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Home My WebLink About0040 OXFORD DRIVE - Health br tukp,, I -je- CAT ION �'y SEW AG PERMIT NO. VIL AGE I N S T A LLER'S NAME & ADDRESS -& b '.`' . ' ® U I L D E R OR_OWN ER DATE PERMIT ISSUED 5-4 _ ® DATE COMPLIANCE ISSUED - `U G D G w\ C .t IU No.. _ll7 r +�l93 j. Fas.. •.............. THE COMMONWk,'%LTH OF MASSACHUSETTS p, BOARD OF HEALTH OF........................................................................................_ Appliration for Disposal Works Tontitrnrtion ramit it Application is hereby made fora Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: , u..a....'Z C.1. ...? .... .. ........ 4......... ........... Location-Address or Lot No. t.0 .��. . . ............. r :.. s a • t ........................................ W Owner /J `Areas a .. ._._... c. Installer Address Q Type of ilding Size Lot.....Z:1, ......Sq. feet U., Dwelling—No. of Bedrooms.....................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) p`' = Other fixtures ....................................................... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—'No............... ........................... Width.................... Total Length.................... Total leaching areasq. 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........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R: ................... .................... ..............•-............... •............... ._....... .............. . Descriptionof Soil............. ... - 1 --•----------------------------------------------•-------•---• x W •-----------------------------------------------•---•------•----------•-•---•---••-•-•-•--------....---.....--•---------•-•••-------------------....................................................... 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 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 119JAh. ned..... &- .. ........... Da Application Approved B `�/ .............................................. Date Application Disapprove or the f owing reasons:.--•.............:........ ................... .................................•-------------------....--------•-------.........-•••.......------..........._.......---•--•----•---------...-- --------------- --•-••---._. ......------•--- Date PermitNo.............................................••-•••--.... Issued....................................................... Date 1 + J I f- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....... ......... ..... ..........--. ..OF........................................-._.....-.-... Appliration for Uiopoottl Work.5 Tonslrurtion rnftfif Application is hereby made for a Permit to Construct (for Repair ( ` ) an Individual Sewage Disposal System at: i Location-Address or Lot No. ........... '..... .� r.Q............. 'O.M4... : .... .................................. Owner - Ad�res Wt1.� .......................... f!�.r..;_.I� .f....,/�?r.. Installer Address d Type of ?ilding Size-Lot............................Sq. feet Dwelling—No. of Bedrooms...... ••--------------------------•Expansion Attic ( ) Garbage Grinder ( ) AJO aOther—Type of Building ............................ No. of persons............................ .Showers ( ) — Cafeteria dOther fixtures --------------------------------------------•---------......--------------•------------...------------------•-------•---------•--•--•---.......---_.... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons 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 ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ G14 Test Pit No. 2.................minutes per inch Depth of Test Pit.................... Depth to ground water--------------- -........ 9 •---------------•-----.......-----------••-•----•----------.........----..........----------------................................................ ••--------- ODescription of Soil........................................................................................................................................................................ x U ----••••-•••-••-•--•------•-••-•••-•-•--•-•••----••-•-•••-••--•--•••-••-••---•--•-------•----•--••--•••••----•----•----......-•-------•..............•--•••••--------------•-----------.........--.--•-- W ----------------------------------•---•......••--•-•-••-------••---••---•.....••••--•-----•-••-••------••-----•---••-•-•-•-----•••---••---••-------•--•••••----•--•----..........•-----•......-----•--- 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 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 hea S ned ._.... 11 ....--•-•- -•- •T••- Da e Application Approved B .. •--....4--= rr-------------------- ........... ........ te�rr`` Date Application Disapprove or the f Zowing reasons-------------------------------••-----.....--•---•---•---------.........-••-----...------•. •--..........--.. . . ...••-••--•-•-••-•-------•-•----•-----•-•••-•••----••-••-•-----•------•-----•--••---•--•-----....-- Date PermitNo......................................................... Issued....................................................... Date I THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................................I........OF..................................................................................... (9rdif iratr of Tontplittnrr T 5ISIS TA- 7:-1-F.s-Y That the Indivi 1 Sewage Disposal System const_uc.ted (� Repairedby...'.. . = ------------------------------------------------------------------------------------------------- -------------••-- Installer aa��, �' - ------- ------------------------ ------------------------------------ h 15eerinstlled in accorda e ith he p ovisions of T T F of The State Sanitary CodZS��P'�7 e in the application for Disposal W r Construction Permit No. !, ................. dated._/.. ' --- ----•--...... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................... F Vq........ Inspector...................JLt..(�".,' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No..1 "� �,f.. OF....................................................•--•------.......-•--•-.......... S t� FEE........................ �i��o�,ttl, ork�,�"un�� ion rruti# Permission is h ranted - =` . to Cons 7or RSqb l( a �idua Sewage Disposal System at No Street as shown on the a plica 'on for Dispo 1 Wor:s Construction Permit No.............� J� ------ ------- L Board of Health DATE.........----- -- -----0--....................................................... - FORM 1255 A. M. 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