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Home My WebLink About0018 KING ARTHUR DRIVE - Health No........... ............ THE COMMONWEALTH OF MASSACHUSETTS BOARD 0 ...............E F H E T ......1� ............... ................................. F �............ Appliration for Uhipooal Worko Tonotrurtion rantit Application is hereby made for a Permit to Construct (4<or Repair an Individual Sewage Disposal Sys....... pn(V: .. ...................... . ............................................................................................ tim A-AYss or Lot No. . ........ ...........f............... ------------------- ------------------------------------------------------- d ............ ero W. Ad ress .. ......... kl�r ............ .. ......... .. . .. .......... .................. . .. .................... ............................. Insta er Address Y Typ?off Building Size Lot/X4.0...7.........Sq. feet U Dwelling—No. of Bedrooms-----3..................................Expansion Attic Garbage Grinder ( ) Other—Type of Building ............................. No. of persons............................ Showers Cafeteria ( ) Otherfixtures ................................................................ ......................... ............................7...... Design Flow.........TO.... .......................gallons per person per day. Total daily flow............10.®_....................gallons. 1:4 Septic Tank—Liquid capacitye" allons Length................ Width..............._ Diameter---------------- Depth................ Disposal Trench—No. .....................)Yidth..........d....... Total ............ Total leaching area....................sq. ft. Seepage Pit No. - ........S� Total leaching area.,kV_,P'...sq. ft. Z Other Distribution box. Dosing tank Percolation Test Results Performed by.------D ------ --------- ------"------------------- Date.... ........... Test Pit No. I................minutes per inch ti 4 �_q of Test Pit---------_-------- Depth to ground water.._....__._..........___. Test Pit No. 2................minutes per inch Depth of Test Pit.__.............._.. Depth to ground water..__._.................. .......................... .......... .... .... -------------- . ...... oteeft...t . ..... 0 Description of Soil.'..... ......I.. f.. ....... A7, ----------*--------*---------------------------- ----------------------------------------------------------------- -------------------------------------------------------------------------- ............................................................................................................. .......................................................................................... 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 TL I Ti IL4 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 board of�iealth. Signe(P ................. ..... Date Application Approved By........ � _____________ ... ............ Date Application Disapproved for the following reasons:............................................................................................................... ......................................................................................................................................................................................:.................. —7/7 Date PermitNo......................................................... Issued---- .... . ....... ....�........ Date No........ "".....� Fss............................ THE COMMONWEALTH OF MASSACHUSETTS f BOARD E L:T A......,e"...---.....OF...................................:.. Appliratiun for Ropmal Works Tonstrur#tun ramit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal S5st t: X T�lation-A ss or Lot No. . .�_.�... .e---------------------------- --------------------------- F-5f ............................ ...•. • � ner Address n aeP! ::....:.:.:.._ � Installer Address Type of Building Size Lotl i_B _.7.........Sq. feet p;, Other—Type Type of Building __.._.___, Expansion Attic ( ) Garbage Grinder ( ) Dwelling No. of Bedrooms....x: ................................... .................. No. of persons............................ Showers ( ) Cafeteria ( ) QI Other fixtures -- ........... ---------- - - W Design Flow........^Y0.............................gallons per person per day. Total daily flow____--__-_-�.-0.....................gallons. WSeptic Tank—Liquid capacity gallons Length................ Width................. Diameter---___:..._..'_. Depth................ xDisposal Trench—No_ ____________________ ldth.................... Total Len Total leaching area....................sq. ft. Seepage Pit No. Aye-t_-- tar......7�. a ... Total leachingarea_._ Q - s ft. z Other Distribution box ( �4) Dosing tank ( C�Le 01 Percolation Test Results Performed by......, . ................................................. Date..._/:-_,fit_/.-:? �....___. Test Pit No. I................minutes per inch Depth of .Test Pit.................... Depth to ground water........................ Grq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 •---•-•. --•-•-----••-•••------•- -- ... O Description of Soil------ .~ ......e�.�_ v �� ii� f. � �'� ` t •Ft��.J_. x 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 TITIZ _: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 board of jiealth. - AApplication Approved B Date PP PP Y--------- ----G • Date Application Disapproved for the following reasons:--------••----------• --••-••--•-----•---•-...._..•-•...------•--------••••------------------•-----•-------- ^ Date Issue(L..... Permit No...................•----.._...._. --•--------•^-- Date---- ------- THE COMMONWEALTH OF, MASSACHUSETTS BOARD OF HEALTH Trrtifirtt , f Toutpliprr r THIS IS 0 CERTIFY, Tha e In h wage Disposal :Sstem constructed (4' or Repaired ) }_ .......- -----• ••. . q - -- ------- has been installed in acc8ance with the provisions of T j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.. C -----------••.. dated ".. ' THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST UE® S A'GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..----... `-.'.��'i? .....:................ Inspector..... . ............. •-- -- THE COMMONWEALTH OF MASSACHUSETTS BOAI$D OF HEALTH No........... ...... FEE......... ............ Raposal Works Tons 1t. tWa V -Mtt Permission is herby granted-----•. ._ ._........ :... — -------i_-_ to Construct (� or Repai>; ( ) n Individual Sew e Disposal System r4. J,,/ Ci "" at No.......... _. . �"" �,,� Street as sho no the application for D• osal Works Construction Per. it No ..__._____.. +Dated..._ __-_:�'.'7f° ............. �,. = Board of Heal DATE................................................................................. FORM 1255 HOBBS & WARREN. INC., PUBLISHERS >.t .. I ..x•-E- .".M11 C>NI, F'LC vv 6-F'•ta. USi<.` lOC7C� t„OC j I C> +Tv t T30T-MAA atzt<A =--4> sr-. ?G 95 To-r,&L -c;,rSkGtJ = d25 G.Pn. �5 fit` re tart } c•T�L ".:,bt L>t' F't,.n�,u = 33L� S.F'D. � i'� � io � � it f-ICU NT1CIQ 04TE C11..1 2-mi ' oiz , TEW YUU s 100.b IWV. T-A 14 K loo0 95� P,T ; WASHED . j Cr--QTIPiF--D PLC>-r -- t_O C A T 10> -1 T VI L.L. , Z _ LG-'r3 �1C7 SGA.I.t raGA[-k-; t C M tZ`r 1 F--1 T t4 A T T i-3 G- -DLU e:t r lJL S t-1 ►.t --��kr1 rL i i- i t!is C wkYt-1 "IIAG -kVEt lI-IE. LoT a LT1 ACt� Y'Gf4UtQGA.A&.k-AT•, CUF=" THE 1 kl1`:= t�(,A1•-t t�; E-1C�T t_".lQ` ( � C)1" t t��J 0 TEV-Vll_t.ir `r116LJLID �{?r�t .l C:� � C= k-0r t C'afs won, e" %j• t--O