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Home My WebLink About0028 FLOWING POND CIRCLE - Health 3g -� Ic�w inca pdyt& (!Jv-c,(�1 0� . L0- CATI N S A E PERMIT. NO. VILLAGE clail� —,-.14 I N S T A LLER'SNAME & ADDRESS e [.4 p B UI'LDE R A �wl N E . DATE " PERMIT ISSUED DAT E COMPLIANCE ISSUED d e �% i��. 92) LO-CATI N S A W. E PERMIT NO. VILLAGE A 1-4 V, Q��q IN S T A LLER'S NAME & ADDRESS 4,ve B 0-11DE R 01F WNE z DATE PERMIT ISSUED DATE COMPLIANCE ISSUED r 17 j,". -7 No. �r r Flz$�........................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HFALT ,:...OF.. r w! ... . . .. ......... ..................... Appliration -for 43ttipuittl Workii Tomitrurtion Vrrufit Application is hereby'made for a Permit to Construct (` or Repair ( ) an Individual Sewage Disposal /61 Sys ...- � ._.'... C. %� ------------- C / Locat ddress or Lot No. 't-la-_----------------- ----•- ---------------•--- ------------------------- �A Tom_ ......... ............... ..._ - ----- ---- - - - rj�h� Ow r Address t nstaller Address f d Type of Building Size Lot. (/- - ?-Sq. feet V Dwelling—No. of Bedrooms__��------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures .----xirz-tr�-�- ----- W Design Flow..................17.0.................. allons per person per day. Total daily flow............I.....®...._..-------------gallons. WSeptic Tank—Liquid capacity.(' alIons Length---------------- Width-_.....-....-.. Diameter_-------.----- Depth..-..-_---_--- x Disposal Trench—No..--•...--••----•---. NV t ------------------- Length To "1 lea ng area-•--- ---------_---sq. ft. Seepage Pit No _6'_ ems-- kF,� :et___ in area---_. � s< ft. � ---- � -.------------ ---� - .. g tom'`------��---- 1. Z Other Distribution box ( ) Dosing tank ( ) d C S Percolation Test Results Performed by------ --------------_--- -------•--•-----...--•---------. .............. Date--------------------------------------- ,� Test Pit No. 1________________minutes per inch Depth of "Pest Pit-------------------- Depth to ground water----------.............. (1 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water...-----._.-----_-_----. a Q 7 ------•--------------- Description of S�Oil. '(� .. ` :----------- " �/ ... U W -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- V 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 Article XI 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 boar, of health ff D to Application Approved By aC"CL6 -..--.-- -. .-- �� . ------------�---- Date Application Disapproved for the following reasons:-------------------- -_-------.------------------------------.---.-.---------------.--_--.-..--.------- --•-----------------------•----•------...---•--•------••-•------•----•--•--•---•----.....--••------------ n Date Permit No. Issued._..-__"`% . Date THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I A , m / �C(�J- IL DATA i .•. t No.. ... , Ficic.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 'Appliratio,h -for :41-4pittitt1 Murk.. Cnonstrurtion Pprutit Application's hereby`made for a Permit to Construct (.i)or Repair ( ) an Individual Sewage Disposal S st .-em at / .. .,�ti/ 7 � .✓` 1 ....t� .....� 1'.......... •f/.... ....! r'Location-Address or Lot No. r - __________________________ ...............................................___...._.___ ______.................... Ownerr_. rl e- • ' Address f t ,...� ..............................................• t ir/�•L.. _ .. .I... r ......-----• ...................••----.... ..._................_..-f-..................------........ Installer k Address Type of Building .. .r, Size Lot_ �_. ___ -_7--Sq. feet U Dwelling—No. of Be'Brooms--- ----------------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of BuiE,iri ............................ No. of et sons...__---__-_-_----'--_---- Showers — Cafeteria d Other fixtures r-...--'' '-' W Design Flow.................. s.¢_:__-__-_____-.gallons per person per day. Total daily flow------------ P4 Septic Tank—Liquid capacity,/� llons tength---------------- Width................ Diameter-----...._.----- Depth..-.--_-..----- xDisposal Trench—No- --__--__1...... Width----------------- Total Length---.-_-__. Total leaching area--------------------sq. ft. Seepage Pit No-----_'_ Diameter sue±►- --------.Dep h-bel'bw i, let__ �!�Total=leaching area. .`�.S--sq. ft. Z Other Distribution box ( ) ' -i-Dosing tank ( ^) *" Percolation Test Results Performed bY------------- L -----------------------------------•----------------- Date_--_--------------------------------._.. a Test Pit No. 1----------------minutes per inch Depth of Test Pit_.................. Depth to ground water...---.------.---..._._- Test Pit No. 2................minutessper inch Depth of Test Pit-,:------------------ Depth to ground water--.-..____-.-_-.--._.. O Description of Sylil;--- '.«.. "� V;i a -. ------- - w� ------------- ----- `'---12 -•-- .._ a U ----•--------------------- --------------------- ---- ---- 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 Article YI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ) sued by the board of health: r / ,� i Date Application Approved BY------)!e�o-vZiw 41,Q .� �V-------- '` Date Application Disapproved or the following reasons: -_._____-- --- uf ............. -----------------------------------------------------------------------• PP PP f f g -----•---------------- -----------------•------------------------------------------------------------_._...----------------------------------------------•-------------------•--------------•----••--•-- Date Permit No................. -== =:,== Issued Date i, THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH wed ...�........T.'..... Y h _ ~ ................................ . ` THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed 41) or Repaired ( ) Y -- -•--• - ---•---------•-•- . . -----•---- ------ b l`l'''�'�' �` r Installer f/ - =^" - =r'k1---------------------------�--- •_:�i3----- application for Disposal Works Construction Permit No. 67i9X._W`A__7 IQf he State Sanitary Coyle as descrtbed,in the has been installed in accordance with the p�ov.ions of � ------- dated- -:-'f,�t- "'--�"'..-��----- ------------- THE ISSUANCE OF THIS CERTIFICATE SHALL. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM V+II L FUNCTION SATISFACTORY. DATE------ ...................... ------- .................................. inspector_--- '"-------------------•---•-----------•----- i , THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................!........!J-.!`.--"OF....: A � , t.�Y i'�r t ` No......................... « FEF........................ Permission is (ed�' - ...- ,.rii-.'�--------------=------------------------------------ ---------•--•----- to Construct orRepair an Individual Sewage Disposal System, , r at No= -= -------.---- 1 .��, ,� 1�s-Jt %a,f',f'c�!•. - -� Street as shown on the application for Disposal Works Construction it No ----; `'_ Dated------------- `-- - ------------_-- DATE------=--------- oar'of Health • -•-•-...-•............. FORM 1255,,. HOBes & WARREN. INC.. PUBLISHERS• - \ \00 r \ yr 14- Q(.oq MAP- V 4/ o R1(�kRf) Gv SAXI�.F1 e► " No. 2M14d OT ao su tgGA,T10N pt� L..t..-a G6RT1 F�( T+4A'T" T14L- F'ouUDATtoN SNoWkJ Pt—A Rs ERE►Ilca NEQ E CW COAAPLYS W 1 TN TWG 51 VS-Ll►-11r Aua SeTgAGK FC-QU(lZEAAEi1TS OP T" G 1O W U OP' LA tJG ue T" DATE BQXTCtZ t. w`(E 1�1G. t2EGl5'�'C-��D 1,.A�1D SUi`vcYo¢.S TWS V-LAW t'S LJOT BASGV C)64 AN OSTE2V�l.LE o II�CASS. IWSfpcJ.tnEtJT 6VZ'VcY .4-ri4a 514owLr� APPLICANT hbT BE USC0 To ocrEeMlN& LOT l..lWaS ►�� t'j�L �DEV.