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791 & 805 PITCHER'S WAY - Health
FLYNN; ,EDMUND 791 & 805 PITCHERS i WAY - HYANNIS r 1 • 7 N'. � i�` � f> ; .+ 4 r " '� '�rP r.•n i :4 .S.. �' FhY ��a}'"i y + da 1:` L .p +.� { , ` � yk! w -� Y t• > l.1. `! •.1 � � xM n N ,r- ti r.f . [. kYS rz /� - r S v i Y r E' }>* ° tt"' .#.'� ii .r•,f c. > 4 y-t r zf•r ♦ r ,. ,".:"�. /i" ,.. ri kfi r iY , k•� 'r' Ww •y- r y^tt *x. } �.° at ° t. ;: r . � c4 > ;. r 'c t• r�"'!`r e., ` y ', 1. `.. ♦ i r' ♦-� > a ,�,•l d P t: y r r Y ,r . r P, I< G.s ,i.} ,'{ �+' ,tCx p. • "J v 4=�.r... v � 4 ` " -b` � X -. r •.w,c r', r t. e i r N� e i �<. +.,. ' > �t - � 4�+ � •• . r s t �•p, 4 � s:' ti, E.r.: r `,y wt Cr �. "..r Y r �� 4��a�r 4 �. �_ t � a s e .+i f r =? 4 iti. � 4 ti`• n !,` f T r ,,, *.f•''�t J t r.y P,.. ; F �, a '. r ~i t ' t <y ♦w ° � i� r'? k ivwt as�.f �'. a .d �'.i�_. �it ., 7 ar > fi e• . f _ •'µ� .t 4 r <_ - �y t ��r`' •"•a� . k i r en "'�r ti ° •� ,� 'f�,r j. _ `•rin s ^ 4 4.1.r i+ i : ,� r 4;.'�d �.{l, r.'« Y C L t t R U' r ,"e. {/_' t• n r.' .i 4 i�. N:. L• i i ,+ . ,� m r- S`.'a !.'.,� y �{`n �• t• +.h~� +} - '. r rr �,,.+, �• •• tiy4 •C r 54. f , f 4 .F •'S ��t • > 4 .S s I � (` {'�'. 'i :9� , ' .4 *•..S'R k :. � .• �`{; ^i 1 Zr A.. r ` " . �.,•'.'} M 1#. ri. y,�-. _ � a,4;•_' a w : ,November,, 7 If 1-984 � � � `rf �. ,� � s 3° � �, �• ad <�e, �;. ;a �t r �}d' �' + c i- ♦ IL :bit .2, c' n.-. �. , *, a- ^ ,S e i r � d w L t t ` ./., •s • r Y, is#;. t , 1 t,, �! n ? a. }pp„ � td 3.��•r`=v7�� s;� i,ra�� r' s.O.W!r � ' F .r+y4 t°`� yk g { �i, ;h a is S y .:t. r es'' to,�-r y°`i � i. ° * e` .r ,r ` 5, M .,( _ ♦ .P.R c xr r `f• t j rc 'r , 44q� Z .y'. Y .eYs!•l` �' � � i� y� 1 �, li £. r } : t r. r r r♦} _> j 3 ° s P 2";"f+r7 �f, tti;�11.'. x"S�W �.` ,re`•`>♦ i.,4 , a`_` •y'":. u P o,t: Y ,y `'t �y 'r ;r„r � �r�. .. R wF -,.t [��,,,,r,DD j"'= 2 y�r. 3.ar, '� ,� :'. Y ^i{ .? �, } ti i � -`'r `•4!E+ .e ...f ° � - 7;. rt,. `'b'4 ".y h,-y. •Fl 4�Y„t ♦ ,♦.,. a'ai 'Y rd'4 `a 4. ; ,,iA,, 4 �'`.'; g } } n r r <s' ;^.(• #,, ,. >. �_'li, •e , r Mf , Edmund:FI n 1,BoiC37 ,;1 ' 'r.> =7+t .,�f dq-! t-.d cr :• f a `I i {,. w,t♦ ir3 �. ` ...,t r 5 >w.� rr C ` az632 Centerville �' e _ t Y t9 ,k `-f S[[ s a :"t ti •^ f r rw. PIZ, t `t „•.,., ♦. �791. �P ;. +• h a aa• �t et ty Re' }variances~ on Lot:2, i itche.rs;=Way,. Hyannis; and `'�` ' t' yr ? _ •" V yLot.3, 805 Pitchers= Way,•-�Hyanni.s '� e'•J �. ^iy,'' � r a y �r r? r .r, ',., � •.+w ,�F;�2„ C •`. d ,A,J..lib`S'rrd e. r r ..t } 1 ' f t d ♦>4 'r�'�,.,.r�`.( y q y dr r S •y r ,t„i ! y 3 y t }&,f.,j 4 , _ ■ a! ' par Mr. Flynn:'12 ' G '`.S 4 r dw ! „'• ri .. a £ 7 S + Zt k 4 Y4.sl. •t -R { ydr"Ys c rer c.'`f + . .fit ?� '+�'.� t �... r-n'it r,t •.•h. .. ''"j 4+.. .,♦,if . > i>ii a'1s ^i �f.,i:,..,, + 9 n r?, Y .• }�s�.ib y t,tt r - •. � ^,ra'ki�t ��-� f1+!r• i 3: te. V is` �..-Sa -+' 'You area'granted` at'vari'ance o install- on ite sewage systems 'on'Lot. 2 ^ '791,'Pitchers WayW`and 'I�bt 3,$A5,'Pi;tcher's Wa' g' i . f < y, yanni�, ink lieu at connecting to the' Town ' k r sewer, with the, €uliowings condY'tion's:' ' ' 4' t t. .tr '^� �+ „?r.c•: "� 'r - �'' v �.!y � +f� �..� y � i r: a -! `� �y.,� k � '`-� '�•rur tt"' cy t - •r ♦ Fer, fi€y s In onsi y '�� ,, X .�£ " �f�� "+rS��cx .,�,. sit $, �1} The ate` sewage systems teuu'st wbe_insta'lled ,in strict 'accordance;.•witih the pYan.eubmitted 5 � • F ° i•'t' A d. ! - Y+,r '� '.r k 4•e `. !�l � rf:. �Y+.'a..,. ft y •$ ,. t�s.,L i , .[�, � ':�# +�• ti f v } - s # �` ,� ..- a i..;, :f '"'� 4] C s:`,ry pr-• :�� .s r �j zRw r� � �. ,, S,p.,,, .r `4' ! (2) The-on'sfte `sewage'.sysemsFmusC be``installed in sri r t• �Ct conipl Tance-with 'Title 5.,: O€ thB S'tHte y.N r ,Elivironinentel Code, and Town of Barnstable Regulatfbns 'ft; v r � ' i d r v�Y J _Y% 4 q,. ,r tN, �.i ', - 't• rn r a e}'`,+t,.y 5+ $ �,.i - c - > t• ' -,3Yr " ♦ x. r s ' (3Y. ?hi's`variance`;expires December"t41, `.1985� i qq " ', " nn •'"t "� 4 Y a 3 6;$ � "4 �it4,4_��r)iS q !cr ., '.sy `g p i tti °, • 's } 'i::.r C� > !Y ,+ .fi 7 as ` w Svt s .' _ • � } ;�.� w r, a'r d?.°-. r+n t ,yrc..?r+ .,w,•r n,i °' � � i ".'•'! ' t y t:+--�' 7•a x�d � � ....- t:� 't+J j'+is "t W 1 ! �.,A t'1C r ; r'" � � a This•.variance 'is grantedsbecaued the,Department of.'Public Works feels '4 is no"trfeasibl -€or they '" ` , f _. s 4 s;r `fE3r. ,applicant �to connect�fiaC;`this mime becadse ay�gra�ity; * ,is not,rava'il'able 4 � In addf tio{n,; Chore,are`''many.,other hoi sesr,my this area Ao[�, dionnected to To },, s y , a� r w ywri sewee ._�VIn addition, the Lots rcombined=are 69;037 square feet ` ' • ' "a``{_ `� ,, `} ^�i4'�' _ v •,ei'w., t .t�. n�.". i t "+' ,fi,i• kk .r+ r'a.i_ 4'r fi,�. h 3 •y�'-' a -:i ti t !r ."-{t t�y ,r• r• 'r '� N • r .j t 1. �. k > wy j'A 1 v ' ]• •, +' l.ya '4 r�' �..f -`"\ v ,. i •>. rulyuyours,,r, ,•,'rir•Y`tc F ,a;, r jt{, , t .x do '�„jp ... ♦ r�3 4 }. ,.♦ f w �� i t{d a 1a :Lx r�' 'dkX 6+. a s 1 •elCti r ° .cx { S a i T;'W. S .Y * `� S s 5 : >,e �t.r"• �. `4. t Se s. :. > ! 'fl f�i ♦ 't :�#,4, r �y 1 G _ .�"'i, .:r.r�' .i'•�.. tn' �d- ,Ci Y,}, .F+ '` t,+,sS' ,t w a i,i •,r , d .�` � f5 '_..r vT ,�.. �'Y'� rF'� >e .,�. �k �"a"1 f5 f r ♦ p r*i .,�, ��. .:.s RoberC It.�.Chi�de, Chafrma ' } � • 13� " Es y .W. r ; , .:� �. i �� ♦., r�`. 0 ;'� v Y , A. p�A k s 'Y +7 ,.er r s�,,,. " >; b,f. .t.fir 'vi` a � t^.S g/ � :'E t� a ;7 n"%:S"!r�Ary rr,: " '�, ,•It S j a 3 3s =r ♦�x q t .j; i s . y - �� An .�$ne Eshbau h tS tr H� 4 F lx 9 v ♦ 1 3 s t > r r r S' ✓�•`£Fuy fir• <y .> 1 �.'> "f t c' iy f.•n'"• °`7• .Si9 ''�r�w.l�'4k #, i4 t F'4� t i�'1. ,fs ! ,} !- y•ilfy •�r s '. +'ti. y '•�l A'-p r� ,_ �i1 �y`.::.w � d., i 3i� 3 ik a :_ S u y'1G � f' � r 1 •rt t t ' BOARD oF.tHBALTII : ;.: ,� };`',, �r ,- ToWji OF BARNSTABL r<' r r y ,t,�r . ' r t ":• � � . ,,ff s M `h T i A . w' r lY d h'r1 i < { Y w• 3_..,.'i i qt .F i -1�• ! i.r'ir li .a1 ��� r ': + :•� 3 .�J� t r 11�,• s r s <� i r. r.�o'�P.`�" •#. �3, !�" r i :�';'`t'. n' nA•1' -r'ir«.,` ". '' .: r f ,y j?" i ....�/mm •♦ .r r v#ra 4 7� 1 z- . ' '�, S +Fii T'd S v 41 " t, •'4 r •�,� tie,'�i� t.-: � W ,k k'� �x�`, �•', r � er S'41 ,,dd '` '' "` E �t ,r` r. .r< t r '.a•�P.::tt s�;k- ^'• +,i , 'a. ,`d. . . •} i ,'3� . t'. '�• �_{ 4 °� ,a .. R 1. t r `�- t' +ti r r �>.. x � -. . t 'r �• 'v,D . - d z_." � ;�, .., � `I„w _ F d�. �,k. ..a �; e' � 1 p' � ` i . 4 r ..•t * . i"f - .tit *, 4 •�y �f.eY * s.' v a2 3 brnirr LW. Y gr•,. ¢ .`y� r `e+. #�1 ta� ,s, r + .v R Y ' 4.• + • , 3 ^ _ � Y` r r ��1. 'di ��{r tT ice; ''d..e~�{t .�°"t• x'n T'�'� +S+:. S . { ��.�.k �;^° ? �` rt��•• �s r :i s: `, - tr ' , r1 ^`r -'° fi +•• t�- ir ! ,qy ;•t. v. r�.; �4r •rit ° .iii f r /.� .` 1.� t•' '' .i 4Y.c. r TowN OF SARNS-1 ABLE OFFiCE OF e BALaS':ABL i ' BOARD OF HEALTH Kxat °°prE16�Y' ��y 367 MAIN STREET K HYANNIS, MASS. 02601 i VARIANCE REQUEST FORM . All variance requests must be submitted five (5) days prior to the scheduled Board of ' Health meeting. NAME OF APPLICANT �,�✓ �/V' TELEPHONE NO. ADDRESS OF APPLICANT �C '7 � ((// G -�j_32- NAME OF OWNER OF PROPERTY LOCATION OF REQUEST / D ✓ / /��TT�f/\� G� Z�wa///'� i VARIANCE FROM REGULATION (List regulation) &1j" VARIANCE REQUESTED (Specific request)�AAE�Id, 11;_Sruzz �tl J 1 . REASON FOR VARIANCE (May attach letter if more space needed) PLANS - Two -copies -of plan must be submitted clearly outlining variance requested. VARIANCE APPROVED NOT APPROVED REAJSC?] FOR DISAPPROVAL i -- 1 i Robert L. Childs, Chairmab I Ann Jane Eshbaugh . H. F. Inge, M. D. BOARD OF HEALTH TOWN OF BARNSTABLE Tov%IN OF E4,RN '5 i ABLE 7 OFFICE OF BALNLXX L BOARD OF HEALTH MI h . °°ATfs63q•k� 367 MAIN STREET k RY HYANNIS, MASS. 02601 VARIANCE REQUEST FORM All variance requests must be submitted five (5) days prior to the scheduled- Board of Health meeting. NAME OF APPLICANT / L ��//V TELEPHONE NO. ADDRESS OF APPLICANT NAME OF 019NER OF PROPERTY � � zE7 LOCATION OF REQUEST O / �I I VARIANCE FROM REGULATION (List regulation)VARIANCE REQUESTED (Specific request)���5� 1 .!5C T REASON FOR VARIANCE (May attach letter if more space needed) '! PLANS - Two copies of plan must be submitted clearly outlining variance requested. VARIANCE APPROVED NOT APPROVED . I i ,3REA$ON FOR DISAPPROVA, ; i I Bert L. Childs, Chairman j I Ann Jane Eshbaugh . H. F. Inge, M. D. BOARD OF HEALTH TOWN OF BARNSTABLE Fps-.....� V THE COMMONWEALTH OF MASSACHUSETTS ' BOARD OF HEALTH . ..........0F........... �r7 L.� .......................... Applira#ion for Uhipoii l Workii Too .gtrnrfiun amit Application is hereby made for a Permit to Construct (V) or Repair an Individual Sewage Disposal System at: op 4- Location_Address or Lot No. Y Owner Address wA. U ....................................... ..ZM131."-- .`, 11 � / �.. a" Installer Address yy Qr Type of Building Size Lot_,:; ?/3_..Sq. feet U 0-1" Dwelling—No. of Bedrooms_________________ _____Expansion Attic ( lfJ Garbage Grinder ((/,6 ax Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) a Other fixtures --------------------------------------------------------------------------------------------------------------------------------------------•-------- W Design Flow............................................gallons per person per day. Total daily flow.............. __ ..............gallons. Septic Tank—Liquid capacity./,3.65gallons 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. Other Distribution box ( ) Dosing tank ( ) PercolationTest Results Performed by-------------------------------------------------------------------------- Date........................................ a 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--------------------------------------------------------------- ---------------------------------------------------•---••---------- -----------------------------------------------------.._...----------------- . -----•----••-•---------------------.............. 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'THE y g g p y 5 of the State Sanitary Code—The undersigned further agrees not to lace the system in { operation until a Certificate of Compliance has been ed by the r .of health. E e Xee Signed ...- .. --------- Date fApplication Approved By................................................ .�.. Date z Application Disapproved for the following reasons---------------------------------------------------------------------------------------------•-=-•-•-•-•--•-._... ,l Date Q /f E. Permit No..... 4�`2�..-.. Z - • Issued....................................................... Date 8 4 No.._k.`LnL,-3:1 FEB.............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH �. Appliratilin for Uiipnaaf Worka Tontitrnrtion ramit Application is hereby made for a Permit to Construct (X)'"or Repair ( ) an Individual Sewage Disposal System at: ............. 2:2 ........ .�1 . 1 ---------- ..............................ZJQ./..........: _..........---....... ......---- Location-Address or Lot No. ;c-s ---------------------------------------------- ��' � �, ..� Owner "Address ` Installer Address d Type of Building Size Lot. '. .x`.✓ .:�...Sq. feet U Dwelling-No. of Bedrooms................. ......................Ex Expansion Attic Garbage Grinder (��a PLO Other-Type of Building ............................ No. of persons............................ Showers ( ) --Cafeteria ( ) d Other;fixtures .. �; ----------------------------------••-••---•-------•------•------..--••••---- W Design Flow....:_.•::.................... -_-gallons per person per day. -Total daily flow..............`�.J5(. ................gallons. - �' Septic Tank—Liquid capacity.l 65gallons Length................ Width................ Diameter---------------- Depth................ W Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. x 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........................ --=----------------=------------ --•---....--------•-------•----------------.....................•-•------------------•----•-•-----••--•........-•--...------ Descriptionof Soil. ...------•--------•------------------------------------------•-......------------------------------------------ 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 roviSionS of'TT LE,p 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ed by the b ar of lie"alth. Signed......................G7 �/.;.X�.4,_Irrl " .. Date Application Approvod By-------------------------------------- ------------- Date Application Disapproved for the following reasons-------------................................................................................................. ---------------------------------------------------•-------------------------------..........-----_--------------------------------------------------------------------------------------------------- /' Date PermitNo..... U: `1'-- .... Z ................ Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _ .......... fill .........OF.................. "r i�>t/ ..`� , ............. t Tn#ifiratr of TompliFanrr THIS IS TO CERTIFY That the Individual Sewage Disposal yster,)_co ;ucted or pa red ,, by----------- c'."o . ..........1 1�. ..a°` - •---•------ � _t ,_. __ '".. 1 t l`�(. 721 ll-- ----------- Installer �R at-----------------4_ 1 -f -`--........ X.-R5-- s has been installed in%ccordance with the provisions of TITLE 5 of� The Statef Sanitary C e a. described in the application for Dis osal Works Construction Permit No.___ z�,��Z ... `dated_. PP p 16---------------- � THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE NST UE®_AS A GU R NTEE THAT THE ,,.'• SYSTEM W F CTION SATISFACTORY. + - - DATE.•..._... ... ......... `""r'. .� _..._...-••-•••---.--- Inspector_. r THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH _ /tr ......... ....OF............ Tt' >-� „� �/_ ............. No......................... _< FEE/- ............... .n��al Permission is hereby granted....... -1------------ -------------•--..•"....---•--•................._..a to Construct ( or Repair ( ) an Individual Sewage Disposal stem ' r� A + Street as shown on the application for Disposal Works Construction Permit No-----_------------- Dated..................__....................... .............................------------•--•-•••••--------•--•----••............. DATE sx:. Board of Health r , .4.: -------------------------••- FORM 1255 HOBS & WARREN �gNC PUBLISHERS NO.._. ;�` �r �. Fps.............................. �. THE COMMONWEALTH OF MASSACHUSETTS � BA JOA RD OF H EALTy^H Apphra#ion for Application is hereby made for a Permit to Construct (,,,-<or Repair ( } an Individual Sewage Disposal System at: .........-- .,1....._. .1f, R' 0 ! .............. ® ---------...--- _. .. ----------------- Location-Address or Lot No. - ... ......r.� .k_ e ----------------------------------- Owner Address a ........... - •--7_.4�A F_.� --.ma c �3/ _" �' 4. '1 !� 1 .g4, 6 Installer Address Q Type of Building Size Lot... .� j feet aDwelling—No. of Bedrooms--_--•-----.-.8-------------------------Expansion Attic (At Garbage Grinder 91/0) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q Other fixtures W Design Flow............................................gallons per person per day. Total daily flow---------- _.0.................gallons. WSeptic Tank—Liquid capacity/%5.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 ( ) W Percolation 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........................ a' •------•••••-•------•-------•-••--•••••---•-•------••--•--•••-••----•-•----•••----....--•-------------•---...-----•-•••-------------•-•...... .-------------- �" Description of Soil........................................................•..................................... x U •-••-••-••-------------------•••----------••------•---••----•-•-••-•-------•••-•-------•-•-•---------•-••-•--•----••----•--•----•-•--•--•-•-----••••-•---••-•--•••-•---•-•-•--------•----•--•----•--- W x ------------------------------------------------------------------- --------------•................................................................................................................. V Nature of Repairs or Alterations—Answer when applicable._______________________________________________________________________________•------_-.--••-. --;----••---•-•••...--•---••-•-•••-----•-•-•-••-••-•---•--•---••-•-----••---••••-----•----••-••-•-•---•••-•--••--•--------------------••-•---------------••••-•---••••••----•••----•••------.._...•--•-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with T the provisions of TT R1T•• T7 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been risd by the iealth. Signed. • .................����.'`� Application Approved By•----•-----••-••--•......-----•-••••-• � Dat ------------ Date Application Disapproved for the following reasons_........................................ : Date PermitNo......................-.................................. Issued_....................................................... Date No........................ Fns.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF...`:.............: ..,c: k.-41I 7/"� L ......... Appliratinn for Bhipoiial i0ork,i T11milrurtiun Vamit Application is hereby made for a Permit to Construct V�or Repair ( ) an Individual Sewage Disposal System at: ............... .._...._...�.r' .�.� ...' �°a l-' ----------------------------------! s,LP/...---- ....... L - ocation-Address or Lot No. f Owner Address ....... ...T..F-;P. ......t=-• 3�r _11. .`.a2._____'..................... '_. f _'{'_'.'_'-i`:!__a' e �•' -/•'_'T' L-� -a• •l-=-s•=d•f/6W:s Installer Address U Type of Building Size Lot__ ' 1 _` __Sq. feet Dwelling—No. of Bedrooms..............8.........................Expansion Attic Garbage Grinder No) Other—T e of Building ............................ No. of persons Showers — Cafeteria QI Other fixtures ........................................ • W Design Flow............................... ...........gallons per person per day. Total daily flow____-__---_cRr____ -. .................gallons. 1:4 Septic Tank—Liquid capacity/ :/'—'gallons Length-------_------- Width---------------- Diameter................ Depth................ W 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........................ P4 -•'•-•--'•..................•-•-•'------"-'--'-•------•"'---'.........___...-•-•-'•--•---'--............................................................... 0 Description of Soil........................................................................................------•-------'---=-------------•--------•------------••-•--••-......_........--• 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 T?T L, y g g p y S of the State Sanitary Code—The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has been i ed by the extti of health. Signed_, _.... .......... --!.�-----�* ,� x-� .�` c P` ' : -- ---- ApplicationApproved By...............................................--•-'-'-----'---•-v---------------------------- ........................................ Date Application Disapproved for the following reasons_____________________________________________________________________________________ ................. ------------ ate , PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _ n1 / .........OF............. _8� ............. Tntifiratr of TuntViianrr— l THIS IS TO CERTIFY Thal, the I ;vidual S wage Dis osa. yst� c strutted a Repaired (- ) bY--------------<_. '� --'-- ................ 'j` /...:.s'`'.. �-} fit Ejq sA 1 ns alter ,� i ................... . Ti { ,�� has been installed in accordance with rovisions of TI > o tat i ry Co e as described in the application for D>s sal"TVoi�rs t o-Permit No.---'-•-•--•--••----•--•--•--• . _ ed------ ----------------------------------••-•••• THE ISSUANCE OF THIS .CERTIFICATE SHALL NOT BE CO RU D AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATI:............................................'---'---....._..------.....'--_..... Inspector.... ................--- A . THE COMMONWEALTWOF MASSACHUSETTS BOARD OF HEALTH , ........... FEE........................ Disposal Workii Tontrnrtua , , rMit �. Permission is,hereby granted'-•-"------ __ .._.. .? to Construct ( ) or Rep,aar ( )'an Individual. Sewa e Disposal ystIn {L at No. = „ .5gli --- ---------------- Street as°shown on the application for Disposal Works Construction Permit No.___-- _ Dated.......................................... Board of Health DATE......................................................... ............... FORM 1255 HOBUS & WARREN, INC., PUBLISHERSfA , i. -------I- - --,-- -----� ---, ------- - I ���� --I I11--111--—,--,----,- - I —--------,-----------_ ,�------ I i � I I � , I I � tI I I I, , � I- I I , -, - I 11 I . � 7 I - ; I I � I � �- I . I I � I � I I , I . A I . ,� � .I. �, �e . I � ,, � -I I I I �I I. I I I .--1--- - � 1.I I - I I � I � 11 I � . � � . 11 - I � I I I � � � I X,, I I I , , � . � , . . ..�, I , - � � .. I, I � . I . � - I �l I I I I I I I I, I I � 1�1 I I I ,I I I I I -1 � 11 I �� 1 I I I � � I I � - � I , ", - 1;, �, ,... - - - , , � " , - - %,� . 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