The URL can be used to link to this page

Home My WebLink About0024 QUAKER ROAD - Health (2) 24 Quaker Road HYANNIS A - 310 - 291 No...��`.-=----�-• Fps.. ...�..�' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............OF ..................................... Appliratiun for Dig#uuttl Works Tonstrndiun 11frutit Application is hereby made for a Permit to Construct ( ) or Repair (, ) an. Individual Sewage Disposal System at: :..-•---•-- ��__.Q V-`•A 2 •- .................� _:�.�.ti �t::��......... •-----.....•••••--.....--:_.......... ... ..... .. ...-----•-•-•----.. ocation-Address or Lot No. ai:'' � .P. a:�.:kV��:1h� .................4—S.SA--ti:e................................................ ------ �a Address•--•___-_____.__1v��G� � e.iG.<,.....1 r!!A�a!_�...................... �lLti''![:'`�.--••-................................................ Installer Address Type of Building Size Lot............................Sq. feet 0-4 U DwellingNo. of Bedrooms...... .Expansion Attic Garbage Grinder `. Other—Type of Building No. of persons.............................Showers Cafeteria A-' Other fixtures .................:....:... --••--•....:•---__..._.___. W Design Flow.......�5.2 .................:......gallons per person per day. Total daily flow._._.. k d.._....................gallons. WSeptic Tank—Liquid'capacity___._._.__._gallons Length................ Width................ Diameter--------- Depth................ Disposal Trench—No..................... Width.....................Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No...../............ Diameter.__,1._..(?-........ Depth below inlet... ............ Total leaching area.................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest 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........................ ................. ................. ....... .................•-----......................._.....----................-------- •--. ---••---- --• ------ 0 Description of Soil_..--•.............................................:.•-------•--................._._......_..----------•------••---------•-•--...-•--•-•-----...............------...... ---------------------------------------- -----------------------------•-•------- ......................................................................... . ..... U Nature of Repairs or Alterations—Answer when applicable......)4-6 _::.._._O.A"'........./-at..-. � w . :........ 5T.&"'`-'..-----Q�F....... r� -�----...T..L:�L.�....� Agreement: The undersigned agrees to install the aforedescribed In Sewage Disposal System'in accordance with the provisions of iITA L 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 b rd hea Signed... ` •.............................. .. - Date ApplicationApproved By............:.................•----•-•--•-----•----•--......-•-----...___-•----•--..........__..._ ........................................ Date Application Disapproved for.the following reasons:....... ...---------•--•.........................................•------...........----•-•------•----..._._.._.......-----....-----...-•---•-------------•-•----------._..........------..............._......... Date PermitNo......... .'..7..._ ..... .......... Issued........................................................ ' Date F No._ --••-- -•-•- ss.... _.... �- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH T OF I^Q Apli ration for Disposal Works Tonstrur#inn rrrntit V Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: --.........r�� _...Q V�A�F r�a_ ......................... :!� n: ......................._-_.............. ........... `. ._.`Location Address .. .............. .. .......or Lot•No---....................---•-••---......... f1a�h; 1 ��? �g� fir✓ �t.TW;2 Z Owner Address a ...... r. -�� ..a �v � 1- f�.� �,::�_................................................... -- Installer — Address Type of Building. Size Lot............................Sq. feet U Dwelling—No. of Bedrooms..... ...............................Expansion Attic ( ) Garbage Grinder ( ) ~ Other—T e of Building No. of persons............................ Showers — Cafeteria PrOther fixtures .....................•--••-•-•-•...._............._...... WW Design Flow....... C.' ........................gallons per person per day. Total daily flow.....:akd•......................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No--------------------- Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No.....�I._.......... Diameter...rLh._...... Depth below inlet_...4�: ......... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.....................Depth to ground water........................ L� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ �+ ------------------- •.... --------------- -•........ •-.... ------------ --------- _..... _... -... __----------------- _.......................................... 0 Description of Soil.............•--•----•--•-•-----....------•-----.._...-----------•--•--------...------•----•-•--...--•-----•-•-•--••-------------.......................•••-••-•-•...... W ...................•-••••••••••-••.......•••--...-•--••••••-••••••••-•---•-••-•••••••••-•••-•---•••.........•••••••----•••••-••-•-•••---••••••--•••...............--•••-•-••••-•••-_••--• •••••••--- U Nature of Repairs or Alterations—Answer when applicable..____?9-oYJ._.._.. _y!` ......_f �_... � ....... ...__. v -TUDC-, 115P.e_y/ 27�M�, f l M`1��1! ' �. ....................... ......... -__�..=...._............._......._..............._.........................................,.. 7 �• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in until a Certificate of Compliance has been issued by the board of h lth' h a operation -••-- .-• . - _..Signed '. �' �..— -- D Date ApplicationApproved By................•------...................--------•---.........---•--....•---••••-•••••-•--....... ........................................ Date Application Disapproved for the following reasons:------•-•--------•---•-••----•-•---•--------•---•.........................•--•-••----•••-••......_--•••••••-_... ................•-•--......--••-•----•--•-•--•-----...-------•-•------•--•-•-----..............----...._.....-----------..........---------•--•--------•--••--•------•--.........--••-•••-•......•••••••- Date PermitNo......... ..--•••••-•••••-•••-....---. Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Trrtifiratr of Tuntplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (�)� by-•..........--•••-.........._��,�>r s ,=--.. ._."!..LM ?�-F.......•--•-------------------n......---•-•--•------...:...........---•--......------. Installer t at.............................. ............ .. --......2� '`-'=--••••-•-••--•••------••---••--•-•--•---••••-•................ 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......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..... "'.__.�...^.........�.................••••_____. Inspector....-----....._� .._..................•-••-••--•••••-•••-•-•••••- --------------- ---- --- _--.--------- -----------------__�—___ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH `U��✓ `r ±�� ................................. No.....0.. FEE...�o Khaposal�Works Top, strnrtion ramit Permission is hereby granted " ' "��• • `' � ` • , ._ --------•-•-••-----------------•-••-•................_.... to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at No.: .. ...._._ r� lr �[.....�?•�-----............I- , ��.-,, ........................................................ z._ - Street r as shown on the application for Disposal Works Construction Permit No._ r -_.7.___ Dated.......................................... .......................... ----`. .,..........----- ................................... .................. r Board of Health 1 DATE----•--------. ---'-�•_--�-- --._...--•--------- v