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HomeMy WebLinkAbout0224 OXFORD DRIVE - Health� "� J LO CATION aa�a.i SEtiUA G E PERMIT NO. 0et VILLAGE INSTALLER'S NAME�O ADDRESS B U I L D E R OR OWN ER © DATE PERMIT ISSUED 's DATE COMPLIANCE ISSUED r � _ Ya � I � , i i � \ h y. \ � Q�1 � z.a 1 m . � . o -� b G_ `^ �r THE COMMONWEALTH OF MA�;SACHUSETTS BOARD OF HEALTH Application is hereby made for a Permit to Construct (Y� or Repair an Individual Sewage Disposal System at: A!zE4...... .... .................................................................................................. LocaWttt or Lot No. Installer Address Type of Building Size Lot.. 23 61P...Sq. feet. 6ar age Z Other Distribution box Dosi%tank Percolation Test Results Performed The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TL I'L LE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in .operation until a Certificate of Compliance has 1--en issued by the�oard of health. S* ......... .............. ........0.21 Date Date Pero Date ----------'--'— —' No.....&95--`_.6P lip Fe .. .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH i - --•................ -------...........OF...........:................_......... ...... _..............._. ApplirFation for Disposal Works Tourdrnr#iun jbrmit Application is hereby made for a Permit to Construct Y) or Repair ( ) an Individual Sewage Disposal System at: b r .......02�6A......zc.� ...... ----------------- - Loc do - d re s or Lot No. •-- ......................................................... ... --- Owner Address "` •------ _----- a :�Y&R��- ---------------------------------------------------•---. ...-----------------.......... ------------------............-----•-•-----•-•--. Installer Address Type of Building Size Lot.... 1_CJ....Sq. feet aDwelling—No. of Bedrooms.............. --•----•---_---------Expansion Attic ( ) Garbage Grinder aOther—Type of Building ••-_-----•-••••----___---- No. of persons Showers ( ) — Cafeteria ( ) Otherfixtures .. ...............•----------------•......................................................... WW Design Flow........... ........................gallons per person per day. Total daily flow..........-. -0..........._..........gallons. WSeptic Tank—Liquid capacityl.000gallons. Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width..._.I------------- Total Length............. Total.leaching area....................sq. ft. Seepage Pit No---------1.......... Diameter....... .. Depth below inlet....... Total leaching area_ 1P Q....sq. ft. Z Other Distribution box ( ) Dosing ) �! t p aPercolation Test Results Performed by. �__ < ._ _. ............................... Date3 .Z..o-,tPA/-------•----_. Test Pit No. I................minutes per inch Depth of �est Pit.................... Depth to ground water....................... fs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ------------------ •---------------------------------- •-•--••---------• ------------•............................................................. Descriptionof Soil...............----------------------------------------------••---......------•------•------------------------•-------------•---•=-------------------...........---•----- (� ------------ ----------------------------------------------------------------- ------------- --------- -........... ------ ••--------------------------------- -------------- ------------ •--••----------- 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 een issued by th board of health. ••------izned Application Approved By...---- •.- �'.r = •--- --... �. _� .........••-•-.----•-....._..._ Kate "' Date Application Disapproved for the following reason --------------•------------.......----------•---------•-------...---------------••--••-•---....---------•--••- Date PermitNo...................................................-- Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................O F...................................................................................... TntifirFatr of T-am liana lii�IS IS TO CERTIFY, That the Individual Sewage Disposal System constructed "") or Repaired ( ) by---j....t......fi.m•�tL,....... �,,.�.- I tall at er has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.._Xr._Lr' -�J.V.�l................. dated..........................,..................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ..- — ................... Inspector..................................................................,................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........OF.....:............................................................................... No............... .. FEE... !'............ Contrnrtion Uprntit Permission is hereby granted.....-----.�.�'_.----- •-UaK•A.-<:..............................--............................................................. to Construct ( ) o r gpair ( an Ipdivi4lual Sewage Disposal Sem atNo........ f1.. o j .. r'T .. .�J 1 s f •...-•-----•-•-----•---•---••-----....--•---•---•........................... Street as shown on the ap lica ion for Disposal Works Construction Permit No..........__/._. ]dated......................................... . DATE. • .... ••- oard of Health FORM 1255 A. M. SULKIN, INC., BOSTON I , <,�tti1GLC- FAMt►-`� - 3 BEOR�oM DN►Ly Pt-OW ; I►v ----- 5EPT1C, 3,30x1 6.P. � U5� 100o GAL. � E I a oD GAt_. B Dt5Po5nt_ PIT 5 z.3 Q/�� 9; " "` 50TTOM 939 0 ' 5� S.F• x I. 0 �� 5.o G.P .TOTAL I7ES1GNv .g25 G.PD. 'TOTAL PAIL-Y PERCOLATION RATE : 1"IN 2MINI 1`11 Ex�,Sy-, Gala. OF 9�) �f,?i4o� +r_.. .G. WILLIAM ✓,r _ �c DAVIQ 4C. G 1 1 P.r + '" l s , THULIN / N Y E " i�� No. 29976 rl). I9334GIV/ �STj�u' `J` FF ►sTE Ei�E .__,9e.o -�T —,� •L ,. I •`v9`�?St1:;1�� a' �. /0NAI -T�-�T `�3GL�7 CG . y8 � y TOP FND'99� No L� .3/z�/�►y��G ' yam'o -'�^ n INV. 7/7 .CGL4M 1000 INV. P 15T. BuX VPTiL L (00o IN�l. 9`S8 TANK LCAGl1 INV. INV. PIT G'L�dN N!17 u `js•y 9S G s a f 1��3/q•lyz , + 67vN6 t ' t ; CEczTIFts0 PLC>T P1.-A-W �t /Z 8Z5 PRUFIL� hoLA-cicN COTU /7"" ' ; NvI�✓rEe No. .SCA1..E rjGpLE REFr= t4 C-C ` G E Q?1 F Y 'T H AT •T N E >< Sr SNO kYN NER6o1�1 GOMPI..`(5 YJITNTNE SIpELIN � SOT "J� • A►JP Sti^"T�•GK R.6QU�2�MENT� of TµE- �� -ToWw 1_ocp.T WITHIN TN G�.oaD P c.IN �L.t/ g,E! Z 7/ /!:-C::57: ;G DAT E ".Cct. BP,x-rE Y REG 1 SZ 6Q 6U li.AN o'5 u v-v EYoZ,5 'Tw3 PL&tJ 15 NET E3n5c p �'� N oSTE�VILI l: MA55. Iu5T9-UM6NT SU9-VE`( �-TNE D1=1=5ET5 SuoU0 No-r DE 'U5EDT0 De`TE�/^11-I t_.oT -INE5 APPLICA►�1'1'� /, ;;: �, �/