The URL can be used to link to this page

Home My WebLink About0096 STONEY CLIFF ROAD - Health 96 STONEY CLIFF ROAD Centerville A= 190- 039 I SMEAD KEEPING YOU ORGANIZED No. 12534 2-153LOR SUSTAINABLE FORESTRY MIN.RECYCLED INITIATIVE CONTENT IO, C.niri.d Fiber Sourcing POST-CONSUMER wwwafioroorlm,oro iFipll9p MADE IN USA GUORGAMZEQATSMEANOM LOCATION SIWA. CE PERMIT NO. LD lT'`f? J�7ZA- Y CL IPE 44 VILLAGE INSTALLER'S NAME & ADDRESS ,Mlle A-6r17,61F 6UILD.ER OR 01NNER �` Tt SMIF DATE�PERFAIT ISSUED DATE COMPLIANCE ISSUED f . _ �v ®9f ' .F .051II No..... - - Fus..... d ...... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH -Ok-O(................OF...............Cti . _ ........---- Appliratioo for Di-sposal Works Tomtrurtion ratnit Application is hereby made for a Permit to Construct ((/ror Repair ( ) an Individual Sewage Disposal 4qb System at ..... ........ Y -.. ...------- A ------------- .....�----------------------------------------------.......-------- (� Location- s or t o. .....->=� ra_e........... .,o .........S ...�,............... ............ . (1.�, . -----------.....................-- O er ®S res a ....n!®.---------.' --------------------------------------- ------------------...-•--------------•- Installer Address Q Type of Building Size Lot.�5,..��..�1.®.....Sq. feet U Dwelling—No. of Bedrooms.......... ............................Expansion Attic ( ) Garbage Grinder '4 Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures . Design Flow g P P P Y �3 W O..............gallons per person per day. Total daily w............ gallons. WSeptic Tank—Liquid capacit}(Vg.gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length-_.. ._;__._...... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.f.... Total leaching area...._.............sq. ft. Z Other Distribution box ( ) Dosing tank� ) Percolation Test Results Performed b .......................................... Date.......A6"-.�_' ? ..... Test Pit No. 1................minutes per inch Depth of Test Pit.................._ Depth to ground water........................ 114 Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water-_-_-__--__--__---_-_--. 04 ••••------------------------------------------- -.............................................................................................................. 0 Description of Soil------------------------------------•-•-------------------------•-----•------•---------------------------------------...------•--------•-----...•-----....----•-.---_.. V •---------------------------------- •--------------------------------------------------------------------------------------- •--•---------•------------•--- 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 iITLE 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.......... �PA �...V.--.,, ........................ -•------- .......... Date Application Approved BY-•-••......-- x l , • ...... ........ � ,� )Sate Application Disapproved for the following reasons------------------------------------------------------------------------------------------•......---------.--•-- -----------------------------•-----------------------------•••---------------------------------------.---.. ---------------------------------------------------------------------------- -------- ---------- Date PermitNo.......................................................... Issued-....................................................... Date No.....�. ,le t` • FRs..... ........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....OF............... Apphration for Uhipoii al Works C ontitrurtion ramit Application is hereby made for a Permit to Construct (ter or Repair ( ) an Individual Sewage Disposal System at: s� Location-Address - or Lot No. l.rr►_s`_'..z..:......:�C. ,rvl=- ===•--------.-•-•- >-('d tx '_. :z -..-`-:�:. a�..: .............. - .......:. .....---.... Owner K ) Ad rest Installer Address Pq UType of Building Size Lot. _.__! �.....Sq. feet .-� Dwelling—No. of Bedrooms.......... ............................Expansion Attic ( ) Garbage trinder (09 aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures .---••-......--•-•------•----- ---------------------- Desi n Flow.................. .. t gallons per erson per day. Total daily flow............... ........................... W..., g .. . g P P P Y Ygallons. WSeptic Tank—Liquid capacityjI�P_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 (� ) aPercolation Test Results Performed by_______________1.(.....t _ /_.............___........._._..._..._.._... Date......./b___" o_.� z- 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........................ g •--•••••--•-------------------------------------••---•-•------.....-----......_..---...........••............................................................ 0 Description of Soil.............................................................................................................-........................................................... x 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 TITLE 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. C'• Signed............... Date Application Approved By.. -��-� ;...... �.... t✓ ........ - t '�, ,A ........ ate Application Disapproved for the following reasons---------------------------------------------------------------------------------•------.._......----------....-- .................•••---------•-•••-•---....--------------•---------------••----------...•----------.......--••••--•-•......----••......-•----••----•.................................................... Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF........... -................................................................. (9rdifiratr of ToutpliFaatrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( 4<or Repaired ( ) by - .. +'` zL---------------------------------•--...........-•---•--•----•--------------------•---•------.........• ----- nstaller (j 1 S ------•----------------- ............--------......-- '-��' -�---)-'`ter" CQ t�'11 v k e— at ------------------------•------•-- has been installed in accordance with the provisions of TITLE ,��o��e 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 ........ \ ......OF................. 07:`............ C _/Y!.,.r.--.......... No:................... '� FEE............. --.. Dioprrs al Workii Tuonotnulion rrmit Permission is hereby granted......... : ............................... '' = to Construct (✓�or Repair ( ) an Individual Sewage Disposal ystem v CJI Street' as shown on the application for Disposal Works Construction Permit No--------------------- Dated_ _.._ _. --"`' -----•-- ................................................ DATE. ............................... B��dof�Health FORM 1255 HOBBS & WARREN. INC., PUBLISHERS 50 NJ—L--, -:A4Etr I OF-2 ,IvGt.0 _F.AMIL`! - BEoRooM - ��uo 6AR8A.GE �jtZINDE2 r .. DAIL,( FL.oW SEPTIC, TASK = 330x15o% =,4956.P. R USE- loon GAL. I o15po5AL PIT v5E t a o0 GAt_. • 150 5T X Q•5 - , �5 G.PoBOT LoT S0 5.F X. I. o F 50 . G.Po 'TOTAL. C>E51614942-5 G.P. D- -ToTA%- TDA►►-Y FL-ov�! = 33o G.Po• j PE2COLATION RATE : 1"IN 2MIIJ oI`t.V=- 55 j' 4s PtSH 0 RriG't••iARD A. p, o ALAN BAXTER 9:� W. i `^ Mo. JON 1 No. 2` ONAI E T65T P I4-2p � To P F*11>="t 1, �y^y I � C'vAriS6 ptST. 64L. dv lNv. Sr.PTIG $ SaabY (DOD IN,I, 0UX _LZ$.L TANK t"PIT INV. INV. wlTu 4.6 6T�N6 �Ald d2 � SnlJ�. G6RTIt=t cm-D pt_oT PLAID PROFILr= EL• I.oGA�IcN �Wv t �'�-V�� C Sa I Its. NO SCALE 5c� V •T,E Fo IATER. PP°'SD p L.A r.1 REF 6tZ.Er► GE Gp gx-r THAT THE ouS� 5NoWN NE.Q6oN GOMFLN?!S 1nlITN"TNE S 1 o6L11.1 E �T q AuD SL--rbAGK rr��,,6QVIR.6MENT� c�F 'fµE f -To V N O� :ArlQ-'7TA,81.•GAt4D I S I�r ll ,,II ry LOCPTED •WITNIAI T .E �� COD P DAT E '� i3AxTE tZ a A.r`(E INC. REG 1 SZ t-_Q6'D li.Aw o 5 u F-V EYo to ,) ;TutS PL&N ►fi•NOT W%5r=D CIa AM os- C-9-VI _LC, • MASS. Iu`5TR-UtAsw,l- 5u2vG--Y 'TNE oFVSE'r5 SuoutI) 1 j Not e C- VSC•C�Tb pCTr;G',lnINC t_�� .ING�� APPt. IGA►�-1'T' t AMA V.- 4M( I 4 eUl-L' -so-A- M. 3° _ l30G�o`c3 4 ' j 8l ill , — � 3t•3^ _ -.. -�� _ -31.4 r ,_ -. r -a��Y fit.,, � CO 7:2 rr, O (op W - ASsEprlr- LN Ar oP. i N Al 4 S -_ Tia N iL �Q sa Qi � AQv P 52 P� �� \12�/� O . S0 3 \ \ Spy � � �, WCHA � C D G E _ ` Flo.24048 ► ' a9.a - - - �//"`--- - of - _ - �'g � �V.3 _S � 2 � � � - j `