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Home My WebLink About0021 JENNIES PATH - Health oZl JenniesTO - _ aSo ; i I a i 'i II i J /C; z ►- � � V 1 ac d t, W V N t N W O t W .� Vf �i vs � Q O W =30 W N lag A ct J Ot me � Lid p J d V W J W r v t O W W � J s$ �91�� I v , V j.,r �.T e �\I � � o ( � O Q�~ '� C � �' N . -� ;- d� ,- No.... � Fws........... �. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF.......................................................................................... Appliratiun for Disposal Vorks Tonutrur#iun Frrutit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: .P . ....................D,A...J.p ......(21 :.h..--^.................. . ............... Location-Address or Lot No. .�.w.r_r........... G............................................. -•--•-•----••----.......................... •-----.........--•---........................ ..... ........ Owner Address a .......... ....................................................... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms...........3..............................Expansion Attic (v) Garbage Grinder ( ) Other—Type of Building _ �iF.............. No. of persons....S!._._._..___._.__._.__ Showers Cafeteria ( ) a' Other s .----------. W Design Flow............ gallons per person per day. Total daily flo _.. gallons. tx Septic Tank—Liquid'capacity......_.....gallons Length................ Width................ Diameter---------------- Depth................ Disposal Trench—No. .................... Width.................... Total Length.................... Total.leaching area....7-_6..,3. ..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........................................--••--....._•-r•-----------------. Date........................................ Test Pit No. 1__ _..minutes per inch Depth of Test Pit.......1-t....... Depth to ground water.....AM-__-_-.___. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -----------------•......-..........................-----------••............................................................................ O Description of Soil............. �----------------'fib O ) `. 5v .5_�7.1..�e, x ----------•-------•---------••----•--•----------••-••------•-------------------•----......--•-...•-----•-•------------•---•-------•--------••-•----•------------------•-------------------.....-•-.--•-- 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 iITLL 5 of the State Sanitary Code—The undersigned'further agrees not to place the system in opera i til a Certificate of Compliance has been issu ed by the board of health. � M &--o' Signed./. _:��s ��_................... Date S Date App i)aio proved By.........-•......... ............. . -------- Date Application Disapproved for the following re s:..--------••-••-----•----------------------------------•----------=----•---------••......_..----...---._..--.._ ...................................•----....----•------•----•------------•------.............-------•--•------------•-------••--•---------------------------•------------•----•----------------•-....•-- Date Permit No.. S.P .................. Issued............... .k. .Q D += 41.cv- J OG No..........•--•-'_....._ .............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................0 F.......................................................................................... Appliration for Disposal Works Tunutrurtiun rumit Application is hereby made for a Permit to Construct ( ) or Repair (L/) an Individual Sewage Disposal System at: �.. . z_ •y ..............._.. _..........'-•^-•-=.............._.... ______......____•........_____. Location-Address or Lot No. ?� .y',- .....•........:......•—^••--•-'---•-•-"-....__......•----.....................-•----•-••-----•- ----••--••--•---•----•....••••---•------'-_..•-•_.........._............-••-••-'--.•.............. Owner Address c' a Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms......... ...............................Expansion Attic (t- ) Garbage Grinder ( ) aOther—Type of Building ................ No. of persons...4_...................... Showers (� ) — Cafeteria ( ) dOther,�fi re -- ------------------------------------------------------------------------------------------------------------------------------••---•---------------- W Design Flow..........