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Home My WebLink About0126 OLDHAM ROAD - Health 126 OI.DHAlVI ROAD Ostervi,J: e ' A =,120 - 119 7 i LOCATION SEWAGE PERMIT NO. ,ZL,4 0e-o 14,f loo �S� VILLAGE INSTA LLER'S NAME & ADDRESS All A /-7/o CsN P S ,5-? -Za,4,e5 ��y i��r� B U IL D E R OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED 34 y7 �� ................. No �.. THE COMMONWEALTH OF MASSACHUSETTS --�� BOA R HEALTH .. .--..---.....OF........ ..Nr.N.S- .kb...-6.................................. Appliration for Uiiliuoal Workii Tomitrnrtion Permit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: SS 0 (t O 3 L cation t ress No. °r a��u►1h! �! _.. S b' � .......-- jam ....... -- ------ Owner dress �.------------------------------------------------ ---------W- .---- Ar--K0.14. v ........................................... Installer Address rr dType of Building Size Lot..1�r__ -------Sq. feet U Dwelling—No. of Bedrooms.................._._..........._.._..Expansion Attic ( ) Garbage Grinder ( ) 44 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures -----••---------------•-------•--- W Design Flow.............ST7_..................gallons per person E cjay/ Total d 1`y fl9, ____._....._�_3�..................gallo s. WSeptic Tank—Liquid capacity]000gallons Length___ ..._....... Width.. Diameter________________ Depth...S.. ... x Disposal Trench—No. .................... Width- ._._._._..__ Total Length........jj.__.__.__ Total leaching area....................sq. ft. Seepage Pit No-------.�............ Diameter-------Q-........ Depth below inlet.....16.___.___... Total leaching area.... Q0-sq ft. Z Other Distribution box ( ) Dos t nk '—' Percolation Test Results Performed by k _f' .._ .4 4 (..0�-_ mate...... . �Q__. � ..... � a Test Pit No. 1......� __minutes per inch Depth of Test Pit.....I.!._-.._.. Depth to ground water......................... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ O Description of Soil---------------E •�- -1N----•----+?- - x ---••-----------••..........................•--..._..------••--------------------•-------•-----••--•-----------------•---------•----•---•-•-------•----------------•------------------------•---------- W -------•-----------------------------------•--•--•----......----- ----------------------•----...--.----------------------.......------.------------------------------------------------------------- Answer when applicable............................................................................................... U Nature of Repairs or Alterations'-- -------------•--••-•--•---..................................................-••--•--...............--------------••-----------•-------••---•------•••----•--------------•---•-......._............:.__. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iIT1:;. 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 health. ned .....--•--•-•------------------------------------------------------------- --- ................................ Date ' .ems Application Approved By /..--••• � �---------------------------- ----- --- ate Date Application Disapproved for the following reasons:.................. ...................... --------------------•---.....---------•-...-------------------•----------------------.......----•....•---......-----•--•---......-•-------------------•-•-••-----•----................................ rl� Date PermitNo.........................................................' Issued....................................................... Date �I THE COMMONWEALTH OF MASSACHUSETTS / F HEALTH ...: .' OF....... ... .....*'. r....... Appliration for Uhipoii al Works Coat uurtuan Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at* Oil �1.cea,&F fof cation ddress KIN ......r....... ................. ................... .....•__....... .....__... __......____ .....0�.. .........__.... .. ....... ......_ a . t . Owner Address ..-•----....,.,.�....-----^---------------•----•-• .................. -•--•--•-•---._..._........---._..__....--•--•-----....... ........--•----•--.......--•----------.. Installer ro' Address dType of Building Size Lot.............:.............Sq. feet V Dwelling—No. of Bedrooms________________.......................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of ersons_____________ ___________ Showers — Cafeteria t�l YP g ----------------••-------- P ( ) ( ) Other fixtures .. - ---- W Design, Flow....____...` -....._. _____gallons per person e & Total I� pyv _------- -' -------_---•--- al S. W Septic Tank—Liquid rapacity 000gallons Length___ ___________ Width_._ ..._._.._.. Diameter---------------- Depth___ ...._95 _.._.. x Disposal Trench—No_____________________ Width____�__.____._.___Total Length....... __r______ Total leaching area---_.._.._._..__._.sq. ft. Seepage Pit No.......I............ Diameter.__..._.__.... Depth below inlet.................... Total leaching area.... ..sq. ft. Other bution box Z PercolationrlTest Results ) Performed Dos g �% - Tbu by.�••••-- ------ - �----___� Date_.....,�__.�`� a Test Pit No. I......#2v._._minutes per inch Depth of Test Pit.....l.+k......... Depth to ground water________________________ G4 Test Pit No. 2................minutes per inch Depth of Test Pit___________________. Depth to ground water.*...................... Description of Soil x'1G ---� ----••---_:_:�34----------------------------:----------------•---------•-------------•-------------.- ----------------------------------------------------------------------- x g U .................................................... i 'k 9y - * P ._.....__ _____.__________.._______. y s N "x'Si YY K� U `Nature of Repairs or Alterations—.Answer when applicable......................................................._ .. ..._...._..._.............. Agreement: The undersigned agrees to install the afor.edescribed Individual Sewage Disposal System in accordance with the provisions of T IT I.;=. .,5 bf the State Sanitary Code— The undersigned further agrees not to place the system in operation until a-Certificate ofCompliance has been issued by the board of,health. igned ---t... .......•................. .................................. Date 7-6 Application Approved By..... # Date Application Disapproved for the following reasons:------•----------------•-------------------------------------------------------------------------•-••-••--_..... --••----------•-----.....-•------•-•------------------------------------------------•-•..._..•---------_...-----•-------••-------------------------•--------------•------•--------------------------_--- Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS `BQA, RD , HEALTH .......................................OF... ................ 5/ ,-.............................••--•- Trr#ifiratr of ToutpliFattrr TH IS T ERTI , Th 7the Individual Sewage Disposal System constructed (� ) r Repaired ( ) by..... ...... ..... .... ................................. ----- .t�---------. .. .. P r nstaller has been installed in ac9rdance with the provisions of � -5 o T, e State:Sanitary C e as descr•b in the application for Disposal Works Construction Permit N .. .. ......... dated _... ''.:li►�__....._� ._........ THE ISSUANCE OF THIS CERTIFICATE SHA OT' BE CONSTRUED AS A.GUARANTEE THAT THE SYSTEM WILL FUNCTION, SATISFACTORY. , P 2yIt DATE...............................................�......_...---------•--• ... Inspector... -- - -�-�--------•-------•----- - ----------------------.._....-- THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH a. _4 ...... ... ..OF....::.... � 1 P 4 No._....... �j. ... FEE .................. i��r�a at1 rk� ,n itr#Wn ramit Permission i by granted------1 -`--. +--- ... ....................... X.............................................. to Cons net ( �) gr Re ( ) an rid idual Sewa .e is o System, at No.V,.J144s Street u "9 e as shown on the application for Disposal Works Construction Permit NO..__�___.. _..._.. Dated---- `:-_r'-�.-/•� ........... 4od S ��/ C ------•-•-•-•----•••- .................................. Board of Health DATE--------•..............................•---..: FORM 1255 HOBBS & WARREN, INC., PUBLISHERS tit= Av Sl�..�Lb G•M�Ita�! d_y3 �1=DtZOQM "• • �• � � � Lao GA2'BAGc— Gtz!Qt r-1 too -C�O 2'�d.l�.\-( F't..Ch,c.� _ t i b � 3 z ��O G•P•17• • �EPr�tc 330.E 150 % - 4956.P0. , uS4F-- tOc>c::� 4SAL-. SPD�Ad. PIT v5E 1c>C>O Gam. .. S TEWALL Atzt~A = 150 S.P. -M, U4n--t-OKII 0 TOTAL "C"?e�tGt.l = 425 G.i?D. t To'�"A t_ �,cLi l._.`•( FC..O� _ •33O"6,P.v, tS � -� .'�° �' �-� 1 + LoA,vt . IPA w +G� � ;� , • Ste«L... 4. a►sr Z IZ �x %.4 Sepnc io• a" „ v ' # A`. IA '$TQu� 17t� ' [,bC.A T I P t-± 'ti/t fit~ GMrzTti=`•T Tr4A -r Tlat-- '`Ow t�J4, Stlowu r •--�-T--- nt.1 GC�trIPL�(5 W t 't-t 'j`tlt'i�G.c.t► LOT-- aura F.tT >n�t4 ` c—:QUIczEME--"T� _64� T14C � Lam t_•1 OT tit-4 1•`-W C7 S.TE '.V 11_tx ti I�rC/L Sri� u e,a-r"', 'ru. t r-f c z M t%.I LO'C" t_r i-.t:.,5 '_ �- �� frS Pt�," �t�.2�,�'1ed LOCATION SEW .3 040 q AGE PERMIT NO. VILLAGE S i/A5, I N S T A.LLER ADDRESS 'S NAME i I /-/o L/,. �5 B UI'LDER OR OWNER wPKFi/�/il oeT -tom I DATE PERMIT ISSUED DATE COMPLIANCE ISSUED /von �! -l000 i /3✓�Ll G .6,57 34 y� 30 �3 x i 1 f � � t