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HomeMy WebLinkAbout0040 MURPHY ROAD - Health 40 7777 14 13 tA A. ip as 1 k c t y n • ` v ° - , : � c a ° u " m 4 � d ` a .. .. :.. - ^., '. r. ,.: 9' 6 ^C- ,ti' ,. #1: - as Q �• o. aa, #a� 71 1 LO CA T ION S A E PE CIVIT NO. jt,�� V" G A LLAGE 7"��\ �� E 1 S LLEIt"S NAIVE i ADDRESS MWEa R UIIDE ItOROPHER DATE PERMIT ISSUED 1� a DATE COMPLIANCE ISSUED ; 7y �' �. : 7:77 tom% �5 Ie IJIJ No.. ..`. _ FEs.., ..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................... ................O F....................---...---........... .......:..... ._....._................ Appliration for 11ispas al Worko Tonstrurtinu thrutit Application is hereby made for a Permit to Construct (x) or Repair ( ) an Individual Sewage Disposal System at: ......... ....__................. . . ... t�..... -- .11 r .h!.t s... - ............. ocati n Address or Lot No. k e9�&.A.X.(..................... 1 ..CQ. .� 1---- .. �!� ......-- Owner Address --•---.. Installer Address Type of Building Size Lot.___:_::y�rdS........-Sq. feet U Dwelling—No. of Bedrooms.........a2................... _Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of BuildingNo. of persons............................................ Showers — Cafeteria a d Other fixtures ------------=----------•------•------••---•--•---------------•----•-----•--•------------•----------------....---•--......------•-•---............_.. W Design Flow.............. .`Z. .................gallons per person per day. Total daily flow... .-� ................gallons. W Septic Tank—Liquid capacity/40A..gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width_.___.... ..._._.. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.... .............. Diameter......46. _ Depth below inlet.................... Total leaching area.... ._.._. _..sq. ft. Z Other Distribution box Dosing tank ( ) /D ,7_j7 Q '~ Percolation Test Results Performed by....R.t.a.a-4&,o-..... ............... Date..... aTest Pit No. 1....01.......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........................ -----------------------------------------------------------•---.....-----•------•----.....---................-•-•......................................................... O Description of Soil....4........k.9A.!^1.....- L................Zd J . x Uw -------------------------------------------------------- ----•••--••-----------•---••------•-•••--------•---•••••---•---•--•--------••-•••---------•••-----------.........---•-•......-•--•--•---•---•- 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 iITM 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been isVaed by the board Qf health. Signed-- °••-• .-•-- ------••••:... �` - 7 Date Application Approved B ff ' PP PP y.....--. -../--['= ��- ,-- ?---.. Date Application Disapproved for the following reasons---------------------------------•---•------------------•----------------------------------................_..•-- .................................................i•-•---•---•-••-----•---••-----••--...------ 17 Permit No.--------7 y Issued....a i�: � 7 ......................Dau Date No..... . .............. Fzs. .. ...>... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...............................--.....-.--.O F...-..--..--..........-.......-...........-_.-.........-.-_..........__....-..._......_._. Appliration for Diopn.iFal Warks Ton rnriinn ami# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: i Locatio -Address _ or Lot No. /'✓/� /y7 A�/ /1,1�(.�L- / . /.5...�a.�.! _1.....tT . •............ WL4A Owner Address ....................................................... .......................................................... Installer ut Address Type of Building `' Size Lot......!f126.......Sq. feet Dwelling—No. of Bedrooms.........j;9..................._..........Expansion Attic ( ) Garbage Grinder ( ) a`4 Other—T e of Building No. of ersons____________________________ Showers � YP g -------�------•--...---•--- P -------------------------(----)_.— Cafeteria-(•---)- d Other fixtures .. ----- W Design Flow............. .:?_ .__.........____gallons per person per day. Total daily flow.............. -�'__U________......_.__gallons. W Septic Tank—Liquid capacity-/:e_(�t_gallons Length................ Width................ Diameter................ Depth____.----------- x Disposal Trench—No_____________________ Width.....__.._____._ Total Length.................... Total leaching area................_...sq. ft. Seepage Pit No--------------------- Diameter.____.f__^_%'_. Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (N' Dosing tank ( ) aPercolation Test Results";: Performed by._..__�e ...... ______________ Date.......fir:.-..3.«_:_1_t....... ,.a Test Pit No. 1.....5a.......minutes per inch Depth of Test Pit___________________`'Depth to ground water........................ f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... , --._._...-•--------------------------------------•------- ••-.....------....._...........-•--------.......................................................... 0 Description of Soil.....`..... '"' =T---- .................�f......... -----•--- t %'.............................. 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 iITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss ed by the bo rd f health. 1 Signed - •--=--=-- - ---- -----• -............... .... . ... -- . . l 7 Date .� Application Approved By.........7............................... ---------------------------------------- Date Application Disapproved for the following reasons:................................................................................................................. ......................................................•---•=---------------•-•-------------..........----•--------...------•-----------------------=----------------------------------•-=---------- - — f Date Permit No..........f 4-=._...--•---••'==4--•---------. Issued-....................................................... Date THE COMMONWEALTH-OF.MASSACHUSETTS BOARD OF HEALTH 1 !mil t�`.... �t1lr: 'r/J/�,.M -.......-.OF.............�:.... .... ........ J 4vu� (Irtifira to of Tompl6nrr THIS IS TO CERTIFY, That,the Individual Sewage Disposal System constructed.,( <) or Repaired ( ) by - - /l ? /- ,,/ 17 ;4 -�( ri f� y Installer _ �� s has been installed.-in accordance with the provisions of TITLE 5 of The State Sanitary Code as described-in the application for Disposal Works Construction Permit No-------- _____________________ dated....... r__ l _7 .............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL .FUNCTION S TgqISFACTORY. / DATE__...- _---- . �` � 1.._•• Inspector__. ........ -t j THE COMMONWEALTH OF.MASSACHUSETTS BOARD OF HEALTH t tefs'.> t. i s✓.. C FEE �. Elispos al Workii n#rnr#inn rrrm i Permission is hereby granted........... ................' f'S to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at-No...................'......................./ - l--'--------------!:.'_� .- „i.% Street I as shown on the application for Disposal Works Construction Permit No____________________ Dated.......................................... 1, —,.2 O f7i-- Board of Health DATE............................•-----.-._._._:..-_----.._........_-----..---•-- i FORM 1255 HOBBS & WARREN, INC., PUBLISHERS llo G:w^,71zsAG1� &;fzj 1JUt.1T G ..►- a { -Z7�6.eL..`•( �t.AW s 11b +c 3 4 �3D G.�':;7. �_ ,.. ,�.,,� .. ' , I 330,e ISO % 4-95 6.Pro. U Ste• t o 00 6 A t r �ISPoSAL PIT user locoMW SO-McwALL AeE A. - 15o S;7. f ,; A 'A ;, 1\ I►�• a i V/A 40eA: � �. - � M1•.t.,t OsI'��� t 1..+ � E v —''j�'� Z (7+ O e �i 1.., X ie. .•TP, 'k , _• •N }� ,' t5k r Tt>TA�. vA1��f Fl..ow = ,33D 6P.n I o1Z LYs Y. 1 it t ! ,. i t y, ,..9 k + ; G.', Y A .S t. 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