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Home My WebLink About0298 PRINCE HINCKLEY ROAD - Health 298 Prince Hinckley Road Centerville A= 171 173 li I o No.. ;Z.. FEE............ ....., .......... THE COMMONWEALTH OF MASSACHUSETTS BOARD 0 HEALTH I jwn._......OF. . ...................llkllll.� ........ ........................ Appliration for Uhipoiial Works Tontitrurtion ramit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal Syst at: 1 1/4� 2- 949 . . ............ . .. .. .............. ..... .............. ......... ....................... .............................................. ----;01 U ............ ------ Location- ress (112 Lot No ........ ...... .... .. ................................ .................... .............6................................ Address ss ............ ................ ......... . .................................. ... ............................................. Installer A Type of BuiUlding Lot... feet Size Address .Dwelling—No. of Bedrooms........U.............................Expansion Attic (14�6 Garbage Grinder (14-)0 Other—Type of Building ............................ No. of persons.....................--..... Showers Cafeteria Other fixtures ..................................................................................................... Z/------------ ........ Design Flow..........3.3w.. ............gallons per person per day. Total daily flow................ ..................gallons. 1:4 Septic Tank—Liquid capacity/, Ions Length................ Width................ Diameter--.............. Depth................ Disposal Trench—No............. Width......,............. Total Length............_....... Total leaching area....................sq. f t. Seepage Pit No.....2;...K66iameter.....4............ Depth below inlet.................... Total leaching area..................sq. f t. z Other Distribution box Dosing tank Percolation Test Results .Performed by.......................................................................... Date........................................ ,.-I Test Pit No. I................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........................................................................................................................................................................ x ----------*----------------------------"------- ---------------------*-----------*"**------------------------------------------------------*--------------------*------------------------------- .1....................................................................................................................................................................................................... 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 TITLE TILEj 5 of the State Sanitary Code L— The undersigned further agrees not to place he system in operation until a Certificate of Compliance has been i d by the board &�alth. Certificate o' Compliance s been i ed by the Dc not to place he System SiSI I Igne .. ............. .......... .................... .................. e ...... ...... ................ .. ... ..... Application Approve'�� ............... B ...... ...... ..... .................................................................. ... ......... Date ................. Application Disapproved for the fo reasons:................................................................................................................ ................................................................ ....................................................................................................................................... Date PermitNo......................................................... Issued....................................................... Date Ii f` IV 146 t, No f,931�-7 . Fxs........................... r d ` THE COMMONWEALTH.OF MASSACHUSETTS BOARD 'OF" HEALTH / fir r` ,��r --( : OF........ .. "rear-•E •-••---------- - .i -. ,Nplifirativil fnr Dhalp oal. Warkii,C�,a rnr#i�an rrutif Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Systeat: , ? 1 � .. -�'._ . r:�i � /..... ... si....roc r� �.� Locationf�°Aqddress fi or Lot No .�... . .✓L7....... �� .••`...vrL �,��4 i1^� �C_ W � J0 Address :.................•-' -•--._ " ..:i1.-------- r--•�-•----•--- -- •---.-••----- --- e'er ,.wtr! —':^•y t x a Installer Address d Type of Building Size Lot_._ie `" aDwelling— No. of'Bedrooms :i_t -:-.--.-_Expansion Attic ( j!J Garbage' Grinder (�.')'! p, Other—Type of Building No of persons ................... Showers ( ) Cafeteria ( ) QOther fixtures ......._ � n4 ` . Design Flow.