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Home My WebLink About1551 SANTUIT-NEWTOWN ROAD - Health 1551 San'buit - Newtew"r, Road Co#Llii A= 024-010 N4 ^' THE COMMONWEALTH OF MASSACHUSETTs BOARD OF HEALTH `-ASSESSORS MAP N0: �`PARCH NO„ -.................. .........._.....O F..........................._...........-----...--------..._..._.........__....._........__ ApplirFation for Uiupoii al Workii Tonotrurttun ramit Application is hereby made for a Permit to Construct (V/) or Repair ( ) an Individual Sewage Disposal System at: /� .L n d s {7__.�f.•1�'�d-��[Y .h.. -.... Ow`ner� A Address a � ....... ..._�.SX�ITN`.. Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms___.................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building ______________ No. of persons.__: _ Showers — Cafeteria a' Other fixtures ____________________________ W Design Flow............................................gallons per person per day. Total daily flow......... 3_.__.....................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. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water........................ f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... --•---------------------------------••-•--••--•-....---•-•----...---------------.._..._....-•----....--•------•--......---..._....._......••-......._-----. 0 Description of Soil.........................................................:..............•--.....------------------------------------....._..._...-•----------.._._....._.........__.._... x W ---•--••---•----------------••---••--••-•---•-••-••------•-•--•••----------•••--•--=--- - --------------- --- x .gam---- � *A 1Gzcjn__ ,� U Nature of Repairs or Alterations—Answer wheyplicable......:....................... ... ___.______._________._...(�_._.____! -' _....,_. `- � � __ _� -----------•------------------------------------------------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System,in accordance with the provisions of TITIE 5 of the State Sanitary Code— The undersigned further grees not to place the system in operation until a Certificate of Compliance a been issu d y t e board of healt --••--.............................. Date Application Approved By.....-••-••-•-- -.............. •-••---••.................•-••--•-••--•-•---........._----------......._ �`/ ............. Daatete Application Disapproved for the following reasons________________________________________________________________________________________________________________ .............•--•---••--•:---------•--._..._.._....._..__.-----------------.._._..........-•----.......--'•--------------•------------••------•---••--•-•--•--•----•-----••-----__ ...................... Date PermitNo............ .- _._.. Issued........................................................ Date �_ ------------------------- ----------------- � ' LOCATION- -- -- EWAJGE PERMIT NO. VILLA E anv� INSTALLER'S NAME i ADDRESS R U I L D E R OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED P I r /3aG o P fbUs p �y o � old / Poo fi new f J� No. .. "--•---•-- Fps... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliratiun for Disposal Works Tonotrurtiun Fermi# Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: .�+,,z i � s�__i{.S.l_ .. �/ ► s Lo i d } � . .. ....... .........................-••_... J.V S...... .......J!�wh. .:. . .........'....... Owner Address �/ (( 1 •--•................••_._....... . --•-•-...................•...:--.................--•--- R , Installer Address Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms:__, _____Expansion Attic ( ) Garbage Grinder ( ) .-, p, Other—Type of Building ..................:c_______ No. of persons................_____________ Showers ( ) — Cafeteria ( ) a Other fixtures d Design Flow................... ......... .gallons per person per day. Total daily flow___:...... V Wgallons, WSeptic Tank—Liquid capacity...........gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.,,................... Total Length.................... Total leaching area...................sq. ft. 3 Seepage Pit No____________ ______ Diameter.................... Depth below inlet.._..._............. Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.._____-_•____________________________----------- _________________________ Date.................................. 04 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........................ --••------•-•-•-•-•-----------------•••--•....._...._._ ...._-•-•- ------..........•.......................................................... ODescription of Soil......................................................................................................................................................................... W V -••-•------••-•---.........•-------------------------_---------__-----------------... ---•--___::.......... ------------•-•----------•---•••--••••••••---.-••---••-....•_____________________•••---_... ...-•-- •-- ... ..._ .._._... 1a U Nature of Repairs or Alterations—Answer when icable 7................. ..................... 4 y� Ih�C.1dti{-. il , __ _________________________________ Agreement: 4 tt- 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 o eration until a Certificate of Compliance been iss by board of healt f k�,,,, l Application Approved, By.................... ....... ........ ......... .... . .......... Date Application Disapproved for the following reasons_______________________________________________________________________________________________________________ .............................................................................................................................................................................. = -- Date !rc--=f• Permit No. a •-a_� ._...... IssuecL.....................................................- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF...................................-................................................. (Intif irair of Tumplittnrr THIS IS FaR ;Y,�jhat the Individual Sewage Disposal System constructed ( ) or RepairedN� by................. {.j Ins a.... ........._..............................._..._................. .._._._ has been installed in accordance with the provisions of TITLE5of�The t Sanitary Code�s�escribed in the application for Disposal Works Construction Permit No_,,. _.. . .__..._.. dated_____________....�.�__..__-_............... THE ISSUANCE OF THIS CERTIFICATE' SHALL'NOT BE CON TRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.............. ."..��?.'- .................................... Inspector............. •••••. ---.].................... TF E E COMMONWALTH OF MASSACHUSETTS r , ' BOARD OF HEALTH FNo. ................ ...........OF......................................-••••••-.......................................: Fn..... Disposal 19orksu u#r tr#iun rrmi .. t Permission is hereby granted............:. _•_... -°�".. ...._....------ 1 .�........_ .i�`LS.4.C?�.I.............. to Construct ( " or epair ( ) an Individual Sewa a Disposal System at„No.._1 1_._ !►...��e.... v! ........................................ ...._._...... ........................................................ Street as shown on the application for Disposal Works,Construction Perini N0 ed5" ____ Dated......... �, �. ......... ..'. ' Board of Health DATE.................-- 1-' j.......••..............•-----••---....... f ,l� FORM 1255 A. M. SULKIN, INC.. BOSTON h g5 TAW ` 5 Ifo po ......... --------- i - - - _ _ .• .. - ICI --------------- � I .00 ' I i i t � - �FX . ? X �3 ,I i li i ti 2prN FM �! ^7111 j x a10 AN 4 I li l �M I i �� a� i ' J3E� 2ooM i l ! 1 F t �Iasr �`E' i 13, 11 �1 1 ' I 10 1� 1 - 31, X �S ^7XI CNN IN --- i I, a co I I 1� 1 i4 Xa� - 1 t 4 r . �. Je ov u i �. 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