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No....l �:76_.1
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.............. Town . ................. OF ................. Yarmouth
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Appliration for Bispoii al Works Tonstrnrtion 1hrmit
Application is hereby made for a Permit to Construct (g ) or Repair ( ) an Individual Sewage Disposal
System at:
......................4_2b inj�.3,9411..._....-•-----------------------......._.......-•--------------------------- Lot. 25. �4A ' •'-........._._.
Location - Address or Lot No.
German--Hill-_Estates-_Associatesj_hAl:stable Holding Co. 100 West Main St Hyannis, MA
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Owner Address oo 2 601
T.••W._-_Nickerson 160• Mill Hill Road So. Chatham, MA 02659
........................ - ----------.._..--------......._._..._------------- --
Installer Address 7,757 —
Type of Building Size Lot ___________________+_.._..Sq. feet
Dwelling No. of Bedrooms____________________ _____________________Expansion Attic ( ) Garbage Grinder ( )
Other — Type of Building --Single FamilNo. of persons____________________________ Showers ( ) — Cafeteria ( )
Otherfixtures----------------------------------••-.,____..----------------------------------------------------------------•-• 2'0_ ----------------------------------
Design Flow .................. 110•---••-•--__._......gallons per-��Ver day. Total dail fl?w____...________ 220-•_•_-__-•___--•----_gall0M.
Septic Tank —Liquid" capacity 1000 gallons Length_ 8_._-6___.. Width__-_______ �__ Diameter________________ Depth_..____.__ 0_..
Disposal Trench — No_ ____________________ Width .................... Total Length ........... _._----- Total leaching area___________ __ sq. ft.
Seepage Pit No ............ 1...... Diameter .......... 10_-.... Depth below inlet
•Total
leaching
D. MasonofYhBordof Heat iq ft.
Other Distribution box (K Dosin tank ( )
,.Percolation Test Results Performed b Flaherty Associates, Inc. 1/31/90
y---------------------------•------------•-• "-•------ Date ..----
13 None O'[iserved
Test Pit No. I ..... ��._._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________________________
i%iDescription of Soil_______ T10"-30" Top & Subsoil30ir-156j'Fneto MediumAmur
______ __ __.______. _ @f
S 74E/ Trace of Silt -------- ----•--- --•--•-----• ----- `�................. .
MARK M.
' �---F[A71FRiY•
Nature of Repairs or Alterations — Answer when applicable ............................................................... .;e- _____ ___eivit_____- �.
y---•--------•-••------•-•--•---•-•---------------•-- -- - PAO.338b2 p
Agreement: 0 '<' I T ��`���
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in
the provisions of TITiE 5 of the State Sanitary Code — The undersigned further agrees not to pla
operation until a Certificate of Compliance has been issued by the board of health. 3 3- 6 fo
Sig---•••-�-`�--------------------------•---•--••••----- --• •... ---------------/_'�
'--------�•- • a�-�c_�J
Application Approved BY •-- - -------------•-------•------
Date
Application Disapproved for the following reasons:--------•-•-----•---------------------------------------------------------------•- -------------------••-•-•----
_...-•--------------•----•-------•-----------•--•-••-----•---------------------------------•-------------"----------------•------------------------------------------ -----------------------•---------
Date
Permit No .........
�4�... l ________________ Issued _-----_�. __....
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
(U1
.......................................... OF .....................'.':-:..........:............._-----.........-........... ..........................
TntifirFatr of Tl mpliatta
THIS IS'TO�CERTIFY, Tlhat .the Individual Sewage Disposal System constructed (�) or Repaired ( )
bY................
=�=
.•.I C 1\�
- ii j Installer
-- ...................
has been installed in accordance with the provisions of h.-I"TI � 5! L The State Sanitary Code ras desctibed in the
application for Disposal Works Construction Permit No-___-Q�-_ ___�<}_________ dated__..____-1_!_.37`-� _1/__ 0- ...........
ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS-A._GUARANTEE THAT THE
SYSTEM WILL NCiION SATISFACTORY.
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DATE........... ... Inspector. - � _-...............................................