HomeMy WebLinkAbout0107 PLEASANT PINES AVE - Health 107 Pleasant Pines Avenue
Centerville
A= 233 —056
SMEADO
No.2-153LOR
UPC 12534
amead.com • Made in USA
4�cvc�
�J
unnt
LOCATION , SEWAGE PERMIT NO.
VILLAGE
INSTA LLER'S NAME i ADDRESS
l j ,(Q '-c
A c,-,
3 U I L D E R OR OW °ER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED ® ��
R
CLW 12 tl
No....8 2=l1.r Fpc.....s ts. ..
e, / O I THE COMMONWEALTH OF MASSACHUSET S
/ BOAR® OF HEALTH
- oF........, ,,,P ----------------------
ApplirFatiun for Diipus al Works Tunitrurtiun ramit
Application is hereby made for a Permit to Construct (A,-)"or Repair ( ) an Individual Sewage Disposal
System at:
................_...............Z` -, ���.tQrl1 •- �T ��.
-N•-.-.........................................---------------
Location-Address orLoto
....MfY /A..o 54 /�� ../5y �.A.... V........ ......e%3... X4R
Own r Address
Installer Address .�
U Type of Building Size Lot____, c ._ t
r., Dwelling—No. of Bedrooms...........Z............................Expansion Attic ( ) Garbage Grinder
Other—Type of Building ............................ No. of persons............................ Showers ( ) - Cafeteria ( )
04 Other fixtures -------------•-•--------._...
-•----•----•---------------------------------------•--•-•-•---•------•--•--------•-----•-----•-•------
W Design Flow.....................sue.5...............gallons per person per day. Total daily flow____.__...._... Z.0.................gallons.
WSeptic Tank—Liquid capacity./%<0dgallons Length, -Width. �- _._ Diameter................ Depth....4"-&-.
x Disposal Trench—No..................... Width.................... Total Length_......_._.j_.____ Total leaching area....................sq. ft.
Seepage Pit No.......,/.......... Diameter�e3_............ Depth below inlet_'.'..._4........... Total leaching area...S`Q..._
Z Other Distribution box (p/f Dosing tank�
a �F
Percolation Test Results Performed by...... g ...........................
..•--••----•-•-•_... Date.....
�tN MAssgc
a Test Pit No. 1----------------minutes per inch Depth of Test Pit....._.i_v _..___ Depth to ground water_._ .. ._. ti
►"' * g P9dA AN <n
(z, Test Pit No. 2•-_____o�D�._-%minutes per inch Depth of Test Pit•___-1'Zo _._.. Depth to ground water.. cz-
a ................................... v_..Ya� AAAN y
O �W10,"TT705 O
Description of Soil Q_.... ... •��R�i '----- --- u S'��' -----------
W ................. ........................................ ---Ally _l�' ��...__�X e__, ................. 4J6�_.� T .�-- CIS/OIVAll-
-- .....
0 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 TITLL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance ha en issued by the boar of health.
Signed `�"� _ � .........................................
D to
Application Approved BY E ,_ ,,.. ,� ............................. . ....•••--
Date
Application Disapproved for the following reasons:................................................................................................................
--......---•--••--•--••--•••---•--•---•--••-•---•••--••--•••-••-------•-••••-•--••...•---•••-••----•-----••---------•-----•-••--•----------••--•--••------•••-•-•-•-•---------•-•------------•.....-----
Date
PermitNo......................................................... Issued.----...---------------------..........•---•-----------
Date
Fnic.. ........................
THE COMMONWEALTH OF MASSACHUSETTS-
BOARD OF HEALTH
......7.0&.1.IV..........OF........... ,I/, ..t....................
Appliration for Klhiposal Workfi Tomitrurtion ran fit
Application is hereby made for a Permit to Construct (A,,) or Repair an Individual Sewage Disposal
System at:
............................... .....................................................................
Location-Address or Lot No.
..........C-45;4J7__.--
Ow'n"er �dress
.......... ............ ........................ ..................................................................................................
Installer Address
Type of Building Size
U
Dwelling—No. of Bedrooms..........-3............................Expansion Attic Garbage Grinder
4
ok Other—Type of Building ............................ No. of persons......_..............._.._.. Showers Cafeteria
P4 Other fixtures ....................................................................
-.!Il ...*---------------------------------------------*-----------"------------------
W Design Flow.....................*:rS...............gallons per person per day. Total daily flow............._.3.3.0................gallons.
9 Septic Tank—Liquid'capacity/,.5.'O.,Ogallons Length 1.o..':7.6."'Width..;��-.4?._. Diameter................ Depth....
W
Disposal',,Trench—No. Width.................... Total Length......_......__...._ Total leaching area....................sq. ft.
Diameter.,x,a.............. Depth below inlet.....J:;�..........
Seepage' .......... Total leaching area..S:�5,6....&q�tdeo
Z Other Distribution box Dosing tank
Percolation Test Results Performed by,..... 'Y-�a. .......................... Date..... .!Z -OF
Test Pit No. I--------;� minutes per inch Depth of Test Pit........e,X...... Depth to ground water....
Test Pit No. 2.......�_-.minutes per inch Depth of Test Pit__...,.!z_."'_ Depth to ground water_ MAN
.0... ............................................................................................................................
0 Description of Soil_.2�/'/... Sc
.0 - ,4e—— ...
..... ., &... X.&U--------- .- !?- ----_--------- ... ND_12705,c�
............................................................... ......... ............................
U -................
----------
............................................ ...................
U Nature of R�pairs or Alterations—Answer when applicable.......................................................................................
......................I..................................................................................................................................................................................
Agreement
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of The undersigned further agrees not to place the system in
5 of the State Sanitary Code
operzqi6n until a Certificate of Compliance hasb!gn issued ty�he board of health.
Signed.. .............11 .
.................................... ...............................
Date
App1KRti6ft'Apprpved By..- .... ...... 15,0.021.............
...
'0' Date
Application Disapproved for the following reasons: . ...............................................................
...............................................I.........................................................................................................................................................
Date
lFf, Permit No............... ........................................... i Issued-.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.................. ....OF......... ...............................
Tatif irate of Toutpliattrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (LP,) or Repaired
b ...........&..C.04 :14
y ju,��........... ....................................................................................................................................
Installer
at--------- W -------- ----------- . . .............................................................
-
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit ............... dated_...-,_ ------ _---------------
THE ISftAN E OF THIS CERTIFICATE SHALL NO-T-BE.CONSTR.. S A GUARANTEE THAT THE
SYSTEM Wy , NCTION SATISFACTORY.
DATE..Zl/....... ......................................................... Inspector._... -----------------...............----------------------------------
CO STR.... ...............
"
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................................OF.....................................................................................
FEE...7-e.- ...
Disposal Vorkg T-FaInarudion "prrutit
Permissionis hereby granted.......................................-.................................................................................................
to ConstruetAr"I epair or R ( )-an Individual Sewage.'Disposal System.:�0 .... !
tNo.........r.k..r—SAr....... ---------------------------------------------------
Street
as shown on the application for Disposal Works Construction Permit Nq.--__-.� ............ Dated.._7
h ...........
oar of e
...................................... ----- ----------------------------
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
` ----- - - - - --�_; - 1a--AL.L Et.-E�/. S �o�✓ AQ E M t�a.J SE t�. �..��IE i
_ t+ —-- - -- --- --�- P l tG L-� A L.-u t ►J E S P, tit 113 t M J ri OF t1P5'i1V,-0lllT
I f � � L�r.iL,CSS c�T4�F�tsE �PEGtFtEt�.
;'• t, A L� Pt PE.S TO .�►_! t I.J TI-4jc SDI STD
. _
ALL- 'li Pox , A► D
I ►.G N i tit C P S "SHAil K.
