HomeMy WebLinkAbout0012 STEVENS STREET - Health � s��r.�s �, �s
LOCATION SEWAGE PERMIT NO.
ea
VILLAGE
A & B CESSPOOL SERVICE
128 BISHOPS TERRACE, HYANNIS, MA 02601
BUILDER OR OWNER
Dr mod,
DATE PERMIT ISSUED
�'-S-J
DATE COMPLIANCE ISSUED +'S
17
Nn
TIN
D
d
g3_ $ 10.00
tiNo.. -- ... ._ Fps............._...............
�,. THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
..................Town..............0F........Rai tabl,e.......--•--------...---------•--•-----•---•-----------
Apptira tiou for Disposal Works Cnoustrurtion Frrmit
N
Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal
System at:
12-.Stayers--St•••,•--1t3 xir�is;..ZA......02LOI................... .....••-•---•-------...-•-•-•-----.......---•-----•--•-----•--•--•------------•-•--.............--
Location-Address or Lot No.
D.au&las...Knot`ts............................•--------.._..•....--•------•-•--....-- J-7._aun..set._I?22x;._.I eeAWaj.,...MA..... Z03...................--
Owner Address
a A $..CespoQ1..Set
............................................... ,._ ...PQ
Installer Address
d Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms.....................3....................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ____________________________ No. of persons____------------------------ Showers ( ) — Cafeteria ( )
G►, Other 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. 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........................
P4 •-•----•----•--••••-•---••-•••-•--••••..............•••-----••-•----.........__....---•-•••-----_---........................................................
0 Description of Soil.........Sand--..................................................................................................................................................
W __ _ _ __ __ ___
x installation of a 1,000 gallon, pre-casfE,
U Nature of Repairs or Alteratio s—Answe when applicable.______.........................................................................................
stone packed leach pit Zoverflow� .
.............
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TI A'11 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has ssVed bey the lth.
9/13/83
Date
Application Approved By......•-•- - /1 /83
Date
Application Disapproved for a lowing reasons------------------------------------------------------------------------........................................
.......•-•-•--••-•••..__......••---•-•----•--•-----••--••---•----•-••-•-......•••••---.......••----•-•--•-•-•--•----•-•-•--••••-•----•••-•-•-•-•--•-------•-••--•••-•--•-•----------•---••--•-•••-•-••--
Date
Permit No.._8_'�-............................................... Issued.........9'J-3/ 3
Date
No..............2L FE$..............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..................Town..............O F........Barnsta1?le........_.--....._..----------------.................
Apphration for Biapooal Work.6 Tonutrur#ion ramit
Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal
System at:
12..Z:Leuens...S1..l...H..yarmia,...YA.....o26ol.................. ..................................................................................................
Location-Address or Lot No.
I1Dl] 8._�27.nt+.S............................. .17..�11J1fi��..��.+t.�..��5�7"Ic1,�!a...YA....Q?Q53----......-----••---
Owner Address
a : .B O s1Z�3s�l.. e�.Y1ce............................................... ..128.B g ops•Terra a...Hyannis.�._;a 2601
Installer Address
d Type of Building Size Lot............................Sq. feet
V Dwelling—No. of Bedrooms......................3....................Expansion Attic ( ) Garbage Grinder ( )
............... No. of ersons._2................._._... Showers — Cafeteria p., Other—Type of Building _____________ p ( ) ( )
w Other 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........................................
1.4
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........................
a •-••••••--•-••--'•--•----•-'•••••••••••---•-••••-•---•••-•-•....-••--•-••.............•---••---..._...-•--•-.......••-•-...................-----....._..._...
0 Description of Soil..........Sand.......................................................................... ---------...------------------------------------•-•'--••-•--•----•-••--••-
x
�, ----------------------------
w
x ................ --•-----'-•------•-••-•--------•------'-----.....-'------------••••-•-•--•-------••---••-installatiori--of-•a•-I;.013iy--ga7Tori;•.pre-cast,
U Nature of Re air or Alterstio s—A wer when applicable................................................................................................
stone pack�I leach pit �01 rrlow) .
---•--------------------------------------------•--
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITIE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance ha�ss, ssued by the�boki=d of l lfh.
S.igr[ed ... .t -�-_ C j1>4 � c�: ?, ►I 9 i3/83...
l�r ' Date
Application Approved By....... ��' -; --------_----•---------- ........9/13A3...............
Date
Application Disapproved f orit-a f>B lowing reasons:--••••---•'---••---•--•--•-•---•-•--••--•-------'--............................................................
....-•--••-•.....-----'•--••-•---•-•---••---•••-•-•-•--'-•••--------•-•-••-••-••----•----...-•-------•--•..••--•••••-•••_..••----•-•-----•••••-----•-•-••--•-----•-•----- ...............................
Date
Permit No...$3:..............
-------------------•--------.... Issued_.........9113 -83---------•-------•---•--•----
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Taan Barnstable
..........................................OF.....................................................................................
VrrtifirFatr of Tontphatta
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ) or Repaired ( X)
MA
by .. .B..GQ .Qo1_.iaQ52.Y1'YQA... isl............ 2...............................................
Installer
at....U._S_t�y®ns••St,., .=i:Y.ann3es- •...A----0260.1..- Rouglas-_K.nott.s
has been installed in accordance with the provisions of TITLE 5 of Tl jState Sanitary Cod as described in the
application for Disposal Works Construction Permit No.___-__-n.-.._ a._ _....... da.ted._..._.9/._13�83.._.._..__..•_._•--••••-
THE ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CONSTRUED A GUARANTEE THAT THE
ti SYSTEM WILL FUNCTION SATISFACTORY.
DATE-------9t.1.3/0........................................................ Inspector---••-. ..... ....................................................................
i
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town Barnstable
.......................OF..................................................................................... 10.00
No.... .". ....... FEE....�.................
Dispolial 1pory�pTpil ion amit
Permissionis hereby grante ---------------•-------------------------------------------------------•-•--•----•---------------.-...-•-----.-----------.--•------.---------
to Construclt2(St)e$ tlBeRaat.( � IWivi �Ial D1 8t l t otts
atNo.............................................................................................•....-------------------'-•-•---•------••-•'••----•---••--••--•-••-•------•-•••-•-...._._.........
Street
as shown on the application for Disposal Works Construction Permit No.837.....e'- ?/Dated.._. .....................
9�13�83 ;fl: ....
DATE_ Board of Health
---••---••--....._•••-••--••••••-•-•--•-
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS