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Home My WebLink About0037 GLENEAGLE DRIVE - Health (2) 3-7 glen&cyl�`!�'�e. I9� - l3y THE COMMONWEALTH OF ,MASSACHUSETTS BOARD F HEALTH Application-is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal Sys&temt: t.011 Add_ & �; . . ....... __elO n. r Owner Address Installer Address Disposal Trench�No..................... .Nl�th_.�....jp - Too eni th...................... Total leaching area--------------------sq. f t. . ___ N �2; Other Distribution box Dosing'tank 0-4 Percolation Test Results XAlt-�__ ------ .......4---------------------------------------------------------------------------- __--_.'---_-'-_.—_--_'—_.—_---_-__-_------'-'--_----.---_-.--_''_'---.----._---- Agccroeoc: The undersigned agrees to install the aforedcsczibed Individual Sewage Disposal System in accordance with the provisions of Article XIof theStateSanitaryCode—The undersigned further agrees not mplace the system in operation oud\ u Certificate of Compliance has been issued by Si d' ' '-------- Applicatioo Approved By—. '�—� -_--_----'-----'' ` . -- Date Application Disapproved for the following rmxu,n«:—..—.------'.-----------------_---__-_------------- | � ............�__. Date PermitNo........................................................ Imaoel......................................................... Date iv, No......'_"3�___f......_.. Fmc....,A.................... THE COMMONWEALTH OF MASSACHUSETTS BOARD .9F HEALTH ............................... �Y .---..........OF.........6. Appliratilln for Elhiposal Worbs Tonotrurtion Prrutit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal SysVte7Mn.,,t 4 1 -131 ------------ -------- ................................. ....... ...... ------- -- _1.1 6, .. ....... ...... .. ... a ion- * A�5reg( Z t N;l fi! IT -Z-04. . ..... e Pe . ................ ...... ........................... Owner 7" Address ............ ............................................. ................................................................................................. Installer Address Type of Building Size Lot--- feet DwellingyNo. of Bedrooms------------- -----_--_--------------Expansion Attic Garbage Grinder aOther-Type of Building ----........................ No. of persons__________-_______________-_ Showers Cafeteria Otherfixtures ------------------------------------------------------__.................................................. ---- --- ------:---------------- 4; 0 -gallons ay. Total daily flow ---;��4------------------------gallons. Design Flow_____________________ W per person per d .........3 W YZI - - Diameter.... Depth.--------------- 1:4 Septic Tank-�Liquid capacity -gallons Length________________ Width---------------- Di, Disposal Trench—No..................... Width---------�74-_ t._,t en th... ............... Total leaching area....................sq. f t. L)eDC�op ow�in e ... See a e Pit N( Diameter :)ept' ow in e .................... p 9 )..........I--------- 10-�)------ dotal leaching area__Jd._;�,_�. ft.. Z Other Distribution box Dosing tank 12, Percolation Test Results Performed by--------------------------------- --------------------------------- Date_____________-________._-__________-__.- Test Pit No. 1................minutes per:inch Depth of Test Pit.................... Depth to ground water_-_____--___________-.-. LL, Test Pit No. 2-----------.-_minutes per inch Depth of Test Pit_..____.____________ Depth to ground water.............•---------- fyi -------------------e. .1----------------------------- .. ................. . ............................................................................ 0 ......�W. ./ r� ........ --- Description of Soil-_------------------------ -------------------------------- ------------------------------------------- U .............................................................................V..................................................................................... --------------------------------- ------------------------------------------I------- ----------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable--------------------------------------------------------------------- .......................... ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------:......... Agreement: The undersigned agrees to install the e 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. .......................... • ��!Da e SiS fini ApplicationApproved By----- - ..................... --------------------------------------- ------------------- Date Application Disapproved for the following reasons: ..................................................•......................................... .........................................................................................................----------------------------------------------------------------------------------------------- Date Permit No. = ................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 0 F.. jult.fz. ............................. k-pWrtifirattr of Tompliaurr THIS IS.TO CERTIF-Y, That thee Individual -Sewage Disposal System constructed (A-'J"or Repaired -_------------------ .............................................................. ... by.............. .....................:d::nweK ...... Installer att ---11J---------- ...... ------ ............ e. has been installed in accordar' e with the provisions Of Article X1 of The State Sanitary Code as described in,the application for Disposal Works Construction Permit No-____ c Z................_ dated.___ 1, _`7-u-3................4-- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED ASA GUARANTEE THAT THE SYSTEM W LL UN TION SATISFACTORY. DATE------- ... ..................................... Inspector..............�-------_--- --------- ......................... THE COMMONWEALTH OF MASSACHUSETTS'. BOARD OF HEALTH Ot-n................OF.��_ ......................... ........ FEE---. 2................ 43hipaga1 Marks TIonstrurtion Errant Permission is hereby granted--- 4-e ...... ............................................. to Construct or. Repair an Individual Sewage,Disposal-System-,Cie at No--- ............... ....................... ....................... ..................................7 -)Street as shown,on the application for Disposal Works Construction it Dated__�,/_ /// ---------------- ....--------------........... DATE......................... Board of'*HeAltli . ................................................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS