HomeMy WebLinkAbout0426 SCUDDER AVENUE - Health 426 SCUDDER-AVE.,HYANNIS
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TOWN OF BARNSTABLE �.G ✓
IAs ATION 0 e/�/c:h A j/ SEWAGE # Kf;Z f/J
)�.LAGE ASSESSOR'S MAP& LOT 1 9 610
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACIL=: (type) — C %'(size)
NO.OF BEDROOMS 3
BUILDER OR OWNER
PERMTTDATE:JW 5' COMPLIANCE DATE: � l
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Botto f 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 wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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No. 4 9, 0 Fee $J
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
01ppCication for Oigpogaf 6pgtem Cow6tructiou Permit
Application for a Permit to Construct( )Repair(X )Upgrade( )Abandon( ) D Complete System D Individual Components
� toc t' n Address or Lot No. Owner's Name,Address and Tel.No.
Scud.d.er Ave . , Hyannisport, MA Barbara Shea
Assessor'sMap/Parcel `,0 PO Box 587, Hyannisport, MA
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Wm. E . Robinson Septic Ser .
PO Box 1089, Centerville , MA
Type of Building:
Dwelling No.of Bedrooms 3. Lot Size sq.ft. Garbage Grinder( )
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 S and.
Nature of Repairs or Alterations(Answer when applicable) To install a new T it l-5 leach
g1TqtEAI to Px i st i ng n-box, ( 2 leach chambers) -e
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 t ' o 06 of Healt .
i
Signed /..!/ Date 7
Application Approved by % Date t-1 I
Application Disapproved for the following reasons
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Permit No. ey 4,P, Date Issued -"
No. �� Fee `'"5 0
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS,
0[pprication for Oigool *p.5tem Construction Permit
Application for a Permit to Construct( )Repair(X )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
IiQ�gtion�Jdress o�LL t No�V e• ' ' Owner' Name,Address and Tel.No.
WWLLOO cuaa Hyannisport MA Barbara Shea
Assessor's Map/Parcel e0 PO Box 587, Hyannisport, MA
Installer's Name,Address,and Tel.No. P Designer's Name,Address and Tel.No.
Wm. E . Robinson Septic Ser.
PO Box 1089, Centerville, MA
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder( )
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 S and,
Nature of Repairs or Alterations(Answer when applicable) To install a new T itl-5 leach
system to existing D-box. ( 2 leach chambers) .,t
�—
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 th' oV6 of Heali
Signed Date �J
Application Approved by Date:
Application Disapproved for the following reasons '
Permit No. + Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
Shea BARNSTABLE, MASSACHUSETTS
(Certificate of (Compliance
THIS IS TO CERTIFY,that the On-site Sewa �ispo al S stem Constructed( )Repaired(X )Upgraded( )
Abandoned( )b Wm. E. Robinson Se is >;er�rice
at has been construct din accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. r dated
Installer Wm. E. Robinson Sr. Designer
The issuance of tt}a pet sl construed as a guarantee that the systewil�_f_unction as designed.
Date ,J J)�not be Inspector
---------------------------------------
No. fle 01111� Fee $50
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Shea lig;po$AY *p.5tem Construction Permit
Permission is hereby gran edt�Cons ct( )Re air(X��)U rage ) band ( )
System located at 26 Scudder Avpe . , Hy� inis�port, I
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 it.
Date: Approved
TOWN OF BARNSTABLE C
LOCATION 1 G .5 (�e/r./C;h A�/ SEWAGE #
VaLAGE_ ASSESSOR'S MAP & LOT
INSTALLER'S ER'S NAME&PHONE NO. 0 6/1.+-s U �- 7 7S'�? 7 4
SEPTIC TANK CAPACITY /o'tl-O
LEACHING FACILITY: (type) (sine)
NO.OF BEDROOMS 3
BUILDER OR OWNER 5-�L=,o
PERMTTDATE: S' > COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjuste.d.Groundwater Table to the Bottof 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 ad;wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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1 4 00--1 51TING-'-_ I REF E—
ROOM BATH LAUNDRY EX15T.
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TITLE
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ws� r-I Ensr , FLOOR
PLAN
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DATE
01/24/02
FIK5T FLOOR PLAN LEGEND REVISIONS
5CALE: 1/4`= I'-O' O EX15TING WALL CON5TRUCTION TO REMAIN
O NEW WALL CON5TRUCTION os/it/oz
EXI5TING WALL CON5TRUCTION TO BE REMOVED 04/23/02
DRAWING NO.
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NOTICE: This-F®rin Is To Be Used For 'It'.h-e Repair-Of Failed
Septic Systems Only.