`_.._.. !.. ::_.._:gallons per person per day. <Total daily flow, .._.:_'e_'".. ..................gallons. §,' W r 4�7 Septic Tank—Liquid capacit- #*A-:gallons Length................... idth Diameter . Depth ... 5."x Disposal Trench—'�To Width Total Length Total leaching area --- sq -ft. Seepage Pit No.....{ . ,kDiameter.._ n------------ Depth below inlet ..:______________ Total leaching area...:.. .........sq.'ft. -z Other Distribution box ( ) Dosing tank,"( ) -'— Percolation Test Results Performed by---------- _-:-- ------- .......................................... Date ... Test Pit No: 1 minutes per inch. Depth of Test Prt.: Depth to ground;water.. w Test Pit No. 2.................minutes per inch Depth of Test Pit..: .............. Depth to ground water------ ,� <w O Description of Soil ••--• ••---- •-•---•. -• ---•- -•--•--- ..... . ..•--•-- -•-•---• . • ------•. ••-•--. •. •-•-•-•----•. "V W V'. Nature of Repairs or Alterations—Answer when applicable. ---- ----- .... -••----- . --- ------------------•- --•- •------• ------ •...... ----•--• .. k Agreement. The undersigned agrees to install the aforedescribed Indiuidual`Sewage.Disposal System in accordance with the provisions of ITLi; 5 of the State Sani ary*Code The undersigned further agrees not to�place'tl system in operation until a Certificate of Compliance has-been i ued by th&boald of-lie'alth.' d �� . � Si e � .. ... N _ d/ "Application Ap roved $y -P. •- Date - Y ` Application DisapprovedJor the fof Wang reasons:.... ......... ..... . ......... ....... .. ......... .... ___..._ ......... ....... • Date PermitNo.....................................................:._. Issued_... •-•---. •--•-- ...... ......... Date i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF . ..... ........ .... .... Trrtif ira# of fin fttt rr THI . YSCERTIFY, That the Iridividual''Sewage D> posal System constructed ( orRepairedby --•-- ..._:: � ,t nstallcrW � -•- has been installed in accordance,with"the provisions of TIT F j State Sanitary. Code as described in the application for Disposal Works Construction Permit No._ _ .................... dated.. . . ......: ....... Q THE ISSUANCE OF THIS CERTIFICATE SHALL NOT MCONSTRUED AS A GUARANTEE THi THE SYSTEM WILL FUNCTION SATISFACTORY DATE.................... ........ � _..a .....f.. Inspector: ;. _ - -----•-• -•-•-•.. ......... ..•.•... --.-- THE COMMONWEALTH.tiOF MASSACHUSETTS a - ....tk vd.' BOARD OF HEALTH ........ O F......... ....... .. U i o.. f FEE. J t, i Ut51tillttl IV Tuntr ltivlt .virmit p. Permission is hereby granted_.._. __:. Y./:_.................. -• . ............................... . t to Construct ( ) or Repair ( ) an Indiv1du�..r S0kag�s o/System , l at No................................... ' ......... -------- ...-./ • . ••---- --• -- Street as shown on the application for Disposal Works Construction Permit No............ ated.......................................... . ................................... .................................................................... )i ` oard of $ealth :. / 7 DATE............:.... ------. 1_- / ...... try FORM 1255 A. M. SULKIN„INC.. BOSTON- - ''- :'�',� n «.�i�� ..r��:i.;a�d•�� ... �'' .��..:w-`s��.•' :is. m3kt a< k,• .y, ,.,aa.z .;f.;1o,j6Lr-- FAMILY WG .,,GA¢BAGE 6QJwDr=cz. / v�a1L•{ FI`ow a Ilo x 3 = 3306•PP SSPT1G TAtiK = 330x15c,% : -491G.PQ LoT Z4-7 t15E l000 GA%.. o15Po5A1- PI'1- vsE lvoo GAL. "S sq0 I 'n N -5�DG.vJAIL A2L-A * 1�0 5.� Ekv • 56TrOM AQEAt .. 5F• 0 LOT M"v 6.P Q o �d 13 'ToTA 1.. l7 S51GN : 14.,2 S G P C. 2 0 PftuP V.S. Z9 � c 'ToTAI.. DA l%-Y FLOW = 33o G vo T n � "t �p •r�,rc. �,ozs c�o 'Pardo � PPMCOLATION RATE i I''IN 2M1N Ot`L6SS 8�t � JI OF M4 I PETER '_•, q4 AL RICHARD o SULLO.Ald I A. :�� PJo. 2�7;;3 � f. l.o T z9 c', BAXTER Na 24048O � n _ i P- Z44 7 SIG ID Top Fwu 759,0 I' ?6>T 10-113- es %r/w I �4 loou IIN• II bugSalr D1ST. INd. SCv.�G ,SSFf L' Joao INS BU7C s$i(o TANK " G&I-. 5So �� SAuv�j LP Tu INv luv. i (�Rs+nl El. M/1 T 1) s Z s 54 YL �I WA S'111:D 6 6 9•o '-A%4D CEptTIFIG0 pLo'T PLA.W PROFILr= L,o C A'T I o N C FNTr-9--l!I LLZ 13� ►JO SGAL.E�� 5CAL-S I", So' � q- IZ-8• FL4So too%.-ATCR• P L A►tJ REF 62EN GE r E m-r 1 j=Y 'T Ei AT 'T N r-- F-ou v V ATI 0Iv 15No WN ry s.m sohl GOtAPL N?!S VATN-T H6 S I IPSUW Qr LOT 2.96 Auto SETeAGK OF 'tNE "TOWN OF BA -Qf rAS AND 1e CENTE(b4lll-F, H IEHLANDS I.OGATE D W ITNIIJ N 6 LOo D PLA NO T 1= gAXT6Qe IJYE 1tJC. R.EG t ST f�Q6'D'LAW O S u ev E�(oeS Tuls PL�►� 15 Lio*1' 4n'5n`D oa AN osTEszvILLFr • MASS. lw5TV-UMAs r Svev*y 4-rgs Dr-FSE'r5 Suouo 1.1n-- M= I III;FOTC! 0 e-T e?—p 0,1 Q t-- l or t- IQ ALAN SMALL =h/l_