HomeMy WebLinkAbout0621 SCUDDER AVENUE - Health 621 Scudder Ave
Hyannis
A= 287— 048
LOCATION 4®f SEWAGE PERMIT NO.
VILLAGE
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I.NSTA LLER'S NAME & ADDRESS
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t U I L 0 E R OR OWNER F
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED ZZg
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THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH � �'. �r act �
--•.......................................OF.....................................
Appliration for Bispusaal Workii Tons raartinn ramit
Application is hereby made for a Permit to Construct ( a.�"or Repair ( ) an Individual Sewage Disposal
System at: 07&4n n i s
> - .--V �.� !xr! a .........................................14.......------•----......--•--------.........----•-.
-r
Locati. -Address or Lot No.
�
Owner Address ............
----.
.tf ... / ...........................
Installer Address
Type of Building Size LotZ7r---S- I.Sq. feet
Dwelling—No. of Bedrooms...........�--••-•••-_--------------••Expansion Attic ( ) Garbage Grinder ( )
a Other—Type T e of Building No. of persons........... ............. Showers
P� YP g --•-----•-----------•--••--• P ( ) — Cafeteria ( )
a' Other fixtures ..............• •------•--•--••-•--••••-.........
W Design Flow.....`__ 0........................gallons per person per day. Total daily flow---------4Q.6_Q...................gallons.
WSeptic Tank—Liquid capacityXW..gallons Length...............: Width................ Diameter.............--. Depth................
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No-------1-.-_------. Diameter,..-._Cam,---------- Depth below inlet..... .._._.._.. Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank
Percolation Test Resin Performed by.......................................................................... Date........................................
Test Pit No. 11:`_�_MIH.-minutes per inch Depth of Test Pit...f._S.----------
Depth to ground water---
rZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
P4 ............................................................................................................................................................
O Description of Soil........tiLo_......_
W
V -•-•••••...•••••---•-••-•--•••----•........•••••-••--•-••••••••-----••----•--•-••-•-••••---••----•••--•-••••------•--••••-••••-•-•-•----••••----•----------•••-•--•••••••--••-•......•-••-•......-•-•••.
W
U Nature 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 iITLB 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation•until a Certificate of Compliance has.4bbeened by t e boar of heaaW..Signed. =-•` ••-•••• .-------••-•--••••---•••--••••......••• Z
Dat
Application Approved By-••••••-
ate
Application Disapproved for the following reasons------------------------------------------------------------------------------------------------------------•_.
... ... .. .. ..... .... .....------....------------------...---------....----- 2----- ----
f� Date
Permit No...2A-..?.5_a............................. Issued_.........`----I -t f 3 -
Date
No,- .a...............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
i
........... ---.................OF....................................... ..........
Apptiratiou for Dispolial-Ifflorks TouBtrn.rtinn ramit
Application is hereby made,.for a Permit to Construct (jar-'"or Repair ( ) an Individual Sewage Disposal
System at:
- .........__. .' . .P P. ...Aerr:- ........................................A.....................................................
Locati -Address or Lot No.
_1----------- =-
Owner Address
w �.. ►.E I.�+... ; d.t' ....................................................
Installer Address
U Type of Building
aa Size Lott .3P.2._9..Sq. feet
Dwelling—No. of Bedrooms,_...... ...........................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ..........::.................. No. of persons............................ Showers ( ) — Cafeteria ( )
Otherfixture .........................-----•------------------•----------•••••••--••-----•-••------------------• -----••-•-....._......-•-••-••••-
w Design Flow....e.ad............... ......:gallons per person per day. Total daily flow.........4.6_1.....................gallons.
WSeptic Tank—Liquid capacity ,04-gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No..................... Width__................. Total.Length.................... Total leaching area....................sq. ft.
f
Seepage Pit No......l-------------- Diameter.....4........... Depth below inlet....:_::........... Total leaching area..................sq. ft.
Z Other Distribution box ( } Dosing tank ( )
Percolation Test Res I Performed by-----------.............................................................. Date.......................................
,aa Test Pit No. 11 .....minutes per inch Depth of Test Pit._ *._______.__ Depth to ground water__ C).Al. `.__.
Gz, Test Pit No. 2...............minutes per inch Depth of Test Pit..................... Depth to ground water........................
a ..............................................
-••••-•••••-•-- ---•---•---••:•- .................•----------.-.-----------•--------------..-------------•--.-.----------••----------•---------------•--
ODescription of Soil.......m�'G2..r..... MY:).......................................................................................................................
x
w
U Nature 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 in
f.operation until a Certificate of Compliance has been '�yaed by e boaLd of heajtYi f•
P
Signed: . '' r� F _' 6 ._
Application Approved BY.................................. --•- ..912.6 �f•-#-------
C Date
Application Disapproved for the following reasons:................................................
---•.............•-••-•••-••--•••.--•- --•••••-••...•------•-----•-----•-...-•••-----••--•-••-••--•--••-•-••=•...................................
�1— �5� Date
PermitNo...'................................................... _ Issued............. ....................................
r Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
............ ....OF.j...... d...::.:.::....::.:.. .......f�.4s....................._.........
muntifirate 16f ToutpfiFatta
THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed ( ) or Repaired (' )
bY-----------------t. sO�n---An,_ ?..........................................=---.............................................-----------------------------------.-.-.-------------------
Installer i e i
at =s/_YZ ..-f" �' Q �' ( C ---- ¢ } f a t i.'
has been installed in accordance with the provisions of TIT F rr of The State.Sa 4y Code as described in the
application for Disposal Works Construction Permit No.__.... ..4' &4r� ....: dated_ . ......................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS RUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE..... ..............................g --
Inspector... = ------•--••-
THE COMMONWEALTH OF MASSACHUSETTS
i
, k SARD OF HEALTH`;
t ...... .... .�...........OF...... ""'................................
No ......... ti FED ................
Elisposal. nrki;Tnn�trautuan. unfit
Permission is herebygranted..... n='� n_. _
to Construct ( ) o Repair ) an Indiividual Sewage Dispo , System 1�
at ..._ 9t7flEC� .........................' ?�.....�".?........"�........
..
Street
as shown on the application for Disposal Works Construction Permit N XC`f Dated-._�1.� R `
PP P �- G'L .r----Y..............
-
r Board of Health
DATE... ----- ��� = �r3••-••-.._..---
FORK 1255 A. M. SULKIN, INC., BOSTON -
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S/vc W,,44 4- �4Z4 d = 3 71 S. G.
,T4 �H OF 4f4,p
r PETER r'ti
SULLIVAN
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