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HomeMy WebLinkAbout0391 STRAIGHTWAY - Health 391 STRAIGHTWAY Hyannis A = 26.9 — 227 ii a I i� e 357vt LOCATION SEWAGE PERMIT NO. VILLAGE INSTAnLLER'S NAME ADDRESS Mly cem vmmC B U I L D E R OROWNER • �'G'�'�r� �Jl dam: � 6f"I�v �D �/�/l"; DA T E PERMIT ISSUED DAT E COMPLIANCE ISSUED v � .� it �� ,, No................J........ ��"7 Fss............._.... ......._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ?Q_W./)..............OF......... ............................... 3� I Appliration for Dispag al Works Tiattstxnrtion Vanfit, Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ....s �! .� -----=--- ..... .........e-ed..r.....A.s-=....................................................... .ocati Address Lo N ?�fi✓ v � . ................. ....... D...r� ... ... �.... L �° ....... Owner Address Installer Address Type of Building Size Lot./0.01..0........Sq. feet U Dwelling—No. of Bedrooms........�................ .Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building .... No. of persons............................ Showers — Cafeteria 04 Other fixtures ©. ----- - W Design Flow............1Z0------- -----------gallons per................................................. M per�ay. Total daily flow.._........3.�.0_.... ............gallons. WSeptic Tank—Liquid*capacity/®..gallons Length.49..416.l'. Width.Y.-'#�,O:"` Diameter................ Depth.S..A.". x Disposal Trench—No. .................... Width.................... Total Length........... Total leaching area....................sq. ft. Seepage Pit No.............. Diameter.....8-_:__..... Depth below inlet...a............... Total leaching area.cR.0_0...sq. ft. Z Other Distribution box - Dosing tank ( ) '-' Percolation Test Results Performed by.rZO.MAi4.-L>.....An..�1A,,50 t. Date...A.f?1�4L.....�1.14�.� as Test Pit No. 1.4 ..minutes per inch Depth of Test Pit....11 ...._....Depth to ground water.N®Q.l6..... Test Pit No. 2................minutes per inch Depth of Test Pit..............._.... Depth to ground water........................ a •--••-•• •---•-------------••--••••--•---••---•-...----............----•--••-------•-............--------•---•---....---------..........--------........----- 0 Description of Soil......0.....A.Y G.....4 �......4.lv.Z?......... ............................................................. v ----------------•------- y Z '`I ` �9 � ... Anr W .........................................................-.............................................................................................................................................. UNature of Repairs or Alterations—Answer when applicabl ---------------------------­I--_;_____......................................................... ---------------------•-----...--•--.........---------------•------------------------................-•-.........-••--•---•---------•...---•....._..••---••••---••--•••...........---.........-----•--••• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iI M 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 board of health. Sign ............................ ................................_..... ... 1Date Application Approved By......... .... ...... .. �U a---------------•- --.. le............ Date Application Disapproved for the following reasons:.....................................................................................:`_ ................. 6.11 --------------------------•-••---....-------•----------------.....---.....---------------......--•-----------••----------•----•------•------•-----••------•--••--••••••---•--••-•---•--•-•••------------ Date g Permit No......................................................... Issued-....X�-'�------ X�_L5117.7...................... -' Date r� 61)� 4. 7& No.. ........ ....... Fxs............................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -.A)..............OF........f,���A�:N..`.�-1�.1'�. :�..��.... ....................... Appliration for Bispaii at Works Tonstrurtinn Prrulit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: •---• ....... -------------------------------------•---............_.... Loc ddres or Lot N Owner Address �1 a --------��(.ill......�... cn!�r--------------------------------•-- --------------------� ----...---------.....----------------........._....