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Home My WebLink About0104 CHERRY TREE ROAD - Health Q c �— /` a-s— i A &:2...4 49...ti_. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH fd. u--..-....-..OF.........�. ..- Tf94«....:. Appliration -for Uiiipmat Worko ( owarurtion Vrrmft Application is hereby made for as Permit onstruct ( ) or Repair ( an Individual Sewage Disposal System at: SC /� �y r- .:_...._./,a.1 . ._.Cf.�G�........'G.. .................................................................................................. ocation• dress or Lot No. -- l L�f1r�� ---------��A e k'--------------------- --- Owner ---•-••.....................................Address Installer Address Type of Building Size Lot----------------------------Sq. feet U Dwelling—No. of Bedrooms-------- ............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Q' Other j5xtures ----- ------------------------ - WDesign Flow---------- ... ........................gallons per person per day. Total daily flow--------- ---------_-.-._-.---gallons. USeptic Tank—Liquid capacity------------gallons Length................ Width................ Diameter---------------- Depth..-------------- xDisposal 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 ( ) aPercolation Test Results Performed by.......................................................................... Date--------...------------------------..... Test Pit No. 1................minutes per inch Depth of "Pest Pit-..--__-____-.__-_-- Depth to ground water.----------------....... (� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ P4 ••--------------------------------------------------........................................................................................................ 0 Description of Soil........................................................................................................................................................................ (xj --•-•--------------------••----•------------ -----•---•------------------------•--------•-------------------•--•-----------------•-------------------•----------------- 7 W --------------------------------------------- ------------------------------------------------------------------------------------------------------------ UNature of Repairs or Alterations—Answer w en applicable-------------------------------------------------------------------------- -- -- / �/ � . (. -_.ST'�w �� /cfG�,cu i�-- s� ris X --5 Agreement: - The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article YI 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 e board; board f Signed_..x--lam - -------- ----' - --------------------------------------------- -------------------------------- Date ^� Application Approved By.....--- - -----= Date Application Disapproved for the following reasons-----------------•...---•---------•----••--------•-•----•----------------------............. ------------------. ----------------------------------------------------------------------------------------•---•-------••-----------...------------------------------..............---•----------------------------------- Date Permit No....... �� = Issued ^73---------------------•-•-- Date t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH f r _.... ' '' '. .............OF........ ... ..... .. r'. �..a .. ApVfirtttiun -fur Uispuiittl Workii Towitrurtiun Vrrtnit Application is-hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: fit SC= s/rG . � A ------•-•--•------------------•----••----------------------•-----------•-------•--------••-•---•-- '-•--------------------------•---•---•---------..-.-.--•-----•--•----•--•-•-••--•----••-••---•-•-- Location- dress or Lot No. ._..--•-----•---• ..!' .....�........................,/�lt� '- •--•--------•---._..._ pOwner Address e-T ' fi flll�° r ---------------•-•--- Installer Address Q Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms------t _________________________________Expansion Attic ( ) Garbage Grinder ( ) aa, Other Type of Building ............................ No. of persons..-______---________-____--_ Showers ( ) — Cafeteria ( ) QP4 Other fixtures -------------------------------- --- - --------- ---------- ------- .-------------------------------------------- W Design Flow_________ �.)________________________gallons per person per day. Total daily flow________ �_�________._____._.._._...gallons. 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 ( ) aPercolation Test Results Performed by-------------------------------------------------------------------------- Date---------------------------------------- Test Pit No. 1----------------minutes per inch Depth of "Pest Pit-.-_-________-____-- Depth to ground water..-._--.----.--.-.--.-_. fs Test Pit No. 2................minutes per inch Depth of Test Pit.--_______-_-____-__ Depth to ground water...-_----_-----.---_.