ASSESSORS MAP NO, 2 9,F
PARCEL NO: a ,Z-0
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__.�`�� g � concernin the
property located at 426 Scudder Ave., Hyannisport,MA meets all of the
following.criteria:
* There are no wetlands within.100 feet of the proposed leaching facility.
* There are no private wells within 150 feet of the proposed septic system.
* There is no increase in now and/or change in use proposed.
* There are no variances requested or needed.
* If the proposed 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) a
(/
B)Observed Groundwater Table Evaluation(according to Health Division well map)
SIGNED: e5IA�) DATE_
LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER 60
(Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan,
this plan should be submitted).
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No........................ Fima.............................
THE COMMONWEALTH OF MASSACHUSETTS
OARD OHEALTH
C ... ...............OF..................... ....... /
Appliration for Disposal Works Tonstrnrtinn Vrrmit
Application is hereby made for a Permit to Const uct ( ) or Repair ( ) an Individual Sewage Disposal
System at
................_ 'C�. " /C ` f %
_ - - ...... .... ............................
i- ` ' � - ------•.....
a-
Locoil
Address� Lot No L
"00,
Owner n Address
Instal Address A—/
U Type of Building Size Lot...... f_-Sq. feet
U Dwelling—No. of Bedrooms--- ............Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Otherfixtures . ----------------------------------------------•---------..._-----------
W Design Flow.............................................gallons per person per day. Total daily flow...... ___ .•_
-- - -------
Ions.
WSeptic Tank—Liquid capacigallons Length................ Width................ Diameter................ Depth------,•--••-•---
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area...Z6.jC.sq. ft.
Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing ta4 ( ) / 1 >
Percolation Test Res is Performed by......._C �1........... ,ci f--............. Date...1 �-Z_ ,��,
minutes per inch Depth of Test Pit.................... Depth to ground water........................
Test Pit No. 1._ IS_..
44 Test Pit No. 2.... Ainutes per inch Depth of Test Pit.................... Depth to ground water........................
94 ...••-•---••••..........-•-•.........................................•...
O Description of Soil...................................f ..
x ................•-•-•------••••---•--.........__...._............--- - - -
••--..... ----- -_...-- - . -
•-- •--.•--- ........_----••---•-._......... ---•-.
W
••-•-----------------------------------•--•-----------•------•----•----•-------•••••-•.....•-••••••----•-------•-------•...----------•••---••-----••-•-----••-••--••---•..............._........_......
M. Nature of Repairs or Alterations—Answer when applicable...........................................................................................:...
-----------•--•-•----•-------•••---••-----••----•-•••--•-•-----••••••--••-•.....•--••-••......---•••-••-•-••--•-•-•--••----------••-••••--•......•. ............... ....................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iITIE 5 of the State Sanitary Code- ndersi.gned further a rees not to place the syst in in
operation until a Certificate of Compliance has been i le the 'r heal
1 9
Signed......... .......... ... ..... ............ .......... .............. -••••-•• --....,. .... ... � ,0 .
Date
ApplicationApproved By................................................................................................•. .......................................
Date
Application Disapproved for the following reasons:....................................................................... .......................................
...........................•---•--•--......---•......._..._..-•---•......-•--_........_.............-----............•---....._.....••-•--••••--•._...••-••-..._....------...........••••••........._..--
Date
PermitNo......................................................... Issued........................................................
Date
----- -- - -- -- - ------- -- - -- -- -------------- --- W....... -------------------
TOWN OF BARNSTABLE,�
1�6CATION /pZ. C ����1�/�rtt, �'C% SEWAGEVIIIAGE 4
ASSESSORS MAP.&'LOT
INSTALLER'.SA,NAME & PHONE NO.
SEPTIC TANK CAPACITY . V6
LEACHING FACILITY (type) :/ ' � „5 (size).
OF BEDROOMS 3 PRIVATE WELL OR, PUBLIC WATER
x
' BUILDER OR OWNER
'.DATE PERMIT ISSUED:
1. Tk< _
,f)ATE' COMPLIANCir'ISSUED-
�A KI NC E GRANTED: Yes
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No....................... Fuic..............................
THE COMMONWEALTH OF MASSACHUSETTS
OARD O�EALTH
..........OF.............
.....................................................
Appliration for Disposal Varks Tonstrurtion 11amit
Applion is hereby made for a Per o Construct or Repair an Individu ewage Disposal
�
System at:
.............. ..... ..... ....... .... .................... .......... ................................
- ---- --------- Location-,A dress No.
..........2W. ...........
...............
[4 vptler jAddress
...................................................... . ......... ... .
4 ..//. ...... .......... .........................................
Installer Address
. ...
Type of Building Size Lo ./J,/Zys,. f et
7*-----
Dwelling—No. of Bedrooms.............L.....................Expansion Attic Garbage Grinder
a
e
Other—Typof Building ............................ No. of persons............................ Showers Cafeteria Other fixtures .......................................................................................................
