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HomeMy WebLinkAbout0106 ANGUS WAY - Health I O( Angus P%cad '),51 - 057 -001 C.en}ervt�le, 'r No. 4210 1/3 ORA Pendaflexo j 10% ., �. . I:.7�.•, ,•-� t+r^ — "� any _� aaC '�*^ ,� a '� �� G''a j �� a 1 ti d r t No..-.�:.... L�..... + �^�•: t Fes$...,7 d............... THE COMMONWEALTH OF MASSACH_U ,ETTS "f'ARD OF HEALTH 491 OF........... i9 ........................... ApplirFation for Ui ,viral Warks Cnnnitrnrtiun firrmit Application is hereby made for a Permit to Construct (/Y) or Repair ( ) an Individual Sewage Disposal System at: ' ........Go .. .......19�Y 11a�'._...'�b..........-••------ -•-•......----•--•---_...�E.rl.!T.E.Ole At.�. ............................. Location-Address or Lot No. ... i ��t1&........................................ ----------G'e�,4/.d/�,e! .I'_._..._ „1.. E.I,�I Owner A Addre�J `� •.......................................• fJ(---�1--�5 �QvicYjur; !�4 ).•c.•aC4 s¢ --------- a t,� q Installer dress Type of Building Size Lot..�s.7 4_41......S feet Dwelling—No. of Bedrooms...............................� .-------------Expansion Attic ( ) Garbage Grinder ( ) Other-Type e of Building ............... No. of persons................ Showers — Cafeteria P� YP g ----=-------- P ( ) ( ) a Other fixtures ------------------------------•. - W Design Flow..................467 ..____.._._____gallons per person per day. Total daily flow.___._....._cQ...................gallons. WSeptic Tank—Liquid capacity/,ddd.gallons Length Width.....S_0. Diameter................ Depth..:�... x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.......... Diameter...... Depth below inlet..d!! G_...... Total leaching area.429.6. .s� ft. Z Other Distribution box (Y) Dosing tank ( ) . ~' Percolation Test Results Performed ---------r------------------------ ........ 4j Test Pit No. 1.......2.r..minutes per inch Depth of Test Pit./:;�.`" Depth to ground water_.___A_10f!vE. Test Pit No. 2.......�_..niinutes per inch Depth of Test Depth to ground water.__,4.*a AC'.- ---•-------------------•----------••-•--------......------..._..............._...---......--•-------......................................................... O Description of --------------------------------------- v •-•--------••-----------------------,�..--.loriA.rX=.�'�v?Z.lbtG-- •�l� �ttr .JSON�'t��.+Qv�.�. ...................................... ------------------------•------------------------------•-------------------------...---•-----------•---------------------=--------------------------••--..---•-•--------------------------------.......-- UNature 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 TITTLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operati ntil aC��er�tifi/cat'e of Compliance has be 'ssued by the/board of health. Signed... .. ._-•-•------(.(/.. . ---------------------•••-•-••------ Date 1...._. proved By.._.._..___ � f ' --- Application L� ---------•-----------------•---------------- ----•---•--- Date Application Disapproved for the following reasons:...............i-•---------•---••-------•••----•----------------•--------•-••-•••--•-•---•----•-•.......••--._ .....................•-----•-•----------......-------------------------------------------------------------••-•-------------•-••-•-----------•---------•-------------.----- g Date PermitNo. �I.•.-•....--------------•------------•----------- Issued....................................................... L — — — Date ' J , No........ .: .... THE COMMONWEALTH OF MASSACKUPETTS 'AR® OF HEALTH _.....: ............OF..........T„�i9.Z/1/S%-i9T ....................... Appliration for Disposal Works Tnnstrnrtinn thrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .......-- .!..._ .......12 �frl.1..,F..................................... ......................... .............................. Location-Address or Lot No. -Aza4r1Y......... C. tt/j/ :�! ,.P......! �.?.- �::�IiZ4— E Owner Address W Installer Address Type of Building Size Lot..ef�Z45g•4_-------Sq. feet aDwelling—No. of Bedrooms................... ....................Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures --------•-•------------••---•--- W Design Flow..................5-.5..._._._._...___gallons per person per day. Total daily flow.............2..4....................gallons. WSeptic Tank—Liquid capacity/2OLl.gallons Length/6.=.6. Width.....�'_d.. Diameter................ Depth..1!.;.�.-.4:.... x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit NO--------.._�___.__. Diameter.....�-_U--- Depth below inlet.16_-.s?....... Total leaching area4ZE ft. Z Other Distribution box (ir/) Dosing tank ( ) ~' Percolation Test Results Performed by._..,V...ieAelljq5� _7?................................... Date.... ........ aTest Pit No. 1......'<.f...minutes per inch Depth of Test Pit-?A Depth to ground water....�Gy Test Pit No. 2......�-...minutes per inch Depth of Test Pit¢.z,.:.._E.:_' Depth to ground �+ •---•------------------------------------------------------••---.....------.._._.._..---•--•-•---............................................................ O Description of Soil-25/•____-... G---------------------------------------- U •-••----•••••••••-••---•--••--• ._.�<<.e2ly'_��.C/�,f e¢�__-_.�je�. 1./t1`!_.C.�w! .7! �+2i.1 �,. -------- W ------------------------------------------------------•--•---••---------•-----------•••••-•-•-•--•••....•-••---•.._...._..........-•-••••-•-•••------••--•--••-••...-------•••-••-••--•-••---•----•..... UNature 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 TITTLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operati ntil a Certificate of Compliance has been issued by the board of health. lw'�f✓. ,~ Signed........................................................................--•---....... .� Date, Applicationproved By--------- •• ••••-••--•••••-•-•••-•••••-••••-•••-•-•-••....................•••...........•-- ,r'' Date Application Disapproved for the following reasons:................................................................................................................ ------------•----•-•-------------------------------------------------------------------------------••--••••••-•••-•••••••••--------•----•-•-•-••---•-••••••••••••---••---------••-•-•••••....... Date Permit No.. 's .................................................. Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Tl.%/1 ..........OF...... ?3,X1��5./'..!�1��.�........................... Trrtifiratr of Tomplianre-., THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (o,,-) or Repaired by...............................................................................................--------•-••-------------••------------•---------------............................................... Installer at............. ,. �.....�/�J%c1 '---•.�, -•: ••--••--•-••-•-•-••--•-••-•---•--------•-•-------•----•------•-----•-•-._......---•••......•-- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No------.......:......................... dated-....f ................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.........R.......................................................................... 1. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........ .. .... .... No......................... FEE........................ Disposal Works Tulanotr ion rrmi# Permissionis hereby granted--------•-------'-............................................................................................................................. to Construct (,.,I or Repair ( ) an Individual Sewage Disposal System atNo.............. --•--- _- ;�. /�/lr�1,�'-..-r J.:................................................................................. Street ✓%! , <",�_rt,, - Lr fs __✓ as shown on the application for Disposal Works Construction Permit No..... ::.......... Dated-- .............?_.............. _-__- �f}15( Board of Health DATE �----...-••••••. ••.................................••-._..... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS e; 7t �r J r� , .77 Ok 1'r I. � Q r t i + �f I x,��� ,,,: ram•.. it I � �� f l��\ �M AI�� •,_✓- U Y n J' Y i ID v y f io i i 1 � Mink ■ 'i4� ! ���■iei ON 11 NJ INSURER=Ii�i.IJ.1.l.1 ■..a. h� I ,;� i11.!® :aim: � + ,.II ;��■�� ,i r JOE Fug■"".IIIIIIII IIIIIIIIIII � i ■�■i�,a1■�1 i . ' 1� ii �� I s a � I+ Is i�l iet�i� I j■ IN ®•.. ■� ii Maimiisii, 1 i : r ®ir�'llllll luua�m �� EII��s1�C�;�l�i lima { lei■e+;ti--- (� k ; E 5;" j=� iC -S 1•� _. �k. lu ■a ; u is �: �' � 1 �l�li ae i�■ 1 ■��t�f i . 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I�EWELr-Wf 5 sev a++1 GAS cas-ru> PL r,►,ktE � 'u13S'diL � 2�- -.Prrcd A-L LIWES A MW,mL) of enrrW C4JisE SF -AIP1'ED. T—'• ff LA- PI PIE 5 Tb AW D i W T U • �1 I"F� SYS�•M S V•�Arl..l AO P,-/C. �. A,LL `SEPTA,° -rauKS, pISTe�B�rTIoJ go><, A"ID r r 0 30 0J s E� Eccaiz l_.E^C:+-1 ►JCr Pfc� SHALL �E �G, 0 fsrC�i4Y�G ! _ — - - --- SO-- szEr�lO✓E Au Un1SviTA3LE f-tATErZIAI. �Er.1E►�TL( lrQyr7s'EL i O { O O U ® - I+JJEer EI-_EVA-r' BIAS OF LEACF•�r� f'fT5 FOC 10 `' 0 lY C 0 ACt.DvS of Io Aa!o endeP%L_ w(114 CL1j->~�c_IE - inT J sb,,fl z �i _ 1 6a--TNEA.r7..uST/Jt3tD o F 'TN MUST o 00 (c) 'oo :. . . � - . . t � �E �-IFiED WHEN! 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' " � ' s :- Lf�U•/%t/6 AQ64 QEQ[//.CEOAre - {� PPOPO.SED LEACHING PIT /V'!3 01 S POS aa.. J I ao% E x NA I.I s I o N2J $J7'"r ' s�w�>z wEs��,►� ,� . _ ,a1 Ff �� � �',�,.ar•� ,� t�u�,r�•TGC�l//....,�G� ~/`�!`i ,. in � J ?3a TTOiy ,g12es`9 r� >11:CAf.•E: ,DATE 9"ErT 1 iR't� ��r:\- , •OR N AW Sy. C1490 Sy. APPO r PL.AN NO IIV 1i r __ - - - Gv - - � 4 �� � � � ��� f 6