___ 9 ------------------------------------------------------------------------------ ------•---•--------••......................................................... 0 Description of Soil------------ -------------------------------------------------------•-•----------------------------------------------------------------------------------------------- x1 s9:_--/= =------------------=--------------------------------------------------------------------------------------------------------------- W --------------------------------------------"�---------------------------------------------------------------------------------_____------------------------------------------------------------------- x Nature of Re sirs or Alterations—Answer when applicable.-. _ ______ U P j ------ ---- - Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI 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 e board of. e 1. Signed _ ------------•--- ................................ r. Date a k Application Approved BY------------- -----Z.A.----•= t Date Application Disapproved for the following reasons----------------------------•-•-•-•--••-•-------•-------•------------------ ..................................... Date Permit No------- _ ? ---------------------------•-._.. Issued.-----•• --= Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Owrrtifirtttr of Tomplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by .. . . .....ra t ------------ Installer at---••-•-•-apj .-'••- - ------ /,, t =}� , •+�. -=,l `t "_ -- A....................rr. .......... _.'' -- ....................... has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.......:..I A_-;_.................._... dated.....�f"'.,�:_..6'�__�:._-_,.............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------f•-- 9_ --- -x-----------------------------•------------- Inspector-------f, != f� ; 57 ------•----- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH y� No.----- `== FEE........................ a � ��u,�ttl urk,� �un�tr�trtiutt �rrntit Permission is hereby granted.....z .............................°�-` ' Cam' ; ---------------------------------------- ................................................ to Construct ( ).or Repair (! ) an' Individual Sewage Disposal System at No.........=`-`-•-.--A_-------4 -=-----C.� __S1:_s�t�ti ----------------------.--•---_...-----. ......................... ---------------------------------------------------- Street ..- as shown on the application for Disposal Works Construction Permit No.-.�..ec_ __ Dated-_:`_.--��:'-_--- ��_______________ -----•---------------•-------- , . � ..................... .......... Heat-!,,.-,. ..rd�of .. DATE ----=°Z-p----- ------------------------------------------------FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS WO, Ad -U I D E—R-S 0.-I.A_ - � o �e I n No.. ��' -[------- Fss... ,....'............... THE COMMONWEALTH OF MASSACHUSETTS �.,, BOARD HEALTH 1V �' — -- OF......... ..... t— Applirativit for ]Nfipiial Worksvnsfrurtivn rrmit Application is ereby made for a Perm to o truct ( or Repair ( ) an Individual S wage DisPI12fal Syst oc ion-Addr s or Lo N . . }}}} --•-----------------------------•------- her I Address W --- - - - ---------Insta--- - - ----- 4-�er �':.,, ! Address QType of Buildi Size Lot............................Sq. feet U Dwelling)CNO. of Bedrooms---------- __._Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons............................ Showers ( ) Cafeteria ( ) QI Other fix/ res _ --. --------------------- W Design Flow... ........... ,�g�r�gallons per person per day.. Total daily flow...... ---------------gallons. Septic Tank Liquid capacity/P----gallons Length'________________ Width.......... ._.- tleachingarea meter---------------- Depth.-..---__-_.__ xDisposal Trench—N _ _________________ ._ otal en __---_...... .._---_-_.__.-.-_-_-sq. ft. Seepage Pit No.__-__�_________ Diameter/ "77 t low/ _.__.. Total le /hin area----- ft. r /.� J• Z Other Distribution box ( ) Dosin - nk ( �� 7 Percolation Test Res s Performed by.. %-- l.- ^wir6�.L ......................... Date---------------------------------------- Test Pit No. 1....!S__._m 5 inch" Depth of Test Pit____________________ Depth to ground water-----------------Id- dOW r3:4 Test Pit No. 2•__--____-_____minutes per inch Depth of Test Pit.................... Depth to ground water......................... •-•---•--•---47V& , 4�y........... ow ._ ._._.�O ------------ Description'- oil. r _0. ----------- ---------� LR . ::. ---------------------------------------------------•-----•--•-•----------------------••---••-------•---•-•••------.....---•-•-•----••--•-...-••-••--•-••••----...__...------._......._......---•-••-=_--, - V Nature-of Repairs or Alterations—Answer when applicable------------------------------------------------------------------------------------------------ --------------------------------------------------•----- ---------•------•-•--------------------------------------•-----------••--•-----------•-•------•------------•------------•-----•-------•-•-- Agreement TFe undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions'of Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been tied by the board ea �..