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Home My WebLink About0102 WINDSHORE DRIVE - Healthr/a2 WOshare Dr., H�q Z"11 � ISM �I I I' L r I 9 VLZ-V0 - d9Z LOCATION SEWAGE PERMIT NO. z -I? It) IN 5-Hoge yez -7-7- ,,f 37 VILLAG10, E INSTA LLER'S NAME & ADDRESS B U I'L D E R OR OWNER i a 0--e Z41Z,00fAoo,'A,'1 Jr DATE PERMIT ISSUED re DATE C OMPLIANCE. ISSUED �� i 9 s -�., �� a�' � � �� a n -�_ �� , �� _ ` A (791 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH y A,?..............OF........ ,�/�� ,,fit- ........... Appliration for Disposal Works (foustxn.rttun Vautit Application is hereby made for a Permit to Construct (&.)--or Repair ( ) an Individual Sewage Disposal System at, -. ocation-A ress or Lot No. Owner Address a .............� ............. .......--...................................... -•--...•--•-•--•---•••-••••--••-•-•••------ Installer Address Q Type of Building Size Lot./X.!t __'p......Sq. feet U Dwelling—No. of Bedrooms..........: ._.._Expansion Attic ( ) Garbage Grinder (XV0 �+ 04 '4 Other—Type of Building No. of persons............................ Showers — Cafeteria dOther fixtures . -- �i = W Design Flow.............._�� gallons per person per day. Total daily flow_.__.._.._..................gallons. WSeptic Tank Liquid capacity�l-___.___.gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No_ ___________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No._/®0�_ iameter��?%;:Ah._ h below inlet.................... Total leaching area... .sq. ft. Z Other Distribution box ( ) Dosing k ) /Q 7' 7 �G"ft 0" Percolation Test Results Performed by._•. ....^..,..._(�_�/��'✓_y................ Date_._,C11'Z - aTest Pit No. 1...... minutes per inch De th of Test Pit.................... Depth to ground water......................... (i, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.__--._____--___--____ •---• --•-•-•-••--. .................... _ - -- --••• - -®"'`� - ............................. Description of Soil.............. .'.2_`._ ..Q� _-•---------- ___� -_.�_4_'. 4�_ x ----- V --__-----•--------------------------------------- ------------ -...... ---------------------------- _------ -------------------------------- W U Nature of Repairs or Alterations—Answer when applicable.______________________________..........................................................I______ ---------------------------------------------------------------------------------------------•-•••••---••-•-••••-•----------•---••-••-•-•-•-•-•-••--•-•--•--•••••-•----------•-••-•-•--••----•-.....•-•• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIli U 5 of the State Sanitary Code— The undersigned further agrees not to place the system4n operation until a Certificate of Compliance has been issued by the board of health. gne �� Date Application Approved By••-•-•-•••••• •e.,= I -----46-,'....... �. ------1 a = 7 Date Application Disapproved for the following reasons__________________________________________________ -•--------••............................ ---------...._ ..................................•---------•---------------•-•--••••-••--•--••••-•--••--- Date PermitNo......................................................... Issued------•----------------------------------------------•- Date SIIJGI� FAMILY! t�jp CaAtZBAG� C�RI 4.1h�1Z. _ - r . ' � �.. ` • 3 33b G.pD -Seas-nc_ TL lIC c 330,r (So % • 4-gr 6 P.Q� I �_•`':. /� j �} USA- l Oocn, C=A,L_ �ISPoSAL PIT - uSE [000 ��.. ' G..�..( �..; !� •;;; '�1, ? N M S��c/A.I..L- �1Q.t✓A = ltjb �•�. 4 1 1 . s�>�T^ � H, . 1 . 1 r7U S I= •c .5 3 7S 1 l-,.I-.. i..:_ (Y' �• Z�o p G.P.D• I s i • zrrM.✓A AMEA T 9A sr. pRa P. rANK fl.�� x 1 .p - SO Ta'rAL *lDtrSIGW = d25 G.RD. i�� o I { ? FLoW t P c_c>L •TIOU %ZATE : Clo 2-mlQ, o2 1 r 2 1 i Y-Q•i ' fl 7 ' Ilk M AL RICHARDA. v TEp j. , i• 1 t-4u.24048 I , '.. 1/y0 S r , '` URd s• - I I I , 1 t• r I I 1 . :, i t r . "reSTf - � . .�,• Tor.Pwossoo.o q7. L 4- r A v \�\ � rye✓ ! - , � � -•Y IWN.� 9�. , . e Ov . Lo�� , ''; � loot IIN. •;A • Z. ` i � 4'�Pfs� 'DISI; Iw. G,a.fr. 9G•70 :;• � � ; Slrt$OI,L.. 'box R r..9 Sc--QnC INV. ( - TAWK l DOD 91611 I t�V ) 1' FIT " �'. STOWE- 89. 7 i.Ao x - toCATIO" H Y A N KX I S C*C 7 No ram W4 r ' PeoPoS R �. I CG IZ'C l t=%�j .' Tk A-r T 1-1 r-- 7Dw 514Ovcl IJ 1. C-Rn.01-1 400APLI-lS \V ITI-1 TI-IG L, O T AWC> SCTMACIG L?GaUICGAAEr Tl; of T14r- ..G• 3`7 G e. G �. To W tJ ot= i�3- Al2 t�`iT'A Q 1.�. otiTc T WOO D. Y.,/n_,l!u �./ �'n � �.� B/�ACT•C_�2. t`. u`f C= I�.J c. w RCGIs ttrLp 1-/LI•IG IuV_ rY ot L TI-��.J h��I+1-1 J 1-�U7' ti�)A�jl C7 Ul•�I /�f.l Ui'TC-.C_V%t.,.LG U MAL ie>1 � 445-1-C ; Jr �jl)L��/1:�.•{ •,�- '>rt�l : Uf=t-,F=('�, il•l APl' PLl r A.t`J'T CA PL W I pE De VF-L.C�G 1...C•>"t l_It•l�"r -- -* U7� 67. ;;Z 4;;4 No. - ......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........OF......... t. ............................................._-A Applirafflan for Dhipotial Works Towitrurtion Vamit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System a -*a ... ..;4 ............ ... ............................................. ...................................................................... im-AA-dress r Lot No.. ..................... ..f.. ........... -----------1-------------------------------- ....................................................... Owner Address ............ .............a.v�..• ............................................... .................................................................................................. Ins tallcr Address Size Lo f.13uj ......Sq. feet Type of Building "Dwelling —'No of Bedrooms. _.__ ..............................Expa�nsiory Attic Garbage Grinder P4 Other� Type of Building . . ................ No. of persons............................ Showers Cafeteria ,*Z/ 1 P4 Other fixt ..... --el............................................................................................................................... 94 ujx-'k�q' ............ lions per person per day. Total daily flow..........40;;;? Design Flow______/......... -7 ------ ................gallons. P4 Septic Tank—'Liquid capacity............ allons Length_______________�Width___.._.._._.__._ Diameter_-------__-_____ Depth_________.___... Disposal Trenqh—No Width....... ,otal Length____________________ Total leaching area_____---- ---------sq. ft. Seepage Pie ITOmeteir 4 th below inlet____.._............. Total leaching area... ft.----- Z Other Distribution box Dosi ng t Percolation Test Results 'o'Performed by..____. ............ ......... Date___._ /_O�t2!tt�."7............ Test Pit No. I.........._�_'mi7inutes per inch Depth of Test Pit.................. Depth to ground water------------------_---- Test Pit No. 2................minutes per inch Depth of Test Pit._.._.________:_.___ Depth to ground water........................ ---------- .......... ........ --- ------- ........... 0 Description of Soil..' ..................... .............................. ....................... ...... ................................. ............................................ ----------- ----------------------------------/_ ------------------------ ------------------------------------------------------------ ...............................................................................;........................................................................................................................ U Nature of Repairs or Alterations—Answer when applicable_____________________________________________________ ..................................................................I......................V........................... -----------I..........i............................................................ Agreement: The undersigned agree's;:to install the aforedescribed, Individual Sewag9;'Disposal'System in accordance with the provisions of T I T LE 5*0'f the State Sanitary Code— The undersigned flikher agrees not to place the. -system in operation until a Certificate of Complkince has been issued by the boa"rd of li;mlL A "-, �..24�_ 1Z. e C14 Date Application Approved By.. ._e ...... .......... ..........x Date --------------------- ---------- i,� Application Disapproved for the following reasons:................................................................................................................ ................................................................................................................................. ....... -----------------..................... --------- :4j'r— -a-Date PermitNo.......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD 0.17..S HEALTH .............................. ....................................Trrtffiratr of Tantlifiaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal Systeiii constructed (4-T—or Repaired by....... 4 --------------------- ---------------------------------------------------- ------------------------------------*---------------------------------- ------------------ at ........40444� ..... .................................................................................... -�0_ i s has been installed in accordance with the pr "Usions of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated..... -----------_ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY 1 . r. 1- MV, DATE_``............................................................................. Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD /9F HEALTH .......7�� .............OF..... .............................................. No......................... FEE..... "' Diaposal Works Ton drurtivit Virrutit Permission is hereby granted...4.'rj.e't........... ................................................................................................. to Con r Repy'r, an hdividual Se-— isposal System atNor............... ....... ........... A_'Vj. ............................................................................. Street as shown on the application for Disposal Works Construction oz 0 Pe?lt N .�_ ------- Dated... ........... ...............................m X Board 4"!�o of H�e. DATE................................................................................ FORM 1255 HOBBS.& WARREN, INC.. PUBLISHERS