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Home My WebLink About0042 EVELYN CIRCLE - Health (2) �l a �velr (¢r,k. GZ- 7 Fmic THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TO_'A.4J,A................OF.:.- ..................... Alyfiration for Bispaaal Works Tonstrurfivit rrrmit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: Ck=-u_� 1Lj_E....................Loa-7_ at Ad .................. ...�A .. ...................................................... 0 Address ....................................................... --------------------- 5talfler Address PQ �O S .14 Type of Building Size Lot......!rt................. q. feet U ........3.............................Expansion Attic Dwelling—No. of Bedrooms Garbage Grinder '4 P4 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria PL4Other fi3tures ----................................................................................................................................................. .< Design Flow......... ......................gallons per person Ver day. Total daily f19W.......�5 0....................gallons. W er f r.9 Septic Tank—Liquid capacity_XCQallons Length!?2.�'Co..... Width..47.0. Diameter..._...........I Depth-,S7..... e Disposal Trench—No. .................... Width.................... Total Length.__................. Total leaching area....................sq. ft. Seepage Pit No.........k----------- Diameter....___10....... Depth below inlet....0.......... Total leaching area..Z�PY...sq. ft. z Other Distribution box YQ5 Dosing tank (pp Percolation Test Results Performed ....... Date.... �--4 �_l Test Pit No. 1_4Z.-...minutes per inch Depth of Test Pit.....IQ......... Depth to ground water..)Qcr_rF_,&4cz 0-4 1 44 Test Pit No. 2................minutes per inch Depth of Test Pit............._._.... Depth to ground water-.-__-_-------.--_-----. W . . ................ .........................................................r -------------------------------------- 0 Description of Soil...0 .............0A-vVL,.4,. ---------------- �4 .# 4 A ................................................................................................................................. U .................I..M-D..........150---V-2,. . _D ..................................................................................................................................................................................................... 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'TTIE 5 of the Sta Sanitary Code—The undersigned further agrees not to place the system in operation until a CeJMcate of Co)m is a Os been issued by e boar ealth Signed..... ... . . . . .. ........ .. ................... ..................... Date ApplicationApproved By--- ... . .......... . .2...... . . ................ . ........................................ Date Application Disapproved for the following reason ............................................................................................................... ........................................................................................................................................................................................................ Date PermitNo.----R-7 ----------------- Issued ....................................................... No..U.' __ ,� E �.T 1'� ` `(-� FEE.. .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH --------------------- Appliration for Di-gVvii ai Workfi (famitxnrtion rnmit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at ............. t, *1 w_.. ...................................l- t !1...; ----------------- 1 ........................................ o do -Add o t No. - W X r` f Address Installer Address rt�^,,��-pp � UType of Building Size Lot_3:M_ ___..Sq. feet Dwelling—No. of Bedrooms_._..._................................Expansion Attic (�f)) Garage Grinder aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )+ Otherfixtures -----•---------------------------------•---------------------------------------------------------•----------------•---------------------------------- W Design Flow.........`'+S.......................... per person per day. Total daily flow......-— ........................gallons. WSeptic Tank—Liquid capacity. +'-, "gallons Length. a't�-a-_'. Width_�-Aa Diameter-_.- -.__ De th_.<""'_ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area-__--__------_------sq. ft. Seepage Pit No........A........... Diameter...... C)....... Depth below inlet....rn..._.._... Total leaching area.?<^`.7...sq. ft. Z Other Distribution box Q 4}� Dosing-tank (M'-) _ a Percolation Test Results Performed .< .............. f'- -: •---•• Date....... ' .. Test Pit No. 1..''-_ _-___minutes per inch Depth of Test Pit.....V.._......... Depth to ground water--. (.4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--._-_----_-_____.--___. O x Description of Soil � '�. � ..�' t r f' ........`� ' a a -----•..---•-- ----------------------------------------------------------•---------•-- t W UNature of Repairs or Alterations—Answer when applicable-------------------------------------------------------------------- ----------•---------------•--------------------------------------------------------------•-•--••-•--•--•----•-••-----•.----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with �-Ia^ the provisions of TT 5 of the State Sanitary Code—The undersigned further agrees not to place the system in era until a Cen '-cate of Com Ia s issued by e boarfi of,iealth �� Signed.------•-•-�� ,� !-°''.� Date A lication Approved By...&4414A..r... 0 Date Application Disapproved for the following reason .-----•---•--•-----••----•-•••-••-•-•----•-••---•----------•--•-------•-••----••-----•-------------------------- ---------••---•--•--•------•-•-----•-•--•---------------------------------•--------...-----------•-----•-•-----••--•-.-•----••-----•------•------------••----•--•-------•-•--•-•------•-•-•---...------ Date Permit No.---�(/.6... -- ------------- Issued--------------------- -;- ---------•------------•-------- ate THE COMMONWEALTH OF MASSACHUSETTS ./sn.) BOARD fjHEALTH ,g f (9rdifirFatr of Tomplitanrr THIS I ORTIFY That the Indiv' ual Sewage Disposal tem onstru,ted ( or Repaired ( ) �$ / 1�' c1 by �'"/G....1, G�fa! � 7.!{l ...----� 5.... l�c`;�'._........ • Ins Ilex at has been installed in accordance with the provisions of TITIE 5 of The State Sanitary Code as doscribed in the application for Disposal Works Construction yPermit No.._a..�5.__ /..... dated-...... .. ................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...-----•-••..............�--'7.=--•-s�.�.....-•----................ Inspector.................. ................................................ /THE COMMONWEALTH OF MASSACHUSETTS BOARD QF �jHEALTH i ,../10 ............OF..--- �•'•,1.AS-:••------ ... --may NO..F_�....:J �� FEE...-• Disposal rkv inn tr as frrnt� Z Permission is ereby granted._.. r".. 1✓Ids: :! .._...lb. ....__�� .......6i.......1 to Construct (V) r epair ( ) an I dividdal S wage D 5�osal Sy at No. 4. & Street as shown on the application for Disposal Works Construction Per No. . G/Dated........ . ... . . Q .... t� .....................................-------� Board of Health DATE............. - .................................... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS 5 iyC. 6tA- T-�� 5 l N fzt_E }-AM1 D< F:D XZ,-C�VtS roe_ 6xv N► `� '�+C/ g95r,?,,D U5 E 1 Doz? G-a.LLOQ S y.7hc 1 ca,sK 7�s�os�l-PI-T usF tC>raa qs&ALL-- �rrC}{=20� �' '` "° �` sy �t�; hfAF�D � PETER X. C S(L A, '�.,: o SULLIVAN {; Aux = 18S sF ST R No. 29733 ". r � 2 �hF'AGCi� =I(3�SF C 2,6 = g7C7 v-D tlaca = 79sF CaQhC-ti-(=7�sti; S t,o = 79 GPt �'oTAL 7D s-616rJ.a t=t o rR./ �i �>~cat.a.-rtatJl�a�Tc ►`v�n�a t� 2M�u.A.2.1.655 ZF=NIUJE ALL vl klSO tTi\gC.t. • . M r-me 4L-,FOE 10 'Aeok-►A D �TA� iv Cd,i 7638—� Top of FU17 3J.0. <o sir v.\ S L H-zp 4"'►'�!G �sz. Sc ` I'c�DU i o 2 d IOD7Z? 3S,0 N Y li C_�aEuy r LE°,C H tN� g$,Z 3$,q Srrc 1 P 1T WJ 1NV . Tia1 tK P WIT-4?,Of g i s.in ° 3-,n IL`^WdH C ERTIFI ED pLaT TOLAN ,-�T 7 �V�t,`{IJ��.►SZLt. CAT t zD N: �.�.5'c''ir��/%t_.►.. 1N(�+f�j- E6l s T REp LAK-R Sit��l a . A N� 5ET'��K 'F\Ec,xl.�l;c r�4>✓tyT'S ��'�E _ vyr i z7r A I.Ii� 1S NNpT 1TV}tQ TttE F> nptdb.>>:a,. TH 15.RAti Is rioT ��tR orvhN INS�RuMENT SuR.: CY AND -FHF—.OFF5E15 5t-OWN 5HOULU 1qqT g-iZ- ' Ci r3E UsEQ 77b E5TAJ3USYA LDT LINES. 0 - Ni' tr -IOO�m F -t �GCTA�,aIti1Go, tTII- �� tuw:GrWAu, �aaow�ri-aw 2A tj � . OF PETER U 1SULLIVAN No 29133 �.�tS—rF�� v �c.3•�l�`Ct�.S Cv i L TEM&i A SEC 5