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Home My WebLink About0007 LAZARUS LOVELL ROAD - Health 7 Lazarus Lovell Road Centerville A= 171 — 151 I i l 0 AT PERM ON SEWAGE T N0. zovP / � a0 '2- V LIAGE r I N S TV ER'S:'' AME i ADDRESS lJ � BUILDER OR OWNER r DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED -/e rf c� o THE COMMONWEALTH OF MASSACHUSETTS BOARD IF HEALTH /.. ................OF................................. ... -- Appliratinn for Digpnaal Works Tnnitrurtiun Prrutit Application is er b a for, Permit to Canstruct ( r Repair ( ) an Individual Sewage Disposal S stem at: ... .... .. ...... ......... ..................................••--•- ............... -•--•--•••--.........--•••.•---- ....--•-••-- •••-•---•••......................_--••-• ----- ----- . Location-A d s nor wner —Addr IiR *----------------- = • ......... Installer Address Type of B ildin Size Lot_ . U YP g 3 �.�,�.�_..Sq. feet �., Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder P4 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a Other, fixtures ..................•----...-••-•-......•---••--........ el L - - - Design Flow........ .... _gallons per person per day. Total daily flow................ gal W �-�•---,.....---- �-�-------•-•-----•--- Ions. WSeptic Tank—Liquid capacit l/"". Ilons Length................ Width................ Diameter................ Depth................ x Disposal Trench—: o_ _________________ Width.................... Total Length_................. Total leaching area....................sq. ft. 3 Seepage Pit No.//. _ ... ..... Diameter____________________ Depth' below inlet............. al leaching area..................sq. ft. Z Other Distribution box ( ) Dosin�tan ~' Percolation Test Result Performed by._ :1... .: !✓:......... Date Date_.....,--W. -------- ----- Test Pit No. 1... ___minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a x ••--••-------------- . .....,� n.....--•-• ......--------•--------.... `..._.. _._`_ .O Description of Soil__......a. .. -. �.... .....* !- . . ...............................•--•----••--••-•-•-------------••-•--•-----------•-••---•--...---...-----------------------------------------------•------•------•---.._......._.._.....-•------..__..... 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 LI':IZ 5 of the State Sanitary Code—The undersi d further agrees not to the system in operation until a Certificate of Compliance has bee ' ed by the boa of health. Sie .::.. ............................. Application Approved B Date PPY..... . - =G% -�l•t`� -- - ---------------•-•--•----•• Application tDisapproved for the following reasons---------------•--------------------------•-----•-•---------._...--•-------•-..............Date----••...._... -•-•---•--•---•--•-••---••-•-----•-------•--•------•----..•...------•-----------•--•-•--•--••---------------••••-----••-••-••••••-•----•••-••--•-....--- Date Permit No......................................................... Issued..4.._.._. ............................................ Date 4 ..�...�....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................... Appliration for Dispog al Works Tnnitrnr#iun Vamit Application is hereby made for a Permit to Construct ( -or Repair ( ) an Individual Sewage Disposal FSystemn at, ........... ................A�4.............. .................................................................................................. � MLocation Address r TAt •..... • ." " !.. ..-...._.. fir... � .� ....... Addv • Owner,� ,r+ess Wr F'' f, . ,.-s'�-- ,r'�� ............ Installer Address w Type of B iu lding .. Size Lot__ ') !e�! ._.Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (,/k) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d t Ms. , Other fix .---•------•-----------------------•--..._..-•------.._....--------.._..-------------.....--------..__ _..----------------....-------...._.......---- W Design Flow....... ` ....................gallons per person per day. Total daily flow_______ __ _ ...................gallons. WSeptic Tank—Liquid capacit gallons Length................ Width_............. Diameter................ Depth................ xDisposal Trench—No________ __________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.!!� `.s�� . Diameter____________________ Depth below inlet............. otal leaching area..................sq. ft. Other Z Percolation r1bution b6xT st Results ' ) Dosin tank '-' Performed b _� � � . . �7 _._ �J Y 6 Xo..... . Date Test Pit No. 1-_ -.._......minutes per inch Depth of Test Pit____________________ Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --•••-••-•------•-- A---------- O Description of Soil------- ." �` " ` ... V ....--••----•••-•----•••--•--•-----•-••-• --•---•---------------------------------------•------.._---....._-----•--•-..._.._----- 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^ITL: 5 of the State Sanitary Code—The undersig d further agrees not to plat the system in operation until a Certificate of Compliance has been� sued by the board of health. ems, f f Sie ...............................................................------•-- e r vol r:/ J�c� �,l Date Application Approved BY 1:'•= + � - ------------------------------ Date � Application Disapproved for the following reasons-------------------------------------------------------------•---------------•--•-----------.........-.......... ......................................................................................................................................................................................................... Date PermitNo.................. ..................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ... ...........OF.......... ............................................. F f� if$rtttr of6( ompliFanrr / THIS IS CE IF�; hat,, Individual Sewage Disposal System constructed (A ) or Repaired ( ) bY--:-=...... - .................... ----•---------••-- r . I Her ,rhas been installed in accordance with the provisions of T � 5 of The Stat anitary Code as describe in the application for Disposal Works Construction Permit N o `�_ ___.______. d tted__.. /� • d PP P r - - - e --- - -•-`........... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A'GUARANTEE THAT THE SYSTEM-1lIIIL UN TION SATISFACTORY. DATE........... r ---- .................................. Inspector._..._._. .................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OIT4 HEALTH ?'totl OF............ .......................................... FEEA ..._... 96WSy1SLti;mV Permission is hereby granted..______ .^:: _: ......._._ .... wZ �to Construct . or Repair ) an iii ual Sewage ik No.• ' Q-' 1 �........ ... .. .q'-/---� fY ----•-- jw at ... Pm as shown on the application for Disposal Works Constructiono._____ ___e�_____ ated.__(�_" L�~ Y .... ' G�-'1� - ........... - �� Board of Health DATE ---------------•----........----..--••-•- FORM 125S HOBBS & WARREN; INC.. PUBLISHERS --- IadtU4 ttCb -4 6,P-.t2. ��''i-1 c TA,`1►�. = 330� ISc �o = aQ S s.P n. Use- t caoc5 64.0 SPO<—AL PtT - u5E i.,; UtEWAL-L AV-EA tcc> S.P. /o T' XA .ZE-:A c C';O ST. .. (1 I f"~� / � w _ .�� r0 TOTAL C7ESIGt.I = •425 G.P.D. Qz7 . ..� _ w t Few "A4 to VM- COLQT100 O ATE ("to Zm Q oa Lri ESS. - n P n•,Hox iC.G'F'IARM 9-�2-Xs�Q Off",i Y -rr--Sr 14-As Top F.i� l-1oz - r'G G10 - 4. L40j# Pv� tuv. 4'j low -80X 46-4- SepriC I C Z tNv. 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