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Home My WebLink About0109 PINE RIDGE ROAD - Health � Aoo Pine Ridge-Road ,ham A=j018=038'* C �+ oLuit I it LOCAT.ION la7 IWSTQLLER-S U&KAE BUILDERS. *Q.l MF- : ADDRESS_' A&f ._ - -DQTE P-ERNI,IT_ ISSUED ' fie =r ATE COMPLI �t�ICE . i_SSU_ED .. -•-- -.-� ...ter- 'Ile i�pO F _ I i f 3 y ` yam:,- � Fsa...�................. } No.. -• --........ THE COMMONWEALTH OF MASSACHUSETTS BOAR® F HE TH ------OF...... . Appliration -fur Uig viial 10orko C owitrurtion Vamit 19 Application is hereby made for a Permit to Construct (4- or Re air ( ) an Individual Sewage Disposal System at: ---....... f rnJE f DG�.K.J....... C.�oTve:T ------••--••------------•--------•--•------------------•-••............................. . �cc#` n•Address or At No. NE .1..'�iVAcJ7) J �' Y - lJGZ4- ----- i4S.S--- Owner Address ....................•..... •••------•-- . Installer Address dType of Building Size Lot----�_ ?7.....Sq. feet U Dwelling—No. of Bedrooms--------_ -Expansion Attic ( ) Garbage Grinder ( ) �- aOther—Type of Building ---------------------------- No. of persons........9------------------- Showers ( .) — Cafeteria ( ) Q' Other fixtures,------------------------------------------------------ W Desi n Flow.................. gallons per person per a Total daily flow:._.._.....-_----_--_--__-.-......... g �`---------------------g� P P P � Y• y gallons. WSeptic Tank—Liquid capacity-l_V!;�-2__gallons Length.....A------- Width.-__!Y-------- Diameter_------------- Depth............. x Disposal Trench— To..................... Widt ...._..____._____ _ 1.Oeh_______ __...�fotal leaching area..-.----_-___----.-sq. ft. Seepage Pit No.._, .._.._._____ Diameter_= _ � � e<__________. GG..EE''.T al 1 chiug area._f_._..___ _.sq. it. Z Other Distribution box ( ) Dosing tank �/ ��7� •" Percolation Test Results Performed by-------------------------------------------------------------------------- Date--------------------------------------- Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water....-----._-.--.--.----- G% Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water...----.-_---_.-----.--- Q+' - -------------------- ---------------------------------------------------------•-----------------------..................................................... O Description of Soil------. .................. x U ------------------------------------- ---------•-•••--------------•••-•------------•------------••----------------•----------••----••...-----------------------------------••--------...------•---- W •-------••--------------- ----------------------------------------------------------------------------------------------------------------------- ------------------------------------- -------------- 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 Article NI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been i tied by the board of healt . igned---- - l -- .... A., -----------. Application Approved B ' .. PP PP Y ......----i Date Application Disapproved for the following reasons:..................................... . ....................... ................................. .........-••..........................•------•-------------------------------..........................................................----•------------------------------------------------------------ q .jWe Permit No. .. Issued -5- ------ -------- ..--------_ Date rNo., ..................... Fuc-........................... THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH 0F..!1.: .t:C.s1. t-tv'.C..- !`� . %.. -- Applirtt#ioo -for Biiipviial Workii Toos#rur#ioo rroti# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at,; ............... ...... .............................. -------------- ------..-f�-� �---------------------------------------....--------- or �C''c Loc ion r(�s�r .7 ..--•-------------•- -•------- b A .. ...... e�/�.y-7.OIv..... ;A`rl' O nor "4 6 ; Address W Installer Address dType of Building Size Lot......XS'6�_____Sq. feet Dwelling—No. of Bedrooms_________ _______ ...._ . Expansion ttic ( ) Garbage Grinder ( ) Showers — Cafeteria � Other—Type of Building ............................ No. of persons------- ( ) ( ) Other fixtures ------- ---------------------------- ------------------------------- W Design Flow..............:_..