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Home My WebLink About0062 SKUNKNET ROAD - Health (2) S/Cli N.CN�TT D, - 0 y LOCATION SEWAGE PERMIT NO. 13 AktuS"frg-aLr VILLAGE C INVA LLER'S NAME 8 ADDRESS BUILDER OR OWNER 442- 9kuwkA)�i DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED �y :,- e � �'► '� � �, a. _ �� NoA/ Yui3.4 THE COMMONWEALTH OF MASSACHUSETTS -� BOARD OF HEALTH 1 ............f OLL........OF...... . Y.r�S. CAL. !... ..................... ApplirFation for,'-Disposal Works Tonstrnrtion Frrmit Application is hereby made for a Permit to Construct ( ) or Repair (L-)•an Individual Sewage Disposal Systemat• - -- --.••----- - t N •--•........................... Location=�sess o ------------- c ....-..... � z'4............. ............0 .....................................ner Address a � DWIL>. 1. ............. :.. /� `1� 1_ .................................... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building •_______•___________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures -----•-•----••-----•••-•••-•_•_• -- - W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter________________ Depth................ 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................... .________-_••------.. Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ........... •-••-•••.._t Descriptionof Soil------••---- - -_-- L� 1-.---•----------------------------------•-------..... ...................................... x W U P PP l-`/l�l>c2 �l60------.----•-------- Nature of Re airs or Alterations—Answer when a licable..._____._ _ .....-----••----••-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of I:f:;. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has en issued by the board of health. Sign ��.��. �... 1 °4., t ApplicationApproved By. -----------------•---------......-.-....._....................... •••��............�.............. D at Application Disappr ed Oe lowing reasons----------------•--------------------•--•----------------------•-----------------•---------------------...._...._ ...............................-•--- ------------------.._...-•------••--••-•-•- --------------------------------------------------------------- ------------------------------- Date PermitNo......................................................... Issued....................................................... Date Fmi............. No................/ ........ ..' ...........y THE COMMONWEALTH OF MASSACHUSETTS .�.(.... BOARD OF HEALTH �,i_ / �; T � .•w �p^� '"r r,ram" f,'� �,e:ec ............................ .... .....OF........t............ +.w +(...............................................- App ira#ion for Bispaa al Works Tonstrurtion ami# Application is hereby made for a Permit to Construct ( ) or Repair (!-,). -an Individual Sewage Disposal 1 � eft if?��"yy??f i• � , 'f,� ................ _.._..._ _.._......__ z. ............ Lpcation Acdr r r .� .9r LotENo ...............y r �.....a �r�Qwveej ............... �Vf r ........................................................:......................................... .........................................:......................................................... Installer Address UType of Building Size Lot............................Sq. feet ,., Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) aI Other fixtures --------------------------------- - ------ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) aPercolation 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........................ +��......... ---•--•-•-•------------------------------------------------------•.......•------ ODescription of Soil-----------------------------------------•- --...............`........------_..•-----•-----•••-•-•-----------......•---------------------------•---•-•.....__------ x U .....•--•--•....---••--•-----•-••-----------------------------------•-•-------------•......•-------••----...-•------•-------...----------------...•--•----------------.....--•-----••--------•---•--•--•- L—, _____________________________________________________________________________________________......................... l E ............ ...{�}.. 4..f� --_----_----- U Nature of Repairs or Alterations—Answer when applicable_......_ ° �__.. ..'�.. l :. ...................... -•---•-•------•..............................•......•-•-•---- 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 until a Certificate o C pliance has%een issued by the board of health S d �1,..........................; .....•. ............................... ....... °........: .- Application Approved By_ --- I� Date Application Disap rov the following reasons_........................................................... ________.__.._ ..................••.......... ' -----------------------...--------------------...------------..........------------------------------------------....------•--•--------------------................ Date PermitNo......................................................... Issued-....................................................... Date - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH, %EntifiraU of Tootphonre THIS IS TQ,CERTFY, That thIni vidual Sewage Disposal System constructed ( ) or Repaired by_........_. - '` F�✓ .st f t,f,d�i1 sr �'°�w`.vr'------------------- , +�L ,f✓`` s,r' i` °f*`�Iar`��,.'�✓,✓�."�,,r� ;"""` �,�d+,✓,P �'.��i`*' �,.�"� at -------- -------- ----------- ------- --------------------------------------------------------- ---------------------- has been installed in accordance with the provisions of TP, IE 16 t(The State Sanitary Code as described/in the application for Disposal Works Construction Permit No......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....................... ............................ Inspector..._/' �-------•------.....--------•---........................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No......................... FEE.....::":...--••_-_.... Disposal ; �rkD ��.�to � Uan rrntt�7 Permission is hereby granted ............... ....._........... ... _.. to Constrii�kr i f) r� p r �}` a�i Indi 6� x� S a e Disp s ,,,,System _,owr as shown on the application for Disposal Works Construction Permit No..................... Date'd.......................................... .....................................••------•---------------...-----------.....---------•-----•---•----. Board of Health DATE.......................................................................... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS No.---jzf.---- F�s. ...... ........... o!J THE COMMONWEALTH OF MASSACHUSETTS T BOARD OFHEALTH 1...�. .... .................OF.....4C3..�� lti .f h/_ Appliration for Rapp al Works ( omitrurtiutt Prrutit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at_� Location-Address or Lot No. w.:.._ Yr_. � ..:....._. . . 1 •------------------------ .......... -10-----------A0� -- �s -------- Owner Address - W Installer Address UType of Building Size Lot............................Sq. feet �-, Dwelling—No. of Bedrooms_--_2...................................Expansion Attic ( ) Garbage Grinder ( ) WOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ......................................................................................................... Design Flow......,�'q.............................gallons per person per day. Total daily flow.............?O_a---------------------gallons. WSeptic Tank—Liquid capacity./MLo.gallons Length................ Width---------------- Diameter---------------- Depth------_.._---_- x Disposal Trench—No...... Tl-20----S--�lidth-------------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..10-049_-.... Diameter.................... Depth below inlet.................... Total leaching area------------------sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by---------------------------------- Date---------------------------------------- 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............................................-- -- •. .............•&------------------------------------------------------------------------------------- ---- ``' �f �sf9rrC. ----------------- ------ 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 Article XI 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 -:/ ............................................................. Application Approved By............. _ ....................Date.............. Application Disapproved for the following easons=------------------------•---------------............----------------------------------------•---•-------•------- --•--•-••-•-•-•----------••-•-•-•--•--•------------------•••••-•---•-•-•-•••----------.....----•••--•--------•-•-••-------•----••-•---•-•--------------••-------------••------------------------•------ p Date Permit No. 31.0 .................................... Issued... ............................................7Z � Date X___- ------------------------------------------------------- - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7,7 ApplirFation for 4%iVotial Iforkii Tonotrurtion Prrmil Application is hereby made for a Permit to Construct ( )0 or Repair ( ) an Individual Sewage Disposal System at:,, -------------------- ----•"-. ........... .............................. ......._- ----""- .....-•' .......................................................... Location-Address or Lot No fr�1._....__. --•-------------------------- ---------- !: = } Owner Address W Installer Address d Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms--- ............._---------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons_._-.-_--______._-__-_______ Showers ( ) — Cafeteria ( ) Q' Other fixtures ................................................................................................................ W Design Flow.___._ `..............................gallons per person per day. Total daily flow..._.._...._.=rF::_'......................gallons. WSeptic Tank—Liquid capacity.__t&,:r-__gallons Length----_---------- Width-------......... Diameter________________ Depth._.:________---- x Disposal Trench—No..........�z_.._�. Width.................... Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No._.fr 1n`i------- Diameter.................... Depth below inlet.................... Total leaching area------------------sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test.Results Performed by............................................................... Date--------------------------------------.. 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__._______.__________._. a .---•-----------------•---•----•-•.......-------------••---•---------------•--------'------'--------......................................................... 0 Description of Soil.......................................----------------'--------'-•---------- x ---• ----------------- _. (� - f -°' -- -----...-•---------------------------•--••-'------------------... W -------------------------------------------------------------------•------------------------------------------------.------------------------------------------------------ ............................ U Nature of Repairs or Alterations—Answer when applicable---------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Agreement: ---------------•----•-•-----------------------------------•-------------•---•-------------------•--------------•-----------------------------------------•-•-------•------------------------------------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI 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---x--............................................................................... --------------------•----.- ate Application Approved By............ .:...%' .� _ f. r .J �,, Date Application Disapproved for the following reasons:-----•-------------•------•-------------•----•------•----------------------•----------------------•---•--------- Date Permit No =r = Issued =- = .................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .. •. Ceurdif iratr of Tomplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired ( ) bY-•-•---•.__-•------------------------------•---------------•-•---------------------------------------------------------------------------------------------------------------------•-----•---------- 1 Installer at = has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No........_ ✓-•-�-'"'.7_...................... dated_______:`_:_� ..'`y:_. _` _ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT TIME SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector-----------------------------'--------------------------•-•-•-'-----"'-"-'----'-- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH s , No. } •---•---- FEE. `= _ IN-spoofal Warkii Tonotrnrtion Pprmit Permissionis hereby.gr"anted................-----------------------------------•------'---------------•------------•---•----------------------------••-•--••-...._------ to Construct ( ) or Repair ( ) an Individual Sewage Disposal System .......................,'" - .............-........................................ -------------------------------------------------------............................ Street as shown on the application for Disposal Works Construction Permit No.__,.`/r7...... Dated___ %___A____. _ _y__~✓_'`_-"'. . . - �' Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS t�a ./<