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Home My WebLink About0137 WINDSHORE DRIVE - Health J di 1 � 137 Windshore'Drive A'=271'—136 x.; Hyannis ,1 I m 1 LOCATION SEWAGE PERMIT NO. VILLAGE INSTALLER'S NAME & ADDRESS Co BUILDER OR `OWNER DATE PERMIT IS UED DAT E COMPLIANCE ISSUED S/p 7d 1 + � u. � � -��- �� V 0 - No........... __ `FE$ .�..... ..... ........... .... f�. X THE COMMONWEALTH OF MASSACHUSETTS \rj BOARD OF HEALTH ...... .. ..............OF...... ,� ,f ppliration for Uhiposal Works Tonstxnrtinn Prrutit Application is hereby made for a Permit to Construct (A/) or Repair ( ) an Individual Sewage Disposal System at: . _r ••---------••---4 ..................................................Loc ion-Address or Lot No. _..... .... .. C� ...................... ........... ........_...............__._...•-•-•-•---......... Owner Address Installer Address Type of Building Size Lot... ?_ cf_Sq. feet U Dwelling—No. of Bedrooms.......... .....Expansion Attic ( ) Garbage Grinder '4 Other—Type of Building No. of persons............................ Showers Cafeteria 04 d Other fixture------..Xl� --Z......................................................................................................................... W Design Flow................ 1----_-- gallons per person per day. Total daily flow...... ..........................gallons. WSeptic Tank 4 Liquid ca.pacity/ .___- allons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No.........:......... Widt..,h,,��._._._-_- .___.__ Total Length.................... Total leaching area.__........•._ q. ft. Seepage Pit No.../OS iameter. l belo�}' inlet.................... Total in g area.-Ll ......sq. ft. Z Other Distribution box ( ) Dosing tank ( Y xe ' ��' 7� '—' Percolation Test Results Performed b ...__.. Date._:_� 4`" Y ------ ------�•-------. Test Pit No. 1........--------minutes per inch Depth of Test Pit---------_.......... Depth to ground water........................ f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ---•-------•----••--•------------- ... _ ........................ 0 Description of Soil-•-•-----------•--...6. --2 -• ..........� � r-- ---� �±-- f- x W 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 TI Av!L- 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. 4 Signedx .:L "� . .. ...........�� A � D to Application Approved BY �� /i _ -- -'--- Date Application Disapproved for the following reasons------------------•---------•-•------------------------••-------------------------------•-- --•----•--......... ---------------------•-------------------'-----------------•-•------------•-----••--•---•......-------_..._ ------------•----- Date PermitNo......................................................... Issued....................................................... Date No........................... ........................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................................................. ii A Appliration for Uhipogal Works Tonotrurtion "trutit V Application is hereby.riliade for a. Permit to Construct, or Repair an Individual Sewage Disposal System t: ......................... ..... ........ -e A.iT.................................................. Lot No. ..... .......... .... ..................... .......... ........................................................ Owner Address 7 Installer Address - --------- '6113uilding, Size Lot..o._' E..!?�..Sq. feet 1, �,"- Type:-� U f d Garbage Grinder R(X-? I.-I 'CDwelliiig No. o Bedrooms..........-A...............__________________________Expansion Attic '4ry Showers Cafeteria e of Bi�Idinh --------il.......... No. of persons__ ---4'. Other Typ V, Other fixtu s ...... `01.............................................................. ............................................................. Design Flow ..........3z�Y allons per person per day. Total daily flow----02.4;)v...... allons. ............ .....................g, I ------ �' ��'Depth....... 1:4 Septic Tank/_,Liquid*capacit� __ ..gallons Length________________ Width_____-__________ Diameter--------- ..... Disposal Trench—No. ... .......... Wit ....... t I Length_.____.___.._______. Total leaching area__-___ s q ft 0 W hea..ie_4z . 1 p 0, Seepage Pit No Diameter q41 ...... le ' Belo inlet.................... TotaLlp og area.!K. q ft' box' i X,*(-- 77 z Other Distribution b Dosing taa �_q A 7 Percolation Test Results Performed 3 o 11 .,Qrm by- -- ------ - ------------------------------------------------- Date-/ ---- Test Pit No. I................minutes per inch Dept of Test Pit._____.__.__________ Depth to"ground water........................ y. Test Pit No. 2_.............miinutes per inch Depth of Test Pit._.__._.___________. Depth to ground water....____.._.___.____ ' ............................... ..........A----------------------e.......................... .............................. 0 Description of Soil...........I.........0.—._2.et... ------- U ....................................................................................................................................................................................................... U ----------------------------------------....................................- ----------------Nature of Repairs or Alteration's Answer when applicable---------------------------------------------:.................................................. ...............................................................i...I.........."M........................................I....... ................................................................... Agreement: The undersigned agrees to install the aforedesc,rib'ed'"In"dividuaI Sewage Disposal System in accordance with the provisions of T IT LE 5 of the,State Sanitary Code—.The undersigned further agrees not toplace the system in operation until a Certificate of Compliance has been issued by the board.,of health. I........ . ... ..Signer ....... .. 'ate Application Approved By.................... . . ...X.V.—..7...7 ... ;7 Date Application Disapproved for the following reasons:................................................................................................................ p., ..................................................................................................... .1�, t ------------- ------------------------------------ -- - ..................... ......L.:,__ T�------ -Da PermitNo....................................................... Issued..................................................... Date THE COMMONWEALTH OF, MASSACHUSETTS BOARD OF,'.HEALTH .....................OF...... .............................................................. Trrtffiratr of Tompliana THIS is TORTUZ That the Individual Sewage Disposal System constructed ��) or Repaired by------------- . ... t,...... -- ---- -------21.....................I...................................................................................................... A�/ I st 11 'o at.010 ... -------- .. .............................................................................................. has been installed in accordance with the provisions of _P, 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit N6,61i ....... ............ dated---'..-/;k7--- 7:�7........ ..............1----S.... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED,AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. `� DAT ...... ...... ........................Q. nsDect.............................. or ... ........................... .......................................... THE COMMONWEALTH OF MASSACHUSETTS BOAR D OF HEALTFt---- ............._OF. ................................................ No..71�d� ........................ FEE.__.................... Disposal Worb Tomitrudion "rrmit Permissionis hereby granted.............................................................................................................................................. .�V to Const or Repaii an I System atNo. ...snL----j r4f ------------- .... ... ... 1, l ,d ...................................................................................... 10 Street as shown on the application for Disposal Works Construction Permit Dated____ -_'7.7......... .I................... -"e Ve.................................... Board of Hea�K DATE................................................................................. FORM 1255F HOBBS & WARREN. INC., PUBLISHERS r�dl Lam{ FIAW s l lt� ,L S • Sso G.pD. 'uEF-nc TAA-i►- = SSO-1 ISo % • 4§15 USA 100(=) 6AL , -t)I5P05A.L PIT • USE looO GA1... 1 Sty��t/4LL AIZE.A = ISD s P. s ISo SF 2.S • 3-75 6.P.ID. SD lril=. 1 .O 1 SO 6-P V. pl aT. � Cj TOTAL. 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