HomeMy WebLinkAbout0060 HITCHING POST LANE - Health (2) fca4l i9&pf C04
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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
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,+ 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