Loading...
HomeMy WebLinkAbout0024 CAP'N LIJAH'S ROAD - Health q CgPT I. KMEAD KEEPING YOU ORGANIZED No. 12534 2-153LOR SUSTAFORESTRYR MIN.RECYCLED INITIATIVE CONTENT10%® Certified Fiber Sourcing POST-CONSUMER wwwsliProgrem.orp W012M MADE W USA GET ORGANVED AT SMEAD.GOR (76) LoitA►l ION Z4 , SEWAGE PERMIT NO.. om f VILLA INSTA LER'S NAME & ADDRESS r � C C B UI'LDE R OR OWNER" Cl DATE PERMIT ISSUED HATE COMPLIANCE ISSUED D � � d�� �` jam`//� �',;. � `�. � � <� L . ����� 130 � � s � ���°� ��� ��° �, �v' a� No. l�®-1 r� .;.. .► Fizx...M.................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration -fur IN-4puiittl Worbi Tomitrurtiutt Vamit Application is hereby'made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Loeat-on-- dd ess or Lot No. —-• � s c�� �7.....c�c� n0.4 O .......... /� Address WW1 --•-•-•••••••--•-•-•-•••--• Q. ! -�•••.-...0.. .................... /zov�i ------------•- Installer Address ;r Type of Building Size Lot.- Qv v--�-Sq. feet Dwelling—No. of Bedrooms.--._--•-...................................Expansion Attic ( ) Garbage Grinder (a ty aType g . �r---.----- No. of persons-----_-6................• Showers ( ) — Cafeteria ( )Other—T e of Building .4.���� d Other fixtures ....-•..-...--.•... W Design Flow.......... v-.-_.--.--•••.-..--•••..gallons per person per day. Total daily flow...... _®. .........................gallons. WSeptic Tank—Liquid capacitvJAgq..gallons Length................ Width_.............. Diameter-------.-------- Depth-----_-_----_. x Disposal Trench—No- -------------------- Width.................... Total Length------------_------ Total leaching area--------------------sq. ft. Seepage Pit No---------/-......... Diameter----6-x.K--_ Depth below inlet_______________•---- Total leaching area-------_-_-_-_--sq. ft. z Other Distribution box (✓f— Dosing tank Percolation Test Results Performed by-------------------------------------------------------------------------- Date.--------------------------------------- Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-....................... G14 Test Pit No. 2----------------minutes per inch Depth of Test Pit----------_--_----- Depth to ground water......-----------------. P; .................... -------------••----:------•-•---••-•------- - - ------------_•------------------------------•-•----------------------- O Description of Soil----- •••-- •• -• --••••- � --� l <------- ---..--.-..0... --- . . ..-.• •—••- ----•-- V 6_ �-••. L =--------------------------------------•--------------------`--.'.- --------------------- 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 \I 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 bo rd f health. Signed k?s�r !/ /!f-•/ ,E�-.-.--= ,�� ..� ---//--- --- D e� Application Approved BY =G ��f. � � l!1.• ........... '�. �' ........ •.. Date Application Disapproved for the following reasons----------------•---•---•------••-•---•--•-----•-•---------------•----••-•-•---------•.•.-....--••-----------•-•- ............................................ --------•---••--•-•--•----•---------•------------•------.--.-•---••-----------•--------------------•----------------•--•--•-----------------•-•--- Date PermitNo......................................................... Issued........................................................ Date .-.. -----� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...............OF........::.,........ ......... .. Ir, r if irntr of TOntliliattrr THIS O COTI That Individual Sewage Disposal System constructed or Repaired ( ) by `L7� I 11e ------- -- has been installed in accorda ce with tb rovisions of : rlt" I of The State Sanitary J: Code as describe in the application for Disposal Works Construction Permit No.' - -a.y.............. dated.... -'../ .7.&.............. THE ISSUANCE OF THIS CERTIRCATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY DATE. '� " Inspector I .r r THE COMMONWEALTH OF MASSACHUSETTS G BOARD OF HEALTH rp te r. ...............OF........6.,?... .. . ------.........................-- ..... :................ No...... --- FEE.-- ................. Dispaiittl or , �rttr#intt rrtni Permission 's hereby granted.-:::. t --`----- to ConsJt��ru,� ( ) oar/ Re I ( r- In ual S'ew gC1 Disp al yste atNo._/� '2 7 � �-- - ---- --- -----•--••-----------------------•--------------- v Street as shown on the application for Disposal W rks Construction Permit .-.----- _.•-- 1t 7�...... ------------ Board of Health DATE..................