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Home My WebLink About0578 SKUNKNET ROAD - Health Road' • • 1 1 1 I' ./■■/■■■■■■■■N/1 l■■■■■■■■ME ■\ /E■■■■M■■■ ■■■■■■■■®■■■■■■■■■■■■■■�■■■�■� ■�■� MEMSEENEEMEMENOMME 1■■■■■ ■■■■■■■■■■■■■■■■�■■■■■■■■■■■ ■■■■■■N■■■■ MEMO EMEMEMOMMEMMEMEMEMIS MOMMEMEMMEMEMEMS OMMEMMEMEMEMEMMEMES IMEMIN MMEMMOMMOMMEMEMEMEN IMEMSE 1■■■■■■■■■■■IMMEMEMEMEMS ■■■■■■■�■■■■■■■�■■■■��■■�■■■■■�■�■; MMOMMEMEMEMEMEMSE 1■■■■■M■■ ■■■■■■■■■■■■��■■M■■■■■■■■■M■■■■■■■■■■� 1■■■■■■■■■■■■■■■■■MM��■■■OMONEE MOM■OMM■■OMMEM■ 1■■■��■■��■■■�■■�■■■■�■■■■ ■■��■��■�■■■�■�■ Eli 1��■■■��/�MIMM■■■■■_ ■■■■■■■■E■■M■■ME■EME EMMONS THE COMMONWEALTH OF MASSACHUSETTS t) BOAR® OF HEALTH 1 ra�\ 8�J17t�.............OF........... C. / .f'Z. .`�....................... Ar 4-t APPRration for Disposal Works Tonstrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal yvstem at: ............. �.!�.1-11.!-�......... �+ ...................... ............•----,. .�®...............--------••------............................... S Location-Address \ or Lot o_......................................... ow ,ddr^es�_s �! .. .......... �r....,�. Installer Address Type of Building '� � Size Lot..V%9j R.....Sq. feet Dwelling—No. of Bedrooms..........k............................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—Type e of Building No. of persons............................ Showers t� yP g ---------------------------- P ( ) — Cafeteria ( ) dOther fixtures ------------------------------------------------------•-----••----•------•--•-----•-----------••-•-•--......---------........ W Design Flow...........\Q........................gallons per person per day. Total daily flow................33P................gallons. WSeptic Tank—Liquid capacity.M D.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..... --� .��. ..._�....N �'—.� ...•_----_- � Date Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water..--.................... fs, Test Pit No. 2................minutes per inch Depth of Test Pit............----.... Depth to ground water....................---. Rai ..........-................................................................................. ................................................................. O Description of Soil...Q.-_.D-....., .-----.------ vlc� �'` --------------------------------••- 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 ITLL 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. Sed-....- ................. S c►v` ................... /� Date Application Approved By............. �..r/.� ----- �� / �.� �................... Date Application Disapproved for the following reasons----------------------------------------------------------------------------------------------------------•-•--. --...--•••.•••-----•-------------•-----....-•-•--•------•-•••-----------......•----.......-----....•--------•---•-----------•---•-•----••----•----------•••---------•-•-•--•--•-------------•-•...•-•--- Date PermitNo.......................................................- Issued....................................................... Date a�IAG17/;, 0 CATION .�'78 E PERMIT NO. VILLAGIL C INSTALLER'S NAME i ADDRESS BUILDER OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED _,�. S/ Y 3� d { 6" No. �r.f.. � fit. F�$.... ...(9 THE COMMONWEALTH OF MASSACHUSETTS BOARD" OF HEALTH own..............OF......... \c,_......................... Appliratiun for Diopuoal Works C-unotratrtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: p ............. rJ•_V.n ;c\e._......._... ....................................... --.............-•...........U..•-•-------------•-••-----•-...........----•......_..._---... Location-Address _ or,Lot nNo. \a tt Owne� _ .. -. :.ddr ess.....Y _. ._ ...... ,. . :.............:.......... � Installer Address U Type of Building - Size LotA52.,QQ.S�.....Sq. feet a Dwelling—No. of Bedrooms.......... W..Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures ................................................. Design Flow........... ..........................gallons per person per day. Total daily-flow.................. 5•a................gallons. WSeptic Tank—Liquid*capacity\q g.gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.......r.......... Diameter.... ........... Depth below inlet.............. Total leaching area.. Q..4!!q....sq. ft. Z Other Distribution box ( ) Dosin tank ( ) , tt,, .. � ~" Percolation Test Results Performed by......... _�_A.:_.I..._N -.................... Date... 1� '.' � .,.........._.. a V 04 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........................ D Description of Soil...Q'�" -� : �?°!.....fit:.--..1,•� ?_ 29A........-----------------•-•-----------•..... -----. ....................................- U a..........L!!.:... Cl(1- J CSC-AV:C.�-------------------- x ................................ -~N'4' m- �- sue^ 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 TITL,i� 5 o3the 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----- C. ......��:c:....�.�''�:..` .. ................................, Date A lication Approved B .................. Date Application Disapproved for the following reasons:................. ................................................................. _.-_-__-...._ -------------------------------••-----••_.._.._...••-••••-•....-•---•-•---...---------••--•-•--•--••••••-••••-•••----•-•-•-••-•-•-•----.................................................. ------------- Date PermitNo........................................•-•--------- . Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD �OF HEALTH ............ .............OF.......... }. .....5 CC,L QJ` CIrrtifiratr of ToutpliFanrr THIS L� TO CERTIFY That the Individual Sewage Disposal System constructed (VI),or Repaired t GEC\ -.D , by .Ll. ..••••---•--••---••---•------• -•c-`....`----------------------------------------- "`" i Inst itT • _0 \� 1 ~ fl \� e= ...... —� �---------- C��c 'Q r V t `\ c---. at .................•-• ........................................................ has been installed in accordance with the provisions of TITLE j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.... . ............. dated................................................ LL THE ISSUANCE OF THIS CERTIFICATE SHA BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. e DATE.......................... .... ............................. Inspector.........k_/� ------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No.....5�...y.�,� �t� FEE..... '..0.....:...Disposalork� �oa��#rttr�ion .ertttt� Permission is hereby granted -,\�T,.CN —.> ...__.__b�_0 5 ,�/ • --'-------•-------------------•----•------------................----••••• to Construct 1 or Repair ( ) an Individual Sewage Dispos S stem at No......... -� ?�..------ J - ? �.L' �` n c_=� `" .."e e s \f\��L_ ---•••• ------ ---•--------------- ---- ......-....... Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... J ----�+"�� r pi ealt DATE................................................................................ Bo/ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS _ "•"_.....�-..---' �bb•ono ttb +c Ot t-lG -r4"v- = SSo-d ISO % 4'91b 6.p.o. s �, U Ste- t 00C� 6.4I✓. • f ..f t S DD"� ' �' AV-P. = 150 ISo 5� 2.S • 75 G.P.D. ,.. �,�►� N r6 $!JT•T-OI(/l -r EA= �� Si= J f T o Sri'. ! I .o - SG c-, 1p f' { �' ToT& ESIGI.I = 42.5 G.RD r _.,._ i } PPIL�o� O L: Aes+4 ? ToTQ l_ tv dl L�f Flow - 33D 6 PD I r rAQft �ERGI�LQTt(��.1 CZI�TE : t"tU �L�rtt IJ•�Q¢ 1,�5tS; � � ' . 4)d °- .. ;� At a,ta ua tj Tor 17wo =IOU.o R IOC —�loola� 4- (t�►`.AA �! Roy I000 If�N 'A a sc1--,•. Le 4pP� I71Sf. IMl. G,at:. `iG,g fg I Z -sox sEgnc tuv " LEAao FIT •.; wvrW AA(�D• WASw1EU , rn STo•,E_ rtA.U 4 t. ' C'EQTtFtEC7 l.�"i" PlzoT:. I L_E= i L bUSTI 0''' =f3f. 12� 14 oS C nL LA - CCtZTiF� TI-(A r T1��. �oU1�AATIr�I� Su u PL A R t^�Iza►.i c:� �-16.1,t_t�t,l Gc��PL.�IS W 171-i TNT:: 51 DE.I.l►-1� �'.l"' 1(� ' • /fl.lL7 `;E~I"L>AC1� Vr-QUIQEA/ iE--wTy OF TNC i --tow Q or' ?„�: •IS�)Tti pL. $�C: 3' �t b� . Q�} 'A BId►)C'f'CiZ. 1t.1G- :, 9zc6t5,ItrzeTD LAIWO 5uv-v-`N Ti-Al P L.AtiI o a-cE.ev%L-tL o A,tAS-i. It•l;t'`;-1l✓�[:�•i� �,Ut:�/I �{ � Tt�C: C3F�:;'�('�, �i1-�GwL.D A.Pc�L.I CAd�IT_ /.I' t,I;or C;I:: UI>LO TO LOT t-tt-i�.—5