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HomeMy WebLinkAbout0051 SOUTH PRECINT - Health 51 South Precint Centerville A= 148-144 IN- S M E A D No.2453LOR UPC 124 oaa ' mob in U" LOISH MAMNII�� i i f LOCATION SEWAGE—PERMIT NO. l VILLAGE INS 7 LLER'S NA 1, ADDRESS (20 7;� ; e U I l E R OR OWNER JR5 rk DATE PERMIT ISSUED 6 _8 DATE COMPLIANCE ISSUED G� 1of r ,� � i' �' � ' r, No.......... `. .��. Fxs.... .!3 ........_ 144 THE COMMONWEALTH OF MASSACHUSETTS BOAR®OE HEALTH OF...:...,' ,2-4w— Cam-'---------------------------- Appliration for Disposal Works Tonstrnr#iun jkrmit Application is hereby made for a Permit to Construct (✓) or Repair ( ) an Individual Sewage Disposal Sys at: .1�-A . .� .................................. ................dam:.....-•--.... ......--•-•••.•-................-•••--.. Location•Address or Lot No. Ana l..__�yl.C�11..H... s�1.1 t�}: .. A. ..y—P71g ..1 M en,.,f�.�.�i...:................................................... Owner / Address s Installer Address Type of Building Size Lot./'�o.�- .....Sq. feet Dwelling—No. of Bedrooms......................................Expansion Attic U4_ Garbage Grinder ( ) Other—T e of Building ..... No. of ersons._......._ .__....._. Showers — a YP g ........................... No. P -- ( ) Cafeteria ( ) d Other fixtures .. .. ................gallons per person per day. Total daily flow ................. W Design Flow.....................: W Septic Tank—Liquid Li uid ca acit .lam. Ions Len 4 �� v P q P Y.l--•-•-� •---•-��------..... Width.Y`l_`:... Diameter................ Depth..S�s!':" x Disposal Trench—No. f� ... Width.....mr . Total Length.......—......,.Total leaching area..............sq. ft. /.... Diameter..... ......... Depth below inlet.....k ._..... Total leaching area._2�. 1...s ft. � Seepage Pit No.._..._ .-._ ,f p g q. Z Other Distribution box ( ) Dosing ) '~ Percolation Test Results Performed by... ��r ......................................... Date......?! '1... ........ minutes per inch Depth of Test Pit.... ......�Y% Depth to ground water... Test Pit No. l,f:.'1�.__._ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 --------- -........ O �:�..... '6 �. ----------------------------------•---------------------------------•--------- --------- Descriptiono o ----.. ..-------�-� .......................................................................................... ..................... *.: ..-...1.!' P.:------/tAv...--•-.i�!........... r :...... .......................... 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 iIT1E 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ti the o rd of h Sign �,;�. y ..1..._....- - - - - - -- -- ate Application Approved By....r.. . . .. . 1�/_ .�-2 .`.. Date Application Disapproved for the following reasons:. ___________________________________.................................................... . ....--•------•............................•------................---•-........--•-------.......'--....._.---•-•--......----•-----...-----....-----•-----------.........--------....--------------------- Date r Permit No ...... Issued. - -d--------- -- _ •-........D ................. r� THE COMMONWEALTH OF MASSACHUSETTS - BOARD OF HEALTH 1 1 :... •-:--...oF...... ............................. Appliration for Diopooal Works Tonotrur#ion rami# Application is hereby made for a Permit to Construct (P' ) or Repair ( ) an Individual Sewage Disposal System at: Location-Address ^-^ '` or Lot No . =h� L1�e..c..,, ......................................... ..... W Owner Address .��.I- ! ..................... ------------------------------------ Installer f Address Type of Building Size Lotl._C.v_J��.....Sq. feet ►-4 Dwelling—No. of Bedrooms....._ .::e .`.......................Expansion Attic � Garbage Grinder ( ) aOther—Type of Building ...... .... ........... No. of persons.......... Showers ( ) — Cafeteria ( ) Other fixtures ... . -._...... --------------------- ------- •------------------- Design Flow..................... .........AkZgallons per person per day. Total daily flow...........2— .............. gallons. Septic Tank—Liquid capacity/-&"...gallons Lengtlo�!r-."____ Widthfi_w ..... Diameter................ Depth_S."e.- W Dis osal Trench—No...... / ............ Total Len h.._..,r- a..._, Total leaching x p f ... Length area............•...sq. ft. Seepage Pit No.1.a�/ Diameter...../ Depth below inlet_..._:A........ Total leaching area_Zr.G.1...sq. ft. Z Other Distribution box ( ) Dosing tank ) Percolation Test Results Performed b0 .............. Date a ' r' s Test Pit No. l�..-v .....minutes per inch Depth of Test Pit-.-_lP i. ...... Depth to ground water.. !�✓Y L� Test Pit No. 2----------------minutes per inch Depth of Test Pit............. Depth to ground water.. ................ a :•-----------------•------• S,d_..._... ... • .... - O Description of Soil......0.- l� a�,•---- .` �� :..:.... (� ----------.-•-----•--- �/ .....r f�- .-,��'---: ------------------------••---•-••-••----...-•----... W U Nature of Repairs or Alterations—Answer when applicable............................................................................................... •- k .....................................................................................................................•...---.•....._.....................--.............._._..._..................._.. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLZ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has"been ' d by the board of hea sign ,/ •- .. Date / Application Approved BY - -----.................- .'-4?4;.----e......... + /. Date Application Disapproved for the following reasons:---•----------------- ............................................................................. -.----•------- - -------- -------------------- -----•- -•-•-------------------------------- -....... •'__.Date --- PermitNo............... - ............ ..... Issued........................................................ Date t THE COMMONWEALTH OF MASSACHUSETTS ISI Va BOARD OF HEALTH ... .:OF........... �.. LZ- -....... .................. (9rrtifiratr of Tontpliatta THIS IS70 C T That the Individual Sewage Disposal System constructed (�or Repaired ( ) , by..-:-...�,,� / l ..................................... ----- ------ --------•-- --•---- --- ---.- ---- t J Installer 0 at....... .. . 7�1e_l.�,1. has been installed in accordance with the provisions of F 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit �' 1.__.____ . ____...... dated... .-__.2.G- _/.............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUN TION SA..T...I.. FACTORY. DATE. /yy ........... Inspector------ C• r ---------------------........................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH lJ / .I,r/?-t..........oF............ j Ya --••............... No............./__ F FEE._�1�1........... Eliopoo IV rko T, no#r ion anvil Permission is hereby granted -'-- 4-'I..................... to Construct ( �or epair f ) an Individual wage DisP�Sal Sybem < V at No..-.,A....--... .40 } r�F �1-- ' Street as shown on the application for Disposal Works Construction Pe N Dated...... :--_.__••. d6/ --------------------------------— y- p d of Healt DATE................ "- ......-----........--•---.......--•--•--.. FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS 1 E _ . ,i., _ ra 'ao - t t tit• I 1 ,1 I ,r d KaCl 7 I C U .. f G. �.J, - .. %1" i�. £. o .fin t I d<l'v RORER7 w �s�'ONAI�.►, r 1�Ff9 �',Pc '�t��1A�0©C3 x '` � CERTIFIED PLOT, L APPROVED - BOARD 0 V HEaL H } ALA DAY 1U L A OF( Gi ll' S C /k y� tit'tit' �� CUE 7 (;o:3yV_Wl..�h`, fat< e y i.9r�C�` ldoo Pi 0. RC9� a 1 D R fa V _ , DR.0 vOF QAWI'VT�DLC _ .._ 712 r7AVN CH. w� 1, I9YAtVfJi;�, h1aSS. ONEET_Z OF _ ®A E t � , _. ? - oce _s �D„fit ;ilE�� r 'I/ f' t t : k .r/�• ! lD . /a 6J✓ .SA;A L GONC. �T� G< E3 co to, co CLcrt.ly SAI�/v r� rTLA -7I fTG` (J J/8 'r� r Q c, ,J Ti, . a p .. �� '. /ROEI PIPE � ° V V G 0 oI o 0 0 0 ° c oh G �4 I (/�/f75f/Ef:JT ti'E M7lJ. P/?Ci/ a . U r. U/ T. - D A Fl 0 , of ) 0 p o 0 0 i i�u PEfe PT. rl SLPr/� �JLa/Vf� ®DX .. o o D :° 0 Q e o i 0 0 0,o NFD .STdh'E PVA5 o 0 O D GG- I'. . C.f 5 r Sd,.FAG E E, Q l 0 01 O /fJl/�RT CG E OVATION a s lllI ER 6 f9 AT 011-2DIAI& 7��i. r � F7' Z,;44frl. f; _ ? I /NGET SE�TI�' S KAT✓ F �----_- _ .--------- �. 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