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Home My WebLink About2423 IYANNOUGH ROAD - Health HYANNOUG H RD. A = 216-046 W. Barnstable 1/3 LOCATION AGE PERMIT NO. VILLAGE v ' INSTA ll R'S A i ADDRESS OR 'OWNER BATE PERMIT ISSUED '= v J DAT E COMPLIANCE ISSUED ; �1 L , � li THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIG➢ NAL(S) A- DATA No. 3. . .......... � .._............... THE COMMONWIEALfrH OF MASSACHUSETTS BOARD OF HEALTH ......................OF.................I.......I.......I........ .......................................... l� Appliration for llhipaa al Works C onatrurtion Prrutit a Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal rSystem at: ation-Address or Lot No. ...................... •......r.�....!i. ..... ............................................ .........................------......•....................... r dress ........ Installer Address d Type of Building Size Lot_�� vf5q. feet U Dwelling 4No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................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........................ ODescription of Soil....,.?.... .....--?---------------------------------•------•-----•---------------------------------------------------------------------------------•------------- x W ---------------------•------------------- -......................- U Nature of pairs or Alteration A saver when applicable....- .........:.... .............................. .......................... .....-- ------------------------------------•--•-------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITIU 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 f ealth. Signed ••----------•---•............. 2 s= -3 .��atee Application Approved BY ---—- 4--- Date Application Disapproved for the following reasons:................................................................................................... ..---•--•-•----------•-------------------•----------------------•--------------------------•--------•-•---------------------------------------------------- ---------------•-- Permit No......................................................... Issued----- ---------�+ D .................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................._.....................OF..........................I.......I—.................................................... Allpfiration for Uhqpaaal Works Towitriartivit rumit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ";?4 ...... . .... .............................. .................................................................................................. Lo ation-Address or Lot No. ....... ......... ........... . .............................................. -----------------------------------------------------------/;;:...... . r * dress I . ... .. .. .....I........... ... .................................... .. .... ... Installer Address Type of Building Size Lot.�2��15"q. feet U Dwelling&Tqo. of Bedrooms............................................Expansion Attic Garbage Grinder ( ) Other—Type of Building ............................ No. of persons._...__..........._........_ Showers Cafeteria ( ) P-4 Other fixtures -----------------_-----........................................................................................................................... Design Flow..................................._.........gallons per person per day. Total daily flow............................................gallons. $Y4 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 ( ) Percolation Test Results Performed by-----------.............................................................. Date........................................ Test 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---_--_____-___--.--___. a0 ----------------------------------------------------------------------"........... -----------------------------------"--------------- WDescription of Soil......I.....?.....0?.............................................................................................................................................. U ......................................................i............................................................................................................................................ ........................................................................................................... --�Z---- --- ----/ -----------a ......A�swer when applicable- - -----W.. .... 1114..- - U Nature of.Rgpairs; or Alteration A .... .... ....................... ................ ............ .....40. ..................................... ........................................................................................ Agreement: * The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T IT 11 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 jof kealth. Signed.. .. .. . ........ - -------------------------------- ........................... ApplicationApproved By.................................................................................................. ................................ Date Application Disapproved for the following reasons:.............................................................................................................. ......................................................................................................................................................................................................... Date PermitNo........................................................ Issued-....j. a.................... ............ ........ Date THE COMMONWEALTH OF MASSACHUSETTS BOA OF H T ........................OF.. ...... . . .......... .................................... %'-wWrtifiratr of Tautpliattre THIOS -,rXk,.R;, Y,.That the Individual �ewage Disposal System constructed or Repaired T TV . .................................... ..................................................................................................... . ... ........ b3 ............... .. Installer at.. 3 .......11.... ..... .................. ........I................................................................................ ----------- ha s been installe * ac ordance wi e provisions of. IT 5 9fThe State Sanitary/& a�, c'r'"e in the I os, Zj st Permit No_b— 11-7 ... .. .. application for Di, osa Work s uction ................................... dated--- km.................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRU D AS A GUARANTEE THAT THE SYSTEM WILL/T"CTION SATISFACTORY. ...... .............DATE........mZ/�-/b....................................................... Inspector ............................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF..................................................................................... No....: ............ FEE........................ 'Pie Permission is h by granted... ...............�/TA jn ............................................................................. .............. --------- 0 .... ....................... . to Cons 11& 0 Repair In Sewa ""'i4posalftstem at42.111..r.. . ....................................... .................... --- Street Permit as shown on the ap I' tion for isposal Works Construction Permit NO...._:-:... ....... Dated... ...... .............................. ............................. ....... ...................................................... ......... DATE................................................................................ Board of Health FORM 1255 HOBBS & WARREN. INC., PUBLISHERS