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Home My WebLink About0935 PHINNEY'S LANE - Health■■■N■■■■■■■M■■■■m■■MMMmMM■MEMO mom■mmo■ ■■MMMMI Comm■■■■■■■■ ■■��■■■�■��■■��■■■�■■■■■��i ■■■■■■EM■■■ME■M■ mM■m■■■■■■■M■■MM'1 'ammUMMEMEN ME EMMONS ■■ M■■■■■■■■■■■■■M■■■l IMMENSE SEE MENES■NEnom ; 1■ems■■� ��■�■■■�1 ■■M■■■■■■■■■■■■m■■MMMMMMMMMMMMMMMmmMM o■�■■■■■■■��■■■�■■■��■■■■�� ■■■■■■■■■■■■■■■■■■■■■■■■■■mommommoommommosomm OMNI ■�■■■■■■■■■��e�■■■■� ors■�■■�■■■�■■■��■■■■■e■��■■■■■�■■■■■■■�■��■■�■r MENEEMEMEMEMI EMEMMEM LOCATION SEWAGE PERMIT NO. VIL AGE INSTA L ER'S NAM , i ADDRESS 8 U I L D E R OR DATE PERMIT ISSUED �- DAT E COMPLIANCE 1\SSUED�� ._ � � �� 1 � �� •� i� . .. � <� � \� �� _ V ;s �e2 Z� Nd------------------------ .......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF.........A0 ----------------- *'*"*'*'**......---------------------------------------------------- Appliration for Uhipaaal Works Tiamitrurthin Vamit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ................ ........... &_WL 'v�C&M"-WWC---------------------------------------------------- Looa ion-Address or Lot N9. -../........................ .............& ..................................... Owner Address —--------------------------------------------- ....................1�------------------- ---------- ..................................... Installer Address Type of Building Size Lot.._12 7. O ...Sq. feet Dwelling—No. of Bedrooms----:M—=.........................Expansion Attic Garbage Grinder ( ) Other—Type of Building ............................ No. of persons........................_... Showers Cafeteria ( ) Otherfixtures ...................................................................................................................................................... Design Flow..............................6:3--.gallons per person per day. Total daily flow.........S.Z.0..a-PP-------gallons. Septic Tank—Liquid*capacity-1 i�---�_ allons Length................ Width._........_..... Diameter---------------- Depth................ Disposal Trench—No,4 goamr.... Width.................... Total Length..._.__............. Total leaching area....................sq. f t. Seepage Pit No.,(/0.-r-W... Diameter-------------------- Depth below inlet_._................. Total leaching area..................sq. f t. Z Other Distribution box Dosing t k Percolation Test Results Performed by---:. � . ..... .......... Datw 1_4 ZZ41. 1 A. " .......... Test Pit No. I.......;2-....minutes per inch Depth of Test Pit-----7A.1..... Depth to ground water---------_------------ rL, Test Pit No. 2................minutes per inch Depth ?f Test Pit.................... Depth to ground water......__................ 0 -------/ G G� = escr tOo --------------------------------------------------------------*----------------*--------------- ------------------------- ---------------------------------------------------------------**--------------------------------------------------------------------------------------------------------".... 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 TLITI-2, 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has l FM by th I of 1jealth )Sign S' Xuot---- ----,Si 4 Application Approved By.......... . ........... . .......7.....- ........Da.t-e. Application Disapproved for the following reasons:...........................................................................................------------------- --------------------- ate ....et f4v'_7 ................Permit No.......................................................... Issued...I Date S..d�.... v FES. .. ........... . .. No........ "THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....OF....... .. ...:" ...............----................................. Apptiration for Disposal Works Tomtrurtinif Prrinit 11 Application is hereby mader for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal 4 ,. System at: ................ �r�!/ �1:j:. :.... i. i ..�y �.�?�� e!t/ �._.... d* ........... Logatiion_Address ) or Lot �1N9. # r dd Owner A dress ---------------------------------- ----- -------- : ----------------------......ei Address 4 Type of Building Size Lot.... ---Sq. feet V Dwelling No. of Bedrooms..._ Installer ,� g— ±___:..•..................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building ............. No. of persons............................ Showers — Cafeteria P4 Other fixtures •-----------------•----•--..__... . . W Design Flow.............................