HomeMy WebLinkAbout0016 WATSON STREET - Health �(= f � �7�
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L O CATION S E W A G-E✓PE}RIAIT •
VILLAGE
I N S T A LLER'S NAME i ADDRESS
J. CRAIG MEDEIROS
142 CorRoration Street:
OR:. OWNER Hyannis, AI ass. 775-0'328
GATE PERMIT ISSUED �� � ''
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ISSUED
A
E COMPII NCE
DAT
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No.?14../0�.. Fps. ..................
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® HEALTH
...............OF....../................................................................................
Alip ira#ion for Diapoii al Vorkg Tnnitrnrtinn Permit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
-" System at: y, 0 '''')
PAO
� ? ... ' - '�" -- ................. ..........!. s ........
Location dress t No.
wner A
W
---- - - -• ---
Installer Address
Tyi' Building Size Lot................ .........Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
pa.I Other—Type of Building ............................ No, of persons............................ Showers ( ) — Cafeteria ( )
p•I Other fixtures -----------------------------•- - --- ---- ..--•-
W Design Flow............................................gallons per person IF y. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity............gallons Len hi....... Width-1------------- Diameter--------------;. Depth................
x Disposal Trench—No. .................... Width............. ..._.1 otal e h.. ._.__._ ___ _. Total leaching area....................sq. ft.
Seepage Pit No--------------------- Diameter.._......__..__... . D.p h' ................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing t ( )
aPercolation 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 Depth of Test Pit.................... Depth to ground water........................
Description of Soil........... ..... ...
---
U -----------------------•............••-• ......-- �� ------.-----...........-•----•---••......---- ----------------------------------------------
----------------------------------------------------------------- - ---- ----------------------••----- _
x
w Nature of Repairs or Alterations— wer when a hcable
U P PP t A;Az.,...
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System n accordance with
the provisions of TITIL- 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has+bbensued the board of health.
Signed- ----- ----------- ---- Date
ApplicationApproved By................................................................... ------------------•-•------
Date
Application Disapproved for the following reasons:................................................................................................................
----•----•--------•--•--•-----..I.................=.......................................................................................................................................................
Date
PermitNo....................:.................................. ✓ Issued.......................................................
Date
t
G,
THE COMMONWEALTH OF MASSACHUSETTS
BOARD'OF HEALTH
{` ...........OF..... ...... ..........................................
C9rdifiratr of Tomplitt rye-,.
THI IS T RTIFY, T at t Individual Sewage—Disposal Systelb constructed ( ) or Repaired ( )
by.. ........ --- --- ..,......
. .
at..... --•••• • ••. ••----•-• ----...... . ..: __ uer.s"-'---- x - -------- -------• ---•-------.. ...........
has been installed in accordance with the prow ions of TULF 5 of The. State Sanitary Code des d in the
application for Disposal Works Construction Permit No.- ....6 Zr......... dated_... .EZ........
THE ISSUANCE 9F THIS CERTIFICATE SHALL, NOT BE CONSTRU A GUARANTEE THAT'THE
SYSTEM WILL U ION SATISFACTORY.
DATE....... . .... .. ••..... ---- Inspector. .................••--•---........•........----••......--••-------••-------
THE COMMONWEALTH OF M SACHUSETTS `
BOARD F HEALTH
""~............O F.. ...................
No.---........ FEE........................
Tun tr ion Vinjuit
' 'Permission is hereby granted---- ---- -----•-----..--...... .��^�"� -...
to ( ) V
ystem
45 at Nonstru or Re. a..._.._div' ual Se age sp
'j Street
as shown on the application for Disposal Works Construc n Permit ..._... .. ......... Dated..........................................
Board of Health
DATE----/2 A4��
FORM 1255 A. M. SULKIN. INC.. BOSTON