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Home My WebLink About0105 LOOMIS LANE - Health 105 Loomis Lane Centerville A = 231-020 SMEAD No.2-153LOR UPC 12534 *mead-cam • Made in USA Ofeycle FwtwN THIS FNOOLOLK OjF1 OF1iESRf'40GA�M LOCATION SEWAGE PERMIT NO. T� VILLAGE INUTIL1 R'S, I AME i ADDRESS on WNER DATE PERMIT ISSUED _. Icy DATE COMPLIANCE ISSUED _ .- �j �`' c,� � N �.� �` �,s '�% _ _ _ . j \ �� ' -�� - c„ •� , l _. wo THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT�+ ...........OF............... . ........... ........ Appliration for Disposal Works Toustrurtion rnmit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at* �� . ............ .......... .................................................................................................. o f0c , ddress or Lot No, _ ------------------------------------------- -----a........... ..... ... .... .............. ...... . .... .. ................................... ..... ...... ...JM�4?---�_' Installer Address Type of Building Size Lot............................Sq. feet U Dwelling4No. of Bedrooms-_�7....................................Expansion Attic Garbage Grinder Other—Type of Building --------------------------_ No. of persons............................ Showers Cafeteria Otherfixtures .................................................................................................................................................... Design Flow............................................gallons per person per day. Total daily flow..............----------------- .............gallons. 1:4 Septic Tank—Liquid capacity/j0gallons Length................ Width------------_- Diameter__-_--_----__-__ Depth........__._.... Disposal Trench—No..................... Width.................... Total Length..___............... Total leaching area-----_------------sq. f t. Seepage Pit No.-J-------------- Diameter/O............. Depth below in1et.#.'_.......... Total leaching area4ZPA....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date............. �_4 -------------*......... Test Pit No. I................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...___...............__. ....................................W........................................................................................................ 0 Description of So - I -----------------------------------------------------------------------------------------------_------ x U ..................................................................................................................................................................................................... ...................... ...... ... . . -- ---------- --------------------- ------------ ------------------------------------- ------------------------------------------------- Al e ALnpw vhen ap 1* e.- ............... Nature of ReDair U ------- ....................................... ------------------ 'AAXICI. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TLITLIE 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-o health. ed �!. ............................... 4 Date Application Approved By................. ..... ..... ........ ..... . . ...............f" ........................................ Date Application Disapproved for the following reasons:............................................................................................................... ............................................................................................................... ....................................................................................... Date Permit No............................... --- Issued...... ................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH .......OF............: ... ........................................... ..E.,:. frdifiratr of Tootplia trr THIS I O TI hat the Individual Sewage Disposal System constructed ( `) or Repaired ( ) by------rF irr = -• Inst••-•--.._....... -----....•----•--•--• ...... .............................................. nst has been installed in accordance with th provisions of TYTr— e �+`�,gff The State Sanitary Code s described in the application for Disposal Works Construction Permit No. ...._.t7...._.....`.f'...-__..._.. dated-.-1 -'""- - - ------------------- THE ISSUANCE OF TINS"'CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY Inspector r =:�1�< tit,-• .,�.. THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH �/ y........ ......,OF........ r�.�/•...i� ....;.---•-•..................................... ,'" ,,�• No.------..•.....! .�' .. . n FEE...:.................. �i��ro��t1 � ott� rrmi� Permission is hereby grante ...... -• --------- ---• =--••-•--•--••...•. ... ................... to Construc or ep ' Indi du I Sewage! D' osal System at No.. i� 1 ee� Stre as shown on the application for Disposal Works Construction Per o. Z....1 ._. ated...tl" .`� ............. 5i t ........_... t� Board o'f. ealthy DATE ................`............................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS - - ,;:No.64 Fz THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT ••.....: OF............... ..: ..._.. ,. ApplirFation for UiipnoFal Works Tonstrnrt nn ramit Application is hereby made.for a Permit to Construct ( ) or Repair (, ) an Individual Sewage Disposal System at: .oc o - ddress or Lot No. Installer.: Address d Type of Building, Size Lot............................Sq. feet Dwelling No. of Bedrooms.__.:...................................Expansion Attic ( ) Garbage Grinder ( ) p., Other—Type of Building _____________•--••--_.-_--•- No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ..---•-••-•----•--••-••••---•--• - 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.. _.__.. Diameter_! ............. Depth below inlet._'��_-- Total leaching area !........s ft. � ------ � P g q• Z Other Distribution box ( ) Dosing tank ( ) `... 0-4 Percolation Test Results Performed by--•--•...•-•••---•---••--•---••--••---••-••---•••••------ -•--------•------ Date........................................ a Test Pit No. I................minutes per inch Depth of Test Pit_._................. Depth to ground water........................ 0x Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P44•---•-•------ - - ODescription of Soil----. ---- ... --•-••--------------------------------•------------------------------......-•----...._. V ..........................................................••••--•-•-•------•---•-•••...........•..... W ----•••••-••---------...•---•-----•-••••---•--------•--•------•• --•-•••. ••-•••••••-•-•-•----••- tx'j Nat re f epair or A erations—A w r when ap 1 le__ _._ _.,� "f _. ___, . ' ..... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITI LE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ss ed b the board o health. ed : ------_--•------_----•---- ....... -. Date Application Approved By................ r Date Application Disapproved for the following reasons:.....................................................••-----------------------•-----------------•------•-••--•- .............................•••--•-•-•--•••-••...•--••---•-••.....-------••-••-•-•-----•----••••--••-••.-•••-•-•••-•._.....•-•-•--•---------•-••-•••--••••-••-••-•...