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Home My WebLink About0068 BUNKER HILL ROAD - Health wil Y'd C�f cqv-- Od 3 i LOCATION EWACE PERMIT 130. VILLAGE 02,3 INSTALLER'S NAME A ADDRESS /i9N �v��a.•4I�J 0 UILDER OR OWNER DA T E PERMIT ISSUED � :?-"qc _c4?® DAT E C 0 M P L I A N C E ISSUED r _ _� �� _ � �� --.---�C a , - � � � � � �,. �� r t FRic.. ..lo.. ..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH --r® .�........... ......oF....��. ! A -----------------------.............. Appliratiou for Dhip anal Works TNamuurtiun Vamit Application is hereby made for a Permit to Construct ( �Kr Repair ( ) an Individual' Sewage Disposal System at: ...... � : . ..............` c]Nu%PL- L...lA.\.��.�:-- ................................................................................................... Location•Address or Lot No. ........../�-.,�,r,'. .. . LAS.-----. �... Y1,�,n�5 1' & x1L-•-•---•--•---------•--•.......................................•---..... �✓1X /{7Ca G/Z—j -/}1v"ff Address Installer 5....62-0 ddress {.................•-----. ----•........................................... � Ad d Type of Building Size Lot... �2d 6 . feet j/Dwelling—No. of Bedrooms........... ...........................Expansion Attic ( ) Garbage Grinder �() p,, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) PL, Other fixtures ....._ W Design Flow....'-'--- -•----_=.gallons per person per day. Total daily flow..__._... . ....................gallons. W Septic Tank—Liquid capacity- 5�gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No....... ........... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.A..'t 7z-___.... Diameter..__1_2........ Depth below inlet...... Total leaching area-ca'J4__....sq. ft. Z Other Distribution box ( ) Dos' tank ( ) Percolation Test Results Performed by. 4:Aurs. . ............. Date... ................. Test Pit No. 1...�....minutes er inch Depth of Test Pit-__-_._ .._. Depth to ground ater. 6_. ._0rr.1UD .� P P I Z---- P g'r ,l�! T-� - (i, Test Pit No. 2.....7 ..minutes per inch Depth of Test Pit.....J.-L------- Depth to ground water.....f1.........ff___ a ----------------------------------- ---------•••-••-•------------ --- - - O Description of Soil----.2'Ile ll-••------- �_v 1--------------•-`5-�/ -----•-- •-•------••---•--•---•-------••---•--••---•---••..•----- 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 i:L - p S of the State Sanitary Code—The undersigned further agrees not to place the system in peration til a ertificate of Compliance has been issu b h boar of health. 3� �® Application Approved By---- -•-- .............................. ----- L Date Application Disapproved for the following reasons:................ ......--•-••-•--------••---•-••-----------------•---•----•---•----------......-•-------------- ••----•----------•••-•....-------•-••-----•--------••---••-••-•-•••-•-•.....--•-•--------------•--••-•-••----••------......•-----•----------•-----------•---•--••-------••-----------•------••-•--.---•- 3 �..--Dat ="� e PermitNo......................................................... Issued......-'/-J--•-` = ---- . ...--- Date No.B .w..� F�s..:..... _'.............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH rt_O.W/V....................OF.....1 (?a • ? .. .1a=~..................................... App iration for Uiipoii al Workii Tomuurtioat thrmit Application is hereby made for a Permit to Construct (��®r Repair ( ) an Individual Sewage Disposal System at: .....LaT.....i A.............. �..... LJ _........_.....--------- --•--..........._-•-•-- [� v n Location-Address or Lot No. Q•- .._.... ........................................... S. Owner 1k)a ..........0 r0/L rj ` /4-I q/l//1/� Address*") ��j t3 a ..A. ----------------•------••--•-------•-----.......................... Installer Address Type of Building Size Lot..R.0.�.(210C!}Sq. feet a /Dwelling—No. of Bedrooms._.,._... -.........................:.Expansion Attic ( ) Garbage Grinder ()() pa Other 'Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) aOther fixtures ----- --------- ------------------------------------------------------------------------- -------------•--....- d �- W Destgn..Flow.... ----- .----____gallons per person per day. Total daily flow._._..... -.p....................gallons. WSeptic Tank-;Liquid capacity. 5M-gallons Length---------------- Width................ Diameter._-_-___-___-_ Depth................ x Disposal Trench=No. ...... :.......... Width................... Total Length......_......._..... Total leaching area..... ft. Seepage-Pit'_No.t- Zn------- Diameter....1.7. Depth below inlet.__....'......... Total leaching area .4. ......sq. ft. z Other Distribution box ( ) Dosing tank-( ) i ~' Percolation Test Results Performed by__ ,: �t(� _�n ....�.Q,. sir�FA.j.............. Date_.��.l.�j.� .e4_................ Test Pit No. 1...2---------minutes per inch Depth of Test Pit____!7_......-- Depth to ground water..f.!!!�?.4.uYVD Test Pit-N o. 2....7----.._minutes per inch Depth of Test Pit----- ......... Depth to ground water---_!!........ L.. D Description of Soil !t'��`'Y '!- � !u!2:?............... r. [.✓1_!1---------------------------------------------------------------------------- x W ---•--------------------------------•-•-------•------------------- S-Z................................... VNature 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 f`17 /•1 5 of the State Sanitary Code— The undersigned further agrees not to place the system in peration til VaCeZrtificate of Compliance has been iss b h boa;Alof health �-, Sig ..... ........ . .�? �( t Ct-c ti G te V—F I ` D e Application Approved By--- �. � -----0----------- Date Application Disapproved for the following reasons:............................................................................................................... --•--•- ..........................................--•--•--•---------...-•---•-----••----•----------•-•----•---••------.--------------------------- ----------- - - --- ---------- --- Date Permit No......................................................... Issued- ------ Date THE COMMONWEALTH OF MASSACHUSETTS F BOARD OF HEALTH,, � POW r ................................. Trr#ifirFatr of Toutph anrr THIS IS TO CERTIFY, That the Individual by rage Disposal S-ste scon tlAtteed /or Rep, �edl'(` ) 9 t� l�� . w...:. Installer at.---- ?e!° r t� --------- t'1!1l/� .---- l_. ......► '� ----.O?i d_ It+(4 �........................ as leen stalled i o al Works accordance with he pr ons of TIT LE5 of The State Sanitary Code as described in the application n P Permit �'o.__ 4/ .1�---------------- dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..............•-----•--••------------........................---•.....----•----- Inspector.,.................................................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF... ✓y No.. FEE......................... �i��v��ttt ork� C�on��raua�n rraati� Permission is ereby granted---------�(A_. W!'r4 -----------------------------------------------------••-•-------•----•--- to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at No..--...A.0.r....`'9'.......ZVt_1s 9.-.....Y ....--.&A..................... jro`"4144C..---------------------------............... Street as shown on the application for Disposal Works Constructio t No..................... Dated-._ .__...._......_.................... = 74-�.'-Vnr." 04 -------------------------- Boa DATE....... �4.. FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS }S