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Home My WebLink About0025 BRETWOOD LANE - Health 25 B re9'w ood L,v C ent6ry �I IE 168 liq Ks:M E A D KEEPING YOU ORGANIZED No. 12534 2-153LOR 0SUSTAINABLE FORESTRY MIN.RECYCLED INWIVE CONTENT100 CertifiedFberSourcnp POST-CONSUMER www.sfipropram.orp Sf{01190 WE W USA GETORGANgwaSuEA mm i LOCATION SEWAGE PERMIT NO. VILLAGE C,Fwro6k Vie L TA IN S LLER'S NAME i ADDRESS 1dE Me1/1-0 BUILDER OR OWNER rT/f DATE PERMIT ISSUED _//- T3 DAT E COMPLIANCE ISSUED Y i� O THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..._.--....��.O........OF...... U.1 MJ ,...G.. -. ........ Appliration for Biopoottl Works Tonotrnrtion Vamit Application is hereby made for a Permit to Construct ( 11_�or Repair ( ) an Individual Sewage Disposal System at: . r.e ............................................. ........... ...... ........._.. ---......... Location-Address ........................ . �► Old' ..�:?�r \-.......................................... W � !a nerS ^.........—.....s....\\:C A"dr-ess .J.�...........--- .................----•••..... Add Type of Building Installer Size rLot s ®O Sq. feet Dwelling—No. of Bedrooms......3.................................Expansion Attic (Q Q Garbage Grinder No Other—Type of Building No. of persons............................ Showers a g --------------------•---•--• P ( ) — Cafeteria ( ) dOther fixtures ....................................•---•----•----...................----------...------..........--- W Design Flow.........\0.......................•..gallons per person per day. Total daily flow__.....3�P........._....._......gallons. WSeptic Tank—Liquid capacity=!; 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 tank � D,, Percolation Test Results Performed by... "`....•... ........ Date..... ......................... Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R: ...........i•----------- ............................................. _.----. ......_.... 0 Description of Soil----••-•-® ��'' C�,rynt..a..... sue.....------�............S (xj ----------------------------- -"...�.z .._....... mom, �� -- - 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 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 f health.. (� ned...... G1...... ......... �`.•,-"`-... 0.�r_ ..Y ApplicationApproved By.......... •••. ...... --••.........................................................•--. ----• .....------- --.....---- Date Application Disapproved f o th ollowing reasons:................................................................................................................. •----------•---------------------•-•-----•-•-•--•---------....-------•-----•-----•------..................--••-•--------.....----•---------------•--------------------------------...••--••-•---•--•_.... Date PermitNo................................................................................. Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration for Diopoottl Works Tonotrnrtion rrmi# Application is hereby made for a Permit to Construct ( 4-l"or Repair ( ) an Individual Sewage Disposal System at: ` � :-•---•.................. ... ....... ... -....... ' Location-Address or Lot T' a...... �: _� �::�.............. - ............................. �a ......................................................... . -•--•--•--....r. ..... - ner Installer Address ^' UType of Buildin g Size Lot............................Sq. feet Dwelling—No. of Bedrooms.._....?.................................Expansion Attic (Q P Garbage Grinder `k Other—Type of Building No. of ` Pk YP g -........-•-------....-•---- Persons.----------•---•------_-_-.. Showers ( ) — Cafeteria ( ) QOther fixtures ------•-•--------------------------------•----•-•------•--•---------------------•----------••----•-:�- W Design Flow.........V\_Q..........................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity ! C: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 tank ( ) �� = '� a Percolation Test Results Performed by._.. ^.K_�-�C.. : ......_ ........ Date..... .......... Test Pit No. I................minutes per inch Depth of Test Pit................`... Depth to ground water........................ rs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -----------t........••--------•----•- 0 Description of Soil.........J ` ....... ---•------• °!- ------..._••... -•-•••-•-•-------------------------------------------•---•--••--•--..._.. W x V 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 TITLL 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. 4 S" ned..... :�Z ( • Ithollowing tApplication Approved BY -`_y...... ...Date Application Disapproved fo reasons-------------------•.....---•---•---------•------------------•---------------•--•--------._...-••--•---••--•--- -•--------•-------------------------------••- ••---•----...... Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 4 C9rdif iratr of Tomplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( r Repaired ( ) by......... .............. ......---- ------ ------. --....-•----------........... ----... .........-- ---------- Installer ' has been installed in accordance with the provisions of T F 5 If The State Sanitary. Code s sc ibed in the application for Disposal Works Construction Permit No.. �.`.��............. dated..... ✓. -._�._---•----._-------- THE ISSUANC OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® S A GUARANTEE THAT THE SYSTEM �4VIL F C/CTION SATISFACTORY. ' DATE..I......... ..................................................... Inspector-------- ----- --...•._...•..---------------------•--•---•----------....------... THE COMMONWEALTH OF MASSACHUSETTS BOARD OFF HEALTH`' �,, . 1'7......OF.............<_ .C.x_�� 5 �..��✓ No........... FEE........ ............. BWVV15�l Works Tono#rurtion "Prrmit Permission is hereby granted �� n-A.• ..__... to Construct ( L„)'or Repair ( ) an._ ndividual Sewage Dispo al System 1 at No. �--�-= -------•�-�-----....... _4 2. -------•--- "`C�y'--�---•-------CQ_(1..C.�:-!�.V1 �\.........`� Street ? M5�/ as shown on the a pli tion for Disposal Works Construction Permit No......:..... ...... ated.......................................... ......................... -•--- .................................................................. oard of Health DATE----- (/ ............................................. FORM 1255 A. M. SULKIN, INC., BOSTON pp- `�a►�GLa ,FOAM +-Y - BEORooM IIu0 sGAR AGE 69ZANDE2 -- - - pA�LY Flow .: Ilo x 3 = 3306.PC? 5EPT►G TAQW_ = 330x15o% -- A956.P o u5c 1000 GAS... ot5Po5AL PIT v5E 1000 GAL. 'S 1 PC-WALL AP-SA. = 1 S,F { 150 5.F >< Z. R-•P�t BOTTOM A2EA- 5� S.F• x I, o �. 5•p G.P o v 70TA L- DESIGN = 42_5 G•P D. ' (LX�U GA+- -ToTA. _ = 33o G,Po. .Q 'S 'T1:. Th►+1� P�2oo�-ATioN FzATE : I''iN 2MIN OP_t_f-=55 �p t�.4D' l¢t }97? r ' 1H OF M ti�L' `�L4ti Or ALAN yG\ N RiCHARD W. A. a o BAXTER H c� JONES No.24048 0. 2s,00 � � At. � G . N v C) ,U G 1 t.�STfc�`yb� f l c v 4No su�� n; 4, Q �f P►ST. INV. vl/�,,+UIL BMX b6pT�G `Z ,`1 IOoo IN�I 'IG�G TANK I..EAGN '• • I PIT INV.. INY. I WITH 96•Z IG H WASucD ' 6TvNE , a9 ' � � CER.TIFIGD PLOT P1-A1�1 i G PRZoFILl= l.o44�loN L.L,6 CL=� NO SCALE I SCALE; yA+Ta ; 1, II G3 Uv,wA'T62 I P EN C, I. GER"('1FY TNAT TNT �Ouhl�A-T��I5No1rYN NE.REo►•1 GOMPL`(S WITN'THE S l o�Llt,1 V ' S GT 154 R_6 Q v 1 u-r~M E t4T> O F �.o A u P � ki 1Z 1-x�(��Fa N'� ►S ►.�v q'� �(�, t_OCp.TE D MIT d•1 N .DA'T E � '- C.l G- I BAXTEcZ.e 1..1`{E INC. _R.SG I to�f��6U't-AND 5 u ZY E�(ot�S I. ' 'T111�j PLati 11:2 N4T E3A5F D p►d AN OSTE2.VILLlr • N�Ass• (u5-1-RuMENT ZVEY -THE C>r- 5 6POULD ' - NET �E'�VSEDTd �ETE�l^11J� L_oT V11-1E�j APPLICP.N'r J ►',1 ►'r'.c� I�., �►-�, r��