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HomeMy WebLinkAbout0035 PHILLIPS ROAD - Health 35 YPhillips Road: Hyannis A = 291 ,004 G 'i Ir LOCATION SEWAGE PERMIT NO. 3S' /(d • Rf - 3 Z V'I LLAG E f'n J,12.2-/o��DC� NNE / �Y9 s m� _ INSTALLER'S NAME i ADDRESS not- 3 cXc/?y.qT/01✓ re/L GA/vae/ !i C -3 9 oo�q c 8 U I L D E R OR OWNER 3r1�' GONG Gov iv� �i1:- JD: S//9lL�Ov�'�j" DATE PERMIT ISSUED 3 Is's DATE COMPLIANCE ISSUED rot-" Fss........s�7 L� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r� .....-- --- .. . ..............OF............................................_._...._.._..._......_._...._............---•- f'� Appliration for Dispniia1 Works Tnntrnrtiun lirrmit I Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at c.f1 ......._....--T - � yiS��L�I�S �Zo ................_....._._..... .....--••-•--•---........-•--•---._..... - --•------•------ r- .......------•----•---- --=•-------.......---•---- Location-Address or Lot No.- ............................. .........................................................................................._..--- Owner Address Installer Address d Type of Building Size Lot___- . S feet Dwelling—No. of Bedrooms:..__._.__._ ........................Expansion Attic Garbage Grinder �(a Other—T e of Building No. of persons............................ Showers — Cafeteria W Type g ---------------------------- P ( ) ( ) Ot ', -------------------•...----...-----------••-----•--•---•---•-- Design Flow...42�:�'-7....................................gallons per person per day. Total daily flow............................................gallons. 0� Septic Tank—Liquid capacity.11)64__gallons Length---------------- Width................ Diameter................ Depth................ x Disposal Trench I No...... V. Width.....;............. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Di ter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( Dosing tank ( ) f Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1..___<...)-minutes per inch Depth of Test Pit.................... Depth to ground water__..................... fi, Test Pit No. 2....... per inch Depth of Test Pit.................... Depth to ground water........."' ........ a' ............................................................................................................................................................ 0 Description of Soil...... CL1,0,._5Z_1A4------------------------------------------------------------------------------------------------------------------------------- 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 TITi U 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be�ued by the board of h h. Sied- ..�----------C(....... ...--•-----------------•---•--- -•-- -----------••--•-- Application Approved By-- ---•-�• ... -v:±.�4. t .._.. --- ate Application Disapproved for the following reasons----------------•---•----------------------------------------------------------------------------------•-•------- •••...-•------•-•----------------------------------•-•--•--------•------••••-------...-••--••-------•••-.•-----•-----....-•••---•--------------••----•---------•----------••••-•--•-----•-•-•-------.... Date PermitNo......................................................... Issued-....................................................... Date .fYLY�,fau Fxs..... ........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................. .---------.....OF..........................._........... Appliration for Diip.as al Works Tonstrurtinn ranfit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................--`�--._..�N........./0�?S_....... r =--------------- ------•------ �` "�..................................... =•---...-•---•--.....---- ----- Location-Address or Lot No. ......... Owner Address w mat r. c�.� ?:r.... ----........ ................................--------• .. Installer Address Type of Building Size Lot...�rj,i ?'--_-__._Sq. feet I—I Dwelling—No. of Bedrooms.............2...........................Expansion Attic 00Garbage Grinder Pk Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ••--•-•••--••-•-----•-•••--•••••••••---••••--•••--•......-•••••••••-•-•----•-•-••--•••••-•••••-••-•••-•••-•--•-•-----••-•••.............•.........---• W Design Flow..4!7.��'......................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid capacity�:D66...gallons Length................ Width................ Diameter---------------- Depth................ WZI Disposal Trench 1—No..._AbOCIF.. Width.....::............. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( 1•«j"� Dosing tank ( ) '-� Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1....<.::L minutes per inch Depth of Test Pit.................... Depth to ground water._-=-_---:____._- 4.1 Test Pit No. 2----- .^"1..minutesper inch Depth of Test Pit.................... Depth to ground water.........--=--_____ pi ODescription of Soil---- e`'`'^' ✓ ------------------•--•-----------------..---------------------------------------------------------------------------------.-.-..----- x W UNature 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 TITIE 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 hPalth. ..",.,...�C :, signed ------------------------- .......................... ................................ f f ( f Date Application Approved BY ----- �` ;.ter.." `! 1' i � `f` a �:-=. J " Date Application Disapproved for the following reasons:--------•----------•---••-----------•---------------------------------------------------•-•.....-•••-••------- .....•••-••••-••-••-••-......••-•-•••-••-•..............•••••.......--•---••-••--•--•---•••-•--•---•••••••-•--•••...........-------------•••-•-•••---------•-•--•••-•----•••--•-•---•-••......--•---.... Date PermitNo................................................... Issued._......------------------------------------------..... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH --- ...............................I..........OF..................................................................................... (9rrtifiratr of ToutplitUtrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) y............................................y!:.A................................................................................................................................................ + Installer el ........-f - .........••-•-••-••....._ has been installed in accordance with the provisions of TITL, 5 of The State Sanitary Cocle as described in the application for Disposal Works Construction P �... ___.__..............ermit No.. �.............. dated_...__!THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO TRUE® AS A G ARANTEE THAT THE SYSTEM WILL FU CT ION SATISFACTORY. Inspector...._._... DATE........................•.q � ........ THE COMMONWEALTH OF MASSACH SETTS BOARD OF HEALTH ..........................................OF........................................--------.......-............................. r o� No.. ..................... FEE...,. 1. -..... Roposnl Dodo Tnntrnrtinn frrufit Permission is hereby granted...........74.....'_ I- %.................................................- to Construct ( ) r Repair ( ) an Individual Sewage Disposal System at No....... �. I ss �< f. -' ..... - ----------------••.- Street ��• as shown on the application for Disposal Works Construction Permit No't �� ..... Dated.-_. e �1'�........................ ��.. _..' �`�� DATE - ----•-•.................................................. Board of Health FORM 1255 A. M. SULKIN. 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