HomeMy WebLinkAbout0077 WINTER STREET - Health 77 WINTER ST
Hyannis
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LOCATION SEW PERMIT NO
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VILLAGE ?'
I N S T A LLER'S NAME 8 i ADDR
J. CRAIG MEDEIR®SO-1
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142 Corporation Street
OR OWNER Hyannis, Mass. 775-0828
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`cam ��j�1 y S/r► ��'�/ S7`'a�C� c.f'7
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED ��/�
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No.... ..:..�. FEE.. .
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF.........:................................................................................
Appliratiun for Digpusal Works Toustrurtinn rrrmi#
Application is hereby made for a Permit to Construct ( ) or Repair. (t-�an Individual Sewage Disposal
System at:
.......... Lot No. .................
cation-Address
Ww Address ess� o
... " Yam..... S A. v v
Installer Address
Type of Building Size Lot............................Sq. feet
;-, Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
a Other—Type of Building ____________________________ No. of persons............................ Showers
Cafeteria ( )
Other fixtures .. =
WW 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 are a...............
':.sq. ft.
3 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................
...._....
Test Pit No. 1----------------minutes per inch Depth:of Test Pit.................... Depth to ground water........................
(L Test Pit No. 2................minutes-per inch Depth of Test Pit.................... Depth to ground water.........................
------------------------------
-----------
_.............
__-___-___-•---•-•------___.--•- ............
-----
--.......
____--•------•-•---_------
0 Description of Soilr_________________________________________
U .._...----•-------------------•---------------------••------- ------....-------.....__....._...--------••------------•-----•-----.....-•-----------------------:......------••----...•---•...._..._.._._.
W -•••-••••------...--•-------------•-•.--•--•------•-•-•---•--------•-•-•-•-••----•--••-----••--••--•----•--------•--••--------=--- �,nt
-
U Nature of Repairs or Alterations—Answer when applicable.._..-..,/,r _ .�____ _________•-C
-•------•----------------------------------••-----------•--•---•--------•--•----•------....--•----------------•--------------------------•--....------...--------......--------------..._......._...
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of LITL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until'a Certificate of Compliance has bee. issued);,pthe.board of health.
Signed G f 2 r�!..........
ate
ApplicationApproved By.................................................................
I '
ate
Application Disapproved for the following reasons:................................................................................................................
----.....--•---•---------------------•--------....----------------•----•.._..---... ...-----
Date ...
PermitNo......................................................... Issued-.......................................................
Date
r k•� ..`d.: .Cl
IL
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.....................OF.....
...-.......................... "`
Appliration for Diiponal Workii Tonitrnriion runfit
Application is hereby made for a Permit to Construct ( ) or Repair (fr -') an Individual Sewage Disposal
System at: ,
. `" �.'..`................ .......
" .G �✓r
Location-Address fit --- or Lot.No-------------
/ c ! 1`� i)✓n Cam" � �.........................................Y � yt�r .- ) �..., .rat.
-...
ner
a �.d_. L-- 1 l e,. A,r! •- o > 1 v,. /°L f �, 4.~')��Y7 . Address J �7 f 1 i t o ����t.✓-�
--------------------------••.........................0..... ... ••-•-
Installer Address !r%
Type of Building Sq. feet
YP g Size Lot............................
.+ Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
aOther-Type of Building ............................ No. of persons......................:_.... Showers ( ) — Cafeteria ( )
a
Other fixtures _________________________________
Design Flow............................................gallons per person per day. Total daily flow..................--................_.._....gallons.
"W Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench.—No. .................... Width.................... Total Length.................... Total leaching are a___....._____..._...sq. ft.
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...................
--------------------
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water...
_..._...___.._....._.
44 Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water........................
P4 ------------------•---------------------•......_._..
0 Description of Soil.....................................
x -
_V .---------------.........................................................................................................................................................:...............................
---------------------•----------._.....----•-------......----------------------•-• --•---...-•--•-----•---•---.......------......---- ......."•---�^-•---- '•---•-------...._........................
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 T I T TLE 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. /� y
Signed..... --f --j-L-------I- -=�l--Ti1 :===`•- �'�--•---- ................................' -",, ' ~.---.----
w J Date Application Approved By----------•-•--•-•---------•..............••------------••----�:_ !....._._ _ ._�.. I-n --�16�}
1 Date
Application Disapproved for the following reasons-------------•-•------.........----------------•-----•-------•---•---------•-•-----•------•----•-•---------------
_Date
PermitNo........................................-................. Issued-.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
----> BOARDt OF HEALTH
.t.b"'?...............I................ F l-...`..........................................................................
(Irrufiratr of ff,antphattrie
THIS IS TO-CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (lr)
by............................... ....................................s ld , ,
--•-. .. ..`---^�- Install �+
-------- ----------•-------••------.------------------••----------.---•--------------------------•-----•-----
has been installed in accordance with the provisions of/TITLE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No.___....__�.._.......E..�?..... dated--------)_�_.-.i.�.__`_.�.�...........
.y r,
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
1
DATE. :...................................f• " Inspector ;-------
rtl
__._---__._ � _. __ ___ __ � ___..�_._.....__ —..�_._..._—_.._�_�__ ____..
THE COMMONWEALTH OF MASSACHUSETTS �p�j�.r�,t? �
(!
BOARD OF HEALTH
NO......... ..'�� FEE...... .............
Disposal Vorks Tansirnriion "prrmit
Permission is hereby grantedf~ ^ , ..._.. �`_?•+'�!��,.. ,r
...-•------•....•-••....-•-•--.
to Construct ( ) or Repair (�- )man Individual Sevk age ,Disposal System r
atNo ......................................
,*.._. ....................- - _=- ----------------•-----------------------•----•--•----------------------------•--
� Street -
as shown on the application for Disposal Works Construction-Permit No....3 :-."3 Dated .......:LT_.__.�-�............
---------------- l� -
2 j i C Board of Health
DATE......................----------1.........................................• '