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0091 CONTENT LANE - Health
rcotu Content Lane it 040 - 040 _ '`I 9 1 LOCATION SEWAGE PERMIT NO. VILLAGE INSTA LLER'S NAME & ADDRESS B UILDE R OR OWNER DATE PERMIT I S S U E D 7-, /3 7L- DAT E COMPLIANCE ISSUED .., „ 7 J � � �� 77P' No........ ............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH e W01410 ,60 ...-----...OF... W............................................................... li2 on is for Mip a 10arks Tomtrartion ramit La4 + 'a#Z or Repair an Individual Sewage Disposal T r a PermitAo onstru X61LIwp,p 9, ,?ereb7mavde for , System at: ........ -C#a 0 ec&C Pe_R_.Y.........la—,.)...... ........................ . .... r t 0. &",M/77.,1.0�...0 ...... .................... .................... A ..S ---------- ............ ..........#4111 ..... ...... ...1;............. Owner Add�re 10110 .........0040-w- .................................................................... ................................................ Yr ----------------- Installer Ad ress v4�--#- Type of Building Size Lot.l�.................Sq. feet Dwelling—No. of Bedrooms.-_..._(?..............................Expansion Attic Garbage Grinder 14 Aq Other—Type of Building ............................ No. of persons............................ Showers Cafeteria 04 Other fixtures ...................................................................................................................................................... Design Flow..............6.715...................gallons per perso:nopei %. Total claily flow-------- ..................gallo 5. P4 Septic Tank—Liquid'capacity/iM.gallons L ...16 ..%iameter................ Depth_.__ '0. Disposal Trench—No. .................... Width.. ....... Total Length_................... Total leaching area..............._ ..sq. ft. Seepage Pit No------------- D i a m e t e r. Depth below inlet.- Total leaching area. ... ....sq. f t. Z Other Distribution box Dosin tank Percolation Test Results Performed bj=—ZAi2jG/.CU?....�WW.....A!<_.J.G. D a t e...!=/............4P------- Test Pit No. 1_4.2_-_minutes per inch Depth of Test Pit.../!Z.�...... Depth to ground water./,7VWA90_-/Z/r Test Pit No. 2................minutes per inc Depth of Test Pit.__................. Depth to ground water.-_.._......_........... 2. " A , � . .......-........................................ ............................................................................ 0 Description of Soil....&e_607,0........&J.Uzi ....... .......:sA,&0-------------------------------------------------- W - - -----------------------**-------------*----------------------------------------------*...*'***-----------------------------*---------------------------------------I----------------"-----------*-------- ..................................................... ................................................................................................................................................. 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 TL I'i IS 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee ed by th r f heal Signed .. ............. ... .. . ............................. .................... Date Application Approved By....... ... . .... ....... = ......... -------- - ...719�---- Date Application Disapproved for the following reasons:................................... .................................................................... ......................................................................................................................................................................................................... &-!ea li Date 7*1 -7 Permit No......................................................... Issued.---....................... .ep ......................... Date - t F� No Fizz ..... THE COMMONWEALTH OF MASSACHUSETTS" BOARD OF HEALTH :_7'a:w.W................. ......-----•---------..._..--------------------- ,r f Appliration for Dhip sal Works Tonstrnrtion ramit Application is hereby made for a Permit to Construct (k) or Repair ( ) an Individual Sewage Disposal System.at $hrr�sf /►?,'//f , .,. =------------------------------ . ---.........•.....�2:...0._••y�--...�......•........._...... ..- Location-Address or Lot No �S ! .... S `�Y G✓/C h vas .. ..•--. .. .... .. :..._.... ............................... Owner Address t a ,jMU-h.......................... ......._..........._....._..._........... !�����s............ Installer Address Type of Building Size Lot_.1'9,A'0G__=t.._._Sq. feet aDwelling—No. of Bedrooms............ ____ ______________________Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) al Other fixtures W Design Flow..........J'✓S.__ gallons per person )er day. Total daily flow WSeptic Tank—Liquid capacitv�Q ___ga]lons Lengthy_G ____ Width y_`ref.. Diameter................ ePth ........... x Disposal Trench No �J� g � l leaching area.___.-,3-..........sq. ft. Diameter... .. ._._..... Depth b, elow i let. ......... Tote _ Width .. Seepage Pit. No................ . p al leaching area..................sq. ft. Z Other Distribution box ( f^) Dosing tank ( ' ) Percolation Test Results Performed by._._,5� _af� � .... �` i��f_____.[.'?: .____ Date- �P _ (''. ,Wa Test Pit No. I J. '�_A____minutes per inch Depth of Test Pit .� __�______. Depth to ground water_._I� Test Pit No. 2.....j....... min tes peg Ir h,�, Depth of Test Pit.................... Depth to grf ufnd water........................ xDescription of Soil...... � � S ---- •--..._._... ...........�----------�- ------------••-----•-... .................................................. U ---- _+.......................... W 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 I:Lb 5 of the'Sitate Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance=has been i u by the board of health. %Signed .. �'� ...l.7._!n_ �r � Application Approved `�- _•�'rY -- •. Date PP PP BY �` . •--- ---��-- - ------- Date ......-----Date---•••-- Application Disapproved'for the following reasons---------------•--•--------------------`---------------_-•------•----------------.. .._.. - Date PermitNo...... :-----------•--•----------- Issued....................................................... Date TH;E 5OMMONWEALTH OF MASSACHUSETTS BOARD OF- HEALTH ..OF...... ���rr�ifirtt�r''laf fTrr�t�li�nrr TV11"JISITIX....9 CERTIFY, That the Individual Sewage Disposal System constructed for Re aared K ` g P �' ( ) P by . Install has been installed m accordance with the provisions of T >of�The State Sanitary Codes described in the application for Disposal Works Construction Permit No THE ISSUANCE OF THIS CERTIFICATE SHALL,NOT BE CONSTRUED AS A.GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ` DATE........:...... -------•_.. Inspector `- ......................................... THE COMMONWEALTH OF MASSACHUSETTS 1^ BOARD OF HEALTH I� "" "1(7f r ............O F.............. .,.......................................... Permission - hereby granted.*" ............... __._ . --- •--•-• ---- -------- -----•. ---- _•-_.. ._••--- to No.. ct ( ) Repair.( ) an Individual Seta �eosal Sy ' g Street a. as shown on the application for Disposal Works Construction Perini o. IJ ed_.. _------ - . .-•� j�: �� e w Board of Health DATE / % ....................................... FORM 1255 HoeBS & WARREN, INC., PUBLISHERS t �,�, E ly s�,. ,� l:'. J Y .{_' I��M1 k Zy�`+Py ,Y .�, y - y� u y� p., (•' 1. a .• .y..y v :n r .. ✓i. •r .. 1. x. ,M, ,..,Sr } , p.. .A.,�: "i-/':. Ma� ^4k d O. ., a ''. 4, 11 y+ c ✓ ,r.:._ .. .. .,:;t0.. ..d.: '�'„ �c. _�..R; .,: x' _ _ Sa:. rv. - ,.. <x : -:w,. .:rs.." >sir. +.. a. : 7 MeW. 11 'Tr , c " .. m.n +. , .rar.v,aaNbw+YrRMws,anM,www:w.nL.nwuYv,ixrwn•nw'w..,r+'sY+t.w. u LY, +islMm+eY�pwes�v. r�y:...ule� , PLAN PpCiFILE OF SYS`7 4s 7 } n.: . ... ' __ _ __ ,�.._._.,,._.__._ _____,.__ t '..h ,,� :. > ? :,a, . S -._..._ .___. - E1!AtlE t,CJ`JR - I 24 _ ._._._._ . . _,_..- _z. __ .. __ __. i a, r . ,, .. GENE (� ACE' r p �J�� 011, ;r ( , _ 1 `�= <:._ i BROUGHT UP WITNEN � E !tvi`�HFiD (GRADE ! Ir'v f� f �� � -���. I! s f l% X ''4 '�::," ..^� r f l i.w, ... .. .4 , . S V r„ +�. .. L..,u.+"sr" , ., 11 .f ,j ' gee B' cf M I It orl F cat i, n w + d ��'t >,_� t we. r�v ':nt r axe _� - I, � � ;£� IAMETE MANNC� Wi�fi � T u' R twE OP; f2E E CQVER r, y« j ..: ,. 1 ,,:!_. '' 'ri+`, p f._vgT ."... ..i,.-,.1 . - y ; 'k _ "trll�, EtC{ 1`C '' 1��" to be `,,,one .:, . :;(;. ,,t: .. x � ., "; i' BP<CtUGH 1P T-0 WITHIN 5 GF FIN* SHED GRADE k+ `i • I r �,. __.._- .__,_. ::� _ -- �� {.. �a�(L°n30' tTn 5.1. crf °...(:,. ,. ,_�_ NISHEU GRADE � y ormt,d iri ',fit .3r. n th tt r.rc 1` I;f ttIf I _... _._ -- `}� Masscic', twits 5'(:te Envlr(�rrn�ntcl . , ,. . z _ . f _- _ r5,, �. i "t S S. !r ) _ _i0 _, ^ _ �..�(� I '�r='! 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P `� iINV."..1�r' '�e'G 00 0 0 0 0 o _ G p 0 tr IUCat1 Ft (}nt: Ittt?! it7 CtY!?ni C.';F c' « , t, I I. i _ r 17 ;Yt', �> . 1, Qrt Ic"te+y Yt t p;! [ _ _._ . _. .. r .k , -. .w.i `,' o, C - ,... 'ta9J i ..F� _._ ►-� S w 0 G Vi ^ <'> I C .. ri�•� I©. . , AP61 ARY EF Ia ItV� °� @ i ac � «` a `,' ! n I +5. Aii wrisned ! mu,,i hcve less than 2 .• E.H ,, "w I 1 ,•0 � o :' to G C+ _ G� ;;I +iGa I(1 tfl'e. �!?Ctltnr tE?iP ..h w uC JfSTRi13i.IT`ON BOX , ,: � G � i �. ;4 . 1 > .,r' r I. --- _ n3 ,n 0 N @ G tl 45 O C J R i+ 0 Irner : an. a nurriber [00 ,ieve� 'R Gic t�•rrytj^P4Ci 4' t'� ,. 5�'II 7sf1(3t�,' i JR l✓F�EC�.,,1 GGN£RIr7C _ -_, _.�--_.. _ • r „ .; 1 .; ,r,t : 0 r - 0 0 0 a .. C. v 0 0 0 Z° c n,c4 , • •�-I ( iotest edition PP0, 1jr T 7r; CENTE.R�iNE __. =' . .►� t.ETS �� A! J1 t 0,0 0 0 O _ C 0111 DE, y.AIVK ��< ' . . @ o t (; r n 0 al 7, igtii jt,int piping tt) cccis st ;t �:"Jvvlrlyi Chloride P;^e r PVr ) , 4,( H r i _. c o i p ' ^l F - ' ` s: r. _, , ALL L 1 t}° C f i n unl�''S's t tber*ise noted. „ a INVERT = ;wEtiJ� !r?NJS DE „ �) T " . E SA,ME c.0 ,, 0 G A O @ ! ,,0( 8, ?n cases where ledge or f0oialUt'•rrs "rP fjI"��efi'1' %hUtlPs(I tttCtii'@TSy tnc. Jt r P rc 'r 4 rJ tP iT "_ G u c ^_�' . v 4 @ , ry'>1 rl�5 dl5t 7!£' fnC !1S5il(+n 4r3@ erftoClrlt +3f (OGk tt7 b�' £t1CU?JRt ?ret I T p�99 __ pp- I :31 Q 1V Ot>, L E. ) L t)ia� C g A _. . ._ ..._ ..., ___._.,, a ' c ` - __ __ _ _ f ' Of; eIJ� Uf E EXP NSION PURPOSES I 3. Schof`;,,'d Bfotners, Inc. wl'i nut be rec.t)onsible far the �+sri(�+ mnrtr.e of thig syst8m I. 6t I + ` _i�'�--3+�.__,_�r�t���3IV (SFI_ € LG L F C "'I0 LE AC H I N k+ olest r:Gnst a)'^ t>. � s sh::wn, Ar;' olterat!on5 must be q approved d ;n ti ) I- J �_ _ _� 1 'I :4^k`> t r tJE^RI'�EJ f:r)tU-RI ?_ ` _._ Schiofit�;d �?rti f r ` - # OJTi_ET PIPITS SHAI L. BE LEV�_ < 1 t+e n rs inc . ~,r 1' I. ' i "_ . ,._ , OR AT LEAST TWO FEF I r � i pus c�Yer th L �t c T 10. rleov rr '; 'I %( $t3(JIt 'sot he pef-m t ed ttJ r„ e ;1 t « �1 t` I�0 SGA+ E t I i . The Ioa I ate n ot. of I cons ruction tha (te5a _.M ��._w __.__..__ olt+� s o'I regs,i-e nspeGtior , ._ _ } . .. _ _�. ' � � ___ _ ___ _.. _ _ ______ __._�__.. _ .__ __._____._._.�.-_.,_._..,,.._«_,_. ___ _�____ _____.»_a,. .___.__.,_,___._-- ,_.,_,-_._ --__.____ - _ ___-..._.-�,._.... 1^ e r ;r , � n! f O a r d a f I t r a r s p h � y n h E' _ 7 n !� Q 1 c n{� t'P t.t G P G *t y � V i__.__,-_.-.,..,.__, r t ,i .r-1 W t1rtC has t7r , ,n, rot �, '"'T hwJ '� r'� � I fl�� @ t' •:C t c F;d& fl �1.: {, �'^r�� }^,¢ C e f �-�' r*-,.sp I �fl ! t l^r C 1 L7 i.± W fl!k 't u beet) 4 n t 'n ,� ,7 r� + , I ( SYSTEM permit and t' e opprGved glens. , , . ,. __ I Z. Pic r,r a t ,• r r 1, �-•.'. ! I ( , , pe ur) (! rtru fu e rr ,y Y N c,:is;r+ar,t« ci c;uer tie iOa l� expansion area.. I S r� i t, r: n , -Tl T1. _ t r Pro )E,,r r n e-T ' t!,• s a 4•r t c > i , t a] "^ ��"'. / �.. •. „� r /I :"'a. t. 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