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Home My WebLink About0031 CHERRY TREE ROAD - Health l Ghe r 7 `.T�-le. r2oy9v G� R- o(0- t)"�-3 ASSESSORS MAP NO: kf s PARCEL NO.: No ...-_��... Fims................................ THE COMMONWEALTH OF MASSACHUSETTS (� BOARD OF HEALTH .............OF,........ . Appliration for Bitipwi l DXk nntrurttAn rutit Application is hereby made for a Permit to Construct ( ) or Repair! ( ) an Individual Sewage Disposal System at ....:...........__. :c c( � , -••-•.-----...... . .---.._......._---... •• -`� ` P l be`11� of No.dd;, s ..00T' � --...•-•--•�. Owner Address W - -� ................ .................. Installer Address - d Type of Building Size Lot,,F:X l�j--Sq. feet U Dwelling it No. of Bedrooms.................:3... Attic ( ) Garbage Grinder Other—'Type of Building No. of ersons._..-Y------------------ Showers — Cafeteria g ......-•---•----•-••---•... P ( ) ( ) dOther-fixtures ......................•---•-••---•-•-------•------------•---•---•-------------------------•--...--•-•-•------------•----------......---............. W 5.,� Design Flow....... -1_-.,.__ ............gallons per person per day. Total daily flow__. =-��? .•.................gallons. Septic Tank—Liquid capacitye/�¢�...gallons Length................ Width................ Diameter................ Depth................ W Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit N&&-____-. Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed bY.......................................................................... Date........................................ aTest Pit No. 1................minutes 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........................ R+' •--•------••-----------•---•---••-••-----•---•••----•------- 0 Description of Soil......{ 'a � .` �5 � i ...---•------------------------------------ ----------- -----------------••-- V ------------------------------------- --------------- •------------------------------------ -...... ------- -----•-•-----•--•-------------------------.-------------------------•--•------- ------------------------------------•-----------------------•--•--------•--•-•--------•-•--••-----••-----...--•--- 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 iIHE 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 bo d of h lth. �.�°� ti 4 Signed.. .�a,� Date' ' Application Approved B -- .aDate Application Disapproved for the following reasons:.............................................................................................................._ ......................•••-••-•-••••--•-•......--•-•--•-----•--•--•-•---•-••.-•-....-•----------------.........................--••-------•-••-•-•.....-•--••...........---•-•-----•...................... p Date PermitNo...... .. ...._.... Issued...--•---•----•------------•..................0......_. Date ....��....... -..-..-.... ---------------- No............ .�—'- / Fss...::..... ....._..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration for Disposal Works Tonstrurtion Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: rr 1I.Le .i. .... ---.., ...•.......------•---••- --------------•-.. .... � .� ..... ocation-Add4,�� (�'r'�I-o-f No... ....._. ........•........ ;� ,---._: :1t.1...`� -•------- - . ............:a��.:��t...:�Y_..--... ......_.._. � ....------ � � Owner . .. Address a ........... ... �- .......------�---------- ..... - U .... ....q:....... � Installer Address �~+ d Type of Building Size Lot,&;,? /�_S feet Dwelling No. of Bedrooms.......................:................... p ( )Showers Garbage Grinder (41P ok Other— e of BuildingNo. ofpersons Expansion Attic Attic W Other fi`x�tur:es . ..----------•-•------------------•----------.......------•-•••---••---•---------.... ( .).._....Cafeteria g '=� A-'.__....j.------gallons per person per day. Total daily flow.... ........................gallons. W Design Flow___.__._ __ __�'.._ � WSeptic Tank—Liquid capacity:;?...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 ( ) Dosing tank ( ) 1.4 Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ D Description of,Soil....... U -------------------------------------------------- •-------------------- --------------------- •------------------------------------ •------ ------ •-•-------- -•-........................... W ----------------------------------•-•••---------••-----••--------------•--- . . 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 TITLE 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 boa d of he th. iSigned..... ? L = �2 .:._.! ...:. - a Application Approved-By--.." . - ,. ..` j�' •--------------------------••----------- Date Application Disapproved for the following reasons:-------•-----------------------•-----•----........--•--------•----------...-----•-•------•---•--....._........ ..................•----•...------------•-----•--•••--------...._..---......-----•••-•--••-••-••----•-•••----•-••••-•----•--------...---....-••-------••--•-----------•--------....-----.....---••---•--- 1.1 Permit No........ '� Date .._ Issued---------------- ..................... ...... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............ ........0F.......�....:y� 't`.............................................. 01rrtif irate of Tontplittna THIS IS TO CERTIFY, That the Irk4ividual Sewzee Disposal System constructed ( ) or Repaired ) l I^aitu at 3 _.... ......E V:�:..�' . ------•.i._ ,. o� -----.._---• ............ ....................... .has been installed in accordance with the pro vi is of TIIz4Fr 15 of The�S to Sanitary Code"t, 'n the application for Disposal Works Construction Permit No.._......_l......._��.- dated------------- ....i-........ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION S,ATISFACTORY. DATE.... ��..... -•....................... . Inspector......r_ ....- -- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH SO............ FEE-- l?...................OF.........�' .- . .�. L := ................... Dispo-on � orks Ton.sfrudion ramit w: �....._. 0�---t......-- ........Permission is hereby granted.. ... to Construct or Repair ( a,n Individualeage Disposal System at Nl_ .h PP P Street 1G..�� 5ed,- ----------- --... ' ........... as shown on the application for Disposal Works Construction Permit No..._�_�__ +-� ��`c ----------------------------------- / Board of Health DATE............... t' • . .1- FORM 1255 A. M. SULKIN, INC.. BOSTON #. t3 C A T 10 ?1 9E M M I T � 13. for C�ec� � VILLAGE C a 71ll 7- _ IXSTALLFR'S NAME A A D 0 R E S S jo CST ----_ I U I L 0 E R OR OWN IR 2-22 DATE PERMIT ISSYE D � - _ OAT E C 0 M P L I A N C I ISSUED �- __ �IN av 1 � 11 AI, J .. $ DESIGN DATA ') STRUCTURE S\1.X^�� GLIIVL\l ��E1_L�1JG /. DESIGN FLOW 3P)TDFZtsk - :NQL. G9-A1GerTi n� �' �j / / �c r�p� 'It3D�Ltvl ►rf _ SEPTIC TANK L.l5E 10QQ C-> .L LEACHING RATES= SIDE AREAZ+S GPD/SF l I Co S. -•� Sao BOTTOM AREAjpGPD/SF LEACHING FACILITY -T / i _ / / / ' ►O' Ip' D R\V� L�2!✓fl.: • 'T7 5'L- _ 7 8:S /. / / • _ _ (�L.S x ►eB:s� + • I .o�c.-18.5) - 549 15 A Q . M�.N ► .. Pam'. POSED. 3 PLAN REFERENCE: Q _ D Ei�\NG U . �Z Atz�.►s-��eL_F. P�C�I STa�j r- a T-n s /0-� LU / cj ASSESSORS LOT NO. 1� PGL Z3. i � g NOTE a • tip / j / 1. ALL MATERIALS AND CONSTRUCTION METHODS TO CONFORM WITH COMM. OF MASS. TITLES: S l=NVIRONM.ENTALCODE . i�-��sF. � � \3` � � � _ Z.• l__OT h.C2.�L�. — 8 od0 S,F —SCE u , Pv c�d -C:E; r E ate- 1 r :a / >E ram,l i��\►�c., 1 n�� 100 OF��`z� u �11 OF M.1 / ! PLANS TP'Ui', v H SCALE 1 =ZO } o:2'.9' ISz �874 TEST PIT NO. TEST 'PIT NO. ;o �' Cv0 ELEV. S-1.Z ELEV. SURD F►tV 1S I �R t�E Ex\s'T. ToP FK\p,_ SOIL OBSERVATION PITS f IODO ►'nno.�t j 1, Fosz �-t.Day DATE OF TEST 55 a I. C�a,L_ a ENGINEER B.O.H.AGENT 1� tj 522iGF=c2 lopTe a 3 i �'o SntvDy. St..►a so\l► EXCAVATOR �s QL� x'.(Q. L a .P 1 . . PERC RATE IN T.P. NO., AT 5 FT.=.L Z.MCN./IN. 0 23 G-ti>=czcz-y�F .Rn 0 4-9.'L, _ , - ELLIS & TH ULIN;"'INc: s INEERS': „ . -',MASS.,.,, -,4 ♦'.. i V f LAN SURVEYORS ANO CIVIL ENG _. W ,t 11 k: ... _ -.. ,.. r r, r^ .- .. „r t :.. G. ., ., _ .. .. ,., ,_ .. .. 4a• - , - S• r.- 1r.1 ✓ M .�,. �. ,.. 1. ` -i,., • ..- <. ,. ., , ._. �,.J-,v ..-...._. : .. , _ .. t - .. e.A, � .. �' � .P .,! ..i t. ..aaf.a .S~+dc..4 ,.. �. .f. ,F L 5. C _ •1' r-4. _•DLO 2'C.. ,.n. a :........ .. .. . ...�t .v .,.., ,..... " ._ Z .J ..... ? >.,. :,. , .. t. 7-. :p'1:- ^..� ,—w•.4'L':.,Y , _.,.: s ....v �: i Ov+`+,. .., e.....v .. ........._ Y., sx i. 5§a ex .t. _ t.. 'r. v _n 1 W" CT N T. 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