�.47...gallons per person per day. Total daily flow.........,,', - ......gallons. WSeptic Tank—Liquid'capacityjl ?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. Other Distributio box Dosing t kI�I( •`'" Y � a Percolation Test Results Perforl'ned by...._ j171 ' :,C.l.� ,_.. i......... Dat �-., " �._._.__.... Test Pit No. I......a.....minutes per inch Depth of Test Pit.....�,�____.__ Depth to ground water.......::............... Gz, Test Pit No. 2................minutes per inch Depth of T;'est APi`t_.__................ Depth to ground water........................ Descripti n of Soil Qt %•� /�` W ..........................-............................................................................................................................................................................. UNature of Repairs or Alterations—Answer when applicable.______________----------------.________________-.-•_-__----_-_____------_---_-___-•___--_-----. -•------•-----------------•--------•--•----•=-----••-----------......---•--•----------....--=•-...................--------------•-----•--••-•-•--•---••-----•---•••-••----•--•-•...................... Agreement i The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI E 5 of the State Sanitary Code-The undersigned further agrees not to place the system in operation until a Certificate of Compliance has IaeM • e by the 'b a d.of health. ,. Signtea. ` ae Application Approved By........ ;--::......__ " Date Application Disapproved for the following reasons:................................................................................................................ -------------------------------------••-----•--------......-----.._..........•---•----•-•--------------...--•--------••••------------••--------•--•-••-•-•---••-•••-----•-•--=------------••--••........ Date PermitNo......................................................... Issued_............................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH a .. Trrtifiratr of Tnntplianrr THIS I TO I hat the Individual Sewage Disposal System constructed ( or Repaired ( } r by .. •--•------------ ----- .----------- ------ --------------at..... ��.�.r---�... . --- --- *Install l.. ... ... ... . . has been installed in accordance witl the provisions of TIT r' of The State Sanitary Cody as. described in the application for Disposal Works Construction Permit No _q:_____ztr` J..��+...... dated-! :.7 ___ -----`-_-T...$!_ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM.19h111L FUNCTION SATISFACTORY.'- < a DATE.. Ka•L!-�'€'.xe '1;' 'Inspector m`K+� s✓ ti 3[+ .fix•n_.}S�sr+c•rst��s:�k.rc srrs_r .. ... ww�li '�a �.h,C��'�31ti.'�,��,� � .L. �• -� ., ..: it � :•tX> s �, .b3 ;,,� �j�'K;rn �?•..+,�t;�t:,4 i•q.gt.a:'. :�t�a T.HE COMMONWEALTH OF MASSACHUSETTS r BOARD F HEALTH ..........Q � �...�tl' .:.t.: OF..... . ::..��. .... :.:. ' tL►,,' No:.7---.:.................. FEE.-- •--. ._....----- Disposal s ion rr" Permission ifOS," hereby ranted ' '�` a_...:... . ---- •-•-••--------••••--•......---••-•---•-•..............................•-•--- Yg to Constr' ( Repair (. Individual S ag Disposal Sys at No..... . `- ,r � �r` �... ! Str et as shown on the application for Disposal Works Cons tr-uctlon P t No.__/___.._.. . Dated... ......... .`..� .'.. M.� E � Board of.Health tR { h DATE..... . -------•----•--•..... ...................................... '7 - � - FORMV'� 1255 HOBBS & WARREN. INC., PUBLISHERS fig,¢ : r 41O G�AtzSAGt� GRI�tt��stZ ' 110 x S = 33o G.P.D. 0 0_ - •-'� USte- l UOC> 6A 1^. ✓✓✓ pit 1 15POSAL PtT - uSE t ooa GA.t.-. �- AA WA mow■ s.r err - e ■ ■ r��. StG.1,c/AtL AMErA. =•(5o S.F. I9�,v SF• )4 2.5 . 3''lS f�•PD. � So s.Rv. TC}TAL TC>TQ U.w. PEtzC C>L&TI0 .J tZaTE C IQ 2hcl u Otz Liss. i�yy P\ 1/t THY l J A'AN 46 AL 'TAT (, '!L 1'2g' hC� �" p(p Tor 17U0 IC>O.O ♦ZXIAmass <.O9ts G t�1V` 91.G PPE I o0o IW Dtsr IW. GA.L. �1G,�ll f 8oX `!L,4-,,� TK, t ti i►1V. 1000 Q.S,L rwV• IW. :• LEACH 6 t?R Ye�E P� 7 e- WA5a1£D STOti[= 9. 1 /o� ,.o' ' � 'Ad L 'tZoF'tL LoCATt01--1 CEPITF- PV iL E ,✓,D p f,.l c� Sa A,Lt~ - t G G It T t 4=�{ T t-(A T T t-1 o c�iut+ t'l�r S Uc�v►J' P�Ix t—f 1Z is i=E R.E i,4 ca %4lCA- ?t_Ot.d GC)vVkPL-eS L.O`P` t 9 ..5r AWr> SC--`rLzACV HOLLY -TO wQ ol= a,4l,RtosTa .e. o a9 c, t2EGtS't�.tZ�t� 't_h.tJt�r 5tJ2v'i:..`(ut<�-. 'j"1- t5 .171_At-! Ili WOT ZA'SGV V � A�J OSTE VI .LE= 0 11�1r1Si. 1tJSt't��:1l.�tC t.t ljc1 �/t=`f T'4 CIF 'it`=(`�i it 1GFill7 A;1p -r'_WAI&WUR W f L.W ►,bj- C,t'n csr�C rc.)