The URL can be used to link to this page

Home My WebLink About0586 SKUNKNET ROAD - Health SMEAD No.2-153LY UPC 12934 smead.com • made In USA 4�YC(0 J WITIATNE i Cutllt�dFmu8ourcino I �Npoanmaro � No..----` y.... a� FEs........3.... .. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH App irFa#ion for Bispoii ai Works Tnnitrnrtion Prrnti# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at ............... ..... ... . ......--------------..--•----- ......... ........... - ...=-' ......................................... \J- Location-Address o Lot No. .............K._......... ��n............ .........-�F-�'�6'AS ._k...��. ...................................... Own Address •-•------•----•--�QA- t._�_c�e•-- �.N..a......................... ............. "�4!�..�C C_V)``_. ..........__..__._._...... Installer Address UType of Building Size Lot-D-5... . .......Sq. feet Dwelling—No. of Bedrooms................:...........................Expansion Attic ( ) Garbage Grinder ((UCH Other—Type e of Building No. of persons............................ Showers C4 YP g ---------------------------- P ( ) — Cafeteria ( ) a' Other fixtures .................................. Design Flow.._______... ® _______________________gallons per person per day. Total daily flow._._._.... _ ....................gal Wlons. WSeptic Tank—Liquid capacity_W.0--gallons Length.......r.:... 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 Dos a Percolation Distribution i T st Re ults ) Performed byng ta nk; � �. ..... __.._ -------- Date.......�.��` ._..g.�----__. Test Pit No. I................mmutes per inch Depth of Test Pit.................... Depth to ground water........................ Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -- --....._ _ ® Description of Soil......... �� ........ M -)=---......� \sa 9 ----•------ -------.--•-----------•--••-•----- x ------------------------- '� -... U -�------.---Scan �• ------. 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 TL ITI,I. 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.......... .....151�. ; ................. .----------- �P� �_ ...._...._. Date Application Approved By.............. .�C_ Date Application Disapproved for the following reasons:................................................................................................................ ............................................•------•--------------------.....--------•-----•----------------•---•••---•-------•---------------••••---------------•----•-----------•---------•--••---•--- Date PermitNo......--.-�-----�--..---•--------•--•------...... Issued_....................................................... 1 Date SEW ti`A E PERMIT 0• L O CAT 10 r O+ ra sk U y� h�" G VILLAGE 1,.. oA ®A INSTA LLER'S NAME i ADDRESS � JT-4v,rlv)c, 6ro!a hc- e U I L D E R OR OWNE Y-Y\k DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED' a ti t • THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH VOW-.!3...............OF..... 4�\d\.5..: -� il- Allpf radon for Bispwial Work i Tonotrurtion rrntit. Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage"jp .posal System at ( \ „. • -......... .vtl ;ct .. i ........................... .......... ........ ....................................................... Location-Address or Lo No. r srr r s .....•--- owner ress a -------------- .n ..... ..E .....------........-----.... .......-:-. .�... . � �. Installer Address VType of Building Size Lotl;�51 1_-------Sq. feet U Dwelling—No. of Bedrooms...............3...........................Expansion Attic ( ) Garbage Grinder Pq aOther—Type of Building ............................ No. of persons....._...................... Showers ( ) — Cafeteria ( ) Q' Other fixtures ......................... . W Design Flow............ .......................gallons per person per,day. Total d ily flow......... ..........................gallons. WSeptic Tank—Liquid ca.pacity_W.C.Pgallons Length........g�.:___ Width.... ......... Diameter................ Depth.....4.7. . x Disposal Trench-No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No._-__6_Y- ... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ~' Percolation Test Results Performed by-------- :'k+........ ......-hL... . Date.. .__ `�l" ' . Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water...____......___.._..__. 0:4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ix .. t O Description of Soil �" ....5..?_`-•----. .�,A Q4M..- a�-�- � .. ---------------- ---------- x 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 TI:sE 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: �0, . .....kl;. S '^ ...................:.... Date Application Approved By.._..___.__` L............... � •• /-''l ............................... Date Application Disapproved for the following reasons--------------------------------------------------------------------------------•---------------•--------------- .....-•---------------------•---....-••-----------....------........-----•...-•------•----------•------•--•--•••--...--------•--••-•-----•---•-•---•-------•------•••.................................. Date PermitNo. --® ---�•-j.....-------•••............. Issued....................................................... Date THE`COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � n............O F...................10A.6?.... .............. f (Irrtifirtt#r of Toutpliane THIS IS,TO CERTIFY, That the 4dividual Sewage Disposal System constructed ( or Repaired ( ) by----------------------Q.t...0_?4_%..N.'..........--- . :.. ---------..------ t ------------------ ..... ........-- ...............---.... at........................... .................. aS = 1\__ r \` .. has been installed in accordance with the provisions of TIi'LE 5 of The State Sanitary Code as described in the �'.._. pplication for Disposal Works Construction Permit No..__. d.ry!.-.. _x....__...... dated............. -__. '- .............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE... = t f•• ................... Inspector.........9....i4.--....---•---•...................•----------------••--•---••-- THE COMMONWEALTH OF MASSACHUSETTS s BOARD �OF- HEAL,TH ?+ .............OF..-...... .-�''... .^.�..�..4°��'N .pk '�""".................. d'e� No.......................... FEE._...> '...?t y�... :`` '. ..`�. Y- �iu�routtl nrku �un�#rttr##ion rruti� Permission is hereby granted--------...�. "?.------ ......... to Construct ( or Repair ( ) an Individual Sewage Disposal System at No. .,...... n . - --- ------ -------- ...... �.'�,d'............... t Street ,.� as shown on the application for Disposal Works Construction Permit No.__"---------- Dated........ '_ -.�----.---_.- ---, ............. � " Board of Health DATE...... 1�7. = J ......................... FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS - �jt V1at�E . �AMtt.� - 3St:�D1ZlJON� All \ u� Gac��r� C•9R1 arn�Z• hd� a, ,� ; iaat�� Ft�w : t 1b 3 • SSo G•P•D. t �Efsl-tc TA"V_ 330,. ISO 'lo • 4-q5 6.Po. a r ' USE- t OOp E,AL. P05 AL. 1=11T uSE l o00 .GAA_. --UrJu/AU_ AeEA - 1C70 "S-P- • I��o St= �c 2.S • 3"7S G.PD. • 8��c/l .aQEA* � ST=. � faugD^T�oN i CA frs•. l .p ti SO G.PD. •3 A TCfr.& . •p ESIG►.1 = 425 G.P.D. / y r f Tt>TQ L. mat u-( t=Low t 330 6.>�. 9 1-•X it tmucoL&TtoQ cz&re . Ito Sic►i o o¢ \. OF y { \ �. 44-+ J G 9°� for F.4o V.10 C,.o Y LOE'� .rf"�pe loco tuv.-�f7•Gd' siuO So�Lw 4�/IPfs 1W 6AL. R(, _r z VL' 'fox 94 , • 1000 t�tv. tw. • ` GAL. 9s.L 9 8 LEAci4 •�, PIT s:N ND WAS"EtS j - � ; STo►.i� 8B• CEQTlF1ED PU!5`r' PL^A.;"_ LOGATI OW 1 2. 6 �..t o Sc ALA GA — " - .4T 4 �C I so 1 G6tZT�tF1{ T�- r TNi✓ F jUtVC>A t09 5"0%"Q 1: ELAt.! 1Zi_i= 4 1-1E:>`t_aiJ GcwIPL%�IS W 171-i 7,,rt-1G: 51DE.LIN� 1 �. A1JD SETL�ACIC 1;c4�1�Ea�l�uTS f7G TN1 � . 'roviQ or-- —P Z) to STh C�A'1I'G -7 �� 1 �1 �l' „ ik•.,�..�� ' REGISt'CR1=•D L-�1-lt✓ SUw�=Y��=` OSTEevtt+t r Tt-115 ; t7 t_A N l5 LAoT ZAS A Cp 064 64 � w itJSt'[cJMtJ� �,ua_�i�Y Tt{c. 01=�,�T•�, 5t4owta Al?fc�t_IGAa�T ;, 6br -ter•.!tj5r-n To N45 S G 5r1