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Home My WebLink About0262 SCUDDER ROAD - Health �� a �� ; T ' III LGJAMV10N SEWAGE PERMIT NO. Vftl- AGE ®��. I I N S T A LLER S NAME A ADDRESS Ott A aJ iv Roo Cq k St w , aq rk/ B U I L D E R OR OWNER a DATE PERMIT ISSUED MPLIA I SUED DATE CO NC. E S � �� o r OWL C we $;-0 %3 ILA 0 ,ScM 40 p VC 4 �.. LCSJ�•=�: {p"� tit3.vf r -- �' •CCs33�+,^04 Pi•C nt�: _ _ - • x 6=0" ;•slaw �nla± �_� , .�-Gt�n�¢'y�rC tf x 6'o f.'e.tcw, Ins¢- _ �'-� 1- t .N i r # 77Zr I t /.� ? S � � YEB S THE COMMONWEALTH OF MASSACHUSETTS ' BOARD OF HEALTH .................... ..................OF..........................--...........--.------.......-•------........................... I� i� ;Si fir afion for Ramat Works Toustrurtivn thrmit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at16 S�G�Q�_� /� ///� ��/y/A� •••-----=--• ... ---•----- ---- -- ----•------------••--•-----------..---•-- ocationAddr`�s . or Lot No. Owner r _ Address li a .. .�v.. w ►,.-'............. ®� _ , cr.l. c 9°�' ---•-- - Installer Address Type of Building Size Lot-..-Q�Q.B®___..Sq. feet �-, Dwelling—No. of Bedrooms...........3...........................Expansion Attic ( ) Garbage Grinder ( ) Other—T a ype of Building _>�_.__!�_____________ No. of persons................------------ Showers ( / ) — Cafeteria ( ) Otherfixtures -------------------------------------------------------------------------------- W Design Flow..................:.........................gallons per perso; per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity........--..gallons Length.................. Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................. Total Length...........7....... Total leaching area........•----•---_-•sq. ft. Seepage Pit No........ ............ Diameter......6........... Depth below inlet.•............... Total leaching area..,��®...sq.*ft. ' Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water..-----................. p 44 Test Pit No. 2................minute per inch Depth of Test Pit.................... Depth to ground water...---.............----. 9 -----------.6 Description of Soil...........__ _ _ x ----•-----------------------------••-......-•-----••------•-- V ..................... -••-••---•.....•••--•--••--•••••-••-•-........-•••--------••••••-----•--•-----•--•-•••••-•-•-•-•••.....-•-•----------•------••-•-••--••-•-•-- W ---------------------------.......................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable........... ............J.0.0.0................. _...&'%�1-------------.�---419....••-•-•-•-••-•----.•••••-•-••--•--•••-••--.........••••----•-•------••----•-•---•----•------•---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with,, the provisions.:of'L I Tj 11 5 of the State Sanitary Code—The un rsigned further agrees not to place the system in operation until a Certificate of Compliance has been i ed t �oard of health. Sig ----- .--• . ------ VJ ID Application Approved B t�l Date Application Disapproved for t e llowing reasons__________________________________________________ --•-••-•--•--••-••......--•-••----� ....................... ----------- -••------- ------------------------------------------------------------•-- Date PermitNo......................................................... Issued....................................................... Date L - --------------- -- -- - - - -- -- - ------------ No..� .�. t. Fim....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................... OF...................................... Appliratilan for Disposal Works Tonstratrtinn Frrafit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: •- .... tdus -------- ----------------------------------------------•----------------------------•---------------------- ...-- L...... -Address or Lot No. Owner , :.Y.r Address •..........................................................•. ...... Installer Address Type of Building Size Lot_? _a,0Q_.__..Sq. feet Dwelling—No. of Bedrooms.......... ________________________•-__Expansion Attic ( ) Garage Grinder ( ) '4 Other—Type T e of Building fR No. of persons........... ............ Showers — G4 YP g - -�------•--•---• P �- (�-->-----•.Cafeteria04 ( ) W Design Flow___Other fixtures 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-------4------.._._. Diameter.._.. ...... Depth below inlet....X_.......... Total leaching area./44042_...sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1........ ::....minutes per inch Depth of Test Pit.................... Depth to ground water.....................__. 4 Test Pit No. 2................minu;e0s per inch Depth of Test Pit.................... Depth to ground water........................ a -( d *------ DDescription of Soil.............C.--b�-�►'-�- ------------------------------•-----------------------------------------------------------•-----------•-------------------•-••-------- W V ---•-----••--•••--••••----•-•••-•--•--....---•------•••-----•----------•---•-----•---•......................................••----•--------•-•------•-•----•-•••........--•------•--....•------------- •------------------------------••---------•--...---...-•---•-----•-•-----------------------.....-----•--••-.•---- ----•• .. -• -- V Nature of Repairs or Alterations—Answer when applicable.......... . ..: »_ __---_ _141.104 ................ �. �-------------P-.�`..............•--------------------------------------------................................................................................................ 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 un ersigned further agrees not to place the system in, operation until a Certificate of Compliance has been i ued t oard of health. ASig ------- Da Application Approved BY ...S . -/ pew ---- - ..._.. - •---••---•.............•------• Date Application Disapproved for t llowing reasons------------------------•-----•-••••-----•-•-----•---------•------•••---••....... •-•-••-. •-----------------•--------------------•----•------ ---• •-•----_--- Date PermitNo.......................................= -- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS - BOARD OF HEALTH ................................I.,.......OF..................................................................................... wr#ifiratle of f ompliaanrr THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed ( or Repaired ( ) ........................ _..... .__..._......._ ...............................................--r•.........._....___........---...._..__..._ by.......................... •-••-••--_.._ � �- Installer ...........W_o.......................................................... has been installed in accordance with the prove ions of TITLE 5 of The State Sanitary Code described in the application for Disposal Works Construction Permit No._ _'�... ... ._...._ dated ...__ _. _.__._ ______.. THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONS UED AS A GUAR NTEE AT THE SYSTEM WILL F CT ON SATISFACTORY. DATE................. I ... Inspector' •--- -•--- R5THE COMMONWEALTH OF MASSACHU TS A. BOARD OF HEALTH OF.......................................... .............................................._...................................... r.- No......................... FEE. . . Disposal oaks Tonotr ion rrntit ` Permission is hereby granted..............IZ!.....V �&MV,--.------•-----•----------------••----•---.--.------------_--._.---------__.-•_----_----------_-__ to Construct ( ) or;Repair (I4 an Individual Sewage Disposal System at No........ " •----- .... -------•--..PP'. :..................... Street as shown on the application for Disposal Works Construction Permit Dated__5.".30_ .................................. - -- -------------- -• _--•- ---••- f ealt h _ DATE---------- �` Lam._-_...`-� -------•••-••-- =-•••-• �'� FORM 1255 A. M. SULKIN, INC., BOSTON