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Home My WebLink About0281 AMES WAY - Health 281 Ames Way � Centerville A== 170--233 e UPC 12534 No.2�153 OR _.. � �� d C/� No....---- OS ... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 0_W. Q..............OF........ Appliration for Dispoii al Works Tonstrnrtion Famit ,Z ff I Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: --.Am1 U. , .��.t9L.��.�ldll�� ........... .l--�.T. ....�....5...................... .---........ Location-Address _•--•. _•.-----•---- ---------•----........................................................... -or Lot No. T ..........--•--•...............•----.....--•--...--- Owner Address ...................... ..�---...---/lfAe( ................................ --.-------- ---.-----------------.---------.--.--•--------- Installer Address UType of Building Size Lot.15.Z.Y_6___...Sq. feet Dwelling—No. of Bedrooms................................ .....Expansion Attic (,"Jo) Garbage Grinder (VO) Other—T e of Building No. of persons............................ Showers — a YP g --------•------•------------ P ( ) Cafeteria ( ) Otherfixtures ----------- --------------------------------------------•------•--- ------------ W Design Flow...........l.1a.....................gallons per �'� pr day. Total daily flow..........�ZZZ.0..............gallons WSeptic Tank—Liquid capacityYQ0. ..gallons Length!R._�`'. Width_'l.'��`° Diameter................ Depth_5'.._8.!? x Disposal Trench—No. .................... Width.................... Total Length................. Total leaching area....................sq. ft. Seepage Pit No........../_..... Diameter.._.. .�..... Depth below inlet.._? _.'...:...... Total leaching areax2_j:9.Q.sq. ft. Z Other Distribution box ( Dosing tank ( ) '-' Percolation Test Results Performed by�97AAVVA,'C..... .�A.t-6'!_> .................. Date...AjnV4....914./91>6 Test Pit No. 1_.�_.._-_'___minutes per inch Depth of Test Pit..../-..-'..... Depth to ground water...�V�Pbl,E�-. fZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •---•--------•--•----- ODescription of Soil----•-.0---®' .�--. .----•-..A.1-,0.......... -a—a'—same.......--.--------=-------------•-••-•------------- V ............•......:/.2--.......... '.2?1.1�, .------..�c.�4r�/.Z�......- Sf��??c-__._�`/l>l rfl�t.�..-....5— W i U Nature of Repairs or Alterations—Answer when applicable...............................____.........__._._............................._..._..._...__. •-------------------------------------•--•------------•-----------------------••--•------•.........----•---•------------------------------------------------------------------------------------.------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iiTU 5 of the State Sanita y.C e—The ersi ed further agrees not to place the system in operation until a Certificate of Compliance has a ssued y e bo of health. Sig ....... ... .... . . ------ Applicationl3 .... D ApprovedBy•-•-•.......................... ••................ --...........................--------•- --•- Date Application Disapproved for the following reasons:--•-----------•------------------------------------------------------........................................... .................•----------••-----.....-----------------•-------•---•--•--------.....-----•----.....------••••••••••-•---••-•-••----•-•••-•••----•...._..•---•-•-•----•••-------••--•----••••-----•---- Date PermitNo. _...7._................................. Issued_....................................................... Date t No......................... FEs... !................ THE COMMONWEALTH OF MASSACHUSETTS h ~ t BOARD OF HEALTH . .A .............oF........ .. . ............................ ,• Appliration for Disposal Works Tomitrurtinn Prrmit Application,is hereby made for a Permit to Construct (IoO or Repair ( ) an Individual Sewage Disposal ,. System at: (' ............................................... Location-Address or Lot No. z: .. — ................. .............. ............. -•J....-•----------........------•----........_._.............._...................................................... Owner Address W F� ------------ ------------------------------------------------------- --------------- ----- Installer S Address UType of Building Size Lot.�.J.Z-YO.....Sq. feet Dwelling—No. of Bedrooms._... .................................Expansion Attic (vol Garbage Grinder (NO) pa, Other—Type of Building ............................ No. of persons....................._...... Showers ( ) — Cafeteria ( ) Other fixtures ------------------------------------ W Design low........... ....................gallons per '�'p lay. Tor`al daily flow...... . r�.V .............gallons. r W Septic Tank—Liquid capacity./-490.gallons Length. ...id__'."". Width.°T..e#! "Diameter............... Depth..$.._4T!? x Disposal Trench—No.................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No............ol ......�Diameter.....+ ......... Depth below inlet....0.`........ Total leaching area.2.0. sq. ft. Z Other Distribution box ( 107 Dosing tank ( ) Percolation Test Results Performed by., •rC+ ./�l _.....4 /.,., .. • -�-':.................. Date... DV.t...-�.L�'�.e✓ >8 Test Pit No. I...tC. _.minutes per inch Depth of Test Pit......._'°..... Depth to ground water..._ ,0Jv.4r_. f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --••-•-• . ti----•-_.. ....................................................................................... O Description of Soil......... -"' '----•---- •-------- ,'+r+`�............................... U ---•-•--•••--••-•--•-••---•-••---...... .f..,� -y ?.------ i+ ,G....--..�. a'1_vs W ... ----------------------------------------------------------------------------------------------•---....-•---------------------------_.... U Nature of Repairs or Alterations—Answer when applicable................................____......__._.................................................. --------------------------------•--••-----------•-------- •------••--------------.....------....------------------------------------... .............................................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITi.v 5 of the State• Sanita y e—The ersi ed further agrees not to place the system in operation until a Certificate of Compliance has a ssued y e bo of health. / Sig ...... .. . . ....._ f ApplicationApproved By--------•-------•••...•------ -•-••----......•.........................................----- ........................................ Date Application Disapproved for the following reasons:......................... "I ............. Date PermitNo-----------.............•---•--•-------------•---•_..... IssuedL....................................................... Date sf THE COMMONWEALTH OF MASSACHUSETTS BOARD F HE L :... ... ..........................O F.... : . ......: .. .... .... ............................................. Trrtif irate of Toutpliatur THIS IS TO CE Xhat the 1 Sewage Disposal System constructed ( r Repairedby-•-----• . ... a4►.... ).ndivtd :��...---- --- ---..._...-- .....................•--......--•-------•-........------....-- 3.X. � I ller r at......... ---•---------•-------• - - ---------- --------------------------•-------------------- has been installed in accordance with the pro sions f The State Sanitary` o e ass1g ribed in the ��Vorks,Corist"ruction Permit ..................................... dated.................................._._..._........ application for Disposal THE ISSUANCE..OF THIS •CER:TIFIC,4TE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ' 3. DATE..... ... - ^..`. ..•��.... ....................... Inspector-•-•--.--••-- ----- . ....................................................... 4 THE COMMONWEALTH OF MASSACHUSETTS. _- / BOAR OF HE T (... � 't .- << • a7" OF -- �0.'W No......................... FEE .. ......... �t �a nrk nn trnrtinn antit Permission is h granted �"'� : to Construct ( or Repa& an In 'vidual.Sew ge isp sal Sysat No ...................... Stre , � � as shown on the application for Disposal Works Construct' Per rtr! ......... Dated'......................................... p� l/..................... !__� ..t......... -= --------------..........-----.......... Board of ealth DATE-------- ---=---- ---------- . FORM 1255 HOBBS & WARREN, INC., PUBLISHERS .. 7- / &A LO�C'ATION SEWAGE ERMIT NO. VILLAGE L, lo_ IV4�a INSTALLER'S NAME . i ADDRESS JOHN A. AALTO B,ACKHOE SERVICE West,Bamstable, Mass. 02668 BUILDER OR OWNER DATE P fRMIT ISSUED DATE COMPLIANCE ISSUED 7y- NOV 2o , 1976 PA PRbP LOT 34 LJATER 144 f"lEWWJi SA, StyH4L -S "f-,YsS 33 i ro' N t i,.) TF"P " .ENCo u N T E RE t)TEST r $;: 7AN1< HO(- `ter. `)'. �.vl�l / 1A :. /S. 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