The URL can be used to link to this page

Home My WebLink About0170 TROUT BROOK ROAD - Health trio ram , oog Qll _ Cam' C r oe- +one:► THE COMMONWEALTH OF MASSACHUSETTS BOARD FF HE TH -...---....OF......... ? ............................. Appliratioo -for BiBpoiitti Works Towitritrtioo Vrrmtit Application is hereby made for a Permit to Construct (X ) or Repair ( ) '.an Individual Sewage Disposal System at: ------Teo...T` 2oa-`r------...� N C�Tv -----------IOT -....------------------------------•----------------------.....------ Location-Add re Lot No S... bob_._ �..6......... oC ASSGT .. ')'9 S S Owner Address a EcclR� L A/Yl P 1 TX .-....� �A--------- Installer Address Type of Building / �lZ $TO �/ C Size Lot...... -__--�------------Sq. feet Dwelling No. of Bedrooms-------- .............................Expansion Attic ( ) Garbage Grinder (0 ) p`4 Other—Type of Building Wes_ C pZ.. No. of persons____________________________ Showers (A) — Cafeteria ( ) Q' Other fixtures ________________ W Design Flow ____________(3`___1................ all ns per person per day. Total daily flow............. _..'--------gallons. WSeptic Tank I Liquid capacity_ _ a Ions Length---------------- Width---------------- Diameter_____....______- Depth.__-______-.--- x Disposal Trench—No- ____________________ Width------------- __ _ rNe e h_______ __ _ Total leaching area-._____---__- _____sq. ft. Cf Seepage Pit No.._._4�----•----- Diameter_./tr0,;!fAin ....`.... Total leaching area.................sq. ft. z Other Distribution box ( Dosing tank ( ) Oh, s4oc- �S � �7e - � Percolation Test Results Performed by.......................................................................... Date--------------------------------------- Test Pit No. 1................minutes per inch Depth of "Pest Pit.................... Depth to ground water...___-__.________-__._- �14 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water_-._..______________ -- - ......... ,/f O � ---------u------------/- Description of Soil = d J'z'"+? �. .-- --_--'------- 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 Article \I of the State Sanitary Code—The undersigned fur her agre not to place the system in operation until a Certificate. of Compliance has been i ed by the bo rd of he h. Sid.. -------------------- Date Application Approved By-.-. G. �� 1 ^ 7 Date Application Disapproved for the following reasons:................................................................................................................ --------------------- --------------------------------------------------- Date PermitNo.......................................................... Issued........................................................ Date No......... --.. Fss.. ................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEAJ-TH _....._. .!/. . ..'i..........OF........... .. ..1,6 i��:L.......-_..-- �--.--------------------- Appliration -fur Uhipoottl Works Tomitrurtion Prrui t Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: ...................................................-............................................. Location-Address or Lot No _ - Ae_4�( - -�v H. -' ti ��A_��uS �' ( ...................... 'v -ass = =-------------------------- Owner s W Address ,-] ------------- !fit k�...------- P `�' / '`3 f'w S T'A• /�'7i4 _._. f Installer Address U Type of Building l /l S i�/ �/ C. �� Size Lot__.-��__c_p�___Sq. feet Dwelling I�'o. of Bedrooms.........., ............................Expansion Attic ( ) Garbage Grinder ( o) pa, Other—Type of Building No. of persons.._________________________ Showers Cafeteria ( ) a' Other fixtures ______________________ _ W Design Flow________________t Wallo s per person per day. Total daily flow_____________-T�____'.._._...gallons. Septic Tank Liquid capacity__ s Length---------------- Width_.............. Diameter-----..--------- Depth.._.__.__.__--. � DSeepage Pit No _�_.__..._ Diameter,ldtj_�,��Dep h�b_el�einle ......................�[• - Total leaching arca....................sq. ft. _. � Total leaching area-_-_-___._._____sq. ft. Z Other Distribution box ( j Dosing tank ( ) O,, /2 -- $-- 2 f-7G aPercolation Test Results Performed by.... --- ------------------------------------------------•---•-•----_----- Date........................... ----------- Test Pit No. I----------------minutes per inch Depth of "lest Pit-------------------- Depth to ground water.._._______.___._-._---- G4 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water...................... G :--------------------------- I • -._.•-•--------------;.:-.._._..._i__ �-----•---- ---•-------------•{---•-I..... Description of Soil -`- )� G_. _..._. :T` 1� S �� - cPtliwJ -T f - x10f 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 Article XI of the State Sanitary Code— The undersigned further agree not to place the system in operation until a Certificate of Compliance has been is'tied by the board of health. Sig ed-- --.._..-- :- . Application Approved By---- --•------------------•--- -"--4�_-1 SDate / Date Application Disapproved for the following reasons:--•----------------- --------•--------------•----------------____-•---•----------------- ---• •-••••-•------ --•-•••-•----•-------------•-•--•---_..--_•-•_---••------------•••..._ ----------•--------•----------_•---- Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O EALTH "b.........0F............. .... .%�r,�Y..... `..... C.rrtifiratr of 01111w aurr T,H S IS TO CE, REIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by :.... ....... ................................ ' _ ------------------•-•------•------ I�aller' / _ has been installed in accordance with the provisions of A clecid XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit Nod.__= ---- -_�__�-- dated__-._._6__-___�_.�-�. ----__7.6...... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST ED ASA,-GUARANTEE THAT THE SYSTEM WILL UNCTION SATIS¢ACTORY. J DATE. / 1 ...................... Inspector------- ................. .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............. ..... ." /Lr... ..OF_ ........�..... / No......... FEE '®r nMrurtion Vrrmit Permission i -hereby granted_._.../ ' ,1��.� t!�''�P ---------------------------------••-•-•-------___-----------------•----- to Construct ( ��r Repair( -) n Indivi, ua Sewage.Dis os' al Sy e �i L at No. 7� `tom � `. _ rri�t:_f f t•/f -�> `--.1 � -------- -----------•-------------- Street as shown on the application for Disposal Works Construction Pe�it .___ ____�:1__ Dated_______________.__._-_________-__________ _ / '� - -----------=---------------- Board of Health DATE - j7` -7, S FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS .. } ,{.' ., 1 ' .• r- � L 'i� ' p t { i k } I y ht .# i z r 1 I- I— k E - F 1 1`� v,1 � � f ,-t � � j ; � !1 � i of {yi.-• r-+ �' - ! �r � t 1• �y �-.'f� t -., .. i;1 p I '''1 1 ^IY 1 mil. '} ; , 1 1 71 t a• d . 1 r .� S. j Z_ } , ;1 t E t �'� '�� V 7 1 I �.!' ;t > tt'} I-p '• " a{ Iw "Pa '� a"- t l +b �'•� kt , t t} v3 ,rr , 2} t � I`;� ° � r '"'V' r T, '' - ' .,{�,;� " t k. + t *� ,� y .,j, t�.� fM1 rp '�"'1 ih' }`I, °r�'F� L, ; t t+..r ( - ".,, - _y, t •+ , r .H.r r'r».� ti, 7 ti°t aI f +r p 1 T-,, .,) t\ yf: N,r -.y,.l%T �� "44t NTRr� ',- 75 . .. .. ..� -• I ' � 1 ° y ~� � + ''r� r �,r, I,r..k 4 w ' ((E ..�., F �� ,{ � +" !' i .,a t } �, _, f ' � i t i- - ` r_ �.yl r e .T� } - F r {kid .:-• r 1. 1 y,:,� '�. r^} I. M1..N .} i i , , f_ yj 1 �. t � _y t t t �;•�• � � + ,! 1 .�.i,,,.: c i{�. S �'.'.' a � ,.�i '+, LI 7-1 -, 1 t -+ t r` + t N tR..r ., +h,� a. f+W -+ 1 •. � •_ -{ r '1 � i ,�. {.• _-t � t ' � � �• �; $'i � I� \"' f 'i f j ��F ; f ,^I ! ,�`?t t Y i + �-a t v L r ,�r � ..,�. ~ j i a . _,� �. g a ,� ,�� t `7�. {}� f l � �: i 4�#,,y} � r»•a; 1 t � r ,,j ,,.p 1 � r,9 ,1 „�, , i � 1� ��,i ;.� _' ,. + t � _.. , �a.t ;e .;t,,k1. ,1� ...E '.f .. � ?•r �.. k . . � .F r .!'_ i til. ;, r ' !. it C- � � 1 y:'r t }•°t °' � ` t Y t .i I_=,� ! t a l-rapi Vi7'� , -t 1 r ! 'w � � �. !S !i ,a,r _y. i i.,;° `r' .. . VI !h r•r �1., �'�� j I '� a c °_ ;( { 1 �j& ti;+•77orl G�i':i�/ + F � � h h•,ti.n-., i_-'i"'k. � 1 �!/{('.��r 'S . . .-._ t f ' y t .�.�.t f +; , �' �' I�Q t d.. - ,-•f i . �� v��. , *+ o ... _ � i r « t r a or 3� !� t j-I t ;r r. � _� 1 r f � � •}•.� iM` - tt °+, 1 _ t. r t ti '. 1 1 r { _.�• +a ! I t s 1 1 R I. { ., 1 Fa. I I i�,1 r +: I, , }• 1, r �_* -� --J' 1 c-., i Y,.e t_.t.y..I�i/ .+ ! ;. r'f:- + 1 '� I__ �+ , }•- + 4 Tr1, .. t• 4 t { + is } ti { r -+ - a },..!. I r' 1.! I � ••f I-,.�r , } '41 '�"�> "Vt.� ,1.�_;� Dial T _ µ I'•I • ' .._� 1>t -1't��V F.-�it [ � -•� �� to �(.4( I yC`l\I�'�iS��I �4Yt .gglt 1 i f 1. -1• �t� 1__�-.� + � �.- � t�- �I . .l ,� -1-. + .. .._ `—'*-��" �..1.+ , �.:{._�^—'1._f t It,.�� ...:.i..•w .o,.,�"�s.'y _Y'Y�.� ( �a;.t�r.� t��.. :1- F -h� � I _..Y"i t__ 1 'F� _T{.y _ .... 4 , u�p,t•��P ''iPl� i3r�r R'�' F11, J it7rf� � �� F S1 /Np4 M `� ,� f IIIPM 1IP (�j 11 t4 • l._d i _F�� AtJ,� 1 �' -- -- r qe t t. µ h i ',`k t { h •''W1`.. �F11_, � Fll-A I G .,.�.. ,mot'. .ti:. F...Ib.� }U�.vs: L? - 1. ° AI - JtONA` a o 1 { LOCL.TION ' 5EW �664E PERMIT 1.)O. WSTQLLER•5 ►J&ME ADDRESS BUILDERS Q &MF— ADDRESS Dtl►TE PER"IT 155UED OATE COMPLI &MCE ISSUED : fto i r`,