HomeMy WebLinkAbout0119 SCUDDER ROAD - Health 119 Scudder Road
Osterville
A= 140— 014
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No. goo I s Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ZppYicotiou. for �Bigo al �&V&em Con5tructtou Permit
Application for a Permit to Construct( ) Repair( ) Upgrade(4 Abandon( ) ❑ Complete System ❑Individual Components
Location Address or Lot No. ��9 $�� (s- R Owner's Name,Address,and Tel.No. , /a,
���l,S-C ct �.��' s .�✓�.rcl�,
Assessor's Map/Parcel �� 4
Installer's Name,Address,and el.No. 9 Designer's Name,Address and Tel.No. ��Ts'Qe� �[.
e `l
(ty s 4o'cl�65
�s 9 y,9L ,
Type of Building: '
Dwelling No.of Bedrooms Lot SizeF— sq. ft. Garbage Grinder ( )
Other Type of Building No.of Persons /� o�� Showers(I-) Cafeteria( )
Other Fixtures
Design Flow(min.required) 5%, gpd Design flow provided 7 4 gpd
Plan Date 0C.T ? Number of sheets 1 Revision Date
Title 9 '724..
Size of Septic Tank�t ,,CS�Q Type of S.A.S. �,g C ,
Description of Soil 4-r.5at o%.e, i c c � _ 3', Z�Z#
C= ' e O c v-,.S 4 s cr 1V of .14 e
Nature of Repairs or Alterations(Answer when applicable) Lire�.2
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 Certificate of
Compliance has been issued by this B rd of Hea h. p
Signed Date �0
Application Approved-by ,Date /(� t,� -U e
.,Applicatiorf Disapproved by; ".'..Date
for the following,reasons
i Permit No. A008— Date Issued II N d
No. �00� t Fee "
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Zippticotion for Mi!gpoZat *pgtem Con5trUction Permit
Application for a Permit to Construct( ) Repair( ) Upgrade(if; Abandon( ) ❑ Complete System ❑Individual Components
Location Address or Lot No. 9 Sc4.61�r Ra Owner's Name,Address,and Tel.No. /N/ G/0Sh r p
ed
Assessor's Map/Parcel �,/Q � � �y T d �.�rf-� � �L A `
Installer's Name,Address,and Tel.No. ,--Designer's Name,Address and Tel.No. .� !, /Se6`/ , �1
J`o ht4 4 LJ�,ie(,e y ,9�- f N�s l a s r
e
TI pe of Building:
Dwelling No.of Bedrooms 4/ Lot Size /, a/ P, sq. ft. Garbage Grinder ( )
Other Type of Building�,{T e t „ No.of Persons 2 Showers(L) Cafeteria( )
Other Fixtures
Design Flow(min.requir 6 gpd Design flow provided _ �/G/ �(o gpd
Plan Date OC7 2_3 n F Number of sheets / Revision Date
Title s,'T. �,r> �e r t !. .. �, c S ki,r� �57
Size of Septic Tank �,(.{f)f1 Type of S.A.S. ,
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
3 y+ E
- Dat,last iinspected:
'Agreein4ii4 i
IThe 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 Certificate of
Compliance has been issued by this Board of Health ( r
Signed t_,/ `\ _ Date
Application Approved by (5 Date /( L/ - O k
Application Disapproved by: ' Date
for the following reasons a
Permit No. Aou�— 46Of Date Issued L(' c)
THE COMMONWEALTH OF MASSACHUSETTS —
BARNSTABLE;:wMASSACHUSETTS
Certifiraie of Compliance
THIS IS TO CERTIFY,that the n-site Sewage Di pos Sy tern Constructed ( ) Repaired ( ) Upgraded
Abandoned( )by r" _1A AA
}} } jjrr
at I S P0�_`) : 'a . d�' I1 ,1C has been constructed
/i�n/accordance
with the provisions of Title 5 and the for Disposal System Construction&rmit No. , rt dated
Installer , > Designer
#bedrooms w Approved design flow _ e gpd
J f- o a
The issuance of this permit shall/not be
cons-rued as a guarantee that the system will fun-c't°ion as jddesigned.Date / ///� � `' Inspector %V / /�1 W t5
�� Fee
U � --- /�-----.
