The URL can be used to link to this page

Home My WebLink About0055 OLDHAM ROAD - Health .35 Oldha.M RwaP QBwVill2. �- Iao -dog ---- S M E A® KEEPING YOU ORGANIZED eta,10334 2-153L MADE IN USA GET ORGANIZED AT SMEAD.COM No. f ,5 Fia... ................. THE COMMONWEALTH OF MASSACHUSETTS BOARYF HEALTH .:.-.. -..-.OF..................................q ......................---.......------------ Appliratinn -for 13iipuiittl Vorbi Tomarnrtinn Vrruiff Application is hereby'made for a Permit to Construct (-�r Repair ( } an Individual Sewage Disposal System at " _ 4 --✓•----------------- ------------------ L Add s r/ o A/Nl ®ry. [ /' `................................. . - ---- 4.......W.....*....A wne.lf.ClF�-�`-D........................ ...l..C._Y..... !U :�!. -- ...... 0.. l ............ .... - Installer Address d Type of Building Size Lot.../V -------Sq. feet V Dwelling—No. of Bedrooms-----------�-------------------------Expansion Attic ( ) Garbage Grinder ( ) P4 Other—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Q' 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.k��/o9®Y_#biameter.................... Depth below inlet-a .....n. Tgt l leaching area...__..___-_•.__sq. ft. Z Other Distribution box ( ) Dosing tank/ ;"C�' '-' Percolation Test Results Performed by...........1`-- '_ � •----------................... Date__ _ 1_!Q'7 al Test Pit No. 1----------------minutes per inch Depth of "Pest Pit-------------------- Depth to ground water...-__.______.___._--. - G%, Test Pit No. 2................minutes per inch Depth of Test Pit----._.............. Depth to ground water__._.__________.____---- Description of Soil-------------••-----=--• ---- ------------- x 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 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. v- P P 27 . Signed.... -Q......- r<«.J .. .. ..............a........ l f�� Date ........ Application Approved By---- `-1_�._... --------•------------------------------------------- -----------•-•--- --------- - 17F=--?--7--- U Date Application Disapproved for the following reasons----------------------------------------------------------------------------------------------------------------- Date Permit No......Idl-. Issued.....7.� -----9................................. Date No. Fs�..f....................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ", pphratiun -fur Rgpviittl lVarkii Tutuarurtiou Vrrmft Application. is hereby`made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at ............................... ------------------------------------------- --------------------------------- ------ --�=-ti/Nl. ...o....t- pur'_.... .v---------------------------------- ---'�-�:----`�:,--�=/-✓�-'j--/j�h�/-�--- �-�---Q /�/J�1i (1-�-j- W !.. C..caner._....••----'--•-----•-••----'•••-••------ --1*- -- •-• '-•- f�_=-•--!YGL.:.. 1 7../-P---'____�"✓,_ Installer Address d Type of Building Size Lot... 47/_da ________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 Flow------------/AP"�:Q...................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./:7_/M_#/Diameter.................... Depth below inlet_______ ____, Total leaching area------- ----------sq. ft. Z Other Distribution box ( ) Dosing tank ) f �-' TM_... ... Date.. A Ff.� Z'/g 77•. a Percolation Test Results Performed by___________ ____ --�'.�u�' a Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water/--_______-______-_-... rZ4 Test Pit No. 2........._.......minutes per inch Depth of Test"Pit____________________ _Depth to ground wateri-.__-_____-_;_-______- a 0 Description of Soil....................................................................................... ----------------------------------------------------------?------------------------ x V --=---------------------------------------------------•---------------------•------•-----•----------------------------------------_-__---_-_-•--------------------------•--------------------------- W x ------------------------------------- -----------------------=--------------------------------------------------------------- = 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 the board of health. .. Signed-- ------�� Date -r---•-- /t r Application Approved By:.... -' - •------- Application Disapproved for the following reasons______________________________________ _____ --________________----""•f•-- -� ---------- -----•---------------------------••••- - ---------------------•------------------ -------------------------------------------------------------------- -- Date Permit No....... .............................. Issued.'------....... �� • . Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �lerttftr�tr �f f�uut�li�nrr THIS IS TO CERTIFY, That the Individual Sew e Disposal S I c ructed ( ) or Repaired ( ) by .�L.r.r , - 1_ __ .f..- rl Gs -••••- ------------------------------------------------'•-••••-•--•'•••••- Installer at_--•---••-- ------------ --------------------------------------------------------------------------------------------------•---------•-•-••-•- .................................. has been installed in accordance with the provisions of Arttcle ) of The State Sanitary Cole scrii i in the .. :. Gam;'i - application for Disposal Works Coisti uction Perintt No.: .__•. -----••----•------ dated THE ISSUANCE OF THIS Ci TIFICATE SHALL. NOT BE CONSTR A ED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. — nspe cto mo ---- -- •...-•----•- DATE. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF -IFfEALTH - ..........................................OF..... ..-.. .... ......................... No...... FE2/j.�":el-6t--•-- �i��,��tl urk,� �unutr�trtiun rrutit Permission is hereby granted------- -. to Construct ( ) or Repair ( ) an In vidual Se ag 7Disposal System at No................•- ........... -�........ Awtzr s e;qq. . Ad as shown on the application for Disposal Works Construction,Permrt No.__-� _ ______ Dated___ _ 27..---------- -------------------------------- i:. /------- --------------------------- DATE �` � Boa'r,d o'f'`YPealYh .---.._...-• --T --•••-•--•-•-••••-'--•--•-•-•-- FORM 1255 HOBBS & WARREN. INC.. PUB'LIS.HERS'`N.,,4,.• �,•5.._�.iV " LOtCATION D � I � � t S E W A G I ,PERMIT NO. VILLAGE FNSTA LLER'S.- NAME & ADDRESS � r B U III)E R OR OW R yp s DA.T E PERMIT ISSUED DATE COMPLIANCE ISSUED P -_ � i � - �( 0 L Ol N ' --28 30 0uI"av a,Ttc)N 33 c r1 },ocroGA%, 5epr,c aria TANit oao l�A PIT 3 � or �h o Nu I-_ -is•r�� CEtZT1Fli=D pI.OT P�::�1.! su1N� LOCATIO" fJs-r E Rv\t~LE 1 CB4ZTIF-,{ T"AT' THE FOUNT)gTJON RlrP=RelIl1GE. W W F=-af�3 GONLPLYS WIT" T14G L O AWr-> SETV AC4 VCQUllZF-ME"TS OF TNT QST E. �/ 1 i_.l_� O U ' 'tO w U olr A Q N T A l.. DATE 41?- �/ � x�i 1+✓ REGIS�T'G7ZcD LAiJ� SU2.VcY��'•', TNIS 1?'L.AW t5 LIOT BASE'S Ott AN OSTEiZV%Ll.E o MASS. It.�st'Qe1,>HE�.1T SUZVEti( j TIaE= Sl4oWLD APPt_l CAt.IT /�P COI..LO CO tid S t- b gE USGo TO OETezmtQt: LoT LINES -