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Home My WebLink About0022 LAZARUS LOVELL ROAD - Health �'11- 14�� KV71-4' LOCATION SEWAGE PERMIT NO. LOT 276 Lazarus Loyal 1 Ed- 79-2 53 VILLAGE Centerville,, MA, INSTALLER'S NAME i ADDRESS Alfred Fuller Cntu i_t Road M rc ons Mills, MA. e U I L D E R OR OWNER Alan E.Small, Inc. Box 536 Centerville, MA. DATE PERMIT ISSUED 5 f DATE COMPLIANCE ISSUED 7`7 �- i 1 �� i �� 5 �' �-�. .,-------- ��a .� f No.......... .2 S. ...... FEs..au` ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD HE L H �/ ...........OF........./ .. 1 I Allp iration for Dwvasa1 Works Tnnitrnrtiun thrrAft - Application is hereby made for a Permit to Construct r Repair pp y ( ) o epa ( ) an Individual Sewage Disposal Sys at• � -� .... ............................... ..............z:�.�... ---• Locatio ddress i t No. ....................... Own ' �ess •--•--•-••- . ....Installer Address Le_" Type of Building Size Lot...... ¢_.Jro....Sq. feet Dwelling—No. of Bedrooms............. .........................Expansion Attic (,,*Vo Garbage Grinder Other—T e of Building No. of persons............................ Showers a YP g -------------•-••----------- P ( ) — Cafeteria ( ) d Ot e fixture --- ...._•---- .....................................--•-•--•---------------•------•-••--•-•---• .......... �,,,,.�.�'� •--- W Design Flow.... .�.� allons per person per day. Total daily flow �� -� .............gallons. WSeptic Tank Liquid'capacity.._.•-•-.gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—N Width.. ............... Total Length................... Total leaching area....................Sq. ft. Seepage Pit No........�____-__-- Diameter....... Depth belo inlet..... :........... Total leaching area..d.l_�.sq. ft. Z Other Distribution box ( ) DosingAn ( _,7 �� I '� Percolation Test Result Performed by._:� " .. . ..'!..!�--�------... Date---Cf---�•�-7�.............- :2____minutes per inch Depth of Test Pit.................:.. Depth to ground water........................ Test Pit No. 1.. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a' ----• ......... ..... .. --------------- Description of So --•---•-•- T- .....�...•. - • ............. 91,et.* V_.....6... , - IV ---------------------------------------------------------------------------------------------------------------------------------------------------•--------------•-----.....--•--------.....--•-•-.... U Nature of Repairs or Alterations—Answer when applicable.............................................................................................. ------------------------:............................................................................................................................................................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sew e Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigne urther agrees not to place th/sys m in operation until a Certificate of Compliance has been d by th oard o health.Si ed. _ ------•.......-•.......•••............. �.Application Approved By...::_ _ : Date Application Disapproved for the following reasons----------------•------------------------------------•---------•-------------•--•----------......--•••....._..... ......................................................................................................................................................................................................... Date Permit No......................................................... Issued_......�/7— Date No...... ......... THE COMMONWEALTH OF MASSACHUSETTS E30ARD HE - -- ---------------- ..OF....OF..........ea.4 Appliration for Disposal Varks Tomitrurtion Vautit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal Sys A-14................................0. ....................... 6 wl ............... '2"1t' Address �Gt N'. .......................................... r ............ ....................... Own r r*�,A dress ...................................... ........... .. AIX .......................................... Installer Address Type of Building Size Lot--- ... ....Sq. feet Dwelling—No. of Bedrooms...._._.....Z� --_----_----_------Expansion Attic (1V0 Garbage Grinder ()IVIO Other—Type of Building ............................ No. of persons_........................... Showers Cafeteria aOt fix .............. ------------------------ .........2........gallons per person per day. Total daily flow................... ... ..... ..... 3; Design Flow...��t .... ._..................gallons. Septic Tank I Liquid capacity,2�::2'" allons Length................ Width...............: Diameter._._......._.___ Depth................ Disposal Trench—N9--------------------- Width.................... Total Length.._................. Total leaching area. -------------------sq. ft. Seepage Pit No........../........... Diameter.......!!............ Depth below inlet.....Z:........... Total leaching area...'.:3... ft. Other Distribution box ( ) Dosing tank ( _)_a,.,/;- /0,' //',k - Percolation Test Results Performed // 1�1 - 7 J: ........ .......... Date... ................................. Test Pit No. I... 1/2- 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..._._.................. ......................... `:'.. ..................... / ............------------- ...............I.............. ........................w.............. 0 Description of,Soil........... ......... ...........y........ x .4 .................... ................. ..................................................................................................................... ..............................I............................................._ U Nature of Repairs or Alterations—Answer when applicable............................................................................................... .................... ................................................................................... ......................................................................0.................. Agreement: The undersigned agrees to install the aforedescribed Individual Sew Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigneVurther agrees not to place the sysym in operation until a Certificate of Compliance has been by thKoard 'health. Signed. .................I....... )6. 0/ .. /;7. . .............0----------------- ---- -- , _�/ �/ ,GI' 3a" Application Approved By. Date Application Disapproved for the following reasons: .......................................... .............7 ...................................................................................0.......................................0............................................................. .............. Date PermitNo...........0............................................. Issued......0................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............ .....OF........... ........................................................... /Trrfifiratr of Tompliaurr THISJS TO �ERTIFYIThiit the Individual Sewage Disposal System constructed ( ��o Repaired ............ ................................................... ........... ........ .. by.........�!..Z ........................... ...... Installer .. 7 t� . .... ............ at---Z�..... .......... ......I ................. J" has been installed in accordance with the provisio of T 0 5 of The State Sanitary Code as described in the application for Disposal Works Construction PermitN .............. dated__....t 2�9_.-_./.. ................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ........ ----A_- DATE................6........... ..7--.71......................... Inspector.... .......................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD Ot HEALTH .............. ..............................................,2 ............i.....OF........... No........... ....... 2 FEE......... Disposal `q Tofistrdition Orrutit Permission ishereby granted.............. ... .................. ........................ ................................ to Construct (,V) or Repair )'an/IndiVidual Sewage Disposal System /TO*............. at No........ 4.7. ..... ....... ... ......... ................. Street as shown on the application for Disposal Works Construction Permit"No Dated.._: - /- -----------------------*0....... ----- ........................ Board of Health .............. DATE-------%Pl� - ----- . .. ............................................. 1:X FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS MIE-7- t(9.�,l pts.TA. - L7,&i U4 FL-ow = I l b G.RD. U15�- t 00C) 64,c. ,b1.5Po54:L PIT - LJSe. loon (GAL.. �\ S U;GWALL AMEA = (SD S.F. ISo SF ,c 'Z.S + 3"7S G.P.r). 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