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LOCATION SEWAGE PERISIT NO.
VILLAGE
INSTALLER'S NAME i ADDRESS
CeSS o/ -�e'ry lc
BUILDER OR Owl
(Inn no
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
I�Q)Ny klloil �)If.iVf
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No.._81 ..132... FEB.... ...a.oo........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
-..............._ _Town..........OF......B;m.btable
-------------------------...............................
App iration for Digpuaa1 Workii Tongtrurtion ramit
Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal
System at:
......135.. ..Q260.................. ............ ------......-•-•---------- --•---------.........--
-----------• -----•-------------•---
Location-Address or Lot No.
Mrs: --
Wm,..B. c o 11911Y-............................................. ..................................................................................................
Owner Address
,Wa ..............................espool_Service..............•-•----........_.......... --12$.3ishop ?1is 026Q.1
Installer Address
UType of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms...............2._.__.._..._..._....._.___Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons.......1................... Showers ( ) — Cafeteria ( )
dOther fixtures ------------------------------------------------------•••---••----.........---•-------- ----•----•--•••------------•----------•••---•------------•--.
W Design Flow............................................gallons per person per day. Total daily flow.............................................gallons.
.W Septic 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......................................
Test Pit No. I.....:..........minutes per inch Depth of Test Pit.................... Depth to ground water........................
rX, Test Pit L'o. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
P4 ,---•--•-•......................•------------------•--------•---------------••--••-----------.................................................................
0 Description of Soil---.Saxld----------------------------------------------------------•--••---------------------------------•---- .....................................................
W
V -----•----•---------------•-----------••----•------...-----••••--------------•---•--------------------•------•••-••----••---•-•-----•----•--....-•------•----••----------•--•-----...---------•----•---.
W
------------------------------------------------------------------------------------------ ----------- --------- -------------------------------------------------------------------------------
U Nature of Repairs or Alterations—Answer when applicable.-ins-tal-tall-atiorl.--o#f..a--],•,QOQ-_.g�].�oI7._pxe-Cr�St.,
stone rocked_leach--pit...(_overflow) .
--------------------------------------------------------------------------------------------•-•----
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of:iT L1_"
p 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the b rd iealth.
Signe,&X? .
Dat
Application Approved BY-_---- . ..:_ ------/�� �--•••-.....•_.
6/6 -81
Date
Application Disapproved for the following reasons:.............--••-•----•-••-----•-•---•---•---••---•--•---------••-••-•-•-----•------------------•-------•-----
---------------------•-----•----.....-----••-•----•-----•------------------------•-----------•----------- ------------------
// Date
Permit No..----- 81............................................ Issued..............6` l81........................
Date
No..$i-..`d...... Fmc...$....59.0q......_
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..................... own...........O F.....Ba gable........
Allp iration for Ili-qpuaal Woriks Tnnitrurtion rrutit
Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal
System at:
.....1. 5..0.41C..N'6.�6.. ,....151M31 6...026.Q1.....---•.......... ..............................................................................................•...
Location.Address or Lot No.
QeeS2=91,1y............................................. .............................................................................•....................
Owner Address
A &B.Cesspool Service---------------------------•--....------ .12a..akehops.Terrace --,- Hyannis..0260i-------•-•------
Installer Address
�11 Type of Building Size Lot................. .........Sq. feet
U Dwelling—No. of Bedrooms............... ......._....._._..___..__..Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons......1-..•_•_--__--__-___ 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................
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
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
t14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
9 --------•-------------------------------•--------------------.......-----------••----•-•-•--------.......---------•-----...--------.........................
0 Description of Soil...mnd...................:...
-------------------------•-•-••-------•---------------------------------------------------------------............................
x
W
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ----------•-------
U Nature of Repairs or Alterations—Answer when applicable._installation._of.-a._1,-000 gallon_..p : Cast,
___stone-_Faeked_-leach_.Pit-_-(overflow)._._...•..................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of T I
p Sot the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of.-Compliance has been issued by the b rd health!
Signed � �. � �?;7'( ,�!!T
Application Approved B 6f....181...-
y---• !_•.----.:,�',lc� --------------------------- /------------6 ------. .1
w ` Date
Application Disapproved for the following reasons:-----------•••-•••-•---•--•-•--•-•-•------•----------------•••••-----------------•--••----••---..._...------...
...............................................................................................-----------•-•------•------------•-...--•-•---•-•--•------------------•-••----•-----•--•----...........
Date
Permit No........$1- -----•-•-•--•---------------------------- Issued---------.....6�....�81.-------------------•---
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.....................T own..........OF......Barnstable
...............................................................
Trrtifiratr of Tuutplittnrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( X)
by A.&.B Cesspool-.Se ^vice. 128.'Bishops.•Terrace1..Hyannis,-_MA____02601 - ?75-62
..........
Installer
at-13 ..Oak Neck_Rd.., H rann s�..14A_ 02601__... Connolly-,••_Mrs._-Wm.- B._.....................
has been installed in accordance with the provisions of TIT 11E j of The State Sanitary Code a de-cribed in the
application for Disposal Works Construction Permit No.-- 1-._.. _ �>............... da.ted-..__-----q--_7 ...................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY. t
DATE.... ..... �y �i a
.........................•-----.........._.......--_. Inspector---•---•••-... = ..............................................
y
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
81 ...................... P?M.........OF............834=etable............---...-----...----................
No......" ... FEE.......00.....-----
�iu�u�ul �ar�� �un.�trttrtuan •erutit
Permission is hereby granted.....A--A. B.Ce992o91-_Service,-_-1 ce,_.Hyann is.-02601
to Construct ( ) or Repair (X ) an Individual Sewage Disposal System
at No.••••13S..%k..Neck__K.�...H.yannis,."� 02601 1,11rs. Wm...B_...C onngly.....
Street /
as shown on the application for Disposal Works Construction Permit N017:---__---_______ Dated......61-.-A; .....•.
DATE.
6/ /G•1 fBoarrd of Health
... ----- --- ------
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS `
i1