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HomeMy WebLinkAbout0959 BEARSE'S WAY - Health '~ �,�1 ��'ses l�l� ��nn�s a�� lI� No. --- -- F ., Fm$.-......to............. -THE COMMONWEALTH OF MASSACHUSETTS rD 4 BOAR® OF HEALTH T- D.v /U__. --..--.OF.....� Appliration -fur Bi-gVviial Workii Tutt,�Uurthm Vrrnift Application,is hereby made for a Permit to Construct (X) or Repair ( - ) an Individual Sewage Disposal System at: 1 Cor-nerd, _ ear�eA1�AY (�e �31 L©T I 1 9 Asseas�rs Location:Address nn or Lot No. R 2�t np Ca_V Q 0 ....................................... ---- -PQ_�S_!_fp.�__ �Y.�.._ 4r Q n M i �.�__...._....---- ..-.J Owner Address aL '' Lg_Ce ------------------ ---�Z-.S Cor-»...-r.....R....-------•-----Os-�.rv�. P --- nstaller Address Q Type of Building \.`E Size Lot_-:_���__bss-____Sq. feet Dwelling—No. of Bedrooms_____ _______--------------------- -----Expansion Attic ( ) S age-f rirtt ( ) p, Other—Type of Building TAv _ P ( ) ( ) = N' No. of ersons-- 0 = ems — 'tea a' Other fixtures ------G I a sS W 0.s_Vn f- - --- -- ------------- - -•-••--•------•-•----•-----• ------------•-- w Design Flow... ___ g111ons per person per day. Total daily flow-------------/YQ!2___________--_-__gallota5�� WSeptic-Tank­-Ligtu caplcity iPgallot}s Length_____8_______ Width.... -_-- Diameter---------------- Depth. -__-. x Disposal Trench NO. ...... Width____________________ Total Length_________________ _ Total leaching area. _-_____- ____sq. ft. Seepage Pit'No.....-3__. Dtameter_.__.� �___.___. Depth below inlet____•_�•2 .____. Total leaching area_.7-)d0_±-Sq. it. Other Dist ributtoti,box (X) Dosing tank (&/n) (,y Z Percolation Test Results Performed b -_ �wJ_h-_ �Y�v n 2 L S-_--P . D �/ Y ---------- ate_--- : as Test Pit No 1 � __z_-...minutes per inch Depth of Test Pit-__�P. r__-_ Depth to ground water.-_No__wa: !q Test Pit No -__..minutes per inch Depth of Test Pit____________________ Depth to ground water-------------------- - •--------•-- O Description of Soi16_,18 �- LO 01WL IL S 0 u SO! 1�-'' g o,� Y�Il o w San �v� gQ n_---O. (xj -----•Z`D'----------CO A-rs.f.--_u/jl a-e Y'p v� S 0—V ------------------------------------------------------------•-•--_------------------------------- w — V Nat re of Repairs or Alterations—Answer when ap licable._-____&�-•�-_-____-_-_---__�-'_________________e� -_.-- = -3 (�1� L-=-- - Ly .�c -�- ��`'s- -•`�--•----------------------------------------------------�r •-----------------•-----••-- •----•-- •---•-- X �. Agreement: - ,f �j7- /, The undersigned agrees to kstall the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has le sued by the board/of he Signed--- -• -----•-•--- ------�r------ Da Application Approved BY-- -_-1-�--- �'- 7 5! i Application Disapproved for the following reasons:... .. _____ _ _ _ _ _ --------------•-----------•-•--•------------•------Date--••---------- --------•--••--------------------------•----------------•---•------------------•-----------------------------•---••---------------•--------------------------•-•---- .............................. Date Permit No________ ________ Issued. .-`3 7�� Date � _ ` r Or No...... f Fs$... .. ..:a............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .ro.w i.. . ....... or..................: N.. Applirtttion -for -Di-qVuiittl Vorkfi T>nstrurtion Vrruift Appfilati'on,�is hereby made for a Permit.to Construct (>� or Repair ( ) an Individual Sewage Disposal System at: corAer(N ItEarSe%WA�j �e '31 LOT 11 q Asses&urg �0 Location-AddressR e-}►, . .. Dj ' or Lot No. u... 9 ._..........-•-•---•---•----•----------•---•---•. .- I Owner Address ,W1 •------ -w G rGQ .--G C� J ?L..........................Co' -��"1 �_5___�or�/J.J ----•----------------------- Sq. feet Ca nstaller - Address UType of Building Size Lot.....��j..PS:S----- ,-, Dwelling—No. of Bedrooms-----------------------------------.--------Expansion.Attic ( ) G per, Other—Type of Building TAV.E eN---__- No. of persons.----7---0_________________� Q Other fixtures :^ W Design Flow_. 00 gallons`per person per day. Total daily flow------------- ...................gallons. WSeptic "I'clnk--Liqui capaciiv-gallons Length_____0....... Width____'.+......:. Diameter................ Depth.____--__.---_ x Disposal Trench—No......N_U___.. Width-----___--_:__------ Total Length...._________------- Total leaching area....._—__._-----sq. ft. Seepage Pit No......3-------------Diameter-----1Ca_'.._..._. .Depth below inlet------L;z._.__. Total leaching area..-,R9-t.sq. ft. z Other Distribution box OC)h Dosing tank (vo) n L y•1�•f�'• '� Percolation Test Results Performed by _G�u!!.n__ _ � ;i ;+^_ .....�L Z __'. C ,.--'Date-----5j 1l_1__7`'�_ ________.. . ,4 - Test Pit No. 1______ ._.._minutes per inch Depth of Test Pit............. __. Depth to ground water._ (z., Test Pit No. 2------- ....minutes per inch Depth of Test Pit---------------- Depth to ground water........................ ___ ___________________________________________________________________ _ `D Description of Sotl _ 18`r -o G v _� S v u tr r �ko' (�- l /1------.. 5_--.r<Gf__ _._ .-G.u_ S-- . ..90_ D. 'x 1 r5n +� h...... . .....-B-u.. "--s c." w ---- ---------------------------------------------------- ------------- ------ Nat of Repairs.or Alterations=Answer when ap licable -____1�1..,�-f._- A- U .................. --- - -------- ------------------ Agreement: S_ h J/iw /'/Ye/T 1�_ The undersigned agrees to Ltall the aforedescribed Indivi ual Sewage Disposal Sy pteiro'4ein accordance with the provisions`:-otArticle NI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee sued by the board �he1•t . Signed -----_--------- -----.- j Date ��-7 q C APPhcatton Approved By . .. .......... ...... •. 3/ Date A licai`;,Disa roved or the ollowtn Pp• - PP f f �g::reasons: -------•--------_--•------------------------------ s•s Date 7 Permit No. � / ---------------------- •i$sued- „ THE CQMM'ONWEA4,.Tf OF MASSACHUSETTS BOARD OF HEALTH Tr if ira#r of Ann tph-ttnrr THIS IS•TO CERT;F That the Individual Sewa e Dis osal S stem constructed or Repaired g P �' (; ) P ( ) by--........ _ i z Installer y - ..................... ................... ......................... has been installed in accordance with the provisions of.Article XI of The 'State -Sanitary C 'de s des'cr i'Y t e a. application for Disposal Works Construction-Permit-No:_:r _ _ ____________________ dated_... , _ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE C®NS RUED AS GU AN TEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY., DATE__. 'J/' Inspector. ? ' : .• :, . - N _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF"' HEALTH .... .... ......... .. No. f/.. ........................................ FE E./ y ' ri� >orttl. f nr �1atcrurilaat i �r; tiµn Permission is hereby granted = - G c _/_.. --- - •... .. ........ .. -•-•-•----._......---... '. p, `lto Construct ( x) or Repair ( ) an Individual Sewage Disposal System s,shown on the apphcatton for Dtsposal Works Construction P strut o. __ _ . +` /- ,?4 _ A r t ti ,s Fp .� ' � ".y.� •.- � � �WnCyal;may � � Board of ea i tI3�ATE - :. - 7- 1------------------- FOM� 12 HOBBS & WARREN. INC., PUBLISkiERS'-'".y r • So t �. Lc6 99.00 ♦. "PEAS�on�E -FOAM � G,�L •��� /I �' Loom 4SLjbsorl 4.I=i. VeLLow S M.N' 1000 ( µ,o. - °°�• - (!,a ( , 6AL 72 I�� IOCxi - G�AI_. I •I / ( Q GIZAVl7L otr ! eo°I TA"IL I `•�. CosaQaCWHITE —>=ou.,,naTlo�, �o = •a° � � o o �°�,a° a -� G Gar�au�Fa2 • 2' -01��2 WAS,.IEC�S-{2,HEe oI SA1J T� WATEQNo 88•� SCI �EL.EVATIOti 51LE"T�FI F— -- —/8' -- —•-� PE�C itATE: 12sS'F�An Z /,t l077 ' 06SGRvAT10N PIT OU6 S1;1J7y f PAUL Mu22Ay - lowNS"StSC ' Ex ypUMb ENGrN66 R R.I�A"�f - BACIGI>OE 97.3^ GO VV 14) 7T 27E 13z '� • z #. R7E' 2,4) G B K 96. 7�0P afMory /0 k 47' 't�'SeP c �ie1d Se�bock/r»a _ i4 96, 2 Ele✓ AMao EXPANS0ON )000 &AL PITS ` Ass /0 r ume. d ,io' �. � �,o / •�'� \ 1000 a l PI} °j'T(!,x ' 0 ti� 64 .X - 3� S {bfrc firff� x � 24 O GAtYA/!:k ,r f DOS 9Q� �,� �, I o' J 1 ` Eh"o or usc-asc6AeEA • ZO X1STf� lVS7 h`Q % Zor Ash . c --9 i. -;. Q�J, � I VEw��- ZQ ' O I�� NOTE; Po PC2,M(:TeQ • �� CoASTe �/OA! SG E " PLOT PLAN p F LAfJ C� IN 0t �l \ ` �t �ItQc.t3 /v,•a/ �� to JVO USE AZLE ARCA Foe LeACHINb .ram � -------•-._ ��� ���c.�_I.,+ :,G'�L�ry 12>, !�;� N Peor'QSCD UCS - -rAVe:tzN " )O Sl:AT3 \ v �' _ _Lidhr, p, poy/P, 2. 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