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Home My WebLink About0124 WIANNO AVENUE - Health J l..... r t 1A - oo(0—0-0 � $.�.. .�..._....._.... No.. ........_.. THE COMMONWEALTH OF MASSACHUSETTS BOARD QF HE;P�LTH .....--.......v:...I....``.............OF.........j...�..tiv�i Appliratiun for Bigpuutt1 Works Tonutrurtiun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair (&-f an Individual Sewage Disposal System at: ....:..........._--.............................................................................. ..............-•••••••••-•...--•-•---••-••-•••-•--•---•........••.............._..............._.. -�' �cationf-%_da�ess or Lot No. © -y ................................1__1.....f�...__�!(.'l S o i—, f �� 1/�d Owner �ess W �A7 Re, / kor a ............... ....... Installer Address Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms.........._./............................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures .................................. W. 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 area....................sq. ft. Seepage Pit;No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water......................... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ••------------------------ x Description of Soil.........---••--------------Sal .--;1 / ------- -------------------------- ----- W ...............__......._____..___._..___.____._._._......_______.._._............................___..__.....T__._ .. - . x l�--/S-f�v S.e . c T�lC U Nature of Repairs or Alterations—Answer�hen,a,� ..................................P_......_.._.._......... .._ ..... ..... ..............:. ', / =�- ©/o( =Pf s o � �•� Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b n 'ssu by the oard of healt . Signed......... ....•---•------- L ' ...................... �— -- •-------------•-- Application Approved B�� — - . — _ a ........................•.-- z G --- --- ---- ------- -------------•-.--.- Date Application Disapproved for the following reasons:...............................•--------------------•---------•-------------•----------------••------•••...... ...........•---------------------•-------•-----�---------..........--•••---••--•--.._..._•----•--•---••--------------.....----•-•-------•-----...---••••---------------------•--•--...-•------........ -�- l i Z r Date PermitNo..... . ... ----------•-••--•----------- ---- Issued..---------•-----------------------••---....._..._•-•--- Date ... �L�.�..��.... —. ---- ------------- No...el _.!t.2--I Fps. . .. .... THE COMMONWEALTH OF MASSACHUSETTS BOARD QF I—MALTH ------- -- -- -'.............OF................�P-t, �... ..--............................................... Applirtttion for Disposal Works Toustrurtion Frrutit Application is hereby made for a Permit to Construct ( ) or Repair (4e� an Individual Sewage Disposal System at: /a 4r � o � ................_.. - -----......:.... - - ---..........----•---- ..................--•-•............._....•-•--.................................................... ation•z d ess I. or Lot No. p •--•-•-•----••----..........................................°-- •-••••. ----•----.•••-- .............- -- ._......_......._ ....... W �D 4,Owner . ��G �!d �� !/+'eY/H s� ! Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms...•..._..y._._........•...............Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria G4 Other fixtures ------------------------------•. . W 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 area....................sq. ft. Seepage Pit No--_---------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by............................. ............................................. Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water......................... fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ --••--------•------ ------- -----------------........---•--•--•---•-----------•--••-•------....---•------•-------........•-----...........•---- D Description of Soil............................. h --..... ....--•---------------------------------------------------------------------------------•-•--•........----•--•---- x W ---------- U Nature of Repairs or Alterations—Answerzhen e, cable 417. !�' --�U ---------------- ---•--•--•--------------------- �'......................................... -. ....../x..-----•---•--(.....; 1/ ... ..........Ac 1��....!..+"s� . .J t�-----...-•--------- Agreement: 'The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be su b aGnd f hett Signed .....................................---•----••-------•-----•--- rr I...................Application Approved B ........ ...... Date Application Disapproved for the following reasons-----------------------------------------------------•-----------------------•--•---•-----•---•••-.....••......_ --•-•-•-•-......----•--------------•-----------------------•-••----.....---------.......--••-•-•-------...-•---..............----....------•-----•----------•---••-----------------------------••......-- Date Permit No...... "y' �.. � f ....•...... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... �rrtgf utt�e of f�ont�ltttnr�e THIS IS T19 CERT Y, T at the Individual Sewage Disposal System constructed or Repaired by = ...= '-------------------------------- .....--•--------.=-------------------...............------ ------ ......... ••• ... InstpW at........................... -. " ~� has been installAd in accordance with the provisions of TITLE 5 Qf�The State Sanitary Code as described to the application for Disposal Works Construction Permit No.__.. ......................... dated-----C .._ .................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTIPN SATISFACTORY. _--- ) DATE.............................. 25 L.•••-••.............----••-------•---- I Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS *- BOARD OF HEALTH ...........OF...... No. FEE .................. Disposal Works Tonotrttrtion "prrnttt I ..-. Permission is hereby granted....--- .....��r..---•-.. ....--'..........................•---......-----......._......._.....-•----•-•--................�.... to Construct (�fj or R air ( ) Individual Sewage Di osal System at No........ --•------ •�� ;1 :_e...... Street L 3 - as shown on the application for Disposal Works Construction Permit,No.Cl-�...._._:_.(Date .. �� ....•'........... Board of Health DATE-----1 ............................... FORM 1255 A. M. SULKIN, INC.. BOSTON `y, LOCATION SEWAGE PERMIT NO. PILLAGE _ -- " I y INSTALLER'S NAME i ADDRESS JOHN A. AALTO .BACKHOE SERVICE Iry Qi:._:+ 3"r West Barnstable, Mass. 02668 e U 1 L D E R OR OWNER A/,�,/LJ /+/ /7U-T_ DATE PERMI ISSUED �2�� ,_ DAT E COMPLIANCE ISSUED AV- f 1' • � 6�� . c� e � � 6 C3� N W U` �..