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PARCEL �0 LOCATION SEWAGE PERMIT NO. VILLAGE r. e•✓/c Me INS.TALLER'S NAME i ADDRESS 0 - (PW OR le s% tu-,& AM,- o e UILDERQq�� OR OWNER l�" I � yUGsa�a DATE PERMIT ISSUED 7 /S DAT E COMPLIANCE ISSUED )a) t ao o C-A-" -TA.f v J9 Z,?,p 66S S (pw2 _ Z® � b i i ASSESSORS MAP NO: � �6 _ p Fss.... ............... No.....�6.. ?.®� PARCEL NO.: -5 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........ .................._...._......OF.....---..................-----•--.....------............-•-•------------.---------•----- Appliration for Ditipwi al Workri Ton,itrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .... ...�... �.------.. . �. L w:.......................... .........•--•-__.---•---..:� �....`y .._..............._._..................._. -•. •- Location_Address or Lot No. h-' h' vi---------------------------•-•-••-------- •- © .._:.. .. ...................................................... owner -�tii Address a �..I e.. i L 19`1► w.1..-•••---•----.._... �goo© > q� Installer Address Type of Building Size Lot./5 ` z. .......Sq. feet U Dwelling—No. of Bedrooms..........3`...........:....................Expansion Attic Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ________________________________ W Design Flow............ 5--------gallons per person per day. Total daily flow.........a_%_e`Z......................gallons. WSeptic Tank—Liquid capacity.10.ja-_gallons Length---1_C<?..5•_• Width__j_�_.?._... Diameter------_.•___-__• Depth.. .......... x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area.._.................sq. ft. Seepage Pit No--------J------------ Diameter.......&_......... Depth below inlet......&........... Total leaching area._L®t>__....sq. ft. Z. Other Distribution box (e`) Dosing tank ( ) '-' Percolation Test Results Performed by... _Wf::1-A�1___._ :A_.r`....d`j°�___•__._-__ Date.....�_lj���E?............. ,aa Test Pit No. 1... .::..._..minutes per inch Depth of Test Pit---}., .......... Depth to ground water. /C.._........ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water..--__-__••---_.__..___. --••--------------------•---------..----------------------...._......-•--------------------------•----•-.....__.....----- r .... .................•-•- W •---•-••------•----•--•--•--•-------•-----•---••--•-••------•-----•----------•-•-----------------•---••---•......--•--.._---•• VNature 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 AITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been i s y the board of health. Signed....... ....---......................................................... 4 ��1 Application Approved By.. --�-•-••.._....._•.---•-•------••-•--- .............6.12�.-/_. �?.. Date Application Disapproved for the following reasons:............................................................................................................... ......................................................................................................................................................................................................... Date PermitNo. _----_. Issued----------•-------•--•................................•------------- --•------•---.....----•--•-----------Date No....................... Fzz........................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH s.................... ....................6F Appliration for 11ispooal Works Toustrurtion ramit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal�.� System at: ............ .................... ......................... .......................... ................. Location-Address or Lot No. L ............................................ . ...... .......(D.qk---SJ U/1 X� ................. V...../-Lill, Owner --Address .........L............ ................................ .... ......... 6 ............... q k- .............................. Installer �ddress Type of Building Size Lot.J_�,E,,_9 ...... ...........Sq. feet ppqqU Dwelling—No. of Bedrooms.._.........................................Expansion Attic Garbage Grinder _PL4 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria P4Other fixtures ....................................................................................................................................................... Design Flow-:.......... ......gallons per person per day. Total daily flow........ ......................gallons. W Septic Tank—Liquid capacity.fW . 1 .1 If 0!?D-.gallons Length....1.0—T.'Width... Diameter................ Depth....y......... Disposal Trench—No..................... Width.._................. Total Length...._............... Total leaching Arm...................sq. f t. Seepage Pit No........_!_.___...... Diameter.......R......... Depth below inlet..._--6........... Total leaching area.._Z-0�....sq. ft. Z Other Distribution box V) Dosing tank Percolation Test Results Performed by..._.. AQ�.......... Date......k --------- Test.Pit No. I.....Z........minutes per inch Depth of Test Pit....i.a........... Depth to ground water..V,&A-/.0.......... 44 Test Pit No. 2................minutes per inch Depth Of Test.Pit.................... Depth to ground water........................ P14 ......Z....................................... 7....*.............*-----------------*--------------...*--- 0 Description of Soil...........:.Z..........LR5.tl .... .......u........ ................ 0.... .............................................!.......................................................................................... . .......................................................................................................... ----------------- --------- ..................................................................... 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 T IT IS 5 of the State Sanitary Code The undersigned further agrees not to place the system in operation until a,Certificate-of Compliance has been i y the board of health. Signed..... .................................................. .......................... Date Application Approved By.......... -7 ..................................... ..................................... ............. Date Application Disapproved for the following reasons:.........................................................................................................--- .................................................................................................................................................................................... PermitNo........................................................ Issued............ .............................. THE COMMONWEALTH OF MASSACHUSETTS been i y tl.. . ....................t.............. . BOARD OF HEALTH ...........�be'7 .....V...............OF............................'.... ................................................. (Intifiratr of Tomplinurr THIS IS TO CERTIFY Th t the In lividual Sewage Disposal System constructed \)"or Repaired by----------------------------------------- ............ AIV P.A---................................................................................................... Installer at...................................la.Q. 4...................... A J4 ... .. ........... ..L.R ......wl..11. ............................................. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works,Construction Permit No.._...... ............ dated.._..._..___, _4........... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARkNTE THAT THE SYSTEM WILL FUN.CTIQN SATISFACTORY. DATE.........................)_ .. .. ...... ...................... Inspector.....e..;,.*...................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF....................................................................................... No......................... ....... 11isposal 11orlib Tonstnuft.0 Prrutit .... Permission is hereby granted........................ .Nb ............ ..........................................................................................---- to Construct or Re air an Individual Sewage Disposal System ......................... at No......4.0. ......... .......D-o— .epi./....4--X r.............. . _/........... Street as shown on the application for Disposal Works Construction Permit NoAk.'AZI ?.. Dated....... -3. V�.......... .............................................. .................................I....... ,.....;-.6 I oard of Health ........... ------- ......................................... FORM 1255 A. M. SULKIN, INC.. BOSTON �1 O Avon /eJ7• fn�o -� edTE I �•/3 /GYv • Z � .r1�� / G _ vr7 7- x'-7Z7 '\� / .ram>�...t i r `ti //i\� /d•7✓. /xv r5z ' a%y 1-!5/ e"7� - ��/• 7:E 7 fir/ ��4T/o�/ �b✓TL/2✓/LLC ZN of,y 2-,--= Clq `MARTI(� �c►�/ �i./G_ 6 E .� v MORAN ti /Oo -re ,a #23417 ASSESSORS MAP NO: 61 PARCEL NO.. .4 t 1 Q _ F>$.............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ... 2 z...............OF........... .P✓ ..........F1. ........................................... Applir6tion for Uiipn,i al Works Tuntitrur#iun rantit Application is hereby made for a Permit to Construct (✓) or Repair ( ) an Individual Sewage Disposal Y st at7--Y.s�!v1" ..../.�I'�...- ``i' ---------------------------•------Lo� 5... - 1 Location-Address or Lot No. t......------••-•-•--••--------------- B.Q_4 Qq.k..S'�'.....tL........ � Owner a Address Installer Address d Type of Building Size Lot... .....Sq. feet Dwelling—No. of Bedrooms................. ....................Expansion Attic (1-'5 Garbage Grinder ( ) '4 Other—Type of Building Ga YP g •--•----•-------------•----• No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ----------------------------•--•__ W Design Flow............. S........................gallons per person per day. Total daily flow...........3.-3.8...................gallons. WSeptic Tank—Liquid capacity_.Ldd®gallons Length_.. Width...s=.. ... Diameter................ Depth.... ........ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area.........._.__._.._.sq. ft. Seepage Pit No......./.......... Diameter......9.......... Depth below inlet....._G.......... Total leaching area....Z2.Q....sq. ft. Z Other Distribution box (V Dosing tank ( ) ''' Percolation Test Results Performed by........... .....E.._k`.,0 Date.... Zl/ff.............. 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........................ -----------------------------------------------------------•---........_..-----.........---••---••--................................- 0 Description of Soil.........-2--............. Q..q—A4..... ----•-skb-- ............1 Z-................../ U ..4r...7...... Y5.---------4O-•--.... ----••-•-----------------•--------•--------------•--•------------•----. ... 