKQIIOtI:pUsCombelorisRet}rrirafbSaamAp�riaw 1teJrp ReA taRaotALLVICKWA.iaoa.a " NGltDESIGN .5AT arrneZt)r�AWuMOTRR a.ti ar 11fsW vlaAee eiesiarca.rw.ctao L V 84^VVw ��e.�"a.na vse s�a cai7e.c,�ey C7�eleb *AM .a 17'1 Jr Wade!Secae eieMq SMra4 kawaiips s ReRwis vrdam est s 5 Trr,A),now"To"M ww"Ju SY& el-(tr,lr+3r+3a-p rK_Tu S` "-' fwsmd Crc4r " t f l � rstucw wre S IATA Now.=1Y c 7e' -J"Sr b Sbackift YsbaMa Ts#iie aM K-angimip�i IA(US MAY p_rg # tart A.a n..:�r� sea sr T i S"k so- 10its Issab-is Aeawdaft a wale o it aO + 310 ° 1�lORTH PRECINCT ROAD sa O.cO _n Cldwwl. itb.�s+1 R @ 1 -, a Tswi P �v✓1 wlS" 77.0 rJ 7 Esid-soptk K4 is be F4.*w QR,f 1k4 a A6aadwrd rIaev_,VlC_v_ ?T"X. LoCgT,6 n.- y 67p0 - �..F.8�8� Cn r i ! i LOT 17SMALL 3 ®• ! MVELOP'ED PROFILE OF PROPOSED SEPTIC SYSTEM IA,O w SF °XXcz suoeeca�ua iucovice ,o' rswsr ac alp20 rya• '— _6e1: taflr}c rAM►®rai la r¢netsercYJ..r �s AMR JO'W"Trs To CBaa"..TILAj.TUE a',Lr ou*ctsr ro=Aar:tw i wY, Mr.conorrwr� c T CROSS SECIIOK OP CHA.SGBER (._ NOT TO$C L - , sq Site t an sus aa3� Ena ? Septic. System Repair Des' n � `m —`—�--- - at:got x®ree Preeset .ae,Crartervr�k Ittg. r a� Date_Ortoerra,t9" Scale 1-=20' ullivan E _ ngineering, lnc. IF PO Box 659 `Ostervifre, MA 02655` 20o-�O / i rnsyeza-zs+,(soa�sas-�i�s m. � 1 4 i lid