The URL can be used to link to this page

Home My WebLink About0583 LUMBERT MILL ROAD - Health (2) �93 1 �1�- 102-- - e 0 ............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH N4 2 0 F............................................17---f ... Appliration for Disposal Works Tonstrurtion thrmit % Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal stem at: . ........ ...... ............................................................ Lo ation-.A-Address r No ................................ ......... ........... . . . ........ Address -------------------- . .........dneV.d .....................�d__d_r,e,,s_s-------------.........*......... Instal Pq vType of Building size Lot../AX ��Sq. feet Dwelling—No. of Bedrooms.__................................Expansion Attic Garbage Grinder Other—Type of Building ......................m..... No. of persons............................ Showers Cafeteria P4Other............................................gallons fixtures ... ........M........................................................... .- ...................... -----------Design Flow - per person per day. Total daily flow-----m W Septic Tank—Liquid capacity- .. .........gallons. ....*/I.IrO..gallons Length________________ Width__.............. Diameter__.____-___-.___.. Depth...._........... 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._../p / /._.. Test Pit No. I minutes per inch Depth of Test Pit.................... Depth to ground water.- 55----- 4- 16— Test Pit No. 2 minutes per inch Depth of Test Pit-----......... Depth to ground water-2tv 4* ..................... ....................................................................................M.............M........................................................ 0 Description of Soil.................m............................. ................................................................................. ...r............................................M...............................M................. U ----------------M------------------ ------ -------------M................... ..........................Mm.........................M-M-MM--mm.............................................................................. U Nature of Repairs or Alterations—Answer when applicable........ ----------------_----M................ ------M_m....................... ....................M.................... ..........................M..................................................................M..................................................MM...... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TAI TJ IZj 5 of the State Sanitary Code—The undersigned further agrees not to place the system in OPIC tiff of nce has been issued by the board of health. Gil Ap ic! Signed----.................. ... ...... ......... .. .. n L�pprove .... IS7* By...... ..... . ...... ............................................. ........a....M. Date of B ny ...... Application Disapproved for the Vlowing reasons:.................................................M................M------M.................................... ..............................................................................M..............................................M......M-M............................M.............M-M.................. Date Permit No........V .................... Issued.......... .................. Date No....................... FEE............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........OF............................................