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HomeMy WebLinkAbout2440 MAIN ST./RTE 6A(BARN.) - Health (2) ���o ��1�ir� See�� , �,ou�. � � c-�s � ,�_ �S�—opt No................_.......•- .............. Fss THE COMMONWEALTH -OF MASSACHUSETTS r� 44 BOAR® OF HEALTH Town.-.. .. OF.............aarnstable ::. ................_... Applira#iou for Disposal Murks Toustrurt un ` prmit Application is hereby made for a Permit to Construct ( ) or. Repair (X } an Individual Sewage Disposal System at• (� . e� Main st,_,�••_Barnstable �, ..... ..... - • •--------........................................................................................ Location-Address or John Ehert _Main Sto,_Barn§A l e ---....._._.. •.......................................... OLvner Address a A & B..Cesspool Service.... 128- Bishops Terrace, Hyannis Installer Address QType of Building -Size Lot.................... .....Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons..........._4............. Showers — Cafeteria a Other fixtures ------------=------------ d ----------------------------------------------- ----- W Design Flow............................................gallons per person per day. Total daily flow__.__.................._._...._....._.._..._gallons. 9 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........................................ 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........................ Descriptionof Soil. Cla.y--arid...5ariff••••••-••................•-•--•--•--•......----------••......•---. ---.-•----................................. x c., W • ••-••••------------------------------•-••-...-•---------•-•--•-.... .........•-- UNature of Repairs or.Alterations—Answer when applicable...............Stona___paokad---oY-eT low---� QQQ gal&,----(-ena---thousand.)---------------------------------------------------------------------------------------------------------------------------- ------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'11TlE 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�bby the board of ealth. gned-- ............ -- ............................................... •-• /12/I.a........ Date Application Approved By......• -r ---------------------------------------- Date Application Disapproved for the following reasons::...................................................................... --•------------------------------- ----------------------------------------------------------------------------------------•-----------......--------•--------------------------------------------------------------------------------•-••-- �ai Date PermitNo.......................................:..:.:............. Issued___...---- ----�-------------•--•--•................ Date - { 7� + � , J 5x r' � No .� FEs. .................... r ' THE COMMONWEALTH OF MASSACHUSETTS + BOARD OF HEALTH :a" n Vr� ....................OF........ . .�' a�f3� .r .,. ... --- =` rp iration for Bi-gValml r' kti Ton.5trurtiun rrmff Application is hereby made for a Permit to Construct, ( ) or Repair (X ) an Individual Sewage Disposal System at =--- - -......•..................... ------------- ----•----------- --- - ................... . .... . . Location-Address or b t del Eh rfi. MAzn fit. Brne � r --- O ner Address w A :`� •�e aa3 �v 2 3 3a ope Terrace, Hyaniv a ..................................... ................. . Installer Address Type of..Building Size Lot____ ____ Sq. feet U Dwelhri :;` 'of 3 of Attic ( ) Garbage Grinder ( ) Other T e of Building _____________ No. of ersons_._._..._..________________. Showers Cafeteria a YP. g P ( )' ( ) Other fixtures =-----------•-••--•--- w Desi Flo} ___________________________gallons per person per day. Total daily flow-------------------- gallons. ` W SeptlgePank Liquid:'ca.pacity_._.._._____gallons Length________________ Width___.._.____._.._ Diameter__.___ Depth................ x DisposF'J, ren' No .................. Width.................... Total Length.................... Total leaching area t ------sq. ft. Z Se Pr ..............Diameter D(Pth)below inlet___..________._ Total M sq. ft.P ei iNb DosintankOther 1Pf;ihtt nox Percola on Test Results Performed bY........................................................................... Date: -•---' t a Tes p>t o ,I—..............minutes per inch Depth of Test Pit____________________ Depth to ground.water i A-__._.__.__.___... (i Test,Prt>.No: ___________minutes per inch Depth of Test Pit.................... Depth to ground water : .................. p s rs � Y and SSYi� Descrip>{iqn o€ Soil., ....................................................... •------•--------------------------------------•------••. -•--- - W d !f - -__ _______________________________________________________________________________ ._ _____ ___ ................ UNatureO(Repairs,or Alterations—Answer when applicable-___-___ Agreer rietts «.x:r= " Tie uriders'igned•agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the rovistons•of 'LT p 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 b the b of ealth. ;. Signed.- �!� ______ ________ ______ ��1��1�........... Date '---.... ApphcaxionApproued B .. .__... G i Y Date Application IIisapproved for the following reasons:_______•_____________________________________________________________________________ ..___________....._ ............ .............................. ___________________________________________________________________________________________________________ ........................... Date PermitNo....................•--•-----•---•----------•-•------_:_. Issued------•-••---•--•--••--.---.....-----....---............ Date f THE COMMONWEALTH OF MASSACHUSETTS41 4 ' BOARD OF HEALT.0 ........ r Trrtifirate of Tomplianrr : T, I 4 S ,T C RTIFY, That t I dividua�age Disposal System constructed'( " ) or Repaired (v 1 by7 ; -e jai -! ".. -- ................ ... rs; Installer has Ib'een installed in accordance with'the provisions of ir' j of The State Sanitary Code as described in the apphcat©n for Disposal Works Construction Permit No. �____�l _________________ dated_.... :- ____� .._____._.______ THE IitUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEEITHAT THE SYSTE. 1dHILL FUNCTION SATISFACTORY. DATEf� wt} .a ^ ±_........ ...---- Inspector------ r• ...... '£ y i s THE COMMONWEALTH OF MASSACHUSETTS BOARD . HEALTH 7 �` l--_/T�' ...............OF........ ...... L' f!1........._........._._.._..._........._. ....... ��c No......................... FEE.................... Disposal, g, -guno ion rrutit Permission is hereby granted�an 7/� i:__ _.�r'!.! ___.. t t� �l___`. _ !N.�'..._��__/7 L� - to Construct ( ) or a T ( I �J'vidual Se Ta!ge Dis•'sal System -------------------•--/--........... "I Street ///� as shown on the application for Disposal Works Construction Permit/No.___ __ _..__ ;__� Dated.__.__-................................... Board of Health• DATE....... ' ?/........................................ -k .. FORM 1255 HOBBS & WARREN. INC., PUBLISHERS 1 -