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 iITLi: 5 of the State Sanita4id ersigned further agrees not to place the system in operation until a Certificate of Compliance has board of health.igned.. --------------------•••---•----•......•----•----••--- L �..Date Application Approved BY------------------- ._.. --- ........................... ..-----•-a :3-- -�-� Date Application Disapproved for the f ollo ng reasons:--------•-------------•--------•----••--............................ .............. -----..................... - ------.................................................................................................................................................................................................. Date PermitNo......................................................... Issued....................................................... Date a No... -••••-••--_....._ Fzs............._....._..... . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF............a.'.�'.............8.................................................. Appliratiun for Raposal Works Tonstrurtiun rrrmit Application is hereby made for a Permit to Construct (v) or Repair ( ) an Individual Sewage Disposal System at: ....... Wl W -l:Location:Address........ ............... ........ ®o �J! - OT t Nu :.✓�........-........ .. , ' Owner o U . © A dress a . ....................•-•--............--.............. . .......8.........................-........ Installer Address Type of Building Size Lot...1 51..�5........Sq. feet Dwelling—No. of Bedrooms...................2'..._..__.._......_...Expansion Attic Garbage Grinder ( ) Other—T e of Building a —Type g ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures W Design Flow..•......._..:5 .......................gallons per person per day. Total daily flow........_._ ............gallons. WSeptic Tank—Liquid capacity.<.dOvgallons Length...�_��.5_ Width•-- :._ate.-- Diameter................ Depth....-/....... x Disposal Trench—No..................... Width.................... Total Length............. Total leaching area...................sq. ft. Seepage Pit No.____._.�...___._... Diameter...pag ...46............. Depth below inlet------- .......... Total leaching area....!?ev...sq. ft, Z Other Distribution box (✓) Dosing tank ( ) _ Percolation Test Results Performed by................... .t,. — ...`_............... o 'vv l?••/�� /�G 2 ................. Date ./.... .. Test Pit No. 1................minutes per inch Depth of Test Pit.....1 ....___ Depth to ground water ,.. a-`' .... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ .....•-----•-----------•---•..................................•-•-----..........' ... -• ...... - O �/I 4 w 2 CrPG n/ �No4d s'n Description of Soil S u 5O, /---•--••. --•....•d...............��?_........---••-------.---•---•.......-•---•---•-•-••--••---•-•--•...--••-••..._...----.... v 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 TITLE 5 of the State Sanitary Code—.T>fupdersigned further agrees not to place the system in operation until a Certificate of Compliance has been i e board of health. Signed------ ............................ _.... Application Approved B 44 Date .... -, __j Application Disapproved for the f ollong reasons:..............................................................................•....... Date.••-.. .................................•-------....................................•..-------•-------•--------....----•------........-------•---...--•-•----...-----••--•••----P...... - -- Date PermitNo......................................................._ Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD ALTH .......... ... "0.�1......OF............ . ...... ... .............. ................................. Trrtif iratr laf Toutplittnrr TW IS TQ_CERTIFY,,What the Individual Sewage Disposal System constructed (�) or Repaired ) by _ ............. ....•-----...........•-••••-•--••-•--••---•--.......•-•---..._.....-•-........... ._...._ _ ..... at.. ©.!. .... -�---•-• ... �. :..!.....__/ .'_1:._...... ter CPS✓1 ---•-----•-•••---•-•------•------••-•...............•-•-•---••--••------ has been installed in accordance with the provisions of TITLE. 5 of The State Sanitary Code as idescribV�in the application for Disposal Works Construction Permit No...........`-6.`_G 27.... dated........... __.....__.___..... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARA✓NTEE THAT THE SYSTEM WI NCTI N SATISFACTORY. .•- -......-DATE....:----- Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ; `Z>t� . O F........`.... a,w r' �� .............. `� t� No...................._.... F ?...:.:_.... Disposal Marks Tunstrnrtiun prrmit Permission is 01 hereby granted........................................ to Construct ( or Repair ( ) an Individual Sewage Disposal ystem_ atNo.............G �....._.....-5.........11/l!�! � ....... .. --•-•-•----•......................................................•. Street as shown on the application for Disposal Works Construction PermiTo ,4 ti............ Dated.:._-. .,...._. ... x - •-••-•--•-•-.......---. DATE..................•-- -.......�....................•--._.......--------•-------- i tBoar¢of Health FORM 1255 A. M. SULKIN, INC., BOSTON U 8 /� • 2 � O/S�b SQL �,r-- 1J�-� /� �aL_ /v2 • o Ic Aw 7e-S E-ST' 1-1,nL C- �.� 41Al �GjaZ-d Zo — . 2 ------------- NA .v 76 c MARTIN ZZ?ckx. E. MORAN.' H #23417-' i