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Home My WebLink About0120 HAMDEN CIRCLE - Health o94indfA ZJCe),, vH�y 'ram a LO CAT I N , SEWAGE PERMIT NO. VILLAGE I N S T A LLER'S NAME & A,DDRESS BUILDER OR OWNER DATE PERMIT ISSUED DATE _COMPLIANCE ISSUED �s� I Jt. a IN' a �S No.................l.. ® ~*Fss...... .✓``.-��_ THE COMMONWEALTH OF MASSACHUSETTS 1 BOAR® OF HEA T ...OF.......3.: `/ . ......... .... .............. 4u Appliratiun for Bispoii ai Vorkfi Tonstrurtiun ramit t Application is hereby. made fora Permit to Cons ruct„(.�} or Repair ( ) an Individual Sewage Disposal System at: ............. ,� - --------------.........-•-•--------. ... - Location•A, ess or Lot No. ------------------- W I � TO � d.lC/ ..:......... ddress Installer j Address UType of Building Size Lot____ _ ---Sq. feet �. Dwelling—No. of Bedrooms___..._.._3_ ________________________Expansion Attic ( ) Garbage Grinder ( ) a Other—Type of Building flo-< No. of persons........ __ Showers ( ) — Cafeteria ( ) Other fixtures .. . W Design Flow.................. --------------gallons per person per Pay.,Total daily f ow.._..._....33.0........__.___._gallons. WSeptic Tank—Liquid capacity/- _gallons Length____._*/Width__- �c..(.. Diameter--------------._ Depth................ x Disposal Trench—No..................... Widtli..•..r.............. Total Length.........P.......1!Total leaching area....................sq. ft. Seepage Pit No--------(.---------- Diameter.......6......... Depth below inlet..�... ----- Total leaching area..................sq. ft. z Other Distribution box ( }- Dosing tank ( ) aPercolation Test Results Performed by........ ....l �. . .... 14 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water....-------__.....././.. (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water..... a ----------- --------------- Description of Soil � f ;E 11 =/ .................................................. ------------------------------------ -----..................................... 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 TITL U 5 of the State Sanitary Code—The undersigned further grew not to place the system in operation until a Certificate of Compliance has bee ssued by the board health igned.•. ..... . ......:.C. Date i Application Approved By......... �� Date Application Disapproved for the following reasons: ................... ...... = ...................................................•---•-----•-•-•-••-------------------•------.....---...---•-•---------••------------------------------------------------------------------------••--•- Date PermitNo......................................................... Issued........................................................ Date _ No.............fltil FEs:......'Z ..:"..... THE COMMONWEALTH OF MASSACHUSETTS ` BOARD OF HEALTH OF.......A./( ry _ -- Appliratinn for Uhip i al Works Tumitrurtiun Prrutit Application is hereby made for a Permit to Construct ) or Repair ( ) an Individual Sewage. Disposal System at //jam/I j//��- ��// // (�'y�/} //)�i�,+�� •:-_• ____•f.+ ��Jf.. . �.Y�t -. .." _ "�'i._..__•_-_-_• ............................................................................ ...__•. •••...._. I ` Location-Address or t No Ownerf ,` Address W '" 'f = ' •• f. � ' '- .;✓Fib r�3' '"r� ,-1 .. .. _ Installer s Address UType of Building tz � Size Lot..... �...Sq. feet Dwelling—No. of Bedrooms ,�, ...............Expansion Attic ( ) Garbage Grinder -( ) Other—Type of Building 13I_4-, /f*��No. of persons._ .�-------------- Showers ( ) = Cafeteria ( ) Otherfixtures • ------•. --F --------•-------------•-----•••••--------•••-----•-----••-••--••... W g allons er erson er da Total dail fl�,ow._------ gal it Design Flow - - g P P P , Y , yam _ ... - Ions. WSeptic Tank—Liquid capacity i A f gallons Length___.__�'. ,Width__.� Diameter__._________•_.. Depth:_______________ x Disposal Trench No .................... Width........._..__.__.. Total Length......__..t �Total leaching area._-......._._...____sq. ft. '4; Seepage Pit No. ____ __________ Diameter _.__.._._ Depth below inlet_.. ..__. Total leaching area..................sq. ft. t< Z Other Distribution box ( )- Dosing tankze ( ) ^ Percolation Test Results Performed b ...___.__V{.f2_4,� ?... � s _..- Date...- _ a Y r z, rs•- - w Test Pit No 1------------- minutes per inch Depth of Test Pit.................... Depth to ground water. °# rzq Test Pit No 2 ..•...........minutes per inch Depth of Test Pit.................... Depth to ground water �, _�► ... O Description of Soil. !? �� .. .. ' .-..---------------------------------------•-.----. ------. 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 1 I T IZ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in r operation until a Certificate of Compliance has beeni'i'ssued by the board of'he�alth../ ti igned sC �� ;� _ 'te Y -; Date . A /f A lication A roved B / _ /// . PP PP Yip ' " /////.�jyyj�� -- ------xe) y... A............... G' Date tApplication Disapproved for the following reasons::....................•..__..._-_.__------__-----------------------------.. A ......................................... ......... ......... ............................................................................................. .... ................. Date . Permit No................. ........................................ Issued_...................................... ........... �g Date THE COMMONWEALTH OF MASSACHUSETTS a BOARD OF HEALTHY wrtifiratr of Toutplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) bG , / ler at f _ ._ fr / Q ` r� 11 has been installed in accordance with the provisions of T a5 ofT he State Sanitary Code as described in the application for Disposal Works Construction Permit No.__ ............................. dated"--__�� .__.7 '::._._.._......... T.HE ISSUANCE OF THIS.CERTIFICATE SHALL NOT BE CONSTRUED AS A CrUARANTEE THAT THE SYSTEM:WILL FUNCTION SATISFACTORY. DAT .................................................. Inspector.................................................................................... " THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _ f r. 7Jy NO................. FEE........................ Disposal Vorhg Tonstrnrtion,' rrntit/ rt Permission is hereby granted.---•• ._: 7 ^` .... - . to Construct )—or Re air ( ) an Individual Sew ge Disposal System at No :•F 't. Street s as shown on the application for Disposal Works Construction PA�io, - .___ _ .._ ated.. .-}- _. ... ,.. " Board of Health 1' ,.; DATE...........-.................................................................... FORM 1255., HOBBS & WARREN, INC., PUBLISHERS f.E��vl 4 � o F��v�sM G�.aa�• �- ��N�k G�P.4 vE �t WSH 6ffAVC -. . . .. ---— —--- �/ O vL-R Ti4 N K d✓ER AST s 7.5 Tap GLE✓,s tU.c� a"�G --_ 0 3w / r.+.vs/et .vE�D67vicFitG DWEGc tNG T - i-----a,-_ -PEASTa s►�6 Li A I CELLAR D IS T 6 p M > I t i L1 c eus.Y,�v sra.vE _; -- {-� fPEI N R7iYGf I7 �:ONG• �, c d �I / �I '� � � O t �•`l IA .SEPT!C TAN K " — _- ` — ro CiE LE vEt- 4 _L 0 -o c C p SYS 6 DES t Gam/ Cam'/ TER/A �/ GAG, oE•2 D.q?/ - __ �._J ___ `70, "'CoAGE 077,4 G Z>Iql4e-y IOCZ CJ S t oE.,�.�A mac.. A c1y� +++ AAl1 •f \ ' /^~ �£,�c,a�.u,\ Z 1pir L; / CG c tl � }O z.; • c � 8 .�. i ! < wp 4 3 4.1'1 sic 2 •Sta.til p �st `j � ^� i _ 1 1 4 P,POPoS�la S�W, 0 SAL S)eS?. IV ivspe c rEv AS DAfF RAJ Z5 I? 571-�. �NyA►�: .:��, M�4SS• rvr. R•QrE= G 2N1,►1��.lcr;� SCA��': I' - lJ ' ..... 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