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Home My WebLink About0042 POND STREET - Health m1wo Pond 6h Fsm:........ s.:.......... THE_COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH-: `f'.ULti/ ............OF.... ABLE................................ Appliration for Disposal Works Tonstrnrtion firrmit Application is hereby made for a Permit to Construct ¢() or Repair ( ) an Individual Sewage Disposal System at: •............ S-•T ------------------------- .....................01......I..........................................-............ Location-Address or Lot No. CAS`SP—Su .4�L: ................................................. Owner Address j ....._..... -- ......•. -----------•--- Installer Address d Type of Building Size LoA.5t.7731...Sq. feet Dwelling—No. of Bedrooms........... .Expansion Attic ( ) Garbage Grinder (V '4 Other—Type of Building No. of persons............................ Showers — Cafeteria ° a' Other fixtures ---------------------------------- W Design Flow-_-....:.:.17•1.......................gallons per person per d��. Total d�ailiY flpw.....�.3-b-........................gallonsir WSeptic Tank—Liquid capacity�.0.0gallons Length-&-n.(c?... Width4:.....10 Diameter................ e x Disposal Trench—No.................... Width-_.�_.._...__.__._ Total Length.................. Total leaching area. .3.....sq. ft. Seepage Pit No......t............. Diameter...14...'..__._. Depth below inlet.M.tl........ Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( p d `" Percolation Test Results Performed by$r�1kT�.ni,6F. R_e_r��tti'�/! 1 ate... - !..1/Q ....... �a Test Pit No. 1................minutes per inch Depth of•Test Pit... -- ._....--._ Depth to ground water_J.0N1E--. r 04 Test Pit No. 2-----Z......minutes per inch Depth of Test Pit...VIL!....... Depth to rounfl water.-I-40ME----. x -rv-1-----.d �3. maps. 14..;�_.. .�t.��c��.Lt_T .. . CoAr�S ....--o O Description of Soils ��.?� .1!n �_'t...--•--. 'Z ... Qps- -43�t' i �.?_�tQ_�� r.......rJ........ 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 TI'i M 5 of the State Sanitary Coe- o — The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been sued by th oar f h lth. w Signed -' Date Application Approved By.............. •--- . ... ----• ............................. Date Application Disapproved for the following a ons:.•------------------•-----------•-•----••----•----------------------------------•--------------•-----••••...._ ------------------------•------------------------•----------------------...--------------...-----------•............----------------------------...-------------•--------------•-•-------------•-•-...._ Date PermitNo.------.. ....................... Issued.......................................... Date ]�� No..3.?.:.7C2 Fps.......f:. ...-..._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .C31 .N............OF.....6 AS145 1ZL..f................................ ApplirFation for Disposal Works Tonstrurtion frrmit Application is hereby made for a Permit to Construct K) or Repair ( ) an Individual Sewage Disposal System at: Location-Address or Lot No. • CSS V 1ar -�,- .......... -------•--------•---....... W , Owner Address a ...................a' .t.........1. .di:'_'.crc... ......................... Installer Address d Type of Building Size Lot4_5.1.3.S__.Sq. feet U Dwelling—No. of Bedrooms........... .............................Expansion Attic ( ) Garbage Grinder ( Other—T e of Building No. of persons............................ Showers — Cafeteria aOther fixtures ----------------•---•--...-------------------_._ ........-----•---•---------------•-•--------------•-----....-----.........................._-------- W Design Flow............�..�5.........................gallons per person per day. Total daily flow...... .3.C1.........................gallons. � WSeptic Tank—Liquid'capacityl.o.abgallons Length.8...'6._. Width`-..—.10-. Diameter................ Depth.s...'.`f�.. x Disposal Trench—No..................... Width....a.............. Total Length.................... Total leaching area.4.0_3-----sq. ft. Seepage Pit No......I.............. Diameter...1A_.......... Depth below inlet._-,?`-_.1....... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.BAK. QVZate...1. as Test Pit No. I................minutes per inch Depth of Test Pit.... =......... Depth to ground water.KJ.0)4.1E,__. T4 Test Pit No. 2.....—__minutes per inch Depth of Test Pit--- ......._. Depth to round water.1QUMZ____. -T'p� o' .r "Ps1]C3 2► .f.'.:-.1 ......C�C?_A�. r_...T_D -. -•--- -r4 61 L ► .. - - �; D Description of S i1,.M )- �, -. 2' -..T Q ✓ �' ; �Jl.�_13��Q-I-1'-� Z....... ........ S 1..1�/......................................... >pS L. c ....M I b!-l.�Wl-..S .hl t`J...:........... 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 TITLE 5 of the State Sanitary Co —The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been sued by th boa of h lth. j Signed _ / ........ �. Date ApplicationApproved BY ............... .............................. ........................................ Date Application Disapproved for the follow%n re ons________________________________________________________ ................................ .__..._.__._ ------------------------••--•----•-----......---•------........----...........--------........-----...---'-----•----•----•---•---....---------------------------••----.....---------.................... Date Permit No------- = !� 2 Issued---------------------------- ---------------•-----------•--- ----------•---------------- Date i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................OF.......r` x:.--: .>:c...................................... (Inrfifiratr of TonapliFanrr THIS ITO CERTIFY, hat the Individual Sewage Disposal System constructed ) or Repaired ( ) �-e ice, �,:. by T• ,.., = ---•-------------•----------••---------_------ 9 , Installer (......... ...------------------------•--•-------•----------••---•--•.......------------....................------.... has been installed in accordance with the provisions of TIXIE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No...2.7.....7 ............. dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...................�...-- / '... .1.......................... Inspector............ .................................................. THE COMMONWEALTH OF MASSACHUSETT'S BOARD OF HEALTH �GU..•Z.�. .OF........1�!7 - Qsv:�wC. No............... // ' V a` FEE. .. Disposal Yorks Tonstrurtion pr mit Permission is hereby granted........... -- __... '`-... to Construct or Repair-( an In dual Sewage DispoW System atNo.. ../.:...................••-...--.••....-----••--••-•-•----•------••--....---...-----•-----•-•-•--------........................ Street 7' / as shown on the application for Disposal Works Construction rmit No7..:_._e. ...... DNealt __..1 ....... ; ard of DATE FORM 1255 HOBBS & WARREN, INC., PUBLISHERS ON D C•ti _ _ ,( G E PF RMIT . YNSTA LL R's*NAM DDRESS UILVE OR 1)rlH,iR DATE PERMIT ISSUED ��/� 0ATE C 0 M F LIANCI ISSUED r a O 0 loco U&r1 'rAnrg 1001) Jb o p B R 8----� Ex\ST 1 NG N F uT7 - G�SSPcA.Ls NOTE too. cLEARING, rR) MM1UG , � �� OTHER �ISTURSAI.IC SHALL ocGutz w l-r�>>� ET d' -^ F. �� \ \ \ � W 1"1"HC7 UT P R 1a R AP P Ro1/,�•L ._ \ F horn TN k:_ T cawN v P { 3An�IJ��rA�L� 151�A�TIc�1 1 I � CIE.- IL C�MM1SS 1GS1�) c LAC P T \ n 1_OO FT STT5AC Y�P1pc \ FROM EDGY- _. ANKi �F �/F'TL.AiJU 1 \ \ \ IT 5EPTIG:TANK I J I.0 5 P\CRES �.V U� C4Z�O GAL nsw I;: / L'E.AC.1 5I fl1-WA L.. " GPU_:_.: T�`rA15 403 Sr 'T77 GPV p-:rah-_5-9-- J-ou/M. : T.. V,0mK11)11G Hkl,� L 4 �AGK>-tad : � -- - -row ��_..,� •�,� 4,. 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