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HomeMy WebLinkAbout0062 BAIRD WAY - Health 62 aq�cd wqy cowvr fft 1 79 - zqy SMEAD KEEPING YOU ORGANIZED No. 12534 2-153LOR SUSTAINABLE FOREST MIN.RECYCLED RY INITIATIVE CONTENT1%D NOW Fib"sourcing POST-CONSUMER w .sfiprogram.urg ffi-01]00 MADE IN USA ^-FT QRGANU-0 AT SMF_ADMU LOCAT10 � SEWAGE PERMIT NO. VILLAGE 4�-- ;;qqA I N S T A LLER'S NAME i ADDRESS f /t l/U _2 5 SA f AG d U I L 0 E R OR OWNER a O DATE PERNIV ISSUED r 'Ip DAT E COMPLIANCE ISSUED �'' � it -------------------- r 9� A4-N h No.......y_'_Zd. 1. Finc.,.�r..D.................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® Off`\ HEALTH ................... ....................OF ApplirFathin for Disposal Works Tons#rnrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................................. ........ --------------------•------------------...------•--....--------- Location-Address or Lot No. • l d� �.`1��OtnNSc�y?.$ . Owner Address .............................................................. Installer Address U Type of Building Size Lot_l:�"Z­_Z4 ..Sq. feet Dwelling—No. of Bedrooms__--- -----------------------------------Expansion Attic ( ) Garbage Grinder ( ) a`4 Other—T e of Buildin YP g --------------------------•• No. of persons.................... Showers ( ) — Cafeteria ( ) d Other fixtures W Design Flow....,5.7_5 ............................gallons per person per day. Total daily flow-----------3a...................gallons. WSeptic Tank—Liquid capacity/.goa.gallons Length.....19....... Width..__.Y....... Diameter................ Depth..... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No--------- .......... Diameter......lAt.5=_ Depth below inlet........_lk....... Total leaching area.--�_Ksq_.4. Z Other Distribution box (✓� Dosing tank ( ) lc� f:11.0 Percolation Test Results Performed ,L-4-� ________________ Date.... . Test Pit No. 1...2........minutes per inch Depth of Test Pit.../_69..._. Depth to ground water..tl 07.r_E/-/ c®Uw�,ee-� rs, Test Pit No. 2................minutes per inch Depth of Test Pit............... Depth to ground water........................ a •-•••-••---------•-•-•-•-•--•---- -••-----•-----•-•••••--...-•-----•-------------------•-•••-_----•--...._.....---------.....----•- O Description of Soil...' _. _�. ....... 4' ...................................... W 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 place the system in Op' on til a ertificate of Compliance has beeplissued by e board of ealth. Signed.....-- .. �� .� C% rS�� a Dte APPY' on ApprovedBy...... - •----------........................... ..................2-Ay-... Date Application Disapproved for the following reason :--.....................-......................................................................................... - -----•--...-•-------•-•-•----------••-•-•-•-----•----•--•---•----•-------•----•--•-------•-••--•----..........•-------•-...--•-•--------•------•----•-----•--•-----------•••-•-•--••----•-•---------••--- Date PermitNo......................................................... Issued............................ ........................... Date 4 No.._,��r.... Fps..... THE COMMONWEALTH OF M,ASSACHUSETTS BOARD OF HEALTH ................... .....OF....................:.................. -�Vp ira inn for Dhipo"s al 10orkii Tonstrnrtinn rrmit'' Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ..�:, ._.. . .. .... ..............x__ ,1.. -----•-------------------- .. ....... L .�?-- .. .... ....... Location-Addres - • —„ [•', - or Lot No. ih---------- -- .......... Owner Address .....-•-.....••- -- _------------------------------------------------------------- Installer Address '•.` '-Type of Building Size feet Dw441ing—No. of Bedrooms.....3----------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building _______________ No. of ., _ Showers a YP g ------------- ersons.._.................._ -------------------P--�- - ( ) -- Cafeteria.(... ). d Other fixtures Design Flow....._e .,ier" gallons per person per day. Total daily flow.____......,; "" gal W s. -- ----- - g P P P, Y .M'�l_�------...-•---••gallons. WSeptic Tank—Liquid capacity/ur_gallons Length___--Length Width....Al......_ Diameter................ Depth..... x . Disposal Trench—No. .................... Width............:__..... Total Length.................... Total leaching area------_.___........_sq. ft. Seepage Pit No---------/--------- Diam�ten...:./_0.,_,j: Depth below inlet.........tea....... Total leaching area... ', ,-;�..sg ft Z Other Distribution box Dosing tank ), ,/-0 '—' Percolation Test Results Performed ?, --- Date....- —Z V;,Z ''t�/--........ Test Pit No. 1..............minutes per inch Depth of Test Pit._,_/_'6 i"._ Depth to ground water. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground wate1.C_ '?.4'A);RW A-'-4 4' .-•---•--•-----------•..• -•--------•..............•••-•-...--••-•-•----------.....--••--•--•---•---•---•-•----------------•---•••••...................---- 0 Description of Soil-- , `'- " �1 +� --------4,4,qA-............. U -•-•-•••-•------•-•-•---•••-----•---••--•---•---•--•-•-----•-••--••-----•---•-•••••.........:...............•-----•-•-•---•-•----•--•=- -r :W ------------------------------------------------------------------------------- -------••--•----•-----••-••-----•-----------•••••---................................................................... e 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 L ITL% 5 of the State Sanitary ode— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b issue b1le,?�pard o lth. e 7 r !�, Signed................................................ - 4 s i Date......... _ Appli non Approved BY...-•-•--•--- Application Disapproved for the following reason ------------------------------------------------- ---•-- ............ ............-............. Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF............. murdifiratr of Tompliattrr THIS IS T CERTIFY, That the Individual Sewage Disposal System'constructed or Repaired' by. .....tee*.e*%.................................................. .................................................................................................... Installer at.................. . .... . ----------- . ..........4-V ...... has been installed in accordance O�'n the provisions of TII�L-1!7 E 5 of The Stat ary Code as described in the application for Disposal Works Construction Permit No.__-... dated________________________________________________ _' ---------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM W!I L N I N SATISFACTORY. DATE.... .. .. ...... ........ .... ........... ...4. ..... ..................................................... Inspector ...................................................... THE COMMONWEALTH .OF MASSACHUSETTS BOARD OF HEALTH ............................ OF...... No......................... FEEYY.................. Y'q- T11notrudiatt "panat Perrm10 * hereby granted................. .. .................................................................................................... 'Iss to Construct or�,Repair an ln�d�iivival��S�ed&:wage isposal System at No.........W .............A--------------c�e--------- - ------------------------------------------------- as shown on the application for Disposal Works Construction ermit No--------------------- Dated.......................................... --------------------------------------------------- .4 Health DATE......... FORM 1255 A. M. SULKIN, INC., BOSTON TOE of Po��N a, 1_ 71, _ L E i -- ._ ---- -- e X JStlr-)cj qrvUnd r9 � � M,lqA.1f-,'UL G E U V E,e5 TO ZAl/T,°-l/AJ ; ' - � v q.-o,ur7 pr•oflle � /2 OF Frti/rSNEL, G scf-IED. 40 P. V c. ©ie - __ FL aw EG?ur9C -T't-J SEPr/c Cr"rnrr»urnl4- per -'oo+) v r-» SEPTIC T,--)AJ t v P G O 7 • \ 8' • _ O • z.� E-7 oT \ SC 4- E . 4LE � CN F't7' ---- L:D E- S i G ti ---_ T E=- 5 T o L E- LOG -- _ [3ED,2Ot7M MCOU5E DATE : �_.�_ .- q TEST BY: LO '_ it�� C L r titiJG. � � ♦ � � - PE,2C. r�fl TE � �' rnr. .✓,V �-` '7`�/E S5 . � �/FFC�,eD��nft�.r-r~�.;~"Q.�1 e __ DATUM E s 57T SEPT/C Tr9/v,e 7 1/ �,�, � •/. � � USEr : � � -'' GAL. 7-iA1VA:: �/ q8� fqA�� L Er4C'H P/ 7-: Lo�M $/DC-w t--L _ / -, S. F. ( 2.5 G. C::'. tJ. r w 11 i Ott.--* r' / CC T/F Y T N-/AT THE BCJ/C. D1.UG e 3•-4¢ � =� Ac . ate" ��� P vq Pr2oP SEEz� t1 TNE-C�r G.CCIUAJO 9S �' 1 0 S H o o A-/ —r-A41 s PL�Ar Z:)©E S ,el-2 Ta THE BUJLD/&!G .5E'7-- , _ - \, ,C- Za c� , O W AJ OF S /4 l.%l N fa L 45 a 0 0 - �' X /$-f"/ h � 4 /� 1!Q T i b/7 B Gr- ,� �. J��7-� /4 C,�• / / y�•►t rr�`�A� i s� Y i�•,-•+ '''` , ' - Y� l2 r7 U UT"H N��SS. oop pr-oPoSed e /a? vafror �2EQUi,BE•/` l�ti/TS '. . _ - -- -- -- — — e X 1.5 f / rn o C n f c,a r•5 r' 9 s , de Ir ItBGaA�Z� lJrc !/�AL_ Thl