HomeMy WebLinkAbout0013 ROSARY LANE - Health (2) _ _
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THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
TOWN OF BARNSTABLE
Appliratinn for Mitipw3 l Nork.6 Cnnnitrnr#inn rnmit
Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal
System at:
....................-3...R9$CRY... ANB.......................... MNIS---------------------------------------•--------
AVELINO LOPES AddressSAME or Lot No.
......................_.......................................................------------------ -------------------------------------------•--------------•-------•-------•-•-•••.......----------
Owner Address
a .............ARCH...CONST.... O-----...............---....--- HYANNIS
Installer Address
Type of Building 3 Size Lot............................Sq. feet
Dwelling— No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( )
aOther Other—Type of Building ............................ No. of persons---------.----_-.._--------- Showers ( ) — Cafeteria fixtures ---------------------------------- ----------------------------------------------------- -------------------------------------------------------------
W Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons.
WSeptic Tank—Liquid capacityl0.0.0--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 ( )
•" Percolation 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....--..................
a ----------------------------------------------------------------------------------------------------................................
....
---------------..----
0 Description of Soil........................................................................................................................................................................
W
U ---•-----------------------------------•-------------------------------------------------....-----------------------------------------------------------------------------------•--•--------------------
W
-------------------------- ---------------------------------------------------------------- ------------------- ----------------------------------------------------------------------•----.------
V Nature of Repairs or Alterations—Answer when applicable..-ADD----1000S-t----TO........................................................
------RCS_I.DTI-N�...L.RMH...P.ZT---T-0... RPUTE...UTLE---V---SYSTEM.......... --------------------------------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compiia _e has been issued by the board ealth.
= '�' - 3/16/9 5 ..
Dace
Application.Approved By .............. -------------------...... 3_47--..9,�---------
A- �+� ------------------------------
1 Dace
-
Application Disapproved for the following reafons- -------------------- -------- ----------------------------------------------------------------------------------------------------
----------------------------------------------............----...----------------------------------- _----...----....................------------------------------------------............. - ---------------------------------------
Permit No. -----.... ...................... Issued .......... 3. . 777?
ace
...qy... FEB...........3 ..........
yt I THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliration for Diti-pw3al Wor1w Towitrurtiun ramit
Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal
System at:
13 ROSARY LANE HYANNIS
AVELINO LOPES `daress SAME or lot No.
......................-.......................................................................... -----•-----------------------------------•-----------------••-----...............---•--.....------
Owner Address
a -------------ARCH CONST.CO------------------------------HYANNIS
Installer Address
Q Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms......-3----------------------------------Expansion Attic ( ) Garbage Grinder ( )
pa-I Other—Type of Building ---------------------------- No. of persons--.......................... Showers ( ) — Cafeteria ( )
a' Other fixtures ............................... . .
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacityl-0.0.0-.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. I................minutes per inch Depth of Test Pit................--.. Depth to ground water...........--..
(%4 Test Pit No. 2................minutes per inch Depth of Test Pit........-.-----.---- Depth to ground water........................
rx ----------------------------------•-.........---------------------------...------------------..........._............................................--------
0 Description of Soil........................................................................................................................................................................
x
U
w
..........................--............................................................................................................................................................................
UNatured Repairs or Alterations—Answer when applicable...ADD_---1000st_-.T0........................................................
EXSISTING LEACH PIT TO COMPLETE TITLE V SYSTEM
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code —The undersigned further agrees not to place the
system in operation until a Certificate.of Compliance has been issued by the board of ealth.f
-
Signed -... _ ? v 3 Dare 9 5
Application Approved By ------------------ ... . --- - ---� ---------
a . �; ". �.
Date
Application Disapproved for the following reasons: --------- ----------------------------------
............................................................................................................................................................................ are --- ........................................
C� Date
Permit No. -------- / !",� ��------------------ Issued ----------�--'--DI-�.. -----------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Clertiti ate of C omplianve
i
THIS IARCHC CONIST' That the Individual Sewage Disposal System constructed ( ) or Repaired
by
1nsnJlcr
13 ROSARY LANE HYANNIS
at .------................-----------------------------------------.._...-----------------------.-------------------- ----------------------..------------------------------------ ----
has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in
the application for Disposal Works Construction Permit No. ...._. .. .L..�L------------ dated - - ..
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE - x. -._ 7... -------------- ----------- Inspector . -.---------- ~--
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
No...7s.- Y�Y FEE.....................
'r Disposal Iforkii Tunutrurtion "rrutit
ARCH CONST.CO
Permissionis hereby granted..............................................................................................................................................
to Construct ((� ) or Reppair ( X an Individual Sewage Disposal System
13 t20SARY LAN----•-HYANNIS---------------•----------- VET.-IN LOPES---------------------------------------••----•-•.
at No. -- •. ........... .
Street
as shown on the application for Disposal Works Construction Permit No2k:.-W-�-.-. Dated----3-_. -7.-?5:....._........
�__s_ ---------------------------------------•--------------
C Board of Health
DATE............... `fCJ.-...------------------------------
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