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Home My WebLink About0110 JAMES OTIS ROAD - Health (2) �� Ja m es ma's Rd., c�r►-�. f No..... - FEs...........5. ...... t THE COMMONWEALTH OF MASSACHUSETTS BOARD F H,FALTH I .........OF...... .. ........................_... Appliration for 'Uhipaiittl Works Tonstrnrtiun Vvermit 1� Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal .••--- at: ..... ..... ............... _-•_---4 a5x.............................................................. Lo ati Address or Lot o .... .. O ner Add r ss itml6r ...................................... _...........-•- ...... . ... Installer Address Type of Building Size Lot_-__L Sq. feet U Dwelling—No. of Bedrooms._._.___..........................Expansion Attic /Iflf,7 Garbage Grinder (/_) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( Ao�O 04 Other fixtures ..............•--•---------....._...--------...•-•....._--•••--•••-••..... . -------- ----- ------------ W Design Flow____._ ' _____ ______.......gallons per person per day. Total daily flow............... ._____._ __gallons. WSeptic Tank—Liquid capacit gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—/No_ .................... Width___.___....._._._.. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No._.,45�:'J.r-.-8 Diameter.._............. Depth below inlet____________________ Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2..............._minutes per inch Depth of Test Pit.................... Depth to ground water........................ PG •--•--------------------••.....------------•--•-•-------•--..__..._.........._......._...••----_.............................................................. 0 Description of Soil........................................................................................................................................................................ W U -------------•--- ----------------------------------------------....--------------....,..._...----------...------------._...._..------------•-------------------------------------------•••-•-•.._..--•• x ----••••--------------------•----••••---•------••••---------...._..••••-•--••--••••••••••••-•---....---••-•••••••-•••----•-•••••--•-••-••••••••-•---•••••-••••••.•••-•-•---••••••-••-•••--•-•---••-••-•- U Nature of Repairs or Alterations—Answer when applicable---------------------------------_............................................................. -------------------------------------------•-------•-------•---.....-----._.._..--------....-•-•-•••••••--•-••-••:••••---•-•-••-•-•--•••--••••-••••••-••-••-••••••••-•••••-•-•-••--••._............--••• Agrees t: h undersigned agrees to install the aforedescribed Individual S age Disposal System in accordance with th pr -• io of iIT 5 of State Sanitary Code—The undersig d further agrees not to place the system in per on it a at Compliance has been ued by th_ 3ar of heat Signed..... .. ................. Date A H t Approve B -- l _w_ ........ _a..__.._ Date p ication Disapproved for the following reasons• ._._....••••--•-•--•-•-•-•••••-•-•••-•-•-•--•-•-••••-••----••----•••••••••••••••••••-•-••__--•••............... - -••---•-••••-•••••-•--.._......••••••••••--..__�•.f+.••..._..-_--•......... •....... ------------- --•----•-••------------------------- ••---- --------•----�-•-- ------------------------ Date Permit No. -�a__!.: .........................••--•-._...... Issued. V - d .::---...- Date No......................... FRis...............1)............ THE COMMONWEALTH OF MASSACHUSETTS .BOARD OF HEALTH Krj' I .... i6LC 77;v��t.........OF....... f..................................... . ................................ AVpfiration for Bhipasal Works Tomitrurtion ratuit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Di;posal ,,yslen,.at: -AX. en _0, �1� , .4e� e- ......................................................................... ....................... -------------------------------------------------------------------- Location-Address or Lot No .. 0 e...l .. e 0 ( ...- ....................... ................ . ..... . .............................. .................. ....... .... ..................................................... Owner Add?ss <Z ,.. ......... ...................................... ............... : _1-------------------------------------------- Installer Address Type of Building Size Lot......... feet Dwelling No. of Bedrooms......... .............................Expansion Attic Garbage Grinder (X PL4 Other—Type of Building -------------_------------- No. of persons............................ Showers Cafeteria ( �C, P4Other fixtures ......................... ............................................................................................................................. Design Flow_._._.. allons per person per day. Total daily flow.._.._.._....__ ............gall6l1s��`= ........... 04 Septic Tank—Liquid capacitbt"t?,O-.r.,,.,%.gallons Length................ Width__.............. Diameter........... Depthx................ Disposal Trench—No. ..................... Width.................... Total Length..................._ Total leaching area..' -, ............sq. ft. Seepage Pit No..__, Diameter....__..__..... Depth below inlet.................... Total leaching,a rea..................sq. f t. Z Other Distribution box Dosing tank Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit..._..............._ Depth to ground water.....................__. Test Pit No. 2................minutes per inch Depth of Test Pit..._..........._.._. Depth to ground water_._................._... .............................................................................................................................................................. 0 Description of Soil..........................................................I............................................................................................................... ....................................................................................................................................................................................................... ..................................................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable................................................................................................ ...................................................................................................................................................................................................... Agrees _7 t-I undersigned agrees to install the aforedescribed. Individual Stwvage Disposal System in accordance with th pr -i-to of=11T 5 of ..e State Sanitary Code—The undersigned further agrees not to place the system in per 'on Eil a, at Compliance has been issued by the-rdardlof health,. �ZSigned... 1'7 ....................................... .................... Date Approve By......................44� Appl* ti ....... ...... .. . ....................................... .......... p ication Disapproved for the following reasons........r........................................................ Date ....................................... Tr................................................................................................................................................................................................... ate Permit No. V.. ...4..............I....... issued.......... ....... .......... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH W. ..........OF............(9rdifiratr of Tonq1tiatta THIS IS TO RTIF That the Individual Sewage Disposal System constructed or Repaired by------------------_ :_.... ............................................ I tall 0 at.......................;e,�t -------- -_-----------4 .. . . ............................................ has been installed in accordance wer�_th: provisions of TITLE 5 of The State Sanitary Code as described in the R.'e4 application for Disposal WorksConstruction Permit No..___ .7.�...7.42.y..... dated- ..................................... %, , W" THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST UED AS A GUARANTEE THAT THE SYSTEM WILL F4NCTI9N SATISFACTORY. DATE-----......-••_ t ..--_--••---•--•...................• Inspector.....------... ... ......... ...................... THE COMMONWEALTH OF MASSACHUSETTS 'BOARD 0 HE ALTH EALTH ............ .....OF.......... .. .. .... . ................................................... No... FEE.....1.01............. Permission is hereby granted.......... ..................................................................................... to Construct (.) Repair ' ispo ys em )far ekair an Sewage D'_ Sal S t atNo............... efi..a.g............ __'n,........ .0�_Ielz..............4�.......... Z41.4............................. Street ;7 as shown on the application for Disp(;ia,Kvorks Construction Permit No W7 Dated-------------14.'JA:.............. ................................ ......... D TE...... t/:t PCIP04 ........................................ Board of Health FORM 1255 A. M. SULKIN, INC., BOSTON '�►+JG� FAMILY Na GACLsAGE GtZ1JO62 Fuow s 110730GPv. -1 � jEiPTIG TPNK = a3ox15o.'d =a9�G.Po f tJSE 100o GAL. '• tvoo GAL. 5 D�WAt.t. A2Cl► * go S.r .i3 ego 5.F .'L•5 315 G.PC SoTTOM ARMA S . l I 't; ,�0 5.F x i•G 5�o . cS.P o , PIT .;)Aar► m 177 ". ?OTAL 'PAIL-Y FLOW( = 33°GPI o r o N " P6siZGOLATtO1J RATE I I"IN 2MIN o�L-65S _ / • 0 \ 28 f � ' OF 5"5 8 PETER cJ,Q-12 SULLIVAN v� .IAFiO N (30 00 •` A. hlo. 257 33 J; r Q BAXTEA 114 To P Irma*G1, L4 54-5AVP ^� • loco INS• - s» DIST. INV. Gel.. `iZS s BVX SGDTIG Z I00O INS INV. P ,Z 52,4- !I � - 7 � 1� 3/n•IYL E i. WASI�GD _ 6TvN6 ' CEtz.-rtFt�t� pLoT PLAN PP-0PILr= LoG4�toN C,Iy,Lr't1rGZV14.L� �p.TE io-ri-a4 p L.A N IMF GRANGE •_ { G E aT 1�Y THAT '�N E 1-ov�1�T10!.1 5Ho�N -'�—•- r `N6R.6ow comp%` 6 VIITN'THEs SIo13L1NE �(' ; LUB A► o g 1r`t eIAGK R.6.Q U%P- 1✓NT'� o f= -t N� o'f* VN--OF I V2- '�TQP; ANv tS (�t1T P�Al, To2- /�1..d�J tA4L 'LOGATE.t� •WITNL TN6 F�..00D PLo►IN - ..DAT'L Myra ING. 1tom 6.iC6ti'4AIJO SuiGYi� Ix "Tu{S PL&W 15 MOM gngc3v cw AM os"rEiZVl�i.fr MASS• 'u5��tASW Su2V�Y "TNE nI=FSET'S 6ucUI,� /�1-AtJ No-r Mr- VSEOTO 0e-TI ?-it\I �� l. o•r 1- I NE�j APPLIGA►J'r