-.--_..................gallons per person per day. Total daily flow....... ----------------------------------gallons. WSeptic Tank—Liquid capacity-1v00_.gallons Length.....�?........ Width.... ...�... Diameter_............. Depth---------------- x Disposal Trench—No_ ____________________ Width---..__------ n—:v-Total Length l' Total leaching area--------------------sq. ft. Seepage Pit No.�(----------------- Diameter� __. epth bwin _.._.`��"�_.....,Total leaching ar a1_.........z......sq. ft. Z Other Distribution box ( ) Dosing tank ( ) `� . '` � � `�• ff �" Percolation Test Results Performed by----------- ==---------------------------------------------------------- Date--------------------------------------- ,� Test Pit No. 1----------------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-----------..-----__.... a .....••-----------------•---•••--•--------•----•---•.---- DDescription of Soil AN -------------------------- --------------------------------------------------------------------------------------------------------------- x V ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ W ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------- vNature of Repairs or Alterations—Answer when applicable..---------------------------------------------------------------------------------------------. ---------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------- Agreement: I The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss d by the board of health. Signed-'= .= --- -----i6l VT r to .. _ X` _- - .f-.. j^ 7APPlication Approved B ` DApplication Disapproved for the following reasons:........................................: _ -----_----__«___- _____ ________•----. .................................•___---.-____---_----.--______--___-__-----._-_--------------_----------.___-_-------__------_-_----____-____._-_____._________-___-___________-_-.__.-.-.-_--___------- ?--` Date R Y Permit No. -- ......---•------------------------------- y: Issued.... tFFy (Datt6 a THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ;.s x • .r .......�.�i 1.,.:j.c _J+,Gr cry trilifirate of foam i ittnrr THIS IS TO CERTI /T J the il Zl, wage Disposal System constructed ( ) or Repaired ( ) Installer at :.. •-•--- ------=-"--------- has been installed in accordance with the provisions of :article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No----------- i................. dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® S A GUA ANTES THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE--------= ........... -------------------------------------------------------- Inspector------- = -' _=------ ..----- THE COMMONWEALTH OF MASSACHUSETTS 'BOARD OF HEALTH ........ ...�. OF..............1 FEE..... �i� o tt1 k1i kn8rurtion Prrmi# Permission is hereby granted ------------- = to Construct (4 ) or Repair ( ) an Individual Sewage Disposal System i. at No.............................................-...............................................................---------------------------------------------------------------------------------- ? I C A / Street as shown on the application for Disposal Works Construction ermit -__-Dated...._.. _. o r oof e DATE.... ^--,Z. '` === -----------------------------•-• FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS +� (r 3 —— V ILL t—��U-1 1.D E R 5 --1.1-/�.L�l.E--:-�---A-D D R-E_SS :�•_. __.._. �r .: . a i M--RLi &I ACE_ ISS.U-ED • s 14 PROPOSED S77 j 1,802 s.f. _ O C.B. fnd. 11?1D h � O EDGE PVMNT. PRO,oO p 2¢, SFp qi CU '9R-9cF h C.B. fnd. �FL�/NG 70 Nc LANDSCAp P,q 332 ry ,2 BORDERED pR�wA >, 2 Q / B. Md. `SL 4' �s )70 - / �• . .01 C 2p Al¢p, �, , ,�h• sEP nc I ^' TANK I I 7p .0 p, ' I I LC { C.B. fnd. I 1 SYS7 (DMGO.) I I O � I 1 LEACHING PIT o w I 1 CER77FICA 77ON LOT 106 s of my knowledge, information, and tify that as a result of a survey �v � �� " ie ground on 0410612015, l find that: o CER re(s) are located on the site as •.°� 40 '� J / 1 S� es and lines of occupation of the LOT 227 shown hereon. I situated in Flood Zone X 28,000 s.f. l 1 250001 0752 J Date: 0711612014) 4or.37 100, 8d` izl ' Lor3� 1 ?0� i©o- C Pk�60- ce ►�_ F�t2�AEt'l'®bSAI__ � s� •-� /4r 3-F" 2©d PINS` RiDc- Road PLOT 38 MAP 18 A�NAW„ �`KESTlN� �T�cvcrvRE 7'uLY I7r l 973 SCALE '1r ,� J___