The URL can be used to link to this page

Home My WebLink About0288 ARROWHEAD DRIVE - Health (2) _ ._ , , t � 320 Arrowhead D'r � ' � � p �� __. __ ` �� q� T270 ' q94� - — ---- 3 � t- , , � .�r .-. � _ _ __ ___ _ �t �-�"Hyannis � � �, �; �r � � C-�� e as 0 ASSESSOR'S MAP NO. c-) O PARCEL 7 LOCATION SEWAGE PERMIT NO. Qo 4zxa-t A Qet. IS, VILLAGE ' yAij INSTA LL�ER'5,.,, NAME i ADDRESS a*-S ti 1 >Jc:k vQa: N C 0 U I L D E R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED sl �I�6 F � .. ,) - ' ., . � ICI - � �' r � � °C -r_� _- �, .. 1� HEALJ H DEPT. Town Office B"uitding .i 6, S3 O - _ - - - Fas. � oa THE COMMONWENL`rH OF MA5SACHUSETTS BOARD OF HEALTH ...............o Appliration for Disposal Morks Tonstrurtion rrrmit ` Application is hereby made for a Permit to Construct ( ) or Repair (Kan Individual Sewage Disposal System at .... n ![�.. .. - . ....................... ................ ------------- ----- c -» L io -Ad a �••�•-- or Lot �-� . ..................... Own Addr ss a ...... ................Q..... ... c ...-..-=-------- -------------------------------------------- --------------•----------................--•-----• Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther .fixtures --------•--------------------------•-------•--•-----........------.....------.................. W Design Flow............................................gallons per person per day. Total daily flow....................------- .................gallons. WSeptic Tank—Liquid ca.pacity............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 ( ) 0.4 Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.....................--. LZ4 Test Pit No. 2................minutes per inch Depth of Test Pit..--................ Depth to ground water.............--......... a ...............................................-............................................................................................................ 0 Description of Soil......................•----...--•--•---------------••--••-----.......--------•-------------------------•------------•--------•----••--•-------•-•--.................---- W U ----------- -------------------- ...---------------------- ••••------------------------- ............... ......-----------------------...--------•------------•-----------------..... -------- W � j� ..` U Nature of Repairs or pation —Answer hen appli 1 -..l f. .... .- --. �""' '"t..-•- -.•••••-- .........-- >LG! . J -------------------•-------•-••-------...--------------------.......................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITL 1S 5 of the State Sanitary Code—The undersi ned further agrees not to place the system in operation until a Certificate of Compliance has be issued by the of ealth. p� C� Signed- -- ---- ------- .... -----,•---- .................................. -v--.--,:;Lg . - ate I ApplicationApproved By.....--••............................ .......• ............... ......------- ........ ......--- •r Date Application Disapproved for the following reas s------------------------------------•----------------•-------...----------•------•-•--•----- ................................••-••----.........-------•---.........----.....-------•••---•----•----------------...--•••-------------------------------......----------------••------.....---.....•--- Date PermitNo......................................................... Issued..................................................... Date No..... —...... Fa........ .._.`...._..... _ (�1X THE COMMONWEALTH OF MASSACHUSETTS BOARD OF H-�EA/LTH 9-t c/ I�l 1A l.C-..................... ..................................---....----------.....---....................... Applutttiun for 11ispuuttl Works Tonstrurtiun Permit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: 12 • �ocionNN-_Addres�s. `/ r ot N>U-•y�o.•L Owner Address; ........j............... _........ .. Installer Address ........ ......•-•-....................._......-•_.... .--- Type of Building Size Lot............................Sq. feet a Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) py Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtures ... Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid'capacity......_.....gallons Length................ Width................ Diameter................ Depth................ W - 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ 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........................ 0 Ix ..............-...................................................................................................:.......................................... Description of Soil........................................................................................................................................................................ W M ------------------------------ --- --------------------------------------------------.-------------- •---------------------------------------------------------- --------•--------- ---•---••--•----------------•------•-----•-•---••---------•--------------.....----...-------•-....--•-----•-----=..../.............................................................................. U Nature of Repairs or Alterations,—Answer when applicabl ...' ..d�f!x �--�',:.,:.e!zz�.,..�..� A-�..tea. _? ° ----ra)1l---- e:1 C:: _. ,r,�t...---------------�--------------------..._..----------------•-------.............---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLF, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has ben issued by the board of health. ' Signedr' _!- �` ` _ g6 s.- r _ I�t ........................................ Application Approved By................... Date Application Disapproved for the followiny;reas n -----------------------•----•-•--•---------•---•----•------------------------•. � k- / Date PermitNo..........:..................•----•••--•....••---:-•---• Issued-..................................................... Date THE COMMONWEALTH OF MASSACHUSETTS , BOARD OF HEALTH , .....��J�l �{. '2.t✓.......0F...... _ ... . .�.!�x, d ,f�c Trrtif irate of Tumplianre THIS IS TO CERTIFY, hat the?Individual Sewage Disposal System constructed ( ) or Repaired ( L-)'"� by............ . �!. ...�..... .. !:!s!t .. ......................................................•---......................................•......-- /n� Ins, 11 at............... ....._ _.... r-�-�- --------------•-•..............•--•---------------------------------.............. 'i has been installed in accordance with the provisions of TITI 5 of The State Sanitary Co as es ribe� n the application for Disposal Works Construction Permit No......................................... dated......._�................................... ; THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL F/UN TIO SATISFACTORY. D ATE............... ? --- •-RZ..---••.---=== ........ Inspector................ — - ---- --- - ---------- THE COMMONWEALTH OF MASSACHUSETTS INw►'11�P f � 7 BOARD OF HEALTH �6-53fl ........ ......OF....+ � 1.. �-� .:.... No......................... FE> j.11.Q. ..... Disposal arks T nstrnrtinn Permit Permission is hereby granted---- �� '� ..----------�-•- ---c------•----------------•-•--••-•-•--........... •to Construct ( ) or Repair ( 4;4-an Individual/,Sewage isp sal System p� ---- -------------•------......._"... ..v> •- •----- �-``cStreet rg,6 -5'as shown on tth applccation for Disposal Works Construction Permit No.............. . ..9�et _.___._....._ ---------------------------------- ------ ---- -.-«. Bo,rd p.f.:,1[calth DATE '