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HomeMy WebLinkAbout0197 WHITE OAK TRAIL - Health 197 White Oak Trail A.= 192 — 194 Centerville i SU/ UPC 12534 ko.2-15533LOR aaaru►os,wM No... "••_76y. Fim.... .:...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH a ...................... ...............OF..........................---• ,XpPlirFatiou for lliupuii al Works Tonstrur#tura tirrmit Application is hereby made for a Permit to Cons ruct ( ) or Repair ( ) an Individual Sewage Disposal System at: --�.•--..� ..��1.............��'/�------ ti. - Cat �.wi .. �1..�.z----------------------- .. ..0C Ownerddress ` ° oAddresso .. ��'"�l fir' --------.. /.. 7 w - "---- .. ��...,1?tt ........ ?............................... ...-- GL_._.!.= � 5'�!� . ... 4C� Installer Ad ress Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.......3.................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons____________________________•Showers — Cafeteria Otherfixtures ----------------•-----------------------------------...-----------------------------•---............................................................. 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. 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------------------------ fXq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water---------------________- P4 ----------------------•--•-•----•-•--•----•---•-._..__...--•---------------._........----•--------•-......................................................... 0 Description of Soil........................................................................................................................................................................ x U ----------------------------------------------------------------------------------------------------------------------------------------•----------------------------------•------------------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- VNature of Repairs or Alterations—Answer when applicable_______________________________________________________________________________________________ --•--•-•-•----•---••-----------------------------------------------------------------•-•....._......--•---•-----------------------•--•--•-•••-•--••----•-•-----••---------•--••--••-----............---• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with f•1T/!f a--. the provisions of T112 5 of the State Sanitary Code—The undersigned furtiner agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed_., . _= + , r�D? � Application Approved By................. ..--...tree...+ ---- -•--•- Date Application Disapproved for the following reasons-------------•-------------------------------------------------•-------------------------------------------•----- ......--•-•---------------•...---------•---------••-------------------------------------•••._..........-•---------•-•------------------------------•--------•---------------------•-----••---••....._.._ Date Permit No.----- Issued-------------------------------------------------------- Datz No.._._.._.... -�' F:m....2..1- ....:........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH j ................... ...............O F..........-----.......................----------------------.._..........-------:......... Applirtttion for Disposal Works Tonstrurtion Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Location_-Address or Lot No. / ' Owner Address .......... ................................................ Installer Address U Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms........ ..................................Expansion Attic ( ) Garbage Grinder ( ) `4 e of Building a Other—T yp g ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ------------------------•-----------------------------.----------------------------------...---------••-------------------...----------...........---- 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. Seepage Pit No.___..--=-:_-_____-- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. ' z Other Distribution box ( ) Dosing tank ( ) ►-' Percolation Test Results Performed by.......................................................................... Date........................................ .-7 Test Pit No. I................mmutes per inch Depth of Test Pit.................... Depth to ground water-._-.--____-_-_______--. f14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -------------------------------------------------------••----------•------------------------•-----.---- •--------------------------------- •------------------- O Description of Soil............................--------•-•-----...---------------.....----•------•------------------------------------------------------------------------.....-----.----- x w . UNature of Repairs or Alterations—Answer when applicable............................................................................................... ---------•--...--•-•------------••-----------------------•-•---------------•--------------------------------------- Agreement: The,undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with IETI�1:•� the provisions of 'T i t 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.._':`-_��.................. .._.. `-= ` =� `f �/ ,.,. .... - . -f ` Date Application Approved BY .""---%%----------•-••-•-•--•----•- Date Application Disapproved for the following reasons----------------•----•--------•-------------------------•---•----------------•--•-----•---------•-------••------ --------•-•--------------------------------------•-----•-.....-----------.....-------••---...------....------••--•........---------------------------------------------------------------------•-------- Date r PermitNo. .`.....r© -•--•----------------- Issued....................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH A1ii!%tij,............OF....... .I ........................................ �pr�ifirtt#le ,af ft�nut�rltttnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by Installer at----_-------------_VC!..7----•-.YJJ9!:t�&-.---------( . __ -•-- s "=,f `^'! QQn has been installed in accordance with the provisions of TIT i . 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No........ °J.......... dated_...._._.__.__________________________________ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................�_.��..'�. -`-- ............................... Inspector Inspector--•----••---•--•-- ......VD THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH t 1 ..........�r-n...�I�.. ..............OF............� ..!.... ..................................... ...... NO.... --- FEE.... . Disposal Works 0-511ndr ion 'rrrutit � Permission is hereby granted a - ....--- '� � r -•-----------------------------•--•----------•-------...-----•--...........---........._ to Construct ( ) or Repair ' an Individual Sewage Disposal Sy tern nJ� at No-------------- 1 .. � ............. C2�1� ;ra.r.� .�.1 ..... ------------------------------------------- Street r V> as shown on the application for Disposal Works Construction Permit No. '� PP P ------.._f?_�. Dated------------------------------------------ J ............................. ._I. ......................................................... Boaid of Health d DATE.. ` . ............... 4 FORM 1255 HOBBS & WARR . INC.. PUBLISHERS �GR'S MAP NO. �10'�� PARCEL l9� 7?`- rjo �vi ION SEWAC ERMIT N 1 CE I N S T A LLER'S NAME A ADDRESS � . e U 1 L D E R OR OWNER DATE PERMIT 1SSU'ED x OAT E COMPLIANCE ISSUED �. •_. �u.-= � a#,fry,' n �..•- ;t Cd t r. S7 # s #4. .. ..,.fie.^ � [, • ,R° ... f,) i � �1y'x 1 I ♦ /A L�/ �.Y r.. • 3a�� _ 1(��� (�'qi/t/ter 4 No......................... FEE... ................. THE COMMONWEALTH OF MASSACHUSETTS BOARD 9F HEALTH / ............. OF........ . ....... ... .. ............................... ......._.......::. Appliratiun -for Uigpofial Worko Tott,itrurtinn Prrntit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal v � ............. Locadoy-Addr s o .................. ----•--............................ wner ddres -®- _----•------_------ �� �"`�d /�..�--------------------------- Installer Address Q Type of Buildin Size Lot..... feet Dwelling No. of Bedrooms..____.4!c��No. _ Expansion Attic Garbage Grinder (/� aOther—Type of Building .. ..._ of persons______________�__--___-__ Showers (�) —'Cafeteria ( ) QOther fixtures -------------------------------------------------------•---------•-------•---•---•--------------------- W Design Flow.......!3-0_____________________________gallons per person per day. Total daily flow........ /.....................gallons. W Septic Tank _iquid capacity)(�Zf_..gallons Length____ ,Q_____��/itlth. -..... 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 ( ) 46—/���z-- X_ .Z3-7 G . aPercolation Test Results Performed by_------------- --------------------------------------------------------- Date........................................ Test Pit No. I_._____-_____-_minutes per inch Depth of Test Pit.................... Depth to ground water..-.----__---.-._.--_-- 1�3;4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_...-. ---.-_---___.._. Ix ........ -- - - OU = Zescription of So ----------� r S- - ._.._..._. ----- -- -------------------------- 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 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 hea h. aSigneDate Application Approved BY - ••-• = �. .- Date Application Disapproved for the following reasons:........................................................................................................._...... ........................................................------------------------------................................................................... -••---------------•--•-•••-••----------•-------- Date PermitNo...............................-........................... Issued...................... ------------------------------•-• Date t L:W, ATION SEWAGE PERMIT N0. 4075 s--�- �r//9' N/T,E oAtr r, VILLAGE 1NSTA LLER'S NAME & ADDRESS Ve m.D deoS r t �. B U I'L D E R OR OWNER DATE PERMIT. ISSUED DATE COMPLIANCE ISSUED lao® 6-A � 3 ��E�7� d` • 'R i r v No......................... Fa$.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD Of HEALTH .... ..------. OF....... . ................................................... Applirtt#ion -fur 4%ipoiittl Workii Toni#rnrtinn Prrnii# t "Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: _ _ -------- Locatio - ens "�. or Lod/No ....................................... tOwner ddress„ CG Installer Address�d Type of Building Size Lot......�-- 0..tA1'V_Sq. feet Dwelling—No. of Bedrooms-------- ----------------------------------Expansion Attic Garbage Grinder (4 aj Other—Type of Building --- No. of persons-----------------(---------- Showers ( — Cafeteria ( ) a' Other fixtures ------------------------------- -- -----------•------------------------------------------------------------------------------------------------------ W Design Flow........` ___________________________gallons per person per day. Total daily flow--------0.G" __--______-I..-.--.gallons. WM/Septic Tank—Liquid capacity.) .g 6 allons Length------ Width._ .._...._.. Diameter................ De pth.......___...... x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. . Seepage Pit No..................... Diameter-------------------- Depth below}'nlet-------------------- Total leaching area-------.-_--____-sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Dd-1-5'c..'-_� -- JP— ,213.7 w . a Percolation Test Results Performed by.... ---------------------------------------------------------------- Date......................................... Test Pit No. 1 ..............minutes per inch Depth of "Pest Pit-------------------- Depth to ground water...-__-..-.---_--___--- L= Test Pit No. 2.''_____________minutes per inch Depth of Test Pit.................... Depth to ground water_-.-..._-_-----_-_-.--- <:.. ' --- -f------------------------------------------ -------------------------- Descripption of Sod- - -t----- � `�J � R- � G � x 2 ' - 2 ------ >t-------------- ------ ----------- v ------------ _ _... - f '� ----------r .t� ------------------------------------- --------------------------=- ------------=�-----------------------------------------------------------------------------------------...--------.....------•---- V� 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 `/ "-'------------- - -mot Application Approved B .� / _ t� ��' _�'."'.`�-C- ... z- -..�_Date_ i Date Application Disapproved for the following reasons: -•-------•-------•----------------------------------------------------•-- ..........•--------------•-----------•---•--------------------•-----------------•-•-----------------••-••........_...•--.....-----------•••-----••-------•-----------------------...........-----------•. Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF EALTH�G���'t---'� �-t ........! O F.............. .. .. .!..... .......t .......................... ........ L Qlrr#if ira#r of f'guntplianrr �,�-- THIS ���1-ll-CERT1F5' at the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by..........j _ n�!� r% = - _-------- �� stalle / � v --- Z. 7 - ------------ at.... ------- .-JAL...0.4.1 �4 has been installed in accordance with the provisions of Artic,;e XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.--_._�`� Al'z_-3____--__- dated_._..: _'.�.3_�._.7__ ........... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED A A GUARANTEE THAT TIME SYSTEM WILL FUNCTION SATISFACTORY. DATE �--0----��---- --- -------------� ... Inspector............... t THE COMMONWEALTH OF MASSACHUSETTS BOARD OFFj HEAe. TH `o-2r�?-i...........O F...........�// " .���� L�`I .........,..%, • No------------------------- FEE---�/J............. Bi-r;Volial_tl rks #rnr#inn rrnti# Permission is ereby granted' 'ie ------ .7-�-----------•------•-••-----•-----------------------------------••-----•---.- to Constru .t { ) or Repair ( ) an vidu -,SeV(age Sy tem / at No..= w'(t>'..............................�f 7'3 C {1,•. -•-••-------.............................. , .-� -- � L Street as shown on the application for Disposal Works Construction Per.-i' No... .... ...... "Dated---- .=... .-'_(......._.._.... Board of Health DATE------/--v a- -------- FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS r L-0 ! 1,3 A uG3US7- 23, /9-26 O', 6 ,, WoODLOA" 74 f \ �: f -• - '' Svc S o/L LEA,-14 ! /�Rd�$E� 6,0,24E& \ t �'ff��11 J I�1 T '_..-;til ys?/ 20 BET,,1tzl`� `TAue 1`J pP o r �..` SEX;vC. Zit 32�f 26 c Q 44Al t A4 nJ/M U/t/! ! 3 cu/z--D1"G S ETc3ACA.-:� 20 F'24/V T /0 Si DE /p T EA rz P20,a0 SEL7 3 BE,a/zooMs SE P T/C 5 YS TEM Gon/S T2 UC T/ON SNA [_.L TO MA 5S DES/G/v F-L o w �3®o GALL pA y ENV/,e on/M G-n/T�L. COOS. Ti 7L E IT An/O 7_0l_4JN OF BA.�NST.dt�3�. L C- A G A-/ 12,4 TE L M/N. //A/C/-/ P/zOPOSEI� A/E.dGT,1/ TZ�GULA T/ONS TOP OF P2 0,oO S E V L..E ACAI .4,2E A 2-70 FO uND.4T/ON MAn/NOLE �Co✓E,p TO E)C rEA/D Tp /� LoE,2✓/OC/S CO VE,e YV/ 7-,A4/n/ P OF F/n//5/-/Ev G e,4 DE. TO ,a2E VE,vT /A/G--S ,c20M /n/F/LT2AT/�t,/6 IO, /8 Co✓G--�7-5 5 _ I D/57- " , (30X 'ST CAST//Zonl --"- -- - � 3"nginl ►. M/nJ/ -6 MrtiJ 4 D/A, ATEIz QY� ~ 3"M,�/ T/GP172- IrT M/N di rCH �4,./FOOT /Or'M/N 14 XF0o7 2 Mini XlirCfi �, P/r D/A. /4" _Y_ MiN �4<"�Faor WA yEb I d � _r_ /n/vEe r r - C�+S ro NE GALLON/ /A/✓E2T `�� 6 ' C�� ALL /A/VZe 7- CA ,a A C/ T Y AR O UA/O S_�T/C TA N e ELEV. CWATG�r/GHT) /NVE '7 SC3TTOM OF �z'I piT / /iV VEZT /VO GA e,5A6E G,e/nIDE,P_ ' C� S / TE PLAN LOCAT/0/l/ C�/�/TE V/LLB AJAS:5. rzEFE2�nlcE l3 ire Z_07-_45 O/V L,4IVZ> Clou/2T 32 373 F ,�,�./ .SEPT/G TANK., /STl2/BUT/ON BOX �S OUTc ETS� AA/D L.E.4CA11A/0 -J-/7 It - ��� TO BE OF ,�E/n/FO,�CED CO.VC,2r- U l COn/C'2,--TE S7;2E,v07;;V 3000 Ps/ Mini 5 /G , 5^4/Th/- C3u!t S TEEL ,. 00000 H- /O LOAD/A/G S/-/O.r-_;>T /NC. /4 TD,ey LAA/E D,P_/VEWA)l n/oT TO BE LOCATED L�'E AJ MA s5. 0VE.e' Un/LE s5 A/- 20 DE.S/G�/ LOAD/wG /S USED. oli Of CRAIG r'y RAYMOND y shOer 6' �N* 27483 O,4 TE HEA L 77-/ A T