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Home My WebLink About0204 AMES WAY - Health (2) ��J /firn�'s �U , Cewt� a 3= _� aa No.....`.-�-/ a• .... J Fizz............... .,K.. THE COMMONWEALTH OF MASSACHUSETTS BOARD /�OF` HEA�TI-� f 68100� Appliration for Uhiposal Iforks Tonstru.rtinu Prrutit Application is hereby made for a Permit to Construct (� Repair ( ) an Individual Sewage Disposal �Syst at �Cd � 6;�7_164�V1zle-------------- ---------- .-..------. .... - --..... ......_.... .... . . ocatio ddr or t No. ore - - Owner Add ss �/�. a -•-•......... .A-----•-----.. .. --------••---•--•----•••----------------- .............. .16.r!'t/ .........._.......-----------•----•---- Installer Address i vv Type of Building Size Lot/-�_4..��6.....Sq. feet Dwelling—No. of Bedrooms......._ .............................Expansion Attic Garbage Grinder No aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) aOther fixtures ----------------•------------------•--••--••-•--••• -•••-••- W Design Flow............s�.................gallons per person er day. Total daily, flow___.._...... __._..... _....._.__.gallons. i WSeptic Tank—Liquid capacity/MPgallons Length__ _.,. .... Width...4......... Diameter----------------- Depth.... ._..... x Disposal Trench—No. ••-.•_---••-•-_-•••- Width..... Total Length............¢...... Total leaching area....................sq. ft. Seepage Pit No......../.......... Diameter.....��............. Depth below inlet....6. 9............ Total leaching area. . ./....sq. ft. Z Other Distribution box Dosing tom `-' Percolation Test Results Performed b ?- -�-:---••••--- ---......•...•. Date...`® �v .................... by Test Pit No. 1-_•-.......minutes per inch Depth of Test it______�6..._.__.. Depth to ground water...M _64q fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Ox , ` ---•••------------------------ Descri tion of Soil.. . « - ....... --- U -••••-•••••••••-•••---•••--••••••••••••-•••-•-•-•----••-•-•••••-•-••••--------•••••••---•---•-•••••-•----•--•-•••••••••••••••-••-•••-•••--•-••-•••-•••••••••••-••-•-•••.......................••--••.... ------------------------------------------------------------------------------------•--•----------------------------------------...----------------------------------•-----.................--•-•-_..... 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'j NT is 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance 4bnissued th f health.Sign . .----- —. -- f ._.....Application Approved BY f� ... Date Application Disapproved for the following reasons---------------••----•--------------•---------------------....--------------------------._........._............ -•--------•..................•-------------------•-------•-••-•--•---•--•------•-..._.....-•-•-------------••-•••---••--•••-•---•-•-••••-••••---•--. ............................. <�G Date �/ Permit No........... Issued_------.......m--------- .............................. Date No......:�7....... F.Hs............._ ..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEA -rLJ n.............OF.....0 .. __ Applira#ion for Elispooal Works.Tunstrurtion ramit k kz Application is hereby made for a Permit to Construct �r Repair ( ) an Individual Sewage Disposal System at: f � .......k1 L /o f 26 ��ek- V/Ile,_ M . .....�-=• - ... ••.... ••. ...... Locatio ddress �.. J` or t No. -- Owner A------s .......--'� a /k/i Lls ......... -• •--.... ......... .........c...........!�!- ' .t... Installer Address Type of Building 1 1 Size Lof/ _i_7.0_�......Sq. feet 1—� Dwelling—No. of Bedrooms............................................Expansion Attic , � Garbage Grinder X0 aOther Other—Type of Building ............................ No. of persons........................__._ Showers ( ) — Cafeteria fixtures ... a. - ---- - -------•---- W Design Flow........... U'__________________gallons per person er day. Total daily _.__ .._.__._......_.__._.__.gallons. WSeptic Tank—Liquid*capacity/d©Dgallons Length.. .!.._ Width........... Diameter................ Depth...-l�-.__�.... x Disposal Trench—No..................... Width .................... Total Length............I....... Total leaching area.._........_...__...sq. ft. Seepage Pit No......../---------- Diameter... .---------- De&,")o th below inlet...k............ Total leaching areaa. 1....sq. ft. Z Other Distribution box (� ) Dosing tPercolation Test Results Performed b ... ,._ � , 5_ � /Y -••- ...... , Date..... Test Pit No. I...�.......minutes per inch Depth of Test Pit_.................... Depth to ground water..................... fs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fYi .....---- O Description of Soil................ �� '".. 4 V ...................•----....--•---..._...----•----------------•-------------------•----•••-••••••---•••.....---•••-•--•-•---••-•----•--- W x U.. Nature of Repairs or Alterations—Answer when applicable............................................................................................... Agreement: r' The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions o iITL, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bern issued bDy th f health. Sign / �.... atc Application Approved By...... __.�...__ __ �`��•` 7� Date 4 Application Disapproved for the following reasons--------------------------------•---------------------=-•---•-------------------••----------.................... ........................................................................................................................................................................................................ � 7 �41 . PermitNo.......-...... - Issued ...................................................... Date 3 `.THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HFTH . :...............................OF........;................................................ (In ifirFatr of TompliFanrr _ THIS IS 0`EERLIbY„,T?at the Individual Sewage Disposal System constructed ( ) or Repaired ( ) bY----------------------- ------• .....................................................------......--------------••-...........-•--•..._......-•--•------•-----------••-••-....._............._. a P :� �ors OU.4 V e t=�t [.r.�t at..................... ------------=-•--- ---- ---••--•---•---------- 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_..../_,,7e/.... JV....._....._.._..... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION JSATISFACTORY. DATE... .. ......_. .. s.: ...........•--•-----...---.. ..... Inspector......................................... -----......-------•--------.......-- THE COMMONWEALTWOF MASSACHUSETTS BOARD OF HEALTH ........................................OF.......................................................................... ...... No........Y7........ FEE 7 S. Disposal orko Tonstraion rrmit Permission is herebyanted__._----_. -.......•--.L `..E '.. to Construct ;(f ) or Repair ( ) an Individual Sewage Disposal System at No. ? �I1 .� ;,�...•... �''•�-y----...... .it Street .r it�*r +.......................•--••---_.... r as shown on the application for Disposal,Works Construction Permit "7•--7- ................ Dated_ . _. ...................................•--•------•----------•......••-••......•-•-- ..... Board of Health 4 DATE........................................................ --- .-- . FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS r, 1,3 'iNfWMc /yTAL �eaDt� �., 77/ � .,��• 1 '`J "0Gt ti P poclo f -%- lapo 44 e,;�eX kv (�••� ''��i } `� �� t.� `; Y� 4 s J+a�t c� ! /rrr-r 7 � / - /car ,C ewc A w / N r� L � raP 041 e, i V IV C'O L� 7 i 0"i r'a CO J --� 21"7/'?'j N 6` f 31 C G• ( , ! �� t --� as � —;- FRANK FRANK + r' COMERY ^ o CaNERY 411 No. 65I3 p �� / / /�'� C^.5 YY J� Y/..,.._... -.._..,.. +w._ ...... , �i `V w �h4s_.-,�yty♦ +k + '�0'9�G/sT�p \�4 �}, v j-D ( — °°.Q LAN OF- LAND EiV Try' V1j �. � MASS. OWNED BY R ANK CONERY 5 TRENTON Si HYANNIS, MASS. G26CI _V 1 �t :;�.S TE�C1 f_Nii1NkEN H LAlt! "JI"N'F 'H SCALE i IN 26r FT