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Home My WebLink About0024 SIXTH AVENUE (HYANNIS) - Health (2) a Li S t�4h Q.ueru,�e_ No.----....._-:.....2 o............ ........ ....................... THE COMMONWEALTH OF MASSACHUSETTS TH -.OF . EA B—O- ARQ, OF A OF .. ... . ... ........................:.......... . ...... Appliration -for Riivviial Vorks Tomitrurtion Vrrutit 4— Application is hereby-made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal &O *, TH'Vv., System at: ........... .................. . ......aw..t............. ............................................. n Address or Lot No. 06 2 - 14 ....... .... - ------------- .................................................................................................. O Address ner . ..... ............ .....tall ----------------- -------------------------------------------- Installer Address < Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms-------------------------------------- -----Expansion Attic Garbage Grinder -1 44 Other—Type of Building ------------------------- No. of persons.-.______________________-__ Showers Cafeteria 04 Other fixtures ----- ........................................... ................................................................................I.................. Design Flow............................................gallons per person per day. Total daily flow...........................................gallons. 1:4 Septic T,.iik—Liqtiid capacity............gallons Length________________ Width...__........... Diameter---------------- Depth---------------- Disposal Trench—No. .................... Width___._.._._..__...._. Total Length._..._.___.__._._... Total leaching area....................sq. f t. 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................minutesperinch Depth of Test Pit_.-____-__-_._____._ Depth to ground water_--------------------- (To Test Pit No. 2................minutes per inch Depth of Test Pit....._.__..-._.__._. Depth to ground water------------------------ 9 ............................................................................................................................................................. 0 Description of Soil------------ ------------------------------------------------------------------------------------------------------------ ................ ......... ------------------- U ........................................................................................................................................................................................................ -------------------------- ---------I------------------------------------------------------------------ .. .... ------ Natyre of R\epairs or Alt4tWins A saver when licable. U ---iA_a . .............. ...... . .... ---------------------------------- A.egreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has Wn)isued by the board of Leal�V_ Si ......._Z.. Da......................... ... Application Approved By---- ---------------- ------ ---------- ........ Date, Application Disapproved for the following reasons:.................................... .......................................................................... ........................................................................................................................................................................................................ Date PermitNo. Issued........................................................ Date A- _!aL_ ------------- -------------------------------------------------------- o.----•--•-------_---•- Flan............................... N . � THE COMMONWEALTH OF MASSACHUSETTS -BOARD OF IJEA T l ......OF .. .. ,d/( ...�11. ....................... ........... Appliratinn -for Uiivu.ittl . nrku Tnnitrnrtimn Vrrntit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System•at: / !r �I -- -- .... ------------•----------•---------•----•-- L�c3t' n•Address or Lot No. ..'..' l` 1 Owner Address Installer - Address UType of Building Size Lot--------------------------•-Sq. feet ., Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—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 capacity-----._._--gallons Length---------------- Width....... Diameter................ Depth................ xDisposal Trench—No- _________________- Width-------------------- Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leacling area------------------sq. fl. Z Other Distribution box ( ) ✓ Dosing tank ( ) aPercolation Test Results Performed by-------------------------------------------------------------------------- Date---------------------------------------- a Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ fiq Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................ -•----------------- --------•---------..._...--••--------•--•--•----•-----...-----------------------......................................................... Descriptionof Soil-------------------...................................................................................................... ----------------------------------------------- x W ------------------------------------- ------------ ----------------------------------------------------------- UNat -re of Repairs or Alter tipns—Answer when applicable. . ._- _. �_ �Q _ .__ _ .___r 1.............. --' . -------- ----------------- -•--- -------------------- ?�'`reem n g e t. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b ri i sued by the boar of heal . / 7 .... D -- sil at Application Approved By---- -- --- -------- -- ------------------------- 1/� -`--..;-4___--- Date Application Disapproved for the following reasons:----••-------------------•-•-•-----------------•---------------------------------------------•----------------•- .........................•--------...----------------------------------....------•-•---•----- Date PermitNo......................................................... Issued----------------------................................. Date 1 THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALT�/� ...........OF....../ .........................................1' ........'........... Trrtifirate of 0.1,11mlrlitturr THISTO ORTI That 1he�Individ Sewage Disposal System constructed ( ) or Repairedby........._--•-- - -• •--- -- ----- ---•---------------------------------•------------- d staller at-- / --------- V_--- ----------- --�•----- ------ -- ••-------- - ----------------------------------------•-------•--------------- has been installed in accordance with the provisions of e X of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.(_-___....-_--✓r_z... ........... dated...I/".�.'_.7 G THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A .UARANTEE THAT THE SYSTEM WILL.FUNCTION SATISFACT DATE--------..1. .................. ............... ..... Inspector--••------•--------. ------- w ---- - ---- ----- >..... --------- THE COMMONWEALTH OF MASSACHUSETTS 7G BOARD O HEALTH r L� ww..`.........0F........ ........ ..... No.......��?. V FEE. . .... a Permission is hereby granted. ` to Constr l( ) or. Zpair (1-1—an Individual Sewag pos stem at No._" �lA'N--•`--il- !�slLs � -.--.F'�"-.�� ............... treet / as shown on the application for Disposal Works Construction it Dated__ _ _ _ 7(� !Ca --- •- • --------- ----• ,...------.....----....---..._ 1 ........... Board of He It DATE. -- ------------------- ------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS -