HomeMy WebLinkAbout0157 SIXTH AVENUE (HYANNIS) - Health �S7
1-7-SIXTH AVENUE;
A=245,075
Hyannis —�----�.-v--.. a.
r
0
0
o �
-*15 75--Z b
LOCATION : 5EW&6%E PERMIT UO.
IKISTALLER S U&ME 6 ADDRESS
���®,vs�— lie• - - - - - - -
BUILDERS Q &MF- A DRESS
DIJ►TE PER"IT 15SUED =— _2
DATE COKAPLI Wt CE ISSUED : 'fir 2 =`7S
O
f, Lol
® m
n8i
0
r
Id
F>�$.
THE COMMONWEALTH OF MASSACHUSETTS
-Ito SOAR® F H TH
S GF _. ... OF ....... ..... . .. . ...' ...............
uVV . _
Appliration -for Diavofial Workii Tonstrurtion Vrrnift
Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal -
System at
....... 1146- ---------------- = f .�' l------------------------------------------
-�� Loc tion-Address or Lot No.
Owner ° Ad r s
� Installer Address
d Type of Building Size Lot------_---------------------Sq. feet
U Dwelling—No. of Bedrooms--------------------------------------- ----Expansion Attic ( ) Garbage Grinder ( ).
7
p, Other—Type of Building _------------------------. No. of persons---------------------------- Showers ( ) — Cafeteria ( )
QOther 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----...........-----------------------
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water-..-_---._-_-------.-.--
(s, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-------
---------------
----------------------------------------------------
a
0 Description of Soil------------------------------------------------------------------------------------------------------------------------------------------------------------------------
U --------------•-•---•---------------------------------------•-------•-•---••--•--------•-------•-...............-----------------•-.-----------------------------------------------------------------
---•-----•-------------- -----------------------------------------------------------------------------------------------------------------------------------------------------------------
g ----
V Nature of Repairs r Alterations—Answer when a livable_.-__-_--1_0?T7�44L--.-_-_-4-'---/0®.0....� :L..
- -�,15-X7" 04--c- - ------- - - - -------------------------------------------------------
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 bee issued by the boar o ealth.
Sig d - ----------- ��` r9......7=. ---
Application Approved By------f ---• ••-• .�'L' ------------------------- .....- ---Dat-!--_
Date
Application Disapproved for the following reasons:................................................................................................................
-•-•--...---•--•--•...............•-•-•--•--•--••----- ......--•-•-•-•------•-•-------••---------------•••--•---•••-----------------•----_----- .. . ..: _�..:... "ie--------------
Date
Permit No......................................................... Issued.;. ........7 ...........
Date
FBI
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F H TH
.. OF....... . . ....
Appliration for Di_qpuiittf Works C owitrurtion , rrutit
Application is hereby made fora Permit to Construct ( ) or Repair ( an Individual Sewage Disposal
System at:
i s',r, r v�.. ---------=-------•--.---••- 1 ,� '- --....._...----
-------
�r� �+► -
Loc ion-Address or Lot No.
--------------
Owner
' r S
Installer Address
Q Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms------------_-------------------------------Expansion Attic (. ) Garbage Grinder ( )
a4 Other—Type of Building No. of persons.................. __ Showers ( ) — Cafeteria ( )
Q' Other fixtures -------------------------------------------------------------------------------------------------------------------------------------
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. 1----------------minutes per inch Depth of Test,Pit....._.__.__..___._. Depth to ground water....____--.-_____-------
(s, Test Pit No. 2----------------minutes per inch Dept of Test Pit.................... Depth to ground water-_.__._--______--,_.-.--
W --------•--•-- ------- .......................--............................................................................................................
DDescription of Soil --------• - ••-----------------------------------------„-----------------------------------------------------
x
W
V ature of Repairs r Alterations—Answer when a licable.________11&r�"A,1��...________ 4
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 bee issued by the
�boar o ealth.
Sig d --_:_•••••• = "" `. "'° ti j at '--
Application Approved By---- - ---- ---- ---- �---- ------------------
Date__
wf
Application Disapproved for the following reasons________________________________•_•___________.._________.._..._.__....._-•.-•-__.•-•_-..... -----:._------
--•-•........................................•---•------•------------------•---•--•----•-•----•-------•-----••--••-`---•--•---------...._•--•-----•--•---------•-----•---•-.._.-----...._.__..----•-----
Date
PermitNo......................................................... Issued.--------------•------------------------------__--•-
Date
THE COMMONWEALTH OF MASSACHUSETTS 4*, .1
BOARD OF EALTH
s
:... :.
'�..........:OF.............
. ................... ..........
rrtifirate of Tilm aurr
TH S TO CERTIFY, Tl at the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by = ---- e•--------------------- ------ -------- /f--�.' ,1 Ile
has Feennstalled in accordance with the provisions of Ar icle XI of The State Sanitary Qode as-described in the
application for Disposal Works Construction Permit No---7Xt_-_X d............... dated.... ............
THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONS ED A GUARANTEE THAT THE
SYSTEM W1,LL FUNCTION S�ATIISFACTORY
,. � '�/` ► S yw r7Hi'ti+'v ay K+ y a'�d• w- _ � �tp^,��`-�f' i`b- p*i.� '�
DATE.--
. 7 ^e
� ` -�
*'.ydy�+tty'.tidt'x'F''kefb,'h` 1 r a y y. p'aEvy�Y vrvtky, �fi�J 't
.�wct¢rciJ7CAvs�V -+ua�r;s�}�Szr�a.•m a>w'u`+�'-'�r�'ua"i5.'r�.*dv�.MW�ioCstaes4YtF2ywTS'sY��'i J-�v`��,����__c.� _ _ _ �- ,,. .�. ... ._. ._ ._
�' L{StY.f�••&'��"^MA.-�t�'NFm'JM V 'Z'R.3 HY i - .. r..,o-. _ .r.. � a
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
-y 1.............OF.......... - .` "........ . o
No.-�•--•-•••-•-•••_.... FEE .............
:. Permission is hereby granted C ......................... -.._...
iv to,"Const ct ) or Re 'r ( an I ivtdual Sewage Dispo;14ret
te
)
as shown on the application for Disposal Works Construction e it N Dated__________________________________________
Boar ' Health
DATE ;-----•- ........
FORM 1255 HOB�BS.&';WARREN. INC.. PUBLISHERS