Loading...
HomeMy WebLinkAbout0034 OAK HILL ROAD - Health 34+OAK HILL ROAD. Hyannis' ;' '3s ' f I o i ASSESSOR'S MAP NO. ' �'� PARCEL ,.'O C A T-ION SEWAGE PERMIT N.O. VILLAGE INSTALLER'S NAME i ADDRESS I> i U I L D E R OR OWNER DATE PERMIT ISSUED . I DATE COMPLIANCE ISSUED L � �� u'� w `� ., @J' F�,. •� m '�� �/� � ; O _ J � - ',' r �: AsBuilt 7 ( Page 1 of 1 4' ASSESSOR'S MAP NO. 'g PARCEL ' LO"CATION SEWAGE PERMIT . RD. 6� ���� �� ��1 VILLAGE INS�TA-�L_L It S NA`ME & ADDRESS ^ BUILDER OR OWNER ; t7 �� 1� DATE PERMIT ISSUED DATE COMPLIANCE ISSUED t -74yv0 , -Z http://issgl2/intranet/propdata/prebuilt.aspx?mappar=248083&seq=1 3/8/2011 ' �1cI . . F. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .Cz-. . w.......OF........ Appliration for Biopoottl Works Tonstrurtion 11rrntit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ----•----- `-'a ....s .. ,,.... .. ._... --------- - '-5----------------------------------------------- Location Address or Lob No. ..........�'n w....ZQ.r_.1A------------------------------•------------- ..................5_..Rom!' ` .. --.........._. O ner Addre ss �. � ....ti _. __, ._ ..�........---• -`t:4............ v installer Address Type of Building Size Lot................ Sq. feet Dwelling—No. of Bedrooms...........................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building a Other—Type g ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures . -•........................:................. Design Flow.......... '` .......................gallons per person per day. Total daily flow....._.__._���___ W .. ...........gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No..:.:_� S,'...._.._._.. Width..... ..._...... Total Length.......-....... Total leaching area....................sq. ft. _. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Other Distribution box ( ) Dosing tank ( ) Percolation Test Results . Performed by.......................................................................... Date........................... .... Test Pit No. 1................minutes per inch Depth of Test 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............................................................................................................ V ...................•••••--•---....--•--•-•--------••-•------•-.......------•---------•---.......-••-•-•------------•----......-•------•------••-....--•--.....-------•--•-......-•-.................._... W U Nature of Rejpairs or Alterations—Answer when applicable._------4_10.0---_---.(-_ ... .�.at0 ... ' . l_Y_J-t��! ..... -----�- _ .. �Q Q . ---------------------------------------------- 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 furth grees not to place the system in operation until a Certificate of Complianc een Issue a boa iea Signed... ----- T-----d�7O � Dat Application Approved By........................ ..... ....... Date Application'Disapproved for the following reasons:---•------------------------•-------------------....----------------------------•---•-••----•-•---•--••-------- .........................••-..............--•---...-----•----•----•--•---•••----•-•----.....------••----.--------------...•-•••-•---•••-•-•-•-•------••------•--•---••--••••=•-----•---•..........._..._ Date PermitNo... ............................... � ' �-l.S�.d_-I.... Issued..----......---•-----------•----...-•----............... Date THE.COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH C, .... Appliration for Dispogal Works Tonstru'divit 1hrmit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: V -47-----I------------------------------------------ .......................... ............ .............................. Location-Address or Lot No. k -. -- -, ............. .................... ... . ............................................ ..................S. ..... .................. Owner Address ......................................... ............ ........e;6:L4............ Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.......(-,.;.L..............................Expansion Attic Garbage Grinder ( ) 04 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria ( ) 04 Other fixtures .................................................................... <4 "k------------------------------------------------------- --------------- Design Flow......... .........................gallons per person per day. Total daily flow........... _n................gallons. 9 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter......_--.-__._. Depth_............... Disposal Trench—No. ...... ............ Width......._<'.......... Total Length--..... ....... Total leaching area....................sq. f t. Seepage Pit No....._................ Diameter.................... Depth below inlet..........._.._..... Total leaching area..................sq. f t. Z Other Distribution box Dosing tank Percolation Test Results Performed by.......................................................................... Date....................................... Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to, ground water...._................... f;rq Test Pit No. 2................minutes per inch Depth of Test Pit--..............__.. Depth to ground water........................ ............................................................................................................................................................. 0 Description of Soil....................................................................................................................................................................... ------------------------------------------------*-----------------------***------------*-------------------------------------------------------------*'*"*----------------------- ...................................................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable------ --------- r ....ru­ ............ .. ......S��'t. ............ ------------------------`----..._....--------- Agreement: —4 . 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 by he &. further- agrees not to place the system in operation until a Certificate of Complianc reFnFirsff-ed e-has- boarof_hea_'t_ � 4 - --------- -------_---------_- --- ---------- ..... ........... te Application Approved By..................... 4 .......... .......... .................... Date Application Disapproved for the following reasons:.............................................................................................................. ....................................................................................................................................................................................................... Date IssuedL....................................................... Permit No.......................................1�61---- Date THEi/COMMONWEALTH OF MASSACHUSETTS '4. BOARD OF HEALTH ........OF....... .............................. (Irdifiratp laf Toutphaurr THIS ISJQ CER-T-L Y, That the Individual Sewage Disposal System constructed or Repaired k_) by............................---------------- .......................................................................................................................... ............ .... Installer at.................................... ... . k%4 \ I.. -.... ...o... . .. .. ... ............................... has;.,been installed in accordance with the provisions of 'J1Tj.:E* 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No. 7�=6f7 .. dated._..'`?.. ..-- --- 1-721 ------ 1_e Cam....... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL fUNIGNON SATISFACTORY. .............................. ........................................................ DATE............................C T Inspec tor........ ................. THE COMMONWEALTH OF MASSACHUSETTS BOARD . OF HEALTH .............OF............ .......... ......... N .....1�p ....... FEE._ . Disposal Workg- Tonstrurtion Firrmit Permission is hereby granted-------- ....... ................................................................................... to Construct or Repair (-)-an- Individual Sewage Di5posal System at No. -. 7................... ........ 1 n_1'!�......... - 1-4 ---­------------­--- ----- ........................................... st'"t as shown on the application for Disposal Works Construction Permit 1- Dated.._.... _Z I i:T-, .......................... - - -- ........ ---------------- ---- ------------------- ...................... . Board of healthDATE........... B I r ' 1 I � J 1 _ _ 1 1 I I 1 + I 1 I ' l I I I� I � 1 I I I I i Je I 1 I I I { I I I i I � I M 1