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Home My WebLink About0141 SETH PARKER ROAD - Health .................... SMEAD No. 2-15MY UPC 12934 amead.com a Made In USA SUSTAINABLE FORESTRY INITIATIVE Certified FiberSotuft wuw afiorooranoro 0 3 n S S 1 33NVIIJW00 3 1 V 0 03ASSI llWd ) d 31Va rev/ MI MAW tl0 1! 3011n a SS3daaV 1 3 W V N 4 V333 V1SN1 - 3y ISVIIIA '0N lIWN3d 39VM3S N011V301 33O�Hd /'ON dHW S doS S SH l Lklo No...... .�c1 Z� Fps..... .. l..... L THE COMMONWEALTH OF MASSACHUSETTS BOA R® O HEALTH .—. -------------- ...-.. °�-.OF...... .... .......... . .... ------.. ............................ a Apptiration for Bispvii al Works Tonstrnrtinn Vamit Appli on ' ereby e for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal system... /,�,�;+,Qrc __ _ _. ..---- --. .-- Location dress or Lot N . nez Address ... Installer Address Type of Building Size Lot... feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder PL4 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) P4 Ot fiat s ••---•--•----•--•-••--••..... W Design Flow......._.. ...................gallons per person per day. Total daily flow................'ASA0........gallons. 1:4 Septic Tank—Liquid*capacity allons Length................ Width................ Diameter................ Depth................ Disposal Trench— T ...... 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........................................ Test Pit No. 1................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____•_-____.___-___-_--- R+' •••---•----------------•••-••••-••••--•---•.........----•----•----•-----•----••---------------------......................................................... 0 Description of Soil........................................................................................................................................................................ W U W •••••--------------------------•••••••••-----••••-•-------••--------•---•- -••-••••--•••--••--•••-•---•-•---------------••••••-••--••--•-----•----------•----•----••-•--••---•-•------•-•-••-•---------- UNature of Repairs or Alterations—Answer when applicable._______________________________________________________________________________________________ ---------- •-------------------- ._.....--------------- --------------------------------- ..._...........----------------------------------- •-------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewa e Disposal System in accordance with the provisions of ii:l.l. 5 of the State Sanitary Code—The undersigned rther agrees not to place the system in operation until a C of C liance�s been s by the rd o ealth. � � 1!5 c� Date Application Approved BY .................)easons: ......•-----•------.....-•----•-•--.....................---•-....-- •-•--------` �1 Date Application Disapproved for the following ....----•••----••--•---•-••••-•--•-•-------•-•--••-•••-••--•----••--------••-•••-•----•--••---••------•--------- --•.............•-----.......---------------•----------------------------.....----------•--••-------•-•--•-------.....••-•---•-•--------••--••-•------••-•••--•---•- ................................... Date PermitNo......... .......-cl2.l.----- Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS � BOARD OF HEALTH • .-- ....................OF...............-----------------..... Appliratiou for Diapniittl Workii Tonstrurtiun tirrmit Appli tion is erebyrade for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System ' f �- 3 ............__. ._.._............................ .............................. _..._...--------••--. •-..._•---•-...-- -------- -----• -- !"� Locatio ddress or Lot No. -E:�:..�"E r wne Address . Installer Address ,I �s UType of Building Size Lot__I_i_ter_________________ _Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Ote_s fix uses ------------------------- ........................................................................................ W Design Flow____.5F77M........................gallons per person per day. Total daily flow--__•__---••-- ......5a---------gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—,Alo ___________________ Width_____...._.