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Home My WebLink About0031 PIRATES WAY - Health 31 Pirates Way Hyannis .`� A= 268 —050 0 o , � � I n iY I. o 4 0 t . ,II a o a ,i a 0 u � , s 0 0 8 LOFATIO&�j SEWAGE PERMIT NO. VILLAGE rr f-- f I w S T A LLER'S NAME i ADDRESS &55 ool 6pr lCb BUILDER OR 0� wNEQ v DATE PERMIT ISSUED DATE COMPLIANCE ISSUED . �� O/ -"Arc ' / G 7 l 1 IZ4 •' - .:� ........................ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ..............:..........................OF.................... ... Allpfira#ion for Uiipnsal Workfi Towitrurfivit ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: . L� 171 .............6..................................................... Lo tion-Address r Lot No. .e'-A:11.`& ./V -----_---•-------•-- ---------- ........................................................ Owner Address a :_... -- --A.............. .. Installer Address UType of Building Size Lot............................Sq. feet �-, Dwelling L-;'IVo. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a`4 Other—T e of Building No. of persons............................ Showers YP g ---------------------------• P ( ) Cafeteria Otherfixtures -------------------------------------------------------------•------------.......---------------------------------- 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. 3 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........................ f3, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------.................. Ix --------------------------------------------------- •-----------••-------•................. ---------- ----------- ----------- •--------- - ---------------------- 0 Description of Soil..................................................................................---------------------------......................................................... W w U Nature of Repairs or Alterations—Answer when applicable..-----t�. f�L�iP�-----------------C)Z a--.------c fly------...�lGu� �d 5 _ K...... lout' Agreement: Z—tow- 4 7�oL,1_ . The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of JITE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issjq by the board Of hea h. v Signed........... . ---• ....... ---- .. . --- ApplicationApproved By............ . -- •................•--------..._---•-- ...4 -------------- Date Application Disapproved for the following reasons-----------------------••----•---•----------------------•----------------..................................... --...----•----•----.......-•-•-•--•----------------------•--•---------------------------•------------------------------•---.----------------------.................................................... Date PermitNo......................................................... Issued-........................................------------ Date J I/ �Y No.._ f.�� "'' _ FizB... .....' ........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................O F............................................... Applira#ion for Uiopoottl Works Tontitrurtion "unfit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: f f�/r�t l 7I"5 f/ �rJ . ' >. r' �f .......... ............................. •------••-•-...............---- ......•-----•-•--------...-----------•--•-•-••------------•......-----...... _ Location-Address or Lot No. �r ..... FrsF _,... 1'> ��... .. / ..............••. ......•. Owner Address Installer Address.......................•---------•---^---- UType of Building Size Lot--__--_--------------------Sq. feet Dwelling!eNo. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building No. of persons............................ Showers � YP g ---------------------------- P ( ) — Cafeteria ( ) Otherfixtures --------•----------------------•----------------•-------------•-•-----•---------•----•----•-•-•-•--•--•-•-------------•-•....----••---...._.._..----- 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........................ �r, Test Pit No. 2..........•_....minutes per inch Depth of Test Pit.................... Depth to ground water......._................ P4 ----......................... --------............. •----------------------------- ••-•-•---------------....... •---........... --------- .---------- .............. 0 Description of Soil------------•--------------------•-------...--------------•--....-•••---------•-----------------------------------•------...-•-•---------------••-••........_.......---- U -•--•-••-•••-••-----••---•-------•---•.....-----•---------•-•---------------•......-----•---.........---...-•-----------•-••-------•------••--------•--.....-----------------••---••---••----------•--• W --------------------------------------------------------------•--- -•------------------•---•-----------------------------------------------------------------------------------•....... --•-- U Nature of Repairs or Alterations—Answer when applicable......... .................. .......................................... r t�!�. . f . Agreement: Z_ ! 'I c /4 •�f rVl� The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TTL, 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 board of�health. ...........Signed...........-- �' " l -L-.-./••----.--�•--'•-..--- ................................ Application Approved By.._... �-.........Z/!%.__ ".1 _,/ ate •.......................•---------- .................. -D t----•--••--•--- Application Disapproved for the following reasons--------------------------------•------•-•---•---------------•---------------•--•-------.._..--................. ....................................................-.................................................................................................................................................... Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......... .. :..^................OF...... •'fit:^ ............................................. Tntifirat a of Toutplianrr THIS IS-TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (�) ------•------------------ ----.---.-----.----.---------------.-.--------------------•------------•--•---------- Installer at --•--------•---•---- --•-----•......... ..........•••._......_..- -------------•---•----•-----•-----•------- has been installed in accordance with the provisions of TI`-LB 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No(�_f)/L•.`.j.b................ dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................................................. �� ....--- Inspector....................---- ---------------•-••--..---------•-••-- THE COMMONWEALTH OF MASSACHUSETTS �-- BOARD OF / HEALTH � "W� ......fi ...OF..... '4 ...................................... No FEE............ v Dio oottl Vorkg Tono#rurtion rrntit 7/ �-- n Permission is hereby granted.............................................- ''=--------1 9� ,.a -•---•---........................................................ to Construct (, ) or Repair_.( f'') an Individual Sewage Disposal System ------•-••-......_- Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... Board of Health DATE............................................................................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS r _ � • t '1 a a Jk IN .r kA ID ' F e� R