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HomeMy WebLinkAbout0239 CLAMSHELL COVE ROAD - Health �39 Ctc�msh�e�� ����� No................------- Fimic.............................. THE COMMONWEALTH OF M ASSACHUSETTS BOARD OF HEALTH ............................................OF......................................................................................... for Uhivviial Workti Tomitrurtion pamit Applicaii6n is hereby made for a Permit to Construct (>Q or Repair an Individual Sewage Disposal System at: 1 ............................................. ................................ L�................................................. Location-Address or Lot No. ...W.0.6-A-0......a=.Q_0.AJY1.0............................................ . ................................................................................................. 0 rm Adf ........A- ................... .................................... . ..............................a. - ....... . ..... Installer Address Type of Building Size ......Sq. feet U Dwelling—No. of Bedrooms...........3.............................Expansion Attic Garbage Grinder (A�— PL4 Other!—Type of Building ............................ No. of persons...._............._.._____.. Showers Cafeteria POI Other fixtures ------------------------------------------------------------------------------------------------------------------------------------------------------ < Design Flow...... -------------gallons per person per day. Total daily flow__..*.*.9-1 ...__............._..........gallons. 1:4 Septic Tank—Liquid capacityl.5o.a..gallons Length................ Width____._...__.._.. Diameter---__-_-_-_---_- Depth................ . Disposal Trench—N9. .'................... Width.................... Total Length.................... Total leaching area...................sq. ft. Seepage Pit No.....1-------------- Diameter....16............ Depth below inlet....._......_............... Total leaching area.13.17'__.....sq�, Z Other Distribution box Dosing tank Percolation Te'st Results Performed by........................................................................... Date.............. Test Pit No. 1<2.,_.....minutes per inch Depth of Test ........ Depth to ground water... / . ......... .... Test Pit No. 2................minutes per inch, Depth of Test Pit.___................ Depth to ground water........._.........._.._ .................................................................................................................................I............................. 0 Description of Soil.....-.�V..........7"040... ...............".."......C-AAq- .........................X......'....I................... U ............................................................................................................................... ....................... .................................................. ............................................................................................................... ..........................................*------------------------------------------ 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 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 board of health. Signed........ ...... ........ ---------- ID Da Applicatiorl'�Approved By....... ..... ............................................................ ........... ..... .................. Date Application Disapproved for the following reasons:.............................................................................................................. ......................................................................................................................................................................................................... Date Permit No...............� _'-S._—_e_62_q Issue(L....................................................... Date ------------ —-—--------------------- --------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............................................O F..........................................--------.__._._.._._._....._....__.._..__.._.._. Appliration for Disposal Works Tonstrur#ion Irani# _ Application is hereby made for a Permit to:Construct (>Q or Repair ( ) an Individual Sewage Disposal System at: r ......----•------••---C1? �' . �T...........................................:. Location_Address or Lot No. ............................................ . ......-----•---------------....._..............---.........-•----y-y----...-------..........._..... nwer re.. df a ..._.1.l�t. ,o................................... .....................................{ ./�P r, s........................ __- - Installer Address Type of Building Size Lot.. , . " ......Sq. feet U Dwelling—No. of Bedrooms...........3:................ .....Expansion Attic ( ) Garbage Grinder (y'r U '4 Other—Type of Building No. of ersons____________________________ Showers Ga YP g ............................ p ( ) — Cafeteria ( ) 0.1 Other fixtures .................................... d ............................ ------ •---•-----_.......- ------------- W Design Flow......�P_'7,�'.__I�P_a............gallons per person per day. Total daily flow_._ .............................gallons. W� Septic Tank—Liquid ca.pacity.):�ii�l�.gallons Length Total Length �-Total leaching area.-•Depth-:--:.- ft. x Disposal Trench—No_ .................._ Width.................... g Total eachi nl area... ....:.......sq ft. Seepage Pit No...... _______.... Diameter.____I .__-..___._. Depth below inlet.... A g 3� q• Z Other Distribution box ( ) Dosing tank ( ) ►-. Percolation Pit Results Performed by.......................................................................... Date....................... ... ,`'la _:__..minutes per inch Depth of Test Pit.../A.......... Depth to ground water...srl✓.�.......... Test Pit No. 2................minutes per inch Depth of Test Pit.......... Depth to ground water........................ a, ...................•--- ..................._-----........---.....----_._... D Description of Soil.......:Z.0.........Ae .S t 1 C' �' > ' "l.................. _... . -'�•-'.. •----•---_____�a--•----••---•-•--..........------•--••----------.. (,) -----•••••--••-••-•••................•-•--••---••--••-•••---••-•---•---•-•-----...............••---•----•-•--•-•.............--------•--......_ --......_................._.......-----••••-•-•--••- W x Nature of Repairs or Alterations—Answer when a licable_______________________________________________•-----•-•-•--•---•-- U M ,, p PP ........-_••-••. ........................................................................................................................................................................................................ ....................•--•--......._..--•--••---_.... Agreement: rr. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIS 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 board of health Signed...........� � •--•• ................... --_ Application Approved B c "._ ' -- ...........................................................` ��_ -" PP PP y......... - Date Application Disapproved for the following reasons:............... .......:._:-___..__._.....__...__________-._...._....______...________..............___ ............................................................ .._..----.....-----...-------•------.......------------------------.._._._........-------- Date Permit No------------- .. .- -tom. . Issued...................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... Tatifirate of Tomplianre THHW IS TO CERTIFY, That the Individual Sewage Disposal System constructed (X) or Repaired ( ) by............}.. �`:........................................................................ .. •-----•---=--...... ........_...._....._..._.._................ _.._..._ - .. + Installer °fir 11 at...................................................................... � --•---� �` has been installed in accordance with the provisions of TITLE 5 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. DATE...................... .............�a. .��. g`'�••-•------........._•-------•-•--_.... Inspector ------- ----- ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No. C.� :•-�. E��f ...........................................OF........_...-----. ........_..._...----- ............................---... . Fa>L.� :..... Disposal 18orks Tonstrurfiatt rrrmft Permission is hereby granted.............. to Construct ( or Repair ( ) aIndividual Sewage Disposal System at No..... `a_.......... ....._..... .. ... y C.`? _...•-••• .... ' . ........... _ r�.. . ........................ . Street as shown on the application for Disposal Works Construction Permit No ....��'�' Dated......./..b..12.y _:�w,....... .. s •......................._ •• _ I Board of Health DATE............. � ...... ...........-•...:........... �. �'?�.V. >FORM 1255 A. M. SULKIN, INC.. BOSTON ..;!.�C��.°.__. r�.M 1�-'C '�'�S�`D 2..x�t�� -M�� Cc. C...��V..�..1; \�`� � �.�t,.✓ `d Czvz tiVz , t t o.K x •z00% -• 6;(�Io c.?"v SH.L �T L�6�:- 1 Carkt�.l.c5►� 'M 1 OF ~ �• i � •T--a �...�"r,Q 1'� py, _ C4�r`^,! .)i.i ii i i V!f'. _ r l`1 r;•, ' 5 9 F 5 _ 30.•Z Ca FT— � /.w •... ( f� /N✓. GAL:� I D X S gZ,7 �433 ,SA c ; 4Tr,�tt :; c 9a.t JJ .5 t-, I,.'ell 0-7 Ll \-7 '9 7.0 / C.E,E'T/.�=}� T</rQr�T-yE�r�w►r`ry`;�x'� - /-rE'.GJFc�.c.' Tox-S'% J•�MB,�.�.r.)S�',k�1..L �-�'�vlJ /,S it'o�-""" AKA t t_ t-A u ..� . 'V• �`.. f l \ 't _ ....'/\ l//� .L j:YIEfI�r—a1�vi�..�VC/ f','!V� �ytG U/Cf'J.LC�3 / 3 hG ry'� ,�,E,2Ea�✓sf/�v�o for!� vsE ja EJT��G/.sy Lor- G/NG,S e i A r�7r. 41 ,..,` Sri , 1 � owN �T�•\2. 87 rp— d,f 00 i � � 2 li T K K 1 EV"/ r -�5 C-'A.L G 1 - AU -.. "rq��, G©`S•Li E 5 -°%E=?10 �a ,,- ��� PETrR Gn , Oil ? I • ` THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................ ...........:.............OF.............................. Appliration for Uiipnsal Works Toustrnr#ion Vautit Application is hereby made for a Permit to Construct ()() or Repair ( ) an Individual Sewage Disposal S stem at ........l�o_�...- ......�. 1 'a e�L....��0 V.e.....1! ---•--•--------•------------••-•---... 'S - •- •-...... Locatio -Address or Lot No. iyi �l. + ► bA ....... ... ....... gdQ__... .. ...L�'k �7'..1� .. Owner _ Address W Installer Address UType of Building Size Lot............................Sq. feet I—i Dwelling—No. of Bedrooms.............. .........................Expansion Attic ( ) Garbage Grinder (X) aOther—Type of Building ............................ No. of persons........................ .. Show is ( ) — Cafeteria QOther fixtures •---•••••---------------•-•--•......-----••---•-••••-•-••--•......--•----•--••....... ------......... ....................................... Design Flow........... ©.................gallons per person per day. Total�aily .. .��... .............gallons. WSeptic Tank—Liquid capacity/'_-gallons Length................ Width........... __ is et -_.-_-__---..-_- Dept .......... x Disposal Trench—No. .................... Width.................... Total Length............... ... to ching area.....__. ..........sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet---------.....-_ o 1 leaching area.. ..............sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by...................... ................................ • ............ Date..... •••-----•--•-•••------•--•••---- Test Pit No. I................minutes per inch Depth Test Pit................ . Depth to grou water........................ r1r, Test Pit No. 2................minutes per inch Dept of Te t it..._._...._..._... Depth to gr nd water........................ x •-•••-------•-•-••-- .••..._.--------•-- ----------•-- ---------------------- -------------•------- . *.... ..-•--------------- D Description of Soil....... lja. �-_.!i.....'=f-0VL.>... . . W U ................................................................................... ......................••. --•-- . .................. ......................................................... W ---------------------- -----------------------------------•------•-••---......-- -------•-•-•-------------• • ---------•-•--•••••--- -••-•-•----•---------------•------•---••---••-----•---•------- U Nature of Repairs or Alterations—Answer hen applicable.......... .............. ................................................................... Agreement: The undersigned agrees o the aforedescribe ivid Sewage Disposal System in accordance with the provisions of TITLL 5 of e tate Sanitary Kod — e n rsigned further agrees not to place the system in operation until a Certificate of ompl nce has be iss by board of iealth. ed........... -• ••... .•• •-- •-•.e ate ApplicationApproved BY -•---••••......•..--•-•. ----••-••-----••................•-•••--•--- •-•----- L� Date` Application Disapproved for t e o owing asons:----- -•------•-••••---•--...•-•••---•------•-•--•-•-......•-------•••-•••.................................. ......•••• .................••-•-----•-------•------•------------••-•------------•--......------............-----....Date PermitNo.......................••-----•-------••--•---- ...... Issued--•--------------------............................... Date .........................•..............................................................•................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..............................................................1............. TatifirFate of TompliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) bY-------------------------------------------------------------------------------------- .....---------------.------------------------------------- - --------•----------------- /� / Installer /", has been installed in accordance with the provisions of TILE of Theme State S dated__ Code as described in the P Y application for Disposal Works Construction Permit o.._____._ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... ................................................•............................................................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF.................................................................................... . ._ No.... ............. FEE.. .......... Uiopsal Work.5 01Aanstrnrtuan rrntit Permissionis hereby granted........................................................................................................................................ .... to Construct (X) or Repair ( ) an Indiv�i ewage Disposal System r 'J9X ....�..W_.e.------a' .---�u -------------•----------------------..............at No.- .. . ✓l? n Street / as shown on the application for Disposal Works Construction Permit No.75�Dated.._.__. �!2/�`�................ �. � .. Board of Health DATE..............•--••-•--•-.....--•••--••-••-•--••.........-•-•-•......••...-•--•- FORM 1255 A. M. SULKIN, INC., BOSTON FEi3 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................... ..............OF Appliration for Dispoiial Workii Tomitrurtion ."amit V Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: L41 A. ...I Sjit......0 ............................................ ................... oc .......... L 't',o Address r N o L ..... .... Owner Address .................................................................................................. .................................................................................................. Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms..............a..._._.._..._..._.