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Home My WebLink About0058 HATHAWAY ROAD - Health �- - wa - . LOCATION SEWAGE PERMIT 7N. 1 J VILLAGE W` S .4vu t A :-, INSTkLLE 'S I AIDE ADDRESS E lcC Ol,\ s 0 UIILDER OR 0WNEIt I�114 t A P, DATE PERMIT ISSUED o DATE COMPLIANCE ISSUED '' y r' Fig THE,COMMONWEALTH OF MASSACHUSETTS �.� 60AR® OF HEALTH 1.....a.L(,Z..V ............0F......./. ,5f Ll.. v/. ........ ........... App iratilan for Dhipos al Worko Tunstrurtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair (1--,T"an Individual Sewage Disposal System at: .... �. .4. ._... . -•---------------------------------------- ----•----------•....................--•--- Lo ation- d ess�.. or Lot No. !.. ....... ...... --•-•- .. _ . . ----•-••--••......-- -•------•••---•--------•...................... 1ll:7F®=.1_-.- .. !.--...... Address---------------------------- ----••--- Installer Address Type of Building Size Lot............................Sq. feet U Dwelling 4eNo. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria G4 Other fixtures -----------------------------------•--- - W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic 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......................................... aTest Pit No. 1................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...................--... 0 Description of Soil-------- _......--------- x W -------------------------------------------------••--••--------•-••------------------------------- -•---••--- UNature of Repairs or Alterations—Answer when applicable------. __.-�1, � .................................................... -------------------------------------------•--.....----------•-•--•---------------------•------•--..............--------------------•-------•----------•--------•---•------------..............•-------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITL U 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 oardd f health. } gned-- . ..=--- -: ....... JO' Date ApplicationApproved By.........•=--- ---------------•-------------------------------•----•...--•--------•--•--•-•-••- Date Application Disapproved f r t following reasons----------------------------••-------•-----------........------••-------•--•---•---••••......-----•............._ .................•--•-•------•---•----------•---------------•-------------•-------------------------------•••-•---------------•--•••----•----•---•--•--•••••••--------------•--------------------------- Date PermitNo..................................................._---• Issued-....................................................... Date No......................... THF, COMMONWEALTH OF MASSACHUSETTS .1 BOARD 9F HEALTH A 4;�7 .. ............... ................ 60..;Q...........OF..... ........ Appliration for Disposal Works (foustrurtion 1hrmit Application is hereby made for a Permit to Construct or Repair (—"�'an Individual Sewage"Pisposal System at: . .............. ............................. ....................................................................................... /z, L ati.n. dress, or Lot No. ............................... ............................................ *-------------------------*-------------- o X5�ress . ................................ ............................................. ............................................... Installer Address Type of Building Size Lot.............................Sq. feet Dwelling No. of Bedrooms............................................Expansion Attic Garbage Grinder 04 Other—Type of Building -----_-------------------- No. of persons............................ Showers Cafeteria 04 Other fixtures Design Flow.............................................gallons per person per day. Total daily flow--------------------------------------------gallons. P4 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter__.__._......._. Depth....___.._....._ Disposal Trench—No. .................... Width.................... Total Length_....................Total leaching area....................sq. f t. Seepage Pit No_____________________ Diameter.................... Depth below inlet,................... Total leaching,area..................sq. f t. Z Other Distribution box Dosing tank Percolation Test Results Performed -----------------------by.. . -------------------*----- _' Date......................................... - -------------* Test Pit No. .1................minutes per inch Depth of Test Pit.................... Depth to ground water.___.....__..._.._..___. fTq Test Pit No. 2................minutes per inch Depth of Test Pit............_....... Depth to ground water..____.........:..______..................... .............. .............'05;...... 0 Description of Soil........... . . ...... ......... U ....................................................................................................................................................................................................... ............................................................................................................... .......... -------------------"------------------------------- '77-------- 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 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 issued by the+oard4ff health. .................. Signed �;............... ... .......................... Application Approved By................... Date --------------- ................................................................. ........................................ Date Application Disapproved for the following reasons:.............................................................................................................. ......................................................................................................................................................................................................... Date Permit No........................ . .. ... Issued................. Date ................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......... F....... ...... .............................. (Crdifiratr of Toutpliattrr, THUI TO CERTIFY h. t the Ind vadyal Sewzgeposal System constructed or Repaired by---.t 12................ ...... ........................... .......... G.................................................................................... Instal j 7 Aoe at__ . .. -- .. .............. ....... ---- . 7-------- -------T----------I------------------ .................................... 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................I......................... dated__.._._.._....._____..:_......_.................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WIA �0 IF CTION SATISFACTORY. DATE.... ....................................... Inspector__.'_...... ....... ............ ------------------------------------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD O)j HEALTH .........................................OF. ................................... .................................................. No......................... FEE.. .................. Itt Vermit o Permission is hereby granted,...... .......•4.6.......................... ............... ...........V................. "00............................ to Construe or A;pai5e (/�.�n Individual. Sew4ge Disposal Sys m, at No.....%2... ...............;......... - ------------ Street as shown on the application for Disposal Works,Construction Permit, No..................... Dated.......................................... ....................................................................................................... Board of Health DATE............................................................................... FORM 1255 A. M. SULKIN, INC., BOSTON No........%................. Fiv& ........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 011, r;A _-----OF....... ------------ ........................ 1 , Appliration -for Ui_qpmal Works Tatuitrurtion Vrruift Application is hereby made for a Permit to Construct (kj0_r'Repair an Individual Sewage Disposal Systemat: _ I........... 7 V-------4'v------------ ............................................................................ ocation-Addrm I or Lot No. - ------------------------------- -------------------- ... ........��.A...... . ............. ................................................................ i Address ➢ t0j,-Z .................. .................................................................................................. Installer Address Type 9f Building-1/ Size'Lot----------------------------Sq. feet U Dwellin Bedrooms-------------01. 9 ------------;-------------Expansion Attic Garbage Grinder OthervType of Building oynil^----V_ No. of persons--_---------------------_ Showers Cafeteria vw --------- ------- Other fixtures 7 ------------------------------------------I------------------------------------------------------ -------- ----------------- Desim Flows.......................I t-10, gal ----- .................... Ions per person per day. Total daily flow-_-_._...._... .....gallons. Septic Tank-4C-Liquid ca)V2acjitvIdMallo ns Length_-----&_-A-- Wi�--------O.. ... Diameter................ Depth......--....._. Disposal.Trench No. ..- VWidth..... tz0tdILgt ----- 'L- Total leaching area--------------------sq. f t. Seepage Pit No_____________________ Diameter._..._-.-.-._._..... Depth below inlet._.__..____.-___-___ Total leaching area..----- ----------sq. it. z Other Distribution box ( ) Dosing tank ( ) �4�_4 Percolation Test Results Performed by------------- ............................................................ Date------------------------------------ Test Pit No. I................minutes per inch Depth of Test Pit........-_._----..-- Depth to ground water-------- --------------- f� Test Pit No. 2................minutes per inch Depth of Test Pit...........____._... Depth to ground water.--.------------------:. ------------------- ----------------h '7__�4L .....................----------- ---------- ------------------------------------------------------------- 0 Description of Soil----------------------------------- ............0�� 7 W ------------------ ------------------- /-------!�------------------------------------------ U -------------......................................................................................................................... -------------------------------------- -------------------------- ---------------- --------------------------------------------------------------------------------------------------- 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 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 the board of health. Signed:r?..... .....w!!n................................................................ .... . ............ . ... Application Approved By_._e��''':;4 ;-------i---- Date ------------------------------------------------------------------------------------- Application Disappioved for the following reasons:.............................. .......................................................................... ....................................... ----------------------------------------------------------------------------------------------------------------------------------------------------------------- Date PermitNo......................................................... Is'sued........................................................ Date ..............................................*.................*.**....................Q............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF. HEALTH _. ............OF........14�"- ........................................... 10.1rdifiratr of (911m I- tanu 40,010, TH,-T-S, IS 90-CE constructed or Repaired 7_,T-I--FY, Th utthielIndiVidual-Sewage Disposal System 1 - b ........I.k.... pul y --------------- All, ..................................................................... . .........................................I.................................... ................ s-at...... . .4 ....I.n..s.t_a_0.V---- ------------------------------------....�r ------------ ----- ... .............. has been installed in accordance with the provisions of Article X of he State Sanitary Code Rs described in the ��wil-------- %.j ' J 2�Codes -7 /-2 T application for Disposal Works Construction Permit No..........................V ---- dated...... ................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE'f....I. Inspector.................................................................................... ---------------------------*------------------------- ........ ----------- ------- -----------—------------------------- No..---�-#-- ....... Fs> ... ........... THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEATH ... OF-------- j� !' � ' ................. 7 Y Apphrtttion -fur Bi,gpuiitt1 Workii 'Towitrurtion Vanift Applicationf is hereby ade for a Permit to Construct or Repair ( ) an Individual Sewage`Disposal System at: ----- +' - --•-•--... Loo�ca��tion��-Ad e or Lot No: r Address W Installer "' .w iri Address d TYPe of.:Buildin A All I Size Lot----------------------------Sq. feet • Dwell' o. of Bedrooms:._`_' _... --- ------------Expansion -Attic ( ' ) Garbage Grinder ( ) Other Type of Buildin "` __-.-- Showers — � YP g -�`•---- -------. No. of persons..:._:-------------� ( ) Cafeteria ( ) Other fixtures .... ........-•--• ------•----- J- �� - -------_--•--- W Design Flo`a-- ------------ ,Ilons per person per day. Total daily flow..-------•--_.!-�+�* ---gallons. Septic Tan L'quid ca acity gallons th_--_____ Wid -- Diameter_.............. Depth.. ----_-.--_ T Disposal'Trench No.__ '_. .-•---- Width.- o g --,_.R_. Total leaching area---------- ---sq. ft. x Seepage Pit No..:...:...: ...._ Diameter-:._.._._,:,_....... Depth below inlet-------------------- To leaching area._.._____.___..sq. ft. Z Other Distribution box,(* ) ' Dosing tank-( ) :Percolation Test Results. Performed bY------=----------------------------------------- Date � Test Pit,No. 1------ mper inch Depth of Lest.Pit _ . Depth to ground.water---------------------- Test Pit No. 2_____ -__-_-minutes per inch epth,of Test Pit---------- ::____ Depth t gr urid tr......:........... . ... - Description of Soil - . -•-- <: x * ++' V ------------------- ------ ---------------------------- -------------- ------------ - ----- -------- W - V- Nature of Repairs-ar-Alterations—Answer when applicable...:_....... . . .............. ...... ........................ ...�._._..._._._._:___... . -Agreement: The undersigned agrees to install ,the aforedescribed Individual Sewage Disposal System in accordance with the provisions of.Article \I 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---•• ---•--•._.....-•------_.. Application Approved BY- ---- . A ate 4r Date Application Disapproved following reasons:.................................................................................................................. --•-•--,,,-•--• •--•-----•--•---•--------------`.--='•----•------------------------•----•-- --•--------.....--•----•-•------------,._..•--•--------......------.............-•-•--•--- --------•---•. Date PermitNo.--..................................................... Issued........................ ................................. THE COMMONWEALTH OF MASSACHUSETTS 50ARDpy HEALTH "3 ........:.:OF. .... ............................................. CIerttfirttte, of Tomptitturr T IS FY, Th t t e' r�td al�Sewage Disposal System constructed (4 ) or Repaired ( ) by ,: �� } Instal r ------------- has been installed in accordance with the provisions of Article of The State anitary Code s described in the application for Disposal Works Construction Permit No----- dated... •�'+, ..._' _7. _ THEJSSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GU RANT,EE THAT THE � SYSTEM. W,ILL,.,F.UN:CT.IO:W SATISFACTORY , ,•,, a, E ,� xa , <, .�:�,� n; e..,, v DrATE k4cx fat s F� 9 ; ikyro } v dr4 u _. r h*""d,"ry r•1++-x s' r?ee sr 5X r y a �'In,spectot' �" •Rl _ Y� 9 THE COMMONWEALTH WEALTH OF-MASS, HUSETTS r. BOAtIRD HEALTH �•' - 00 - 4 - ..: ...:.. O F=. . k --t ---- """ +►.. o._. --- FEE I �t»a er sk omi r ilQ Permission is ereby granted ---- --- = ••-••-----•-. to`Cons ct or Repair (�` ) ndividual Sewa e ystem at N str t. .- as shown on the application fo`r Disposal Works Construction No t /�j //�yy -- -- - DATE '.�Z g •- ...:!{�+ ------------_----- FORMBoar e # = d of Heal � ' - 1255 1.HOBBS & WARREN. INC.. PUBLISHERS r ' � :r^.'�•x.-.^-rx.,44......� vr✓��..xw-�r.�r. xS:u.Yh-. '.�.--..r=. Yvfilx�.itp.SySM+d.'Mrw aof1J6.14 a.. .�-•i•wY 1".L -- y- � _ t Lot a4 > , EX STI Wq 4tl�w . tioc�LSi: A®ta+ j tp cv 00" ,! r 12.0 24. ILA ,z N ?ia o4 1417 MASS. �oslfs t¢ aJONN �mRN<1Qp -OW INC . AN - ta1 �'�G S FROtA PL&N wr_� ; NOV 29 LF i"= 30 LY t .4 L .y�( f y }�� <r �y��✓q�.'rey�j�,�`.'t3,y�� $,t� } ,.•1y��'�r q .�' r i