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Home My WebLink About0740 STRAWBERRY HILL ROAD - Health f` 740 Strawberry Hill Rd Hyannis A=250-007 f� P � DD7 No.-V.-g Fig.....J.. ..�_0 r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..I. .....................OF............... ..C_-..........................-1.. ._ ... . . VIAiratijan for UhiV aal Works Tnnitrurtinn rprutit Application is hereby made for a Permit to Construct ( .--or epair � an Individual Sewage Disposal stem at• " ----- . . --- . •----- -- ---- \ y oca own-Addre ; \ © t qr I of No ................ - -"" (t ......... .�., ....c.1.._..._... p a_.._......:/.............. W\ ... ` . .�9....... '� �� 7 � AYYISCt � C'"P _ CS 1 3 O ,-� -•-• --- ................ -------------•----- -------- -------- Installer t Address r Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.................•. ..........._-..._..--_Expansion Attic ( ) Garbage Grinder ( ) a Other—T e of Building .... No. of persons............................ Showers — Cafeteria .04 Other fixtures ................................... d ----------------------------------------------------------•----------------------•-------......------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ W Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. �t Seepage Pit No----------_--------- Diameter•-______---_-_-..._- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by...............................••-•-------------------•-------••-------... Date........................................ a 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........................ •-- • -----_... • 0 Description of Soil....................... W ------------------------------------- -----------------------------•-------•---•----------....._....---•--••---_•_---•------.... t x Nature f Repairs or Alterations—Answer when applicable--- �` -�� ove`^?___.___....�. U P •� PP i - `3 S. .h... -----•---4-�- �L.:................. 2 ...............................................................' -`•-�... Agreement: —� The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i T".. of the State Samtar o e—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has ee�su y the bo r of health. to ,ri ned.-•--- ------- -,-- ,._ Date Application Approved By---- -----••••.........-•---------•-----•........................•------- Application Disapproved for the following reasons:---•-----------•--•-------------•-------••--------------------•----------•--------------------•---•••.....-_---- ----•--•----•.••--_.....••••---•------_---•--•-•----....---•••••••-•••.........•--------•------••.......... ® N f ® Date t� . PermitNo... .................... Issued_-- .................................................. Date -- _----- r Na f EJA 0.� N Fizz..... ................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF.............. ...................... ...... ----------------------- .. .. ...... Appliration for Bhipasal Workri Tonotrurtion Urrmit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System kQ. #4 -7 -X ..........T ----------------------- .......*--------------------------------------------------------------- -------------------- e V �ocat:on-Addr or Lot No.0 C, o .................. ................................. ...... ............................... ...................................................**"-*------------------- 74ss S, 0 .......... ....... ....................... ................ PQ 1_4 Installer Address Type of Building Size Lot............................Sq. feet U —No. of Bedrooms______________.____.___._____ Dwelling .... Expansion Attic Garbage Grinder ( ).......... Other—Type of Building ............................ No. of persons............................ Showers Cafeteria ( ) Otherfixtures ----------------------------------------........................................ -----------------------------------------------------!--------------- Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 0� Septic Tank—Liquid capacity............gallons Length________________ Width._.__.._.___.._. Diameter._.-___-__._____ Depth................ Disposal Trench—NTo. .................... Width_._.._.__._.__.____. Total Length_._________.-__.___. Total leaching area-----_------------sq. ft. Seepage Pit No_____________________ Diameter._.____._.-_.___._._ Depth below in-let.................... 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----------------_----- Test Pit No. 2................minutes per inch Depth of Test Pit__.__._._________.__ Depth to ground water.................... ..................................................................................................................................... 0 Description of Soil.......................C _._. -'�4 �4 ------------------------------------------------------------------------------------------------------------- U ....................................................................................................................................................................................................... --------------------------------------------------------------------------------------------------------------------------------- .................................................................. 4 ; �\ t_,Z�? _� A U Nature of Repairs or Alterations—Answer when applicable_..__..-.................................. ----- ---------------- < . .................U�. .. ..............i.a1=1...............--------_-------------7------------------ . ........ ......................... ................ 51 Agreement: The undersigned agrees to install the aforedescribed Individual. Sewage Disposal System in accordance with the provisions of ice.LE 5 of the State SanitaryC6de— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has;bee�.ssued by the board of health. A crams _ 'Signed.........L............11 ............................................................. ...... ........ A Date� Application Approved. By..... ........................................... ------- e Application Disapproved for the following reasons:................................................................................................................ ......................................................................................................................................................................................................... n 4 ....._/ 5Date q, C7 Permit No.._ .............................. Issued.. 0 �:-- � !,............. .................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................................OF................ ............................... ............. (Entifiratr of Toutpliatta _THIS,',�S TO CERTIFY, That the Individual Sewa t e Disposal - ystem constructed (.-,�--j,--Cr'_Repaired k 1 .� 16;1- A.....4� ,_j ..- by............ .......z...... ................. ...........----------------.............. - ....................................................................... CA at ..... Installer 1, ........... ........................................................................................................................................ ............ t----------------- has been instailed in accordance with the provisions of Ti,;!E 5,,oi-TheState Sanitary Code as-d4e-scribedE�in the ::� 1 = application for Disposal Works Construction Permit No....V..'7::�AY_6 _...... dated------ �;,9.' --------I............... ...... .... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -4, OF................. .4m........ ......................................... Q No.0....4....6�2... FEE..._ Disposal Vor,kii Tonstrurtion 11amit Permissionis hereby granted..... ....................................... ......t............................................................................ to Construct (:;/g)-_or Repair an Individual Skwage Disposal System - I� � "N, , . y a- No............................. .... ............... �N E .................................................. ---------- _5 ....P�.....401.......................... Street ion Dated_______'.. as shown on the application for Disposal Works Construct' Pe Noi�...4............D ..................... .......... ....................- —-------------------------------------- Board of Health DATE....... ...... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS