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Home My WebLink About0516 MAIN STREET (OST.) - Health _MAIN STKI� — _ OSTERVILLE A = 141 085 a____x' Y ' LOCATION SEWAGE PERMIT NO. n?lj 012 VILLAGE I N S T A LLER'S NAME A00RfSS ILOEIt 0 OWNER lay DATE PERMIT ISSUED —l .. � DATE C 0 M P L I A N C E ISSUED A4i A 917 7 r , ,THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALT - J -------------C V VeO......OF...... �Y ApplirFa#ion for Ui"as al Work.5 Towitrurtinn Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ()--)-an Individual Sewage Disposal Syst_ "------------------- ------------------------------------ ......------------.................... I, do -Address r Lot No. ........ __._.,1� .1� x.. ..----_------------------ ----------a /�'�'}'�1.1�.r........--------------••-------------...........--- O ner dress tp Qff Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) �`4 Other—Type T e of Building No. of persons............................ Showers YP g ---------------•------------ P ( ) — Cafeteria ( ) Otherfixtures . •------•---•--•--------------------"--------------"------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic 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........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ODescription of Soil---------"-------------� (1'-_ � �1__ =...................................................- ....... x .......---------------------------"----"-------•---------------------------.....------•-------------------------J--••.. ) - -------------•••-••---------••- U Natt.re of Repairs or Alterations—Answer when applicable------l-_,/vt90_ ---- /---------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIS 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issued by the bpa f health. igned_ :. . . F...... ��. " .-- � - - Da Application Approved By. •... ... . •-•••-•-•••........•••-•••••-•••----•-•-•-•..........-••-••....... C; �I Date Application Disapproved for a following reasons:......................-................................. ................................................. ---------------------•-----•-----•----------•---...-----------•-----------•-----------.......------......--------------•--------•--------------------------------"--------------------------------•----- Date PermitNo......................................................... Issued_ ,........................ Date THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) \1 rA\G(�� I DATA ti re No..-,l.� '�� Fss...'... ..'.. :.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH G t , Appliration for Dispoout Works Tonstrurtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ()—)--.an Individual Sewage Disposal System at: Location-Address. / _ or Lot No. Owner) / ! Address Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ...................................................... w Design Flew............................................gallons per person per day. Total daily flow............................................gallons. WSeptic 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 Dist-ibution box ( ) Dosing tank ( ) '-, Percolatior Test Results Performed by.......................................................................... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (T., Test Pit No.,2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ----•---•--------------------------- --••-----•------------•---•-- -----•---•---.--.............................................................. O Description of Soil................................/ c i I ).f/ J e, i __- .. ..............•------------------. ----------------•---------------------------•-------...........----- x W ---•-•------------- ------------------------•--•--------------•••••-•-••---•--••-•--••••--•-------••-. ----•--•--------------------••------------••---•-•-;••--•••------•---•-•-•-------•--------------- UNature of Repairs or Alterations—Answer when applicable______-:--_.:________ _______'�-- rr ----•-•-- ------•--•--••- = =-----------------------------------------------------------------• Agreement. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT11 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.boarrd;/of health. ilg_.n/ e_d� e' .....:_APPlication Approved By... !�af•' ... D followinApplication Disapproved or reasons-.............................................................................................................. ....................----...-••-•----------------•---•------•-----------••-•--•-•-•-.........----------........._....................................................................................... _ Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...r.......`..... .r...........OF........�..... ..:.: ...................................................... wrtifiratr of'Tontpliatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( )• or Repaired -- by--- .....:.. •---�==�/(= =: ...... ...........................- f'=`. �. ( nstall�'- i at = ......................................•••--- :_... _.__. .. - ------------ has been installed in accordance with the provisions of TI T LE 5 of The State Sanitary Cod as escribedf in the application fa- Disposal Works Construction Permit No.__.9.3.--301/............... dated_..5� �4V---___.___................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE /CONSTED AS A GUARANTEE THAT THE SYSTEM I"F CTION SATISFACTORY. DATE. '- .-.. ....... -------•-----.-•--_. Inspector ... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......; ........ /1 No.. 3ge FEE.:..........................r..._.. ... Disposal lVarkii %Tontrnriion fautit . - Permission is hereby granted...........1 ..1.2 10. {. L1_1-�/r- `- ._.:_=................. =t .... < to Construct ( ) or Repair ('--)-an Individual Sewage Disposal System 1 at No !.�/✓l l l , . 1 ./r i.. ... ...... f.�. ..... J Street D rr as shown on the application for Disposal Works Construction Permit No................. _.____ ............................ .............................................. G 1..-------. ...-----...._ oard Health DATE................................................................................ FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS DATEKt . 7 L C: a ,, i'' 'a _ INSPECTOR'S ACTIONS/COMMENTS F r Ct¢ t e 1M a�� q;�-''tea. u•-. *w�-, ��,� -t:��r�;*e� :�, � � � r�:-. tn ,I � 1xt`�•b,y Sx :4`r.c i�i��. ,f 4 4 fir' t ti9''�+'.� £,$ .X� i"c�� ,ti2�C•. �U �: �., � •...».�s.�.:sa<aa�a...�M�','.„..'w��^�! 'E'�f p;.+u" ,L �y".�b�r ��rr Wa o F�* a� �a �r a �,�r� 'G y � �+e�I �x. ♦ •.I 1 qkD 0-9 �� o �� t� � c,,,��q �� / boo ��m o �- �� a she � �-�P_ �° ,--��,�� v � �� - a- Q,tirrc�r� ��ude 12 m e e �