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Home My WebLink About0525 OLD STRAWBERRY HILL ROAD - Health 0771 552.5 OLD'STRAWBERRY:.HILL RD ytA =' 173.`` Oo14 ,? r� s I ;l 0 fo........ . . .... FEE 2:s................ THE COMMONWEALTH OFI�MASSACHUSETTS BOAR® O HEALTH j. �------------------OF.......... .. ..,� .........—_----......................._.._.................... 6 0 Appliration for Dig oti al Works Tonstrurtuan ramit Application is hereby made for a Permit to Cons•ruct ( ) or Repair ( ) an Individual Sewage Disposal System at: rr - .....__... --........ ....r�`- ��:'.!te_a_/._o.....�... •L--o•c a/tOw�sA r d d y o No. it ) �.:.. � ----------------- !- ..------- ....................... ess Installer Address d Type of Building,.-' Size Lot...1Y�, 600-------- Sq. feet U Dwelling�N. of Bedrooms_- Expansion Attic (. ) Garbage Grinder W4*- -.---------- '� Other—Type e of Building a yp g ..........:.......�..�No. of persons.._._.�.._____..._..._... Showers (�) — Cafeteria ( ) G" Other fires ........................................ W Design Flow......... .................. ...........gallons per person per day. Total daily flow_::..... .......................gallons. WSeptic Tank—Liquid capacity.�P_...gallons . Length................ Width---------------- Diameter................ Depth................ x Disposal Trench—No..................... Width•.. ............... Total Length......_•. .....: Total leaching area....................sq. ft. Seepage Pit No---------/-------- Diameter........ ...._ Depth below inlet..... .......... Total leaching area.__,2.a/•-...sq. ft. Z Other Distribution box ( ) Dosing to '~ Percolation Test Results Performed by........ lr �.....�.®Y-� .'............... Date--_�---• J. ..... •----_-. a Test Pit No. 1....2--------minutes per inch Depth of Test Pit.................... Depth to groun water........_...._......._.. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ....-•---- ---- ...... ....... •-•.............. .... •------•-------------••--------•••--•---•-------------- s i e Description of Soil......C0---2.....------ •-•---`— �-- � -•-••---•--•-•--•------•-----�� --� 1.�' - !1�d........� (JrYI e c. l b=r�� .........................•.. W ----•-----------------------------•-------------------•--------------------------------•--------•------------•--------------•--•---------•------------------•-----•-----------•-•--•---------------•••-- VNature 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 TI'i 1Z 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued the and of health. (� Signed. .. c ....... .......... ... ........7L_.... Date Application Approved By--------• •.... ........... .......... ._........---•------_.. ..... = Date Application Disapproved for the following reasons:................................................--------------------------------------------------------------- ..............•-•----------••--------•.......--------•--•----...------------------------....-•----••••-----------•-•-•-----••------------•-------•--•-------------------------•-----------••-•----_.... Date PermitNo....................................................... Issued-.................................................... Date - lo"% . '3rt tvv2Jo.Md- C. . ov :�3^ a ►M d b+ D Ir+v51-ldev et�s0 �� lorn all�otis *Jze.�- /4a^2tl6; '. lt^t-qwnal`JS'tl r-id ri o QgSVa IOTI 'Sl t`+V"16 ipFt11 V rtv-i <imm m t._st"7"�21 r ..�,�1 ��T`9 � '?J�1X°V� i.-•�, -v,,; w 1 ,� --r;�:�� y ,r i , - �l'cJd • _mil._ �°;,' � �� r _ .�� LO ; "3rl-L A �a.1r+�W' aictL 71 ?+7d91�p. Qtwd �ti1. H11M S�"�d � h03ZD3ti r+moms '3"-L J..'v'til AAt1�s�7 1 fit` 2T� Z3 r-t b-1d zs=+ dIA oN D2r c �.1-i74 1= OS= N�( �,VaS �•e,-.,5 Or} 8 'g2 1zi C)�d CI t_-j t_L-131FIol - � U� �hCZ1S 3N01S t�9f�4YJ11 , ' �i• � r'9 J�'1 - •' c'L'?b '1bh Y♦f1f � 1SIQ 9a�„� • 9 %OF�1 000I r� W` or7 ` - c �t b �fv�t . • d t3 GL Ak f3. 44, iD its QOS- vT` '� S 9 S a �x'�21�'f W01:Lo4t3 . s `2 X :::I 5.:o;`1 .00 o I ��Cl Ltd '1"da3dS1G iin �- 55' -¢� a 7oCYJI t`1'G'.1. t�r j : z >` Ott = n�a"t.� y♦..ytt�rd, , 4N0..- .... .7Y.... Fss.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD O, HEALTH . /0'0� . --... OF..........::......... ..... .... .... ............................................. Applira ion for Mnpwial Workti Tonstrnrtion ramit Application is hereby made for.;a,,-Permit to Construct ( ) or Repair ( ) an Individual Sewage. Disposal Loc�* Pd r s r ivh ------.....-•-•------- ss ----•-•-••--_-•--- -•-•-- .------•--••••- - -- ---------....... ----------•- -------- ...--------------- ......... .------•--•-- .....� ..-•---------- Installer' Address PQ d Type of Buildit Ot�O q.Size Lot_____ S t . a Dwellin —No. of Bedrooms _ ___________________ Expansion Attic ( ) Garbage Grander �+ p, Other—Type of Building _._:_,. ' `- No. of persons_ ___________________ Showers Cafeteria ( ) a' Oth .� res ._ W Design Flow____' _ .............. ..._--gallons per person per day. Total daily flow______: +±........_ .._________________gallons. WSeptic Tank—Liquid capacity gallons Length................ Width................ Diameter................ Depth................ Disposal:-Trench—No. . Width __._ Total Length....__. Total leaching area sq. ft. Seepage Pit No________ ___ _______ Diameter_______ ._:___..__ Depth below inlet____:___ __._.____ Total leaching area._ q.f �' l�/---s ft. Z Other Distribution box ( ) Dosing Ve� Percolation Test Res is Performed by_ ___ _..__.f__�'I--��_�_________________ Date_�__��._�' .......... aTest Pit No. 1. ........minutes per inch Depth of Test Pit____________________ Depth to groun wat ....................... Test Pit No. 2---------.......minutes per inch Depth of Test Pit.................... Depth to ground water........................ Description of Soil r 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 T I T I Z 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 the�oard of health. F - 7 Date _ Applica ion Approved By.......... _.__......• -••- ••---- 6 Date Application Disapproved for the following reasons---------------------------------------------------------------••------------•-------_--_-•--•---•••--•-•------ a ............... ------------••••-------------------------,_'..................................................................................................................................... Date PermitNo......................................................... Issued--•-----------•---.................................... Date THE COMMONWEALTH OF MASSACHUSETTS 1 BOARD HEALTH OF..... .. .....:. ! ....................................................... Trrtifiratr of Tomplianrr THIS f � IFY, That the the Sewage Disposal System constructed or Repaired ( ) b ............................................................. Y /. r at......................................................i has been installed in accordance with the provisions of of he State:,-SanitaryCode. a �rdUed in the j application for Disposal Works Construction Permit NZ? _)__........ ___•-_-______. dated -. _ f._..__.__._________ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A TEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. 7� K-- 7 DATE Inspector.... ._. .. -`- -_•-•--..._.._..•-•-----•- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH a . No.......................... ............... Ui1111 eflL':S 1 ?.,orkv Tnnitrudion rrntit Permission 's hereby grant ............................................................................... to c ) or Repair ,( ) a Individual Sevtr e sal S stem (,�t�3 ,j,� Street as shown on the application for Disposal Works Construction P t No ate !'' ._.. .•---- • -------- c•_•........................_ i—/�` (/ -Board of`Health DATE.-•----••-----✓ f1 FORM 1255'HOBBS & WARREN. INC.. PUBLISHERS '