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Home My WebLink About0267 COMPASS CIRCLE - Health � \ Rio/yam a� 17 LOCH 10 SEWAGE PERMI NO. VILLAGja INSTALLE "t NAME & DDRES,. � i R U I L D E R OR . NER /512 I� 'DATE PERMIT ISSUED DATE COMPLIANCE ISSUED Z4 O v c � o.. 3 .. s. Fx$....Q�S_f THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �c.r�✓... OF. �i !srR.Q. ... ................................................ Apptiratiun for Diu#uua1 Works Tonutrnrtiun rrmfit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: .�o.T....yy-. -....... '� ../�X...... /-'-'` c........�`�!.r9,r�,;s.------.IfRs.s...----.... Location-4�ldress ...................................................... .74/ //++ (' •• r Lot � A ....L..!C'1I ... �:.4. ................................................e uc r o �� T.__ n!rC_.../..�wlC...........:..... ./,�ie!!fQ�[1...�.---.... own r Address ►� a7 .._.. ---•......... ......----•-•-•-----•...............................•----.....---- Installer Address UType of Building Size Lot_./0,.r90_'1------Sq. feet Dwelling—No. of Bedrooms........13...............................Expansion Attic ( ) Garbage Grinder ( ) �'4 Other—Type e of Building LLB�� yp g .�S.rt.........: ... No. of persons._.......(R..........----- Showers ( � ) — Cafeteria ( ) Q Other fixtures ................................................. W Design Flow_.___._._.._...........................gallons per person per day. Total daily flow...............1.30....................gallons. •9 Septic Tank—Liquid capacity.l+ma..gallons Length.....!/9...... Width._.,-......._. Diameter................ Depth..&_'......... 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 !'t.!➢"�._.`^..SS.!`.....!........................ Date.... 1.4 Test Pit- No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.. ...... Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... •---•--------------------------------•-•---•-•---------••-•-------.......------.........._........_......................................................... 0 Description of Soil----- .9 -�.....: k.�._ia.e L.......... �"Ru a L--------------•-------•-•-•---------------•----...--------.....-----•----- x w 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.I.�. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by t e board of health. Sign i� li� ............................. 7 ----•••. / Date Application Approved BY E •- <� a.................... f =1 -.7 Date Application,Disapproved for the following reasons-------------- ..------....------------------.....----••---------------:........-•--•-•-••---•-•--.... ....................•-----•-••---•----•-----•------••--------...--------------------------------...---•••--•-•-•----------------•-•-----••-•-••---------••-•-------•-••••--•---••--------...---...._..-- Date PermitNo......................................................... Issued_....7�-11--zf........................ Date .._._... _.._.... Fims....r�. ............... �+ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH f Appliration for Dippusaal Works Tonstrnr#inn ramit Application is hereby made for a Permit to Construct (,/ ) or Repair ( ) an Individual Sewage Disposal System at: - //� ( / C .................. .......................................................•-----------•------•--- .................................................................................................. Location-Address or Lot No. / s ��i r a / �',..��.�'U r .-•,. -. � ........................................ ................................. .... ...f F.----... .... ....Z :'`.......%......-C / Ow.�n/gr Address -" ......................................... Installer Address d Type of Building Size Lot...fr?_... :.:? S . feet U q Dwelling—No. of Bedrooms......... ..............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building No. of persons...._..._.�----•---__.____ Showers ( 1) — Cafeteria ( ) Otherfixtures -----------•------------------------------------------.........--------------•------------•-------•---.................-•--•----......---._......----- W Design Flow.........d....._...Ln....................gallons per person per day. Total daily flow.................. ....................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.......................... .F..._. as 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........................ ---•---------------------------------------------------------------•------...................._.......-----•-•---............------•......................................................... O Description of Soil..... _`_:, _ j /'- 4. 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 SIT LE, 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signe ..?.t�._ .... -= fi ' t '. ---------•�- Date Application Approved By.-_.._ i.� ..-•-•f.;7_j Date ' ... Application Disapproved for the following reasons:.:..................... -------•----•----------•----•.................................. -----......... ...........................................•••--•••••--....------:--• -----------------...--------•----.......................................................... ................................. Date ••• �,.. Permit No.. -------------- Issued--•-•----........---•-----•-•--::..... ....._..._••--•- Date THE COMMONWEALTH OF MASSACHUSETTS } BOARD OF EALTH .._OF O F. C9rrtifirab ToutpliFanre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) r Cr-.'. 11er .... S. - • le..C. ... .rt_I ..._..-e •---••-------•------•----•--------------------------------•-•-•--......._...----•------------•---•-•------------- at•---•---------------`•- .....• -----••-•-......_ has been installed iri accordance with the provisions of T Q�.A 5 of The_State Sanitary. de`as.described in the application for Disposal Works Construction Permit.No.. ............. dated...... .......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. �� lL 4 DATE.. .. ..........9. Inspector------ -------• ..._. ....----•--•=--•-•..__:..............._.._....•-•.•----- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................OF.. .....................It-r .........._....._.............._............ a RoVosal Vorks %Tagn Wit Vamit Permission is hereby granted.... ._........ ��r-�':1._,Z.= . . -----•-------•••----••............................................................. to Construct or Repair ( ),an Individual Sewage Disposal System atNo. ' ................ .............••••......••••--.--••• --•-•••-----••••---------•-•••....•••------••----••...--------•..................... Street as shown on the application for Disposal Works Construction Pe t No. . _�__ Dated.._"'"a �;6........... Boar od f ..--- ---............................................. �He. FORM 1255 HOBBS & WARREN. INC., PUBLISHERS yr. ......� �.• - r r , "ji"r+ai <t H t • y yk -A' cAep!' :glwZ /-F/V+S14 CV,4ca•-qm( FiNLSN G*1Ar)E cIMrtCN �-itADc! To f rd j Arv. 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