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HomeMy WebLinkAbout0156 STURBRIDGE DRIVE - Health c - ' v i No...... Fms.... ...........�...& THE COMMONWEALTH OF MASSACHUSETTS BOARD OF-. HEALTH ...OF.....B. Appliraation for Disposal Works TnnstrurtWti Urrmit Application is hereby made for a Permit to Construct (k) or Repair ( } an Individual Sewage Disposal System at: Location-Address or Lot No. .. �1r1..�.9_�� �f.�✓ic�4.I. :�_ t�c��?.eQ�_�a���....._....�?�.E....�!e��o=� i �6J. --•---•--••-...__... _... Owner Address W Installer Address Type of Building Size Lot............................Sq. feet U Dwelling moo. of Bedrooms.............................. . . .Expansion Attic ( ) Garbage Grinder ............................ No. of ersons_..-..........._........_... Showers — Cafeteria Other—Type of Building p _ ( ) ( ) p-' Other fixture ----. ----------------------- W Design Flow................. ..........� --gallons per person,,p�er day. Total lily---- Diameter-_-6.4..... Depth...._��.... x Disposal Trench—No..................... Width_._............... Total Length................._. Total leaching area.....................sq. ft. 0o Seepage Pit No-------/.....'..R.._.. Diameter.......T......... Depth below inlet.....42.......... Total leaching area...�®.....sq. ft. Z Other Distribution box W l Dosing tank ( ) Percolation Test Results Performed .......... Date.5_.7-.� ................. aTest Pit No. 1._ .._.minutes per inch Depth of Test Pit___ _ .._..... Depth to ground water.. ��------•L Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.ova'-.!...._.?.. Ra' -------- -------------------------------------------------------------- -..... ....... ------- -----•------------------------------- ------------ -.............. O Description of Soil......_��l10,w....:sA_. ' V ....-•---••-•-•-----•---•---•--••-•---•--------•--•......----••••-----------------------------------••-------------••-•--•--••------------•-------•-•---•.._.......----...•---•--••------•----•-------•-. 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 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. � r Signed '�Z��'!' Lc%• ......-- . ..�....`%............ 7y Application Approved B At ate Date Application Disapproved for the following reasons------------------------------------'---------._....-----------------------------------------------------....... ....................................................................................................................................••-•-------•--•--•---•-•---•-----------_----------_---------- Date t� � PermitNo.......... .................................... Issued........S g ��-•------•------------ Date r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Ta c,�� o F............. i� T ... ................................... Trrtif iratr oaf Tout r1iFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Installer at L a T � �.T�i .��f 0 --------°Sr���ic� has been installed in accordance with the 1frovisions of TITLE' 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No------ /.I----------------------_--. dated-._..--; 7. -_71._....._...._.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No.----L2 FEE_..................... Disposal Works Tanntrndinn "truth Permissionis hereby granted--------------------------•---------•---.......---•----------------------------------------................................................. to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atNo....- G a - y .......J.111A-....��t.��-�........ ���,--.-..------c�S f..C'.� �..--=-------------------------------••-•---•---•-- Street as shown on the application for Disposal Works Construction Permit No_2/7..------ Dated----Sf__J.17:71r'................. ---------------------------------------------•------------------------------------------.......-•-•------ Board of Health DATE........................................._...................................... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS I � � No.....,.�, ------ Fim...... _..... THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH r , j it, s j OF. . r f e �f 1. -----'--------------------------------- Appliration for Disposal Works Tonstrnrtiun Fermi# $' Ap°p>cation is hereby made for-a Permit to Construct or Repair ( ) an Individual Sewage t,f.1sposal System at .. ,l a `. .° --- ----- --------------•---.........----------------------........ .. ................5....._.:..._..................... ......... ...._..r................ ....._..... Location=Address or Lot No. ......................-----------------------------••---•--•-------.._..........-------......._..- ----------------------------------------------------.......................----------------------- Owner Address Installer Address Type of Building Size Lot............................Sq. feet Dwellings No. of Bedrooms............r ..........................Expansion Attic ( ) Garbage Grinder aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a Other fixtures -------------------------------- d W Design Flow.................. =*-------------------gallons per person per day. Total daily flow............. x._rx ...gal�on� WSeptic Tank—Liquid capacity��j" ..gallons Length k I�_.... Width. .?A... Diameter------------------ Depth_4_-6__- x Disposal Trench—No. .................... Width.... Total Length............ __.... Total leaching area....................sq. ft. Seepage Pit No...... ............ Diameter-------- ........... Depth below inlet... ........... Total leaching area.RLSQ.......sq. ft. Z Other Distribution box F,f) Dosing tank ( ) Percolation Test Results Performed by ..,.. :...: K _'��� .... .... Date.? .1-_ . _ ! ,aa Test Pit No. ....mmutes 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_.—F..................~� a ---------------=-------------------•----•--•------------------------------------....................-----......---•----..........•---......---.•---- r DDescription of Soil......': !? -'t..............•--•----------------------------------------------- ----------------------------- V •-------------------------------- •-• --------------- -------------------------------- •---------------------------------------------------- ------------- -........ •---------- -------------------- 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 TITTIE 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...................................................................................... ................................. Date ......--- Application Approved By------ -----------------------------------------------------------------------------•---... Date Application Disapproved for the following reasons:................................................................................................................. ......................................................................................................................................................................................................... Date PermitNo.............•- -r................................... Issued-------- -'-- ...................... Date :THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH : :.. a.W ...............OF.............. . ............................................... K , Trrtifiratr of Tomplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by----------------------------------------------------------------------------------------- -----------------------------------------------------------------------------------------------------•-- Installer at......------.. r-- .��y . has been installed in accordance with thel�rovisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No �V.x........................... dated---.--- ................ THE ISSUANCE OF THIS CERTIFICATE SHA&NOT BE'CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..................................................................... -------- Inspector.................................................................................... THE"COMMONWEALTH OF MASSACHUSETTS BOARD-OF* :HEALTH r +r/r/c............OF... !f f S G................... No....L .. FEE........................ Disposal luorks .01nnotrurtion rrmit . Permissionis hereby granted----------------------------------------------------------------------------------------------------------------------------------------------- to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at No.----. ....6.o-T.....&�!G�------.�f_l,(✓1....,lj.t.��f.r.=.....- ��G r;----------e2.,5_-�="�&Al�� Street as shown on the application No Disposal Works'Constructions 3/Permit No 7........ Dated-__R _ _�-._ t!................ a .t-.1: r ......................................................................................................... Board of Health DATE...................................................................-............ FORM 1255 HOBBS & WARREN. 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V �ty>-WALL AZFA = l�jQ S.t=. 5F• P41 . �A 15en-T-OAA Af�EA ST-. aoX MIA SO S.FvTOTAL L7ESIGt.I = d25 A PD• 't';t>TQt- ; ptT"&',t , G'I�r2r-OL .T10t..1 CZl�T� ��Ytu Sm w 02 Ujq5OF nY ALAN 8 to, 1953U4 OL rr�C'1OTCp su 5^✓17/7`J 2c iTO? G•uo c 11oo.c \� LOAN d'p„oG �000 ' 1tN .7 A Q-P,pe u►sr: 5015 so#t- -Sox qG.9 Sc-pr►c Z IWV. 1600 IiuV. t R6•Zr G4L-. 9l..o • PIT N e; VC/�-r1-1 •r SA N ta, STONESIR C Sv_TtF«o PLC P>L-.ham i Przo�-t L — - � LaGATio1-1 OS T'E 21c' t L..�C Z., to SGAL y� t� p' A.''C 5/ZS /`71 N O wYAK m 7- ('flat-Oroe.c> Q'LAA-1. R1,1=`PE--�.1GC t�IZ`Ct1=�{ Tt4AT FouNvA-,T4or.45" ut.J VJ I r to T l-1 51 v: L.1► t L p T q- �=} A►Jta ��"`��hGIG �'C4JI�EM�.uTy OF T►-tt=: -TO W+J t` vn.T� .� �� �},��. �.. �` ; _ _ a h.•,;-rem. �;. uY c= t��=_' , � r t2EG1S t :D t�.1.1G 5U2�Jir.Yvt`4 Tt=V-V L-►..G o /�rLSyY Tt-A t5 VI-A" t s t_J oT t'Av7C.[7 ', ItJrr('C'JMC ►�1i �,c�t��> `C y. 1t1{= t:F� �i�T°r ?��Gl�lL1J ' A:NIat IGA.hJT� ToNy FRAt-4CHI _ C7 • ? -' .. ', _+ . `7� ' to k' x - . ... ' 4 May' 30;' 1979 Mr. Anthony,Franchi w Woodridge Road, -Weston `Massachusetts 02193 ..... y ; ' Dear•Mr. Franchi s on May 29 when you applied for' twoYsewage ,permits for Lot 49 Deerfield Itoad. and Lot 44 Sturbridge Drive, 0ste`rvil'le, you..: submitted a check..in ,the► amount. of $30;00 '•Each% application for akeewmge permit is $25 00{ and"the cheek should have read.,,.-�.rs.ax , "We -shall hold the, two sewage permits u#Wreee3.pt of your additional check .for $2.0;00. ,.1w Thank you fcr your cooperation, D Very truly aura t ` John M. .Kelly' Director`.of Public Health y .. • ^ Y .. ,. .....,i r s b, < M-. # • ,.il. t Ott F {