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Home My WebLink About0120 OAKDALE PATH - Health )a� �.f�0.�, pie,, 6�-�-, d�a�� oZ��oo � s J M E A D KEEPING YOU ORGANIZED INo.10334 2-153L MADE IN USA GET ORGANIZED AT SMEAD-COM LOCATION SEWAGE PERMIT NO. L"dr i �� .� i �'y� -7 - VILLAGE IN TA LLER'S NAME i ADDRESS B U I L D E R OR OWNER � ee/C- DATE PERMIT ISSUEDsr�- � y DATE COMPLIANCE ISSUED L,qR" :e 1 No.11--.....7� •' FR$ ....................... THE COMMONWEALTH OF MASSACHUSETTS. BOARD OF HEALTH Gt oF.......P. .101M�1 `T' Cam-----------..._.__.....-- a Appliration for Uhipagal Workii Tomitrurtiou Vautit Application is hereby made for a Permit to Construct ( vl/or Repair ( ) an Individual Sewage Disposal System at: .................................: ®/�{ b...................... I` ...... ............-------•------.......--•-----�,la-I.......................................... -- Location-Address J' or t No. ------- ` ...................... ...............-----..._. .......................•---------------U w#er ------------------Address Installer Address Type of Building Size Lot_____4 1..�._'---Sq. feet Dwelling—No. of Bedrooms................... ............�... .._:..__..Expansion Attic ( ) Garbage Grinder ( ) a Other—T e yp of Buildin g�.._ GAV5 l�A No. of persons............................ Showers ( ) — Cafeteria ( )Q' Other fixtures ....... ............... _.. d ; ....................... W Design Flow...........................:............:..gallons per person per day. Total daily flow_ .__...�t...............................gallons. WSeptic Tank—Liquid capacity_ -.gallons Length................ Width__.._........... Diameter________-____._. Depth................ xDisposal Trench: No..................... Width.................... Total Length...-._...............(Total.leaching area--_-. ------------sq. ft. Seepage Pit No------------i....... Diameter........... Depth below inlet......?......... Total leaching area.gP.Q....sq. ft. Z Other Distribution box ( ✓S Dosing tank a" Percolation Test Results Performed by-------------------- 4 _--------------•----------•-•••••......•--............. Date........................................ Test Pit No. 1................mmutes 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------------------------ R+ ----------------------------------------------------------------•-----..........---•-----........_...............-•-------•••--------...........-----.--•-- 0 Description of Soil..............................................................a......................................................................................-•••-•-----•••--- x W •-•--•---------------------------••--•--•--•-------•----------------•------------------•-•------....-----------------•--------------•--------------•--•-•••-•-•----•---•-------•--•-----•.....---------- VNature of Repairs or Alterations—Answer when applicable.................t...__.___...._._........_......_..___._..............................._...__. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iI'LU 5 of the State Sanitary Code—The undersi ned further rees not to place the system in operation u '1 a Certificate of Compliance has be issued b t healt B � ,. .- Signe ..__... .---------• ... _ . . . .•................ ................................ Date Apprtion Approved By.............-...................... ...................................................... Date Application Disapproved for the following redsons------------------------------------------------------------------------........................................ ..............•-•--....------•-•••----•.......-•••--•---••-•••----•-•-•-•--•--••---..........----•---•--_.. Date PermitNo......................................................... Issued....................................................... Date L 77 No..A............-....... Fizs.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �.- ...............OF....... Appliration for Biiiposal Works Tonstrurtion 1hrmit Application is hereby made for a Permit to Construct ( 114 or Repair ( ) an Individual Sewage Disposal System at I�(L��.. l Location Address w er ...................Address Installer Address Type of Building Size Lot.... ... ...Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Buildin �✓-. _ a Other—Type :_..._____�1�___�:. No. of persons____________________________ Showers ( ) — Cafeteria ( ) 04 Other fixtures ----------------•--------------•----------------•-----.•-------•-----------------------•-- ........................................................... Design Flow............................... _ ______gallons per person per day. Total daily flow............................................gallons. W Septic Tank—Liquid*capacity ____ t ___gallons Length................ Width................ Diameter---------------- Depth................ Disposal Trench—No� ____________ Width_._. _______..__.__ Total Length.................... Total leaching area___y .............sq. ft. Seepage Pit No...................... Diameter.......... ___.___ Depth below inlet:___.______......... Total leaching area._..._._,_P:....sq. ft. Z Other Distribution box ( 0_11) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ W Test Pit',,No. 1.........._-----mmutes per inch Depth of Test Pit.................... Depth to ground water........................ (s, Test Pit No: 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ --------------------------------------•-------_-__-------•-----------------------------•-•----------------........ -------------•------------------- 0 Description of Soil.............................................................................................................................................................. W :: U ---••--•----------------•-•-----.-..--•--•----------•-•--------•--.........-•------...----••-•------....------------•--------------••----------...-----------..._._._.....----------•-...---._..._..---- W -----------------------------------------------•-•-----------------•------------------•-•---------------------------_..-------------------------------------------••---------------------•-----•------- Z. 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 o eration uXil a Certificate of Compliance has been issued by the board of health. Signed Date Applk4tionApproved By.................................................................................................. Date Application Disapproved for the following reasons----------------•------------------------------------•---------....-------------•------------------._...---...--- -------------------------••--•-----------••-•---....---------......_....-•-------.....---...--•---------. ------------•-•--- Date PermitNo.......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS �-�- BOARD OF HEALTH . 1.5. ..............OF.... .............................. Tntifiratr of Toutpliatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by-•-....-•.................... •�'.--•-•-- ---------...----------------- ------. Installer at.............. ..............-0A K.b4 L_e---•-- -----��a.PLC------•---------- O.'r/-----------...---- has been installed in accordance with the provisions of TITLY, 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..... `.__� _. ............ dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. � DATE..................................................... -:Z�__: L_.. Inspector....................��.: '� THE COMMONWEALTH OF MASSACHUSETTS ^c BOAR OF HEALTH c ............. No.. ............ FEE...... .................. Utupsal Vorkii Towitr ion rrutit Permission is hereby granted............ =---R......&'O !A?----•------------•---•-------------•------------------....------....._._.__......___.. to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at No........ Q? 1... .......... /Q .................... a, ............................................................ Street as shown on the application for Disposal Works Construction Permit No................... Dated.......................................... /� � Board of Health DATE-----•-'•-• ------•--------/-, = ---------------------------•-- FORM 1255 A. M. SULKIN, INC., BOSTON -+ 6Al2.A4wE -ro t4 A (?aodi( AU7 aU6 �Anl nyivb ( GhL S 'tG 't-AQtc.'bl-TM E U noa T3o� A40 dF d FT Ate/Ls WATT T.A WLa• f p`C �xP io' PST P�oA 10, Ll 51 Ss � J 22'1 .4. n i 4 •l1`, .w cE,e T��'iEo SLOT o�A�v pool-oSc�u LOCAT/O.t/ 7;L/A7' TA4/� C „SNOWit/yE,2EO.v COM,oG yS k//�h' SCA L / 50 0�4 TE t �►-,c/E .S/OE�C 1,41E AA/,5;'SETB/a Cl--' ,2E4!/�,2EMEA/lS of TA/E �►-ow�t/aF A 2A1'557-,q Lc. ,4Ovo /s Nor LvT 4 0CA T;'L=> /, 17,411-V T//E &4 X OA TE- Q `�1�� .�� :L� G'i /,_,-,l-`��•_. , T,E,26 Al/ /,/C i TAIIS P.C.4.v/S ,t/oT BASSO D.c/ A.,V .eEG/STE•�?EO, ZAA/o SU.eY6Yb� /,�sT,evME Sv,2✓EY€ �"y� c�srE,eYi,<.,Z.� i O�.rv�E'7-S S.yo�/�✓Ss,�ovt� .t/oT BZ APi�I./CST �..1A M�S A I�✓'°�,/ �� ! t � CUT 2 OF I�. �Of f 3 i \ �O 20.11 V TIDIJS � 767- A.e. F,-�rz- d — lNy. iuv• 16,Z i� looc� iuv— laao 'p TANS --� i ST0,jg ,j, LOCATION SEWAGE PERMIT NO• VILLAGE bog I N S T A LLERIS NAME i ADDRESS BUILDER OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED /� �j v�-c,� �o-F' ffc�u Se ��+ � . �' THE COMMONWEALTH.OF MASSACHUSETTS BOAR® OF HEALTH ...........................................OF.......................................................................................... Y Appliration for Disposal Works Tonstur#inn ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...lip.... ......Qcm...........1 vs.;. -t� -------------------------- ---- -------------•-------•--------•----•-•.....--- •- Location-Ad Tess or Lot No. tim.................................: .....................`... . � ,��./-.� � •..'tess ' - '_YZ ......... M Installer Address Q]i Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures .. = _... ...----.--------------------------- 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...........•............................ a ,.� Test Pit No. l................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........................ Q+' ------•-•---------•-•••.....---•------•---•-••-------•••...........................••-••--••-...._...........--------...----------•----•••......•-•••-..•••-- 0 Description of Soil......................................................................................................................................................................... x U •-•-----------•--•-•----•...............••............-•-•---------------•----------..........--•-•----------------------------------------------••-•••---•--------•---•••-•---------------•---•-------- x --•-----------------•...................----•-•-----------.--•----•------•------------------------------------------•----------------...---••---••-------•---------------•-------------------•-•------ U Nature of Repairs or Alterations—Answer when applicable......, ----� (....V ......1,9v-o. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TL1 12 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b ued by the board of health. Signed........... ................................ ............... ------•---•- •--------------*'*'* Application Approved BY ........ ,... ......= � ` ✓------••._.... .............. Date Application Disapproved for the following reasons:.......................................t......................................................................... --•-•-•----.....-•--•--•--•---------------------•-----------------------------•--.....-•---•---------•--.•----•-•--•----•---•-••----•-•------•-------------------------•--•••••---------•---•••--------- Date PermitNo......................................................... Issued....................................................... Date No( ... Fx$.....-� . .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................... ....................O F...........------------------..........------------------.............--•......._........ ApphrFation for Dispati al Works Touts rnrtiun. rami# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at ................ ..... ...... . ........... .. :r.. ----------------------------------- -----•-------.._......._............-------- Location- ess � w or Lot No. ................ ...... ... ... -•------•----•----- -«----^------------.----•--- --------•-------------------- --.--..--.--- a�w•3!r._ C_5!"r ' f •Rc�J`'" cress ". L'x ..._..._. ............................. ....... -•-•-•.......................... ....:e" Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................... . .....Expansion Attic ( ) Garbage Grinder ( ) `k Other—T e of Building No. of persons............................ Showers — Cafeteria aOther fixtures ------------------------•-••••--••-•--•-•-.... 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. 3 Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water•-___._____-_--_---_---. G Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R+' •---.......-••-••......-•------•-••••-•-•-•------•-•••••-•--•--......---••-••---•---._....---•--• ......................................................... 0 Description of Soil...........................................................•---------------.....------------------------------------••--•--------------•----..._...---•-------------•••- x w ....-••-••-•......•-----•------•--------•--•---.....•---••-•-••••-••-••••••••....•••-•--•-•--•-----•------------•••--•---•--••••-------•--•-•-•--••-•------•-••-••••-••••......................•------- 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 TIT12 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b en ' ued y the bAar c health. Signed -•--•-• ••.. Date Application Approved By......... ......_ � S_ �. --------••--•............... Dlate Application Disapproved for the following reasons:.... --------------------•- ...........................................................-•••••-•••••-•--- ..............................•••-••--•••--••-••---•-••...............•------•••-----•--•••------••--••--•---._...••-•••-•-•••-••--•:•••---•••--••---------------•----••......-•----------•-•••-....... Date PermitNo...............................................---------- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS _ - BOARD OF HEALTH Trdifiratr of Tnntplittnrr THIS TO RTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) / �. by . ......._••... ., ,... ............................... ---------..__....--•---••••---•-----•-•-•-•--••-•-••---•••--•--•••••-•---...._........••--•----------- `_ nstaller has been installed in accordance with the provisions of T rr f of The State SanitaryCode as described in the application for Disposal Works Construction Permit No..4'� '.... _T P............... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...........................................G1..r? fz Inspector........... .'THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �% 'z r® ..... ...................OF..... I..................................... m� Disvao tl Work" T11notrurtion ramit Permission is hereby granted.........Sn --- :f�'•_.___' `' y --- -- .-- -------•-.....--•••-•-•---•---...-•-•--•-••---•••••.................•....._•-••..........------ to Construct ( ) or Repair ( a ividual Se'rage Disposal System Y _.......... Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... k-------------------------- •------------------- DATE ealth FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS