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Home My WebLink About0070 BAY LANE - Health (2) ,� - � / S y / -� 3� --��/ 4 � , t r � _ ._ _w . _- - _ ._ . i .. .�.. a � }� r^.. ,r„ .� _ .`. �. _ ,.,v ,�_ � _ .�, .�. ,� _ _ „�r +.,.� ...,..,,..r.....� ... No......_...__.._`31.. g - `a�� bo Fps.............................. THE COMMONWEALTH OF MASSACHUSETTS ' BOARD OF HEALTH D ...__._..... . .................OF....... ---------------------------------------- ApVfiraflon for Bh4poott1 Forks Tonitruction ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .........71.........Bm. 1��1 / . Lom...4.......................................... Loc ti n-Address !f prrj t No. .-••._. r ..._. . .( _ __________________________________________________ ___________ _________ _ ...._...._ -- -.._._..._.. caner. A r s Installer Address d Type of Building Size Lot... p q......Sq. feet aDwelling—No. of Bedrooms.............. ........................Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures .. ------•------- ----- ----------------------------- ------------------------------------------------------------• W Design Flow..._________________55�_..._.___________gallons per person �r day. Total daily flow......................�3�..........gallons. W Septic Tank—Liquid capacity l�l?t _gallons Length Width__�_'id'.. Diameter________________ Depth_. :nT". 4..� e -5 o x Disposal - h—No. ......i_............ Width___._�!�.._._.___ Total Length...�:a._......... Total leaching area----Z_5P.....sq. ft. Seepage Pit No_____________________ iameter..__.:............ Depth below inlet.................... Total leaching area.........t:.......sq. ft. Z Other Distribution box ( Dosingtank ( ) '—' Percolation Test Results Performed by r�T'L__+._�./iy. ..'. _ _��%fJ ___P Date........._____ �1 a 6 wf'' '` 9 ...•-- a Test Pit No. 1....�'.....minutes per inch Depth of Test Pit........c(_........ Depth to ground water.__--I __-'. ._._ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water___________________-._._ ---•------------ ----------------------•------------------•---_....--------._......._..----------------- Description of Soil ' -J� .'1- t..w�-----.--.---��-=�=�=��---------•` W --------- ------------------------------------------------------------------------•-----------------------------------------------------------------------------•--•---------•------•--••-•-_-•---- VNature 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 TIT1 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issu the bo of 1 ea1t,I., 7 7 . .... .... Signed....................-------•--------------•--•-•-------------------•--•--..._...---•-------.. .._. _/ .... ... D to ApplicationApproved By.................................................................................................. ----43 -.-.?--....... Date Application Disapproved for the following reasons--------------------------------------------------............................................................... -----------------------------------•---------•-----•------------------------------------•--••---------------------•----•------------------------•--------------------•---------•------------------------ Date PermitNo---------------------------------------------------------- Issued...............................................:_...... t Date r A THE COMMONWEALTH.OF,MASSACHUSETTS BOAR OF HEALTH ..........-.O.W.�::`�..............0F........-.. ..1.. &Z................... Ae Watifirtttr of tom rl� nr� THIS IS ITO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by---•----•--•-------- ........................... Install-=----------------•---•--•-----------•------------------•---•------•----•---•---------------•--- Q A— at ----- - -----• -�------ ---- has'been installed in accordance wi i,the provisions of T 5 of The State Sanitary de s described in the application for Disposal Works Construction Permit No. ______- O 7. -�------------------- da.ted_-.:------'�--7.--.................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE........................•--•------.........-•---------------•--•------.......... Inspector................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARr11OF .HEALTH 1, ...........OF... ............................. FEE.._� � No..._.. ®...�....._ A..--•--•---_••-•- i o 1 orb Tomitrudion Vrrmff Permission is hereby granted ---------.iA.......... B7. '--------------------------------------------------- ------------------------------------ to Construct ( or Repair L ) an Iqdividual Sew e Disposal System at No.------..!OT ---------- 5A.1----- t--••------- :. Street as shown on the application for Disposal Works Construction P it No ___ _*oa Dated____s _'_. _-..z ............ --- .---•-• f Health DATE.---•------------------------------------------•-•--•--_..----......----- ) FORM 1255� HOBBS & WARREN, INC., PUBLISHERS - y. REE.............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ........... 0.................0F....... ..A ........................................ Applirtttiun for Dispulittl Works Tow3 xndiun Vernfit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: :�:. , �.. ......... .......... 'rft. :�al w it l ... 1 ......... ---•..... -- r--•-•-- . J l' Loc on-Address C� o t No 1 .. ........ ........................... - _ '_v.�_� o. ........... Wne A dr ss ar -------------------- ---------------- � ............................ ---- Installer Address Type of Building Size Lot--- r9 ......Sq. feet U Dwelling—No. of Bedrooms.............. .......................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons_-_--___-- ____-_______ Showers ( ) — Cafeteria ( ) Otherfixtures .•.... -••-•--•••••----.....•••-•••------••--•-•-••-....•---••---•••••---•---•-------._..................•-----•-•�..------...••................. Design Flow................... <......._._.....__.gallons per person per day. Total d*ily flow...._.................,�1.37- ..........gallons. W rn d ;a 1..�a! WSeptic Tank—Liquid capacity uQD..gallons Length___ _ ..__ Width.'_'10?_.. Diameter................ Depth_.5 .. Disposal res h—No ............. Width.....0.......... Total Length... ........... Total leaching area_._.Z. .....sq. ft. x . Seepage Pit No.__.--•________...... Diameter-------`_------------ Depth below inlet.................... Total leaching area...................sq. ft. z Other Distribution box ( Dosi�,n�,.��,,tank ( ) ,, gg t `-' Percolation Test Results Performed by:�;iM_'X r. ._. f ! Date......... . . .......... Test Pit No. 1---..7.....minutes per inch Depth of Test Pit........5......... Depth to ground water_-_" _�_--±----.-__. ' Gt, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -•••----- •-••...............•-• ---•----•.......---•--•. ....--•-...... Description of Soil . ...! � t a'?°1`''----------- ✓.r t ...........` U •--••-•----------------------------------•---------•--•-------•---------------------•--....-------------------------------•------------------ ......................................................... W ----•••••-••----••----------••-•••••••--------•-•-•••--••-••---------------------------••••--•-•-••----••--•----••---•---•••-•---•-•--•--•--------••••--••••--•--•••---••-••-•-•-••-•---•••-•-•-...----- UNature 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 TITi.I y g g p y 5 of the State Sanitary Code undersi signed furtl era agrees not to lace the"s stem in operation until a Certificate of Compliance has been iss y the bo of eal Signed.........- D to ApplicationApproved BY.................................................................................................. fY"r Date r Application Disapproved for the.f ollowing reasons-------------------------------------------------------------------------------•---------.......-•••---------•-- Date r '3 r � x PermitNo......................................................... Issued...................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARQ OF ,HEALTH yN TOW: .............:.'oF..... 21 '" t- .................................. �er�ifirtttp of f�unt�t�ittnrr - THIS IS TO CERTIF , That the Individual Sewage Disposal System constructed or Repaired ( ) h Installer has been installed in accordance wi h the provisions of T j of The State Sanitary Code as described in the ---_.. dated rt " `", application for Disposal Works Construction Permit No._. : ., ................. `�'„................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector--•---•------------------------------------....................................... THE COMMONWEALTH OF MASSACHUSETTS BOAROF HEALTH OF G / `` LS -5.. ....- NO.:...... .P._...._ FEE Diupru d urku %uns#r iun amit Permission is-hereby granted 1'_�-G..' !S.r --•-----. A..------. f► l `----------------------------------•----•-----------------.......-•--------................ to Constr t (I/-or Repairi4XI-L.—a-l. ) an Idual Sew ge Disposal System at No........ --.-------_--_- •....--•--.� �±_......--- o `�----••--•--.-•--- Street as shown on the application for Disposal Works Construction P it No..... ........... Dated--.a__._�__..___._ ............ . )oard o t DATE......................................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS GV } ! r sG �� J q i i )4 vv A. � .. o,rj..� AAA tit ' ZI)II yJ EDO 4 it 10 0 i x \ ,a ILI i 'If it \ a �l , ! t \ � � ��-=�*�;.,. �v1f�`�`' '.>,� t►�l ��Qt-I�� T l.tA.vi+T �T .;x Uj Gfzvt ��ies MA T t o A -AC-SL - 0-a,3`` \ � ) l° F k t48+'! Cie . 4, , h � r • -\� sir ,� ," \ �� \ 17. • ! ► ` s'=' -�... 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