__......Expansion Attic Garbage Grinder (.X aOther—Type of Building ............................ No. of persons............................ Showers — Cafeteria Otherfixtures ................................................................................................. Design ........................g Flow..........&&p T ..... allons per person per day. Total daily flow----------- .. .. ..............gallons. 1:4 Septic Tank—Liquid capacit/.��...gallons Length................ Width...____._....... Diameter__-_____.._..... Depth................ W Disposal Trench—No..................... Width_...._.............. Total Length_................... Total leaching area....................sq. ft. Seepage Pit No_____________________ Diameter..__.....__......... Depth below inlet................_... Total leaching area..................sq. f t. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.__.__..........__.. Depth to ground water.__......_.._.__.._.__.. rZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 ............................ ............ --------*----------"----------*........."------------------------------------------------------------ 0 Description of Soil......C qvi, W .1. ..... . ....I...... ---�,Z ..................................................................................................... U ........................................................................................................................................................................................................ W Z ....................................................................................................................................................................................................... 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'11TIL' 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 board ofhealth. igned...�t ---- Date Application Approved B .... ....... .... ......... ....... ............................. ........... Date Application Disapproved for the following reasons:........................ ................................................................ ........................................................................................................................................................................................................ Date PermitNo................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF...................................................................................... Tprtifiratr of Tautpliatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by------------------------------------------------------------------------------------- -----------------------------------------------------------------------"------ --------------- ---ins dler 'at. .............. ..............�...........CIO ox! ...0.4-e...... ---------- LZ:7� - ----------------------------- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.._.. ----1� ..q...... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................................................................... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - ...........................................OF..................................................................................... No . ................ FEE ........... Roposal Work.5 ToMnotrurtion "pamit Permissionis hereby granted.............................................................................................................................................. to Construct (X or�Repair an Individual, Sewage Disposal System 1 ..................................... at No....... ---I;,!.....I.. . ........41— 4 Street 71i % -- as shown on the application for Disposal Works Construction Permit No Dated_.____ - ................ .......................................................................... ..... Board of Health DATE................................................................................ FORM 1255 A. M. SULKIN, INC., BOSTON �► e 'S I N f�L E�q►./\l t_�( -3�Ep i��4 t•�'S vkL-A A„� cam! -DAB L.Y F to Xs x k so&/. = 19 5 GPP '6 EPTt G-T+�an�.IC.. = t to K 31C zwYo = 66C) 6:vpD &" ;/Z +Sr'L aL ►-t- -• u6c IM0 &ALL*q.6 Wt-rtA 3 6-2:�v4c %OS WALL AzEA 22( s F ALaa ► 13 4 �' s�tuvr'' � . 113 1,0 .. 1 13 GADt ry,. 29733 i TEST f/G,�E 'EL '?(-)or2 I CO.— ^' y /� Pic.) s � ' /.vim 9�•7 2 - 97.7 BOX /N✓. GAL, /Nt/ :• b fxaL 9T,7 �a 3 SL-PnG L ,• 3' e 7.q.v.Ac -40' ^t i '✓ : ,? C_OTC3 L�E,�Eov GOMP�Y.S lt�/TX/T,yE'S/OE�✓N� B.dX7�,2�NyE /tic. .4.vO,sErlAe` T,y4 ,eEGiSrLSP1=J>,Ge vo,SU.2t/Eya,P�S Tox%v of­56,Z-Q-5rNeLr, A VZ7 A,c3v,Gica,s7- Wt1.L\F;M� �sU®L"�t10 Al Al,4 /1$-1$7e- -�/�1Eyr'.,Sv.2r/�YflNO T.�/E o�FS�1.s S/�K/�yE,2�4N si4/p�/G�SOT!�E USEp CDA �_r'J. • 60001 6 ' J� r 2A ' lipco /lam ��aj• �d,. D � �°� • �•r akl�..���.1^ TVA • � ,dp Z z��y,cxp ao• 'o T L.a.r.�► Y 1 E�e�/ AD of '14- 1..v-t" 65 P4TER COTC1 IT (:f4Y ES - J1ecriot li WJILL No. 29733 a �sr�oK� ,r• / A/1 LL I a.1.� �'Z003aN0 ai LOCATION Ca765 -*1�13 ,SEWAGE PERMIT NO. VILLAGE INSTA LLER'S NAME A ADDRESS S U I L D E R OR OWNER °i cr 14, 6132 0122 ram. DATE PERMIT ISSUED o DAT E COMPLIANCE ISSUED C 43 ' :q®f 5 = q2 A16 tam��-