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HomeMy WebLinkAbout0164 OLD COLONY ROAD - Health (2) tin Strc 162 Old C n is rolony Road Hyan AF325,j 039 — 001 I e P L �4 .,r . No-----7.9=2.GY ............ THE COMMONWEALTH OF MASSACHUSETTS 80ARD OF* HLALTH Town---:...OF.....Barnstable -- -- ............................................ Appliration for Disposal Works Tonstrnrtiun Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (X, ) an Individual Sewage Disposal System at: .1.6.2....01d_._Oral.any...Rd... ...H.y_annJ-a---Q26.0 Z. ..................................................... -......................................... ... Bostonian Inve°se�1`�e idt"'Trust 279 Ridge St. ,"t flis, Ma, 02054 ----------------------- ......_............ ------..........................---•--•-------- -•---.....--•-------•-....-•-........-•------•-------•-.......................................... Owner Address eruinE--------------------------------- -128...Biahaps....�erra�E,---H anni s....02601 Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................. .....Expansion Attic ( ) Garbage Grinder ( )U a'4 e of Building eX........ No. of persons..... Other—Type g .DU.P l......................•---------p-•- 5--••---•----•---•---- Showers ( ) — Cafeteria ( ) dOther 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................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........................ --•------------------ ...................................................................................................................................... 0 Description of soil....... and_____________•------•-------•-••---•---- .. --•-•--•--------•-••----------------------•-----------•---------...........--•--------------•-••---.. .--- � ' W -------------------------------------------------------------------------------------•--------------------------------. ----------------------------------•----------------------------•---•------... U Nature of Repairs or Alterations—An wer when applicable.:...IriStalla.tiOri Of a 1,000 g...110ri leach pit___(stone-__.PackedU,........................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITi:;,,. 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issuelhe boar f ae lthSign Application Approved By... Gar f --• ......................................... ..------ 9 Date Application Disapproved for the following reasons: ...--••---------••.........---•-•---•--•-------•-•---•-----------•------------------••._....................- ••------------------------•-•-----...----..........--•-•-----•-•-•--•-••-------•--••••--•----.....-•----•.. Date PermitNo..-79^--•--•-•--•-•.............................................. Issued........... /---7/.79........................ �� Date �. 4x Fi$`1..1t.00........... m THE COMMONWEALTH OF MASSACHUSETTS BOARD" OF_ HEALTH .......................Town.......OF.....Barn.stable...... '-- . Appliratioat for Disposal Works Tonstratriioat rruti# Application is`hereby made for a Permit to Construct ( ) or Repair (X ) an Individual, Sewage Disposal System at . . ......:..,. . ., ,. _... . .,._ -16.2 � � �� Ad-,• ...Her=-nls...026CLI. -••--•--•-- -••-----•••-•--•-•---••--•-----•--•--•-•--•............... ..... ......... Bost ir> A Invs��`mend�-5'Trust 279 R�dge St. ,°rI �3 is, Ma, -02054 ... - ............................................................. ------... .----....-•••-•--.....-••••-----••........... .... . e Owner Address w t � E 1 rui c e-----------------------•--•------ -.12 8---?u shapa...Ty r:�^�.c e.. .�iy. nr�� ---Q2 6.01 Installer Address Type of it $tiilding Size Lot...... �,...Sq. feet Dwell>ng ,x No :of Bedrooms_____ ____________________________________Expansion Attic ( ) Garbage Grinder ( ) aOther xType,.of Building ..D pj,.eX........ No, of persons._...5.................... Showers ( ) - dafeieria ( ) �dt� ��O•ther:=fixtures .•--....•---•----•--•-••••---•---•••••••----•-•---•-•-•------••--••---- ........ ..••---------•-- W Design .......................gallons per person per day. Total daily flow.. :_ gallons. WSeptic TankTl iqutd capacity............gallons Length................ Width................ Diameter__--__ Deptl ............... x Disposaf?tTrench No .................. Width......................•Total Length..................... Total Teaching area sq. ft. Seepage jt fNo. . Diameter..................... Depth below inlet.................... Total leaching area:: , ....sq. ft. Z Other D�}iystt iution box' ( ' ). Dosing'tank a Percolation Tes't Results Performed by. __ Date___ ....... _____________ .� Test Pit No 1................minutes per inch Depth of Test Pit____________________ Depth to ground water (sl 'Test.`Pit No. 2................minutes per inch , Depth of Test Pit.....................Depth to ground water......... R+ --•---------------------------------------------------------------------------•---•--•-----............-••--•--•._.............................................................. Descriptionof Soil r � 1t --•-------•-•-----..._..-•-•----•--•-------------------------------•--------------------...--------...._. ....._ U ............ M... ............ ............................................................................................................................................ .............. W ..J'.. .M . .. �`j Nature of Repairs or Alterations Answer when applicable...__ nstallat+ o of t on ..:pack.ed. 0...--••-•-•-•-•.................•-----. ---•-- Agreement ' The#undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisionsrot TIT 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operatid&ilntil a Certificate of Compliance has been issued b_y Pe boar 1 alth. , e �Signe - - I 7/79 Applicat ori'OA�b ed'B /. t.. l�'/t! i ----... ?D� .............. y :._`: er4 br ?: DSte Application Disapproved for the following reasons:..... --........................•----...------------------------ ----•-:-. ......... ......... ! Date" "Pentuti No. --------•-••--•--•----- Issued Date a . THE COMMONWEALTH OF MASSACHUSETTS :f� * BOARD OF HEALTH ...... .......T.o.W.n......OF..... ...BaM$'. t �,8 ...... Zntif irat a of -TampliFaatrr THIS IS, TO CERTIFY That,.the Individual Sewage Disposal System constructed ( ) r Re it ( }� by -A. C 3 Ce ppi Service, 128 �B sho s -`.Terrs.ce� IyAAD Ida. � 1 at 16? In1drG'oiony Rd• Hyannis, 0 �' Bostonian Invesment Test t --- 4 ---------------------- -- has been-instilled in accordance with the,provisions of T �`.. 5 of The State Sanitary Co je as,#i4bed in the apphcatiori'for"Dlsposal Works Construction Permit No. •;.%�- _. �...._.._... dated. ..-..._. !!// 77 TH.E ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE TE AT THE SYSTEM' WAl "_ 0014dTION SATISFACTORY. DATE.. —�/ / ...................................... Inspector . • ------.----- ' . iKr tr> r THE COMMONWEALTH OF MASSACHUSETTS +.. - f BOARD OF HEALTH Y1 , f. '. TOWn OF...... Barnstable No /�' " E`9.' FEE ....7.. iry'. ..... .�. •... Aampooaal Vorks T.oato#rttr#ioat anti Perrn> siori"is'hereRby granted & B Cesspool 4e vfce, 1 8 BiSh©ps Terrace, Hyannis to Constr ct ' ) o epair ( J� an T'Wividual Sewage Leis o 'al`S stem lf'2 d� colon annis �o oloia�sn Investment Trust atNo.•--•-•-•-•..... ...... --.............................................r-••-••••----•..•-•••••------••--•-••---••--•••••-•••••-•-••••-•--•--•-•••-••--•-••-••-••••-•-...---•--•....... K s+ Street as shown�onKthe'application for Disposal Works ConstriAction rmit Aa D/ FIealth DATE .._ ...........` FORM 1.255 HOBBS & WARREN. INC.. PUBLISHERS �Ve k.fJLR'3N:Vka3IA1•[kkwk..{x _.__ _'$� _ - - . •��• -_..�. �