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Home My WebLink About1045 SHOOTFLYING HILL RD - Health 1045 Shootflying Ijill Road Centerville A= 19l —028 UPC 17534 o. -15 CORPos,ro � KASTINQS•UN r pl- LO C A T191i S E W E P RMIT NO. VILLAGE INSTA LLER'S NAME & ADDRESS r 9 UILDE OR OWNER DATE PERMIT ISSUED _J � _ z� DAT �, - COMPLIANCE ISSUED i. � /� .. \ 0 i� � E �' � ' � � • i0 �_ }, ' , x . s _�, c �. 4 00a NO..&........ ............ THE COMMON'WEALTH OF MASSACHUSETTS -.7 BOARD HEA,.. TH ---------- . ..............OF.......... ...... ............................... A firation for Uispviial Works Towitrurtion Vanal Applicatio err by ade for a Permit to Construct or Repair an Individual Sewage Disposal �,I�Uqe System at: 1. t,C pby 7- F4 Vjn,� su��o .... ... .......... ........... Location Address or Lot No ........ ............................... ;................... ... . ..... .... ......................................................... Owner Address .. ... .. . .. . .......................................................................... .......................... ........PF ....!�.#7 9 4-�4& Installer Address Type of Building Size Lot.!.j.dA!2.....Sq. feet U 3 Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder ( ) �_l 114 Other—Type of Building ............................ No. of persons.....................__.__.. Showers Cafeteria ( ) Pa Other fixtures ..................................................................................................................................................... Design Flow.......J_�_ ................gallons per person per day. Total daily flow.............: 0..................gallons. ------------*----------- 1:4 Septic Tank 4Liquid capacity/e gallons Length................ Width._............__ Diameter..._......_..... Depth___--__-__.--_-. x Disposal Trench—No..................... Width...._............... Total Length_____........_...... Total leaching area....................sq. f t. Seepage Pit No.__.../............ Diameter.....Z.4_6.. Depth below inlet....5..P....... Total leaching area....20.../...sq. ft. Other Distribution box Dosing t?nk C 46. /- - -7 e- Percolation Test Results Performed by.....Ir. X�...................................... Date..........._-Y........................ Test Pit No. I---4A-----minutesperinch Ve'pth of Test it.................... Depth to ground water_-_____-________-_-__--. Gi, Test Pit No. 2................minutes per inch Depth of Test Pit...._......._.__.... Depth to ground water..._._.............._... 4-------- .. .... - ------- 0 Description of Soil..........jo.-..2 ------------T W ....... ...* ................... U ...................................................................................................................................................................A................................... 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 TIITL 1L 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee i sued b he`boar of health. Sign . .... .... .. ------------ ----------------- .....**------ ------- Date Application Approved By......... . ... ..... .... ............ . . ...................... ....kn/tF.:n--7-&........ Date Sign Application Disapproved for the following reasons:......... 7.................................................................................... ......................................................................................................................................................................................................... ' .....� - Date No........... IssuedL...Qc -ff-... z ..................... Date No. ... ...... .............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD O �ATH .........." t ): .....0F......- : ... ........................ Appliration for Uispoii al Morks Tonstrurtion Vrrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at ........ ......... ......... -•--••••...... ........................ Location-Address or Lot No. -•••--•• ............---- •--...... ..........--...................................................................................... Owner Address a ...............OAS-:.... 'A....._ A eZ ............................................... ...... ............ Installer � Address N Type of Building Size ....Sq. feet No. mDwelling— .................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures -------•---••-•••••••••----•-•.._...•-•••---•---••-•••.•••-•-••••-•-••••--•----•-----•------••----•-•••.....;••••---••-•.........-•--•-•--•-•--•-••-- Desi n Flow......._-'.. --,_._....•..................gallons per person per da . Total daily flow............. Q..................gallons. W g g P P P Y Y WSeptic Tank,t Liquid capacity/N.Ogallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..,.................. Width.__..........._._.. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No...... Diameter.__... ..ds.. Depth below inlet..._�_P....... Total leaching area....jW'Q.�..sq. ft. z Other Distribution box ( ) Dosing tank ( ) t�, `. �� 'y '-' Percolation Test Results Performed by..... x r" r ��- ---- ._.. ..f ._ -..---. . Date----._... •---------- Test Pit No. I... .....minutes per inch IIepth of Test it...............•- Depth to ground water......................... (s, Test Pit No. 2.............:..minutes per inch Depth of Test Pit.................... Depth to ground water........................ r - � .. ..... -... Y......... " ...................... � escrptono Soil.......... . ........... - . ••-••-. • 2....•..... - U ••............•-••--•--••-••••••••-•••••-•-•-•-•••...........................•---.....-•••.... .......•........••••---••••-•-••-••--•--••-•••-•-•-••-••••-•••-...........-••---......•••••...-•--•-.... W UNature 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 TIT11 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued by he" .boar of health. �d �Sign /c ... � r -r ,/�,r'---• `�...�''--------------- --------•-------- - t/ Date/ Application Approved By......... f=-• -•••• • ... - ........... +�`�r " ....... Date Application Disapproved for the following reasons---------------------•-•-•-••• ••••-•••••••---••--•--••-••--•-•--•--•-•••......---•••--•-••a•--------------- -----------------------------•----------••---------------....-------•-----------•---•----......--------...-----------------------•------. ............................................................... Date PermitNo......................................................... Issued----------•---------------•-•-•-••-•--•••-••-••-••--•-• Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 46.je�. e.,- .�. Je........ee..... .................. ........OF........ Tntifiratr of Toutplittnrr THE IS OP %RTI7F , That the Individual Sewage Disposal SWystem constructed (�or Repairedby... Gcr' t..... ..........Wk . ..................................... at w lv� -7� ..0...1.1 ��Iler .� .. has been installed in accordance witl he pro/isions of T � ' j of /T111hh...e State Sanitary Code as described in the application for Disposal Works Construction Permit No. .._...../f:............... dated-_../---- ----- ............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST /A5.AUNTEE THAT THE SYSTEM,W L FUNC IONS TISFACTORY. DATE.... / _ •---•-•----••-•--•.............. Inspector•-•-- • .....•... ..- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH,, No.............. ........ FEE....t s1....�'�.. t �rDtu arks onlitrudion rruttt Permission is hereby,granted_--•..... .........Z X------------------------------------------------------------------------- to Construct ) or Repair ( an Individual Sewage )isp sal Systemf at No..... ---•t �� '" .... �'1' �'. E--.. '..., t 1�°` lt.cr�7j 1 � ?e , Street as shown on the application for Disposal Works Construction PersAit N Dated...... `_. "" ...... DATE oar of Healt FORM 1255 HOBBS & WARREN. INC., PUBLISHERS t µ. , t ems-' f � •p _ � C-�.RD. �� - _ ' . -t�C�r',�•L �ESIG�.1 = d25 G.RD. �� 5 ,�4°` :c'.r'LQTIC.��I FATE 1� IQ 0 02 1"Z. •U J 2 N i � Q ` a sr.F3uk O 4 — ( toor,C,,u, s,�•u� "w 1r1 lov Io c7cP a " o t- T Tor 1-uo =Ioo.o tr..9M paw ►uy=q�,0 o '�P� I o0o s••�ss�<< 4 a� iw. 6AL. f 'r3ox 9 t.� ScQrtc 1 a „�• wv. ) T-A�tK l 000 9b '� ,u� `�6 0 , L�H q6.S t •A jti Pt T ; � wire °•' WASMED G SToN� 4 r _ ` y t C>~QTtV-- E,ID LbCAT1U?,! ��--�i _VI LL E7 l� t-t:-r I i= T r-4 A-r T t4 t~ �12�? 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