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HomeMy WebLinkAbout0028 BREAKWATER SHORES DR - Health (2) q� G-t�Vl+ —_— __— o � °":, '���(o > e � . o � o a � . _ � _ i ( CC ?CCt anns— -0A 3 t - o v ,R e y , Yfy f Yin l z 113 4350: RED r C ;Z._ J No.81 22 .... - Fxs.....$...5.,.QQ....... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH n ........... ......._ ......Town.....OF......R XrWtable-........................................................... Appliration for Diiprntial Works Toutitrurtiun Vamit Application is hereby made for a Permit to Construct ( ) or Repairs ) an Individual Sewage Disposal System at: haxlw.�r.3...H,ya.nnis_,r..Il26LQl... ---•--------------------------------------------------•---------------------...._.._..-------•--•- Location-Address or Lot No. raa�.d._ n�.exs an.......................................................... _402__Gentex__S:lia- S.. Etas au...Z&................--•-----.. _Owner Address a •--A--&._B-C......l,..s..Zvicg................................•-----•-- Installer Address dType of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms...............3..........................Expansion Attic ( ) Garbage Grinder ( ) Other.—Type of Building No. of.persons------------4_____________ 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................ 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. 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 --•-------------------------•--•--------•...----•------------•----------........-•---•-•--•--------......................................................... Descriptionof Soil Sand-----------------------•----------------------------._...--------------------------•----------------------------------------------•- x c, W ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ UNature of Repairs or Alterations—Answer when applicable----Ins:ta_ll-ati.on--- f-_a__l_,_QQQ__gallon____-pxe Cast, ...stowe--- _.pit--k-4yexflQW.)------------------------------------ -------------------------------•------------•--•---------------_____--•--•----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TTL; 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 bten issued by the board health. Si ........,. 5 .•-1/81----------•-- /J T ate Application Approved By........... '�', -�1�� �� 1 81------------- Date Application Disapproved for the following reasons:................................................................................................................ .........................•------------•-•-•--•-•--•-•--------------------•••-------•-----------------•-...--------------------------•--------------•-------•-------------------------•-•---------•-•--•-- Date PermitNo._81-_................................................•-•-•--••--•--------•-•-•-------•--. Issued_....S1--1,81.................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................ ........ Town..._.OF.... ..rnstab.1.Q.......................................................... Appliratilan for Diipniial Norkfi Tomitrnriiun ramit Application is hereby made for a Permit to Construct ( ) or Repair (K ) an Individual Sewage Disposal System at ---Hyamis....026.01... .................................................................................................. Location-Address or Lot No. .._Ronald--Andar q ,. 402_.Center_.5t .e S._E4�tpn.,J4A-----•--------•---...---... .-----.-•--- Owner Address A_& B Cess o03_ Service 28 BSshops__Terrace_,__Hyannis, N.A___ 02.....©1___ p Installer Address QType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms...............3.......................---Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............ '............. Showers — Cafeteria 04 Other fixtures -------------------------------- - W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W Septic Tank—Liquid capacity............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......................................... 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........................ --------•--------------------------•---------------•-------•---...--•--•-••---•.........---.................................................................. ODescription of Soil.......................Sand..............................................................................----------------------------------------••-•---•-•------ x W �. UNature of Repairs or Alterations-Answer when applicable....Snstallat1_on__of__a_1_�000__{a11o21____p2�e-Ca t, stone..Packed__;k@* z__pxt.. oye:^flow).--------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the'provisions of'T`i'L: p 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has�b��jjen��issued by,the ���iealt����' �t 5 1//81 pSined.;%` 1z ��• 1 1............. Application Approved BY•-••-•.... lxt-• ------•---....----••-------- 5L M Date Application Disapproved for the following reasons:------•---------------------•------------------------........................................................ ..•-•--••--••-••-------•--•--•-----------••••-•----••---•-•-••-•-•-•••-•---•---•-------•..................---•-•••-••-•••-••-----•-•---------•-•••••....-------------•----------------------•---......... Date ` Permit No...81-._.._.. Issued_...5/•-1/� -------------•--•----•------------ Date I \ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................Town........OF...........Barnstable............................................... Trrtifiratr of Tomplitanrr TT I 1S TO CF FY That lhy�I giv'dual S wa e Disp al S temrutted L ) Repaired (X) A c Cesspool erv3ce, 2� Tsvgops er aee, yan>�i s, 69 1 - ?75-6 4 by------------------------------------------------- .....-----------••- •-------.......--------.....------.....-------•--•-•---------•--•--•--...--•-•-----............--------------------------- 4 Breakwater Shore Dr., I;tyannis 0260instaallTionald Anderson at----------------------------•----------•----------------------------------------•-•------------------------------••----••------------------------------.......-------•------------------------------- has been installed in accordance with the provisions of T6`1L� j��rrf The State SanitaryCod s IdSribed in the application for Disposal Works Construction Permit No----- ... f.1................... dated _.-_---- .....�-......-_-................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.. .......5/ao.../81. Inspector < - • •/.............•-•-•-•----.....-•------ W.Q THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Tom Barnstable ' 81 $ 5 No....... °: .... FEE ............... , 4r 11iilrniia1 Morkii 041mitrudion anti# , A & B Cesspool Service, 128 Bis ops Terrace, Hyannis 02601 Permission is hereby granted --------------------------------- ----•-.--- •--•• ••---- ----........... -•------•---•-•• --....................-•--.... to Constr t 11 or RRe ai ( x Ind• 'dual $ev ispo S t I3relkwate�r horil fir.0 liyannis bL6 Ron c Anderson atNo.....................................................................................................----- -------------..._..-----...----•--------•--------------------------•----•---------- Street as shown on the application for Disposal Works Construction Pgrmit No._8 .----_--- Fated....................................18.. - - -- --------------•--..._..............•-•— �ooffagrrd of Health DATE................................................................................ "AW FORM 1255 HOBBS & WARREN. INC., PUBLISHERS