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Home My WebLink About0223 NYES NECK ROAD - Health 223 Nyes Neck Road Centerville , A= 233-002-001 I i i ' i N . ..1��', ............. o. THE COMMONWEALTH.OF MASSACHUSETTS 2-33_ 062. 00 BOARD OF HEALTH ....................O F..........--.--................................................------..................... ZZ Appliration for Disposal Works Tongtrnr#iun Permit Application is hereby made for a Permit to Construct ( . ) or Repair ( ) an Individual Sewage Disposal System at: LoT AECK L4AC Loy- i ................__.------.................. - .......-----....•-•-................... .......---•••-----------•--•••----•-•-•--•••••-•--•-------•••-•-•-------•---•..................._. L a ion-Ad�Y dr ss or - ...� �..Q.:}..f.. ��'rY.... ovnC7'----------------•----. .......i!._ --a� Own .............................•._Address Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms......._._y............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons.....................--.---. Showers ( ) — Cafeteria ( ) 04 Other fixtures ..........._ ----------------------------------------------------------------------------------------------------- Desi Flow...........W gn , . ...........ar--. ---.gallons per person per day. Total daffy flow.............la Ord.........._......gallons. WSeptic Tank—Liquid capacity ..gallons Length..101:.4i.._.. Width..�.-0...-- Diameter---------------- Depth., ....... x Disposal Trench—No..................... Vidth.................... 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.---..............---... (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-..-----..-.---.-_---. P+ •-------•--------------------------•------------------------------.................._......_._............................................................... 0 Description of Soil......................................................................................................................................................................... "W 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 TIME 5 of the State Sanitary ?ode—The undersigned further agrees not to place the system in operatio until a Ce to of Compliance has b-en issued by the board of health. ell- -A--c. ............ ........ -_ ..ram_._ a y Application'Approved By Y �_ ✓� � ate Application Disapproved f t ollowing reasons---------------------------------------------------------------------------------------------------------•-...... ---------------------•-------------- •.... -----------......_..--------•---------•••••--•-------•---••...--------------------•--•--•---------------•••-•-------•-----......•••---- ..........---••- Date PermitNo......................................................... Issued....................................................... Date s ' , IVO..t ..� ..� JWFxs... . ............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............. .........................OF................................................. Applirtttion for Disposal Works Tonotrnr#inn rrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Lrt �c,e A > ' - .. ................ .............. . -�-- ! .. .................... ---•---••----•--------•--•••••............• ------------.......--------------........ Lo a eon-Address .or Rio. • .�i.Q+ ?l'r► ... 1`tt. .. !1.. Ch +fO.L. + Own Address Installer Address Type of Building Size Lot............................Sq. feet 4 Dwelling—No. of Bedrooms----------- ----------------------------Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ---------------------------------•--------------------....----------------------------• W Design F low........... .....................gallons per person pej day. Total daily flow............. o_0 c-A,.__...._._...._..galons. WSeptic Tank—Liquid capacity.i.TO.0_gallons Length___._..&..._ Width..5._Q.... 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................minutes per inch Depth of Test Pit.................... Depth to ground water........................ L� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-----................... a .••••••••----••••••---------••••--•••-•-....----••-•••-••...•-••••-•-•-•••••-••....••-•-••-----••-•-........................................................- 0 Description of Soil............................=........................................................................................................................................... x V W UNature of Repairs or Alterat ons—Answer when applicable............................................................................................... -- ------------------------------------•-------------•--------------------------------.....------------------.................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T ITS 5 of the State Sanitary,,`�ode'— The undersigned further agrees not to place the system in operatio until a Cer ' to of Compliance has b en issuedby the board of h lth. Sig .. ... .l�! _.._........ ....... -- - ..................................................... ,3," `2 iiate �"-�-� Application PProved By.. ti D e Application Disapproved. t e�f ollowing reason:.:_.__.._ --------------------------------------------------------------------------------------••••--•----•--•. ...............--------------------------------------------------------------------------------------.......-- Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ->.• ...OF......................... Trrtifiratr of Tomplittnrr T F I TO CERTIFY, That the Individual-Sewage Disposal System constructed ( or Repaired ( ) by...... •..... ... ..._...... .-� ----- =--=-- -------------------------------------------------------------------------------------------------------- Installer j has been installed in accordance with the provisions of TI of TT}}� tate Sanitary Code,a. de c ' dr the application for Disposal Works Construction Permit Na__ _._____ •--e�fr?------------- dated_.. _�. ___ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A SYSTEM WILL FUNCTIONARANTEE THAT THE SA S CT�RY.` A DATE................................., .......V...� Inspector -------•-••- :` THE COMMONWEALTH OF MASSACHUSETTS ` BOARD OF HEALTH /a OF...........................................No.._. ': FEE................... .. Diopr ,,`�.;�works Tono#rurtion rani# Permission is he eby granted.?.. .. Z_< /.. --------•-• ---------------------------------------•-------...-------•-----..-----------.----.-- to Construct Repair �Ml IndivduaL ewage Disposal System at .. '`.^v - ..--.-------------------------------------------------------------------•------------....------•-•-- Street � as shown on the application for Disposal Works Construction Per, .' R�"•.............. Dated.......................................... r -------------- -------------------------— Board of Health DATE.......... - 'g. ....................................... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS Lo-74 � � fie/ 'off �L0CAT10 SEWAGE PERMIT NO. .VI LLAGE �33- ®�--n�► INSTA LL R'S NAME & ADDRESS DA:o-e e U E R R 0 ER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED t� a � � � 0 Nd-e/ ��"� 4 �3-/169 . 00AT10 SEWAGE PERMIT NO. ,VILLAGE m :v33=oo2--read INSTAL R'S NAME i ADDRESS d U E R R 0 ER I DATE PERMIT ISSUED DATE COMPLIANCE ISSUED s -15-8y f o .. o` 0 -.., Tr-Y _ J� 233 ,u, 60,-001 v � v �41 LK m, o F iST. r Td 8 6 ` � o C. i+r CIP i XI i . b 4 tie, Ij l N a A y ♦ / / h /10, \ - o r � PRECAST LEACHING CHAMBER (jEOCC AL tJ0 TIE S D ♦t_L. E Lr V. j ARC ME ArJ SEA L C V9L '/ s � ( Q • PJAZEC ro.J G�1TW"� P%.I4ram. 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APPI.ICA.WT : ENa t tJ ME rE� = FG -,- K '., - /,/a11y 1 7— 4. . � .. /Vcj OF G•F/s�aL; - H� �F.VT�p�i�Ll_�_' /.�,c ? MOP A .n _ —_ -- --- �o GRQ$ M� DATE: SHEET v �0 7ZL 5,0 TiQ Z 01 S t = �'_ cs�7 �' ��9 � / DRAWN BY CHKO BY APPO B`� PLAN NO. SsIONa�`�� _ r