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Home My WebLink About0057 OCEAN AVENUE - Health 55 Ocean Avenue Centerville A=226—036 i 8MEAD No.2.153LOR UPC 12534 amead.com • Made in USA �.®r-CYC4,e NC ......... L THE COMMONWEALTH OF MASSACHUSETTS BOARD OF -HEALTH _...)0W)2...OF. .......................... Allpfiration for Uhipasal Workg. Tanstrurtion Vamit Application is hereby made for a Permit to Construct or Repair an OIdual System at: - 611,11W Sewage Disposal A09vc........................................ . ....................................jr........................................ Location)ddre S or Lo, Vo. .............. ..................................... . . .... ............!DZ4 ... . ........................................ ........ 4...... ...... ----4-0,T?--- ---------------- ................................... Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms________________________________ _____Expansion Attic Garbage Grinder A4 Other—Type of Building -----------_----------_- No. of persons............................ Showers Cafeteria Otherfixtures ............................................................................................ ---------------------------- ------------Design Flow.......................................:....gallons per person per day. Total daily flow_._.__._______._____.________...._______.___gallons. gallons. 19 Septic Tank—Liquid capacity............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. f t. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by................................................................. Date_____________-_-- ..................... Test Pit No. I................tninutes per inch Depth of Test Pit__._________________ Depth to ground water er rX4 Test Pit No. 2.................minutes per inch Depth of Test Pit_____._.___.____._.. Depth to ground wa er....................... P4 ................................ ................................................................................................... 0 Description of Soil........... 77�...AL7-jair_l.................................................................................................. -------------------------------------------------------------------*-------------------------------*----------------------------*----------------------------------------- ------------------------ -------------------------------------------------------------------------------------------------------------------------------------- ------------ ---------------*----------- Nature of Repairs or Alterations—Answer when applicable__ /Z,92 0...IL.... U .................. Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has�eql issu�d�y thoeard ofAhealth Sig ,d.. ... .....it. . ............... ....................... Date Application Approved By........ ... ........... Date—* Application Disapproved for the following reasons:..................... . .................................................... . ......................................................................................................................................................................................Date Permit No......................................................... Issued.... /*/, ':ZK............... Date `7 3 �q LOCATION SEWAGE PERMIT NO- CSC� ' VILLAGE INST. LLER'S NAME i ADDRESS BUILDER OR- NE_R W = _ DATE PERMIT ISSUED DATE COMPLIANCE ISSUED r m �C�� o , ✓�IU� N� ........}r._.. .......................%..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ! ! r� , pphration for Di-opus al Works Toustratr#iun Vamit Application is hereby made for a Permit to Construct ( ) or Repair an *idual Sewage Disposal • System at: f� Location-Address or Lot No. Owner / Address •,'..14 . l . ..i .. ..... r i .. `. -•---------- . ............ .... ... ...............................•........ Installer Address UType of Building Size Lot............................Sq. feet 1•-1 Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Buildin a yp g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) � Other fixtures ........................................... ........................................... Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter-------_........ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No------_--------_--- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date......................................... Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water..._.................... 1-4 4.1 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Ix ..........-.............................................-.................................................................................................... 0 Description of Soil............................................. ... r x W 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'LT LE 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 thea'lio6ard o health. Sied 3 Nov ..................... ................................ j' ,�f, Date APPlication Approved By..` rf �' ' "� --•------------------ f d. ' ,�" Date Application Disapproved for the following_reasons:....•................ .... ------- __.___ ............................................................................... 3 Date PermitNo.............................. ---------------------- Issued-....................................................... Date r� it THE COMMONWEALTH OF MASSACHUSETTS H . BOARD OF HEALTH f ............................ .........OF....................................................,.................................... (Irrtifirate of ToutpliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( -) by............................................................................... . ••-•-------•-'•-•••••-•-•-----•-•-•-•-•-•-.....-•-••-•-•-•••••........--•..._.........-••••-•-•--......_...._. Installer at.................. ----------......_.._... .......................... '` =------------......._..----•--------------------------------••-••......- has been installed in accordance with the provisions of 5of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..._......�.•.K---_-. ?.............. dated---/-40- `_, ...�_/ y��........•... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. f. fi DATE:.. �,/-�� Inspector .. .�� . A ,� r ?r ; a �`�•" ............................................... THE COMMONWEALTH OF MASSACHUSETTS � m�rty'" BOARD OF HEALTH 9�! ............ ......OF.....;? � ;" "IZ . ................... 7' N0........................ FEE........w; :='`f :'. Disposal Hill tuniftruc tuan nuttt f Permission is hereby granted....= * �... 0112/.;., A. e''. r r__ %F ...... to Construct ( ) or Repair (Z , an In#yv dual Sewage Disposal System r, �• s Irl Street as shown on the application for Disposal Works Construction Pe No. .. ___....: . Dated.....104- Health DATE_ �_.(/ y' � oad of FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS