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HomeMy WebLinkAbout0060 HUCKINS NECK ROAD - Health 60 Huckins Neck Road A= 252- 181 Centerville N 5MEAD No.2-153WR UPC Inn em"OlImm • Umb to USA SFIww�o�ira�ns �aauo i '9 FIZZ - ...... No................_.._.._ THE COMMONWEALTH OF MASSACHUSETTS BOAR® 0,OAF HEA/L.TH ..............OF........... ,e.� a/..tL ,� �irtt#i�an for Bhgvoii al Works nntitrnr#iun Vamit Application is hereby made for a Permit to Construct ( or Repair ( } an Individual Sewage Disposal System at ........................rl-,vr. ......................f---------•------------•-----•-------------------------........-------- * J ocation-Address or Lot No. �,g�, j p ss �C!.f1@�.�a4. A� P #ram Owner Address i �.� y •• ' /itA.-_'............................................. -------- __-______-_-_----- Installer Address Q Type of Building Size Lot... et 5"1 V......Sq. feet Dwelling—No. of Bedrooms......j.4a_,�---___________________Expansion Attic ( ) Garbage Grinder (PL4 ) Other—Type of Building No. of persons............................ Showers — Cafeteria Other fixtures d --------------- •........._..._.....------•• W Design Flow.................................>_�__-_.gallons per person per day. Total daily flow............ _............._.___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---1.+DV '...... Diameter........e_S._ Depth below inlet.......... Total leaching area...Z_Q_�--_sq. ft. Z Other Distribution box (k-r Dosing k _ '-' Percolation Test Results Performed b ,_ �� Date__.. .-z S ��a y -• =---.....-- ,� Test Pit No. L-,!__-________minutes per inch Dep i of Test Pit____________________ Depth to ground water...................... (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Pa' -----••---•--•------•--•........ ..........••-.. ............:......-..----.....----•-----......................................................... Description of Soil ?r > -�.` : �g {✓---�' � -- --.�1�.�.men:. a3;j-------1 V�-------- X;'..../. .-•----. . ..---- 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 iITI.;;:. 5 of the State Sanitary Code— The undersigned further agrees not to\place the system in operation until a Certificate of Compliance has been; sued by the board of health. Signe ir a te`............................. f " a '�.75?... Date Application Approved By............ .� --•----._._..�--��- - ---..........----•- ---•-•........... Da te--------- Application Disapproved for the following reasons_________________________________________________________ .................................................... ......--•--------•--•-•----•-•---•--------•-•------------------------•----•------•------•------------------------------•--•--••----------------•-•----------------•...--------------•---•---••--------•- Date PermitNo..................................................-...... Issued.....# - ....................... Date T q. D. ,y FEs• THE COMMONWEALTH,tOF MASSACHUSETTS BOARD OFF HEALTH S .F . Anpfira#inn for DiipmFal Workii Tnnitxnrtinn Trani# Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at / ,1 ---------------- .rc 4 . s� .! "r .. r ifi/f ---------- - 11--•-----•------ --..........------..... .................._.... o._Location-Address or Lot No. ,� s. FL:c _________________ _ ... $+ei ::.~.! ryo„- ....s��-i!�f ............_.......--- �,r�f� Owner Address q .............................................. ...... � �.....__L�'�✓'r E ::<"£ .l�d � ............ Installer Address.. Type oflBuildingfs Size Lot._ "d. ''�� !' ......Sq. feet Dwelling—No. of Bedrooms.. ........................Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ......e.................... No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures -------------------------------- W Design Flow................................<_",C'..gallons per person per day. Total daily flow............?,:m*"__........:...........gallons. WSeptic Tank—Liquid capacity 4 gallons Length................ Width................ Diameter................. Depth................ x Disposal Trench—No. .................... Width.................... Total Length........... __..._ Total leaching area..... _______:_._sq. ft. Seepage Pit No._,/ ------- Diameter........ ..;7 Depth below inlet................... Total leaching area.. .d.......sq. ft. Z Other Distribution box (k-)' Dosing k ) -2 cam"" 7g. `'' Percolation Test Results Performed by.4 .._""_..__ __�_.. _....__'..._........ Date... .........................:....... minutes per inch De h of Test Pit____1_d,-_ Test Pit No. 1""__�.___.____ p p _______ Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................._. Depth to ground water......................... a' ................................................. ----------•-•--••-- ------ -- ,q-,-�-- -�/ •-- ' O Description of Soil.:_ t" ,, "fa ' ��. !sr. ,�� .t--------'�� 41P -------------------------------------------------------------------------------------------------------------------------------------------=........................................................... 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 TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation' ntil a Certificate of Compliance has bee�ssued by the board of health. Date 1p ;w Application Approved By............ j .41 - ----------------- Date Application Disapproved for the following reasons:......................... . ---------------------------......-•-------------------------------..._.....-- .............••••••••-•-•-----•-••...••--•-•-••-•--•-•--•-•-••••-••......•••--•••-••-...-••••••--.:_........•-•---------••-••••--•-•••----------•--•----------------------------•----•--•--••--••-••-••- Date 'r Permit No.........................-- ...................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS t * '•, BOARD OF HEALTH .1,. _ f r ` OF. ........46A.-Il".................................................... (Irr ifiratr of ToutpliFatta TIRIS I OY011= t theIndividual Sewage Disposal System constructed ( ) or Repaired< by ,..:. - ------------ .. I taller " --- -------- -••-•-- . �ance at....,,,,.... .. _... � - ---- r . .has been installed in accor with the rovisions of T _ > of The State Sa.nitar Code a describe in the application for Disposal Works Construction'Permit N'o. .7 ` � da.tedy_..l_�:..... � . ....._ F THE ISSUANCE OF THIS CERTIFICATE SH4LL NOT BE CONSTRUED AS A GUARANTEE THAT THE a SYSTEM WILL FUNCTION SATISFACTORY. DATE...........................•--•----•---._....---•---••--....------.....---...... Inspector........----•-•••--•------------ Y u THE COMMONWEALTH OF MASSACHUSETTS V BOARD OF, 1JEALTH N0717 .G.l ...... n --------------------------------- �,J_. FEE........................ Disposal k �n � inn rrntit Permission is, hereby granted---------- ----- --'...--- �/' to Construct ( or Rrklir ( ) an Ind• ld al Sewage posal System at No._---•• '' ------............... �, f r � GtYt ,A�. .._.._l. "_ �..' tree, as shown on the application for Disposal Wl grks Construction P its o--- --------id •- Dated.._."��1.•_ '"__.T�' ,....__. r_ r o ealth DATE........ .. /----•--••••••-•••••.......••--• .......... FORM 1255 HOBBS &.WARREN, INC., PUBLISHERS - u- r L7��1�.►�l �7h,TA - �,t+.,SGL� G•n.�ntt.._�-( - 3 �3t�ttc�o�K �'-». G► L.10 GAtzR6�� �L�fZt 1.tb'ttSt- tit L,� >`Low l to 4 3 = SS G.P.V. n �Er• c -r-A"►� = 33oJ tSC % • �S 6.PD. U Ste- t oOc� 6AL-.. rLCJ�.LL Ae& = toj0 S tP- ?JO p 1 SF ,c 2.S • 3-!S G.P.Q. nT uzrrmm SO sow. 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VILLAGE INSTA IIER'S NA i ADDRESS R U I L D E R OR l /Jn��oir/Iy-t✓l�(� DATE PERMIT ISSUED DATE COMPLIANCE ISSUED -- 1� -�© � �` '" 2c ` \ �, 1� \� � � � .�. �� �- '''� �_ a � �