� A - g _ e / Date Application Approved By------- ------ ----- --- --- -- ----� !L Application Disapproved for the following reasons:.__... --••---•-----•--•----••---••-----•----•-•------•--••----•-----------------•------•--------••-------••.....-••••••----•-----••-------••-----••------•------• ................................... Date PermitNo......................................................... ' Issued.--------• .......... .............-�-- ------ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD. O HEALT OF......... �Inr- of "I'umlifiattrr / THIS.' 0 C RT , T e Individual Sewage Disposal System constructed (.W/or Repaired ( ) by-/- - ---- . ---- t -------------------........ •----•---•------- --------••--------•--•--------•--- t � a• sa r at... . . ...•-�..... -------- .._.. .. has been installed in accor ce with the provisions of Artic e The State Sanitary Cod as des ribed in the q application for Disposal Works Construction Permit No..... ...... . ..................... dated._.. _.��.1r__-__.__-------- THE ISSUANCE OF THIS CERTIFICATE SHALL. NOT BE CO S RUED A GUA ANTEE THAT THE SYSTEM WI L FUNCTI N S/ TI FACTORY. DYYATE -----............................... Inspector: THE COMMONWEALTH OF MASSACHUSETTS BOARD / F HE L ... .. ........ ......O F.... .............- ------ ---..........-- Jf��r No.-� 7.-_----. FEE.,ilfl..----•---_------ �i� g g amt ion Vrrmit Permission is hereby granted.-/ ... .......: _.L4 •.............•-------.... ........ ................................... to COT uc�j( or, R�epf ii( Indi i a ewag Di al SyX- ------------- at No. r treet as shown on the application for Disposal,Works Constr ction er it N __ -- -------. _ Dated----� --- -------- -----�✓ - - --------------- --- - ' Board of Health - -_.•�--•--•-----••-----•---� DATE.... ............... ,.:___::_ ........- - FORM 1255 HOBBS 11 WARREN. INC.. PUBLISHERS• ' No.--=a�fl------- ................... THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH . ... -- ..OF......... . ... ..� . LG� .----..ti..- Appliratiun -for i,s oiial orkii owitrurti�n Permit Application is ereby made for a Permi to Construct ( ) or Repair ( ) an Individual • wage DispEral System .% ocation-Addr s -• or L. •IV . ....- --------•-•--------•-•----•----------------- ner Address W Installer Address QType of Building Size Lot----------------------------Sq. feet U Dwelling KNo. of Bedrooms_-__-____J,• .........................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons.--------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures i W Design Flow............... tgallons per person per day. Total daily flow._._._ __._____ _______---_..___gallons. W _______ Septic Tank 4 Liquid capacity__ _gallons Length________________ Width-------------_..-Diameter ----------- Depth-__--_-___-__--- x Disposal Trench—No. Width______________ otal. eng ____________ oral leaching area_,------------------sq. ft. Seepage Pit No______ __________ Diameter__ .___". t low/ fI ._._._. ______ _ Total le hill area_-___-___-______.sq. it. z Other Distribution box ( ) Dosin nk ~" Percolation Test Results Performed by.- -_ --- _ .1. _......................... Date........................................ ,tea Test Pit No. 1____ min�t- ch Depth of Test Pit____________________ Depth to ground water-----------------Vie � (� Test Pit No. 2________________minutes per inch Depth of Test Pit____________________ Depth to ground water____-__________-_____-_- --------- ------- --------------------------------- �, l ... Description of Soil---"•-----••-- `�---- ------ ----�- -`------ ----- •-------"-- . . ------- x 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 Article XI of the State Sanitary Code—The undersigned further a rees not to place the system in operation until a Certificate of Compliance has been issued by the board f-healt . Signed.--- �; �� - .........../117 Date Application Approved By---- - - -- -----•---- '1 C t ` _---- Application Application Disapproved for the following reasons______________________________________ _________________________________________________________________________ --•--•-•--------------------------------------------------------------------.......................................................... -------------------------------------------------- Date �(Permit No--------------------------------------------------------- ----............. D e 1 r i I t r f i 1 s. F-r ; 1 f � i ex�s7�r✓v f ` t F1 T � 9 i i TEST 1 r ( { S r-f'7 r C 7-•9 nr jk, NJ t -,;---- t i �wkGL;/rF 3 z' } � } 1 / �'k'/STrr✓ Fn;G o wEL L ► G?,p } q 4 i 1 S i 49- 1 i ram/=K C •7 A� 7-4 ,r I 197-7 el r /mot A_> TO Zr- r L ,JUL Y /v, 197 x`� R09ERT L ,r• BL MIS C//l1 A/ S11 V t" ,'0" /1V C ,�No.221G2�4 .r �IV0 A/F4-,A'-5 SUf?VE yf?rf'S i