�'1 {; l �- 2.EctaJE Au` ur.lSvlrac�LE MATEt21A.1_._ BE�..lEt1•Tt-i
l -`
O 1F LE AC 1-E ti P Fbc-
C)
.�•�-t � _ - / A yam'
N \✓ — - N a _ {tv 30In
.�.,. . .. .. .. _ ► N . . . E 10 ( � 1• _ 0
1 CC"Q��T-1
�,. ?�.? Z"�.-- �--�1 ►q� ({ T V I o O "' ® ''( A"i
QI V G T SAS-1�rAe�
_ _� CoMPo,,�EtiTs s►� 16 ,►.)SraL,%.i i4.1
21l { TE Z { i O ® O ®
Ty t CA L` D t ST 1 t-i a r.1 F3 o X- O (OD � t TAe,,{ covE A."D A.Ny Lcxb.� cZUL-�Es
(300
TtijF'tCAt✓ t5.7p c �A� SEPTt�. T^1iL
D
�1 y �t ►. �t- T� SALE �-a(:!,T To ,dam E
p D •L'J'
'� W iTl-1 E��L TIZic: w EL.OE 7 �l t 2.E w t Trt�
ACCESs� MA►JI-�OI E� Tb
1 Tin
SEPTIC Aii
T 8E -Bu t L:-I )O -ro t 21► iC_µt�S
ppbbJE
Y2 SZ-_ 'GaAN �_ �.a'GAiy 1
�-- _----� r 1 I J.'U�.S'p,L /F 41..11 S4a UQA�7E=-'�t�'�5 E 2 �A,_i K_ d"S�'J' C�II E(t 'U Cam:'73'K� I.EAC_!•-�I...IC� = � f 3
44-
i
36 CG►A E I CoR S� / UGF-iT (JEi6�-+1` �1`ECI. CCU% C1a,tr•t� �
Z 4-
4� �Q8~ "� ii1�=4( too
ttity_ * ' y _._� s� " Ir 1 T d ° • ;1 ' v,''El
t �liurl i7c'b�u�'1 ��J d�+5� 7 ` •<
C�1�.t_ _ j ° �J ® O ° = >�iS{'IEL"7 z7n, l c
0
48 \ / 1 t� lFOCC-E� coo,.k:. UtS-! 80)(- T O 0 � •�
`J .
m d 0 0 ( s
e S i ►✓1 PfT
�jfcf'Tt�- TA ti.1 k'-�I s � o • e a a�l.��/ _ �AQG'
IVO
06SER�/AT �C>r� t�E ),..�/E�� sr;�$�t , � �� G, v � �\
---
'G•�`
t� �,,.r�° 4 `, PEtr'COL.PtT iC�► ► L�AT� = 2 /M ��li lr.1L.N T-VF�t GL�L_ 'S Ew�aE ��T�M P���- i L_E
L.._. --
�+.g.L1rC'HIi.1l T-1�lC� �L7►..)TO`��
' ►; I v E t �� c r�(T E t A PROP05Eo 5 E'A1^E a I SPOSAti.. S%i5TEM
/ } It' SLPTt TAu✓_ NvMt3E �_ OF [iEaCG MS 52 r� ExtST SPA r" EL-E-U �.1.-,1 ` -
/
=n.
l .(AAi `, Q 7► � 5 - ET)SZ�-:�pH,� '� 52}O G�1�L1P 5PdT- C�ev
1 441a�! , f C*ALt-aJS Pl PECZ K-) PEQ- �ArY _ ` P5 � PEQcn_�.A; toil T7E.s f +aL�
f
tOt7` .sN� L-EACµt,,1�+ �'ErJ��i(2E'� _ �'°` -- �% m �BSEt2�/AT tc>�S T�.ST '� '` `:> /�.�`; ' 'Rci , /itdk., � M AS4 .
Sc AL_E At> ►.1pTEO ID ATE lA•i C_!- i:r . 1''J ..
-� � •1 i 1 1 t oc�% �Pt�r.t 51 o,J -
x
�, S f-�}1 c G-► 2 )c M :-7 k•�J : 4� C7 • `p µOf yj H OF�yq3 3 C�Go R�E
X J F
j r r
6 SVO
it�IA/. ,t�,ta (-�;,jr n'j C 3 t L ��' _ �� 1 ` !+ ror
? ta4W511!A?+� Et.1Gcl►.1cE�' ' 1 1�52��1At�� t �_�S� (�ifa,r.�
SCALE. ly,� �6 t d �� i ��..., � 01 c,ISY.�t�j � ..
-,�\`'�•' Gtl�i/ O�V t�X.�7'r✓ IC 2 5 f�G. .2� �b,SUR`��/`