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Home My WebLink About0581 MARINER CIRCLE - Health C' -- ozq - ��3 LOCATION' SEWAGE PERMITlNO• 96 VILLAGE INSdA LLER' ANTE i ADDRESS r- BUILDER OR OWNE dA4,l &e4a A �. DATE PERMIT ISSUED DATE COMPLIANCE ISSUED Ora ws.. � '� 1� � �� O .. _ Fps... THE COMMONWEALTH.OF MASSACHUSETTS BOAR® OF -HEALTH 04V...d..I.............O F....� Appliration for Disposal Works Tongtrurtinn Prrutit Application is hereby made for a Permit to Construct (>� or Repair ( ) an Individual Sewage Disposal Systemat: ._....... ............ ................................•-- ..... 6:i'L.vLJ.atio or Lot _o. ....... ..........._-.-........... :... _•^_......................_...: ... la ....... -N •• W ner a .. ......... Installer Address Type of Building Size Lot._JQ.,.5 A _-...Sq. feet �-, Dwelling—No. of Bedrooms. _.__.._... . --------•-_----_---_.Expansion Attic ( ) Garbage rinder ( ) aOther—Type of Building ��..... No. of persons..... ._......... Showers ( ) — Cafeteria ( ) Otherfixtures -------••----------------------------------•-•--------....------•------------•-------------- W Design Flow.................... ..-.__.--......--..gallons per person per day. Total daily flow.....3- ......................gallons. WSeptic Tank—Liquid capacity _gallons Length..,/e. :._.. Width__-J.._..... Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.....................Total leaching area----- ft. 3 Seepage Pit No............/...... Diameter....... ........... Depth below inlet....C? .......... Total leaching area..z._.._..._....Sq. ft. Z Other Distribution box Dosing tank ) Percolation Test Results Performed by.......... . ,� �_ a ._. ... Date....-oi'. .�....--/-............. Test Pit No. l.- minutes per inch Depth of Test Pit Depth to ground ater-.-•-- . /4A Test Pit No. 2................minutes per inch Depth of Test Pit---------------••-• Depth to ground water- ---------- 9 -------------- ---- ----------- -------.----------•-----------•--------------------------•-------------.-----•--------------------- O Description of Soil...i _`�.�............ .... . ® .. ---•--- -----------------------••---- --- ------ --------------•---------•------------- ------------- x __ x •------------------------------30.-Aely..------.P_Zmi..:- f� ------------------------------ -----------------------------------------------------------.......--- 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 TIT L- 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been 'ssued by the b d of health. ' s /11 Sign -- - ate Application Approved B --•----/ _-- •• . ....-• ...... Application Disapproved for the following reasons:............................................................... ...................•--•-•---Date y .............. .---•••---•----••----•----••--------------•-•------------•-••--•-•---------------•---•-•--•-------------••••-•••------ ------------------ Date PermitNo......................................................... Issued....................................................... Date f, No... ... ............ ......... THE COMMONWEALTH OF MASSACHUSETTS BOAR® Off` HEALTH _ u...`tJ--------------OF....._ ........�- ................................................ Appliration for R-4posal Workri Tnnitxnrtion ramit Application is hereby made for a Permit to Construct (X or Repair ( ) an Individual Sewage Disposal System at: Lo or Lot No. a tionr ts ss T Installer Address Type of Building Size Lot... ..Sq. feet U Dwelling—No. of Bedroom�.i _Expansion Attic ( ) Garbage Grinder ( ) U r_ 'Pk �LG�c Showers — Cafeteria p, Other—Type of Building ___________ _____ ______ No, of persons.______ ________________ ( ) ( ) Other fixtu s --•-------••---•--•-•-•---••-••. - W Design Flow.................. ...........gallons per person per day. Total daily flow........ .....................gallons. WSeptic Tank—Liquid capacity.& C-'2gallons Length._. Width._._ '....... Diameter________________ Depth................ x Disposal Trench—No..................... Width_.. .__._.____.__ Total Length______l_.�_______ Total leaching area____ _ �q. ft. Seepage Pit,No_____________ _..... Diameter---_.___/�._......... Depth below inlet___._:'............ Total leaching area....__............sq. ft. Z Other Distribution box (/) Dosing tank, ) Percolation Test Results Performed by.._____.._....__ �!._:'.'.`�' �� ------- --------------•-•------•--•--------------- Date-----------�.----------water.. j`M?� Test Pit No: 2................minutes per inch Depth of Test Pit____________________ Depth to ground water__ .....�lv/___. •••------•---•------- - .--------••--------------------•--•---......_._...----.....--------•--•-----------•---------._......_..-----•-•-----......-----•-•-- ODescription of Soil `fi;pyZ-••=-------•----•------------------------------------- ---------- xb.:..: G_.._... < ----------------------------------------------------- U -3v•.�`��I 1 =-----------------------------------------------------------------------------------------------------------------------------------------•---- 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'LIT, ,. 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Cetificate of Compliance has been issued by the board of he Ith > Sig •':�r(� (1 ------------ - ----------- - /�` ate ' Application Approved By...... 1==•--- J ..... ......................... ... I IDate Application Disapproved for.the following reasons---------------------------------•-------•--------------•-----------------------••---•-----• -•---•--••----•---- -•.............••---••-•-•--•--•••---••-......-••-•-•---.._._.---•-----•--------------......_•.......................................... Date PermitNo.....................................••--•-••-••--•----••_. Issued.............................................--------- ".0 Date THE COMMONWEALTHS{OF MASSACHUSETTS M .. 4,. BOARD. OF HEALTH ' t ............ .................oF..,.... 1� rTd.�.......................................... MwrrtifSrtt#r of fir mptiaurr TIC IS TO CE F That the Ind' 'd al Sewage Disposal System constructed (: or Repaired ( ) _j -4 �� !E- e qw&'O " � by.......... . •-•-- --• -•--....----•--••- ----•--•-•/----------------------- .............. ----------------...-----------._._...------...._..------ at �-,l . 6,••'f. Installer has been installed in accordance with the provisions of r of The State Sanitary Code as described in the application for Disposal Works Construction Permit N _�� ............ dated...f!: _/Z-- ............ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS YA GUARANTEE THAT THE SYSTEM WILL FUNCTION"SATISFACTORY. �-..G..�� k DATE._..._..____ Inspector .!%T' THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH / ....................................... No......................... Fes, ...I__..... Permission is hereby granted-••----- --== ----•-- �::< to Constru t 4X) r Repair ) an Individual pwage isposal System at No. --._.. .�__ .�� 'v!.�t-•.....4 �1G_--A----- ..................................................... Street as shown on the application for Disposal Works Construction mit o Dated./1 ................ a ,y � ---------------- / • � • Board of He. DATE.-! ------------------------•--•-••--•-••--••----•- 4• FORM 1255 HOBBS & WARREN. 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