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Home My WebLink About0305 PRINCE HINCKLEY ROAD - Health 305 PRINCE HINCKLEY RD Centerville A = 171 — 121 i LOC T 1 0 �5�� 3as SEWAGE PERMIT NO. 72 VILLAGE I N S T A LLER'S N ME i ADDRESS 1 . �� ' G �. 2 U I L D E R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED �� _,� �i 1 � ��__ � � �� , yam , �� ; � „ 0�� y�. 7 No................... .... Fim.t:3. ._............... THE COMMONWEALTH OF MASSACHUSETTS � BOARD F- HEAL H 4,1 ...........__OF...... -•.................................. Appliraation for Disposal Works Tonstrnrtilan thrutit Application is hereby e r a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal S s em f . ..!...... .................... ....... .. ......... ......•.•......--•-- --... ...... ocation d s j �- . ... ...................................... -• •-• ----- ... .. .............................................. r Address a ............... ....... r.. r ......_. .......... Installer Address Type of uilding Size Loy_ .....Sq. feet Dwelling—No. of Bedrooms...._............................Expansion Attic Garbage Grinder Other—Type e of Building No. of persons............................ Showers — r� YP g -------------•----------•-•- P ( ) Cafeteria ( ) a'' Other ctur�.. __ W Design Flow.... ` . ..... .... gallons per person per day. Total daily flow____._._. .... ... ..............gallons. WSeptic Tank—Llquid capacitA. ......gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No............:....... Width._ _ ....... Total Length..........._��rt Total leaching area....................sq. ft. Seepage Pit No... _ _ . ___ Diameter.................. Depth below inlet........C..__. Total leaching area.242._�....sq. ft. Z Other Distributio box ( Dog ' ( ) Percolation Test Results Performed by.-_._ ...................... Date-- 7�'`...__. minutes per inch epth of Test it____________________ Depth to ground water..__.................... Test Pit No. 1...... LL, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 4- 0 Description of Soil-•---• ._ .`. .... `_. -:__ -L•-- -• t V ...................••--....---•-•-•-•-•-•-••------•--•-•-----s•---••-•.....•----_..... --•-------�•--•-•......------............-• ---•--------.... _....--•-•-----•--•.--- . ..-----.. W W. ----•-----•----------------------------•--•••••••-•----•---•--••---•----•--•---••-••--...----•----••----•-•--••------------------------••-•-------------•--•......-••--....----•-..........•-------•••-- 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 Ti lTM 5 of the State Sanitary Code—The undersi ed further agrees not to place the system in operation until a Certificate of Compliance has been ' d by th oa of health. • Si e .... .---- ••- -••--•----•-••-•-•-•-•_--•-- s .......... ... fa e Application Approved By..... •-• .. .. 1 1_ . �._.. 4 . . ' Date Application Disapproved for the following reasons: ---------------•-----•--•-------•------•--..................................................... ......................................................-........................................................................-••-•-•••--•--••-•-••---•••-----••-------••.............••••---.....:•--- te PermitNo......................................................... Issued..... �-----Ad-•----------a..•---G- -...--- Date Sao A— THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEAL H .....................OF.......1............ 2...... ::.... ........_.........._.._..._._. Appliration for Disposal Works Tonstrnrtion t erntit, Application is hereby n e r a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal ..... Address .. � -..._. yLoc_ation Addz�s - -- ... .,._..,-f: ^•�- --•'mac#.L^,v ! ...... -z•----•-•-- .....-.-'_ _J-`.... ::7C_.aa .......................................... Address �........ " :_.. .............. � ...... a V Installer Address Type of Building Size Lok ,,_ .....Sq. feet �., Dwelling—No. of Bedrooms......... ......................;...._Expansion Attic (I )) Garbage Grinder ( � a`4 Other—T e of Building .............. No. of ersons............................ Showers YP g --------•••--- P ( ) — Cafeteria ( ) } dOther fixtures--'.•- --- -- •-----. --••------- .... •--•......................I..------•---------•--- W Design Flow.... ._.._. __...... gallons per person per day. Total daily flow..____._. ''., ___: .............gallons. WSeptic Tank—Liquid capacity, Length................ Width... Diameter_F_......__.... Depth_:_..___.._.... x Disposal Trench-No..................... Width................... Total Length...........,,.//�� Total leaching area............... sq. ft. Seepage Pit No.__ .�.. Diameter..__.. .__.._. Depth below inlet..-......6...... Total leaching area.2 ./...sq. ft. Z Other Distributioi box ( Dosing tan Percolation Test Results Performed by...._ _-........ 4ift �..................... Date._-��Z-`--I •-` d'"`--_----.. Test Pit No. 1.....1.4, minutes per inch epth of Test .................. Depth to ground waters,:':------------ ........ 44 Test Pit No. 2................minutes per inch :Depth of Test Pit..................... Depth to ground water...___........:......... 0.i .. " r U Description o oil----------------,-.........-------------•-••----------•-•-------•------••-••-----------_- .4.]� ......................................................... 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 ofi:';. 5 of the State Sanitary Code— The undjeec further agrees not to place the system in operation until a Certificate of Compliance has been ed by the•.hf health. R , Si a '�,J r r;' a Application Approved By...... 4- - . = - �= '---------- Date Application Disapproved for the following reasons: 7 r -----••------------------- ---------•-----------------------•--......•-• --•-----••------•- ...............................••-•--••-----•------•--------...--------------------------...-------......._....---------•---•--------------•-----------------------•-----•------------------------- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH ........... .... ..........OF........ .:.d'! 1.... .............................................. f Tlertif irate of f gmplianrr TH 0 E I the Individual Sewage Disposal System constructed ( or Repaired ( ) by..... ............ --- ............. ... .......... •--•-••-•----- - -_...._.._. Install tr has been installed in accordance with the provisions of "T o e State Sanitary Code as descri d in the application for Disposal Works Construction Permit N -- .._...... ............... dated.....s�''.�r'. _c,............. THE ISSUANCE OF THIS CERTIFICATE SHAL NOT BE CONSTRUE® AS A"GUARANTEE T T - SYSTEM WILL FyNCTION SATISFACTORY. J�/ r // _ � DATE.............. L-. ------ .Inspector.-••----- ---•-•-----••-••...................•....._......-••.....--- THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH ..�L�'........ .........T,;�,__ _ ....OF............'Y...... � " : ............................................... No............ FEE........................ Disposal rk o cation "permit Permission is reby granted...... T.... .................................................... _. .......... to Construct ( or R , i (' ondividual a TagA Dispo System r at No... +� .. Street (� Works Construction�",, it o n.._ .._ ...___ Dated....2.`' `. .............: ass own on the application for Disposal /� .DATE Board of }4 FORM 1255 HOBBS & WARREN. INC., PUBLISHERS Fr' LLO AtzB.AGt= 6,21�1D1=1Z tads L_4 t`Lew : 1 tb +� 3 = '330 G•P•v. �E�T1C T411C - 33o e (SO % • 4-95 6.PD. 15PG'�At PtT - USE loco Gam. I�>o SF ,c 2.S = 3775 Bc'rM,IA r-.O ST-'. CE�D sue. A t .o - E>o TOTAL -Z>ESlGkl = 42ZGG'- tT ToTA t_ z>,dt L--f Flow = 33D 6.PU. d Peop ''' �t �. Pm$zcDL&TtOQ CZl&TE C'Q 2MIQ Otz LP- . Ae" N � PeaP rANK Z c PAP t tiyCti.Acta p , 1 sac; ER •,^; "..try�+� p - - TEST F-G= �. I OAM �'P.Pe i o0o iu� i SuS. f -Sox s Inc 2 IWV t TAwK I Doo GG tW. 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