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Home My WebLink About0035 INDIAN HILL ROAD - Health 35 Indian,Hill,Road, A = 336 7.004 Barnstable J I �I ASSESSOR'S MAP NO. PARCEL _/ G/� �$ `�'�' 0 p O e A T ION SoE/W�A7 G E PE RMIT ` NO. `7 VILLAGE INSTA LLER'S NAME A ADDRESS J. ,CRAIG MEDEIROS . HYANNIS, MA 02601 Q W OWNER DATE PERMIT ISSUED `ate. DATE COMPLIANCE ISSUED tµ� 10 �ed �i��16, Elam d�� q J � `Y THE COMMONWEALTH OF MASSACHUSETTS D� BOAR® OF HEALTH ApplirFation for UhipmFai Workii Towitrurtinu Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: ................—................................................................................ .....-----.....................-----............................................................. a s n r -3 ��,v c/ -•- t D�n .. --�s� .....__.. .. ....--------•----- ----------------------------------------/71--t..................................................� �. ----4.1 .......Owl ........ ......................... ............................ ........................ Installer Address d 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 Q' Other fixtures ............................... .. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ 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-.--_______-_-_--_...__. 40 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ P4 .. . . ODescription of Soil........... ._. _.�-. ��..........................................------••---•---•-•......------------•-. ---------•-------._-•----••-- x --------------------- V Nature of Repairs or Alterations—Answer when applicabl ___�� ' _ J....'."�..__®_� • ....... (�?v?r... Agreerr�en +� i ---------------------------------------------------------• The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of 'T:LE 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 board of health. Signe ... . Date Application Approved By............ y ------ -- --- --------------------------- ...... Date Application Disapproved for the following reasons:................................................................................................................ -------------------------------------------------------------------•---•-•----------•. Date Permit No....... �------------------. Issued_............................... ........................ Date THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) MA � � C DATA THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH OF7�77.............................. ................................................................. .........-----------------------------............--•------- ApplirFation for Disposal Works Tnnitrnrtiun rrrntit Application is hereby made for a Permit to Construct ( ) or Repair '(tom)an Individual Sewage Disposal System at• , , / 1.7 Location-Address _3 or Lot No. s"� r e. C. ... ......... .. .........................' ......r.?- -a— ..............-�.....^..........•........... ................................. ..�- - 'rrl'� Owner/j r r. "° l• Address Installer Address Q Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( ) ►� Other—T e of Building No. of persons............................ Showers — Cafeteria Q, Other fixtures -•--- Q -•----.---•--••--=---•----••--•-•---•--•--------...-••---•-•-•-.................................... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity______---•-gallons Length................ Width................ Diameter................ Depth................ 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_--____--._--------_---_. f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water`..____---______---__-_. a' -----------------------•=-------------------.....----------------•-......--•-••-•------....-•-•-•---------------------------................------ O ' Description or Soil.............:- -------- ..._...-•--•--•--•---•--.............._..-•----------------------------•------------------------------------------------...----- x W . U Nature of Repairs or A_lterations—Answer when applicable._..e---------- `--—_'_^- ' _ - ' = 11 i` . .� ... .. i Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with T/'1'••^ the provisions of T IT= 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 board of health. � .� j .+ 1 Signed :...�.....'....: �`''�' .... _ e 47, a _ ,, Date ell Application Approved By.......... rl ------ ...... Date Application Disapproved for the following reasons--------------------------------•--------------------•--------------------------•-----------------------•--...._ ................•----....----•-----._....••-••--••-•---•-----------•-----••--•--•.._..-----•--.........--••---------•=------•-•-•--------•-•----•-•-----•---•----•--•--------------------•-------....... C� ................... Issued -------------------------- ate.------ Permit No.------V_L THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH C�rr�if irtt�r ,af f�nnt�li�nr�e � THIS IS TO CERTIFY, �T,hat the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by `' -C `'...... .......:°�--_:. --t--.=---f'=`......-----------•----------------...---........... ......_ ... ...- .. � ,Install er J �+ p {fat .2u i_ ._-ri .........................................._.i r1 .I.. / 7... #....�. r....�.r f..�/ has been installed in accordance with the provisions of TIT'— 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit .To.__.. __.._ � ... __ ._. dated........................................:....... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE t SYSTEM WILL FUNCTION SATISFACTORY. DATE.................•...... --•-------•-------•---- Inspector.................... -..............•......................---.....--- THE COMMONWEALTH OF MASSACHUSETTS BOARD �OF HEALTH ................................... ..............._....................................................NO.. ... . �.� FEE.: ..-... . Disposal, arks Tnntra ion rrmit Permission is hereby granted ......................►... `r<<::...., c_' s •--•.---•- ----•---•---------•••..................•-..............--.•.... to Construct ( ) or Repair Individual Sewage Disposal System-. ,. as shown on the application for Disposal Works Construction Permit Street Ne ,�, ,7___ Dated.......................................... ----•---•--------- • ----------------------------------------------------- ^ ...................................DATE......... FORM 12515 HOBBS & WARREN, INC., PUBLISHERS -