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Home My WebLink About0140 MINTON LANE - Health �� i�Y� �,q�X3�, 1`7�—oz3 —aa� 'rc�-Qs� _\ DO FES ................ . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH L(�0�-2-) :..j® oF................. -�--C�lv- %, -(��.../��.---------- Appliration for Disposal Works Tonstrurtiun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal S stem at IL do -Address or Lot No. __ .�1! r ,.._...._ --------- -------------------------- _ax.. - ...... Owner e, Address ' M f_....q� -•- ••----•. -•----••------------•-----•---•----••-�-4. µ ---•-•----------------•-------___----- Installer Address U Type of Building Size Lot..... //-- 71 7_Sq. feet t, Dwelling—No. of Bedrooms___________ ____________________________Expansion Attic (/ � GarHage Grinder (xj15 aOther—Type of Building ____________________________ No. of persons............................. Showers`'( ) — Cafeteria ( ) a' Other fixtures _______________ ----------------------------------------------------- ---------------- W Design Flow________________ .....................gallons per pqrson per day. Total daily flow..............3._3_.D.................gallons. WSeptic Tank—Liquid capacity.�.AV_Q_gallons Length................ Width................ Diameter________________ Depth................ pisposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. -Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (,-I- Dosing tank ( ) a Percolation Test Results Performed by........................ 1__,._._._.__ .......... Date-------S � __.....- . Test Pit No. 1...4r.11__minutes per inch Depth of Test Pit......_-Wit_____.. Depth to ground water------pr.��/,�/� f=, Test Pit No. 2...._. >inutes per inch Depth of Test Pit-----__._.._'__`______. Depth to ground water_____________................... -----------------------------------------------------•- » ° r -------•-------....-•-------------- - Description of Soil-•------------•-•---------------------------------—-. v1`� j", 5 S.�t! x --- •-�------------ - -A ,,� -------------------------------------•-.-.--•------------.--__.__..____ _______•'-'-.---.--_.__-_._.. 7-'______.__..___._ 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 TIHE 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 byjthe boarof he. � f(� igned•------------...... ..----._...----------------- Application Approved By--- -------=- ..:....-- C J Z. -----• Application Disapproved for the following reasons---------------••------------•-----------------------•------•-------------------•----------------------........_ .....------•--------------------•-----------._.•-.-•---------------•--•--•-•-- --------------••--------...... ----Date Permit No.......Y 5 3 D 2 - f C ------�------ ------------------------- Issued_.-----------------------1------------�}---------.. Date _ l r_ No. �''.t^ Fhs.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -------F°``''" OF...............��..�.�1tc s.��................................. Appfiration for Disposal Works Tonstrnrtion Prrutit Application is hereby made for a Permit to Construct (,,or Repair ( ) an Individual Sewage Disposal System at: •---------------__...-----•-•••---•-------------------•-•......--------•-----••-------•--....... ...-••-----.....----•-............._.....-------• Location-Address Lot N —� o. O ,`) o� Address l (� nr ( oil a ................................•••-••-•--•--•••-... ( o----------------------.......--•--•------ .................................................................... -.......... Installer Address Type of Building Size Lot............................Sq. feet aDwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons........_.__............__.. Showers ( ) — Cafeteria ( ) Other fixtures . W Design Flow.........................�IC.1_..........gallons per person per day. Total daily flow.............. ..................gallons. WSeptic Tank—Liquid capacity_U.2.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..................sq. ft. z Other Distribution box (may Dosing tank ( ) aPercolation Test Results Performed by..............................�YjffkGA. _.._�l.�G Date.........�5.1>11#....... Test Pit No. L.-:x.-7-----minutes per inch Depth of Test Pit-----_ _ _. Depth to ground water... __...... (s, Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water........................ R+' -----------------------------------------------------------.t............................................. Description of Soil------------------------------------------------------. ............�" - x g: 5�. ______________________________________________________________________•-------__-___--------_-_-_---__...__._..._.__..___ _.Y- _ $f/' U Nature of Repairs or Alterations—Answer when applicable........................... ?'X!_Art,.< ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•--------• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees pot to place the system in operation until a Certificate of Compliance has been issued by tl3e-board of he�h h. / Signed........................... . . - ------- ---------------- Application Approved By----'. --- .. ..........z.... ..... .... ...::.: J ....................f._.. ........... _ Date Application,Disapproved for the following reasons--------------------------------------------------•------------------------------•-------------••......•••--...._ •..........................•-------------------------------.....---------------------•---------------------------------------------------------------------------------------------------------- Date Permit No.......2 5— l a _. Issued__...__.z.........................8 Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7�ww............. °'..... . .�. '° ........... OF......... �. .................. .:. (IntifirFa#r of TOMpliFanrr THIS IS TO CERTIFY, Thg!:Innd Individual wave D's osallySystem constructed (. or Repaired-( ) by------------------------------------------------------------------- r = -- - •--- ---- -- -- - •--- "°a` 1 taif- m , "4�6 .. V+4'x'"^r V" ZM° ••P-' di A''� .. ata .. ---- ----- ----------------- has been installed in accordance with the provisions of TITLE 5 o The State Sanitary Code as described in the application for Disposal Works Construction Permit No.__.... _`_._-_................................. dated......_Z--------��.__-__$.�............ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO STRIKE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.. S. .. ........$`e...................................... Inspector........ ... •---- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF i ALTIg No................ CC Disposal rn ! ' rntti r Permission ' hereby granted... r°�✓:. to Construct (" or Repair ( ) an Iat>d' ual,5W_;Xge/ sposal�rS.ytat No ,. l�irr Street - f l/as shown on the application for Disposal Works Construction.-Perznit No.................... ated.....:___._ ...:_. ..._....._........ ,,ryrye�. _ .................... _ ...q_�` ` ttGas S" Board of Health DATE- -------------------- FORM 1255 A. M. SULKIN, INC., BOSTON l N� - J N I � 7�sr I l• � �, 3 _ zz 60 _ (Its5- _ fa' N 15-6 OF p�S 41 O / '1 q� sB�� j OR$E in [ L.ic rrr M,7 I v !< yppP° /. - No.10951 O % t, 1.Ef�N\ io, .��.'('� ' ii - \ /)C.o � ,/ •1 �j... �FSSIONAL�a� �`-�+l '.'3 '��° CERTIFIED PLOT PLAN M, .. s , TA.NI M9 2 175 D 7 0 2 •.BAR . r� La r./G /Al"DA/ ^,v IN /Lc—I%isn Y 85 ILI r 3CALE� / 1f U" DATE 1 /oi6�85z DREDGE ENGINEERING Ca ING CLIENT 1 CERTIFY THAT THE PROPOSED ��---= E(i1STERE REGISTERED �08 N0. �' BUIL,DINO' .SHOWN - ON THIS PLAN x CIViI: LAND �C:ONFORMS.' TO THE• ZONING, LAWS Da.BY� A ENtiNEER R Y OF BARNSTA8LE MASS. 712 M A I N STREET CH 4;z— T85,HYANN1511,MAS::S. E REG. LAND SURVEYOR . it s_^ :. r F e � �,.• r ,_•,! ., �{,:'` i ��#. Si 4ki.V hJ W LQ 03 14 WW14 ut� ki VFW � � �. . 4e; . . • o .�a � � � � �,. � -42� �.. - . . _ . . . . 14 it � S .14 J }• UrAv 2 do . • • • � � Y �, k Ll VI -4 h Qj K ►: kI. �Q 4, a� �V Lj In k k h• h. Q O: ySETTS �� oW off` �IJA I tj 2 m Z o 14 Ankk ay 14