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Home My WebLink About0158 SCUDDER BAY CIRCLE - Health 158 Scudder Bay Circle Centerville A= 187-019 SMEAD No.2-153LOR UPC 12W anwd.aom • Undo in USA 1 � +wu�Mwswmrcrw SFI I TOWN OF BARNSTABLE LOCATION $ v&e,�- 94-1 Gv'dC , SEWAGE #,?� I,-Id 5 7 VILLAGE 1. Cn Je—V U l 1 l tL ASSESSOR'S MAP & LOT / 7-O/9 INSTALLER'S NAME&PHONE NO. CRz AIC, Mf-C,)Ei i20S SEPTIC TANK CAPACITY I SOO GAL— LEACHING FACILITY: (type) 2-P12E CAS-t' ,Q�x (size) /0-9O 66(— NO.OF BEDROOMS y BUILDER OR OWNER PERMI TDATE: IITU ks Co COMPLIANCE DATE: I r 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 oftleaching facility) Feet Furnished by • f 5 � IPA l0 CAT 1p�Lo+- SEWAGE PE VILLAGE 1� 'a INSTA LLER'S NAME A ADDRESS I CRA€G NtE-Ei C,� TrurtIng & tzlfflolrlq 142 Corporation Street *4m—%m-VR OR OW ER Hyannis Mass.75 OC28 6).5 7` DATE PERMIT ISSUED /Zz�--vZT- T DATE COMPLIANCE ISSUED �� r , 739 S-o ° , No........ �5 / Fus.............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH .. -...- OF......... .......: Z eel------------------------------ Appliration for Uhipaii al Workii Cna nstrurtinu Frrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Locati ress orp Lot - ----.'� �- .!'-........�`'. caner Address Installer Address dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................ Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures .................................. w Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-_----------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date............................... .....t aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 4A Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.......................... "r a --�---------- ----------------------------------•--------------------•-••---------------------------------=-•••••---------------------.._......_...... ODescription of Soil-----------� "`4 eI ----------------•---•--•--------•---------------------------------------------•-----------------------------•----•-•--.------------- x V ....-•---------------•-----------------------•---------------------------•....-•--------------------------•-•--•----------------------•-•-. W -----------•-------------------•-•-----•---••--•--------------------•--•-•-------------..........--------•- ' ��_� x -- - i U Nature of Repairs or Alterations—Answer when applicable._._.. .......:. ......L�._�`�`�.__.... e_��................. = 4, ` apt r. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iI'L U 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issue y the board of health. t -- Date Application Approved B t 1' ` 0 Date Application Disapproved for the following reasons--------------------------------------------------------•-----------------------•------------------.....----•-••- ............................................................ •------------------- -----= Date PermitNo......................................................... Issued....................................................... - Date THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ram......,-�.. C�.t , OF......!. ;c......................... ..............---.............. Applirtttilan for Uhiposttl lVorkii Tvun rnrtiun Permit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ............ .......Location''Addre..../ -S..' or.Lot No. .................................... •� "s . •(��)t�.C� .tt/. ..f, ��+- C..,. v•,�: ( ..-• •"',� ,� ! • ti Owner /' Address r ............. ... Installer Address UType of Building w Size Lot............................Sq. feet Dwelling—No. of Bedrooms............!...............................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building � yp g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures ......................... Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter........•.-.-.-- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by................................................... ...................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.........----.-.•-.----- f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 - ----------- -------••------••••••--•-•---•---•----------•-••-------•........---••-••_•----•......................................................... 0 Description of Soil........... - 2 `I...-`. -----------------------•-....-•'-------"---------------------•-•••---------•--•-----------•--••---•---------------•-•-------•-•-•- ►�i i UW ••--••-'---•-------------------"••------•'--.....----••--------••---•-••---•---...............•....---••'.... -•• I Nature of Repairs or Alterations—Answer when applicable.Z; _' !''..1�' `_t•~'� -<`°�•� f-i i l I -� �. _ ....... --• ----- ~7 ? t............... + -:.:_ Y y J i� f} rA t Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT12 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is§ued.by the board of health. .`.•'�.. ..-•�".' / !.�. ..................................................... t� r^-"' 'Date Application Approved By..................................................... .....>, .........................' ' ---- ------ Application Disapproved for the following reasons:.......... -••-•-----•••-•--•--••--•----•••---•---'--•---•-•--'•-•--•-----•--'--------....Date----------••-- ---------------------••---...---.....---...-------------•-------...••--------•---•-------...'-----•-•---.I--•--•"---'--------'•-••-•------••-----••--•'--------------•••-----------•----•••'---•--•-•-_. Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS �+ BOARD OF HEALTH �CW ...... ...`.............................OF...... ::' .........................:............................._... �' der ifirtt#e of f omplittnrr THIS IS TO-CERTIFY That the Individual Sewage Disposal System.constructed (_! or RepairedPV ' ( ) Q.y-- �^^ tw f Installer I /• �+ t• 1 /3^ hays been installed in accordance it the provisions of TITLE, 5 of The�StWe Sanitary Coded� as de cr�ed in the application for Disposal Works Construction Permit No..-._`i.li......!.1__.- -.-�....... dated-..........L........... ....................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM. WILL FUNC/TIONI SATISFACTORY. DATE.................. 6-k--••----._...-----•------....._. Inspector----�r_�--------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS f � f , BOARD_�OF HEALTH .....•... -"''',__,-•...n•v� '�- _. u .�.......15`-:......................OF................. 'f 7{✓ .... ................................................................ No...................z FEE.......' Dispoiiol arks Tnnstr ion Permit 4 Permission is hereby granted .......................................... ......- •----...._.............. to Construct, ( ) or Repair,({ -) an, 1�}dividua Sewage Disposal..•• ystem /- at Noc'7 , ,..,.,�.,... --a.,. ....,y.. --------r"- = ,«vl L..�• �.....� .✓Y F (( 1 Street _, /,i- l as shown on the application for Disposal Works Co`n'struction Permit No.._C........ b .!.'._f atefl:'- ....�. _. zt:.�- ........ its Board Health `Cl DATE. -•-••------•• --•---... -••----•---•-••---......-•---•-•-----•---------•• FORM 1255 HOB S & WARREN, INC., PUBLISHERS