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Home My WebLink About0396 NOTTINGHAM DRIVE - Health (2) 39 � IJo}t�r,cj�,arn fir . 1 CPO No.. / Fss... ®............... THE COMMONWEALTH ®fi MASSACHUSETTS BOAR® OF HEALTH � - I� I � ...-..oF.....�� ' /,1. .5.. 1 ��Z................. Appliratiun for Uiipuiial Workii Chun.5trnriiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ------------------- oc n-Address or Lot- o. fF .... ................. O /r a Address---------------------•--•-----------•-••-••--- -•-------•--•-••-•--••--. -•---------•-•-.....:.....---•---•-•-•---- Installer Address / -yd T e f Building Size Lot.Z-`�-,,- ......Sq. feet ,., Dwelling—No. of Bedrooms---- o...............................Expansion Attic ( ) Garbage Grinder (/0 '_4 Other—Type of Building No. of ersons____________________________ Show s'( ) Cafeteria ( ) (� Other g ----•----------•-•--••----- -...........................................-•---••-------------------....------•.......---••- Otherfixtures ......................................................... Design Flow...................�.e�...._......._..gallons per person per day. Total daily flow !•.c - gallons. Tank=Liquid capacity/42 gallons Length__ '_'. Width.V'./ u Diameter__y'6_�___. Depth. `. x Disposal-Trench ?vo- ______-- -_----- Width.................... Total Length.....................Total leaching area....................sq. ft. Seepage Pit No......../....... Diamete' _-- _�_-- Depth below inlet___.�t_ .... Total leaching area..vS sq. ft. Z Other Distribution box (oo) Dosing tank '� Percolation Test Results Performed by.._.. �d_-•_•,lye? --. ,-7 .. --••---•---••-•--- Date-w�J-�f=--�-"f� --' Test Pit No. 1... .�1__minutes per inch Depth of Test.Pit..... _, .__.... Depth to ground water.,l_0?4-'I Test Pit No. 2................minutes per inch Depth of Test Pit.............. Depth to ground water........................ Description of Soil = ® -------------- G d ! a�' /I� � ' - -----------------------•--.---------------- W x --------------------------------------------------------------------------------------•---------------•--•-•••----------•--•--....-----•-----------••-----•---•----------•-------•-•••--•-----••--•---- 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 I 5 of the State Sanitary Code Th nd gig ther.agrees not to place the system in operation until a Certificate of Compliance has be n ed b t oar o2ealth. Sig L'" ---- -- �.2�� °..... ---•---------------------------•----.---- --- Date Application Approved By------- { •----. Date Application Disapproved for the followang reasons: -------••----•-•-----•----•-----•--------•---...-•---------•---•--......•-----••-------•--•----....-- .................•-..........-------------•.---••---•------...--•----•-••--------•--••--•--•--•--•------.--•••--••••--•-••--•-•---•------•------•-•-••....-----------•--------••----......---•-...._..•- Date PermitNo......................................................... Issued._.... - ....................... t. Date No........161'.. ........... /AQ THE COMMONWEALTH CF MASSACHUSETTS BOARD 'OF- HEALTH ................. .......................OF.......................................................................................... ApIn.1-1tratiou for Bitipasal Work.5 Tomitrurtion Frrmit Applicatiow,is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: -- 93 Z X_ z9M11, ...... .1 ............ ............................ ......------------ ------------ ------ fi n- �ress or Lot . .... ..... .......... .. ............................ ...7'� ..�-"o---- ---------------------------- --------Address . ---------------------*......... - ----------------------------------------....d.r.e..s""*'./..-----"...*-------------...----------Installer Ads . .. 0 e of Building Size Lot. . ..... ........Sq. feet U Dwelling—No. of Bedrooms...._...!..................................Expansion Attic Garbage Grinder Other—Type of Building ............................ No. of persons............................ Showers Cafeteria Otherfixtures.•........................................................................................................ ......I........................ J ............... a -�Lliensv Design Flow............................. gallons per person per day. Total�_il �ow ........... .V1_14. .................g W 0 :> 4 04 Septic Tank—Liquid capacity.��e allons Length... Width----............ Diameter......--..--.... Depth................ ,Disposal Trench—N?l .................... Width--- ---------- Total Length.......9..Z...... Total leaching area....... ft. 'Seepage Pit No---------i---------- Diameter-_--.._.:.......... Depth below inlet.--................. Total leaching area............--....sq. f t, Z Other Distribution box Dosing tank Percolation Test Resu_4s,,, Performed by.. ...................7�2...................... 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...-.--..---.:-...---... . ............... N, --------- ----------------*---------------------------- �5 Descriptionof Soil.................................... .......................... - -1 ....................................................... U ........................................................................................................................................ .............................................................. -----------------------------------------------7----------------------.................................................................................................................................. U 'Nature of Repairs or Alterati6ns—Answer when applicable------------------------------------------------------------------------------------------------ ........................................................................................................................................................................................ /;Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TT LE 5 of the State Sanitary Code,! The undersi e further agrees not to place the system in operation-until a Certificate of Compliance has b i ed by t 0 d ealth. Si . . . . . .. ... ...... ................................................ ------................ )late -I_, -Application Approved By....... 49 7....................... ......i( ...... ......... .... Date Application Disapproved for the follo g reasons:.......................... ............................................................................... ....................................................................................................................................................................................w.................... Date PermitNo........................vl................................ Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS ypti BOARD OF HEALTH '17 ....OF................ ................................... .............................................................. ofif rat of ToutpliztUrr THIS IS TO CERTI at the 1 I ewage Disposal System constructed �orRepaired by.......:.................... ..... ... .... . .. . . .. . ............................................................................................................... 5�7 Instaper at.......................... --------------------------*.......*----------*---------------------------------- has been installed 1 acc r ance with the provisions of T The 4tat e Sanitary Code as described in the 11 A-;e X -application for Disposal Works Construction Permit No.. -------/ dated__.'�J--------/L;...7.... ............ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATI....................t............................................................. I.ns ector,.............................................. p ...................................... l . THE COMMONWEALTH OF MASSACHUSETTS '1BOARD OF HEALTH Ig4 w's -7 f . ...............................................OF.. .............................................................................. --------- FEE..., ............ n ion Virrutit Permissionis he granted---- ... .................................................:%,-!......................................................................... to Construct ( �'or pair Individual Se)vage Disposo-19st at No. -------_:_? .......... --------------------------------------------------------- 1,,3........ . . 2� , Street .4�ndi:i, as shown on the application for Disposal Works Construction Pe4hii N Dated._/_iZ.-_//........................ ------------------------ Board of Health(/— DATE----po',--_off. .,mv-----------_------------- ... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS A V � HOB l71 ea I . � z TjFa I`Z- vm �, !t r: t v { r 19,E I' 3.3' .,.. CD/tirG S E7-0,4 CAc- A, u/,2 E;AI J777 S C-4 L E J /-/0, 0 F20iv 7' l 0 51 ` P2O DO 5ED 2- BED.IZOo.MS �.� SE P T/G 5 y5 TEM CONS T2 UG T/ON SHALL COAlFO1zA4 TO ,v/A55 . C'ES iG N FL o w 2-2O B ENV/,Q O�/M L-n!Tom}L CODE. Ti TL� ]Z GAL�b� Y " L L A Gam! 2.4 TE - n7/A/ f/VCN HE.cI4IW TZ�C,CJLA T/O�NS '�EQU/�G-1� LE�IC.?1 -". � ►A.C"�� . TOP OF .020,00'S - .:..,cpun�Y�AT/4�/.= MANHOLE #CO V6,C- TO e-X TEnlD Tp fM.oC,2✓/OCIS CO c/E TO ,a2E V,5iVT Gin/�� J i !�1/I Tf-//i1/ /' OF G/n//5�/6-0 (3,e.4 DE, `7 �/F/LT2AT/�t/6 Z:S _ 1 Q} I ��':Go✓c-ems _- S r _ I D/5T. IC)J Sro�vE /��MUM 4"cq Sox -I z/"w,De 0VaR 3"M/iV 4 DIA. _ F TIC Ow L,i✓E �4 o0T /O'"Min/ / i 7cN 2- M/N :v c / •a/T /4" _ 4 ��Do7 ircfi �.rf _ /Z D/A. Y /boo Min? ,�. /4"�coor ..� 1 WAS HE17 -Y- - . /7 C ( � S TO n/E GALL.0ni /,A/✓Eer i � 4u /n�vEe T T 1 ,4 2 0 un/o i SE IJT/G TA A/e l�; ?a U /7, j �C ELEV• Q �LVA TG�T/G�/T�. 1AIVEZr �c�T/OM O n r r,lU GA)25A6E vlin%i gut uM / 6 SITE, PLAN L'OCA 7 1 oA-1 _/.--�. 1--/ t J ✓ �,E� �' '., SEDT/e TANK S7-l2/4�5U7-/ON 80X FOIZ i%�`. �5 OUTGETS� AND LE.aC,'-11A G ,air a SHORT ; pTO BE OF .2Ei�/GCJ.2CEL7 G'O.VC1zETE ea NO. 2?4.93 � t ��, I- C nNG'2E TE ST,2E�v 7, . 3000 T�s/ STEEL ,. 20000 NAL - /O LOAD/A/G Ck Get VVA>' /,/O 7- TO BE L C)CA; L� �^ 9"4,e A4 C./7'' ,„�` ,; /�/"[ ;.$ 01/E 2 S yS T�M Un/L 5 j f/- 20 ,G .Y, s'R* I h/ }t1` !C •.t;a�'� 'r d° � '�x��E-S/vn/ LOL1 L7/il/v /� lJSEJ. /J` ��; ;,�"/-y*,-x•,;1,r�fr' f�/1/��` .,I�- �'iJ.�x.:PY �"�;i.��<�,a= ,`,f ... ��.., {4 ` ^ "ra ,ram -°art a '✓ :' " < ' C r AO SATE 4-1E4Z-7;z=/