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HomeMy WebLinkAbout0190 FAWCETT LANE - Health 190 Fawcett'-Lane Hyannis j A = 270­ 136 LOCATION SEWAGE PERMIT NO. VILLAGE y Y1 oY►V i C INST A LLER'S NAME & ADDRESS 8 U I L D E R OR OWNER 1 —o DATE PERMIT ISSUED z�i 'Fs DAT E COMPLIANCE ISSUED �a _ 10 _ ate wri YN I , O . i� r- �- o S �tll.-'%, 'i�' :;-,i I 36� _,==P ;��-- No..�R�-__10 q alb l Fss.......N .......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 777;::�)_w--- ....._0F......G.CA.r.w�� � ..................................... for Ui ngtt1 arks Tomotrur#inn .ermi# ,21���tP�Y#tnn � Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal S stem at: j^• — .....�,.!'�. .? .. j=-:�.. ... ................:�... �� ...... c?............................................ Location-Ad ess or Lot No. ... .C2_►.f��_.....-c4a�...._.. -- ............... r._�s .���•iti.........at_t � -A � . _.._...... ..............._ p Address Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria a Other fixtures ----------------------------------- W Design Flow............. ....................gallons per person per dday. Total daily flow......... _ .................gallons. f4 WSeptic Tank Liquid capacity/ gallons Length.... Width.--`/Z...... Diameter________________ Depth................ x Disposal Trench—No. .................... Width- _�. ........ Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.... -------- Diameter.....I... ... 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........................ Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 Description of Soil.........................................................:'-•---------------------------------------...------••-----••--•----....-----------------------•-•-------.•-_.. x W •----------------------------------------•--•-••-------------------------------------••'-----•---••-----------------------•------------•-------•----•---•••---•------------------------------------•--•- UNature of Repairs or Alterations—Answer when applicable_..._I - !! ._:...\ - ....an ...-------•---�.........4�Sd....... Fw �,-1-s......"LAre ......"4�?.r� - ------•-•---------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System.in accordance with the provisions of I I'L iE 5 of the State Sanitary Code— The undersigned further agre not to place the system in operation until a Certificate of Compliance h iss"e the boa d o ealth. Signed ...... .... --'' -- ------------"- •-'------------------..... ......... a J Date .... ..... . .. ............................ Application Approved BY f Day g Application Disapproved for the lowing reasons:...............................................................................................................- .........'--------•-'......'•--------------------------------•'-•'--------•--•---•..................--"-------------......------------------•-----------•------------------•------------------••---'--- Date PermitNo.------. �--------------•..... Issued....................................................... Date No......................... Fima..................._..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH < .tw.. ......OF...... i:!!! '`«aG�b!`-^ ,................................... Appliration for llhipoiitt1 Works Tomitrnrtion runfit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................�:......��. .� ��"° '�. ------•----------._....` .: : F ::ti. ....................._...........---...._,. Location-Add(ess © �(_ or Lot No ............... y�Jl S C��a - '••:.�iS.2 ,f.!+ _.!:?_4t x . ........................r�-2:.1W Nw... ... _.z................................ } Address _r 'a.S`. .L'(ya 6c F.1 .......... ..................1/f ..b� ..............7 A Vl.t +PS "1 { ---•-r.... ...... Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons____________________________ Showers — Cafeteria Other fixtures ____________________________ _ w Design Flow........_.... __ ....................gallons per person per day. Total daily flow____._.__ ..................................gallons. W Septic Tank 'Liquid capacity/ gallons Length---- 111______ Width__.`ai 16...__ Diameter_______________ Depth................ x Disposal Trench—No_____________________ Width............._._._._ Total Length............1....... Total leaching area....................sq. ft. Seepage Pit No.... ............ Diameter._._. ._�?__..... Depth below inlet....W........... Total leaching area....................sq. ft, Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-----------•••-•---••---•--•-•--••----•-••••-----------------------•---•- Date. ----------•.......................... a Test 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-------_................ W 0 Description of Soil.........................................................=------••-•----•---...----------••-------•-----•-------•-...----•-•--•--•--••--••----••---------••••...._•••--• x U •----•-•••••-•-•--•--•--•--•••-------•---••---•----••-----•-•••...-•-...._....--•••-•••••••...............•---•----••--•-•-•-----•-••--••--•-•...........................................4------------- w x ---------- ------ U Nature of Repairs or Alterations—Answer when applicable_____ _ __� `^`' _..._....___'Q�t�.... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with ,the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agree not to place the system in operation until a Certificate of Compliance the boa d o ealth. _ Signed -•---• • x" •-•---- ••-- r Date ApplicationApproved By----••----- ' . . ............ •..• `•---•- -- --------------•-•---••-•••--- -••---•... Date Application Disapproved for the lowing reasons--------------••---_-----_-•--•-----•-------------------------•----------------••-- --------••--------•-.----•- ----•--------•---------••-----___Date --•--•-•--- Permit No. l Q- , ---. Issued-------------------------------•---•------------•--•-•-- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....... T: .. - ....OF............t .r.�+ 4c� 1�............................. (9rdif iratr of Tuntplittnrr THIS IS Tea ,, �FY That the - ' a1.,Sewage Disposal System constructed ( ) or Repaired ( ) y --•--- = Installer. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as de cribed in the application for Disposal Works Construction Permit No.___.__ __S___!�_`..______________ dated-------►J.. ,�. __$j____.___________. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRU AS A GUARANT E THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE -•.................................... ._.. Inspector-•--••-•--••-•-•-•- I....................... . ...J THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . Al .Vv..'........OF.....17�e.�/_�[d-r.��t:�� -!4.......--••..................... i No... "..� ?�� FsE..... , RaposgSurks Tu iun�Wrmff Permission > hereby granted. ._ ...�..---•.----- ......----•--••--•--------------•-•-----•-....-•---.................. to Construct ( ) or Repair ("-T an Individual Sewage Disposal System , ate,No......................7•---3---•---.... .' ----•--- '•'' ---------------------------------------------,---------------------------- t Street as'shown on the application for Disposal`Works Construction Permit No.�a _.-.l.OELJDated...... --- --------- -------- ------- _ ` oa DATE...........d . . .............................................. of ealth FORM 1255 A. ).:�,:LIIN,5 INC., BOSTON f,r � -1' LV o i3O Qs 4.F-,A PVT S �010 C • /2 t O � �s F-l41 w/SRry o 0 SEPT'iG 7 1 Z+ Ali•• P7Q� Sc�, Uo 0 Puc. 44 `7 . If 33 i oo,o0 LOCATION . SEWAGE PERMIT NO. VILLAGE ?7 N yV4,c i iu,l P\ASS-, I N S T A LLER'S NAME ADDRESS S U I L D E R OR OWNER DATE ".PERMIT ISSUEDgs DATE COMPLIANCE ISSUED 6U6 !9 IVY 473 ` l7' as C&o K.= FT s-m IV