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Home My WebLink About0059 CASTLEWOOD CIRCLE - Health 59 Cash Or. a o llk, L O-*C AT ION Gcrs�`awo� SEMI G E PERMIT NO. Q/rG/.? VILLAGE I N S T A 1. T NAME & ADDRESS IVILDER OR OWNER t s . DATE PERMIT ISSUED; '. „ DATE COMPLIANCE ISSUED r I �'. . "�. ,.�Q / � S• w :7' w ' • ,C • M '� '� �. �H ., i� �� •� � � ! + .. ; � ems . f I - t� r � t' � • �-,, 0 �� t .w 1il ♦, rib" � i � . i , � � r .. � � � No.......3�l...� __ Fss../o.._............ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...........................................O F......:....................................-•----...................._.........--------... Appliration for Diipnsal Works Tonstrurtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage .Disposal System at: /-**Vocation-Address / or Igt No., , U� .. ~ O }er �- Address W Q �fY...._... � r!�19 1-1�.-----••--------•--•-•-----•- `f a-•---•.0-V °'r' ----.Sr....---•- a Installer . Address Type of Building Size Lot............................Sq. feet ., Dwelling—No. of Bedrooms.............................................Expansion Attic ( ) Garbage Grinder ( ) p`4 Other—Type T e of Building ,� yp g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ................................. . --•--------------------------------------------------- W 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. Seepage Pit No--------------------- Diameter..................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by................:•--------•-•----.................._-•-•-----••••-•--_.... Date.................-•.........--•-•--_.... Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water......................... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ --•-•----••----••--•••••••---••-•--••-•---•-••----•••------•-------•........................................................................................ 0 Description of Soil........................................................................................................................................................................ W ...•••••-•-•-••••----•-•••••--•--------------•-•---------•-•---•.........•-----•----•----.......•••--•-•--•-----------•--------••-••-•----------•----•••-•----•-•••••---••----------•-------••••---•--••. W -----------------------------••--...................•----•----..._....................-----•-------------------••--l-----: ----- ••- r U Nature of Repairs or Alterations—Answer when.applicable.____>_.. _yL........� /�? /......-�,/' � ...---••-•----------•-•--•••-----•-••-•----•-•---------•--•-•-•-••••-•-••-••••••-•..................•--............-•------....----••••----••••••••-•-_...•--........••••••......-••••-----------.--••- 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 bee issued by the board of health. igne .. ....... Application Approved BY - �f 2 � -------------------------------------•• -- Date Application Disapprov for a following reasons:...--•---•--•-...•----•----••••••--•--••-••-•-••-•:----•--•••--••--•--•--•--•----------•........................................................... ---•-•-•-••••--•-----•------•--.....••-•....•••••....-•---•••--•-•••-•-•••-------•--------------------•--•........_.....-•-------•-------------=-----•---•---•--••-•••-------------•............•-••••. Date PermitNo.......................................................... Issued-................................. Date f ,, No. ?.........Y.�.... Fxs.......................... _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................O F.................................................................................... ...... ApplirFation for Dhipos al Works Tonstrurtion rranit Application is hereby made for a'Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 59 �s7`,C . 00 ' Jcation.Address ..........................�$ or Lt No.,,, -. ...----•---•.................................. •• •••••- --..... ........................... . ... s . .-•- O Address .......... ........ r _......................... .o.__o.................................. ' .............. Installer Address Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder .( ) ►� a ,� Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Pa Other fixtures .------••---•--•••-••---•-----•• - W 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. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( - ) Dosing tank ( ) . '~ Percolation Test Results Performed by-•••-••••-•--••••-•••••--•--••••-•-•---••••••-•--•••...........•---•----• Date........................................ ,� Test Pit No. 1................minutes per inch Depth of Test Pit..................... Depth to ground water......................... Test Pit No. 2................minutes per inch 'Depth of Test Pit.................... Depth to ground water-_______--_-___------___ ---•------------------------------------------•-••-----•---•-----------......................_...---......................................................... 0 Description of Soil---•-------------------•--------•---------------------......--•----•----•--------------------------------------------------------------------------------..............• x c, W ••--••---------------------- ----••----......-•••-•••-•-•-••--------••-•----•---••••-•--•-••-......------•-•••••----- ••- A. A}- U Nature of Repairs or Alterations—Answer when applicable......... !�!��' L............ ' 'Ti .. �/ N ---------------•--------------------------•---•---------------•------------•-•-•--.....--------...------------------------------------------------------------------------............-••-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLs; 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee ssued by the board of health. _ ` ApplicationApproved By..e :.. ...................................................................... .... = Y Date Application Disapprove •f or a following reasons:................-............................................................................................. _ ..................................................•--•••••-•••--•-•-•-•-------••--•..._...•-------•.....-'••-----•-------•--••-•------•---•-----•----•-••••••---••••-••--•--------... ----_......._. Date PermitNo......................................................... Issued---------......---------------•--••--••......•-•---•-- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... C�rrtifiratr of ToanpliFanrr T Isis F-�E , That the Individual Sewage Disposal System constructed ( ) or Repaired .... ......_. 52�` .... ...........vj�r�.�:..e Instal Cam•...._-. _ ................................... has been installed in accordance with the provisions of TI�//' 5 of he State Sanitary Code des bed in the application for Disposal Works Construction Permit No--- .-. �.............. dated..... ! r-7................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector................................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ��. .........OF.......................... ...: v .................................. ....................................................... No.• _. _.... - FEE../................. Diopo at r-h-D tnution rranit Permission is hereby gr to .. . ••.••-• --------•-----•------------------------------------------•--.............................. to Construct ( . or Indiv' u �'"��.age Disposal System at No 1,� � .............. -•-•••......•• ----- ........... . Street as shown on the application for Disposal Works Construction Permit No..........:.../ofiHi�ealth .y/ - .._........... B DATE................................................................................ FORM 1255 HOBBS & WARREN.'.INC.. PUBLISHERS ,