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LO CAT ION SEWAGE PERMIT 130.
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INSTA LLER'S NAME & ADDRESS
IDUIL0ER OR 0P ER
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DATE PERMIT ISSUED
DATE C 0 M P L I A N C E ISSUED
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No.. .�..1. .. Fx133 ...................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...........T own...................o F.........Ba rns to bl e
Appliration for Uhipaii al Workii Cnoaa.itrurtion ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at*
,..... , .•-- �xv. .. ................ .` .Hannsa.. A
Location Address or Lot No.
.Capricorn Realty. Trust -6 --FalmQutpaSHyanrl, ................
Owner Address
w Steve Lebel
Installer Address
Type of Building Size Lot............................Sq. feet
U Dwelling ' No. of Bedrooms......3...................................Expansion Attic ( ) Garbage Grinder Q�
44 Other—Type of Building RE&TIch.............. No. of persons............................ Showers (2 ) — Cafeteria ( )
Q' Other fixtures ..........................................
W Design Flow.................5.5_....._...............gallons per person per day. Total daily flow.._......._......................... ons.
Ix Septic Tank=Liquid capacityl•0-OQ•gallons Length_8.'_6...... Width__.U.O.� Diameter................ Depth-�_:._8 wl_...
x Disposal Trench—No..................... Width.................... Total Length---------
.._...... Total leaching area....................sq. ft.
Seepage Pit No.__1•............... Diameter.....6�.._._.__.. Depth below inlet...... �........ Total leaching area._26.6........sq. ft.
z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by......EldrQ..d ;e_..Eng Tle.exing.......... Date.....11_ma5.-_81............
Test Pit No. 1<..2-.Q...minutes per inch Depth of Test Pit-----12!...._.. Depth to ground water none...enc-ounted
_4 Test Pit No. 2�I/A...___._minutes per inch Depth of Test Pit__N�A......... Depth to ground water.N,A _
-----------------------------------------..............................................................------._............--•••-----------••--.............
O Description of Soil........... •'_Z.•--•--------LQam-&...1OP.SQ_ .1----------------------------------------•---...............................................-.•--•••••.Mad!.=---IeII.Q.W..Sanc1------------------------------
v
W ........................................1Q —1-2.------...Mad...__White---Sand/trgQ.e.Q---Q;'-Graye. .....-Wate..............
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 iI':Li 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 boy •d of h It
Fin
i d-- ----• . . ----- -- ..----•--- --•-•- --Z�r........
t
Application Approved B .. Z... ...
Da e
Application Disapp ve g reasons-----------------------------•----------------------...--------•------------------------------•-•-----...........
............................... .•--- --------•-----••---------------------•-...---------....._----
Date
PermitNo........ �`�.....................•-................ Issued.......................................................
Date
7 ?:fir
LOCATION
SEWAGE E PERMIT N0.
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YIL.LACE
I N S T A LLER'S NAME i ADDRESS
5 )-,eLe Tr.
i UIL DE R OR Ow ER
C �iCe e
1 Av
DA T E PERMIT ISSY E D
DATE COMPLIANCE ISSUED
It
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No......................... Fss.............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...............nvm.......------.....OF.........
Appliratiun for Ropuoal Vorkg Tonitrur#ion truth
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
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RMioness or Lot No.
�anrinOY'YI ''2e`t� 'i-1J ''t^t1.4 k 7 i Ks-Irltt t b+ I na r1 '[tra.nn i
....---•-------------------------------•-----. ......_.............------•---------•----...... ..... _ ..........................................I................
----..........-•-•--••---
Owner Address ,
W ��,Qve Ze�b�Z
Installer Address
Q Type of Building Size Lot............................Sq. yg
U Dwelling—No. of Bedrooms..... ....................................Expansion Attic ( ) Garbage Grinder
pa•, Other—Type of Building .............. No. of persons............................ Showers (Z ) — Cafeteria ( )
f•4 Other fixtures --------------------•--••---•-••-•---•----------•------•---•--
W Design Flow................. 5.....................gallons per person per day. Total daily flow...........33Q........................gallons.
WSeptic Tank—Liquid capacity..OGOgallons Length.xi.'.6....... Width..4..'.10. Diameter................ Depth..5.'8......
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No--- --------------- Diameter.....6............ Depth below inlet.......6.......... Total leaching area..26.6.......sq. it.
Z Other Distribution box ( ) Dosing tank ( )
`" Percolation
Test Piles oRl 12..-rJ-.m nutesm e inch De th of Test Pit. n r r r.. Date......�..�,.-25-$1............
y rQ ri. P
N p p 1j Depth to ground water.none encounter-
(i Test Pit No. 21`_�,1A.......minutes per inch Depth of Test Pit... 11.-a.______. Depth to ground water........................
e
a --•-------------•---•---•-------------------------------..........-•----._..........._...._......---......------------............................_--••---_..
O Description of Soil........... .-2'_._._.......I!oa?. ...--.l.o�SOi... -
v
---2 -10 .......... edium_.lellow Sand
w ---------------------_--.--.• . 1 '-12 ' M d_,...`jhite-_ Sand traces of Gravel no water at 12 '
Q ---------------------- -------•--•- --------------------- •-•---•-----•--•••---- . --------•-•-••-e.r......t...-
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 TTTILS 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.-I, {
Si ned.... "� '_ :-- �-'"i. '` .�✓e, G11
g, _• -..
