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Home My WebLink About0020 QUAIL ROAD - Health �o LOCATION SEWA PERMIT NO. a v tlA VILLAGE INSTALLER'S NAME i ADDRESS Av K,� ccw�&lus o /L/ - ' B U I L D E R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED � ,� �' � (' n � , Z1. � �� f �� o ,,; . ., i No.... ..... Fms....... ........ THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH �G1�. ...............OF.... fPt �- � Allp iraftaan for Uftipaa al Works Tonifrurfton Prratit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: ............... ?��a 6� � 6 . .. .................................................... ... .- - ..... - _••. ... .. Location-Address -- or Lot No. ...--••-•-•-....4�a.....�.: i �1' � •-----------------------•- Owner Address ._..... a :........ .. .:..:. .' ._A. k " /!Cd. d?1.af.0uj.................................................................................................. Installer Address U Type of Building Size Lot_ 4_"_1 1.....Sq. feet Dwelling—No. of Bedrooms................ ...................... Attic ( ) Garbage Grinder 'q Other—Type T e of Building No. of ersons____________________________ Showers Pa YP g ---------------•---•-------- P ( ) — Cafeteria Q' Other fixtures _______..� _ d W Design Flow_______________ _S�•. .��. az__gallons per person per day. Total daily flow____._._..____ gallons. - ------------------ WSeptic Tank—Liquid capacity/500_gallons Length-------_-----_ Width................ Diameter-------_........ Depth................ x Disposal Trench—No..................... Width_..__ .y........... Total Length.................4;... Total leaching area....................sq. ft. Seepage Pit No_________ _________ Diameter...... Depth below inlet___: 5-_____ Total leaching area____ V ...sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 1� ~ ____ i._____7 Q • 1.7.1 Percolation Test Results Performed by ( d �c:-�`��E� _. ."W. ___ .. Date___.____ . _" __.-_____.. Test Pit No. l___�._.minutes per inch Depth of Test Pit.......l-L...... Depth to ground water......' (i Test Pit No. 2______ __minutes per inch Depth of Test Pit........ Depth to ground water......._'___..____.. a .................................-..................................................................................................................... 0 Description of Soil.................. _.. -------•--.......... ^---------•----=------------------------^---------------------------••-•••--••---•----._...---..- A a0 kv% UW ------------------------------------•-----------------------------.-.----------------------------------------------------------...^-------------------------------...------------------._...._._._..--- 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 iITL 12 5 of the State Sanitary Code—,The undersigned further agrees not to place the system in operation until a Certificate of Compliance has ben issued by the board of health. B �_ p Signed.. 5. . `V...........----------••-- � �. , Date i Application Approved B ----------------------- ....... Date Application Disapproved for the following reasons-------------------------------------•••••••-••••-•-••-----------•-•-- ........................................ ...................................=.................................................................................................................................................................... Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS g ., BOARD OF HEALTH [" .1:'_..................OF.... ....-- Appliration for lliopooal Worko Tonotrurtion ramit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: , V. .. ✓ #_ Location-Address I . or Lot No. r"D• v t-€ 6" .8 lam . `... $....... ----•••-••---•-A--------------------•------•••- -•-------•--•--------------•---- ................ Owner Address W Installer Address Type of Building Size Lot. �_-___ .....Sq. feet U Dwelling—No. of Bedrooms.................. .....................Expansion Attic ( ) Garbage Grinder a'4 Other—T e of Building .... No. of persons............................ Showers Other—Type g ------------------------ P ( ) Cafeteria ( ) dOther fixtures ' -------------------------------•-------------------•--------------------•---------------- _--------_---------.. W Design Flow.................. ._:.. ._gallons per person per day. Total daily flow-___...._._._.-�`--_-�-�- 5..............__gallons. WSeptic Tank—Liquid capacity/ ?.gallons Length................ Width................ Diameter . Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. "` � Seepage Pit No_____________________ Diameter....._ :,.:___.__.Depth below inlet___•,�:_'�___._.__ Total leaching area...."'I�. .__sq. ft. Z Other Distribution box ( ) Dosing tank ( ) p ° '4 Percolation Test Results Performed b kow—.1_�l-o 7..--..: { -- t I� a y..-: Date P--- -----_.._. Test Pit No. 1....: �-_-minutes per inch Depth of Test Pit.......i ._.__ Depth to ground water........................ (i Test Pit No. 2......!I=..minutes per inch Depth of Test Pit........ _ ___ Depth to ground water........ ........... P4 -•--------••----------------•-------•----------.........----------••----•------•-••••••••-.....----......................................................... Descriptionof Soil _, ...--••-------••-•-----r -------•--------------------------------------•------------------------------------------•--•-_----- txj --------------------------------------r°Vie rJt-1r'$^�-a »r�rd1 --...... ----------------------••--- ------------------•-----------------------------------................................................ ..............--------------- ------------------------------------------------------------ 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 TITLE 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. Signed.... - (,A t f IQ ' Date ApplicationApproved ...........-------------------------------•---•---•------------------ ........... �• " Date Application Disapproved for the f ollowang reasons--------------------------------------------------------------------------------•------------------•---------.._ .................:.......................................--.............................................................................................................................................. t.h. Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS q BOARD OF HEALTH .. ..................OF....'.: GfrP, r ................................... Trrfifiratr of Tuntplionrr THIS IS 7 o CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by-------•-•-----••----- --� "• � -----�-*--...... J1E .....A 1"4-/0-r?_V...--•--••-•...............................•-----•---•----------- Installer at--------e--0-7----___1_4--------t (tv �c. ''-- 4#+-z....--- o"- h.------.a_-------------•-•-•-----...--------------------------•--.....----------------- has been installed in accordance with the provisions of _ TLE ` of The State Sanitary Code as described in the application for Disposal Works Construction Permit ............... dated................................................ -THE ISSUANCE OF THIS CERTIFICATE SHIA NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE... ... Inspector_.: .....,, ...._..--•--•--- a, }" THE COMMONWEALTH OF .MASSACHUSETTS BOARD OF HEALTH OF........ ................. No.. bb ..%� lCl 1 'a . r�-....G7.� FEE........................ Dispoottl Vorkii �ono#r ion anti Permission Is, , .,hereby granted . to Construct or}} Rej air ( ) an Individual Sewage Disposal System at No.. , j;y+/� 7`.d►�'. ^_-..:. �i�i d y -......---^..............••-• Stree ... !_ as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... �......................................... DATE.........=..........5 1 ............................ Bof Health �.. FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS Lot fro L,c C• Vo-nz 4 is • 3 `�►i 1.�M�=' �t�1 Tc . ` R •�(`i.5 Top1 , �► • -+-- -r '�"a�L, 'tom}. """�""`"�`-r-- '' . , 4' LOAA ' 'L. Git m � 'W vj*{ 7 f� ! ` i 3 '-� •� , �+'A s ,* c,Ac .ltt•� 4 ca' nmay. i9' ' WST .w• ,,,�, _ � .,� � ,�� . ... � \ as r •'�� i .. - -. 4e?�'T � � }� A , . '� �� rib• t�'Z _ T �_ 1' �+. 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