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Home My WebLink About0033 PARTRIDGE WAY - Health cc r �a op3 No...... ........ FEE............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Toc...... OF..................c� 's - -c- :------=............. Ap iratinn for Bispauat Marko Cnons rurthut ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Indivi u 1 Sewage Disposal �vsC +� - SG=y lv v e/f `/ System at: ®q�,a it c.. �V--••- --.f��U/c........................................ _,� ..T.. � .......lv y ..... .. ............. CEw e t Address or Lot No. C .....S ehzo...t�.�4.d------------ --------------------------•--•--.....-•----........................_.............................. Owner Address ------------------- G/.11.=--- - ----------.....----- --- .....------..............------...---...... ---------------------------------- Installer Address Type of Buildi Size Lot............................Sq. feet aDwelling—No. of Bedrooms.......3................................Expansion Attic ( ) Garbage Grinder ( ) p., Other—Type of Building ............................ No. of persons_______-__-_------._.---- Showers ( ) — Cafeteria ( ) P.' Other fixtur ................................................. 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..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-� Percolation Test Results Performed by.......................................................................... Date........................................ aTest 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 -------•---••---------••--••-----••-•-••--....•---------.................................................................................................... O Description of Soil...................5l �(�...... , ,etGG4 V/ ----------------------------------------------------------------------------------------- U •---•---•-•--•--••-••-------•---•---------------------------------•..........-----ff--•--------•------•--•••-••••-•-----•--•---•-----•------•------•••-----------•---•-••----------------•--------•---- 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 Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issue b the b rd o ealth. Signed -• --- ................................ Date ApplicationApproved By....--- �-= • .......................-.................................................... ................... .............. Date Application Disapproved fo44Z following reasons:•-•-------•----------•--•--•-................................._--••-•••---•--••••••--••••-•.................... ------------------------------------------------------•---•--............------..._..._..._............._._._......_..........................•-•--••-•-......•----•------------------••--•-.........---- �jDate PermitNo............. / ............................. Issued.----- `� 7 ................... Date ...._... .-.------ ----L__........_._ No.....yU?........ Fmc............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............... ............... OF................. ! J'. ....... .............. Aphramnt for Bisp.usal Works Tr nstrurfitin rrutil" y.gy Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: C .k LocatM�n Address or Lot No. --..................... ....- - .._.. ..... ............... --•---- ------------------•---•.......----.......-•--•------•--..._....------------•-----.. Owner Address Z41" &l1--•-•------- -.1..................... Installer Address Type of Buildi g Size Lot _ ..Sq. feet aDwellingNo. of Bedrooms ( ) g ( )— _____________ __. Expanslom Attic Garba .e Grinder p-, Other—Type of BuildingNo of ersons P Showers ( ) — Cafeteria ( ) SOther fixtures ---------•----•-----......-...-•-----•--••••• -x c f W Design Flow_.......... `.:.._.r'__.ballons per person per day. Total daily flow............................................gallons. W Septic Tank--Liquid;capacity_::::._a:_.gallons Length................ Width_............... Diameter................ Depth................ �.. n, x Disposal Tr Width___•._______.__...__ Total Len-th.................... 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-----•--------------•--------•-..... a 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........................ ' -•--------------•--------------------------._...----.......--------.....---•---•--•--------•-•-......................................................... Description of Soil-----------------•- - - x , ,��i46-G-E ---•-•-•----•---• U ----•••••••-------•...--•--------------------•----•------•----------------•--.... :-_------•-----------------•--------------------------------•---•-------------------------------•------------------- W UNature of Repairs or Alterations—Answer when applicable............................................................................................... s --------------------------------•---------------•----------•---••--...-•.---••---------....----•-------------...-------------------------------------•-----------------------------------...------------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI%of the State Sanitary. Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issue 'b, the rd o ealth. • Signed ' ' -.... --••------------- .................................. Date Application Approved BY -•-------------------- -------------------•-•-•••....._...--------•---- Date Application Disapproved f the following reasons:•--••--•----•-•••••---••••--•-••-----•--•••--•••••••-•---••--•--••---••••••-------•---•-•-•---••----•-----•--- ----•------------------------------------•---------------.•.---------------...----------.-.....---......-••---------....:.-••••-----•-----•-•-•------------•-••-•-•------•-•-----••---••---------••-•--- [� Date Permit No...........=r' �J ---•---------•=-•----......... .,..,. Issued....... .�.. .........� .� ---•-------•------- Date ",THE, COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH, .................. " ......OF......... �` � ..........................:.. Tntifirate of Tout E THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) bybl.G..IC do '. 4 1 ` •-• ---- ------------ ------ ----------•------•--...-- -------------------__----------------- Installer at------.... .X'h-1,nIt -.. `--------I........ ----------------------- has been installed in a cordancerwith the provisions :pf Article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No'_'_, �:Ci'__'________________ dated....---_�� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARk\ *EE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE_.. ;?�. Inspector...--•------•--------------•---•----•------- id1. t y F . .................. THE COMMONWEALTH O MASSACHUSETTS -BOARD OF i-1EALTH: { t1 ............. ' . s • �r Q� �`"��i��n��a� . ��k� (��t�irt ��t �r�utii Permission is hereby granted................ ............... ........................................................ ? to Construct (fr ) or Rgair ( ) an Inividual Sewage Disposal SystenT atNo._..,lb /t i ,l Cat . ? ........... - - ---- -------------• ....................................rf .. t L Street as shown on the application for isposal Works Construction Per- ikvNo _ f _G Dated..... _-. q ]. ........... oard of Healt DATE.... .,c .. b r', FORM 1255 HOBBS & WARREN, INC ,'''PUBCISHERS