HomeMy WebLinkAbout0411 FLINT STREET - Healthrx
No... sue- ..`-7 F ms........1..�..QO.....
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
Town....... ...OF.....Barnstable
...................................................•--•------.......--••-
Appliration for Disposal Works Tonotrnrtiun Prrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at: N)
411 Flint St. . -, Ma. 02601
......... _.................................:....... ................. •......-•-••-•-•----•-••-•--•-..,...:........----••--•.........._..-------•-•......_...........•--
ocatio Address or Lot No.
Lenord Go ie
-•--•----------------•-•--•-•••----------..._.........-------------••-•--•------••••-----..... -• 411 k_1.a.n.t... t.---•--..._..........._..---................
Ow r Address
W A&B Cesspool ervlce .....1-28...Bishops_-T.errac.a,_•-H,yannis.,...Ma.
.
Installer Address
d Tyke of Building Size Lot...................:........Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
�1
ether'Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
lJOther fixtures --------•-----------------------------••--------------.....---------------••--•----------------------------•--•----......_............--••-----•------
Ta Design ow----------------•-•------------------_-----_gallons per person per day. Total daily flow............................................gallons.
a.* Septic Tank—Liquid'capacity............gallons Length................ Width................ Diameter---------------- Depth................
.,>. Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
x
page Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
►�' rcolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. 1................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........................
ODescription of Soil.........................................................................................................................................................................
x
V ................................--•------•-----.....--•--•------•----------------------•---•--•----•----------••----------•--------------------.....------------•--------..._-••-•••---••-•------•---•.
W
x ----------•---- ------•---------•--••••-••------•---------•-------------------•---•--•----•••-•-- .........------•-------------•--•-----••-••---•••-•••--••-••---••••-•--•••---
U Nature of Repairs or Alterations—Answer when applicable.____Overflow 1000 Gal. Stoned packed
---- .............................................................
..... ---••------------------•---------------•----------•-•-----------------------------.....•-•••••-•-•-
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 urth r agrees not to place the system in
operation until a Certificate of Compliance has been issued b e board e
Signed •--•. �j
-..._.... .. ..__ ..........
./_.. ...
cr&, f Date
ApplicationApproved By--•••-•-••---•-•-----•-•-----••-•-•••--•-••••••.............•--•---------------=----....--•------ ......
Date
Application Disapproved for the following reasons----------------•----••-----••--•----------------------•------•---•-----•---•-••-•--._-•-- ••••-.._.........._
..---•---•----•-----•-----------------------....._.._....---•------------••----••--------••--•----------•-••-•------._..Date -----....---
PermitNo......................................................... Issued.......................................................
Date
No..=:.=?.: �. �/ Fiz$......
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town Barnstable
------. ...-- ......................OF......................................
AVVIiration for Disposal Works Tonstrnr#inn Trani#
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
411 Flint Ste Hyannis, Mae 02601
......... .......................... .. ----------....._---...............•--- --•--..............................---...-- ----•-.......----•---.....................
' -Address
T enord 9�0 aj t 1 1 Flint�roo.
_... -- .... 1.... ..................•••--••••-•-••-••••-------••-....._..._........---
W ,A&B CesspoollwSexvice Address
a . .......... i2$ Bisl o s Terrace.>•.._Hyannis -Ma'.
Installer Address
of
TypeDwelling—No. of Bedrooms.__ Size Lot............................Sq. feet
U g— .....Expansion Attic ( ) Garbage Grinder ( )
aOther—Type
of Building ......:..................... No. of persons............................ Showers ( ) Cafeteria ( )
04 Other fixtures .-.-•-•••-•-•-•-----•--••-••-•---•--•--•--••--•-••-•-•-----••-------••---••-••-••----------•-•---•--•--•--•--•---•-•---•-••-••-•---•--••--
W Design Flow.......................................:....gallons per person per day. Total daily flow............................................gallons.
Wx P •--.gallons Length................ Width................ Diameter.-----------_-- Depth................
Septic Tank—Liquid capacity.,
Dis osal Trench—, No. ....._...:.........;Width.................... Total Length.................... Total leaching area....................sq. ft.
P q P
Seepage Pit 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____•-.___--_-__-----__.
rX4 Test.Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
---•----•-------------------------------•-------....------.........------•-•----•----------.........-----......---...........----......._.._•-•-•-...--_...•.
0 Description of Soil.......................................................................................................................................................................
U
w
x .....-----------------------------------------------duet'flew---}-400---4a1-;---StQned---paek-e-d
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 TIT U 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 h2r the boar .
Signed_ •---•....................
Application Approved By.... _ __. _..G! `� � ,. .Date
-------------------------••------•--•----•----••-••-•........_. == i'•..........
/ Date
Application Disapproved for the following reasons----------------------------------------------------------------------------V-----------••--•-----•-------•••.....
..............................................•-----•--......----••.......----••-•••----•-••------•••-•-..................---•----•-•••--•--•---••--•••---•------••-......----••.......................
Date
PermitNo--------------------------------------------------------- Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town Barnstable
..........................................OF.....................................................................................
�n#ifiratr of Tuntpli�anrr
THI N& d f YS� :Jb�eIndividual Sewage Disposal System constructed ( ) or Repaired (X )
by------------------------------------------------------------
411 Fihnt..St;....... 7T' aririis 0---Mi taii -----.-----
at
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.........177 ._:.r.c_''1_Z......... dated_--. .__ __.97_ C_'--------------------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................ '' .....--••-•--•------------------•.. Inspector........... ------.......... --- .............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD. OF HEtAL JH
Town arns a IS
.....................................O F...............--- ........ ....................._..__.................................
No ..�f.y..... FEE.I .,.`�..........
Disposal Works �.1nstrnrtion rrntit
Permission is hereby granted..............................�oi_l,_ .....................
.................
to Construct ( ) or Repair (/) an Individual Sewage Disposal System
Street
as shown on the application for Disposal Works Construction Permit Nib._ ._ l_.... Dated_..41 k__2_. :, >,M
�5Z
.---.--------------------------------------------------------------------------------
DATE- _._..__ Board of Health
FORM 1255 A. M. SULKIN, INC., BOSTON
3 2 ✓
LOCATION i -� SEWAGE PERMIT NO.
VILLAGE
A & B CESSPOOL SERVICE
128 BISHOPS TERRACE, HYANNIS, MA 02601
BUILDER OR (OWNER l
DATE PERMIT ISSUED
T -
DATE COMPLIANCE ISSUED
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