_...... ...... Appliration for Disposal Works Tomitrurtion rantit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ............ .... catio - dress or Lot No ............................... ..................................... "a Address 4 ..................................................................... - ---------d'• Ita 'r Address Type of Building Size Lot../n./FeXe�5.Sq. feet U Dwelling—No. of Bedrooms....... .._j------_----------_-------Expansion Attic Garbage Grinder ( ) P4 Other—Type of Building ............................ No. of,persons_-_.-_-__-__-____._-_______ Showers Cafeteria ( ) Other fixtures ---------------------------- ------------------*-------*---------------------------------------------------------------------------------------Design Flow............................................gallons per person per day. Total daily flow................ 0..........gallons. 9 Septic Tank—Liquid capacity--,&-Ogallons Length................ Width---____________- Diameter__._____-___-_.. Depth.............__. Disposal Trench—No..................... Width..._................ Total Length..................._ Total leaching area..........--........sq. f t. Seepage Pit No_____________________ Diameter--____-_-:__.__..._. Depth below inlet.................... Total leaching area..................sq. f t. Z Other Distribution box ( ) Dosing tank Percolation Test Results Performed by___...... 0 --4 )_�------------------------- Date......./ � Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.... fZq Test Pit No. 2--- Pelinutes per inch Depth of Test Pit.................... Depth to ground water.._ " ........................................................................................................................................................ 0 Description of Soil............................................................................ �4 -----------------------------------------------------------*------------------------------ ........................................................................................ U .......................................................... W �4 ........................................................................................................................................................... ............................................ 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 T I'I IE 5 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......................... .. . ...... ...... . ........./� .. 44 Date ApplicationApproved By........................... .... ............ ...... ...... ........................ .......... Date Application Disapproved for the followin reasons:................................................................................................................ ......................................................................................................................................................................................................... Date Permit No.............e ....................... IssuedL.............. ------------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................0 F.................................................I.................................. (9rdifiratr of Tompliatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by......... r/0--,V................................................................................................ Installer Z' ............................................................................)- at has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.____T._�- ------[.4. ......... dated-.�/ ;.- ...................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GU TEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...................... ---------------- Inspector........ ... ... ... ------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No... ..........................................OF.................................................................................... SIP Roposal Workii Tonotnuton "pautit Permissionis hereby granted------------------............................................................................................................................ to Construct ( or Repair an Individual Sewa sposal System at No.- Ar..V......... r+ 0 ...........................ctm.Vaj..e................................................... Street as shown on the application for Disposal Works Construction Permit No Dated--____ ---------- -o.(-,,-o f Health DATE................................................................................ FORM 1255 A. M. SULKIN, INC., BOSTON I�.'.1 f s t • \ #.AS qy.4 a - - I I "fit yq 1"" _g Xr .'s f .e, ),✓^L. f. �.F L f.A(lr a 5. .bid .P. ,$ `� f� (J :II r ..'a^t t A-- LU! i �� U✓,r✓ 1. s .a- � .. �/N.a ' "i� j r �,i r a''- EGA J, r.: '' A , d f S 4 ti r; b.` I , t �/y'{S'I't Y`1X� '",, rl s ek ak / _ " , ri i,j� I. .(�I—(I�0�0 L II ,�/It v,,;,,-.F,Ii r !:t^' a li;II l , s s l +1 :i y YT, # 1 4A '!`i.i YI' 1'4 n 1 'r 4� t1'a't.1 ii fV. �...�1 y a Y Y:: ( ' / S b K 4 ,1 �..,,r t'� � ,,/,' . G�=S i j 4 ♦ - �£ "# N - I , F / r 7? \UI , A f / rj t fi� ` ..-p.,,e w�'—:.....-m��.I.l-,�r.�.,,I.,I I II.I m I,1wI1I1�.��:.1.%.�I.I..,l�1 I,-,.:�.I��-w—��I�.�.X.-I�II..�I,:_..;1 1..�,�..:...�,�.,�.I,.:II'1.I:-/I-.,.,-.-�,.,-..a.,..I,I,,,,--,-5:I,rI�._�-.....,.I+,1-I 1.,I.I-""1�I�,I...I.,1.I.I,-.-1��I�,.:..-��..,14�m.I-I,��?I�..,.—�-../.-.I1_I,'��f��1�-�.Ij�....,II,�,,-o.��;1�.'. ,O1,4�-1*(..1�t:��:,1�",.,0,,,---,"I;-'1�-,�.�,'�'-,-"--��-I'- �,,.':,..�.�I,,oI,I,.�,.-��*.,.�..,1;,I-.�,;",.-.I.,1.�.,�-�.,.�,,...,,,1..1-,'-::,...,�-��,.x;�t,,;I.,I".,.,,-;�I1,,I II...1...,,;.;"i.�f.:�.:�-,-.I,I-.,/'I,�-:.I,:I�...�-,-�-�.:,I.I,_.-.,,I,.,'.I.� J '"y t" to ; 1 I 14' + f 4 5 Ys Ly,• f ram.i ''# t ' ` ti rye .-,j ,'�d �10 /.. `! II .V ' 1n /' l 3* a r yr•;L rD3' r: t x+ ; t� '4 ' � .F r1T Y "I ! f' - ar-,,,,�rcw ra "r_*i I ! ' A L.;_ s ' x yhl ' s l 4 u� - ��vP?'1f.'II�--�,IN�r,"V"-fi91'�X��l�I.��,11;I',A�iIIa�,.I.-.IIi!r�;l4�1f�1ll,!.-,,1.-�,zL1 I—i�r,--2-�t,,',IQI-4�'t I.�,,;'I,6I1(1 I,g--1 .11 1. I. G i 9 s a- .5,. „ s-{ k sit/^, '-"/ GUG 4. * J'. IA`- „r#/Ir t./. - .. r t '' �J .� a 2. A:- /`1 Lam!`,9jT ' }..a ' . K . Pof 7# y '� n^ S2 �, :mot -79I' ';,l I �+A �':t k `. t w' cX >a x k s s r 1`'`r - t 21,. \,< /� _�- /� I St a ok/' I 0 / Yf x�;.s *s- ,' o, . r1 !00` l .DEAF i .�p 1 t_' a 9. t M 11 .� t <+t s r t y N c) a �l I w Y s ,.is }�f yta ,4t 1 7L t t �'.i I _ a r i `�1 P 4t '� f,w 'W` Ms"�ry.j d E' , r II,w, .t ` /�J Vn r ' /'�� \.`� ,�4 . .. aF :t `v i /O #' (fly "J Nry�lZ �. .y\\9 \� .j f. d z �( day 4 ,Y, 7""� ` `� T $ �1 rl vn ,� •s�"^a, u.-'i` t r t. c a 5 t . yt r C ,� f - g - s ,: f f / r••5�, lr o?# o�kr'.kzt i.tr a -1 ? �� ,,, y .tr 2. s 6 ° S r Y. e l�;c fi� r�'. 3- . - t'. 4(�1 a A•s "� �� f }Y t }, r -e- t r xr � 4h YV�, . �N Cr f:H- pU{t �� ;ter z V I?" ..,Im4RL 1 V"v �� ASS lull-"fit Y "P ., 'o 4'..`.r,fl '..}'S'C i• i�' 'G/ \ 9 1 p �. ,� ��' _ 'i I 5 '' L' E�� .9v 'jyt"`S €, LX r^r y+ a '�"k; .'-il�r q-s:'y KY c a ran a ri i ', r - .V� ��.BE ,� 'V� ,,,+y�� ;�. 4a �4 1. i & 31 Q �Q , ter S s j F. } t .1 �F to P t4/� .: ♦ 5- Ti, r iC�( � �� x. ar-{'.` '�' �'�7, �c s. 3rga rr ka 4) ' a r r ItiNF O -" "s9 3 :: T '•`� y.C* d %1 5 ry` �?3 Y k L1 "�',.\. '� 1 t, ,,` •r F t.. ~ I0J51 O �a 4 '{Ut L i q - ✓ '��3"X r F'""1. 4 AP_xI�3� H rC,� ,• wS _V�'�.7" , ')6� } �` rA G1C// �(I' (k i,J �6Li)F�i LI,.2}7`' rrf , LLB_ s ; , M V' x `Pp fiGIST ' -' c " ' , ate. s (' 'IFS �N�\, .- , t ' + ,yr ay < // s SIONAI c� 41t`a rkY i:Yti � x -'4 z5 g �t k "a,i a :_4-.�T,. ! r'. ,€„� b _ :9•\ ,5 A�' �,k: 3 ',.,:'` ,. ,rt .d "Yr„ /tgx- wa s 4;,a ri 'i`•_ r rr. { e - .` ,e# 6ssa,lJ 'd"'� ;-. -SF7 S `` .,. t P I 1111-y ,^ ,y.(t"tii `o- Sit i, - " ,r � ir,. ��Y LEGEiV.D " I '' "rye , 4'� j � '" - CE'RT•IFIED PLOT FLAN z EXI�TINa gPD'i' ELEVATION - A� 7 �� .2, � �,¢'� ,.;L�*g ma's , 9 XISTtNC CONTOUR- ® _ 4 -- ' �,sa. ,FIN �>F /. ,, Lo'T 8" �rJn-rr3 r r Mac �� , y W, IS:HED�\■ 'S�:POT E1L'I VA'�IOtd ; � �v= % �Ky N � �N%,-�'✓/�� V �t}" 1-'i I N I S,H ei J -.^ /O�T O I R f F ® 1 ,e:-ts �. t ��I a�� , ! y�y� K r s{u §,r' ai.g r �.+ 1 ., + ti` 1t+ . ''-"""` ..�..• a._ `,} xAm-�..tk,�' 4�ft:ft'r, *" t t t a .'. a,. r A Y / r a , a N '�. . •i y #�s� y . 5 F APPROVEl'%O AR0` OFF HEALTH '` ° 4 ,�� < J; ` �; `T d F ,J � ! n k # 3-'`#x SF 'taxa:•r �� < , a k�i s ? l j 'yY' �' r+''F� t w e �S +""'s ,qq��3X''�;4'i a�''°s Fy.y �r ` tf`x + r y: _;t 4.�? 5 sx I � �bYk'S�4-�i'b � ''r cl3 w£a.�`t�t:" , N A '�c a t."+t .. n is 4 .✓/;b k - Ji f , ' _ I.r1& .- h z.#'AaENT�a' y � , � , SCAI.Et' � DATE I/� �° a ,e - t ' v •_', ,1k;, `£ -f•57 �V S^!'r"4 YG4�.,5t t, I., +' ? . ' C ;..z f. L�OA', ' �`F#�EAIGONE�RltG. CaI:l9V F 4 ` P .. 'tx T, =~ a°' .,, �:��. r —.r. , CLIENT ..._ •3� <, " " I. CERTIFY T.HA�T� THE .PROPOSED �yc '.Ei�1S'TIEp ` ` ;RESIST. ,� -, k;; �/(Jc�,x ` BUIL`DI.NG SHgY�N ON` :,THIS PLAN — K :I ;Y- � � . � ��... � s-, t:R,EDJ � � JOIN N0� € l „° 1 tQI•V:IU";I � �:r � I ANDf� � = °� ,;. �:� .:,{�,{r'. 4 CONF0t2MS: T® THE ZONING ;lgVfrS tz �' ,. n's'Ca -I" .c 3ss2t?;.' �. �.. .ky. iit i,��f S I.�r: rY'1'.:'* "!. a .:�, f ,,.. f .. �', NG"VEER'; ��`. :y DR AY ,".. a �<� OF ,r3rrR//4:7�+/f ,� MASS {°- .`+f'3r, r b,.�,• :•uc ;�. s .5a r .j_ t.pk.` 1 .er" _..M '""r x , Y,, ' + •F, - 1 .s; c,1, n '<.�'.g'3'.` .;�•p:± ��. � :e F4 � - ,: �F,�"'IL ,f � A'r;_ ;��' a a .t� : ?I ¢Mfq:I%N S TARE ET,,.�t CH .. - , I t,':} /p `,�, :3 �5 tj+�. ,�5.. 2. +"la ... 3.f s.. .YC =t t a.:Xi I �, � _ 'A' ,"- .,v�5u ft •f°car�' .' Fa•a'�^$ r 7 -;I ,„, �: x �, { s}rM+> 6': ;.t H'dY iIili,I"S h ..A Q.tG� .+? �" �.� "fity'�.4 '; r tip:.1 fit. :'ti - I#4 v�7 t .,, - �� , :�� > �,, , A Ed 'A 1p ' S R:VEYOR ' qq ,;eau+�v..'rL #wfYt ,.,"`q �`i' 7-,s' 4 y�`3' ,#,pry• E' >ya'"' T 4 :+w�+4r,� r k e.• .� }: H F ,.,I 1i. Il �'� S EE 0 L r b�°-`'.a w"5`1. ` '� `t cY `Hpt�µi "._..,. r3•�Nl%1 fir" �,a�^ r`, 3�:?6 ;>~-'f Ni- r #f xa. t.I,.-'`,P,--II,-)�/l,i.� F ;,"I�,%I._,.I-1�-o,�,�.-I�/��,../, ° ' j �x'#� fr >3! r c lid{ F y a' ¢' o-..z,.> ., r r.-, . hs, 3 4 ® �� . ram . ul m b y \ 2. t 3 tj �� .lL 1 0 a •4 P • q aj •�'� a L�._ �'J ,0' - �. pU �y� � '�' ;.�; .44 O V ,a' e a a a a a. s s �1 R�•�•® f\ t � 7 • ® • m ® ® ft +`� ep1 h, Ithe " n t�t'' • • r r. • • ®: IN l9 ` $ • e ® � • • � a q �� ".'t�, to Vit As q 44 • ®• ® o a • • (� "T ram; Z'.1V (1�,,, � � 0. � '0 Q .® O®° ®a • �V®� t � ,� - y' vt� �ry� � `�`7t ylk o� b � ic *; �' 1V X. x ►s \0 SETiS t / Y tj .� o /. o .�, \ ��•7.•� :,Q. � �"' f �. __tL �C ,t��IV(�p� AA •L''� 'SDI . VaRj • ` V: `t. ;N o�� ,J ?batik u* tn < 4 ® wHEM, IN 1.5 - �b•' �tT.••a ,!O�.r-.�..1/' �.. r {�'t�; Oc