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Home My WebLink About0670 PITCHER'S WAY - Health �670 Pitcher's Way Jyannis k= 271 — 172 I �I G - LO ATION --// SEWAGE PERMIT N0. 77 - C VILLAGE INSTALLER'S NA E & ADDRESS 72 _ B UT D E R OR OW R DATE PERMIT ISSUED DATE COMPLIANCE ISSUED f - 7 f? � e � . , ' 1 C-7�1) No..........� .... At ............................_ THE COMMONWEALTH OF MASSACHUSETTS D r • BOARD F HEA T /—GL` --....O F.... ... Appliration -fur Ii-4pustt1 Morkii Tomitrurtion Vamit Application is hereby'made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System e - Locatio ddress or Iyot No. Ow Addr L�1CIO a .............."'--•" .!L........'. ........ . ----- ................ .... .... ... ...... s.-�:•• Instal]er / Address Type of Building %/ Size L -.. --- -----3 R_�.j'_-__Sq. feet U Dwelling—No. of Bedrooms------- -------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons.--------------------------- Showers ) — Cafeteria dOther fixtures . -- --------------•-------------------------------------------------------------------------------- ''------------------- W Design Flow............6:_�0-------------_--.__--gallons per per-son per day. Total daily flow........... .................---gallons. WSeptic Tank—Liquid capaciti% dlons .Length................ Width---------------- Diameter__._-_--.-_--_ Depth-._.-----..-.--. x Disposal Trench—No..................... Width------------------_ Length------------ -_---- otal leaching area_...................sq. ft. Seepage Pit No----- "'-'......_.. ............. ..... al leaching area. f1 ----sy. it. Z Other Distribution box ( Dosing tank ( ) C�— .2- — `/`7 7 Percolation Test Results Performed by-------------------- ---------- ------------------------------------------ Date---------------------------------------- .-1 a Test Pit No. 1----------------minutes per inch Depth of "Pest Pit..-_-_--__-____--_-- Depth to ground water....___-.------.....__.- rXq Test Pit No. 2_-------------minutes per inch Depth of Test Pit-------------------- Depth to ground water_..-.._..____--.--__---- 0 --------------------------------- ------- ,� c�' 1-•-•••-- --- - Description of Soil -..� f� "` "1 ��' UNature 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 Article XI 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 bard of ealth. ..... •--•- Dat ` - Application Approved By---• ` L --- = ^ 7 S Date Application Disapproved for the following reasons:-•-•-------••-•---•-------------••--------------------------•--.---•-•--•------------------•------•------------- ........--•................••...-••-••-••-••.._..-•--------------•••••-----------•-•-••--•-•--•---•........••-•-••••-•-------------•------•--------•-----....------------------. .-.----------- ......... Date PermitNo......................................................... Issued.... .. -�-•--...-•-••--•-•--•-- Date �.. - .. --- -----------------------------� C-7 7) - 3 No........... FizIc ............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......OF.......!� < *1./�r✓1 � ................................................................ , ppliratintt -fur Eliquatial Works Tottitrurtion Prrutit Application is hereby'made for a Permit to Construct c(- or Repair ( ) an Individual Sewage Disposal System at• Q1 . - -j , Location,='_ ddress or Lot No. / / L <............................................� ! f••��!J= -.-.-•------ ------- ------------- G r�s t Pry Owner Address --------------------- Installer / Address d Type of Building / Size Lot.../s5,-..3?_'_Sq. feet U Dwelling—No. of Bedrooms..------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) QIOther fixtures ------------------------------------------------------------............................................................... w Design Flow............`__ _____________•--•----_gallons per person per day. Total daily flow......_.....?i4�L.a--------------------gallons. USeptic Tank—Liquid capacity I lons Length---------------- Width................ Diameter__.------- ----- Depth---------------- xDisposal Trench—No..................... Y ' th__.._............ _ .__otal Length..--__.--.- ....7otal leaching area--------------------sq. ft. Seepage Pit No.---. f1 DT ffiefe -____-�epth�)V e _ __•_ ' -al leaching area-- __.sq. ft. Z Other Distribution box ( ) Dosing tank ( ) QI / / `��7 7 aPercolation Test Results Performed by-------------------------------------------------------------------------- Date---------------------------------------- Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water.._.-.-----.---._..-_... w Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water--..-.---_-._--.----.__. O ------------------- ----------;------- , f--------------------- - Descri Description of Soil. x p _ , - �; Piz- - 1- ----p �f _._.-.._ _ '� `�- w UNature 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 Article NI 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 hoard of�hel , � x at_-/_ _ Application Approved BY :----------- = �------.-•-- ! l Date Application Disapproved for the following reasons------------------------•--------•-------------------------------•--•----------------------------•--------------- -------------------------------------------------------------------------------•------- ------------------ Date PermitNo......................................................... Issued----------_-------------- ......................... Date k THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH ....... ........... i!.......".....OF... /: a?, ?.!..... ..•1� ........................ (Eprrtif iratr of TOutp atirr THISJ5 TO CERTIFY hat,the It4idividual Sewage Disposal System constructed ) or Repaired ( ) / Installer at.. 1 tc /,�.r�v�� /1�,c-y�� ----�;, --------- --------------------------------------------- has been installed in accordance with the provisions of A is�_ f T%he State Sanitary Code as descr,'bed in the application for Disposal Works Construction Permit NO---- —.............. dated---•---�- _/--`-- ---7------•--- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..........................................................................•---- Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS '"-"�'�r BOARD HEALT 77 ,�t�.�- ... ..�vx�.............. No. FEE/. ................ Binvoiitt .ark � tttrixrjtitt rrtatit Permission is hereby granted......... .. .. r - e_____...___..� _ -------------------------------------------............. to Construct ,or Repair ( ) an n ' ' Sewage Disp all Syste r at No. � rd1 *1 /'� - - r -- -------•---------------------------- as shown on the application for Disposal Works Construction Permit- o _ /........ ......... Dated -.. _.:�_..��.... -•-----------•--�.--�- �- -----•---------------------- ' Boardalth DATE.......�_ . FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS ~ a r ► r� ti /S, 3t34 0 P k ice. 45 Z o r ; 1L 090 CJ�1... pvr V "NAKK O o f ' L. 0 7` ` RIC HARD A. BAXTER w 24 Ito. 048 CEP—T1 F#tE.D P LO-r P L A+,N 0 su LoGATi4ty HY,4,NKII'5, MASS Sc t tN= 3�' UAL 2�ZS�� CEfaTt�Y '�4-ll� Ti41Z Fout4v.-Tloht sjAowq PL..At,4 RE.FEREVACF- -W. ERR` Oi,j COMPLY$ WIT!4 THE St'DG%-kNE AND Sf-Tf3ACt; OF THE L.o 'T ! co -ice Tovvt.1 of ARKST1�QLC: , PL.H� N ZK- 3G � t'boa, SZ, D^T E 6AxTe.R, � #VYE 04C. (ZEG+5T$iZtt7 LA+�I D .SUR�L•.�(�RS T1-06 PL&1 .4 IS NOT 5AS�.':� CAN A USt!"sR ./�� + . a MISS. ►wsrRVMPINT 5VtVE.Y e T IE OFFSaTS Swpv4D APP cA.t.t:t' No'r BE. V5CD To DE-"ERM1NM LOT OaJES I}eV. � O.