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Home My WebLink About0264 BARNSTABLE ROAD - Health 264 Barnstable Road .Hyannis ': > A I i I Ir uSS C i NA � �rn � G2 sTFl C�L� R K3"N , LoC'A7')o N � lea 54� ass uF De iv LJ A A.L C u !,1 K- . IV l q:y 2 a ` \ z-:3 /o0o J�,4-MN f,K. � SsELL Cr `-K)P- L , To,4fl tor uST N-s-r A3 Lz--- RsS . 000 j Ff-ON 7- co L3 -/000 _ - J No..... Fim.....21............. THE COMMONWEALTH OF MASSACHUSETTS —BOARDAF HEALTH . ............OF....... ............ Appliration -for Dhipviial Works Tomitrurtion Vrrmft A plication is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal y at 1 ,e_1 ............ .... .. ............... ------- ----------- ------------------------------------------------------------------------------------------------- IZ9tion-Addres or Lot No. . ....... .... ner Ad ss --------------............... ... ................ ................................... -------------------------------------- ........ .......... .............. .... ...... ;.... ........... Installer Address Type of Building 7 Size Lot............................Sq. feet U Garbage Grinder Dwelline No. of Bedrooms. . .. .... ........... -Expansi At ic-C G, -1 "Type of Building ........................... No. !Y.O — Cafeteria D4 Other persons..._ ............... Showers 04 Other fixtures ........... Design Flow--------Zd Ilons per person per day. Total daily flow----------- ........gallons. C4 Septic Tank I Liquid capacity Ions Length................ Width..__............ Diameter__.._.........._ Depth................ Disposal Trench—No. .................... W i d t,�............. tal L th------ ....yotalleaching area....................sq. ft. t'21 el0 pth be w n'l .... .... ,9tal leaching area 1. f t. Seepage Pit No--------------------- Diameter- / -4e?p�th%w i I T ------------ Z Other Distribution box Dosing tank Performed by.............................................................. ....ja/' Percolation Test Results - ------- Date---------------------------------------- Test Pit No. I----------------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----- --- ----------------------------- ... �' ------------- ...... . ----------- U ................................ . . ........ .. ..................................................... --------------lc� U Nature of Repairs or Alterations Answ�=,when applicable. ------.. ....................................................................................... ................................ A,,..�O. L.IVA --- ? Agreement: The undersig agrees to install the .aforerri�be Individual ew e sposal'Systern in accordance with the provisions of Article XI of the State Sanitary _'_ lyhe undersigne rther agrees not to place the system in as b th operation until a Certificate of Compliance beeFo!�- ed' h 0 alth.�y t_ _0. ......... Sign ;dd e e w D'ispos' r i i u dersigne th er agrees h 0 alth. ......... .. ... . ..... Date 0 Application Approved By 7-3---- D te Application Disapproved for the following reasons:................................................................................................................ ------------------------------------------------------------------------------------*-------------*------------------------------*-------------------------- ------------------------- Date PermitNo......................................................... Issued..... ................ Fsg.... ................ THE COMMONWEALTH OF MASSACHUSETTS ` L BOARD 9F HEALTH jt'fit/l . ...........OF....... ... ......... .. . ilZ.l ....................... , pphration -for Dispviial Workii Tonotrnrtfon Vrrnift Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage DisposalF� System at: - 3 / d*--' yy hon•Addr or L,ot No. r ........................... ---------------------------------- •---•---- vner - Ad ss a •. ....... �'......--•-- ••-------- •--•• ••---- ---• ---------------------................. Installer Address Q Type of Building Size Lot----------------------------Sq. feet U Dwelling -No. of Bedrooms. - _ ExpansianAt�t'c� ) Garbage Grinder ( ) �/ V a Other Type of Building ............................ No. peI-solis.........._..._.____________ Showers ( ) — Cafeteria ( ) a' Other fixtures ________________ c Q ------------------------------•------------------•-•---.._...---•-.-.-------•----- � ------.-- w Design Flow.. ...."20 _X.__ __i.�__ Mons per person per day. Total daily flow.........__�,?___��-.........gallons. WSeptic Tank Liquid capacity _____. allons Length................ Width................tDiameter_____------.---- Depth................ x Disposal Trench—No. .................... W'd I .___.---.. _.. .__ tato L 1____._ --_--__Ji otal leaching area....................sq. ft. 3 Seepage Pit No..... '_. ...... Diameter -h 6e w in ________.._.G_.r.•T tal leaching area_______________ _ cl. ft. Z Other Distribution box ( ) Dosing tank ( ) 6tl.+� ; " ~' Percolation Test Results Performed b ................I.... Date........................................ Test Pit No. 1................minutes per inch Depth of "Pest Pit-------------------- Depth to ground water..-.-.--."-----._-.----- �14 Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................ R; ..............••-----•-•-----•---...-- O Description of S oil...... ----------- w x ................ 94 ....... _. ........--•- �f V Nature of Repairs or Alterations—Answer when applicable............................................_._................................................. •-•••-----••••••-•-•'-•••••--•...-•••••...•••••---•-••--•-•-••-••------•----------------------•------ Agreement: The undersigned agrees to install the afore cri5�he Individual Sew e Disposal System in accordance with the provisions of Article \I of the State Sanitary od undersigne rther agrees not to place the system in operation until a Certificate of Compliance has bee ed by th o alth. Sign d- .--....... -• ..... .... ............... ............. .........-- - -- ------ -- ate Application Approved By........ --- --- .. �... Date Application Disapproved for the following reasons: ............................................. ...................•-------.----- .........--•-••-••••--------•----•-----•-•--------------------------------•------•---•------.........._ .. // Date PermitNo......................................................... Issued..3�l.. .. ........ ....................... ate THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ... L.........OF.......T4 .. ... . ... �t"44.......... (11pdffiratr of TomViianrr V THkSLT04ART1',Eey�Ahat the dividual Sewage D*sposaI System, tructed ('" ) or Repaired fby n:at.........•• --- -----A-4.1---------- has been installed in accordance with the provisions of Article I The tate Sanitar Code as scribe in" the application for Disposal.Works-Construction Permit No............... ...._.;.; . ' dated......../.'2' ..3 �,,.�...... THE ISSUANCE OF.THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 3� J �"Z !! ......OF....... FEE--�------------- Dinvia for trnrA.! rrmn, Permission is ereby granted_....- .�'----- ----------r_'----"� 8`�:- _,, _ to Construe t,�1 or Repair ) an divtd )Se ge Dis os Systemi� �� .. . . at No... ° ••• .... as shown on the application for Disposal Works Constructio rmit t .. ... ...: . ..... Dated__�Z� j�.3�/_ .o.a rdHelthZ7 DATE. ------------------ FORM • 1255 HOBBS & WARREN.N4NC.. FYJBLISHERS _• " // /� A� 4 L� c > vS P ur y i f r/.7 L. S / 1 '4 �✓ HL .�'° ..�---� .� T f ��'G-- sue:?..--+,,�` c'�.�=-=° G- �! �./.�.� y IIi'Xu r ' am T s�1 . 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