-"�s.•m 7K��I� p-_gallons per person per day. Total daily flo l WSeptic Tank—Liquid capacity.........._.gallons Length................ Width................ Diameter-----_.......... Depth................ W Disposal Trench—No..................... Width.................... Total Length.................... Total.leaching area...--_1,b._.. ---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........................................ a Test Pit No. I.G.�_._.minutes per inch Depth of Test Pit......[.`r__....... Depth to ground water....NA............ _ G4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-_____-------_--.__.__.- ------I-----t-•--•-...........•••-••.............•--•-• •••••.....•••�_.....-••--•..........--_•-•........................................ _................ x0 Description of Soil----•-•-•--.-L.. ............. ..P �-)----- -----•-- w2-- ------ . -e`•-••••••-•••••--••-•••-•-•••-•-••----•-•-•••...---....... 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 TITLE✓ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in Operation until a Certificate of Compliance has been,issue-by the board of health. �r-r✓ Signed -- .... ... �! •�� •= -- - A lica io roved By-•-...---•------•-••......••••....-VC*.�P�'�! , _ to........................................ s Y i Date Application Disapproved for the following reoso4s:--•--•-•••--•---••-••••--•-•--•••-•••••••••••••••••-•----•-••••-------•-•••--••••---•------•----•••••........._ J .............................................................................................................._...._....._.......•...-----....._....._.._.........c........___........_..._........__.... 'Date Permit No......... .S._`_ _ .` .................. Issued_.................. - 1 j• _ =�- ..... D THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.................................................................................... (9rrtifiratr of TourptiFanre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed K) or Repaired ( ) b s� Installer c�- J•._ 11 V1%P s .....................•---------------.....---------------------------------------------------- at_-------- •• ...................... .. .--••- -........ --- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary. Code as described in the application for Disposal Works Construction Permit No......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST ED AS A GUARAN E THAT THE SYSTEM WILL UNCTION SATISFACTORY. DATE................ ... ...�.-----�-__--•----•---••----•_--_... Inspector................•• ........................... ...... THE COMMONWEALTH OF MASSACHU TTS BOARD OF HEALTH v No:... .. 6 6. FEE..._ _....... •--- - Diu uu�al 19u u lin udwit rrmit Permission is hereby granted ............1----------------------•------•---------.....------............--_._.... to.Construct ( ) rjRepair ( ) a Individua eV.a ge Disposal System at No.- - � - ; 1� as shown on the application for Disposal Works Construction Permit No....._: Z 9s Street � �- -----V Dated---------- -- ---------- -------•-•--- ...............••-----•-•-••-••••• .. - -• --• •------- _ -.....------..� ---------•--•-•--•-_..________ of Health DATE.--•---------------� - ---��- FORM 1255 A. M. SU I,IN, IN BOSTON .00 22 ' W13' Stone. 12 8,:27.8 S.F. ' ' 28.9 2G3 S•F N — D.B. r 0. 3G' /Oo.'7 /SOD;C.S.T N 27.0 LTP_.. N F;- l"73p:- Lofose Z7.7 ,,23 R• , .1500 45\ PLAN SCALE 40� � Q 28.5 297,. DRtc ' 4.•lL•_85 M Friel, SrK 18.v� 35,2. . . -PROFILE- NO SCAIn LE l ,TENAIlES 7�ATH ('40' c.Ui � N4. 30.0 SKETCH PLAN OF LFlIVDJIV MM)NA WSJ, Md. -ALt CAP�--ENGIM� RING._ 49 HAR,3OR ROAD ? ; Nt/ n��vis : . : : M2. Cf-lf1/��ES F�. MRDOCY IV),i: :O 2 G;O./ j :.T3E%NG. Lo7' 22. tqj ,S�-wolN 4)IV rh/E PLNl1/. of Ajo; ; ' SaIWIL /5106> 7.3ooK 286 -P.4cE /6, NND . . f�f�'p?DEQ /iJ�TNE�8ff�?iVSTfIBLE RcG7ST/ty OF DEEDS ON 4.4. A S S U M`t_» . 1_3I 77aJ l j 'VA 7f.;, ' �/ rnstab/eZ5c,,wzv of EA[TN (it1�•�'� Nla.JAM Cuv�l.ow .. ..; � Ak EN C o u r,r'E 2 E D i fP-,1zC. RATE 21�9,'?i• 1�E,2. )" 29.5 To p 27.0 OF Cow tS� Sotiey WILLIAM y�'\ i H. FARDIE cq 9o�FGISTSP6\�i, ONA1. �,. 1.3