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HomeMy WebLinkAbout1927 FALMOUTH ROAD/RTE 28 - Health � aa� �c��,►�t� 12cl� .,Cam--. �/ � __ 0 No....% .............. Fmc.............................. THE COMMONWEALTH OF MASSACHUSETTS KI ocol BOARD OF HEALTH 't0Wn.............._0F.........)3.14 ................................. Apptiration for Bhipoiial Work.5 Toutitrurtion ramit Application is hereby made for a Permit to Construct or Repair ( ")-"an Individual Sewage Disposal System at: .........E&... ........Rd.......................... ....ced� Qak....tAA�..........0a6.xz............ Add_.#S n �T I? Locat r Lot No. .. ....... j.............................. ..... . ............... ............................k .. ......................................................... er Address ... ................................ .... AMI............................................................................ Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.... 10 Garbage Grinder Bedrooms...........................:S.............Expansion Attic P4 Other—Type of Building _------------------------- No. of persons........................... Showers Cafeteria P4Other fixtures ...................................................................................................................................................... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 9 Septic Tank—Liquid capacitylOPP.gallons Length................ Width..____........._ Diameter_............... Depth_....__..._..... 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 ( L.)r,' Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.._................. Depth to ground water____.__..............._. f� Test Pit No. 2................minutes per inch Depth of Test Pit..____._....._..._.. Depth to ground water____._.............._... P4 .........................................................j.................................................................................................. 0 Description of Soil.......SAno.........A1.1 D.........C, . .................................................................................................. -------------------- ------ -----------------------------------*-----------------------------------------------------"---------------**--------- .................................................. ..................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable..............................•.__._______._.....__.._..._..____...__...__..............._...... .......I.............................................................................................................................................................................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TJIT�U 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 the bDo d ff hhgdl�h. Signed_ . ... ... ........................ ..........I.. ......... Date ApplicationApproved By..................................... ......................... ............................. ......... Date Application Disapproved for the following real rs:.............................................................................................................. ..................................................................................................................................................................................................... Date PermitNo......................................................... Issued....................................................... Date ---------------------- No.._. ?._ .�..�. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -----"r°ar7 .................OF.........'s',..�ri " ,& i!$a G-f..---...------.........._........... Appliratiun for Disposal Workii Tonstrurtion runfit Application is hereby made for a Permit to Construct ( ) or Repair (✓<an Individual Sewage Disposal System at: .� _ la I.......�� �.�.�: ��........................... . ��:���_���.�� �...........��� Locaf Add ess or Lot No . �. A. . . . - -- - .............................. ............................................................................ canerp� Address Installer Address 11 Type of Building Size Lot_.........................Sq. feet 1-1 Dwelling—No. of Bedrooms...........................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 0.1 Other fixtures W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacityi 5;Lgallons 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 ( ) aPercolation Test Results Performed by........................................................•---------------- Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ C4 .............................................................----- ..--•-- . . -----•.......--- --- -•-------- ......----•• . O Description of Soil..---. k't ........APIOL.-------- AA JVEJ---•------------------------------------------------------ V .....-•-----------------------------------••-------------------•---------------•--------••••••-------•------------------•-------------------------------•--------------------------••-•----------.------ W 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 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 issued by the bo rd f h 1 h. Signed..I - ----------------•-------------- ` Date ApplicationApproved By...........................--------- •-----'a-..•--------.........----........------•------- .................................... --- Date Application Disapproved for the following real ns---------------•-------------•-------------------------------•-------------------•---------------------......•--- -----------------------------------------•------•-•---------•----------••---------------......-------•-----....----------------------------------------------------------------------------------------- Date PermitNo......................................................... Issued------------------------------------------••-••-----•-- a`« Date r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........ .................OF.......' t ' ." .................._.......:. Trrfifiratr of Tompliana THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by..:.. .E_ ........S.>.------..Lai--_A.!!`kA.......-----•-------------- Install at...v�_s_._l.._------ .: .C?_sr _ ._....._. -!;kk............ I.7= _r�.tt., E..Act...................................................... has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No--- ._ _"..1r-_Z.......... dated-..............-.!__`}...`.. ......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. —� DATE....------.. �a�l t2...................................... Inspector-v!:!q------..................................................................... f - 1 C a 9 - o b-7 THE COMMONWEALTH OF MASSACHUSETTS i BOARD OF HEALTH F�G - 12g . a pNo....8_ ._. : Z FEE..... ...... Disposal Vorkv 'Ul.onotrnr#ion rrmit Permission is hereby granted 77 --........................................................................ to Construct ( ) ora.Repair an Individual 'Sewage Disp W al System '„ n` 1 atNo......................................7............ ._....._...�.. �t��v �! YO �I Q pp p street 86 ..1 . 2flj Dated as shown on the application for Disposal Works Construction Permit No.................... -y� _--...-------.... (� o of Health DATE--------..------ . 1 IL " 'F?#M 1255 A. M. SULKIN, INC., BOSTON i r t No... c�_�� � Fizz ........©�. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH YOlV0 ...............OF.... ApplirFation for Disposal Vorks Tonstrnlr#inn jhrtnit Application is hereby made for a Permit to Construct (�,,<or Repair ( ) an Individual Sewage Disposal System at: ! ----------------------------------------------------------------------------------------- L tion ddress or Lot No. ra ..-•----------------- --- ------------ ...._._......... --•---- Owe Address a �� ._.._.... '�. - ------------------- ---------- Installer Address d Type of Building �+ Size Lot.......................:....Sq. feet U Dwelling—No. of Bedrooms........R---_6Q ---------Expansion Attic ( ) Garbage Grinder ( ) 44 Other—Type of Building ............................ No. of persons............_............... Showers ( ) — Cafeteria ( ) Q' Other fixtures -------•----•------•---•-------- . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity]MP__gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. .... .............. Width.................... Total Length.................... Total leaching area___--__----..__---sq. ft. Seepage Pit Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( 6-y- Dosing tank ( ) '-. Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water--_-_-__________--_-___. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 Description of Soil........ZA Cs...•----t•----..! aft ._&. ..----••------------------•-----------------.--- --.-----------------.......------•- x U ---------•--------••------•----------------------•--•------•-•-•------••--•-•------------------•-••---•-------------•---.._..------------------------•----------•---------------•-•-•...--•------------- -----•---------------------------------------------------------------------•-----------•-•--------------•------------------------------------------ ---------•--- U Nature of Repairs or Alterations—Answer when appli bl ---------- _�`7 __._.CI.�_�-------___+.�.1, ..... .................. - -•------- ----------------------------- Agg reementt The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLEE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance h en issued by t boar f heal . s Date Application Approved By..................... ----- ---- -_ - - -------------- ..........0 -- ---- Date Application Disapproved for the f ollo ng reasons-------------•------------------------------------------------•------------------------..__... ---------•-•--------•-----------------------•---------------....---•-----------------•-•---•-------------•-••---------•-••----•---•-----------------------•-••---------------•••-------•-----•-•--•----- Date PermitNo......................................................... Issued_....................................................... Date -- _ -- - -- -- - - - - _ - - - --- -. �.�.-- -- -- ---- No......................... -- Fss............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . V►a.. _.:................o F .................................... Appliration for Disposal Works Tonstrur#inn Vprrmit Application is hereby made for a Permit to Construct (V<or Repair ( ) an Individual Sewage Disposal , System at: 4 s ----------------------•-•------------------------------------•--••-------...-----------... .I L tion ddress or Lot No. --------------------- on Address W � _ 1. ......... �...---_ g . Installer Address •.U Type of Building Size Lot----------------------------Sq. feet Dwelling—No. of Bedrooms.............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of:Buildiu a yp g -••-••-••------------------- No. of persons............................ Showers ( ) Cafeteria ( ) d Other fixtures .................... W Design Flow............................................gallons per person per day. Total daily flow............................................galIons. WSeptic Tank—Liquid capacity4.COq.gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No.___________________ Width•••:................ Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No.j"Tl . Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( vY Dosing tank ( ) Percolation Test Results Performed b ......._.. Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f.4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 .................................................... •••--•-•-----•----t�--------•- ••--••......•... ...................................................................................................... `Q. Description of Soil :A:d"1Z ---mcx.•----•-----••-----------------------•---------------••---------------•-----------------•----:. V W . 4kk U Nature of Repairs or Alterations—Answer when appli ble...____....I+PP_..__q_l �__....� A:!�l�...... :.................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI.> 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance h n issued by t boar f h 1 ��U&k D to Application Approved By...•••--•-•••••--Ig �� *~-�e Date Application Disapproved for the f ollog reasons---------------------------------------------•-----------------•-----------------------------------....._......._ ................................•••---••--••-•-•-•-••---•-•-••-•---•--•••--•••--•-...--••-•••-•----•-....._.....•-••-••-••-•••......................................................................... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF ,HEALTH ..........................................OF....................... ............ Clrrtifiratr of TontpliFanrr THIS IS TO CERTIFY, That the I dividual Sewage Disposal System constructed ( ) or Repaired ( ) by--------------------------------------- I!Wt. i -•-•-------------------•- ,.._... s alley at•-•-----••-•..................•-•-•� '� -----_-----• -F�.t �!J � • ;C vI.LL f. has been installed in accordance with the provision-s of TITLE r 5 of The'State Sanitary Code as described in the application for Disposal Works Construction Permit No.........................._..._.._...... dieted--------------------------_..................... '-'THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEla9 l91IIL F NCTION SATISFACTORY. qq , DATE �L .��- -. .. Inspector: ! ,, F;. ----- THE COMMONWEALTH OF MASSACHUSETTS`, Vh14t ANGC 136ARD,. OF HEALTH ry ...........................................OF......................--•--......................._..................._._............ _ No... ..._.1.-•- I FEE......�............... Disposal Works 'IT us rnrrjtion rrutit Permission is hereby granted..............•S-�ll-5........... '�_�4!' _. !E to Construct ( ) ortRepair ( ) an Individual Sewage Disposal System at No.............................1u-Z-7---........... i2 Street as shown on the application for Disposal.Works Construction Permit No...........1_ .r_4Dated.. --------_ T_-_--••--- 11 .......................................... .............. DATE_ B a d of Health FORM 1255 A. M. SULKIN, INC., BOSTON NJ01 011' THE COMMONWEALTH OF MASSACHUSETTS I�� BOARD OF * HEALTH ... _ ...... ............ Apphratiun -for Ditipg.itt1 lVorkfi Tonstrurtion . rrui t Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at --- 190,7 lmpuT� &c-d �� '-'----- — ------------------------�--------------•---•------------- ---------------C� �'-'-----�-----------•----------------•---...---•-- Lot h;V'------•-(---`- ------------------Location-A res - ��...................... •-----`- ---��-'�-----•-FjI A-t4 f✓( --- _•�___!_�__L '..............F77!y/l W lVi D h/d !Installer stall iJ iM U'jiffs L ld�g Y ,-� ss ---------- 't --.... OW "_.. .. 1` — E e �� •---- er Address Q Type of Building Size Lot-...........................Sq. feet U Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) pa, Other—Type of Building ............................ No. of persons---_----------------------•_ Showers ( ) — Cafeteria ( ) QOther fixtures ---------------------•--------•-----•--•------------------------------------------------------ --- W. Design Flow--------------------------------------------gallons per person per day. Total daily flow----------------------------------..........gallons. WSeptic Tank—Liquid capacity___-_._.___gallons Length________________ Width................ Diameter..........------ Depth---------------- xDisposal 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 ( ) aPercolation Test Results Performed by------- -----------------------•••••••--•-...•-•.....:--- Date------------------------------------.... Test Pit No. 1................minutes per inch Depth of 'Pest Pit-------------------- Depth to ground water__._-------.--.-_.------ fXq Test Pit No. 2-----_..........minutes per inch Depth of Test Pit---____________-._- Depth to ground water............--.-_--_.__. ------. --•---------------- ------------------•----------------------•-•-----•-•-------­-­-------------------------------------------------------------- 0 Description of Soil----- ------------------------------------------------------------------------------------------------------------------------------------------------------------- x W ------------- ------------------------------------------------------------------------------------------ e W --- v Nature of Pepai is or Alterations—Answer when al cable...___ _ .. .__. -- ------ ------------I___------- .--.---------.-.___-_.... ------�.'k c S"� ' � �'r`�:S 1' ?2 ----•-- d''+C -�'i' - - - ---`-----•-------------•--- 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 -1. operation.until a Certificate of Compliance has issued by the oa d alth. ,j + Date Application Approved By----------K �' i.�!I�� .......r...7.....7-6---- 7 Date Application Disapproved for the following reasons: -----------•----------•-------••-----•----------------------------- •-----•------------ ..............•••••--•-----------•--------_-_----_--•.---••---------- Date PermitNo----------------------------------...................... Issued........................................................ Date -- r NOSI zk. Fizic THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH liration -flax lhti aott. , �� � 1 Works -Cnott5trurttott•.Vrruttt Application is hereby made for a Permit to Construct ( ) or Repair .( ) an Individual Sewage Disposal System ��¢at: fir^ p T j 1= 'R! � / �+•A !�lion[ Address (b� <! }__Y_ ____________ ........................................... _____________________.________________..__ ___!________________.___...__ Locat s �? ' or Lot No, r// CJ Ower Address .+ / L>a !"���---`��=-r`''-�_ t." . l� M,t fyt f'_ <i ;f' ,;�!�f1N�-•• �='-•�---r•�.-- '�'-=�-��---� �--��--- '�._.. ��----• t ��`✓-�/�//6 l/�`/�/� r q Installer Ad ress V Type of Building Size Lot____.__E Dwellin ___________________Sq. feet Dwelling of Bedrooms_____________ __________ ______--_ ___Expansion,Attic (' ) Garbage Grinder ( ) ..� Other—T e of Buildin No. of ers6n5 ___-__ Showers Cafeteria Other fixtures -------•------------ ----- W Design' FloW............................................. per person per day. Total daily flow__..___.._::._::.__:______________-_-___.:__gallons.- P4 Septic Tank—Liquid capacity. _-_._ _.gallons Length___:_---------------- Width-_ ;._.. Diameter__.___ Depth--- 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 ( ) aPercolation Test Results Performed by----- ------ -----------------=---------- ------ Date_____-----------:------_ ___ -.... Test.Pit No. 1-----------------minutes per inch Depth of lest Pit..................... Depth to ground water-_-___- _-___-_-__ t14 Test Pif No. 2.................minutes per inch Depth of Test Pit............._______ Depth to.ground water------------------------- ------------ -------- -,-•-----------------------•- •-•------...............--•---=--- =------••-----•-•--------=•---•--•-- ----•-•----------- DDescription of Soil-------- ---------- -----=--•-:••----------=-------••---•---•----••---•-------•---._.................................................. , U __ - -----------=-------------••--------------- ------------,................... ----- - ------------- --------------------------- Pe U Nature of Repairs or Alterations Answer,when :applicable / i< __ ___-j _ Y _. -`�� ---- 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 laoard of ealth. • (,� . r• ----------------------- Date r � ` - Date Application Approved BY -�` q.. ---9L- 4 - �! T -------------- ---- ` , E� { Application Disapproved for the following reasons:_____________f___:.___._._..__.__..-----------_----'........ ---------------------__._.._.____Date_._------__--- ••------------------------•-------•-•-----•--•----•-----------------.__----------------------------•---•----•---------------•------•-----•-- Date . PermitNo........................................................ Issued........................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH i '?........OF........ .. .. /.. ...... ... . %:.I.rrfifirate of f"nutpliatta T S IS TO CER" IFY, That the Individual Sewage Disposal,System constructed ( ) or Repaired ( ) , �y ` by. _.. �' -- ------- •. ---------------------- .,�,�'t �_�Installer f has been installed in accordance with the provisions of hr idle XI..o The State Sanitary Code as described in the application for Disposal Works Construction Permit N1..... ��,f 7 '.. ---------- dated- -' �� THE ISSUANCE OF THIS CERTIFICATE SHALL. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WIL UNCTION SAT FACTORY. DATE • ------ram '"' ..................... Inspector----------=-- -- -- ----•-•-•---- ............................................. THE COMMONWEALTH. OF MASSACHUSETTS >G L� BOARD F _HEAL �' L........................OF. ...-. .....-...----- r No.-- FEE s--------------••_.. Bitiva,itt tarkinf—I l5trurtion Prrtnit Permission is hereby granted ----- _-�4; - --------------------•---___-_----------____---------•--•------_______ to Co t t ( ) o R air n tidal Sewage . i posal System �j� gp , at Nd' 1�'= = L '1 Gr-...........................3i .- /_ %Z f •! --------- Street LL_-" _.�as shown on the application for Disposal Works Constructio> rmit :. _______ Dated�J " --------�C_______________ �. 7 �/ f Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS