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HomeMy WebLinkAbout0118 SACHEM DRIVE - Health 118 Sachem Dr. -- A= 229—094 Centerville S M E A D No.2-153LOR UPC 12534 emead.com a Made In USA AM SFI M&9FWWM a LOCATION SEWAGE PERMIT NO. i �Qy�=ter nr2, e - z 3 VILLAGE INSTA LLER'S NAME i ADDRESS ze e&A1r 6tlz ,, n. B U I L D E R OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED r *JV'-. 1 �} 0 Ck No.....:.................. Fps..... .a............. THE COMMONWEALTH OF MASSACHUSETTS IV SOAR® OF HEALTH ......................I........----------..OF.................................................. Appliration. for Disposal Works Tonstrnrtion ermi# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: p� ------- ---------------- Location Owner ` Address Installer Address U Type of Building Size Lot..A.1 t.8Q0_.Sq. feet � �-, Dwelling—No. of Bedrooms.....01........ d... .................Expansion Attic ( ) Garbage Grinder (� / aOther—Type of Building kg-�.1179 4r! No. of persons..........J�.............. Showers Cafeteria ((J) Otherfixtures ......................................................-----------------------------..--........_.. W Design Flow............����..... ..........gallons per person per day. Total daily flow.-_....g6_10.....�i�--�....gallons. Septic Tank—Liquid capacit _."_....fgallons 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 ( I ) Dosing tank ( ) Percolation Test Results Performed bY.........................................................•••• ••...... Date........................................ Test Pit No. 1-/_'.-W-Q..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........................ U Description of Soil--./-a� c> �X�l f�. U 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 TITLI: 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is ed by the board of healtbe Sign .•••••.... _ ...... .... D,p ... at Application Approved B PP PP Y..... r.._ •. Date Application Disapproved for the following reasons-------------------------------------•--•------------------------------------------------ ---------------------- ................••--•---••--•••-•-•--••---••-•-••-•••----•••--•---•-------••-•••....•--••••-----••••.........--••---•-•••••••--•----••-••••-•••---•-•-••--•--•--••--••••-•----•-••••--------••••-•....... Date PermitNo......................................................... Issued-....................................................... Date No. FEE... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 9y ......................... -----------.....OF.........---...................._..... ApplirFation for Disposal Works Tonstrnrtion Vernfit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at ................-........_...................................................................... ----...---.....---------...--•-••-•-•----------•-----•-----------•---.....------_............----- Location-Address or Lot No. ......................--........................................................................ ..............•••---•-•--•---•---•••-•...-•-•-•-----......._...---•_.............................. Owner Address a --•-• .1................. ................. .................................................................................................. Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Buildiw. .............A------------- No. of persons_______---_---_-__-_______ Showers ( ) — Cafeteria ( ) Design Flow fixtures -- -------------------------------------'-------•--------------•----------.......................................................... ign ._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 ( ) ,� aPercolation Test Results Performed by.......................................................... -- Date Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to grourid water...-_-__----_--------__. 44 Test Pit No. 2................minutes per inch Depth-of Test Pit.................... Depth to ground water........................ P+ .............................-----•--•--•-•-•---•-••••-••••-•--•---•--••-•-.........•-•------....•---•-•--•-----•------•-•••-•-•--------••--•..........