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Home My WebLink About0042 SETH PARKER ROAD - Health 42 Seth Parker Road Centerville A= 170— 179 it *"PendafleYr OEM& AM 42101I3 ORA 100/(o P4 ASSESSO 'S MAP NO. 17 O PARCEL 7� �G ` LI�C3 L 0 G A T 1� I� --- . 1,_ 07' --- Y IL L�A� 17 �14z-T-ItLLE NAME & ADDRESS 0UIlDER OR Q+1AER DATE PERMIT ISSUED . L -a � t�,� DAf E COMPLIANCE ISSUED r �N 27 Ar No.--- �'-� Fps..... . ..... . THE COMMONWEALTH OF MASSACHUSETTS �. BOAR® OF HE T . ............OF...... . ... ...................................................................... Apptiration for Diipnsal Workii Towitrurtion runfit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System sue/ - .......-- aLocatio e, . . ss ........... ......... ........... --.....o r ................................................... Address ................ .[/ ........................................................................ Installer Address Type of Building U Size LotZ-gf. ...Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( � Garbage Grinder (AP aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria (OVr �. Other fix res .•• ----------------------------------------•----•-----•--•------•--•-------•-_--- ------------------................------------ W Design Flow.......... .' . ...._.gallons per person per day. Total daily flow........... -�.�..........gallons. WSeptic Tank—Liquid'capacitYy-.Iallons 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........................................ W 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........................ � .-••-----•-•-----•--•••••••••---------•---•-••-•-...---•--.......---•••...--•----- - -----------------------------••---------- --------------------- 0 Description of Soil-------------------------------------•---•------........------.......--------...-------------------..................................................................... U ..............................-----•-•-----•---------••--••-••••-•---------------•-•.........-----•-••------•--•-•-•''••---•-•-•-------••----•-------•-•••-------•••••-••-•......--------•••-----------•- W x ............... ---•--------••-••--------••••••••-•-•---••-------••-•••••-------••••-••-•••------•------•--------•-•-••-----------------••-••••-----------••-•---•••--••••••-----•--•-•-................ 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 TII'11 5 of the State Sanitary Code— The undersi ed further agrees not to place the system in ope��n Cnt��teom � has be ed by�o of health. � � Signe ----------- �� f Date Application Approved By..................................... ........... - Dat ......- Application Disapproved for the following real s:.............................................................................................................. ......................•----------------....--•-----...------....-•--------....--------......----..........-----------------------------------------------------------------------•------•••-••--•------- Permit No.. • e------ ............... Issued--------------•--------------------•----•-. -Date Date ? -q� � No.....---.......'---•--- � FEs.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH l Appliratiou for Disposal Works Toatotrurtiort Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ---------------------------- ----------------- ..................................................... •-----•------------ ---------- Location-Address r o //�� r r Lot`No ......................_.................................................. :.. ..f ..._..._ ......._....t..._`..._..... _........................................... f .... C ...__.... Owner a Address r . f . .. . /- 'e -----•-•---••---••-•' -... ...=- -----•.`•- . --f•------------ .............................�...._.........----- -i----------•.. - Installer Address UType of Building .Size Lot_ ._r. ...`.....Sq. feet g— ...........................Expansion Attic ( . )'` Garbage Grinder ( � 1-1 Dwelling No. of Bedrooms.._____:=`-�:- � a`4 Other—T ype of Buildin g ____________________________ No. of personsf:'`______.__.____._________ Showers ( ) — Cafeteria d Other fixtures .................................••--•--•••••--- W Design Flow..........................................gallons per person per day. Total daily flow.._.........:_.....r_.:�_:} 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........................................ a Test Pit No. I................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........................ -------------------------•----.....-----------.....---------------.........---•-----........._.....--------------------------------•••---••---_-•.-- 0 Description of Soil......................................................................................................................................................................... x 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 TITIE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation untiLa C tificate om has beet,issued by the board of health. Signed..'••<.l�` `_-•-- L: ,i �y Date �. Application Approved BY ..`.Y(/_...../ -------- a > ... �--- .: -� Dat Application Disapproved for the following real s:••••••••--••--••------------•••-••---•----••-----------••--•-••••-••••------•--•••••--••--......••.............. .................................•---•--...------------------•--••--•-•--------------------•--------------•----•-•--------•-•-•••••-•---•-••----••--•-•---•---••--•---•-----•••-•---••---•--•--••---•--- Date PermitNo.._ �------- -----------•-- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH v.... Qw � �...............OF........... r.... ..................................... dr wrtifiratr of Toutpliattre THIS IS TO CERTIFY, That the Individual Sew, e Disposal System constructed ) or Repaired ( ) by........................................................................... .................s<.. ..------ ---......•--•..---..... ••-----•-•---------------- stalle at .-•------ -ZJ-�--------��N... r�� E yt has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as�.escr'III in the application for Disposal Works Construction Permit No..___._.`x�_l.__._`f�l _____._._. dated______________-.- :=} ................... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FU TIQN ATISFACTORY. {/ DATE................. ..------• ... ......... ........•-----•---------------•----- Inspector.................................................................................... �U�J^ THE COMMONWEALTH OF MASSACHUSETTS - -I BOARD OF HEALTH FEE........ :........... '<�59 � Disposal Works Tonstrurtion Vrrmit Permission is hereby granted................................R L,'=.;_4--•------Q` ............................................................... to Construct ( or Repair an Individual Sewage isposal System at No. (", 4 ...... - �"`• . -- ................. Street Sa C- -9 ci as shown on the application for Disposal Works Construction Permit No...........A........ Dated_____________ l 1 Ad � ai---___••..._ Board of ealth DATE....... ---- .__ /... <� FORM 1255 A. M. SULKIN, INC., BOSTON " ` 'J a ..<<. DE51C-N D�T� ,S ` � ` . 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