HomeMy WebLinkAbout0869 PITCHER'S WAY - Health 869 Pitchers Way
Hyannis
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LOCATION SEWAGE PERMITN0. (fi
VILLAGE
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tNSTA LLER'S !ry NAME & ADD 6E.SS
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B U Il D E R OR OWN ER T
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DATE PERMIT. ISSUED 3_ 2_ 77
DATE COMPLIANCE ISSUED
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THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
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Appliration -for 4igpnial Works Cnnnitrurtiun Vamit
Application is hereby°made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System at:
•�
�. Location-Address o or Lot No.
rRoSTe�.P� C® _..Q[�e`:Q�2'.F <NG.------------
I Own �y. / .y y Add --�-/
a •-----••--•-----•-•-��jry.� .•-W a./lQ--------------•-----•--------•- ------/.�� Wialh_l�f.!__s�Z...Wtietl.5.1EibwP..-------•--•-•-•-
Installer Address
Type of Building Size Lot____47".__ ReP-----Sq. feet
Dwelling—No. of Bedrooms._____-
Dwelling Attic ( ) Garbage Grinder
pa-, Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
Q' Other fixtures •---•---•----------••---------
Design Flow.............!j�._._...____.___.____._gallons per person per day. Total.daily flow........... ___.__._____ ___gallons.
W
WSeptic Tank—Liquid capacity/P470__gallons Length Widtli_ '1'.1� ._._ Diameter________________ Depth_'P*-_.__._._--
x ------------
Disposal � Width o Length
1_.._._..__________. Total leaching area....................sq. ft.
Seepage Pit No./_��PstyAiametg_1-------- Depth belowet_____4_�___________ Total leaching area------------------sq. it.
Z Other Distribution box ( } Dosing tank ( ) 4AI- 3 7.7
aPercolation Test Results Performed by----------------------------.............................................. Date____--_------.-------------_--------....
a 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__.__._____________._...
.....-•------------ ---------------------------- —---- -•----.........-------••--
Descri Description of Soil .�1� `�------------ •-- • - --- --------- °z.__-- ..__ ------ .-
UG --- - - -- --- �mztn d.. � ' /-- ---- -----------
W
• --� �� -------------------------------------------------------------------------------------------
U Nature o Repairs or Alterations—Answer when applicable------------------_-----------------------------------------_---------------------_-----------
------------------------------------------------------------------------------------------------------------------- ..
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been iss ed by the board of health.
14;je FRo&a i C_4pc CeD AtOiLpeAs.4vcsig d_ �t
••-- -1------ ----::•-- --- - -•- ----••--------•---------------•• �.� 3 7-�•---
Date
Application Approved By--__--- .......... . ..... ...�� � -sue -------•-- ---v�'��=--•- 1.-------------
Date
Application Disapproved for the following reasons:.-•------•-------------•------------•----------•------------•---•----••----•-••-•------------- ------
............................•------•---•--------••--•--•--------•-•-----••--------•-------------•-•----......----------------•------...--•-----------------------•--•-•--•-----------------------
Date
PermitNo._..................................................... Issued........................................................
Date
� t3
No.... y Flora.... .
THE COMMONWEALTH OF MASSACHUSETTS
/_ BOARD OF» -HEALTH
._....1. 4v Y8.... ----..--OF... n. *�'�1 p�..d.+. ..'., .............................................
Appliration -for Diqu.aiia1 Evrks C owitrurtion Vvirnift
Application is hereby'made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal
System at:
Location-Address or Lot No.
C �jgC.C:�!J_.1.gy[4IIC'2k 0./�. ...•-•-------
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g .....................................................
Installer Address
UType of Building Size Lot....1� .._ -----Sq. feet
�-, Dwelling—No. of Bedrooms------- -----------------
----------------Expansion Attic ( ) Garbage Grinder (d�
aOther—Type of Building ._-._---------------- ----- \To. of persons---------------------------- Showers ( ) — Cafeteria ( )
dOther fixtures --•-----------------•--••-•------•---------------------------•---•----------------------------------------••-•--- --•------•-------------••----------
W Design Flow............./V_-V__._........_.....__.-gallons per person der day. Total daily flow----_....:� _. -_-.-..-----.gallons.
� Septic Tank—Liquid capacity/,000.gallons Length_j___er"._._. Width_�� _h.--._ Diameter................ Depth. '...
xDisposal Trench—No----------- -- ----- Width___--------------- Total Length-------------------- Total leaching area--------------.-----sq. ft.
Seepage Pit No./?1>704..Ziameter--------T..__..___. Depth below inlet-----4_____________ Total leaching area-----.------------sq. ft.
Z Other Distribution box ( ) Dosing tank 10EO:APL-- /:-?- 77
Percolation Test Results Performed bY--------- ---------------------------------------------------------------- Date---:--:--------------------------------
Test Pit No. 1________________minutes per inch Depth of Test Pit-.--._-______-___--- Depth to ground"water-.___.-----------i....
w Test-Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water.-_.._.._-._---.----..
.
R AC D �"Gescr Description of Soil.. . �
-----..- . .-__.__ .........
U -------- >W-A0%-&r I--- --- ie
41
U Nature o Repair or AlterationsA1 � +gi• ab ......
r
nswer when
.--- -----•---------------------
Agreement
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article YI of the State Sanitary°Code— The undersigned further agrees not to place the system in
operation until.a...Certificate of Compliance has been iss ed by the board of heal di.
X R*S'rCRPC COP BVILDV S raw
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Date
Application Approved BY------ =/ / fit * 1:"'-7'?.
.--
Date
Application Disapproved for the following reasons-------- =---==--------- -...................................-----------------------------------------------
...........................--------•-----•--•-------•--=------•-•--.••--- -
Date
Permit No. ................................... Issued. -
Date
THE.COMMONWEALTH.OF MASSACHUSETTS
BOARD OF HEALTH
'... .........OF... �r. ' 1.. f' .............................................
Trrtif tratr of f�4imphaurr
THIS IS JO CERTIFY Th _the Individual Sewage Disposal System constructed ( r Repaired ( )
bY..................... Ah..... _.
--------------------------------------------------------•-....
Instiller��/
--------------------------------------------------
has been installed in accordance with the provisions of A07 .1?�
of-The State Sanitary C de as described in the
application for Disposal Works Construction Permit No. -------------------- dated....0 !_ :L-� �___-.----__ -----------
THE ...
ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY. Tit
s�
- DATE------- --z- -•---�------------•----- ------ ---� •-----�------- Inspector----- --�.:�.----��-1=��-='-- ..............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
'•• ...`" w-e... .. .....OF..14AVO.J../�' /..-�:............................................. rdl
No.
,.. FEE.. ✓.
...........
RnVwial lVarkii (1-1111unitritruou Vvirmit
Permission,is hereby granted.......... -------------------------------------•---------------------- _____ ..................
to Construct ( fs� or Repair ( ) an Individual Sewage posal System
atNo---------------- -------------------•------------, sl�j.P� --- A�--------Illy/
--'� ----------------------------
„ Street
as shown on the application for Disposal Works Construction Pt N ._°__ -_-__ Dated- _ _.fl41.__..-.`_?-%•
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Board of Health
DATE................................................................................
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS - r • '
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