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TOWN OF BARNSTABLE
LOCATION C Ad Al Af &kk lZ LA SEWAGE # GD
VILLAGE C ef1fie1 yf.011 e ASSESSOR'S MAP & LOT -J00 INSTALLER'S NAME&PHONE NO.'— 214 ,4 C 014 4 e JQ t S D.�/
SEPTIC TANK CAPACITY A rQ 0
LEACHING FACILITY: (type),- '/O W C/YA Af 1612X 'S (size) S 0D GQ i-
NO.OF BEDROOMS
BUILDER OR OWNER
PERMITDATE:-6 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
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TOWN OF BARNSTABLE
LOCATION C
L V
E A
t R AN � nRXv a
SW
G E # D D /� O
VILLAGE_ C Pit9fief° yj, e ASSESSOR'S MAP L b,
I OT
INSTALLER'S NAME&PHONE NO. A4 A c D,mot fg el? t s oA/
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type)A-FLO W C//,4 H!a -OR 'S (size) S do . G a
NO.OF BEDROOMS 3
BUILDER.OR OWNER
PERMUDATE: , COMPLIANCE DATE:
Separation Distance Between the:
Maximu
m Adjusted Groundwater
nd a ter 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
-------------
i
Fee$ 5 0.0 0
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 1/
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
Zipprication for Migo.5al 6pgtem Construction Permit
Application for a Permit to Construct( )RepairXX )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. Francis LaPlante Owner's Name,Address and Tel.No.Franc is LePlante
54 Cranberry Lane 54 Cranberry Lane 362-2797
Assessor's Map/Parcel Centerville,Mass. 02632
Centerville Mass. 02632 �3�/ 02
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 3 3 0 gallons per day. Calculated daily flow 3 x 1 1 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 medium fine sand
Nature of Repairs or Alterations(Answer when applicable) Om i t t i n q two cesspools.
Installing 1 -1500 gallon septic tank, 1 —Distribution box and
two 500 gallon leaching chambers packed in 4 ' of 1kIf stone_
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 Co a and not to place the system in operation until a Certifi-
cate of Compliance has been issuep by this ar of alth.
Signed r - Date 3/1 3/0 0
Application Approved by Date 3 Aezzcwo
Application Disapproved or the following reasons
Permit No. Date Issued
t l;
No. eeIJ7 / O .:; Fee $ 50.00 z
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes
A/ PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
Tipprication for Mizpoml 6p!5tem Construction Permit
Application for a Permit to Construct( )Repair4X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Addessor Lot No. Francis LaPlante Owner's Name,Address and Tel.No.Franc iS LePlante
54 Canberry Lane 54 Cranberry Lane 3F$22797-
!entervi YA�9Mesvijl Mass. 02632 Centerville,Mass. 02632
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 H—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 3 3 0 gallons per day. Calculated daily flow 3 x 1 1 0 gallons.
Plan Date Number of sheets Revision Date
P a Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Loamy sand to medium fine sand_
*s
Nature of Repairs or Alterations(Answer when applicable) Omitting two cesspools.
Installincf 1 -1500 gallon septic tank,AnDistribution box and
two 5090gallon leachincl chambervspacked in 4 ' of 1�" stone.
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 Co a and not to place the system in operation until a Certifi-
cate.of Compliance has been issu by this of alth.
Signed ZDate 3/1 3/0 0
Application Approved by Date
Application Disapproved or the following reasons
Permit No. Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
fertif irate of Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired4XX)Upgraded( )
Abandoned( )by J.P.Macomber & Son Inc.
at 54 Cranberry Lane Centerville,Mass. has been constructed in ccordance �'
with the provisions of Title 5 and the for Disposal System Construction Permit No. 7-"Z—16 6) dated Z Tid"+y'� .
Installer J.P.Macomber & Son Inc. Designer J.P,,-Macomber & Son i,I�Ic. o
The issuance of this pennitfshallyndbe construed as a guarantee that the syst�e�mf w�ill..funlctio as design, dP t
Date I/ �� Inspector �y J ! JF'_.�•w-��119%
No. G--yvv f�� --------------------------,Fee 50.00
- -- -_•--
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
Migozal *pgtem Conotrurtton ermtt
Permission is hereby granted to Construct( )RepairY((XX Upgrade( )Abandon( )
Systemlocatedat 54 Cranberry Lane Centerville,Mass.
t
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 pennit. Q
Date: 3 6 Approved by
r
1V
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 3/1 3/0 0 concerning the
property located at 54 Cranberry ..Lane Centerville,Mass. 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.
• 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 Abe 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 fourteen(14)feet above the maximum adjusted
groundwater table elevation,
Please complete the following: /
A) Top of Ground Surface Elevation(using GIS information) y
B) G.W. Elevation ''3 +the MAX. High G.W. Adjustment.
DIFFERENCE BETWEEN A and B
SIGNED : DATE: 3/1 3/0 0
(Sketc Zoposed plan of system on back].
q:hWth folder ccrt
II
2-500 gallon
leaching chambers �N
packed in 4 ' of 1-' l•
stone. With a 3/8"
stone cap. 1 -Distribution box
r: c.�
Pize- F114 r 0 Omitting two block
`nr /n/ g
1 -1500 gallon 16 1 cesspools.
septic tank. 10