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Home My WebLink About0068 GREENBRIER LANE - Health 68 Greenbrier,Lane 268-078-018 Hyannis a 0 o N P P A v `l a o A N _ C 310 0 o i r i �^ p'7 C w 1 i`` 1 `!-� �. � � 1 _ � _� �: rJ r^ .— t �- i I i yi V .. •s� FEz THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH �'L�lll7...........OF......... .................................. Appliration for Uiipnsal Works Tonstrnrtinn lirrutit Application is hereby made for a Permit- to Construct (41r or Repair ( ) an Individual Sewage Disposal Sys at: f -• Location ddress WM Loto. C/ Installer / k -----•Owner Addre •. ....... .. .......... ... ....... ...........a Address Type of Building Size LotAl .0.�?d......Sq. feet U Dwelling—No. of Bedrooms.............3.._.....__ .__..Expansion Attic ( ) Garbage Grinder ( ) 4 Other—Type T e of Building persons............................ Showers — C4 YP g -------------------------... No. of P ( ) . Cafeteria ( ) a'' Other fixtures -------------------------------- . W Design Flow............................................gallons per person per day. Total daily flow................'g-5t).............gallons. WSeptic Tank—Liquid capaciq/000.gallons Length................ Width................ Diameter.................Depth................ x Disposal Trench—No..................... Width.......f_.___.___ Total Length...........j,_..__ Total leaching area............ __ sq. ft. o Seepage Pit N ..._____--_�_.. Diameter..../0........ Depth below inlet.._�j............. Total leaching area... _sq ft. Other Distribution box Dosing t . d' Percolation Test Results Performed by..... __ n � Date......... l Test Pit No. 1-'--�---.minutes per inch Depth of est Pit.... Depth to ground water...._. (s, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a' •--------...- ..... O Description of Soil................. .....z...... f�W��'�'1...........-- x VW -------------_-._.. ............................�--/Z......-----�=� --- -�-J.--� ._------. ........................................ Nature of Repairs or Alterations—Answer when applicablEr ............................. ...-----'------'--------------------•--.....--".........--•---------....._....---•-•--.............'-•......'----------'--•'--------•'-""---•---•---'-'----........'•--"-"'•'---•-'---......:...__. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITIE 5 of the State Sanitary Code/The undersigned fu agrees not to place the system in operation until a Certificate of Compliance has been is by he ard.of 1 lth. Signed--' . '... ..•. .................. . - ---- ----- --------•--------- Date Application Approved ' . .............................. Date Application Disapproved for the following reasons---------------••--•-----......--•------•-----------•---------...---------------------'--------•--._....._...... .................................•--------------------------.......----•-------------•-------------'-•----"--•----'•-'••'-"------------------------"^----•------�'----'. ------- ate Permit No......................................................... Issued.:..-----/,-- Date r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 2...........oF..... .!�„ "I,V__, ........................ Appliration for Disposal Works Tontrurtion Prrmit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: -AL.f ............................zint/...........;!!!!!T...... ...................... oc dressLation o�. � . ...................... owne Addre a ;; ....4ara*--------•-- ---------------------------------- �j Installer Address -+ Type of Building Size Lot__ ®_.....Sq. feet Dwelling—No. of Bedrooms____________________________________________Expansion, Attic ( ) Garbage Grinder ( ) `4 Other—T e of Building a yp g ____________________________ No. of persons............................... Showers ( ) — Cafeteria ( ) Otherfixtures -----------------------••------•-------------._.._..--'-------•---•-------------------------------------•------------------...---------....-----_----- WDesign Flow......................._..........._.........gallons per person per day. Total daily flow.............. .............gallons. WSeptic Tank—Liquid capacit/40✓_`0._gallons Length________________ Width................ Diameter................ Depth___.________.__. x Disposal Trench—No..................... Width....... Total Length.___.__.___----- :Total leaching area............ -.sq. ft.. 3 Seepage Pit No._________ ..,: Diameter _.,,,°i)._______ Depth below inlet____.:......... Total leaching area__ _sq. ft. z Other Distribution box 41 Dos g ) aPercolation Test Results Performed by _. .�Vite� :....6�n5 Nam____ Date___.____ ..'__!_ __ Test Pit No. L__ ___-...__.minutes per inch Depth ofest 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________________ x '. ��U ijz ----------------------------------------------------••------•-•-••-------- a----••----•----••---•...........................•---•------•-----•_. t ° -------•- ------------•-•-- --..._---•---•---•---------•------•---•---•--•-•-•----•---._...._..---- U Nature of Repairs or Alterations—Answ;er when applicab ............................___.............................._________________________________ ........•--------••---....•-•--•-••---•-•---••---•••-------•••-._..._,_;--•---•---••-••----••_.._.._.....•---•---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of:ITL; 5 of the State Sanitary Code The undersigned fu e�r agrees not to place the system in operation until a Certificate of Compliance has been isgl&by the ar of h,6alth. Date Application Approved B3z-- �'------- .. .. .............................. Date Application Disapproved for the following reasons:................................................................................................................ --------------------------•-------•------....--•-------•--•--....------•--.........-----....----•-•-•-...•••-.._..•------•----•---•-------••-•-----•------•------_.__.-.-----••-•-•--...------ Date PermitNo......................................................... Issued........................................................ Date, THE COMMONWEALTH OF MASSACHUSETTS w, BOARD OF HEAL /H� .......144010............OF....... Z:.... .......................... Trrtif iratr of Tontplianrr THIS IS /(•OERTIFXTha th Individual Sewage Disposal System constructed ) or Repaired ( ) �- � by-------------------- = � 1_.....? ....... Inst y�^ filer at-•...................... l;�....................... -----' `"d'f`' 'v�l �"'' ---- '`'y am yi /............ has been installed in accordance with the pr v sions of TI T IZ 5 of The State Sanitary.Code as 6-escribed in the application for Disposal Works Construction Permit.,No.......................................... dated_-_:_____._._.___._________.________________... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-----..�.. 1- ........................................... Inspector........- ------- =fl, , ... ------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEAL H� .. `............OF........,Aa; t! .. :,r.. ............................. No......................... FEE. .... Disposal iyorks Tonsi ttiftuan rrrmit Permission is`hereby granted.. "r" ` ✓ ......... to Construct<� o Rfpair ( ) an Indivld Sewage Risposal Sy., •• !'� at No..................... �' !''r+ ._.� tom. '� ,-• �. r h •rw-•--------- Street ••---.... as shown on the application for Disposal Works Construction-n ermit No..................... Date_._.__`---_.___..____.__..__._._....._.... ��da --------------------------••--•----- ' DATE '. ..... ........... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS "' " THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HE !- H IratN v /7 .........,�.�r�.........OF......... it .. .. �....D..--•• FEE._..... ... � .�4Permission is h eby granted ��,... -_... •--`--••-� . �� .................... ..:... ....... ... ..to Construct o R pair _ an ndividu Sewage isposal Sy em o.----••------ - ------..- Z------ �� f!' '� .`` Street I as shown on the application for Disposal Works Constructio ermit No..................... Date - . >��.. ................................... DATE-- - -- - -2.... ........................ Board ealth �--��--� FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS