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Home My WebLink About0131 OLDHAM ROAD - Health /3l 6�dh,�m boa �I S M EAR KEEPING YOU OROANIND No.10334 Z-153L MADE W USA GET ORGANIZED AT SMEAD.COM rv) N6.1 THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HE T i---------.of........ ��. ' �------------------ Appliration for 11ispno�al orkg Tonotrn.rtion ramit Application is hereby made for a Permit to Construct 44r0000r Repair ( ) an Individual Sewage Disposal Systgm a� -------- ......... . ............ ........ ........A ..... ................. ..... Loc Ad No, d @� �s r lP[7 ' l-.x ... ml� --s� °� -- 1�_.......� ner Address .Ea t &.....XV .........1 -�--,--.------•------------------------- ............��4 • . ...-••--• .... ...• . . .................. Installer Address U Type of Building Size Lot___/�_�_ t Dwelling—No. of Bedrooms.__...................................Expansion Attic ( ) Garbage Grinder A-) Other—Type of Building ............................ No. of persons............................ Showers ( ) Cafeteria ( ) 114 Other fixtures ------ ----------------------------------------------------------••----- ------------•----------•-----•------------.--------.---- WW Design Flow............4tv,:_..................gallons per person per day. Total daily flow---------_...........-. ................gallons. k� Septic 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..®._Z..sq. ft. z Other Distribution box ( ) Dosing tanl ( .,a) 7` 79� a , Percolation Test Results Performed by...--.. j,�y�._/l .�c____:: r_ �........ Date._._.. .- -� �•.......... Test Pit No. l................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........................ r O Description of Soil------------Q.-. .. ....... �.. -----a-=...- � --- - - ---- x 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 iIT1Z 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beipi issued by th r of lie It . Sign `_'..'........... ................................ F _ Date Application Approved By........ ,� -ll �j•--•--. Date Application Disapproved for the following reasons:................................................................................................................ .........................---•--------------•------••--•---------•--•--•---------•-•-------•-------.---- Date PermitNo.......................................................- Issued....................................................... Date 4-T Fi@B................... THE COMMONWEALTH OF MASSACHUSETTS BOARD F HE LTTi/ 1, 0 F........ ......................... .......... wv*.......... A- Appliration for Dhipatial Works (foustrurtiott ramit Application is hereby made for Permit to Construct 4�<or Repair ( ) an Individual Sewage Disposal Sysa � 90* y........................ .. .......d^... . ....... ..................6.A...........VK.... . -- ----------- ------ hoc Add 0. . ......... ...... . ........ ........... :.rZ n Address........oft" " #40, .......... ...................... .. ............ ............................................................. .. .......... ...ft. Installer Address Type of Building Size Lot... 'fr- t U9 Dwelling—No. of Bedrooms...........�h______________________________Expansion Attic Garbage Grinder Other—Type of, Building ............................ No. of persons............................ Showers Cafeteria 04 Other*fixtures -------------------------........................................................................................................................... <4 Flow, 021. X d . besign ........!V6......... gallons per person per day. Total daily flow............................................gallons. ------------ Tank 1 04 Septic Liquid capacity-/A.Wigallons Length________________ Width________________ Diameter__-_..___,_.___. Depth................ Width .......... Total Length.... Total leaching area....................sq. f t. Disposal Trench—N - --------- -------- Seepage Pit No______Z----------... Diameter..._.__.____.__..._. Depth below inlet___..._...._.._..._. Total leaching area.._ — ft. Z Other Distribution box Dosing Percolation Test Results Performed by tan1j .......6j�.Test Pit No. I................minutes per inch D)ep�tgh--- �.(ON)A4......... Date�................. �4 • ............ �4 o Test Pit____.________.__.___ Depth to ground water_:_____-_______________- �-4 44 Test Pit No. 2................minutes per inch Depth off,Test. Pit__._._._.._________. Depth to ground water____._._.__._______.__.. A ............. . ...... . P4 ..... ------ ....... -------------- 0 Description of Soil.............40----- ..... ............... ..... . ....% .. . ................................... U ...............................I..................................................................................................................................................................... ......................................................... .............................................................................................................................................. U Nature of Repairs or Alterations—Answer when applicable.,---,,,,------------------------------------------------------------------------------------------ ......................................................................................................:-------------------- ........................................................................... Agreement: The undersigned agrees to install the aforedescribed Individua'l Sewage Disposal System in accordance with the provisions of TLITI-E 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b issuh by thj?c2W of heajtV Sign . ...... . . .. .. ..... ............ ............................... Date Application Approved By----------- ... ........ --------------------- Date Application Disap,�rDyed for the following reasons..---;'......................................................................................................... ....................................................................................................................................................................................................... Date PermitNo.......................................................... Issued.---....._......._,_ ..---•---••----... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALT , ..........................................OF.... .... .. ...... .............................................................. (ffrrtifiratr of Toutpliattir T S &ERTL at th vd I Sewage Disposal,,-System const uctedJ�07-) or Repaired by......: ... . .... .... ........... .... ....................... ........... ...... ....... .......0... .............. ............ at-- I. ........X..... . ............. ............ ---- - ------------- .. .... ............ ............................... ............................... has been installed in accordance with the provisions of T 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No. f1f................ dated- /,W/.'-7f............... THE ISSUANCE OF THIS CERTIFICATE SHA �NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................ Inspi6ctor... ..............a............................................................................................................. ---------- ,,THE COMMONWEALTH OF MASSACHUSETTS BOARD O-rn,,HEALTH H ............ ....OF....... ...:. ........ ... .......... No........_...-........... FEE.........._ 0 HEALTH _ .......... ........... Khiiposal er( ;nt 0 .en -:�iduaLIS( ereby granted..... ... ........................ ... ....... ... .. .... .......................................................Permissio missio t Construe I o it -'vidual Sewa rut o onst4 r n atNo.-. . ... .. .............. .... . ............. ..................................... Street as sho h'on the application for,Disposal Works Construction r t No. Dated.......................................... ...... . .... . .. ......... ........ . . .... .... ..... ........................ Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS �-/- V4 ZIL�pL/� LOCATION SEWAGE PERMIT NO. 131 VILLAGE e::�' s 7157e)116e 15 W1 I N S T A LLER'S NAME & ADDRESS BUILDER OR OWNER 10,0—C,A1�iS OPOQ l �y� I>ol/?cam /PO DATE PERMIT ISSUED S 1E,,_ �9 DATE COMPLIANCE ISSUED �_ � �_ 7 � Alm ��F y � � 2 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) m A 7-\c(' 7 L DATA Tfi f3 `yr3� • t e �cx�w,at� A�:�-A• .. t �,.�. AA AMA= S �'• tom' t i Ij TaT"at. -C>G-Sl(Svll= d'L5 �•i?v. '}�• ta`r��{. • '� 1�F'''jf . C VC GLT1[-,U tZhTE ( tc.1 ZEE t ij OE LL.% . qq .. kA t G4-P3 W. tOG�p t�f,G`� t.atV. tti,tyi•S��' � t�sJ� ,'3-. .. FIT � trC!iT�i „•t Ap 14 `vi! 1 if !, � � �/�'�" `t'Jai^�'Ybl'�."�.�"-�-a,,.t�f,`i!•.��r,�1 --"-".."'�.' (3 44%.1 (�C>i.J tA1•50 �. _1• -•.::,�tiL�tJ"' fit.3;-•!L'`t' 7 t;#C.-: 4tt:t»;,?':.f•i ttic.Y:..�ln +�tJ'tjl. t :�'��--�.'~..: '��t��t:t'