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HomeMy WebLinkAbout0573 OLD STRAWBERRY HILL ROAD - Health (2) 573 Old Strawberry Hill Road Hyannis A — 273 - 005 4 J—z � .����� r ,�ts='�' ,Y,`'mac .(/ R- 1 �� nor �Fx� ,,� ::�¢,� No.------ Fims.....25.. ...... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH 3 ------... - .. ....oF........ ....... Appliration for Disposal Marks Tanstrortiort ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: --.Cam_tS✓ y.------.�%=�----------------- Loca Addr s or Lot o. .4sr© ....... "P�eo� rlP� -- C�Q......4Z.Y�IrYOc�Cft...���. / --- ----- ........................... a Jc . /I �o✓Q etS Owner i Installer Address Type of Building Size Lot.,1 d4P---•--__-Sq. feet aDwelling No. of Bedrooms..... .....................................Expansion Attic ( ) Garbage Grinder (✓!�� " p., Other—Type of Building .AKIM.. No, of persons......A................. Showers Cafeteria ( ) a Other res ---•-• -----•-- ------••--••• . W Design Flow........... .________________......gallons per person per day. Total daily flow___ .Q._'-•_._--_--------_......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........1.---------- Diameter........ _________ Depth below inlet........6........ Total leaching area.t! P 1.....sq. ft. Z Other Distribution box (//r Dosing tl& ) 0-4Percolation Test Results Performed by...... ..... ..........e._........................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ G14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Ix ............................. . ..•-----------•------------------- - ............... 0 Description of Soil--------------- ---•--- � .-.......... \ ......--� � V ------------------------------------------------- ------------------ -------------------------------------- -------------------------------------------------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 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 been issued by the board of health. Sig d-- ---•--•-•---••................. Tr ��� Date Application Approved By-------- -----. .. _ L1lf!t. l FE Date _._-___ Application Disapproved for the following reasons____________________________________________________ _ ........--•---------------------------------•---------------------------•-••-----•----•---•---•--- ---•- ----------- ....... Date Permit No..................................... W Issued_---- -- � THE COMMONWEALTH OF MASSACHUSETTS ti • BOARD OF HEALTH at - ApplirFation for UhipooFal urkii Tonstrurtiun Famit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at Qof' 13?Y......................................... --•--•----- .... ---------•--.....-------•--•--------•----•---••----•-•--.........._......_... --- aI*"'** a T f l/ ey 4"t� Owner //;� '~- --------------------- ....-•-......---•--•-------------------•-••-•--•----- --_Y� d� Installer - Address Q�Or1U q UType of Build Size Lot ___ _____________________S �feet Dwelling—No. of Bedrooms. .:............... .............:.Expansio Attic ( ) Garbage Grinder a —Type g __._ ........ No: of persons-----ow-.................. Showers ( ) — Cafeteria ( )Other—T e of Building a' Others.fires ------------•----•-----•-•------•-----•--------------•-- ._ W Desi n Flow......._�w....................... ..gallons per person per day. Total dais flow._.�.._...._�.. ..._.._.._ g � g P P P Y• Y --------------dons. WSeptic Tank—Liquid capacit, _.gallons Length________________ Width................ Diameter................ Depth................ x Disposal Trench—. o..................... Width _ ....... Total Length........ ..__ Total leaching area--- __ ____....sq. ft. Seepage Pit No.......!______A____�___ iameter........ .__._._. Depth below inlet....... ._....... Total leaching area..........f____._sq. ft. Z Other Distribution box Dosing yle Percolation Test Results Performed by.._ ............................................ Date........................................ aTest Pit No. 1................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......._................ ;14 _ � D Description of Soil ..._..... 4�. ..'._._.... Z- �, •-d--- --- - V ---------------------••-•-----------•--------•----•----------•-------------••-•-------------------------•-•------------•-•-•---------------••-----•--••-•------•-------------------------------•---_. 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 provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificat of.Compliance has been issued by the board of health. Sig d - _ ------------- --- •----------------•----------- Date Application Approved BY ,+ ::.. ........................ � ---- .._A Z �lr-....:__ Date Application Disapproved for the following reasons: ...................................................................................................................................................................................................... Date PermitNo......................................................... Issued Date - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH I. ............ .............................O F........... .r............................................ (9rrtifiratr of Toutpliatta TA IS IS TO CERTIFY, That the Individual Sewage Disposal System constructed - ). or Repaired ( ) by .44= 4aO.Af.. ................... ----------------------------•--• --- -------___------------•-----__-____--_.-•---•-----__-_----___.---•----___----______-_______-_-- Installer at.....:_ ...Wr_,Pe........ ----- - " �1 ' A1GG. has deen ted___..- �,, described in the ed in with the provisions of a application for11Dispo alcWorkseCon Construction tion Perm t No m ofiThe State Sanitary Code a THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. e� DATE................•-------•---•-----------•---.....- ______..._. InsPctor..y.: '------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r174f ........ ......OF..... G.:................................... No......................... FEBcr2__1, Bispo 1 World Tonotfn ion an it Permissionis h reby granted.... '.-._ .0 f.''"--------------------------------=--------••----•-----------------•-•-•--•-•----••-•------.._..........----- to Construct, or Repair ( .) an Individual Sewage Disposal- System at N U E' , � I +........44.1� ram` Street as shown on the application for Disposal Works Construction P it N _- Dated..._ �r?'�� ..... as ��_ �� Board of Hea DATE --------------•-•---------......................... FORM 1255 HOBBS &'WARREN• INC., PUBLISHERS e , "C> AGz-b<Gam- 64-GI4 JU - Jr, T-!G T A:,J K = 3 ,r ISc 7o = A-9 5 6,.P.D. I J t ,s - IC>Cx) SAL-. .. I C>cc to Gn.C` (yam WALL AZEA - t5C> S1=. jq sue. l .o = 5o CS:FV. 'PIT 3s 'f OVA•L -C>ESIGtJ TOTAL 6.P!D �, r GEf'GOLL\T1C�iJ SZLTE t� 1►t 17 MI/.J OSZ'L.ir:s. a .N't, ( J T. HPc zw 33 , ;y Tub i wv tom cr s.�•t7%' T - 4'prv� ►.N. Gay. �: .�� - f -�X •x� T�-K.. 1 r> � IKv j G/sC LA4 P�T V4 i T-W a WASHED STo�.it= C'T.s• �:cnt_k 11;. ;IATC _f7v }fit_. 1�,1_-1 i:►- �_[ F i.i cC7 ��A T- T i-�:__ 4-�� •y �l-�cy..�e i�i ..^__ ___. t-li.l�'(�t'�c..t «1�1('L�(S. \�/ 1'�I-Z Y►�:=: �-1DG: L11-•JE: A•►.fi.� :�`r l ,i�c i!, S'�lb:.���::...Ut�::u r:; ;;t- -�`�.,c_: L C ._ L' .. 4 ..z `Flit-, t't__1:►,I ( r C.-L Ue .; F,®.J Ci°� tC_i�V\l l (': e� rS.S�• i1�1`;I". �� �•,{, ';CJ /l:.•j ti .�+ice � .i l::"•r. 1-�� II� tJ�D 11IfLiC"ls ! -! T. t-l•..1' l.'.i.V l'-.i��"y ic., i-i1-.t i�:�h"l� �Ji:_ t.c C- ►.,ItJ;:-. _� � _