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Home My WebLink About0275 STRAWBERRY HILL ROAD - Health 275 Strawberry Hill Road A= 247-218 Centerville SMEAD No.2-153LOR UPC 12M smsad com • Made in USA YM91N Ojaemue®wtFaoaooucrwt F1 OF ni SR VAMSFFROGRANLORG t IL No FBI iA THE COMMONWEALTH OF MASSACHUSETTS BOARD PF HE L H --- WLH 4,�EL T�H OF..... . ......... Appliration -for Uiiipooat WOrks Tonotrurtion Vrruiit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal Syst at: Z .... 4a- ......................... .... -------------------- ... ------------------------------------------------------------------------------------------- .................. ..... ......�-e....... ..................... .........................W--------------------- ----- ----------- 0WA. Address ----------------- - a ----------------------------------------. .................................................. ................................................................................................. Installer Address Type of Building Size Lot_... Sq f et q* Ie, U �6__*-'der Dwelling—No. of Bedrooms-------------- Expansion Attic e Grinder ------_-----------------_-- Garbag Caf Other—Type of Building ---------------------------- No. of persons._.________________________ Showers af/ete a C _...._.....gallons. A4 Other fixtures ----- ------------------------------------------------ ------------------------ Design Flow___________________,_-0..................gallons per pet-son per day. Total daily flow.............. .Z__41_7�51 Septic Tank—Liquid capacity.-1-6'%-- allons Length________________* Width.___-........_. Diameter.......... epth---------------- Disposal Trench—No_ -------------------- Width.................... Total Length_-...______________- Total leaching ar,>a--------------------sq. f t. Seepage Pit No... ----- Diameter-_- ...... Depth below i�let Total leaching'area_---------------sq. it. Other Distribution box Dosing tank ( ) Z Z _41W, V-2 ?_ Percolation Test Results Performed by_______________________ __ Date__________-__________.____--___-__.----. Test Pit No. I................minutesperinch Depth of Test Pit..-____....____.._._ Depth to -round water-.._____..__.._--_.._ f14 Test Pit No. 2................minutesper inch Depth of Test Pit-_________________-_ Depth to ground water__-_.....__-_____._..... P4 ------....... -------------------- - ------- 0 0, Ir--------- -------j - --- -- ..........I. . 6--------------------- -------- dwnej Descript* of So* 4� .. .... -------------t--------------- --- -------- U ..... .............. ./.....i- i...... --- ---------------- - ------------------------------------------ ------ .... .................. rf--------------------- 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 7 operation until a Certificate of Compliance has bee ssued f hj��y the board o _6 ------------- jigne . . ..... ... ......... ............................................. ...... Date Application Approved By...... . .... ...... .. ------ --- -------- 7 Date Application Disapproved for the following reasons:------------------------------------I/--------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------_------------------- IF Date PermitNo...........................................--_--------- Issued.--- Date ------------ -------------------------------- IQ THE COMMONWEALTH OF MASSACHUSETTS BOARD, HE H �~~� �� '�w�x� �� Works Toustur4o*l Vrxn»ft Application is hereby*made for u Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: /0 �? � \ ............. ........ -------------------- --_---'--_-'--_---_----..�'-'-'---' or ___-'--_!��]�-L��~�'�=__�/r� ____-- � Address � ........... Installer ----_---------_'-'----'--_-.------.-------. Installer Address�peofBnJdizg » Size r Lot '� '� � 3 S� Z feet __ -''~' ' -'- '^�� Dwelling of Dedroomy-----��.--.----.-. �tt� Garbage ��6nder [( ) Cnrb °1 Other--Type of Building ............................ No. c6 persons----.--.---.. Showers ( ) -- Cafeteria ( ) ~� Other 6 -------------------------------------------------------.-____---._'___-._-----_--�_____' � D ' F�n�--_---.�� per person per day. Total '' flow-----�� ./6-r_2)..............gallons. Septic Tank—Liquidcapacity '[« " Length ----- Width_----- Diameter----- ---------- Depth------ Disyosu Trench—No .................... Width....... ------------ Total Length-------------------- Total leaching area--------------------sq. 6. Seepage Pit No.-'1jgV._ Diameter-------------------- Depth below inlet-------------------- Total leaching area.... ----------sq. [c � Other Distribution box ( ) Dosing tank ( ) ~� ~ � Percolation Test Results Performed 6y'�------'--.----.-.--'--------- Dat�-'------------ � Test Pit No. l................minutes per inch Depth of Test Pit-------------------- Depth to ground ~ater-------- �Tq Test Pit No. 2................minutes per inch Depth of Test Pit- Depth Ix 0 � �� ' U Nature of Repairs or Alterations—Answerwhen ---------.-------'--------------- / --'''----_'-_---_----.------'--__'---_.''--'-''-'-'-------__.--'-.---'---'-- Agrrcozco,: The undersigned ogrcru to install the uforcdeucribe6 Individual Sewage Disposal System in accordance with � the provisions of Article %I of the State Sanitary Code— The undersigned further agrees not to place the system in operation- until Certificate of Compliance has _e. ��- J-�//� �^=~ __4 Application Approved D�-. . ,�_»"* __ 7 ,w� o"u -- Aupo�atou Disapproved for the following reasons:------'---'�!-��------.-------------.--............. --'-----------'------'—'--'—'-----'----------------------------------- | _ ~^e � | � Permit No�-. - Iuooe� Date...................| '' ------------'---- -------'---- � � THE COMMONWEALTH oFwAssAonussrrs BOARD OF .,HEALTH . | � ......-u»F...... ...... --� � ` (IrWrtifiratr of a Ilk. i / d G d � � o r \ v NNI 6 t © 7. 25 1e, T 4 F�cA�IE J 3.4 46 -- � + �b + pt Niti.+aM C) 'ltILI �.. a Ccv../FUSS 7Z) 771 �.�i�.� 6-- r .. / ' 1 > DA&76- 450e4,Y fn e �37Z;;e(,-'IL4,e, AA455� LOCQ TION S ' EW8,C4E PERMIT k10. IWSTQLLER 5 1 WE 6, ADDRESS BUILDERS tJ &"F- ADDRESS DATE PERNA T ISSUED 0 ATE COMPLI &t 4CE ISSUED ; �� r y� � 1e � io �, � . ,3