-------------------------------------------------------------• ,.. FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA C No.. w Fimic.../.p................ THE COMMONWEALTH OF MASSACHUSETTS ^� BOARD OF HEALTH J _..._...._....OF.........f�:.:....".'.�........... :.................................................. Appliration -for Di1 orittl Morkii Towntrurtion Vrru it Application is hereby`made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: _ if - �^ Locations-Address or Lot No. .......................:__."'....=...........•..--.....--..-.._...--.--. .n Owner" Address a . .. Y ...........................................rz %: :..... .................................•--..._.....,----- Installer Address UType of Building Size Lot--� :.:..... :... ..Sq. feet Dwelling—No. of Bedrooms----------- --------------•--------------Expansion Attic ( ) Garbage Grinder (� aOther Other—Type of Building �1 .s i� _- No. of persons.--____r------------------ Showers ( ) — Cafeteria fixtures ...----------------------- -------• W Design Flow------------................................gallons per person per day. Total daily flow-____----_-S_----..__--:----____-.-.--.....gallons. Septic Trunk—Liquid capacity A_o --_gallons Length---------------- �Vidtli................ Diameter-------......... Depth---------- xDisposal Trench—No. .................... Width._.-_-_--_-.-----_-- Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No--------/---------- Diameter...r...u----,-_--__ Depth below inlet____________________ Total leaching area------------------sq. ft. Z Other Distribution box (—)- Dosing tank ( ) — o, - 0,, /),, - S--2 6-7G- �" Percolation Test Results Performed by----------- -------------------------------------------------------------- Date----......--- --------------------------- Test Pit No. 1----------------minutes per inch Depth of Test Pit_------------------ Depth to ground water........................ fi Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water--.--.-----_----_--_---- a ------------------- -------•-----•--...••--•-----------•---•-••......------------••-- -•----------••-••-•-••---•-•-----•...---------------------------- -- ( .Description of Sotl_._.......... U .-- a-------3 ...... l-- - . W ------------V--- ---- -------- 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 health. / jSigne DateApplication Approved By--•--` JG 1�1_- —----------- ' /2----�`•3 .e Date Application Disapproved for the following reasons-------------•• ............................................................... --------------------------------- Date PermitNo.......................................................... Issued....................................................... Date I 4.: 40' _ - -26 A=41.69 Gca.7' Z AuL Mc.rtMA� } ' Q=25.00cs 24 ,� �'�'" {�: r3. � .s' s'sEn, a• 6 /S' cue Z d� +/ �� f- ��lL Sv L�5 U�L.. T 48 h/4'612 MiAJ/MC//t// 1 CJ/L.D/nrG S ETOACA--� 26QU/,eE-ME�tJ7 20 . j"24NT /o ' S/DE /O ' T.2E�1T� f�l2o,ao SED . ' BE.DI200MS SEPT/C. 5y5TEM CoNST2UGT/O/�J ' SHA L.G.. GONF02M TO MASS- De-S I O AJ FLOW 3 o o GAL CO A Y F1vV/,eo"AfZV7,-4Z- COOe- TiTLI- Y LG-AGN 2,ctTE AA/o TOwn! OF c3,�721A-,5 7"4 a C•� < M/Ai //ti/Gfl N,EALTf� 7Z�GULA7'/ONS ?O p' .TOP OF ,020�05 E a L E<1C�/ A,2E4 FO uN,CDAT/DA/ ------ MAN!-10LE Co✓E,E TO EacTEnlD TO � -1,ocn2✓/OUS VER W/ TN/A/ /' OF TO .a2E Vf-A/T ,�iA/C-S 1 .c20M /A/F/LT/zAT/itl6 '}0' STt�NE M rJ _ /8"co V,r7-e covAe BOX �) Z/"N/iDG- 6 DI A. 'A' T/G i 4` T D/a. M/N p/ AN �cGw L/niE ,_� .�,TGy �4„/FOOT /O"MiN "2" M//V /�/TcA, A P/7-Y /OOQ M,N FooT WASHED -Y- IAJIlEA77— STO NE GALLONI /NV62T `� � 0 ALL /A,VE..2T CA PA C/ TY• ATLOUA/O Z ->771C. T,4 ti� /�v verzr 8o7cu f OF (WATG>z -1C -� ' /NVEZT /N VE 2T f a GAr28A6E GRJNF_D ,2 ' al b c� 2o' M/A11A4 / r.4 x � > LOCH( T/D/V CG-n/. �,� •a ' �r2vM ,=©c� ,Jz7.y r/c,�1 .=llvfa /AJ %~'GIN �• G,f[ 024 7� Cr(E S- SEAT/C TAN.L C)/,5T,e/BUT/ON BOX �S OUTLETS AND LE,4C,411A/G F->/T" TO �5E o� QE/A/F4�CED CONC,dzET� _ CONCZETE ST,2E.t/GT/y 3000 Ps/ M/N. STEEL ,. 20000 gill O�� ,�-/-/O LOA O/A/6, 43V C. ,2: SA/OA"-'T /NC. /4 TOIL y 1-4 A/z-= CRAEG .U)e/VE WAY NOT TO BE LOCATED RA�h+RT OVE2 SYSTEM UNL_�.55 4/- 20 syoe; w, DE.AJ,V/S MLI S$. '' Nc.. 27483 DES/GA/ LOAD/A/G /S USED. L C E ,Z >,�'!/ T�✓,,c/�' �""��, C X.$T N C� �<^ 4a �. 1 i. �•- � vtit� A �'/oIL! LoCAT� ON �S CcJ12 - t CitST-� ,`2 C T fI 5 SN U w n/ i4/v D C C ;�O At. pv E 0 v/L 27 /Al G SE 7 19 4 G� 9 , MICe/'rs o 7',WE -To wN a.c 8,41ZNS >A 3 IRATE A/E.41-77-1 AGEX17- A pae0 V,4L