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Home My WebLink About0142 GREELY AVENUE - Health (2) c P THE COMMONWEALTH OF MASSACHUSETTS � 1 i o/(ot OAR® OF HEALTH .............OF...............!1 ApplirFatiun for Diuvuual Works Toutitxnrtiun lirrmit Application is hereby made for a Permit to Construct (' ) or Repair ( an Individual Sewage Disposal system at -•y-- -� - �'P-- ---- 1e....j-�4 - . -----• ®�------------- ------------------------•-----___---•--____----- .. ..._._..p _._........ocat.Wit....a ._lJ .�-!X .........O�\�. F Owner dr ss ' .... a --•-••-�� ••- ..... ------------------------------------------------ `CM ...----clwsi ................ Installer Address //� UType of Building Size Lot_-_`Y- _:_,FCT__7._Sq. feet a Dwelling—No. of Bedrooms.............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) el Otherfixtures -.._..... 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. Seepage Pit No..................... Diameter--_-_--_----__---- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date......................................... W 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........................ I ---------------------------•-------------•------•-------------------...-•-•--•---••------._...-------------•._.....••-------•-•• -------•-------------- 0 Description of Soil-------------•-----•--•---------------------•---•-----...---._......-----------------------------------------------------------------------•-•----•-•---•••-•-------•--- U ......................................................-.................................................................................................................................................. W x ------ V Nat f Repairs or lterations—Answer when"appl•cable---_---�p ii .. �' l 2 Agreement: . " The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i T'�Li; further ,F p 5 of the State Sanitar C de— The undersigned agrees not to place the system in operation until a Certificate of Compliance ha n ue rd of healt1h�_� u D t Application Approved By............. ------ .�--••----------•--•----•------•---•-•--•-......-----•-•----- ... y--1-�7 -•------ / Date Application Disapproved for the f olloz&ing reasons:-------•-----------------------------------------------------------------------•------••--•••••-•-•----••---•--- ....--•------•---••-•-•••-•---••-•---•••••••----••-•-•-----•--•--••••-----••--•••._...-----•-•-••--••------••••••••-•••••---•••--•••------•••--•---------•-••-••-•------•-•----•-----•-••--•---••-•----- Date PermitNo.- a --�v--------------------- Issued....................................................... Date Lie No...--...----... F THE COMMONWEALTH OF MASSACHUSETTS OAR® OF HEALTH ................OF............... ................................................ Appliratiun for Disposal Works Tonitrurtion Vamit Application is hereby made for a Permit to Construct (` ) or Repair ( ) an Individual Sewage Disposal System at: kcv)- - - r7iZ� ocat r -•-••-.. N -• .... ... . .. .�: ............................. Ownez �- ss a ------------------------------------------ ��a. y .......Q� _.k3�.-----....------. Installer Address Type of Building Size Lot___-Q__.X(!7_5q. feet ,-� Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building ............... No. of persons............................ Showers � YP g ------------- ------------------------•---P ( ) — Cafeteria ( ) dOther fixtures -•---•......------ --•.---•-••_._....•-•---•••-•-•••••----•-••--••-•----•-••••---••--•---•---------------------------- w Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter________-____- Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................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--- --•---••------•-••-•---•-•-----•---- a 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-___-______-____---_____ P4 - ---------------------------------------------------------- •--- ------------------------ •----------- •---------------------------------•----------•--------••-- 0 Description of Soil........................................................................................................................................................................ x U ..............................................----•-------------------------------•-------------•-•--•-----•---••------------------•••--------••---•.._...-----------•-•-------------------.....-•-••--- w ---- ------------------- ........................... V Nat Repairs or Alterations—Answer when applica:ble;,_..._k.A_ ��. �_._._.. ...... .�:1---.. F ..u� . . cal 't ati�vvlE .t';, r i Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of 1-i , p 5 of the State Sanitar C e—The undersigned further agrees not to place the system in operation until a Certificate of Compliance ha n ue rd of health. S ................................................. ................................ Date Application Approved B ................... Date Application Disapproved for the following reasons__________________ -•--•----••••----•••-•..................................................................... ----------------------•-•------•-----•---•-•--•---------------------....-•••--•------------- Permit No._-' --- �g---------------------- Issued-----•-•-•--------------------------------D---ate---------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............................................. Qurrtif iratr of Toutplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( } 1 i C Installer �i at. GC', + ...........+t s Y . ---------- = = G - has been installed in accordance with the ovisions of i i i ii; 5 of The State Sanitary Code s described in the application for Disposal Works Construction Permit No-__�-- _�7__-'____4J__-<�... dated__..._.! _1=_,�C_�.............. THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GU RANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY.. DATE... .-�•c = 5.7.... Inspector.....JA `' ............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -' .........Wn1 ....-. No._.. FEE........... .......... Disposal Works �ono#rt ion rruti# f ( 1c Permission is hereby granted---•------••---•... ---•-••-•--•. -----Q................................................................................. to Construct. ( o{ Repair ( ) Individual Sev�age Di posal System atiV o.. --------•••--... --- ••.....• ...... 0 ---••.•- Street as shown on the application for Disposal Works Construction Permit Dated....!___/_f/'/ 7.............. Board of Health DATE.................. ........................ �.t....... 1..---.. FORM 1255 H 65 & WARREN, INC.. PUBLISHERS A14 Cuq.d Arire '< Route 130 Mashpee Masi;.chusetts 02649' `"(617) 477-0349 0 DATE:Janua.ry 9 , 1987 TO WHOM IT MAY CONCERN: THE SUB-SURFACE SEWERAGE DISPOSAL SYSTEM SERVING THE DWELLING LOCATED AT142 Greely Avenue Hyannisport ,, Nia. IS CURRENTLY IN OPERATIONAL CONDITION. It has a 1500 gallon holding-1 ,000gallon Leachin Pit HOWEVER, THERE CAN BE NO ASSURANCE GIVEN. AS TO THt LENGTH OF - TIME IT WILL REMAIN OPERATIVE. y SEPH eBARROS ABCO CESSPOOL 'SERVICE ti l l