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HomeMy WebLinkAbout0520 MARINER CIRCLE - Health c�"aa MG-rivie2 0o-cC-c- LOCATION SEWAGE PERMIT NO. VILLAGE Cai v/ 7- IN ST ALL ER'S, NAME i ADDRESS 5/'"a THea/f�9/-( /I) i S C'eo/4e? 1(,el LTA 7'Irv1T IUILDEIII OR OWNER T11e,-1 r DATE PERMIT ISSUED DATE COMPLIANCE ISSUED r,. \ .b �' �f�.. ,,rr .� ism° �,.� �". A •` �,.✓' i r ��` ,�,' ��� � � � l�,4 ,�?fj��`� �"r�'1 C C E No....&. 537 .......... Fizz.2.&_��......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........ .....A).... ......OF........ ...................................... Appliratiou for Disposal Works Toustrurtiou rrrmit Application is hereby made for a Permit to Construct (� or Repair an Individual Sewage Disposal System at: :4051-11 P02 ....e:�.... .... ................................................................ --+06tion--bddrus o or I of .......................... ......... ...................................... caner Address ...71Z ............................... .................................................................................................. Installer Address Type of Building Size Lot..CP�..YcSq. feet U C9- Dwelling No. of Bedrooms............................................Expansion Attic Garbage Grinder ( ) Pq Other—Type of Building .............................No. of persons........�/--------------- Showers Cafeteria ( ) Other fixtures ................................................................................ ................................... --------------­.........*.... Design Flow.___._____ .:................gallons per person per day. Total daily flow----49.AD.0.........................gallons. s ' ' / 04 Septic Tank—Liquid capacity./ gallons Length. JC6 ... Width,3-.'.O' ..... Diameter................ Depth................ Disposal Trench—No..................... Width.....__._....__..... Total Length.....................Total leaching area...................;-;2.q, ft. Seepage Pit No--------/.......... Diameter........_..._. Depth below inlet...2.. ........... Total leaching area...,S.26T.�.sq. ft. Z Other Distribution box ( ) Dosing tank Percolation Test Results Performed by---7 XL4 9 .............. Date.. -./�O/ ------------- Test Pit No. I................minutes per inch Depth of Test Pit._____._............ Depth to ground water._ _ &_em---4e--y----------- Test Pit No. 2................minutes per inch Depth of Test Pit..__........__._._.. Depth to ground water____._.................. . ... ............................................................................................................... 0 Description of Soil_.... ..... . .................................................................................................................... ----------------------------------------------------------------------------------------------------------------------- ---------- -------- ..............................36.--IYjV......... .. ---------------------------------------------------------------------------------------------------------- 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 TITLE LE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in n issued by operation until a Certificate of Compliance has been the bo -,d of ealth.. 4�- Ze2 ................ ................... Signed_ ... .... . ...... ........... Date ApplicationApproved �- .141..... --- --- ................................... ..... ....... .. ........... ate Application Disapproved for the following reasons:..................................................................:.............................................. ......................................................................................................................................................................................................... Date Permit No......................................................... Issued.--- .......d—,_1............. Date No................_....... Fins............................_ THE COMMONWEALTH OF MASSACHUSETTS BOARDO� F HEALTH --•...............................I....... _ ..........................----`------ Appliration fur �ispos al .arks Cna ustrur#tun Vrrmit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: � _ .................................................=• ......_....�1 � 1�'� -•- ----------- .............................. -� ^ L ��� � or Lot caner Address a 2 Ar co ----------------------------------•-- ---------------------------- -------------------------------•----------- Installer Address UType of Building Size Lot_.A;�YsP.,�'Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons.......5/............... Showers ( ) — Cafeteria ( ) dOther fixtures -----••-----------------------------------------•. -•••••-•-•••-•••---••••-----•------------•-••••-•-•-••••••-••---•-•••-•-.......-•--•-•--••••_.. Design Flow............ ..................gallons per person per day. Total`da}1y,flOW____:1_�O__......................-gallons. W y WSeptic Tank—Liquid capacityA gallons Length_...L__.... Width ..U...._ Diameter________________ Depth................ x Disposal Trench—No..................... Vidth..................... Total Length............... . Total leaching area..................._sq. ft. Seepage Pit No......../--------- Diameter........y........ Depth below inlet._2.___�........ Total leaching area...-'. .sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by.,l� l- - ... �-y .................... Date.. ........... Test-Pit No. I................minutes per inch Depth of Test Plt.................... Depth to grou w ......_..............._. f=, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground waterf� .___.._._ a •••••-•--•••-•------•-----•-••-•--•-......•••---•••-•-••••-•••••-••.........................•-•-•--...-••-------•--••-••...-•••._...........•----•----•---•-- O Description of Soil..C`_4.---•-•• __ ?(�,� �� r ---------------------- c., G ••-- -��- 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 TIT iZ 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 b and of health. J - g -- - txz.�.r / �`-_•- YI a Application Approved B ........................................ ...............................--- .� Date Application Disapproved for the following reasons---------------••------••-------•------------------------------•-----------------•------•--......•-•...•---_... -----------------•--•----..........------•----------------------.............------------.......-•---------••-•-•--•-••••-•-••••--••--•••••••---••-•••••••••-••-••--•••-••---•••----•••••-•••••----..... Date PermitNo.......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH U...u:�.................oF......./ U �t ...................................................... Tntif iratr of Tout rliFaatrr TH'S IS TO IFY, hat the/Individual Individual Sewage Disposal System constructed A) or Repaired ( �) 1 � by ` P,-�----- .------- .'__--------•----•-- •--Instali•-••••-----... /� Installer �K; has been installed in accordance with the provisions of T T' ` 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. ^` ... -----------------••---••---•---... Inspector {�-! DATE.-•---.....�........�..__...--• --! --y _f-------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS Ali BOARD F HEALTH 6d ./Oa ................O F.......... .......----•-•................ No......................... FEE........................ Disposal Ivor s %Dynstrildion lirrmit Permission is hereby granted... '� = `�?' _.�?-U! ! T..... ... to Cdnstr t ) or Repair ( n Individual S��age isposal Syst �- Al at ..r.. Street as shown on the application for Disposal Works Construct' mit No................ . D 4......................................... �� .............••••..•• ..........•--•-•------_-•-•_ /gdo Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS . . _ _, . . ;_ _ _>}-b� ti MEA.►,,! SEA �...��/E�•' �p��B._o.HE'D O:•-� U S C �' G 5 CaecTU►- i �..It.,J � f'tTCW p. L t ►_l ES A tit f kJ ( NI L)t.� pF tabII/V;c� t�►.J��SS OTt-4E�•.��5 E �F'EGi F1 E t�. 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