HomeMy WebLinkAbout0040 CATS PAW WAY - Health 40 Cats Paw Way
Centerville
A= 192 - 114
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UPC 12534
No.2 15_R gym,
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No..... ... Fis...............` ...........
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® F HE T A� � P iqa._�/�
O ...._..... � - OF..... .......................................... 'V'
Appliratinn for Diipuiial Workii Tnnitrnrtinn ramit
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
Syst at f--
.. ....6'S• - .. ....................... . .. ....---•-------
c I Location-A s or Lot No.
... . .............. .......... •. • -- ••......_....•....... -------------------f -------• ----............----
AlOwn dress
W ........... .......................... ...................................... ...
Installer ddress
d T of Building ize Lot....../e_��q. feet
U Dwelling No. of Bedrooms-__--. .Expansion Attic Garbage Grinder
aOther—Type of Building ............................ No. of persons............................. Showers ( ) — Cafeteria ( )
Q' Other fixtures --------
W Design Flow.............3�`' .....................gallons per person per day. Total daily flow.......... __a..o_.................gallons.
WSeptic Tank—Liquid capacity-._-•--. ons Length................ Width................ Diameter---------------- Depth................
Disposal Trench.—No. ........... Wi ................... Tot gth......_.._.----•-.-- of thing area....................sq. ft.
Seepage Pit No..../ 1 ✓---------------- g �• q
.._ De e a eachin area_ o. .. s ft.
z Other Distribution box ( ) Dosing tank 77
aPercolation Test Results Performed by-_.._..::,�('.�!_> 6�?=�' l_.-_. Date.../.n._ ................
Test,.a Test Pit No. 1................minutes per inch Depth of Test Pit..___..........._... Depth to ground water........................
r3 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water•___--_--__--__---_-___-
-•••---•---••. ••-•-...z...........................
/ - J
Description of Soil-• ........�•. -1 �� ...................
1
V `, =7- �?h�; =�r=- — v...��j_� ',/*T�l -•-•--------------•-----------------•-•-- -----------•---------•-------•-----------------
W
VNature 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 iITL- 5 of the State Sanitary Code—The undersigned further agrees not to lace the system in
Signed.*!
i ned. been issued by the�adof h th.operation until a Certificate o Compliance has be
g -----•.........
ate
ApplicationApproved By.................................................................................................. ........................................
Date
Application Disapproved for the following reasons--------------------------------------------------------•-----------------------------------------------••-•_....
.........................•---------------------------------....--•---.....------------------•------••_••...
Date
PermitNo..-•••.....------•---•-••.... .. Issued........................................................------------•............. Date
No......
................. Fps.. ..................._
THE COMMONWEALTH OF MASSACHUSETTS
BOPS R® F H -�
.. ......... ey..........0F..'... ...._::...: ...........................
Appliration for Disposal Works Tonstrurtion Prrmit
Application is hereby made for a Permit to Construct fl" )o Repair ( ) an Individual Sewa e .Disposal
System,a ,,.� ,,,,�•-
..I. ... - -- •...!�`��......•._....r •...Y'•...................... .... - ----.....................................................
Own
ress
Installer ddressRyy
Tyke of Building ,' Size Lot_____ . f�....Sq. feet
U Dwelling—No. of Bedrooms._...3:-._•___________________________Expansion Attic ( ) Garbage Grinder ( )
`4 Other—Type T e of Building ............. No. of ersons_____:______•__•.___________ Showers — Cafeteria
Q, YP g --------------- P ( ) ( )
a' Other fixtures ....... -
W Design Flow............ _ gallons per person per day. Total dailyflow--________ gallons.
W Septic Tank—Liquid* y capacit -_: . on_--. s Length................ Width................ Diameter................ Depth................
x Disposal Trench—No.................... W _................ Tot -ength _. ot, ching area.., ...sq. ft.
De a leachin area._._ ..sq. ft.
Seepage Pit No. D gg
Z Other Distribution box ( ) Dosing tank 97
`f • 7`7�
~' Percolation Test Results Performed by._..__" ` .. �' �'._._""T�'` "�'`._.. Date.. ._. ....................
a
Test 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........................
o -- a .� ► f} �
x Description of -.''_ .. , -' ••......•-• ------------------
--------------'�' t..----- .--- -d---.±-�V ..
w � -
x •'•-•'••--••......------'--------•------•--'------•---••••-•---------------------------••-•--•-•'-•----•••---'•------•--••------•-•-............----•-• ...........................................
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 TITIE 5 of the State Sanitary Code— The undersigned further agrees not to lace the system in
operation until a Certificate of Compliance has be . issued by t e boa d of health.
Signed•- -=-"-
1/`"�r Date
Application Approved By...................................................--•-••.............•-'-'••••-
Date
Application Disapproved for the following reasons-------=-=---"----'-----'----'------•'-'-------'---------'--------------------------.........•.."------------•.
.........................•------------•--•'--•--'•-•-----------------------------.•...-----••--=--------..-"•----•'--------•----••'-----•------------------------•--"•-------------------_-----------
Date
PermitNo......................................................... Issued-........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F HEALT
?r�+......OF.. .:
Trrtifiratr of Toutphattrr
THIS IS,,TO CERTIFY, t t dividual Sewage Disposal System constructed ) or Repaired ( )
by---------------- ------ •--•-• ---.. ----•-•-• . �.- -------.........
at............ ... nstal - ..... -"
has been installed in accordance with the provisions. of , )of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No------------------F9----------------- dated-.A0-`_Z�_"___� 7
---- ... ...
..............ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
SATISFACTORY.
DATE--...-.: 4..11......./,/.............���. ............ Inspector.. . . --- -•--'--------=---------------------------••-•---•-••--
THE COMMONWEALTH OF MASSACHUSETTS
BOARD HEM T
..OF.... .,� :.. ...--•-- --•--.---•--•...............
pp ....--
No.......�. ....... FEE....f�...............
DisM-50-100t
To rrmit
Permission • reby grantn---•---- .: '-'• ••. •• •.... --•.--••-
to Construct ( or Repair ( wage Dis sal System
at No.- ' gym . '"'... - --- ------------- - ......._....
e
as shown on the application for Disposal Works Construction Pe No.__ Dated_ ^�.6_��
Board of Heal
DATE..... ..................................•...••---•-•-
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS
I61
y
►._10 GArzT3A.G,� �rz1�� � — tSt•SO� -
Iid t L�4 t`Lost/ _ I t b x 3 = 330 G•PXX
% - A-q 5 6.P.n. - +S \ 44 l
U Sf---- l OOCI SQL.
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DISPOSAL P1T - u5E tc>oo
-C,UrG /A.LL AV-EA = (50 s•1=.
I c o sF 14Sze rd
2.S = CIS C7•P.t�.
8 :;,=0A( Q- TS'# FND TANv, 1(,
TOTAL -peSt6Q = 425 G•P-D-
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'CATION SEW P
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VILLAGE
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�S�. �.ram//!/ i/ire'.- �-�• I
STA LLER'S . NAME & ADDRESS
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UIL`DER OR OWNER
f , PERMIT ISSUED
= DA,TE COMPLIANCE ISSUED
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LOCATIONS v SEWAGE PERMIT NO.
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VILLAGE "
INSTA LLER'S NAME S ADDRESS
R U I'L D E R OR OWNER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
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