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HomeMy WebLinkAbout0534 LINCOLN ROAD EXTENSION - Health 534 Lincoln Road Ext. Hyannis - A=272-180 r `I I LOCATION J3� SEWAGE PERMIT NO. VILLAGE r �' INSTA LLER'S NAME i ADDRESS BUILDER nOR OWNER p to rtt6,h u i p (4 e-y,� DATE PERMIT. ISSUED ' DATE COMPLIANCE ISSUED dl._a_aC/ �� • 'Y K',�. �.— .1 _ � e c� '� G �`�1 �r �, �` �`. ����� �� r-t l.�� v r .....r-- _; �- f, -� �; /� ,. No. . ................... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH .....O F......................................................................................... Appliration for Disposal Works Tvastrnrtinn "rrmi# Application is hereby made for a Permit to Construct (X`) or Repair ( ) an Individual Sewage Disposal System at: // * 5 3 Y L./.J G oz-A,, 4J . �x7-• [.oT ................_..-----....---.....---......---------•--•-•-------........-•--•-......-•--•----- ................----•-•...---...•-•----•-----------------------•-••-•......-----.........-------- Location- ddress or Lot No. &6&P-L72%d_ P,es of �R45- Cap /N�: ....• ------• ----•------••-•-••--- -•• -•••- Own r r Address W Installer Address PQ Q Type of Building Size Lot...B.;5el._..Sq. feet Dwelling—No. of Bedrooms............3..........................Expansion Attic ( ) Garbage Grinder (me)) P4 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures ................................. . W Design Flow................. 5............._...gallons per person per day. Total dais flow--_-__-...................................... ons. WSeptic Tank—Liquid capacity/WLgallons Length-----9-.-...... Width................ Diameter---------------- Depth.....47. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------- Diameter.__..._ -1----- Depth below inlet.......6...-...... Total leaching area..4d o.....sq. ft. Other Distribution box ( Dosing tank ( ) � ~" Percolation Test Results Performed by...... ....................L J­.4--6 ^._________________ Date.,.•7 _________l_7__-je0..__.._.. as Test Pit No. 1-4Z......minutes per inch Depth of Test Pit---L44...... Depth to ground water_ UT_��.— Test Pit No. 2_�_Z...minutes per inch Depth of Test Pit--- .11_ .... Depth to ground water-Q?4W --------•..............................•••-----------•---- �,c .. O Description of Soil.... --Z-f----•-- r �a LDF1 ------ .............................' j�If p '�- _ - - - -... v ?ED e_._ DA Wei!1 T .... D-------------------- -------------------------------------------------------------•------------------- W --------------------------------------------------------------------------------------•---------------------------------------------------------------................................................ U Nature of Repairs or Alterations—Answer when applicable----------------------------------------------------------------------------------------------- ......................................................................................................................................................................................................... Agreement: The undersigned agrees to instal the aforedescribed Individual Sewage Disposal System in accordance with the provisions of 7 t IE, 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has een issued by . board of alth. Signed---- --�`,"`_....I..-----•-- ....................... ................................ e____ Date Application Approved BY - ----------------------------- Date Application Disapproved for the following reasons:---•--------------------------------------------------------------------------------------•-----•--•--------•••- .............................................-......-.................................................................................................................................................. Date PermitNo......................................................... Issued........................................................ Date r 6'0 No .. �..��. ..... •- r_ Flzs.3.v.:� ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................................OF...............-............... ...... ...... ............................. Appliratilan for Di_gpaa al lgorkii Tnntitrurtinn thrmit Application is hereby made for a Permit to Construct ()() or Repair ( ) an Individual Sewage Disposal System at: / 41 5.3 c/ L/,�J G. oL N D . X T. L.o7- -IL4 .....................................................................•-------•--•................. ....•---•---•--------•---...........--------•--•----•------....------------....................... � Location-E�lddress or Lot No /.!lam!7t3z�.8L i2S aF G R/�� D • Z8/ G606, E - ----------------- -- _ Addr--- --->----.-S----�----,-- ess iJ�?..t.:...�..�. J Installer Address QType of Building Size Lot..Z_ 59/.....Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder kW) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' OthC11er fixture W Design Flow................-�`-�. ....___..........-_gallons per person per day. Total daily flow--__-_33Q...__.._.._ .._.._._.___gallons. W Septic Tank—Liquid capacity/ODU._gallons Length...... ........ Width....s........ Diameter________________ Depth...!...... x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.............._.._... Diameter_._.__ ....... Depth below inlet------ I...... Total leaching area..Zgq.....sq. ft. Z Other Distribution box (p-) Dosing tank ( ) '-' Percolation Test Results Performed by._..�F-�.._.....GO ................................ Date..___.___... W ���7- U Test Pit No. 1 C.Z..__._minutes per inch Depth of Test Pit-- 1i:.R.... Depth to ground wateryr/.-Z.--.6!J f� Test Pit No. 2. __Z__..minutes per inch Depth of Test Pit__ . ."___ Depth to ground waterG'vv� D -------------- ------------- --- 41 Descri Description of Soil---._.--�----------- � ----------- - -- -- -- ----- --J W --------------------------------------------------------------------------------------------------------•-------------------------------------•-•---•---•--•-----•••-••-------•-------•--------•---•--- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ------------------------------------------------------------------------------ -----------------•----------------------......--------------------------------------------------------------.......•----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of:i:L 7, y g g p y 5 of the State Sanitary Code— The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has keen issued by e board of wealth. �' Signed.--. °"':•-._=-------•------------= -------------- ---------•-------------- ----------------------••------- (� �-� c� Date Application Approved By..... ..!s---l/ == •............................ ---,2_-,.IM2. Date Application Disapproved for the following reasons------------------------------------•--------------------------------------------•---------....------------------ -----------------------------------------•-••-•-••-•-••••--•-----......-----•---------••------• .................................. Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH G '`........OF........ ..................................... TUrrtifiratr of Toutph anrr THI, R I Y- What the Individual Sewage Disposal System constructed (� or Repairedby ( ) ..... --------------------------•----•-• -- ••--••-•-----------•--•----•--••--•-.................•--••---•-----..........._...---•-•--------- -Ins ler at .. _ r ---------------------------........................... has been installed in accordance with the provisions of T �' j gfihe State Sanitary Code as described in the application for Disposal Works Construction Permit No_ ____ _______________________________ dated---.._-_--_.-----___------'. ....._______.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS UED AS A GUARANTEE THAT TIME SYSTEM ►/ILL F NCTIO�SATISFACTORY. DATE ............. Inspector. �--. -------------------------------------.--- THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH P.^....'...............O F.................................................................................... .............. FEE..��............. Billpvsal lvarkg Tian trnrtion rrmit - 'Permission is hereby granted "` . •------------------------------------------------------------••-•...................•. to Construct ) or 1�epair ( n Individual Sewage Disposal System- ' ►'.'. --------------------------------------------------- Street as shown on the application for Disposal Works Construct mit No..................... Dated.........................._............... .....f=...... --- ' '--------------------------------....... of Health DATE............... ..................................--------•--•••=----------.-... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS Lo -r 44 _ t - 43 35• 6x/ST (jam Q CO�tC. 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