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Home My WebLink About0186 SEVENTH AVENUE (HYANNIS) - Health SeveAA gve., mris �7-- TOWN OF BARNSTABLE t� LOCATION /'A Ave, :SEWAGE #� a VILLAGE �% ASSESSOR'S MAP & LOT INSTALLER'S NAME &.PHONE NO. Q SEPTIC TANK CAPACITY 0 r t? LEACHING FACILITY:(type) J)`i (size) Y NO. OF BEDROOMS PRIVATE WELL q`R PUBL_IC WATER BUILDER OR OWNER 1c C 2,gr�v� DATE PERMIT ISSUED: �3 - 7 DATE 'COMPLIANCE ISSUED: 1 a 7 VARIANCE GRANTED: Yes No Q � � ?( CA �. TIN F SSESSORS MAP NO: No.. ... ... Fss... ................ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH °.......0F... ..G:! . ��^.L-_G....................................... Appliratiou for Disposal Works Toustrurtiuu Prrutit Application is hereby made for a Permit to Construct ( ) or Repair �i) an Individual Sewage Disposal System at: l.&i— )v�s-,-- .............—_--I...........�...... ......��.�'.. ---- Gr!' `°"L?P .............. L cation- ess or Lot No----------—---- - ------`L.---- I/L--...... ........... Address cn s _'.'n`nm ........................................... O.ner a ....... .................:.. - �....�.. ��, - ? § ................. Installer Address UType of Building ^ Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building _-________----------------- No. of persons__---__-_-__-__-_-_______ Showers ( ) — Cafeteria ( ) Q' Other fixtures . W Design Flow............ .._._..........gallons per person erdday.......Total Bail flow..._.................. gal WSeptic Tank ....I_iqu id capaci 4_0 allons Length__........_. Width.__.__' _._... Diameter................ Depth................ x Disposal Trench—.\o. ..__/.............. Width.'.._�__J_. ...... 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........................ Gi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-__-__-__---___...___-_. . 1:4 ...............................•............................................................................................................................. 0 Description of Soil........................................................................................................................................................................ x U ---------------------------•----------- W U Nature of Repairs or Alterations(Answer when applicable....._._Is.- _ ___•----.-_.. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i T i t p S of the State Sanitary Code— The undersigned further agrees n t to place the system in operation until a Certificate of Compliance has been issued by the bo d o health. Signed------• j- .....----- - - Application Approved B =--..ws_p ... ................ ....--- PP PP Y•---•---- ---- Date Application Disapproved for the f ollowi reasons----------------------------------------------------------------------------------------------------------------- ------•-------------------------•---......••---....--••--------•--•-.......--------....-----•..........•.-----------------------------------------------------•---•-•••----------------•--•--------•---- Date PermitNo..... ................................................. Issued........... ........................ Date No....1.1• i....... � � FEs.. . ..............._ • THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF App irFation for Disposal Works Tonstrnrtiun Prrmit Application is hereby made fora Permit to Construct ( ) or Repair ) an Individual Sewage Disposal System at: t..••••--.. ....... - `. ------------•----------------- ............................................ Location r1d ss r Lot No. -----.....--•- .:.� _...••... .&----•---A.44, •----------------------- -------------------------- `- ------------------------------.--.-..--.----•---- a Own Address -� - . ...... ------------------- ...•....-•----- ► Installer Address d Type of Building Size Lot----------------------------Sq. feet V Dwelling—No. of Bedrooms---------�............. .. .....Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) pa Other fixtures ------------------------- ----------------------------- DesignFlow............ .. .. .. gallons per person per day. Total daily flow............. .................. W �----------- ---------g P P Y. e y _...-- gallons. R; Septic Tank—Liquid capacityV. gallons Length.... Width............. Diameter---------------- Depth................ Disposal Trench—N?o. _-___r....._...... Width.....1:O�....... Total Length......a.,]..... Total leaching area--------------------sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area---..............sq. ft. Z Other Distribution box ( L4 Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ ,_l Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water________________---____. rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--------------__-__-___. a ----------------------------------------------------------------------------------------------------........................................................ 0 Description of Soil......................................................................................................................................................................... x x ...................................................................................................................... -•---------•-----•--•-•-----------•---------•-•-•----•-- ................. U Nature of Repairs or/ Alterations—Answer when applicable............ ----Ce5-/' ............. ......... �r.ct�r'C�?' '✓1L �'t tz � '.e......._5��_.VeK.-----------�.....�`!�+51,: Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i? ...: p 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 b r _ r Signed :_ ....•. ---' _... _ e Application Approved By......... ` -------.. !T!4�---......................-------------------- ----•-- .. ----------- Date Application Disapproved for the f ollowW reasons-------------------------------------------------------------------------------------------•-----......-----•.. ---------------------•---------------•--...--•--••-•-----------------------•--------------................_........:.._...------------------------------------------..._-------------------- Date PermitNo.... -•------ -------------------------•------. Issued_--•--..._.....-•---•--------....... ..•.... .------ Date / THE COMMONWEALTH OF MASSACHUSETTS BOARD OF' HEALTH .......................... UTrrtif irtt#.r of Tlantplianrr THi S TO C IFY, That th Individual Sewage Disposal System constructed ( ) or Repaired by.................. .L --•----•-------------------------------------------------------•----------.........................._. Installer ------------------------- has been installed in accordance with the provisions of ii""�' " of he State'Sanitary C�gde as descr-° ed in the application for Disposal Works Construction Permit No.___!! -__ �. ..:........... dated.....;,--- �.::: .•. .._.._.._______.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION cSATISFACTORY. DATE ...�`' `... *� � Inspector......�� d ��-t��-+^ . -.....-•-•---------------- v iJ�� / •.' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............................. OF .... ( ...........-................ N 0:....:.................. `� FEE..:: dam' ......... Disposal Wor ns#rnrtinn Vermit Permission is hereby granted ��.-:a.............. �.d -•---•---------•---.._............-•-------.......-----•-•--........... to Construct �) or Repair ( G ndlvldual Sewage D��Y_5 Systemr atNo............��................... ..._ 5..........._. et c y r as shown on the application for Disposal Works Construction Pe mrt No'......... _. -._._.. Dated..._. .................................... a •- Board of Health L,.l DATE....... ............................................................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS