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Home My WebLink About0415 NOTTINGHAM DRIVE - Health (2) 023 No.. .�....`_. 7 - "' FEB.... ..Q...ems. THE COMMONWEALTH OF MA1SSACHUSETTS BOAR® OF HEALTH 7.-40 )'l -----------OF..........i,�./q./l_I S..T-,�q -.0 . ............................ Appliraation for Bh4pog al Workf Tontitrurtiun Prrutit Application is hereby made for a Permit to Construct ( '') or Repair ( ) an Individual Sewage Disposal System at: 17 ..••...... - .1... ..Location-Addres ..51_.... w-`•t C' / _._.c r..I�t — •• w er Address W v Installer Address------- d Type of Building Size Lot.... �5_ � .....Sq. feet U Dwelling.—No. of Bedrooms.......... ___..Expansion Attic ( ) Garbage Grinder ((Vq .a cad,.... — Other—T e of BuildingNo. of ersons____________________________ Showers Cafeteria . Q' Other fixtures -------------------------------------- -------- ---------------------------------------------------------•------•----.-_--------------------------- Design Flow--------//l•---------------------- g ��P Y Yllons. W gallons er day. Total daily flow........ a- ................ WSeptic Tank—Liquid capacity/0120..gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No_—Z---------- Diameter....&........... Depth below inlet..... Total leaching area......sq. ft. Z Other Distribution box ( Dosing tank ( ) Percolation Test Results Performed by._-,A4/4-A/.......apt-O?tit.f-S�............................. Date......L/ ...... Test Pit No. I................minutes per inch Depth of Test Pit____- .... Depth to ground water..-M_D?v Test Pit No. 2................minutes per inch Depth of Test Pit____-____---____--- Depth to ground water._.--.____..__•---______ a ---•----------------------•---------------------------------------------------------------......------------•...-•-•--•-•-------..........---...------.--•- ODescription of Soil------------- 4---------------------------------------------------------------------•-•------------- V .....•--•----------------•••------------•--••-�=��---`s- .... l e' .h�l �l.�sJ"E---•-•�/Q/�� 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'TILE y g g p y 5 of the.State Sanitary Code—The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has b�een,issued by the board of health. Signed... klx-fill ate ----------Date'***---------- - Date Application Approved BY....... i-•-(r,�- Date Application Disapproved for the following reasons-----------------------------------------------------------------------------------------------•-----------.----- ....................•••••--•------------------------------•-......•---••--------------•-••-•----------------•----•--•-------•-•-•------ --•- i---ti------------------------------------------- Date PermitNo......................................................... Issued.... .........41-•-.......................... Date _4 v -. .:.. THE COMMONWEALTH OF MA~'SSACHUSETTS BOARD OF HEALTH .............-OF.............. +Q. L.i - . A "----------------------------• Applira#ion for Dhipati tl Works Tontitrnrtiun Permit Application is hereby made for a Permit to Construct ( ') or Repair ( ) an Individual Sewage Disposal System at: M.. t:U S f_£. it`GI rP D C� ... Location Address �- Tr yt No. O .r"t �_ t3_. _ ?c ' ................... !e{ 1C G� J PI✓t a t^ ... .. --- ...... �_.. ... •- � r Address W d�• ---------- ---------------------- - ...................-------••---------•------......-•---- ♦� Installer Address d / Type YP of Building ; g Size Lot________. _. __..........Sq. feet Dwelling—No. of Be`drooms._________c ____________________________Expansion Attic ( ) Garbage Grinder aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures . ------------------------ --- -----------------------------------•-------------------- a „ Z W Design Flow--------r!4?..........................gallons pe�jAr."rrper day. Total daily flow.........________-__.___.____.____..._gallons. WSeptic Tank—Liquid;capacit}i O _gallons .'Length................ Width:............... Diameter---------------- Depth................ x Disposal Trench—No............... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.....Z---------- Diameter....a ----- Depth below inlet.___..'___._. Total leaching area_*2,a .....sq. ft. Z Other Distribution box (V Dosing tank ( ) ~" Percolation Test Results Performed by---A,4_4A,,''....... .r+:!�k„z_......................._..... Date..... ......... a Test Pit No. 1................mmutes per inch Depth of Test Pit....Z?......... Depth to ground water_. gar. ~ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....................... 94 ------------•----------•------••--•-•--•------•--•-•---------•--••-•--------•••............................................................................. 0 Description of'Soil..............On.*A-."......4:4.2?n--. �` . 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 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 bjeerh issued by the board of healt . Signed_ --------• U�--- --M..� - Date Application Approved B Date Application Disapproved for the following reasons---------=-----•••-..--------------------------------------------------------------------....................... -------------------------------------------------------------------------------------------••---------•--...------------••------------------------•------------------------------------------------------ Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Trrtifiratr of Toutpliatta THIJ IS 'TO C TIF t the Individual Sewage Disposal System constructed or Repaired ( ) bY--••-•-• 7� /� .................. -----------_. GInstaller has been installed in accordance with the provisions of TITL: 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.. -------------- dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE IAS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ��_? � ..DATE ..._... Inspector....b ' THE COMMONWEALTH OF MASSACHUSETTS, BOARD OF HEALTH .� ........ 4%'�1:f. .........OF............... , i b. ..- .�_+...i Did ns nVewage Litt Mottemit Permission is . erebY g ranted____.__ .__________' ,�. to Construct ( or Repair ( ) an Indivldu Disposal S stem at No.---------°•� Q!*"`�-------..4'�►�----------------�!11.4�'�'`"/!St�..��--_- - 7 e..-----------•--� .' e..... Street as shown on the application for Disposal Works Construction Permit No..................... Datod.......................................... '420_ .a.... ................ - �� DATE............... Board of I Olealth FORM 1255 HOBBS & WARREN. INC., PUBLISHERS D�:r 1Gtit 17ATA � .59 0 , Tadt Lam{ F7Low a Ito 'k 3 t 3-4o C. P•tb z-o 'c-r=j=,- "I G TAB!k = 330 J I SG % • d�r7 6.P D. t n_u �[P. { uSte- 1000 GAL. PiT 63 S�ISPO�AL PIT - uSE lOoo Gdt_ , oNi .O = 7yfd ,Ur--WALL AQZE•A . t5D S-1=. sI= rc 2.S + 1�77S G Pam. PeoPcesLA ;�-. 7307-M A new_ C�PO Sr--. SD iW=. A 1 0 - 5o Ij.PD. TOTAL '1�C-S1GtJ = Q25 G.P.D. ToTA L U,d1 of Fc.aw = 330 6.m. PEIZGDLQTIOL.I tZI&TE : C Iu ZMI Q* oe ley,. Y1 ti + \ h IV 07--r G NflM D Y .�N .... 9 7, 1 .: r PA �O R-* i oa0 uN ' .3ug -WIL 4 IW. GAL. 9G• 7 •f 95.$ .. 'Sox �G.S Sc-QnC I o �r ►I H IWV. TLC hi K I 000 q5.� INv. IW. MevluM GAL. CIGD q6•Z A soh!) PST 91.7 WtT'tJ •; WASWMD COJM507 STONE 8 SAMJ?• C-aQTIFIED pl_c)T ILL A y j t P9ZoF'1 LE: L O CAT I o" G,E N-r e P,Y I 1.:;. Nc� W A T U P, CMWNF-( T!-(AT TN�Pkppas�DFovNtmo+�15N��►J 1�t--4t�1 R�F�R��1GE CC.V�PLVG W I ri4 TN`. v T G 3 A1•.iD SE-.TVACV, VGQUICENtE-i-tTs OF T►Ae -To W Li ofr= bl�R N s T 1'�.8 1•-•� L U M 3 ERT NI. 1 t*t_S 'PL^ N 13W-,- Z5Z Pam. 3Z- P I(fig ATG ,l,rt 0. ' B�.XTE� <;. W YC 1�G- t2CG151'LiZ>=D 1.11.►JG SU2v�.Yo�S TWIS VLAW t...IOT AN 05'TEzvu- -- v LASS. 1(4,g cJAA G-%-J i �jUt /t_�( :Tt�G: CIF{=5 , �i!�c,Wla AI�{�L-1 C_A.I-J I b-r T'u v�l'c�MI►J�:. 1.�'T t_IN �.;