•---••••••-----•-•--•------•--••-- Date PermitNo......................................................... Issued....................................................... Date --No.7•. :...S�._. Fns.....��..... ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................: ...�2......OF........ Appliratinn for Disposal Voikii Tonstrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: --• ® - o°h!1••S .L N c. rl Tj��..i� k -•••••-••--....----•_......-! ......................................... _tdT ffiE �..........�.......•....................•. �_ .7 — `...............................I--....P-.-.---' Owner Address W a -------------------------------------------------------------------------------------------------- ---------------------------------•-------•--------.....---..._.__.........^..._...-----....-.--- Installer Address Type of Building Size Lot..l__f.__ v_U�.....Sq. feet aDwelling—No. of Bedrooms........'.��.'...............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures ............................................................ gal W Design.Flow..........S� 4�.C2 .......................gallons per person per day. Total daily flow....... _ ........................ lons. WSeptic Tank J--Liquid capacity./00gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—Nccyo�..................... Width.................... Total Length.................... Total leaching area...........__.___..sq. ft. Seepage Pit No.......A......... Diameter.................... Depth below inlet.................... Total leaching area.................-sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ LL, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ --••-----••----------------------------------------------------------------••----------•--•-----.......----------...-•-------...---•..---............---- 0 Description of Soil........................................................................................................................................................................ "4 V --------------------------•-----........_......•-•--••--•-----......_..---•---•....------•--••--------------------------------•-•-•--•-•-----------•----•-----•----•------•••-•---•--••----•.......---- W ............ .__.._. �r... ... ......... ;1 V• Nature of Repairs or Alterations—Answer when applicable_ Q ll al.: G --------•---------------j=.......---------------------------------.......-----------........------------....................._......... •--------•-•--•---------------------------•--•----------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of:IT,TL: 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. igne ................................. ..........................-.... ` ate Application Approved By----.----- = . ----•--- �... ----- - =.. Date Application Disapproved for the following reasons----------------------------•-•------•-••-------•-------•--•--•-....-------..................................... .............................•----•-----..........•--------....-•--------••••---------•-•--••---.........---•-------•------------...----••---•-----------------------------•-------------•--•-••......-- Date PermitNo......................................................... Issued--- .............................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH ?...... ° ?n.......OF........ +IY, !-................................................ atifiratr of (gampliattrr THIS IS 0 E Y, a't the Individual Sewrage Disposal System constructed ( 4roor Repaired ( ) by..: ......... r __- Installer r at... 6p, " 6 _ ....._-----•--•.._..has been installed in accordance with the provisions of j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No _.... 2� ...._..._... dated_ /f"_... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. . Inspector-------------------------------- DATE................:......................•----•-----------•. -q v THE`COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -tI .. N ..................... FEE........ ............. Disposal .'s Uan andt Permission is Hereby granted.:--..�.. ----f---.... ....t� . . ..�............................................................................. to Construct ( ) or }R�epai an Individual Se I ge Disposal Sy tetn / i at No.......... - f�- -- __----- �Ar' f` �►a", = t' ". Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... f ........................ ---------•-----------------------------•--. •---- „ � Board of Health -� DATE.................................... - FORM 1255 HOBBS & WARREN, INC., PUBLISHERS 'No.........''�. ......... FRs.....f ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .O .....OF...... .. .. .. ,. . Appliration for Disposal Morks Tonstra.r#iun Prrmit Application is hereby made for a Permit to Construct ( .),or Repair ( ) an Individual Sewage Disposal System at I-00 ... ............. .. ................................................. ........................................... ... ...1:...... ocat Owner Address .. a . ............. � Installer Address �y U Type of Building Size Lot... 4' .:..:Sq. feet U Dwelling—No. of Bedrooms..........'...............................Expansion Attic ( ) _k "M Gjgrbage Grinder ( ) 04 Other—Type of Building ............................. No. of persons............................ Showers ( ) — Cafeteria ( ) a Other fixtures ----------------- W Design Flow.......... l.......................gallons 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 below inlet.................... Total leaching area..........__ ....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 1.4 Percolation Test Results Performed by.......................................................................... Date....................................... . 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........................ P4 ...................................................................................................-••----•--•--•.......•••...... ------------------ O Description of Soil...................................................................................................................................................... ................. x (� --------------------------------------------------------- •-------------------------- -------------- ..................•---•---•----••- --•---••------ -------------------- •------------------- ----------------------------------•----•--•------•----•--•-•--........--•-•-..._._.....................-- -- --.... 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:'LL 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. igned ..-- .---•• --------------••..._......•. ................................ .,. ate. Application Approved By........ � - �...- Date Application Disapproved for the following reasons:__...-••••--•----•-•--•-- •---- ........•--•............................•---••-•--....•••---•--•--•.......----••......•-•--•---•-•.......••----•-----••-•------••-••----••-••--•--------•••-------••---•••--•-------------•-•-•••---•--- Date PermitNo......................................................... Issued-...................................................... Date AsBuilt Page 1 of 2 LOCATION SEWAGE PERMIT NO. VILLAGE I N S T ll R'S A E i ADDRESS 110441411* OR W ER DATE PERMIT ISSUED _ ._ cy DATE COMPLIANCE ISSUED 1��Y��71 WN http://issgl2/intranet/propdata/prebuilt.aspx?mappar=231020&seq=1 9/8/2016