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Home My WebLink About0012 BUTLER AVENUE - Health 1 2 Bvver Ave, Ce ntervrll)e 2z6'— 018 ESMEAD KEEPING YOU ORGANIZED No. 12534 2-153LOR 0 NABLE ESM MIN.RECYCLED INITIOVE CONTENT10% CergSed Flier Sourcing POST-CONSUMER WWW.dpragramorg S"17G0 MADE IN USA GET ORGANIZED AT SMW.Cau . I LOCATION SEWAGE PERMIT NO. ld2 11 � �s 2� G VILLAGE A & B CESSPOOL SERVICE 1 128 BISHOPS TERRACE, HYANNIS, MA 02601 0 BUILDER OR OWNER uo DATE PERMIT ISSUED - �1 DATE COMPLIANCE ISSUED fl r 1 d t14 i FEs...... ... ............... ` THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........I...........O F.......................................................................................... Appliratinn for Uiipusal Workii Tnni#rurtinn Frrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System a �v � C I2. .u'�L 3...........................r�?At�v1��t`t ..........0--1 ------...............--•-----....---------------.....-------•------....------ ..................... ............ Location-Address or Lot No. ....... ...K............�15aR t•TAJWx.rZA................................. ................................................•------•--...........................^--......... Owner Address l ._. .. .0 S P -.......................................... ••--............•-•••_..... ........--•---••-------.....--------....... Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms......3..................................Expansion Attic ( ) Garbage Grinder (A/o), aOther—Type of Building ............................ No. of persons...................---..---. Showers ( ) — Cafeteria ( ) 04 Other fixtures ................................. . W Design Flow............5,.r........................gallons per person per day. Total daily flow..........5�2_a....._..................gallons. WSeptic Tank—Liquid capacityAA .gallons Length................ Width................ Diameter------------.--- Depth................ Disposal Trench—No...:................. Width.................... Total Length.................... Total leaching area....................sq. ft. x Seepage Pit No..................... Diameter......8........... Depth below inlet................ Total leaching area..2'7'�.....sq. ft. Z Other Distribution box ( ) Dosing tank ) / '~ Percolation Test Results Performed by............ .��........................................... Date.......21L,l �......... Test Pit No. 1 _ -.....minutes per inch Depth of Test Pit..... ...... Depth to ground water....."-l-,!---------- (s, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ rx ...................................................................O Description of Soil.................. `--v........qc::�E.............. - . .............................. x W UNature 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 undersigned further aarees not to place the system in operation until a Certificate of Compliance has beeffssued y th of 1 Signed•. ------------- ................................ Application Approved B �- -- �....... / ate ? PP PP Y... ...............I.............. Date Application Disapproved for the following reasons:.......................................................................................... ................. --------•----•••••.........--••-••---••-•••--•-••-•••••-----•.....•---•----...---•--•.............................--•••••-•---••------••--•-•-•-••--••••--•-•-•--•---•-----•••---••--•-••••••••---•----•- Date PermitNo......................................................... Issued_........................................................ --- - --- -------------------`------D____----- ---------------- ----•gym- -�I --_---�;-.r--.Date PermitNo--------------------------------------------------------- Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........................I................OF..................................................................................... Tatifiratr of Toutphatt r THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by........................ -- -_...--•------- •--•--•-•-----....-•--------------- -----------------------•-----•-----•------•-••----------.......---•--•-•-•-----•-------.....--- >_�i�� Installer at /I-••••--•-•.Z�r .--•-- .�.� -----•------------------------------•------...........-•---•-•----......---•-•----•••--•••--•- has been installed in accordance with the provisions of TITS 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.--..�Z........................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM, Wl F NCTION SATISFACTORY. DATE.. . ..""..f•-----------------------•.........------.........---- Inspector--.---//. --•--•-----.......-----.......-----.............---------•- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF..................................................................................... C No......................... FEE...--- D--.......... RsVouttl Works Tonotrnrtion nutit Permission is hereby granted........... ... 'IT�.--•-•---------•-•--------•••-•-•-----••----•--•--•--..........•••-•-......•-••............................. to Constrict ( ) or Repair ) an Individual Sewage Dis osal Systegi atNo. /_Z: ��` ..... ... `r--•------------•--------------- ................................... as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... ,p J *ar�ollalth DATE................................................................................. FORA 1255 A. M. SULKIN. INC., BOSTON 6t FEz // / -• THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...........................................OF......................................................................................... Appliratiun for Diiputittl Works Cfunmtrnrtitun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System a 11................... .........._.._.................... ......._......... .........-•----........... --....._...........................------. sLocation-Address or Lot No. ................................. ---•...............•----...........-•--•---......... ,��7f�, / Owner Address W !?-A Owner 5. 17.��i� P�-....................................•--.. .....--••-•----------•-......------------........---•-•---.........---............................ Installer Address Type of Building Size Lot............................Sq. feet V ...........................Ex Garbage Grinder Expansion Attic ba hQ. Dwelling—No. of Bedrooms...._3....... p ( ) g aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ________________ ________________ _ W Design Flow............S.r........................gallons per person per day. Total daily flow..........?2.0........................gallons. WSeptic Tank—Liquid capacity.WM.gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter------8........... Depth below inlet.....4........... Total leaching area.. .....sq. ft. z Other Distribution box ( ) Dosing tank ( ) .. Percolation Test Results Performed by..............&Y.N//.......................................... Date........2X 14?._------ a Test Pit No. .._._minutes per inch Depth of Test Pit----/3.....•. Depth to ground water-----A/.,/A......... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 1:4 ----................---------------•--••--•-•--...................•----------....--•-......._...................................................... o Description of Soil..................4)--`-..L...........G.4' ............. .............................e f ~................................. x w --------------- ----------------------------------------------------------------------------•---••---••------•---------------------•----------••--••------------------------...._......-•----....------ 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 TITLZ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beer} ssued th 6`r of h th. �� i Signed............`'� r_.�,� --..7,-2 --•--------- -------------------------------- nn ,ems D to Application Approved By.........-•-- ..... ..---Z f�� :/ - . _ %�................•---•-. ................... Date Application Disapproved for the following reasons---------------------•--•---•--------._...------------....----------------------.........._...................... _— ------ ................-------- ------ - - F F242 642. a Z cam . T74�-�.,. Itµ f��.i�6— Ct y cr tot LO r .A X 111Y ( 1.4F� E - lag IRS 18.7 ALAN p �r t ! •�J ai W3 QF 140 .9334 y IJ 4 �.�`,�c#�,�— IS71 Ft.... NQ � the 15- tit 3 YC k_ 49 ' �r Y.. ..e '` u