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HomeMy WebLinkAbout0035 BRIDGET'S PATH - Health 35 Bridget's Path Centerville A= 169 - 101 N SMEAD No. H163OR UPC 10259 smead.com • Made in USA qf.GyczFO LO�c�T � SEWAGE-.,PERMIT NO. VIL GE LLX:ua , 1 INSTALLER'S NAME & ADDRESS B UiLD R OR 0 Z Z cc. scc��C� M DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED .Z 2 ,, r _ •� t FEE THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH IV f nor 1. ...77..............OF...... ....................... _.7 .�4 .. Appliration for Uispnoal Works Tnntitrnr#inn ramit Application is hereby made for a Permit to Construct ) or Repair ( ) an Individual Sewage Disposal System at• n .......................................... .Ma A ddress 7 a ................... / �, /vc.�C�.• i`7at Add •'^Qi'S rd?il..........I �S Owner ress ... --•----•--------------------•---•--••------------- ----•- l...b/ � a Installer Address Type of Building Size Lot V�O.....Sq. feet Dwelling—No. of Bedrooms.......... ..........................Expansion Attie Garbage Grinder VYl aOther—Type of Building ............................ No. of persons............._.............. Showers ( ) — Cafeteria ( ) aOther fixtures -------------------------------• ---•-•------- W Design Flow............. ..________-•--__gallons per person Der day. Total daily,flow-------/.p .............gallons. WSeptic Tank—Liquid capacity.��agallons Length...E.4�_._ Width.... Diameter________________ Depth... x Disposal Trench—No. .................... Width.................... Total Length............ Total leaching area....................sq. ft. Seepage Pit No......I------------ Diameter......r.......... Depth below inlet..... -........... Total leaching area.R Z...sq. ft. Z Other Distribution box (/) Dosing tank `" Percolation Test Results Performed by._../.�.._....�!�.... ___.40 ............... Date.._..I� /�'. ? ...•..... aTest Pit No. 1....Z.......minutes per inch Depth of Test Pit-------A6........ Depth to ground water._/Y_?2__�,. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ C� --•-•---•-------•--- - -- --------------•--------- -'-••-------... O Description of Soil....._...__ txj .----•-••-------•-••--------•----------------•---.......-----._...-•----•---•----............-•-•-•------•---•----•-•--•----•---------•-•-•--••---•-•----•------•--•---••.....------••-•-----•-------•••. W ------------•-----------•----------••--•----•--••--•- ---•------------------------•-.....-•-•----------••--•------------------•----•---•-•----•------------------•---••-------•-•-•----•-------.....---- VNature of Repairs or Alterations—Answer when applicable--------------------------------___________________________________•--.-----_-_-----_---.-----. ----------------------------•----•---------•----•--•------•----•----------------------.-......-....------------------------------------------....•-•------------•-•---•--------.........0.............. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT?;. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance hjben issued the health. SigneApplication Approved BY -- -A...-•••-•... •••• --------•--------...---------•••......•--------- .........................te� ...---- D ate Application Disapproved for le following reasons:................................................................................................................ ...................•--....------...----------.......----•---...--------------------•--------------------------•----••••------•--•--------------•-•--- ................................................. jr- 7r Permit No.....-7.! 1------------------------------------------ Issued.--•-••---//. ate Date No................_....... Fim...a....._x... THE COMMONWEALTH OF MASSACHUSETTS BOARD /�OF HEALT C.u-..7"7................OF.....r�✓....��'1 ..)? 5..�.G F? /C. .................................. Appliration for Disposal Works Tonstrnrtinn rranit ,-,t-rr o Application is hereby made for a Permit to Construct X) or Repair ( ) an Individual Sewage"Disposal System at: / // Ile / _ C/ s f�Gi-A /(-O� /( C C 7i �F'Y t��Ile ma SS `� •.... ................ Ps�YLocation-Address or IE �h �r<< a................................................. ...... -�� Owner Addre s V. Installer Address /�O O .0 Type of Building �{ / Size Lot............................Sq. fee ; ' Dwelling—No. of Bedroom .........1-3 ........................ Attic/l` o) Garbage Grinder (/�/�o p, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q( Other fixtures ---------------------------------- M, . d ................................ .....•----------------••.••- Design Flow.............. vf~________________gallons per personp,J_ijy. Total daily flow._.....__......__._.........................gallons. WSeptic Tank—Liquid capacity�OOO.gallons Length_.4.'._._..__. Width..._��jj_._._.__.. Diameter________________ Depth__..$....._..._. x Disposal Trench—No..................... Width...7----------------- Total Length...........t.___.__ Total leaching area..._. ..._.._._____sq. ft. Seepage Pit No �_____________ Diameter................ Dept below inlet................ Total leaching area. ©.�'...sq. ft. Z Other Distribution box (I ) Dosing tan210ov;_': 9 0 ~ r I 1 � �0 �3/.2�Percolation Test Results Performed b �.._..___..._ Y.............. ._ Date...._...- _--._......_______ Test Pit No. 1...�e-------minutes per inch Depth of Test Pit....... _________ Depth to ground water_ `�....�..W Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ �+ Descriptionof Soil ��_.. •-- ...•-••-•••••---••••--------•-•---••-••-•-•--•--....-••-•••-••-•......-•--•-•........._•---•- x U 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 TITt' 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b en issu d the health. 'f Signe .. • i� iaT � Application Approved B . .... ......... Date Application Disapproved for the following reasons-------------------------------------------------•••-••••••....-•-•----•--••-•--••--••-......-••.........•••••- ---------------------------------•--•-----...---------------.............--••--------•-------------------••-•-•••..._....•-••-•-•--•••••••-•••-••-••••••-•-•---••••-••••••----••--------••-••••--......_ Date Permit Nd........................................................ Issued-------------- ------ ------ �D "' Ft' r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH (9rrtif irFate of TompliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed:!( , f) or Repaired ( ) by.................. ..... ...... ----------nstaller............................................................................................... _ ��.� ..r............................. Installer .G_ ^ ", } has been installed in accordance w ihfalle provisions of%`£ET � The State Sanitary Code as described in the application for Disposal Works Construction Permit No............. _..-..•-_•---.-- dated_........_. �. �- or ,� _._....._._.._._. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BVCO STRUE® AS GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. f DATE.......... ^... �.:/�:..:...... .... Inspector.-•--••- ~,.,:, T:HE- COM'M'ONW.EAL'TH°OF +MASSACHUSETTS BOARD OF HEALTH ti. nY .;. .O F........... No... ......... .............: ....... FEE........................ Disposal l nrks Tuntrudion amit Permission is hereby granted. zz�r ---------•------ to Construct ) or Repair ( ) an4ndi idual Sewag Disposal System at No............ �r f. �A 7 43 k /l,�-E�ljl /. / treet as shown on the application for Disposal Works-Construction Permit No. �..._..___ Dated_-- ............. in'v_ b•L' G' _ ..................................................�...................................................... Board of:Health DATE................................................................................ FORM '1255 HOBBS & WARREN, INC.. PU,BLISH'ERS"'P"'`",:."''-� _5 17 C)J_A.� r'7 p ?) /'"� ce 77 f/G G' f..Jd PV 17_./7 �. 1 � �� /'� �fZ 7,3 f' 1 W ✓7�'L r.d 7r r7 's r 13 •� ' Q1 /-1-A ss, ,V V�r'*'r� V/'t•'1.� .�,' � ,dJ 4 C�'c�-0 a Jr x /19 f3 S. A 'f fir. \�0 '`a�\ /pow `/ �', �rn4 .A< IL 6,rJ r sw r - - -- 4 4 � _ ' �✓fd�/ d` ,5 `. � ?ram' rya / f 1 471 J,7 �J"d r' / d (N 0s^Miss T �N OF M,t _ + FRANK m{ 4' FRANK _ 1 CONERY i \ o CONERY « ,R No. 6573�O Q 1 'Q No.6232 O /STS it t �s1ONAl vi PLAN OF LAN® Tj e 7- �.S �i't 7-y ,�G- tN OWNED By � 4 .r FRANK CONERY 5 TRENTON ST. HYANNIS, MASS. 02601 /i➢D►S7�J��►al0ltE�R 8 &AMD St"r'f"O" „?D FT- SCALE t IN = /a