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Home My WebLink About0136 JAMES OTIS ROAD - Health 136 -,LTaMeJ o-tis 170 SMEAD KEEPING YOU ORGANIZED No. 12534 2-153LOR FO�RESATR1rl E MIN.RECYCLED INITIATIVE CONTE lmos CvmWF'-s-'iny POST-CONSUMER W101m MADE IN USA GET ORGANIZEn AT SMFAG1 COM T+o•z ~�Z FEs................ THE COMMONWEALTH OF MASSACHUSETTS BOARD-OF HEALTH oc/ K..............OF...... .................................... Appliration for Mipasal Work.5 Cfnnstrnrtinn funfit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Syst t o �/-- ��ocadress . ._ t No. .......... -•................................•.....- --•------^--...........•...................._. Owner Address a L ------------- --------- ................................................. ,.. Installer Address d Type of Building Size Lot../ 4�._Sq. feet J Dwelling—No. of Bedrooms........................`........_...__.._..Expansion Attic Garbage Grinder (.14Q aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtur . W Design Flow_.__._., z'b -------------------gallons per person per day. Total daily flow...... —�� .+?©.................gallons. WSeptic Tank—Liquid capacity.1_k-4'dgallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. ................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No._...�-4_.x'&Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Grq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 04 ..------••-•--•-••-•-•-•••••---------•--•...................................•--••---•--•----•---•............................................................. 0 Description of Soil........................................................................................................................................................................ x x --- ---------- -- ----------•---••••--•--•-----•--------------•--••--------•----•---------•-----...----•-•------••••••••-••----•-•-•------•------------•••-•-•-...-••------------------................ U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ......--••-•------••----••--•-----------------------•---•--•-•-•--•----••--•••-•---••-•••-•--.-----•--------...........-•--•-•---------•-.....--- ......-•------------------------------••-•-••......--- A nient: he undersigned agre s to install the aforedescribed Individual Sewage Disposal System in accordance with the ov' 'ons f of the State Sanitary Code— The undersigned f ther agrees not to place the system in o rat' n r • to of Compliance has been iss d by the board of h lth. _ ..... ... ...... . ................ .. ...............................•• .......... to A tion Approved By................. ................... �.... ¢_.._.. 0 �` 5 Date PPlieation Disapproved for the following reasons:---•------------------•--------•--------••---------------•-•--...._..-----•---------•---•--------.._......_..._ ----------------------------•---•-----------•--------•-•-.....-----------•••--•-••------••----.........•.-----•--................--------------------•-------_...........--•-----••••-----•---------•--- Date Permit No......I `� � 2- .�:---................. Issued..---.�.------•--��...:- ......... --..._..----•-••---• Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration for Uiiipasal Workii Tnntrnrtijan Urrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: � .. Location_Address or Lot No. Owner /` Address W r. l Installer Address UType of Building Size Lot...zL._- ..............Sq. feet a Dwelling—No. of Bedrooms.................::.........................Expansion Attic (,#p, Garbage Grinder aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) QOther fixtures ..................................•----•--•-•--•--.....-•--•---•---........._.....--•--------•--.... W Design Flow..__._t:'_....'...:.......................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....................... Diameter____________________ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by--------- -------------------------------•--......-••--•---•••......_..... Date........................................ Test Pit No. I................mmutes per inch Depth of Test Pit.................... Depth to ground water........................ fs. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 04 .....-•------------------------•--•-----•----------•---------------------------.....---•--------............................................................. Description of Soil....................................................................................:................................................................................... x U ._...---••--•----••----••--•••••--•---•--•-•••-•••-••------•-•••--•-••-•-•-•••••......--••••••-•---•..._.....--•••--•-•---••-•-•---•••--••-•--•••••••-•••-•--••-•---•--•-------•._.....-•••-........•--.. w -------------------------------------------- --------------------------------------------•------...-----------------..------------------....-----------------------------------------------------•-_... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... .............. •.........---•••-•--•--••.--•----••••----••---...........•-•••••••-•-•--...__--•-••--•-•-•-•-........-•------•.........•-•-..........•-•-•......._..-••••••-••-•••••--.......•--...------ A ment t he undersigned agre s to install the aforedescribed Individual Sewage Disposal System in accordance with the ov ons f t of the State Sanitary Code— The undersigned further agrees not to place the system in o at n '� rt' to of Compliance has been issued by the board of health. netl -•---------•-•---•..................................•-•-...-----/-•-•--.......... --•------ . /.......------ �. to Ap tion Approved By............... ..............<:!2-..................................................�—".. .... .......... f Date plication Disapproved for the following reasons:........................................................................----•---•--•••........................._ -------------------•------•••-•••---•--••-••...._•-----•-•-•••-••-•--....---••---•-•••---•--•...D.u•-•-....._.._. Permit No...... � .::__...��C_ .: Issued.......---_..........Z. ......... ... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF......................................I............................................... (9rrtifiratr of Tnmplianrr THI IS TO CERTIFY That the Individual Sewage Disposal System constructed ()() or Repaired ( ) by....:. : ';: ? .. _..----••--••-......---••--•-•-• ......-•-•-•••---•.... .............. ........•-•••-••--•••....••.................••-- - --- - ----- --- has been installed in accordance with the provisions of TIT F 5of hes. tate Sanitary C as do ed application for Disposal Works Construction Permit No.__ .............. ...__ .- - ea..... dated_ ..._ ......................... - THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION-SATISFACTORY. .�. DATE.__.._. s Inspector......... .;,..:.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....................OF.......... -.--......._. FEE........................ Uhip a ial Vorkii Tuntrurtion rrmit Permissionis hereby granted.....` ...................... .................--< ----------------------------.......-•---............-••••...-••-•-__ to Construct O or Re air ( ) an Individual.Sewage Disposal Systerp �....------ l!-- -------------------------------------------•----..........-- at No. 4` --...... .... Street as shown on the application for Disposal Works Construction Permit Dated__ ��.5 .. L � Board of Health DATE................. ---•••. •-•--••••-••••••--•-••.......••-•-•------ FORA 1255 A. M. SULKIN, INC., BOSTON V�51 c,NJ L,) i I e es N;. .,►N(,LC- FAtAkLY -- :5 BEOR40M t!o GAr2.$AGE 6v-1 r)GP- 7 %L FLOW z 110 X 3 = 730G.PR I � 7AY 'Z•L SEPTIG TASK = 330x15o% =�9�6.P. Al use- 100o GAL. f �31.23 015Po5Al- PIT y5E ►000 GAL. A QOTTOM AsZEA= , 50 S,F; N •T - - 2z �oP Zo Pfr -TC)TA I-. D ESI6M = 2 G.P D. 35 t fi /xis. TOTAL DA F%-0W..= 330 G.PD, e. PE2GoL-A-rlou RATE: VlIN 2MIN OV-L1=5y H OF 414SOF 3Cv 7 L1- PETER i.. RICHARD St1LLIVAN �i' Jf u BAXTER NO. 29733 y . 749 No.2404E34 cosT�� S`` .•; . . r � lam' ,..;� - "'�",• � � - - -�- Pz� 1; I NV. 6 Z ,b �!✓PiSOK� loov INV. p�ST. INS. oat,. 511 ' t000 INY i�oK SIG TANKLp SI,C �AIJW LI-AGL1 PIT INV.. ..IN%l G-aA✓e— WITq �a- �I•�L WASt1fiD 6TvNt~ -; SAND GERTIFIG0 PL cn,T PL-AQ hR0r-ILG 41 l3 W O 5 CA.LE (t� 5CALS _cam �AT� -2'1-f�S 0 ;UJ QT�tZ 1 G E�cz.T 11+Y T N AT `T H am . 0Uh)1�/aT/C� 5>-tO 1r�1 N P L-A N REF E2Ect GE 1{E,REo1�1 GOM(�L.�(S yJITN'THE SIoELItJ� ANo-sE-ce�GK 2 a�Iu.>=r�>=�t-r� -cµ� •�' �o� . To W N F O F �1T��L-t A NU 1 S t1T LOGp.TED'•WITNI TN� GLoaD PLAII•! BAxTE2e myr-- INC. REG 1 SZ E•R6'D'I.Au D 5 u MY EYde•S Tu15 PL�ti 1 hlo� (3n5c-_D oki AN vs•r-E�vtLLr - �KASS IW5T_R.UMEI�I-t Sv9_VC-y 4- VAS 01= ,SETS S�tou►,'D No't''i3Enu5E-DTC� pETEFL1nli.1� t_o•t' 1_IN�S APPLICANT' Al AA-) � . �f�4�� 4L L 0 C A T 10 N '. ..__.__.-_. SEWAGE PERMIT NO. 60 r, z. VILLAGE 6.1 KINS ll-ER'S NAME i ADDR S i '�B UILOE R OR OWNER d DATE PERMIT ISSUED 2- gS DATE COMPLIANCE ISSUED �- r 3� d