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Home My WebLink About0047 IRVING AVENUE - Health .47 Irving Avenue Hyannis A=286 - 015 I 0 44-117 LO-CAT10 - / SEWAG.'E PERMIT NO. !/o / "�f> c ST' VI LA i I N S T A LLER'S NAME k ADDRESS f BUILDER OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED f ti 4 5 J r� 41 .aa :'•=i //_�No.._. .........L...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH lira#ion for Disposal Works Tonstrnrtinn rrmi# ` g� ' ` Appli on is hereby made for a P rmit to nstruct ( ) or Repair ( ) an Individual Sewage Disposal 71 S at: ocatioo dress or Lot No. .... --- .....---.t.............. •----•.........__........__.... ......._._._... O er --•- -----•Address nstaller Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( } Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................. Showers ( ) — 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................... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 ... •------------------------------ ••---------- •................... _--------- -_______------------------•-•--•---------------------•••••••--------------------- ODescription of Soil----------------------------•-•-----...._._.._.__...........---------------•--------------------------•-----------------------------------------•••-•....----------•-•-- -----•----------------------------------------•---------------------------------------------------------------•-- l_ _ IOO.o U Nature f epai s or Iteration —Answer whe app ble______ _.� V _________________________ .___ ___._._.__._.____..___.__. o doh;._ --. ---------------------------------------------------• Agreement: �� The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITI.E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b issued by the board.of h lth. Si ------•-•.. ......... ..... Date l - Application Approved BY ............... Date Application Disapproved for the following reasons--------------------------------•----•-------------------------•-----------------------------------•-•--------_.. -••-•--•--•-----------------------•--•--...-----------------•-------------•---------...---------------------•-•-------------•----------•-••---•----------------•••--------••------------••--•---•------- Date PermitNo..................................................._._.. Issued....................................................... Date FICB... ''"'""' THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH Appiiration for Diupuu°al WorkS Ctunstrnrtiun Frratit Application is hereby made for a P rmit tL C nstruct ( ) or Repair ( ) an Individual Sewage Disposal System at: .. . c *•, cation dress or Lot No. S •--••--• - .....w'✓.. ......................••------•-,-------- ---------------------------------- ----- Address -. ---. Address j st, 1t s� Address ' Type of Building Size Lot..................•... ..Sq. feet Dwelling—No. of c rooms.............................. Expansion Attic ( )', .. Garbage Grinder ( ) i a Other—Type of Building ............................ No. of perg`bns,. _..___..__...._•__.__.. 5howei s ( ) — Cafeteria ( ) Q' Other fixtures dW .. -er da I ot-a-l--dol-l-- -f- loDesign Flow...... .......• •---------• gallons per person X w.._....ri . --••-- ....gallons. tx Septic Tank—Liquid capacity ,_gallons ' Length___--__ ....... idth Diameter*�........... Depth................ Disposal Trench—No. Width .. 71._.. Total Length .._k A� Total leaching area-------- sq. ft. Seepage Pit No_____________ Diameter -------- Depth below inlet .... . Total`'deaching area._., ;....sq. ft. Z Other Distribution box f.(" ) "E Dosingank ( ) a Percolation Test Results Performed b .. � t ;..: .... ..._._'Date Test Pit No. ................minutes per me + # epth of Test Pit __._. _........... Depth to giourid Water................... (x, Test Pit No. 2................minutes--erillnch � Depth of Test Pit.................... Depth to grou __nd,water___ ....... ......... --" x, ------------------------- --�--Description of Soil -- -------------------- U ----------------------•---------------------------- s ._....___..._•..... ......•..' ............................................. ------------------------------- - ;----- ... ---•- U Nature epai or Ite arions nswer whe 'apl' ble `. QG O ............................ t ------- ----------------•----•---- Agreement l _ The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITHE 5 of the State Sanitary Code— The undersigned further agrees not to place th'e system in operation until a Certificate of Compliance-has b issue by the board f Ith. Date Application ApTroved BJ Date Application Disapproved for the following reasons:. ....... ..... ........................ .-:.-_.___-.._.-.......................................... Va� Date, F . t r � Permit No................. .............. Issued. .................. Date .4 THE COMMONWEALTH OF MASSACGHUSETTS „. { BOARD OF HEALTHOF hN _ f�rr�ifirtt�e of f�utZt�r�i�nr�e :k = ._: r T S IS TO C R.TIFY, That the vidual Sewa e.Dis osal System constructed h or Re aired - g P �' �( ) P ( _ � f Installer a� has been,i lied in accordance with the provisions of TI r f The State Sa.nitarY Code as described in the r application for Disposal Works Construction Permit No.""--- ------ �.)........... dated._. e..1 A.1. 7_7.._._...._... THE ISSUANCE OF THIS gERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY ='�x �-�sc+-_—� DATE.............•. . �^ 22 �InsRector v TH.E COMMONWEALTH OF MAS$ACH;U,SE TTS a ''"=t. �1 � BQAR}Ds OF H: LTH rr .................,.... "'66 ^<<� F... ..... .... ' ' .ram No......................... $ :. FEE m .............. M1111u.6 I79,� Tin fr `�� err 4 .. Y <f Permission is hereby granted. _ .?_.___. . '� ._x"' r ,. I....... to Constr ( ) -or Repair ( -an divldual �-jewa isposal System at NO. '"�:'t!a�rt �'t t �+a - 6 wi... ..... ....... . "" "' !� g. Street - ,. _,as,shown on the cation for Disposal Works Construction P Nor ...... DATE..... `'..l�``_j_. t' Bosr of Health d h Hea i 'FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS - - LO-CA.TION' SEW GE PERMIT 'NO.fly//Y ��Jc VIL LAC E Zv/�T' INS'TA LLE.R'S NAME ADDRESS B U I'L DE R OR OWNER , E1-7 DA T E P El MIT ISSUED DATE ' COMPLIANCE ISSUED 1d < J v oC � _j 4 j