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Home My WebLink About0014 CIRCLE DRIVE - Health smith S eet Hyannis A= 288 — 044 o� l arc an ill 'ay a is A= 2 - 024 i i a a 1 SMEAO No.2453CR UPC 17734 amead.com * ��jjM��ade to USA t VSFSSQRS PAP N044 ` acu " " =- u"'_ .;w.r rr.:. .,�....';, ., • `_'_....�• :-- Fim . ............. "+.. H C!:W1,V70 IWLALTWC-vMASc�n'\_CHI' 0'plirFafinn for Disposal Mocks Tonstrurtinn Vrrmit Applicatio ; hereby. ade g6F4 Pe rr t�o onstruct ( ) or Repair (X an Individual Sewage Diso�al System at: �� - ?�' / ,,.z re—O� ... --------------------------------- ..... .......................................... - Lgcat' n-Add res ` {� / A or Lot No. -` SO n —`?s� + 4a... MA 91...SeS—�1��........l�.1/_(� —row A Installer �/`( r�� Address UType of Building Size Lot---- �®.....Sq. feet Dwelling—No. of Bedrooms....?.......-_.��............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ................... ..... No. of ersons._..-_....._................ Showers ( ) a ---: p ( ) — Cafeteria 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 ( ) aPercolation Test Results Performed bY......................................................................--- Date........................................ Test Pit No. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water........................ G=, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ----------------------------------------- ----------------------------------------------- ••--- ------------------------------------------ --------------- 0 Description of Soil.........................................................................................................................-............................................... W U -----------------------------------------------------------------------------------------•-----------•----------------------------------......--------------------------------------------------------- W U 7CNature of Repairs or Alterations—Answer when applicable-----lz. �� 1 ........;:�Q..... L._.--C7_-- L -t-N-----------------1,_04V-------&...--..6 ..:.I6----'4AT1--<--------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of IT _; 5 of the State Sanitary Code—Th dersigned -urth agrees not to place the system in operation until a Certificate of Compliance has been issued by board of lXQlt Si --•-------------•--. �... 30 Application Approved BY------------ -z'/-z��------------- Date Application Disapproved for the following reasons---------------------•------...__-----------------------•------------------------•----........................ ..-•-•-•-------------------------------------------------------------------------•-------....-----------......_.......--••--------.-•--- •------------------------------------------------------------- �"'"`� �` � Date PermitNo....... �l ------- Issued-------------------•--................................ Date ....�/ THE COMMONWEALTH OF'MASSA`CHUSETTS .: �J0r ARD'kOF�j-1`EALI`I-I - rlir ay 9 11Urt � ion Urrmit, Application is hereby made for a Permit-,.to Construct ( ) or' Repair X) an Individual Sewage Disposal System at ...... ...._ 5 C7N 5.-------�` --------- ........................................... .............................................. L cation.Address or Lot No. � W! ? �-�r� -----•---------•----- ---------Cs------___. _ ...S` .__.... 1 _ dress V v . /`' Address� Installer ;--- � �(� d Type of Building Size Lot......I....................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—Type of Building ........ No. of persons__________________________ Showers - Cafeteria Q' Other fixtures ............................................................ W Design Flow...................................-.........gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity------------gallons Length..........:..... Width..................Diameter---------------- Depth................ Disposal Trench—'_`To. .................... 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______-______-_-----._-. fr,, Test Pit No. 2................niinutes per inch •%.,Depth of Test Pit.................... Depth to ground water----_............... __._. -------- .....................................................•---------� ----------...-•--- =... aI - O Description of Soil Q`----------•----------- -----------------------------------------------------------------••--•---•-•-------......------------------------.... „y. W ____________________ _____ ___________________ ____ } Y 4-----r---------- UNature of Repairs or Alterations 'Answer when applicable �`'-�G �- 00 �� I•." L ----- Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iiT E . 5 of the State Sanitary Code—Th ndersigned 'urti r agrees not to place the system in operation until a Certificate of Compliance has been issued b board of al xed . -- �•' -- fig ._-_-. _.... _ _.__ Application Approved BY------------------ -------- -------- ---------•----------.....---......-•_•---- Date Application Disapproved for the following reasons------------------------•-•-••-----------------------------------------------------------------------------_._. ...........-... ----------..... Date 4 Permit No......................................................... Issued....................................................... Date - l THE COMMONWEALTH OF MASSACHUSETTS r-- BOARD OF HEALTH ..........................................OF.................;.. "::::. .................................................. fit THIS; ','�N�C�ERTIFYGTh t t I vldu J ew age'Disposal System constructed ( ) or Repaired ( } by = •---•-•.................................................................... �''',f ..r �'<}...... at -� ---- --------------------- -------- -------- -------- ------------ ._...........----------- has been installed in accordance with the provisions of "i Z f T-he;,Mate Sanitary Code escribed in the application for Disposal Works Construction Permit No........�M'_..___...�__.�_......... dated_.�.�:.r_.�".��._--______________________ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE .SYSTEM WILL FUNCTION SATISFACTORY. -2 i DATE................... ---------------1 1-� ---- Inspector......-......---...-----...... THE COMMONWEALTH OF MASSACHUSETTS F _ BOARD OF HEALTH ............................OF..................................................................................... O No......................... ' FEE........................ Permissionis hereby granted.......... ...............................................---•-•----------------------------------------------------............._----....... to Construct (� ) or„IZair (: ) an Indi a ua Sewa a-D.i o System -- 2L No................ ................................................................ .-........_........._..______.__..............._...._........._......._.__....____..__._....___........___ Street as shown on the application for Disposal Works Construction Permit -No.--_______________,D ed__.___.................................. _____ __ t Board of Health ATE............................................................................... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS p