HomeMy WebLinkAbout0139 BUNKER HILL ROAD - Health r
No................101
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
7
Appliration fnr= i n gal ,axk r rtiun runt
Application is hereby made for a Permit to Construct ( ''or Repair ( ) an Individual Sewage Disposal
System at:
................_... is .�. :: ... ----........-- —�` -. —9-4............................
Location-Address fY am. wr t11 , �7. _..... irr� ._.. ._..._
O_ wn¢f f 'Address
I R,
Installer Address A _
d Type of Building Size
U Dwelling—No. of Bedrooms................4......... .....Expansion Attic ( ) Garbage Grinder ( i,,I'
Other—Type of Building No. of persons............................ Showers — Cafeteria
Otherfixtures -----------------------------------•--•---•----..........-------•--------------------------------......--------•-- -------- ...................
Total
� DSeptic Tank—Liquid cap i gallons p L ngth person per day.Width daily ... Diameter................ eepth:--dons-
W Disposal Trench—No..................... Width.....,.............. Total Length......... ..i....Total leaching area..... sq. ft.
x
Seepage Pit No...........&...... Diameter._.... ..... Depth below inlet.......&...... Total leaching area....� .sq. ft.
z Other Distribution box (10 Dosing tank (� ) _.
Percolation Test Results Performed by.... . _ r ........................... Date..........-- ." 93.6.
,.a Test Pit No. 1.......Z—. -:minutes per inch Depth of Test Pit.........../; - Depth to ground water..___.--.._....
Test Pit No. 2.........Zw.minutes per inch Depth of Test Pit........../Z.. Depth to ground water----- ..........
q x
. �.:
Description of Soil -- r
............................................. -----_---
x ............................. : .. - --4 1 ...-------------- `� ..........r
U
W -----------------------------------------------------------------------------------------------------------------------------------------------------------------------p
U Nature of Repairs or Alterations—Answer when applicable.... -��!.L_....�v.........!.,
..,... r.... 1 r vC...k-
-----------------------------------------------•-•--------..............-----•----•---••---•--•-------••---...-•----•---------------••------...----------------------------------------------•---••----
r
Agreement
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLL 5 of the State Sanitary Code— The undersigned further agr s not'to place the system in
operation until a Certificate 4the,ollowing
ce has been ' d b�the boar of h h.
Signed../-------------------•-••-•---..... ................... ......----.....----.....
Date
Application Approved By--- ------- Date
Application Disapproved for reasons-----------------•---------••-------.......------------•----------------------------..._--•-•--•-------....._.
....-•---••---•------•----....----•-•---.....---•--------•-••----•-----•-----------•---------------------.---••---...........------------•..............................................................
Date
Permit No....... �� :`'.�
---- �.__ _._---•------. Issued_.......................................................
Date
No» .�-� i p► Fps ......
«�
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
16 1
....1..+ :.,1-�t'€ - OF......�'`'� •t .. .. , t ' 1 .,�........................
,�pp iration for Disposal Work, T nstrnrtion ramit
Application is hereby made for a Permit to Construct ( f or Repair ( ) an Individual Sewage Disposal
System at: 1' p
Location-Address or Lot No. ,
.r'1?..._» .3 �=;•!� 0,•'�'0.---•.......... ......•--------------•---••-.... �; .5'.:�a 4.. :'�ry-9 - ..................
»1waa1._
Owner Address
_..._...:-` .......... .......•--.....---•--------••-•--•---•----•------------...--------..........................•.....
Installer Address
UType of Building Size Lot.��'.z.4.1- --Acsq. feet
Dwelling—No. of Bedrooms.................:`_.................__..__Expansion Attic ( ) Garbage Grinder ( )
Other—Type T e of Building ......... No. of persons............................ Showers
Pa YP g ------------------- P ( ) — Cafeteria ( )
Q' Other fixtures ...-•-------•----------•-------- .
W Design Flow..................... ............_.gallons per person per day. Total daily flow..................... ? .......gallons.
WSeptic Tank—Liquid* f"'a capacity >gallorisf Length................ Width................ Diameter................ Depth................
x Disposal Trench—No. .................... Width.................... Total Length.............. Total leaching area....................sq. ft.
4�w::
Seepage Pit No-----------L�...... Diameter.......'.r"2..... Depth below inlet.......i<12...... Total leaching area.._..te.._'= _sq. ft.
Z Other Distribution box (+r')`y Dosing tank ( ) _..- �,.
a Percolation Test Results
�r Performed by_ � ' ...rs� ......;�................... Date............I -..�. ..
,.a Test Pit No. I.__._...<� __minutes per inch Depth of Test Pit..........�..::.'-�`... Depth to ground water......._----........
fi Test Pit No. 2.........7--!minutes per inch Depth of Test Pit..........4 .. Depth to ground water........................
a ----------------------------------------------------------------------------------------------------------------------------------------------------------
D Description of Soil.......................
p ------.....�' ....................................................ff ----- ✓. ,c l Ic Y'1 °-�
.............................. _.___... .._.._._...__.V � " '
,
W ........................................................................................................................................................................................................
VNature of Repairs or Alterations—Answer when applicable.... ......�Ra? Qt .
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITi-E 5 of the State Sanitary Code— The undersigned further agr s not to place the system in
operation until a Certificate of Compliance has been ' d b the boar of he h. `
Signed----... -------- ...-----.---•- ••-•••--.......................
Date
Application Approved By.. _...---•-----•.................._----•-.....-•--••--••--•---..............----- --649
Date
Application Disapproved for the following reasons---------------•--•--j------•---•------....------------------•-•--•------.. ....................................
-•-----•------------------------------------------------------------------•-----•-•-•-----•-••-----........
)T`,T` Date
Permit No._... .��' _.:'-----------------=------------ Issued-------...----•-------------
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD ALTH
� ..M ..
(Irrtifiratr of font fiFanrr
THIS �CE �Y, Th/�`t th Inciivi ual Sewage Disposal System constructed ( ) or Repairedby-------------------- 1 4 ------------------. ... ........-----....................------....-----....------...---
---- ---- -----
.... Installer
at.._..., 'fin s! ------. -------------- `.•-------=�........................................................................
has been installed in accordance with the provisions of TIT,I, 5 of The State Sanitary Code as dribed in the
application for Disposal Works Construction Permit No.........� ._-..�!_0_15 dated_._.._ -------. .t _cZ .
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL F NC ION SATISFACTORY.
DATE...............4 .. .. ..@.G....................................... Inspector......................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..................OF.........................................._..._...................................... c^
FEI�...............
Disposal Works notrurtion rranit
Permission is hereby granted 1---•-------- .......................................................
to Construct ( ) or Repair ( ) an I d�iyial Sew_a,,gge .-ispos System
at No..•-�_`' ....... -a'• ��il�, f-- - d C.. .r
. , Street �_ /t � �
as shown on-the application for Disposal Works Constructio_ n_,Permit No..................... Dated........______.
•=------------------------ »
Board of Health
DATE-----------•-_...� ... -- ...............................
FORM 1255 HOBBS WARREN, INC.. PUBLISHERS
------.
,6.o2Al
rVLoT q t�
A c czc s
"Lai Z 3
7-1
0
P
1
A5 73uILT
of �9ssq LOCATION OSrL fz.�1 t .I;l I`I a s�
PETER
1 .
o SULLIVAN SCALE i'� DATE JuNE 25,��4vG
No. 29733 H 'PLAN REFERENCE
��oFsn cl
�-\Q tr) COIF 12T' S z S
BAXTER t NYE, INC.,
REGISTERED LAND SURVEYORS
OSTERVILLE, MASS.'
APPLICANT Dr2. . �-OC—
44,
q45B N� l
30� \AJ C-T
.�
4 as
,lb ITAN,
ASSESSOR'S MAP. NO.WP-0 PARCEL
LOCATION SEWAGE PERMIT' MQ.
YlLLACE
Vlae
. INSTA LLER'S* NAME Z . ADDRESS
lF'3�G 5�di• �j
4�e Ole CCU 4�2Z6 3 L
E U I L D E R OR OWNER
D A T E P E R M I T I S. S U E D
ov• /9e4e. S
I
DATE C0MP;LIANCE ISSUED
--------------
;.fit
ASSESSOR'S MAP N0.96 7-4 PARCEL ,lo r '96
LOCATION 1-0-rq(o SEWAGE PERMIT NO.
/39 gamlece 1,IiGC A,o &1w etwee- - -/Or, '
VILLAGE - T3c/f,
A ." 09(� 001 O01-
INSTA LLER'S NAME i ADDRESS
vL T L&rsL-A �L�t��< eoAwr- C'o. )
-B UILDER OR OWNER
� LE3GG loirsT �� � ri�.��r��-T ��vv�-QvrctLr
DATE PERMIT ISSUED //ov. 748L4,--
DAT E COMPLIANCE ISSUED 91.E
i ���.��
�D� i f
�~ w
oa � .� °•o M `�
� �
4'�' ��
� �._
� .0
��
�L�(/G L
r -
----- --- --
_.,��
'Pp ; x..,so Y Goo G:PQ, t
SE�i/L44 A. 440 C ZO O G PD
'-' � �;: - - ��� Pin-IJ oiJ ��L ►��Ylt3a�'
e- AZ
-t
1
i crT-QL
�E5/6.v/F? 1OA//Z4 i
%c% LESS ; .
r
OF��y
s
s
o� RtCNAR
L
_ A GIIIAN
BARTER y No.;2,973 y
Nagy 24048'
A;.. , N
P-454/
a o
� Tiles _ $�4
I.
W. I
/ate 4�4G � X
3 Z
,
EC 2/ {
_ .r � n�oSvD
Z-0C,4T/O/C/
;S/yOWiui f�E/E'EO.C/COis-!GG YS G1//Thy 5'C�1 L G G O.�I TE I(' S-g
EQU/,CE E/ -S C 7'oN�it/ I -
�3.d 2�15T�4 Los Av 'iSo
r' q
,C a c,4 rEr� WiT's�/�./ TyE . Loar�PL�4/�f!
LR IJ Co vE2T' S`l'ZS
.B�4 XT, t/C.
7, IS iP.L.941A5'*o,,VoT B,4,SE'p:�//.4�t/ .P_EG/.STE•2EI� .L W� SU.eYEyaFc�
T: y� OSTE,2Y/�
0•�•4SE'TS..S/,�1Al�/ShC�UL IV107
.'l/.SEp•7� OET�,P-iLr/�/E L!>T�./N6S. i �2� ���1J� ��I L-�...
I e i i
9 I
L
�
2
o \ 1
oo
c,2. x ai 1 3 •�.
V� 4z.it T
s
J
84.7
3.y o
I
4/ 4
\ .�
i
R5
- --SLoPa gs� "° ' a�
Nr G
i
tip\I" OF
`, s�
s
- . •�.�.,_.... . , .,. v RiCHARD -PETER!
�.
q„ SULLIVAN '
BAXTER
No.t4tu, " 2^.o48Q No. 29733 ";
� —//� •y/� �� �,�.� Pam_��,� ��, @ , 2 \t.�
�GIC +1 fr f.. ��.SY' y�,\Q