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Home My WebLink About0083 MARINER CIRCLE - Health 83 �'launer CcircAo- � 1 �a3^ o,4. � LO�CATIONy > SEWAGE PERMIT NO. VILLAGE t-ksI SA<� L.o �'7� /4 I N S T A LLER'S NAME i ADDRESS 3 U I L 0 E R OR OWNER :7 z� / r ;DA T E PERMIT ISS E D DATE COMPLIANCE ISSUED i 33 f ti 1� No....................... P Fps^ ®.. .••... THE COMMONWEALTH OF MASSACHUSETTS .� BOARD OF HEALTH .................OF......B .i�l/� ;-•.`�� Appliration for Disposal Works Tanstrurtion Frruat Application is hereby made for a Permit to Construct (A or Repair ( ) an Individual Sewage Disposal Syst ....a --•• - �� / .�` ........ _ ........... ..... - l n`��G —ion-Address r ` or Lot Nyal- W � �. Owner F%�'L�'LAktSrtss .......... = ��...._..._._ ................................... ........................................ Installer Address U Type of Building Size feet Dwelling—No. of Bedrooms.........._ ,...........................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building l� Y. ..... No. of persons............49------------ Showers ( ) — Cafeteria ( ) �. Other fixtures ------------------------•-----................----------------••••......-------•-••-.... ......................................................... W Design Flow..............6.5....................gallons per person pef day. Total daily flow.....3,3.CL................._......gallons. WSeptic Tank—Liquid'capacity.!_ ?..gallons Length.lCk..... Width..S.'? "� Diameter________________ Depth................ xDisposal Trench—No..................... M�idth.................... Total Length........._..........Total leaching area....- _;e/ ft. Seepage Pit No.......... Diameter....... Depth below inlet..- . /-.-------- �--------- P �=----......... Total leaching area..................sq. ft. Z Other Distribution box Dosing tar�Jc�( ) `-' Percolation Test Results Performed by....... ..... / .... .____. r �....... Date...� � a ................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.._... j�' '! (_, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...._� ............ . a' . -•-•--••--•------•--......••••--•--•.......•••--•--•'-'--'-.......----••••----------------••••........--•--•...........•... O Description of Soil.... .= __. c.� 10.---.30..• -- x . --• •-- - ........................................................................................................... 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 iITI.L 5 of the State Sanitary Code— The undersigned further agrees not to place the system " operation until a Certificate of Compliance has been' sued by the borr', healt Signe ..•.... -..-..---- � � � -��-•� - a Application Approved By---• r'�rr ----•. ----. -•--- . 4 ...---11�2-......................... Date Application.Disapproved for the following reasons:............................................................................................................... ..........................•-----------•--•-----------------.........------•------•------•------..........._......_....•....-----------------------------------`----v--------------------------••------- Permit No......................................................... Issued- ... /� Date ate No.......... .... ....... FE s- ................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH oF......... ...-.:.: �................................................................. Appliraation for Uh4pnii al Workii C utuitratrthin Prrmit Application is hereby made for a Permit to Construct V) or Repair ( ) an Individual Sewage Disposal System at: ��// />% z�. ....................---------------- ......f.....- ........•--....... Lo ay' n-Address or Lot No. � ) Ct`-�L�L �G(. t... � Owner J Z'�i9tddk�es Installer Address /� QQo UType of Building Size Lot... ..f..................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) p`4.1 Other—Type of Building Z)...�_.-..!V...... No. of persons............(P............ Showers ( ) — Cafeteria ( ) Q' Other fixtures ---------------------------------- W Design Flow............... � ......._....._..gallons per person peg' day. Total daisy flow......-133<-..........._............gallons. WSeptic Tank—Liquid ca.pacity.l4Gv.gallons Length../K..b.._.. Width.--:? C. Diameter................ Depth................ x Disposal Trench—N __ ................'_.. Width _....._........ Total Length.......__..��.... Total leaching area___.J ft. Seepage Pit No__________ __-------- Diameter........ ........ Depth below inlet._7.3._..._._ Total leaching area..................sq. ft. Z Other Distribution box Dosing tank!( ) Percolation Test Results Performed by-------r� ..."."�!.`�:'. :y?: ------ Date---��s�� Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water---��j_%t/� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.._..................... O Description of Soil.... Aee Q .. . x ---------------------------------------------------------------------------------------------------- wJ /----------- ----------------................................................ 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 TITL1 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. igne •--•- Dat Application Approved By........ .. ..... -......... Date Application Disapproved for the following reasons-------------------------•----------------------------------------=------------------.....-••-•-......-•----•---- -•-•--•••-------•-••-•-•-••-•-•••----•--•.............•••••-•----•-••••-•--••--•••-----------••-••------•I--••-••--••--•••-----•----•---•----•-•-•-----•-••••-••-••••••••••----•••-•••••......-•••---•--- Date PermitNo......................................0..........----•--- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...... ...QG�` ............OF......% v.J. ��'`...." ...............................•...•• /Tntifirate of ToutpliFattre THIS•IS TO C Yi IT /t the Individual Sewage Disposal System constructed K) or Repaired ( ) by... " ........ ........... .•• -•- -•...... --•----L�-v�C----- l Y --------------------------------------------------------------------------------------------------- `u� ) � `' 2 Installer has been installed in accordance with the provisions of "' 5 of The State Sanitary Code as described i the application for Disposal Works Construction Permit ..__ .............. dated___./�_-' 4.'...�.__..... PP P Tit o 1 O THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WI L FUNCTION SATISFACTORY. DATE............ ........ _`. ..................................... Inspector--..•-- ...................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH 1 )...........oF....... �...........................•-----........ �J No...........••............ FE9........................ i rrrs�al irk Tom tr uan rrms it. Permission is hereby granted........ ..: ---.s-�`?!'?. _G 1C ---•- to Construc ), o Repair (X) •n I - "` I � Street as shown on the application for Disposal Works Construction P r't� No___ _____ _________ ;ated..lf .............................. G -� - .............. _ DATE. Board of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS ,•' � I -- - - - - - -- - - --'_' IQ--'4LL E��\/. S�� AQ.F �1E.A..J SEA �.�1JEt~.. ��g._a'SE t� o�i V S C � Gt .5 t�,ec��M G1.�.►J E. --� �♦ i -- -- ---- p 1 TG La A t,.i i1 E S P, tit ►J l M l�►'� OF t/b'/'Fo� I f A L-t- P�PE5 To A.►� t�f T�}� Sy STEM S HA.I� .�„ - , i ` m � � o J - _— bE CAST l�•J c�2 X'�-t�t�U�.E AO P �/.C . • Z � �� _' � it (� � � Q � � � O ® � � AFL �EPT�C TA�1�5, �tSTet6tJTI.o�J fix , Al..tp ' I..EAG►a,«J�r PrrS S�+al_t_ 8E �Es�,►.�Eo Fes. ALj- 0f4SU i T-AaL-E MATEr2l A l.._ �E�JE..�T1-1 r o go o T� It. 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