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Home My WebLink About0082 SETH PARKER ROAD - Health 82 Seth Parker Rd. Centerville Map 170 - 183 S M E A D KEEPING YOU ORGANIZED No. 12534 2-153LOR SUSTAINABLE MIN.RECYCLED 19 NI INITIATIVE IAE T IVE CONTENT 10% terrified Fiber sourcing POSTCONSUMER® wwasepregrem'" SFW1290 MADE IN USA GET ORGANIZED AT SMEAD.COM ASSESSOR'S MAP NO. O ig ARCEL RC— l '3 (y-3 Nsl— LO WAGE PE 2MIT NO. 71,<i, #�� ow VILLAGE INSTA LLER'S NAME ADDRESS -� f` e. UILDER 0R OWNER I� DATE PERMIT ISSUED DATE COMPLIANCE ISSUED �� b 1y� 0 cza No...... ---.... Fps................ ............ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH c`3u4 ................o,i3ke ............................ ApplirFa#ion for Diip.aii ai Workii Tnnitrnrtion rantit Application is hereby made for a Permit to Construct ( � or Repair ( ) an Individual Sewage Disposal System a� -� ..... Location-Address or Lot No. Owner Address �. ............................................ Installer Address d Type of Building Size Lot.A.5.7..`)C:.:.>.......Sq. feet U Dwelling—No. of Bedrooms...... -------------------Expansion Attic 4AO Garbage Grinder (1J 6 aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixt es --•-----•-------••-•--•--•-••••-----•--•••-•-•••------.-----•-•--•-----•-•---•-•-------------••-•-•--•••----- W Design Flow.............. �.............................gallons per person pere day. Total daily flow........ ......._..__...........gallons. WSeptic Tank—Liquid capacity..J2.�Qallons Length.l�?.._...__ Width..).._.._..__. Diameter_'__-......... Depth 5..-4_.. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No------- --______- Diameter..... ?--------- Depth below inlet......(C2........ Total leaching area..Aoo..sq. ft. Z Other Distribution box Dos' ank (iCt A Percolation Test Results Performed by �4XT35;;1� ...l�A .�_LXC-................ Date... [.'..�_ �.�� ........ P-1 _ Test Pit No. 1..4�....minutes per inch Depth of Test PitAZ............ Depth to ground water.. ,To 5 COc "MECCA? L14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water..__...........-........ ----------------------- ---•-•-• ..................................................... ..........P w UNature 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 TITL LE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compl' nce has been issued by the board of health. Signed.. -`tY'Z..E....- --------------- --- --------•••---------• ... .. ..... Date ApplicationApproved By--••-.--------•--•--••--•--- ..................... --------... . ... ..... ......... - {�.... Date Application Disapproved for the following reasons------------------•----------------------------------------------•-----------•-------------------------=------... --------------------•------...--------------------••-----------•---------•---.....--------••---------•--------.......•--•-----•-----•---•-•-----•••-•---------•---•------••--••-- ...................... Date PermitNo......................................................... Issued....................................................... Date . n No................_....... Fu$............................. rya G a� S/ THE COMMONWEALTH OF MASSACHUSETTS V BOARD-OF HEALTH ............. t21a5. 7 t Applirafion for, DhgpasFal 18orkii Tonitrnrtion rrmit Application is hereby made for a. Permit,to Construct ( � or Repair ( ) an Individual Sewage Disposal System at• �— S��"il-1�r�Z1�EiZ. 7 T t=tZV( LL C: � 1 f .......... -. ...................... ..... __.... ....._...... ..._....... ........................................... ---�------•-----------._................. • Location-Address or Lot No. V)n.............. e ,► ------------------ ..........--...................................................................................... Owrlbr Address a C.Ar ... ................................... r't:,, =` � Insalior Address Type of Building Size Lot__l�_._)_`� ......Sq. feet Dwelling—No. of Bedrooms.____ _________________________________Expansion Attic ({.� Garbage Grinder aOther—Type of Building ___________________________ No, of persons............................ Showers ( ) — Cafeteria ( ) Othergtrs.-----.._..••. --.................................................................................... W Design" Flow............................. gallons 6 TA n e ....... ........... Septiccapacity... Width___-__....... Diameter_" "_.____ Depth_5._'A_-- Disposal Trench—No_____________________ Width.................... Total Length....._.............. Total leaching area....................sq. ft. Seepage Pit Nei-------- -______ , Diameter.___..-........ Depth below inlet......�2._______ Total leaching area___' _.sq. ft. Z Other Distribution box Dosi ank (l1� tl � `" Percolation Test Results Performed by_ A� t�c .__l�..� _ ___�_ �_________________ Date....4 °_i _�. __..__. t... Test Pit No. i._.C.Z__._minutes per Inch Depth of Test Pit_._�Z�___._.____ Depth to ground water______________-_....__. Gr, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ____ _ _: _ --•_ . � -ODescription of Soil D L0Aw\ SU%3 SO t ........... ___ UW ----•--------------------------------------------------------------------------•----•-----------------------------------------------------------------------------------------•--••--•-._...._.._--•--- 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 5 of t e State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of p ' nce hh .been issued by-the board of health. QM * Date Application Approved By.._..•-• •-----•••-•--••• = •--- --•----- -• ....... ........... - Date Application Disapproved for the following reasons:.. x --.....-•-•---------------------------------•----------------....--------......-----------••--------•-------..._..•-•---------•-•••-----•••-•------••----------•--•••---•--=--•-----•••--••-•-•••--•---- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF.............. "'�-r"l .............................................. (9rdifiratr of Tomplitanrr THIS IS TO CERTIFY, That the Ir <.•vidual Sftwage Disposal System constructed ( or Repaired C..trr v►� r by------------------------------------------ ..._•----- - . at " I 'u 0.�.-----------' has been installecPin accordance with tale provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No...... 6- _"a___-�'2_______. d'ated::...-._-.w�'`=-�__"`��„-•---•--•••- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL F NCTION SATISFACTORY, DATEZ _. Inspector_ ....__ .. .:......._ THE COMMONWEALTH OF MASSAC SETTS IV i� /)'95 BOARD OF HEALT - 6 3 g� OF............................. t.. ....__....---._.............. '"' ... NO...... `,..., FEE.................. �:4 m �i��r�a��tl ork� �on��rioirrntit � �,._y Permission is hereby granted...............-----Ct__A. -•-......... ! ? . ................. •-• -�.............. ............ to Construct ) or Repair ( ) n Individual Sewage Disposal System at No.............. M'f ' �._ _..�_(J... ------•---- �-o-••••--._S_.e�+h r \d..t.v- _ Q._'__ _..r. 11)to Street 96 as shown on the application for Disposal Works Construction Permit No-------- Dated.____ ...... and of Healt +m DATE-------• •-- ----•-•-------•----•----•-••• / *:, *. FORM 1255 HOBBS,,& WARREN; INC., PUBLISHERS' _ - 7rA. . N F Y L/�G 12 50� 64L SEP7'rC 7'A�J1 ,�.., Ex �S/A L-e- 4Z E.4 i00 )G.,aU. 5 050 �ESlG.c/Ft'.E'.GoL,4—ia.✓/ aiE $Z . R PETER ssq°ya '.t�o�� S 15; I t cJ S,�, . _ •- �` 53 . N� �. 1 I$UlrtiVAN : CHARD /,� oD o. -aN 29133 H. BA TER � - f .. K1 ; s �. ♦.:c f Vv TCS77 14oL.E -P-4�8� , 4-1 1WJ -gS t t3Ax a.wxa, I i�c:. 4' J /�l L /.NV L xv . �aX. is�•i' `" - „�.—�i✓C ' `� •4 . .. 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