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0176 MARSTONS LANE - Health
tA76 Marst ,Lane; � y Bamstbble, yrw r a � r ..r y w 4 b � r r, I s r. rr ' e DWN OF BARNSTABLE LOCATION l io f')fi—,e N 4 o9,4) � SEWAGE # VILLAGE ASSESSOR'S MAP & LOT i INSTALLER'S NAME & PHONE NO. ; SEPTIC TANK CAPACITY ( 2 LEACHING FACILITY:(type) 0-0,4 AZ&4, �� ) NO. OF BEDROOMS PRIVATE WELL O PUB C WATER BUILDER OR OWNER rd,� T' (rd2 E 1J T HT ISSUED: g a -- DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No � S l dye L i)lu � o-k, of t t TOWN OF BARNSTABLE 9 LOCATION 2M A 9 510&S LA SEWAGE #i 2001" �6 `ILLAGE A A- CUM A A 0-U`,0 ASSESSOR'S MAP & LOT 330 INSTALLER'S NAME&PHONE NO. T/V A A C 6 A O N SEPTIC TANK CAPACITY Z 10 O LEACHING FACILITY: (type)2c— V P V 4.y&1/5 (size) 13 X •� NO.OF BEDROOMS BUILDER OR OWNER � h�. PERMIT DATE: 02? o Z COMPLIANCE DATE: S z G 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) I Feet Edge of Wetland and Leaching Facility.(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by— f ` -i �n '\ �(i � � / � / � / � \ CT� ��� � �3� � ��9 �9 � '1 / � O � � o b ---{� ! 1 �. O vdf l 7 No. / s Fee 50 0 0 THE COMMONWEALTH OF_MASSACHUSETTS Entered in computer: / Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE. MASSACHUSETTS 01ppItration for ;hgoaf bpotem Con2truction Permit Application for a Pennit to Construct( )Repair(x)Upgrade( )Abandon( ) ❑Complete System O Individual Components Location Address or Lot No. pvCr's ame Address and Tel.No. `i ti Greene 176 �Ia�gtons lane Cummaquid AssessorsMap/Parcel �O �� 176 Marstons Lane Cummaquid Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Joseph P. Macomber & Son Inc Jospeh P. Macomber & Son Inc Box 66 Centerville 775-3338 Box 66 Centerville 775-3338 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 6-3r, gallons per day. Calculated daily flow 0,460 = 39 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Loamy sand to clay to fine sand. Nature of Repairs or Alterations(Answer when applicable)Install i ng 1500 gallon tank, Distribution box, 2-500 gallon leaching 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 issuSA by this B f He Signed a & .,V,7 Date Application Approved by Date Z 0 Application Disapproved the following reasons Permit No. Date IssuedA W Ij Fee 5 0 00 THE COMMONWEALTH OF MASSACHUSETTS f Entered in computer: �* Yes ,PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS:, A` 01ppYicatiori for 30i6pozaf *p!tem Courtruction J)ermit Application for a Permit to Construct( )Repair(x)Upgrade( )Abandon( ) O Complete System O Individual Components Location Address or Lot No. O r's. are Address and Tel.No. 176 Marsgtons lane Cummaquid E `�ti Greene Assessor's Map -� 6 176 Marstons Mine Cummaquid Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Joseph P. Macomber & Son Inc Jospeh P. Macomber & Son Inc Box 66 Centerville 775-3338 Box 66 Centerville 775-3338 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 1'b'. gallons per day. Calculated daily flow ft110 = gallons. Plan Date Number of sheets Revision Date Title .. Size'of Septic Tank Type of S.A.S. Description of Soil Loamy sand to clay to fine sand. t Nature of Repairs or Alterations(Answer when applicable)Installing +1 500 gallon tank, Dis Distribution box, 2-500 gallon leaching chambers Date last inspected:' Agreement: J 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 issuSo by this B, f He lth. c� Signed r Q 0, Date V- Application Approved by �0 l �- Date 0 Application Disapproved r/the following reasons ( ' r Permit No. E'' Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS y� i Z rtifirate of Complianre . THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired(X )Upgraded( x ) Ab ndoned( )byJoseph P, Macomber & Son Inc at ?76 Marstons Lane Cummaquid e construct in acrprdance � d with the provisions of Title 5 and the for Disposal System Construction Permit No. ated Installer J.P, Macomber & ' Son Inc Designer).P_. Macomb r Son rim ' The issuance f this pemnit shall not be construed as a guarantee that the sy wil/function�esigned. Date () Inspector Mom! — — -------------------------- ————— ZKV No. Fee50,00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS r ig o�aY bpztent Conotrurtiott 3 Permit Permission is hereby granted to Construct( )Repair(k)Upgrade( X)Abandon( ) System located at 176 Marstons Lane Cummaquid 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 c ple ed wi three years of the date of this a t. Date: ©�/ Approved by , 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) Joseph P,Macomber Jr. hereby certify that the application for disposal works construction permit signed by me dated 6/2 8/01 concerning the property located at 1 76 Marstons Lane Cummaquid,Mass.. meets all of the following criteria; • The failed system is connected to a residential dwe lling only , There ar eno 8 Y commercial or business uses assoctatcd with the dwelling. r' 8 • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. f • 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 mLbe located less than five feet above the maximum adjusted groundwater table elevation. (Adjusvttie groundwater table using the Frimptor method when applicable) t • If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will M tie located less than fourteen(14) feet above the maximum adjusted groundwater table elevation, Please}complete the followia g: A) Top of Ground Surface Elevation(using GIS information) rV B) G.W. Elevation / +the MAX, High G.W. Adjustment.. 97a DEFERENCE BETWEEN A and,B. r SIGNED DATE: 6/2 8/01 (Sketc r sed plan of system on back). q:health rolde een is r r Omitting cesspool New; 2-500 gallon n j leaching chambers �L, New Distribution box packed in 4 ' of 1 '-z" stone. 25 'X13 'X2 ' Omitting New 1500 gallon Cesspool Tank. , s r TOWN OF BARNSTABLE LOCATION !PK A A if S-f6 Al s LA SEWAGE # 2001' �6 VILLAGE AQ A A• C UM Al A &U/L7 ASSESSOR'S MAP & LOT 3,50 INSTALLER'S NAME&PHONE NO. A A C CA 2 I� • �o/✓ SEPTIC TANK CAPACITY /,J 00 LEACHING FACILITY: (type).Z— V P fAA911s (size): 13 K -:2%f NO.OF BEDROOMS .� BUILDER OR OWNER '7t^ the PERMIT DATE; Z COMPLIANCE DATE: S 2 G Separation Distance Between.the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well ind 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 h i 1