-•--•---- ,Installer Address e of Building x V Type g A Size Lot-/ 0.9.0........Sq. feet �-� Dwelling—No. of Bedrooms!..........................................Expansion Attic ( ) Garbage Grinder (gyp) Other—Type e of Building No. of persons............................ Showers C4 YP g ----=----------•------------ P ( ) — Cafeteria ( ) dOther fixtures , �iic'A o_...... -- W Design Flow._..._.....« _._:..........::.....gallons per person per ay. Total daily flow.......... . 0......_....__._....gallons. (� Septic Tank—Li Liquid ca ac ty.�00...gallons Length_5�.."_t�.. Width�e.'!A".. Diameter______________- Depth.,`.._*8.-'-y. W P 9 P .�- - x Disposal Trench—No......_.-,:`__._.':_.,. Width ........... Length.................... ...................---------- ....... Depth below inlet_................ Total leaching area _..04?...sq. ft. Z Other Distribution.box ( Dosing tank ( ) Percolation Test Results Performed byIZOA.A4A!'t..../ t... ...R:.S.o.... Date...s?PRp to....__�..1.92-1 al Test Pit No. LG.��..minutes per inch Depth of Test Pit---/_Z:.......... Depth to ground water k+ ?Al_:e�..--. (i, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •••-----••----••-•--•-----••-••---••--•-------•-•-••............................•--•------------•--•........................................................ D Description of Soil...... .. ....A-y""..... a......:+—4).b....---=- -:? ............................................................. V -••-••......;0/:-_ ��.........C 9192 5`�`-•.........5.4zv---D----------•-------------------------------•--........ --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------••--------•-----.. 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 TITLl 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 board of health. Sign � Date Application Approved By........ ---•• �- - _ . .....a-------•------_- .. 4-............... Date Application Disapproved for the following reasons:............................................................................................................... --•--•--•-----•••--••-••-•-•---------------•-•-------•--...........-•-•------•-•.._.......--•--•............•---------•----•----------••------••----------••----------••--•--•------- -----......... Date i PermitNo......................................................... Issued-................................----•---------•----•-• Date H 'COMMONWEALTH US THE C MM NWEALTH OF MASSACHUSETTS BOARD OF HEALTH f ` ....a�0401N...............OF.....!.9AR,1.Q..7.1.9.V.1L4�........................ Tnrtifirtttp of Tomptianrr THI S TO CE TIJFY, That tU Individual Sewage Disposal System constructed (d✓') or Repaired ( ) by.........I ��.... ��l'✓L� `---------------------•---••------•--•---------------------•---•----••---....-•--------- ........................................ Installer at e''; " �"' e ----...----+'y'f '1�/ f� ............................................. has been installed in accordance with the provisions'of j of The State Sanitary ode as described in the T�E;5 .. application for Disposal Works Construction Perrhit No .._�..�................ dated._� _ " _ ..................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE AS A GUARANTEE THAT THE SYSTEM ILL FUN TION SATISFACTORY. Vr, DATE.. ........................ I Inspector............ ............... - ._... ........................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No ........... FEE.-�................. Dispos a nrk u ut.r uan rrutit Permission > ereb ranted � ...............`.. sid /.•-•---------••-••---••............-••-•-•--......._..:........_----- /�' Y g to Construct (� ) or Repair ( ) an Individ 1 Sewage Disposal System atNO....L._4.20. ...... ..-----IMWAA."a.................................................. Street q as shown on the application for Disposal Works Construction Pe . No .__ .___. Dated___= � _7_9............... 3_._.j� =r•• ►1 !�1 ----------------------•-------- Board-of Heai FORM 1255 HOBBS & WARREN.-INC., PUBLISHERS - - 1 �--- + �-- /0 D-. Dv APR IL 3, l9 73 i --YWVTV�; r y PA vL M C1 r, .RAY EL -V s9. q 4� .: a---'-- E 0- 24 LOAM ANC ' �,, 6i SU/35O/L sovrrc 144 J CDA SANG i 7A N A r i xyf3 i PROPOSE:D O , 24 NO_ C�7HTE� ENCL7UIV7fRCD f f TEST y�,LL� J.,J 'TE R /S A IAJL-A BLE �.•.,/,;art I ¢ TOCaJN a�,r L a T ' UN DE. I=INED PULLfC . 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