The URL can be used to link to this page

Home My WebLink About0031 MERIDETH WAY - Health (2) �� i �r�� ,� --- 1�� J � � ._� �- IL N . VV -//.1... •- Flls.:. ................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH :O&A.-i-c----------------------OF�r9�'i�u51.- ' , ' ------------..............................•. -� 1, ationfor Did viia1 Workii Towitrurtion Prrutit 1 J Applica is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal Syst ............. °N /e .......................................�ln: Location-Address or Lot No. Owner / Address Installer Address dType of Building Size Lot_/6.,._940.......Sq. feet U Dwelling—No. of Bedrooms.............._........................Expansion Attic K,49j Garbage Grinder (•;/)5 '4 Other—Type T e of Building p� yp W-_C h_..._.____ No. of persons_..a3___________________ Showers ( ) — Cafeteria Q' Other fixtures ....7:............................................................................................................ W Design Flow...................................5- allons per person per day. Total daily flow............... ..................gallons. WSeptic Tank—Liquid capacit/,.c4.�.O..gallons Length------- Width------"------- Diameter---."---------- Depth....._--_•_-_-. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area------ ft. Seepage Pit No....__._--,�-------- Diameter...._?_.......... Depth below inlet................ Total leaching area...,9_0/! sq. ft. Z Other Distribution box (1 ) Dosing tank ( ) '"' Percolation Test Results Performed by........9/--o9ti...........°.... ............................... Date_�f_:___a :=.7 .......... „a Test Pit No. 1_.___•/__-.__.minutes per inch Depth of Test Pit....! ........... Depth to ground water..N 9............. f0 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-.____-_-__--_____--__-. 9 --------•-------------------------------------------------------------•---•••....._.........__-••-----..._..._..--------...------••----.....-----------_---- Descriptionof Soil --- -- SLJ/- ---------------------------------------------------------------------------------------------- V ...._......•--•-•--•-•----•-•_.....�-�•------_---_- ,r •�t3_�r�----------------------------------------------------------------------•------------------------------ W ------------------------- ----------------------------------- ---------------------------•-------------------------------------------------------------------------------------------------------------- UNature 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;11`,T E 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 Ord of health. i Date Application Approved By...... ---• --- .---•. ----------•-----------•• -•- - ................. Date Application Disapproved for the following reasons:.........=...................................................................................................... •--•-------------•--._._....-•------------------------•-•--•----------•-------•----------•---•••--••-•-•--------••-•----•------•--•----------.--------------------------------------------------------- Date PermitNo......................................................... Issued....................................................... Date No.......... ....::..... FRs.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH '"�J�`cSt iv-.. ............ ---------------------------------------------- Appliration for Ui4pna1 10orkii Tongtrnrtinn rantit Application is hereby made for a Permit to Construct ( 4-lor Repair ( ) an Individual Sewage Disposal System at: / ,.ys� y e ,q .........1 -�.�._'_'_'t.��G(Cs ....:<G'l"#1 ......../�/ '-` r.►!cG'.,�'. .'•----"��-'-'="-'--:c.� '.. ....----- •- Location-Address or Lot N Owner Address Wflr� A��"O .96!etiv7' �Sye • '�.! F'..y,� _4' Installer Address d Type of Building Size Lot__ 940--_____Sq. feet U Dwelling—No. of Bedrooms________________ _Expansion Attic (ICA j Garbage Grinder (AW p 1 Other—Type of Building .......... No. of persons-...-S................... Showers (a) — Cafeteria (: ) fW Other fixtures _•- •------------------------ . WDesign Flow____.___.'_____.____..______.____S� allons per person per day.jotal daily flow______________�_d.................gallons. WSeptic Tank—Liquid capacity _gallons Length......."....... Width.......'."....... Diameter-_------------ Depth......_`........ x Disposal Trench—No_ _............._____ Width.................... Total Length.................... Total leaching area...... : ft. Seepage Pit No-_.__-__"-.�-:___.__ Diameter______ __--�_-_-_ Depth below inlet.....A........... Total leaching area....A24-:Aq. ft. z Other Distribution box (/) Dosing tank ( ) Percolation Test Results Performed by..___.44?9ti...... ^4-0'________________________________ ....... aTest Pit No. I....../______-minutes per inch Depth of Test Pit....A .......... Depth,to ground water_. F_+.............. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ x O Description of Soil C .q!• -- >vB.SI�-----•----------------------------- ----------------------------------------------------------- -- - ------------------ W -- ----- - - V Nature of Repairs or, Alterations Answer when applicable.............................._..._____.....__._.___....___.._._._.__...__....___._________._. t Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of LI`:p 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 bgard of health. V Date Application Approved BY . .: �'` - ............... Date Application Disapproved for the following reasons-....................---------------•--------------------------------------------•-------------------......_..--- ................................................--------------------------•----------------------------------------------------------------------------------------------------------------------------- Date PermitNo...............................-=-••----------------•------- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT 0 F............ ...............!.:..... .. ...I.......... �rr#if iratr of fauntpliFanrr TH4 I TO R MY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) bY- ` .. '•. au --------------------------- ------------ ae ` eV ! has been installed in accorda� e with the provisions of T j o The State Sanita�,�'s&sC cri ed. in the application for Disposal W9"rks Construction Permit No __._ _______/I(�________________ dated_. ^Wit.-rjd_ _ ...... THE ISSUANCE OFF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT<THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..............................................................dam ` ��. Inspector_....._._.....----•-•.----------e -`--A ....................... THE COMMONWEALTH OF MASSACHUSETTSs 1 BOARD OR HEAL ... ...... ..... GG ...........OF........... e-� .:/ ...... .......`................ No._._..--- -• FEE. .. 1 nrk 01 ndila , rrnti# . Permission }s ereby granted ----- ---•... ......... to Construct l ) or p ( an I duall�ewag > osal em at No.- �." o - . `....... Street as shown on the application for Di posal;Works Construction it No __ ...1___ Dated.__ _ '*-+�. ."�./_._.... IJ fir= •-•....... .......................... h oar of He th DATE-----------------------Zwol ..._/....-----•---------•--•-- 1 FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS - �1�.sr�� c�n�t✓�-t - '-� ��er�o�vr, '� � ✓'�'l��/�� r+ �/r� � LAO 6,AM-aXN-!F L�IZI i.fta�J� �a/O ¢• CJ r� vat ul-� I~LCAAw : 1Io W y� �o �, �� •`�' U44r--- t ooca <5:4,L.. 9e. 7 SP -AL uSG loco GA.t._. tCv -t 'OIL `A;) TOTAL 'c7ESIGta 4SS raTA� JAIL-ter r--Lr>w = 3W 6.W. =`It�OON cv4 714W PEf2GDLQTIO� C?_l�TE `��tt,! Ztlr.) Otz. tfs 1).bow each To? Pwo t c>o.c �. 1 I voo Iuv V 'box 9c,'}m Sepric tNV. "f-A�lK 10 IQop 1I6.8 tsv. 4►r►'gy. ;. GAL. 96.0 �. X444D WAS,.IED - Lo(JATIO" GENAT&.g VtLL— S /Z uo GC.ALt' 40 FT AT� 3,1Z��P�I �� Lt/ATi�T 1, G G tz T t p,( 'i t-(A l- T 14 t� F 0 0 1-41A F'I OM5 t� Ow N Pt_ t`E t.!C ti4ZjZt7zot,1 -c. kkPLVS W inA tw;z: StOe.Lt► E-- L A1.jD C;A'rC r• r- l 6A-AT ccZ R[GISt�- c.D �•NG SU2v'c.`f�L=� ' T't- 1-5 t7t.._A" l5 'JOT �A�,CC7 v� 1 Ate! o5?Ef'vtt..lG o /�rCASy" ItJ�(iv?:J:✓�t:tJi ��c)C:�/t��{ TI{(� UFt�;e=t"�. 511GW1.D ItPPL.tC-Aa-�I-r