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Home My WebLink About0046 WATERSIDE DRIVE - Health r , co- I S--? -i 7 Fim ... .. ...... THE COMMONWEALTH OF MASSACHUSETTS BOAR�DF HEALTH -X-A................. ......................... Appliration for Disposal Works Tonstrurtion Prrutit Application is hereby made for a Permit to Construct (Y-,)- or Repair an Individual Sewage Disposal System at: Lis ...................L pp Location j Address r t No. ....... • 'g. QfZ_ III.........................EQ.49y. 1 ...... _A4&.�.....ao ------------------------------------- ....... ........a.5' d rc 14 Installer Address Type of Building Size Lot..... ..Sg. feet Dwelling—No. of Bedrooms___.._ ..............................Expansion Attic �(b Garbage Grinde". PL4 Other—Type. of Building ............................ No. of persons........_._........._._.____ Showers Cafeteria 04 < Other fixtures ......................... Design Flow.......55............................gallons per person per day. Total daily flow--------3 ......................gallons. Septic Tank—Liquid capacityl=..gallons WidthA'—n..'. Diameter___........ Depth_'.5_.2:7A_ ." Disposal Trench—No..................... Width........_........... Total Length.................... Total leaching area....................sq. f t. Seepage Pit No------------------ - ... Diameter.......&....... Depth below inlet......6.......... Total leaching area.?-.J.C.)=)....sq. f t. ZOther Distribution box Dosi tank 0-4 4 _ a 4_�) Percolation Test Results Performed b�� -V.44T!�. qE.7..... Date.....5115. Test Pit No. 1----4�Z%....minutes per inch Depth of Test Pit----12........... Depth to ground water.....Q GZ4 Test Pit No. 2---4.'Z_....minutes per inch Depth of Test Pit----I Depth to ground water.0,0t.a�K.O_Vk,�_ 1:4 ..............'1.] .. ....................... .......... L_e,----A�.'3'L'------ - ------------- ............... 0 Description of Soil.....AC>—.Z. ... ...• ................... ...... ..... .............. �4 .............................e------------- *---------------- I-------------*------*-------------------------------*-------------- --------------------------------------------------------*----------------------------------------------- ....................................................................................................................................................................................................... UNature of Repairs or Alteratie%,5—Answ er Khen applicable................................................................................................ ... ............................................... fz�5�jq.4............................................................................................. 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 iss by the board health. S gned.. .......... ..... ........ D, Application Approved By...................... ............. 1. / (?L_ Date Application Disapproved for the followi4 reasons:................................................................................................................ .........................................................................................................I............................................................................................... Permit No. G�....:� Date ........ .. ............. IssuedL....................................................... ng, No......................... FRs............................. THE COMMONWEALTH OF MASSACHUSETTS _ BOARD-79F HEALTH ................. ...:...............OF..... -Ac�'�- c�J. L. ...... .............. AppfirFa#ion for Dhipvii ai Works Tnnitratr#inn amit Application is hereby made for a Permit to Construct (Y4 or Repair ( ) an Individual Sewage Disposal Systelp at ..._ ........................... ........................................ -.._....--- - -----...------•--------...----•---.......•-------•---•-------......---........ Location-Address or Lot No. ......................_.......................................................................... ..........--................................. ............................................... Owner Address W Installer PQ Address v Type of Building J i > Size Lot....,•...'..)__..�3__S eet Dwelling—No. of Bedrooms............................................Expansion Attic (l > Garbage Grinder C aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherf xtures --------•--•------------•-•-••----•------••-•-------•.--•----------•-••-----------•--••-----•----_----. W Design Flow...........................:................gallons per persol ,peer day. Total daily flow..........'.�'.t-�.�......__._-_.,gallons.° WSeptic Tank—Liquid*capacity ?.gallons Length -, ... ='..____ Width.. ........ . Diameter________________ Depth_._^.._.. x Disposal Trench—No. .................... Width_ ....... Total Length.................... Total leaching area...„f-------------sq. ft. Seepage Pit No--------------------- Diameter........ Depth below inlet...... ......... Total leaching area_-'_...sq. ft. Z Other Distribution box (�( ', Do�i�tank '-' Percolation Test Results_ Performed bY "�'_ u 4-( ;c �{ Date..... 1 �-' W = . -•-- -------•--- ------. Test Pit No. 1................_G:_...minutes per inch Depth of Test Pit....t�-_.__.._.. Depth to ground water......... .__._c`_.9_ "`_�-� L� fs. Test Pit No. 2................minutes per inch Depth of Test Pit.......''_`___. Depth to ground water 6. .... � .� O Description of Soil•--• •-�_--.��`u-'�'-y._�'L)f ..... �--� l� �"::t:�� .��.. x . ----------••--------------•----------••-•----•-•••---- 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 TIT!Z- 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. S ned_____________ Application Approved B 1 `V f i / �� PP PP Y .. ........ Application Disapproved for the f ollowi reasons---------------------•--------------------------------------•-------------------•-- ............................ ---------------------------------- •----------- •......... •---------------------------- .--_------------------- _-.--------------•------------------------------------------•--•--•---••-...... _ Date Permit No............ ' � - __..... Issued-....................................................... '`��► Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........OF...........*%...:............... ............................_................ (9rdifiratr of Tautph anre THIS IS TO SF Th t th Idividual Sewage Disposal System constructed ( ) or Repaired ( ) bY---•---••----------•-_--- d�FY •--••• ........ --•e n •-- -•-----------•--Instal -�--------•-.....••--•..............•----•--......-•--------•..._....._•-•-•-•------•------ / /� _ Z (y�r�) has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Bode as described in the application for Disposal Works Construction Permit No----- _----__- �........ dated_-$ _J.6_[ ___________________ THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCT N SATISFACTORY. DATE............................ . .. Inspector..._._-....o-- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No.................. _ FE ........................ �i �raY �a1Wharkii Tnnil rnri NO ruta Permission is hereby granted------------•-----.... ' 0:-::..........................................•----- to Construct ( ) or Repair ( ) an IndiviI ual Sewa e Dis ossa1 System atNo... ----- -•• •--- ----•-. --••-------•---------•---•-•••••------•.....--•----••---•-----------------•------•••-----•......._. Street as shown on the application for Disposal Works Construction Permit No..-- Dated.......... .............................. ,b C'd wt. -�...................... LA NL and of Health DATE---------------------------•-•-- ...j V FORM '4255 HOBBS & WARREN, INC., PUBLISHERS i DES 1C—N DA\-TP\ SINGLE 'FAMtUjT\\� No �A�ZL3AGE GtzltJ DEtZ � r- � 1 I _ _.�� DAILY FLovJ = Ito K 3 330 G.P t�. f / �� Zo S5 P c- TANle- = 33n n ISo'o 4.9s G.I'• D• �:z uSE loon GAL. TAK�Y, \ -, / �� ;/ / ,/�7,y33 z2 z/ OtSPoSAI_ 91-r --- vsc (1� l000 GAL.-- / zy 2� s1 oCWALL ARLEA z 1 S-o s. 1=. ISo S.F. & Z ,S 37S Cr:P. 0. BcoTroM AREA = 5o S.F. / 3z 56 S.F. x 1. a �- S� G, P. D. To-rA U OESIG&J = 4ZS G. P. 0. 3& 7 TAL LAIL.Y FLoW = 33o G-. P. D. (� i ' _ . ® / �� N / -:20 PE7P,C,aLAToti1 RATS • . 1"�N Z ty„v .c)iL(.IESS `7� R�,. ✓C�'•b{ -fit � — .,: � /. .�` .,''fo yi S•Q� .=,mod._ � .� RICHARD p / A. =;1 �° PETER y�-O o I3AXTER SULLIVAN �• No.240480 No. 29733 " 3S�-"_ i'• �� NA l EtiG 1 T"E ST H 0 lZ 'PAA27' fAMN' ,\%S 1U6'rALL FC.C.oN�. -1 kL35.0 TO W��}}1L.1 '�Z��DF+.�. MA-2 EL.2?.0t E� O ) t ,• /.t/,/. 3S.o ��4C. / Box /.v✓. G,4L, 3y S Gc 1 / o• P•T A TAN.iC' /O " �gd7o//�-'1 's w s H c-D '• 3 z 3�` c•.E.er�F/Eo P�or ,o�:aN • .= sr A.)45 Lj Oe i/E,�Eav cco�P�Y,s Wiry/T,y�•Si��-,�✓icr� B,�xrB.eF,//YE;I've. AiS/l>.f�T,Q/•�GY_ ,e�4lJ/.�EHI�NTS d� Tf�� .EG/.ST�.E�G=IJ.G4N0.SU.e f/�YO,�S ToW.v of F��./�—,4��•E .Q.v� �S�Vor .��vvPG.Q/y .1q.c .G/c.Q,vf LLL 009ZWdl4l /-I '0�7 la'4J-4�41'- •s�lyit/h�E.e�4NS.�oUGo ypT-(�� USE f} � `7 t S -7 LOCATION SEWAGE PERMIT NO. VILLAGE HSE. 16 k) il12Q L11c INSTA LLER'S NAME i ADDRESS d U I L D E R OR OWNER J�Q '�3tyl klsyl (yo DATE PERMIT ISSUED DATE COMPLIANCE ISSUED v Lo T zz iS All, L� R i��tI De DIP,