The URL can be used to link to this page

Home My WebLink About0028 WAGON LANE - Health oT$ w a, r1 �.4tnC� is o? oacwu ��NMJMyI ®gJL'�11�0 imams vsn m am Y� OLLZL•ANt1 a � s T ION SEWAGE PERMIT NO. LO � A � VILLAGE INSTA LLER'S NAME A ADDR4ESS iu T FEE i D U I L D E R OR OWNER TT // i .� DATE PERMIT ISSUED _ OAT E COMPLIANCE ISSUED L$� J �0 o n 0 � N � e jo Y i No.. ... 'J. . .. _ Fps........�................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ......... ......... .. ..............OF........................................----....---------------------..................... ApplirFatiun for Uhipvii al Works Tonstrurtiun "truth Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...�.---...W..�S.C_ O W �2E4i..r-.......... 4 .. W V`G O �. .. .` . ocation=A or Lot No. Me- Owner Address a --------------------- .:..I'y1.A. F_ _f._..._... .�SZ 1n . ,/. ?.t1T. ................. Installer Address Type of Building ��77 `•, Size Lot....Y3, 560--..._Sq. feet aDwelling—No. of Bedrooms Garbage Grinder (f................................Expansion Attic ( ) 1l Pk Other—Type of Building ............................ No. of persons............................ Showers ( ) .7 Cafeteria ( ) a Other fix es --------------------------------•---------------•--•------------------.:.-------------------------- W Design Flow........ ............................gallons per person per day. Total daily flow.___._..__.. ......._...:...........gallons. WSeptic Tank—Liquid capacity.06%no.gallons Length................ Width..:............ Diameter----------------- Depth ............. x Disposal Trench—No..................... Width..9.............. Total Length'...b............. Total leaching area...ag ....sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing-" ( ) � aPercolation Test Results Performed by.._...___ __. T qm.....W...F........................ Date...............01=17�>.. Test Pit No. 1................minutes per inch Depth of Test,Pit___.._.............. Depth to ground water--_-_-_-___-_-_--_- f14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---•------------------------------•----------------------•----•--•-------------•------•-••--.---•-•......................................................... 0 Description of Soil------------------------------------------------•--•-------•---••-•---•--••---------------------------------------------.............................................. W V .-----------------------------------------------------------------------------•----.......--••-•----............----------------------------.........------------------••---------•-•------•----•-•----- W ................---...................................................................................................................................................................................... V 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 TITLi: 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been *ssued by the board of health. Signed................ -- APPlica'tion Approved BY " - ............ ... ........ --------------- `r�� -_,P.,�---..--.--- -�e Application Disapproved for the following reasons:................................................................................................................ ..............•-------------••---•--------•-•------•---------------------....•----------....-------•----. Date PermitNo......................................................... Issued-....................................................... Date 4,9,t Fizz............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...... ............................OF...................................... ..........I...................................... Appliration for Uhipoaal Works-ToniArurtion ramit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: 2 - VNf*, GO�.i Fk V_. ............ ............ ................................................. No...h ......10 ................ —Location--Addfr'�K 2....... ...a........... ........... Owner A A.F.. _F .................7T-o.R.!y.. JX. ............................... ...............3( .... ............................................... ................ Installer Address Type of Building Size Lot..... Sq. feet U .J..............................Expansion Attic (Dwelling—No. of Bedrooms___.... Garbage Grinder (JVP 1.4 134 Other—Type of Building ............................ No. of persons_._..__.._..._......._._____ Showers Cafeteria Other4x?t es ........................................................................................ ............M?.......................................r Design Flow...........;.>..............................gallons per person per day. Total daily flow__-_.-. 0.....................gallons. C4 Septic Tank—Liquid capacity.1.6w.o.gallons Length................ Width.............. Diameter__._._....__.._. Depth W 9 _Depth_ ------------- Disposal Trench—No. .................... Width...-.:...__._... Total Length----6............ Total leaching area.._i;1A........sq. f t. Seepage Pit No..................... Diameter.................... Depth below inlet.._................. Total leaching area..................sq. f t. Z Other Distribution box ( ) Dosing'M, ( )_ �Performed by............ ...............J....................... to—.8 �4 Percolation Test Results Date..._... .......... 1_4 Test Pit No. I................minutes per inch Depth of Test Pit._____._............ Depth to ground water_.______________---____. 0 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-._________-___-----____ x ......................... 0 Description of Soil---------------------•-•------•----••----------------------.....------•--••-------------......----------------•--------------------------------•-•----•.......--•-•---- W .......................................................................................................................................I.,................................................................. U ......................................................................................................................................................................................................... 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 TITS 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been . sued,by the board of health. . .... ---- --- A Signed................ ....1:6 ......... .. .. ....... .......................... D Application Approved By.............. ...........I. . .... .................. ................ ....... yZ-A),---------- Date Application Disapproved for the following reasons:................................................................................................................ ......................................................................................................................................................................................................... Date PermitNo.......................................................... IssuedL....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... Tntifirate of Tomphaurr . . -, il THIS 1 0 CE�R FY,VTh t t I he,,Ind,,*vidual Sewage Disposal System constructed or Repaired by...................S�..c.......... . ........ . . ........................... ....................................................................................................... Installer at. pr.4.................... .......... ......... . ....... --------- ------------------------*--------------------------------------- has been installed in accordance with the.provisiKiis,bf TITLE, r) of T tate Sanitary Code as described in the application for Disposal Works Construction Permit No....Ai�.: at. .... dated................................................ THE ISSUANCE.OF THIS CERTIFICATE SHALL NOT BE CONSTRUED A GUARANTEE THAT THE SYSTEM r�LVFU CTION SATISFACTORY. ...................................................... Inspector........ ....................................................................... COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............. ................ .....OF..................................................................................... No.....10....... FEE.... .................... RsposaLgorkv Tonstrudion "pamit Permission is-bereby grant .... S" ...................................................................................... or Repair (granted an Individual Sew-�* 0 al S t to Construct D s s erg ... ................................................................. at No......... 6 ........... ...... ------ �P_t�0- . . . ......... ------- _- :!----- Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... 0-../............................................................ Board of Health DATE..................................X�/o� . .................. FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS 151 W G toot= 1.10 GARBAGE G�NDEs2 I I I oA►�`( F�ow = Ito Y. - 33o G•P A � 1 330x1 .495G.P,5EPT1G TAIJKa � � 015 oSAI_ PIT vsE tvo0 C�A1-. �1r- •� . 51 pr WALL AQ.EO► ° 150 5. `� L 50TTOM A2rz.A rst 1� �F• � �' P•p.. 'TaTA1- PES1GN ' ,g.25 , -ToTA1- DA 11-Y PE2Go�AT1oN GATE� 1 IN 2MIN o1�L65s A ),. . ; 0 OF I. RICHARD , O� AIAN aka BAL19 y o W' , No.2'0.48 O 4`/sT fia�o� k0 SU �R�� A b; :._1 y � `r ' '�� •.�o/ Top F►+os1oR•o jrCgF� to o t/ t N�1• loop., ccau2sc G A�. 99 / :I ,4,Vz=l LEaGII INV.. INY. - G�vFL P IT wlTu � .. . `�•3 99's . WASNGD �t•l �I �. C�R.TIFII:sp P1-oT P1..atJ / PROF 1 L� 1,.o L A't►o N �j��9�/��S /,- No SGALE 5c�_ �ATIL REFEv-sw tort G E RT 1 F Y 'f H o►T T N 1c PP.o Pa SGD 1•{W�µO WW N6,26oN G0MP�••`(5 yJITN'TH6 Slo�1-IN'C �m7-- �� Auc> 56T5AC. R.6QVIR.I�MEN'r� oF•tµ� ��8��8� P6. J 7O W 1J D F 1342-wl STAB ANC �o-r- 1,ocp.TE •Wrrw► 'T 'z G�.00p P�n.IN DATE� 3 gAxT6� S��Y�ro2`� REG�'y'�E•� OSTELZ.VIL1.Fr • �'SS' 'TI•lIS Pt.Q1� Ili Nam' gA,5GLD N6 DAFWSE'r5 . I• �,uMEN-1 SVQVG-,`( r r APP1-I<-P►-IT &e4a� �40ce /&4:: L-r t: .-� .t�.ft�I NC ` .t.. 1. I I l ls. _