ApplicationApproved By-----------------------------------••----........---------...••--•••-----..............._•-•-_...
Application Disapproved Jor,the/ Date
following reasons--------------•-•--•------•-------------------------------------•••-----•---•----•-••-•--•--- ...--•--_._...
i
Date
PermitNo..........T1......................................... Issued_.....................................
..................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
_own zra.-Jtable
..........................................OF.....................................................................................
Trriifiratr of Tootplianrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( 4 or Repaired ( )
a>)eve Ltlu .L
by.................. ...-•------...... ............•• ---------------------------------------------------------------------------------------------------••••--......------..--
�,
x ✓ � � ,� / f r' Installer
at---==-------•---......---•------------------------------------------•-----`-...----••------...--------•---•----------------•--•-----•---•-•---•-•----•----------............
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code described in the
.application for Disposal Works Construction Permit No..-- ..�_...�-7-�............. dated-..��:/�!�%(r�
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST AS A GUARANTEE THAT THE
SYSTEM WIkL NOTION SATISFACTORY.
DATE...// �..��r�'_..................••------.........------•--•--------.. Inspector._... .....
..........................................................
THE COMMONWEALTH OF MASSACHUSETTS
? BOARD OF HEALTH
- - :No ......................OF................... .......................................................... .
...............
MiVosal orko �onotrudion rrntii
Permissionis hereby granted...--•-------------------------------------•---------------•-----•-------••------••----------------•------- ...... ......._....... ._....
to ConstructO .or--Repair' ( }��n Individual'Sewage Disposal System
at No ,f r j -
Street
as shown on the application for Disposal Works Construction Permit No..................... Dated..........................................
.......................•••-------••-------•
By id of Health
DATE------- :...........:''
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
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LEGEND ��NOFM+s� ✓ CERTIFIED PLOT PLAN
` EXISTING SPOT ELEVATION Ox0 � o
EXISTING CONTOUR ——— 0 ——— �� O HN yG� .4n7- e su0/3u12Y �/1rVE
FINISHED SPOT ELEVATION S .
FINISHED CONTOUR 0
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APPROVED , BOARD OF HEALTH STEsu
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DATE AGENT SCALE:
CDREDGE ENGINEERING CO. WC., CLIENTA
I CERTIFY THAT THE PROPOSED
LEGISTERE REGISTERED JOB NO. B/ZOS BUILDING SHOWN ON THIS PLAN
CIVIL LAND CONFORMS TO THE ZONING LAWS
ENGINEER SURVEYOR DR.BY PM OF BARNSTA LE, ASS.
712 MAIN STREET CH. By:
H YA N N I S, MASS. SHEET OF Z DATE G. LAND .SURVEYOR
20 FT. MAN. - NOTE -, /F EITNER TNe SEPTIC TAN ACOR.
LEACN/NG `PIT A/tE _"/610RE rNAIV /2"&Ed-0K/
!D � M/� - GRAOE�/4 �'!�/AMETEK L'ONG•R•ET� fOiiER :
$NALL BE.BK000�yT,To 41�AOE.�AN .EXTRA
K---- 4"PYC PIPE
GONCR!'TE N,6,4VY CAST IRON GO✓ER .SNi4LL L3E US�O
MIN. P/TCN /F/N ZPT/VeWAY
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E-i = 101.o COYERS "PFfp
2 jG MEAL COWCRE TE a
.?e: pi4oE CO YER CLEAN .SANG
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?SLAYER
4'CASS , . e• QF
•?:� IRON PP/PE • .o
M/IV.P/TC/fl GAL.. s 1foil
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yyASHED S72�NE
SEPTIC .TANK • . . . , . .
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s • �� • •• OEPTN •t • •. -�: WA51yED STONE zr
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ON7 44FT SEPTIC"TANK
80 I
JA/LET DJSTR/1!L?!ON X.�4 Fl. TAQLE tY
VD. /1�4TEI�
ECTialy,o� k t k
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.�N7ZETD/sTR/BUTloN BO�X�fT. .` �-� � h t<
lNLtT',LEACN/AAG /T �i7 o FT '� 4 �T�8G/l/1T/ON
VA GO ADP Sf�OrSA
F t +
f �= LEACHING P/T f CO
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...4VEs/6w _. CA/r_aG MIA
_
GARCGtGEO/SPO.SAL.t/N/T. '�` SOIL LOG '
TOTAL EST!/rLtTED IcLON/ 330 GAL SOIL 7AST2 `
XUMBER QF t,C°acXlNG Pl7S f^ECEY. 99 EL�Y A4TE OP'SOIL TEST ,����5•�
S/CL=LEACHING PERPi7* sa -r. . r Jew/'.f
y lA��_ - ,� „ , RESULTS iV/TNESSED dY_—T
OOTTOM LCs�ICH/N6 PER P/T 7g .SQ. �T.•' O 2; Pc AEytC4LA7Y0I1►dRATdK / �-� MlIV�IINGM
2(oCvOrr.
TOTAL lEACN/NG AREA-: SQ. r J�12`1lCOLAT'!DN RATE J�2 Al':
RESERVE LEACN/N6 AREA _
tH OF 1yAJs �t1 OF tv;s Z'IOW 23 SvflFvR-lE
oz� JOHN oyGN o�'3 q~ qc�G C, wN rrE I �1/�te�f:J15
ERT
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No. 1095i o �' �o' 12' �NiTI��.. FLOREDGEENG/A/.E�R/IVGCQ,ING.
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