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Home My WebLink About0594 MAIN STREET (OST.) - Health ��' `Ynain �� t��r'�u� �e PL(4tA I t1 r! 1 I i 1 E 1 1XISME D KEEPING w0U ORGANIZED No., 12134 2-153LGN SUSTAINABLE RECYCLED INITIATIVE CONTENT 10% Canifi.dFberSourcinD POST-CQQMER awvw.xr,pro2 raiw9 "4.0110D MADE W USA W QRGANMA1 aM i LSO CAT T ION ,. � S E Dl A RMiT NO. VJ L LAG E Mo I N S T A LLER'S NAME i ADDRESS J. CRAIG MEDEIROS t 2 142 Corporation Street OR OWNER Hyannis, ma . 775-0828 �s 7 9 9-7 DATE PERMIT ISSUED DATE COMPLIANCE ISSUED � � i o I No.. '.� F. Fss.../. �......._. THE COMMONWEALTH OF MASSACHUSEI�TS— BOARD OF HEALTH ..................0F...�"rJ.... ^^ k-- ............................... Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal system at: _ 1/+ ion-Add 4-171 ` •••-- O ner .- ... . Installer Address T of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) Othe-—T e of Building No. of persons............................ Showers — Cafeteria Gt' Other fixtures -------------------------------• -- - W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth...:............ Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) . Dosing.tank ( ) Percolatior. Test Results Performed by.......................................................................... Date------------. aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ------------------------------------•-------•--------------•---....------------..._.......................................................................... ® Description of Soil............C.7-•-•-•.... ..........••••••..................••----•-------•-...---•--•--------•-----------------•-•••---•---••-•----------•---•-----..........---- x U --------------------------•-------------------• ------------..........------......--------------------------•----•---........................................................... VW - •--- •----•--••- • ---- --------- ----- Nature of Ee rs or Alterations—Answer when applicable._. ,- _ ------ _-_. .. _ d. � -----~ - ....... ... _ ---------- --------------- ? eemen —c "'��' 'v � 4 The undersigned agrees to install the aforedescribed Individualt ewage Disposal System in accordance with the provisions of iITIE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance h4bbe issu y the board of h a�Signe .... ....... .. ............................................... ... ...• ----.1..... ate Application ,,kPProved By........................................................... .................................. ........................................ Date Application Disapproved for the following reasons---------------------•-------•--•----•-------------......------------------------............................... ......................-...............---•-••-------•--•---•--•••---•----------•-••-•-•----•-•-••••-•---•--••--•-••--•--•---------------------••--•-•-------•-•-•--------•----------•......----------- Date PermitNo.................................•........................ Issued-....................................................... Date No. -... -........... Fizz............._............... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH App iration for Disposal Works Tongtrur#'tun rrmft Application is hereby made for a Permit to Construct ( ) or Repair ( )man Individual Sewage Disposal System at: ,; Location--Add VJ ...---- ................ ;_ No"";= y 7O ner { 1CddPEs'•s"� J j 1t j � Installer Address we of Btilding Size Lot............................Sq. feet U Dwelling—af Bedrooms------------------------------ -- -----Expansion Attic ( ) Garbage Grinder ( ) Other—TYP e of Building ---•-------•---•-----------• Cafeteria No. of Persons............................ Showers — ( ) a ( ) ctlDesign Flow_Other fixtures ....:............. ----- - g ..__... W -------------------------------------------gallons per person per day. Total daily flow----------------------------------..........gallons. 04 W Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. _................. Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pi: No-_------------------ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation 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........................ C4 --------------------------•..----•--•-------------------.....--------.............._.._•-•----•-•••--._..............-••-•--••••---•-.........--....•. Q Description of Soil.....,.,_ U ......................................�-T---� .... .--•--•---------....-------.......------------------. -----------•--------........---------------- --- -----....__ W ' .a..... UNatur of 1< rs or Alte ons—Answer hen applicable_+ _ +� �--:........Y . �igreemen�f' Y ,�'�� "' ''"'1� -� �f/---•--• - ------ --- The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TILT r p of the State Sanitary Code— The undersigned further agrees not to place tbje system in operation until a Certificate of Compliance has been iss ed;,by the board of h lth. ✓ Signe :...i�.-- -----•-- � Date ApplicationApproved BY ............. ...............................•---....._-_.... ........................................ Date Application .Disapproved for the following reasons-----------------•-...•..--------------------------------------....------------------...............---••••_...- -----•-•-...•-••-•••••-•........•••••-••..............•••-•...----•-•-•----••---.....•--...._..•••-•----•-•-••--•-•-•-•-•-•••-••--•-•••••••-••--•••••-•-•••••••-••---••--•• ............................ Date Per-nit No......................................................... Issued....................................................... Date :i THE COMMONWEALTH OF MASSACHUSETTS 1 I� ---- B®ARD H NTH-.A ........ OF..........................:......................................................... wrrtif iratr of To ' anrt THI$�I3,.,,TO CERTIFkvThhat the IndividVu le wwage Disposal System constructed ( ) or Repaired ( ) by - - ... _..... j 4 € �r at. ' v..-. ----- ,- has been inst -fled in accordance with the provisions of TIT IE j of The State Sanitary Code as described in the application fo- Disposal Works Construction Permit No.-,..................................... dated_.............................................. THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUEP-AS.,A GUARANTEE THAT THE SYSTEM WIT FU CTION SATISFACTORY. DATE.... lk- --L1------------------------••......-•.........._....... Inspetor. .....-----------..........----.................................................. THE COMMONWEALTH OF MASSACHUSETTS BOA OF HEALTH r �� pot/ `" + r.......................................................................'OF.�-rv--....... NO.......................... FEE........................ i erns 1 rk n rnr#innX-amit Permission is hereby granted..fit :......" � _:____. ` ' ": ..._._' ----------------------------------•-•...............•••-- to Constr (, or & i an �verlua � Disgos, ,Sy tem at No.. ..�'' Street as shown on the appli tion Vr Disposal Works Construction Permit No.... _.:......._ Dated.......................................... ................. ----.......... -•-- �' Board of Health DATE............ ....... ........................................................ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS ' i