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Home My WebLink About0166 FIVE CORNERS ROAD - Health (2) 7 N .........4t.iZ Flcs...,1 " ,:,THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH %r,. .�f ..... .....oF..... .N.�S .. ................... ApplirFation for Disposal Works Tonstrurtiun Prrmit i 4Application is hereby made for a Permit to Construct ( j or Repair ( ) an Individual Sewage Disposal stem at: CvP,ocN s �jo� C� ll� 7, 7 /-9�L a No�3. /,ZV ... ----•--. ----------- . .................... .rot. - - d a n- dress ... Owner Address . . .. Installer Address JJ Type of Building Size Lot.. .._.�Z.�....__Sq. feet U Dwelling—No. of Bedrooms._.........13..........................Expansion Attic o) Garbage Grinder (/ 6 '4 Other—Type e of Building ............. No. of persons.;................. Showers W YP g --------------- P ( ) — Cafeteria ( ) W Other W fi s -------------------------------.. . Design Flow............... ...................gallons per person er qay. Total daily flow.._...a3®.._....................gal ,,PIons. ('1 W Septic Tank—Liquid capacity/999.gallons Length_.?_ ..... Width__ ... Diameter---------------- Depth..4.. ..... x Disposal Trench—Ng. ................... Width.. Total Length..............7.... Total leaching area....................sq. ft. t Seepage Pit No....__..l.--__--_-- Diameter.._e....._..... Depth below inlet...... .......... Total leaching area. �....sq. ft. " Z Other Distribution box ( / ) Dosing tank ®) `~ Percolation Test Results Performed by...__.e e____ __F? ,d=K' �......��___________________ Date...... ,ll �!-.�.�_._._ .._.. . r Test Pit No. 1.....eZ------minutes per inch Depth of Test Pit...hq......... Depth to ground water�.z.a__-�!!X- . 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ .................................. •---...........----- - O Description of Soil ® �°�-------2d• �®` mod- --->f_�?ma's--- �®�4'.C----- f ® wx --------------- �----......I............................... s�� - /.Z o �------------------ ----------------•- -----------------------------------------------------------•-----•------ x ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 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 TL I lilEj 5 of the State Sanitary Code— The undersigned further agrees not to place the system in .operation until a Certificate of Compliance has b n issued the�ofigned-- --... ---- ..- ....................... l Z 7 ---•- y Date Application Approved By--- ------ --- ... .._................. ..... Date Application Disapproved for the following reasons--------------------•-- -------------•---------...----------------•----------------------------------......... ---------------------•--......---•--------------------------•------------- ............ -----•--•-•---••---------------------------------------------------------------------------•--- Date lk-f fnit--m._....-----�...................... ................. Issued....................................................... Date No1f.. • � � - .� 4��`i Fps... •��.... r"THE COMMONWEALTH OF MASSACHUSETTS = BOARD OF HEALTH .��...............0 F ,+6.r'P... ..... "•.. a to fux Wvnlitti arks Town trur ion ramit Application i hereby'made for a Permit to"Construct ( ) or Repair ( } an Individual Sewage Disposal System at . ve. .. t?N�0� ..---_.. s td .....-••---:.v.-..... .. ---•-- oht N o --------- oca n- ddress.. � rL Owner Address ........................................... --------- Installer ; Address f/ ,i/./ UType of Building Size Lot___________________________Sq. fe t Dwelling No. of.Bedrooms.............................................Expansion Attic dt) Garbage Grinder (M) Other T e of Building No. of persons..........................:_ Showers — Cdfeter"ia w ,.YP g P ( 4 ) ( ) a Other fi "" ------_--------- -•------•-------------------------- W Design Flow '_._ .. .____gallons per person clay. Total daily flow_..___ue ______________________ lyns. w P4 Septic Tank-Liquid capacity., gallons, r Length_ -:! ..... Width__:.._.____ Diameter________________ Depth________.. Disposal Trench N� __..._.. Widtb T ._.. Total Length._._____ Total leaching area.. „ ---- sq. ft. � Seepage Pit No........ ......... Diameter ... .......... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( �') Dosing ta.Ak .0 Percolation Test Result Performed,b :.____1�.�_ svo A�___��~ Date____ 9/��~�� a y ff' s- ••••��}} Test Pit No. I.....___________minutes perrinch Depth of`Test Pit.__l'___.._...___. Depth to ground water ........ 3!... f4 Test Pit No. 2................minutes pe174inch Depth of Test Pit.................... Depth to ground water..............._........ t O ��'P fr - 0J _ ,St' Chi^« � 7-1 or, Descriptio Soil; -------- -------- ------------------------------------ ------. ---------------------------------------------------------•------------------------•-.................................. U Nature of:,Repairs or Alterations—','Answer when applicable............................................................................................... ------------------------------------------------------- .. ............................................................................................. Agreement: The undersigned agrees to: install the aforedescribed Individual Sewage Disposal System i accordance with 4•. the provisions of TITS is 5 of the State Sanitary Code— The undersigned further agrees not to place the system in ,op,eration until:a Certificate of Compliance has b n issuedbv the board of health. ,, g Date Application Approved.B . Date Application Disapproved for the following reasons:....................... --------------------------------------------------•---------•-•--•----•--•--•-...._... h Date' Permit No......................................................... ,. Issued. ------••-•------•------.._. Date ¢ THE COMMONWEALTH OF MASSACHUSETTS r BOARD. OF HEALTH , ,, .......... ,. .. .. ............... ... , , , . ............................. Ra. (9rdifiratr of Tompliaurr k' o-w THIS',A 0 CER , That the Individual Sewage Dis osal System constructed ( Repaired ( ) Y ....................... /nstaller x -----------• - rl ► ------------------------ has been=installed in accordance with the'�rovisiorls of T l`� iihe State Sanitary Code as describe in the application for Disposal Works Construction Permit No__. ..... ........ ....__t - dated_ __ _______ ____l - R �w.0 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE°CONSTRUE® AS A GUARANTEE THAT THE SYSTEM 1lUI F. FI .:......CTION SATISFACTORY. �A . --•-------------•--------=---- Inspector...--- - TE......�.............5lf. } THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH % 4 . � .. 1�7 Maps nrk Tonstf ion lermit Permission is hereby granted..__..; • •---........••-- ......-- 1 k to Con stru or Repair ( an Indivi ual Sew ispo S st ---- treet as shown on the alication f �tT pp F. or Disposal oiks Construction APero.. __ _.__ ated: �►,2.�,�+.�_ .._......_. --------------•---•---- DATE. / { Board of Health �/ - ----•-. ,----.......r -•--••-•------- FORM 1255 HOBB§"&>WARREN.,.INC.,,.PUBLISHERS ' Large Format Box #� Doe,# Image g I M A DATA o W OZ a 77 Al, � 51 c/ a, 0, ---- �, �. ` Q r (o � rn o/ls 2L�t4 v c �1 •0; _ /�/ Ise �C. /7t Cd. O T7 '#� S JE v e Z,3zo 16Q W ►: ��VCo G4.1/err ZFs iA �z o » 8�aZ 9 &� 9�/!�7 7 6•j e A3 t"c+ ymay. your'r� M� 1hlA- 14- n \° 1Jy o �� A T �c .,�r'3 z''E� lA A/ 1 , NJ� ss, E„ v.kbrmC'n -/eL X !/0f/rt.6v. = 3. ./3 x /.s 6/v = 5�9e 4 y p aI i ¢9•S y/,d X O. S� .7f�� _ /.9& .1�fr f re-9t.lk=a/ / 1 /- /ODD leach 190 //� .3r �rr.. �ja /s GY4J�c.djC° _�� _�____•� L✓ s� / - //nt�rao 01 0 /L.�.C A p J, t o// ,� / s1o77� i to Z/'� ea A; / 0 /Vo �aA, a Cc G/l�4I"rfy � e!- Ste�4ac a zvra ej- /S `Q � l�� /r /OUP o� l�'Gc/7 � e j ft a �- Cl 1 DO'S PLAN OF LAND 10�a = IN 1- 4E MASS. Zr OF OWNED BY P` y ! N O r I CERTIFY THAT THIS PLAN SHOWS �� s �`� " .e ujo 154C P �q 5Ao"a c THE ACTUAL LOCATION OF THE X (RANK —STRUCTURE ON THE LAND AND J No. 5231 CONEi.Y ` , FRANK CQNERY 5 TREhITOAI ST. a CONERY �^ FRANK �� THAT IT CONFORMS WITH THE c�'` R�a� �" � " HYANNIS, MASS. 01$Ol SST t yQ �\ , 4�NC 55I a��f/`l/� RE615TLRlD FMORIFUR A L-"D GURYh^10R BY-LAWS OF THE TOWN SCALE I IN -20 Fi•. /0/14-177