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Home My WebLink About0045 DANIELE STREET - Health � ��- a�c� cd,u�� r LOCAT N SEWAGE PERMIT NO. VILLAGES� I N S T A LLER'Sr ' NAME & ADDRESS Cel (<e�`t9, B U I L D E R OR OWN ER 6- let F DATE PERMIT ISSUED 11'7 IP,, y DATE COMPLIANCE IS_,SUED 4 _2 � _ 4` �� . �. C'. � _ _. .. -`3�' -- � ` �q .�� z� � .,� � k No.... ................ Fps... .._ THE COMMONWEALTH OF MASSACHUSETTS BOAR® PF H A H OF...... ...... CC ........................................... Appliraatinn for Disposal Works Tonstrnr#inn Prruat Application is hereby made for a Permit to Construct (V1 or Repair ( ) an Individual Sewage Disposal System at: /V — a -7 �ft/ AVA 5� � ..................................--.---- __._...... --.. ..... . ------ 1� ---_.. /Wes / �� .--. . Lot No. a ner / f�.� . ............... �T/�/YJ s ............................................ Installer Address UType of Building Size Lot. f..................Sq. feet Dwelling—No. of Bedrooms.......... ..............................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers a YP g ---•--•--•----------•---.... P (--- )--- Cafeteria ( ) Otherfixt .. -------------•-------I.••-••-•---------•--•-•-•-----••-••--•--•- W Design Flow.................., ...............gallons per person per day. Total daily flow.........S2 ..........•..........gallons. WSeptic Tank—Liquid capacit. allons 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 Test Pit.................... Depth to ground water.____...__....._..____.. 0:. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ...--•--•• ....- .....e................................................................... ODescription of Soil........ lam- l '/' `'............................................................. x _-•--- -----------------•- _- .............................. ---` ._....---------------•---••------••---------•-----._.......-----•---------....... 0 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 iITIS 5 of the State Sanitary Codd— he u rsigned further agrees not to plaYete system in operation until a Certificat of Compliance has bee iss t e oard of health.N 7 �s-" igned ...._ -- --•--•---•--- ---•--------------•----------• --•• -......-•--••---••- . -� late Application Approved By-•-•••. -••-•-•. ��-----•----••--•--•--•--....------ -------�1�-3__S----•----- Application Disapproved for the following reasons------------------•------------------------------....--•-------...------------....----•--•---•-••------•--....-- --.......--•--•-•---•-•-••----••------•-------••.....�.••-----•••--•---------•__- Permit No.----- -•-----------•--- Issued. / _Date Date No................... ---•-. Fizz. ............. 6Q ''" " THE COMMONWEALTH OF MASSACHUSETTS BOARDf F H a , �Aj _ :. . . ' ApplirFation f nr 0iopos al Works Tonstrartiun-- rranit Application is hereby made for-'a Permit Otto Construct ( "oar, Repair ( ) an Individual Sewage Disposal system at �i40 lk 5b..... ___./ot ; 7 --- - -------- -------------- - r --... ..........._....... f /4'' J f f or o ...................... ....... ie _ .........----------------------- ........ Lot N ... i �(('*''�� a � . 1 Installer Address ,�g� Type of Building Size Lot .jl V--Sq. feet a DwellingNo. of Bedrooms.......:3.. _._..Ex anion Attic - _ =•----------•-•--------- p ( ) Garbage Grinder ( ) Other—Type of EBuildin _..... No. of persons..................... .. Showers — a YP .Building ---------------------- P ----- ( ) Cafeteria Other fixt ) Design Flow....... ...... gallons per person per day. Total daily flow...__.._ gallons. Septic Tank—Liquid capaci/gallons Length................ Width__:. Diameter__= Depth....._.._.._.__. Disposal Trench—No ................... Width Total Length _..._,,_ss..._.._.__ Total leaching area... sq. ft. Seepage Pit No..................... Diameter.....� -_------ Depth below inlet...Via......:... Total leaching area __Sq. ft. 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.._._.__._...........__. frq Test Pit No. 2......:.........minutes per inch Depth of,Test Pit.................... Depth to ground water...__.................... ------ ----- t ---••••••........•••••...... O Description of So<l x , ... . : - . , -•-------- ---------•--•- ---- : : U Nature of Repairs or Alterations—Answer when applicable................................................................ ............................. ..........................................=..............-----------------------............................---------•-------------------------------•----------•-••-------------------------.----•------- Agreement: r The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI 4 5 of the State Sanitary Code— hdursigned further agrees not to place t e sy tem in o eration until a Ce fica a ofCom liance has bee iss dP p yard of health. e l' ' 6` >gned _ c -r """'W J D to ApplicationApproved By....... Application Disapproved•for the following reasons:.............................................." 4 ---- F,--- --= - :h Y. •• Date ^ Permit No...... ' ........................ Issued........... -� JB—S \ Da4e THE COMMONWEALTH OF MASSACHUSETTS y BOARD HE .............O F....... ...... .................... t t.� j ' �;�,4 THIS IS TO CERTIF hat the diva 1 Se a e Disposal System constructed ( or Repaired'(,''. IRS ---------------------------------••----•--------------- has been installed in accordance with the provisions of TITIF -5 of The State Sanitary Code as' escribed in the t application for Disposal Works Construction Permit No......_ :. _ d_ _l,.I ..................... �..... date THE ISSUANCE OF`iTHIS CERTIFICATE SHALL NOT BE CQN, RUE® A �aet� R ' TEE THAT THE SYSTEM WILL UNCTI N SATISFACTORY. ,: DATE.......... . .. .. Inspector.....--.. rSETTS -- •• -- ----••. = THE, COMMONWEALTH OF MASSAC BOARD F HrL ; '" O F... ; '� .......... ..e.... . ............................ j. " NoU ,,l... . FEE....................:... Dispnlaa1 rhn n tr rrnnit Permission > e y granted ... rG'' ............. ..... to Construct ( or,Rep it ( ) an Individu �r e. osal S t at No =- ... , Street as shown on the application for Disposal Works Construction Permit No.Y:.-:__ .._._ Dated.....V., _�.........:............... ....................... ............... .............................................• Board of Health DATE - =--;._---------------....................................................... FORM 1255 A. M. SULKIN, INC., BOSTON =ZA S/N6L E F<Iiy/L Y -- 3 BE0�2aoM , �L IL OA/LY F.LOl c/ = //e9 x 3 = 330 G.FPO. - -_-//�, o620 O/,:.Ti�2S,4L �/T•-USE /,000 6'.d� . Z/ ,.�0� .� � /�.v � , 7107";4f4 17425 7'o7 4 6•.o0- N i � 7E,s/G�t/ �.E',2GOL4T/a�t/.2.,4�' /"/�!/2•N/N. O.�LE� ��"`�"�'`�'�� '�� ''y OF iV'i R I CH ARLD �`�+.,`�` ��• ti� r 4 V., � NJ 5. t�r!-`� I'4C.:��b(j`� 1�,• FG• =.�. ' -� .+ `� ( fl" OAST. (�'.�.IE /000 /� :,'•� f�c�' i i /N✓. GAL. 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