HomeMy WebLinkAbout0055 KINGS WAY - Health 55 KINGS WAY, H
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LOCATION��✓ � . SEWAG 1 Q
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I N S T A LLEIt's NAME i ADDRESS
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G U I L D E R OR OWNER
DATE PERMIT ISSUED
DAT E COMPLIANCE ISSUED
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° - •-84 ®---- FRa...... ...15.00
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
T own Barnstable
----------.....................OF...........................................
......._....... ....................._...._..
Appliration for RsVasal Works Tonstrnrfion Vrrmit
Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal
System at:
.55...1{.in&'_s--Za-Y.....HYann-i&,-.2M.....Q2LQ1................... ------•-----------------------•-•-•-----•---------•------•-------••-----------•--..............._.
Location-Address or Lot No.
Iloaal.d---Roger a........................ ......._._.... 55..King's-..Way.,.-Hyaunis - -�'- -.02601 -.........-
Owner Address
A_.&..fi_.Casspon]..Sewvine_,...Inc................................. 1�$..Ki hQp ..der ce,.•Hyannis, MA....02601•.....
Installer Address
Type of Building Size Lot............................Sq. feet
U ...................Ex Expansion Attic
,-, Dwelling—No. of Bedrooms...................... p ( ) Garbage Grinder ( )
�`4 Other—Type T e of Building No. of,persons........... .............. Showers
YP g -------------•-•------------ 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 ( )
Percolation Test Results Performed by.......................................................................... Date........................................
a
14 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
0:4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
R4 ...........................................................................-..............................................................
0 Description of Soil....Sand------------------------•-----.....•....----•-----.....----------•------------------------------•----------..........................
x
w
U Nature of Repairs or Alterations—Answer when applicable..____..irbs tal lati on .. .........�6�S..gaY�on.,...gY'e-cast,
stone packed leach pit �overflow) .
-------------------------------------------•-----------------------------•••--•-........_.
Agreement:
The undersigned agrees to install the aforedescribed, Individual Sewage Disposal System in accordance with
the provisions of TITLi: 5 of the State Sanitary Code—The undersigned furtl r agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of •e h.
84
Signed .... =------- -- •--------�/12/
��� 1 -
Date
ApplicationApproved By.................................................................................................. ---------•-------7/_.12/84••••-
Date
Application Disapproved for the following reasons:.............................................................................................................._
........--•----------------------------------------------------------•--•-------•-------........---------•----•---•••......•-••-•-•--•-•-•-•-••--••••---••----•-•-•-----•••-•-•-•---•••-•-•----••••••---
84- 7/12/84 Date
PermitNo.......................................................- issued-......................................................
Date
, l
'fHE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town ......OF...........Barnstable
A pliration for Disposal Works Tonstrurtilln Prrmit
Application is hereby made for a Permit to Construct ( ) or Repair (X ) an',Individual Sewage Disposal
System at:
•5 i ' r �:�... �}s�, -----02601------------------ .................................................................................................
ocation• ddress or Lot No.
•Do cl--Rg4rs-----------••-----:••---------=---•----•------........---•----••- --5.5--Xing!s.. ......Q?..b01.........._.....
Owner Address
A & •��sspcl Seric�x= lr�c...............................
12$_.3a.shops..Terra,�,a,.:Hyarinis.,...MA...:Q �2Q1
Installer Address
Type of Building Size Lot.:...:::....................Sq. feet
U Dwelling—No. of Bedrooms......................3. _._._Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building ____________________________ No. of persons._.___.__.__.4__----------- Showers ( . )` Cafeteria ( )
Q' Other fixtures ..-----•-----------------------•-----•------•---------•-•--__-------•••-•••-•••••-•••••--••••-•••---•----------
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—}Liquid capacity............gallons Length................ Width................ Diameter__-__________-`\Depth_.____________..
ix Disposal •l-�� -••.- Width o g l g ......................sq. ft.
Seepage PitvNo._ _ .._._... Diametr . Dept below inlet__________________-
Total leaaching 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........................
G14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
Descriptionof Soil••--;M4-------------•-------....•---....._......--•---------•--.._...---•------------••-•-------••••-•--•••--------•--•-••••••-----•••-••-
V --•--•---••--•---••-•••----------------•-----•-...--------••---------------._._._..-•------•--•---•-----...•----•-----------•-•--•-••-•-••--••••--•••--•-__•-•--------•-••----------•-..._•-----------_.
W
iris tallati on of a 1,000 gallon, Tare-cast,
U Nature of Repairs or Alterations—Answerten applicable.----------- ................................................................................
-stone--packed leach_•p9.t.•-.oy(overflow
-._....-•-•-•------••-------_____••----•--•---•-•----
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 fur er agrees not to place the system in
operation until a Certificate of Compliance has84
�ss�y the G d th.
Signe
?/1z/
=---------------------=•-- ............................................ --------•• -
Date
ApplicationApproved By.................................................................................................. ..................7/121&J:.....
Date
Application Disapproved for the following reasons:-------•-•••---•----•-•-------------------------------••------•-------------------.............................
----------------------------------•-----...--------------••-•---••--------•------•-.......-•-•••---------•------•--------•----------•••--•-•••••-•----.____-••---•------••---•--•--------._------_......
84- 7/i 2/84
Date Permit No............... - Issued ---------•---- ....._..... -•---- .....
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
........................T,own......OF..........Barnstable
.................................................................
Trrtifiratr of Toutplianrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( X)
by---•.A..&_-H__Cassponl_.SerSims,...Inc...._1 _. 1 hog�__T x G ,...14Y t3 026Cr<.....
Installer
at.......-r35--K-ng' 02601--._A_QYald._Rgw=
has been installed in accordance with the provisions of TITLE, 5 of The State Sanitary Code ja�s described in the
application for Disposal Works Construction Permit No.�"................................ dated---7AV—
THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED S A GUARANTEE THAT THE
SYSTEM WNIL FU CTION SATISFACTORY.
DATE......?
-------------------------------------- Inspector.------ ...- -----------------•--••----------•---------•-•--•----•-------..-......
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
T aw n Barnstable
.............OF......................._........_....-•••-•._......_._.._.._..__......_._......._.... 15.00
No........... ,�L1� FEE........................
Disposal Works Tonutrurtion rrutit
IA & B Cesspool Service, Ino....................................................................
Permission is herebyppgranted___________________________________________________ SS
to Construct( K or=�se7ar ( H)arias Individual Q �re Doiialdyogers
atNo... 5 •-•-- --------•-y_._..y_......-•---�••--•.................. D
Street 7/12/8
,. C7W
as shown on the application for Disposal Works Construction Permit No, .'-._._---. Dated.....:....................................
----------------- ---•• ---'-----------------------------•---------------------------
DATE
Board of Health
--. �----- ------•----•-•-•-•-•-------------
FORM 1255 A. M. SULKIN, INC., BOSTON
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