Design Flow.............................................gallons per person per day. Total daily flow......... .... .... ...................gallons.
1:4 Septic Tank—Liquid capacity/ flons Length................ Width.__......._.._.. Diameter___......._._._. Depth............._._
Disposal Trench—No..................... Width.............___.... Total Length__.................. Total leaching area___-`71-CC sq. f t.
Seepage Pit No..................... Diameter.._..........__..... Depth below inlet........_........... Total leaching area..................sq. f t.
z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by._......._ _ ...........
� I ...a. ____________ Date....
Test Pit No. 1 f- nutes per inch Depth,of Test Pit.................... Depth to ground water....................
!f --A.i
Test Pit No. nutes per inch Depth of Test Pit.................... Depth to ground water___.....__...._....._...
0 -- -----------I --------------------**...........*---------------- ---------- ---------------------*--------------------------------
Descriptionof Soil......I..................................................................................................................4...............................................
..........................................................................................................................................................................
----------------------------
......................................... -------------------------------------------------------------------------------------------------------------------------------------------------------------
U Nature of Repairs or Alterations—Answer when applicable------------------------_---................................................................
........................................................................................................................................................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Sanitary Code— The dersigned further agvbes not to place the system in
operation until a Certificate of Compliance has been issue board of-health.
Signed. .......... . ......... .... .... ......... .....— Date
Application Approved By .... .............
.............................. .............................................. ........................................
Date
Application Disapproved for the following re&ons:................................................................................................................
.......................................................................................................................................................................................................
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................................OF............
wrtifiratr of Toutpliattrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired
by...........................I..........................................................................................................................................................................
_.rInstaller
at...................................loo."e;
............ ............................................ ................................................
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction.Permit No......................................... dated_....______...______..._.._.___._..........._...
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WjVL#NCTION SATISFACTORY.
DATE...&0 ..............
...................................... Inspector_ 5?0.."9 --------------------------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
. ...................OF........... ...........................................
No.....;re/- J--� .......... .......... ... .
.................... FEE........................
ffi712
svosal , ks nstr ion amm
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Permission is hereby granted........ ...... ............................. �VC671 c .......................to Construct (A) orr.,Repair an Individual Sewage Dispos System
?- .............................................................I.........................
at No...---.......4...a............... .......3...........
........................... X;----
Street /3. 'PY
as shown on the application"for Disposal Works Constiuction.i Permit No.................... Dated....L
....................... ..........
Sewage ge ispos System
..... ...........................
ie
DATE....... . -----------------------------------------BoarHealth
. ...........................................
FORM 1255 A. M. SULKIN, INC., BOSTON
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No.10951 Q
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LEGEND
EXISTING SPOT ELEVATION Ox0 ' " ����� CERTIFIED PLOT PLAN
EXOSTING CONTOUR -- __
— 0 — �-, �,, � �.-:{ �� ��� �� �,T«-16F7P 's why
FINISHED SPOT ELEVATION : ,y", ,"/ r09ERr� rc A iy'/1�I�/��:�r'�
FIKISHED CONTOUR 0 , URUCE
cap ELDRED ' IN
DATE . AGENT : wO suc _ SCALE /-' � ` DATE ,
LDEDGE ENGINEERING CQ CLIENTS i CERTIFY THAT THE PROPOSED
E4ISTERE REGISTERED Jq�,NO, q4Z BUILD.INa SHOWN ON THIS PLAN
CIVIL LAND - CONFORMS TO THE ZONING LAWS
'ENG NEER t!R DR9Y� OF BARNSTAB E , MA
712 MAIN STREET
c HYA NN I S, MASS, SHEET III _ Z— DA E REG. LAND SURVEYOR
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SHALL �F ,9RO[J1t�NT' TO GRe�OE. i9N .�X`TRA
.p .PVC tiERYY CAST!Ro/Y -Co✓ER S//ALL BE CUSEO
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&WTLET S&P77C TANK 9 5-I Jc ,.
//VL,ET AISTR/A5!/T/ON BOl+e 9 4 9 FT, GROtJNO J 1 TER 734$LE --
0V7ZETD/STR/A&W0N" 94,7 SECT'/O/V 4F
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G04R45AG,P15,P05 J-vrvJr i/0 :. SOIL LOG ®/.L 'TEST
TD-rAL E3T//► TED FWsv 3 3 0GAL1pay SO/L TEST A/ SOIL 7FST �
Num&Ei? ar LEAcmN& P/7-3 f ELEV. flo'S ELArY. AATF OF$OIL. TLtST /O -2-`7� 3
StaE LEAGH/NG PER PJT S T c r. ccgc�
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