----- 0 Description of Soil.......................................................................................................................................=-----------------------------••--- V •-------------------------------------•--------•-•-•-------------------------------------•------------------------------------------------=--------------------------------------••----•••••----••••.... W -----------------••-----------•--------------------------••---•--•-•---------------................................................-----•--•------••-•-•---•---••-•---•--•-••-•••--•--•-•-----•-•--•• A,V 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 TITLZ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health- Signed! -= - Dat Application Approved By........... .... r... ...... .. . . .......................•---•-- ........ Date Application Disapproved for the following reasons----------------------------------------------------------------------------------------------------------------- .......••-•--•--•-•-•-•••....••••....•--...-•---••••-•----••-------•--•-•-•---......-•--•...•••--•-•...--•-•--•••....._...•••---••••----•-•-•••----•-----•••-------•--•-•---•--•----•--•--••---•-.....-- I Date PermitNo........................................................ - Issued--•--------------------------......................... ? Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................O F...................................................................................... vEnrtifirtt#r of TuntpliFanrr THIS IS TO C TIFY,'That- the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by-------------------- '. .....................=............. j-- staller at.--•••-••••-- ........ •-••-••••• •=- �'� has been installed in accordance with the provisions"of TIT FF 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No----- ........ dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.......................................... 'R f� Inspector... ........................................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF, HEALTH ................................ ........OF.._..............................._..............._.................................. No.-•...................... FEE....S.d.......... Disposal Vorks . onstrurtiottfrrnfit Permission is hereby granted................... - <- �z' -----------------------........................................................ to Construct ( ) r Re air ( ) an I ivid al Sewage Disposal Syst a atNo. ............ -'-------------- r/ ............................................. Street as shown on the application for Disposal Works Construction Permit No................... Dated.:}_`__-.____---:_.,....._....._....... oard of Health DATE------------------------- 'l z= . a. . FORM 1255 A. M. SULKIN, INC., BOSTON o ' FA AA I U,A I Lt Fi.o w w.4 +So //7 '° SE'�'TIG rA!J v- 44o x 'Loo 70 7 I Ex, PISp034\1- PIT', - AL. /21Nt3 SI D�wAl.l� Q21�A = S-11 5F P Peon iia. � � /io,? 3"1'1 Sr x 2 S - Rd 2 G PD Q Prof; Per �i, r a�rtq , 71 73ar7VAA A2aA r 151 S I' oe o / `-�'a7-r�L 'D�516►J �09 �1 m GPI __ K i�9. . / r o. .� 3 Z. . Tvt�nL `Dn t Ll rco� PtDc PAT& I►Itu ZMIW C%75 �/o - - "/09.� p��� � � � , %o.spo II �yD^�tt Of AIAss S��N Of`M�s 7� f;ICHARD �, „�,;�` DAVID I ( A. THUi c. IN naxTER v, I S, No. 29975 IN To7 OF � �/Srff� �"��F�/STEM` �`� Io /v3 ` pD 5Ur. F' � S'ONA � TV— -r TOP FNu = II O NoLF zl�S�Bd r�--•/ . s loo.13 ~7�z7fy�^� 4- INV. A + 5 AIL. Z ©UX' IoGINY. -eiJ:PTIL ILb•B .G Z 1,000 INS. I TANK GAt_. IoL,p 1f\ I. LCAC+1 PITS INV. INV. *, �ftTu IaG Z 4 A' r 6L At l VWl+SNLD /�/�fib- °d•00 C•�2TIF-ll� p pLoT' P1...A►J e9 _ P 4Z o F 1 `c L a L A'T 10 N C a/ �•c.c3 .. IJ� i. i 4 SCALE SCALa �!! �(v DATt~ 8 W&V. to-!?-94 p WATt�- (moo P oS tTr�+ p L A N R E F S 2E N GE e GEczTIFY TNAT THE P�Nr�u�NG 5HoWN NEREOi~i GOMPI-`(S Y�ITN "THE S 1 V6LIt-1 LOT g A 56TEAGK 26QQU+R•EM6NT!�, 0IIF 'Tl�� -Tca W N O F '(3 P12I,14 TA 13 LZ A N_0 t S I�IUi"• ��. i�tL- I�g �G. Q 1 Locp.TEO WITNIW TN*E F:">C>0 PLra1N ' D ela-T 4 -'o Y t, •- V� ,� BAXTEcz R.EG I SZ f--26D'►.Aw o 5 u V-Y EYoeS "Ta15 PLA.► l 15 N07 Eat 5c P p►d AI'-J asTEczvILL� - MASS. INS-T-R,uMENT '5v2Vey � -rNE n1=FSE"rS Su0UL No-T C:�, TD DE-TE.RJ^I►,l oT t_INE�) APPLICANT ID