HomeMy WebLinkAbout0036 ORR'S AVENUE - Health 36 Orrs Ave
290-065 Hyannis
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LOCATION SEWAGE PERMIT NO.
ORR
VILLAGE
yi9r�ils
A & B CESSPOOL SERVICE
128 BISHOPS TERRACE, HYANNIS, MA 02601
BUILDER OR OWNER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED j/ ��
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THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
lV�//.1/.......OF......J 1 � L.......--------------------------------•------
Applira ion for Diipnia1 Works Towitrurtion ramit
Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal
System at:
iA�n�i -------------- ---------------------------------------------------------------------------------•----------------
Location-Address or Lot No.
_ Owner Address
a ".6--c.... e.......0 ((1�.: irt�.............. �r ` ° s l S/ ¢P?t ....-•--•---..........---.•
Installer Address
dType of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms...........0-..............................Expansion Attic ( ) Garbage Grinder ( )
44 Other—Type of Building ............................ No. of persons.......___.................. Showers ( ) — Cafeteria ( )
Otherfixtures --------------•-------.....----- -----------------------•----------------•-----.-..._............•----------
W Design Flow............................................gallons per person per day. Total daily flow..-----...............--......----.._.......gallons.
WSeptic Tank—Liquid capacity--..........gallons Length................ Width................ Diameter.........---..-- Depth................
xDisposal 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........................
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a ----------------------------------••---------------------------------------------------.................................................-....................
0 Description of Soil........... /1 ................................
--.........................................................................................................
'
x .
W ------------------ ----------------=---------------------------=---------------------------=-----------------------------------------------------------------•--•------------------•-------•---•-••
UNature of Repairs or Alterations—Answer when applicable........1,&V2,5.4.......1,00.6......
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System ' accordance with
the provisions of iITI : 5 of the State San' y ode The undersig ed furt� grees not pl ce the system in
operation until a Certificate of Complian a n ' su d by the b ar ,
ApplicationApproved .......---- .................................................................................. ....... . .......................
Date r
Application Disapproved f t ollowing reasons---------------------••-.---,--.--:
.._.--•-------•-----•-•--------••..._--•--•-----------•---------------------------------------••-••••-•--'--------....-----•---•-----------•--•-----....................................................
Date
PermitNo......................................................... Issued--------------------------------------------------------
Date
a
No3-,/o FEB
. ?- --•---.. _.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
........TOV- /11-------.OF....... 6w' / 1� '.......................................
ApptirFatiun for DiBpoii al Workii Tome rurtiou ramit
Application is hereby made for a Permit to Construct ( ) or Repair (,A) an Individual Sewage Disposal
System at:
........... v, : .... .............. ..................................................................................................
Location-Address or Lot No.
.......
Owner Address
.......5. r? !. :...::....... .../ z.......rs.............s.....7'...-,e1.................---------------
Installer Address
Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms___...._..��'____..___.................Expansion Attic ( ) Garbage Grinder ( )
'4 Other—Type T e of Building
p l yp g ............................ No. of persons.....3........_..__.____ Showers ( ) — Cafeteria ( )
G" 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........................................
,4 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water_-___-_______-__-_--.__.
�14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-___.______-_-_----____.
O Description of Soil..........
V ....•-•••-•-•-•-----•--------••----••-----------•---••------•----------------------•--------------••--------•-••--•-•-•----•......--•--••••.----
W -----•----•................•--------------:---------------------------------•---------••-------------------------------.......-----------------------------•------•--------•--••-•-•-••-•----------•••-
U Nature of Repairs or Alterations—Answer when applicable--------1, t !_A�.......h2 r1_-__-_ ` w 1"!c..7- 4.:(-
r
-------'-'- 4
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System,jn accordance with
the provisions of T ITIZ 5 of the State San wry Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance been ' sued by the Uard f�aea
Application Approved ---rfollowing
-•-•-••••--•-----------••--------------- -------------------------
-----........................
Date
Application Disapproved f reasons-----------------------------------------•--------------•----------•-•---------------------------------••........
......................................................................................................................._..-••----....----..._..._...------.._....------......_..........._....__.........
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
tT}.s.
r ifirat e of TontliliFanrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (,O
Installer
at--••------....-ve...S---...-..'-........- l Y i ...ri...... ----..-----------------J-°r}r`-............`....----------------------------------•-
has been installed in accordance with the provisions of ITbE 5 0 State Sanitary Code S described in the
application for Disposal Works Construction Permit No.____ 3---_ -. •--- dated_..../��C:�,-- ..............
THE ISSPANC OF THIS CERTIFICATE SHALL NOT BE CONSTRtB D A GUARANTEE THAT THE
SYSTEM 111+/ L fVNCTION SATISFACTORY. � 4,------------------•----.....---------•--...............
r
DATE...lj � 1/• --------•------••- Inspector. ........ w-
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF .....5' G ..........
............................ ... _.. e D
No...1.................. FEE........................
Biipoo4l Workii Tonotr ion rranit
Permission is hereby granted.....�'t.j--�......`��.' y
to Construct ( ) or Repair (X) an Individual Sewage Disposal System
_ ,
at No........ ``r-�' _> i .....----•- '` i`{�t•�� ... rlJl f
Street
as shown on the licat' n for Disposal Works Construction Permit NoS1�"-�. ;, Dated..�z' �. .. ....1. ........
s•'.. .................................. - -•_-__......'-----•--................--------------------
y 1 Board oealthr
DATE,4�•...... ............................................................ .,-
` FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS .>
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