HomeMy WebLinkAbout0154 SCUDDER ROAD - Health 4.54 SCUDDER RD.
OSTERVILLE
A = 140 033
No. / Fee $5 0
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
es
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
01pprtration for Migool *p5tem Congtrurtion Permit
Application for a Permit to Construct( , )Repair( x)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.
154 Scudder Rd. , Osterville Steve Costello
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Wm. E. Robinson Septic Service
P 0 Box 1089, Centerville
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 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^n ri
Nature of Repairs or Alterations(Answer when applicable) Title-5 s e p i _ s V s t Pm c on s i s t i n c_
Of a 2,000 gal. tank, D-box and 4 precast leach chambers with
stone all around_ -
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 this Boardof Healtth./J
Signed E Date
Application Approved by Date '�'°� ��l
Application Disapproved for the following reasons
Permit No. Re ` Date Issued
x "
$5 0
No.. /4ws /_ �/_�'� Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
0[ppfication for Miopozar 6pelem Con!6trucriou Permit
Application for a Permit to Construct( )Repair(x)Upgrade( )Abandon( ) ❑Complete:System ❑Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.
AsselskiAp Mer Rd. , Osterville Steve Costello
Installer's Name,Ad res ,and Tel. o. Designer's Name,Address and Tel.No.
Wm. E. Robinson Septic Service
P O Box 1089. Centerville
Type of Building:
Dwelling No.of Bedrooms J _ Lot Size sq. ft. Garbage Grinder( )
Other Type of Buildin,i 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
Sand
Nature of Repairs or Alterations(Answer when applicable) T
itle-5 septic SyStell! CUn5:tbthLg__7
l VMO with
stone all around.
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 this Board of Health. �r
Signed Date
Application Approved by Date�F. �i5'•... r�
Application Disapproved or the following a sons
Permit No..R.O : r-J Date Issued P-� -w
---------------------------------------
'THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Costello Certificate of Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( X )Upgraded( )
Abandoned( )by uT�_ is Septic Service
at 154 r s terville has been constructed in accordance
with the provisions of Title 5 and�he for Disposal System Construction Pe& dated A-4 !:? s �
Installer _ Designer p
The issuance of this permit shall not be construed as a guarantee that the system will functio s des' �d.
Date 'a� Inspector
---------------------------------------
No. Fee _
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Costello Mi5poaf *p5tem Cott.5truction Permit
Permission is hereby granted to Construct( )Repair( X)Upgrade( )Abandon( )
System located at 154Rd. , 05turv , e
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 er''-nit.
Date: Approved b�/ �a s
G/
THE FOLLOWING
IS/ARE THE BEST
IMAGES FROM POOR
QUALITY ORIGINAL (S)
I A ,
m / �0(�'J IL
DATA
A 9�
TOWN OF BARNSTABLE
..00AT1_ ,N SEWAGE #
VILLAGE d ASSESSOR'S MAP & LOT /Y0-033
INSTALLER'S NAME&PHONE NO. 276'-9 2 7
SEPTIC TANK CAPACITY 6 `�
LEACHING FACILITY: (type) �/ ,`� 1- L (size'
NO. OF BEDROOMS ��/ is
BUILDER OR OWNER G O SI
PERMITDATE: Ll i�.s D / COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the ttom of Leaching Facility Feet
Private Water Supply Well and Leaching F cility (If any wells exist
on site or within 200 feet of leaching cility) "Feet
Edge of Wetland and Leaching Facility If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
s- -
• r
S M-r
r
Li
r
� 1
NOTICE: This Form Is To Be Used For the Repair Of Failed
Septic Systems Only. -
CERTiFICAMON OF SKETCH AND►APPLICATION FOR A DLSPOSAL. —
WORKS CONSTRUC•I'ION PERMff(WITHOUT DESIGNED PLAN
William E_ Robinson,S> ycen3fy dku the application ti-dmposal anodes
consuuction pesmit signed by me dated �"� .� 0 , concerning the
prop" located at 1 5 4 Scudder Rd. , :O s tery i l l e meets all of the
Mowing criteria:
• The failed is amneewd to a re ade nt4d dwelling oily. There ace no comm ermw or business
uses associa .' with the dwelling. m
i
The soil is - as CLASS I and the pn=Mu rat is less man or equal to 3 minutes per inch
There arc wetlands within 100 feet of the pr*Mel sepanc aVVem —
There arc private wefts within 150 tee t of the proposed septa:system
Theft is. incte a in soar andlor cimage in use proposed
• 'there no variances mquested or needed
The:b:of the ptapomed ltac>ttraag faaltcy win nlbe boated less than five feet above the
ma ttm adjusted Woundwater table elevation:(Adjus the gtounihmea table using the Frimptor
JWhen ap0 iCWble(
IfS&.,A-S-will be hteaud with 2%facet oat an .the bottmn of the proposed
faafty will nt be located Icss than fourteen(141 feet above the maximum adjusted
ater table devation,
omplece the MMwing:
) Top of Ground Sncfaoe E cu�igg GIS infonnationl
Bl G.W:Elevation +tlke MAX H50 G.W. t _
DIFFERENCE BETWEEN A and B
SIGNED: � �'L � a./`,
[DATE. ( 'V
(Sketch prep sw per►of system on ba ti.
