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HomeMy WebLinkAbout0060 HITCHING POST LANE - Health (2) fca4l i9&pf C04 az/d iAS No.....L_.�. .... y '` ' Y Fas. ....I. THE COMMONWEALTH OF MASSACHUSETTS '..I BOARD H LE:A'Y!-H", OF... . .. .. . .. ............ ApVtiratinn -fax Uiipuiitti Workii Towitrixrtion Vrrutit Application is hereby made for a Permit to Construct ( ?C) or Repair ( } an Individual Sewage Disposal -(,,,O System at: Hai1fe � �osr l :-- �y cation- d r -- /` or Lot No. - Owner Address w dog - RyeW- A 40 ,a --•-••--•--....................................... = ----'-••--•--•--••-- ----•--------------------•---•--•--••-.....-•-................ ......---••-............-•--•-•... Installer Address UType of Building Size Lot..... ------Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic (M9) Garbage Grinder (!C) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------- - - wDesign Flow.. ..t.................................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..fP.41.4>........ Diameter•___________________ Depth below i let.......__---.Total leaching area.-_-___.........sq. ft. z Other Distribution box ( ) Dosing tank ( ) -(��r�C / _ l b'- 7,Y aPercolation Test Results Performed by.......................................................................... Date........-•-•-----•---------•-•--.----- a Test Pit No. 1................minutes per inch Depth of "Pest Pit-------------------- Depth to ground water...-____--_--._..--__-_- t14 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water-_._...--_--_------_.--- Pi ------------ -_-Z--- f /--lr --•---------- O Description of Sol 9' --------- - -1 ----.-...` ... --�------ - - ---------------- -------------------- x -- - yam,f ._ w -----rod . _ v- Yam:... --------------------------------------- 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 further agrees not to place the system in operation until a Certificate of Compliance en issue by the board of h alth. _�U Signe . ..... .r... :. i _ ------------------ r,����s----- Date Application Approved By.... Application Disapproved for thfollowing reasons:------------------------------------�----.._._._._.......-•--:-------._.......----___ Date ---.............................................................`� , Date Permit No......................................................... rl �' Issued.`"--- ----=` j 1----7---------_--------- Date----------- ---- ---- -- - No..... .f...s...... Fas..//')................. THE COMMONWEALTH OF MASSACHUSETTS BOARD H EA r Li . _.f/... l...........OF......... ... ... ............... Appliratiun -fur M.ipuutt1 Works Tonntrurtion Vrrniit Application is hereby made for a Permit to Construct O or Repair ( ) an Individual Sewage Disposal System at: / Location-Ad r s or Lot No. ........................................... ........................... -- --- -••••-• .............................................................. Owne l Address ....................•....... ............� �? r •------ ......... ............................................. - ............................................ Installer Adddresres s U Type of Building Size Lot.....�.. 9..f...Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic (Mo) Garbage Grinder ( K) aOther —Type of Building ............................ No. of persons............................ Showers ( ) - Cafeteria ( ) dOther fixtures ..............................................................---•--.........................................••----.........----•.....-----......---- W Design Flow.-.--�d...............................gallons per person per day. Total daily flow.....•�o.^'�...._-_..._.._.........-.gallons. WSeptic Tank-L Liquid capacitv?'O -..gallons Length................ Width................ Diameter....-:...--..... Depth..-.........---. xDisposal Trench—No- -------------------- Width-------------------- Total Length.................... Total leaching-area---.-----.--_-_---sq. ft. Seepage Pit No..f�e2Q------- Diameter.................... Depth below i let............. .... Total leaching area...-.--_.....__--sq. ft. z Other Distribution box ( ) Dosing tank ( ) -• J -/C — / O _ / S'- 71— Percolation Test Results Performed bY-------------------------------------------------------------------------- Date.-•---•------------------------•-------- ,� Test Pit No. 1----------------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.........--............. W4 ----------------- = ............ ....-----•�.;--� .�...•----•......••-••-...... --- , ! ..^..... ODescri Description of So}1-.... -- ----------------- ...��/ --y--- ------------_-. . - • •• r-I.f ................................. W V Nature of Repairs or Alterations—Answer when applicable..............................................................................................-- ------------------------------------------------------------------------------------------w----------------------------------------------------------------------------------------- -------- ...... 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 lags'been issue by the board of health. Signed ✓ ,.(c(: %j !_z ... W I1� -l 7 s..� ... ----- Date 7�— Application Approved BY {�4- '`� ��.-5Da.te---------•---- Date Application Disapproved for the following reasons: "•----•-•----------------------------------•--------------------------...---•----- ,< ----------------------------•-----•---------•-------.---•------•-------.•.••-•---•-••--•------------••----.--••-•-••---•..------•--•--•---------------------..........._..--••--------.-----.•--•-.----- Date PermitNo......................................................... Issued...................... ................................. Date THE COMMONWEALTH OF MASSACHUSETTS, BOARD OF EALTH t)'.4/L ............OF...................... .....� -............: Qrrtifiratr of f1,umViiaurr THI IS TO fCC TIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by. .--- = "-- ..... ------- -------- at...� Js" I = .-a r�• •-••... ----- ------ -------------- has been installed in accordance with th/provisions of Art' e XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.... "_...._ �s".......... dated...r/..... .......ice's THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................................................................... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7........OF............ ... ........ . . . ..• -.................. � urk,� unntrnrttuat �rrmtt Permission s ereby gr nted u �a / \ ..... ----------------------------------------------------------------•---------------...... to Constr ct or R ) an In ' 'dtia Se ge Dispo a) Syst� No.M �=at - ------------------- --••-----------• ---- � Street� — as shown on the application for Disposal Works Construction Permit No.. .;_.._ .._/�ted__.._/,.'.�... �-:...._........ -� --• �� •---.....--••-._ DATE. Board of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS ;3 G v yl Lo-rO- 16 cfj cC � r C� r- - r ►--- r h y J•, F� s3 1 a ,+ FH ,AH%ILi1i11; CERTIFIED PLOT PLAN LOCATION Centerville , 1-lass. . . . . . . . . . . . . SCALE . .1 _30 . . . . DATE .3. JTOV .75 . } PLAN REFERENCE . . . . . . . . . . Court Plan //32851 "Old Stage Village" Thomas E. Kelley, S=3u eyor. Dec. 10,.19.7.1. . . . . . . I CERTIFY THAT THE . .Foundation SHOWN ON THIS PLAN IS LOCATED ON THE GROUND Daniel Brown Jr. Inc. AS SHOWN HEREON AND THAT IT CONFORMS TO 36 Quincy Avenue THE ZONING LAWS OF THE .-TOWN OF (East)Braintree bass . . . Rarnatab.l,e. • • • • • *H;fN CONSTRUCTED. 02184 DATE � .NOV PETITIONER : EG. . LAND S RVEYOR