HomeMy WebLinkAbout0058 HENRY F LORING ROAD - Health 58 Henry F. Loring
Centerville`
A= 172-179
INISMEA D
No.53LOR
UPC 12543
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L'O. CATION SEWPI
E PERMIT NO.
.
VILLAGE ell
INSTA LLER'S Ti�
i ADDRESS
d�
e U I L D E R OR OWNER
,.e Z,i a�.Z 0,
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED L _ .�_7l
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0
4 ems'
No.0�.. Zr Fms... /.................��c
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
..................... . .. ........OF.......I..................---...................................... ................
Apptiration for Bh4patial Workii Tundrurtinn tbrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System a
... .. - -• ----- . .......................•-•-•----•-------•••• ------------•------•..__......---------•-
L tion-,Addres or Lot No.
....... •••-••--•----•••-- ....... .... ..... . ...................••---•-----•--• .......... ------•...
r -ddress-
w a ..........
....-
-•-• •---•- ---_.....--••--• • ••--.•---- �.....------•-----....2-•---•••-_...._ . 1 ........................ ..........
Installer Address q
d Type of Building Size Lot_.2.J--.`-_Z,3...Sq. feet
U Dwelling LNo. of Bedrooms___ ______________________ __ Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building .... No. of persons............................ Showers — Cafeteria
a' Other fixtures __________________________________
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity------------gallons 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 ( )
Percolation Test Results Performed bY........................................................................... Date......................................
1
a Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................
114 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.___•-__-__-____--_____.
0 P4 ---------- ---- ----------------
Description of Soil-- �G ?` ---• .........................................................................................................
x _
UW ------ --------- -- ----------------------
Nature,of epairs o Alterati s— swe when applicable__
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of I i "
p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been i s ed by the b ar o health.
� i ed_ _ `
D to
Application Approved By............ . ••. •••••• . .. .......... ••••. ...... `_`_5 ...7.19
Date
Application Disapproved for the following reasons:..............................................................................................................
---•-------••---•••----•-----•••••---•••................••-----•-••-•••••--•--••••----.......••-•-••---••-•••-•-•-•••••-•-•--••••---•-•••••-•...--•------••-•••••••••-•---------•---••••---•---••--•---
f Date
Permit No......................................................... Issued-._1_�_^.._`�^�
Date
NO.. > / + Fins... ,'>.............. .. �
THE COMMONWEALTH OF MASSACHUSETTS •
BOARD OF HEALTH
............ .. ...... ...............OF.......................................
ApplirFation for Dh4paii al lVorkii Towitrurtt in Vvermit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at
• ............
...: .. ... .........re!._.. •--•-•....-•-........••--...-or Lot No.......•-^..............:........_...._..
L tion- ddreess
. C.................................... ........... .. ... ............
W . w er ddress fr
PQ Installer Address
.i__ _.-Type of Building Size Lot. ......-- ..Sq. feet
Dwelling L°'No. of Bedrooms.... .....................................Expansion Attic ( ) Garbage Grinder ( )
`k e of Building Pk Other—T yp g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
Other fixtures
-------------------------------------
-
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity............gallons Length................ Width---------------- Diameter---.------------ Depth................
Disposal Trench—No. ................
x .... Width.................. Total Length.:._-_:_,..__.__..._ Total leaching area.................... ft.
..,
� Seepage Pit No--------------------- Diameter-_-__..--_-------- Deptl?_below-inlet................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing-tank ( )
0-4 Percolation Test Results Performed bY------------------------------------------------------------------------- Date
a
Test Pit No. 1-----------------minutes per inch Depth of Test Pit.................... Depth to ground water........_-----.-------.-
w Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...................--...
fyi --- 't
O Description of Soil....,,"" _ __ ._ �......... . . ... .
U ••••-•••-•••-•-•••••--••---••----•-•..................••---•---•-•••••--••-••-•--••••••--•--•••-•--••--••••-------•••••-•••-----•-•••--•--•----•------•••-•...........................................
W -- - --- ----- ------ ---1
U Nature,o epal.�?oAlteratic s— swe when applicable.. ............. - CIT -.--.:--:
----------------------------------------------------------------------------------------------- - ----••-
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of i1:'L ;
p 5 of the State Sanitary Code—..The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been i s ed by he bg,4rd iealth.
edY ,j ------••-• •...• ••••. •-----..
Application Approved By............• •---•- ...... .
Date
Application Disapproved for the following reasons-----------------------------------•••--- ----------------------------------------------------------------------
---------------------------------•---•--------------------------•-----------------------•••••••----•••••---••-:-•••---•••-------•••----••-------••••-•------••••-••-•---••-••••-----•-----••--•L--------
`.yti Date
PermitNo......................................................... Issued_----------...------------..........--•--•--•-----•-----
" Date
THE COMMONWEALTH OF MASSACHUSETTSI
BOARD O HEALT `
......... ..... �........OF......... ... ................... .................................................
THIS I T G RTIF T e d Ji ual Sewa e Dis Disposal S-stem constructed kr lReaifred
g P �'
has been installed in accordance with the provisions of T 1 E j o -T e S e Sanitary Code as e cribed,' the
application for Disposal Works Construction Permit No _ _...._1`�.7 __._-....-. dated_`'... ...... ...._..".-... - ----....
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY
�nr Rr��.�;�r•A3��".": �'S'r'y.`"��f'•F*a, ty.�• 4r`k'^{KG S 4< ,.s.
Inspector
THE COMMONWEALTH OF MASSACHUSETTS
BOARD/dbF �T
..... L.........OF. V 4b
�'7 --•--......--••- •-••••..........................
No...:................1. _... FEE.._ ..
t ergoal n
Permission hereby grante = ----•••--
to Construct ) o Repair ( an Individua SevtT isposal S �'em
atNo...f 1 ..•••.-- s -------- ------ ................................
tre - -• �•�, ,,
as shown on the application for Disposal Works Construction Per it o..._.... -__r. at ci....-lf �!.41. ..
I
DATE.... -•
_ ••• ��yy� He e� -- --•-?.......................................... Board of alth
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS — -
THE COMMONWEALTH OF MASSACHUSETTS
BOARD I` F HEALTH
� iJ,r?��J .._..........OF...... .:......��. . .. G - ..._............-----
c ''�'`` ration fnr �ts�u�at Worko Tonstrurtion Vrrtnit
Application is hereby`made fora Per,rnit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
Sy. at
— �-
. ...... .... ..
.....--
cation ddress orZ"6[^�PYo.
•-- --- � ..-- •---._: ..... .----•------•-•-•-•... �-�- .......----
..-•-
ner Address
a .... - ------.. ......... ---------••-- .............. ....1�- °----------------------------------------------
Installer Address
Type of Building Size Lot.......!, >t ............Sq. feet
Dwelling—No. of Bedrooms..--_�--------------•._.----_-_---.--.Expansion Attic Garbage Grinder (�1�
aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( )
Q' Other fixture
W Design Flow__-_•___-__...�'.�..................gallons per person per day. Total daily flow-----�..�..0-.--_---_---.-..-_-_-gallons.
WSeptic Tank—Liquid capacity, allons Length________________ Width.------ -------- Diameter................ Depth......_._...._.
x Disposal Trench No. .. e ___ Width----------- ----- Total Length.................. Total leaching area--------------.-----sq. ft.
Seepage Pit No._t_ _ Diame�f-et'�_•_s_�_•_�_-._ epth below let... ..... ...... Tot leaching area.._....._.________sq. it.
Z Other Distribution box ( ) Dosi tan ( ) / ' �G
Percolation Test Results Performed by- G� = -------- Date....11 � �------
Test Pit No. 1____ -.---minutes per inch Depth of T st Pit-------------------- Depth to ground water....-.--.----..-_.--__.
rZ4 Test Pit No. 2---_____________minutes per inch Depth of Test Pit-------------------- Depth to ground water--.-..-------._.---...__
a = ,
- - -4-
--.
-------
-------- --_--------- r------ aDescription of Soil...__-- - �" -----
J
xV ----------------------------------------------------------------------------------------------------
W
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 \I of the State Sanitary Code— The undersigned fu ther agrees not to place the system in
operation until a Certificate of Compliance has been issued by of alt�� - -�----
P g y — .
il� �. � Date
Application Approved By----- 1 ------------------------ .....
Date
Application Disapproved for the following reasons:................
------•-,--............................................................... .......------.
----------------------------------------------------------•---------•--••------------•••-•••--•----------•------------•--•....------•-------------•---------....-..------------- ----------------
- �� ® �pp, Date
Permit No. Issued ------ -- --- --- ---•--
Date
THE FOLLOWING
IS/ARE THE BEST
IMAGES FROM POOR
QUALITY ORIGINALS)
I M ^C&L
DATA
70c
7
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
........ c..._. ...... .
Appliratinn -fur Ui!pwittl Works C vastrurtion Vamit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:_--,
--------------------------------------------------------------------••------..------ ..._ .........................
—Location-Address / `or Lot No. ,
Owner
W / Address
r ,
—�'mac.-•E_( .. .................................................a'
Installer Address
Type of Building Size Lot--.-:-- -:_--.--_.-Sq. feet
Dwelling—No. of Bedrooms..._.__T----------------------------------Expansion Attic ( )r; Garbage Grinder
per, Other—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( )
0.1 Other fixtures -----------------------------------------------------------------------------------------------------------------d
W Design Flow............................................gallons per person per day. Total daily flow----- �.._'_-_. ..._..............._...gallons.
Ix Septic Tank—Liquid capacitv_'�'__:_-_gallons Length----------_--- Width.----_.-__---- Diameter........-_-.___ Depth.__.__-_-..._-.
Disposal Trench—No------------ ------- Width.................... Total Length-------------------- Total leaching area...............-----sq. ft.
Seepage Pit No.-f---_X...:yr_ Diameter`...:...._ r_t___{•Depth below inlet;_ ....... . Total leaching area_-_______.__-_-sq. ft.
z Other Distribution box ( ) Dosing tank ( ) O iJ ��/�
Percolation Test Results y Performed by.__S-,c �__;.�!_�z, _�__....�t:. ------- Date----/1L.- .5_-_77---__.-_..
Test Pit No. L___- -____minutes per inch Depth of Test Pit._...__. ----------- Depth to ground water________________________
fl, Test Pit No. 2................minutes per inch Depth of Test Pit._--_-..---__-_-__-- Depth to ground water--.-.--.._-__---_-_..._.
a' - ----------------------------------------�,f........................... -------•-- -•---------
Description of Soil..--`"--------------- t��S t..• y r _.. 2 - 7 �` �!'. ( , ul
U _ / y
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 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.
;,Signed--- t....'........................-• - _ *Z--r'
- ---- ------------------- --------------------------------
�� Date
Application Approved BY ... •,x � _ ....................... ...... = 7-7 ...__..
Date
Application Disapproved for the following reasons:.-•---------__-.------ ---•-•-••---•----•---------------•---••-----.._...-•-------•----........----------•-.
---------•-•----•--.-----•------------•--------------•-------------.-----•-----------•-------------------------------------•---------------•--------------------------------------•---------------.-•---
Date
PermitNo......................................................... Issued........................................................
Date `
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF........... ! A...............................................
Trrtifiratr of 0,11mphaurr
THIS IS TO CERTIFYy`That the Individual Sewage Disposal System constructed ( or Repaired ( )
by / ------� �! �=� ---- .. _ ---------•----------- --•----------- ... -----------------------
r ;=
n Installer /4
at..... .... 1 =- ..................................... l `l.•. :z- ti .....
has been installed in accordance with the provisions of Artic e-)XI of The State:unitary Code as described in the
application for Disposal Works-Construction Permit No....... -------_-_7 ~_----------- dated'.... �.'..7.. ...............
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY. /
DATE •!L....s ty ------•-•------------------------- Inspector.......A '
= ------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF) HEALTH
7 - i /..... '1.....OF..........�� .1u�t:.................................................
FEE----•------.............
�i� >att1 ork,fil ��trti�atrrmit
Permission is hereby granted-_ __-__ - -.---_-__./_..C .1�f' ''L-
to Construct ( ) or Repair ( ) an Individual Sewage Disposals System
%' ! r� s/ v ..k;,4t 4" , =� . i,_�:f G-4 / "/tr// l__lc-Z./----------------------
at No.-i'} -=•......._ . -•--•-..--•-----..._....---
.......... .... i - y / lstreet___..._._
as shown on the application for Disposal Works Construction Permit No----___----,._-_-__._- Dated---. :_' �
' �
�jS�GL�rr/ �/ i%l�[�l/lij Cf
...--•---... •. ......� -- of - --•--=--•...................••...............
Board of Health/
DATE................................................................................ i
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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L0•CATION SEWAGE PERMIT NO.
VILLAGE
INSTA LLER'S NAME & ADDRESS
B U I L D E R OR OWNER
�L,Y ✓r.36 -"�i�Tfk-vie✓_-•�- /Jl�•
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED '12_20177
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