HomeMy WebLinkAbout0111 BREAKWATER SHORES DR - Health _ 0
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L0CATION SEWAGE PERMIT NO.
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VILLAGE
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I-NSTA L L E R',$L, NAME & ADDRESS
BUILDER OROWNER
'DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED '`
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WITH AR 'V' , rL�FLI $�
SAN1TgRY CLd S gTSN�E
REG �TIC)N
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No.••29.-_.. .. Fics... 5. oe.........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town OF Barnstable
, Apure#ion for Bispootal Works Tonstrnrtion rnmit
Application is hereby made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal
System at:
flit B ._.... ......_.
Mary Summers Location-Address Breakwater Shore Dr. , Hyannis, Mass.
Sho�e6 �9r. , Hyannis, Mass.
...
..... ............ ..............------ -------- - ......---......_.
A & B Cesspool Se:PVTce f......_ 128.Bishops Ter Cle , Hyannis,-:..Mass.
•----------------------------------------•-•----•------•-----•......-•-- . ---•••-•--••--.........-•--•.........•----------•-••--•-•--•-.......
Installer Address
Type of Building Size Lot............................S feet
Dwelling—No. of Bedrooms........4..............................Expansion Attic ( ) Garbage Grinder ( )
a'_l Other—T e of Buildiil ___.... No. of ersons...___.._.�________________ 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................
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 ( )
aPercolation Test Results Performed by---------------------------------------••••-----•-•......-------••-..... Date........................................
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.........................
(s, Test•Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
W --------------------------------------------------------------------- ................
O Description of Soil--••--....--•- `.'nd------•-----------------------------
x
W
x --••--------------------•--•-----------••----••••••••--••--•--•-•----•-••---•--••-•--•-••-•-•-•-------•-•-------•----.._...-----•••-•----•--------••------------•------•-•-......-•••••--•----------•---
U Nature of Repairs or Alterations—An wer when appicable._--Instdllation of a 1,000 gallone
Stone hacked leach.pt___ oyerflow .
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iITL.E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued Vthe bo ofalth.
...... .... ---•---------------------------------------- -----2-1-5-4- 9----------
Date
Application Approved By..... ...................1W2/-5��9
Date
Application Disapproved for the following reasons: - ...... .................................................•---•--•---•--••--........._...._
L
.................................................................................•__•_-_•____..__....._...._. ..__n .................
'�.------------------••-----•---••-•---•---------------••----...Date
Permit No. 9....--••-------...--•------•-------•----._...... �. Issued.........2/5/79......................
Date
THE COMMONWEALTH OF MASSACHUSETTS
a BOARD OF HEALTH
z t
..*.�:. Town Barnstable
__............ .. ....OF..........................-----.......----------.........----........_....................
ppliration for Dispmal Works Tonstrurtion rrntit
Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal
System at:
Breakwater Shore Dr. , Hyannis, Mass..
----------------------.-_...........--..........._.............................-.............. - •- .......-......
Loca*ion-Address
Mary Summers Breakwater ShofleV re , Hyannis, mass
......................_.__..................----------•-................---------•--............ --•--.....-----------•.......................------.......--•---......----------•..........._.._..
A 2. Cesspool Sefffee 128 Bishops Terig8bo dnni__s.j...
Installer Mass,
. ...... ----•••......................... .... -
.... .... .........
-.; Address
Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms.......4..................................Expansion Attic ( ) Garbage Grinder (` )
04
......_... Showers —
Other—Type of Building ............................ No. of persons..._..... _.._. ( ) Cafeteria ( )
04
d Other fixtures ------------•-------------------------------------------------------------------------- .............................................................
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 ( )
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........................
04 11 1 •---•........................:......................... .........................•------•---•---....................._.......--•--•------•-•--------------
O Description of Soil--------------sa
U ........... -
.............................................•----------------------••------- -------•-- ....----------------•----------.....----•:...............------ -_...............
W
U Nature of Repairs or Alterations—Answer when applicable..Insta11at .oln-f..a...
Stone. hacked..leach---oil----(overflow
------------ -----------------------------------------------------------------------
Agreement:
The. undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iiTLL , 5 of the State Sanitary Code—The undersign5o further agrees not to place the system in
operation until a Certificate of Compliance has been issued b ,he�oa lth.
.•
Sig d _9....._....
/'� ate
Application Approved By....... t,..-•-� ._ . ..--•--•--------• ------------ -
� �51
Application Disapproved for the following reasons-..................... ..................................................---------------ate------.....--
-•---••--------------------------•----------•-•.......---•-------•--•------------._...•----•------....._....------...__...------------------------------------•----------...............................
Date
Permit No. 9.........................•-----------....-------- Issued---------221-5/9--------••-- ----------•----
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
To n OF stablyo ............... .......... ............
...........................................
Tnr#ifirate of Toutplianrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (X )
by.A..&-•13...0e.sg0.Q3••-19Ar..Via R. 1.2A.-1 110ps...TeTTA".r.. -----------
Installer
at..$ elk t k� e s fir.. ,... y .a• 0 .....�.....m yy....Summ r__�s_... ------
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the t
application for Disposal Works Construction Permit Nod .-.......1. '................ dated......1l51_ 9_........._..._._........
THE ISSUANCE OF THIS CERTIFICATE SHALE. NOT BE CONSTRUE® A G RANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
- t z� 77
DATE.. ...... 4 ............................................... Ins pector ........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
`7I / ..................Town...........OF.......... rna qb1 e.----------................................ $5,.00
No.........:....tt • FEE. ..----......
Disposal World TUan#.rnrti.on anti#
Permission is hereby granted..!k._A..gessjo a '3I t; s �'-2ZV BiGhOIDS Terp.,.Hyannis
to Co truct or Re ><r a Indivl Sever a D's, osal System
reaiw for .® e fir. , 'y�nn s. . !9,ikry Summers
Street
as shown on the application for Disposal Works Construction Pep 't N ..:9-___ Dated...?t5/79......................
x :. � ----------------��5�7�
Board of Hea
DATE .........---------------------------............................
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS _
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