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LOCATION G J �+ SEWAGE PERMIT N0,
VILLAGE � )
G"Y
A & B CESSPOOL SERVICE
128 BISHOPS TERRACE, HYANNIS, MA 02601
BUILDER OR OWNER
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DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
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THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town Barnstable
............... O F.-.........................-...........
Appliration for Di-qVoiiFal Works Tonotru�anolndividual
n ermit
Application is hereby made for a Permit to Construct ( ) or Repair ( Sewage Disposal
System at: Lot. 306
306 Oakland Rd. Hyannis, Ma.
................. ............................................. --•-••----.....--•-------••-•-----•---•-•--••--•....-••••--•............--•••••••--............__.
Location-Address 3o6 Oakland Rd. or Lot No.
Mr. Nathan -•---.......--•------•-------•-----•--..i�.��>1i:�..Ms�� ...........................................r.. -Nathan -
- •- Address
W A & B Cesspooiw ervice 128 Bishops Terrace Hyarl ,--- ................:.......
,.a ---.....- .
Installer Address
Q Type of Building Size Lot............................Sq. feet
U Dwelling No. of Bedrooms...... ..................Expansion Attic Garbage Grinder
Other—Type of Building ............................ No. of persons.....---._...------- Showers ( ) — Cafeteria ( )
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.
3 Seepage Pit No..................... Diameter.............--..... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed bY.......................................................................... Date........................................
aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.....................--.
(i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.---................--..
0 Description of Soil........................................................................................................................................................................
x
W -----•-•-•------------ ............................... .....................................................1000-gar--0vsr-Tow---(Stbrie Wmd)-----------••--
UNature 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 TITLL 5 of the State Sanitary Code The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issue by the bovd of ealth.
9...... - �
9_ Date
ApplicationApproved BY •......... ................•----------••• •-----......_ .....---•--....
Date
Application Disapproved for the following reasons:------•-------•-------•---------------••-----------.....-----•-----------------•-•--•-••-----••---....------..
------•--------------•--•-•--•---••-----•-------•-•--•••••-------••••--•----•---••-....................-••-•.......-------•-••-•-•----•-----•---...•------••--••----------••-------•----•---.....--•---.
Date
PermitNo..................................................._--. Issued.........................................................
Date
Fas �'S:��.._.W.
THE COMMONWEALTH OF MASSACHUSETTS
:_...;; BOARD OF HEALTH
Barnstable
:.Town.. ....................O F............................................................
Appliration for Di-ollustt1 Works Taniitrnrtion "permit
.00
Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal
System at
Lot. 306
............ _9a.k7and..Fi._.El�tanni.s Ma�.............
:.3.Q
Location-Address or Lot No.
..................Mr. ;ia:ban.....O nee.---.....--. 306 Oakland Rd. l.YA'%d&Jft.------------------_._.
Owner Address
W A & ...CesspooI._ rvim........................... . ..1ZS..r1shopa..Tar=ce...?Iy� n�a, ......................
a -•• -
Installer Address
Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
04 Other—Type of Building ............................ No. of persons.................:.._........ Showers ( ) — Cafeteria ( )
04 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. I................minutes'per inch ...Depth of Test Pit.................... Depth to ground water........................
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
•-••----------------------------------•----•-----..._--••..........•--.••--- •----•------....--..........................................................
ODescription of Soil........................................................................................................................................................................
U ----•-•------------•-•----•---.
x ----•-•--------------------------------•---•-----------------------------------•-- --.....-•---...----------iDUC._�1---t�ver-�ffiow--(s�one--paelsed -•------.....
UNature 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 TITLE 5 of the State Sanitary Code—.The undersigned further agrees not to place the system
operation until a Certificate of Compliance has been issueJ>Ythe bgafd o ea`ith.
...................... ✓ �GJ
f�=
ApplicationApproved BY ........................... ......................................................
Date
Application Disapproved for the following reasons:..........................................................................................................---
......•••-•.......-••--........••---•.........................................••-•-------•--....._..........•-•-•---•••---•••....---------••----••-•..........••.....................---..............
Date
PermitNo......................................................... Issued.....................................................
Date
A.
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THE COMMONWEALTH OF"'MASSACHUSETTS
BOARD OF HEALTH
..........OF......Baxnstatble
°''fin.............. ....... ...........................................:..........
Tertif iratr of Tompliana
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired
by..:. .....A._&._B Cesspool..SeXyjgje ._........ - ... .._... =-
..... ............................•--......................................_
Installer
at.............. q6 Qakland Rd...:.Hyannis_Ma...026_Q3 -
has been installed in accordance with the provisions of TI 5 f T State Sanitary Cod!ls� ribed in the
application for Disposal Works Construction Permit,No..... ......... . .................. dated.............._f� _.. �'................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE_ CONSTRUE AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE..............:`.::-... -•��-•----g .................,......... Inspector ......-• 1 ..._1...............--•-- ..
2
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town Parnstahle
No. D' 3 ...... ................OF .........------.............-- ...--•-•--•--•-. F>a$...�...�. ....
i �r,a tt1' di A,.trnrtinn Permit
Permission is.hereb anted�,
a rn
to Construct (( or. air v dual a e Disposal S stem
at No........ t? '.�� M� � nrtS Y ..........
- ...................... .•------ •.
street qq
as shown on the application for Disposal Works Construction.,Permit No. �.�-- Dated.....7.�� .�'
................. ----... -•----•. ---• ....
Board of Health
;DATE..............•--•--------- .........................................
FORM 1255 A. M. SULKIN, INC., BOSTON -'