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Home My WebLink About0011 ELLAS LANE - Health 11 Ellas Lane Centerville A= 188 — 167 S M EA6 UPCIM4 sm*=Lo m • Mob to tom► fQ No..9A.^.7_ Fps.............................. �✓' THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEAL H C3 .. 1..........o F..............��..G�,Iv�(1 ......................... Appliratiou for Uhipoii al Works Tonstrurtion Errant App tion is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ------------------------------------------------------------------------------- Locat�oy.-Addre ; � C Ot No. _ 1. ........- ---•••--•- -••------•----•-•-.._.... c o. ` �..----------------•-••-••-••........•--... ' Owner ddr ss Installer Address QType of Building Size Lot.�........................Sq. feet Dwelling—No. of Bedrooms.............. ...................------Expansion Attic No Garbage Grinder QV 0 Other—Type of Building ............................ No. of persons.....--.................--.. Showers ( ) — Cafeteria ( ) 0.' Other fixtures -----•......---•--•------------- . d ------ W Design Flow...............��.®.......__.._..__..gallons per person per day. Total daily flow..------_$ .�.....................gallons. WSeptic Tank—Liquid capacity b.gallons Length................ Width---------------- Diameter-..--.--.----.-- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-----------------_- Diameter....--.......---.... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing ta�( ) '~ Percolation Test Results Performed by........... ....0 C........ .......U... ........ Date......�=..�.�... Y. aTest Pit No. 1................minutes per inch Depth of Test Pit..------............ IIepth to ground water........................ Li, Test Pit No. 2................minutes per inch Depth of Test Pit--.................. Depth to ground water.....--.....---......... P4 ......................................... T 0. O Description of Soil ................................... oil - a �. � ... `� --\--------------------------------------------------------- ------------- ••-•----------....------- VW --------------------------------5 ------------------------ .......5_.<.r............. ----------------------....................................................... 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 iITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of I ealth. gne , --------------------- ..... ........... ApplicationApproved By......-"----"•--------------------••••--•--------------•--•-----•--•---••---••------••..•--•-• ......••r •1� ..... Date Application Disapproved f t following reasons----------------•----•--•---••--------------------------------------------------------------•----••-------...._.. ------------------------------------------•--•--........-------•-•---•---••---•-------••-•--••---------•.--- ------------------------------------------------------------------------- --------•--------- Date PermitNo......................................................... Issued_....................................................... Date e. No. ...- i Fxs...............' ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Q<. n----.....OF..............� ck_"L.P..'J ApplirFa#iou for Uiipooal Works Towitrartiou Frrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ..............tA. ...---� �'=- --C � c-............. - �-, ................•---------------......--------------........--•---.......-----•-- Loca'o '-Addres"'' "�,,.. r - AAO Iof tNo Iiit- ......... .---• ----......••••-�--••-...-•---••-•.-•-•• ....................................................... ........ Owner 1 "� ddr ss a •-- u : ? `. 1—�.�' .........._ .�.................... --••--... .. ....\' !�"".----........---•-------------•---•- Installer Address I Q Type of Building Size Lot.\`�. .....Sq. feet Dwelling—No. of Bedrooms..............C:`_....................._...Expansion Attic NO Garbage Grinder (N Q aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) QOther fixtures -----•-----------------------------•------------•-----........................................... W Design Flow............... . .z ............... ..gallons per person per day. Total daily flow----___.._._..... gallons. WSeptic Tank—Liquid capacityk O.gallons Length................ Width................ Diameter________--- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. �y Seepage Pit No------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing to � ( ) i '-' Percolation Test Results Performed b ._.....