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Home My WebLink About0021 ELAINE ROAD - Health (2) r&Y JqCAr)n� s No.. /----------�16Iv' Fims.....3.. ...0........ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratilan for Disposal Works Cnnntrnrtinn Fumit Application is hereby made for a Permit to Construct ( ° ) or Repair (X ) an Individual Sewage Disposal System at ; ' 32 Elaine Rd Hyannis MA -... ................ ................_ ........... .. _.. Location Addr..ess or Lot No. Girard A. Gaouette .. ...... - - -- •---•--•---------------------------------- ..........--.................................. . .......................................... Owner Addreess s s ...._W._E-.•RobinacLa---Septic...Servi.ce............... Bs2x.__1-0-89_ Centerville MA 02632 Installer Address Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.........3..................... .Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria a 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 ( ) '-� Percolation Test, Results Performed bY.................... ..................................................... Date........................................ aTest Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water--___-_-:-___-__--_.,__. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a - ........................................ ...................................... 0 Description of Soil.....gravel...............•-•----------------------------•----------_ x W ---------------------------•-------------••-•... -----•---•------------•---•---•-•------------------------•------------•------------------------------------------...-_-------------------------------- UNature of Repairs or Alterations—Answer when applicable_... 9.4.1................................ stone-packed overflow ----------------------------------------------------------------------------------------------------------------------------------•--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued b and of health. q / �_ ! � ✓ Signed - - -- ----- -- ....... --------- --- .....................-- -- ---- ............................ Da[e Application Approved BY .- ... L' ...-.-. .- ------------------------- ........................-............... Date Application-Disapproved for the following reaso - ------------- ------------------------------------------------------ - ---------- ------------- ---...................... ----------- ------------ ------- - - - ..... .._... - e Permit-No. '- _._Issu, - -------------- ___ d � $30.00 Fps............._............... THE COMMONWEALTH OF MASSACHUSETTS N BOARD OF HEALTH a TOWN OF BARNSTABLE Appliratiun for Disposal Works Tonutrurtiun Frrutit - Application is=hereby..made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: . ...32 Elaine Rd Hyannis _MA �i�ll)I---5•-------- ......................................... Location-Address or Lot No. Girard A Gaouette . - owner Address Hlk?i.ns -.S� i ... Pr_�rcP .B +�...1089 Centerville _MA A2632 Installer �'^�^ Address U Type of Building Size Lot............................Sq. feet a Dwelling—No. of Bedrooms.........3........1 �......,.............Expansion Attic ( ) Garbage Grinder ( ) aOther—'type of Building ..............;............. No. of persons....................:....... Showers ( V ) — Cafeteria ( ) dOther fixtures ..........................................................--........................................................................:.................. W Design Flow---------------------------------------------gallons per person per day. Total daily flow.............................................gallons. P4 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter:............... Depth................ Disposal Trench—No..................... Width..................... Total Length.................... Total leaching area..........7---------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....--.................. O` Description of Soil---- gravel -----------------------------•------....------------------------------.....--•-•-- Wz -----------;..-•------------------------------------•-------•--......... --• -----y--------.....---------------•------------------.............................................. f ------ `------------------------------------------ ------------------------------------------------------ -----------... ........................ U Nature of Repairs or Alterations—Answer when applicable....inf ta_�:1....(1_�_... 1_,00:0 cfal. stone-packed overflow .......................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribedIndividual $ewage Disposal System in accordancerwithi the provisions of TITLE 5 of the State Environmental Code-`The undersigned,further agrees not to place the system in operation until a Certificate of Compliance has bee (issued b e b rd of health... - Signed - .!�r ..`':+fit. # J _... .... .... GZ7' � ✓'Date - Application Approved By .... :.; .. ..... ..�---- -/.... . . ` 4Dare Application Disapproved for thef ollowing reaso . .........- ..............................< ------------------------ -----------------------I?------ = ~ ........... Permit No. e l'� Issued I a THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Ce>r#tftrtt#e of Crom lianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed( ) or Repaired ( X ) by......W.-E.....Robinson....Septic Service.. ........................................ --------------- Installer at ............3:2____Elane_Rd Hv-annis, MA ,,--x has been installed in accordance with the provisions of TITLE 5( f/The t M.Environmental C e des �' ed in the application for Disposal Works Construction Permit No. .......,/..(.. f y f dafe .......... of....... THE ISSUANCE OF T 111 CERTIFICATE SHALL NOT BE CONSTRUED AS A UAR TEE r Af THE SYSTEM WILL FUNCTION SAT Ca ISFACTORY. i[( i DATE......... ............................................................................................ Inspector ................................................. ............................................... THE COMMONWEALTH OF MASSACHUSETTS *` BOARD OF HEALTH - No.. FEE... TOWN OF BARNSTABLE $3 0. ...00 .... ...- ..../.... ............. Disposal Works Tunuirttr#ion "prrutit Permission is hereby granted...........GPI,R e RAbi-nson Sevt�.,e_-_Service .. ........----•-• •................................................................•- to Construct ( ) or:Repair ( X) an Individual Sewage Disposal System I� at No....... 32 E. >?e-•Rd• Hyann s.e....MA................................................ ..................................... .. .... ' Street i as howno n the a plica.ti,n for Disposal Works Construction Perm' 1 bej� .....,___. Dated. _a.. ... ..`. d .............................. .. .�---.---!�- . -- ......� �-e Board of Health l DATE.. C v V .............•-••---•--•................. : r el I FORyM 36506 HOBBS h WARREN.INC..PUBLISHERS t