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Home My WebLink About0061 FOX RUN - Health r 61 Fox Run' -4 Centerville A= 227-158 JMEAU No.2-153LOR UPC 12534 am"&emn • Mob in u" (0IW b 1lU1oN1r11001RTw OIR 8Y- Aq p 4;2, �� F �� No........................ t_ Es........... d........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...............:.....OF A;ip iratiou for Di-4vn.ittl Vorkg Tonstrnrtiun Urrmi# J-' Application is hereby made for a Permit to Construct ( !,jr Repair ( ) an Individual Sewage Disposal System at: Fo.k....RO.)........G - �1..1.....--°�---- /Z........................... ............ �®® Locati -Add ess �J _ or Lot J L.... �!�/ 1�;- l.d.. .. ...........................� .._... ` Owner //f Vd4s a ........ :� LFJ�SI�(L� ....... .. Installer Address // d Type of Building Size Lot..a.7rV/-........Sq. feet U Dwelling—No. of Bedrooms..........:3.............................Expansion Attic QVO) Garbage Grinder (QUO) Other—Type of Building ..1_4 00.A...__...... No. of persons.....�.................. Showers (3 ) — Cafeteria (A/0) p' Other fixtures --._...-----•------------------------------------- -- W Design Flow...........ir .....................gallons per person per day. Total daily flow.......... . ......................gallons. WSeptic Tank—Liquid capPa,ct}', _ .gallons Length--- Width.... ._._..._ Diameter.....,_..... Depth............. x Disposal Trench—No. .N...:�"... . Width.................... Total Length.................... Total leaching area.....q..r._}1.....sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area....;.............sq. ft. Z Other Distribution box (✓f Dosing tank ( ) Percolation Test Results Performed by...... ---AJ Lj..L'.................... Date..........._......-.0 E... aTest Pit No. 1.. .._ ...minutes per inch Depth of Test Pit..._ '__..__._. Depth to ground water........................ L� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •--•-------------------------------------f..........................................................•........--•---.._...........---•--••---•......---.•-•-- ODescription of Soil........D.n.-_c)..--•---.to—O.dkWL.... ..... --------------------------------------------------------------------------------•----. xR?--_.l.!f.------C.1.t:r�c,u�,...t/l!1 A-�-----�r�N�1------------------------------•---•---......---•-------------•-•------••-•------------ 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 iITL E 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. Signed...... ...... -- . -•-- •--•----------------------------------- ----1.�...... ... .�/ / a Application Approved By-------------------- ----- �.._.... . . .- •-- �l..L ... Date Application Disapproved for the following reasons:---•-••-•-•---------------------••------...-----..._.....----------------•----------•----- •--•--......•---- ................•-----•-----.................._.......-------------------•-------•-----•-•......--••••--•------------------------------------•------------------------------------•--•---•---.....--.•-- Date PermitNo....................................................... Issued....................................................... j No........................ FEs............._............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 150 ...r e."tal............... . ..OF.......' "'...!.!..�......... ..../... Appliration for DiiiVuiittl Workii Tonstrurtiatt ramit Application is hereby made for a Permit to Construct ( 4'or Repair ( ) an Individual Sewage Disposal System at: Location-Address/ _ or Lot No. / . _.. Owner J -••Address -------------------••-•......----•----•-_......::-'=• ��---•-••--....................--- ...........-----••----•-- .. Installer Address Q Type of Building Size Lot..-.__I__ /........Sq. feet Dwelling—No. of Bedrooms............ .............................Expansion Attic (+Ut) Garbage Grinder (k,',) Other—Type of Building ................. No. of persons.....!................... Showers ( ; ) — Cafeteria ( ) Other fixtures ................................ . W Design Flow............ � ......................gallons per person per day. Total daily flow.........3. ....................gallons. WSeptic Tank—Liquid capacity.!_!_�`, ,.gallons Length-__ v....... Width....4.......... 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 tank ( ) a Percolation Test Results Performed by...... �f.... '__f _..s........... �.`(._ .-...•-----•-------- Date........................................ 1 Test Pit No. 1__:4...- _-_-minutes per inch Depth of Test Pit....!-�-�-......_... Depth to ground water...._.r�__ �!....... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •-•-•----•••-•-------•......_..••-••••-•--•--•-••-••---••...----•-••.......................•--------......................................................... O Description of Soil--------'-- ......... ............... -i ,tl x ------•-•---------------------------------------------------•----.....-•-•-----•--------•.......-•-------•-•- w x ----------------_--- ---------------------------------------------------------------------------------------------------------------............ ..................................................... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... 1 ..... ................................................................................................................................... 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. Signed................................................` ' =' 6h r ------------------•...........•-- ------------......_.... Application Approved B Date `f Date Application Disapproved for the following reasons------------------------------------•-------------------•-----•-----=--------•-•-••-••-•-- •----._.........._ -------------•----•-•-•-----•----------•-••-•••-•••--••-----••---••-•-•-•--•--•-•----•.•---••••--••....._•--•---•----------------•-••---•-••-••....-•-••----•-------•---••-------•------••--•-------•--- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH ......... !.:.....:......................O F.........�................ ...J.. .......................................... (9rrtif iratr of Tautpliatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ((.,)�or Repaired ( ) by - - •..-•---••-•-•--••---•-------•------...•------•----••---•----•••--•----•-•----••-••------•-•----••-------------------•-••---•-•-----•.._.._..... Installei at.--•-t-�y- ` t' % "- — '.. I / •----••-•-•-•-_.... ......_..---•••---• -----••-•--••••-----•-•--•-•--...-•-•....•-------•-•------------•-•--•----•••---•-•-••-•-...------••. has been installed in accordance with the provisions of TIT_ _.. J__.5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.___--- -----_._I—)..... dated_............................................. THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...................................... .:•.e J..... Inspector... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH C ✓ .....................!...................OF.....Jr-�%..t._. - NO..............`....1 FEE........................ �i��a��tl �rk� �laat,�trttr�ilan l�rutit Permission is hereby granted........!.........1......... __ to Construct ( `)'or Repair ( ) an Individual Sewage Disposal System at No.......° t .--••••-••--...••••-••--........ " ..••--• ..... �,. Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... --------------- j.. .....----------------------------------------------......------------.--•-- / a TE it....... Board of Health DA ........ ...... . FORM 1255 A. M. SULKIN, INC., BOSTON L0CAT10N G / SEWAGE PERMIT NO. L.()f # 11 Fox 1�u4 $Y- �S's VILLAGE 1�, I N S T A LLER'S NAME i ADDRESS w1At 5- o!2s VL I,• 11S S U I L D E R OR OWNER V DATE PERMIT ISSUED DATE COMPLIANCE ISSUED `;2_ _/j . $y L �5 LOCATION I y GC)+ # 1 � � / SEWAGE PERMIT NQ. �o VILLAGE I N S T A LLER'S NAME b ADDRESS S• .3. �C�SGJ�� , Sa►� ------------ vM_AcS � . ,is N U I L D E R OR OWNER C,e t.., - — �- DATE PERMIT ISSUED I DATE COMPLIANCE ISSUED /�2_ i z� 3 3AG c5 F IN - -7�W 10 yyr � r ''� � -ti� -•. ... � ,. � / ,/' r,...•s,� � � �Se..�..`16��ac" ` ?j �~ — Lla.dl'- LG�i.JG� :�fr� � � ...'�.,t�'�!�i�. 1 ` 3 t J .M -57 �4 C ,�C !:..� f C ta�^ff ,1; � ;- T.«:✓ 7,V —.5r?Z31�rI4 .!� �r•r' i �� CV" —�.. 74 41 e, N Gf hV /,/'rC..:�?"��'`/�irYy?` !''`�'..., d,�'li�"'��!"` �/�.t r�I.�' ,/."'sff''� �d�=,�"��"'"�..]. - 1 .. { �� •.4>