___a-? �-(- ( �� ►-7 Y ---------------••-•-•••••............•.t j ... Date Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 .---•-•----•-•--------------•••......•--.....---••••••......--••••.......--- ------•---.....:.... :.... .--•----------------------_- �0�,�11 Description of Soil......�"��--•`•�=---------------- 4�--�'-'`-•-•••••�•••--...••••.�s_.V,�_.�_..�...\-••-•-•--••-••••-••-------•---...........•-•-••......•... (� •-•-•-•--••------------ •---------=---------•-•-•---- •.....,r- �-��•• ` _ UW --------------------------------------�------------------------- -=f=---A....•..m. ,. �.•-------•-..I.............................................................................. 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 TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. f••,� yy f Signed'_....'�. ��1J�:... k� I " k� ' \ , .......................•••••...•--•- ----------••••.....---------- Application Approved B / / r Dat€ -: /. / Date Application Disapproved for the following reasons-------------------------------------•---------------•--------------------------••---•••••• ••----•-••-••.----- .....---•--•--------------------------•------•------------------•-----------•-----------•--•-------•---••-------------Date--•----.._.. PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ... .0. io..............OF.............d,cu q.:S..�....Cc_� ............................ %rdifirate of TompliFattre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (—I or Repaired ( ) by----------------------- C-.n' ....--.........--•--- ........................I.............................. :........................ --------- C` taller has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as'descfibed in the application for Disposal Works Construction Permit No....%_ :.......... ............. dated-------<:....... __'f'_._..._._._._........ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® A GUARANTEE THAT THE SYSTEM 1Al L F CTION SATISFACTORY. 7 .......... ......-----........................................... Inspector........ ------- -••'---•-------------••-•-----•---••-----....._................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No. �::....!.....�..... FEE......................... Biopos a1 Workii Tomaudum Vantit Permission is hereby granted----------- -- --•-•----------- ......................... to Construct ( r�r Repair ( ) an Individual Sewage Disposal System at No.......... ----•------- -_ .... �' �e'r `„-y;-'•: t2�I/ "✓i �.,,_ Street as shown on the application for Disposal Works Construction Permit No.__........��'Dated.......................................... .�` ' DATE.................. •---------•-----p-----------._.---------•--•----........ Board of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS (p 7? �_ A LOCATIONS } SWAGE PERMIT NO. 1-, T4 �7 ; L1 � S v-li- y VILLAGE E `1iw comic INSTA LLER'S NAME i ADDRESS i UlL.DE R OR OWNER V( 6 i xl DA L- E P E-RMIT IS-SUED D-AT E COMPLIA-LACE IS-SUED - / 3 __... t � � a � � �� _ _ _ � 7 ` r 3�'�� i �'�il 51NGLr-- FAMILY( - BEoaQoM A . IJG�C�R`�A61= �jWNDE2 \ DA LY FLoW s 110 A 3= 3306.P0 5EPT1G TAwK c 33oxl5c>% =-495G.P. USE l000 o15PoSA1- PIT vst3 t000 GAL. N23 6%DG.WALL AP-SA. * I'5a 6A 15o 5.t= x a-5 a 375 G.P`o. I ' 9' ► BOTTOM AP-5-Az .. YO AF•- 1 S0 S.F X. 1- o a 06 G.P o~ - pir A� TcrrA 1-. 01a51614 * .4-Z 5 G.P t:X ► •TOTA1_ pA 1 LY FLOW = 330 G.Po � � � r FND TN. I PEtZccLAT1oN RATE i IIN ZMIN o�1.�55 c zlf 6 EXP �/ / SSA i, / J"A OF II R6CNAFD o`' AL II A. ' OAXTER y 10 i� f4s 2a( Q N 2 �Q1fIT P�O� ` T P, DP I W ,oNi i E k D� TOP FNU= No LC- a-ZG.eZ �cG =4Z 6. ¢Z.o INv. � c� loon tNv. Su so�L D�4T. INd. GAS. 4ole SCPT��. ii 2� IGOO tN�( 9oX 40•G TANK SAIJDY (SAL.. 4o.0 �I 6�A�El. LEAGLI INV. INY. 1 -' w 14 6 6TuNt"a �, NED �•o i it C.a IPIGD Pi-o-t' PLp►N PROFILE l.oC4'T1ol►J C IF"71 t SILL No. 5CA1_EP- SCALE �,•= Gc' VA-r g- LZ-f�Z •v o WATETL p 1,,;P,N REF EIZEN GE 1 GE RT11=Y ZNAT THE F"u&3DAT)0&) SNo1KN H6.R6o►J COMPL` !S WITN-f HE T Z7 A u D SET e�c►GK R.6 Q J►R.1ccNa E N`f> O F 't µ I 'To W N Or- BA RN t.rA B L E' AND 1 S IJ o7- LNND �Ou12� 3= ¢a LOCP.'TED WIT141 oe3,D PI.k•IN DXT E -ZZ- 8 z. C!` BAXTE�L� NYE INC• i R.EG I'SZ V--Q6.'D'6Aw D 5 u MY RYoZ'5 'Tu15 PL&W If) NOT �n�jt3D 01d AN _ OST�c2VILLFs - MAss� F iWiTRufAeWT Su2vG-Y -THE Or- 5E-rg 6619U0 uo r ter_ v�iC.C�'fd ' is' A1C 14r- 7 NpGr Jr