___...___ Total Length.................... Total leaching area.................... ft. Seepage Pit N - Diameter.................... Depth below inlet_.__..._.__________. Total leaching area........... ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ 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........................ 04 --------------------------------------------------- •--- •-------------------------------- ------------ •--.... ---------------------- --•------------------------- 0 Description of Soil........................................................................................................................................................................ W U ----------------------------------------••••••-•--•••-----------•--•-•----••--•••-•---•----...•••---••....•-•-•---••••-••-•--------•----•••-•---•-------•-•-••••-••••-•-••-••-•-•---...-----------•••••. 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 T-I'T'LE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a C e of C phance has been 'ssued by th pard f'Xealth. 7 All Date _. Application Approved B _ �::��C.L f�,V; cam.. �j ` `) l� PP PP y••• -------•--/------------------- Date.............. Application Disapproved for the following easons:..................... --------------•-•---.........•--•----••••.....--•--•••--•••••......--•••--•-----•••-••-........•••-•-----•••••••••-•••••--•••••-••••------••---••-•.................................................... Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH ............ F................... .......................... ....... Tutifiratr of Toutpliattrr THIS CER Y t e I 1 Sewage Disposal System constructed ( ) or Repaired ( } by................ stallido id . ---------------- has been insmiled in accordance with the provisions of T i T LrZ j of The State Sanitary Code as descrrib d in the application for Disposal Works Construction Permit No.___�(,._::_n_Z.�........... dated_..,--- ._{__U_.._:.�_�............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTIOY SATISFACTORY. � DATE..................�L�� ................................... Inspector.-_.... `! THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH D Z� OF...... ...... NO._. ......... FEE. 7 ..... �i��rla� t• � #rttr#irrn rrmit ------------------------------------------------------------------------- Permission is reby granted•... to Construct r Repair ( ) an Individual Sewage isposal System at No......�0,77-•----........4-?( A-----.... --------- --- Street J as shown on the application for Disposal Works Construction Permit �No._ b...IDDated.__- -_l_.�.::`_r ------------ 1dl•----- - -- --- -----------_-------- /u f Y4 Bo of Health DATE-----( ._......-•-•-----•-----••--•-----•-•-••--•••.........-••••-•••--....... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS I J j �T ��51 G-s FFII�J�TA - St1�lE�1.E;F/lM)c.�('-3f3EDM5 — Ivs,00' "D�a t t..�C.'��r�s t 1 D x 3 4.� 33a f�'PD •` -' � � � S E'P'i�G-T'iWkC,s 33a x�Sa�G� g956�4•? � T �i \ ;, 7)ts•Po S I.�P rT�- u s lr �C>tx!> .i.o `cA : %wo sF j pos v I 6 Ckv�ccrl %TOsF0,2.is! ' 3Z5Cx4'i !+ - ; -� 40 M �tL/l t SabF ! �T `O zd w 44, 1 C&'VIICIT`(s 6pSR 0, 1.0 : S�GPO 4tVf. i Per 9� 'i'aT4ti.. "T ?Sol ec&A FLo v/t 425 EtQj� r ( yi ttDy t KlkA.0ZL% i ak' OF r 1 bS Sao �c}Jai Ul iV,AN I •�� 4� C-a 43.3 -Tc-P aF Fti1,7 fir, 4"PVC- iUDo loan •� ,�.r ;,, �%' 2ZA lil1 x G& PIT tuJw4.�ov 40.9' Tf uK 3q,ol�W�s� CERTIFIED Pl-aT Pt,AN s'iuur i/�I�1:� l� } `•. '. EL=S 1-ocATION: CCE-iK TFYz�llL.1_"`r NO y Jl�T L T 6 6 z. TFP 3A Mr R t I G Et T IF`t T!4A-r-(>E-�r '5 H awt�1 R EErI S Rtt� -i�R��1�1 era1+�C�4-`t5 kl C'Cld'11-4'� S It��I-1r�tr e..�vl� �►.►�tu�szs �N� 5�`T`��K "FiF.�t1�?.�M I✓NTS �'��-1 E �s��I t-1..�.�-- �l h� , ':;'F P AtX0 IS hsd-T �4T 1_1�l�?�IT: Tt-t is R ti N 1 N ST R u M (\1T R 15 Nt�T"$ASt•R DNA �-�.. G 7��w 5uRYEY AND 1 NE0FFSET5 5jj0WN 5H�LILU Tq4T 13E 11SELF Ta ESTM31-15H UV T' L )NE5. H VS(E'S'SOR'S MAP N0. ' 0 PARCEL 9 d LOCATION SEWAGE PERMIT NO. rYILLAGE c �x M— INSTALL It NAME a ADDRESS /_'1Y � t UlCAI d U I L D E R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 44