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Home My WebLink About0024 GARTH COURT - Health (2) i�� 01161 No........40...... Fps./o.. . HE BO ^ �DALTHCOFLMASSACHU u TS ,�j+ / 71 f f 1 f 7 /�9 *i - ......... OF.... ...... - --------------------------------- . ppliration -for Uhipvii l darks lautitrurtiou Vaniit Application is ereby'made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal ' S a ?`--•-•-- ••••--••---.•� .••-•• - .•• i ........ '�-' ..........................— •-........ Oca...... ress /�� Y1 �!lt �G'� Y -_ • or Lot-No------•--•--............................ 445��y ✓ r ( dress � A Installer Address �+ Type of Building Size Lot... --- Sq. feet Dwelling—No. of Bedrooms---------3......................._......Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons--------.-------------------- Showers ( ) — Cafeteria ( ) dOther tires -----------•----------------------------------------------------------------------------------------------------------------------------------------- W Design Flow----------- _______________________gallons per person per day. Total daily flow__-•------300--_--------_-_-__-__-gallons. W i Septic Tank—Liquid capacit ._ __ _ allons Length _______ Width_- _ }� --------- Diameter---------------- Depth................ Disposal Trench—No./ _____. .__- al Length____________________ Total leaching area--__ --sq. ft. See av-I / �/ _6 `� ' ... p �___ Diameter_______ ____________ Depth below inlet--- Total leaching area..................sq. it. 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---_____-____-__-----_-. fS, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-_.__-_--__-__-_______-. -•------•- --------•-- _---•- O Description of Soil 0`fr `� �' ' '1-- --3 ` :!.Jr' P `� x �` �� a --------------------------------------------------------------------------------------------------------------------------- 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 sy em.in operation until a Certificate of Compliance has ee issued by the boar - health 3 Y � Signe ••----•.------•-•--= .. Date Application Approved BY •-•---•--•---•---•-•-----------------------•-••--- ------ -------------- Date Application Disapproved for the following reasons----------------•---•----•---------------•------------___---------___-_--•-----------•----------•-••-•-•--------- -----....•------••••----•-------•---------•-•---------------------------•-------••-••---•-•----•-- Date PermitNo......................................................... Issued........................................................ Date No.-------� ....... FIB$./v...'..... ALTHCOFUASSACHT u TS DTH V 9 -(� j ...... O F.... .. ..V1, �j J G%� Appliration -for Uhipooal Worku Cnonotrurtion Vrraliit Application is er by`made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: I alll�lz,�11 4t, oc io ddress or Lot No. r Address ..... -------•••---•-•--•. - /.•%�-- � 0 .......................................... Installer Address .r ,�.. Type of Building Size I ot ---------Sq. feet Dwelling—No. of Bedrooms--------- ------------------------------Expansion Attic ( ) Garbage Grinder ( ) �-1 Q, Other—Type of Building ._......................... No. of persons---------------------------- Showers ( ) — Cafeteria ( ) P' Other futures ------------------------------------------------------ W Design Flow----------- .......................gallons per person per day. Total daily flow.........020......................gallons. 9 Septic Tank—Liquid capaciV_ _ �_ allons Len th_ -5 _.__._. Width--6;------._.. Diameter---------------- Depth-------------_- Disposal Trench 6`7 A' --2 tal Length------------------- Total leaching area....LL54--? --.sq. ft. See a ��_//�� Dtameter____.�o..__.._._. Depth below inlet.._._. P p �............ 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...------.---.-.--.----- (� Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water--..-.-..__.---.---_-. - ---------------------- G ,-- ----- -------- Description of Soil --� r1 ^+-c�.-- f? 3 U `� � =��------ " U ------------'�-\=--- �.� ^�4rfi_ �� ter/ Z `(`ti`� ... . . •-••--•-•-•--•---------------- 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 Article XI of the State Sanitary Code— The undersigned further agrees not to place �e sy tem in operation until a Certificate of Compliance hasKen issued by the boar f health / i�X ? y Signe ------ --------- Date ApplicationApproved By-------------------------------------------------------------------------------------------------- ......................- -------------•-- Date Application Disapproved for the following reasons------------------------•-•-•----••-----------......----••-----------------.._............_......----•--•---•--•- .......................................•-------------------------------...-------•-------•-••-•--••----.-------------...-------------------•--....... --------------------_---------•-------------.----- Date PermitNo......................................................... Issued---------------------- ................................. Date THE COMMONWEALTH OF MASSACHUSETTS c� BOARDF HEALTH, lyC'1- 1 i ..........................................O F...... ..P.......... .......... ........................................... Trrtifirate of 01,ontphattrr THIS IS TO CERTIFY T 1 Sewa e Disposal System yS,,y�stem onstructed (L.-ror Repaired ( ) by - - "' '/ /' ..lil.•'�•=-------------------•----......_-------•-•- ,� � � )/ Installer at. •--------------------------- �' .�C ��' -----------------•--•-------------•--------------------•-------------------------------- has been installed in accordance with the provisions of e XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No._ G_-__--__G--_11............... dated..��_,O-_t----- ..... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. � �j DATE..... .........:!; -P�-------------- p�--- Inspector.—--- ---- _. ... .............................. THE COMMONWEALTH OF MASSACHUSETTS �f BOARD OF HE AI vf ..................of.....-,.��...rh..................................�i'.. ...................... FEE.A2 FEE.A2............... i o 02 ork Towitrurtiou Vrrutit Permission, i�s h eby granted._..._.. ---="---------- -------- ..._..�....--_/ J/J . _t-------------------••------•---•------- to Construct V) o R . ai / an Indd�''uidual S e D' osal �y stem at No._----••.....(...... � ----•--�---------C�-1--_fig--- lC2-T--------- C��c/T�%2-----1 ---------------- ................ Street as shown on the application for Disposal Works Construction P- mit N _.. --..---- Dated`! --- {: ---------•-•--..._------ / Boar of Health DATE........--------...--- FORM 1255 HOBBS & WARREN. INC.. 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