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0289 OAK NECK ROAD - Health
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NO.OF BEDROOMS 2- 3 PRIVATE WELL OR PUBLIC WATER �d/iC, BUILDER OR OWNER 5,tgJ t " A o 1 DATE PERMIT ISSUED: DATE .COMPLIANCE ISSUEDs J-(/`L @ o? 1-7 VARIANCE GRANTED: Yes No �✓ ., , b x��� c �a + � S� x Al J, t F$s.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �d �J................OF... /As?^7 Appikatiun for UWposal' arks Tnntrurtta tt Prrmi# Application is hereby made for a Permit to Construct ki-or Repair ( ) an Individual Sewage Disposal .. e Rd -•- •-- ....................... ... - .......... _.._ L atio Addres . or Lot No. ne Address W ------------- ........ : � .-.------... ----------------------- Address Type of wilding Size Lot_l©,/..d!2/......Sq. feet 14Dwelling—No. of Bedrooms._ ................................Expansion Attic ( ) Garbage Grinder ( ) ..l p, Other—Type of Building ............................ No. of persons.:.-._......._.__._.......... Showers ( ) —.Cafeteria ( ) a' Other fixtu s d ........................................................_..... ........-------------_..... ------------------------------- WW Design Flow...........c ...... gallons per personFr d,ay Total fly f�gw--:- � .Q.3.0........................ WSeptic Tank—Liquid cap.... Qgallons Length- ____S�!!-...•Wid............. ... Diameter................ Depth_......__....... x Disposal Trench—No..................... Width..1._.......__-..... Total L'ength............f......Total leaching area__��__._/�__�._i•--...._.sq. ft. ./..... 3 ........_. iameter. ___.__:..__ Depth below inlet.....:......... Total leaching area.. Seepage Pit No-_-._--1._ Z Other Distribution box (' Dosin tank ( ) Percolation Test Res is Performed by... 6._1.....r uc.'� .__.� C: Date.../P._-d ...._.. j Test Pit No. 1_ _Z____minutesperinch .Depth of Test Pit._ `!` T*._ Depth to ground water... fi Test Pit No. 2. 2minutes per inch Depth of Test Pit_ ._.._.. Depth to ground water! ?'� ..__G �'v x ............... -...------.............----•- •--.............._...................•--......................................................... 0 Description of Soil_.._.::.-__-.. . .......... ....... ...:... , =_c �L:�-�----------------------------------=--------------------------------------------------------- ----------- ..........................................................................................................................................--- 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 iI'IU 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.. ...........• ---•----------------•----------------------•----......--•----_.... ..........................-.... Date Application Approved BY---.--- _.......�.e�QL.......-^-------------•-----..._...----------........... •----• �-Date Application Disapproved for the fol `ng reasons:.........__................................................................................................___ .........-•---•--•--•-••------------------------•------•----•-------•------------._..------•-•------...............................................---•--•--------•-----------------..........-------- ' Date PermitNo...................................................._._.. Issued........................................... Date NoV... ..... Fss THE COMMONWEALTH OF MASSACHUSETTS 3 ' BOARD OF HEALTH ULCJ�................OF......9 .��_•--•- 6..................------...:_._. Appliratinn for Dispnlltti Marks Tonstrur#ion Prrmit Application is hereby made for:a Permit to Construct �4) or Repair ( ) an Individual Sewage Disposal system� � G, ----• ��,q c�.c�i.S...... . L v T Jam.... .................... -- -- ......... •--- .a..._------------------------- ------------------------------•-----..».....-----........................ .....- _- L »..'-'.....»»»»»»»».......—...ocatiott Address or t o. � Owne Address n n ..............................r �..». s ........»_.... f Installer Address Type of Building Size Lot_f �..GO ...... feet Dwelling—No. of Bedrooms........................:................:..Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type of Building ............................ No. oft persons............................ Showers ( ) — Cafeteria ( ) p' Other fixtur s ...._ Q -------................................ WW Design Flow..........::..5_........................gallons per person..p�er day. Total daily fl9w.---..uJ..:' .......................ga�lons. WSeptic Tank—Liquid capacityZ gallons Length_?__ .�p--._ Widths.-.g--_ Diameter...... ...:.... Depth:Y.---....... x Disposal Trench—No..................... Width_....................Total Length----_-------------Total leaching area_.:L,:�..:...........sq. ft. 3 Seepage Pit No._.....I_........�.. Diameter..:/ ........... Depth below inlet.....Y... Total leaching ar;a-4-../--:sq:jc Z Other Distribution box ( 1/) Dosing tank ( ) `"' Percolation Test Results Performed by... /� ! _,. ....T ��G�. �G 0.=-v'3-6..XV_.__... -.. . Date . t-] Test Pit No. 1_............._._minutes per inch Depth of Test Pit..N.V... Depth to ground water...•--.•___________...If.AX Test Pit No. 2»?� ze....minutes per inch Depth of Test Pit./V�_.* Depth to ground water 7 Chi -- Description of Soil.-----•------••........................ � 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 TITL L 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.. _.. Date Application Approved By. 1? ��....... °' .... - '2�-: A - ,_ / Date Application Disapproved for the'lot lowi'ng reasons:-------•-----•-.•--••---------------------•-__-------_.------...------..........-----•••-• •-----.-_»» -•....................•..----........--•-------•---------------------------•---......------............_.------....---......................................-----.......•----••--•••......•--......... ,t Date PermitNo................... .. ...».... Issued_............................................_..._....» - Date -------------------{�--� ----- -----A-------------- q� THE COMMONWEALTH OF MASSACHUSETTS 7' BOARD OF HEALTH ................OF... _ ........r..f............................................. Trr#ifutt#r of Tantphaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (X or Repaired ( ) by........................ ---- -•--•----------------..........-•---------------..............---•----..............-•------•--•-•-- Installer at_... G C' I rIG /l/C�C?, .. -------•-------- ' -----` has been installed in accordance with the provisions of W. F 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit iV'o .�_._.I �-- Z PP P dated ..._ .._..... r.............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.........:......:�............... - --------•--------------•. ..... Inspector -v "'�'"�\...��• - :.......................................... -------------------- ------------------L------ A THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -1 N No..IJ................... FEE.......A.............. Dtspnott1 Works Tons#rnr#uan fpruttt Permission is hereby granted............-.)R 1 r s Q!L 1 to Construct (y) or Repair ( ) an Individual Sewage Disposal. System .................. ....y •---••.. . - .................... Street r as shown on the application for Disposal Works Construction Permit Nol�__.3 .-__... Dated.........5_._-4.__.. ,�......... �J ................... �v^�^^� ----------(. ...._.._.................. �i 7 Board of Health DATE..... (n4f V �) •i �Z L. 8 fOAo 10.00 r O 4 , oo 2 o i _ _ AJO TE . - - - - - - -- e>tisfin r-oUnd ro�ile 9 9 ** 7-/ O A MANNOL E CO(/E�S To —o—o—o—o— proposed ground pr-oy"i/e -"' VEi2T. SGF-ALE : / _ /O FL OGA/ ---,_- SCNED. ¢d F?V c. oi2 •• Z' la er Crninimurr �• per foof,� y A EQUf�L To SEPTic ale".peas 41 -fone --- - _ J.", 14 DIST. BOXMR- i000 Gf�L, SEPT/C..-TANK ached shon G ..._ �p(O / ` _ t ., a•: T - 57 f / © L. � L. 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