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Home My WebLink About0083 WILD WAY - Health 83Wild Way } 1} I A�027 p 1 � 1 I I III s R= Ate. �� NA - 5 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH /Q..l -N................OF...... ... ....��----.-•---------:...... Appliration for Pispnsal Works Tons#rur#iun f rrutff Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at• . .. .- �..`!............. ........... .. . ....-7 .......... C�'!._......__.... Lacation�d •�-� o �j �o. Ow er Address •... pq Installer Address 4 Type of Building 2 Size Lot,5R.L, 7._..Sq. feet U Dwelling—No. of Bedrooms.....�............•.............•......Expansion Attic ( ) Garb .�.age Grinder ( ) `4 Other—T e of Building No. of persons............................ Showers — Cafeteria Other fixtures = ..--•--............ -•-----•-•-------------•-•-•-•----•-•-•----•-•......•--•-•--•--........._. WW Design Flow....J,4 &.......................gallons per person per day. Total daily flow....c�0,0........................gallons. . WSeptic Tank—Liquid ca.pacity............gallons Length-----:.......... Width................ Diameter................ Depth................ x Disposal Trench—No............:........ Width.... ............. Total Length.........._.. Total leaching area____. _......._.__sq. ft. ------ 3 Seepage Pit No......I............ Diameter--1.2;.......... Depth below inlet............... Total leaching Z Other Distribution box (V-) Dosing tank ( ) Percolation Test Results Performed by......LQl4-)... .....1 �_L i �..__JA-)L.. Date......-.1..27 _.....__.. minutes per,inch Depth of Test Pit V.... Depth to ground water_ a Test Pit No. 1.C+.7i.... p p ep gr PN Test Pit No. 2................minutes per inch Depth of Test Pit..............:..... Depth to ground water......................... a .................: 0 Description of Soil................................. r------ ------=•----•----••---•.................:....•--••-•-----•---................................ ------------------------ -------- _h :. L = - x -•--•••--•-•---•---•-•-----•-•---------------------•-•----•--•-----•=•-•-••-••-•--•••--•---•--•--•-•------•-•-•......-•-----•---•=••---•-•-•-•-••-----•-•-•----.....••--•-••-•-•..........._............ 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 TITI.% 5 of the State Sanitary,Code The undersigned further agrees no o place a system in on ntil a Certificate of C pliance has been issu he b r f hea Signed.. •---• •-• ............. -••-•-•-....... ................. •••-• .... ................. Date �•v Applin Approved By....... . . . ... ........... ... •-•-••-•----....:......----•-----••----•--. ) ---- -r• a e Application Disapproved for the f ollo 'n reasons:---.•...--•----...........................................................................••-•------..... ...............•--•--•--••---•-•-•-••-------•--------...-----.•...---.....---------------.........•.........•..:---=------...................................-----.......----.................---..._.._ . Permit No............ �. -�-�.................... Issued..........................................D� ` te t a.. w FEB ------- - [ � w THE COMMONWEALTH OF MASSACHUSETTS ` �. BOARD OF HEALTH OF............... Appliratiun for Disposal Works Tonutrurtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal 661 Location Address.- -- j`f;,.f'�1.. O..:�:..... �� ..._ /j.. k'._ • �.� 1��7R1� �.f1Y,lLf:_ u.2S'3� • _ ~� y`.." ow ... Address V r a ...................................... .- - --•-------•- ••...•--•--.........._ _.................... ---•-••. •--•••..•--........---------...... Installer Address Type of Building Size Lot_!2 .i_ 7....Sq. feet aDwelling—No. of Bedrooms..... ---------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) A, Other fixtures ..-••.......---•--• -•••--•...... ...--- W< Design Flow.... .......................gallons per person per day. Total daily flow..... ........................gallons. Septic Tank=Liquid capacity............gallons Length................ Width................ Diameter____....... Depth................ Disposal Trench—No:.................... Width.._.............._ Total Length......_............. Total leaching area...................sq. ft. 3 ,.Seepage Pit No......I............. Diameter...�.7........... Depth below inlet..''.I.......... Total leaching area..:!!�.'-).d.sq.-ft.�L,�d z Other Distribution box ( .) Dosing tank a `Percolation Test Results Performed by...... C?t:! ... .._..r .r.�: _... / (s 71� 1� . Date ,-'- - - ,.a Test�PityNo. L 4.7.._..minutes per inch Depth of Test Pit.... 4��._.. Depth to ground water.��C�!� _..—I\.IUJ�J%� fs Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ x ------------------------------------------......---------------------------................................................................................. ODescription of Soil.....................•-••---..__...._..........•-------- ------------------------------ ._..- .... ---...... W ---••-••-•••••--•••••-••-•••---••-------------------•------•-------•--------•---•-•-----------•----------------...-----------------------------.............-----.........................-••--......... FV 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 iITI.i 5 of the State Sanitary Code—The undersigned further agrees notno place the system in operation ntil a Certificate of C pliance has been issued-�byy, the boa&rd;of hea th. �^ \ Signed !----tt�.`",'-�h -I - .............................•—,� X f APPIin Approved By......... -..- r---•-•------•-•---•------•-•------•-----_ ...-----�-- r� Dat,e P Application Disapproved for the follow& reasons:...........................................................................................................--- .......................•-----•-•-•-••----•--.....----•-•-•---•--•----.....------------------......•...._...----•---•---•--------------•----........-•----------•-------................-----•--...._.._ _ Date PermitNo............K 7- 5•y 6n......__..._.... Issued.........................................-•-........ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF......................................... ................. / f9rr#ifirutp of (hum littnrr ' THIS IS TO C RTIFY, That the Individual Sewage Disposal System constructed or or Repaired ( ) bY............................... f ...... 1 :.- _ in.wiiu ... ! .. ------ = %�t .............�t . at.. '4� . �� ( !. -�.n I(,�vlI�t 4f � I "� .. ..................................................... has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as de gibed" the application for Disposal Works Construction Permit No. ............ dated_... ' -' r. -- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............... �� ? l .r::.. �_....... Inspector ................................................ --------------f--- -- - -_--------_ -------- 1 3" 'T? THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH * - ...........................OF..................................................................._...._........... 1 �...- FEE... . ........ Otupuud Works Iffuttutrnrtiatt f rrmit K.. Permission is hereby granted... -•.• .-•• •.................................•-•-----..........................................__.. to Construct (1() or Repair ( ) anf Individual Sewage Di �osal Systeml at No.... .........f/................ .......... � -, s �;�. _ ... ----•-••••.. ... ............. �' '' Street t r7 i' as shown on the application for Disposal Works Construction Permit No� �4- .. D'ated..__.T_ ":�.g...-- .!. { rr .... �s., ...._ ... a:r..............--•............................... / / Q Board of Health DATE............... •-------•------------------•. T P O� 63o.z / ExTEiI/D ALL /9PPL/CF-ABLE �c--a—o--c_ exisf-ir,c� 9/-Duna/ Prod/e HOR/Z. SCFgLE : / ,•_ /o• S �- O / v l/E /e T, SGRLE• : / /O• 2•RpF F ti//SHED G2ADeTH/�l/ ' Proposed ground Prof'i/e FC.ow — <m 2- la er of ScHE•D 40 Pv ^_. ..�,2 �rninimum %" P�r foo�� 3/e.• c�sfone EQU,'94- TO SEPTi c r plPc:: To Be. _ 3'Mrn!• C.EVEL FOR. Z'. 4.EVEL/o D/ST BOX LeV r 4 Q 314=l�Z dal!' , I ✓ O 7- LJ W0-shed stone 4i �r GAL. SEPTIC TA�,JIC EACI-! P T 1 DESIGN TES -T --/ OLL- LOG DA7-E: 1- .4- "7 TEST 6Y= L ow N /EL-LE7Z jn/C- -_--. 82,11V `KEEN• •8...rs ,. �y- OFf�EATf/ ' •v �" I q Z O S P 7-1 c Tr9 ti/k : .33 o x /.S= 4-9S G, v. DOO � --- o k� � LEACH/NG F1,eEA : / Q A � . 84 -51DEWFILL: "� � � G. P.D. _ Ic" _ _ - �i; G.P.D. I Q 4` c-' U� AC+l PT " 222 .46 2A\A L / c:'E,427/Fyl THAT Tf-!E BU/C- D/tiJG //o W�TE R PkOPoSED oti/ -rf-rE Gr2oUAJO A5 - NCOUNTi'QED S1-i<:)WAJ ON TN/S PLPI`/ DOES I cO�1Fo�2/�I To -rHE BUILD/!vG SET — ,Sl TE - SE E PLC) tJ To LAJ l-/ OF 3 R N 5 TA,,a �- E Fo,e : �, o T /�B• P i FS7CN -5 MILLS GEORGE LOW. P2EPRRED FOQ: SOCA rT CAP6 REALTY 28 SCALE: AS Ajo7-ED DF1TE: C.� t..Y w \`U Rve<1 p� A 7�y PL _I� lU (scALE: /.. .301) ` / 247 vil O. 00 e xis-f-irly e /eva•-tion BL D(S. SETBACK DA rE= o. 00 _ proposed e /evatioh APP 30 , reoVED X r- .• LOGJ 6-JELLE27 Inc . �S'f'i r► c/ con-f-ovrs on t 15. �f• BOr9,E�D OF HEALTf-! �14 I")fl/ti/ STQEET - -`o —''— — propo.5ed core-ours S� e � , MFl ss• YAr21`70U7'H PoQT, MFlss . PRoFE55lONAL ErvGlNEE/25 � LAND SUQVEYOr2S �86Og¢