HomeMy WebLinkAbout0377 MEGAN ROAD - Health ni�
u�l , SEWAGE PERMIT NO.
VILLAGE
INSTALLER'S NAME i ADDRESS
4- ALA 1)12V CoRlo. . 13 014
BUILDER OR OWNER
DATE PERMIT ISSUED .
DATE COMPLIANCE ISSUED
1
ail
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
Yawn......................O F.............Barn.atab,le..------------------------•---....__........
Applira#iou for Uigpooal Works Tom1rurtion ramit
Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal
System at:
...............Map cm__aaad....................................................... ............................Lut---2........................................................
. Location-Address or Lot No.
�. P....-------•------------- --------t . - �c. . �d_,x...._._ . '.7........................
O ner r Address
eh�.1 SAA_ ----------------------------------
Installer Address 10 2 5$ q Q Type of Building `2 P hicH Size Lot........... S . feet
Dwelling—No. of Bedrooms........................................Expansion Attic ( ) Garbage Grinder PO)
Other=T e of Building ............... No. of persons......................... Showers — Cafeteria
Q' Other fixtures .................... -:__...
W Design Flow...............55_.__......_________.__.gallons per person pi� ...day. Total daily fflow _._.._33 _____.-._..._._._._.....__.gallons.
WSeptic Tank—Liquid capacit} QQQ--gallons Length............. Width_4_..10_ __ Diameter---------------- Depth._4__.Q.....
x Disposal Trench—No.•-----------------•- Width....................
Total Length________._T........ Total leaching area....................sq. ft.
Seepage Pit No---------- _..__.... Diameter.........1Q__-... Depth below inlet.....6............ Total leaching area...26_7.......sq. ft.
Z Other Distribution box (X ) Dosing tank ( )
'-' Percolation Test Results Performed Wa.L..pe---CQd... .ryey..-CD IAlta tSDate......1/22/19•...•....._... ' ,
`_l.a Test Pit No. 1......2--------minutes per inch Depth of Test Pit---------12?... Depth to ground water.Il e__.__..._..
Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
s ..
----------------------------------
--------------------------------------•-•••-------.-----------------------.:_.:.......
•---------------
•---.--
Description of Soil__ 0 8 ...
_. -_..brown-•-.. •••7-,Q-
.
medw ------•---.._
��ytN �FMgssgc
------------------------ ---- ----- ------- --------------------- ---- - ------------ --•----- -......... ' - 7ENWICK
tiN
U Nature of Repairs or Alterations—Answer when applicable-------_-------------- _______ ... o- ----------$---
.... /.-_`... ... ........... •...-CHAPMN C",
Agreement: /� 7 .o p No. 27654 p
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in acc
the provisions of iIT?. . 5 of the State Sanitary Code—The undersigned further agrees not to place the S�h+Ng1�ENG
operation until a Certificate of Compliance has be l sue by he board of health.
_ '��Si d '-• -•.................•---•••--•---•-------•--•-•---•••......---•-•_.. .... ��
Date
Application A roved 'B .... ...-- •/S-r! ---
PP PP Y / �'�/� Date
Application Disapproved for the following reasons.,................................................................................................................
--•......•-••••••------••••-••••-....------•-••••--•----••=•••---•••••••--••-•...............••-•••--•-•••••••---------••-----•----••-••-•----•-••....................................................
Date
Permit No......................................................... Issued___l _'1'i� _7'
Date
ry��q f
No.......... ; - FEs �.. .........
_. t. '
/ THE COMMONWEALTH OF MASSAC,HUSETTS
A
^` ,} BOARD OF HEALTH
>> TOtira ...............OF...:........Barn►.� ble ..................
,� lima#ilaat for Uhippii al Works Tvastrurtinn ramit
Application its hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal
System at: `
Location-Address
fi A "fit o r t f'b "
1..3 .......... ..........................................Address............................................
Fner t �A kA
W ........................ ....... p '....-----------------•--•- ---.•-•--•......._._...•. --........-••"`•-- ---..----------------------•-------------........_._....---..........--
a Installer e, Address
dSize Type of Building ot____�O-M......Sq. feet
Dwelling—No. of Bedrooms..........:................................Expansion Attic ( ) Garbage Grinder PO)
'4 Other—Type of Buildin w No. of persons............................ Shower" �'( ) — Cafeteria ( )
Pa� Other fixtures -----------------=--------------------------------------------------=-=---=------------'------------------------------•--•-•------------._...--------
Design Flow...............55............•........___gallons per person per day. Total dail flow_.------330..........................._gallons.
W s . Ts s st s ft
WSeptic Tank—Liquid*capacit�•� ...gallons Length._$..6..... Width__. .._...... Diameter................ Depth.. __.Q.___.
x Disposal Trench—No-••-_--••-••-_.--_ Width.................... Total Leigth................... Total leaching area....................sq. ft.
s
Seepage Pit No.........l.._._---- Diameter........3•d_t ,-_... Depth below'inlet..._6............ Total leaching area..2. 7..._...sq. ft.
Z Other Distribution box (X ) Dosing tank
'-' Percolation Test Results Performed b9Ay_e.:- Q ...Suiv y onsultaxi.t s Date__..•. 23/79--•__----_-_-.
aTest Pit No. 1..... ........minutes per inch Depth of Test Pit .t..__ Depth to ground water 11Y3 .._.....__.
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
O Description of Soil• :19 .1Q . U Z.O.U.s•-10.77X.•t}a .t_.br4'►rx...
�4 Ct e io h t g.. .$and. ._...------•--•-•....... •-••--•-----•-••••••-••......_....•-•`----••-•.
V ........................... LPL SS
W ---------------------------------=------- ya 9�y
UNature of Repairs or Alterations—Answer when applicable._________________________________ _••__ _ ............._..... ...REpluvlCJC__. Gm
B.
........... -••-----•-•----•••-•--•••-•••••-•--•--•••-•---••••••-----•--••........................................
..-• ... .. .... .... ............. v CHAPMAN N
Agreement: u� Z �/ No. 27654
The undersigned agrees to install the aforedescribed Individual Sewa e Dispos System in c nce ����
the provisions of TITL:
5 of the State Sanitary Code—The undersigned further agrees not to pia OVAL
operation until a Certificate of Compliance}has been issued-by the board of health.
S ed .... , -------• `
Date
Xr
__._ ?'_ /Application APProved BY •• ...... ... ...-' Date _.
Application Disapproved for the following reasons:----=............................................................................------------- ---------------
............................................................................._.....-----.._..___.........._.._....._.._......._.....-•---......__....._........_...._...._..---_ ..................
Date
Permit No...................... _.__.......i.' .. ,. Issued•---........-----•-----• ..._....._..............__. ,
1 Date
O3` �
;. THE CMy+MONWEALTH OF MASSACHUSETTS
'M BOARD OF ,HEALTH .
r ..Iv .... +SCV' .......
OF... ........... t
K�
k �rrxifirtt# .,alaf"f ampliFanrr
THIS IS TO CERTIFY Thaat tphpe Individual Sewage Disposal System constructed ( : -�.or Repaired ( )
by.................................... y ..,. a
� t Installer
t f i4 4 f r0,� 4 i x
has been installed in accordance with the provisions of T r j of The State Sanitary Code as d ibed in the
application for Disposal,AVorks.Construct ion Permit-0No{... _......_.1_ ...:............ da.ted_. . .. *................
THE ISSUANCE OF TMlS C_�RTIFIar TE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTON SATItFACTTORdY
InspetorDATE............... . !
, -. --...--•-------M..............---
' -----
THE COMMONWEALTH 9
OF MASSACHUSETTS
��/��^ OARW OF 'HEALTH
6 • # !r ...........................``� ....._........
.................. �'7.. .O F... ..... f � i.., ` -. '
No...-..... 7Z...... FEE........................
:r
.d, i� tt1rk Moni#rinn Vrn 4
Permission is hereby granted ~• -• :.,�! r°�.........---•-•----•----= ................... ............., ,:._..
-
to Construct,( ) or Repair ( )'an Individual Sewaq Disposal System
at No. '` ` Es' y�JYr f '4 ,' ') s� Q l""111..1 a
........................................---- .--
Street f c
as shown.,on the application for Disposal (Yorks Construction Pe N ------ __. Date _ ......................
oard of I ealth
DATE..........
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FORM 1255 HOBB '!k WARREN, INC... PUBLISHERS
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