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Home My WebLink About0148 COMPASS CIRCLE - Health `tor i LOCATION SEWAGE P MIT N0. N VILLAGE INS TA LLEX'S NAME & ADDRESS B U I-L D E R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED �'' �� c'` � �. _- W 1 � � `=�- '� ( C� I � � � �, ,g, �_ ._ a � -��-- �c .. iL No.. '/1 R: Ficz............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD ALT OF. Appliration for Disposal Works Tinuitriartion lirrutit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal Sy t t r ..� .......... .. ............. . . ------------------------------- -e_ 62-14 L % Add ress ress 0 ........... . . ....... .....Y s 0 d�re, .............. .... . ...... Insta er Address �............. T of uilding Size Lot..,��_ _,f7�3 Sq. feet U �,p Dwelling—No. of Bedrooms.............3..........................Expansion A tic G Aage Grinder 0 —Type of Building .......... Cafeteria Other o. of persons ........ Showers /) Otherfixtures............... .......... . ..................................................... ........... ------------------------------------------ i Design Flow........ ................gallons per person perk ay, Total daik .........37. .Z. v) . :Y.0....................gallons. 1:4 Septic Tank—Liqu_-Jcipacity gallons Length___._ ,_/"Width.�-y... Diameter________________ Depth.....__......... -i—No. ....................•Width................... Total ength.............. ,7- Total leaching area.....................sq. ft. Disposal Trench ai Seepage Pit No__________ Diameter.__..._ Depth below inlet......d.......... Total leaching area.................sq. f t. Z Other Distribution Percolation Test Results Performed by_/Y&-T4j4,44j...A a 4-).. Date- A// Test Pit No. I................minutes per inch Depth of Test Pit._.__............... Depth to ground r....................... fZ4 Test Pit No. 2................minutes per inch Depth of Test Pit............._...... Depth to ground water....._..............___. P4 .......... ....... .... ..... ..... .. ... .......... 0 Description of Soil......... ------- -4------ W U ........................................................................................................................................................................................................ 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 TITLE 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 i ed by the board of he Signed.... 4AV -------- .. .... ............... as been i e.d.- board of he d.. Application Approved By.......i. ........................... ....................................................... -------------------------------- I Date Application Disapproved for the following reasons:................................................................................................................ ......................................................................................................................................................................................................... Date ._7 Permit No....Z19........................................... Issued...... r ...................... • Date L No..:..........._....... FE$.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD f,OF HEALTH Appliratinn for UhipaaFal Works Tongtrnr#inn Famit Application is hereby made for a Permit to Construct •_)-or Repair ( } an Individual Sewage Disposal System t r •=w r`..........." � .......... ,. ywr cr wner'•cr '7 1 f X-k �.r e .:t:- . aadd�ress Laton Address rLotNo ' r{ rr� ...... O ------------- .W ,C1�^e i� J;T _r� ✓. 6 i d.�',.,p.f'�'-t'1,------•• �.... j e -, '7 Installi` k s /� Address UType of:Building Size Lot. �r�t'I..�'_�. �..._Sq. feet Dwelling—No. of Bedrooms .__ ....................Expansion Attic ( ) Garbagennder ( ) pal Other—Type of Building f ' r {`y�� -.,No. of persons............. ............. Showers ( ) — Cafeteria ( ) Otherfixtures --------------------------------`•----------------------------------------------------------------------t---------------------..............-------- W Design Flow................ . '....................gallons per person per, days, Total dai y fly�w__.._.. . .___.__.._..._....._gallons. W Septic Tank—Liqui capacity/_y_i ?.gallons Length.___ __ .._ Diameter________________ Depth................ �"�' . _ Width.f�----- x Disposal Trench-No. ...................Width.................... Total Length___...7...._..... Total leaching area.........._.__.:....sq. ft. 4r; Seepage Pit No......... ........ Diameter....... --------- Depth below inlet....../......... Total leaching area..................sq. ft. Z Other Distribution box O Do ing tank ( ) Performed b _Percolation Test Results _ ! • Date_ia ��a . 0 .%"'y'# z••.--_{ _ ... 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........................ W .._....___ ------ r............................._ O Description of Soil-----.... /I ' e �' x �. v .-•-----------------•-------------•-----------------------•---..---•- ------------ .......---------------------------------------- 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 TITIZ- 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 the board of health:-" Signed ........... Application Approved BY--•- =A................................. Date Application Disapproved for the following reasons:-------•------------------------•-•---------•----------•----------------------------------------._..........-•-- ......................................--------------------•-----.........._..--------•-------------------------------- ........................................................... Date PermitNo.--'( _1---•-------•---------------- .......... Issued....................................................... Date a. 'rH:E COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r.. '.:6,4 jt OF...... �'��,°� f�rrxi�irtt�p of f�nnt�li�anrr THIS IS TO CERTIFY, That thp-Individual Sewage Disposal System constructed ( ) or Repaired ( ) by .,fir . � rt -, ...... ................................•--•--•---•------------•---•-•--•............_ - �- � in tatter at. .!: � .�'' ..... -_ p"/ ,fi t 4 � = tom a .. + 4 r.-;r C r - has been installed in accordance with the provisions/of TITLE 5 of The State Sanitary Code as descLihed in the application for Disposal Works Construction Permit No........4 ,y...................... dated....... '.-.OX...... .................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION .. ... .. . ... SATISFACTORY. DATE. ..:..... ... ..-•-- Inspector....... ...L...... ^ -----------------------• THE COMMONWEALTH OF MASSACHUSETTS a BOARD OF HEALTH ............... r .!r.. .z ).OF !r'; 5= No......................... FEE... Raposal Workii Tonotnut nn rrmit,,-, � Permission is hereby granted------ --..:.:- -•--•�r .......-........------�.-�__..._ .- - ..y--� �- -�"=`• to Constr t '(' ) or Repair ( ) an Individual Sewage Disposal System f� - f ° 1 Street as shown on the application for Disposal Works Construction Permit No.._I1__'?....... Dated--------- .......... ............................. : ........................................... Board f Healtlf DATE........................................-....................................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS