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Home My WebLink About0021 FIRST AVENUE (HYANNIS) - Health (2) a(dri-o2. 7 i THE COMMONWEALTH OF MASSACHUSETTS , - BOARD OF HEALTH _ ..T ub :.-.....- oF......�� r r L- --.................................... SAppliration for Disposal Works Tonstrurtinn Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: f ......... �..:.. ... ........................ ? . , o ............. .1.�.,.[.fnr:. ... ...... Logati Addres/5.................................. .....1.... �'�F{ v: 9..U ......L0�S ...._ �- O erg Address ..........C�..o.�,q..........4..... /.?...................................... ................................................................................................. Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms_,.............................................................................Expansion Attic ( ) Garbage Grinder ( ) �PL4-1 Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other_fixtures ........ ........ Design Flow........ ...0............... .�....... all s er 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. i> p Seepage Pit No.,/ Dl1_ 1 - ameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution boY( ) Dosing tank ( ) Percolation 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___________-___-_-_-_-_- ------------------------------------------------•------........-•---...-•--•---•-••......---••------......................................................... ODescription of Soil.......x..... ------------•----------------------------------------------------------------•-----------•----------- x V .........-•••-••--•-••-••••-•••--•-•-•••---••-•----•-----••---•-••--•-•----•-••-•-•--•.•-•••--•-•••-•-•-----•-•........•-----------•-••--•--••••---•--•••--•-•--•••--••••-•----•-••.....................•. W ------------ -----------------------------------------------------------------------•--------•--•----------•--...------..._._....•-•••....---------••----•-------•-•--•- ............................. U Nature of Repairs or Alterations—Answer when a livable...............................................�j�.................... Toles ?Gl� ��D Agreement: 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 been issued by the boar f th. Signedx� � ... '/ / Date Application Approved BY -G = /� � ( -------------- Date Application Disapproved for the following reasons-------------------------------------------------------------------------------------••-----•••-----------....... .............................................. -------------••-•-----•-------------..........--------•--•-----•-••----••----•--- ----- ------......---------••--• ---•----••-•......-----•-•••.-•--•- g Date Permit No. ...................... Issued. ...... Daie •___-------------- -- ------------------------------J 4'r No....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 4_. ......... ......11 ................. OF........ .............................................. pplirativit for 19iiiVesal ]Vorkg Tonstrurtion Vantic Application is hereby made for a Permit. to Construct or Repair, an Individual Sewage Disposal System at: Z 1715..:...... ....T....... ......................................... ........................................................................................ . ......... tion Address or Lot No. 4� ................................. ........ ...................... ... ........ .......... ....... ......................... 0 ...... xwter Address ................................ ...................................................FBI s ............................................................. 14 Type of Building Installer Address USize Lot............................Sq. feet Dwelling—No. of Bedrooms.— ......................................Expansion Attic Garbage Grinder P-4 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria P-4 Other fixtures ............................ .................................. ...................................................................................... Design Flow........ ......................I................gallons er person per day. Total daily flow............................................gallons. �4 Septic, Tank—Liquid capacity_ ��-.`-"kalldns Length................ Width_-------- ..... Diameter....____........Depth_....__..____--. Disposal Trench Nor Width...._............... Total Length.................... Total leaching,area....................sq. ft. Seepage Pit No. Diameter____________________ Depth below inlet.................... Total leaching area..................sq. ft. _-__...._111._:�,,f�.1.: Other Distribution box/( Dosing tank Percolation Test Results Performed bv.......................................................................... 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......................... ............................................................................................................................................................. 0 Description of Soil------I-X_,.-4.1"�.h".A�............... ....................................................................................................................... �4 �, U ......................................................................................................................................... ................. ............................................. -------------------------------I...................................................................................................................................... .............................. U Nature of Repairs or Alterations—Answer�vhen applicable____-__--_ -..-_.--•_•.r ----------------------------------- �7,7611,e- APe-&64,-" - -- .................................................�w.................... ............................. ............. ..................................................................... Agreement: ?_ i�p The undersigned agrees to install the aloredescribed 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 been issued by the board.,pf hoAth. Signed_,' I i ................. X.......... ............. ............................... % Date ApplicationApproved By---------....... ................................................I.......................... ..7--?L----------_---- Date Application Disapproved for the following reasons:............... ................................................................................................. ..................................................................................................................................................................7.................................... Date Permit No....iv. 2V. .................................... issued._. 11 ..Ie ............................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......................OF.......... ............. ........I...............n............................. Tprfifiratr of (Somptiana THIS IS TO CERTIFY, That the Indiviclud Sewaze Disposal S stem constructed 4/or Repaired by................ ---------------------------------------------------------------------------------------------------------------------------------------------------------------------- Installer, at.. .............. ........................ . ------------------------------------I--------------------------------------------- has been installed in accordance with the provisions of Article XI of The State Sanitary Cod s�esc�ri I bed in the al Works Construction -mit No......application for Disposal Pei ---------------------- dated //71-74'4 _............ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSjNE0 AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....................... ......................................................... Inspector_ !!��k.44.41i..................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........�........:....j...........0 F............. ................................... No .. .....L�? FEE....../;;............. Permission is hereby granted.......- 7....--------------------------- .................... .............................. .......... to Construct O or Repair an Individual Sewage Disposal System * I / q- 5, at INTO...... i, 7 .1.......................... .... ...... , , -1 7111*�,....;.I.. ...... ............. .... .................. ............. . ,Street -the application for Disposal Works Construct --ii; 70. 41,1 as shown'on �n .... . ......... Date lion In t .......................... Z 10� ...... ---- -- .................. --------------------- Board of 11e,10th DATE...... ................................—........ V FORM 1255 HOBBS FQ WARREN. INC.. PUMLISH.ERS