.r health!older_Lien[
.�
,�
�� G
,�
_.___.�
s=J
PEEP OBSERVATION IIOLT LOG HoleIt1
Depth fium Soil 11orizon SuilUxturo. Soil Color Suil Other
8uihioe(In,) (USDA) (Munsoll) Molllliig (Structur0,S10110s,Bouldels.
Cnuslstlin4v ° draveD
•
--1
c l: +rflY
( •4 0 3 • .
jy to
DETT,P OBSERVATION HOLD LOG IIo1e ff Z
. Depth from Soil Horizon Stoii Texture Soii Color Soll Other
Surface(in.) (USDA) (Mmisell) Molding > (Structure,Stones,Boulders.
Consistcncv.%°Gravel)_
O la
90-mz0., Pr
C_
DE,DP.ONE,RVA'TIONROLI;LOG LIolc#
Depth from Soil Horizon Soil Texture Soli Color Soil Odicr .
Surface(in.)' (USDA) . (Munsell). Motiling (Struclure,5tunes toulders.
Consistcncv.%Biro c
_
DEEV OBSIGI UATION I10U, LOG , Mule
Depth horn Soil Horizon Suil,Texture y Suil Color Suii Other
Motilhig (Structure,Stones,Boulders.
Surface(in.) (USDA); (Munsciq
Consistcncv %Grovel)
'I II
777 7-77-77-
41
I.
Flood Insuriince Rate Mon
Above 500 year flood bomidary No Yes —
Within 500 year boundary ! No Yes
Within too year flood boundary No 1'es
De lh.of aturall Otit urrht I►ervl us trfcrial
Does at least four feet,ofnaturall} occ rruo pervioub material exist ui:all areas oUserved throughout the
area proposed for the boll absorption sste ? 1tC5_-
)f not;what is We depth of I. ra�ly oecurri ig'perT.
,
material?
ccrtincation
11. assed lice soil evaluator examination approved by the -
n on
r o«
�datd .P
certrf th t �:. ;
1 with
Y
Department of Envitoturtcutal Protectt n and lint tie above analysis was performed by me cons stem
the required training,ex ertiso nn l cxpericnco described hO 10 CMR 1.5.017.
Signature
Dato `3 66 0
Q:I 1cA1:Tl-1/wrrreltcrGttM
f Barnstable ��#
Town o "
o DeplI artment of Regulatory Services
! -RMNIFFAS Public Iealtl>i Division _ Date &
Roo Main Street,Hyannis MA 02601
rto
qd
OG DO
Time Fee Pd.
Date Scheduled
Soil Suitabilit, :Assess�nd. i for Sewa to s oral o ,
D 1
Performed By. i h Ii!t I . Witnessed BY:..
r
LOCATION� GENERAL JrJr0A,TION
Location Address Owner's Name&rbara, %7�e rP.,J�')
154 SCudcLar Road Address 16 4/ SGUdc&-r.
o s�lervi,I/e, rn A �st�.rY,'lJc , rr� ►4 G�b�S,.
Lngineer� aire
Assessor's Map/Parcel: Lr )'/'i�L�t'�'► !' .
/ 40033 ` �u111van �
New CONSTRUCTION REPAIR: Telephone N 08 '��
0
Slopes(ye) 6�S It Surface Stones
hand Use k
8(oc On' _
DO Il
`'�. Drinking Water Weil S
Distances from: Open Water Body db R Possible Wet Area g� Ott Drh g. _
Other Al fl R
Dratnnge Way 26D I R :Property Lble
r ,
mensiora of tot,exaci locations of t6atholes do pert tests,ldc,.10 Wetlands in proximity to holes) I
1 ,:
SKETCH (Street namg di
BLAN><D ROAD
40' WIDE )
S032T05' —273'*TO HOWNGSWORTH
76.55'
A� EXISTING FOUNDATI .
PROPOSED GARA
1 a' x 18'
LOT 18A
. 15,729 SFf
Z �
SHED:
54
SMR
1100.00'
H N 3730'W 1
l Mo
SCIUDOER ROAD r
�. -- Depot to Bedrock...
d
Parentrnaterlel(geologic)' — =— I p
c
DepUl to(iroundwalcr: Blinding wale i Hote Nb
Weeping from Pit race � --
Estinmted Seasonal.High Uroundwater 3Z Z
o IVA ON T® F SFI ASONAL IIIGI1•WATI';R TABU
DE,TCR1 H
Method Used: ft
in. I)epU1 to soil mottles: n.
Depth Observed standing in s:hole; - i11, Groundwater Adjustment
Depth to wecpittg Ront side o ow dole: Ad.Groundwater Level
Readin Date Ad.fsclor j
Index Well N g rode; Weill
R OLAMN U,S.T.
ante ai o Time
Observation. i Tin naat9"., T-- ---=-
Hole P
Depui of Pere
y i� Time at 6" .
Start Pre-sonk Tin1a Q "I
Time(9"-6")
End Pro-soak
Rate MinJinch <Zl vn .
Site Suitability Assessment: Site Passed i✓
$ire PnileJ: Additional Testing Needed(YM)
ortginst: public Health Division
observation Hole Data To Be Coinpleted on Back-----
***If percolation test is to b6 c�n(1uctc�l within 100' of wetland,you must first notify the
atone 1 wcelE prior to beginning-
Barnstable Ic s
• table Conservation Dii�is�on a �
'Bat ns I
Q:i lEALTI VW P/PERCrORM
i '
R, MR tiN�Nlq!
wm
TOWN OF BARNSTABLE-
LOCATION
SEWAGE # 61
VILLAGE-0 S J
ASSESSOR'S MAP & LOT 1?0-033
1 INSTALLER'S NAME&PHONE N 0.1
1 SEPTIC TANK CAPACITY (Y G 10
LEACHING FACU_lTY
EA (type) 5 Y'7
NO. OF BEDROOMS_,1 :BU1LDER:_OR OWNER;_ a 6:1!
'PERmrrDATE: 6 4 . COMPLIANCE DATE:
Separation Distance Between the:
Maximum um Adjusted Groundwater Table:to the ttom of Leaching Facility Feet
Private Water Supply.Welland
cility (If any wells exist
on site or within 200 feet of leaching cility)
Feet
.'Edge of W tlan..,,d and.Le4qhi,;1gFacifi If any wetlands exist
.withjn'3'W feetoff
ea facility)hi
t
Furnished by
z4.
Table to
the t'
u g F cillt)
/leaching cillty)
ty If any.wetlands.
U-1
TOWN OF BARNSTABLE
1ON SEWAGE # 'SV4
v , GEw� � ASSESSOR'S MAP & LOT 61j.
INSTALLER'S NAME-& PHONE NO. Cam. A� _ � J L
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) P;
NO. OF BEDROOMS PRIVATE WELL PUB�WATE _
BUILDER OR OWNER
DATE PERMIT ISSUED: /p - !f r
DATE COMPLIANCE ISSUED:� 51 3
VA RIANCE,G RANTED: Yes No
`o
e ,F
l"4/v 03 3
No... ---,. FRs.......3.0.....
THE COMMONWEALTH OF MASSACHUSETTS y
BOAR® OF HEALTH �
TOWN OF BARNSTABLE
,���ltrtt� •'� nr �i��.�n�nl �nrli� C�ngt�#rnr#inn anti#
Application is hereby made for a Permit to Construct ( ) or Repair ( 1<an Individual Sewage Disposal
System at
....a.. 5 .. _
Cv '
` o ,ion-:\ddress t`�� �Q or Lot No.
J�Jv /...� /�1 '`_[/.'......................................?..................
W ...---' 1J�N n D���,
dType of Building installer Address
v. ExpansionSizerLot.....-rb----•-------.....Sq. feet
U Dwelling—No. of Bed oo Attic ( ) Garbage Grinder ( )
aOther—Type of Building ----------------_----------- No. of persons............................ Showers ( ) — Cafeteria ( )
<4 Othe fi�ctures .----•--------- -------------•-
d
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.
3 Seepage Pit No..................... Diameter_____.____....-__._. Depth below inlet........._.......... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date........................................
aTest Pit No. I................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........................
P4 •-••••-•--••--------------•-•---•--•---...-•--•-••--•••••-••---.....-•-••---•-•-•------•••----...-- .........................................................
0 Description of Soil.........................................................................................................................................................................
V
W ••-•-•••-•--•------------------------•••-••••••••-•••---------......--•--....--•--•-•--••---------•-----•---- 1
U low-n
ature of Re airs or Alterations—Answer when applicable.�._i ___i �.\-.__1� ..`�!``-�rt._ �x.�.. �J .....
.�t-----�...`5 - '--------------------------------------
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 ' sued t e at th.
Signed .............. ................... ......... ....... ..... . ...... .....
Dace
Application Approved By .... t,¢ ..................................... ......./..d. .e,� ^. ..
Application Disapproved for the following reasons: ....................................................................................... . ..... .................................
................................................... . .......................... ...............
Dale
Permit No. ..... ........................... Issued
Dace
o 3 3
� r
� � J
t'
No....7..3__.S 3 5
Fas............._.. ._...
- THE COMMONWEALTH OF MASSACHUSETTS l
BOARDS OF HEALTH � ,
/ TOWN OF BARNSTABLE
f ,� i iratiou for #i��pwial Wi�urk,s C�vagarurfiun prmit
Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal
System at: t
.. ...............................' .. ----- ------ -- -------- - .-
i Lo ion-Address or Lot No.
__
� t i � Address
1/. .,.....
V0,++:r cr ,Installer Address
UType of Building Size Lot............................Sq. feet
,., Dwelling—No. of Bedrooms........................................_..Expansion Attic :,( ) Garbage Grinder ( )
Other—Type of Building ..... ...................... No. of persons---------------------------- Showers ( ) — Cafeteria ( )
at Other matures ------------------------------
W Design Flow........155--------------------........gallons per person per day. Total daily flow-.--�3jD.............................gallons.
W '_ Septic Tank—Liquid capacity------------gallons Length................ Width................ Diameter.-_..--....---- Depth................
x Disposal Trench--No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
3 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........................
4 . Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to_ground water........................
�+ -----------------------------------------------•--...-•--------•---••••--.-•-•--.........................................................
0 Description of Soil.................................................----------------------------------------------------------------------•------------------------------------•--........
x
x --••-•-•--•-------'•...............•-------•----•-•------•---•--•--•----•--•.............•-------•-------••---------------•------- _•------•--- .....- �..... ------.. ---......_..._.........
U 1 Cf eo f�Repai rs or�Alltera�t�i�On Answer when applicable_ ... 1<�� .``. .. (" � .0G'
-----f....---•--•-•---•---•-----•••-•--•...........
----------•-- -
r
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 boar o�-health.
F
a
Signed `". - .! ......... - ------............ ................. I...............
.I
Application Approved B !
te
- ' -------------- ra.-=-
A
PP PP Y - Dace
Application Disapproved for the following reasons: ...................................... ........... ..... . ....._.......... .....................-------------------
................ ................................................ ........................................................_.......... . . . .--..--.................. ........................................
Dare
Permit No. ....�.�i..-...J1-..�- _... .._.......... Issued -----------------------------------------..-----------.
Dare
THE COMMO__NWEALTH OF MASSACHUSETTS
t BOARD OF HEALTH
TOWN OF BARNSTABLE
T rtifirate of Tomyliunre
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired
by ; 1 ? d ,... .t f �,.Q jG 't- (JtV-- ! � �� -- .......... .-. ........... . ..
"� :( c
Lf
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. -..... 5_. 3. -_.-.- dated __.__.............
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY. ,
DATE........ .. � ` ................. ----:-- ---._..-------:--------._..._...
.
---------------- ------ ---_ —__—_ _----_--------- _ -----_ ---„------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
No.......... •' _ 3 7 FEE.....4 r..
Permission is hereby granted._. `) `},I � t t ....� 1. t` ...--- bl.�..
to Construct ( ) or Repair ( an Individual Sege age Disposal System
atNo..... .UdC.!P > - '`' t(Jlil-`'--------- ----- -------•-------------•-----------.........--------------•--..............
Street pc�
as shown on the application for Disposal Works Construction Permit Nole?"..,,5'3 Dated..........................................
................................
� � ----------------------------•--•--------•--•-•.............^'`•
DATE............/2....... ._-- 3-------------------------------- Board of Health
FORM 36508 HOBBS Q WARREN,INC..PUBLISHERS
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