HomeMy WebLinkAbout0036 HADRADA LANE - Health 36 Hadrada Lane
A = 148- 098
Centerville
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No......................... .........
Fps.
3� � THE
I BOP'1RD COMMONWEALTH F,MA�S'S^CHU u TS/ (— f-7 G r'1 f-1 /61k'C:p-
..._..... .---.OF..........................: `� �' i�"
Appiiratiun -fur Bi,ipuutti Works Ton,itrurtiun Vrrn tit
A lication is hereby made for a Permit to Construct o/r,Repair an Individual Sewage Disposal
PP y ("T P ( ) a P
System at:
•---•-----------------------•-------------....----------•- ........................--------•--•--------------..................................-----_-----
or
Location-A dress ( ~C— l� ................... Lot No. {
Address
Inst ler Address
UType of Building Size Lot....�^/C' 9<3_____Sq. feet
.-� Dwelling—No. of Bedrooms---------C>2--__________________-.__._--_-Expansion Attic ( ) Garbage Grinder ( )
a ...
Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
dOther fixtures ------------------------•-----------•---------------------------••---•------•--------------------•--------------------------------------•-•--•----
W Design Flow.............-...............................gallons per person per day. Total daily flow........... .............................gallons.
WSeptic Tank—Liquid cap a -----gallons Length------- Width................ Diameter................ Deptli------------
x Disposal Trench—No_ ____________________ i_______ 1_ _.._.._..__._.... Total leaching arca.....�e'L.sq. ft.
Seepage Pit No.._.__. {J � 4ep�)tbelow
inlet____________________ Total leaching area------------------sq. ft.
Z Other Distribution box ( ) Dosing tank ( ) d l- /-,c/'"'i 7' 5�"i'� y
aPercolation Test Results Performed by------- ---------------•-----••--•---•----••..................--...----_. Date---------------------------------------
Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water--.----..-._--_--.--....
fX4 Test Pit No. 2................minutes per inch Depth of Test Pit.----_-_-__..______- Depth to ground
u : water
-_.C-. ..r_„-._a_.--_-_.__..
........... ------------------ -•-•- - ---- •...................... - ----------------- --
SwQ � it
`� / �:R�Z ' .2--
4 ..._. ........... - -e . /._U �O Description of --
W
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 Article XI of the State Sanitary Code— The undersi ed further agrees not to place the system in
operation until a Certificate of Compliance ha ee issued by th boa of heal
t A�ve�Si . --- . ......................................... ......... ---� G-----
Date
Application Approved By------ ✓�' �-----/ -----L f ..:.. x - c�- .......
Date
Application Disapproved for the following reasons---------------------- ---------------------------------- ------ --------------•.-----------••-----------------
.................•---....--•------•-•------......._...----------•------•---------------•---•--••--------•----_---------------------------------------------_----.-----------------------•---------------
//
Permit No......................................................... Issued-•-. 7_�----��-•---Date......
Date
No.......f.. �•---- Fes$............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F HEA H
..._ .. ---------OF.............................. I—.............................
Appliratiott -for Bi.ipoiittl Works Towitrurtiou Vrrotit
Application ' hereby made for a Permit to Construct ( or Repair ( •�} an Individual Sewage Disposal
System at: c�� �1�-�+��/4
------------------------•------......--------------- ........ -----------•------- .........------------------------------------------------------------------------•-•---•--------
Location-A tress or Lot No.
l) Owner r (/ Address
....................... ...
(� ---------
--.-_-...... �--c... - _'E� ...._.........-----.-____---__--.------__------------
� Insta ter Address r,
U Type of Building Size Lot
..._lr_,� ----Sq. feet
Dwelling—No. of Bedrooms..-------- ............................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
A, Other fix es ------------------------------------------------------
W Design Flow................. ... .....�............77___.gallons per person per day. Total daily flow............
WSeptic Tank—Liquid capa�,4V_r_ -gallons Length,,-------�ii ......------ . Diameter------ _.---_-- D,e��th---------------
Disposal Trench—No. -•------------------ i....__ t ------------- Total leaching area-•--- �.sq. ft.
Seepage Pit No. �<>"-" ' --------- Depth below inlet`. ........... Total leaching area-------------•---sq. ft.
z Other Distribution box ( ) Dosing tank ( ) d- /� 3- 5/ -7G -
Percolation Test Results Performed by-------------------- -------------------------------- .................... Date----------------------_-- -----------
W Test Pit No. 1................minutes per inch Depth of "Pest Pit.................... Depth to ground water-.-._---___.___.__-----.
LT, Test Pit No. 2----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water-------..-- . ---_----
, f
a-_-..- -----c-h---- Ju-+-em --7-- - -_---............
- -- u. Y - Gr/`r-�r1P G Description of Sff
W
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
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 Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance ha een issued by th boa of health /
Sige ------ - --------• ---••-------....._._....--------------------
Date
Application Approved BY �'�- ------�� ---------- Lv� :- '-_ d- 7G
Date
Application Disapproved for the following reasons:----•----------•---•-- ----------------•-------•--•----•---------------------------------------------•----.--•--
...................................•--.--.---•--......----------------------.....------------------------
Date
PermitNo......................................................... Issued........................................................
- Date --
THE COMMONWEALTH OF MASSACHUSETTS C
BOARD F HE T .
..........:/ ..........O F.... .................................
01,prtifiratle of T"Tomplitttur
THIS IS TO CERTI " , That the Individu e ge Dis -sal S- em nstru ted (4-<Or Repaired ( )
bY...........
. = --- --------- =
/ (; Installer f L
at............ -- ---- ---- /�-------------
has been installed in accordance with the provisions of Art' g�XI of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No......................_-1�............. dated..._' _ _.-.7 G
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO STRUED A A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SA ISFACTORY.
DATE.......... ......�---` 7_ .............................. Inspector---f................................. ------.._.. ....... .........................
THE COMMONWEALTH OF MASSACHUSETTS GG
BOARD F HEA
/� � r
�o ..........................................OF............... ...................................--...........------------....
(i
No------------------------- .. FEE........................ �
i� o� orks rt� ti// rr
Permission is reby granted-------- ------ ---•.------........ ... ----r---- --- - ......
to Construct (r .pa' ( ) Ind' idual .ewage sposal Syst
atNo. . ...... ---- --------------------- ---•-------•--------•--------------
Street G
as shown on the application for Disposal Works Construction Pe No._.__,_F..:__.__ ated-------J �-- -----------------
Board of Health I/
DATE-----------------------------------------------------------------------------•--
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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LOCATION ' SEWO,C,E PERMIT UO
VILLAGE �'���ere 4 ge — — —
INSTQ LER S �J tJIE ADDRESS
BUILDERS Q &MF— ADDRESS
DNTE PERNA T ISSUED '_' = 2v= —
DATE COMPLIWACE ISSUED : '�=��