No. I�
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION—,BARNSTABLE, MASSACHUSETTS
'i!5po$al *p5tem Con5trUction Permit
Permission is hereby granted to Construct ( ) Jf.
epair ( ) U grade ( ) Abandon ( )
System1ocated at u „
Zand as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty 4
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 p�.—it. /
Date I C 'd Approved by ,/
TOWN OF BARNSTABLE
LOCATION /'/1` .� Sc�.c�g0e� SEWAGE #Qd
VI4LAGE S vv�v� �C ASSESSOR' & LOT d
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) 0`,eoyC( (size) 3 X y -X NO.OF BEDROOMS / d-
BUILDER OR OWNER �Qs KJ v
PERMITDATE: . COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility n�L1 Fee[
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) _ IVA Feet
Edge of Wetland and Leaching Fa If any wetlands exist �A
within 300 fee of a chin f c' ' /Iy e Feet
Furnished by
C
d L 'o At
1,
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pro fn
Towns of Barnstable
T , Regulatory Bekaa
Thomas F.Cei$er,Director
Public Health Division
Thomas McKean,Director
200 Main Street,Hyannis,lA 02601
Fax 508-790-63t?4
Office: 508-862-4644 -
InstaRer&Desaener Ce Foram
Date: zp
08
io
Designer. Iais'taller:
Address: Address
was issued a permit to install a
on
(date) (installer)
septic system at ,P f based-on a design drawn by
dated, , lI�ti� OCX3 r
certify that-the septic systern referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank.
I certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical.relocation of any component
of the s tic system)but in accordance withState & Local Regulations. Plan revision or
certifi built by designer to follow.
OF Pwgss�0
ON
R.
Igo HALL
�>
No.5�a �� 3
,.
. OTC
s S (A�1�s_ W_S Stamp Hm) ;
PU&ASIE RETURN TO BARNSTABLE PUBLIC EIPALTH ON. CERTMCATE
®F CQ1IpjMCE W11LL NOT BE ISSUED I7NT11L BOTIN THIS FORM' AND AS-
VV. T(AHD A1�E RECEI TEI3 BY'IiHF �STABLE PUBLIC HEALTH D.1VISIDN.
THANK Y0U_
Q_Heaitla v i �CerocaOiaa Farm
TOWN OF BARNSTABLE
LOCATION SEWAGE # >�'"— �
VILAGE ®s/rw, ,= ASSESSOR'S MAP & LOT
INSTALLER'S NAME 6s PHONE NO.�[�/, '
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) )-77 (size)
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER
DATE PERMIT ISSUED: ,• ?
a
DATE COMPLIANCE ISSUED:/7H/Lc'�
VARIANCE GRANTED: Yes No
� r
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e
------.........
ZD
.57
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FEB.. ^.
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
TOWN OF BARNSTABLE
Appliration for Disposal Works Tonotrnrtion ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
................-- .--- .................. ......=- ......... - ----------------
Lac ion- ddress - or Lot No.
....... S.
�' P .2D.......----•-•------------•---------- ..................................................................................................
,o ner Address
Installer Address
dType of Building Size Lot.................... .....Sq. feet
aDwelling—No. of Bedrooms---_.........................................Expansion Attic ( ) Garbage Grinder ( )
p., Other—Type of Building ............................ No. of,persons....._..........._.......... Showers ( ) — Cafeteria ( )
Otherfixtures ----------__--------•------•-------•---•---------------------------------------------------------••--------------------•--------------------------
:/' W Design Flow.,..........................................gallons per person per day. Total daily flow............................................gallons.
W Septic Tank—Liquid capacity............gallons Length---------------- Width....
p---------- Diameter---------------- Depth--_--_•-.-----.
x Disposal Trench—No. .................... Width_..._._._...._.._... Total Length.;3,,0....._._... Total leaching area__ 1__0...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. 1________________minutes per inch Depth of Test Pit-------------------- Depth to ground water........................
44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
p+' -----------------------------------------•-----------•---------------------------------------------•-----------------•-------•------------•-------' .
O Description of Soil................ �e�/,1---------.---Caf1!z�e_..---.-----......
x -• --=........................................................................................
V .....----•--•---•-•--•--•---••-•-••-•-•---•...---•--••••-----••------•-•--•--••---•---........•••------•-...--------•................•-•-•--
W •--------------------------------------------------------- ---------------------------•-----------------------------------------------r------•---•-•-•••E-•-•-•-•••-...... .�
U Nature of Repairs or Alte atio Answer when applicable_ ! :__2`✓N!?J___`_.__l�If _._ _!_(.fl?IJ�U'J
----------..C2.... %_� 1 rt ........................................................................................................................
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 ce has been issued by t bard of health.
a ^ a ?_
Signed ............ ...... .--- ....... ................................---------------------------- -- .
Application Approved By ---------- r - -` �
Date
Application Disapproved for the following reasons:-,---------------------•----------------------------------------------------_----_--------------------............................
..............................................-------=------------------------------------------------------------------- ............................................----------------------------------- -------................................ce
Permit �
��--.. --------- ------- -- --- _Is
No. ' �rr
to
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliration for Disposal Works Tontrnr#ion "truth
E
Application is hereby made for a Permit to Construct ( ) o_i Repair ( ) an Individual Sewage Disposal
System at:
..........--•d rv-�R .......................... Z/
Aze
- -Coca ion- ddress or Lot No.
Owner Address________________________________
Installer Address
Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms...-j___________________________________Expansion Attic ( ) Garbage Grinder ( )
P14 Other—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.36)_ ________ Total leaching area____;_0-___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. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-----------------______.
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
L_ a --•----------••••-•-•-••••---••••-•••••-•-•-•-•---•--•----••••.........................................:..•--••---.......-•-•-._....__........-•••••••----•-
O Description of Soil---------------- ----. :._G^aRe2�......
----------•--•---------------•---•---•--...----•-------------
x
U ----------------•-••------•------•----------••-••-•••••--•---•---------------------••-------=-----••-------••-•----------------------•-•----------------------------._..._....•---••-------•-••--------
W •-••-•-•••••-------------------------------------••----------••••-•-•-•••••••--•••--•••...••-•---------••-•-----------------------••--•.--------•-•-- •••-••• - ......x _ ��----
U Nature of Repairs or Alterations—Answer when applicable_ lY►-!i__ •- d��� _____.____zafZ_-.?_1..__ __.,Try_ �2g/o�/
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 b 9 and of health.
i ,
g ------------------------------ ---------------------- .............. --� ,�--
Si ned?a�i — �' a
Dace
Application Approved By ------------- '----- -- -------------- . ---------1-...........w.......................
Dace
Application Disapproved for the following reasons- ---- ---- --------........
-----'-..i-....-...--------------------------------...------- ---........------------------------------
------------------------ ----------------------------------------------------------------------------------------------------------------------------------------.......................------------- ---------------------------------------
Dale
Permit No- -----r-. "` _^ ---------------- Issued ---------------0�----no-t�7
THE COMMONWEALTH OF,MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Celrt#tftrate of (guntlaitnnre
THIS ISO CERTIFY, hat the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by..................... %. 'Vie......10,00--l"0 -----------------------------------------------------------------------------------...---------------------------------------------------..---------
p� ,�� � In le�
has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in
the application for Disposal Works Construction Permit No. ............... dated
dated
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY. ,
DATE �------ '� -------------------------•- ....-- Inspector `'
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
��� TOWN OF BARNSTABLE
31
No.,..�.._•• -••-•_.... FEE: ..�`1.,.�...
Disposal Works Tonotrndion "pawt
Permission is hereby granted......... - e e!!J___.s..0.4_ y ,
to Construct ( ) or Repair (911) an Individual Sewage,Dis` sal Syst /
at No........_ ��__.'Q.._.....: 1�.�a! z�...
x-�.• ••--..•-• - --• ._........ ....................•-•••-•••-
Street
as shown on the application for Disposal Works Construction Permit
_ Board of Health y-
DATE......-•-- �� .......................
lJ
FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS
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TOP OF FOUNDATION ✓� r
CONCRETE COVERS
_
5�.4 Lr
�` 4 CAST IRON 9 F
� �:� ORSCHEDULE4
' /���2C L � ��//�/F % . �?'��da�-�: ✓ o-s ��$6 PVC.PIPE MIN. 4 SCHEDULE 40 P.V.C. (ONLY ) �. LEACHING TRENCH
-� ,� ► �` :•.; PITCHl"ER.FT" 1/4PIPEPER FT.
PITCH 9 IN (2)REQ. 398'
(. lh �` �NVERT BAFFLE .`Al
1} ly,.'. -� >7,G.-sE SEPTIC TANK INVERT STONE�fNYERT •� Q 0 0 1.� ��S r
\ ` •..� n( Ci (N'VER `�E --- EL. /!S '? �•�.
w /0 75
0AL. INVERT ` DI'ST_ INVERT y I I .. ��
i:.% EL��i.��.. EL.y ,S,�... BOX IS L%s. r . . . . . . . . . ► a , .
,,CRUSHED STONE EL S,7_cf _ 4�lG�
PROFILE O F ��,,•, c,-i�c;
� EN�
SEWAGE DISPOSAL SYSTEM GROUND WATER TABLE
,. i..�._ -u• - , SOIL LO G
DATE jfT��LY,6 TIME NO SCALE
TEST HOLE 1 TEST HOLE 2 -
ELEv.y,�i�>!' ..... ELEV. DESIGN DATA
SCUDDEP R O D .'lJt4l,3�'�T:•.-S,+i�s 1:'p�:atl/LW� _
y �' .✓o -�M�''� ���rl;�17
/��j'�c�''NUMBER OF BEDROOMS
-' _ Q �/�TOTAL ESTIMATED FLOW .!M)... . . .GALLONS/DAY
BOTTOM LEACHING AREA'`�� � s. .SO.FT-/ TRENCH �� / i0.7S
SIDE LEACHING AREA v! r- <«. Sd✓.=` SQ•FT./TRENCH
�C/J� ,� =�� 'J �Q �j ��,�y�A) GARBAGE DISPOSAL . . .N�. . : :(50% AREA INCREASE )
T �. �<>✓-J '����✓� C NSF TOTAL LEACHING AREA �n �i�. .. SO.FT.
�S� ra ,
/ y� 7�J ^ •• /Qy� �/7ff
PERCOLATION FATE . . . .�zMiN . ... PER. INCH
LEACHING AREA PER PERCOLATION RATE17c/4 - SQ.FT. i
v
- GROUND WATER TABLE
�n•�.
D p OS E J L L E APPROVED BOARD OF HEALTH
SITE PLAN �--� l 19 SCUDDER h T R V M A .�4.WATER ENCOUNTERED Lil . . . . ... . .. .. . .. ... . ,
� DATE .. . . . . . .. ..... . . ... . . . . . . . . . . .. ... . . .. � �.
J� ��JWIT'N /ESSED Y • AGENT OR INSPECTOR
F O I �Lk✓Nf .! !!P.'��Nr:3!. (� BOARD OF HEALTH . .. . ._ . . �a� °•'�"`
ENGINEER ---• - - - - --. . _ •_ . _-_-_ . . . . �~ T���
PAUL CHEES-BRO . . _ . . . _ _ . _ . . . ... .
� to
PETITIONER �f` CfYEsaRp �' r.
- - - - - EDS�i`
G�( EVAI�P-y: