HomeMy WebLinkAbout0042 SCUDDER ROAD - Health 42 SCUDDER ROAD
Osterville
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APPROVED THE COMMONWEALTH OF MASSACHUSETTS
Oepartme:: BOAR® OF HEALTH
.4 .TOWN OF BARNSTABLE
Date
Applira#ion for Diipuial Mirkii Tnnitrnr ' n Prrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal
System at:
.................................................. --•-•-•---•-••--•-...._....----•-----------....---•-•-•-•---•---•----••--•-------......._......---
..: L' _. 4Location/Address i U G� No.
V Gf...... -. 00
Ow -.
...............
4 .. ................
Installer Address
Type of Building Size Lot............................Sq. feet
U Dwelling No. of Bedrooms............................................Ex Expansion Attic a g— p ( ) Garbage Grinder ( )
aOther—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( )
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........................................
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................
tX., Test Pit No. 2................minutes per inch Depth of.Test Pit...:................ Depth to ground water........................
a' �r
� ,R ✓1 „L, ..l.d._... Q
Description of Soil.........------ / ` l/� '
----------
x . -----•-•--------•-•.....•-------------•-••--------....---
�_.. -....- -�-.---- � ..c�< -.. : 1 -S��nee
........................ .......--- ......._........_...
U Nature of Repairs or Iterations—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 Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Complia• e ha�bn issued by the board of health.
Signed ----- -------- - --------------- -----`---- ----
.A
,, Dace
Application Approved By ... CJ J ... - ..-.:a 7::---9_�
------------------------------- Dare
Application Disapproved for the following reasons: ................................... . ................. .. ............. .................................... •............
--------------------- --------- --------------------------- -- --------------------- --- --------- -- --------------- -- ----------------------------------------- ------------- -- ....................................
Dace
Permit No. ..�,.- ........... .. Issued ...............
Dace
a
Y
THE COMMONWEALTH OF MASSACHUSETTS
'BOARD OF HEALTH
���-arm =2'tn^o•`�� TOWN OF BARNSTABLE
ApplirFation for Uhipoii al Vorkii Tomitrnrtiun JIrrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
................-................................................................................ •----•----------------------••----•--•----•-----•-•--•--------•---........---------..........-----
Location-Address or Lot No.
......................—.......................................................................... ..........--..............................................................................._.....
Owner Address
W
Installer Address
C11 Type of Building Size Lot............................Sq. feet
U Dwelling No. of Bedrooms............................................Ex anion Attic a g— p ( ) Garbage Grinder ( )
Other—Type of Building ............................ No. of persons................._.......... Showers ( ) — Cafeteria ( )
Otherfixtures --------------------------------------------------------------•--------------•---•----------------••-•----------------.......--------....__......----
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........................................
14 Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................
fZ, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
tx ----•-------------------•--•------•--•••----•••-------•-....--------..._..------...----........----•.........................................................
0 Description of Soil.............................................................................................................................. .....................................
W
V .............................................--•------------------------•--------------.......-----•------------•-----.....-------------------•--•--------•-----•-•----------------.....---------------
W
VNature 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 Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compliance has been issued by the board of health.
Sighed""----..`-----------`---------
:.... ---------------- ------ -- .................
` Date
Application Approved By ----------_-__. _.....-.....�'�-tea. ..-------33-- �-�_
- --------------'—..................--.............------'-----..- Dare
Application Disapproved for the following reasons- ....................................... -- -- --------------------------- ----------------------------------------------
---------------------------------------------...................................-------------------------------- -- ---------------------............................--------------------------------- --------------------- --------------
Date
PermitNo. .,�: ~.. t t -------------------------- Issued -------------...........................-- ------------------
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
C�er#tftctt#e of (110raylian e
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by ............ --------- - ------ ----------------------------------------------------------------------------- ------ ----------- -=-
Installer
at .................................
has been installed in accordance with the provisions of TITLE 5 oahe State Environmental Code as described in
the application for Disposal Works Construction Permit No. ......... .-.--1-��2 ........ dated ................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION A IS A TORY. r!1,6,1; ,/ �'( I` - C ; .'
� �� r
DATE------------------------------------- ---- - -- ---------. ---- Inspector ------ ........-------- ------------------.-- ----------....................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
GG TOWN OF BARNSTABLE
No......7- _-..I FEE....3C...... .
�t���a��a1 nrk� �nn��ry�yuan �ermi#
Permission is hereby granted......11�....................................
to Constructer{ ) or Repair,( )an I dividual Sewage Disposal Systemat
1
..................................................... ............ •-----------------•-•---......-••---------......-----•-•--------••------•---•-----...-----
Street /� //�
as shown on the application for Disposal Works Construction Permit No.;/......._........... Dated..........................................
................................. ' -----------------------------•---------•-•--------•----
DATE_ 'j 1 /y'• /j Board of Health
FORM 36508 HOBBS dr WARREN,INC.,PUBLISHERS
TOWN OF BARNSTABLE
e,,LOCATION G ��`/�`' Rd SEWAGE #
VILLAGE 11 ASSESSOR'S MAP & LOT
J.INSTALLER'S NAME & PHONE NO. CRAIG EDEIROS sin
,p
SEPTIC TANK CAPACITY ° C� 1 HXAIVNIS,M�k 02
LEACHING FACILITY:(type) �-° � a��° �aL size)
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
R-OWNER
DATE PERMIT ISSUED: -3/2,-7/
DATE COMPLIANCE ISSUED: �/2z
VARIANCE GRANTED: Yes No '/
'57 ?mil - -
�M
G
f
TOWN OF BARNSTABLE
;kOCATION � � S c- Rd SEWAGE
VILLAGE C52 S-t'e 11 C ASSESSOR'S MAP & LOT,/ 2
J.INSTALLER'S.NAME & PHONE NO. CRAIG MEDEIROS�„
EIN
_ ,p
SEPTIC TANK CAPACITY HYANN•IS, MA 0260-1
LEACHING FACILITY:(type)
NO. OF BEDROOMS PRIVATE WELL OR(PUBLIC WATER
OWNER e
DATE PERMIT ISSUED:
DATE COLIPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
��� - ` -
"Assessor's office(1st Floor. n !�
Assessors map and lot 3mb r IC 6 (1 3 of TH E To
Conservation(4th Floo 4 l�� \`9y EPTIC SYSTEM MUST� P`�e e
Board of Health(3rd or): Q FF INSTALLED IM COMPLIA 9 w
Sewage Permit num r_ ! e t saaiTr
Engineering Department ° 1 <. fl 9-H TITLE 5 ray�tlG6 •
House number `'` ENVIROI�MEN IAL CODE A p 39
Definitive Plan Approved by Planning Board 19
Y®M I kIULATEONS
APPLICATIONS PROCESSED 8:30-9:30 A.M.and I:00-2:00 P.M.only }
TOWN OF BARNSTABLE
BUILDING INSPECTOR T
APPLICATION FOR PERMIT TO
TYPE OF CONSTRUCTION _
19- 9-- ---
ly
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information: .
Location �� �12 /L
Proposed Use r�22-
Zoning District r\� Fire District 0
Name of Owne y6z �/1��/y Address 2 /
Name of Builder. f C/ C ✓�/"/�'�T/V Addressl•(21� 19Z2�
Name of Architect /l/ �C , � Address /4
Number of Rooms Foundation ����� � -7 TG
Exterior A' ' �• ��I//V if//C � Roofing L
Floors G Interior .•' l��.� �/(��:5/
Heating Plumbing* ,
Fireplace /V Approximate CostD OO D d d
/ 7 Area
o
Diagram of Lot and Building with Dimensions Fee O
;: