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Home My WebLink About0326 OAK STREET (CENT./W.BARN) - Health (2) lay � ooi/oi3 No �. -� p Fps................:... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...............OF........ ;..N-7 . ................ Applira#ion for Uhipoii al Votkii Tomtrurtion Vrrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: C,- p anon dd e .. Lot No. 0 Address .......................... -- Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms---------__. Expansion Attic ( ) Garbage .Grinder ! .1 aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria 00) G" Other fixtures .................•------------•- - W Design Flow.......... ...................gallons per person per day. Total daily flow------------------ _..___::_.__._._gallons. � Septic Tank—Liquid capacityi.....gallons Length................ Width................ Diameter................ Depth.......,........ Disposal Trench—.To_____________________ 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-----------••-----------•--•--••--•••-•-•••-•--•----------•-•-•--------- Date........................................ aTest Pit No. 1...... per inch Depth of Test Pit.................... Depth to ground water-___-___-____-__:.---_.- f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ----------- - . . O Description of Soil.......... r _( ?_e.. .4___ _. _______ ----------------------------------------------------•-----------•----------------.------ x t., W -------------- _/° i UNature of Repairs or Alterations—Answer wh applicable.__ f_. �_ ______ �YiR..__ T__.______... --------------------------------------------------------------------------------- ..... ----- Agreement: at e The undersigned agrees to install the aforedescribe In 'viduai Sewage Disposal Sy em in ac ance with the provisions of i Tm;, of the State Sanitary C e n rsi ned further agrees n t to place t system in operation until a Certincate of Compliance h n su e a ea Date ApplicationApproved By.................................................................................................. Date Application Disapproved for the following reasons:................................................................................................................ ....-•---••----------------•------•-•--------•---••------•----------------------------.................-------------......•----•------. -------------------•-------------------...-----•--•----------- Date Permit No..... . ......................... . Issued....................................................... Date F ' Cyr No5�- -!.. 2�f © �s.............l...�� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............U.�'`9�J... OF........ . n'c ?'!^-�..c....................... Appliration for Disposal Workii Tonotrurtiun amit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: /I'--- _Location ddress or Lot No. .............. 9 v� ��. .... •i=- LL-- --------- ..........--............................................ C� Owner Address a ..................... ..............................................................................................•-- Installer Address UType of Building Size Lot............................Sq. feet �—•1 Dwelling—No. of Bedrooms---------- ..............................Expansion Attic ( ) Garbage Grinder O l aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria (1/o) Q' Other fixtures -------------------------------- d ---- --•-- --------------•--------- Design Flow......_ ....................gallons per person per day. Total daily flow.............__/!�_.............gal W _. Ions. 9 Septic Tank—Liquid capacityla 11...gallons Length................ Width................ Diameter---------------- Depth................ Disposal Trench—No..................... Width_j..........._.... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.....1'2-------- Diameter........___I------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date......................................... Test Pit No. 1-___----2�-_-minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ L�, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -------- -------•-------•-•••••-- ---- ............-----------------------.......----------.....------------ O Description of Soil......... ± ..-___.......__....__. V .--------------•----••••-----••--•------......•---............_..........-------••-••---------•••••....--••- W ..........................-............................................................................................................................................................................ U Nature of Repairs or Alterations—Answer when applicable__ . .t: _30..�.�.._ l _ _- ........:....... ........................................................................•___._.. ..._.._Ta`.. r'... ._._. .G a�............ _•• ^ 6•(c'l..:Cj a'i Agreement: The undersigned agrees to install the afo�r�Zescr�fibe`d' t �Individual'Sewage Disposal Sy m in acc dance with the provisions of iiT_ . 5 of the State Sanitary Co T Un/d signed further agrees n to place the'system in operation until a Certificate of Compliance ha b i ue e b rd e a e, - n . ....---- ... ------ •••• .... ................. ..... ate ApplicationApproved By......................................................... •---------------•--------•--•- ....................................... Date Application Disapproved for the following reasons:------•-----------------------------------------------------•----------------•-----------------------••-••.... ...-•--•--•------------------•---•-•-•-....--•---•-----------.....---•----•------•------•-...:------...--•--------•----------••-•-•-----••-••---•-•-••------••------•----•-----••-----•••---•--...._.._. Date Permit No....... ... .........Z� �. Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......l......................OF..................:. eft-C?...... ... �rr�i��rtt#r ,af (�unt�li�anr�e ', THIS IS-T-0 qERTIFY, That th. Individual Sewage Disposal System constructed ( ) or Repaired ( } by �- _ _s �:_....... 1J.1�, _.�..4 ----•----------------------------------...--------------...................__._._:_.... Installer C � , has been installed in accordance with the provisions of i i i IZ j of The State Sanitary Code as described in the application for Disposal Works Construction Permit ._---_)_-- v-•- dated__.__.!-_��.�__�_��.�........ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SA ISFACTORY. DATE........................................./•. ---.- ------••---- Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 12 .................... ... . 2.:..OF.---......---...-•--••---........._.`..Vic............ ....................... N ........... FEE.:7]..::-:.?.. Raposal- n k ��an #rnnr inn �erntit Permission is hereby granted........... .... .�:.;e�....._.._. to Construct ( ) or Repa' ( ) an Individu Sewage Disposal System atNo........... �...... ---......----...... .--...... Street - - --- Dated 1 e ��--- as shown on the application for Disposal Works Construction Permit No,_�� 1 Z�� !._ _ � z-G...- 016 - - ii a• Board of Health DATE------..= 1 ..........-•-••--•-•-••---••---•.... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS - - I t A7 27 3g 5a l I � r"